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Person Memorial Hospital Inc
Roxboro, NC 27573
| Bed count | 50 | Medicare provider number | 340159 | 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: 2010
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 $ 42,474,921 Total amount spent on community benefits as % of operating expenses$ 2,795,332 6.58 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 833,540 1.96 %Medicaid as % of operating expenses$ 1,961,792 4.62 %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: 2010
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$ 3,012,402 7.09 %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 Filed lawsuit Not available Placed liens on residence Not available Issue body attachments? (an order by the court commanding a sheriff or other official to physically bring before the court a person who is guilty of contempt of court) 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? NO 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? YES 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: 2010
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? Not available Did the CHNA define the community served by the tax-exempt hospital? Not available Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital? Not available Did the tax-exempt hospital make the CHNA widely available (i.e. post online)? Not available Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA? Not available Did the tax-exempt hospital execute the implementation strategy? Not available Did the tax-exempt hospital participate in the development of a community-wide plan? Not available
Supplemental Information: 2010
- 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 $ 37355765 including grants of $ 0) (Revenue $ 36966958) PERSON COUNTY MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT HOSPITAL LOCATED IN ROXBORO, NORTH CAROLINA. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF ROXBORO, PERSON COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL CONSISTS OF 50 ACUTE BEDS AND 60 LONG-TERM CARE BEDS. THE HOSPITAL PROVIDES CARE TO PATIENTS WITH OR WITHOUT THE ABILITY TO PAY.
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Supplemental Information
PART I, LINE 3C: AN APPLICATION IS COMPLETED AND SUBMITTED BY AN APPLICANT REQUESTING FREE OR DISCOUNTED CARE. APPLICANT MUST PROVIDE SUPPORTING DOCUMENTATION FOR THE AMOUNT OF INCOME, SIZE OF FAMILY AND AMOUNT OF PROPERTY/ASSETS OWNED. DEPENDING ON THE LEVEL OF INCOME AND SIZE OF FAMILY, AN ADJUSTMENT COULD BE PROVIDED BASED ON THE FEDERAL POVERTY GUIDELINES (FPG). IF INCOME IS 1) LESS THAN 125% OF THE FPG, AN ADJUSTMENT IS 100%; 2) IF BETWEEN 126 AND 150%, THE ADJUSTMENT IS 75%; 3) IF BETWEEN 151 AND 175%, THE ADJUSTMENT IS 50%; 4) IF BETWEEN 176 AND 200%, THE ADJUSTMENT IS 25%; 5) IF OVER 200%, THEN ADJUSTMENT IS ZERO.
PART I, LINE 6A: N/A
PART I, LINE 7: AMOUNTS SHOWN IN PART I, LINE 7, COLUMN C WERE COMPUTED USING THE COST-TO-CHARGE RATIO WORKSHEET (WORKSHEET 2) FROM THE IRS INSTRUCTIONS FOR SCHEDULE H.
PART I, LINE 7G: N/A
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 $ 7688390.
PART II: N/A
PART III, LINE 4: THE HOSPITAL USES HISTORICAL COLLECTION EXPERIENCE AND A REVIEW OF CURRENT RECEIVABLES TO PROVIDE AN ESTIMATE OF THE ALLOWANCE FOR UNCOLLECTIBLES AND THE BAD DEBT EXPENSE. ACCOUNTS PAST DUE FOR MORE THAN 90 DAYS ARE INDIVIDUALLY ANALYZED FOR COLLECTIBLITY. IF DEEMED UNCOLLECTIBLE, ACCOUNTS ARE REFERRED TO ONE OF TWO OUTSIDE COLLECTION AGENCIES UNLESS THE ACCOUNT IS BEING REVIEWED UNDER THE HOSPITAL'S CHARITY POLICY.THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES FROM BAD DEBT EXPENSE. THESE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO THE COMMUNITY SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION A, LINE 2:THE AMOUNT ON LINE 2 WAS DERIVED BY TAKING THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS AND MULTIPLYING IT BY THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED USING WORKSHEET 2 OF THE IRS INSTRUCTIONS FOR SCHEDULE H.PART III, SECTION A, LINE 3:THE HOSPITAL DOES NOT HAVE A PROCESS IN PLACE THAT ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER A FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8: THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES BY SERVING MEDICARE PATIENTS. THE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO THE COMMUNITY SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION B, LINE 8:THE COST TO CHARGE RATIO AS CALCULATED BY THE MOST RECENTLY FILED COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B: THE HOSPITAL'S FINANCIAL COUNSELOR MAKES NOTATIONS IN THE PATIENT ACCOUNTING BILLING SYSTEM RELATIVE TO CHARITY CARE APPLICATIONS THAT ARE IN PROCESS. ACCOUNTS ARE REVIEWED EVERY MONTH BY THE BUSINESS OFFICE STAFF AND IF UPON REVIEW, NOTATION IS MADE RE: CHARITY CARE APPLICATION IN PROCESS, THEN ACCOUNT IS NOT REFERRED TO OUTSIDE COLLECTION AGENCY. A STANDARD COMPUTERIZE STATEMENT IS MAILED EVERY MONTH ON ALL UNPAID ACCOUNTS EVEN ON PENDING CHARITY CASES UNTIL CASE REACHES A DETERMINATION.
PART VI, LINE 2: THE HOSPITAL NEEDS ARE ASSESSED BY OBTAINING INPUT FROM THE MEDICAL STAFF, BOARD OF TRUSTEES, AND THROUGH DEVELOPING STRATEGIC PLANS. ALSO, MARKET SHARE ANALYSES ARE REVIEWED TO DETERMINED INFLOW AND OUTFLOW OF PATIENTS WITH ASSISTANCE WITH THE DUKE MANAGEMENT AGREEMENT.
PART VI, LINE 3: UPON PATIENT'S REGISTRATION OR ADMISSION TO HOSPITAL, IF PATIENT IS UNINSURED, HOSPITAL STAFF PROVIDES A LETTER TO PATIENT OR RESPONSIBLE PARTY IDENTIFYING INSTRUCTIONS AS WHAT ACTION SHOULD BE TAKEN. HOSPITAL FINANCIAL COUNSELOR THEN DISCUSSES OPTIONS AVAILABLE TO PATIENT SUCH AS GOVERMENTAL ASSISTANCE OR THE HOSPITAL'S CHARITY CARE POLICY. ALSO, HOSPITAL CASE MANAGERS WILL DIRECT APPROPRIATE PATIENTS WHO ARE UNINSURED TO THE FINANCIAL COUNSELOR.
PART VI, LINE 4: PERSON MEMORIAL HOSPITAL SERVES THE PEOPLE OF PERSON COUNTY AS ITS PRIMARY SERVICE AREA. THE POPULATION OF PERSON COUNTY IS APPROX. 35,000. THE PRIMARY INDUSTRY IN THE COUNTY IS AGRICULTURAL, GOVERNMENTAL AND HEALTHCARE. THE HOSPITAL IS THE ONLY HOSPITAL IN THE COUNTY WITH NEIGHBORING MAJOR MEDICAL FACILITIES APPROXIMATELY 30 MILES AWAY. THE COUNTY HAS SEVERAL PRIMARY CARE PHYSICIANS AND A URGENT CARE CENTER.
PART VI, LINE 6: PERSON MEMORIAL HOSPITAL OPERATES WITH A 14 VOTING MEMBER BOARD OF TRUSTEES MADE OF VARIOUS PROFESSIONALS WITHIN THE COMMUNITY. THERE IS AN OPEN MEDICAL STAFF CONSISTING OF APPROXIMATELY 23 ACTIVE MEMBERS. THE HOSPITAL PROVIDES EMERGENCY SERVICES 24 HOURS A DAY REGARDLESS OF PATIENT'S FINANCIAL STATUS.
PART VI, LINE 7: PERSON MEMORIAL HOSPITAL IS MANAGED BY THE DUKE MEDICINE IN DURHAM, NORTH CAROLINA. DUKE MEDICINE PROVIDES HOSPITAL MANAGEMENT (CEO AND CFO) AND PROVIDES A LIASON AT THE MONTHLY BOARD MEETINGS. DUKE MEDICINE PROVIDES SERVICES IN THE AREA OF MARKET SHARE ANALYSIS, STRATEGIC PLANNING, AND PHYSICIAN RECRUITMENT.
REPORTS FILED WITH STATES PART VI, LINE 7 NC
