Community Benefit Insight - Tax-exempt hospital

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Reynolds Memorial Hospital Inc

Reynolds Memorial Hospital

800 Wheeling Avenue
Glen Dale, WV 26038

Bed count	127	Medicare provider number	510013	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 550357045

Display data for year:

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

8.87%

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

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

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	$ 1,271,995 1.13 %
Medicaid as % of operating expenses	$ 8,680,741 7.70 %
Costs of other means-tested government programs as % of operating expenses	$ 48,719 0.04 %
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.	$ 1,025 0.00 %
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: 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	$ 3,061,433 2.71 %
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	$ 36,532 1.19 %

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 $ 28697110 including grants of $ 0) (Revenue $ 33096285)
Our hospitalist team is staffed with internal medicine trained physicians and mid-level providers who work closely with nurses and other ancillary staff to provide a multi-disciplinary approach to adult patient care. We provide care for a wide range of patients with multiple disease processes including but not limited to critical care, cardiac, pulmonary, nephrology, infectious disease, orthopedic, and gastroenterological conditions. Our team has the ability to provide bedside diagnostic procedures such as paracentesis and thoracentesis to help aid in diagnosis and treatment of our patients. We also have two outpatient internal medicine clinics that see patients throughout the year. In 2021, these outpatient clinics had 4,853 patient visits.

4B (Expenses $ 13286216 including grants of $ 0) (Revenue $ 11358356)
Our medical oncology and hematology clinic is staffed by an experienced team of physician, nurses, therapists, social workers and other clinical staff. Our 3,606 square-foot facility includes a five chair infusion room, two private infusion rooms, and two patient exam rooms. Infusion treatments include chemotherapy, biotherapy, monoclonal antibodies, immunotherapy, hormonal therapy, therapeutic phlebotomy, vitamin therapy, and more. The cancer institute also provides supportive care for patients undergoing chemotherapy, which includes IV hydration, electrolyte replacements, and growth factors. The hematology and oncology clinic had 3,442 patient visits in 2021.

4C (Expenses $ 9608325 including grants of $ 0) (Revenue $ 18208828)
The Emergency Department at Reynolds Memorial provides emergent care 24 hours a day, every day. The emergency department had 20,427 patient visits in 2021.

Facility Information

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

Group Reynolds Memorial Hospital Line Part V, Section B, Line 5
The CHNA was prepared by Reynolds Memorial Hospital, Inc. with assistance from the WVU Health Sciences Center, Office of Health Affairs. It focused on its primary service area, Marshall County, WV. Two primary sources of data were utilized to inform the CHNA 1 a focus group and 2 supplemental Marshall County survey data from neighboring WCH. RMHs community focus group was organized by a Family Resource Network partner on the RMH CHNA leadership team and was conducted by WVU OHA staff. Six attendees of this focus group represented the following agencies Marshall County Family Resource Network, National Alliance on Mental Illness, WVU Extension and 4-H Youth Development, and CASA for kids. The CHNA leadership team consisted of hospital leadership, public health representative, vulnerable population representatives, Marshall County Schools representative, Marshall County FCU representative, Marshall County Emergency Management representative, and Marshall County Chamber of Commerce representative. The CHNA can be found here https//wvumedicine.org/wp-content/uploads/2022/08/RMH-2021-Community-Health-Needs-Assessment.pdf.

Group Reynolds Memorial Hospital Line Part V, Section B, Line 11
The existing secondary data, new survey data, community input through the focus group, and lessons learned from the last CHNA cycle all factored into RMH leaderships prioritization decisions. The top health concerns were organized into three that will be the focus moving forward with implementation planning. These three health concerns are substance use and mental health obesity, chronic disease, and nutrition and cancer. RMH is involved with a sponsorship of community physical activity events such as the American Heart Association walks to combat obesity and chronic disease. RMH is also exploring the possibility of partnering to implement a food FARMacy program in the community as well as partnering with local school systems to provide youth-centric nutrition education programming. RMH would like to support local public schools and EMS partners in provision of Drug Free Clubs. RMH also plans to support a local drug abuse prevention coalition by hosting monthly meetings on site, providing the space for this community effort. Lastly, RMH is in the process of implementing a free lung cancer screening program and intends to host community cancer support groups when COVID protocols allow.

Group Reynolds Memorial Hospital Line Part V, Section B, Line 13b
Reynolds Memorial Hospital offers discounted care only to individuals who qualify for free care. Reynolds Memorial Hospital offers a Prompt-Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either prompt pay discount, the patient/guarantor must meet certain requirements.

Group Reynolds Memorial Hospital Line Part V, Section B, Line 24
All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient.

Supplemental Information

Schedule H (Form 990) Part VI

Part I Line 3c
Discounted services, for those over 200 FPG, are determined by evaluating income, assets, and liabilities on a case by case basis. The hospital also offers discounts to self pay patients for prompt payment, and also accepts payment plans over time without charging interest.

Part I Line 6a
RMH community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found on WVU Medicines website at https//wvumedicine.org/about/leadership-and-more/community-benefit/

Part I Line 7
Total community benefit expense for 2021 is 25,962,666 and is 24.69 of total net expenses. To calculate net expense, provision for doubtful accounts of 7,642,708 was deducted from total expenses of 112,779,322 as shown in Part IX line 25 of the core Form 990, for a net expense of 105,136,614.

Part II
RMH did not report any community building acitivies for 2021.

Part III Line 2
Bad Debt Expense at cost was calculated by multiplying provision for doubtful accounts of 7,642,708 by our cost to charge ratio of 40.06 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 3,061,669 less DSH allocations to self-pay patient accounts of 236 for a total of 3,061,433.

Part III Line 3
Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 15,000. The total of that report was 91,192 which we then multipled by our cost to charge ratio of 40.06 for a total of 36,532.

Part III Line 3
The estimated bad debt attributable to patients eligible for charity care of 36,532 should be considered community benefit due to the fact that anyone with outstanding balances of 15,000 or greater usually qualifies as catastrophic if the patient completes the application process. In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay.

Part III Line 4
Reynolds Memorial Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters.

Part III Line 4
The System grants credit without collateral to its patients, most of whom are local residents, and are insured under third-party payor agreements, primarily with Medicare, Medicaid and various commercial insurance companies. The System records accounts receivable net of estimated prince concessions and such amounts have historically been within managements expectations.

Part III Line 4
The mix of accounts receivable at December 31, 2021 and 2020, from patients and third-party payors is as follows For the year-end December 31, 2021 Medicare - 31, Medicaid - 16, Blue Cross - 21, Commercial, managed care and other - 28, Patients - 4, totaling 100. For the year-end December 31, 2020, Medicare - 29, Medicaid - 17, Blue Cross - 21, Commercial, managed care and other - 28, Patients - 5, totaling 100.

Part III Line 8
The amount reported in Part III Line 6 52,981,334 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME.

Part III Line 8
Reynolds shortfall, 9,286,789 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients.

Part III Line 9b
RMH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.

Part VI Line 2
With assistance from the WVU Health Sciences Center, Office of Health Affairs, Reynolds Memorial Hospital completed a Community Health Needs Assessment CHNA in 2021. The CHNA can be found here https//wvumedicine.org/wp-content/uploads/2022/08/RMH-2021-Community-Health-Needs-Assessment.pdf.

Part VI Line 2
The CHNA process for Reynolds Memorial Hospital included the collection and analysis of primary data. Both public and private organizations, such as government agencies, educational systems and health and human services entities were engaged to assess the needs of the community. RMH believes that the health status of a community depends on many factors, including quality of health care, social and economic determinants, individual behaviors, heredity, education and the physical environment. Population and demographic data is obtained through WVU Medicines population health and enterprise analytics department.

Part VI Line 3
The hospital employs one resource finding clerk to assist patients in obtaining benefits from Medicare, Medicaid, Vocational Rehab, and other federal and state sources.

Part VI Line 3
Our charity care eligibility guidelines are also listed on our website at https//wvumedicine.org/bill-pay/financial-assistance/.

Part VI Line 4
Reynolds Memorial Hospital RMH defines their community service area as Marshall County. Marshall County has a total population of 30,115, a median household income of 48,179 and an employment rate of 51.2. 13.7 of Marshall County residents live in poverty and 7.6 are without health care coverage. Population and demographic information was obtained from the United States Census Bureau https//data.census.gov/cedsci/.

Part VI Line 5
RMH has taken various actions to promote community health within its defined community service area. In an effort to offer more specialty care, RMH has employed a cardiologist for their new oncology center. RMH has also hired three primary care physicians and opened an urgent care office to make health care services more convenient and readily available. RMH has partnered with HealthNet Life to station a life flight helicopter in Marshall County in an effort to improve critical emergency care.

Part VI Line 5
The Reynolds Memorial Hospital board of directors is a community board, with thirteen members, most of which reside in or around Glen Dale, WV.

Part VI Line 5
Reynolds Memorial Hospital extends privileges to all qualified medical staff in Marshall County and surrounding communities to meet its healthcare needs.

Part VI Line 6
Reynolds Memorial Hospital is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery system. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its services area, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.

Part VI Line 6
System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, West Virginia Healthcare Cooperative, doing business as, Summersville Regional Medical Center in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV, Wetzel County Hospital, Inc. in New Martinsville, WV, Harrison Community Hospital in Cadiz, OH, Wheeling Hospital, Inc. in Wheeling, WV, Uniontown Hospital in Uniontown, PA, and Barnesville Hospital Association in Barnesville, OH.

Part VI Line 6
In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients.Wheeling Hospital Ambulatory Surgical Center, LLC a surgical center located in Bridgeport, OH was acquired in 2021.

Operating expenses	$ 112,779,322
Total amount spent on community benefits as % of operating expenses	$ 10,002,480 8.87 %