Community Benefit Insight - Tax-exempt hospital

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Logan Health - Conrad

Logan Health Conrad

805 Sunset Blvd
Conrad, MT 59425

Bed count	20	Medicare provider number	271324	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 810232406

Display data for year:

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

18.88%

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	$ 9,000 0.05 %
Medicaid as % of operating expenses	$ 222,440 1.32 %
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	$ 2,944,195 17.50 %
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	$ 314,963 1.87 %
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	$ 58,268 18.50 %

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 $ 10039073 including grants of $ 0) (Revenue $ 14772172)
Logan Health - Conrad (LHC) is a 25-bed critical access hospital. LHC provided 69 inpatient days and 737 swing bed patient days along with a 24-hour emergency room that accounted for 1460 visits for the year. Outpatient services such as lab, x-ray, physical and occupational therapy, wellness center, surgery, ambulance, cardiac rehab, DME, home health, speech therapy, sleep lab and respiratory therapy were provided to members of our rural community so they could receive the services they needed close to home. The services are essential for the survival of our community.LHC maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone for services provided under the facility's charity care policy was $41,105. LHC provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient and resident service revenue.

4B (Expenses $ 2430767 including grants of $ 0) (Revenue $ 3616138)
Logan Health Care Center is a 59-bed nursing home offering 24-hour care and nursing services provided by licensed, certified and compassionate staff members. The facility had 14,756 total patient days. Specialized services are also available including those offered by a physical therapist, occupational therapist, speech therapist, and medical social worker. The Care Center has a remarkable life enrichment program that offers activities 7 days a week to include exercise, socials, games, theme parties, pets, gardening, cooking, live music, crafts and outings.The Center has a 14-bed Special Care Unit designated for residents with pervasive memory loss and confusion, providing an extra touch of attention and supervision.

4C (Expenses $ 1407513 including grants of $ 0) (Revenue $ 1235505)
Logan Health Rural Health Clinic is a Family Practice Rural Health Clinic dedicated to providing and coordinating comprehensive services to the entire family. Our physicians are Board Certified Family Practitioners. Boarded Family Practice Physicians must complete an additional three years of specialized training above and beyond that of medical school. Family Practitioners are trained in all avenues of medicine, so they can provide a full range of care. LHRHC Physician Assistants are licensed by the State of Montana and specialize in Family Medicine and Urgent Care. Our Providers promote healthy lifestyles and continually strengthen the relationship between the clinic and community, with excellent, timely, and compassionate patient care. The Clinic has 1 physician, 1 physician assistant, and 2 nurse practitioners who provided 4,371 total clinic visits including 272 extended care visits and 144 swing bed visits.

Facility Information

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

Logan Health - Conrad
Part V, Section B, Line 5: We conducted two meetings with a 14-person steering committee which included public health, health care providers, commissioners, business owners, parents, farmers, and many other persons from the community. We sent out a random survey to all areas of our patient population and had a high response rate. We conducted 4 focus groups with persons of all age groups and demographics throughout the community. Other input was accepted via email.In addition to the survey process, LHC continues to collaborate with community partners on the implementation of the CHNA. LHC works closely with Pondera Healthcare Foundation and Pondera County Health department. Staff from LHC also serve on DUI Taskforce, Mental Health Advisory Board and Pondera County Health board which further integrates LHC with the community and helps with understanding the needs of the community. LHC also collaborates regionally with other CAH in projects related to cardiac disease/stroke and patient care transitions to promote access to healthcare and promote wellness. LHC utilizes feedback received from surveys conducted at RHC, Home Health, DME, Rehab services and HCAHPS to explore opportunities to improve healthcare delivery

Logan Health - Conrad
Part V, Section B, Line 7d: The CHNA report and Implementation strategy are available at https://www.logan.org/health/about/community-health-needs-assessment.

Logan Health - Conrad
Part V, Section B, Line 11: In the most recent CHNA, the following needs were identified that will be addressed:1) Improve access to health and wellness2) Promote and explore opportunities to expand senior services 3) Improve access to health care servicesDue to financial restraints and space limitation, we will not be expanding worksite wellness.Due to the PHE related to COVID-19 and outbreak status the facility continued to experience challenges with delivery of healthcare in all venues due to restrictions. In an effort to continue to reach our goal to improve access to health and wellness the facility continued with increased presence on social media and local radio station to provide health and wellness updates. Additionally, the RHC continued to utilize the use of Telehealth to address the healthcare needs of the community and access to specialists. Our community outreach programs were limited based on community outbreak status but we were able to host the annual Fun Run during the community Whoop-up event and participated in National Night Out. The biggest growth opportunity for the facility was the partnership with the Conrad School District in providing a school nurse to increase education, wellness and mental/behavioral health awareness. Our RHC continued with the chronic disease management and mental health grant. In 2021 the hospital partnered with Logan Health and became Logan Health-Conrad which will provide additional opportunities to our community to improve access to care.LHC Marketing specialist has promoted services provided at LHC via various social media platforms and has partnered with our community partners on promoting health and wellness. LHC RHC continues to work with specialty providers including Pulmonologist, Cardiologist and Oncology and expanded access to telehealth. The RHC was able to bring in an Orthopedic provider monthly as an additional specialist. The addition of MRI services weekly at LHC helped enhance services for the community. One of our objectives was to increase women's health services at the RHC which was met with the recruitment of a FNP in 2019. The Opioid and Mental Health Grant which is being well utilized at the RHC with positive patient outcomes continued to be utilized in 2021. The RHC implemented a Chronic Disease Management program in 2020 which will further promote health and wellness. During the PHE even with restrictions for community events the facility was able to continue promoting health and wellness through increased marketing using different platforms.

Logan Health - Conrad
Part V, Section B, Line 16j: Patients are informed about their eligibility for financial assistance during conversations at registration and during follow-up on outstanding account balances. Information regarding financial assistance and applications are available in the Patient Financial Services department. The financial assistance application is also available on our website. We also have partnered with the Medical Advocacy Services for Healthcare, Inc. (MASH) program. They contact our private pay patients to see if they might qualify for state funded programs and help them complete FAP if they don't qualify for state programs.

Logan Health - Conrad
Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures.

Part V, Line 16a-16c
https://www.logan.org/health/locations/logan-health-conrad/billing-and-payments

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7:
Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. The cost for medicaid and subsidized health services was determined using the Medicare Cost Report interim reports.

Part I, Line 7g:
Line 7g subsidized health services includes costs of $1,716,680 from a rural health clinic.

Part III, Line 2:
The amount reported on line 2 represents implicit price concessions. LHC determines its estimate of implicit price concessions based on its historical collection experience with this class of patients and residents.

Part III, Line 3:
LHC estimates that the percentage of implicit price concessions attributable to patients eligible under the financial assistance policy is based on the percentage of the population that is below the federal poverty guidelines. In 2021 the percentage of the population that is below the federal poverty guidelines is 18.5%.

Part III, Line 4:
There was no audit for the December 31, 2021 year end.

Part III, Line 8:
Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.The Medicare shortfall, if any, represents a cost absorbed by the hospital as a result of providing care to Medicare patients. The cost of providing this benefit to the community should be reported as such.

Part III, Line 9b:
Patients must complete a financial assistance application to be considered for charity care. Those patients known to qualify for financial assistance or that have contacted the business office and are in the process of completing an application or setting up a payment schedule will not receive additional collection notices. Patient accounts are not sent to collections until 120 days from the date of the first invoice for the service. If a patient applies for financial assistance within the next 120 days all collection actions will cease.

Part VI, Line 2:
LHC continued to utilize social media platforms when necessary to participate in the Pondera County Health Board, DUI Taskforce and Pondera County Health Department Coalition. We continued to provide annual lab work at a discounted rate during patient's birthday month outside of the Health Fair to promote wellness. The facility continued to use survey platforms to provide feedback on services provided and opportunities to improve healthcare delivery to the community in our RHC, Rehab, Home Health, Durable Medical Equipment, ER and Acute.

Part VI, Line 3:
Information about financial assistance is available in admission areas, patients are informed of financial assistance as part of the intake process, financial assistance contact information is printed on patient bills, and patients are informed of financial assistance as part of the follow-up process if patient is unable to make a payment.

Part VI, Line 4:
Logan Health - Conrad serves the population of Pondera County, Montana. Per the US Census Bureau, the population of Pondera County in 2021 was 5,994 and is considered rural. The median household income for 2016-2020 was $54,235 in which 18.5% of the population was below the poverty level. The racial makeup consists of 82% white, 14% American Indian or Alaska Native with the remainder being other races. The largest income producing segment of Pondera County is agriculture. Healthcare, including Logan Health - Conrad is the major employer in the county, with small business wholesale & retail trade, construction and accommodation/food services being the other majority of employers. The nearest hospital is Logan Health - Shelby, a 20-bed acute care hospital located in Shelby, MT approximately 27 miles north of Conrad, MT.

Part VI, Line 5:
The Board of Directors is comprised of community members throughout Pondera County and all board meetings are open to the public. Surpluses of cash, when available, are invested back into the Hospital for equipment purchases and wage considerations. Logan Health Conrad extends medical staff privileges to all qualified physicians in the community.Logan Health Conrad operates an emergency room available to all regardless of ability to pay, 20 acute care beds for hospital stays, surgery center, 59 bed extended care center, dementia care unit, rural health clinic, wellness center, cardiac rehab, home health agency, physical therapy, occupation therapy, speech therapy, cardio pulmonary rehab, and DME and numerous other services to meet the communities daily and long-term health care needs. Logan Health Conrad Care Center has utilized volunteers and community members in our facility; however, for 2021 that continued to be limited due to visitor restrictions and outbreak status. LHC continues to partner with MSU for Senior nursing students to complete their leadership training at LHC and RUOP students along with students who wish to shadow healthcare workers.LHC has continued to provide Basic Life Support and First Aid training to community members including the School District, Law Enforcement and Daycare providers.LHC also trains for ACLS and PALS and invites healthcare professionals from regional communities.

Operating expenses	$ 16,819,272
Total amount spent on community benefits as % of operating expenses	$ 3,175,635 18.88 %