Community Benefit Insight - Tax-exempt hospital

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Memorial Hospital

Memorial Hospital

3073 White Mountain Highway
North Conway, NH 03860

Bed count	25	Medicare provider number	301307	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 020222156

Display data for year:

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

8.4%

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	$ 564,842 0.59 %
Medicaid as % of operating expenses	$ 3,584,206 3.73 %
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	$ 3,221,358 3.35 %
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.	$ 692,179 0.72 %
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	$ 2,210,644 2.30 %
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 $ 88838874 including grants of $ 0) (Revenue $ 102617263)
MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE AND THE WESTERN REGION OF MAINE. MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDES ACUTE INPATIENT SERVICES INCLUDING GENERAL MEDICAL AND SURGICAL, OBSTETRICS AND INTENSIVE CARE UNITS. THE HOSPITAL HAD 5,260 ACUTE PATIENT DAYS IN 2022. THE HOSPITAL ALSO PROVIDES A VARIETY OF OUTPATIENT SERVICES SUCH AS IMAGING, LABORATORY, DIABETES, ONCOLOGY, PHYSICAL REHAB, EMERGENCY MEDICINE, PRIMARY CARE, ORTHOPEDICS AND GENERAL SURGERY. THE HOSPITAL HAD 58,768 OUTPATIENT VISITS AND 59,732 CLINIC VISITS IN 2022.

Facility Information

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

Memorial Hospital
Part V, Section B, Line 5: THE PLANNING COMMITTEE INCLUDED TWO REPRESENTATIVES FROM POPULATION HEALTH AT MEMORIAL HOSPITAL AND ONE REPRESENTATIVE FROM MAINEHEALTH SERVICES. ADDITIONAL UNRELATED MEMBERS OF THE COMMITTEE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ENGAGED ORGANIZATIONS: -WHITE MOUNTAIN COMMUNITY HEALTH CENTER: PRIMARY CARE SERVICES AND HEALTH EDUCATION REGARDLESS OF ABILITY TO PAY-NORTHERN HUMAN SERVICES: MENTAL HEALTH CARE AND INDIVIDUALIZED SERVICES FOR DEVELOPMENTALLY DISABLED OR SUBSTANCE ABUSE COUNSELING-T MURRAY WELLNESS CENTER: DIET, EXERCISE, NUTRITION, AND TREATMENT SERVICES-CARROLL COUNTY COALITION FOR PUBLIC HEALTH-VISITING NURSE HOME CARE & HOSPICE OF CARROLL COUNTY & WESTERN MAINE: PERSONAL CARE, SKILLED NURSING, REHABILITATION, AND PALLIATIVE CARE AND HOSPICE SERVICES.-MINERAL SPRINGS: LONG-TERM CARE, ASSISTED LIVING, AND REHABILITATION CENTERTHE PLANNING COMMITTEE HELD A FORUM REPRESENTING THE FOLLOWING SECTORS: PUBLIC HEALTH, HEALTHCARE PROVIDERS, LOCAL/STATE GOVERNMENT, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON-PROFIT AGENCIES, LOW INCOME, BUSINESS/CIVIC LEADERSHIP, COLLEGE/UNIVERSITY, PROFESSIONAL MEMBER ORGS, MINORITIES (RACIAL/ETHNIC), AND PUBLIC SCHOOLS. A NUMBER OF ADDITIONAL ENGAGEMENT ACTIVITIES WERE HELD IN SMALLER GROUPS. IN ADDITION TO THE ABOVE, AN ONLINE STAKEHOLDER SURVEY WAS DISSEMINATED TO CAPTURE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE.

Memorial Hospital
Part V, Section B, Line 6a: THE CHNA WAS CONDUCTED THROUGH A PARTNERSHIP BETWEEN MAINEHEALTH SERVICES, CENTRAL MAINE HEALTHCARE, NORTHERN LIGHT HEALTH, MAINEGENERAL HEALTH, MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE NEW HAMPSHIRE DIVISION OF PUBLIC HEALTH SERVICES.

Memorial Hospital
Part V, Section B, Line 11: FOR THE 2022-2024 CHNA, THE ORGANIZATION HAS IDENTIFIED PRIORITIES AND DEVELOPED STRATEGIES TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND PROVIDED REASONS IF IDENTIFIED NEEDS ARE NOT BEING ADDRESSED. PLEASE SEE THE 2022-2024 CHNA IMPLEMENTATION PLAN AT www.MaineHealth.org/chnaFOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION.

PART V, SECTION B, LINE 7a:
THE CHNA AND IMPLEMENTATION PLAN STRATEGY ARE POSTED ON THESE WEBSITES: www.MaineHealth.org/chna

PART V, SECTION B, LINES 16a,b,c:
THE FINANCIAL ASSISTANCE POLICY (FREE CARE POLICY AND BILLING AND COLLECTION POLICY), FREE CARE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON THE FOLLOWING WEBSITE:https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 6a:
MEMORIAL HOSPITAL'S COMMUNITY BENEFIT DATA IS CONTAINED IN A REPORT PREPARED BY MAINEHEALTH SERVICES (EIN 01-0431680), THE ORGANIZATION'S SOLE MEMBER. THE REPORT CAN BE FOUND AT THE LINK BELOW:https://annualreport.mainehealth.org/#community

Part I, Line 7:
A COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED INTHE TABLE. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. ACOST-TO-CHARGE RATIO WAS USED.

PART I, LINE 3C:
CHARITY CARE LEVELS ARE DETERMINED BY A THREE PRONG TEST FOR ELIGIBILITY. RESIDENCY, INCOME LEVEL, AND HOUSEHOLD SIZE ARE EXAMINED TO DETERMINE LEVEL OF ELIGIBILITY. DISCOUNTED CARE IS REQUIRED BY NEW HAMPSHIRE STATE LAW FOR ALL UNINSURED SELF-PAY PATIENTS. THE DISCOUNT WAS 33% DURING THE TAX YEAR.

Part III, Line 2:
SEE PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS

Part III, Line 8:
MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO.

Part III, Line 9b:
PATIENTS WHO QUALIFY FOR FREE CARE HAVE THEIR ACCOUNT BALANCE ADJUSTED ACCORDINGLY ONCE FREE CARE HAS BEEN APPROVED. AS A TAX EXEMPT HOSPITAL, MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES.

PART III, LINE 4:
"MEMORIAL HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIALSTATEMENTS THAT DESCRIBES ""BAD DEBT EXPENSE."" HOWEVER, REFERENCE ISMADE WITHIN THE FOOTNOTES TO THE TREATMENT OF BAD DEBT. WITHIN THE FOOTNOTE DESCRIBING ""PATIENT ACCOUNTS RECEIVABLE"", THE FOLLOWING EXPLAINS THE PROVISION FOR BAD DEBTS:PATIENT ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF.WHEN THE HOSPITAL HAS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED SELF-PAY ALLOWANCES THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE. THE AMOUNT OF EXPENSE ASSOCIATED WITH THE PROVISION OF SERVICES, ULTIMATELY WRITTEN OFF AS BAD DEBT AT MEMORIAL, HAS BEEN CALCULATED AT$4,737,378 FOR THE CURRENT FISCAL YEAR. BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES MEMORIAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX-EXEMPT ORGANIZATION, MEMORIAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. MEMORIAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION. THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT. HOWEVER, BECAUSE OF THEIR INCOME LEVEL, THEY DO NOT QUALIFY FOR FREE CARE. BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES, MEMORIAL BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT."

Part VI, Line 2:
THE ORGANIZATION PREPARES A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. SEE www.MaineHealth.org/chna

Part VI, Line 6:
MAINEHEALTH IS A NOT-FOR-PROFIT FAMILY OF LEADING HIGH-QUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA. RANKED AMONG THE NATION'S TOP 100 INTEGRATED HEALTHCARE DELIVERY NETWORKS, MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN, CENTRAL AND WESTERN MAINE REGIONAL SERVICE AREAS. THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS, MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES. MAINEHEALTH INCLUDES THESE MEMBER ORGANIZATIONS: THE MEMORIAL HOSPITAL AT NORTH CONWAY, N.H., MAINEHEALTH CARE AT HOME, NORDX AND MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION. THE STRATEGIC AFFILIATES OF MAINEHEALTH ARE MAINEGENERAL MEDICAL CENTER AND ST. MARYS REGIONAL MEDICAL CENTER.

Part VI, Line 7, Reports Filed With States
ME,NH

PART VI, LINE 4:
THE CHNA DESCRIBES THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS ITSERVICES. SEEwww.MaineHealth.org/chna

PART VI, LINE 3:
"MEMORIAL HOSPITAL'S POLICY OF CHARITY CARE AND FINANCIAL ASSISTANCE ISEASILY UNDERSTOOD, PROMINENTLY POSTED, AND PUBLICLY AVAILABLE. APROCESS EXISTS FOR OFFERING CHARITY CARE OR FINANCIAL ASSISTANCE TOPATIENTS WHO ARE UNABLE TO PAY AFTER THEY HAVE ALREADY BEEN BILLED. INADDITION TO MONITORING COLLECTION PRACTICES, COPIES OF THE CHARITY CAREPOLICY ARE MADE AVAILABLE TO PATIENTS AT ALL ENTRY POINTS(REGISTRATION, ED, ETC.) AND WITH BILL/COLLECTION NOTICES. MEMORIALHOSPITAL USES SIMPLE APPLICATION PROCEDURES FOR CHARITY CARE ORFINANCIAL ASSISTANCE THAT DO NOT INTIMIDATE OR CONFUSE APPLICANTS.MEMORIAL HOSPITAL'S EMPLOYEES WHO WORK IN ADMISSIONS, BILLING, ACCOUNTSRECEIVABLE, OR PATIENT SERVICES ARE FULLY INFORMED AND EDUCATED ABOUTALL FINANCIAL ASSISTANCE POLICIES. THESE STAFF MEMBERS IDENTIFY UNPAIDBILLS WHERE PERSONS ARE UNABLE TO PAY, AND SEPARATE THESE POTENTIAL""CHARITY CARE"" BILLS FROM OTHER BAD DEBT ACCOUNTS. ON A CASE-BY-CASE BASIS, WE HAVE GRANTED ASSISTANCE TO INDIVIDUALS THAT MAY EARN ABOVE 200% OF THE FEDERAL POVERTY GUIDELINES BUT HAVE MET THE CATASTROPHIC ILLNESS PARAMETERS."

PART VI, LINE 5:
THE TAX EXEMPT PURPOSE OF THE ORGANIZATION TO IMPROVE THE HEALTH OF THECOMMUNITY IS PROMOTED AND ENHANCED IN THE FOLLOWING WAYS:- THE MAJORITY OF THE GOVERNING BODY IS COMPOSED OF PERSONS LIVINGWITHIN THE HOSPITAL SERVICE AREA THAT ARE NEITHER EMPLOYED BY, NOR HAVECONTRACTUAL RELATIONSHIPS WITH, THE HOSPITAL OR ITS AFFILIATES.- MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS INTHE COMMUNITY.- SOLICITATION OF COMMUNITY INPUT IN THE STRATEGIC PLANNING PROCESS.- COMMON GOVERNANCE OF THE HOSPITAL, LONG-TERM CARE AND PHYSICIANSERVICES PROVIDED IN THE COUNTY TO PROMOTE COMMON HEALTH CARE ANDIMPROVEMENT PLANNING AND CONTROL COSTS.- VOLUNTARY CAP ON INCOME FROM OPERATIONS TO RESTRAIN PRICES AND TOFUND HEALTH CARE AND HEALTH IMPROVEMENT ACTIVITIES.- SURPLUS FUNDS ARE REINVESTED IN CAPITAL EQUIPMENT AND IMPROVEMENTS TOENSURE HIGH QUALITY CARE.

Operating expenses	$ 96,024,231
Total amount spent on community benefits as % of operating expenses	$ 8,062,585 8.40 %