Community Benefit Insight - Tax-exempt hospital

View data for this organization below, or select additional hospitals to create a comparison view.

Search tax-exempt hospitals
for comparison purposes.

Hospital Development Co

Roane General Hospital

200 Hospital Drive
Spencer, WV 25276

Bed count	60	Medicare provider number	511306	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 550484469

Display data for year:

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

3.15%

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	$ 0 0 %
Medicaid as % of operating expenses	$ 1,808,423 3.10 %
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.	$ 25,344 0.04 %
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	$ 2,962,219 5.09 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 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 $ 44643974 including grants of $ 0) (Revenue $ 53002154)
Roane General Hospital generated gross revenue of $111,935,758 of which $62,244,357 was uncollectible due to contractual agreements with Medicare, Medicaid and other third-party payors. Bad debts due to inability or unwillingness of patients to pay amounted to $2,962,219. Additionally, charges for patients meeting 200% of the poverty level and who qualified for charity care were written off totaling $460,058.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
As a Critical Access hospital we provided health care services to our community which included the following days of care: Skilled/Intermediate Care Facility 11,689; Swing 1,387; Respite 0; and Acute Care 1,181.Additionally, we provided 50,916 outpatient diagnostic visits; 7,376 emergency room visits and 36,026 rural health clinic provider visits.Revenue and expenses related to these services are included above in box 4a.

4C (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
The Hospital provided community health education and health screening services at reduced fees during the year including health fairs; diabetes education seminars and screenings; and sports physicals. The Hospital served a total of 4,235 community participants through its community health education and health screening programs.

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
Other programs provided include Cardiac Rehab, Laboratory Services, Emergency Room, Pharmacy, Radiology, CT Scan, Ultrasound, MRI, Nuclear Medicine, Physical Therapy, Operating Room and RHC's. Revenue and expenses related to these services are included above in box 4a.

Facility Information

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

Roane General Hospital
Part V, Section B, Line 5: Key Informant SurveyParticipantsIndividuals selected to participate in the key informant survey were health and human services providers, business leaders, and individuals with unique knowledge of the community and/or public health.Survey MethodologyKey informants were identified and were requested to participate in the health care needs assessment process by completing the key informant survey. Invitations to take the survey were communicated to 47 community and business leaders and health care professionals. The surveys were distributed in June 2022.Results of the Key Informant SurveyThe overall response rate was 30% for the key informant survey. Key informants were asked to respond to the questions regarding health care and health service delivery issues in the community. Respondents were also asked to identify their perception of Roane General Hospital and how the community is addressing key health care services. In addition, key informants were asked about potential solutions to health care issues and their priority for solving the identified issues. Detailed key informant survey results are located in Appendix A of the CHNA.

Roane General Hospital
Part V, Section B, Line 11: The hospital is addressing the significant needs identified in the most recently conducted CHNA, in multiple ways, including:Major health issues: 1) Weight management, physical inactivity and poor nutrition; 2) Obesity as precursors to hypertension, cardiovascular disease, and diabetes; and 3) Mental and behavioral health Mental Health Services - implementation of tele-psych services September 2018; RGH hired a social worker who is training to transition into the role of a certified counselor to begin an internal behavioral/mental health service line. RGH will explore the expansion of the behavioral / mental health service line by hiring different health care providers. Weight Management /Obesity opened a new Center of Wellness which offers an expanded community fitness center, expanded outpatient therapy services, and the new Healthy Way Caf. Grants funds used refurbish and create new walking trails; and several programs and partnerships implemented to provide education and support for healthy eating. RGH will continue to look for opportunities for partnerships to improve food insecurity in the community. RGH will continue to expand on nutrition education offerings through the Prescription for Your Health Program.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7:
"The cost of charity care was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.The cost of community health improvement services was derived from three factors: 1. Average hourly rate per department x employee hours. 2. Actual supply expense 3. Total charges that would have been generated if services were not ""free""."

Part I, Line 7, Column (f):
The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 2,962,219.

Part III, Line 2:
Bad debt expense as reported on the audited financial statements.

Part III, Line 4:
Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.

Part III, Line 8:
Medicare costs and revenue were obtained from the hospital's Medicare cost report.

Part III, Line 9b:
SCREENING: All patients identified as self-pay will be screened for Medicaid eligibility referral, provided financial counseling and processed for appropriate financial assistance. FINANCIAL ASSISTANCE: Roane General Hospital encourages patients to apply for financial assistance; patients will be screened according to eligibility rules as defined in governmental assistance program guidelines and/or Roane General Hospital's Financial Assistance Policy and Procedure. CHARITY CARE: Patients with income at or below 200% of Federal Poverty Guidelines are eligible to apply for Roane General Hospital's Charity Care program. Remaining self-pay accounts will be flagged and followed up for financial education regarding their obligation to finalize a mutually acceptable financial agreement to resolve their bill.

Part VI, Line 2:
Specific goals of the health care needs assessment was to identify:1. Health Care Issues of the Community: The health care needs assessment identified prevalent health care issues and gaps in the current health services delivery in this region.2. Vulnerable Populations: The health care needs assessment identified persons with barriers to receiving health care services. Rural citizens are a vulnerable population in general due to the lack of specialty services and the required travel to meet many health care needs, and this region provides no exception. Children, seniors, and uninsured/underinsured citizens face the greatest barriers due to the lack of specific services that are available for these populations. If these populations are also of low income, this further compounds the barriers and subsequent access to health care.3. Disparities in the Health Care Services Delivery System: Although many health care services are offered in the region, a number of factors influence access. For example, insurance status, income, and provider and community awareness all affect the ability to access care.4. Health Care Resources in the Community: An assessment of health care services was completed in order to gain an understanding of the availability of health care services in the country. The assessment of the health care services was compiled through general data collection.5. Next Steps (Strategic Planning): The community health needs assessment is a crucial step in future strategic planning. Setting priorities cannot be accomplished without gaining an understanding of the community's health care needs and concerns. Addressing the health care service issues identified during the assessment is the next step in the process.

Part VI, Line 3:
All self-pay patients are screened at pre-registration, registration or final bill and are referred to the Financial Counselor for charity eligibility or referred to our in-house Medicaid Case Worker to establish Medicaid coverage.

Part VI, Line 4:
The total population in Roane County is 13,831 within a total land area of 483.56 square miles; the population density of the area is 29 (per square mile). The total population decreased by 3.37% from the 2000 to 2010 US Census and 6.02% from the 2010 to the 2020 US Census, for a total decrease of 9.2% over the past twenty years. The decrease is significantly higher than the population change in WV (-.9%) and the US which has seen (+17%).The median age of individuals residing in Roane County is 46.1, which is higher than that of the state (42.7) and the US (38.2). In addition, approximately one-half of the population in Roane County is above the age of 45.The population is 50.55% female, which is comparable with state and national data. Roane County shows little ethnic diversity with a population that is 96.6% white; this ethnic diversity rate is similar to the rate for West Virginia.The population with any disability is a relevant indicator because disabled individuals comprise a vulnerable population that requires targeted services and outreach by providers; Roane County has a higher rate (26.45%) than the state (19.31%) and national (12.69%) rates. Roane County has a comparable rate to WV and the US for the percent of the population aged 18 and older who identify as a veteran at 10.09%.

Part VI, Line 5:
The members of the Board of Directors of Roane General Hospital are all local business leaders and other community representatives. Medical Staff privileges are extended to all qualified employed physicians, consulting physicians, independent practice physicians and medical staff of the local Federally Qualified Health Center. All surplus funds are reinvested in the new medical equipment, technology or upgrades and renovation of facilities built in 1970. Specifically in 2011, funds were invested to upgrade technology for Electronic Medical Records and to meet the standards for Meaningful Use. The hospital filed for Stage 1 Meaningful Use in September 2011 and was one of only two Critical Access Hospitals in West Virginia to meet these standards of providing and tracking quality patient care. The Emergency Room is operated 24/7 and is staffed by Board Certified Emergency Medicine physicians. The hospital also operates four Rural Health Clinics, provides walk-in services and two community/school based clinics staffed by physicians employed by Roane General Hospital. Physicians including an orthopedist, urologist, podiatrist, and general practice/wound skin care use our clinics on specified days to screen and provide care not available in our community. Roane General Hospital's Auxiliary, operated independently from the hospital, has approx. 40 members who provide information and customer support services. They also conduct several fund raising events during the year and proceeds from their sales are donated to the hospital to offset the expense of new equipment or renovations. Roane General Hospital Foundation, Inc. was formed to allow charitable contributions to support the hospital and also as a vehicle for formal fundraising activities as required by the Hospital. This Foundation has a separate Board of Directors which oversees the operation and approves any donations to the Hospital. In 2016, Roane General Hospital hired new specialists to meet the needs of their community. An interventional pain psychiatrist was hired to combat the opioid epidemic, a full time cardiologist was hired to provide greater access to care for the community, and a part time orthopedic surgeon was hired to provide greater access to care for orthopedic needs. In 2018, Roane General Hospital helped form and facilitate the community group, Roane County Coalition Against Substance Abuse, implemented tele-psych services, and purchased a van to assist patients get to and from the hospital in non-emergent situations.

Operating expenses	$ 58,246,041
Total amount spent on community benefits as % of operating expenses	$ 1,833,767 3.15 %