Community Benefit Insight - Tax-exempt hospital

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Mclaren Bay Region

Bay Regional Medical Center

1900 Columbus Avenue
Bay City, MI 48708

Bed count	387	Medicare provider number	230041	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 381976271

Display data for year:

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

1.98%

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	$ 2,234,241 0.65 %
Medicaid as % of operating expenses	$ 3,418,560 1.00 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 1,123,959 0.33 %
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	$ 9,595,865 2.80 %
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 2022 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 $ 274724487 including grants of $ 106952) (Revenue $ 331112847)
MCLAREN BAY REGION TREATED 12,407 IN-PATIENTS & 206,038 OUT-PATIENTS FOR THE 2021/2022 FISCAL YEAR AND PROVIDED DISEASE DETECTION, PREVENTION, AND COMMUNITY EDUCATIONAL SERVICES. THESE SERVICES WERE PROVIDED WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. MCLAREN BAY REGION PROVIDED CHARITY CARE TO THOSE PATIENTS IN OUR COMMUNITY WHO DID NOT HAVE THE ABILITY TO PAY IN THE AMOUNT OF $1,673,257 FOR THE 2021/2022 FISCAL YEAR. CARDIOLOGY, BEING A SIGNIFICANT PRODUCT LINE, PERFORMED 295 OPEN HEART SURGERIES AND 4,795 CARDIAC CATHERIZATION IN FISCAL YEAR 2022.

Facility Information

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

MCLAREN BAY REGION
PART V, SECTION B, LINE 5: MCLAREN BAY REGION WAS IN CONSULTATION WITH: BAY HEALTH PLAN - A GROUP THAT SERVES THE NEEDS OF THE INDIGENT POPULATION IN BAY CITY; BAY AREA BEHAVIORAL HEALTH - A MENTAL HEALTH OUTPATIENT ORGANIZATION; BAY SPECIAL CARE HOSPITAL - A LONG TERM ACUTE CARE FACILITY; AND BAY COUNTY HEALTH DEPARTMENT. MANY MEETINGS AND FOCUS GROUPS WERE FORMED TO DISCUSS THE ISSUES AND WORK ON PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE HEALTH IMPROVEMENT PLANS AND THE CHNA IMPLEMENTATION AND TIMELINE PLANNING. PLEASE FIND A COPY OF THE CHNA AND IMPLEMENTATION PLAN AT:HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

MCLAREN BAY REGION
PART V, SECTION B, LINE 6A: MCLAREN BAY SPECIAL CARE

MCLAREN BAY REGION
PART V, SECTION B, LINE 11: PLEASE SEE THE CHNA AND IMPLEMENTATION POLICY FOR THE NEEDS THAT WERE IDENTIFIED AT: HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTTHE ORGANIZATION HAS FOCUSED ITS EFFORTS ON THOSE NEEDS THAT IT CAN IMPACT THE MOST. THE OTHER NEEDS IDENTIFIED WILL BE ADDRESSED BY OTHER COMMUNITY SERVICE PROVIDERS.

MCLAREN BAY REGION
PART V, SECTION B, LINE 13B: PRESUMPTIVE FINANCIAL ASSISTANCE MAY BE APPLIED BASED ON THIRD PARTY INFORMATION OR A PRIOR FINANCIAL ASSISTANCE DETERMINATION. DESIGNATED PERSONNEL WILL MAKE REASONABLE EFFORT TO NOTIFY THE INDIVIDUAL OF ASSISTANCE.

PART V, LINE 13A:
FINANCIAL ASSISTANCE GUIDELINES ARE BASED ON 400% OF THE FEDERAL POVERTY GUIDELINES (FPG) PUBLISHED ANNUALLY IN THE FEDERAL REGISTER. CARE IS DISCOUNTED 100% UP TO 400% OF THE FPG. DESIGNATED PERSONNEL WILL ACCESS THE FEDERAL REGISTER AND UPDATE THE FINANCIAL ASSISTANCE GUIDELINES ANNUALLY. THE DISCOUNT IS BASED ON FAMILY SIZE AND ANNUAL INCOME.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
INCOME CRITERIA IS BASED UPON 400% OF THE FEDERAL POVERTY GUIDELINES PER THE FEDERAL REGISTER. COLLECTIONS MAY BE CONSIDERED IF THE PATIENT HAS SUFFICIENT LIQUID ASSETS.

PART I, LINE 6A:
OUR PARENT, MCLAREN HEALTH CARE CORPORATION, PREPARES AN ANNUAL REPORT OF ITS MEMBER HOSPITALS. THIS ANNUAL REPORT IS AVAILABLE ON OUR WEBSITE.

PART I, LINE 7:
A COST-TO-CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. ACTUAL COSTS FROM THE PROVIDERS RECORDS WERE USED FOR LINES 7E THROUGH 7I.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $9,595,865.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY-BUILDING ACTIVITIES ARE DESIGNED AND IMPLEMENTED BASED ON COMMUNITY NEEDS ASSESSMENTS AND INPUT FROM COMMUNITY-BASED ORGANIZATIONS AND OTHER COMMUNITY STAKEHOLDERS, INCLUDING BUSINESS VENDORS, RELIGIOUS ORGANIZATIONS AND POLITICAL LEADERS. EACH ORGANIZATION DEFINES ANNUAL COMMUNITY-BUILDING AND OUTREACH ACTIVITY PLANS. THESE PLANS ARE DESIGNED TO ADDRESS THE SPECIFIC HEALTH PREVENTION, EDUCATION, DIAGNOSIS, TREATMENT AND FOLLOW-UP CARE REQUIREMENTS OF UNIQUE DISEASE, DEMOGRAPHIC AND GEOGRAPHIC COMMUNITIES IDENTIFIED BY ONGOING NEEDS ASSESSMENTS DESCRIBED ABOVE.

PART III, LINE 4:
ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE 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 SIGNIFICANT IMPLICIT PRICE CONCESSIONS 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.

PART III, LINE 8:
THE MEDICARE SURPLUS (SHORTFALL), FROM THE MEDICARE COST REPORT, WAS CALCULATED BY UTILIZING COST ACCOUNTING ACCOUNTING WHEN APPROPRIATE AND AVAILABLE. IN SOME AREAS A COST TO CHARGE METHODOLOGY WAS REQUIRED. SHORTFALLS ARE CONSIDERED TO BE COMMUNITY BENEFIT.

PART III, LINE 9B:
A FORMAL WRITTEN DEBT COLLECTION POLICY IS IN PLACE. THE COLLECTION POLICY WILL ASSESS A PATIENT'S ABILITY TO PAY FOR SERVICES INCLUDING METHODS OF PAYMENTS, ENTITLEMENT PROGRAMS, CHARITY CARE POLICIES, DISCOUNT POLICIES, INQUIRIES OF CREDIT REPORT AND OTHER AVAILABLE INFORMATION RELATIVE TO THE PATIENT'S FINANCIAL SITUATION. THE COLLECTION PROCESS BEGINS AT THE POINT OF SERVICE AND IS COMPLETED WHEN THE BALANCE IS RECONCILED AND MAY INCLUDE USE OF EXTERNAL COLLECTION AGENCIES AND OR ATTORNEY'S.

PART VI, LINE 2:
PRIMARY AND SECONDARY MARKET RESEARCH IS CONDUCTED BY AND THROUGH COMMUNITY-BASED HEALTH COALITIONS, ACADEMIC INSTITUTIONS, THIRD PARTY DATA ANALYTICS ORGANIZATIONS, HEALTH NEEDS ASSESSMENTS AND SURVEYS, HISTORIC HEALTH SERVICES UTILIZATION PATTERNS, DEMOGRAPHIC ANALYSIS AND POPULATION-BASED HEALTH CARE SERVICES UTILIZATION FORECASTS.

PART VI, LINE 3:
AVAILABILITY OF FINANCIAL ASSISTANCE INFORMATION AND EDUCATION IS PROVIDED AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS-OF-SERVICE. INFORMATION AND EDUCATION IS ALSO AVAILABLE THROUGH THE ORGANIZATION'S WEBSITE(S). FINANCIAL AND APPLICATION FORMS ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT POINTS-OF-SERVICE, INCLUDING PROVIDING ASSISTANCE IN COMPLETING THE APPLICATION. THE ORGANIZATION AND ITS SUBSIDIARIES/AFFILIATES ALSO PROVIDE SPECIALLY-TRAINED COUNSELORS TO ASSIST PATIENTS AND REVIEW ELIGIBILITY FOR FEDERAL, STATE AND OTHER GOVERNMENT PROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICAID, DISABILITY, SOCIAL SECURITY, AND ANY OTHER FORMS OF THIRD PARTY PAYMENT.

PART VI, LINE 4:
THE SERVICE AREA OF MCLAREN BAY REGION IS COMPOSED OF 76 ZIP CODES AND IS CENTERED PRINCIPALLY ON THE CITY OF BAY CITY, MICHIGAN IN THE COUNTY OF BAY. THE PRIMARY SERVICE AREA, ACCOUNTING FOR 75% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 8 ZIP CODES AND CAN BE CHARACTERIZED AS LARGELY URBAN IN NATURE. THE SECONDARY SERVICE AREA, ACCOUNTING FOR 25% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 68 ZIP CODES AND CAN BE CHARACTERIZED AS LARGELY RURAL IN NATURE. PRIMARY SERVICE AREA DEMOGRAPHIC DISTRIBUTIONS:AGE DISTRIBUTION0 - 14 17.6%15 - 17 4.0%18 - 24 8.7%25 - 34 12.4%35 - 54 27.5%55 - 64 13.5%65+ 16.3%EDUCATION LEVELLESS THAN HIGH SCHOOL 3.3%SOME HIGH SCHOOL 8.8%HIGH SCHOOL DEGREE 35.2%SOME COLLEGE/ASSOC. DEGREE 33.2 %BACHELOR'S DEGREE OR GREATER 19.5%HOUSEHOLD INCOME DISTRIBUTION<$15K 14.3%$15 - 25K 12.9%$25 - 50K 29.5%$50 - 75K 19.1%$75 - 100K 11.2%OVER $100K 13.0%RACE/ETHNICITYWHITE NON-HISPANIC 91.7%BLACK NON-HISPANIC 1.5%HISPANIC 4.1%ASIAN & PACIFIC IS. NON-HISPANIC 0.5%ALL OTHERS 2.1%

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 5:
THE PARENT ORGANIZATION AND EACH OF ITS SUBSIDIARY/AFFILIATE MEMBERS MAINTAIN A LOCAL COMMUNITY-BASED BOARD WITH POWERS, RESPONSIBILITIES AND ACCOUNTABILITIES FOR THE OVERSIGHT OF THE OPERATION OF THEIR RESPECTIVE ORGANIZATIONS. EACH SUBSIDIARY/AFFILIATE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF ALLOWING ANY PHYSICIAN OR OTHER CARE PROVIDER WITH PROPER CREDENTIALS TO JOIN THE STAFF AND PROVIDE APPROVED CARE. THE ORGANIZATION FUNDS AND MAINTAINS OVER 500 MEDICAL RESIDENCY AND FELLOWSHIP PROGRAMS TO TRAIN FUTURE GENERATIONS OF PHYSICIANS; ORGANIZATION FUNDS, OPERATES AND MAINTAINS NUMEROUS HEALTH CARE EDUCATION PROGRAMS AT THE HIGH SCHOOL, COMMUNITY COLLEGE, UNIVERSITY AND POST-GRADUATE LEVELS OF EDUCATION. THE ORGANIZATION PROVIDES SPONSORSHIP (FINANCIAL AND IN-KIND RESOURCES) SUPPORT TO COMMUNITY-LEVEL ACTIVITIES (HEALTH WALKS AND RACES, FITNESS TRAINING, DISEASE AWARENESS EVENTS, CULTURAL EVENTS AND OTHER HEALTH-RELATED NON-PROFIT ACTIVITIES, EVENTS AND ORGANIZATIONS). THE ORGANIZATION ALSO DIRECTS, FUNDS, SUPPORTS AND PARTICIPATES IN FUNDRAISING ACTIVITIES THAT SUPPORT HEALTH PREVENTION/EDUCATION, DIAGNOSIS AND TREATMENT PROVIDED BY OTHER NON-PROFIT COMMUNITY ORGANIZATIONS.

PART VI, LINE 6:
THE ROLE OF THE PARENT ORGANIZATION IS TO SET THE VISION AND STRATEGIC DIRECTION FOR THE ORGANIZATION AS A WHOLE. THIS INCLUDES THE DEVELOPMENT OF THE ANNUAL STRATEGIC PLAN WHICH DEFINES THE STRATEGIC PRIORITIES FOR THE ORGANIZATION AND ITS MEMBERS, THE METRICS TO BE MEASURED FOR EACH STRATEGIC PROGRAM AND THE BENCHMARK OR TARGET/GOALS FOR EACH METRIC. STRATEGIC PRIORITIES DIRECTLY ADDRESS AND MEASURE (AT A SUBSIDIARY LEVEL) CLINICAL QUALITY AND CLINICAL OUTCOMES; PATIENT, PHYSICIAN, EMPLOYEE AND COMMUNITY SATISFACTION WITH THE ORGANIZATION AND ITS SUBSIDIARY/AFFILIATE MEMBERS; AND DEVELOPMENT OF NEW SERVICES TO IMPROVE ACCESS TO, QUALITY OF, AND COST OF HEALTH SERVICES.THE ROLE OF THE ORGANIZATION'S SUBSIDIARIES/AFFILIATES IS THE DEVELOPMENT AND IMPLEMENTATION OF ANNUAL STRATEGIC AND OPERATIONAL PLANS THAT SUPPORT AND ADVANCE THE STRATEGIC PLAN OF THE PARENT ORGANIZATION. ALL LOCAL PLANS ARE DEVELOPED AND DESIGNED TO REFLECT THE UNIQUE POPULATION-BASED HEALTH CARE NEEDS AND REQUIREMENTS OF THE COMMUNITIES SERVED BY THE SUBSIDIARY/AFFILIATE ORGANIZATION.ALL LOCAL SUBSIDIARIES/AFFILIATES HAVE FULL AUTHORITY AND DECISION-MAKING POWERS TO DEFINE AND EXECUTE THE STRATEGIC AND OPERATIONAL PLANS INTENDED TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITIES THEY SERVE.

Operating expenses	$ 343,122,650
Total amount spent on community benefits as % of operating expenses	$ 6,776,760 1.98 %