Community Benefit Insight - Tax-exempt hospital

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St Francis Hospital Inc

St Francis Hospital, Inc

2122 Manchester Expressway
Columbus, GA 31995

Bed count	376	Medicare provider number	110129	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 580641240

Display data for year:

Community Benefit Spending- 2015
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

1.15%

Spending by Community Benefit Category- 2015
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2015

Additional data

Community Benefit Expenditures: 2015

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	$ 3,612,969 0.88 %
Medicaid as % of operating expenses	$ 847,430 0.21 %
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.	$ 227,209 0.06 %
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: 2015

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	$ 36,822,101 9.02 %
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: 2015

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: 2015

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 $ 337591404 including grants of $ 0) (Revenue $ 359389912)
The hospital is a 292-licensed bed general acute care hospital with a hospital-based 84-licensed bed behavioral health center serving Southwest Georgia and East Central Alabama. St. Francis is home to 300 physicians offering a full range of inpatient, outpatient and emergency room services, including the area's only open heart surgery program. St. Francis continues to reach for the highest standards of quality and safety to offer its patients the best possible care. St. Francis has many areas of expertise:- St. Francis Heart Hospital, the area's only open heart surgery program, provides high quality cardiac care- St. Francis Orthopedic Institute offers outstanding orthopedic care- Top-notch surgical services are performed at St. Francis Center for Surgical Care- St. Francis Spine Center houses pain management and relief from back and neck pain- Women's Health services are provided at St. Francis Women's Hospital- The Bradley Center is St. Francis's mental health care facilityThe hospital's program service revenues are generated predominantly from the provision of inpatient and outpatient services for the year ending December 31, 2015.

Facility Information

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

St Francis Hospital, Inc.
Part V, Section B, Line 3j: The study area for the survey effort is defined as each of the residential ZIP Codes primarily associated with Muscogee County in West Georgia, including 31820, 31829, 31901, 31903, 31904, 31906, 31907 and 31909. To ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random-selection capabilities.The sample design used for this effort consisted of a random sampling of 900 individuals age 18 and older in Muscogee County. All administration of the surveys, data collection and data analysts was conducted by Professional Research Consultants, Inc. (PRC), a nationally recognized healthcare consulting firm.As part of the community health assessment, two focus groups were held on August 16, 2012. The focus group participants included representatives from public health, physicians, other health professionals, social service providers, and other community leaders. A list of recommended participants for the focus groups was provided by St. Francis Hospital and Columbus Regional Healthcare System. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions.

St Francis Hospital, Inc.
Part V, Section B, Line 6a: The Hospital organization conducted its CHNA in partnership with Columbus Regional Healthcare System: The Medical Center, Doctors Hospital and Hughston Hospital.

St Francis Hospital, Inc.
Part V, Section B, Line 7d: St. Francis Hospital provides many community benefit programs that address the health and social determinants of health throughout Muscogee County and the surrounding communities. Muscogee County is fortunate to have a large number of health and social service agencies who work individually and collectively to provide service programs and support for the county residents.

St Francis Hospital, Inc.
Part V, Section B, Line 11: In 2012, St. Francis Hospital reviewed the healthcare needs prepared in partnership with Columbus Regional Healthcare System and identified a number of initiatives for focus. Action plans are in place to address these needs. Other at-risk behavior identified in the CHNA has been communicated to outside social service organizations in order for them to assist in addressing these needs.

St Francis Hospital, Inc.
Part V, Section B, Line 16i: The policy was attached to billing invoices, and the policy was provided, in writing, to patients on admission to the hospital facility.

St Francis Hospital, Inc.
Part V, Section B, Line 20e: All uninsured patients are given a 45% discount off gross charges regardless of their ability to pay.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 6a:
he hospital's community benefit report is reported as part of the combined annual report prepared by St. Francis Hospital. This report is distributed to the community in print and is available on the hospital's website.

Part I, Line 7:
"The cost of Financial Assistance and other Community benefits is reported based on the ratio of cost-to-charges. This ratio was derived from the ""Ratio of Patient Care Cost-to-Charges"" worksheets provided by the IRS."

Part III, Line 2:
Amounts included on Part III line 2 represent the amount of charges considered uncollectible after reasonable attempts to collect and written off to bad debt expense.

Part III, Line 4:
Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an allowance for contractual adjustments. The contractual allowance represents the difference between established billing rates and estimated reimbursement from Medicare, Medicaid and other third party payment programs. Current operations include a provision for bad debts estimated based upon the age of the patient accounts receivable, historical write-offs and recoveries and any unusual circumstances (such as local, regional or national economic conditions) which affect the collectability of receivables, including management's assumptions about conditions it expects to exist and courses of action it expects to take. Additions to the allowance for uncollectible accounts result from the provision for bad debts. Patient accounts written off as uncollectible are deducted from the allowance for uncollectible accounts. Patient service revenue is recorded prior to assessing the patient's ability to pay and as such, the provision for bad debts is recorded as a deduction from patient service revenue, net of contractual adjustments in the accompanying consolidated statements of operations. For receivables associated with self-pay patients, which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill, the Corporation records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the agreed upon rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The Corporation's allowance for doubtful accounts for self-pay patients was 74% and 76% of self-pay accounts receivable at December 31, 2015 and 2014, respectively. The decrease in self-pay allowances for doubtful accounts as a percent of self-pay accounts receivable is due to the Corporation being more proactive in qualifying accounts for charity. The Corporation has not changed its charity care or uninsured discount policies during fiscal years 2015 or 2014.

Part III, Line 8:
Medicare costs on line 5 are from the Medicare cost report and include both direct and indirect costs allocated using the appropriate statistical basis. Amounts on line 6 represent the payments received for the related Medicare costs.

Part III, Line 9b:
Patient accounts receivable balances are written off for patients who qualify for full financial assistance and no further collection efforts are made. For patients who qualify for partial financial assistance, collection procedures follow the same process as other patients who are responsible for unpaid balances. All uninsured patients are offered a self-pay discount of 45% of charges, regardless of their ability to pay.

Part VI, Line 2:
To determine how to best serve the community, we conduct regular needs assessments by seeking inputs from members of the community and through our alliances with other local agencies. Our strategy is to develop and enhance programs and services that meet the changing needs of the community we serve.A formal community health needs assessment was completed late in 2012. This assessment consisted of a systematic, data-driven approach to determining the health status, behaviors and needs of the residents of Muscogee County, Georgia. The goal of the community health assessment was threefold:- To identify needs that if addressed could lead to improved health status, increased life spans, and elevated overall quality of life;- To reduce health disparities; and- To increase accessibility to preventative services for all residents of Muscogee County, Georgia.

Part VI, Line 3:
"Patients who have no insurance, limited coverage and Medicaid patients without supplemental insurance have the opportunity to meet with financial counselors who provide applications for financial assistance for full or partial discounting of their bills and who aid patients in obtaining Medicaid or other coverage. We inform patients about our financial assistance program and assist them in making an application. All uninsured patients are offered a self-pay discount of 45% of charges regardless of their ability to pay.Patient education on the organization's financial assistance program is conducted during pre-registration and through floor visits by business office representatives for those patients who have been identified as possibly qualifying for financial assistance or other programs. The ""Patient Guide"" booklet distributed to all inpatients gives additional information about how we can assist uninsured patients in qualifying for public assistance or our financial assistance program. Patient statements encourage patients to call for information on financial assistance."

Part VI, Line 4:
We are located in Columbus, Georgia and serve a metropolitan population base of approximately 300,000 people. The local Muscogee County service area reports a 2010 population of 189,885 residents consisting of a racial mix made up mainly by: 46.3% White, 45.5% African American and 6.9% Hispanic residents. Our service area is noted to have a significantly higher percentage of chronic disease conditions related to diabetes, heart disease, stroke, and cancer when compared with both state and national levels. These conditions have necessitated the development, operation and maintenance of community-focused services.

Part VI, Line 5:
St. Francis' leadership and its volunteer boards are comprised of business and community leaders, as well as local physicians who bring varied professional and community service experience to these positions. Our emergency department operates 24 hours a day, 7 days a week and is open to all, regardless of their ability to pay.We seek to maximize benefit to the community by utilizing delivery of care models that can most effectively meet the needs of the community (e.g. the Trinity Center for Women offers access to quality prenatal care and counseling to low income women in a newly renovated outpatient clinic). The hospital's medical staff is open to all qualified physicians in the region. For physicians in the region who do not have privileges, a process is available to admit patients throughout hospitalities or other physicians.St. Francis' facilities include the hospital, The Bradley Center, and physician offices that further their exempt purpose by promoting community health in a variety of ways. St. Francis takes a multi-faceted approach to improving the health of its service area, such as: better access, greater capacity, building physician and community partnerships and developing leadership.St. Francis reinvests funds in the community to improve health care services. An example is St. Francis' seniors' program, Primetime Seniors, which is offered free to the public. Members receive access to free health screenings and free seminars presented by physicians and other health care professionals. Funds are used to support outreach efforts, provide medical education to the community, enhance safety, increase capacity and implement new technology to provide the highest quality treatment.

Part VI, Line 7, Reports Filed With States
GA

Operating expenses	$ 408,442,829
Total amount spent on community benefits as % of operating expenses	$ 4,687,608 1.15 %