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Nelson County Health System-hospital
Mcville, ND 58254
| Bed count | 19 | Medicare provider number | 351308 | 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 $ 4,246,724 Total amount spent on community benefits as % of operating expenses$ 137,431 3.24 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 0 0 %Medicaid as % of operating expenses$ 129,471 3.05 %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.$ 7,960 0.19 %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$ 0 0 %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? NO
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 $ 3373965 including grants of $ 0) (Revenue $ 3498985) NELSON COUNTY HEALTH SYSTEM IS A 19 BED CRITICAL ACCESS HOSPITAL LOCATED IN NELSON COUNTY FOR ACUTE, OBSERVATION, EMERGENCY ROOM AND SWING BED SERVICES. THE HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY.
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Facility Information
NELSON COUNTY HEALTH SYSTEM-HOSPITAL PART V, SECTION B, LINE 5: THE CENTER FOR RURAL HEALTH AT THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES SUPPORTED NELSON COUNTY HEALTH SYSTEM IN CONDUCTING THIS ASSESSMENT BY ADMINISTERING THE SURVEY, LOCATING AND ANALYZING SECONDARY DATA SOURCES, CONDUCTING INTERVIEWS, AND WRITING THIS ASSESSMENT REPORT.DATA FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS COLLECTED IN A VARIETY OF WAYS: (1) A SURVEY SOLICITED FEEDBACK FROM AREA RESIDENTS; (2) ANOTHER VERSION OF THE SURVEY GATHERED INPUT FROM HEALTH CARE PROFESSIONALS WHO WORK AT NELSON COUNTY HEALTH SYSTEM; (3) COMMUNITY LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY TOOK PART IN ONE-ON-ONE KEY INFORMANT INTERVIEWS; (4) A COMMUNITY GROUP COMPRISED OF COMMUNITY LEADERS AND AREA RESIDENTS WAS CONVENED TO DISCUSS AREA HEALTH NEEDS; AND (5) A WIDE RANGE OF SECONDARY SOURCES OF DATA WAS EXAMINED, PROVIDING INFORMATION ON A MULTITUDE OF MEASURES INCLUDING DEMOGRAPHICS; HEALTH CONDITIONS, INDICATORS, AND OUTCOMES; RATES OF PREVENTIVE MEASURES; RATES OF DISEASE; AND AT-RISK ACTIVITIES.
NELSON COUNTY HEALTH SYSTEM-HOSPITAL PART V, SECTION B, LINE 11: WE ARE ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA BY THE FOLLOWING: - CLINIC STAFF ARE DISTRIBUTING EDUCATIONAL INFORMATION DURING PATIENT APPOINTMENTS RELATED TO WELLNESS, OBESITY, HEART DISEASE, DIABETES AND SMOKING,- PROVIDING ACCESS TO AVAILABLE RESOURCES INCREASE COMMUNITY MEMBERS ACTIVITY LEVELS,- HOLDING A WELLNESS HEALTH FAIR AT NCHS HOSPITAL FOR COMMUNITY MEMBERS WITH SCREENING TESTING DONE FOR DIABETES, CANCER AWARENESS, HEART DISEASE, STROKE AWARENESS, AND DEPRESSION, AND- IMPLEMENTATION OF MENTAL HEALTH SERVICES VIA TELEMEDICINE AT HOSPITAL,- INCREASE THE NUMBER OF PRIMARY CARE PROVIDERS AND IMPLEMENT A RURAL HEALTH CLINIC IN THE NORTHERN AREA. OFFER LOAN-REPAYMENT ASSISTANCE,- HOLD COMMUNITY-BASED INTERVENTIONS AND PREVENTION MEASURES. SUPPORT TELEHEALTH FOR THERAPIES AND HOLD SYMPOSIUMS EDUCATING YOUTH AND ADULTS,- WORK WITH THE LOCAL CITY TO CREATE A PLAYGROUND TO MAKE YOUR PARK KID-FRIENDLY AND FAMILY-FRIENDLY,- IMPLEMENT A HOME HEALTH PROGRAM AND TRANSPORTATION FOR MEDICAL APPOINTMENTS. - ADVERTISE AND PROMOTE TELEHEALTH SERVICES FOR PATIENTS TO BE SEEN FOR MENTAL HEALTH SERVICES, INCLUDING COUNSELING AND PROVIDER VISITS. CONSULT A LOCUM TO COME INTO THE CLINIC ON A REGULAR BASIS TO PROVIDE MENTAL HEALTH SERVICES. WORK WITH LOCAL HOSPITALS AND CLINICS ON A REFERRAL PROGRAM FOR SPECIALISTS.OUR FACILITY HAS A CHARITY CARE PLAN TO ASSIST THOSE COMMUNITY MEMBERS WITH THEIR FINANCIAL NEEDS. PUBLIC HEALTH IS A COUNTY PROVIDED SERVICE, AND THE COUNTY SOCIAL SERVICE OFFICE IS AVAILABLE TO ASSIST THOSE IN APPLYING FOR SERVICES, AS APPLICABLE. WE HAVE A SOCIAL WORKER DESIGNEE ALONG WITH INSURANCE COUNSELORS IN THE COUNTY WHO ARE AVAILABLE TO ASSIST COMMUNITY MEMBERS IN THEIR INSURANCE AND HEALTH CARE NEEDS.
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Supplemental Information
PART I, LINE 7: THE COSTING METHODOLOGY USED BY THE ORANIZATION IS MOST ACCURATELY REFLECTED USING THE COST TO CHARGE RATIO. THE RATIO OF PATIENT CARE COSTS TO CHARGES WAS DERIVED USING THE APPLICABLE WORKSHEET IN THE SCHEDULE H INSTRUCTIONS.
PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY EVENTS PROMOTE THE HEALTH OF OUR COMMUNITY CITIZENS. WE PROVIDE INFORMATION AND HEALTHCARE SERVICES TO THOSE INDIVIDUALS THAT MAY NOT RECEIVE SERVICES OTHERWISE. THE IDENTIFIED NEEDS OF EARLY DETECTION LED US TO OFFER MAMMOGRAPHY CLINICS AND THE WELLNESS EVENT, WHICH FOCUSED ON PROSTATE CANCER SCREENING, CHOLESTEROL TESTING, BLOOD PRESSURE, BLOOD SUGAR, HEMOGLOBIN, AND COLORECTAL SCREENING.
PART III, LINE 2: NO BAD DEBT EXPENSE WAS REPORTED IN OPERATING EXPENSE AS NOTED IN THE NETPATIENT SERVICE REVENUE NOTE IN THE FINANICAL STATEMENTS. DISCOUNTS ANDALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.
PART III, LINE 3: IT IS POLICY TO MAKE FINANICAL ASSISTANCE AVAILABLE TO PATIENTS WHO FIT THE FINANICAL ASSISTANCE CRITERIA. IT IS THE ORGANIZATION'S GOAL TO MAKE CERTAIN THAT THEY ARE PROACTIVE IN THE DETERMINATION OF FINANCIAL ASSISTANCE. ALL EFFORTS ARE MADE TO ENSURE THAT FINANCIAL ASSISTANCE ELIGIGLE PATIENTS DO NOT PROGRESS TO BAD DEBTS ADN THEREFORE NO DOLLAR AMOUNT FOR BAD DEBT IS INCLUDED.
PART III, LINE 4: THE AUDITED FINANICAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GAAP.
PART III, LINE 8: MEDICARE COSTING METHODOLOGY USING THE MEDICARE COST REPORT, WHICH DOES REMOVE CERTAIN NON-ALLOWED MEDICARE COSTS.
PART III, LINE 9B: FA POLICY IS PROVIDED TO ALL PATIENTS AT THE POINT OF SERVICE OR ADMISSION; POSTED NOTICE ON COMMUNITY BULLETIN BOARDS WITHIN THE NCHS FACILITIES; POSTED NOTICE AND INFORMATION ON THE NCHS WEBSITE; GENERAL INFORMATION RELEASED AT LEAST ANNUALLY IN THE LEGAL NEWSPAPER LOCATED WITHIN NCHS'S PRIMARY SERVICE AREA; AND OTHER ASDEEMED APPROPRIATE BY THE ADMINISTRATOR.
PART VI, LINE 2: NELSON COUNTY HEALTH SYSTEM ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITIES BY TRACKING IDENTIFIED TRENDS FROM DATA FROM THE STATE HEALTH DEPARTMENT FOR BOTH PROACTIVE AND PREVENTIVE MEASURES. THE ORGANIZATION ALSO GATHERS INFORMATION THROUGH INPUT FROM COMMUNITY MEETINGS.
PART VI, LINE 3: THE ORGANIZATION EDUCATES PATIENTS BY DISTRIBUTING WRITTEN INFORMATION TO PATIENTS INCLUDING INFORMATION ABOUT DURABLE POWER OF ATTORNEY FOR HEALTHCARE AND FINANCIAL NEEDS. PROGRAMS AVAILABLE AND CONTACT INFORMATION ARE POSTED THROUGHOUT THE FACILITY AND ARE INCLUDED IN ALL PATIENT ADMISSION PACKETS. BROCHURES FOR THE NCHS FINANCIAL ASSISTANCE POLICY ARE ALSO AVAILABLE. SOCIAL WORK ASSESSMENTS MAY IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR ASSISTANCE. ADDITIONALLY, REFERALS ARE RECEIVED FROM COMMUNITY ORGANIZATIONS.
PART VI, LINE 4: THE ORGANIZATION SERVICES A RURAL AREA OF NORTHEASTERN NORTH DAKOTA. THE AREA OF SERVICE IS PREDOMINANTLY NELSON COUNTY, PRIMARILY THE CITY OF MCVILLE, INCLUDING AN AREA 20 MILES IN RADIUS FROM MCVILLE. THE POPULATION OF MCVILLE IS 383. THE COUNTY POPULATION IS 3,044, OF WHICH 25.8%, OR 785 PEOPLE, ARE AGE 65 OR OVER. MEDIAN HOUSEHOLD INCOME IS $56,724. THE PERCENTAGE OF INDIVIDUALS BELOW THE POVERTY LEVEL IS ESTIMATED AT 10.4%. NCHS IS THE ONLY HOSPITAL IN NELSON COUNTY (982 SQUARE MILES). NCHS ALSO PROVIDES THE ONLY CLINIC IN MCVILLE AND MICHIGAN, ND. NELSON COUNTY HEALTH SYSTEM IS IN A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA. ALL DATA COMES FROM THE U.S. CENSUS BUREAU FACT SHEET FOR NELSON COUNTY AND THE DATA SETS WITH DETAILED TABLES.
PART VI, LINE 5: THE GOVERNING BODY OF THE ORGANIZATION IS COMPRISED OF PEOPLE WHO LIVE IN OUR SERVICE AREA AND ARE NEITHER EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION. NCHS EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY FOR ALL DEPARTMENTS. OUR EMERGENCY DEPARTMENT SERVES ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. NCHS PARTICIPATES IN MEDICARE, MEDICAID, AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. NCHS IS ALSO DESIGNATED AS A CRITICAL ACCESS HOSPITAL. OTHER ACTIVITIES TO PROMOTE HEALTH IN THE AREAS SERVED INCLUDE POSTING COMMUNITY WELLNESS AND INFORMATION NOTICES ON THE LOCAL CABLE CHANNEL, AREA NEWSPAPERS, AND FLYERS. IN ADDITION TO THESE POSTINGS, COMMUNITY EDUCATION IS PROVIDED ANNUALLY, AND THE ORGANIZATION'S MEDICAL STAFF IS AVAILABLE AND PARTICIPATES IN COMMUNITY EVENTS AND EDUCATION.
PART VI, LINE 6: N/A
