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Pickens County Medical Center Inc
Carrollton, AL 35447
| Bed count | 56 | Medicare provider number | 010109 | Member of the Council of Teaching Hospitals | YES | 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: 2012
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 $ 23,973,248 Total amount spent on community benefits as % of operating expenses$ 756,720 3.16 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 23,526 0.10 %Medicaid as % of operating expenses$ 716,805 2.99 %Costs of other means-tested government programs as % of operating expenses$ 12,495 0.05 %Health professions education as % of operating expenses$ 0 0 %Subsidized health services as % of operating expenses$ 3,544 0.01 %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$ 350 0.00 %Community building*
as % of operating expenses$ 3,686 0.02 %- * = CBI denoted preventative categories
- Community building activities details:
Did tax-exempt hospital report community building activities? YES 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$ 3,686 0.02 %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$ 0 0 %Coalition building as % of community building expenses$ 0 0 %Community health improvement advocacy as % of community building expenses$ 0 0 %Workforce development as % of community building expenses$ 0 0 %Other as % of community building expenses$ 3,686 100 %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: 2012
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$ 4,197,448 17.51 %Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program? YES - 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$ 1,133,311 27.00 %- 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 YES Filed lawsuit YES 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? NO
Community Health Needs Assessment Activities: 2012
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? 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: 2012
- 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 $ 1866379 including grants of $ 0) (Revenue $ 5778757) EMERGENCY DEPARTMENT - PROVIDES 24/7/365 EMERGENCY SERVICES TO THE CITIZENS OF PICKENS COUNTY WITH 12,421 VISITS FOR THE FISCAL YEAR 2013.
4B (Expenses $ 1005800 including grants of $ 0) (Revenue $ 1374252) REFORM PRIMARY CARE - PROVIDES PRIMARY CARE PHYSICIAN SERVICES TO THE CITIZENS OF REFORM AND SURROUNDING COMMUNITIES WITH TOTAL OFFICE VISITS OF 8,013 DURING THE FISCAL YEAR 2013.
4C (Expenses $ 995112 including grants of $ 0) (Revenue $ 1276386) CARROLLTON PRIMARY CARE CLINIC - PROVIDES PRIMARY CARE PHYSICIAN SERVICES TO THE CITIZENS OF CARROLLTON AND SURROUNDING COMMUNITIES WITH TOTAL OFFICE VISITS OF 8,669 DURING THE FISCAL YEAR 2013.
4D (Expenses $ 20105957 including grants of $ 0) (Revenue $ 13386243) PICKENS COUNTY MEDICAL CENTER OTHER SERVICES INCLUDE ICU/PCU, GERIATRIC PSYCHIATRIC IP AND OP SERVICES, OR, LABORATORY, RADIOLOGY, PHYSICAL & SPEECH THERAPY, HOME HEALTH, DURABLE MEDICAL EQUIPMENT DEPT. (DME), AND WELLNESS CENTER.
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Supplemental Information
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 $ 4197448.
PART II: OUR COMMUNITY BUILDING ACTIVITIES IN FISCAL YEAR 2013 WERE FOCUSED ON CANCER AWARENESS, WHICH IS THE SECOND LEADING CAUSE OF DEATH FOR BOTH MEN AND WOMEN. WE HOSTED A BREAST AND PROSTATE CANCER AWARENESS PROGRAM FOR THE COMMUNITY TO EDUCATE WOMEN AND MEN ON PREVENTITIVE MEASURES. ALSO, WE WERE THE TITLE SPONSOR AND HOSTED THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE AND SURVIVORS RECEPTION ON OUR CAMPUS.WE SEND STAFF TO SPEAK TO CIVIC GROUPS AND CLUBS ABOUT VARIOUS HEALTH TOPICS TO INCREASE THE COMMUNITY'S GENERAL KNOWLEDGE.
PART III, LINE 4: THE HOSPITAL USES COST-TO-CHARGE RATIO TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE AT COST. THE LATEST CENSUS DATA FOR PERSONS IN PICKENS COUNTY BELOW THE POVERTY LEVEL, WAS APPLIED TO BAD DEBT EXPENSE AT COST TO DETERMINE BAD DEBT ATTRIBUTABLE TO CHARITY CARE.
PART III, LINE 8: ALLOWABLE COSTS IN THE COST REPORT ARE USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO MEDICARE PAYMENTS.
PART III, LINE 9B: PATIENTS CAN CONTACT THE BUSINESS AND REQUEST A SFS APPLICATION AT ANY TIME AND RECEIVE DISCOUNTS ACCORDINGLY PRIOR TO BEING SENT TO COLLECTIONS. DISCOUNTS ARE AVAILABLE ON ACCOUNTS IN BAD DEBT, IF PAID IN FULL, APPROVED BY THE DIRECTOR.
PICKENS COUNTY MEDICAL CENTER, INC. PART V, SECTION B, LINE 3: A CHNA SURVEY WAS COMPLETED IN MAY OF 2013. AFTER THE SURVEY, A COMMITTEE OF STAKEHOLDERS WAS FORMED FROM PEOPLE IN THE COMMUNITY TO ADDRESS THE ISSUES AND WORK ON SOLUTIONS. THE COMMITTEE CONSISTED OF THE FOLLOWING: MARNETTA MCDANIEL, PICKENS COUNTY DEPARTMENT OF HEALTH PATTI PRESLEY-FULLER, COOPERATIVE EXTENSION SERVICE LILLIE HENDERSON, PARK CAMARON OF THE HOUSING AUTHORITY DOUG SANDERS, PICKENS COUNTY HERALD DONNA NANCE, WEST ALABAMA BANK, ALICEVILLE, AL MARY FUSEYAMORE, MAYOR OF PICKENSVILLE, AL CAROL MCKINZEY, WEST ALABAMA BANK, REFORM, AL CRAIG PATTERSON, MAYOR, GORDO, AL NATALIE LAVENDAR, INSTRUCTOR, PICKENS COUNTY HEALTH OCCUPATION STUDENT ASSOC. MARGARET SHIELDS, VOLUNTEER, PICKENS COUNTY MEDICAL CENTER CHARLIE WILSON, PASTOR, ALICEVILLE FIRST BAPTIST CHURCH, ALICEVILLE, AL SHERI PARKER, HOMEMAKER, (PHYSICIAN'S WIFE) THE FOLLOWING ARE NEEDS IDENTIFIED THROUGH THE CHNA PROCESS:1. ENCOURAGING AND EDUCATING THE COMMUNITY TO UTILIZE THE EXISTING PROVIDERS IN THE AREA BY FAR THE MOST IMPORTANT PRIORITY2. WELLNESS, TO INCLUDE ADDRESSING PHYSICAL INACTIVITY, NUTRITION, AND SMOKING A. DRUG ABUSE B. TEEN PREGNANCIES THE FOLLOWING ARE ACTIONS THAT WERE TAKEN FROM THE RECOMMENDATIONS:1. A BLUE RIBBON CAMPAIGN WAS INITIATED TO INCREASE THE UTILIZATION OF THE HOSPITAL AND ITS SERVICES LETTERS WERE SENT TO THE COMMUNITY CHURCHES; CARRIED TO THE COUNTY SCHOOLS FOR CHILDREN TO CARRY HOME TO THEIR PARENTS; THE ADMINISTRATOR OF THE HOSPITAL VISITED SCHOOLS AND COMMUNITY CENTERS; AND ADS WERE PLACED IN THE LOCAL NEWSPAPERS.2. A YOUTH WELLNESS CAMP WAS HELD IN THE HOSPITAL'S WELLNESS CENTER IN PARTNERSHIP WITH THE PICKENS COUNTY FAMILY RESOURCE CENTER AND THE PICKENS COUNTY COOPERATIVE EXTENSION OFFICE. ACTIVITIES INCLUDED WERE WELLNESS, NUTRITION, PHYSICAL EXERCISE, GARDENING, DRUG EDUCATION AND TAR WARS, MUSIC, ART, AND BULLYING.3. A COMMUNITY HEALTH FAIR WAS HELD AT THE HOSPITAL'S WELLNESS CENTER THAT INCLUDED MORE THAN 25 VENDORS AND OVER 300 ATTENDEES. THIS INCLUDED BLOOD PRESSURE, GLUCOSE, BODY MASS, AND CHOLESTEROL SCREENINGS. TRAINING ON GROCERY SHOPPING, HEALTHY PORTIONS, AND OVERALL HEALTHY EATING WAS ALSO PROVIDED. THE SHERIFF'S DEPARTMENT CONDUCTED DRUG EDUCATION. DENTIST AND EYE DOCTORS SET UP BOOTHS FOR EDUCATION. REPRESENTATIVES FOR ENROLLMENT FOR THE HEALTH EXCHANGE PROGRAM WERE ALSO PRESENT. ALL DEPARTMENTS FROM THE HOSPITAL WERE REPRESENTED WITH STORY BOARDS, BROCHURES, ETC. DOOR PRIZES WERE GIVEN AWAY. SCHOOL BUSES TRANSPORTED CHILDREN FROM ALL COUNTY PUBLIC SCHOOLS.
PICKENS COUNTY MEDICAL CENTER, INC. PART V, SECTION B, LINE 4: THE CHNA REPORT WAS CONDUCTED WITH DCH REGIONAL, NORTH AND FAYETTE HOSPITALS.
PICKENS COUNTY MEDICAL CENTER, INC. PART V, SECTION B, LINE 5C: THE CHNA REPORT IS MADE AVAILABLE TO THE PUBLIC THROUGH MEMBERS OF THE COMMITTEE, HOSPITAL BOARD MEMBERS, AND DEPARTMENT MANAGERS.
PICKENS COUNTY MEDICAL CENTER, INC. PART V, SECTION B, LINE 20D: CHARGES ARE POSTED TO EMERGENCY ROOM ACCOUNTS AT THE GROSS AMOUNT. NOTICE OF OUR FINANCIAL ASSISTANCE IS POSTED IN THE EMERGENCY ROOM WAITING AREA AND ON THE BILING STATEMENT. UNINSURED PATIENTS CAN CONTACT US FOR ASSISTANCE ACCORDING TO THE POLICY.
PICKENS COUNTY MEDICAL CENTER, INC. PART V, SECTION B, LINE 22: CHARGES ARE POSTED TO ALL ACCOUNTS AT GROSS AMOUNT. PATIENTS WHO REQUEST AND THEN QUALIFY FOR FINANICAL ASSISTANCE THEN GET THOSE CHARGES DISCOUNTED.
PART VI, LINE 2: THE ORGANIZATION ASSESSES COMMUNITY HEALTH CARE NEEDS IN A VARIETY OF WAYS: PHYSICIAN INPUT FROM MEDICAL STAFF MEETINGS, ADVISORY BOARDS, MANAGEMENT TEAM MEETINGS, EMPLOYEE MEETINGS AND FEEDBACK RECEIVED ON PATIENT SURVEYS.
PART VI, LINE 3: NOTICES INFORMING PATIENTS ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WILL BE PLACED IN ADMISSION AND REGISTRATION AREAS AND WILL BE INCLUDED ON ALL HOSPITAL BILLING. ALL REGISTRARS AND PATIENT ACCOUNT REPRESENTATIVES WILL PROVIDE CHARITY AND SLIDING FEE SCALE APPLICATIONS FOR PATIENTS WHO REQUEST FINANCIAL ASSISTANCE. THE HOSPITAL ALSO CONTRACTED WITH A COMPANY TO CONTACT ALL UNINSURED INPATIENTS TO CHECK FOR ELIGIBILITY FOR FEDERAL OR STATE PROGRAMS.
PART VI, LINE 4: PICKENS COUNTY MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL LOCATED IN WEST CENTRAL ALABAMA ON THE STATE BORDER WITH MISSISSIPPI. WE ARE A RURAL COUNTY AT THE START OF THE ALABAMA BLACK BELT REGION WHICH IS A PRIMARILY RURAL AND ECONOMICALLY CHALLENGED AREA.THE 2010 POPULATION OF PICKENS COUNTY IS APPROXIMATELY 19,750. THE MEDIAN HOUSEHOLD INCOME (FROM 2010) IS $28,280 AND 27% OF THE POPULATION IS BELOW THE 2010 POVERTY LEVEL, WHICH IS GREATER THAN THE STATE AVERAGE OF 17%. OUR PRIMARY MARKET IS MEDICARE AT 52% FOLLOWED BY MEDICAID AT 15%, BEING A TOTAL OF 67% OF BUSINESS.
