Community Benefit

Community Benefit / en Fri, 25 Apr 2025 16:09:19 -0500 Wed, 16 Apr 25 16:03:41 -0500 AHA responds to Lown Institute report on hospital community benefits /news/headline/2025-04-16-aha-responds-lown-institute-report-hospital-community-benefits The AHA April 16 responded to the Lown Institute's <a href="https://lownhospitalsindex.org/report-making-hospital-tax-breaks-work-for-communities/">latest report</a> on hospital community benefits.In a <a href="/press-releases/2025-04-16-aha-statement-lown-institute-fair-share-report">statement</a> shared with media, AHA President and CEO Rick Pollack said, “Every day, all of America’s hospitals and health systems demonstrate their commitment to patients and the pursuit of advancing health. Consistent with this mission, nonprofit hospitals take their accountability for the federal tax exemption they receive very seriously. The benefits these hospitals provide include a broad range of activities chosen based on community input about community need. And these activities are publicly reported every year. Yet some organizations continue to distort and diminish the value of these activities.“The truth is reports like today’s from Lown that focus on nonprofit hospitals serve as distractions. These reports often rely on methodology that directly omits essential information, data and other factors that can seriously skew results, allowing them to apply an arbitrary ‘fair share’ threshold that is anything but ‘fair.’ This undermines genuine efforts to improve health care access for millions of patients. What is clear and consistent is this: Nonprofit hospitals deliver significant community benefits, far exceeding their tax exemptions.”The AHA and Catholic Health Association of the United States recently released a <a href="/nonprofit-hospital-community-benefits-addressing-each-communitys-unique-needs">report</a> on the value of benefits nonprofit hospitals and health systems provide for their communities. Wed, 16 Apr 2025 16:03:41 -0500 Community Benefit AHA Statement on Lown Institute Fair Share Report /press-releases/2025-04-16-aha-statement-lown-institute-fair-share-report Rick Pollack President and CEO �� AssociationApril 16, 2025Every day, all of America’s hospitals and health systems demonstrate their commitment to patients and the pursuit of advancing health. Consistent with this mission, nonprofit hospitals take their accountability for the federal tax exemption they receive very seriously. The benefits these hospitals provide include a broad range of activities chosen based on community input about community need. And these activities are publicly reported every year. Yet some organizations continue to distort and diminish the&nbsp;value of these activities.The truth is reports&nbsp;like today’s from Lown that focus on nonprofit hospitals&nbsp;serve as distractions. These reports often rely on methodology that directly omits essential information, data and other factors that can seriously skew results, allowing them to apply an arbitrary “fair share” threshold that is anything but “fair.”&nbsp;This undermines&nbsp;genuine efforts to improve health care access for millions of patients.&nbsp;What is clear and consistent is this: Nonprofit hospitals deliver significant community benefits, far exceeding their tax exemptions.### Wed, 16 Apr 2025 12:09:08 -0500 Community Benefit New AHA, CHA report highlights value of nonprofit hospitals to their communities /news/headline/2025-04-09-new-aha-cha-report-highlights-value-nonprofit-hospitals-their-communities The AHA and Catholic Health Association of the United States today released a <a href="/nonprofit-hospital-community-benefits-addressing-each-communitys-unique-needs" target="_blank">report</a> on the value of benefits nonprofit hospitals and health systems provide for their communities.Key report findings include:<ul><li>Nonprofit hospitals provide numerous community benefits in addition to financial assistance, adapting these services to regulatory changes and communities’ evolving demographics and economic conditions.</li><li>Community benefits vary by hospital characteristics, such as the type of patients the hospital serves, core functions, status as a sole provider in rural or underserved areas, and size.</li><li>Providing care at a loss to low-income patients covered through Medicaid and those in need of financial assistance is an important and related component of community benefit. Shifts in federal and state policy can significantly impact the distribution of community benefits from year to year.</li></ul>“Advancing the health and wellness of the patients and communities they serve is a foundational mission for all our nation’s hospitals and health systems,” <a href="/press-releases/2025-04-09-new-aha-cha-report-shows-how-hospitals-meet-their-communities-unique-needs" target="_blank">said</a> AHA President and CEO Rick Pollack. “This report shows that hospitals of all kinds — urban and rural, large and small — are demonstrating the value they provide and solidifying their commitment to making their communities healthier in ways that address specific local needs.” Wed, 09 Apr 2025 15:20:46 -0500 Community Benefit AHA Report Shows How Hospitals Meet Their Communities’ Unique Needs <div class="container"><div class="row"><div class="col-md-8">U.S. hospitals go above and beyond to advance health, according to a <a href="/nonprofit-hospital-community-benefits-addressing-each-communities-unique-needs" target="_blank" title="AHA, CHA Community Benefit Report">new report</a> released today by the AHA and Catholic Health Association of the United States. The report shows how hospitals meet the unique needs of their communities, including by providing financial assistance, supporting groundbreaking research to discover future cures, training the health care workforce, running community health programs and absorbing below-cost reimbursement from means-tested government programs, such as Medicaid.Nonprofit hospitals, which make up a majority of U.S. community hospitals, are required by law to identify the range of challenges faced by their communities through input from residents, support community programs and services aimed at addressing these issues, and publicly report data on these community investments. While nonprofit hospitals report these benefits to the IRS through Form 990 Schedule H, it is important to take a comprehensive view of community benefits and the myriad ways nonprofit hospitals impact their communities.Key report findings:<ul><li>Nonprofit hospitals provide numerous community benefits in addition to financial assistance, adapting these services to meet the evolving needs of their communities.</li><li>Community benefits vary by hospital characteristics.</li><li>Providing care at a loss to low-income patients covered through Medicaid and those in need of financial assistance are important and related components of community benefit.</li></ul><h2>RESOURCES</h2><ul><li>View the AHA and CHA report <a href="/system/files/media/file/2025/04/aha-cha-community-benefit-report-press-release-4-9-2025.pdf" target="_blank" title="Community Benefit Press Release">press release</a> on the report.</li><li>Download the <a href="/system/files/media/file/2025/04/community-benefit-report-social-media-content-toolkit.pdf" target="_blank" title="Digital Toolkit">digital toolkit</a>. Use the AHA graphics and social media messages or adapt them for your organization.</li><li>Use&nbsp;the hashtag #WeAreHealthCare when posting your social content and consider tagging the AHA (@ahahospitals).</li><li>Share the AHA <a href="https://youtu.be/yTTy173QWmU?si=hWux_UhGk1nu9fy9" target="_blank" title="Benefits to Communities Video">video</a> to inform your community how hospitals’ commitment to their communities benefits everyone.</li></ul><h2>FURTHER QUESTIONS</h2>For more information on how AHA is working to tell the hospital story or for general questions, please contact Alicia Mitchell, AHA’s senior vice president of communications, at <a href="mailto:amitchell@aha.org">amitchell@aha.org</a>, or Emily Gustafson, AHA’s vice president of digital strategy and public education, at <a href="mailto:egustafson@aha.org">egustafson@aha.org</a>.</div><div class="col-md-4"><a href="/system/files/media/file/2025/04/aha-report-shows-how-hospitals-meet-their-communities-unique-needs-advisory-4-9-25.pdf" target="_blank" title="AHA Report Shows How Hospitals Meet Their Communities' Unique Needs"><img src="/sites/default/files/inline-images/cover-aha-report-shows-how-hospitals-meet-their-communities-unique-needs-advisory-4-9-25.png" data-entity-uuid data-entity-type="file" alt="Cover Image Member Advisory" width="679" height="878"></a></div></div></div> Wed, 09 Apr 2025 09:05:05 -0500 Community Benefit New AHA, CHA Report Shows How Hospitals Meet Their Communities’ Unique Needs /press-releases/2025-04-09-new-aha-cha-report-shows-how-hospitals-meet-their-communities-unique-needs <figure><img src="/sites/default/files/inline-images/header-image-aha-cha-community-benefit-report-press-release-4-9-2025.png" data-entity-uuid="42fcf9fe-d606-4fd9-b225-0716dbdd895f" data-entity-type="file" alt="AHA CHA Community Benefit Report Press Release Header Image" width="621" height="143"></figure>&nbsp;Findings Demonstrate Financial Assistance Programs are Only One Part of Hospitals’ Overall Commitment to their Patients and Communities Contact:&nbsp; Colin Milligan,&nbsp; <a href="mailto:cmilligan@aha.org">cmilligan@aha.org</a> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Marie Johnson,&nbsp;<a class="ck-anchor" href="mailto:mjohnson@chausa.org" id="mailto:mjohnson@chausa.org">mjohnson@chausa.org</a> &nbsp;&nbsp;WASHINGTON (April 9, 2025) — The �� Association (AHA) and Catholic Health Association of the United States&nbsp;<a href="/nonprofit-hospital-community-benefits-addressing-each-communities-unique-needs">released a new report today</a> showing the value of benefits that nonprofit hospitals and health systems deliver to their communities. The findings reinforce that the entire hospital field goes above and beyond to advance health by meeting the unique needs of their communities — whether by providing financial assistance for patients in need, supporting groundbreaking research to discover future cures, training the health care workforce, running community health programs, or absorbing below cost reimbursement from means-tested government programs, such as Medicaid. Since every community is different, the benefits and services hospitals provide are similarly unique and tailored to those community needs.&nbsp;Nonprofit hospitals, which make up a majority of U.S. community hospitals, are required by law to identify the range of challenges faced by their communities through input from residents, support community programs and services aimed at addressing these issues, and publicly report data on these community investments. Nonprofit hospitals report these benefits to the IRS through Form 990 Schedule H (the focus of today’s report), which groups them into several different categories. It is important to take a comprehensive view of community benefits and the many ways nonprofit hospitals are impacting the health of their communities, rather than focusing only on one area, such as financial assistance.“Advancing the health and wellness of patients and communities they serve is a foundational mission for all our nation's hospitals and health systems,” said AHA President and CEO Rick Pollack.&nbsp;“This report shows that hospitals of all kinds — urban and rural, large and small — are demonstrating the value they provide and solidifying their commitment to making their communities healthier in ways that address specific local needs.”&nbsp;“Hospitals are more than places of healing—they are lifelines to their communities,”&nbsp;said Catholic Health Association President and CEO Sr. Mary Haddad, RSM. “The care we provide for our patients and our neighbors extends beyond the walls of our facilities as we seek to meet people where they are.&nbsp;Through our community benefit work, we address pressing individual needs, advance community health, and expand access to programs that promote human flourishing — all contributing to the greater good."Key findings from the&nbsp;<a href="/nonprofit-hospital-community-benefits-addressing-each-communities-unique-needs">report</a> include:&nbsp;<ul><li>Nonprofit hospitals provide numerous community benefits in addition to financial assistance, adapting these services to meet the evolving needs of their communities,&nbsp;which&nbsp;are&nbsp;shaped by factors such as demographics, economic conditions, and regulatory changes. Nevertheless, some stakeholders have argued that the value of community benefit should be measured solely by the provision of financial assistance or some other limited combination of benefits. &nbsp;</li><li>Community benefits vary by hospital characteristics, based on the type of patients the hospital serves, core functions, status as a sole provider in rural or underserved areas, and size. &nbsp;</li><li>Providing care at a loss to low-income patients covered through Medicaid and those in need of financial assistance are important and related components of community benefit. Shifts in federal and state policy can significantly impact the distribution of community benefits from year to year.</li></ul>The full report can be found&nbsp;<a href="/nonprofit-hospital-community-benefits-addressing-each-communities-unique-needs">HERE</a>.&nbsp;### About the �� Association (AHA) The �� Association (AHA) is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA advocates on behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups. Founded in 1898, the AHA provides insight and education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at&nbsp;<a href="/">www.aha.org</a>.&nbsp;About Catholic Health Association (CHA) The Catholic Health Association of the United States (CHA), is a national leadership organization representing more than 2,200 Catholic hospitals, long-term care facilities, clinics, service providers, healthcare systems, and other facilities across all fifty states. For more information, visit the CHA website at&nbsp;<a href="https://www.chausa.org/">https://www.chausa.org/</a>.&nbsp; Wed, 09 Apr 2025 08:00:00 -0500 Community Benefit Intermountain Health partners with Ad Council to address firearm injuries among youth /role-hospitals-intermountain-health-partners-ad-council-address-firearm-injuries-among-youth <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><img src="/sites/default/files/2025-04/ths-agree-to-agree-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Intermountain Health partners with Ad Council to address firearm injuries among youth. Agree to Agree poster shows two men talking" width="700" height="532"></div>For the past three years, firearm injuries have been the leading cause of death for children ages 1 to 17 in the United States. In response, the Ad Council, in partnership with Intermountain Health and a coalition of health care and business leaders, launched the social impact program "<a href="https://agreetoagree.org/" target="_blank">Agree to Agree</a>," an initiative to reduce gun-related tragedies affecting children and teens. The program focuses on the full spectrum of firearm injuries, including suicides, intentional and unintentional shootings.“Over the past year, Intermountain caregivers have done extensive work in the areas of suicide prevention and gun safety,” said Rob Allen, president and chief executive officer of Intermountain Health. “By raising awareness and offering training and resources, we help to both save lives and remove the stigma around conversations on gun safety and mental health.”Intermountain Health has been actively working to protect communities by distributing nearly 67,000 free firearm locks and increasing access to mental health resources. The "Agree to Agree" campaign focuses on the idea that gun owners and non-gun owners can agree that firearms should not be the leading cause of death for children and teens. The campaign includes public safety announcements for parents and health care professionals, directing them to resources on how to prevent firearm injuries and have supportive conversations about gun safety and mental health.<a class="btn btn-primary" href="https://news.intermountainhealth.org/intermountain-health-joins-initiative-to-curb-impact-of-firearm-injuries-and-deaths-on-americas-youth/">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/community-benefit">Benefiting Communities</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 08 Apr 2025 15:43:46 -0500 Community Benefit Nonprofit Hospital Community Benefits: Addressing Each Community's Unique Needs /nonprofit-hospital-community-benefits-addressing-each-communitys-unique-needs <div class><div> /* Banner_Title_Overlay_Bar */ .Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 25px auto; } .Banner_Title_Overlay_Bar h1 { position: absolute; bottom: 40px; color: #003087; background-color: rgba(255, 255, 255, .8); width: 100%; padding: 20px 40px; font-size: 3em; box-shadow: 0 3px 8px -5px rgba(0, 0, 0, .6); } @media (max-width:991px) { .Banner_Title_Overlay_Bar h1 { bottom: 0px; margin: 0px; font-size: 2.5em; } } @media (max-width:767px) { .Banner_Title_Overlay_Bar h1 { font-size: 2em; text-align: center; text-indent: 0px; padding: 10px 20px; } } @media (max-width:530px) { .Banner_Title_Overlay_Bar h1 { position: relative; background-color: #63666A22; } } /* Banner_Title_Overlay_Bar // */ <header class="Banner_Title_Overlay_Bar"><img src="/sites/default/files/2025-04/2025-community-benefit-report-header-image-sample.jpg" alt="Banner Image" width="1206" height="302"><div><h1>Addressing Each Community's Unique Needs</h1></div></header></div></div><div class="container"><div class="row"><div class="col-md-9"><div>&nbsp;</div><img src="/sites/default/files/inline-images/image_48.png" data-entity-uuid="9318d7c5-78b7-44d5-91f3-4cd87e680219" data-entity-type="file" alt="Blue Nonprofit Hospital Community Benefits: Header Image" width="511" height="110" hspace="10px" vspace="10px" class="align-left"> While all hospitals provide critical services and play a vital role in serving their communities, this report specifically examines the benefits reported to the IRS by Form 990 Schedule H provided to communities by nonprofit hospitals and systems. Nonprofit hospitals make up the majority of the U.S.’s community hospitals and account for nearly three-quarters of all community hospital admissions. They play a critical role in providing essential care and services tailored to the unique needs of their communities. Beyond offering 24/7 emergency, acute, and chronic care, they support initiatives to make communities healthier and invest in research, medical innovation, and workforce development. These benefits provide invaluable support to communities across the country, and it is critical to take a comprehensive view of their provision and impact.To qualify for tax-exempt status under Section 501(c)(3) of the Internal Revenue Code, nonprofit hospitals must demonstrate that they provide broad community benefits and serve the public interest. Hospitals report these benefits to the IRS through Form 990 Schedule H, which groups them into several different categories. This <a href="/system/files/media/file/2025/04/nonprofit-hospital-community-benefits-addressing-each-communities-unique-needs-report.pdf" target="_blank">report</a> focuses on eight key areas of benefits reported under Part I of Schedule H to highlight the dynamic relationship between nonprofit hospitals’ provision of benefits and the evolving needs of their communities.&nbsp; &nbsp;<img src="/sites/default/files/inline-images/image_50.png" data-entity-uuid="71221ac3-5c4e-483b-8d52-52a814831e01" data-entity-type="file" alt="Key Findings Header Image" width="176" height="50"><img src="/sites/default/files/inline-images/image_56.png" data-entity-uuid="8af60437-0239-4a0d-9cf3-3840a5672da8" data-entity-type="file" alt="Figure 1 Distribution of Benefits Reported under Schedule H Part 1, Tax Years 2011 vs. 2021" width="437" height="488" hspace="10px" vspace="10px" class="align-right"><ul><li>Nonprofit hospitals provide numerous community benefits in addition to financial assistance. These benefits are tailored to meet the evolving needs of their communities. Hospital resources are finite, and therefore, their allocation varies based on community needs, which are influenced by factors such as demographics and economic conditions. Additionally, regulatory changes may lead to shifts in spending across these categories over time (Figure 1). It is imperative that policymakers, researchers and the public take a holistic view of how nonprofit hospitals serve their communities.&nbsp;</li><li>Community benefits vary by hospital characteristics. Community benefits vary based on the type of patients the hospital serves (e.g., children), core functions (e.g., teaching or research), status as a sole provider in rural or underserved areas, and size.</li><li>Providing care at a loss to low-income patients covered through Medicaid and those in need of financial assistance are important and related components of community benefit. Shifts in federal and state policy can significantly impact the distribution of community benefits from year to year. For example, Medicaid expansion resulted in an increase in Medicaid shortfall, as more low-income individuals gained coverage under Medicaid. At the same time, the need for financial assistance for uninsured individuals declined as more individuals gained coverage. As a result, hospitals experienced an associated increase in Medicaid shortfall (given the larger number of Medicaid beneficiaries) and a decrease in financial assistance (given the smaller number of uninsured individuals). These and other policy changes, while not intended to impact hospitals’ provision of community benefits, will influence how benefits are delivered in relation to each other.<hr></li></ul><img src="/sites/default/files/inline-images/image_57.png" data-entity-uuid="d66dbc59-910c-4c1f-9bd9-c97dabb14ea9" data-entity-type="file" alt="Image header reading Nonprofit Hospital Community Benefits: Addressing Each Community's Unique Needs." width="500" height="185" class="align-left"><figure>&nbsp;&nbsp; &nbsp;&nbsp; &nbsp;<img src="/sites/default/files/inline-images/image_63.png" data-entity-uuid="989524a1-e805-44a4-ac98-ee7155a124af" data-entity-type="file" alt="Image of Introduction Header" width="174" height="56" class="align-left">Non-governmental, nonprofit hospitals make up the majority of the U.S.’s 5,129 community hospitals and account for nearly three-quarters of all community hospital admissions.1 Nonprofit hospitals and health systems, in addition to providing critical emergent, acute, and chronic care, give back to their communities in multiple ways to meet the unique needs of the people they serve.Nonprofit hospitals ensure access to health care for low-income individuals and families by absorbing below-cost reimbursement from means-tested government programs and providing health care to those who might otherwise struggle to access care. They promote healthier communities by helping patients navigate and find support for a variety of health and community needs. This includes providing health screenings, transportation to medical appointments, education and other community health programs like vaccination clinics, and addressing many other needs that affect their communities’ health and well-being. Additionally, many nonprofit hospitals invest in lifesaving research and medical innovation, train the future medical workforce, and subsidize vital health services, such as burn, behavioral health and neonatal units, which are essential resources provide 24/7 365 days a year for communities nationwide. Critically, these efforts are tailored to meet the evolving, specific needs of their communities, allowing hospitals to provide targeted, high-quality care and address broader health issues in a way that most directly benefits their local populations.Recent discussions of non-profit hospitals and their tax-exempt status have focused on concerns regarding specific measures of benefits while ignoring others in a way that misrepresents the extent of the community benefits provided. Every community is different, and the benefits and services nonprofit hospitals provide are similarly unique and tailored to those community needs. It is imperative that policymakers, researchers and the public take a comprehensive view of the numerous ways nonprofit hospitals serve their communities.<hr><img src="/sites/default/files/inline-images/image_66.png" data-entity-uuid="87ceef0b-be54-448b-a451-aa68a2f03bad" data-entity-type="file" alt="Blue Background Header Image" width="335" height="147" hspace="10px" vspace="10px" class="align-left"> To qualify as federal tax-exempt entities under Section 501(c)(3) of the Internal Revenue Code, nonprofit hospitals and health systems must “demonstrate that they provide benefits to a class of persons that is broad enough to benefit the community and operate to serve a public rather than a private interest.” The U.S. Internal Revenue Service (IRS) sets out a series of factors, known as the “Community Benefit Standard,” to demonstrate community benefit.2&nbsp;Nonprofit hospitals are further required by law to report on these benefits to the IRS through Form 990 Schedule H (hereinafter Schedule H). Though the Schedule H requires reporting on a broad set of activities and expenses, this analysis focuses only on the eight categories of benefits reported in Part I: Financial Assistance and Certain Other Community Benefits at Cost (Table 1). The purpose of this analysis is to show how these categories relate to each other and why they may differ from hospital to hospital or community to community. &nbsp;Table 1. IRS Form 990 Schedule H Reporting Categories3&nbsp;<table border="1px" cellspacing="0" cellpadding="0" width="735"><tbody><tr><td width="182">Schedule H Section</td><td width="146">Schedule H Category</td><td width="408">Definition</td></tr><tr><td rowspan="8" width="182">Part I: Financial Assistance and Certain Other Community Benefits at Cost</td><td width="146">Financial assistance*</td><td width="408">Free or discounted health services provided to persons who cannot afford to pay all or portions of their medical care and who meet the organization's financial assistance policy criteria.</td></tr><tr><td width="146">Medicaid shortfall</td><td width="408">The difference between the cost of care provided under Medicaid and the revenue derived therefrom.</td></tr><tr><td width="146">Other means tested government programs</td><td width="408">The difference between the cost of care provided under non-Medicaid means-tested government programs and the revenue derived therefrom.</td></tr><tr><td width="146">Community health improvement services</td><td width="408">Activities and programs for the express purpose of improving community health. Such activities focus on health promotion, wellness, prevention, and address social needs.</td></tr><tr><td width="146">Health professions&nbsp;education</td><td width="408">Educational programs that result in a degree, a certificate or training necessary to be licensed to practice as a health professional, as required by state law, or continuing education necessary to retain state license or certification by a board in the individual's health profession specialty.</td></tr><tr><td width="146">Subsidized health services</td><td width="408">Clinical services provided despite a financial loss to the organization.</td></tr><tr><td width="146">Research</td><td width="408">Any study or investigation the goal of which is to generate increased generalizable knowledge made available to the public.</td></tr><tr><td width="146">Cash and in-kind contributions to community groups</td><td width="408">Contributions made by the organization to health care organizations and other community groups restricted, in writing, to one or more community benefit activities.</td></tr><tr><td colspan="3" width="735">*Also known as charity care.</td></tr></tbody></table> While hospitals exist to serve their communities, continued government underpayment results in finite resources. As such, hospitals must make decisions on how to use these finite resources to meet the evolving needs of their local communities. Those needs vary depending on factors such as geography, demographics, payer mix and economic conditions. The spending associated with different Schedule H Part I categories has shifted over time, reflecting both the changing nature of community needs and the impact of legislative and regulatory changes<img src="/sites/default/files/inline-images/image_68.png" data-entity-uuid="4486f391-5c45-4caa-9a0c-2609e5686059" data-entity-type="file" alt="Image of Figure 1 table: Figure 1. Distribution of Benefits Reported Under Schedule H Part I, Tax Years 2011 vs. 2021" width="437" height="517" hspace="10px" vspace="10px" class="align-left">For example, the significant growth in Medicaid enrollment over the last decade has meant that more of hospitals’ community benefit resources are needed to offset the losses resulting from well documented underpayments by state Medicaid programs. From 2011 to 2021, Medicaid shortfall increased as a share of Schedule H Part I benefits by 39%. This increase was fueled by a substantial rise in the number of people covered by Medicaid following both the implementation of Medicaid expansion in 40 states and in D.C. At the same time, the share of hospital financial assistance decreased by 37% from 2011 to 2021 as the uninsured population in the U.S. declined. This decrease in the number of uninsured was driven by the Medicaid expansion, as well as the other coverage initiatives. The impact of Medicaid expansion on Schedule H Part I benefits is examined further in the Policy &amp; Regulatory Changes and Schedule H Part I Benefits section.&nbsp;This report highlights the dynamic relationship between the benefits nonprofit hospitals provide and their community needs, with a focus on benefits reported under Part I of the Schedule H. It is important to look at the totality of benefits that nonprofit hospitals provide to understand the unique value they provide to the communities they serve. &nbsp;<img src="/sites/default/files/inline-images/image_69.png" data-entity-uuid="cd807fed-1e18-44ab-a8d0-0999a45bdc45" data-entity-type="file" alt="Header Image that reads Nonprofit Hospital Characteristics and Schedule H Part 8 Benefits" width="510" height="110" hspace="10px" vspace="10px" class="align-left"> Hospitals, just like the communities they serve, are not monolithic. There is considerable variation in their characteristics, including the types of patients they treat, the services they offer, and their size and scope. When examining the benefits that nonprofit hospitals provide their communities, it is important to account for these differences. The examples below highlight the ways in which different communities rely on the unique benefits and services their hospitals provide, even though those benefits and services may be different from community to community.&nbsp;Nonprofit hospitals come in many different forms, including children’s hospitals, academic medical centers and critical access hospitals (CAHs). As illustrated in Figure 2, nonprofit community hospitals provide a higher share of financial assistance as a percentage of community benefit spending as compared to these other specific types of nonprofit hospitals. On the other hand, while children’s hospitals provide the lowest amount of financial assistance across hospital types, they incur the highest amount of Medicaid shortfall as a percentage of community benefit. This is because children are disproportionately covered by Medicaid and the Children’s Health Insurance Program (CHIP), covering 38 million children nationwide, and thus are less likely to be uninsured.4 Children’s hospitals also allocate the highest levels of benefit dollars to research, reflecting the complex and unique medical needs of the population they serve.&nbsp;Teaching hospitals, with their distinct role in educating and training future medical professionals, allocate the largest share of community benefit spending to health professions education. Teaching hospitals tend to be located in large metropolitan areas and often serve a disproportionately high number of Medicaid patients, providing a significant amount of care to low-income populations.5 This means that teaching hospitals cover a greater degree of the Medicaid shortfall and, consequently, see lower levels of charity care as a percentage of community benefit spending. Teaching hospitals, which often include advanced medical research centers, also allocate one of the highest shares of benefit dollars to research. &nbsp;<figure><img src="/sites/default/files/inline-images/image_70.png" data-entity-uuid="c2f3e83c-30d3-4ecc-9ac7-263ee0c59695" data-entity-type="file" alt="Image of Figure 2. Distribution of Benefits Reported Under Part 1 of Schedule H by Hospital Types, Tax Year 2021" width="846" height="523"></figure>&nbsp;The unique position of CAHs further illustrates the importance of evaluating the full picture of community benefits and, conversely, the risk of undermining those benefits with an unduly narrow perspective. To qualify as a CAH, a hospital must be located more than 35 miles from another hospital, must have 25 or fewer acute inpatient care beds, and generally must restrict patient length of stay to no more than 96 hours.6 These facilities are widely recognized as essential for maintaining high-quality health care access across nearly 1,400 rural areas. CAHs are often the only access point for essential health care services in their communities but low population volume makes it a challenge to finance core services that must be available in a community, generating a significantly higher share of health services expenses subsidized by hospitals at a financial loss, including clinical services like burn and wound care, behavioral health, and pulmonology.7 The critical importance of CAHs’ very presence in their communities is undeniable; the benefit they provide to their communities is self-evident. Yet, they have lower shares of financial assistance and Medicaid shortfall, given the need for them to instead use their limited resources to subsidize a greater number of core services.Benefits also vary by hospital size, as measured by hospital expenses (Figure 3). Medium-sized hospitals provide the highest share of Medicaid shortfall (46.9%) and financial assistance (21.1%) as a percentage of community benefit spend, whereas large hospitals, which include major academic medical centers, allocate the largest share of their community benefit spend on health professions education (19.3%) and research (5.4%). Conversely, small hospitals see a significantly larger shortfall from subsidized health services as a percentage of community benefit expenses (27.8%).&nbsp;<figure><img src="/sites/default/files/inline-images/community-benefit-report-figure3.png" data-entity-uuid="b137a528-d620-47d9-bde0-0168a82f8a9a" data-entity-type="file" alt="Image of figure 3: Distribution of Benefits Reported Under Part 1 of Schedule H by Hospital Size, Tax Year 2021" width="1004" height="753" class="align-center"></figure><hr><img src="/sites/default/files/inline-images/image_74.png" data-entity-uuid="a5328c0d-1e42-4d39-873e-56a247bfd275" data-entity-type="file" alt="Image of the Header that reads Policy &amp; Regulatory hanges and Schedule H Part 1 Benefits" width="511" height="128" hspace="10px" vspace="10px" class="align-left">&nbsp;In addition to hospital characteristics, policy and regulatory environments can significantly impact how hospitals allocate Schedule H Part I benefits year to year. Changes to coverage policies and reporting requirements, for example, can cause sizable shifts in the distribution of benefits. As such, a singular focus on a particular benefit category — such as financial assistance — can generate a false narrative of the benefits hospitals provide their communities.&nbsp;<figure><img src="/sites/default/files/inline-images/image_75.png" data-entity-uuid="e0d9a14f-8fef-4a08-ba15-7c7f9481a195" data-entity-type="file" alt="Image Header Medicaid Expansion" width="268" height="50"></figure>The intent of Medicaid expansion was to increase access to insurance for low-income individuals across the country. Indeed, that was the result of the program, providing Medicaid coverage to individuals who were previously uninsured. As a result, hospitals saw uncompensated care levels decrease as patients who may have previously qualified for the hospital’s financial assistance policies were now receiving coverage through Medicaid and other coverage expansions, including subsidized coverage in the Marketplaces. Unsurprisingly, hospitals then generally experienced increases in their coverage of the Medicaid shortfall and decreases in financial assistance expenses.8This trend is evidenced by data from hospitals located in states that have expanded Medicaid. After Medicaid expansion took effect, these states saw a 34% increase in Medicaid enrollment, covering 13 million new Medicaid beneficiaries.9 As a result, hospitals in Medicaid expansion states experienced an increase in their Medicaid shortfall, with an associated decrease in financial assistance, as individuals who were previously uninsured and would have otherwise sought financial assistance were now enrolled in Medicaid. This rise in Medicaid coverage and reduction in financial assistance following Medicaid expansion was a widely expected trend among policymakers and researchers.10 As shown in Figure 4, Medicaid shortfall expenses for hospitals located in expansion states were 2.4% of total expenses in the year before those states implemented expansion. Three years after expansion, Medicaid shortfall expenses increased to 3.2%. In contrast, hospitals located in the non-expansion states had Medicaid shortfall and financial assistance levels that remained approximately the same before and after 2014.&nbsp;&nbsp;<a href="https://www.kff.org/status-of-state-medicaid-expansion-decisions/" target="_blank" title="State of Medicaid Expansion Decisions"><img src="/sites/default/files/inline-images/image_77.png" data-entity-uuid="72a93729-b1f1-4d9d-9c5b-db760e63163e" data-entity-type="file" alt="Image of Figure 4" width="1151" height="609" class="align-left"></a> &nbsp;</figure><img src="/sites/default/files/inline-images/image_78.png" data-entity-uuid="a138bff4-9ed0-4a3d-ac53-69a18565a15e" data-entity-type="file" alt="Image of Research Header" width="177" height="50">Other policy changes have caused substantial shifts in the allocation of hospitals’ Part I benefits and further illustrate the complexity of Schedule H reporting. For example, significant shifts resulted from a 2014 regulatory change in how research expenses were accounted for and reported to the IRS. This change required hospitals to report restricted research grants and contributions that were used to provide benefit expenses as offsetting revenue, meaning that grants and contributions for research were subtracted from the total research expenses reported. This accounting shift resulted in a net reduction in the reported benefit expense for research.11 The data show that the share of research expenses (as a share of total Schedule H Part I benefits) decreased by 59% between 2013 and 2014, dropping from 11.1% to 4.6%. But in reality, the actual investment in research by nonprofit hospitals did not decrease; the decrease is attributable to this reporting change.<hr><img src="/sites/default/files/inline-images/image_82.png" data-entity-uuid="a21b7f79-179f-4304-b502-2b2af316f122" data-entity-type="file" alt="Discussion Image Header" width="328" height="153" hspace="10px" vspace="10px" class="align-left"> Nonprofit hospitals provide a broad array of benefits that vary depending on the unique needs of the communities they serve, as well as federal, state, and local laws and policies that may affect their operations. The data clearly show that it is essential to holistically examine community benefits in the context of the local community needs and policy landscape when assessing how nonprofit hospitals contribute to their communities. Nevertheless, some stakeholders have argued that the value of community benefit should be measured solely by the provision of financial assistance or some other limited combination of benefits.&nbsp;Beyond what is reported on the IRS Form 990 Schedule H, nonprofit hospitals engage with their communities in a variety of meaningful ways that advance health and well-being. For example, hospitals partner with a range of local organizations to address community needs, such as housing and health screenings, as well as with local health departments in emergency preparedness and response efforts.It is important to take a comprehensive view of community benefits and the ways nonprofit hospitals are impacting the health of their communities. Nonprofit hospitals and health systems remain steadfastly committed to addressing the unique challenges of the communities they serve and effectively allocating their finite resources to improve the health of their communities.<hr><img src="/sites/default/files/inline-images/image_83.png" data-entity-uuid="1052e367-6d22-4a02-af1e-71714be59091" data-entity-type="file" alt="Image of Methods Header" width="287" height="153"> &nbsp;<img src="/sites/default/files/inline-images/image_84.png" data-entity-uuid="8829a366-9d9b-4154-be2c-fb35fff3ccba" data-entity-type="file" alt="Image of Community Benefit Calculation Header" width="335" height="47">The community benefit expenses used for this report are those reported to the IRS net of any offsetting revenue. Net community benefit expenditures were summed across hospital employer identification numbers (EINs) and expressed as either a percentage of total Schedule H Part I benefits or a percentage of the total EIN expenses reported by the same hospitals.&nbsp;To get total EIN expenses, hospital level expenses were taken from a RTI International analysis of the Community Benefit Insight (CBI), a publicly available database that aggregates U.S.-based nonprofit hospital community benefit spending data reported to the IRS, for years 2011 to 2021, and the AHA’s Annual Survey of Hospitals, for the equivalent tax year and summed up to the EIN level under which those hospitals reported.12 Numbers and Figures include all EINs unless otherwise specified.&nbsp;For purposes of the IRS Form 990 Schedule H (Schedule H), the tax year is equivalent to the calendar year in which the reporting year begins (e.g., a fiscal year beginning Oct. 1, 2021, would report under tax year 2021, not under the fiscal year end of Sept. 30, 2022). &nbsp;<img src="/sites/default/files/inline-images/image_85.png" data-entity-uuid="5eddd722-34ee-4c2f-b426-3bacc5913da6" data-entity-type="file" alt="Image of Individual and Group Schedule Hs" width="434" height="50">Hospitals submit a Schedule H for a single hospital (individual Schedule) or as part of a combined Schedule that includes other hospitals (group Schedule), depending on their organizational structure. The 2020 file contains 2,288 Schedules. Upon review, AHA identified 2,790 total hospitals in the Schedule H data file and matched these records with the AHA Annual Survey database.<h2>Size</h2>Definition:&nbsp;Categories based on total hospital expenses.<ul><li>“Small” is less than $100M.</li><li>&nbsp;“Medium” is $100M-$299M.</li><li>“Large” is $300M or more.</li></ul>Source: AHA 2022 Annual Survey<h2>Critical Access Hospital</h2>Definition:&nbsp;A critical access hospital (CAH) is a hospital designated as a CAH by a state that has established a State Medicare Rural Hospital Flexibility Program in accordance with Medicare rules. To qualify as a CAH, a hospital must be in a rural area, located more than 35 miles from another hospital, limited to a maximum of 25 acute inpatient care beds, and maintain an annual average patient length of stay of 96 hours or less for acute care. Further details about the criteria for the CAH designation can be found at CMS.gov.Source: The national CAH database is maintained by a consortium of the Rural Health Research Centers at the Universities of Minnesota, North Carolina-Chapel Hill, and Southern Maine, and funded by the Federal Office of Rural Health Policy. The list contains the most current information and is updated regularly based on CMS reports, information provided by state Flex Coordinators, and data collected by the NC Rural Health Research Program on hospital closures.<h2>Nonprofit Community Hospital</h2>Definition: Nonprofit community hospitals are defined as all nonprofit, nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; long-term acute care; rehabilitation; orthopedic; and other individually described specialty services. Nonprofit community hospitals include academic medical centers or other teaching hospitals if they are nonprofit, nonfederal, short term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.Source: AHA Fast Facts on U.S. Hospitals, 2024<h2>Children’s Hospital</h2>Definition:&nbsp;A children’s hospital is a center for the provision of health care to children and includes independent acute care children’s hospitals, children’s hospitals within larger medical centers, and independent children’s specialty and rehabilitation hospitals.Source: AHA 2022 Annual Survey<h2>Teaching Hospital</h2>Definition:&nbsp;A teaching hospital is a hospital that provides training to medical students, interns, residents, fellows, nurses, or other health professionals and providers, provided that such educational programs are accredited by the appropriate national accrediting body.Source: AHA Membership Database. To be identified as a teaching hospital, the hospital site must meet at least one of the following criteria: be recognized for one or more Accreditation Council for Graduate Medical Education accredited programs; have a medical school affiliation reported to the American Medical Association; be a Council of Teaching Hospitals (COTH) member; have internships approved by the American Osteopathic Association (AOA); or have residencies approved by AOA.<h2>System Affiliation</h2>Definition:&nbsp;A hospital is considered “affiliated” if it is owned, leased, or managed by a health care system. Unaffiliated hospitals are called “independent” or “stand-alone.”Source: AHA Membership Database<h3>End Notes</h3><hr><ol><li>�� Association (AHA), “AHA Hospital Statistics, 2023 Edition.”</li><li><a href="https://www.irs.gov/charities-non-profits/charitable-hospitals-general-requirements-for-tax-exemption-under-section-501c3">irs.gov/charities-non-profits/charitable-hospitals-general-requirements-for-tax-exemption-under-section-501c3&nbsp;</a></li><li><a href="https://www.irs.gov/pub/irs-pdf/i990sh.pdf">irs.gov/pub/irs-pdf/i990sh.pdf</a></li><li><a href="https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data/index.html">medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaidchip-application-eligibility-determination-and-enrollment-reports-data/index.html</a></li><li><a href="/guidesreports/2022-10-21-exploring-metropolitan-anchor-hospitals-and-communities-they-serve" target="_blank">aha.org/guidesreports/2022-10-21-exploring-metropolitan-anchor-hospitals-and-communities-they-serve</a></li><li><a href="https://www.cms.gov/medicare/health-safety-standards/certification-compliance/critical-access-hospitals">cms.gov/medicare/health-safety-standards/certification-compliance/critical-access-hospitals&nbsp;</a></li><li><a href="/costsofcaring" target="_blank">aha.org/costsofcaring</a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li><li>Taitane Santos, Simone Singh, and Gary J. Young, “Medicaid Expansion and Not-For-Profit Hospitals’ Financial Status: National and State-Level Estimates Using IRS and CMS Data, 2011-2016,” Sage Journals Medical Care Research and Review 79 no. 3 (April 22, 2021): 448-457,</li><li>Medicaid and CHIP Payment and Access Commission (MACPAC), “Medicaid Enrollment Changes Following the ACA,” March 31, 2022, at&nbsp;<a href="https://www.macpac.gov/subtopic/medicaid-enrollment-changes-following-the-aca/" target="_blank">macpac.gov/subtopic/medicaid-enrollment-changes-following-the-aca/.</a> The 34% increase in Medicaid enrollment represents growth from 2013 to 2020.</li><li>See, for example, Susan Camilleri, “The ACA Medicaid Expansion, Disproportionate Share Hospitals, and Uncompensated Care,” Health Services Research 53 no. 3 (May 8, 2017): 1562-1580,&nbsp; and David Dranove, Craig Garthwaite, and Christopher Ody, “Uncompensated Care Decreased At Hospitals In Medicaid Expansion States But Not At Hospitals In Nonexpansion States,” Health Affairs 35 no. 8 (August 1, 2016) 1471-1479.</li><li>Schedule H instructions were updated in 2013 and included the following direction: “‘Direct offsetting revenue’ also includes restricted grants or contributions that the organization uses to provide a community benefit, such as a restricted grant to provide financial assistance or fund research.” While this change had the largest impact on the research category, it could also impact other benefit categories if a hospital received grant funding for activities included under another Schedule H category (e.g., a grant related to community health improvement services). See&nbsp;<a href="https://www.irs.gov/pub/irs-prior/i990sh--2013.pdf" target="_blank">irs.gov/pub/irs-prior/i990sh--2013.pdf.</a></li><li>For more information on the Community Benefit Insight (CBI), see&nbsp;<a href="https://www.communitybenefitinsight.org/" target="_blank">communitybenefitinsight.org/</a>. &nbsp;</li></ol>&nbsp;&nbsp;&nbsp;&nbsp;</div><div class="col-md-3">&nbsp;<div><div><div class="text-align-center external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/04/aha-cha-community-benefit-report-press-release-4-9-2025.pdf" target="_blank">Download Press Release PDF</a></div><a href="/system/files/media/file/2025/04/aha-cha-community-benefit-report-press-release-4-9-2025.pdf"><img src="/sites/default/files/inline-images/cover-aha-cha-community-benefit-report-press-release-4-9-2025.png" data-entity-uuid="54e38ca5-063e-4f34-8f35-8052f3d5de17" data-entity-type="file" alt="Image of Community Benefit Report Press Release" width="653" height="845"></a></div>&nbsp;<div class="text-align-center external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/04/community-benefit-report-social-media-content-toolkit.pdf" target="_blank">Download Toolkit PDF</a></div><img src="/sites/default/files/inline-images/cover-community-benefit-report-social-media-content-toolkit_0.png" data-entity-uuid="ac9be2b2-ca70-48db-ab2b-69e6ea1e252f" data-entity-type="file" alt="Cover Image of Community Benefit Toolkit" width="640" height="828"></div></div></div></div> Tue, 01 Apr 2025 15:52:32 -0500 Community Benefit Leadership Dialogue Series: The Importance of Advocacy and Storytelling in Rural Health /advancing-health-podcast/2025-03-31-leadership-dialogue-series-importance-advocacy-and-storytelling-rural-health In this Leadership Dialogue conversation, Tina Freese Decker, president and CEO of Corewell Health and 2025 AHA board chair, talks with Lori Wightman, R.N., CEO of Bothwell Regional Health Center, about the challenges that rural hospitals and health systems face, including razor-thin operating margins and workforce staffing, before pivoting to discuss the importance of advocacy in telling the hospital story.<hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:05 - 00:00:23:09 Tom Haederle Welcome to Advancing Health. In the face of today's multiple challenges, every hospital needs support and buy in for its mission of great care. Storytelling - sharing the right kinds of stories with the right audience at the right time - is a great way to build and maintain that support. This is particularly important for rural hospitals and health systems, most of which have razor-thin operating margins. 00:00:23:12 - 00:00:40:10 Tom Haederle In this month's Leadership Dialogue, hosted by the �� Association's 2025 Board Chair Tina Freese Decker, we hear more about the importance of advocacy and of all team members participating in telling the hospital story. 00:00:40:13 - 00:01:07:25 Tina Freese Decker Thank you so much for joining us today. I'm Tina Freese Decker, president CEO for Corewell Health, and I'm also the board chair for the �� Association. Last month we talked about trust and how our hospitals and our health systems can strengthen that trust with our communities and the people that we serve. Our rural hospitals are uniquely positioned to do this, as they are often the largest employers in their towns and communities, and frequently the only local source of care. 00:01:07:27 - 00:01:28:07 Tina Freese Decker Rural health care is about being a family. We take care of each other in our communities as best as possible, and we're here to provide that care close to home, no matter what headwinds that we all face. I recently had the opportunity to attend the �� Association's Rural Conference and you could really feel that sense of family and community in the room. 00:01:28:09 - 00:01:59:15 Tina Freese Decker We work in hospitals in red states and blue states all across the country, but we are all focused on the same thing: helping our neighbors in our communities to be healthier. There are some big challenges that are facing real health care, but together with a unified voice, we can get what we need. As I have traveled around our country meeting with the �� Association's regional policy boards and visiting the rural hospitals and my health system and others, the number one concern that I have heard from our hospitals, our communities, is access. 00:01:59:18 - 00:02:22:28 Tina Freese Decker And that is why it is so integral to the �� Association strategy and it is why it is so important that we come together as a field and that we're united as a field, because these challenges that we are facing are real. So today, I am pleased to have a distinguished leader in rural health care with us to talk about how we can all work together to advocate for the needs of our hospitals. 00:02:23:01 - 00:02:45:09 Tina Freese Decker I'd like to welcome Lori Wightman. She is the CEO of Bothwell Regional Health Center, a 108 bed acute care hospital in Sedalia, Missouri. Laura has served in this role since 2019, but even prior to Bothwell, she worked in real health care as the president of Mercy Hospital Ada in Ada, Oklahoma. So, Lori, welcome. Glad you were able to join us today. 00:02:45:15 - 00:02:46:17 Lori Wightman, R.N. Thank you, Tina. 00:02:46:19 - 00:03:03:20 Tina Freese Decker And I wanted to start out with just telling us a little bit about yourself. I know you started your health care career as a nurse and then you made the shift to administration. Can you tell us about yourself and how you see that family aspect in the hospital and the community in our rural areas? 00:03:03:22 - 00:03:30:01 Lori Wightman, R.N. Sure. Well, my father was a hospital administrator and my mother was a nurse, so I did both. And so it was a natural progression. And I think the foundation that nursing lays gives you all kinds of transferable skills that have been very helpful as I went into hospital administration. My career and dating advice has always been, you can't go wrong with a nurse. 00:03:30:03 - 00:03:57:14 Lori Wightman, R.N. And there's certainly served me well. And you talk about that family atmosphere. That is why I continue to choose rural health care. I've done the CEO position in a suburban hospital, and I sat at our senior leadership team meeting and thinking I was the only one on our senior leadership team that even lived in the area that we served. 00:03:57:17 - 00:04:23:24 Lori Wightman, R.N. Everyone else lived in a different suburb, and I just thought that was strange and disconnected. And, so I returned again then to rural health care because it is like a family. And it's ironic because we just finished revisiting our mission, vision and values. And our new mission statement talks about together we work to provide compassionate and safe care to family, friends, and neighbors. 00:04:23:27 - 00:04:37:07 Lori Wightman, R.N. Invariably, when I met new employee orientation, a significant number of people were born at the hospital. That's why I love rural. It's like that "Cheers" phenomenon where everyone knows your name. 00:04:37:09 - 00:05:01:02 Tina Freese Decker Very true. I used to lead a couple of rural hospitals as well. And like you said, even just walking into a rural hospital it feels like family where everyone there knows your name and of course, protect things from a confidentiality and a privacy perspective, but that feeling that we're all in this together. So I love that your mission statement is about together, that you can make an impact on people's health. 00:05:01:05 - 00:05:13:28 Tina Freese Decker I described a little bit about what it's like to walk into a rural hospital. Can you share a little bit about what is like to be a rural hospital, what it means in today's environment and why it's such a great place to work? 00:05:14:01 - 00:05:47:06 Lori Wightman, R.N. Well, in many ways, rural hospitals are uniquely the same as our suburban or urban counterparts. Forty six million people depend on a rural hospital for their care. So we struggle with the same labor shortages, the cost of labor supplies and drugs is rising faster than our reimbursement. We have all of those same struggles. Unique is that family atmosphere, I think. 00:05:47:06 - 00:06:13:26 Lori Wightman, R.N. And we have multiple generations working at the hospital. Now, you can't say anything bad about anyone because invariably they're somehow related. Or they were best friends in high school, or they used to be married to each other. So I mean, it's unique in that way. We have the same types of struggles that &nbsp;our counterparts do. 00:06:13:28 - 00:06:18:03 Tina Freese Decker What pressures are you feeling the most acutely right now? 00:06:18:06 - 00:06:47:09 Lori Wightman, R.N. Well, you take all of those common challenges that I talked about, and you turn up the volume a little bit. Because for us, 78% of our patients and our volume is governmental payers, so 78% of our business, we're getting reimbursed below cost. You can't make that up in volume. So we rely on all of the governmental programs, you know, disproportionate share all of those things. 00:06:47:09 - 00:06:54:22 Lori Wightman, R.N. And, 340B is doing exactly for us what it was designed to do, save rural hospitals. 00:06:54:25 - 00:07:11:22 Tina Freese Decker Those areas are critical that they remain. And so that we can continue to provide that sustainable, high quality care in our communities and all of our communities. 78% being governmental. It's a huge portion of what we do and what we rely on for access and caring for people. 00:07:11:29 - 00:07:23:15 Lori Wightman, R.N. Right. We are the typical rural hospital. We have razor-thin margins and aging plant of 18 years. 00:07:23:18 - 00:07:31:10 Tina Freese Decker So those are challenges that you're trying to navigate right now with all of the other things that happen. And how is your staffing levels going? Are those going okay? 00:07:31:13 - 00:07:55:12 Lori Wightman, R.N. Have the same labor shortage issues. We still have 22 traveling nurses here, but we have started being very aggressive in a grow your own program. And so as soon as the next month we're going to cut that number in half and then, within six months, we're hoping to have all of contract staff out. 00:07:55:15 - 00:08:02:04 Tina Freese Decker Is that something that you're most proud of, or is there something else that you want to share that you're most proud of from a rural hospital perspective? 00:08:02:06 - 00:08:29:24 Lori Wightman, R.N. I think what I'm most proud of is you get to personally view the impact of your decisions on people. I'm very proud of our all the talented people that we have here, from clinicians to community health workers. All of our physicians get to use all of the things they learned in medical school and residency, because there isn't a lot of subspecialists, so they are working at the top of their license. 00:08:29:26 - 00:08:50:21 Lori Wightman, R.N. Just several months ago, one of our critical care physicians diagnosed a case of botulism. Now as an old infection control nurse I get very excited about that because I never thought in my career I would see botulism. But it was diagnosed and treated here and the person's doing well. 00:08:50:23 - 00:09:25:27 Tina Freese Decker Oh, that's wonderful to hear. When you talk about all the different people that are part of health care in rural settings, or also another settings, it's quite amazing to see how many different areas we need to come together to take care of our community. When you think about an even larger scale, from rural hospitals to urban and teaching hospitals and others, how do you think about the whole ecosystem of our field and how we, you know, do we need all of us or and is there a way to form that greater fabric and social connection, or is there something else that we should be doing? 00:09:25:29 - 00:09:50:21 Lori Wightman, R.N. We are all very interconnected and I believe we are all needed. And I especially feel that as an independent hospital, not part of a health system, this is my first independent hospital. I rely on my hospital association more than I ever did when I was working for a health system, because it all comes down to relationships. 00:09:50:21 - 00:10:18:13 Lori Wightman, R.N. And so how do you develop, how do you get yourself in situations where you are meeting and now working with your partners around the state or the region? Because it comes down to relationships, you really need to know who your neighbors are in terms of other hospitals, who you're referring your patients to and develop that working relationship because it is all interconnected. 00:10:18:13 - 00:10:25:06 Lori Wightman, R.N. And we rely on our partners that we refer to, and they rely on us, too. 00:10:25:08 - 00:10:43:23 Tina Freese Decker One of the things I heard you say about the Rural Health Conference that the �� Association just put on, and the value of the �� Association is that we're not alone. And those values of relationships are really critical. So I appreciate that. The �� Association also talks a lot about how do we tell the hospital story. 00:10:43:25 - 00:10:55:15 Tina Freese Decker So how do you engage in advocacy to make sure we're telling that hospital story so that our legislative leaders and others know the value that we're bringing to the community? 00:10:55:17 - 00:11:22:11 Lori Wightman, R.N. Well, we are surrounded by stories. And so the first thing is to always be picking up on what is the story that is surrounding us, and how can we capture that? Because the most effective way is to bring that patient or nurse or physician to the legislator to testify, because they are the most effective way of communicating a message. 00:11:22:18 - 00:11:49:07 Lori Wightman, R.N. You know, the suits can go and talk about data, but nothing is more effective than what I call a real person telling their story and how a decision or a potential decision is going to impact them and how it feels. The other thing we do is every October, it's become tradition. We have Advocacy Day with our board, at our board meeting. 00:11:49:09 - 00:12:21:12 Lori Wightman, R.N. We invite our state elected officials &nbsp;- so people representing us at the state capitol - to come to our board meetings. On election years their challengers also come and I invite the hospital association and they all answer two questions: What do you hope to accomplish in the next legislative session, and what do you think might get in the way? That sets the scene for my board to understand that part of their role in governance is advocacy. 00:12:21:14 - 00:12:29:19 Lori Wightman, R.N. And so I've had two of my board members...almost every legislative session I go and testify on on some bill. 00:12:29:21 - 00:12:50:01 Tina Freese Decker That is really a good idea. Thank you so much for sharing that. Do you have any other final suggestions for us as AHA members, as other hospitals, whether it's rural or urban, that we should think about or do as we think about advocacy and access or also field unity? 00:12:50:03 - 00:13:22:11 Lori Wightman, R.N. You know, having been on the board of two different state hospital associations, I get it. You know, sometimes members can be at odds with each other on a given issue. And my advice to AHA would be to play the role of convener, facilitating conversations between members to better understand each other's position. And if a middle ground can't be reached, then that might be an issue that AHA remains neutral on. 00:13:22:14 - 00:13:34:07 Lori Wightman, R.N. But there are so many issues where we can agree on and that is very much the role and what all of us depend on AHA to play in advocating. 00:13:34:09 - 00:14:02:15 Tina Freese Decker There's a lot that binds us together. Like you said, we're all caring for our neighbors and our communities, and that's the most critical piece of it. And we have to keep that front and center with every decision that we make and every action that we do. Well, Lori, thank you so much for being with us today on this AHA podcast, for sharing your expertise in rural health care and for talking about some new ideas that all of us can take forward to ensure that we're telling the hospital story in the best way possible. 00:14:02:18 - 00:14:21:09 Tina Freese Decker So while I know that we have our work ahead of us, I know that I continue to be energized every time I speak with committed and passionate hospital leaders like Lori. Again, appreciate your work that you do every single day for the neighbors and for the people in your community that you serve. We'll be back next month for another Leadership Dialogue conversation. 00:14:21:13 - 00:14:23:01 Tina Freese Decker Have a great day. 00:14:23:03 - 00:14:31:13 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </details></div> Mon, 31 Mar 2025 01:41:00 -0500 Community Benefit Rural care provider secures critical funding to stay open and serve patients /role-hospitals-bucktail-medical-center-rural-care-provider-secures-critical-funding-stay-open-and-serve-patients <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><img src="/sites/default/files/2025-03/ths-bucktail-medical-center-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Bucktail Medical Center facility exterior" width="700" height="532"></div>A grant from the Pennsylvania Department of Community and Economic Development has prevented the impending closure of Bucktail Medical Center and preserved its ability to deliver essential care to thousands of rural residents of central Pennsylvania.Beset by many of the same financial and economic challenges currently affecting numerous rural health care providers nationwide, Bucktail Medical Center’s services — including hospital care, a community clinic, imaging, lab, physical therapy, a 24-hour emergency room, acute care and more — represent access to lifesaving care for people who otherwise would face with much longer travel times for the same services.A coalition of local and state lawmakers coordinated efforts to secure the state funding, noting that the hospital is central not only to the health of the community but also to its economic well-being and ability to attract new business and thrive.“The $1 million makes it possible for Bucktail Medical Center to continue serving the health care needs of the Renovo community and western Clinton County,” said Laura Murnyack, CEO of Bucktail Medical Center. “Our doors remain open, and we offer comprehensive healthcare services for people of all ages, from infants to seniors.”<a class="btn btn-primary" href="https://bucktailmedicalcenter.org/bucktail-medical-center-secures-1-million-in-dced-funding-to-sustain-vital-healthcare-services/">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/community-benefit">Benefiting Communities</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Fri, 28 Mar 2025 15:12:58 -0500 Community Benefit Stellar care helps identical quadruplets to thrive in Arizona /role-hospitals-banner-university-medical-center-phoenix-stellar-care-helps-identical-quadruplets-thrive-arizona <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><img src="/sites/default/files/2025-03/ths-phoenix-quads-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Banner- University Medical Center Phoenix. One of the Vargas quadruplets rests in a bassinet." width="700" height="532"></div>Rachel and Marco Vargas recently welcomed four identical baby girls at Banner – University Medical Center Phoenix, a rare occurrence with odds estimated at one in 40 million.&nbsp;Despite facing numerous complications and high-risk factors, the couple remained hopeful and sought multiple medical opinions. Their perseverance paid off when Rachel successfully delivered the quadruplets on Jan. 24 at 30 weeks and three days, with the help of renowned multiple birth specialist John Elliott, M.D., who said he’d never seen a pregnancy like Rachel’s in his career.&nbsp;The sisters, Sofía, Philomena, Veronica and Isabel, are currently in the neonatal intensive care unit, receiving the necessary care and monitoring. Rachel and Marco, who also have a 1-year-old and a 3-year-old, recently moved to a new home to accommodate their growing family.&nbsp;“It certainly hasn’t been an easy journey,” Marco said, “but we’re so grateful for the realistic yet positive attitude that Dr. Elliott instilled in us, as well as the stellar care from all of the teams who have helped us at Banner.”&nbsp;Banner – University Medical Center Phoenix is recognized for its advanced care for high-order multiples and complex pregnancies. The Vargas family is looking forward to bringing their four little girls home soon and starting this new chapter in their lives.<a class="btn btn-primary" href="https://www.bannerhealth.com/newsroom/press-releases/quadruplets">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/community-benefit">Benefiting Communities</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 11 Mar 2025 14:26:17 -0500 Community Benefit