Community Benefit Insight - Tax-exempt hospital

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Huron Memorial Hospital

Mclaren Thumb Region

1100 South Van Dyke
Bad Axe, MI 48413

Bed count	64	Medicare provider number	231340	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 381474929

Display data for year:

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

7.24%

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

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2021-2021

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	$ 190,009 0.37 %
Medicaid as % of operating expenses	$ 3,560,504 6.87 %
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	$ 2,100,454 4.05 %
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 $ 36780571 including grants of $ 0) (Revenue $ 46086351)
HURON MEDICAL CENTER IS A FULLY LICENSED ACUTE CARE HOSPITAL, WE PROVIDE WOUND CARE SERVICES, OBSTETRICS SERVICES, LOCATED IN A RURAL AREA AND PROVIDES QUALITY HEALTHCARE TO AREA RESIDENTS CLOSE TO HOME. PROVIDING PATIENT CARE: TOTAL PATIENT DAYS = 3,050 AND TOTAL OUTPATIENT REGISTRATIONS = 41,790 FOR ADDITIONAL INFORMATION VISIT WWW.MCLAREN.ORG/THUMBREGION.

Facility Information

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

HURON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 3J: THE COMMUNITY NEEDS ASSESSMENT CONDUCTED FOCUSED ON ASSESSING COMMUNITY HEALTH NEEDS, LOCAL HEALTH RESOURCES, BARRIERS TO CARE, GAPS IN SERVICE AND TRENDS REGARDING HEALTH AND HEALTHY LIFESTYLES.

HURON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: THE FULL CHNA, WHICH INCLUDES THE IMPLEMENTATION STRATEGY CAN BE LOCATED AT THE HOSPITAL'S WEBSITE: HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTCOMMUNITY HEALTH SURVEYS WERE DISTRIBUTED WIDELY DURING THE FALL OF 2021 THROUGHOUT THE SERVICE AREA AT CLINICS, COMMUNITY EVENTS, LOCAL BUSINESS, HOSPITAL EMPLOYEES AND INDIVIDUAL REQUESTS OF COMMUNITY MEMBERS. THE SURVEY WAS AVAILABLE WIDELY IN BOTH PAPER FORMAT AND THROUGH EMAIL.INDIVIDUAL'S PROVIDED INPUT THROUGH THE BEHAVIORAL HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH SURVEY. VULNERABLE POPULATIONS WERE REPRESENTED IN BOTH SURVEYS:1. 780 PEOPLE PARTICIPATED IN THE COMMUNITY SURVEY RELATED TO BEHAVIORAL HEALTH NEEDS. OF THE 750 THAT ANSWERED THE QUESTION, MANY REPRESENTED A VULNERABLE POPULATION: 37% RESPONDENTS HAD A MENTAL HEALTH CONDITION, 23% CARED FOR SOMEONE WITH A MENTAL HEALTH CONDITION, AND 61% HAD A CLOSE FAMILY MEMBER OR FRIEND WITH A CONDITION.2. VULNERABLE POPULATIONS WERE WIDELY REPRESENTED IN THE COMMUNITY HEALTH SURVEY. OF THE 366 INDIVIDUALS FROM THE SERVICE AREA, 47% INDICATED THEY REPRESENTED A VULNERABLE POPULATION.

HURON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH MICHIGAN CENTER FOR RURAL HEALTH, HOSPITAL COUNCIL OF EAST CENTRAL MICHIGAN, AND THUMB RURAL HEALTH NETWORK.

HURON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: THE CHNA WAS USED TO IDENTIFY COMMUNITY NEED AND ASSIST THE HOSPITAL IN PLANNING AND PRIORITIZING ITS COMMUNITY BENEFIT INVOLVEMENTS. FOCUS AREAS1. WORKFORCE DEVELOPMENTA. RECRUITMENTB. RETENTIONC. CUSTOMER SERVICE2. COORDINATION OF SERVICES BETWEEN PROVIDERSPRIORITIES1. MENTAL HEALTH2. AVAILABILITY AND ACCESS TO SERVICES3. PRENATAL CARE-INFANT HEALTH4. CANCER5. CHRONIC DISEASENOT ALL THE NEEDS IDENTIFIED IN THE CHNA WILL BE ADDRESSED DUE TO RESOURCE CONSTRAINTS.

HURON MEMORIAL HOSPITAL
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 ON A 400% 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:
THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE AMOUNTS IN THE LINE 7 TABLE FOR LINES 7A-7D. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN COLUMN F IS $2,100,454.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE HOSPITAL IS THE LARGEST EMPLOYER IN THE COUNTY AND HAS BEEN INVOLVED IN BIKE HELMET SAFETY, DISASTER PLANNING, TRAINING EMERGENCY PERSONNEL WORKING CLOSELY WITH THE FIRE DEPARTMENT, IN ADDITION TO PARTICIPATING IN CAREER DAYS FOR WORKFORCE DEVELOPMENT. THE HOSPITAL ACTIVELY PARTICIPATES IN THE HURON COMMUNITY COLLABORATIVE WHICH PROVIDES AN ONGOING FORUM FOR THE PROMOTION OF INTERAGENCY COMMUNICATION, PLANNING AND COORDINATION RESULTING IN AN ACCESSIBLE, EFFECTIVE AND COMPREHENSIVE HUMAN SERVICES SYSTEM FOCUSING ON EARLY INTERVENTION, PREVENTION AND THE DEVELOPMENT OF NEW PROGRAMS RESPONSIVE TO THE NEEDS OF THE COMMUNITY. THE RELATIONSHIP INCLUDES A COMMITMENT TO MUTUAL RELATIONSHIPS AND GOALS; A JOINTLY DEVELOPED STRUCTURE AND SHARED RESPONSIBILITY; MUTUAL AUTHORITY AND ACCOUNTABILITY FOR SUCCESS AND SHARING OF RESOURCES AND REWARDS.

PART III, LINE 2:
THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX.

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 HOSPITAL CONSIDERS ANY MEDICARE SHORTFALL AS A COMMUNITY BENEFIT DUE TO THE ELDERLY POPULATION IN THE HOSPITAL'S SERVICE AREA. THE MEDICARE COSTS ARE TAKEN FROM THE MEDICARE COST REPORT USING THE REQUIRED MEDICARE COST-TO-CHARGE RATIO METHODOLOGY.

PART III, LINE 9B:
THE COLLECTION PROCESS IS THE SAME FOR ALL PAYERS, WHICH INCLUDES THREE STATEMENT MAILINGS TWENTY-EIGHT DAYS APART, FOLLOWED BY COLLECT LETTER 1 TWENTY-EIGHT DAYS LATER AND COLLECT LETTER 2, 7 DAYS LATER AND MAILED TO GUARANTOR. APPROXIMATELY TWO WEEKS AFTER RECEIPT OF COLLECT LETTER 2 AND NON-PAYMENT OR UNSATISFACTORY PAYMENT ARRANGEMENTS (CONTRACT AMOUNT), THE ACCOUNT IS FLAGGED TO THE FINANCIAL COUNSELORS AS ARE ALL OTHER SELF PAY RECEIVABLES WITH THE SAME COLLECTION EFFORT. MINIMUM COLLECTION CYCLE IS APPROXIMATELY ONE HUNDRED FIFTY DAYS. A BAD DEBT LISTING IS GENERATED FOR REVIEW BY THE FINANCIAL COUNSELOR, WHO DETERMINES UNCOLLECTIBLE ACCOUNTS AND GENERATES A REPORT THAT IS TRANSFERRED TO A COLLECTION AGENCY. THE FINANCIAL COUNSELOR MONITORS THE COLLECTION ACTIVITY ON A REGULAR BASIS.

PART VI, LINE 2:
THE HOSPITAL WAS FOUNDED BY FRANK W. HUBBARD AS A MEMORIAL TO HIS FATHER, OPENED IN 1903 AND WAS CHARTERED WITH THE STATE OF MICHIGAN IN 1906. THE PRIMARY NEED THE HOSPITAL HAS ADDRESSED SINCE IT OPENED IS GEOGRAPHICAL ACCESS TO MEDICAL CARE, ESPECIALLY OBSTETRICS. THE HOSPITAL HAS EVOLVED OVER THE PAST 120 YEARS BY OFFERING SERVICES THE AREA NEEDS INCLUDING OUTPATIENT DIAGNOSTIC AND PROCEDURE SERVICES IN ADDITION TO CARDIOLOGY AND ONCOLOGY SERVICES. MICHIGAN HOSPITAL ASSOCIATION (MHA) OFFERS MARKET INFORMATION AND SHARES REPORTS ABOUT THE NUMBER AND TYPE OF SPECIALTY PHYSICIANS NEEDED IN EACH ZIP CODE FOR OUR MARKET. ONCE ASSESSING THE NEED FOR A SPECIALTY, THE ASSESSMENT IS FURTHER REFINED TO INCLUDE WHAT KIND OF SERVICES AND RESOURCES ARE NEEDED TO SUPPORT THE SPECIALTY PHYSICIAN. WE COORDINATE THE DEMOGRAPHICS OF PATIENTS, COMORBIDITIES, AND SOCIAL NEEDS TO ROUND OUT THE ASSESSMENT.

PART VI, LINE 4:
"THE HURON MEDICAL CENTER IS LOCATED IN BAD AXE, MICHIGAN AND IS THE ONLY FULLY LICENSED ACUTE CARE HOSPITAL IN HURON COUNTY AND THE ONLY HOSPITAL IN THE TRI-COUNTY AREA PROVIDING OBSTETRICAL SERVICES. WE SERVE PATIENTS IN THE HURON, SANILAC AND TUSCOLA COUNTY AREA. BAD AXE IS THE COUNTY SEAT OF AND IS THE LARGEST COMMUNITY IN HURON COUNTY. IN THE MOST RECENT CENSUS DATA, THE POPULATION OF BAD AXE WAS 3,046 AND THE MEDIAN HOUSEHOLD INCOME WAS $44,375 REPRESENTING 64% OF MICHIGAN ESTIMATED PER HOUSEHOLD INCOME. THE ""TIP OF THE THUMB"" IS POPULATED WITH THE FOLLOWING RACIAL MIX: WHITE 92%, HISPANIC 6%, AND TWO OR MORE RACES 2%."

PART VI, LINE 5:
THE HOSPITAL, PHYSICIAN PRACTICES, AND AFTER-HOUR CLINIC LOCATIONS PROVIDE ACCESS TO TIMELY HEALTHCARE SERVICES AND BASES WHERE HEALTH EDUCATIONAL OPPORTUNITIES CAN BE PRESENTED TO THE PUBLIC. IN ADDITION, THE AREA IN WHICH THE FACILITIES ARE LOCATED WORKS WITH THE MARKETING DIRECTOR TO SETUP HEALTH SCREENINGS, SELF-HELP OR EDUCATIONAL PRESENTATIONS AT LOCAL OR COUNTY EVENTS.

PART VI, LINE 6:
HURON MEMORIAL HOSPITAL PROVIDES CARE AND SERVICES TO ALL PATIENTS AND ITS COMMUNITY REGARDLESS OF INSURANCE OR ABILITY TO PAY. HURON MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. HURON MEMORIAL FOUNDATION'S FUNDRAISING ACTIVITIES SUPPORT THE CHARITABLE MISSION OF HURON MEMORIAL HOSPITAL SO THAT IT MAY PROVIDE HEALTH SERVICES TO THE COMMUNITY.

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 3:
THE HOSPITAL HAS A PATIENT FINANCIAL COUNSELOR REPRESENTATIVE FOR BOTH THE HOSPITAL AND THE PHYSICIAN SERVICES WHO INFORM AND EDUCATE PATIENTS AND PERSONS BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS IN ADDITION TO THE HOSPITAL'S CHARITY CARE POLICY, FOLLOWING THE DELIVERY OF CARE. NO FINANCIAL CONVERSATIONS TAKE PLACE UNTIL CARE IS GIVEN. THE HOSPITAL ALSO HAS A COMMUNITY BOARD THAT APPROVES BOTH THE DISCOUNTING AND CHARITY CARE POLICIES. THE HOSPITAL POSTS ITS CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE ADMISSIONS AREA AND IN THE EMERGENCY ROOM. THIS INFORMATION IS ALSO PROVIDED AT ADMISSION, AT DISCHARGE, AND ON PATIENT BILLS AND IS PROVIDED BY THE HOSPITAL'S BILLERS AND FINANCIAL COUNSELORS ON A ROUTINE BASIS.

Operating expenses	$ 51,818,183
Total amount spent on community benefits as % of operating expenses	$ 3,750,513 7.24 %