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Clifton-fine Health Care Corporation
Star Lake, NY 13690
| Bed count | 20 | Medicare provider number | 331307 | 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 $ 9,961,807 Total amount spent on community benefits as % of operating expenses$ 0 0 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 0 0 %Medicaid as % of operating expenses$ 0 0 %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$ 625,077 6.27 %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$ 8,837 1.41 %- 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 $ 8100578 including grants of $ 0) (Revenue $ 10980997) A CRITICAL ACCESS HOSPITAL PROVIDING HEALTH CARE SERVICES FOR THE BENEFIT OF THE RESIDENTS OF THE STATE OF NEW YORK AND THE TOWNS OF CLIFTON AND FINE.
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Facility Information
CLIFTON-FINE HEALTH CARE CORPORATION PART V, SECTION B, LINE 5: FORMAL SURVEYS OF LOCAL RESIDENTS, CREATED BY ST. LAWRENCE COUNTY COLLEGES.
CLIFTON-FINE HEALTH CARE CORPORATION PART V, SECTION B, LINE 6A: OTHER HOSPITALS INVOLVED THROUGH THE NORTH COUNTRY INITIATIVE - CLAXTON HEPBURN MEDICAL CENTER, MASSENA MEMORIAL HOSPITAL, GOUVERNEUR HOSPITAL, AND CANTON POTSDAM HOSPITAL
CLIFTON-FINE HEALTH CARE CORPORATION PART V, SECTION B, LINE 6B: THE HOSPITAL'S CHNA WAS DEVELOPED IN PARTNERSHIP WITH THE ST. LAWRENCE HEALTH INITIATIVE, ST. LAWRENCE COUNTY PUBLIC HEALTH, OTHER AREA HOSPITALS, ST. LAWRENCE COUNTY SUICIDE PREVENTION COALITION, ST. LAWRENCE COUNTY COLLEGES AND UNIVERSITITES, AND COMMUNITY-BASED ORGANIZATIONS.
CLIFTON-FINE HEALTH CARE CORPORATION "PART V, SECTION B, LINE 11: A THREE YEAR ACTION PLAN WAS DEVELOPED AS PART OF THE CHNA ACCOMPLISHMENTS, THE PLAN INCLUDES: 1.) ADDITION OF MENTAL HEALTH SERVICE INTEGRATED INTO PRIMARY CARE. THIS INCLUDES A PSYCHIATRIC NURSE PRACTIONER AND A LICENSED CLINICAL SOCIAL WORKER. 2.) COMMUNITY WELLNESS COMMITTEE MADE UP OF HOSPITAL STAFF AND COMMUNITY VOLUNTEERS. ACTIVITIES INCLUDE ""WEIGHT WATCHERS"" PROGRAM, EXERCISE CLASSES, AND HEALTHY EATING EDUCATIONAL PROGRAMS."
CLIFTON-FINE HEALTH CARE CORPORATION PART V, SECTION B, LINE 13B: BY HOUSEHOLD INCOME AS A PERCENTAGE OF FPL.
CLIFTON-FINE HEALTH CARE CORPORATION PART V, SECTION B, LINE 24: YES IF THAT PATIENT HAD HEALTH INSURANCE AND WE WERE DISCOUNTING A CO-PAY OR DEDUCTIBLE.
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Supplemental Information
PART I, LINE 3C: THE HOSPITAL OFFERS FINANCIAL ASSISTANCE TO EACH PATIENT WITH A HOUSEHOLD INCOME LESS THAN OR EQUAL TO THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY LEVEL ESTABLISHED BY THE FEDERAL GOVERNMENT (THE FPL) IF SUCH INDIVIDUAL HAS NO INSURANCE OR HAS EXHAUSTED HIS OR HER HEALTH INSURANCE BENEFITS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY HOSPITAL CARE AND IS UNABLE TO PAY THE FULL CHARGES FOR THOSE SERVICES.
PART I, LINE 7: DURING 2019 THE HOSPITAL RECEIVED FEDERAL FUNDS ATTRIBUTABLE TO 2015-2018. THE PAYMENTS WERE IN EXCESS OF 1.2 MILLION DOLLARS AND SIGNIFICANTLY IMPACTED THE CALCULATIONS.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 52,323.
PART III, LINE 2: CFH'S BAD DEBT EXPENSE IS CONFIGURED THROUGH THE ORGANIZATIONS INTERNAL OPERATION SYSTEM, CPSI.
PART III, LINE 3: CLIFTON-FINE HOSPITAL'S BAD DEBT EXPENSE IS CONFIGURED THROUGH THE ORGANIZATIONS INTERNAL OPERATING SYSTEM, CPSI.
PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABLILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS AND FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 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.
PART III, LINE 8: DUE TO THE COMMUNITY'S LARGE MEDICARE POPULATION, THE TOTAL SHORTFALL IS CONSIDERED TO BE PART OF THE COMMUNITY BENEFIT EXPENSE.
PART III, LINE 9B: OUR POLICY STATES THE PERCENTAGE TO WHICH THE PATIENTS ACCOUNT WILL BE REDUCED BY AND IT ALSO STATES ACTIONS THAT WILL BE TAKEN IF THE PATIENT ACCOUNT IS NOT PAID.
PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH MONTHLY SURVEYS.
PART VI, LINE 3: POSTERS ARE PUT THROUGHOUT THE FACILITY, ESPECIALLY IN THE WAITING AREAS AND IN REGISTRATION, NOTING THE CHARITY CARE ASSISTANCE POLICY. INFORMATION IS ALSO GIVEN TO THOSE THAT DO NOT HAVE INSURANCE IF INQUIRING.
PART VI, LINE 4: FINE COMMUNITY IS LOCATED IN THE RURAL, NORTHWEST PORTION OF NEW YORK STATE'S ADIRONDACK PARK. THE HOSPITAL IS LOCATED IN SOUTHERN ST. LAWRENCE COUNTY AND SERVICES THE TOWNSHIPS OF CLIFTON, FINE AND THE SURROUNDING AREA. WE HAVE APPROXIMATELY 6,700 YEAR-ROUND RESIDENTS. THE POPULATION EXPANDS BY APPROXIMATELY 30% IN THE SUMMER MONTHS.
PART VI, LINE 5: WE ARE PARTICIPATING IN A COMMUNITY NEEDS SURVEY. WE OFFER SEVERAL COMMUNITY WELLNESS PROGRAMS, AND WE HAVE SEVERAL PLANNED OVER THE NEXT COUPLE OF YEARS CENTERING ON WOMEN'S HEALTH, CHILDREN AND WE ARE CURRENTLY OFFERING WELLNESS EXAMS TO THE VETERANS IN OUR COMMUNITY.
PART VI, LINE 6: PASSIVE PARENT MODEL WITH SAMARITAN MEDICAL CENTER, SAMARITAN MEDICAL CENTER HELPS WITH THE IMPLEMENTATION PLAN.
PART VI, LINE 7, REPORTS FILED WITH STATES NY
