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Scott & White Memorial Hospital
2401 S 31st Street
Temple, TX 76508
EIN: 741166904
The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more
Individual Facility Details: Kings Daughters Hospital1901 Sw Hk Dodgen Loop
Temple, TX 76502
Temple, TX 76502
2 hospitals in organization:
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| Bed count | 138 | Medicare provider number | 450008 | Member of the Council of Teaching Hospitals | NO | Children's hospital | NO |
Scott & White Memorial HospitalDisplay data for year:
Community Benefit Spending- 2011
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
16.21%
Spending by Community Benefit Category- 2011
(as % of total functional expenses)
(as % of total functional expenses)
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.
Operating expenses $ 977,981,326 Total amount spent on community benefits as % of operating expenses$ 158,531,551 16.21 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 34,620,247 3.54 %Medicaid as % of operating expenses$ 34,087,188 3.49 %Costs of other means-tested government programs as % of operating expenses$ 3,734,783 0.38 %Health professions education as % of operating expenses$ 57,417,746 5.87 %Subsidized health services as % of operating expenses$ 15,036,527 1.54 %Research as % of operating expenses$ 13,190,586 1.35 %Community health improvement services and community benefit operations*
as % of operating expensesNote: these two community benefit categories are reported together on the Schedule H, part I, line 7e.$ 198,138 0.02 %Cash and in-kind contributions for community benefit* as % of operating expenses$ 246,336 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: 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$ 25,112,220 2.57 %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:
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.
After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid? NO 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.
If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines? YES 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.
Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute? YES
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? NO Did the CHNA define the community served by the tax-exempt hospital? Not available Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital? Not available Did the tax-exempt hospital make the CHNA widely available (i.e. post online)? Not available 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? Not available
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 $ 819837241 including grants of $ 0) (Revenue $ 920292348)
"Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital facilities, two additional announced facilities, a 240,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 178 clinics at 65 clinic locations providing care in 46 medical specialties. Scott & White Memorial Hospital (""SWMH"") is a subsidiary of Scott & White Healthcare (""SWHC"")(EIN: 26-4532547), the parent corporation of the Scott & White Healthcare System (the ""System""). The Scott & White Healthcare Foundation (""SWF"")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System provided at cost approximately: $60 million in unreimbursed charity care, $46 million in unreimbursed Medicaid, $4.5 million in unreimbursed indigent care, $21 million in unreimbursed subsidized services, $63 million in unreimbursed health professions education, $13 million in unreimbursed research, $1 million in other community benefits, and had a Medicare shortfall of approximately $96 million in the fiscal year ending August 31, 2012. The Scott & White Healthcare System had more than 14,000 employees, including over 1,000 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2012, and served over 537,000 patients accounting for 2.2 million patient visits. Scott & White Memorial Hospital (""SWMH""), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Memorial Hospital operates a 610 bed acute care hospital and a 78 bed stand-alone children's hospital which opened October 4, 2011. Scott & White Memorial Hospital had 204,427 patient observation days (excluding newborns), 24,180 surgical cases, 28,415 admissions and 79,791 emergency room visits for the fiscal year ending August 31, 2012. The McLane Children's Hospital at Scott & White includes 48 private rooms, 16 pediatric intensive care rooms, 14 pediatric emergency room suites, and provides 24-hour emergency room services dedicated to and specifically equipped to respond to children's needs. The McLane Children's Hospital at Scott & White had 25,729 patient observation days (excluding newborns), 3,509 surgical cases, 3,906 admissions and 16,125 emergency room visits for the fiscal year ending August 31, 2012. The McLane Childrens Hospital is the first dedicated children's hospital in Texas, and third in the country, to install the latest in computed tomography (CT) technology. The Sonotom Definition Flash CT system from Siemens Healthcare produces images with up to 128-slice detail at more than twice the speed of most CT systems used in children's hospitals in the U.S. Scott & White System personnel strive to do more than merely meet the healthcare needs of patients. Employees go into the community to educate about living a healthier life. Targeted populations are provided information on specific needs. For example, physicians specializing in geriatric care hold regular seminars discussing subjects such as preventing injury from falls, questions patients should be asking their doctor, how to maintain a healthy lifestyle with limited mobility, and more. Health educational programs regarding prevention and treatment are offered free or at minimal cost to all community members in a variety of subject areas, such as weight loss, smoking cessation, education on coping with a diagnosis, support groups for families, child safety, heart disease education, diabetes education, sex education for teens, domestic violence prevention and many more. Staff and physicians attend health fairs in the community and provide regular community presentations about health issues for different populations. Clinics in the region offer healthy cooking classes led by a Scott & White dietician to instruct families in creating easy and cost effective healthy meals. As an integrated health care delivery system, Scott & White is able to leverage the Scott & White Health Plan to provide health education information to the community and is actively working to make that information more widely available.Scott & White uses various forms of media to promote health in the community. The System website, blogs, social media, printed flyers, and newspaper and magazine articles written by staff and physicians throughout the year provide information that community members can use to enhance personal health. A specific website has been created to instruct on wellness initiatives (wellness.sw.org). Also, Scott & White staff dedicate many hours serving on community boards and collaborative groups whose missions are to improve the overall health of the community. In addition to these efforts, the System has designated specific funds to be used to enhance healthy initiatives occurring in each community. For example, Scott & White provides substantial financial and in-kind support for multiple free clinics to assist in providing better access and more affordable healthcare to the medically underserved. Scott & White is one of sixteen major U.S. health systems to be part of the National High Value Healthcare Collaborative (""HVHC""). This partnership is designed to improve healthcare, lower costs and make best practices available to the national provider community. The Dartmouth Institute for Health Policy and Clinical Practice leads the collaborative which is studying nine prevalent condition/disease specific areas that have been shown to have wide variation nationally in rates, costs and outcomes. Additional high variation, high cost conditions that affect diverse populations will be added over time. The healthcare systems in this group are responsible for 50 million patients and are using private dollars and research and grant funds to identify ways to get the most out of every healthcare dollar. In June of 2012 the HVHC received a $26 million grant from the Center for Medicare and Medicaid Innovation (""CMMI""). CMMI projects the service improvements funded by this grant will save $64 million over three years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.Scott & White strives to better serve patients while decreasing costs to the healthcare system. One way this is accomplished is through better communication between specialists and primary care physicians creating coordinated and integrated care. Scott & White's electronic medical records (EMR) system allows specialists to review a patient's medical history and lab results and make recommendations to a primary care physician possibly eliminating an office visit. If the specialist needs to see a patient the specialist has access to all tests and lab work prior to the office visit which can prevent a second or third specialty follow-up visit. Scott & White is also using the EMR system to practice active rather than passive medicine. The new EMR system allows Scott & White to automatically remind physicians that patients are due for preventive tests such as mammograms or cholesterol checks. The system allows doctors and nurses to use e-mail to provide patients with test results or to answer questions that previously would have required an office visit.The Scott & White Healthcare System has received numerous awards and accreditations. Scott & White Memorial Hospital was ranked for the eighth time as one of the Top 100 Hospitals by Thomson Reuters. For the second consecutive year, SWMH was named one of the nation's Best Regional Hospitals according to U.S. News & World Report.SWMH serves patients qualifying for federal Medicare and state Medicaid programs and other federal and state means tested assistance programs. Services for indigent, uninsured and underinsured patients are provided according to provisions of the Scott & White Healthcare Financial Assistance Policy, which provides financial assistance to patients up to 375% of the Federal Poverty Guidelines."
4B (Expenses $ 79058977 including grants of $ 0) (Revenue $ 21641231)
"Scott & White Healthcare (""SWHC"") is the primary teaching affiliate to the Texas A&M University System Health Science Center College of Medicine (the ""College of Medicine""), with the Scott & White Memorial Hospital (""SWMH"") main campus in Temple, TX being the primary Scott & White teaching location. Scott & White hospital and clinical facilities in College Station, TX, Round Rock, TX, Brenham, TX and Taylor, TX also participate in teaching activities. The College of Medicine is a fully accredited, seven year medical school. Currently 298 medical students receive their basic science and clinical training at Scott & White. Virtually all physicians on the Scott & White Clinic staff hold faculty appointments at the College of Medicine and teach classes for first through fourth year students. A full four year medical education program was recently initiated on the SWMH main campus in Temple. To support this expansion on its Temple campus, SWMH has committed to self-fund over $15 million to expand classroom and lab facilities, purchase equipment and provide support for faculty research projects aimed at promoting healthcare innovations and the College of Medicine. With support from Scott & White, the College of Medicine intends to expand to an annual class size of 200 during the next five years, with four year campus locations at Scott & White facilities in Temple, Round Rock and College Station. Scott & White also hosts rotations for fourth-year students from many other medical schools. Through the fiscal year ending August 31, 2012, Scott & White has self-funded $12.1 million of their $15 million commitment to expand facilities to support expansion of the College of Medicine.The Scott & White Graduate Medical Education Program currently consists of 38 resident and fellowship programs with 434 residents and fellows receiving training for the fiscal year ending August 31, 2012. Scott & White hosted medical students in their 4th year rotations from 27 different universities. SWMH self-funded approximately $63 million to support medical education activities during the fiscal year ended August 31, 2012.The main SWMH campus in Temple serves as the clinical campus for the Scott & White School of Nursing at the University of Mary Hardin-Baylor in Belton, Texas. A baccalaureate degree program is offered through the School of Nursing. In addition, SWMH also facilitates the clinical training of registered nurses and licensed vocational nurses in cooperation with Temple College and Central Texas College in Killeen, Texas. A Master's of Science in Nursing degree program is offered through Texas A&M University-Corpus Christi. In total, more than 1,000 nursing students rotate through the Scott & White System annually. Scott & White also hosts allied health-training programs in its own name and in affiliation with other academic institutions, taught by nationally recognized physicians and professionals. These training programs and seminars are open to all medical professionals, as well as internal staff. In fiscal year ended August 31, 2012, approximately 9,638 physicians and 6,675 medical professionals attended continuing medical education programs hosted by Scott & White."
4C (Expenses $ 16422774 including grants of $ 0) (Revenue $ 6295623)
"One of the cornerstones of Scott & White Memorial Hospital's (""SWMH"") mission is providing quality patient care with a focus on research activities. Efficiencies are gained through innovation. The focus of much of the research is to find innovative & cost-effective ways to treat patients, while increasing patient safety, improving quality and focusing on better outcomes. SWMH has all of the research components to be able to take an idea from the research bench to the patient's bedside. SWMH has the following research departments, centers and institutes: cancer research institute, cardiovascular research, center for applied health research (""CAHR""), center of cell death and differentiation, center for bone, joint and spine research, clinical simulation research, digestive disease research center, ophthalmic research, neuroscience research, podiatric research, division of research, family medicine, investigative pathology and ob/gyn research.SWMH is positioning itself to become a nationally recognized leader in cancer research and treatment. The Cancer Research Institute has been created to partner research and clinical care. The mission of the Cancer Research Institute is to find effective cancer therapies quickly and cost-effectively. The institute is performing clinical trials for: Cutaneous T_Cell Lymphoma, B-Cell Leukemia or Lymphoma and Refractory/Relapsed or Elderly/Poor-risk AML. In 2010 the Scott & White Glenda Vasicek Cancer Center received the Outstanding Achievement Award from the Commission on Cancer of the American College of Surgeons. The Cardiovascular Research Institute (""CVRI"") is a joint effort of the Texas A&M Health Science Center, Scott & White and Central Texas Veteran's Health Care System (""CTVHCS""). This unique program pairs the world-class research of molecular biologists with clinical applications for the treatment of people suffering from cardiovascular disease or stroke. By discovering better strategies for prevention and intervention of these conditions, the work of the Institute will benefit patients and the entire community.To facilitate such research Scott & White has focused significant efforts on outcomes based research. SWMH has established the Center for Applied Health Research. This Center focuses on diverse research areas, and brings together expertise in many areas such as health services research, community based health research, patient centered safety and patient activation research, along with research mentoring and the academic development of clinicians. The center brings together collaborators from SWMH, Texas A&M Health Science Center and the Central Texas Veteran's Health Care System. Within the CAHR, the Patient Engagement and Safety Research Program centers on a team perspective in patient care. This program partners patients, family members, clinicians and other community and healthcare providers to create the best possible healthcare outcomes. The research is based on clinical trials, clinical simulation models, program evaluations, patient education and common intervention strategies. The Health Outcomes Core conducts health services research focusing on severe mental illnesses and the management of care for patients with complex medical and psychiatric comorbidities. This group works jointly with SWMH, the CTVHCS, Darnall Army Medical Center at the U.S. Army's Fort Hood, and the Center of Excellence for Research on Returning War Veterans located in Waco, Texas. Clinical Simulation Research is another area directly impacting patients' healthcare quality and safety. The Clinical Simulation Center was created, in collaboration with Temple College, to allow healthcare students and providers to design and test new processes and procedures prior to performing them on patients. The Clinical Simulation Center is used by medical and nursing students, residents, fellows, nurses and other healthcare providers. Simulation work enhances communication skills and performance of healthcare providers, preparing them for the realities of patient care.The goal and objective, of the Digestive Disease Research Center (""DDRC""), is to discover and share cutting edge knowledge about the digestive system and the diseases that affect millions in the United States. The SWMH research team consists of basic scientists and physicians from a wide variety of backgrounds with varying interests and disciplines. These combined investigators support the practice of ""bench to bedside"" research to benefit and contribute to human health. Along with seasoned investigators, the DDRC also believes in training of future scientists and provides an excellent learning environment for the training of undergraduates, medical students, graduate students, postdoctoral fellows and residents.Scott & White has committed significant resources to establish a one-of-a-kind Ophthalmic Vascular Research Program (""OVRP""). This is a joint venture between the Division of Ophthalmology at Scott & White, the Department of Systems Biology and Translational Medicine, and Cardiovascular Research Institute at the Texas A&M Health Science Center. New theories developed regarding the pathogenesis of various eye diseases as well as potential new therapies proposed and tested in the basic science laboratory, if appropriate and promising, can be taken into the clinical setting to benefit patient care.The Neuroscience Institute (""NSI"") at Scott & White and Texas A&M Health Science Center College of Medicine conducts state-of-the-art translational research, with scientific interests including drug and device trials in humans. The NSI is home to an invasive human brain chemistry and electrophysiology lab, neuroinflammation, neurogenesis, a neuromodulation lab, which includes a frameless stereotactic image-guided transcranial magnetic stimulator (""TMS""), an autonomic psychophysiology lab and a functional neuroimaging (""fMRI"") lab. One of the main scientific objectives of the NSI is the multimodal analysis of human brain function in both healthy and diseased populations. Research within the NSI is highly collaborative and expanding, with an internationally recognized team of basic and clinical researchers in the Departments of Neurosurgery, Neurology, Psychiatry and Behavioral Sciences and Radiology.The podiatric research team has 12 studies in progress. They have received two National Institute of Health (""NIH"") grants to fund two five-year studies. The total contact cast (""TCC"") study focuses on foot wounds, compliance and cost of care and complications. Another study is a collaborative effort with a research team from the U.K., which will study the recurrence and prevention of foot ulcers. The podiatric research team also has studies sponsored by the American Diabetic Association (""ADA"") and American Podiatric Medical Association (""APMA"") and are looking into the occurrence of ulcers in diabetic patients that are currently undergoing dialysis and how foot care affects diabetic foot complications. They are also looking into new therapies to deal with treatment of foot infections and open amputations.The Division of Research, Family Medicine (""DORFAM"") has completed research projects focusing on: moderate exercise for obese individuals, the referral of patients to specialists from primary care physicians, the over prescribing of antibiotics and the use of e-mail communication between health care providers and patients. The DORFAM has current research projects focusing on: bicycle related traumatic brain injuries, weight and contents of backpacks carried by school children, concussions among high school football players and miscommunication as a cause of medication errors in elderly ambulatory patients.Investigative Pathology is the research component of the Department of Pathology at Scott & White. They are focused on the research and development of anti-cancer drugs, understanding the mechanisms by which these drugs function, so that more potent drugs can be developed and educating and training the community on recent advances in cancer therapies. They are guided by the principle that drugs should be non-toxic to patients and are committed to developing effective heat-shocked protein-based therapies. SWMH has developed a virtual data warehouse which promotes Comparative Effectiveness Research. This virtual warehouse allows SWMH to share clinical and research data with other research and healthcare organizations. By partnering with other institutes, the data necessary for effective research is quickly and readily available, resulting in larger and more comprehensive data pools and increasing the cost-effectiveness of research.The Scott & White system employs many physicians, scientists and technicians devoted to various aspects of research programs. In the fiscal year ending August 31, 2012, there were approximately 610 active research projects, of which approximately 36% were self-funded."
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Supplemental Information
Schedule H (Form 990) Part VI
"Part I, Line 6a: Scott & White Memorial Hospital (""SWMH"") did not prepare a community benefit report for the fiscal year ending August 31, 2012. SWMH is located in Bell County Texas, and the Bell County Community Needs Coalition (the ""coalition"") completed a county needs assessment in August of 2010. This assessment is the product of a collaborative process of systematic collection, analysis, and distribution of information on the health and human services needs of Bell County. Various data collection tools and methods, such as surveys (printed in 3 languages), interviews and focus groups, were used to conduct the needs assessment. The assessment resulted in the coalition identifying the top challenges, by region, affecting the citizens of Bell County and surrounding areas. While SWMH was not actively involved in conducting the assessment, the assessment is being used to reassess the current programs and services to better serve the community."
Part I, Line 7: The costing method used for Schedule H is the cost to charge ratio, as calculated in Schedule H, Worksheet 2. This method was applied to the costs reported on lines 7a, 7b, and 7c.
Part I, L7 Col(f): Bad debt expense subtracted from total expenses on Part IX of the Form 990 to calculate the operating expenses used in calculating the percentage in column (f) is $85,247,413.
"Part III, Line 4: In the Scott & White Memorial Hospital (""SWMH"") accounting system, bad debt is recorded as the cost of forgone charges. To calculate the cost of bad debt for purposes of Schedule H, Part III, line 2, the cost to charge ratio calculated in Worksheet 2 of the Schedule H Instructions was applied. Due to patient screenings which occur prior to recording bad debt charges, bad debt expense should not contain community benefit expenditures.Audited financial statement footnote: The presentation of the provision for bad debts as a reduction of patient service revenue is based on an entity-wide assessment of the significance of patient revenue that is recognized without assessing patients' ability to pay. Scott & White has experienced an increase in write-off trends related to bad debt and charity across the system driven by changes in insurance plan structures shifting financial responsibility away from the health plan to individuals and general economic conditions. There have been no significant changes to the charity care policies for the year ended August 31, 2012."
"Part III, Line 8: Scott & White Memorial Hospital (""SWMH"") is a nonprofit hospital that voluntarily participates in the Medicare program. Medicare payments received do not cover the costs incurred to provide services to Medicare patients. In reporting the community benefit portion of the American Hospital Association/Texas Hospital Association survey, the Medicare short-fall is included in community benefit reporting.Costing methodology/source: The Medicare revenue and costs are from the Medicare Cost Report which has a year-end August 31, 2012. All payments to providers of services must be based on the reasonable cost of services covered under title XVIII of the Social Security Act. Reasonable cost includes all necessary and proper costs incurred in rendering the services. Reasonable cost takes into account both direct and indirect costs of providers of services, including normal standby costs. The general services or overhead cost is stepped down and allocated through statistical data to equitably allocate the expenses to the hospital service departments."
"Part III, Line 9b: The Scott & White Healthcare Financial Assistance Policy has a section for coordination with collection policies. It states: ""notwithstanding any other provision of any other policy or provision at S&W regarding billing and collection matters, S&W will not engage in extraordinary collection actions before it makes reasonable efforts to determine whether an individual who has an unpaid billing from S&W is eligible for financial assistance under this Policy. ""Reasonable efforts"" includes notification to the patient by S&W of this Policy upon admission or discharge and in written and oral communications with the patient regarding the patient's billings, including invoices, telephone calls, and such other communications as may be set forth in future guidance from the U.S. Department of the Treasury or Internal Revenue Service."""
Scott & White Memorial Hospital
"Part V, Section B, Line 13g: In addition to the methods of publication listed in question 13, Scott & White Memorial Hospital (""SWMH"") annually posts a notice in the principal newspaper of its service area."
McLane Children's Hospital Scott & White Part V, Section B, Line 13g: In addition to the methods of publication listed in question 13, Scott & White McLane Children's Hospital Scott & White annually posts a notice in the principal newspaper of its service area.
"Part VI, Line 2: The Scott & White Healthcare System (the ""System"") subscribes to Healthy Communities Institute, which supplies continuously updated community data on 75 to 200 health and quality of life indicators. Data for each hospital in the System including Scott & White Memorial Hospital (""SWMH"") can be found on the website www.sw.org. Scott & White routinely monitors local health trends, reviews hospitalization inpatient and outpatient records, and takes feedback from community leaders and public health officials regarding the current community health needs. Scott & White staff members regularly participate in exchanges with government, education, and human service organizations to identify other issues in the community that may be underlying causes of healthcare problems. Scott & White executives assist other community health service organizations with strategic planning in the delivery of services to the medically underserved. In an effort to get regular feedback from the community, Scott & White created a new department to actively engage patients and the community in continuous dialogue to provide them an opportunity to discuss their unmet medical care needs. This platform allows the opportunity to understand the community's perspective regarding helpful service improvements. A strategic plan has been implemented for conducting extensive community health needs assessments on a 3 year cyclical basis, the first of which will be completed by August 31, 2013. Data pertaining to changing demographics, hospitalization rates for the top 15 conditions, and 100 health and quality of life indicators will be collected, monitored and reported on a regular basis on the hospital's website. The data will show how counties within the SWMH service area compare to other counties in Texas and the U.S. Healthy People 2020 goals. Also, information gaps in the current data will be identified and targeted for future exploration in the form of surveys, key informant interviews and focus groups. The process for conducting the community health needs assessment was presented to the SWMH Board of Directors and the Directors were given the opportunity to provide input and make suggestions."
"Part VI, Line 3: Scott & White Memorial Hospital Hospital (""SWMH"") provides patients with information regarding eligibility for financial assistance in a number of ways. Patients are notified of the Financial Assistance Policy upon admission or discharge and in written and oral communications with the patient regarding patient billing statements including phone contact information for patients seeking information regarding billings, invoices and telephone calls. Scott & White personnel attempt to screen uninsured patients for eligibility for financial assistance, as well as alternative funding sources, prior to providing services. When screening prior to services is not possible, Scott & White personnel attempt to screen uninsured patients prior to billing. Scott & White financial counselors contacting patients regarding outstanding accounts attempt to screen patients for eligibility for financial assistance and opportunities for alternative funding sources."
Part VI, Line 4: The Scott & White Healthcare System provides care for patients in 35 counties in the state of Texas covering 29,000-square miles. Eighty-five percent of the patients come from the primary service area including the counties of Bell, Brazos, Coryell, Falls, Lampasas, McLennan, Milam, and Williamson. Eight percent of patients come from the secondary service area including Blanco, Bosque, Brown, Burleson, Burnet, Comanche, Grimes, Hamilton, Hays, Hill, Hood, Johnson, Lee, Leon, Limestone, Llano, Madison, Mills, Robertson, San Saba, Somervell, Travis and Washington counties.In Scott & White's primary service area, the total population is 1,268,822 and the median household income is $46,930. Twenty-seven percent of the population is under the age of 17; 42% is between the ages of 18 and 44; 21% is between the ages of 45 and 64; and 10% of the population is over 65. The top three ethnicities in the primary service area are Caucasian Non-Hispanic with 61.08% of the population; 20.67% are Hispanic and 12% are African American.General Health Summary: The March 2010 public health rankings list Bell County as 74th out of 223 in the state of Texas. A community health needs assessment was completed in August 2010 by the Bell County Community Needs Coalition. The following information was taken from the results of that assessment to help provide a snapshot of the overall health of the immediate community that Scott & White Memorial Hospital serves: Forty percent of nearly 3,000 survey respondents indicated they would qualify their overall health as either fair or poor. The most common health diagnoses that residents of Bell County have received from physicians are high blood pressure (36.8% of respondents), high cholesterol (24.5% of respondents), and mental illness such as depression, anxiety or substance abuse (23.2% of respondents). The number one cause of death is cardiovascular disease, followed by cancer. Referencing the risk factors for CVD, almost 30% of adults in Bell County do not participate in leisure time physical activity, 27% of residents are smokers and over 75% of adults eat less than five fruits and vegetables a day. All of these indicators are a slightly higher percentage than the state levels. The top two possibly preventable conditions that Bell County residents were hospitalized for are congestive heart failure and bacterial pneumonia.
"Part VI, Line 5: All Scott & White Healthcare System facilities are operated in a manner that furthers exempt purposes. Scott & White Healthcare officers and executives plan and direct the activities of all System facilities under the direction and oversight of the Scott & White Healthcare Board of Trustees. The Scott & White Memorial Hospital (""SWMH"") Board of Directors is comprised of persons residing in the service area. As explained in response to Form 990 Part VI, Section A, Question 7b, the SWMH Board of Directors does not consist of a majority of independent directors because SWMH relies on the Scott & White Healthcare Board of Trustees, which is controlled by a majority of community trustees, to meet community board standards. Surplus funds are reinvested in facilities, equipment and programs to further SWMH's exempt purposes. SWMH is operated for the benefit of the public and no part of income inures to any private individual or serves a private interest. Surplus funds are used to improve the quality of patient care, expand facilities, advance medical training and education and fund research. Scott & White Healthcare has a Financial Assistance Policy that all hospitals in the Scott & White Healthcare System, including SWMH, follow, which provides assistance to individuals with incomes up to 375% of the Federal Poverty Guidelines."
"Part VI, Line 6: Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital facilities, two additional announced facilities, a 240,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 178 clinics at 65 clinic locations providing care in 46 medical specialties. Scott & White Memorial Hospital (""SWMH"") is a subsidiary of Scott & White Healthcare (""SWHC"")(EIN: 26-4532547), the parent corporation of the Scott & White Healthcare System (the ""System""). The Scott & White Healthcare Foundation (""SWF"")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System provided at cost approximately: $60 million in unreimbursed charity care, $46 million in unreimbursed Medicaid, $4.5 million in unreimbursed indigent care, $21 million in unreimbursed subsidized services, $63 million in unreimbursed health professions education, $13 million in unreimbursed research, $1 million in other community benefits, and had a Medicare shortfall of approximately $96 million in the fiscal year ending August 31, 2012.The Scott & White Healthcare System had more than 14,000 employees, including over 1,000 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2012, and served over 537,000 patients accounting for 2.2 million patient visits. Scott & White Memorial Hospital (""SWMH""), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Memorial Hospital operates a 610 bed acute care hospital and a 78 bed stand-alone children's hospital which opened October 4, 2011. Scott & White Memorial Hospital had 204,427 patient observation days (excluding newborns), 24,180 surgical cases, 28,415 admissions and 79,791 emergency room visits for the fiscal year ending August 31, 2012. The McLane Children's Hospital at Scott & White includes 48 private rooms, 16 pediatric intensive care rooms, 14 pediatric emergency room suites, and provides 24-hour emergency room services dedicated to and specifically equipped to respond to children's needs. The McLane Children's Hospital at Scott & White had 25,729 patient observation days (excluding newborns), 3,509 surgical cases, 3,906 admissions and 16,125 emergency room visits for the fiscal year ending August 31, 2012. The McLane Children's Hospital is the first dedicated children's hospital in Texas, and third in the country, to install the latest in computed tomography (CT) technology. The Sonotom Definition Flash CT system from Siemens Healthcare produces images with up to 128-slice detail at more than twice the speed of most CT systems used in children's hospitals in the U.S. Scott & White System personnel strive to do more than merely meet the healthcare needs of patients. Employees go into the community to educate about living a healthier life. Targeted populations are provided information on specific needs. For example, physicians specializing in geriatric care hold regular seminars discussing subjects such as preventing injury from falls, questions patients should be asking their doctor, how to maintain a healthy lifestyle with limited mobility, and more. Health educational programs regarding prevention and treatment are offered free or at minimal cost to all community members in a variety of subject areas, such as weight loss, smoking cessation, education on coping with a diagnosis, support groups for families, child safety, heart disease education, diabetes education, sex education for teens, domestic violence prevention and many more. Staff and physicians attend health fairs in the community and provide regular community presentations about health issues for different populations. Clinics in the region offer healthy cooking classes led by a Scott & White dietician to instruct families in creating easy and cost effective healthy meals. As an integrated health care delivery system, Scott & White is able to leverage the Scott & White Health Plan to provide health education information to the community and is actively working to make that information more widely available.Scott & White uses various forms of media to promote health in the community. The System website, blogs, social media, printed flyers, and newspaper and magazine articles written by staff and physicians throughout the year provide information that community members can use to enhance personal health. A specific website has been created to instruct on wellness initiatives (wellness.sw.org). Also, Scott & White staff dedicate many hours serving on community boards and collaborative groups whose missions are to improve the overall health of the community. In addition to these efforts, the System has designated specific funds to be used to enhance healthy initiatives occurring in each community. For example, Scott & White provides substantial financial and in-kind support for multiple free clinics to assist in providing better access and more affordable healthcare to the medically underserved. Scott & White is one of sixteen major U.S. health systems to be part of the National High Value Healthcare Collaborative (""HVHC""). This partnership is designed to improve healthcare, lower costs and make best practices available to the national provider community. The Dartmouth Institute for Health Policy and Clinical Practice leads the collaborative which is studying nine prevalent condition/disease specific areas that have been shown to have wide variation nationally in rates, costs and outcomes. Additional high variation, high cost conditions that affect diverse populations will be added over time. The healthcare systems in this group are responsible for 50 million patients and are using private dollars and research and grant funds to identify ways to get the most out of every healthcare dollar. In June of 2012 the HVHC received a $26 million grant from the Center for Medicare and Medicaid Innovation (""CMMI""). CMMI projects the service improvements funded by this grant will save $64 million over three years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.Scott & White strives to better serve patients while decreasing costs to the healthcare system. One way this is accomplished is through better communication between specialists and primary care physicians creating coordinated and integrated care. Scott & White's electronic medical records (EMR) system allows specialists to review a patient's medical history and lab results and make recommendations to a primary care physician possibly eliminating an office visit. If the specialist needs to see a patient the specialist has access to all tests and lab work prior to the office visit which can prevent a second or third specialty follow-up visit. Scott & White is also using the EMR system to practice active rather than passive medicine. The new EMR system allows Scott & White to automatically remind physicians that patients are due for preventive tests such as mammograms or cholesterol checks. The system allows doctors and nurses to use e-mail to provide patients with test results or to answer questions that previously would have required an office visit.The Scott & White Healthcare System has received numerous awards and accreditations. Scott & White Memorial Hospital was ranked for the eighth time as one of the Top 100 Hospitals by Thomson Reuters. For the second consecutive year, SWMH was named one of the nation's Best Regional Hospitals according to U.S. News & World Report.SWMH serves patients qualifying for federal Medicare and state Medicaid programs and other federal and state means tested assistance programs. Services for indigent, uninsured and underinsured patients are provided according to provisions of the Scott & White Healthcare Financial Assistance Policy, which provides financial assistance to patients up to 375% of the Federal Poverty Guidelines. Scott & White also serves private pay patients and contracts with health plans and insurance companies to provide medical services for their participants."
Reports Filed With States Part VI, Line 7 TX
