Community Benefit Insight - Tax-exempt hospital

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Arnot Ogden Medical Center

600 Roe Avenue

Elmira, NY 14905

EIN: 160743905

The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more

Individual Facility Details: Arnot-Ogden Medical Center

600 Roe Avenue
Elmira, NY 14905

2 hospitals in organization:
(click a facility name to update Individual Facility Details panel)

Arnot-Ogden Medical Center

St Josephs Hospital

Bed count	266	Medicare provider number	330090	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

Arnot Ogden Medical CenterDisplay data for year:

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

6.02%

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	$ 4,847,619 1.27 %
Medicaid as % of operating expenses	$ 10,271,525 2.69 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ -4,076,628 -1.07 %
Subsidized health services as % of operating expenses	$ 11,951,817 3.13 %
Research as % of operating expenses	$ -20,843 -0.01 %
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.	$ 19,339 0.01 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 515,458 0.13 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	3
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	1
Coalition building	1
Community health improvement advocacy	0
Workforce development	1
Other	0
Persons served (optional)	201,427
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	1,427
Coalition building	85,000
Community health improvement advocacy	0
Workforce development	115,000
Other	0
Community building expense as % of operating expenses	$ 515,458 0.13 %
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	$ 1,140 0.22 %
Coalition building as % of community building expenses	$ 127 0.02 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 514,191 99.75 %
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	$ 2,673,433 0.70 %
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	$ 1,569,587 58.71 %

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 $ 299845575 including grants of $ 0) (Revenue $ 330621660)
The Arnot Ogden Medical Center continues to provide of health care related services since it opened in 1889, serving Chemung County and the Twin Tier Regions of New York and Pennsylvania. The Medical Center specialized in the fields of Cardiology, Oncology, Renal, Neonatology, Bariatric and Emergency Care. Other sub specialized services include, but are not limited to, Anesthesiology, Surgery, Laboratory, Imaging, Physical Therapy, Obstetrics, and Gynecology. In 2021, the Medical Center's 2,272 Full-time equivalent of employees cared for 8,541 inpatient admissions in its 226 staffed beds. The Medical Center provided Outpatient Services to approximately 493,077 Outpatient Visits in its subspecialty services. The approximately 177 Full-time equivalents of physicians provided for 311,979 office visits in the areas of primary care and specialty services.

4B (Expenses $ 709119 including grants of $ 0) (Revenue $ 251002)
The Arnot Ogden Medical Center School of Nursing began in 1889 and fully migrated to offering a two-year associate program accredited by the National League for Nursing with approximately 23 students enrolled in 2021. The Arnot Ogden School of Radiologic Sciences began in 1953 continues to offer a two-year certificate program, which is accredited by the Joint Review Commission on Education in Radiologic Technology with approximately 12 students enrolled in 2021. Upon completion of their program of study, students are eligible to take the NYS licensing examinations for Registered Nurse or Radiologic Technologist.

Facility Information

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

Schedule H, Part V, Section B, Line 5-Group A
In 2019, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents.

Schedule H, Part V, Section B, Line 6a-Group A
Arnot Ogden Medical Center prepares the Community Benefit Report for three hospitals- Arnot Ogden Medical Center, St. Joseph's Hospital, both in Elmira, NY and also for Ira Davenport Memorial Hospital in Bath, NY.

Schedule H, Part V, Section B, Line 6b-Group A
Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community.

Schedule H, Part V, Section B, Line 7d-Group A
Arnot Health will use a variety of methods to disseminate the Community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPS for Chemung and Steuben Counties: Website documents will be posted on the healthcare system's website at the following URL: http://www.arnothealth.org/aboutus. Arnot Health developed a section of the system's website dedicated to community outreach in 2019, budget permitting to bring community service work to a more prominent place within the website. This can be assessed at: https://www.arnothealth.org/community-service-plans. Partner websites of Chemung and Steuben counties will post links to their CHA and CHIP on their websites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies.

Schedule H, Part V, Section B, Line 11-Group A
Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. The Chemung County Health Priority Partnership (HP2) has expanded to include insurance navigators. The Steuben County Health Priority Team (SHPT) worked to brand their coalition and has the new name, Smart Steuben. Both coalitions include organizations that are committed to improving the health of Chemung and Steuben County residents. The groups have met on a bi-monthly basis in Chemung County and monthly basis in Steuben County to conduct a Community Health Needs Assessment (CHNA) and develop a Community Health Improvement Plan (CHIP)/Community Service Plan (CSP). The members of HP2 and Smart Steuben have agreed to continue expanding their partnerships and meet on a regular basis to ensure that the initiatives outlined in the Community Health Improvement and Community Service Plans are implemented, monitored, and evaluated.

Supplemental Information

Schedule H (Form 990) Part VI

Schedule H, Part I, Line 7
Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The Medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services.

Schedule H, Part II
Arnot Ogden Medical Center was significantly impacted by the COVID-19 pandemic and due to specific restrictions, the organization was unable to conduct as many community building activities compared to prior years. During the 2021 calendar year, Arnot Ogden Medical Center conducted the following programs that had community benefit and created expenses associated with our filing: Telehealth, Blood Pressure and Diabetes Screenings, Home Visits, Flu Shot Clinics, COVID-19 Vaccine Clinics, and provide COVID-19 testing sites.

Schedule H, Part III, Section A, Line 4
The Organization determines the transaction price based on standard charges for services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with its financial aid policies, and implicit price concessions. Estimates of contractual adjustments and discounts are determined based on contractual agreements, discount policies, and historical experience. For uninsured patients that do not qualify for charity care, the Organization recognizes revenue on the basis of its standard rates for services provided. Based on historical experience, a significant portion of the Organization's uninsured patients will likely be unable or unwilling to pay for services provided. Thus, the Organization records an implicit price concession to reduce accounts to their net realizable value at the time management believes it is probable a receivable will not be recovered. 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 patient 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 collections 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. Estimates of implicit price concessions are determined based on historical collection experience with these classes of patients using a portfolio approach as a practical expedient to account for patient contact as collective groups rather than as individual contracts. The financial statement effect of using this practical expedient is not materially different form an individual contract approach. In Line 2 & 3, the Organization's methodology to estimate bad debt expense is based on historical data of bad debt write-offs by Primary Financial Class. A percent of AR is calculated, and that percent is applied to Open Accounts Receivable and posted against the AR on the balance sheet.

Schedule H, Part III, Section B, Line 8
Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The Medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services.

Schedule H, Part III, Section C, Line 9b
Self-pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self-pay accounts. These accounts are reviewed using the self-pay work list. If insurance is located, self-pay collectors must verify eligibility for the date of service. The self-pay staff will change the health plan to the correct one for all covered dates of service and Arnot Health Billing will submit claim or claims. If no insurance is located, it is confirmed if a patient may have qualified for Medicaid. If Medicaid coverage is approved, self-pay staff will change the health plan to Medicaid for all covered dates of service and follow the correct billing process. Self-Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self-pay staff will attempt to make payment arrangements and notify patients about the Arnot Health Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. Self-pay collectors document all activity in Soarian, and enter any necessary hold to support resolution. Self-pay collections staff enters the payment plan and documents comments in Soarian. A payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections.

Schedule H, Part VI, Line 3
The Arnot Health communicates our Community Care Program in the following ways: Signage in waiting rooms, brochures in waiting rooms and Admission Packets, notations on billing notices, staff education so they can share availability of program and contact information with patients. Communication and education of our Certified Application Counselor for patient insurance enrollment are done so they are informed of the program details and contact information. Communication is also done with collection agencies and collection attorneys so they can also share the availability of the program and contact information with prospective enrollees. The information is also posted on our website at: www.arnothealth.org.

Schedule H, Part VI, Line 2
In 2019, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. The year-long process of assessing community health needs was facilitated by consultants contracted by the Chemung County Health Department from the S2AY Rural Health Network and Common Ground Health. Arnot Health, in partnership with this dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership) to collect and analyze data from a variety of sources. Valuable input was gained from data retrieved and analyzed by the Finger Lakes Health System Agency from the New York State Prevention Agenda Dashboard, multi-payer claims data, EBRFSS, SPARCS and additional sources. Also, input was gained from diverse community focus groups made of both Chemung and Steuben County residents. The focus group meetings were facilitated by S2AY, Chemung and Steuben County Health Departments, Arnot Health and other partnership members. The residents were engaged in discussions concerning their current health status and opinions on specific county-wide health challenges. Areas of disparity were assessed within each county. Findings from the Community Health Assessment (CHA) data and community focus groups identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties.

Schedule H, Part VI, Line 4
Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. The Chemung County Health Priority Partnership (HP2) has expanded to include insurance navigators. The Steuben County Health Priority Team (SHPT) worked to brand their coalition and has the new name, Smart Steuben. Both coalitions include organizations that are committed to improving the health of Chemung and Steuben County residents. The groups have met on a bi-monthly basis in Chemung County and monthly basis in Steuben County to conduct a Community Health Needs Assessment (CHNA) and develop a Community Health Improvement Plan (CHIP)/Community Service Plan (CSP). The members of HP2 and Smart Steuben have agreed to continue expanding their partnerships, and meet on a regular basis to ensure that the initiatives outlined in the Community Health Improvement and Community Service Plans are implemented, monitored, and evaluated.