Community Benefit Insight - Tax-exempt hospital

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Kershawhealth

Kershaw Health

Haile And Roberts Streets, Box 7003
Camden, SC 29020

Bed count	121	Medicare provider number	420048	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 576005963

Display data for year:

Community Benefit Spending- 2015
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

3.62%

Spending by Community Benefit Category- 2015
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2015

Additional data

Community Benefit Expenditures: 2015

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	$ 739,770 3.62 %
Medicaid as % of operating expenses	$ 0 0 %
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.	$ 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: 2015

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	$ 1,751,609 8.58 %
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:
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: 2015

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: 2015

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 $ 17819950 including grants of $ 991651) (Revenue $ 19294730)
THROUGH OCTOBER 31, 2015 KERSHAWHEALTH OWNED AND OPERATES A 121-BED ACUTE CARE FACILITY, A 96-BED LONG-TERM FACILITY, A HOME HEALTH/HOSPICE AGENCY, A RURAL HEALTH CLINIC, PHYSICIAN CLINICS, AND TWO MEDICAL COMPLEXES FOR THE BENEFIT OF KERSHAW COUNTY, SOUTH CAROLINA AND SURROUNDING COMMUNITIES. THE HOSPITAL OPERATIONS WERE SOLD EFFECTIVE OCTOBER 31, 2015. FOR THE REMAINDER OF THE FISCAL YEAR KERSHAWHEALTH OPERATED THE 96 BED LONG-TERM CARE FACILITY.

Facility Information

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

KERSHAWHEALTH
Part V, Section B, Line 5: THE HOSPITAL FACILITY COLLABORATED WITH SEVERAL ORGANIZATIONS THAT ARE LISTED IN DETAIL ON THE CHNA.

KERSHAWHEALTH
Part V, Section B, Line 7d: WEBSITE URLhttp://www.kershawhealth.org/media/22067/lwk-chna-report.pdfNEWSPAPER AND CIVIC ORGANIZATION MEETINGS

KERSHAWHEALTH
"Part V, Section B, Line 11: The top priorities addressed in this CHNA were identified as"" Nutrition/Physical Activity/Obesity The objectives to addressing this need include: encouraging activity on breaks at work, improving neighborhood safety to encourage physicial activity, recreation department to provide a wide range of activities for all ages, developing community gardens, developing mobil market to access ""food deserts, and expanding farm to school programs. Access to Appropriate CareThe objectives to addressing this need include: identifying strategies to increase transportation, identifying strategies to increase primary care in rural areas, providing research grants for voucher-based programs, and collaborating with community health care centers to develop strategies that help recruit and provide equal opportunities for students working towards medical degrees. SmokingThe objectives to addressing this need include: identifying community education campaign, assessing any current policies, engaging key stakeholders, and planning for policy implementation.Sexual Activity & Teen HealthThe objectives to addressing this need include: developing strategies to address primary prevention in schools, coaching adult leadership, building a network of advocates for policy change, and educating the correlation between sexual abuse and teen pregnancy.The other risk factors that were identified include: proverty/disparities, chronic lower/respiratory disease, and accidents. Due to the broad scope of poverty and disparities, it was not chosen specifically as a priority area, but instead, was incorporated into the strategies the group would undertake within each of the 4 chosen priority areas.With regards to chronic lower/respiratory disease, it was not specified as to how many cases were linked to smoking (first or second-hand smoke), which was selected as a priority. While no direct correlation could be made, the group felt that targeting first and second-hand smoking prevention strategies could indirectly impact this issue. Both strategic issues will continue to be monitored in future assessments.Accidents were not chosen as an area due to its broad and inconsistent definition. Therefore it was unclear as to what types of accidents had the largest impact on health outcomes. The group also noted that with regards to motor vehicle accidents and DUI-related deaths, the Kershaw County law enforcement agencies are already targeting this area."

KERSHAWHEALTH
Part V, Section B, Line 16i: SELF PAY INPATIENTS ARE VISITED BY A FINANCIAL COUNSELOR TO DISCUSS ELIGIBILITY FOR GOVERNMENT PROGRAMS OR FINANCIAL ASSISTANCE. ALL SELF-PAY PATIENTS ARE CALLED BY AN ADVOCATE TO DISCUSS ELIGIBILITY FOR GOVERNMENT PROGRAMS OR FINANCIAL ASSISTANCE. WHEN PATIENTS CALL TO DISCUSS BILLS, THEY ARE INFORMED OF THE POLICY.

KERSHAWHEALTH
Part V, Section B, Line 20e: Financial Counselor meets with self pay inpatienst. Contracted agency calls all self pay patients to discuss financial assistance. Included in Patient Information book.

KERSHAWHEALTH
Part V, Section B, Line 22d: THE HOSPITAL USED FEDERAL POVERTY GUIDELINES TO DETERMINE THE MAXIMUM AMOUNTS CHARGED TO INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7:
THE ORGANIZATION USED WORKSHEET 2 OF THE 2014 SCHEDULE H INSTRUCTIONS TO COMPUTE A RATIO OF COST TO CHARGES FOR PURPOSES OF THIS LINE.

Part I, Ln 7 Col(f):
THE AMOUNT ON FORM 990, PART IX, LINE 25 INCLUDES BAD DEBT EXPENSE OF $ 1,751,609 THAT HAS BEEN REMOVED FOR PURPOSES OF CALCULATING PERCENT OF TOTAL EXPENSE.

Part II, Community Building Activities:
KERSHAWHEALTH INCURRED EXPENSE IN 2014 FOR LOAN FORGIVENESS ASSOCIATED WITH PHYSICIANS PREVIOUSLY RECRUITED WHO CONTINUED TO MEET THEIR OBLIGATIONS IN THE MEDICALLY UNDERSERVED SERVICE AREA AS WELL AS EXPENSE ASSOCIATED WITH CONTINUED RECRUITMENT EFFORTS FOR THE MEDICALLY UNDERSERVED SERVICE AREA.

Part III, Line 4:
BAD DEBTS ON PART III, LINE 2 ARE PRESENTED AT GROSS CHARGES PER THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.THE HOSPITAL PROVIDES SERVICES PRIMARILY TO THE RESIDENTS OF KERSHAW COUNTY, SOUTH CAROLINA AND SURROUNDING COUNTIES WITHOUT COLLATERAL. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED IN AN AMOUNT EQUAL TO THE ESTIMATED LOSSES TO BE INCURRED IN COLLECTION OF THE RECEIVABLES. THE ALLOWANCE IS BASED ON HISTORICAL COLLECTION EXPERIENCES AND A REVIEW OF THE CURRENT STATUS OF THE EXISTING RECEIVABLES.THE ORGANIZATION ESTIMATES THAT APPROXIMATELY 50% OF ITS BAD DEBTS MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THERE ARE A NUMBER OF IMPEDIMENTS TO OBTAINING THE NECESSARY DATA TO QUALIFY A PATIENT FOR CHARITY CARE. THE HOSPITAL MAKES EVERY EFFORT TO OBTAIN THIS INFORMATION CORRECTLY AND TIMELY; HOWEVER DUE TO THE LIMITATION ON THE AVAILABILITY OF INFORMATION AND THE WILLINGNESS TO PROVIDE IT, IT IS ASSUMED THAT SOME ELIGIBLE PATIENTS ARE CHARGED TO BAD DEBT. THE HOSPITAL EXAMINED ITS GROSS CHARGES FOR SELF-PAY PATIENTS FOR WHOM ALL INFORMATION WAS AVAILABLE AND DETERMINED THE PORTION OF CHARGES THAT WERE WRITTEN OFF TO CHARITY CARE.

Part III, Line 8:
ALL SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT AS THE GOVERNMENT SHOULD BEAR THE COST OF A GOVERNMENT PROGRAM, AND DOES NOT, LEAVING HOSPITALS TO BEAR THE UNREIMBURSED COST OF THE PROGRAM.

Part III, Line 9b:
THE COLLECTION PROCESS IS SYSTEM-AUTOMATED AND ADJUSTS ACCORDING TO A MATRIX SET UP FOR EACH FINANCIAL CLASS. ADJUSTMENTS FOR FINANCIAL ASSISTANCE ARE MADE UPON APPROVAL, AND THE SYSTEM GENERATES STATEMENTS TO THE PATIENT (IF A PATIENT BALANCE REMAINS) AFTER A CERTAIN NUMBER OF DAYS FROM FINAL BILL DATE (I.E. DATE PATIENT BECOMES LIABLE AFTER ALL OTHER PAYMENTS/ADJUSTMENTS HAVE BEEN MADE).

PART V, SECTION B:
KERSHAWHEALTH SOLD ITS HOSPITAL OPERATIONS EFFECTIVE OCTOBER 31, 2015. THE ORGANIZATION NO LONGER OPERATED A HOSPITAL FACILITY AT THAT TIME. THE ORGANIZATION'S WEBSITE THEREFORE DOES NOT CONTAIN COPIES OF THE FINANCIAL ASSISTANCE POLICY (AND RELATED MATERIALS) BECAUSE IT IS NO LONGER OPERATING A HOSPITAL FACILITY.

Part VI, Line 2:
AS PART OF A STATE COLLABORATIVE, THE HOSPITAL PARTICIPATED IN A HEALTH SYSTEM PROFILE PERFORMED BY THE SOUTH CAROLINA RURAL HEALTH RESEARCH CENTER, UNIVERSITY OF SOUTH CAROLINA FOR THE SOUTH CAROLINA HOSPITAL ASSOCIATION. THE OBJECTIVE WAS TO IDENTIFY ACCESS TO AND UTILIZATION OF HEALTHCARE FOR THE UNINSURED. THE RESULT OF THE PROFILE WAS IMPLEMENTATION OF A PROGRAM CALLED ACCESSHEALTH SC FOR SEVERAL COUNTIES, INCLUDING KERSHAW. THE PROGRAM IS FUNDED THROUGH A GRANT FROM THE DUKE ENDOWMENT WITH KERSHAWHEALTH BEING THE PASS-THRU ORGANIZATION FOR KERSHAW COUNTY. ACCESSHEALTH'S FOCUS IS TO DEVELOP A COMMUNITY NETWORK OF CARE FOR THE LOW-INCOME, UNINSURED IN THE COUNTY. THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO IDENTIFY HEALTH NEEDS OF ALL CITIZENS. AS OF THE FILING OF THIS RETURN, THE REPORT IS IN DRAFT.

Part VI, Line 3:
ALL SELF PAY, URGENT CARE, AND INPATIENT PATIENTS ARE OFFERED A FINANCIAL ASSISTANCE APPLICATION BEFORE DISCHARGE. IN ADDITION, ALL INPATIENTS ARE VISITED FACE-TO-FACE BY A REPRESENSENTATIVE TO DISCUSS FINANCIAL NEEDS AND INFORMATION IS INCLUDED IN THE PATIENT INFORMATION BOOKLET. INFORMATION IS GATHERED TO ASSESS QUALIFICATION FOR MEDICAID, A MEDICALLY INDIGENT ASSISTANCE PROGRAM, OR HOSPITAL CHARITY. THE INFORMATION IS GIVEN TO A SOCIAL WORKER FOR APPLICATION OF AND DETERMINATION FOR THE APPROPRIATE SOURCE. A PHONE BASED TRANSLATION SYSTEM IS AVAILABLE FOR NON-ENGLISH SPEAKING PATIENTS. A CONTRACTED AGENCY CALLS ALL SELF PAY PATIENTS TO DISCUSS FINANCIAL ASSISTANCE AND OTHER PROGRAMS. ON THE WEBSITE UNDER THE BILLING SECTION IS INFORMATION REGARDING WHO TO CONTACT FOR QUESTIONS ABOUT FINANCIAL ASSISTANCE.

Part VI, Line 4:
THE ORGANIZATION'S SERVICE AREA IS DEFINED AS ELEVEN ZIP CODES SURROUNDING THE HOSPITAL IN CAMDEN, SC, LOCATED IN KERSHAW COUNTY. THE POPULATION OF THE COUNTY WAS ESTIMATED AT 62,516 IN 2013. THE COUNTY LAND AREA OF APPROXIMATELY 740 SQUARE MILES WAS THE 23RD LARGEST COUNTY IN POPULATION AMONG THE 46 COUNTIES IN THE STATE OF SOUTH CAROLINA BUT WAS THE SEVENTH FASTEST GROWING ONE, ACCORDING TO THE 2000 CENSUS. GEOGRAPHICALLY, THE COUNTY BORDERS RICHLAND COUNTY TO THE WEST, HOME OF THE STATE CAPITAL, COLUMBIA. ETHNIC DEMOGRAPHICS IN 2013: 69.0% WHITE/CAUCASIAN, NON-HISPANIC 24.6% AFRICAN-AMERICAN, NON-HISPANIC 4.2% HISPANIC/LATINO 2.2% OTHER THE UNEMPLOYMENT LEVEL IN 2013 WAS 6.7% VERSUS THE STATE LEVEL OF 7.6%. THE AVERAGE INCOME WAS $ 44,787 VERSUS STATE LEVEL OF $44,310. KERSHAW COUNTY INCLUDES FOUR MEDICALLY UNDERSERVED AREAS.

Part VI, Line 5:
A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY TO ITS DEPARTMENTS. KERSHAWHEALTH USES ALL SURPLUS FUNDS TO PURCHASE NEW AND IMPROVED EQUIPMENT, PROVIDE ADDITIONAL SERVICES, IMPROVE EXISTING SERVICES OR FACILITIES, RECRUIT NEEDED PHYSICIANS TO THE AREA, ALL IN ORDER TO PROVIDE QUALITY HEALTH CARE TO THE RESIDENTS OF KERSHAW AND SURROUNDING COUNTIES.SEE PROGRAM SERVICE ACCOMPLISHMENTS FOR ACTIVITIES AT HEALTH RESOURCE CENTER. KERSHAWHEALTH CLOSED ITS HEALTH RESOURCE CENTER IN 2011 IN ORDER TO MORE EFFECTIVELY DEPLOY RESOURCES OUT INTO THE COMMUNITY. THE FOCUS OF THESE EFFORTS WILL BE THE LAUNCH OF THE HEALTHY KERSHAW COUNTY INITIATIVE WITH A GOAL OF MAKING THE COUNTY THE HEALTHIEST IN SOUTH CAROLINA. THIS IS A COLLABORATIVE EFFORT INVOLVING KERSHAWHEALTH, A BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS, LOCAL GOVERNMENT AND BUSINESSES, THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, AND THE ARNOLD SCHOOL OF PUBLIC HEALTH AT THE UNIVERSITY OF SOUTH CAROLINA. IN ADDITION TO THOSE ACTIVITIES, KERSHAWHEALTH IS ACTIVE IN THE COMMUNITY AND LEADS AND PARTICIPATES IN DISASTER/EMERGENCY EXERCISES WITH OTHER COUNTY AGENCIES. WE OFFER PROGRAMS TO COUNTY EMPLOYEES SUCH AS CPR CLASSES. INFECTION CONTROL AND DIABETES EDUCATORS PARTICIPATE IN PRESENTATIONS TO COMMUNITY GROUPS AND SCHOOLS WITHIN KERSHAW COUNTY. KERSHAWHEALTH ACTIVELY PARTICIPATES IN RECRUITING NEEDED PHYSICIANS TO THIS SERVICE AREA WHICH INCLUDES MEDICALLY UNDERSERVED AREAS. WE FINANCIALLY SUPPORT THE COMMUNITY CLINIC OF KERSHAW COUNTY WHICH SERVES INDIGENT PATIENTS. WE AND OUR EMPLOYEES SUPPORT THE UNITED WAY THROUGH AN ANNUAL GIVING CAMPAIGN. KERSHAWHEALTH OWNS AND OPERATES THE COUNTY AMBULANCE SERVICE WHICH OPERATES AT A SIGNIFICANT DEFICIT. KERSHAWHEALTH SUBSIDIZES THE COUNTY 911 DISPATCHER SALARY AND FUNDS A PERSONAL TRAINER FOR THE SCHOOL SYSTEM.

Part VI, Line 6:
THE ORGANIZATION IS NOT A MEMBER OF AN AFFILIATED HEALTH CARE SYSTEM.

Part VI, Line 7, Reports Filed With States
SC

Operating expenses	$ 20,416,142
Total amount spent on community benefits as % of operating expenses	$ 739,770 3.62 %