Community Benefit Insight - Tax-exempt hospital

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Nmc Services Inc Fka Northcrest Medical Center

Northcrest Medical Center

100 Northcrest Drive
Springfield, TN 37172

Bed count	109	Medicare provider number	440065	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 621046595

Display data for year:

Community Benefit Spending- 2020
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

5.23%

Spending by Community Benefit Category- 2020
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2020

Additional data

Community Benefit Expenditures: 2020

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	$ 1,315,224 1.79 %
Medicaid as % of operating expenses	$ 2,521,132 3.44 %
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: 2020

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	$ 6,074,585 8.29 %
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	$ 485,967 8.00 %

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: 2020

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: 2020

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 $ 49565144 including grants of $ 334109) (Revenue $ 77575421)
IN ADDITION TO HEALTH SERVICES, NORTHCREST MEDICAL CENTER SPONSORS MONTHLY SUPPORT GROUPS FOR GRIEF, CANCER AND DIABETES EDUCATION, HOSTS PRENATAL CLASSES, PUBLISHES A QUARTERLY NEWSLETTER, AND PROVIDES STROKE AND PROSTATE CANCER SCREENINGS ALONG WITH FREE BLOOD PRESSURE CHECKS. NORTHCREST MEDICAL CENTER ALSO CONDUCTS SEMINARS ON EXERCISE, NUTRITION, WEIGHT LOSS, ARTHRITIS AND SODIUM PROTECTION.

Facility Information

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

NORTHCREST MEDICAL CENTER
PART V, SECTION B, LINE 5: THE NORTHCREST EXECUTIVE COUNCIL WAS CHARGED WITH THE CHNA PROCESS. THE COUNCIL DETERMINEDA COMMITTEE WOULD BE CREATED TO CONDUCT THE CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY.IN DECEMBER 2018, NORTHCREST IDENTIFIED KEY STAFF MEMBERS TO BEGIN WORK ON A COMPREHENSIVECHNA. KEY COMMUNITY HEALTH AND SOCIAL SERVICE STAKEHOLDERS WERE ENGAGED TO ASSIST IN THEPROCESS TO ENSURE INPUT FROM THE UNDERSERVED, CHRONICALLY ILL, LOW INCOME AND MINORITY POPULATIONIN THE NORTHCREST SERVICE AREA WAS TAKEN INTO ACCOUNT. SPECIFICALLY, THE FOLLOWING SERVED ON THECHNA COMMITTEE: NAME COMPANY/DEPARTMENTKIM PRIDGEN NORTHCREST ACCOUNTINGADELE WATTS NORTHCREST FOUNDATION CHRIS LOCKE NORTHCREST BUSINESS DEVELOPMENTROB DEBERRY NORTHCREST PHYSICIAN SERVICESMICHAEL LEWIS, MD COMMUNITY PHYSICIANKELLY MILLER D.N.P. DIRECTOR OF HIGHLAND CREST AND NURSE PRACRITIONERCHAD SMITH ROBERTSON COUNTY FAMILY YMCARACHEL WRIGHT ROBERTSON COUNTY PUBLIC HEALTH EDUCATORCASEY BLEW NORTHCREST COMMUNITY DEVELOPMENTTHE COMMITTEE MET THREE TIMES OVER THE SIX MONTH TIME-FRAME AND WAS REQUESTED TO ASSIST WITH AND PROVIDE DIRECTION FOR THE FOLLOWING RESPONSIBILITIES:* IDENTIFYING PRIMARY ADN SECONDARY DATA SOURCES* IDENTIFYING KEY COMMUNITY PARTNERS* DEVOLOPING THE ORGANIZATION'S CHNA INSTRUMENT AND METHODOLOGY* DEVELOPING TARGETED INTERVIEW QUESTIONS INCLUDING IDENTIFICATION OF ITS COMMUNITY'S POPULATION HEALTH EXPERS* COMPILING AND INTERPRETING THE DATA ACCUMULATED THROUGHT THE SURVEY* ACHEIVING CONSESNUS, WITH ITS IDENTIFIED COMMUNITY PARTNERS, CITIZENS AND PUBLIC HEALTH EXPERTS, IN IDENTIFYING THE TOP HEALTH ISSUES FACING ITS COMMUNITY* DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY TO ADDRESS THE FINDINGS OF THE CHNA

NORTHCREST MEDICAL CENTER
PART V, SECTION B, LINE 11: NORTHCREST MEDICAL CENTER IS ALWAYS LOOKING FOR BETTER WAYS TO SERVE ITS COMMUNITY. WE USE MANY DIFFERENT SURVEYS TO GATHER INFORMATION ABOUT OUR HEALTHCARE SERVICES FROM OUR COMMUNITY. THE PATIENT SATISFACTION SURVEY PROVIDES OUR PATIENTS WITH THE OPPORTUNITY TO TELL US HOW WELL WE ARE PROVIDING OUR SERVICES. THE COMMUNITY PERCEPTION SURVEY ALLOWS THOSE THAT MAY NOT USE OUR FACILITY THE ABILITY TO PROVIDE US FEEDBACK. ALSO, ANOTHER OPPORTUNITY FOR FEEDBACK IS THE COMMUNITY NEEDS SURVEY WHICH ALLOWS THE COMMUNITY TO EXPRESS WHAT ADDITIONAL SERVICES IT WOULD LIKE FOR US TO PROVIDE.

PART V, SECTION B, LINE 13H:
DEMOGRAPHICS

PART V, SECTION B, LINE 20E:
COLLECTIONS AGENCY HAS THE HOSPITAL POLICY ON FINANCIAL ASSISTANCE AND SUPPLIES THIS DURING THE COLLECTIONS PROCESS IF REQUESTED.

PART V, SCH B , LINE 5
THE NORTHCREST EXECUTIVE COUNCIL WAS CHARGED WITH THE CHNA PROCESS. THE COUNCIL DETERMINED A COMMITTEE WOULD BE CREATED TO CONDUCT THE CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY. IN DECEMBER 2018, NORTHCREST IDENTIFIED KEY STAFF MEMBERS TO BEGIN WORK ON A COMPREHENSIVE CHNA. KEY COMMUNITY HEALTH AND SOCIAL SERVICE STAKEHOLDERS WERE ENGAGED TO ASSIST IN THE PROCESS TO ENSURE INPUT FROM THE UNDERSERVED, CHRONICALLY ILL, LOW INCOME AND MINORITY POPULATIONS IN THE NORTHCREST SERVICE AREA WAS TAKEN INTO ACCOUNT. SPECIFICALLY, THE FOLLOWING SERVED ON THE CHNA COMMITTEE: KIM PRIDGEN NORTHCREST ACCOUNTINGADELE WATTS NORTHCREST FOUNDATIONCHRIS LOCKE NORTHCREST BUSINESS DEVELOPMENTROB DEBERRY NORTHREST PHYSICIAN SERVICESMICHAEL LEWIS, MD COMMUNITY PHYSICIANKELLY MILLER D.N.P. DIRECTOR OF HIGHLAND CREST AND NURSE PRACRITIONERCHAD SMITH ROBERTSON COUNTY FAMILY YMCARACHEL WRIGHT ROBERTSON COUNTY PUBLIC HEALTH EDUCATORCASEY BLEW NORTHDREST COMMUNITY DEVELOPMENTTHE COMMITTEE MET THREE TIMES OVER THE SIX MONTH TIME-FRAME AND WAS REQUESTED TO ASSIST WITH AND PROVIDE DIRECTION FOR THE FOLLOWING RESPONSIBILITIES:* IDENTIFYING PRIMARY ADN SECONDARY DATA SOURCES* IDENTIFYING KEY COMMUNITY PARTNERS* DEVOLOPING THE ORGANIZATION'S CHNA INSTRUMENT AND METHODOLOGY* DEVELOPING TARGETED INTERVIEW QUESTIONS INCLUDING IDENTIFICATION OF ITS COMMUNITY'S POPULATION HEALTH EXPERTS* COMPILING AND INTERPRETING THE DATA ACCUMULATED THROUGH THE SURVEY* ACHIEVING CONSENSUS, WITH ITS IDENTIFIED COMMUNITY PARTNERS, CITIZENS AND PUBLIC HEALTH EXPERTS, IN IDENTIFYING THE TOP HEALTH ISSUES FACING ITS COMMUNITY* DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY TO ADDRESS THE FINDINGS OF THE CHNA

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,075,585.

PART III, LINE 3:
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24(B), 8% WAS AN ACCURATE ESTIMATE FOR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY.

PART III, LINE 4:
AND PART III, LINE 2:PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ESTIMATED ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE AND OTHER THIRD PARTY PAYER PROGRAMS. RECEIVABLES ARE GENERALLY UNCOLLATERALIZED, BUT CREDIT RISK RELATING TO ACCOUNTS RECEIVABLE IS LIMITED TO SOME EXTENT BY THE DIVERSITY AND NUMBER OF PATIENTS AND PAYORS. THE HOSPITAL ROUTINELY ACCEPTS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS OR POLICIES. LATE FEES AND INTEREST CHARGES, IF ANY, ARE RECOGNIZED WHEN RECEIVED. THE BAD DEBT ALLOWANCE IS ESTIMATED BASED UPON THE AGE OF THE ACCOUNT, PRIOR EXPERIENCE AND ANY UNUSUAL CIRCUMSTANCES WHICH AFFECT THE COLLECTIBILITY INCLUDING TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS.

PART III, LINE 8:
MEDICARE ALLOWABLE COST WAS OBTAINED FROM THE 06/30/2021 COST REPORT.

PART III, LINE 9B:
THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME.

PART VI, LINE 2:
NORTHCREST MEDICAL CENTER IS ALWAYS LOOKING FOR BETTER WAYS TO SERVE ITS COMMUNITY. WE USE MANY DIFFERENT SURVEYS TO GATHER INFORMATION ABOUT OUR HEALTHCARE SERVICES FROM OUR COMMUNITY. THE PATIENT SATISFACTION SURVEY PROVIDES OUR PATIENTS WITH THE OPPORTUNITY TO TELL US HOW WELL WE ARE PROVIDING OUR SERVICES. THE COMMUNITY PERCEPTION SURVEY ALLOWS THOSE THAT MAY NOT USE OUR FACILITY THE ABILITY TO PROVIDE US FEEDBACK. ALSO, ANOTHER OPPORTUNITY FOR FEEDBACK IS THE COMMUNITY NEEDS SURVEY WHICH ALLOWS THE COMMUNITY TO EXPRESS WHAT ADDITIONAL SERVICES IT WOULD LIKE FOR US TO PROVIDE.

PART VI, LINE 3:
PATIENTS ARE SCREENED UPON REGISTRATION TO SEE IF THEY QUALIFY FOR CHARITY CARE. THE PAPERWORK IS EXPLAINED AND PRESENTED AT THAT TIME. UNINSURED PATIENTS WITH NO MEANS OF PAYMENT ARE ALSO MAILED CHARITY APPLICATIONS AFTER DISCHARGE AND PRIOR TO COLLECTION AGENCY PLACEMENT. COLLECTION AGENCY IS ALSO EDUCATED IN EXPLAINING CHARITY POLICY AND WILL REFER QUALIFYING PATIENT TO HOSPITAL FOR REVIEW. WHILE SCREENING FOR CHARITY CARE QUALIFICATION, THE HOSPITAL DOES MEDICAID ELIGIBILITY SCREENING IF THE PATIENT IS MEDICAID ELIGIBLE. THE HOSPITAL ASSISTS THE PATIENT WITH THE APPLICATION AND FOLLOW UP. THIS BENEFITS THE PATIENTS LONG TERM WITH A PORTABLE INSURANCE OPTION.

PART VI, LINE 4:
NORTHCREST MEDICAL CENTER IS A COMMUNITY, NOT-FOR-PROFIT HOSPITAL LOCATED IN ROBERTSON COUNTY, WHICH IS LOCATED IN NORTHERN MIDDLE TENNESSEE AND INCLUDES EIGHT INDIVIDUAL MUNICIPALITIES. NORTHCREST MEDICAL CENTER IS THE ONLY HOSPITAL LOCATED IN THE COUNTY WITH A POPULATION OF APPROXIMATELY 71,813 CITIZENS. ROBERTSON COUNTY HAS A MEDIAN HOUSEHOLD INCOME OF $61,774, AND ITS POPULATION IS MADE UP OF 83% CAUCASIAN, 8% AFRICAN-AMERICAN, 7% HISPANIC, AND 2% OTHER.

PART VI, LINE 5:
NORTHCREST MEDICAL CENTER IS A NOT-FOR-PROFIT, INDEPENDENT, COMMUNITY HOSPITAL THAT HAS BEEN PROVIDING COMPASSIONATE, QUALITY HEALTHCARE SINCE 1956 WITH A MISSION OF ENHANCING COMMUNITY AND PATIENT WELLNESS. NORTHCREST PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY MEDICAL SERVICES TO NORTHERN MIDDLE TENNESSEE AND SOUTHERN KENTUCKY. NORTHCREST MEDICAL CENTER IS GOVERNED BY A BOARD OF TRUSTEES MADE UP OF LOCAL COMMUNITY-MINDED MEN AND WOMEN. NORTHCREST'S LOCAL BOARD ALLOWS US TO FOCUS ON THE NEEDS OF OUR COMMUNITY AND USE THE MEDICAL CENTER'S RESOURCES TO PROVIDE ADVANCED, HIGH QUALITY CARE IN A CONVENIENT LOCATION FOR OUR CITIZENS AND SUPPORT OUR COMMUNITY'S ORGANIZATIONS AND EVENTS. NORTHCREST'S MEDICAL STAFF IS MADE UP OF HIGHLY TRAINED AND SKILLED PHYSICIANS FROM THROUGHOUT THE WORLD. THE MEDICAL STAFF IS DEDICATED TO SUPPORTING THE MEDICAL CENTER AND ITS MISSION. NORTHCREST IS ALSO LOOKING TO ADD SERVICES AND PHYSICIANS THAT ARE NEEDED FOR THE COMMUNITY.

Operating expenses	$ 73,289,364
Total amount spent on community benefits as % of operating expenses	$ 3,836,356 5.23 %