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Madison Community Hospital
Madison, SD 57042
| Bed count | 25 | Medicare provider number | 431300 | Member of the Council of Teaching Hospitals | NO | Children's hospital | NO |
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
(as % of total functional expenses)
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.
Operating expenses $ 32,360,165 Total amount spent on community benefits as % of operating expenses$ 2,092,287 6.47 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 205,000 0.63 %Medicaid as % of operating expenses$ 92,046 0.28 %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$ 1,789,848 5.53 %Research as % of operating expenses$ 0 0 %Community health improvement services and community benefit operations*
as % of operating expensesNote: these two community benefit categories are reported together on the Schedule H, part I, line 7e.$ 5,393 0.02 %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$ 2,080,788 6.43 %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$ 199,756 9.60 %- 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:
Reported to credit agency Not available 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.
After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid? NO 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.
If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines? YES 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.
Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute? NO
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
- 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 $ 26128192 including grants of $ 100000) (Revenue $ 33389021) MADISON REGIONAL HEALTH SYSTEM (HOSPITAL) IS A 22-BED ACUTE CARE HOSPITAL LOCATED IN MADISON, SOUTH DAKOTA. FOR THE YEAR ENDED JUNE 30, 2022: ACUTE PATIENT DAYS =1,430; NEWBORN DAYS = 80; SKILLED DAYS =1,924; AND INTERMEDIATE DAYS =18.
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Facility Information
MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: MADISON REGIONAL HEALTH SYSTEM (MRHS) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH ASSISTANCE FROM EIDE BAILLY, LLP, AN ACCOUNTING AND CONSULTING FIRM SPECIALIZING IN FINANCIAL, OPERATIONAL, AND HEALTH-NEED CONSULTING WITH HEALTHCARE ORGANIZATIONS. QUALITATIVE AND QUANTITATIVE INFORMATION FROM LOCAL, STATE, AND FEDERAL SOURCES, AND INPUT FROM PERSONS THAT REPRESENT A BROAD RANGE OF INTERESTS IN THE COMMUNITY, PERSONS WITH PUBLIC HEALTH KNOWLEDGE AND EXPERTISE, AND PERSONS REPRESENTING MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS WAS USED IN DEVELOPING THE REPORT.
MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING THE 2021 TAX YEAR. THE FOLLOWING COMMUNITY HEALTH AREAS WERE IDENTIFIED AND THE FOLLOWING ACTIONS ARE BEING TAKEN BY THE HOSPITAL.1. URGENT CARE/CONVENIENCE CARE2. TELEHEALTH3. LONG-TERM CARE OPTIONSTO MEET THESE NEEDS, WE RE-OPENED OUR URGENT CARE SERVICES AND CONTINUE TO WORK ON TELEHEALTH OPTIONS WITH OUTREACH PROVIDERS AS WELL AS OUR PROVIDERS. WE CONTINUE TO OFFER LONG-TERM CARE OPTIONS, INCLUDING:-CONTINUING TO OFFER HOME HEALTH SERVICES ALONG WITH SWING BED PROGRAMMING THAT INCLUDES SKILLED AND INTERMEDIATE CARE.-CONTINUING TO COLLABORATE WITH BETHEL LUTHERAN HOME, A NURSING HOME IN MADISON, SD THAT OFFERS A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING.-ENHANCING MARKETING EFFORTS AROUND WHAT SERVICES ARE OFFERED AND AVAILABLE IN THE COMMUNITY TO EXPAND THE COMMUNITY'S KNOWLEDGE OF AVAILABLE RESOURCES AND THE PRESENCE OF A FULL CONTINUUM OF SENIOR SERVICES.SOME HEALTH ISSUES OR NEEDS THAT WERE IDENTIFIED THROUGH THE CHNA PROCESS ARE NOT PRIORITIZED AT THIS TIME DUE TO BEING OUTSIDE THE SCOPE/ABILITIES OF MADISON REGIONAL HEALTH SYSTEM AND/OR THE ISSUE IS BEING ADDRESSED BY OTHER COMMUNITY RESOURCES OR ORGANIZATIONS. IN OTHER INSTANCES, THERE ARE ALREADY INITIATIVES IN PLACE AT MRHS TO ADDRESS SOME NEEDS. MRHS INTENDS TO COLLABORATE (WITHIN ITS ABILITY) WITH OTHER ORGANIZATIONS TO ADDRESS AND MAKE PROGESS ON THE FOLLOWING IDENTIFIED NEEDS THAT ARE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY: MENTAL/BEHAVIORAL HEALTH, OBESITY AND RELATED ISSUES, DENTAL CARE ACCESS AND AVAILABILITY, HEART HEALTH, COPING WITH STRESS, DOMESTIC VIOLENCE, AND EDUCATION FOR PROVIDERS WORKING WITH THOSE WITH DEVELOPMENTAL DISABILITES.
MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 13B: HOUSEHOLD SIZE
MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY MAY BE USED IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.
MADISON COMMUNITY HOSPITAL PART V, SECTION B, LINE 24: THE HOSPITAL FINANCIAL ASSISTANCE POLICY DOES NOT COVER ELECTIVE PROCEDURES. THE HOSPITAL MAY HAVE CHARGED FAP ELIGIBLE PATIENTS GROSS CHARGES FOR SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY.
PART V. SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ATHTTPS://MADISONREGIONALHEALTH.ORG/ABOUT-US/#COMMUNITY-HEALTH-NEEDS
PART V. SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND ATHTTPS://MADISONREGIONALHEALTH.ORG/ABOUT-US/#COMMUNITY-HEALTH-NEEDS
PART V. SECTION B, LINE 16A-16C THE FAP, FAP APPLICATIOIN AND FAP PLAIN LANGUAGE SUMMARY ARE AVAILABLE ATHTTPS://MADISONREGIONALHEALTH.ORG/PATIENT-VISITOR-GUIDE/#FINANCIAL-ASSISTANCE
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Supplemental Information
PART I, LINE 3C: PRESUMPTIVE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY MAY BE USED IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.
PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINE 7B AND LINE 7G WERE DETERMINED USING THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY. LINE 7E WAS DETERMINED USING THE GENERAL LEDGER.
PART I, LINE 7G: LINE 7G INCLUDES PROVIDER BASED CLINIC REVENUE OF $4,572,670, AND EXPENSE OF $5,105,416, FOR A NET COMMUNITY BENEFIT OF $532,746.
PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS.
PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2021. THEREFORE 9.6% OF IMPLICIT PRICE CONCESSIONS CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE.
PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS FOUND ON PAGE 11 AND 12 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 06/30/2022.MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.
PART III, LINE 9B: ACCOUNTS THAT MEET THE CRITERIA FOR THE FINANCIAL ASSISTANCE POLICY WILL BE WRITTEN OFF IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS THAT DO NOT MEET THE CRITERIA FOR FINANCIAL ASSISTANCE WILL PROCEED THROUGH THE COLLECTION PROCESS. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT AN ACCOUNT IN COLLECTION BELONGS TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT WILL BE REMOVED FROM COLLECTION AND RETURNED TO THE HOSPITAL FOR RESOLUTION.
PART VI, LINE 2: THE CHNA WAS PERFORMED AND UPDATED IN 2022. WE ALSO WORK WITH LOCAL GOVERNMENT AND ORGANIZATIONS TO STAY ON TOP OF DEVELOPMENTS THAT WILL IMPACT THE FUTURE NEEDS OF HEALTHCARE.
PART VI, LINE 3: A SUMMARY OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE EMERGENCY ROOM OR WAITING ROOMS, POSTED IN THE ADMISSIONS OFFICE, GIVEN TO PATIENTS ON ADMISSION, AND UPON REQUEST. DISCHARGE PLANNING PERSONNEL IN THE BUSINESS OFFICE COUNSEL PATIENTS UPON ADMISSION AND THROUGH THE DISCHARGE PLANNING PROCESS ON MEDICAID, COUNTY WELFARE PROGRAMS, CHARITY CARE, ETC. FINANCIAL ASSISTANCE PROGRAMS ARE DETAILED EITHER IN PERSON OR THROUGH A BROCHURE THAT EXPLAINS THE HOSPITAL'S FINANCIAL ASSISTANCE AND PAYMENT REQUIREMENTS. COVERED VS NON-COVERED CHARGES ARE DISCUSSED WITH THE PATIENT. A PATIENT ASSESSMENT, INCLUDING A DISCUSSION ON FINANCIAL RESPONSIBILITIES, CONCERNS, AND GOVERNMENT PROGRAMS, IS COMPLETED ON EACH INPATIENT BY DISCHARGE PLANNING. A FINANCIAL COUNSELOR MEETS ONE-ON-ONE WITH PATIENTS PRIOR TO DISCHARGE TO GO OVER INSURANCE COVERAGE AND WHAT TO EXPECT ONCE INSURANCE IS PROCESSED.
PART VI, LINE 4: MADISON REGIONAL HEALTH SYSTEM IS THE ONLY HOSPITAL IN THE SERVICE AREA. EIGHT PHYSICIANS AND FOUR PHYSICIAN EXTENDERS PRACTICE IN THE COMMUNITY. THE SERVICE AREA FOR MRHS INCLUDES 14 ZIP CODE COMMUNITIES THAT ARE WITHIN A 2-MILE RADIUS OF THE HOSPITAL. IT INCLUDES ALL OF LAKE COUNTY AND PORTIONS OF BROOKINGS, KINGSBURY, MINER, MOODY, MCCOOK AND MINNEHAHA COUNTIES. TOTAL SERVICE AREA POPULATION IS APPROXIMATELY 32,000. ESTIMATED MEDIAN HOUSEHOLD INCOME IS $62,843 ACCORDING TO THE U.S CENSUS BUREAU.
PART VI, LINE 5: THE GOVERNING BODY OF MRHS IS COMPRISED OF COMMUNITY MEMBERS, NONE OF WHOM ARE EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND FACILITIES. THE HOSPITAL OPERATES AN EMERGENCY ROOM WHICH IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH RESIDENCIES AND INTERNSHIPS FOR NURSING STUDENTS, THERAPY STUDENTS, PHYSICIANS AND PHYSICIAN'S EXTENDERS. THE HOSPITAL PARTICIPATES IN SEVERAL GOVERNMENT SPONSORED HEALTH PROGRAMS, INCLUDING BUT NOT LIMITED TO: MEDICARE, MEDICAID, VA, TRI-CARE, AND ALL-WOMEN-COUNT. THE HOSPITAL OFFERS VOLUNTEER OPPORTUNITIES TO MEMBERS OF THE COMMUNITY.
