Community Benefit Insight - Tax-exempt hospital

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Jackson Hospital And Clinic Inc

Jackson Hospital And Clinic Inc

1725 Pine Street
Montgomery, AL 36106

Bed count	344	Medicare provider number	010024	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 636001820

Display data for year:

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

7.74%

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	$ 8,623,088 2.78 %
Medicaid as % of operating expenses	$ 15,187,772 4.90 %
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	$ 177,141 0.06 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 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	$ 14,119,504 4.56 %
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	$ 9,460,068 67.00 %

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 $ 261894523 including grants of $ 85217) (Revenue $ 294556571)
JACKSON HOSPITAL OPERATES A GENERAL ACUTE CARE HOSPITAL THAT PROVIDES CERTAIN TERTIARY SERVICES SUCH AS NEUROLOGY AND NEUROSURGERY, CARDIOLOGY (INCLUDING CARDIAC CATHERIZATION AND CARDIOVASCULAR SURGERY) AND ONCOLOGY. JACKSON HOSPITAL IS LICENSED FOR 344 BEDS THAT INCLUDE 30 INTENSIVE CARE BEDS AND 22 OBSTETRIC BEDS. PLEASE SEE SCHEDULE O FOR A CONTINUATION OF OUR PROGRAM SERVICE ACCOMPLISHMENTS.THE INPATIENT ANCILLARY AND SUPPORT SERVICES OFFERED BY JACKSON HOSPITAL ARE AS FOLLOWS; ACUTE DIALYSIS, BLOOD BANK. CARDIAC CATHETERIZATION LABORATORY, NUCLEAR MEDICINE, NURSERY (LEVEL II), PHARMACY, PHYSICAL THERAPY, POST ANESTHESIA CARE, RESPIRATORY CARE, ELECTROCARDIOLOGY, INTENSIVE CARE, LABOR AND DELIVERY, MRI, CARDIOVASCULAR SURGERY, CARDIOVASCULAR LABORATORY, CLINICAL AND ANATOMICAL LABORATORY, COMPUTERIZED TOMOGRAPHY, CORONARY CARE, DIAGNOSTIC RADIOLOGY, SURGICAL FACILITIES AND ULTRASOUND. THE OUTPATIENT ANCILLARY AND SUPPORT SERVICES OFFERED BY JACKSON HOSPITAL ARE AS FOLLOWS; BLOOD BANK, CARDIAC CATHETERIZATION LABORATORY, EMERGENCY DEPARTMENT, ENDOSCOPY, LITHOTRIPSY, DIABETES TREATMENT CENTER, PAIN MANAGEMENT, PHYSICAL THERAPY, RESPIRATORY CARE, SLEEP LAB, ELECTROCARDIOLOGY, MRI, CARDIOVASCULAR LABORATORY, CLINICAL LABORATORY, COMPUTERIZED TOMOGRAPHY, DIAGNOSTIC RADIOLOGY, AMBULATORY SURGERY, ULTRASOUND AND WOUND CARE CENTER. FOR THE 12 MONTHS ENDING DECEMBER 31, 2021, JACKSON HOSPITAL HAD 11,796 ADMISSIONS, 69,978 PATIENT DAYS, 1,203 DELIVERIES, 22,635 TOTAL SURGERIES AND 49,708 EMERGENCY DEPARTMENT VISITS.

Facility Information

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

JACKSON HOSPITAL & CLINIC
PART V, SECTION B, LINE 5: THIS CHNA INCLUDES INFORMATION FROM THE FOLLOWING SOURCES:-INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED BY JACKSON HOSPITAL-IDENTIFYING FEDERAL, REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES, WITH CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY JACKSON HOSPITALCONSULTATION OR INPUT FROM OTHER PERSONS LOCATED IN AND/OR SERVING JACKSON HOSPITAL'S COMMUNITY, SUCH AS:-HEALTHCARE COMMUNITY ADVOCATES-NONPROFIT ORGANIZATIONS-ACADEMIC EXPERTS-LOCAL GOVERNMENT OFFICIALS-COMMUNITY-BASED ORGANIZATIONS, INCLUDING ORGANIZATIONS FOCUSED ON ONE OR MORE HEALTH ISSUES-HEALTHCARE PROVIDERS, INCLUDING COMMUNITY HEALTH CENTERS AND OTHER PROVIDERS FOCUSING ON MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS OR THOSE WITH NEEDS ARISING FROM CHRONIC DISEASE

JACKSON HOSPITAL & CLINIC
PART V, SECTION B, LINE 11: 1 CHONIC CONDITIONSHEART DISEASE IS THE LEADING CAUSE OF DEATH IN ELMORE, AUTAUGA, AND MONTGOMERY COUNTIES. THE CHRONIC LOWER RESPIRATORY DISEASEMORTALITY RATE IN AUTAUGA COUNTY IS SIGNIFICANTLY HIGHER THAN THE RATE IN THE OVERALL STATE OF ALABAMATHE HYPERTENSION HOSPITALIZATION RATES IN ELMORE, AUTAUGA, AND MONTGOMERY COUNTIES ARE HIGHER THAN THE OVERALL RATE IN ALABAMA CANCER WAS THE SECOND MOST COMMONLY MENTIONED HEALTH CONCERN DURING COMMUNITY PHONE SURVEYS. RESPONDENTS FELT THAT THE CONCERN IS GETTING WORSE OVER TIME THE BREAST CANCER INCIDENCE RATE IS HIGHER IN ELMORE, AUTAUGA, AND MONTGOMERY COUNTIES WHEN COMPARED TO ALABAMA. THE COLORECTAL CANCER MORTALITY.2 DIABETESTHE DIABETES MORTALITY RATE IN MONTGOMERY COUNTY IS SIGNIFICANTLY HIGHER THAN THE RATE IN ALABAMA. DURING COMMUNITY LEADER INTERVIEWS, INTERVIEWEES NOTED DIABETES AS ONE OF THEIR MAIN HEALTH CONCERNS. THE MOST COMMONLY MENTIONED HEALTH CONCERN DURING COMMUNITY PHONE SURVEYS WAS DIABETES. RESPONDENTS FEEL THAT THE CONCERN IS GETTING WORSE OVER TIME.3 OBESITYTHE PREVALENCE OF OBESITY IN MONTGOMERY MSA IS SLIGHTLY HIGHER THAN THE PERCENTAGE STATEWIDE. ACCESS TO HEALTHY FOODS IN AUTAUGA AND MONTGOMERY COUNTIES IS SIGNIFICANTLY LIMITED COMPARED TO THE REST OF THE STATE. OBESITY/BEING OVERWEIGHT WAS ONE OF THE MOST COMMONLY MENTIONED HEALTH CONCERN BY PHONE SURVEY PARTICIPANTS. PHYSICAL INACTIVITY IN ELMORE COUNTY IS HIGHER THAN THE ENTIRE STATE OF ALABAMA. THE PERCENTAGE OF OBESE AND OVERWEIGHT INDIVIDUALS IS SIGNIFICANTLY HIGHER THAN THOSE OF NORMAL WEIGHT.MATERNAL & CHILD HEALTHTHE TEEN BIRTH RATE IN MONTGOMERY COUNTY IS HIGHER THAN THE STATE RATE. THE INFANT MORTALITY RATE IS HIGHER IN MONTGOMERY COUNTY WHEN COMPARED TO THE RATE IN ALABAMA. WOMEN IN AUTAUGA, ELMORE, AND MONTGOMERY COUNTIES ARE LESS LIKELY TO RECEIVE PRENATAL CARE IN THE FIRST TRIMESTER OF THEIR PREGNANCY WHEN COMPARED TO OTHER WOMEN IN ALABAMA. WOMEN IN MONTGOMERY COUNTY ARE LESS LIKELY TO RECEIVE ADEQUATE PRENATAL CARE DURING THE COURSE OF THEIR PREGNANCY WHEN COMPARED TO WOMEN IN ALABAMA. INFANTS IN AUTAUGA AND MONTGOMERY COUNTIES ARE MORE LIKELY TO BE CONSIDERED LOW BIRTHWEIGHT BIRTHS WHEN COMPARED TO INFANTS IN ALABAMA.

JACKSON HOSPITAL & CLINIC
PART V, SECTION B, LINE 13H: ALL SELF-PAY PATIENTS RECEIVE A 78% DISCOUNT SO THAT THEY ARE ONLY BILLED FOR 22% OF TOTAL CHARGES. IN ADDITION, FINANCIAL ASSISTANCE WILL BE PROVIDED TO THOSE WHOSE INCOME IS AT OR BELOW THE FPG OF 100%. ADDITIONAL CONSIDERATIONS ARE INSURANCE/COVERAGE STATUS.

PART V, SECTION B, LINE 16A:
WEBSITE FOR FAP:HTTP://WWW.JACKSON.ORG/MEDIA/1244/FINANCIAL-ASSISTANCE-POLICY-REVISED-6-28-16.PDF

PART V, SECTION B, LINE 16B:
FAP APPLICATION WEBSITE:HTTP://WWW.JACKSON.ORG/MEDIA/1242/FINANCIAL-ASSISTANCE-APPLICATION-REV-7-19-16.PDF

PART V, SECTION B, LINE 16C:
PLS WEBSITE:HTTP://WWW.JACKSON.ORG/PATIENT-RESOURCES/PATIENTS-VISITORS/FINANCIAL-SERVICES-BILLING/FINANCIAL-ASSISTANCE-PROGRAM/

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
ALL SELF-PAY PATIENTS RECEIVE A 78% DISCOUNT SO THAT THEY ARE ONLY BILLED FOR 22% OF TOTAL CHARGES. IN ADDITION, FINANCIAL ASSISTANCE WILL BE PROVIDED TO THOSE WHOSE INCOME IS AT OR BELOW THE FPG OF 100%. ADDITIONAL CONSIDERATIONS ARE INSURANCE/COVERAGE STATUS.

PART I, LN 7 COL(F):
THE AMOUNT LISTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $14,119,504 THAT HAS BEEN REMOVED FOR PURPOSES OF CALCULATING PERCENT OF TOTAL EXPENSE ON PART I, LINE 7, COLUMN (F).

PART III, LINE 3:
THE ORGANIZATION ESTIMATES APPROXIMATELY 67.2% OF ITS BAD DEBT WOULD QUALIFY FOR FINANCIAL ASSISTANCE IF PATIENTS WENT THROUGH THE APPLICATION PROCESS. THIS ESTIMATE IS BASED OF PATIENT POPULATION.

PART III, LINE 4:
RECEIVABLES FROM PATIENTS, INSURANCE COMPANIES, AND THIRD-PARTY CONTRACTUAL AGENCIES ARE RECORDED AT REGULAR PATIENT SERVICE CHARGE RATES. A MAJORITY OF THE COMPANY'S PATIENTS ARE INSURED BY CERTAIN THIRD PARTY INSURERS (PRINCIPALLY BLUE CROSS, MEDICARE, AND MEDICAID) BASED ON CONTRACTUAL AGREEMENTS WHICH GENERALLY RESULT IN THE COMPANY COLLECTING LESS THAN THE ESTABLISHED CHARGE RATES. FINAL DETERMINATION OF PAYMENTS UNDER THESE AGREEMENTS IS SUBJECT TO REVIEW BY APPROPRIATE AUTHORITIES. ADEQUATE ALLOWANCES ARE PROVIDED FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS AND OTHER UNCERTAINTIES. CREDIT LOSSES HAVE HISTORICALLY BEEN WITHIN MANAGEMENT'S EXPECTATIONS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBTS IF SUBSEQUENTLY COLLECTED.

PART III, LINE 8:
THE ORGANIZATION USED ITS MEDICARE COST REPORT TO CALCULATE ALLOWABLE COSTS OF CARE RELATED TO MEDICARE FOR PURPOSES OF PART III, LINE 6.

PART III, LINE 9B:
THE ORGANIZATION QUALIFIES PATIENTS FOR ITS CHARITY CARE POLICY AT TIME OF DISCHARGE. DISCOUNTS ON SELF-PAY PATIENTS ARE APPLIED USING A NON-FINANCIAL MEASURE, SO ACCOUNTS IN BAD DEBTS ARE NOT LIKELY ELIGIBILE FOR FURTHER FINANCIAL ASSISTANCE AFTER HAVING THEIR FINAL BILLS ISSUED. THE HOSPITAL PRIMARILY USES A THIRD-PARTY TO HANDLE BAD DEBT COLLECTIONS, AND ROUTINELY REEVALUATES ITS BAD DEBT ACCOUNTS TO DETERMINE PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY.

PART VI, LINE 2:
HOSPITAL PERFORMS A COMMUNITY HEALTH ASSESSMENT EVERY 3 YEARS. INCORPORATING KEY COMMUNITY STAKEHOLDS IN THE PROCESS. HOSPITAL ALSO WORKS CLOSELY WITH PHYSICIAN & PHYSICIAN GROUPS WITHIN KEY COMMITTEES TO DISCUSS SERVICE LINE NEEDS FOR THEIR ASSOCIATED SPECIALTIES. HOSPITAL ALSO RELIES ON VARIOUS DATA POINTS REGARDING KEY DEMOGRAPHIC DATA AND HEALTH NEEDS.

PART VI, LINE 3:
FINANCIAL ASSISTANCE ARE AVAILABLE ON COMPANY WEBSITE, BILLING STATEMENTS, ON-SITE FINANCIAL CONSELOURS AND THEN MEDICIAD ELLIGIBILITY AND SSI/DISSABILITY COUNCELORS.

PART VI, LINE 4:
JACKSON HOSPITAL & CLINIC INC, SERVES THE GREATER RIVER REGION. DUE TO CHALLENGES ASSOCIATED WITH OVERALL EDUCATION, HEALTH LITERACY TRAILS PEERS COMPARED TO OTHER STATES. JACKSON HAS EXPANDED IN SURROUNDING COMMUNITIES TO HAVE A GREATER IMPACT IN IMPROVING HEALTH EDUCATION AND OUTCOMES. CHRONIC CONDITIONS AND COMORBIDITIES ARE HIGH THROUGHOUT THE AREA. JACKSON SERVES A DIVERSE COMMUNITY.

PART VI, LINE 5:
A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, NOR A FAMILY MEMBER OF AN EMPLOYEE OF THE ORGANIZATION. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY TO MOST OF ITS DEPARTMENTS. IN ADDITION, ANY SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO EXPAND HEALTH SERVICES AND SERVICE LINES. HOSPITAL HAS A PHARMACY RESIDENCY PROGRAM AND IS CURRENTLY IN THE PROCESS OF ESTABLISHING A FAMILY PRACTICE RESIDENCY PROGRAM.

PART VI, LINE 6:
THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

PART VI, LINE 7, REPORTS FILED WITH STATES
AL

Operating expenses	$ 309,973,114
Total amount spent on community benefits as % of operating expenses	$ 23,988,001 7.74 %