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Alamance Regional Medical Center Albemarle Hospital Alleghany Memorial Hospital Angel Medical Center Annie Penn Hospital Anson Community Hospital Ashe Memorial Hospital, Inc. Beaufort County Medical Center Bertie Memorial Hospital Betsy Johnson Regional Hospital Blowing Rock Hospital Blue Ridge Regional Hospital Broughton Hospital Brunswick Community Hospital Brynn Marr Behavioral Healthcare System Caldwell Memorial Hospital, Inc. Cape Fear Valley - Bladen County Hospital Cape Fear Valley Health System CarePartners Health Services CarolinaEast Health System Carolina Medical Center Carolina Medical Center - Lincoln Carolina Medical Center - Mercy Carolina Medical Center - NorthEast Carolina Medical Center - Pineville Carolina Medical Center - Union Carolina Medical Center - University Carolinas Rehabilitation Carteret County General Hospital Catawba Valley Medical Center Central Carolina Hospital Central Regional Hospital Charles A Cannon, Jr. Memorial Hospital Charles George Department of Veterans Affairs Medical Center Asheville Chatham Hospital Cherokee Indian Hospital Cherry Hospital Chowan Hospital Cleveland Regional Medical Center Coastal Plain Hospital Columbus Regional Healthcare System Davie County Hospital Davis Regional Medical Center Department of Veterans Affairs Medical Center Durham Duke Health Raleigh Hospital Duke University Hospital Duplin General Hospital, Inc. Durham Regional Hospital FirstHealth Montgomery Memorial Hospital FirstHealth Moore Regional Hospital FirstHealth Richmond Memorial Hospital Forsyth Medical Center Franklin Regional Medical Center Frye Regional Medical Center Gaston Memorial Hospital, Inc. Grace Hospital Granville Health System Halifax Regional Medical Center Harris Regional Hospital Haywood Regional Medical Center Heritage Hospital High Point Regional Health System Highland-Cashiers Hospital Holly Hill Hospital Hugh Chatham Memorial Hospital Iredell Memorial Hospital, Inc. J. Arthur Dosher Memorial Hospital John Umstead Hospital Johnston Medical Center Kings Mountain Hospital, Inc. Lake Norman Regional Medical Center Lenoir Memorial Hospital Lexington Memorial Hospital, Inc. LifeCare Hospitals of North Carolina Margaret R. Pardee Memorial Hospital Maria Parham Medical Center Martin General Hospital McDowell Hospital Medical Park Hospital Mission Hospitals Morehead Memorial Hospital Moses Cone Health System Murphy Medical Center, Inc. Nash Health Care Systems New Hanover Regional Medical Center North Carolina Baptist Hospital North Carolina Specialty Hospital Northern Hospital of Surry County Onslow Memorial Hospital Our Community Hospital Outer Banks Hospital Park Ridge Hospital Pender Memorial Hospital Person Memorial Hospital Pitt County Memorial Hospital, Inc. Presbyterian Healthcare Presbyterian Hospital Huntersville Presbyterian Hospital Matthews Presbyterian Orthopaedic Hospital Pungo District Hospital Corporation Randolph Hospital Rex Healthcare Roanoke-Chowan Hospital Rowan Regional Medical Center Rutherford Hospital, Inc. Sampson Regional Medical Center Sandhills Regional Medical Center Scotland Health Care System Select Specialty Hospital Durham Select Specialty Hospital Winston-Salem Southeastern Regional Medical Center St. Luke’s Hospital Stanly Regional Medical Center Stokes-Reynolds Memorial Hospital, Inc. Swain County Hospital Thomasville Medical Center Transylvania Community Hospital UNC Hospitals Valdese Hospital WakeMed WakeMed Cary Hospital WakeMed Fuquay-Varina WakeMed Zebulon/Wendell Washington County Hospital Watauga Medical Center Wayne Memorial Hospital Wilkes Regional Medical Center Wilson Medical Center Yadkin Valley Community Hospital

Hospitals Eager to Help in the Assessment and Hospitals Eager to Help in the Assessment and Provision of Community Health NeedsProvision of Community Health Needs

Sarah Broome, PhD, Director of Economic ResearchSarah Broome, PhD, Director of Economic Research

When Did Community Benefit Start?When Did Community Benefit Start?

Why Do Hospitals Measure Them?Why Do Hospitals Measure Them?

What Counts as a Community Benefit?What Counts as a Community Benefit?

How Big ($) are these Categories?How Big ($) are these Categories?

Where Is the Public Health Dept. Overlap?Where Is the Public Health Dept. Overlap?

What Impact Will Healthcare Reform Have on What Impact Will Healthcare Reform Have on Community Benefits?Community Benefits?

Does Your Hospital File a Community Benefit Does Your Hospital File a Community Benefit Report with the IRS?Report with the IRS?

Nonprofit hospitals fall under 501(c)(3) “charitable Nonprofit hospitals fall under 501(c)(3) “charitable

purpose” tax exemptionpurpose” tax exemption

1956 IRS Revenue Ruling 56-185: “Free care” standard1956 IRS Revenue Ruling 56-185: “Free care” standard• Organized as nonprofit to care for sickOrganized as nonprofit to care for sick• Maintain open staff Maintain open staff • No private inurementNo private inurement•Serve those unable to pay to the extent of the Serve those unable to pay to the extent of the hospital’s financial abilityhospital’s financial ability

501(c)(3) hospitals file IRS Form 990 each year.501(c)(3) hospitals file IRS Form 990 each year.

““Provide as much free care as you can” = ambiguousProvide as much free care as you can” = ambiguous

New ruling: Hospital is tax-exempt if:New ruling: Hospital is tax-exempt if:

• Full-time E.R. open to all, regardless of ability to payFull-time E.R. open to all, regardless of ability to pay

• Care provided to everyone who can pay or on Care provided to everyone who can pay or on Medicare/MedicaidMedicare/Medicaid

• Community board; open medical staff; and use surplus Community board; open medical staff; and use surplus for building, improve care, medical education, etc.for building, improve care, medical education, etc.

The North Carolina Medical Care CommissionThe North Carolina Medical Care Commission• Is a state commissionIs a state commission• Issues tax-exempt revenue bonds to finance Issues tax-exempt revenue bonds to finance

construction and equipment projects for nonprofit and construction and equipment projects for nonprofit and public hospitals…(usually for a cheaper rate than the public hospitals…(usually for a cheaper rate than the private market).private market).

• Collects annual information, mostly financial reports, Collects annual information, mostly financial reports, from those holding an MCC bond. from those holding an MCC bond. Since 2001 annual Since 2001 annual reports have required community benefits reports.reports have required community benefits reports.

Public has access to any report filed with the MCC.Public has access to any report filed with the MCC.

Revenue rulings tie Community Benefits to Revenue rulings tie Community Benefits to

Nonprofit Status, which affects tax coffersNonprofit Status, which affects tax coffers

• National attention was growing.National attention was growing.• NCHA members were asking for a common NCHA members were asking for a common

definition for benchmarking purposes.definition for benchmarking purposes.• The press was asking for it as they compared The press was asking for it as they compared

individual hospitals’ public reports.individual hospitals’ public reports.• The Medical Care Commission asked us to help them The Medical Care Commission asked us to help them

with their reporting requirement.with their reporting requirement.• North Carolina’s State Fiscal Research had started North Carolina’s State Fiscal Research had started

“measuring” it and publishing results.“measuring” it and publishing results.All of these prompted the NCHA Board to direct All of these prompted the NCHA Board to direct

NCHA action.NCHA action.

A defendable community benefit report that can A defendable community benefit report that can be used in multiple settings:be used in multiple settings:

• The The Medical Care Commission Medical Care Commission required required Hospital Community Benefits Report,Hospital Community Benefits Report,

• Hospital IRS 990 form,Hospital IRS 990 form,

• NCHA’s advocacy efforts,NCHA’s advocacy efforts,

• Hospital press releases and public reports,Hospital press releases and public reports,

• And, anywhere elseAnd, anywhere else

Then, in 2008, IRS re-wrote their form…Then, in 2008, IRS re-wrote their form…

In response to Grassley’s pressure, the IRS adds In response to Grassley’s pressure, the IRS adds “Schedule H” to Form 990 (“H” is for hospital). “Schedule H” to Form 990 (“H” is for hospital).

•Their definition of what counts as Community Their definition of what counts as Community Benefits provided by hospitalsBenefits provided by hospitals

• Not exactly the same as everyone else’s.Not exactly the same as everyone else’s.

•Will not produce comparable reports. Estimates Will not produce comparable reports. Estimates will be sensitive to:will be sensitive to:• Costing methodology choice.

• Legal definition of a hospital.

Measured in hospital Measured in hospital costscosts (not charges): (not charges):

• Charity Care Costs, Charity Care Costs, • Medicaid Losses, Medicaid Losses, • Other Means-Tested Government Program Losses, Other Means-Tested Government Program Losses, • Medicare Losses, Medicare Losses, ……

• Community Health Improvement Services & Community Health Improvement Services & Community Benefit Operations,Community Benefit Operations,

• Losses on Health Professions Education,Losses on Health Professions Education,• Subsidized Health Services ,Subsidized Health Services ,• Research Costs,Research Costs,• Cash and In-Kind Contributions to Community Cash and In-Kind Contributions to Community

Groups,Groups, and and• Community Building ActivitiesCommunity Building Activities

Bad Debt CostsBad Debt Costs

• Health-related activities Health-related activities

• That do not generate a bill and That do not generate a bill and

• That target the That target the community's healthcommunity's health as a as a whole. whole.

These include health fairs, public screenings, These include health fairs, public screenings, and babysitting training. and babysitting training.

They do not include any activities that could be They do not include any activities that could be interpreted as marketing-related. interpreted as marketing-related.

• Direct financial contributions or in-kind Direct financial contributions or in-kind donations of supplies, equipment or staff time donations of supplies, equipment or staff time to not-for-profit or other government entities to not-for-profit or other government entities that provide Community Benefits. that provide Community Benefits.

• Examples include checks given to SAFE Kids, Examples include checks given to SAFE Kids, to clinics and matching funds to not-for-profit to clinics and matching funds to not-for-profit groups. groups.

Community Building Activities are activities provided for the Community Building Activities are activities provided for the benefit of the community by the hospital that do not directly relate benefit of the community by the hospital that do not directly relate to the health of the residents:to the health of the residents:•Physical improvements and housingPhysical improvements and housing•Economic developmentEconomic development•Community supportCommunity support•Environmental improvementsEnvironmental improvements•Leadership development and training for community membersLeadership development and training for community members•Coalition buildingCoalition building•Community health improvement advocacyCommunity health improvement advocacy•Workforce developmentWorkforce development•Other community building activities Other community building activities that protect or improve the that protect or improve the community's health or safety community's health or safety that are not captured in the that are not captured in the categories listed above.categories listed above.

Source: NCHA FY2008 Annual Survey.

Charity Care25.4%

Medicare Losses30.9%

Medicaid Losses33.6%

Prof. Education3.3%

Other Gov Ins Plan Losses0.4%

Comm Health Improvement

2.1%

Community Group Donations

1.8%

Research Costs0.1%

Community Building Activities

1.3%

Subsidized Services1.1%

No Bad Debt


Charity Care20.0%


Subsidized Services

0.8%

Research Costs0.1%


1.4%


1.0%

Bad debt21.4%

Prof. Education2.6%




1.7%

Source: NCHA FY2008 Annual Survey, based on 83% response rate. Missing respondent values were imputed using licensed beds.

Measured in Millions of Dollars

$4

$20

$33

$51

$257

$310

$411

$661

$673

$768

Research Costs

Community Building

Community Health Improv

Cash & In-Kind Support

Subsidized Health Services

Health Prof Education

Medicaid Losses

Bad Debt*

Charity Care

Medicare Losses

Charges by Payer

Source: Advocacy Needs Data Initiative, 2009, Financial Report, FY 2009, All NCHA member hospitals

$454 $538 $673 $751$306

$336$411

$480$556$695

$768$776$594

$639

$661$695

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

2006 2007 2008 2009Source: NCHA

Charity Care Medicaid Medicare Bad debt

Average NC Margin Trends

-10%

-8%

-6%

-4%

-2%

0%

2%

4%

6%

8%

Jan-Mar

2007

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2008

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2009

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2010

Source: NCHA ANDI, August 25, 2010

Patient Margin Operating Margin Total Margin

New Requirements for Section 501(c)(3) Status New Requirements for Section 501(c)(3) Status Community Health Needs AssessmentCommunity Health Needs Assessment

i.i. The organization must conduct a The organization must conduct a “community health “community health needs assessment” needs assessment” not less frequently than not less frequently than every three every three years years and adopt an implementation strategy to meet the and adopt an implementation strategy to meet the community health needs identified through the assessment.community health needs identified through the assessment.

ii.ii. A “community health needs assessment” must include input A “community health needs assessment” must include input from persons “represent[ing] the broad interests of the from persons “represent[ing] the broad interests of the community served by the hospital facility,” including those community served by the hospital facility,” including those

“with special knowledge of or “with special knowledge of or expertise in public expertise in public healthhealth.” .”

iii.iii.The assessment must be made widely available to the public.The assessment must be made widely available to the public.

• What is the IRS definition of a “Community What is the IRS definition of a “Community Health Needs Assessment?”Health Needs Assessment?”

• What are the IRS requirements for an What are the IRS requirements for an “Implementation Strategy?” “Implementation Strategy?”

• Will a multi-county hospital do one assessment Will a multi-county hospital do one assessment per county? Or one mega-area-assessment?per county? Or one mega-area-assessment?

• What should multi-campus hospitals do? One What should multi-campus hospitals do? One assessment? Many?assessment? Many?

• Does this mean Public Health will be Does this mean Public Health will be switching to every three years???switching to every three years???

To start a dialogue with your local hospital To start a dialogue with your local hospital about community benefits and assessments, about community benefits and assessments, contact:contact:

•Hospital Foundation StaffHospital Foundation Staff

•Public Relations or Marketing DirectorsPublic Relations or Marketing Directors

•Chief Executive OfficersChief Executive Officers

•Anyone you are currently working with on Anyone you are currently working with on community projectscommunity projects

Alamance Regional Medical Center

Alleghany Memorial HospitalAngel Medical CenterAnnie Penn Hospital

Ashe Memorial HospitalBeaufort County HospitalBertie Memorial Hospital

Betsy Johnson Regional HospitalBlowing Rock Hospital

Blue Ridge Regional HospitalBrunswick Community Hosp.Caldwell Memorial HospitalCannon Memorial Hospital

Carteret County General Hosp.Chatham HospitalChowan Hospital

Columbus Regional Healthcare System

Community Care PartnersDuke Raleigh Hospital

Duke University HospitalDuplin General Hospital

Durham Regional HospitalFirstHealth Montgomery Memorial

Hospital

FirstHealth Moore Regional Hosp.FirstHealth Richmond Memorial

HospitalForsyth Medical Center

Gaston Memorial HospitalGrace Hospital

Halifax Regional Medical CenterHarris Regional Hospital

Heritage HospitalHigh Point Regional Health Sys.

Highlands-Cashiers HospitalHugh Chatham Memorial Hospital

Iredell Memorial HospitalLenoir Memorial Hospital

Lexington Memorial HospitalMargaret Pardee Memorial Hosp.

Maria Parham HospitalMCHS - Greensboro Operations

Medical Park HospitalMission Hospital

Morehead Memorial HospitalMurphy Medical Center

North Carolina Baptist HospitalOur Community Hospital

Park Ridge HealthPender Memorial HospitalPerson Memorial Hospital

Pitt County Memorial HospitalPresbyterian Healthcare

Presbyterian Hosp. HuntersvillePresbyterian Hospital MatthewsPresbyterian Orthopaedic Hosp.

Pungo District Hospital Corp.Randolph Hospital

Roanoke-Chowan HospitalRowan Regional Medical Center

Rutherford HospitalScotland Memorial Hospital

Southeastern Regional Medical Center

St. Luke's HospitalStanly Regional Medical Center

Stokes-Reynolds Memorial Hosp.Swain County HospitalThe McDowell Hospital

The Outer Banks HospitalThomasville Medical Center

Transylvania Community HospitalWakeMed

WakeMed Cary HospitalWatauga Medical CenterWayne Memorial Hospital

Wilson Medical CenterYadkin Valley Community Hosp.

www.ncha.org/communitybenefitswww.ncha.org/communitybenefits

Contact InformationContact InformationSarah Broome, Ph.D, Sarah Broome, Ph.D, Director of Economic ResearchDirector of Economic ResearchNorth Carolina Hospital AssociationNorth Carolina Hospital [email protected]@ncha.org

Alamance Regional Medical Center Albemarle Hospital Alleghany Memorial Hospital Angel Medical Center Annie Penn Hospital Anson Community Hospital Ashe Memorial Hospital, Inc. Beaufort County Hospital Behavioral Health Care of Cape Fear Valley Health System Bertie Memorial Hospital Betsy Johnson Regional Hospital Bladen County Hospital Blowing Rock Hospital Broughton Hospital Brunswick Community Hospital Brynn Marr Behavioral Healthcare System Caldwell Memorial Hospital, Inc. Cape Fear Valley Health System Carolina Medical Center Carolina Medical Center - Mercy Carolina Medical Center - Pineville Carolina Medical Center - Union Carolina Medical Center - University Carteret County General Hospital Catawba Valley Medical Center Central Carolina Hospital Charles A Cannon, Jr. Memorial Hospital Charlotte Institute of Rehabilitation Chatham Hospital Cherokee Indian Hospital Cherry Hospital Chowan Hospital Cleveland Regional Medical Center Coastal Plain Hospital Columbus Regional Healthcare System Craven Regional Medical Center Davie County Hospital Davis Regional Medical Center Department of Veterans Affairs Medical Center Asheville Department of Veterans Affairs Medical Center Durham Dorthea Dix Hospital Duke Health Raleigh Hospital Duke University Hospital Duplin General Hospital, Inc. Durham Regional Hospital FirstHealth Montgomery Memorial Hospital FirstHealth Moore Regional Hospital FirstHealth Richmond Memorial Hospital Forsyth Medical Center Franklin Regional Medical Center Frye Regional Medical Center Gaston Memorial Hospital, Inc. Grace Hospital Granville Medical Center Halifax Regional Medical Center Harris Regional Hospital Haywood Regional Medical Center Heritage Hospital High Point Regional Health System Highland-Cashiers Hospital Highsmith-Rainey Memorial Hospital Holly Hill Hospital Hoots Memorial Hospital Hugh Chatham Memorial Hospital Iredell Memorial Hospital, Inc. J. Arthur Dosher Memorial Hospital John Umstead Hospital Johnston Memorial Hospital Kings Mountain Hospital, Inc. Lake Norman Regional Medical Center Lenoir Memorial Hospital Lexington Memorial Hospital, Inc. LifeCare Hospitals of North Carolina Lincoln Medical Center Margaret R. Pardee Memorial Hospital Maria Parham Medical Center Martin General Hospital McDowell Hospital Medical Park Hospital Mission Hospitals Morehead Memorial Hospital Moses Cone Behavioral Health Center Moses H. Cone Memorial Hospital Murphy Medical Center, Inc. Nash Health Care Systems New Hanover Regional Medical Center North Carolina Baptist Hospital North Carolina Specialty Hospital NorthEast Medical Center Northern Hospital of Surry County Onslow Memorial Hospital Our Community Hospital Outer Banks Hospital Park Ridge Hospital Pender Memorial Hospital Person Memorial Hospital Pitt County Memorial Hospital, Inc. Presbyterian Healthcare Presbyterian Hospital Matthews Presbyterian Orthopaedic Hospital Pungo District Hospital Corporation Randolph Hospital Rex Healthcare Roanoke-Chowan Hospital Rowan Regional Medical Center Rutherford Hospital, Inc. Sampson Regional Medical Center Scotland Memorial Hospital Southeastern Regional Medical Center Spruce Pine Community Hospital St. Luke’s Hospital Stanly Memorial Hospital Stokes-Reynolds Memorial Hospital, Inc. Swain County Hospital Thomasville Medical Center Thoms Rehabilitation Hospital Transylvania Community Hospital UNC Hospitals Valdese General Hospital Wake County Alcoholism Treatment Center WakeMed WakeMed Cary Hospital WakeMed Fuquay-Varina WakeMed Zebulon/Wendell Washington County Hospital Watauga Medical Center Wayne Memorial Hospital Wesley Long Community Hospital Wilkes Regional Medical Center Wilson Medical Center Women’s Hospital of Greensboro

North Carolina Hospital Association

Distribution of Operating Margins

31% 33% 35%46%

28% 35%45% 49%

27% 21%30%

45% 39%

34%39% 36%

33%

36%33%

36% 33%

40%42%

39%

33%

24%

35% 28% 29%21%

36% 32%19% 18%

33% 37% 31%22%

37%

Jan-Mar

2007

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2008

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2009

Apr-Jun

Jul-Sep

Oct-Dec

Jan-Mar

2010Source: NCHA ANDI, August 25, 2010.

Negative Operating Margin Operating Margin 0% - 5% Operating Margin > 5%


Charity Care24.3%



Prof. Education13.9%

Bad debt17.3%


3.2%


2.3%

Research Costs0.5%



1.3% Other Gov Ins Plan Losses0.5%


Charity Care13.4%


Bad debt46.2%



0.2%


0.7%

Research Costs0.0%


0.7%



Prof. Education0.1%


Charity Care29.4%



Prof. Education16.8%

Other Gov Ins Plan Losses

0.6%


1.6%


Research Costs0.7%


2.8%


3.8%

No Bad Debt


Charity Care25.0%



Prof. Education0.2%




1.3%

Research Costs0.0%


1.4%


0.3% No Bad Debt

Charity Care Costs (in $ millions)

$587

$532$569

$521

$0

$100

$200

$300

$400

$500

$600

Basic FASB Basic GASB CHA AHA

Bad Debt Costs (in $ millions)

Medicare Losses (in $ millions)

$1,029

$550

$846

$450

$0

$200

$400

$600

$800

$1,000

$1,200


$583

$311

$479

$269$220

53%

82%

46%38%

100%

$0

$100

$200

$300

$400

$500

$600

Basic FASB Basic GASB CHA AHA Medicare CostRpt

0

0.2

0.4

0.6

0.8

1

1.2

Note: This is based on 74 hospitals’ FY04 data. Medicare losses are in the millions of dollars.

$424

$294

$383

$276

$0

$100

$200

$300

$400

$500

$600


Medicaid Losses (in $ millions)

AHA AHA AHA Medicare

Estimated Costs of Treating Charity Care Patients per Admission

$402$372

$191

$336 $344

$231

$396

$166

$387$364

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA

California(2004data)

Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)

RhodeIsland(2004data)

NCHA Data Source: NCHA FY2005 Annual Survey.

Estimated Costs of Treating Bad Debt Patients per Admission

$607$550

$318

$573

$842

$288

$589$539

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA


Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)


AHA AHA AHA MedicareNCHA Data Source: NCHA FY2005 Annual Survey.

Estimated Costs of Treating Uncompensated Care Patients per Admission

$1,010$922

$509

$909

$1,186

$902$976

$799

$596

$357

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA


Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)




Estimated Losses of Treating Medicare Patients per Admission

$1,064

$569 $529

$1,125

$465

$874

$257

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA


Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)




Estimated Losses of Treating Medicaid Patients per Admission

$439

$304

$243

$411

$180

$286

$396

$45

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA


Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)




Estimated Losses of Treating All Non-Negotiated Government Patients per Admission

$1,534

$891$772

$1,558

$473$319

$1,296

$768

NCHABasicFASB

NCHABasicGASB

NCHACHA

NCHAAHA


Indiana(2004data)

Iowa HA(2004data)

Maryland(2004data)

MichiganHA (2004

data)

MissouriHA (2004

data)

NebraskaHA (2004

data)




This is an introduction into a hospital’s world of “community This is an introduction into a hospital’s world of “community benefit reporting” and “community health needs assessments.” benefit reporting” and “community health needs assessments.” Many NC hospitals have been reporting community benefits for Many NC hospitals have been reporting community benefits for years and most are required now to perform community health years and most are required now to perform community health needs assessments. needs assessments.

•Learn about the recent federal changes in the community Learn about the recent federal changes in the community benefit landscape, benefit landscape,

•How the needs of hospitals now overlap with local health How the needs of hospitals now overlap with local health directors and local health educator goalsdirectors and local health educator goals

•Which categories of community benefits most relate to local Which categories of community benefits most relate to local health initiatives, andhealth initiatives, and

•How to involve your local hospital How to involve your local hospital

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