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Androscoggin Valley Hospital Inc
Berlin, NH 03570
| Bed count | 25 | Medicare provider number | 301310 | 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 $ 75,124,640 Total amount spent on community benefits as % of operating expenses$ 5,473,530 7.29 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 320,545 0.43 %Medicaid as % of operating expenses$ 3,457,350 4.60 %Costs of other means-tested government programs as % of operating expenses$ 0 0 %Health professions education as % of operating expenses$ 82,174 0.11 %Subsidized health services as % of operating expenses$ 842,662 1.12 %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.$ 78,230 0.10 %Cash and in-kind contributions for community benefit* as % of operating expenses$ 692,569 0.92 %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$ 1,521,416 2.03 %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:
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? YES 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? Not available 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 $ 55670105 including grants of $ 692569) (Revenue $ 65565425) Androscoggin Valley Hospital is a critical access hospital. The Hospital provides a broad range of inpatient and outpatient services to meet the health needs of the upper Androscoggin Valley and surrounding communities. With a commitment to the highest quality surgical care - AVH is leading the way to a healthier future for our health care community.
4B (Expenses $ 258784 including grants of $ 0) (Revenue $ 334176) Educational programs offered by AVH include childbirth classes, babysitting course, wellness fairs, lecture series, CPR and first aid courses, nutritional counseling, and a variety of support groups.
4C (Expenses $ 7189144 including grants of $ 0) (Revenue $ 8361839) Other community benefits provided by the Hospital include the provision of care to the underinsured; the promotion of good health for children through participation in the healthy kids program; and the sponsorship of numerous clinics and programs supporting good health in the community.
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Facility Information
Androscoggin Valley Hospital Part V, Section B, Line 5: An electronic survey was sent to a select group of local experts that included information from well-respected secondary sources on the current state of health care in the community. Individuals and agencies involved in Public Health and State & Local Health were included as were individuals from priority populations, chronic disease groups and other community members.
Androscoggin Valley Hospital Part V, Section B, Line 6a: The Hospital's CHNA was conducted along with Weeks Medical Center and Upper Connecticut Valley Hospital.
Androscoggin Valley Hospital Part V, Section B, Line 6b: The Hospital's CHNA was conducted along with Coos County Family Health and North Country Home Health & Hospice Agency. The first is a local FQHC.
Androscoggin Valley Hospital Part V, Section B, Line 11: Please see attached CHNA and Implementation Strategy.
Schedule H, Part V, Section B, Line 22: All patients are charged the same amount for services and procedures performed, regardless of whether they were insured or uninsured. The net amount due to the hospital is based upon contractual adjustments for insured patients and administrative adjustments for uninsured patients, which may include free care, charity care, and discounted care.
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Supplemental Information
Part I, Line 7: A cost accounting system was used to calculate the amounts reported in the table. The cost accounting system addresses all patient segments. A cost-to-charge ratio was used. The ratio was derived from Worksheet 2.
Part I, Line 7g: All costs reported on Part I, Line 7g are attributable to a physician clinic.
Part III, Line 4: Please see pages 8-12 of the attached audited financial statements.
Part III, Line 8: The Organization used a cost report as the costing methodology to determine the amount of allowable Medicare costs.
Part VI, Line 2: Every 3 years, Androscoggin Valley Hospital participates in a community needs assessment with three other members of the community's health care system. Using information from that assessment allows the Hospital to provide healthcare services to the North Country community on an ongoing basis.
Part VI, Line 3: Androscoggin Valley Hospital offers many financial assistance and referral programs to ensure that cost will not be a barrier to patients getting the healthcare services they need. If payment of healthcare expenses could create a financial hardship, Hospital staff will work with patients to apply for financial assistance. Information regarding financial assistance policies is available at the Hospital's entrances and patient registration and on the Hospital's website. As part of the financial counseling application process, the Hospital will assess eligibility for health insurance coverage through federal or state programs such as New Hampshire Medicaid and assist in the application process.
Part VI, Line 4: The geographic area served by Androscoggin Valley Hospital is the Berlin service area. The Berlin service area is composed of the city of Berlin, and the towns of Gorham, Shelburne, Milan, Randolph, Dummer, Errol and Stark. These communities are within the boundaries of Coos County, which is bordered by the State of Maine to the east, the State of Vermont to the west and Quebec, Canada to the north. The city of Berlin defines much of the region as the largest community in the County with a population of 10,025. The total population of the Berlin service area is 16,121. The changing economic landscape and the closing of paper and pulp mills over the last decade in the Coos County have significantly impacted the area's unemployment rate and population compared to those experienced by the overall state of New Hampshire.
Part VI, Line 5: Androscoggin Valley Hospital is the leading provider of healthcare to thousands of families in the small-town communities of New Hampshire's North Country. As a Critical Access Hospital, AVH offers 24/7 emergency care, in-house treatment of most medical issues, and an arrangement for treatment of all other problems with the nearest tertiary-care facility.Over the past decade, AVH has invested significantly in expanding and improving our facilities and services, and enhancing our team of dedicated, highly trained doctors, nurses and other staff. The result is a hospital that more effectively contributes to the health of our communities than ever before. Our new location in North Conway, NH offers comfortable and private treatment rooms for pain procedures as well as some elective treatments. Recent renovations have taken place to update the Obstetrics and Gynecology space offering an improved patient experience through open reception and more natural flow for patients as well as closer proximity to the inpatient women's services area. At the end of the day, our top priority is to ensure the highest level of quality healthcare to those that we are so fortunate to serve.In an effort to continue to provide a high quality of healthcare for all patients in the North Country, the hospitals of Coos & Grafton County came together to explore collaboration. We, the boards and senior management of Androscoggin Valley Hospital, Upper Connecticut Valley Hospital, and Weeks Medical Center realize that significant national, state and local economic pressures are jeopardizing local access, quality and sustainability. We have therefore formed North Country Healthcare (NCHC) with the stated objective of working collaboratively to better serve the healthcare needs of North Country patients. This collaborative effort will work to:1. Ensure access to quality care within the communities in which our patients live2. Provide local and high quality care with positive outcomes to our patients in the North Country 3. Control the cost of care through innovative programs and the use of shared resourcesNational healthcare reform demands lower costs and higher quality from all hospitals, requiring collaboration in patient care across all providers: from primary care to specialist, from ambulance to hospital, from hospital to rehabilitation to home care, from local hospital to tertiary (specialty hospital) care. Therefore, Androscoggin Valley Hospital, Upper Connecticut Valley Hospital, and Weeks Medical Center have formed this joint venture to identify and implement sustainable opportunities for our future. The NCHC and its member hospitals are prepared to manage costs and coordinate care in a way that is financially sustainable, while continuing to provide local access to quality care throughout the county and beyond. The hospitals of the North Country must work together as critical parts of our economy and community.
Part VI, Line 7, Reports Filed With States NH
