Community Benefit Insight - Tax-exempt hospital

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Little Company Of Mary Hospital Of Indiana Inc

Memorial Hosp & Health Care Ctr

800 West 9th Street
Jasper, IN 47546

Bed count	123	Medicare provider number	150115	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 350985964

Display data for year:

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

0.87%

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	$ 449,685 0.17 %
Medicaid as % of operating expenses	$ 1,815,078 0.70 %
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.	$ 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	$ 7,571,183 2.90 %
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 $ 213542239 including grants of $ 591972) (Revenue $ 259162558)
GENERAL PRIMARY ACUTE CARE HOSPITAL EXPENSES INCURRED IN PROVIDING EXCELLENT HEALTH CARE SERVICES CONSISTENT WITH THE NEEDS OF THE COMMUNITY. SEE FORM 990, SCHEDULE H FOR ADDITIONAL SERVICES PROVIDED TO THE COMMUNITY.

Facility Information

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

MEMORIAL HOSPITAL & HEALTH CARE CENTER
PART V, SECTION B, LINE 5: A SERIES OF FOCUS GROUP AND ADVISORY COUNCIL MEETINGS WERE CONDUCTED TO PROVIDE AN OPPORTUNITY AND FORUM FOR COMMUNITY REPRESENTATIVES TO PARTICIPATE IN IDENTIFYING HEALTH NEEDS. THERE WERE 156 PEOPLE THAT PARTICIPATED IN THE FOCUS GROUP FEEDBACK PROCESS FOR THE 2020 CHNA. THE ADVISORY COUNCILS WERE DEVELOPED IN 2014 AS A WAY FOR THE HOSPITAL TO STAY CONNECTED WITH EACH COUNTY OUTSIDE OF DUBOIS COUNTY AND MEET ON A CONTINUED BASIS TO UPDATE THE HOSPITAL ON COUNTY NEEDS.

MEMORIAL HOSPITAL & HEALTH CARE CENTER
PART V, SECTION B, LINE 7D: THE MOST CURRENT TWO COMMUNITY HEALTH NEEDS ASSESSMENTS ARE AVAILABLE ON THE HOSPITAL'S MAIN WEBPAGE LABELED COMMUNITY NEEDS.

MEMORIAL HOSPITAL & HEALTH CARE CENTER
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

MEMORIAL HOSPITAL & HEALTH CARE CENTER
PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY FOR DECEASED AND INDIVIDUALS IN HOMELESS SITUATIONS.

MEMORIAL HOSPITAL & HEALTH CARE CENTER
PART V, SECTION B, LINE 24: GROSS CHARGES FOR NON-MEDICALLY NECESSARY SERVICES (ELECTIVE SERVICES) INCLUDING COSMETIC, SURGICAL WEIGHT LOSS, EXPERIMENTAL (NON-FDA APPROVED DEVICES) PROCEDURES, SPECIALTY REPLACEMENT LENSES, HEARING AIDS, SERVICES DENIED BY INSURANCE FOR NO PRIOR AUTHORIZATION OR NON-EMERGENCY SERVICES PROVIDED AS A RESULT OF BEING OUT-OF-NETWORK ARE NOT ELIGIBLE FOR DISCOUNTED CHARGES OR FINANCIAL ASSISTANCE.

MEMORIAL HOSPITAL & HEALTH CARE CENTER:
SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.MHHCC.ORG/COMMUNITY-NEEDS-ASSESSMENTS/

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
A PATIENT MAY QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE IF THE PATIENT'S HOUSEHOLD INCOME IS BETWEEN 200% AND 400% OF THE FEDERAL POVERTY GUIDELINES. PRESUMPTIVE ELIGIBILITY FOR FREE CARE WITH REQUIRED VERIFICATION IS AVAILABLE FOR DECEASED INDIVIDUALS WITH NO ESTATE AND NO SURVIVING SPOUSE; AND, FOR INDIVIDUALS IN HOMELESS SITUATIONS RECEIVING ASSISTANCE FROM SUPPORTIVE SERVICES SUCH AS GOVERNMENTAL, RELIGIOUS OR COMMUNITY SERVICES.

PART I, LINE 7:
MEMORIAL HOSPITAL AND HEALTH CARE CENTER CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO- HARGES. OTHER BENEFIT AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM.

PART I, LINE 7G:
THE ORGANIZATION DOES NOT PROVIDE ANY SUBSIDIZED HEALTH SERVICES ATTRIBUTABLE TO PHYSICIAN CLINICS.

PART III, LINE 2:
MEMORIAL HOSPITAL AND HEALTH CARE'S ANALYSIS AND ASSESSMENT OF THE BAD DEBT EXPENSE IS BASED ON THE EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.

PART III, LINE 3:
PART III, SECTION A. BAD DEBT EXPENSE CONSIDERED COMMUNITY BENEFIT: NO OTHER BAD DEBT AMOUNTS HAVE BEEN INCLUDED AS COMMUNITY BENEFIT. THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY AND EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON, THE ORGANIZATION BELIEVES IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.

PART III, LINE 4:
"FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: SEE PAGE 15 OF THE AUDITED FINANCIAL STATEMENTS FOOTNOTE 3 UNDER HEADING ""PATIENT SERVICE REVENUE"""

PART III, LINE 8:
THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2022: HOSPITAL STATEMENT OF REIMBURSABLE COST.

PART III, LINE 9B:
THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY INCLUDES PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED DURING THE FOLLOW-UP PERIOD AFTER A PATIENT IS DISCHARGED AND INCLUDES SPECIFIC INSTRUCTIONS FOR SELF-PAY WHO MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE.

PART VI, LINE 2:
NEEDS ASSESSED: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED EVERY THREE YEARS. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES WITH HOSPITAL COMMITTEES DEVELOPING STRATEGIC PLANS FOR THE HOSPITAL TO PROVIDE QUALITY CARE TO THE COMMUNITY MEMBERS. ADDITIONALLY, IN 2014, THE HOSPITAL IMPLEMENTED ADVISORY COUNCILS WITH THE ADJACENT COUNTIES TO DUBOIS COUNTY, INDIANA, AND MANAGEMENT COLLABORATES AND OBTAINS ONGOING FEEDBACK FOR NEEDED ASSISTANCE WITH THESE COUNCILS. THE COUNCIL'S PARTICIPANTS INCLUDE ECONOMIC DEVELOPMENT DIRECTORS, COUNTY HEALTH NURSE, CHAMBER OF COMMERCE LEADERS, EDUCATORS, EXECUTIVES, PASTORS, EMS, SHERIFFS, BUSINESS OWNERS, AND OTHER HEALTH CARE ORGANIZATION LEADERS.

PART VI, LINE 3:
"PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:APPROPRIATE SIGNAGE IS VISIBLE IN THE HOSPITAL AND ALL HOSPITAL-OWNED FACILITIES, SPECIFICALLY IN PATIENT ACCESS AREAS, CREATING AWARENESS FOR THE FINANCIAL ASSISTANCE PROGRAM AND THE FINANCIAL ASSISTANCE THAT IS AVAILABLE. THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY (COLLECTIVELY THE ""FAP PACKET"") ARE AVAILABLE FOR DOWNLOAD AT THE HOSPITAL'S WEBSITE PROVIDED IN SCH H, PART V. THE FAP PACKET CAN BE OBTAINED FREE OF CHARGE FROM THE HOSPITAL'S MAIN REGISTRATION DESK, THE REGISTRATION AREA OF THE EMERGENCY ROOM, OR THE CASHIER/FINANCIAL COUNSELOR'S OFFICE. REQUESTS FOR THE FAP PACKET CAN BE MADE VIA EMAILING FINANCIALASSISTANCE@MHHCC.ORG OR BY CALLING 812-996-0413."

PART VI, LINE 4:
DESCRIPTION OF COMMUNITY:AS A REGIONAL HEALTH CENTER, THE STAFF PROVIDES A COMPREHENSIVE RANGE OF MEDICAL CARE FOR RESIDENTS OF DUBOIS AND SURROUNDING COUNTIES WITH A POPULATION OF APPROXIMATELY 168,000 WITH AVERAGE HOUSEHOLDS RANGING BETWEEN 5,000 TO 16,200 FOR THE COUNTIES. THE UNEMPLOYMENT RATE HAS BEEN BETWEEN 3.1 AND 4.4 AND PERSONAL PER CAPITAL INCOME RANGES BETWEEN $36,000 AND $51,000. THE POVERTY RATE RANGES FROM 7.6 TO 11.1. MORE THAN 80% OF THE ADULTS HAVE HIGH SCHOOL DIPLOMAS AND OVER 10% HAVE BACHELOR'S DEGREES. IN DUBOIS COUNTY THE PERCENT IS HIGHER WITH 18.7% OF ADULTS AGED 25 AND OLDER HAVING BACHELOR'S DEGREAS OR MORE EDUCATION. LESS THAN 7% OF THE POPULATION IS REPORTED AS HISPANIC.

PART VI, LINE 5:
OTHER COMMUNITY HEALTH PROMOTION:THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. ANY SURPLUS FUNDS ARE APPLIED DIRECTLY OR INDIRECTLY TO IMPROVE PATIENT CARE SERVICES. ALSO, THE ORGANIZATION OPERATES UNDER THE PREMISE OF AN OPEN MEDICAL STAFF WITH REGARD TO QUALIFIED PHYSICIANS IN THE 9 COUNTY COMMUNITY IT SERVES, HOWEVER IT DOES NOT ACTIVELY PURSUE THOSE PHYSICIANS WHO HAVE NOT APPROACHED THE ORGANIZATION REGARDING THESE PRIVILEGES.

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

PART VI, LINE 7, REPORTS FILED WITH STATES
IN

Operating expenses	$ 261,112,324
Total amount spent on community benefits as % of operating expenses	$ 2,264,763 0.87 %