Community Benefit Insight - Tax-exempt hospital

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Geneva General Hospital

Geneva General Hospital

196 North Street
Geneva, NY 14456

Bed count	132	Medicare provider number	330058	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 160743032

Display data for year:

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

12.38%

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	$ 767,079 0.67 %
Medicaid as % of operating expenses	$ 10,106,842 8.80 %
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	$ 3,274,345 2.85 %
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.	$ 72,955 0.06 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 468,900 0.41 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
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	$ 468,900 0.41 %
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	$ 0 0 %
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	$ 468,900 100 %
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	$ 3,180,015 2.77 %
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	$ 1,266,917 39.84 %

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 $ 34382051 including grants of $ 0) (Revenue $ 32381861)
PATIENT SERVICE PROGRAM: INPATIENTGENEVA GENERAL HOSPITAL IS A 132-BED ACUTE CARE HOSPITAL PROVIDING BOTH PRIMARY CARE AND A FULL RANGE OF SECONDARY LEVEL SERVICES. WE OPERATE A 10-BED INTENSIVE CARE UNIT, AND A 12-BED TELEMETRY UNIT AS WELL AS SIX PEDIATRIC BEDS. THE HOSPITAL ALSO OPERATES A REGIONAL ACUTE PHYSICAL REHABILITATION CENTER, INCLUDING AN IN-PATIENT, 15-BED UNIT.

4B (Expenses $ 59810706 including grants of $ 0) (Revenue $ 56331192)
PATIENT SERVICE PROGRAM: OUTPATIENTA FULL RANGE OF DIAGNOSTIC AND TREATMENT SERVICES ARE AVAILABLE AT GENEVA GENERAL HOSPITAL. WE ARE DEDICATED TO PROVIDING A COMPREHENSIVE ARRAY OF HEALTHCARE SERVICES TO PEOPLE IN THE FINGER LAKES REGION.

4C (Expenses $ 1732008 including grants of $ 0) (Revenue $ 1631248)
EDUCATION PROGRAM:EDUCATION PLAYS AN IMPORTANT ROLE AT GENEVA GENERAL HOSPITAL. OUR EDUCATION DEPARTMENT, WHICH INCLUDES HIGHER EDUCATION PROGRAMS FOR LICENSED PRACTICAL NURSES (LPN) AND REGISTERED NURSES (RN), IS A DIVERSIFIED TEAM OF PROFESSIONALS WHO PROVIDE LEARNING OPPORTUNITIES TO THE MEMBERS OF OUR ORGANIZATION AND RESIDENTS OF SURROUNDINGCOMMUNITIES.

Facility Information

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

PART V, SECTION A:
"GENEVA GENERAL HOSPITAL:PART V SECTION B LINE 5: THE ONTARIO, SENECA, AND YATES COUNTY PUBLIC HEALTH DEPARTMENTS, IN COLLABORATION WITH FINGER LAKES HEALTH, OTHER HOSPITALS, THE S2AY RURAL HEALTH NETWORK (NOW PIVITAL HEALTH), COMMON GROUND HEALTH AND THE COMMUNITY BASED AGENCIES REVIEWED DIRECTLY PREVAILING DATA AND CONDUCTED SURVEYS OF RESIDENTS IN THE THREE COUNTIES THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. SURVEYS WERE DISSEMINATED THROUGH MANY DIFFERENT METHODS INCLUDING E-MAIL, WEB PAGES MAILING OF PAPER COPIES, DISSEMINATION OF PAPER COPIES IN LOCAL STORES, HEALTH CARE FACILITIES, PUBLIC HEALTH AND COMMUNITY FACILITIES AND DIRECT ASSISTANCE WITHIN COUNTY BUILDINGS/AGENCIES. FINGER LAKES HEALTH INVITED PUBLIC PARTICIPATION IN THE NEEDS ASSESSMENT THROUGH THE SPRING 2020 EDITION OF THRIVE OUR COMMUNITY HEALTH MAGAZINE. THRIVE MAGAZINE IS MAILED TO MORE THAN 90,000 HOUSEHOLDS IN THE HEALTH SYSTEM'S SERVICE AREA. READERS WERE INVITED TO LOG-IN TO THE ONLINE SURVEY OR TO CONTACT FINGER LAKES HEALTH FOR A PAPER VERSION OF THE SURVEY. FURTHER INPUT FROM THE PUBLIC WAS COLLECTED THROUGH A NUMBER OF FOCUS GROUP SESSIONS THAT WERE HELD THROUGHOUT THE COUNTIES. THE MAAP PROCESS WAS USED TO DISTILL AND PRIORITIZE COMMUNITY HEALTH NEEDS.GENEVA GENERAL HOSPITAL: PART V SECTION B LINE 6B: FINGER LAKES HEALTH COLLABORATES WITH PUBLIC HEALTH DEPARTMENTS IN OUR SERVICE AREA AS WELL AS OTHER HUMAN SERVICES PROVIDERS, TO USE THE FRAMEWORK OF THE NYS HEALTH COMMISSIONER'S ""PREVENTION AGENDA"" AS A BASIS FOR OUR COMMUNITY HEALTH PLANNING. WE WORKED TOGETHER TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019 AND ESTABLISH HEALTH PRIORITIES FOR 2020-2021. BY DRAWING UP ON THE STATE'S PREVENTION AGENDA, STUDYING DATA COLLECTED THROUGH PRIMARY AND SECONDARY RESEARCH AND PARTNERING WITH LOCAL HEALTH DEPARTMENTS IN ONTARIO, SENECA, AND YATES COUNTIES WE IDENTIFIED HEALTH PRIORITIES AND SUBSEQUENT COMMUNITY OUTREACH INITIATIVES TO ALIGN WITH THOSE PRIORITIES.GENEVA GENERAL HOSPITAL: PART V SECTION B LINE 11: ACTIONS TAKEN BY GGH TO ADDRESS THE SIGNIFICANT NEEDS ADDRESSED IN THE MOST RECENT CHNA: -PROVIDE SEASONAL FARMERS MARKETS, WEEKLY AT THE JIM DOOLEY CHILD CARE CENTER. - ENCOURAGE HEALTH CARE PROVIDER INVOLVEMENT WITH SMOKING CESSATION ATTEMPTS AT AFFILIATED PRACTICES.-UTILIZE EHR (EMR) TO MAKE PATIENT REFERRALS FOR SCREENINGS AS APPROPRIATE. STAFF TIME OF .15 FTE TO COLLECT AND REPORT AGGREGATE DATA. - VICE PRESIDENT OF NURSING AND OTHER STAFF AS APPROPRIATE WILL ATTEND MENTAL AND SUBSTANCE ABUSE DISORDER/SUICIDE PREVENTION MEETINGS AND WORK AS PARTNER - 0.04 ADMINISTRATOR FTE- HOST AND PROMOTE WALK-IN MONTHLY MAMMOGRAPHY SCREENINGS. - TRACK # MAMMO REFERRALS MADE BY PCP'S (BY ZIP CODE AND PROVIDER) TRACK # MAMMO SCREENINGS COMPLETEDAT HOSPITAL (BY ZIP CODE AND PROVIDER) DISPLAY CANCER SCREENING MATERIALS ON SITE. PROVIDE COMMUNITY EDUCATION RE CANCER AND CANCER SCREENING. 0.2 FTE AND FUNDING FOR PROMOTION OF SCREENINGS IN FLH MAGAZINE. - ASSESS FOR BARRIERS TO CANCER SCREENING: TRACK # MAMMO AND COLOALRECTAL SCREEING REFERRALS MADE BY PCP'S (BY ZIP CODE AND PROVIDER) TRACK # MAMMO AND COLORECTAL SCREENINGS COMPLETED AT HOSPITAL (BY ZIP CODE AND PROVIDER). PARTNER WITH CAREER TERM AND OTHER ORGNANIZATIONS- PARTICIPATION IN HYPERTENSION SCREENINGS WITH COMMON GROUND HEALTHGENEVA GENERAL HOSPITAL:PART V SECTION B LINE 23: AMOUNTS GENERALLY BILLED: THE AMOUNTS GENERALLY BILLED ARE BASED UPON THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THE CARRIER WITH THE GREATEST VOLUME.PART V SECTION B LINE 6B: SENECA, ONTARIO AND YATES COUNTY DEPARTMENT OF PUBLIC HEALTH, COMMON GROUND HEALTH, SAY2 RURAL HEALTH (NOW PIVITAL HEALTH)"

GENEVA GENERAL HOSPITAL
PART V, SECTION B, LINE 6A: SSMH

GENEVA GENERAL HOSPITAL
PART V, SECTION B, LINE 6B: SENECA COUNTY DEPARTMENT OF PUBLIC HEALTHCOMMON GROUND HEALTHS2AY RURAL HEALTH (NOW PIVITAL HEALTH) ONTARIO COUNTY HEALTH DEPARTMENTYATES COUNTY PUBLIC HEALTH

Supplemental Information

Schedule H (Form 990) Part VI

PART III, LINE 2:
COSTING METHODOLOGY:HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION P&P BOARD STATEMENT 15, IX. VALUATION AND DISCLOSURE OF BAD DEBTS, 9.1 HAS BEEN APPLIED TO THE AMOUNT REPORTED ON LINE 2. THE BAD DEBT AMOUNT IS RECORDED AT THE AMOUNT THAT THE PAYER IS EXPECTED TO PAY. THE AMOUNT REPORTED ON LINE 3 IS VALUED AT PATIENT CARE COST, I.E. THE EXPECTED PAYMENT AMOUNT INCLUDED IN LINE 2 HAS BEEN MULTIPLIED BY THE RATIO OF PATIENT CARE COST TO CHARGES (44%). BASED UPON AN ANALYSIS OF INCOME LEVELS FOR ACCOUNTS INCLUDED IN BAD DEBTS WE ESTIMATED THAT 35.6% WERE ELIGIBLE UNDER FAP.

PART III, LINE 3:
RATIONALE FOR INCLUDING A PORTION OF BAD DEBT AMOUNT AS COMMUNITY BENEFIT: IT IS NOT ALWAYS POSSIBLE TO OBTAIN SUFFICIENT INFORMATION TO MAKE A DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE OR RECLASSIFY BAD DEBTS AS CHARITY CARE. WHEN INCOME LEVELS ARE LEARNED WE IDENTIFY INDIVIDUALS UNABLE TO PAY FOR SERVICES. HAVING PROVIDED SERVICES TO THOSE INDIVIDUALS WE BELIEVE REPRESENTS A COMMUNITY BENEFIT.

PART III, LINE 4:
BASED ON ITS HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF GGH'S UNINSURED PATIENTS WILL LIKELY BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, GGH RECORDS AN IMPLICIT PRICE CONCESSION TO REDUCE ACCOUNTS TO THEIR NET REALIZABLE VALUE. THERE ARE VARIOUS FACTORS THAT CAN IMPACT COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, UNEMPLOYMENT RATES, THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE VOLUME OF PATIENTS THROUGH THE EMERGENCY DEPARTMENT, THE INCREASED BURDEN OF CO-PAYS, CO-INSURANCE AMOUNTS AND DEDUCTIBLES TO BE MADE BY PATIENTS WITH INSURANCE, AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.

PART III, LINE 8:
RATIONALE FOR INCLUDING SHORTFALL AS COMMUNITY BENEFIT:MEDICARE PAYMENT RATES REFLECT CONSTRAINTS ON FEDERAL GOVERNMENT EXPENDITURES. IN SPITE OF THE SIGNIFICANT LOSSES CAUSED BY THESE LOW RATES WE PROVIDE ACCESS TO HEALTH SERVICES FOR A LARGE SEGMENT OF OUR COMMUNITY. WE BELIEVE THIS ENHANCEMENT OF POPULATION HEALTH REPRESENTS A COMMUNITY BENEFIT.SOURCE OF MEDICARE ALLOWABLE COSTS:COST INFORMATION IS TAKEN FROM THE MEDICARE COST REPORT.

PART III, LINE 9B:
AFTER THE CUSTOMER SERVICE REPRESENTATIVE'S INITIAL DETERMINATION OR THE DETERMINATION RENDERED AFTER AN APPEAL REVIEW, THE PATIENT'S HOSPITAL ACCOUNT IS ADJUSTED TO REFLECT THE AMOUNT OF ANY FINANCIAL ASSISTANCE DEDUCTION TO BE APPLIED TO IT. THE PATIENT IS BILLED FOR ANY REMAINING AMOUNT DUE, AND IS OFFERED THE TELEPHONE NUMBER OF AN INDIVIDUAL WITHIN PATIENT ACCOUNTS WHO IS AVAILABLE TO ASSIST THE PERSON IN CREATING A SELF- PAYMENT PLAN THAT OUTLINES PATIENT RE-PAYMENT STEPS OVER A SPECIFIED PERIOD OF TIME SHOULD THE PATIENT REQUIRE SUCH ASSISTANCE. INDIVIDUALS WITH VALID REQUESTS FOR FINANCIAL ASSISTANCE ARE EXEMPT FROM REFERRALS TO A COLLECTION AGENCY.

PART VI, LINE 4:
THE HOSPITAL PROVIDES A FULL RANGE OF ACUTE CARE SERVICES TO RESIDENTS OF THE FINGER LAKES REGION IN UPSTATE NEW YORK. THE HOSPITAL REVIEWS DEMOGRAPHIC DATA FROM SOURCES SUCH AS THE US CENSUS TO IDENTIFY TRENDS. THE HOSPITAL USES HEALTH INDICATORS AND UTILIZATION DATA FROM NUMEROUS SOURCES AND RECEIVES COMMUNITY INPUT FROM PUBLIC SURVEYS. WE HAVE A COMMUNITY ADVISORY COMMITTEE WHICH SERVES AS A REGULAR FORUM FOR COMMUNITY INPUT AND FOSTERING COLLABORATION. WE GATHER OPINION RELATED DATA FROM FOCUS GROUPS, SATISFACTION SURVEYS, AND EMPLOYEE OPINION SURVEYS. WE PARTICIPATE IN A NEEDS ASSESSMENT PROCESS AND PARTICIPATE AS AN ACTIVE MEMBER OF THE COMMUNITY THROUGH BOARD PARTICIPATION ON NUMEROUS LOCAL AND STATE-WIDE HEALTH RELATED ORGANIZATIONS.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

Operating expenses	$ 114,912,348
Total amount spent on community benefits as % of operating expenses	$ 14,221,221 12.38 %