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Sayre Memorial Hospital
Sayre, OK 73662
| Bed count | 46 | Medicare provider number | 370103 | 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: 2013
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 $ 11,504,193 Total amount spent on community benefits as % of operating expenses$ 636,135 5.53 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 30,916 0.27 %Medicaid as % of operating expenses$ 605,219 5.26 %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: 2013
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$ 2,109,868 18.34 %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? NO
Community Health Needs Assessment Activities: 2013
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 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: 2013
- 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 $ 9577828 including grants of $ 100) (Revenue $ 7290968) RURAL HOSPITAL PROVIDING MEDICAL CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS TO AREA RESIDENTS. CARE PROVIDED INCLUDES EMERGENCY, OBSTETRICS, SURGICAL AND PHYSICAL REHABILITATION. CARE IS PROVIDED REGARDLESS OF RACE, CREED, COLOR OR ABILITY TO PAY.
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Facility Information
SCHEDULE H, PART V, SECTION B, LINE 3 CITIZENS OF THE COMMUNITY WERE INVOLVED IN A COMMUNITY SURVEY CONDUCTED BY THE TURNING POINT COALITION, OKLAHOMA UNIFIED RESOURCES. LEADERSHIP FROM THE SAYRE MEMORIAL HOSPITAL ARE ACTIVE MEMBERS OF THE OKLAHOMA UNITED RESOURCES TURNING POINT COALITION. THOSE THAT SERVE IN LEADERSHIP AT SAYRE MEMORIAL HOSPITAL HAVE SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH.
SCHEDULE H, PART V, SECTION B, LINE 20D MAX CHARGE EQUALS 60% OF GROSS CHARGES (40% DISCOUNT).
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Supplemental Information
SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2
SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF 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 $2,109,868.
SCHEDULE H, PART III, LINE 2 THE HOSPITAL ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF EACH TYPE OF PAYOR. THE HOSPITAL'S BAD DEBT AT COST WAS DETERMINED BY APPLYING AN OVERALL RATIO OF COST TO CHARGES.
SCHEDULE H, PART III, LINE 4 THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8 THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. COST OF PROVIDING CARE FOR THESE PATIENTS AND THAT SHORTFALL OF $527,926 SHOULD BE COUNTED AS COMMUNITY BENEFIT. THE COST TO CHARGE METHOD WAS USED.
SCHEDULE H, PART III, LINE 9B IF A PATIENT IS DETERMINED TO BE FINANCIALLY INDIGENT, PATIENT FINANCIAL SERVICES WILL ASSIST THE PATIENT/GUARANTOR IN APPLYING FOR FINANCIAL ASSISTANCE. IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE, THE HEATH CARE CENTER WILL REVIEW THE ACCOUNT FOR CHARITY ALLOWANCE.
SCHEDULE H, PART VI, LINE 2 SAYRE MEMORIAL HOSPITAL IS VERY INVOLVED IN EVERY ASPECT OF THE COMMUNITY AND THROUGH THAT INVOLVEMENT AND THE ANNUAL HEALTH FAIR THAT WE ARE ABLE TO PROVIDE FOR THE COMMUNITY, WE TAKE TIME TO LISTEN TO THE HEALTH CARE WANTS AND NEEDS OF OUR CITIZENS. WE UNDERSTAND THAT A GOOD SHARE OF OUR POPULATION IS ELDERLY AND THEY HAVE LIMITED MEANS OF TRAVEL TO A LARGE AREA FOR HEALTH CARE. THEREFORE, WE STRIVE TO PROVIDE A WIDE DIVERSITY OF SERVICES TO MEET AS MANY OF THEIR NEEDS LOCALLY AS WE ARE FISCALLY ABLE TO DO SO.
SCHEDULE H, PART VI, LINE 3 UNINSURED INDIVIDUALS ARE PROVIDED COMPUTER ACCESS TO THE MEDICAID SYSTEM TO APPLY FOR ASSISTANCE AT THE TIME OF ADMISSION. WE ALSO PROVIDE A PATIENT ACCOUNT MANAGER WHO INFORMS THE PATIENT OF THE ORGANIZATION'S CHARITY CARE POLICY.
SCHEDULE H, PART VI, LINE 4 SAYRE MEMORIAL HOSPITAL PROVIDES CARE TO THE RURAL COMMUNITIES OF SAYRE, ERICK, CHEYENNE, SWEETWATER, CARTER, MANGUM, AND DELHI. OUR PATIENTS ARE 60% MEDICARE, 8% MEDICAID, 22% COMMERCIAL INSURANCE, AND 10% UNINSURED.
SCHEDULE H, PART VI, LINE 5 GOVERNING BOARD MEMBERSHIP IS OPEN TO ANYONE OVER THE AGE OF 18 YEARS WHO IS DULY ELECTED. ALL MEMBERS IN GOOD STANDING ARE ENTITLED TO ONE VOTE IN ANY REGULAR OR SPECIAL MEETING AND TO EXERCISE ALL OTHER PRIVILEGES OF MEMBERSHIP. THE MEMBERS HAVE THE POWER, BY MAJORITY VOTE, AT REGULAR, SPECIAL CALLED, OR ANNUAL MEETINGS, TO REMOVE ANY DIRECTOR OR OFFICER FROM OFFICE. THERE IS AN ANNUAL MEETING HELD TO ELECT THE BOARD OF DIRECTORS AND OFFICERS AND TO TRANSACT ANY BUSINESS THAT MAY COME BEFORE THE MEETING. OUR MEDICAL STAFF IS OPEN TO ANY LICENSED PHYSICIAN. USE OF SURPLUS FUNDS ARE INVESTED BACK INTO THE HOSPITAL FOR FURTHER CONTINUATION OF SERVICE.
