Community Benefit Insight - Tax-exempt hospital

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Marian Community Hospital

Marian Community Hospital

100 Lincoln Avenue
Carbondale, PA 18407

Bed count	112	Medicare provider number	390095	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 240711230

Display data for year:

Community Benefit Spending- 2011
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

5.49%

Spending by Community Benefit Category- 2011
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2011

Additional data

Community Benefit Expenditures: 2011

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	$ 205,559 0.52 %
Medicaid as % of operating expenses	$ 1,922,927 4.82 %
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 expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 60,820 0.15 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 60,820 0.15 %

* = 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	$ 60,820 0.15 %
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	$ 60,820 100 %
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	$ 0 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: 2011

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	$ 534,093 1.34 %
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	$ 106,818 20.00 %

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	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.
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: 2011

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?	YES

Supplemental Information: 2011

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 $ 32571359 including grants of $ 0) (Revenue $ 27249256)
Marian Community Hospital is sponsored by the Sisters, Servants of the Immaculate Heart of Mary. The Board of Directors, Medical Staff, and employees are committed to providing quality health care and programs which contribute to the well being of the people in the communities which are served. Marian Community Hospital is operated as an acute care Hospital, which provides inpatient, outpatient, and emergency care services for residents in the service area. Marian Community Hospital offers a Charity Care Program in which medically necessary services will be made available without charge or at a reduced rate to eligible persons who cannot afford to pay for all or a part of their care.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 6a: Marian Community Hospital's community benefit report is contained in a report prepared by Catholic Health East.

Part I, Line 7g: Charity Care and Other Community Benefits are calculated at cost using the cost to charge methodology. This process encompasses all patient segments including inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay. The cost to charge ratio used in the calculation of cost related to charity care, unreimbursed cost of Medicaid and Community Health Improvement services is calculated and derived from the latest filed Medicare Cost Report.

Part I, L7 Col(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 $ 1,567,634.

"Part II: The Carbondale area has a significant elderly population and so Community Programs are designed with particular concern for the needs of those who are elderly and those who care for them: Advance Directive education, Grief and Loss Support Groups, Elder Law Program, various screening programs, etc. Marian Community Hospital stays actively involved in the community through the Ladies Auxiliary and its Volunteer Department. The mission statement adopted by the Marian Community Hospital Auxiliary states the following:""We are an organization of volunteers committed to support the healing mission of Marian Community Hospital. We accomplish this through fund-raising, volunteer services, and by generating a positive connection between the hospital, its employees and the community. Our service is offered in response to our awareness of the gifts we have been given, the kindness we have experienced, and our concern for our community."" Hospital VolunteersMarian Community Hospital Volunteers serve the mission in a variety of ways and assist with clerical activities in a number of outpatient and support departments. Patient resource volunteers distribute donated magazines, books, puzzles and newspapers. Patient safety volunteers make rounds on patients to check for potential safety hazards in the patient rooms. Information desk volunteers offer information to patients and their families and also deliver greeting cards. Material management volunteer sassist in delivering supplies to all hospital departments and food service volunteers assist cafeteria/kitchen staff in preparing and delivering food."

"Part III, Line 4: Charity Care is provided to a patient with a demonstrated inability to pay. A patient is eligible for Charity Care consideration based upon meeting certain income eligibility criteria as established by the Federal Poverty Income Guideline Sliding Scale. A patient whose family income is equal to or less than 200% of the mostrecent Federal Poverty Guidelines is eligible for a full discount off allowable charges. A patient whose family income is greater than 200% and less than 400% of the most recent Federal Poverty Guidelines is eligiblefor a 50% discount of allowable charges.Charity Care data reporting for services provided is based on cost of patient care services, not charges, with costs being determined by application of the standard cost to charge ratio. Charity Care may include unpaid coinsurance, deductibles and non-covered services if the patient meets the Charity Care eligibility criteria. Bad Debt is payment not received for service rendered for which payment was anticipated and credit extended. Bad Debt patients do not meet the criteria for Charity Care, that is, they are considered able to pay but unwilling to satisfy their outstanding obligations. Marian Community Hospital attempts to perform financial screening upon scheduling, admission or registration (discharge processing in the ED) as part of the overall Financial Counseling process. Patients who represent increased financial risk as a result of the amount they are expected to owe ""out-of-pocket"" should be referred to a Financial Counselor for assistance in applying for alternative payment programs (e.g., MedicalAssistance), determining Charity Care eligibility, establishing payment plans or other financing arrangements. Financial Counseling services are to be made available to all elective, urgent and emergent patients. However, some patients could be missed if they do not agree to share their financial information with the Financial Counselor and this amount of charity care would be undetermined."

Part III, Line 8: The amount here is determined by using the actual patient charges, the Medicare cost-to-charge ratios that we are currently being paid on, and the payment-to-charges from the actual remittances. Based on the calculation this shortfall should be viewed as uncompensated care provided to those patients and thus treated entirely as community benefit.

Part III, Line 9b: The Charity Care patients are not included in debt collection efforts since it was determined that they qualify for charity care.

Marian Community Hospital
Part V, Section B, Line 3: The meetings were held with the public representatives and each idea was recorded by the administrative assistant.

Marian Community Hospital
Part V, Section B, Line 5c: The public was invited to the assessment by invitation from the CEO.

Marian Community Hospital
Part V, Section B, Line 9: Part V, Section B, Line 7: If the hospital facility did not address all of the needs identified in its most recently conducted Needs Assessment, explain which community health needs the hospital facility did not address and the reasons why it has not address such needs.

Part VI, Line 7, The list of states in which CHE's community benefit report is filed are: Alabama, Connecticut, Delaware, Florida, Georgia, Maine, Massachusetts, New Jersey, New York, North Carolina and Pennsylvania.

Part VI, Line 2: Marian Community Hospital participates in community events that keeps the Hospital informed on community needs. These events include the following:February 12th Blood Pressure Screening19th Blood Pressure Screening26th Blood Pressure ScreeningMarch4th American Red Cross Blood Mobile26th American Cancer society Daffodil Days CampaignMay 12th Attny Gigliotti Elder Law Program13th Health Insurance ForumJune2nd Vascular Screening Program9th Vascular Screening Program12th Lackawanna Medical Society Health Fair16th Vascular Screening Program23rd Vascular Screening Program30th Vascular Screening Program July7th Vascular Screening Program10th Carbondale Area Prosper Team Fundraiser14th Vascular Screening Program21st Vascular Screening Program28th Vascular Screening ProgramAugust4th Vascular Screening Program11th Vascular Screening Program13th State Representative Wanczacs Senior Health Fair18th Vascular Screening Program25th Vascular Screening ProgramOctober28th Ladore Lodge Senior ExpoNovember22nd Project Hope DistributionThese events contribute to the assessment of community needs by providing feedback on the community's needed services. Marian Community Hospital also conducts a demographic analysis of the area which includes the population statistics. This analysis provides the necessary information to analyze the appropriate services needed for the community.

Part VI, Line 3: Marian Community Hospital meets with and assists evey patient who does not have any health insurance coverage to help them obtain health insurance or set up a self-pay account. Marian Community Hospital posts its charity care policy in the Emergency Room and in the Admissions area. A financial counselor reviews a copy of this Charity Care policy and other government programs the patient may qualify for with eligible patients.

Part VI, Line 4: Marian Community Hospital is located in Northeastern Pennsylvania and serves Carbondale and the surrounding communities. The community has experienced a decrease in population over the past 10 years and consists of a high concentration of elderly patients.

Part VI, Line 5: Marian Community Hospital's governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments.

Part VI, Line 6: Marian Community Hospital is affiliated with Catholic Health East (CHE).

Operating expenses	$ 39,885,691
Total amount spent on community benefits as % of operating expenses	$ 2,189,306 5.49 %