Community Benefit

July 2016 Community Benefit Update

We would like to share the following community benefit news and resources with you.

Reporting Costs of Mentoring as Community Benefit
Congress Requests Information from IRS on Tax-Exempt Hospital Billing and Collection Practices
New Resource on the Social Determinants of Health
Updates from Hilltop Institute
Upcoming CHA Events
Community Benefit in the News

Reporting Costs of Mentoring as Community Benefit
CHA has updated its guidance on reporting the costs related to staff time mentoring/precepting students in nursing and other health professions. The previous guidance suggested that organization report no more than 25 percent of a staff person's time whereas the new guidance describes the various factors an organization should consider when determining these costs. CHA feels that this will provide a more accurate picture of the organization's contribution.

Revised Guidance
We recommend including the incremental cost of hospital staff who mentor/precept nursing students (and students in other health disciplines) based on each hospital's experience with this type of health professions education. In general, while nursing and other students are receiving clinical experience, patient care is being provided and incremental costs are difficult to determine. Hospitals should include the cost associated with training their nurses and other staff to serve as preceptors, and also the cost spent by staff in educational activities that occur outside of regular duties (e.g., didactic/classroom experiences before or after regular shifts).

Each organization should quantify staff time devoted to mentoring or precepting students based on their unique circumstances, recognizing that when students are present, they may or may not affect staff productivity. The students may perform work that otherwise would fall to staff. Hospitals should ask staff members to estimate the amount of time they devote to precepting students away from their regular duties (which may increase staff time), and value incremental costs accordingly.

Congress Requests Information from IRS on Tax-Exempt Hospital Billing and Collection Practices
On June 9, 2016, Sen. Charles Grassley (R-Iowa), chairman of the Senate Judiciary Committee, sent a letter to the IRS commissioner requesting more information about the agency's oversight of tax-exempt hospital billing and collection practices. The letter was prompted by the senator's investigation into Mosaic Life Care, a nonprofit hospital in St. Joseph, Mo., whose billing and collection practices had been the focus of a 2014 news story.

On May 24, 2016, Sen. Grassley sent a letter to his colleagues on the Judiciary and Finance Committees documenting the results of his investigation into Mosaic and the changes the hospital made to improve its billing and collection policies. Sen. Grassley closed this letter by calling for greater scrutiny of tax-exempt hospitals, "It is unclear how many other charitable institutions may be engaging in similar practices. However, vigorous oversight is vital to finding and fixing other examples of such abuse."

New Resource on the Social Determinants of Health
Addressing the social determinants of health is widely seen as a way to have a major positive impact on population health and health equity. Tax-exempt hospitals, given their mission to serve their communities and federal requirements to assess and address community health needs, are seen as having an important role.

CHA has created a page on its website to help it members learn about major initiatives, the latest research and tools, models and frameworks related to addressing the social determinants. The page also has examples of programs and activities addressing social factors from across the Catholic health ministry. If you have suggestions for items that should be added or if your organization has a program that we can feature please contact Indu Spugnardi at ispugnardi@chausa.org.

Updates from Hilltop Institute
The Hilltop Institute's Hospital Community Benefit Program has just released the June 2016 update of its online resource, the Community Benefit State Law Profiles, and has published a new issue brief in its Hospital Community Benefits after the ACA series. The Profiles is a compilation of each state's community benefit laws and regulations analyzed in the context of the ACA's community benefit framework. The new issue brief, titled Hospital Community Benefits after the ACA: Trends in State Community Benefit Legislation, November 2015-May 2016, not only describes the legislative changes made during this time period, but also discusses bills that were not enacted to depict trends in states' community benefit legislation.

Upcoming CHA Events
Registration is now open for the following CHA programs. Use the links below for more information and to register.

Community Benefit 101 – Oct. 4-5 in St. Louis

Preparing for the Ethics of Population Health: Our Moral Tradition Considered Anew, Oct. 25, webinar

Community Benefit in the News
Recent articles from Catholic Health World and Health Progress featuring community benefit news and programs from the across the ministry