Community Benefit Insight - Tax-exempt hospital

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Casa Colina Hospital and Centers for Healthcare

Casa Colina Hospital And Centers For

255 E Bonita
Pomona, CA 91769

Bed count	99	Medicare provider number	050782	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 951643989

Display data for year:

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

4.73%

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

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2016-2021

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	$ 176,013 0.18 %
Medicaid as % of operating expenses	$ 2,018,329 2.05 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 1,070,305 1.09 %
Subsidized health services as % of operating expenses	$ 796,895 0.81 %
Research as % of operating expenses	$ 397,632 0.40 %
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.	$ 100,858 0.10 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 95,145 0.10 %
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	$ 5,879 0.01 %
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	$ 1,117 19.00 %

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

Community Health Needs Assessment Activities: 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 $ 91344984 including grants of $ 442173) (Revenue $ 100784692)
During the fiscal year ended March 31, 2022, Casa Colina Hospital had a total of 22,415 inpatient rehabilitation and 4,819 medical/surgical patient days. Also, the Hospital provided 119,536 outpatient visits plus an additional 11,286 Children's Services visits. The Organization seeks to enhance the dignity and quality of life of every person served by providing the highest level of care and that no individual in need of physical rehabilitation care shall be refused because of his/her inability to pay. It is the policy of Casa Colina Hospital to provide charity care (uncompensated care) for those who demonstrate such inability to pay. Casa Colina Hospital community benefits analysis consisted of benefits provided to patients for medical services and on a broader basis to the community at large. The cost of such broader community support included salaries, supplies, equipment and outside services. Refer to schedule H for additional discussion of Financial assistance and other community services provided.

Facility Information

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

Facility: Casa Colina Hospital & Centers - Part V, Section B, Line 5
Information and opinions were gathered directly from persons who represent the broad interests and perspectives of the community served by the hospital. Collection methods included telephone and paper interviews as well as on line surveys targeted towards patients and community stakeholders.In addition to reviewing the secondary data available, the CHNA team collected primary data through 10 interviews and 418 community surveys in an effort to identify the key issues that most impact the health of the communities served by Casa Colina Hospital. The interviews and surveys engaged a spectrum of local health experts, community leaders, and residents.Secondary data were collected from a wide range of local, county, and state sources to present indicators on demographics, mortality, morbidity, health behaviors, clinical care, social and economic factors, and physical environment.

Facility: Casa Colina Hospital & Centers - Part V, Section B, Line 7d
The Community Benefit Reports with the CHNA as attachment is submitted to the California Department of Healthcare Access and Information (HCAI), which was formerly the Office of Statewide Health Planning and Development (OSHPD) and all submissions are published on the HCAI website.

Facility: Casa Colina Hospital & Centers - Part V, Section B, Line 11
Refer to the community benefits report and needs assessment which details activities and goals based on the needs identified in the CHNA. The report also discusses the specialized nature of the hospital and the patients that are served and how they do and do not overlap with the identified needs.

Supplemental Information

Schedule H (Form 990) Part VI

Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense
In evaluating the collectability of patient accounts receivable, the Company analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowances for both contractual adjustments and the provision for bad debts.

Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit
In order to calculate the estimate of bad debt expense attributable to charity care, the Company reviewed household income statistics from the 2007-2012 American Community Survey for all cities within a 10 mile radius of the hospital campus and calculated the number of household that would qualify for charity care based on a 200% of the Federal Poverty Limit threshhold.The calculated amount was not included in the community benefit summary above as the Company requires a sucessfully completed charity care application for an account to be included in the charity care at cost line above.

Part III, Line 4 - Bad Debt Expense
The Organization estimates the transaction price for patients with deductibles and coinsurance and from those who are uninsured based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by an contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Subsequent changes that are determined to be the result of the adverse change in the patient's ability to pay are recorded as bad debt expense.

Part VI, Line 2 - Needs Assessment
The Community Health Needs Assessment (CHNA) is the primary method of assessing the needs of the Organizations community. The CHNA is intended to be a resource for the Organization to continue developing and maintaining activities and programs that can help improve the health and well-being of the community. Casa Colina must complete comprehensive data collection and analysis to identify and address key community health priorities. With the help of these assessments, we can better identify, plan for, and respond to evolving community healthcare needs and act as a more responsible and productive member of our local healthcare network.We understand that the health needs of our community extend far beyond specialized medical and rehabilitative interventions. As such, we are dedicated to identifying and working to decrease the prevalence of disease processes that increase the likelihood for adverse health outcomes in our underserved community, such as individuals with diabetes and cardiovascular disease. Over the past several decades, Casa Colina has continually expanded its services to develop a continuum of care that better addresses the healthcare issues facing our diverse community, including barriers to care for multiple medical conditions including obesity, senior health, amputation, and more. The Community Health Needs Assessment offers a timely, critical birds-eye view that not only helps us identify those at risk for a medical disabilityit allows us to better understand how broadly unmet healthcare needs impact overall health outcomes. It is an essential exercise toward the development and implementation of services that meet the needs of our growing, dynamic community.

Part VI, Line 3 - Patient Education of Eligibility for Assistance
Upon arrival, each patient is provided with a patient's handbook that outlines what they can expect during their stay at Casa Colina. A portion of the handbook describes the process by which patients are authorized for treatment and the possible funding resources as follows:Prior to admission, department coordinators inform patients of funding sources and receive authorization for admissions. Throughout the patient's stay, case managers regularly keep funding sources informed about the patient's progress and future rehabilitation needs. Services provided are covered by most health insurance and Worker's Compensation plans. Some services may be eligible for Medicare or Medi-cal reimbursement.Per Casa Colina's charity care policy, the Casa Colina Foundation provides funds for uncompensated care to economically disadvantaged patients.

Part VI, Line 4 - Community Information
The Casa Colina Hospital Service area population includes 31 zip codes and 15 cities or communities within the Los Angeles and San Bernardino counties. In Los Angeles County, the hospital is located in Service Planning Area 3. In 2021, there were 1,268,987 people living in the Casa Colina Hospital service area.Nearly half of residents are between the ages of 20-44 (48.8%), over half of the population is white (55.1%), and about half of residents are Hispanic or Latino (51.5%). While the median household income for the service area is $80,803, over one-quarter of households are food insecure (27.4%), and about one in five residents fall below 150 percent of the federal poverty level (19.9%). Overall, the majority (90.5%) of Casa Colina service area residents have health insurance. Within the Casa Colina service area, 18.7 percent of residents report fair health, and 3.0 percent of residents report poor health. In Casa Colina Hospitals service area, 10.8 percent of adults reported serious psychological distress, and 10.2 percent of teens reported needing help for mental health problems in the past year. In the service area, 35.5 percent of adults are reportedly overweight (Body Mass Index, or BMI, of 25.0-29.99) and 23.4 percent are obese (BMI of 30.0 or higher). A complete breakdown of service area demographics, social and economic factors, and health indicators data, as well as community input on health issues, are available within the Community Health Profile and Description and the Key Findings sections of the report.

Part VI, Line 5 - Promotion of Community Health
Casa Colina's focus, paraphrasing from the Mission Statement, is to provide individuals the opportunity to maximize their medical recovery and rehabilitation potential, thus promoting the health and well-being of he community and continually fulfilling Casa Colina's exempt purposes. Although most direct care services are reimbursed, there are many ways in which Casa Colina provides benefits to the community toward these ends on a subsidized or no-cost basis.

Part VI, Line 7 - States Filing of Community Benefit Report
CA

Part VI - Additional Information
Schedule H Part V Line 21The organization does not provide emergency medical services. The organization has a written policy and procedures for referring patients who may need emergency medical care to a nearby hospital facility which provides emergency services.

Part VI, Line 4 - Community Building Activities
As part of coalition and capacity building for community organizations pertaining to health care and the needs of persons with or at risk of disability, Casa Colina sponsors or participates in events for a range of other charitable, non-profit and educational organizations. During the current fiscal year, Casa Colina as a organization made significant contributions to organizations through direct sponsorships and events. In addition to direct support through sponsorship, and as part of its own citizenship in the non-profit community, Casa Colina makes donations available to other organizations, particularly in cases where their overall mission or particular goal is aligned with Casa Colina's mission of service to persons with or at risk of disability. Community benefit in this sense was provided in forms ranging from sponsorships to donations of equipment, financial support, technical assistance, and the use of certain equipment.Finally, Casa Colina staff members participate in many local organizations that have individuals with disproportionate unmet health care needs (DUHN)as their focus. These range from organizations that focus on Down's Syndrome, autism, spinal cord injury, brain injury, MS, Parkinson's and many other diagnostic and disability related areas. A significant amount of staff time paid for by Casa Colina was utilized for the benefit of these local organizations in the current fiscal year.

Operating expenses	$ 98,390,786
Total amount spent on community benefits as % of operating expenses	$ 4,655,177 4.73 %