Community Benefit Insight - Tax-exempt hospital

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Titusville Area Hospital

Titusville Area Hospital

406 West Oak Street
Titusville, PA 16354

Bed count	25	Medicare provider number	391314	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 250965579

Display data for year:

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

6.98%

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

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2014-2021

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	$ 275,415 0.53 %
Medicaid as % of operating expenses	$ -2,900,810 -5.53 %
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	$ 6,267,750 11.95 %
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	$ 17,107 0.03 %
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	$ 1,559,805 2.97 %
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	$ 372,088 23.85 %

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 $ 44219673 including grants of $ 0) (Revenue $ 54906574)
TITUSVILLE AREA HOSPITAL IS AN ACUTE CARE, CRITICAL ACCESS RURAL HOSPITAL WITH 795 ADMISSIONS, 4,624 PATIENT DAYS AND 74,476 OUTPATIENT VISITS.

Facility Information

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

SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT: THE RESEARCH PROCESS INCLUDED A WIDE BASED SURVEY OF THE POPULATION. THE SURVEY INCLUDED INPUT FROM UNDERREPRESENTED GROUPS IN PUBLIC HOUSING. ELECTRONIC SURVEYS WERE COMPLETED. A GOOD DIVERSITY OF RESPONSE WAS REALIZED.

SCHEDULE H, PART V, SECTION B, LINE 6A
OTHER HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH MEADVILLE MEDICAL CENTER, AN AFFILIATED ENTITY.

SCHEDULE H, PART V, SECTION B, LINE 6B
OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH ALLEGHENY COLLEGE AND VARIOUS LOCAL COMMUNITY PARTNERS.

SCHEDULE H, PART V, SECTION B, LINE 7A
HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX

SCHEDULE H, PART V, SECTION B, LINE 7B
OTHER WEBSITE: HTTPS://WWW.MMCHS.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. ASPX

SCHEDULE H, PART V, SECTION B, LINE 10
IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX

SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING IDENTIFIED NEEDS: IN RESPONSE TO THE RESULTS OF TITUSVILLE AREA HOSPITAL'S (TAH) MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION BETWEEN MEADVILLE MEDICAL CENTER, TITUSVILLE AREA HOSPITAL AND ALLEGHENY COLLEGE LOOKED AT DATA COLLECTED FROM MORE THAN 1,100 ADULT PARTICIPANTS FROM ACROSS CRAWFORD COUNTY. ONLINE SURVEYS SHOWED A NEED TO SUPPORT COMMUNITY MEMBERS IN LEADING A HEALTHIER LIFESTYLE. INTERNAL DATA AND SURVEY DATA ALIGNED TO IDENTIFY LONGER THAN ACCEPTABLE WAIT TIMES FOR CERTAIN HEALTHCARE SERVICES. 7.1% OF RESPONDENTS STATED THEY DID NOT ACCESS MEDICAL CARE WHEN THEY NEEDED IT BECAUSE WAIT TIMES WERE TOO LONG AND WAIT TIMES OF UP TO MANY MONTHS FOR A NEXT AVAILABLE APPOINTMENT IN CERTAIN OFFICES MAKES THIS A PRIORITY FOCUS. COST OF HEALTHCARE, ALONG WITH NATIONWIDE ECONOMIC CONDITIONS, IS A CONCERN. TAH REMAINS A LOW-COST HEALTHCARE PROVIDER IN THE REGION, ACCORDING TO THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL, HOWEVER WITH RISING INSURANCE DEDUCTIBLES, CO-PAYS AND INCREASING LABOR AND SUPPLY COST MANAGING OPERATIONAL EXPENSES IS A PRIORITY. IN THE 2016 CHNA, 73% OF ALL RESPONDENTS SAID THEY HAD AN ANNUAL CHECKUP IN THE PRIOR YEAR WHILE IN 2022 80% HAVE RECEIVED A CHECK-UP IN THE PRIOR YEAR. DURING THE 2019 CHNA THERE WAS A DECREASE OF 14% AMONG RESPONDENTS WHO STATED THEY HAD A PRIMARY CARE PHYSICIAN. THE GOAL IS TO CONNECT INDIVIDUALS WITH A CONSISTENT CARE PROVIDER, BUT OUR HOPE IS THE MOST RECENT DATA SHOWS THERE HAS BEEN A POSITIVE IMPROVEMENT IN INDIVIDUALS GETTING ROUTINE SCREENINGS. IN THE 2016 CHNA 14% OF RESPONDENTS SAID THEY USED TOBACCO, IN 2019 35% REPORTED SMOKING (CURRENT AND FORMER) AND IN 2022 9.2% REPORTED USING TOBACCO. THIS DECREASE REFLECTS POSITIVE OUTCOMES FROM PRIOR STRATEGIES WHICH WILL CONTINUE INTO THE FUTURE. THE MOST IMPORTANT HEALTH ISSUE IN OUR COMMUNITY, SELECTED BY 63% OF RESPONDENTS, IS MENTAL HEALTH. INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES BY ADDING ADDITIONAL PROVIDERS AND CONNECTING WITH INDIVIDUALS IN REMOTE AREAS OF THE COUNTY IS CRITICAL. PEDIATRIC COUNSELORS AND SUPPORT SERVICES ACROSS THE COUNTY AND IN THE SCHOOLS NEEDS TO BECOME A COMMUNITY-WIDE PRIORITY.

SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C
FAP, FAP APPLICATION, AND PLS WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/BILLING-INSURANCE/ FINANCIAL-ASSISTANCE.ASPX

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR USED EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990.

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3 AND 6.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT NOTE CAN BE FOUND ON PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION B, LINE 8
COSTING SOURCE: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: TITUSVILLE AREA HOSPITAL COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ON A REGULAR BASIS TO DETERMINE HEALTH CARE NEEDS. THE MOST RECENT ASSESSMENT WAS COMPLETED IN 2022. TITUSVILLE AREA HOSPITAL WORKS WITH MANY COMMUNITY PARTNERS INCLUDING HEALTH AND HUMAN SERVICE PROVIDERS, EDUCATION, GOVERNMENT, FAITH, LAW ENFORCEMENT, AND OTHER INTERESTED PARTIES IN COMPLETING THE ASSESSMENT OF THE COMMUNITY HEALTH NEEDS.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE CHARITY CARE POLICY IS POSTED IN ADMISSIONS AND EMERGENCY ROOM AREAS. COPIES OF THE CHARITY CARE POLICY ARE AVAILABLE IN ADMISSIONS AREA AND EMERGENCY ROOM AREAS. IF A PERSON IS ADMITTED WITH NO INSURANCE THEY ARE VISITED BY A FINANCIAL AID COUNSELOR AND MADE AWARE OF THEIR OPTIONS.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: TITUSVILLE AREA HOSPITAL SERVES RESIDENTS OF CRAWFORD, FOREST, WARREN, AND VENANGO COUNTIES IN PENNSYLVANIA. THE MAIN SERVICE AREA IS CRAWFORD COUNTY. CRAWFORD COUNTY IS A RURAL AREA WITH A POPULATION OF APPROXIMATELY 83,938. THE 2020 ESTIMATED MEDIAN HOUSEHOLD INCOME WAS $51,919, WHICH IS WELL BELOW THE PENNSYLVANIA ESTIMATED HOUSEHOLD INCOME OF $63,627. APPROXIMATELY 12.5% OF RESIDENTS LIVE IN POVERTY.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: OUR STAFF IS COMMITTED TO THE CARE AND IMPROVEMENT OF LIFE. IN RECOGNITION OF THIS COMMITMENT, WE STRIVE TO DELIVER HIGH-QUALITY AND COST-EFFECTIVE HEALTHCARE WITH AN EMPHASIS ON COMPASSION, PERSONAL ATTENTION AND RESPECT. WE BELIEVE IN THE FOLLOWING VALUES: -WE WILL MEET OR EXCEED COMMUNITY STANDARDS FOR CARE EXPECTATIONS OF PATIENTS AND FAMILIES. -WE WILL MAINTAIN A POSITIVE AND FULFILLING WORKING ATMOSPHERE THAT BOTH MOTIVATES AND ALLOWS CAREGIVERS AND SUPPORT STAFF TO GIVE THEIR BEST. -WE WILL ENSURE THAT THE ORGANIZATION IS ADEQUATELY COMPENSATED FOR SERVICES PROVIDED, THEREBY MAINTAINING VIABILITY AS A CRITICAL REGIONAL HEALTHCARE AND ECONOMIC ASSET. -OUR VISION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE SERVICES ENHANCED BY HIGH TECHNOLOGY APPROPRIATE TO COMMUNITY NEED. -WE WILL MAINTAIN A HIGHLY QUALIFIED MEDICAL AND SUPPORT STAFF IN A POSITIVE WORKING ENVIRONMENT FOCUSED ON EXCELLENCE. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS RESIDING IN PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS. THE ORGANIZATION USES SURPLUS FUNDS TO PROVIDE THE LATEST IN TECHNOLOGY TO IMPROVE PATIENT CARE.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: MEADVILLE MEDICAL CENTER (MMC) IS A CORPORATE MEMBER ALONG WITH TITUSVILLE AREA HEALTH CENTER. AS OF THE DATE OF ACQUISITION, MMC HAS DIRECT AUTHORITY OVER THE STRATEGIC, FINANCIAL, AND OPERATIONAL DIRECTION OF TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES. TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES (HEALTH CENTER) CONSISTS OF TITUSVILLE AREA HEALTH CENTER, INC. (PARENT), TITUSVILLE AREA HOSPITAL (HOSPITAL), THE TITUSVILLE AREA HEALTH CENTER FOUNDATION (FOUNDATION) AND TITUSVILLE AREA HEALTH SERVICES, INC. (HEALTH SERVICES). THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. THE FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH CENTER AND AFFILIATES. HEALTH SERVICES OPERATES SEPARATELY FROM THE HOSPITAL OFFERING MULTISPECIALTY FAMILY MEDICINE PEDIATRICS TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA.

Operating expenses	$ 52,451,524
Total amount spent on community benefits as % of operating expenses	$ 3,659,462 6.98 %