Community Benefit Insight - Tax-exempt hospital

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Bennett County Hospital And Nursing Home

Bennett County Hospital

102 Major Allen Street
Martin, SD 57551

Bed count	14	Medicare provider number	431314	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 432040599

Display data for year:

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

15.13%

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	$ 1,490,614 13.25 %
Medicaid as % of operating expenses	$ 211,183 1.88 %
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	$ 58,012 0.52 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
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	$ 58,012 0.52 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 58,012 100 %
Other as % of community building expenses	$ 0 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	$ 170,212 1.51 %
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	$ 48,170 28.30 %

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?	NO

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 $ 9457362 including grants of $ 0) (Revenue $ 10799622)
BENNETT COUNTY HOSPITAL AND NURSING HOME IS A CRITICAL ACCESS HOSPITAL LOCATED IN MARTIN, SD. THE ORGANIZATION IS THE ONLY HOSPITAL IN THE COUNTY SERVING APPROXIMATELY 3,400 RESIDENTS. BENNETT COUNTY IS LOCATED BETWEEN INDIAN RESERVATIONS IN A VERY RURAL AREA. BENNETT COUNTY HOSPITAL AND NURSING HOME HAS 14 HOSPITAL BEDS, 3 ER BEDS, AND 50 NURSING BEDS. DURING 2021, THE HOSPITAL WING HAD 184 PATIENT BED DAYS AND 447 SWING BED DAYS. THE NURSING HOME HAD 14,456 RESIDENT DAYS.

Facility Information

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

BENNETT COUNTY HOSPITAL
PART V, SECTION B, LINE 5: WHILE CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT THE HOSPITAL DID TAKE INTO ACCOUNT THE VIEWPOINTS OF AND DATA PROVIDED BY NUMEROUS INDIVIDUALS WHO REPRESENTED THE BROAD INTERESTS AND CULTURAL NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE INDIVIDUALS INCLUDED HOSPITAL PROFESSIONALS, LOCAL, REGIONAL, STATE, AND FEDERAL ANALYSTS, RESIDENTS OF BENNETT COUNTY HOSPITAL'S SERVICE AREA, AND PROFESSIONALS WITH BOTH THE UNDERSTANDING AND KNOWLEDGE, AS WELL AS SPECIAL SKILLS AND EXPERTISE, IN PUBLIC HEALTH. EIDE BAILLY, A NATIONAL NEEDS ASSESSMENT AND CRITICAL ACCESS HOSPITAL CONSULTING FIRM, WAS PAID BY THE NATIONAL RURAL HEALTH ASSOCIATION APPROXIMATELY THE VALUE OF $1 MILLION TO PROVIDE ADDITIONAL ANALYSIS AND INSIGHT INTO THE NEEDS OF THE COMMUNITY AND THE HOSPITAL. THE RESULTS OF THIS SFOA WERE INCLUDED IN THE COMMUNITY HEALTH ASSESSMENT RESULTS. ALL THESE INFORMATION DATA POINTS AS WELL AS CRITICAL INPUT FROM COMMUNITY MEMBERS WERE DEVELOPED USING INDIVIDUAL INTERVIEWS, FOCUS GROUP MEETINGS, NUMEROUS LISTENING SESSIONS, AS WELL AS DATA ANALYTICS FROM AVAILABLE KNOWLEDGE AND DATA.

BENNETT COUNTY HOSPITAL
PART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE VIA ELECTRONIC FORMAT/DELIVERY UPON REQUEST.

BENNETT COUNTY HOSPITAL
PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY, TAKING INTO CONSIDERATION ALL THE INFORMATION DEVELOPED AND ACCUMULATED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT, HAS DEVELOPED A PRIORITIZATION TO ADDRESS THE NEEDS IDENTIFIED:ONE OF THE MAJOR NEEDS IDENTIFIED WAS THE NEED FOR A NEWER FACILITY AND EQUIPMENT. THE FACILITY HAS HIRED AN ARCHITECT AND ENGINEERING FIRM AND HAS APPLIED FOR AND BEEN PROVIDED APPROVAL FOR A USDA RURAL HEALTHCARE FACILITY LOAN, AS WELL AS A COMMUNITY DEVELOPMENT BLOCK GRANT TO FUND THE NEW FACILITY. THE FACILITY HAS ALSO FORMED A NONPROFIT CAPITAL CAMPAIGN SUPPORT FOUNDATION WHICH HAS DEVELOPED MORE THAN $1 MILLION OF FUNDS TO CONTRIBUTE TO THE EFFORT FOR THIS NEW BUILDING. THE FACILITY ALSO SUCCESSFULLY WROTE A GRANT PROPOSAL FOR THE PURCHASE OF A NEW ULTRASOUND MACHINE, A NEW PORTABLE X-RAY MACHINE, TWO NEW AMBULANCES, A UV-LIGHT STERILIZING MACHINE, AS WELL AS OTHER EQUIPMENT. THE FACILITY ALSO HAS ACQUIRED GRANT FUNDING FOR THE PURCHASE OF A NEW COMPUTERIZED TOMOGRAPHY MACHINE AND A NEW ADVANCED LABORATORY ANALYTICS MACHINE.ONE OF THE OTHER MAJOR NEEDS IDENTIFIED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS THE NEED FOR MORE STABLE PROFESSIONAL STAFFING. THE FACILITY IS CURRENTLY DEVELOPING A RURAL HEALTH NETWORK WHICH INCLUDES TWO TRIBALLY OPERATED UNIVERSITIES AND COLLEGES PROVIDING EDUCATION AND TRAINING FOR NURSING AND HEALTHCARE PROFESSIONALS. THE HOSPITAL HAS ALSO INCLUDED THE AREA AIR AMBULANCE SERVICE S A MEMBER OF THIS RURAL HEALTH NETWORK, WHICH WILL FREQUENTLY BRING IN EXPERT EDUCATORS TO TRAIN COMMUNITY MEMBERS AND HOSPITAL STAFF ON HIGHER-LEVEL CARE APPROACHES SUCH AS TRAUMA, OBSTETRIC TRAUMA, ADVANCED CARDIO LIFE SUPPORT (ACLS), ADVANCED TRAUMA LIFE SUPPORT (ATLS), AND BASIC CARDIO LIFE SUPPORT (BCLS).THE FACILITY HAS ALSO HIRED MENTAL HEALTH PROFESSIONALS TO DEVELOP A PROGRAM FOR ADDRESSING MENTAL HEALTH NEEDS, WHICH WERE IDENTIFIED AS PART OF THE OVERALL NEEDS ASSESSMENT.USING A PHASED APPROACH, THESE MAJOR AREAS INCLUDING A NEW BUILDING, NEW EQUIPMENT, NEW TRAINING, NEW NETWORK FOR TRAINING, AND OTHER PROGRAMS, WERE THE MAJOR AREAS THE FACILITY DETERMINED COULD FIRST BE ADDRESSED. OTHER LOWER PRIORITY AREAS ARE NOT BEING ADDRESSED SO THAT THE HIGHEST LEVEL OF NEEDS EVALUATED AND IDENTIFIED WILL BE MET THROUGH CAREFUL UTILIZATION OF AVAILABLE RESOURCES. EXAMPLES OF THESE INCLUDE BETTER-TASTING WATER, LESS EXPENSIVE VEGETABLES AND MEAT, AND BETTER SKIN CARE PRODUCTS IN THE COMMUNITY.

BENNETT COUNTY HOSPITAL
PART V, SECTION B, LINE 20E: THE POLICY IS POSTED IN EMERGENCY ROOMS, WAITING ROOMS, AND IN THE ADMISSION OFFICE IN AN EFFORT TO COMMUNICATE WITH POLICY TO PATIENTS AT THE TIME OF SERVICE.

SCHEDULE H, PART V, SECTION B, LINE 8
THE HOSPITAL LAST ADOPTED AN IMPLEMENTATION STRATEGY IN 2019 FOR THE 2018 CHNA. AN IMPLEMENTATION STRATEGY FOR THE 2021 CHNA WILL BE ADOPTED IN 2022.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7:
COSTING METHOD IS RATIO OF PATIENT COST TO CHARGES AS DETERMINED WITH WORKSHEET 2 IN THE INSTRUCTIONS FOR SCHEDULE H.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 170,212.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE HOSPITAL CURRENTLY DOES NOT ENGAGE IN ANY COMMUNITY BUILDING ACTIVITIES.

PART III, LINE 2:
BENNETT COUNTY HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE.

PART III, LINE 3:
BENNETT COUNTY HOSPITAL ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FAP BY USING US CENSUS BUREAU POVERTY STATISTICS FOR THE AREA SERVED.

PART III, LINE 4:
PATIENT AND RESIDENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT, RESIDENT, AND THIRD-PARTY PAYOR OBLIGATIONS. PAYMENTS OF PATIENT AND RESIDENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM.PATIENT AND RESIDENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 8:
MEDICARE ALLOWABLE COSTS ARE DETERMINED DIRECTLY FROM MEDICARE COST REPORT USING METHODOLOGIES PRESCRIBED BY MEDICARE.

PART III, LINE 9B:
THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS PRIOR TO COLLECTION PRACTICES BEING PERFORMED.

PART VI, LINE 2:
WHILE CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 THE HOSPITAL TOOK INTO ACCOUNT THE VIEWPOINTS OF AND DATA PROVIDED BY NUMEROUS INDIVIDUALS WHO REPRESENTED THE BROAD INTERESTS AND CULTURAL NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE INDIVIDUALS INCLUDED HOSPITAL PROFESSIONALS, LOCAL, REGIONAL, STATE, AND FEDERAL ANALYSTS, RESIDENTS OF BENNETT COUNTY HOSPITAL'S SERVICE AREA, AND PROFESSIONALS WITH BOTH THE UNDERSTANDING AND KNOWLEDGE, AS WELL AS SPECIAL SKILLS AND EXPERTISE, IN PUBLIC HEALTH. EIDE BAILLY, A NATIONAL NEEDS ASSESSMENT AND CRITICAL ACCESS HOSPITAL CONSULTING FIRM, WAS PAID BY THE NATIONAL RURAL HEALTH ASSOCIATION APPROXIMATELY THE VALUE OF $1 MILLION TO PROVIDE ADDITIONAL ANALYSIS AND INSIGHT INTO THE NEEDS OF THE COMMUNITY AND THE HOSPITAL. THE RESULTS OF THIS SFOA WERE INCLUDED IN THE COMMUNITY HEALTH ASSESSMENT RESULTS. ALL THESE INFORMATION DATA POINTS AS WELL AS CRITICAL INPUT FROM COMMUNITY MEMBERS WERE DEVELOPED USING INDIVIDUAL INTERVIEWS, FOCUS GROUP MEETINGS, NUMEROUS LISTENING SESSIONS, AS WELL AS DATA ANALYTICS FROM AVAILABLE KNOWLEDGE AND DATA.ADDITIONALLY, THE BOARD OF DIRECTORS CONSISTS OF MEMBERS OF THE COMMUNITY WITH WHOM THE PUBLIC CAN DISCUSS CONCERNS ABOUT COMMUNITY HEALTH ISSUES.

PART VI, LINE 3:
WE HAVE POSTED OUR CHARITY CARE POLICY ON OUR WEB SITE, WWW.BENNETTCOUNTYHOSPITAL.COM. OUR BILLING STAFF IN THE FACILITY INFORM PATIENTS OF OUR FINANCIAL ASSISTANCE PROGRAM WHEN PATIENTS ARE HAVING DIFFICULTIES IN PAYING FOR THEIR HEALTHCARE. IN ADDITION, WE HAVE POSTED THE POLICY IN NUMEROUS LOCATIONS WITHIN THE FACILITY.

PART VI, LINE 4:
MARTIN IS A COMMUNITY WITH A POPULATION OF APPROXIMATELY 1,100, WITHIN BENNETT COUNTY. THE LOCAL ECONOMY IS LARGELY AGRICULTURALLY BASED. OUR FACILITY IS THE SOLE HOSPITAL FOR BENNETT COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 3,400. BENNETT COUNTY IS SITUATED BETWEEN THE PINE RIDGE AND ROSEBUD INDIAN RESERVATION. BECAUSE OF THIS PROXIMITY, APPROXIMATELY 60% OF THE POPULATION IS NATIVE AMERICAN. ON AVERAGE, APPROXIMATELY 88% OF OUR FACILITY PATIENTS ARE NATIVE AMERICAN. ALTHOUGH PRIMARILY SERVED BY THE INDIAN HEALTH SERVICE (IHS), NATIVE AMERICANS WITHIN MARTIN UTILIZE OUR FACILITY. IN MANY SITUATIONS, OUR FACILITY DOES NOT GET REIMBURSED BY IHS FOR THE CARE PROVIDED TO THEIR BENEFICIARIES. THIS IS A TREMENDOUS FINANCIAL BURDEN IMPOSED UPON US, IN ADDITION TO SERVING OTHER COMMUNITY MEMBERS WHO MAY REQUIRE FINANCIAL ASSISTANCE. IN ADDITION, BENNETT COUNTY AND ITS NEIGHBORING COUNTY (TODD) ARE AMONG THE POOREST COUNTIES IN THE UNITED STATES. 28.3% OF THE BENNETT COUNTY POPULATION HAS AN INCOME LEVEL BELOW 100% OF THE FEDERAL POVERTY LEVEL.

PART VI, LINE 5:
OUR BOARD OF DIRECTORS CONSISTS OF COMMUNITY MEMBERS WHO ARE ACCESSIBLE TO COMMUNITY MEMBERS FOR INPUT INTO SERVICES PROVIDED. EACH YEAR, WE PROVIDE A HEALTH FAIR FOR COMMUNITY MEMBERS. VARIOUS HEALTH INFORMATION TOPICS ARE PROVIDED TO THE COMMUNITY.

PART VI, LINE 7, REPORTS FILED WITH STATES
SD

Operating expenses	$ 11,249,358
Total amount spent on community benefits as % of operating expenses	$ 1,701,797 15.13 %