SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Southcoast Hospitals Group Inc
 
Employer identification number

22-2592333
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    9,464,410 4,271,140 5,193,270 0.800 %
b Medicaid (from Worksheet 3, column a) . . . . .     176,247,623 167,434,371 8,813,252 1.360 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     185,712,033 171,705,511 14,006,522 2.160 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     13,628,241 537,095 13,091,146 2.010 %
f Health professions education (from Worksheet 5) . . .     5,376,289 0 5,376,289 0.830 %
g Subsidized health services (from Worksheet 6) . . . .     4,068,696 636,399 3,432,297 0.530 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     418,071 0 418,071 0.060 %
j Total. Other Benefits . .     23,491,297 1,173,494 22,317,803 3.430 %
k Total. Add lines 7d and 7j .     209,203,330 172,879,005 36,324,325 5.590 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 1   2,353   2,353  
2 Economic development            
3 Community support 9   25,650   25,650  
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building 5   25,223   25,223  
7 Community health improvement advocacy            
8 Workforce development 2   59,380   59,380 0.010 %
9 Other            
10 Total 17   112,606   112,606 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,065,681
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
4,561,188
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
395,311,097
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
402,706,548
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-7,395,451
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SOUTHCOAST HOSPITALS GROUP INC
101 Page Street
New Bedford,MA02740
http://www.southcoast.org/
V113 		X X         X   ACUTE CARE HOSPITAL  
Schedule H (Form 990) 2018
Page 4
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SOUTHCOAST HOSPITALS GROUP INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Page 5
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SOUTHCOAST HOSPITALS GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SCH H, PART V, SECT C
b
SEE SCH H, PART V, SECT C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
SOUTHCOAST HOSPITALS GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SOUTHCOAST HOSPITALS GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Page 8
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B, LINE 3e As a community-based health delivery system, Southcoast Health System continually strives to identify the priority health needs of the community and to ensure that its services are aligned with these needs. The Community Needs Assessment assists with this goal by documenting the major demographic, socioeconomic, and health trends among Southcoast residents and by engaging the community to develop information-driven priorities and strategies that can be implemented to improve the overall health of Southcoast residents. All significant health needs are identified in the CHNA. PART V, SECTION B, LINE 5 SHG, IN 2016, CONDUCTED A MAJOR, THREE-YEAR HEALTH NEEDS ASSESSMENT WITH A PARTICULAR FOCUS ON ADDRESSING HEALTH EQUITY ISSUES IN AND AROUND THE COMMUNITIES THAT WE SERVE. AS PART OF THIS NEEDS ASSESSMENT, WE REVIEWED FOCUS GROUP, INTERVIEW AND OTHER DATA FROM VULNERABLE RESIDENTS IN OUR COMMUNITIES INCLUDING BOTH QUANTITATIVE AND QUALITATIVE DATA. WE ALSO HELPED LEAD A PARTICIPATORY RESEARCH PROJECT, IN COLLABORATION WITH THE COALITION, VOICES FOR A HEALTHY SOUTHCOAST, THAT UTILIZED NEIGHBORHOOD RESIDENTS FROM TWO VULNERABLE NEIGHBORHOODS IN OUR REGION, THE SOUTH END OF NEW BEDFORD AND THE FLINT NEIGHBORHOOD IN FALL RIVER, TO ASSESS OTHER RESIDENTS' ATTITUDES TOWARD HEALTH. OUR NEEDS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE UNIVERSITY OF MASSACHUSETTS DARTMOUTH PUBLIC POLICY CENTER, WHO COMPLETED A RETROSPECTIVE ANALYSIS OF LOCAL, REGIONAL AND NATIONAL HEALTH AND DEMOGRAPHIC DATA. IN ADDITION TO HEALTH DATA ANALYSIS, WE ALSO CONDUCTED OVER 30 KEY INFORMANT INTERVIEWS WITH BOTH SERVICE PROVIDERS AND CONSUMERS. INTERVIEWS INCLUDED: GREATER NEW BEDFORD COMMUNITY HEALTH CENTER; COMMUNITY HEALTH WORKERS; PUBLIC HEALTH NURSE, MATTAPOISETT; PUBLIC HEALTH NURSE, MARION; STANLEY STREET RESOURCE AND TREATMENT CENTER; HEALTH FIRST COMMUNITY HEALTH CENTER; GREATER NEW BEDFORD ALLIES FOR HEALTH AND WELLNESS; SEVEN HILLS BEHAVIORAL HEALTH; POSITIVE ACTION AGAINST CHEMICAL ADDICTION; HIGH POINT TREATMENT CENTER; SOUTH SHORE MENTAL HEALTH; STEPPING STONE INC.; CHILD & FAMILY SERVICES; WAREHAM SUPERINTENDENT OF SCHOOLS; ASST. SUPERINTENDENT, NEW BEDFORD SCHOOLS; SCHOOL ADJUSTMENT COUNSELORS, FALL RIVER PUBLIC SCHOOLS; FAMILY RESOURCE COORDINATOR, WAREHAM SCHOOLS; SCHOOL NURSE, FALL RIVER; NORTH STAR LEARNING CENTER; INTERCHURCH COUNCIL OF GREATER NEW BEDFORD; WAREHAM AREA CLERGY COUNCIL; MAYA COMMUNITY OUTREACH; PARTNERS FOR A HEALTHIER COMMUNITY, FALL RIVER; UNITED NEIGHBORS, FALL RIVER; YWCA OF SOUTHEASTERN MASSACHUSETTS; IMMIGRANTS ASSISTANCE CENTER; SOUTHCOAST COMMUNITY HEALTH WORKER COLLABORATIVE; UNITED WAY GREATER NEW BEDFORD; COMMUNITY ECONOMIC DEVELOPMENT CORPORATION - NEW BEDFORD; CHILDREN'S ADVOCACY CENTER OF BRISTOL COUNTY; FATHER BILL'S AND MAINSPRING; NEW BEDFORD HOUSING AUTHORITY; CATHOLIC SOCIAL SERVICES, WOODS AT WAREHAM; WAREHAM HEALTH DEPARTMENT; FALL RIVER HEALTH DEPARTMENT; WAREHAM SELECTBOARD; MAYOR'S OFFICE NEW BEDFORD; DOG TAG NAVIGATORS, REGIONAL; VETERAN AGENT FALL RIVER; VETERAN AGENT NEW BEDFORD; TRIPS FOR KIDS; DARTMOUTH YOUTH SERVICES; FALL RIVER YOUTH SERVICES; COASTLINE ELDERLY SERVICES
PART V, SECTION B, LINE 6B SOUTHCOAST HOSPITALS GROUP, INC. COLLABORATES WITH THE UNIVERSITY OF MASSACHUSETTS DARTMOUTH PUBLIC POLICY CENTER.
PART V, SECTION B, LINE 7A HTTPS://WWW.SOUTHCOAST.ORG/WP-CONTENT/UPLOADS/2016/05/SOUTH-COAST-CHNA-201 6-FINAL.PDF
PART V, SECTION B, LINES 7D Our needs assessment is widely shared with community partners and is often used in grant writing and collaborative strategic planning. In FY 2019, our needs assessment data was shared with and utilized by: Greater New Bedford Allies for Health and Wellness (CHNA 26) Partners for a Healthier Community (CHNA 25) United Way South End Engaged Initiative Wareham Community Services Collaborative BMC Healthnet Plan Coastal Foodshed Laundry of Love Boys and Girls Club of New Bedford and Wareham New Bedford Health Department New Bedford Housing Authority Substance exposed newborn committee of SEMA Wareham Health Department Wareham Public Schools' Beyond School Time YMCA Southcoast.
PART V, SECTION B, LINE 10A https://www.southcoast.org/community-benefits/community-benefits-reporting /
PART V, SECTION B, LINE 11 Southcoast's Community Benefits Strategic Action Plan was first formulated in 1998 as the result of an extensive needs assessment and since is updated annually. Our current plan is based on the community health needs assessment completed in 2016. Through the needs assessment process, Southcoast identified nine priorities for 2019 to address the most pressing health needs of the community. These priorities were: 1. Reduction of the high rate of chronic disease (including diabetes, asthma, cancer and other diseases) in our region. 2. Reducing Health Disparities including racial and ethnic disparities, income-based disparities, and education-based disparities. One other aspect of this is increasing access to health care for vulnerable populations through insurance enrollment and outreach. 3. The development of programs and services that support the reduction of homelessness in our region including strategies for increased collaboration among agencies serving homeless residents. 4. Innovative approaches to population health, i.e. improving health and wellness for defined populations such as specific demographic or geographic groups. 5. Reduction in the incidence of youth risk behaviors such as teen violence, high rates of teen pregnancy and substance abuse. 6. Behavioral health issues that include substance abuse and mental health, including improved coordination of behavioral health providers and systems. 7. Development of healthy "System and Environment" change, including healthy food options, increased access to free and low-cost opportunities for active living, such as public parks, bike trails etc., and reduction in the high rate of smoking in our communities. 8. Maternal and Children's Health, including fetal and infant health, abuse and neglect, hospitalizations, substance abuse, healthy weight, and mortality. 9. Increasing Emergency Preparedness in our cities and towns, including basic infrastructure equipment. All activities of Community Benefits are completed in accordance with these priorities and include: conducting ongoing community health needs assessments, awarding Community Benefits Impact Opportunity Grants to community organizations working on projects aligned with CHNA priorities, coalition-building, and collaborating with community partners in the planning, implementing, monitoring and evaluating of Community Benefits programs as described below. Responsible Attitudes Towards Pregnancy, Parenting and Prevention (RAPPP) Youth Program, Smoking Cessation and Prevention Community Health Worker Projects, Maternal Child Health Education and Outreach, Cancer Screenings and Outreach, Mobile Health Van, Health Access Outreach, Emergency Preparedness, Council to End and Prevent Homelessness, Behavioral Health Connect, Substance Use Prevention Education, Health Advocates, Cardiac Prevention and Stroke Outreach, Diabetes Education and Outreach. To address needs, target populations are determined by our comprehensive health needs assessment and are reviewed on an annual basis. Our 2019 target populations included: - South Coast residents who suffer disproportionately from chronic disease such as cardiovascular disease, diabetes, cancer and respiratory disease. Particular focus is given to residents who experience barriers to care due to language, culture, race, income or education. - Area youth who are at high risk for problems such as teen pregnancy, violence, substance abuse, lack of educational attainment and other risky behaviors that affect health and wellbeing. This includes Gay/Lesbian/Bisexual/Transgender (GLBT) youth. - Residents who lack access to regular primary health care due to lack of health insurance or other barriers. - Residents and their families who are impacted by mental/behavioral health issues, including substance use disorder, particularly those who experience barriers to or breaks in care and are forced to rely on the Southcoast Emergency Department for regular care. - Area Boards of Health, Emergency Medical Services and other municipal agencies whose programs impact a number of aspects of health for their residents, and who have experienced severe budget cuts that have impacted these programs. This may include smoking cessation and prevention, chronic disease management and emergency preparedness. - Public housing residents, who suffer disproportionately from health disparities and have high rates of unhealthy risk factors including smoking, obesity and hypertension. - Homeless residents on the South Coast, particularly in the town of Wareham, where the rate of unsheltered homeless exceeds other towns in the region and approaches South Coast cities that have five times the population. - Those in our communities who experience health disparities due to racial, ethnic or economic factors. These include residents for whom English is not a first language, especially undocumented immigrants. In 2019, we focused resources on residents who are at risk for or suffer from disparities in cancer prevention and treatment. - The fishing community in New Bedford, who experience higher rates of chronic health issues due to barriers to health access and care.
PART V, SECTION B, LINE 16A HTTPS://WWW.SOUTHCOAST.ORG/WP-CONTENT/UPLOADS/2016/09/CREDIT-COLL-POL-2016 -FAP-FINAL.PDF
PART V, SECTION B, LINE 16B HTTPS://WWW.SOUTHCOAST.ORG/WP-CONTENT/UPLOADS/2016/09/APPLICATION-FOR-FINA NCIAL-ASSISTANCE-ACA-3-ENGLISH-4.16-1.PDF
PART V, SECTION B, LINE 16C HTTPS://WWW.SOUTHCOAST.ORG/WP-CONTENT/UPLOADS/2016/09/PLAIN-LANGUAGE-SUMMA RY-FAP-OVERVIEW-2016-1.PDF
PART V, SECTION B, LINE 20A-D SHG DID NOT ENGAGE IN ANY OF THE ACTIONS IN LINE 19 IN FY2019.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Page 9
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2018
Page 10
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C DISCOUNTS ARE AFFORDED TO A "QUALIFYING PATIENT" - PATIENT WHO IS NOT ELIGIBLE FOR OTHER FINANCIAL ASSISTANCE AND WHO IS UNINSURED FOR MEDICALLY NECESSARY HOSPITAL SERVICES. ELIGIBLE BALANCES ARE THOSE AMOUNTS FOR WHICH QUALIFYING PATIENTS HAVE FULL RESPONSIBILITY DUE TO LACK OF INSURANCE. OBLIGATIONS DO NOT INCLUDE CO-INSURANCE, DEDUCTIBLES OR BALANCES DUE AFTER INSURANCE OR OUT-OF-NETWORK SERVICES. A DISCOUNT OF 25% OF THE TOTAL CHARGES WILL BE APPLIED AT THE TIME OF INITIAL BILLING. ADDITIONAL DISCOUNTS MAY BE POSSIBLE BASED ON THE SIZE OF THE BALANCE, TIMELINESS OF PAYMENT AND FINANCIAL NEED. THESE ARE GIVEN INDIVIDUAL CONSIDERATION. SHG WILL SEEK TO ADVISE QUALIFYING PATIENTS WITH RESPECT TO AVAILABILITY OF DISCOUNT PURSUANT TO THIS POLICY AS WELL AS THE AVAILABILITY OF LOW INCOME AND MASSHEALTH BENEFITS.
PART I, LINE 7 ACTUAL COST FOR ALL SHG PATIENT SEGMENTS WAS USED TO CALCULATE THE VALUE OF CHARITY CARE.
PART I, LINE 7G INCLUDED IN SUBSIDIZED HEALTH SERVICES AT COST ARE COSTS AND OFFSETTING REVENUES ASSOCIATED WITH SHG'S LEVEL II NURSERY AND INPATIENT REHABILITATIVE SERVICES. SHG IS THE SOLE PROVIDER OF THESE SERVICES IN ITS COMMUNITIES AND PROVIDES SUCH SERVICES AS A COMMUNITY BENEFIT DESPITE THE LOSSES INCURRED.
PART II Southcoast engages in a number of community building activities that promote infrastructure improvement in communities and the development of policies and programs that address social determinants of health such as housing, behavioral health, education and workforce development. Southcoast is the co-leader of the Bristol County Opioid Alliance, a regional coalition focused on increasing communication and collaboration of all entities working to address the Opioid Epidemic across the South Coast Region. We also lead collaborative groups that have helped expand housing options in the town of Wareham and the city of New Bedford and address groups that address other social conditions that influence health. Southcoast has provided leadership training and support on health advocacy issues such as regulations to limit tobacco access and has worked to increase access to healthy food through food rescue programs, supporting local initiatives led by community partners and by hosting weekly farm stands at our three Hospital sites each summer that are open to our employees and community members.
PART III, LINE 2 THE COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 WAS BASED ON A RATIO OF COST TO CHARGE METHODOLOGY. DISCOUNTS AND PAYMENTS ON ACCOUNTS CONSIDERED AS BAD DEBT OFFSET THE TOTAL BAD DEBT EXPENSE RECORDED. PART III, LINE 3 PER SHG'S ASSESSMENT OF THE COMMUNITY IT SERVES, A CERTAIN PERCENTAGE OF THE POPULATION WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DO NOT APPLY. DUE TO THIS SHG CONSIDERS THIS AMOUNT OF BAD DEBT AS A COMMUNITY BENEFIT EXPENSE. PART III, LINE 4 FOR PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, SHG RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED BY POLICY. ON THE BASIS OF HISTORICAL EXPERIENCE, A PORTION OF SHG'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, SHG RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. FOOTNOTE 2 BEGINNING ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS DISCUSSES BAD DEBT EXPENSE.
PART III, LINE 8 THE COST ACCOUNTING METHODOLOGY USED IS THE SAME METHODOLOGY USED FOR THE MEDICARE SHORTFALL. THE MEDICARE SHORTFALL SHOULD BE RECOGNIZED AS A COMMUNITY BENEFIT SINCE SHG IS REQUIRED TO PROVIDE SERVICES TO ALL REGARDLESS OF THE ABILITY TO PAY FOR SUCH SERVICES.
PART III, LINE 9B SHG'S CREDIT AND COLLECTION POLICY CONTAINS PROVISIONS REGARDING COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR OTHER FINANCIAL ASSISTANCE. FOR INDIVIDUALS DETERMINED TO BE LOW INCOME PATIENTS ANY SERVICES PROVIDED PRIOR TO SUCH DETERMINATION DATE AND NOT COVERED UNDER THE SAFETY NET (HSN) WILL BE WRITTEN OFF AS CHARITY CARE. ANY SERVICE DENIED BY THE HSN FOR MEDICALLY NECESSARY SERVICES WILL ALSO BE CONSIDERED CHARITY CARE. ANY COPAYMENTS OR DEDUCTIBLES FOR MASSHEALTH AND MASSHEALTH MANAGED CARE RECIPIENTS WILL BE CONSIDERED CHARITY CARE IF UNRESOLVED AT THE CONCLUSION OF SHG'S COLLECTION PROCESS. THE FOLLOWING ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS: 1. PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, EXCEPT SHG MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM FOR THEIR REQUIRED COPAYMENTS AND DEDUCTIBLES AS SET FORTH IN EACH PLAN; 2. SHG MAY INITIATE BILLING AND COLLECTION FOR A PATIENT ALLEGING TO PARTICIPATE IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF SHG SERVICES BUT FAILS TO PROVIDE PROOF OF PARTICIPATION; 3. SHG MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME DETERMINATION, HOWEVER, COLLECTION ACTION WILL CEASE ONCE ELIGIBILITY IS DETERMINED; AND 4. SHG WILL NOT SEEK COLLECTION FROM AN INDIVIDUAL WHO HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HSN WITH RESPECT TO THE AMOUNT OF THE BILL EXCEEDING THE MEDICAL HARDSHIP CONTRIBUTION. SHG WILL NOT PURSUE COLLECTION FROM A PATIENT INVOLVED IN BANKRUPTCY PROCEEDING AND WILL NOT CHARGE INTEREST IN AN OVERDUE BALANCE OF A LOW INCOME PATIENT.
PART VI, LINE 2 In addition to completing a comprehensive, regional community health needs assessment every three years, Southcoast participates in and leads over 30 community coalitions and actively participates in a number of projects every year that collect and analyze information about the social and health care needs of the residents living in the South Coast Region. These activities include tracking hospital data such as the number of patients reporting homelessness, overdose data, and food insecurity; to working with coalition partners to conduct outreach/surveys and focus groups on a number of topics (aligning with our priorities). We meet regularly to discuss the success of these projects and to make sure that we are having the desired impact within the community. In 2019, Southcoast Health completed its fourth Community Benefits Impact Opportunity grant program. This is a competitive grant process focused on addressing unmet health needs on the South Coast. The grant proposals aligned with the nine priority areas, previously identified through the 2016 Community Health Needs Assessment. We received 45 applications and awarded 18 grants for a total of $150,000 plus in-kind donations. Grantees are expected to set at least 2 SMART goals and evaluate the success of their programs, submitting data at six months and one year. Finally, through community benefits programs, such as the Mobile Health Van, we are able to document and track pressing health needs as reported by staff conducting outreach and through the patients served.
PART VI, LINE 3 Southcoast posts notifications of insurance eligibility in multiple languages throughout all of our inpatient and outpatient facilities, and provides information on our website. Southcoast also utilizes multilingual outreach brochures, displayed in our facilities and also distributed at a number of health insurance outreach events and also through regular outreach on our Mobile Health Van. In 2019, our Patient Access Department held 48 community outreach events, which is 41% increase over FY18. The department served 15,858 patients, which is a 20% increase over FY18.
PART VI, LINE 4 Southcoast Health system serves a diverse region along the South Coast Region of Massachusetts, including several urban centers with a number of demographic challenges, and rural and suburban towns. Overall, the South Coast's population increased by 2.8 percent since the beginning of the century and by 12.2 percent since 1970, both of which lag behind the statewide population growth rates for those periods. This gap appears to be mostly driven by long-term population declines in Fall River and New Bedford, although the population of New Bedford has increased slightly since 2010. Perhaps the most significant demographic trend in the region is its changing racial makeup. This is particularly true in the city of New Bedford, where non-White residents account for 36.6 percent of the city's population. Communities throughout the South Coast are becoming more diverse. Between the 2006-2010 and 2013-2017 periods, the minority population in the region increased by 4.7 percent (16,945 people). Fall River experienced the largest percentage increase in its minority population (7.7% or 6,895 residents), followed by New Bedford (6.7% or 6,433 residents), Fairhaven (6.6% or 1,056 residents), and Wareham (5.4% or 1,329 residents). The schools of the South Coast are often more diverse than the communities as a whole. For example, New Bedford's public schools are now majority non-white with Hispanic and Black students representing 40.5 and 12.5 percent of the total student population, respectively. The higher share of minorities in the school system compared to the community is, in part, a product of the national trend of minority births exceeding white births. As this trend continues, the student population in the region will only grow more diverse. The South Coast has long been an attractive place to settle for immigrants, as evidenced by foreign-born residents representing 14.5 percent of the region's population. As Gateway Cities, New Bedford and Fall River have been traditional destinations for new arrivals to America since the late 18th century. During the 2013-2017 period, 18.7 percent of residents in Fall River and 20.0 percent of residents in New Bedford were born outside of the country. In both cities, Portuguese immigrants make up the majority of the foreign-born residents. However, as emigration from Europe to the U.S. has slowed, Latin American and Asian immigrants make up increasing shares of the populations in New Bedford and Fall River. As major destinations for the region's newly arrived immigrants, New Bedford and Fall River have the highest shares of residents reporting limited English proficiency, 14.0 percent and 17.5 percent, respectively. The age cohorts in the South Coast generally reflect their counterparts at the state level. However, the region has a slightly higher share of residents 65 years of age or older, which is more pronounced in the region's towns. Fall River and New Bedford have larger shares of the population under the age of 35 when compared to their metro areas and the South Coast overall. As a region, the South Coast has long struggled with low levels of educational attainment. Although the regional average is primarily driven by the low levels of educational attainment in Fall River and New Bedford, many of the region's towns also lag behind the state in educational attainment of post-secondary degrees. In both cities, the majority of the population 25 years of age or older has never attended a college or university. Additionally, when compared to the adult population statewide, both Fall River and New Bedford have nearly three times the percentage of adults who have not completed high school (27.9% and 27.3%, respectively) compared to the Commonwealth (9.7%). Inflation-adjusted median household income increased in seven South Coast communities from the 2006-2010 to the 2013-2017 periods. Seven South Coast communities have median incomes that are above the state average. Median incomes are particularly low in Fall River (4th lowest in Massachusetts) and New Bedford (7th lowest in Massachusetts). Acushnet, Fairhaven, Somerset, and Wareham also have median incomes below the state average. While the South Coast has a higher share of people living in poverty than the state, the region's cities are home to disproportionate shares of people in poverty. Over 20 percent (20.2%) of all people in Fall River and 23.1 percent of people in New Bedford live in households with annual incomes below the poverty level. This translates to 39,247 individuals living in poverty in just the cities of the South Coast alone. Poverty rates decreased in five South Coast communities between the 2008-2012 and 2013-2017 periods, while rates increased in eight communities. In Fall River and New Bedford, these measures of poverty are higher than the region and the state as a whole. For example, less than 10 percent of all families statewide live in poverty (7.8%), compared with 11.9 percent of all families in the South Coast and 17.5 percent of families in Fall River and 19.3 percent of families in New Bedford. In addition, the percentage of families with children living in poverty in Fall River and New Bedford is more than double the statewide percentage. The region's changing racial makeup and continued socioeconomic struggles place unique stresses on healthcare delivery, particularly in addressing health disparities based on race, income, and education. The region's health is affected by the physical conditions of the South Coast. A person's physical environment can profoundly affect health outcomes. Environmental factors that affect health outcomes include, but are not limited to, access to healthy food, air quality, water quality, and environmental contamination. In particular, exposure to contaminants through pathways from the air, water, soil, and food can lead to extreme health issues. The analysis shows that South Coast residents face environmental factors that may be a detriment to their health. For example: - Bristol County, which comprises most of the Southcoast Service area, has the highest rate of food insecurity in southeastern Massachusetts, with 10.3 percent of all county residents lacking access, at times, to enough food for an active, healthy life. - Walkable communities allow residents to reduce or even eliminate their use of automobiles, typically the second largest household expense in the U.S. These communities also convey immediate benefits to the environment since, unlike motorized transportation, walking produces no pollutants. Walking has the potential to confer beneficial effects for health, personal finances, the environment and more. The South Coast cities of Fall River and New Bedford scored a WalkScore of 66 and 65 out of 100. This means they are characterized as "somewhat walkable" communities. However, the more rural town of Wareham, is much less walkable and scored a 48 out of 100, characterizing the town as "car-dependent". - The South Coast is home to a number of sites that contain and/or generate contaminants that can negatively affect residents' health. The South Coast is home to 57 of the state's 1,012 brownfield sites. Twelve of these are located in Fall River and 28 are located in New Bedford. On a per square mile and per 1,000 population basis, these cities have higher ratios of brownfield sites compared to the state. of these are located in Fall River and 28 are located in New Bedford. On a per square mile and per 1,000 population basis, these cities have higher ratios of brownfield sites compared to the state.
PART VI, LINE 5 Southcoast Hospitals Group invests in direct services and programs designed to address pressing health issues across our region. We collaborate with hundreds of community partners to adopt best practices in community benefits needs assessment, planning and implementation, with the shared goal of improving the health of our communities. Targeted activities included: Behavioral Health Issues Expanded usage of our Behavioral Health Connect database (by over 34%), which links providers and residents with up-to-date resources for behavioral health services. A number of our staff also played a leadership role in 12 local and regional coalitions to address the opioid crisis, including supporting the availability of Narcan in our region. Smoking Cessation Continued work on smoking cessation and prevention that encompasses regulatory system and environment change along with education and clinical support for smoking cessation. The Southcoast Health Van continued work on a grant from the Thoracic Foundation to expand smoking cessation support for public housing residents throughout the region, as more municipal Housing Authorities in our region embrace smoke-free regulations and increase the age of which a person may purchase cigarettes or other tobacco products from 18 to 21 years old. Health Screenings Outreach to vulnerable residents with a range of health screenings and referrals. Over 5,000 residents visited our health van and staff provided over 20,000 screenings and vaccinations. This included screenings for cardiovascular disease, cancer, diabetes and stroke and targeted our most vulnerable and under-served populations. In FY19, in partnership with the New Bedford Health Department and New Bedford Public Schools, the Mobile Health Van assisted in 13 pediatric clinics that assisted students to receive school vaccinations. Overall, 178 students received vaccinations for a total number of 456 vaccinations given. Youth Risk Behaviors Due to unfortunate circumstances, the Youth Risk Behaviors program was canceled in June 2019. Health Insurance Targeted outreach that helped residents obtain health insurance, staff assisted 15,858 patients with applications in 2019. Our patient access team conducted over 48 outreach events that reached thousands of vulnerable residents who still lack health insurance or have difficulty renewing their health insurance. Community Health Workers Collaboration and programming to address health equity issues in our region by working to increase the capacity and training of community health workers, particularly those serving residents who face cultural, linguistic and economic barriers to health care. This past year we were able to expand CHW outreach for chronic disease management and helped organize supervisor and other CHW trainings. Collaboration Coalition building and engagement that helped make meaningful connections across communities and our region. We participated over 30 coalitions region wide to address the pressing social conditions that impact health including access to safe and affordable housing, transportation, food security, educational attainment, employment, environmental justice and mental health and substance use disorders. Grant Support This past year we offered a Community Benefits Impact grant program to provide funding which better aligns Southcoast community benefits priorities with projects undertaken by community partners. We supported 18 community partners with $150,000 in funding for projects ranging from outreach to the homeless to providing opportunities for physical activities for inner city youth. This program has not only supported worthwhile projects in the community but also has enhanced collaboration and common goal setting with our community partners.
PART VI, LINE 6 The Southcoast Health Community Benefits program works with other Southcoast affiliates including, Southcoast Behavioral Health, Southcoast Visiting Nurses Association, Southcoast Physicians Group, Southcoast Health System and Southcoast Network, to coordinate all community benefit activities designed to address pressing health issues in our region and improve access to health care. Overall approach incorporates the social determinants of health framework, and takes into account environmental, social and other demographic factors that may influence health status. Representatives from affiliated systems participate as active members of an internal Community Benefits Leadership team that meets bimonthly to share program information, discuss needs assessment, develop strategies, implementation process, evaluation and reporting of all community benefits programs. This team consists of individuals from departments that regularly engage in outreach in the community, including staff from our Southcoast Health Van, Social Services, Stroke Outreach, Diabetes Management, Behavioral Health Services, Patient Access Services, Cancer Outreach, Smoking Cessation, Youth Risk Behaviors program, Urgent Care and the Southcoast Physicians Group. The Community Benefits Manager oversees Southcoast's day-to-day community benefits activities and leads the internal Community Benefits Task Force. Southcoast also shares regular updates and presentations on community benefits activities to all Southcoast Hospital staff and affiliates through leadership meetings, employee communications and in digital media campaigns.
PART VI, LINE 7 YES, AN ANNUAL REPORT IS FILED WITH THE OFFICE OF THE MASSACHUSETTS ATTORNEY GENERAL.
Schedule H (Form 990) 2018
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