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Cuba Memorial Hospital Inc
Cuba, NY 14727
| Bed count | 20 | Medicare provider number | 331301 | 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 $ 11,487,389 Total amount spent on community benefits as % of operating expenses$ 1,747,398 15.21 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 76,817 0.67 %Medicaid as % of operating expenses$ 1,670,581 14.54 %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$ 0 0 %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.$ 0 0 %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$ 76,195 0.66 %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 $ 9160472 including grants of $ 0) (Revenue $ 7260406) CUBA MEMORIAL HOSPITAL IS A NOT FOR PROFIT PUBLIC BENEFIT CORPORATION. ACUTE AND SKILLED NURSING HOME CARE IS PROVIDED IN ADDITION TO A 24 HOUR URGENT CARE CENTER. THE HOSPITAL PROVIDED $122,000 IN CHARITY CARE AND FREE CARE ASSESSMENTS TO THE STATE OF NEW YORK IN 2021.
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Facility Information
CUBA MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: A CORE GROUP OF KEY STAKEHOLDERS ASSEMBLED ON OCTOBER 30, 2019 THEY DISCUSSED CHANGES TO AND REVIEWED POSSIBLE FOCUS AREAS AND HEALTH PRIORITIES.
CUBA MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE COMMUNITY ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH JONES MEMORIAL HOSPITAL IN WELLSVILLE, NY.
CUBA MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE COMMUNITY ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH THE ALLEGANY COUNTY DEPARTMENT OF HEALTH AND ARDENT SOLUTIONS, INC.
CUBA MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE WORK PLAN INCLUDES THE GOALS, OBJECTIVES, INTERVENTION STRATEGIES AND ACITVIITES THAT WILL BE IMPLEMENTED FOR THE PRIORITY AREAS AND THE PROCESS MEASURES USED TO TRACK PROGRESS.
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Supplemental Information
PART I, LINE 7: SPECIFIED WORKSHEETS WERE UTILIZED TO DETERMINE APPROPRIATE REVENUES AND COSTS TO BE REPORTED USING A RATIO OF COST TO CHARGES AS DEFINED IN THE WORKSHEETS.
PART I, LN 7 COL(F): FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 2: A RATIO OF COST TO CHARGES WAS APPLIED TO THE NET UNCOLLECTIBLE BAD DEBT PROVISION.
PART III, LINE 9B: IF A PATIENT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS MOVED TO A PRESUMED CHARITY CATEGORY AND COLLECTION EFFORTS ARE TERMINATED.
PART VI, LINE 2: THE HOSPITAL, ALONG WITH OTHER COMMUNITY STAKEHOLDERS CONDUCT COMMUNITY SURVEYS, FOCUS GROUPS, STATISTICAL DATA ON THE LEADING CAUSE OF DEATH AND PREMATURE DEATH, AND COMMUNITY HEALTH INDICATORS. THE STAKEHOLDERS MEET TO REVIEW THE RESULTS AND PRIORITIZE THE NEEDS.
PART VI, LINE 3: PATIENTS WHO ARE NOT COVERED, OR RECEIVE SERVICES NOT COVERED BY A THIRD PARTY INSURER WILL BE GIVEN AN EDUCATIONAL PACKAGE BY THE PATIENT ACCESS REGISTRAR. THIS EDUCATIONAL PACKAGE WILL ICNLUDE INFORMATION REGARDING THE SELF PAY DISCOUNT APPLIED TO ALL UNINSURED OR UNDER INSURED PATIENTS AS WELL AS INFORMATION ON THE FINANCIAL ASSISTANCE PROGRAM. THE PACKAGE WILL INCLUDE A FINANCIAL SCREENING DOCUMENT CHECKLIST AND AN APPLICATION FORM. PATIENTS HAVE 90 DAYS FROM THE DATE OF DISCHARGE OR SERVICES TO APPLY FOR FINANCIAL ASSISTANCE AND AT LEAST 30 DAYS TO SUBMIT A COMPLETED APPLICATION.
PART VI, LINE 4: THE COMMUNITY ENCOMPASSES THE TOWNS/VILLLAGES OF FRIENDSHIP, WELLSVILLE, BELFAST, BOLIVAR AND CUBA AS PRIMARY SERVICE AREAS, AND OLEAN, BELMONT, ANDOVER, SCIO AND RUSHFORD AS SECONDARY SERVICE AREAS.ALLEGANY COUNTY IS A RURAL COUNTY LOCATED ALONG THE SOUTHERN TIER OF UPSTATE NEW YORK, WITH AN AREA OF 1,030 SQUARE MILES. THE POPULATION DENSITY IS 47.6 PEOPLE PER SQUARE MILE ON THE 2020 CENSUS. THE 2020 ESTIMATED POPULATION IS 46,456. CAUCASIANS COMPRISE THE VAST MAJORITY OF ALLEGANY COUNTY RESIDENTS, MAKING UP 97.03% OF THE POPULATION. AFRICAN AMERICANS (0.28%); AMERICAN NATIVE/ALASKA NATIVE (0.28%); ASIANS (0.72%); HISPANIC OR LATINO (0.91%). THE 2020 U.S. CENSUS SHOWED THE MEDIAN AGE OF ALLEGANY COUNTY RESIDENTS TO BE 35 YEARS. CENSUS DATA ALSO SHOWS THAT 24.4% OF THE POPULATION IS 18 YEARS OF AGE OR YOUNGER. 61.6% OF THE POPULATION IS AGE 18-64 AND 14% IS AGE 65 OR OLDER. THE DATA ALSO INDICATES THAT THE COUNTRY'S POPULATION IS LIVING LONGER. THE CENSUS ALSO SHOWS 54.2% OF THE POPULATION IS MARRIED; 9.0% HAD A FEMALE HOUSEHOLD WITH NO HUSBAND; AND 32.3% WERE NON-FAMILIES. 26.0% OF ALL HOUSEHOLDS WERE MADE UP OF INDIVIDUALS, AND 11.3% HAD SOEMONE LIVING ALONE WHO WERE 65 YEARS OF AGE AND OLDER. THE AVERAGE HOUSEHOLD SIZE WAS 2.53 AND THE AVERAGE FAMILY SIZE WAS 3.04.INCOME LEVELS IN ALLEGANY COUNTY ARE AMONG THE LOWEST IN THE STATE. PER CAPITA INCOME SHOWS THE COUNTY'S STANDARD OF LIVING AT $14,975. ABOUT 10.50% OF FAMILITIES AND 15.50% OF THE POPULATION WERE BELOW THE POVERTY LINE.
