Community Benefit Insight - Tax-exempt hospital

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Newman Memorial Hospital

Newman Memorial Hospital

905 Main Street
Shattuck, OK 73858

Bed count	79	Medicare provider number	371336	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 730570773

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

16.77%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2016-2021

Additional data

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.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 57,000 0.60 %
Medicaid as % of operating expenses	$ 258,898 2.74 %
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	$ 1,269,804 13.43 %
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: 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	$ 687,172 7.27 %
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	$ 109,948 16.00 %

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:
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: 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

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 $ 8398482 including grants of $ 0) (Revenue $ 12335697)
Newman Memorial Hospital is a 25-bed critical access hospital located in Shattuck, Oklahoma. Newman Memorial Hospital strives to provide its community and patients a wide variety of services with exceptional care and convenient scheduling. We provide general medical and surgical care for inpatient, outpatient and emergency room patients. In addition, our urgent care clinic is open 7 days a week with no appointment necessary to see a physician.Newman Memorial Hospital provides quality medical healthcare regardless of race, creed, sex, national origin, disability, age, or ability to pay. (Continued on Schedule O)Although reimbursement for services rendered is critical to the operation and stability of the Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community with respect and provide healthcare services and healthcare education. Therefore, in keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by governmental programs at below cost, health activities and programs to support the community will be considered where the need and/or an individual's inability to pay coexists.The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $57,000 for the year ended December 31, 2021, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients.

Facility Information

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

Newman Memorial Hospital, Inc.
Part V, Section B, Line 5: Newman Memorial Hospital hosted three community meetings between September 4, 2019 and September 25, 2019. The Oklahoma Office of Rural Health facilitated these meetings. Community members in attendance at these meetings included: -Newman Memorial Hospital representatives -Shattuck Public Schools representatives -Shattuck Chamber of Commerce -Hospital board member -Retired community members -Local domestic violence representative -Local EMSAverage attendance at the community meetings was 17-20 community members. Community members were invited and encouraged to attend the local meetings through email invitations, notices on the Newman Memorial Hospital Facebook page and website, the Newman Healthcare Associates Facebook page, text messages, community marketing visits, partner emails through the Shattuck Chamber of Commerce and an invitation was placed and published in the local newspaper. A significant effort was placed on reaching out to those who work with or represent racially diverse and low-income populations. Ellis County does not have a local health department.

Newman Memorial Hospital, Inc.
Part V, Section B, Line 6b: The CHNA was conducted with the assistance of the Oklahoma Office of Rural Health. The Oklahoma Office of Rural Health worked closely with the Hospital to develop an economic impact of the local health sector, develop and analyze surveys, and gather local health data.

Newman Memorial Hospital, Inc.
"Part V, Section B, Line 11: The Community Health Needs Assessment was completed in December 2019. The top priorities are identified below. The needs have been addressed over the past 3 years. There were no needs identified that the hospital did not address. It must be noted that the Covid-19 pandemic greatly impacted the implementation of some of the priorities and outreach opportunities during 2020 to present.1. More care coverage, specifically VA Care and access to more specialists such as Podiatry and ENT a. Newman Memorial Hospital was awarded a Community Care Network contract by the Department of Veterans Affairs (VA) in May of 2020 b. The hospital has promoted this widely. For example, a representative shared information about this program at the Laverne Chamber of Commerce meeting in June 2020 (20 people attended), and this was also shared again widely in March 2022. The hospital has provided press releases and signage to notify the community. c. The Hospital's provider based primary care clinic transitioned to a Rural Health Clinic. The clinic is part of the VA CCN network with an approved VA Provider so that veterans can switch their current PCP to a local PCP. d. The Hospital has added an Ophthalmology clinic and surgery after the departure of the previous ophthalmologist. In addition, Pulmonology and Endocrinology services were added via telemedicine. Respiratory Therapy was added for inpatient and outpatient services and Occupational therapy and Speech Pathology service lines are available for Swing Bed patients. Furthermore, the hospital has opened an outpatient behavioral health department, Senior Life Solutions, specifically designed to meet the mental health needs of our Senior Community. 2. Expand education outreach to youth and families a. The hospital currently provided educational outreach in the form of public service announcements in the newspaper regarding prevalent health conditions along with where to access resources and services. Some of the relevant topics to date include: How to Stay Safe When Spending Time Outdoors This Summer, Don't Forget Immunizations on Your ""Back to School"" list, How to Enjoy the 4th of July Safely, Eating Right for All of Life's Stages, Keep Safety in Mind While Enjoying Your Summer, Getting Enough Sleep for the School Year, and Planning Healthy Snacks for Back to School. Expert input was obtained from physicians, local nursing staff and the dietician. b. Community Outreach was impacted by the COVID-19 pandemic. However, the hospital was able to engage with schools, students and young adults in the community in the following ways: - Speaker provided for Coffee and Conversation (young mother's group) on multiple occasions (Breast Cancer Awareness, How to use MDSave, Healthy Hearts for Kids) - Hosting Annual Family events such as Business Trick or Treat Night and Facebook Costume Contest - Presentations to Shattuck FFA students, Fargo FFA students and Arnett FFA students about Healthy Heart practices and the Blue Coat to White Coat program. - Partnered with Arnett Schools to have a Senior Healthcare Mentor Day - Met with school employees in our county to secure WIC brochure placement for enrollment - Provide Ellis County's WIC program - Provided information re: annual wellness exams to Shattuck Elementary to go home in student folders - Presentation on Hand Hygiene to Shattuck Elementary students - Met with county superintendents and Laverne Public School Superintendent to establish liaison contact - Provided priority scheduling to teachers and school staff during the Community Drive-Thru COVID testing - Tour of High Plains Technology Center to discuss ways to partner and foster LPN and other tech programs for recent graduates - Community Lunch and Learns: Nutrition Across the Ages, How to Improve Your Strength and Balance in the New Year - Multiple Facebook posts re: WIC Services, Immunizations, Wellness Exams, Childhood Safety and Nutrition, Healthy Sleep Habits and Outdoor Safety c. Birth education- The hospital has partnered with a local certified birth education instructor to provide birth education and infant care classes at the hospital for expecting parent."

Newman Memorial Hospital, Inc.
Part V, Section B, Line 13h: Patients who qualify for the following aid programs will automatically be awarded financial assistance:- SSI/Disability- Food Stamps- Patients who qualify for Special Low Income Medicare Beneficiary (SLMB)will have any consumer responsibility adjusted to charity.- Patients who have Medicare and Medicaid (dual eligible) and Medicare denies the claim or a portion of the claim, i.e. ambulance determined not medically necessary, non-covered self-administered drugs, Medicare Local Coverage Determinations (when an ABN is signed), those charges will be adjusted to charity once Medicare and Medicaid have been billed and have assigned an amount to patient responsibility.

Schedule H, Part V, Section B, line 7:
Community Health Needs Assessment website:https://newmanmemorialhospital.org/about-us/#community-health-needs-assessment

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 3c:
In addition to the federal poverty guidelines, the hospital also uses the following factors to determine free or discounted care:-asset level-medical indigency-insurance status-underinsurance status-residencyPatients who qualify for the following aid programs will automatically be awarded financial assistance:- SSI/Disability- Food Stamps- Patients who qualify for Special Low Income Medicare Beneficiary (SLMB) will have any consumer responsibility adjusted to charity.- Patients who have Medicare and Medicaid (dual eligible) and Medicare denies the claim or a portion of the claim, i.e. ambulance determined not medically necessary, non-covered self-administered drugs, Medicare Local Coverage Determinations (when an ABN is signed), those charges will be adjusted to charity once Medicare and Medicaid have been billed and have assigned an amount to patient responsibility.

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 II, Community Building Activities:
Newman Memorial Hospital has partnered with the Ellis County Health Coalition and Ellis County Sheriffs Dept to provide a free program in which Ellis County residents can sign-up for a daily phone call (Monday-Friday) to check in with them and make sure that they are doing okay. This program is designed to help identify elderly and disabled residents who live alone and may not have daily contact with others. There are procedures in place to provide help in the event that it is needed. The hospital also prepares Meals on Wheels for the community.

Part III, Line 2:
Patient accounts are written off to bad debt after every effort is made to collect the balance and patients are given opportunities to complete charity care applications or set up payment plans. All discounts and contractual adjustments are applied to accounts before they are written off to bad debt. Current payments on accounts previously written off as bad debt reduces bad debt expense.Bad debt expense on line 2 is reported at charges as presented on the financial statements.

Part III, Line 3:
A reasonable estimate of the Organization's bad debt expense attributable to patients under the Organization's financial assistance policy is 16%. This is based on the percentage of individuals living in poverty.

Part III, Line 4:
The footnote to the Organization's financial statements can be found on page 12 of the attached audited financial statements.

Part III, Line 8:
Newman Memorial Hospital continues to provide services to Medicare patients whether there is a surplus or shortfall because access to healthcare and individual's health is important. In the years where there is a Medicare shortfall, it is considered a community benefit. Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been $21,322.Medicare fee schedule revenue $ 37,511Medicare estimated costs of care relating to payments (58,834)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:
The hospital has a 120-day application period where any patient is able to apply for financial assistance and there are no extraordinary collection actions. Patients are sent a notice 30 days prior to any collection activities. After 120-days any account may be turned over to collections however, a patient has another 120-days to complete an application for a total of 240 days. Once a patient is determined to qualify for financial assistance any personal portion due would follow normal collection actions.

Part VI, Line 2:
In addition to the CHNA, the hospital addressed the health needs of the community by hosting monthly lunch and learns focusing on community health, education and safety. At the end of each session, a program evaluation was completed by attendees, giving them the opportunity to request additional topics of interest. Due to COVID, our monthly Lunch and Learns were postponed, with educational materials being shared via Facebook and local Newspapers. Newman expanded telemedicine opportunities, purchasing monitoring carts for specialists outside of our area, contract with SSM Health Telemedicine program.

Part VI, Line 3:
Patients are provided literature at time of registration and then are contacted by the financial counselor after they receive a statement. The financial assistance policy, application, and plain language summary are provided on the Hospital's website. The health care needs of all individuals residing in the immediate and adjacent communities are considered. No individual will be deprived of emergency or critical care because of their inability to pay; however, every effort will be made to collect funds owed to the hospital for elective care since the ability to continue to provide and improve services to the communities served depends on financial stability.

Part VI, Line 6:
Newman Memorial Hospital is a St. Anthony's Hospital (SSM) affiliate. The Hospital accesses their electronic health records through SSM along with transfer agreements for a higher level of care.

Part VI, Line 4:
Newman Memorial Hospital, Inc. is a 25-bed critical access hospital located in Shattuck, Oklahoma. Shattuck is a very rural town about 3 hours from any metropolitan area with a population of approximately 1,317. The median household income is approximately $45,357. About 16% of the population is below the poverty line. The most common employment industries are health care and social assistance, retail trade, and transportation and warehousing. The economy of Shattuck, OK employs 633 people. 85.4% of the population of Shattuck, OK has health coverage, with 47.3% on employee plans, 14% on Medicaid, 12.7% on Medicare, 10.4% on non-group plans, and 1% on military or VA plans. Primary care physicians in Shattuck, OK see approximately 1,600 patients per year on average. AllianceHealth Woodward is approximately 30 miles away.

Part VI, Line 5:
The hospital provides health counseling at as many local health fairs as possible. The hospital participates in various community activities to increase their presence in the community.Newman Memorial Hospital runs at minimum 3 blood drives during the year. They also held multiple flu shot clinics, with 3 being at local senior citizen centers, at the hospital itself, and local businesses. The hospital provides a monthly lunch and learn program with the goal of providing a speaker each month to teach on a topic that improves the health and safety of the community. When Lunch and Learn is not available, education is shared via Facebook and Local Newspapers Some of the topics addressed include:COVID Signs and Symptoms, Age related eye issues, Healthy Hearts, Medication Safety, Traditional vs Advantage Medicare, and Know Your Veteran's Benefits.The hospital operates a 24/7 emergency room available to all regardless of ability to pay. The hospital participates in education and training of healthcare professionals by working with High Plains Technology Center LPN Program.

Operating expenses	$ 9,453,821
Total amount spent on community benefits as % of operating expenses	$ 1,585,702 16.77 %