Community Benefit Insight - Tax-exempt hospital

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McCurtain Memorial Medical Management Inc

Mccurtain Memorial Hospital

1301 Lincoln Road
Idabel, OK 74745

Bed count	91	Medicare provider number	370048	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 736617937

Display data for year:

Community Benefit Spending- 2018
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

1.83%

Spending by Community Benefit Category- 2018
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2018

Additional data

Community Benefit Expenditures: 2018

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.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 100,865 0.50 %
Medicaid as % of operating expenses	$ 253,552 1.25 %
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	$ 17,051 0.08 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: 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: 2018

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	$ 6,826,665 33.57 %
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	$ 2,136,746 31.30 %

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:
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.
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.
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.

Community Health Needs Assessment Activities: 2018

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: 2018

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

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 $ 18131392 including grants of $ 0) (Revenue $ 19892322)
We continue to provide quality health care to McCurtain County, Oklahoma and its surrounding areas. In addition, we endeavor to serve the public through such activities as wellness programs, community education programs, special programs for the elderly, handicapped and medically underserved and a variety of broad community support activities.To fulfill our mission of community service, we provide care to patients who meet certain criteria under our charity care policy without charge or at amounts less than our established rates. We maintain records to identify and monitor the level of charity care we provide.These records include the amount of charges foregone for services and supplies furnished under our charity care policy and equivalent service statistics. The amount of charges forgone, based on established rates were approximately $343,376 for the year ended June 30, 2019. The estimated cost of providing these services was approximately $100,865 for the year ended June 30, 2019.The Hospital has a Wellness Center-exercise area that community members can subscribe to and use the exercise equipment. Personnel are available to assist them. This program is available to all community members at a low-cost with discounted rates for seniors and is free to employees in order to help advocate healthy lifestyles. Total expense includes overhead cost (administrative & utilities) and the cost of depreciation for equipment. The Garden Meadows Walking Trail located at the Hospital is open to the public, in addition to employees, 24 hours a day, 7 days a week at no charge and is intended to promote physical activity for healthier lifestyles. Hospital expense to maintain the walking track includes labor, water, electricity, and depreciation.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

McCurtain Memorial Medical Management,Inc
Part V, Section B, Line 5: McCurtain Memorial Hospital participated as the main speaker for March 2019 Coalition for Change meeting. This meeting was held on March 19, 2019. During this time, the Executive Director of Little Dixie Community Action Agency shared the findings of the Little Dixie Community Needs Assessment, and the Oklahoma Office of Rural Health presented demographic and health data and facilitated the discussion to identify health priorities for McCurtain Memorial Hospital to address. Data input was provided by the Little Dixie Community Action Agency needs assessment previously completed in January 2019 which was comprised of data gathered via survey, focus groups, and community meetings during May 2018 through November 2018. The complete methodology and findings of the Little Dixie Community Needs Assessment can be found at: https://www.littledixie.org/resources.Community members in attendance at this meeting included: -McCurtain Memorial Hospital -Little Dixie Community Action Agency -McCurtain County Health Department -Oklahoma Healthcare Authority -DHS This group was selected due to their broad representation of the community and the diverse populations they serve. These individuals work with diverse populations and low-income populations, and they provide great insight into the needs of the community. Representatives from the public health sector were included to provide insight into what they see from a public health and underserved population perspective of community needs.

McCurtain Memorial Medical Management,Inc
Part V, Section B, Line 6b: McCurtain County Health Department, McCurtain County Coalition for Change, Little Dixie Community Action Agency, Oklahoma Office of Rural Health, OSU Center for Rural Health

McCurtain Memorial Medical Management,Inc
"Part V, Section B, Line 11: The following needs were identified in the CHNA completed in 2018. The hospital began addressing the following needs in fiscal year 2019 and will continue over the next 3 years. Two of the needs will not be addressed:The hospital has chosen to focus on five identified needs and regrets that a lack of hospital resources prevents us from specifically addressing all of the needs identified in the community meeting. Although the hospital will not specifically address motor vehicle crash death rate and potential correlation with substance abuse and teen birth rate along with STI's, they will fully support any education efforts made by other community organizations by providing meeting space and limited resources for educational events aimed at achieving overall healthcare improvement in our community. Further, the hospital will continue to serve as an active member of the local health coalition and other partnerships. Other community agencies do exist with specific goals and objectives aimed at addressing these needs: - Teen birth rate along with STIs - Motor vehicle crash death rate and potential correlation with substance abuse Overall wellness and education, improve quality of life In continuing efforts in actively recruiting and retaining physicians and other healthcare professionals for the medical service area. A general surgeon with trauma care experience has been recruited and employed by the Hospital effective 6/17/19.A new family practice physician has been contracted to open a family practice clinic and is scheduled to arrive in mid-October 2019.Concerning Nurse Practitioner recruitment, the hospital will provide a location to provide medical services rent free for one year effective Mar 15, 2018 - March 14,2019.The hospital will provide higher quality of nursing staff through increased level of standards and by encouraging staff to obtain further education and certifications.Skills fairs are held at least annually to keep nurses and other clinical personnel up to date in certifications.CNO, pharmacist and new hospitalist team is working to train nursing staff in the administration of certain drugs in order for care to be continued on an inpatient basis rather than transferring patients to other facilities.The Hospital is working to partner with Oklahoma State University to offer specialty services not currently provided in the county.Partnership plans are in progress with OSU School of Medicine to provide telemedicine services for Cardiology patients.Increased access to healthcare is provided through outpatient clinics with extended hours. Plans have been completed and purchases made for the 7/1/19 opening of an Urgent Care clinic with hours of operation outside of regular business hours. The Clinic will be staffed by a newly hired nurse practitioner and supervised by a family practice physician.The Hospital continues to provide reduced rate medical screenings which will offer the opportunity for services to those who may not normally be able to afford the usual rates despite having insurance. Special rate mammography screenings are offered during Breast Cancer awareness month. Special rate PSA screenings are offered at certain times of the year.The Hospital provided health screening booths at the annual Hospital Foundation festival on 5/18/2019.The Hospital participated in RAM Clinic providing free dental, vision, and limited medical care provided on first-come first-served basis. There were no income qualifications. This was a Hospital volunteer booth.Plans are in progress to open a Free Care clinic one half-day a week to provide health care evaluations and lab tests to uninsured/underinsured individuals and to provide education in types of health insurance and how to obtain public assistanceThe Hospital will continue to provide meeting space and other resources, such as public speaking, for Hospital and community healthcare educational events as well as at civic organizations and other public venues. Efforts will continue in researching and securing outside grants and other funding as well as committing its own resources to the improvement of overall community health. ObesityThe Hospital will continue operation of the Patricia R. Baggs Rehabilitation and Wellness Center at low cost to all community members with discounted rates for seniors and free access to employees of the hospital and other groups of the community such as teachers. The Hospital will continue to maintain the Garden Meadows Walking Trail located in the front of the hospital which is free and open to the public. Encouraging the consumption of healthy snacks to all patients, visitors and guests will continue by making fresh popcorn available during weekdays in the front lobby of the hospital. SmokingInformation will be provided on smoking cessation and other alternatives to assist patients in their efforts to discontinue smoking. There will be continued enforcement of a ""No Smoking"" campus policy. The Hospital will encourage the use of other community resources such as the smoking cessation hotline.Access to mental health providers The Hospital will continue to actively recruit licensed mental health professionals and work to partner with Oklahoma State University to provide telehealth mental health services on an outpatient treatment basis.The Hospital will explore the possibility of intensive outpatient treatment programs. Meeting space will continue to be provided along with other resources for educational events addressing Mental Health issues, such as an Alzheimer's support group. Trauma Informed CareThe Hospital will create awareness among care providers and staff of Trauma Informed Care through resources available through the Oklahoma Department of Mental Health and Substance Abuse Services."

Part V, Section B, Line 7b:
https://osururalhealth.blogspot.com/p/chna.html#mccurtain

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7:
Charity care at cost on line 7a was calculated based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services on line 7g was determined using the Medicare Cost Report.

Part I, Ln 7 Col(f):
The amount of bad debt expense removed from total expenses to determine the percentage was $6,826,665.

Part III, Line 2:
Accounts are not written off to bad debt until all payments, discounts and contractual allowances are applied and internal collection efforts have been exhausted. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense.

Part III, Line 3:
The amount of bad debt estimated to be attributable to patients under the Organization's charity care policy is 31.3%. This is determined by using the percentage of the population in the service area that is under the federal poverty guideline established for charity care.

Part III, Line 4:
The footnote to the Organization's financial statements can be found on page 8 of the attached audited financial statements.

Part III, Line 8:
McCurtain Memorial Hospital had a Medicare shortfall. The Hospital continues to provide services to these patients because access to healthcare and individual's health is important. Therefore, the Medicare shortfall is considered a community benefit. Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.

Part III, Line 9b:
Self-pay patients will be notified of the Financial Assistance Program upon registration during face-to-face interviews if possible. First time billing statements will be mailed to the responsible party of all patients within approximately 15 days of discharge. Information regarding making application for financial assistance is included in the statement. Applicants are notified by mail or phone call when their application is incomplete and are given an opportunity to provide the missing documentation or information within 90 days of notification. Before finding a patient eligible for assistance under this Policy, McCurtain Memorial may require patients to apply for public health coverage programs, such as Medicaid, for which McCurtain Memorial presumes the patients are eligible, as instructed by the hospital's Financial Services Department. McCurtain Memorial may deny eligibility for the Financial Assistance Program to patients who have been screened for a public health coverage program and are presumed to be eligible but are not cooperating with the process to apply for the health coverage program. If the individual does not provide the required information or the application is denied, normal collection procedures will commence. A patient has 120 days to apply for financial assistance from the date of discharge the account is sent to an outside collection agency. McCurtain Memorial, as well as third parties working on behalf of McCurtain Memorial, will not use extraordinary collections efforts within the first 120 days post discharge. Nor will McCurtain Memorial use extraordinary collection efforts while the patient or representative is actively in the process of applying for financial assistance. In the event that a patient or responsible party applies for financial assistance within 240 days of first statement date and has been found to be eligible, any extraordinary collection efforts by McCurtain Memorial or third parties working on behalf of McCurtain Memorial will cease and retraction will be made for any adverse reporting to credit bureaus in regards to the services for which they have been approved.

Part VI, Line 2:
Hospital Administration continually communicates with the Board of Trustees and seeks their input each month on community health needs and the Hospital's ability to meet those needs, evaluating internal and external issues that affect the organization. The Administrator's report each month gives an update from previously discussed items to include progress reports on how the Hospital is addressing or intends to address each need identified.

Part VI, Line 3:
"The Hospital posts its charity care policy summary with financial assistance contact information in the financial services office. Financial Assistance guidance and information is provided to patients upon completion of medical evaluation and screening at which time potentially eligible patients are counseled by Financial Services. Financial Assistance information is not provided with discharge materials. Financial Assistance information is provided in ""first-time"" statements of patient bills. Financial Services counsels all patients who are potentially eligible for financial assistance by providing guidance in applying for assistance through federal, state and county programs. Should a patient not qualify for one of these programs and is not eligible for nor enrolled in private or public insurance plans, the patient may still be eligible for financial assistance through the Hospital's Financial Assistance Program upon meeting the criteria outlined in the policy (78-06-20)."

Part VI, Line 4:
McCurtain Memorial Hospital is the only hospital located in McCurtain County, which is the 3rd largest county in the state. The entire county is designated as a Medically Underserved Area with portions of the county designated as Health Professional Shortage Areas due to geographical area, census tracts, and/or a Native American tribal population. According to the 2018 U.S. Census Bureau QuickFacts (Small Area Income and Poverty Estimates, SAIPE) estimates, the percentage of McCurtain County individuals (all ages) whose income was below poverty decreased from 26% to 21.1%. Of the estimated population for 2014-2018, there were approximately 21.4% of persons under the age of 65 years without health insurance coverage, compared to 16.7% for the same category in the entire state of Oklahoma. Approximately 30% of the people in McCurtain County are covered by Medicaid and the unemployment rate ranks as one of the highest in the state. The primary service area is approximately a 35-mile radius around Idabel. The 2010 US Census Bureau population estimates base for McCurtain County is 33,154, with an estimated 32,832 at July 1, 2018. Of the 2018 estimated population, 18.2% are in the age group 65 and older and 25.1% are under the age of 18. These county percentages are above the Oklahoma state percentages for the same categories, 15.7% and 24.3% respectively. With the exception of McCurtain Memorial Hospital there are no other major hospitals located within the county. McCurtain County has major employers such as International Paper, Tyson Foods, Hagale Industries, Huber Paper, Georgia Pacific Pan Pacific Products and the Hospital. McCurtain County continues to have one of the highest unemployment rates in the state averaging 5.7% in 2019 and 5.5% in 2018, above the Oklahoma state average rate of 3.3% in 2019 and 3.4% in 2018.

Part VI, Line 5:
McCurtain Memorial Hospital is a sole community provider with a Board of Directors comprised of persons who reside in the Organization's primary service area. Five members of the Board are non-physicians and one member is a physician as of June 30, 2019. The Hospital extends medical staff privileges to all qualified physicians in its community for all of its departments. The Hospital applies surplus funds to improvements in patient care and medical education. The Hospital continuously evaluates and monitors quality control initiatives. The Hospital's emergency room is available to all regardless of ability to pay. Continuing education classes are provided to personnel on a regular basis including EKG monitoring classes, Venous Thrombo-embolism Prevention and Prophylaxis, ACLS, PALS, CPI, CPR, Medicare Workshops, Credentialing Updates in addition to allowances provided to employed physicians and CRNA for continuing medical education workshops and seminars.Emergency services are available to all regardless of ability to pay. McCurtain Memorial Hospital is an active community member within the county and participates in community events such as health fairs, blood drives, seasonal festivals and parades, county fairs, etc. with the purpose of educating people of the community in health, wellness and disease and illness prevention. Pamphlets and other useful information are provided as well as free blood pressure checks and glucose screenings.The Wellness Center is an exercise area that community members can subscribe to and use the exercise equipment on a regular basis. Personnel are available to assist them. This program is available to all community members at a low cost with discounted rates for seniors and is free to employees in order to help advocate healthy lifestyles. The Garden Meadows Walking Trail located at the Hospital is open to the public 24 hours a day, 7 days a week at no charge and is intended to promote physical activity for healthier lifestyles.

Operating expenses	$ 20,334,133
Total amount spent on community benefits as % of operating expenses	$ 371,468 1.83 %