2016-08-15T06:02:46-07:00 2015-12-31 Langlinais Broussard & Kohlenberg PO Box 1123 Abbeville LA 705111123 990 2015-01-01 721479692 SPRINGHILL MEDICAL SERVICES INC DBA SPRINGHILL MEDICAL CENTER SPRI 3185391001 2001 DOCTORS DRIVE SPRINGHILL LA 71075 VINCENT SEDMINIK CEO 2016-08-15 true PATRICK M GUIDRY CPA P00111160 3378936232 2015 2016-12-15 16:53:06Z 18878341 false false X N/A X 2000 LA PATIENT CENTERED CARE FROM OUR FAMILY TO YOURS. 11 9 267 0 1323846 178966 18603175 18305151 143226 206872 166927 187352 20237174 18878341 0 0 11492988 11825763 0 0 7957322 8237329 19450310 20063092 786864 -1184751 10788428 9721128 5274493 5391944 5513935 4329184 PATIENT CENTERED CARE FROM OUR FAMILY TO YOURS. false false 17577777 SMS OPERATES A 58 BED ACUTE CARE HOSPITAL WITH MEDICAL, SURGICAL, DIAGNOSTIC, AND EMERGENCY SERVICES. IT OPERATES ONE CLINIC IN SPRINGHILL, AND ANOTHER CLINIC IN OUTLYING COMMUNITIES TO PROVIDE EASIER ACCESS TO HEALTH CARE. THE HOSPITAL PROVIDED 3,214 INPATIENT DAYS OF CARE (MEDICARE DAYS-2,126).SMS, INC. MAKES AVAILABLE FREE MEETING SPACE TO NONPROFIT ORGANIZATIONS SUCH AS THE LOCAL LIONS CLUB, AMERICAN CANCER SOCIETY, AND MINISTERIAL ALLIANCE. SOME OF THESE GROUPS MEET WEEKLY, WHILE OTHERS MEET MONTHLY.SMS, INC. IS VERY ACTIVE WITH THE LOCAL SCHOOLS IN THE SURROUNDING PARISHES. STAFF FROM THE HEALTH SYSTEM'S CLINICS PERFORM PHYSICALS FOR THE AREA SCHOOLS SPORTS TEAMS. THE HEALTH SYSTEM PROVIDES SHADOW OPPORTUNITIES FOR AREA HIGH SCHOOL STUDENTS TO LEARN MORE ABOUT MEDICAL PROFESSIONS. THE HEALTH SYSTEM PARTICIPATES IN THE AHEC PROGRAM, WHICH IS A SIX WEEK PROGRAM FOR AREA HIGH SCHOOL JUNIORS AND SENIORS TO OBSERVE AND ASSIST IN AREAS OF INTEREST AS THEY PREPARE FOR COLLEGE CAREERS. SMS, INC. IS ALSO VERY ACTIVE IN THE COMMUNITY. THE HEALTH SYSTEM HOSTS A NUMBER OF HEALTH FAIRS FOR THE COMMUNITY. THE HEALTH FAIRS OFFER THE COMMUNITY ACCESS TO A NUMBER OF FREE HEALTH SCREENINGS, ACCESS TO VENDORS OF INTEREST FOR THEIR HEALTH AND A COMPLETE CHEMISTRY PROFILE AT A REDUCED PRICE. SMS, INC. ALSO CO-SPONSORS A COMMUNITY HEALTH WALK WITH THE PROCEEDS GOING TO THE AMERICAN HEART ASSOCIATION. THE HOSPITAL PROVIDES EMPLOYEES TO SPEAK TO LOCAL CLUBS AND ORGANIZATIONS. 17577777 true true false false false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false false false false false true 42 0 true 267 true false false false false false false false false 0 false false false false false false false false false false X 11 9 false false false false false false true true true false false true true true true true true true true true false X SPRINGHILL MEDICAL CENTER 3185391001 2001 DOCTORS DRIVE SPRINGHILL LA 71075 DAVID ANDERSON BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT BUSH BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT A COLVIN Secretary 1.00 0.00 X X 0 0 0 DIANNE STEPHENS President 1.00 0.00 X X 0 0 0 ROBERT GARLAND BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN D HERRINGTON BOARD MEMBER 1.00 0.00 X 0 0 0 RAYMOND ROBERTSON BOARD MEMBER 1.00 0.00 X 0 0 0 DON TEAGUE Treasurer 1.00 0.00 X X 0 0 0 WAYNE MCMAHEN DVM Vice President 1.00 0.00 X X 0 0 0 SS HOLLIDAY JR MD ADVISORY 1.00 0.00 X 0 0 0 MARY ARMWOOD BOARD MEMBER 1.00 0.00 X 0 0 0 WAYNE SESSIONS MD CHIEF OF STAFF 1.00 0.00 X 0 0 0 MICHELLE PARDUE MD ADVISORY 1.00 0.00 X 0 0 0 VINCENT R SEDMINIK CEO 1.00 0.00 X 145000 0 32422 LAYLA CHASE CFO 40.00 0.00 X 106437 0 290 DANA JONES ASSISTANT ADMIN 40.00 0.00 X 105430 0 8631 DONNA MORRIS PRACTICE MANAGE 40.00 0.00 X 79214 0 7311 RHONDA PEREZ CNO 40.00 0.00 X 88279 0 4040 VINCENT LOCOCO MD-FAMILY PRACTICE 40.00 0.00 X 394334 0 18558 DAVID W LAW MD-FAMILY PRACTICE 40.00 0.00 X 201734 0 9034 MICHELLE PARDUE MD-FAMILY PRACTICE 40.00 0.00 X 203547 0 9802 JERRY WAYNE SESSIONS MD-FAMILY PRACTICE 40.00 0.00 X 192168 0 11883 JENNIFER RANZ MD-FAMILY PRACTICE 40.00 0.00 X 186825 0 13229 1702968 115200 8 false true false NEW DIRECTIONS B&B 504 TEXAS STREET STE 200 SHREVEPORT LA 71101 MANAGEMENT SERVICES 120575 EMCARE PHYSICIAN SERVICES 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 EMERGENCY ROOM COVER 784401 CPSI PO BOX 850309 MOBILE AL 36685 INFORMATION SYSTEMS 362673 WILLIS-KNIGHTON HEALTH SYSTEM PO BOX 32600 SHREVEPORT LA 71130 CEO/LAB SERVICE 196301 J STEPHENS MAUHUGH & ASSOCIATES PO BOX 77458 BATON ROUGE LA 70879 CRNA SERVICES 153615 5 28424 150542 178966 PATIENT SERVICE REVENUE 621500 18305151 18305151 18305151 206872 206872 0 0 42545 42545 42545 42545 0 0 0 0 CAFETERIA 722210 77472 77472 MISCELLANEOUS INCOME 67335 67335 144807 18878341 42545 18656830 0 0 0 0 524360 524360 0 9615101 9615101 262685 262685 720231 720231 703386 703386 0 10174 10174 59762 59762 0 0 0 0 36786 36786 15716 15716 0 0 292262 292262 71748 71748 0 0 169559 169559 0 926222 926222 311312 311312 OUTSIDE SERVICES 2859643 2859643 SUPPLIES 1757258 1757258 COMM & STAFF 768701 768701 RENTALS & MAINTENANCE 264348 264348 693838 262414 431424 20063092 17577777 2485315 0 1948695 2452770 0 0 2305001 1971498 0 173100 517933 168921 413266 483731 272825 298630 12882156 8776678 4475432 4105478 0 67000 67000 0 0 788276 0 10788428 9721128 1730429 2271942 71147 3252496 2839542 291568 209313 5274493 5391944 X 5513935 4329184 5513935 4329184 10788428 9721128 -1184751 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 243251 243251 5125093 2913017 2212076 172134 139682 32452 7341678 5723979 1617699 4105478 CREDIT BALANCES 79748 DUE TO THIRD PARTY PAYORS 122347 INTEREST PAYABLE 7218 209313 18878341 18878341 18878341 20063092 20063092 20063092 true true true X true X true true true false false false 484380 484380 0.02500 3270592 1650364 1620228 0.08370 3754972 1650364 2104608 0.10870 63388 13242 50147 0.00260 1527381 504196 1023185 0.05280 1590769 517438 1073332 0.05540 5345741 2167802 3177940 0.16410 true 2520798 1225060 8365957 8499675 -133718 X true true SPRINGHILL HOME CARE HOME HEALTH SERVICES 0.33000 4 1 SPRINGHILL MEDICAL CENTER 2001 DOCTORS DRIVE SPRINGHILL LA 71075 X 2 SMC DOCTORS CLINIC 401 11TH ST NE SPRINGHILL LA 71075 PROVIDER BASED RURAL HEALTH CLINIC 3 NORTH WEBSTER MEDICAL CLINIC 106 TRI STATE DRIVE SAREPTA LA 71071 PROVIDED BASED RURAL HEALTH CLINIC 4 SPRINGHILL HOMECARE 1112 DOCTORS DRIVE SPRINGHILL LA 71075 JOINT VENTURE SPRINGHILL MEDICAL CENTER 1 false false true X X X X X X X X X 13 true true true true X www.smccare.com X true 13 false false false true X 100.0000 200.0000 X X true true X X X X true X www.smccare.com X X X X X true X X true X X X X X X true X false false SMC DOCTORS CLINIC 2 false false true X X X X X X X X X 13 true true true true X WWW.SMCCARE.COM X true 13 false false false true X 100.0000 200.0000 X X true true X X X X true X X X X X true X X true X X X X X X true X false false NORTH WEBSTER MEDICAL CLINIC 3 false false true X X X X X X X X X 13 true true true true X WWW.SMCCARE.COM X true 13 false false false true X 100.0000 200.0000 X X true true X X X X true X X X X X true X X true X X X X X X true X false false SPRINGHILL HOMECARE 4 false false true X X X X X X X X X 13 true true true true X WWW.SMCCARE.COM X true 13 false false false true X 100.0000 200.0000 X X true true X X X X true X X X X X true X X true X X X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community PART V, SECTION B, LINE 3 - EXPLANATION OF HOW THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY AND THE IDENTITY OF THE PERSONS THE HOSPITAL CONSULTED:SPRINGHILL MEDICAL CENTER ESTABLISHED A STEERING COMMITTEE TO ASSIST IN THE DEVELOPMENT OF THE CHNA. THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE (SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSISTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). THE STEERING COMMITTEE SERVED FOUR PRIMARY PURPOSES: TO IDENTIFY AND INVITE KEY COMMUNITY STAKEHOLDERS TO SERVE AS CHNA COMMITTEE MEMBERS, TO SCHEDULE, ORGANIZE, AND FACILITATE CHNA COMMITTEE MEETINGS, TO COMPILE STATISTICAL DATA FOR CONSIDERATION BY THE CHNA COMMITTEE, AND TO PREPARE THE FINAL REPORT FOR THE ORGANIZATION. THE STEERING COMMITTEE CONSCIENTIOUSLY TOOK INTO THE HOSPITAL'S SERVICE AREA WHEN SELECTING THE GROUP OF INDIVIDUALS TO SERVE ON THE CHNA COMMITTEE. REPRESENTATIVES FROM THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS (DHH) WERE INVITED AND ATTENDED EACH COMMUNITY MEETING. IN SELECTING COMMUNITY PARTICIPANTS, THE STEERING COMMITTEE CONSIDERED EACH RESIDENT'S INVOLVEMENT IN THE COMMUNITY AND ENSURED THERE WAS ADEQUATE DIVERSITY FROM THE SERVICE AREA. THE FOLLOWING COMMUNITY MEMBERS PARTICIPATED: PEGGY ADKINS (ALDERMAN/MAYOR PRO TEM SAREPTA, LA),KEVIN BOUNDS (PAFFORD EMS SPRINGHILL, LA), CARROL BREAUX (MAYOR SPRINGHILL, LA), SUSAN BYSON (HEALTH SYSTEMS DEVELOPER DHH), JESSICA CARAWAY (NORTH WEBSTER CHAMBER OF COMMERCE SPRINGHILL, LA), GINGER COVINGTON (RN, NURSING EDUCATOR, SOUTHERN ARKANSAS UNIVERSITY), GERRELDA DAVIS (DIRECTOR BUREAU OF PRIMARY CARE & RURAL HEALTH DHH), EL EDWARDS (MAYOR SAREPTA, LA), BEVERLY ELLIS (ADMINISTRATIVE COORDINATOR FOR CULLEN SENIOR CITIZENS, INC.), D. NICOLE FRAZIER (ALDERMAN SPRINGHILL, LA), SHANNON GILLILAND (MAIN STREET MANAGER SPRINGHILL, LA), BROOKE GRANT (RN, LOUISIANA HOME CARE SPRINGHILL, LA), KELLY HARRIS (SPRING THEATER & LUMBERJACK LANES SPRINGHILL, LA), MARY ANN HOOF (POLICE CHIEF CULLEN, LA), GLADNEY HUNT ( PASTOR ASSEMBLY OF GOD CHURCH BRADLEY, AR), SUSIE HUTCHINSON (PRACTICE MANAGEMENT PROGRAM MANAGER DHH) CHILLON LATIOLAIS (COMMUNITY EDUCATOR LA ORGAN PROCUREMENT AGENCY), REBECCA MARTIN (NORTH WEBSTER PARISH INDUSTRIAL DISTRICT SPRINGHILL, LA), MOLLY MCCALMAN (COMMUNITY LEADER BRADLEY, AR), JONATHAN MONTGOMERY (YOUTH PASTOR FIRST BAPTIST CHURCH TAYLOR, AR), TIM MOUSER (MAYOR SHONGALOO, LA), JOHN PICKETT (EXECUTIVE DIRECTOR GAMBLE HOSPICE MINDEN, LA) JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), DAVID SMITH (CARTER FEDERAL CREDIT UNION SPRINGHILL, LA), LISA SMITH (OFFICE MANAGER FAMILY SERVICES UNLIMITED), WILLIAM STRANGE (WEBSTER PARISH TAX ASSESSOR OFFICE MINDEN, LA), CHARLES STRONG (NORTHWEST LA TECH INSTITUTE), AMY VOLLMER (EXECUTIVE DIRECTOR ARC OF NORTH WEBSTER SAREPTA, LA), EASTER WHITE (COMMUNITY MEMBER CULLEN, LA) AND FLOYDEAN WHITE (COMMUNITY MEMBER CULLEN, LA). THE CHNA COMMITTTEE MET IN THREE SEPARATE OPEN FORUM MEETINGS. IN THE FIRST MEETING, AN INTRODUCTION WAS GIVEN THAT INCLUDED THE PURPOSE OF THE CHNA. A PAPER SURVEY WAS GIVEN AND COMPLETED BY EACH MEMBER. MEMBERS WERE GIVEN ADDITIONAL SURVEYS AND TASKED TO REACH OUT TO COMMUNITY MEMBERS THEY REPRESENTED TO HAVE THEM FILLED OUT AND RETURNED AT THE NEXT MEETING, THE COMMITTEE REVIEWED NATIONAL, STATE AND PARISH HEALTH INDICATORS AS WELL AS LOCAL INDICATORS PROVIDED BY SPRINGHILL MEDICAL CENTER. THE COMMITTEE ALSO REVIEWED COMMITTEE MEMBER SURVEY RESULTS AND HAD A FACILITATED DISCUSSION BASED UPON THE ABOVE TO BRAINSTORM IDEAS TO IMPROVE SERVICES IN THE COMMUNITY OFFERED BY SPRINGHILL MEDICAL CENTER. DURING THE THIRD AND FINAL MEETING THE COMMITTEE REVIEWED THE COMMUNITY SURVEY RESULTS AND PRIORITIZED COMMUNITY HEALTH ISSUES THAT WERE IDENTIFIED. THE COMMITTEE THEN PROPOSED WAYS TO RESOLVE THE HEALTH ISSUES AND SUMMARIZED RECOMMENDATIONS. PART V, SECTION B, LINE 20 D - EXPLANATION OF CHARGES TO FAP-ELIGIBLE INDIVIDUALS: MAXIMUM CHARGES ARE BASED UPON THE HOSPITAL'S CHARGEMASTER WITH A DISCOUNT TO THOSE THAT ARE FAP ELIGIBLE PER FEDERAL POVERTY GUIDELINES. Part V, Line 5 - Account Input from Persons Who Represent the Community THE COMMUNITY AND THE IDENTITY OF THE PERSONS THE HOSPITAL CONCULTED: SPRINGHILL MEDICAL CENTER ESTABLISHED A STEERING COMMITTEE TO ASSIST IN THE DEVELOPMENT OF THE CHNA. THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE (SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSISTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). THE STEERING COMMITTEE SERVED FOUR PRIMARY PURPOSES: TO IDENTIFY AND INVITE KEY COMMUNITY STAKEHOLDERS TO SERVE AS CHNA COMMITTEE MEMBERS, TO SCHEDULE, ORGANIZE, AND FACILITATE CHNA COMMITTEE MEETINGS, TO COMPILE STATISTICAL DATA FOR CONSIDERATION BY THE CHNA COMMITTEE, AND TO PREPARE THE FINAL REPORT FOR THE ORGANIZATION. THE STEERING COMMITTEE CONSCIENTIOUSLY TOOK INTO THE HOSPITAL'S SERVICE AREA WHEN SELECTING THE GROUP OF INDIVIDUALS TO SERVE ON THE CHNA COMMITTEE. REPRESENTATIVES FROM THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS WERE INVITED AND ATTENDED EACH COMMUNITY MEETING. IN SELECTING COMMUNITY PARTICIPANTS, THE STEERING COMMITTEE CONSIDERED EACH RESIDENT'S INVOLVEMENT IN THE COMMUNITY AND ENSURED THERE WAS ADEQUATE DIVERSITY FROM THE SERVICE AREA. THE FOLLOWING COMMUNITY MEMBERS PARTICIPATED: PEGGY ADKINS (ALDERMAN/MAYOR PRO TEM SAREPTA, LA),KEVIN BOUNDS (PAFFORD EMS SPRINGHILL, LA), CARROL BREAUX (MAYOR SPRINGHILL, LA), SUSAN BYSON (HEALTH SYSTEMS DEVELOPER DHH), JESSICA CARAWAY (NORTH WEBSTER CHAMBER OF COMMERCE SPRINGHILL, LA), GINGER COVINGTON (RN, NURSING EDUCATOR, SOUTHERN ARKANSAS UNIVERSITY), GERRELDA DAVIS (DIRECTOR BUREAU OF PRIMARY CARE & RURAL HEALTH DHH), EL EDWARDS (MAYOR SAREPTA, LA), BEVERLY ELLIS (ADMINISTRATIVE COORDINATOR FOR CULLEN SENIOR CITIZENS, INC.), D. NICOLE FRAZIER (ALDERMAN SPRINGHILL, LA), SHANNON GILLILAND (MAIN STREET MANAGER SPRINGHILL, LA), BROOKE GRANT (RN, LOUISIANA HOME CARE SPRINGHILL, LA), KELLY HARRIS (SPRING THEATER & LUMBERJACK LANES SPRINGHILL, LA), MARY ANN HOOF (POLICE CHIEF CULLEN, LA), GLADNEY HUNT ( PASTOR ASSEMBLY OF GOD CHURCH BRADLEY, AR), SUSIE HUTCHINSON (PRACTICE MANAGEMENT PROGRAM MANAGER DHH) CHILLON LATIOLAIS (COMMUNITY EDUCATOR LA ORGAN PROCUREMENT AGENCY), REBECCA MARTIN (NORTH WEBSTER PARISH INDUSTRIAL DISTRICT SPRINGHILL, LA), MOLLY MCCALMAN (COMMUNITY LEADER BRADLEY, AR), JONATHAN MONTGOMERY (YOUTH PASTOR FIRST BAPTIST CHURCH TAYLOR, AR), TIM MOUSER (MAYOR SHONGALOO, LA), JOHN PICKETT (EXECUTIVE DIRECTOR GAMBLE HOSPICE MINDEN, LA) JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), DAVID SMITH (CARTER FEDERAL CREDIT UNION SPRINGHILL, LA), LISA SMITH (OFFICE MANAGER FAMILY SERVICES UNLIMITED), WILLIAM STRANGE (WEBSTER PARISH TAX ASSESSOR OFFICE MINDEN, LA), CHARLES STRONG (NORTHWEST LA TECH INSTITUTE), AMY VOLLMER (EXECUTIVE DIRECTOR ARC OF NORTH WEBSTER SAREPTA, LA), EASTER WHITE (COMMUNITY MEMBER CULLEN, LA) AND FLOYDEAN WHITE (COMMUNITY MEMBER CULLEN, LA). THE CHNA COMMITTTEE MET IN THREE SEPARATE OPEN FORUM MEETINGS. IN THE FIRST MEETING, AN INTRODUCTION WAS GIVEN THAT INCLUDED THE PURPOSE OF THE CHNA. A PAPER SURVEY WAS GIVEN AND COMPLETED BY EACH MEMBER. MEMBERS WERE GIVEN ADDITIONAL SURVEYS AND TASKED TO REACH OUT TO COMMUNITY MEMBERS THEY REPRESENTED TO HAVE THEM FILLED OUT AND RETURNED AT THE NEXT MEETING, THE COMMITTEE REVIEWED NATIONAL, STATE AND PARISH HEALTH INDICATORS AS WELL AS LOCAL INDICATORS PROVIDED BY SPRINGHILL MEDICAL CENTER. THE COMMITTEE ALSO REVIEWED COMMITTEE MEMBER SURVEY RESULTS AND HAD A FACILITATED DISCUSSION BASED UPON THE ABOVE TO BRAINSTORM IDEAS TO IMPROVE SERVICES IN THE COMMUNITY OFFERED BY SPRINGHILL MEDICAL CENTER. DURING THE THIRD AND FINAL MEETING THE COMMITTEE REVIEWED THE COMMUNITY SURVEY RESULTS AND PRIORITIZED COMMUNITY HEALTH ISSUES THAT WERE IDENTIFIED. THE COMMITTEE THEN PROPOSED WAYS TO RESOLVE THE HEALTH ISSUES AND SUMMARIZED RECOMMENDATIONS. PART V, SECTION B, LINE 20 D - EXPLANATION OF CHARGES TO FAP-ELIGIBLE INDIVIDUALS: MAXIMUM CHARGES ARE BASED UPON THE HOSPITAL'S CHARGEMASTER WITH A DISCOUNT TO THOSE THAT ARE FAP ELIGIBLE PER FEDERAL POVERTY GUIDELINES. Part V, Line 5 - Account Input from Persons Who Represent the Community THE COMMUNITY AND THE IDENTITY OF THE PERSONS THE HOSPITAL CONCULTED: SPRINGHILL MEDICAL CENTER ESTABLISHED A STEERING COMMITTEE TO ASSIST IN THE DEVELOPMENT OF THE CHNA. THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE (SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSISTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). THE STEERING COMMITTEE SERVED FOUR PRIMARY PURPOSES: TO IDENTIFY AND INVITE KEY COMMUNITY STAKEHOLDERS TO SERVE AS CHNA COMMITTEE MEMBERS, TO SCHEDULE, ORGANIZE, AND FACILITATE CHNA COMMITTEE MEETINGS, TO COMPILE STATISTICAL DATA FOR CONSIDERATION BY THE CHNA COMMITTEE, AND TO PREPARE THE FINAL REPORT FOR THE ORGANIZATION. THE STEERING COMMITTEE CONSCIENTIOUSLY TOOK INTO THE HOSPITAL'S SERVICE AREA WHEN SELECTING THE GROUP OF INDIVIDUALS TO SERVE ON THE CHNA COMMITTEE. REPRESENTATIVES FROM THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS WERE INVITED AND ATTENDED EACH COMMUNITY MEETING. IN SELECTING COMMUNITY PARTICIPANTS, THE STEERING COMMITTEE CONSIDERED EACH RESIDENT'S INVOLVEMENT IN THE COMMUNITY AND ENSURED THERE WAS ADEQUATE DIVERSITY FROM THE SERVICE AREA. THE FOLLOWING COMMUNITY MEMBERS PARTICIPATED: PEGGY ADKINS (ALDERMAN/MAYOR PRO TEM SAREPTA, LA),KEVIN BOUNDS (PAFFORD EMS SPRINGHILL, LA), CARROL BREAUX (MAYOR SPRINGHILL, LA), SUSAN BYSON (HEALTH SYSTEMS DEVELOPER DHH), JESSICA CARAWAY (NORTH WEBSTER CHAMBER OF COMMERCE SPRINGHILL, LA), GINGER COVINGTON (RN, NURSING EDUCATOR, SOUTHERN ARKANSAS UNIVERSITY), GERRELDA DAVIS (DIRECTOR BUREAU OF PRIMARY CARE & RURAL HEALTH DHH), EL EDWARDS (MAYOR SAREPTA, LA), BEVERLY ELLIS (ADMINISTRATIVE COORDINATOR FOR CULLEN SENIOR CITIZENS, INC.), D. NICOLE FRAZIER (ALDERMAN SPRINGHILL, LA), SHANNON GILLILAND (MAIN STREET MANAGER SPRINGHILL, LA), BROOKE GRANT (RN, LOUISIANA HOME CARE SPRINGHILL, LA), KELLY HARRIS (SPRING THEATER & LUMBERJACK LANES SPRINGHILL, LA), MARY ANN HOOF (POLICE CHIEF CULLEN, LA), GLADNEY HUNT ( PASTOR ASSEMBLY OF GOD CHURCH BRADLEY, AR), SUSIE HUTCHINSON (PRACTICE MANAGEMENT PROGRAM MANAGER DHH) CHILLON LATIOLAIS (COMMUNITY EDUCATOR LA ORGAN PROCUREMENT AGENCY), REBECCA MARTIN (NORTH WEBSTER PARISH INDUSTRIAL DISTRICT SPRINGHILL, LA), MOLLY MCCALMAN (COMMUNITY LEADER BRADLEY, AR), JONATHAN MONTGOMERY (YOUTH PASTOR FIRST BAPTIST CHURCH TAYLOR, AR), TIM MOUSER (MAYOR SHONGALOO, LA), JOHN PICKETT (EXECUTIVE DIRECTOR GAMBLE HOSPICE MINDEN, LA) JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), DAVID SMITH (CARTER FEDERAL CREDIT UNION SPRINGHILL, LA), LISA SMITH (OFFICE MANAGER FAMILY SERVICES UNLIMITED), WILLIAM STRANGE (WEBSTER PARISH TAX ASSESSOR OFFICE MINDEN, LA), CHARLES STRONG (NORTHWEST LA TECH INSTITUTE), AMY VOLLMER (EXECUTIVE DIRECTOR ARC OF NORTH WEBSTER SAREPTA, LA), EASTER WHITE (COMMUNITY MEMBER CULLEN, LA) AND FLOYDEAN WHITE (COMMUNITY MEMBER CULLEN, LA). THE CHNA COMMITTTEE MET IN THREE SEPARATE OPEN FORUM MEETINGS. IN THE FIRST MEETING, AN INTRODUCTION WAS GIVEN THAT INCLUDED THE PURPOSE OF THE CHNA. A PAPER SURVEY WAS GIVEN AND COMPLETED BY EACH MEMBER. MEMBERS WERE GIVEN ADDITIONAL SURVEYS AND TASKED TO REACH OUT TO COMMUNITY MEMBERS THEY REPRESENTED TO HAVE THEM FILLED OUT AND RETURNED AT THE NEXT MEETING, THE COMMITTEE REVIEWED NATIONAL, STATE AND PARISH HEALTH INDICATORS AS WELL AS LOCAL INDICATORS PROVIDED BY SPRINGHILL MEDICAL CENTER. THE COMMITTEE ALSO REVIEWED COMMITTEE MEMBER SURVEY RESULTS AND HAD A FACILITATED DISCUSSION BASED UPON THE ABOVE TO BRAINSTORM IDEAS TO IMPROVE SERVICES IN THE COMMUNITY OFFERED BY SPRINGHILL MEDICAL CENTER. DURING THE THIRD AND FINAL MEETING THE COMMITTEE REVIEWED THE COMMUNITY SURVEY RESULTS AND PRIORITIZED COMMUNITY HEALTH ISSUES THAT WERE IDENTIFIED. THE COMMITTEE THEN PROPOSED WAYS TO RESOLVE THE HEALTH ISSUES AND SUMMARIZED RECOMMENDATIONS. PART V, SECTION B, LINE 20 D - EXPLANATION OF CHARGES TO FAP-ELIGIBLE INDIVIDUALS: MAXIMUM CHARGES ARE BASED UPON THE HOSPITAL'S CHARGEMASTER WITH A DISCOUNT TO THOSE THAT ARE FAP ELIGIBLE PER FEDERAL POVERTY GUIDELINES. Part V, Line 5 - Account Input from Persons Who Represent the Community THE COMMUNITY AND THE IDENTITY OF THE PERSONS THE HOSPITAL CONCULTED: SPRINGHILL MEDICAL CENTER ESTABLISHED A STEERING COMMITTEE TO ASSIST IN THE DEVELOPMENT OF THE CHNA. THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE (SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSISTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). THE STEERING COMMITTEE SERVED FOUR PRIMARY PURPOSES: TO IDENTIFY AND INVITE KEY COMMUNITY STAKEHOLDERS TO SERVE AS CHNA COMMITTEE MEMBERS, TO SCHEDULE, ORGANIZE, AND FACILITATE CHNA COMMITTEE MEETINGS, TO COMPILE STATISTICAL DATA FOR CONSIDERATION BY THE CHNA COMMITTEE, AND TO PREPARE THE FINAL REPORT FOR THE ORGANIZATION. THE STEERING COMMITTEE CONSCIENTIOUSLY TOOK INTO THE HOSPITAL'S SERVICE AREA WHEN SELECTING THE GROUP OF INDIVIDUALS TO SERVE ON THE CHNA COMMITTEE. REPRESENTATIVES FROM THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS WERE INVITED AND ATTENDED EACH COMMUNITY MEETING. IN SELECTING COMMUNITY PARTICIPANTS, THE STEERING COMMITTEE CONSIDERED EACH RESIDENT'S INVOLVEMENT IN THE COMMUNITY AND ENSURED THERE WAS ADEQUATE DIVERSITY FROM THE SERVICE AREA. THE FOLLOWING COMMUNITY MEMBERS PARTICIPATED: PEGGY ADKINS (ALDERMAN/MAYOR PRO TEM SAREPTA, LA),KEVIN BOUNDS (PAFFORD EMS SPRINGHILL, LA), CARROL BREAUX (MAYOR SPRINGHILL, LA), SUSAN BYSON (HEALTH SYSTEMS DEVELOPER DHH), JESSICA CARAWAY (NORTH WEBSTER CHAMBER OF COMMERCE SPRINGHILL, LA), GINGER COVINGTON (RN, NURSING EDUCATOR, SOUTHERN ARKANSAS UNIVERSITY), GERRELDA DAVIS (DIRECTOR BUREAU OF PRIMARY CARE & RURAL HEALTH DHH), EL EDWARDS (MAYOR SAREPTA, LA), BEVERLY ELLIS (ADMINISTRATIVE COORDINATOR FOR CULLEN SENIOR CITIZENS, INC.), D. NICOLE FRAZIER (ALDERMAN SPRINGHILL, LA), SHANNON GILLILAND (MAIN STREET MANAGER SPRINGHILL, LA), BROOKE GRANT (RN, LOUISIANA HOME CARE SPRINGHILL, LA), KELLY HARRIS (SPRING THEATER & LUMBERJACK LANES SPRINGHILL, LA), MARY ANN HOOF (POLICE CHIEF CULLEN, LA), GLADNEY HUNT ( PASTOR ASSEMBLY OF GOD CHURCH BRADLEY, AR), SUSIE HUTCHINSON (PRACTICE MANAGEMENT PROGRAM MANAGER DHH) CHILLON LATIOLAIS (COMMUNITY EDUCATOR LA ORGAN PROCUREMENT AGENCY), REBECCA MARTIN (NORTH WEBSTER PARISH INDUSTRIAL DISTRICT SPRINGHILL, LA), MOLLY MCCALMAN (COMMUNITY LEADER BRADLEY, AR), JONATHAN MONTGOMERY (YOUTH PASTOR FIRST BAPTIST CHURCH TAYLOR, AR), TIM MOUSER (MAYOR SHONGALOO, LA), JOHN PICKETT (EXECUTIVE DIRECTOR GAMBLE HOSPICE MINDEN, LA) JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), JASON ROBERTSON (DENTIST SPRINGHILL, LA), VICKIE SHINE (WEBSTER PARISH CHILD SERVICES MINDEN, LA), DAVID SMITH (CARTER FEDERAL CREDIT UNION SPRINGHILL, LA), LISA SMITH (OFFICE MANAGER FAMILY SERVICES UNLIMITED), WILLIAM STRANGE (WEBSTER PARISH TAX ASSESSOR OFFICE MINDEN, LA), CHARLES STRONG (NORTHWEST LA TECH INSTITUTE), AMY VOLLMER (EXECUTIVE DIRECTOR ARC OF NORTH WEBSTER SAREPTA, LA), EASTER WHITE (COMMUNITY MEMBER CULLEN, LA) AND FLOYDEAN WHITE (COMMUNITY MEMBER CULLEN, LA). THE CHNA COMMITTTEE MET IN THREE SEPARATE OPEN FORUM MEETINGS. IN THE FIRST MEETING, AN INTRODUCTION WAS GIVEN THAT INCLUDED THE PURPOSE OF THE CHNA. A PAPER SURVEY WAS GIVEN AND COMPLETED BY EACH MEMBER. MEMBERS WERE GIVEN ADDITIONAL SURVEYS AND TASKED TO REACH OUT TO COMMUNITY MEMBERS THEY REPRESENTED TO HAVE THEM FILLED OUT AND RETURNED AT THE NEXT MEETING, THE COMMITTEE REVIEWED NATIONAL, STATE AND PARISH HEALTH INDICATORS AS WELL AS LOCAL INDICATORS PROVIDED BY SPRINGHILL MEDICAL CENTER. THE COMMITTEE ALSO REVIEWED COMMITTEE MEMBER SURVEY RESULTS AND HAD A FACILITATED DISCUSSION BASED UPON THE ABOVE TO BRAINSTORM IDEAS TO IMPROVE SERVICES IN THE COMMUNITY OFFERED BY SPRINGHILL MEDICAL CENTER. DURING THE THIRD AND FINAL MEETING THE COMMITTEE REVIEWED THE COMMUNITY SURVEY RESULTS AND PRIORITIZED COMMUNITY HEALTH ISSUES THAT WERE IDENTIFIED. THE COMMITTEE THEN PROPOSED WAYS TO RESOLVE THE HEALTH ISSUES AND SUMMARIZED RECOMMENDATIONS. PART V, SECTION B, LINE 20 D - EXPLANATION OF CHARGES TO FAP-ELIGIBLE INDIVIDUALS: MAXIMUM CHARGES ARE BASED UPON THE HOSPITAL'S CHARGEMASTER WITH A DISCOUNT TO THOSE THAT ARE FAP ELIGIBLE PER FEDERAL POVERTY GUIDELINES. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE(SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSSTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE(SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSSTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE(SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSSTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment THE STEERING COMMITTEE CONSISTED OF THE REPRESENTATIVES FROM THE HOSPITAL'S BOARD OF DIRECTORS AND SENIOR MANAGEMENT: DON TEAGUE(SPRINGHILL MEDICAL CENTER BOARD TREASURER), VINCE SEDMINIK (CHIEF EXECUTIVE OFFICER), MICHELLE PARDUE (CHIEF OF MEDICAL STAFF), MARILYN MOW (ASSSTANT ADMINISTRATOR), LAYLA CHASE (CHIEF FINANCIAL OFFICER), DANA JONES (CHIEF NURSING OFFICER), DONNA MORRIS (GROUP PRACTICE MANAGER), AND ASHLEY ORTEGO (HUMAN RESOURCES/MARKETING/RISK MANAGEMENT DIRECTOR). Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why SEE SUPPLEMENTAL INFORMATION Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why SEE SUPPLEMENTAL INFORMATION Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why SEE SUPPLEMENTAL INFORMATION Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why SEE SUPPLEMENTAL INFORMATION Part V, Line 22d - Other Billing Determination of Individuals Without Insurance THE AMOUNT CALCULATED AS BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS WAS DETERMINED USING STATISTICAL DATA BASED UPON THE PERCENT OF APPROVED FAP APPLICATIONS TO RETURNED FAP APPLICATIONS. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance THE AMOUNT CALCULATED AS BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS WAS DETERMINED USING STATISTICAL DATA BASED UPON THE PERCENT OF APPROVED FAP APPLICATIONS TO RETURNED FAP APPLICATIONS. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance THE AMOUNT CALCULATED AS BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS WAS DETERMINED USING STATISTICAL DATA BASED UPON THE PERCENT OF APPROVED FAP APPLICATIONS TO RETURNED FAP APPLICATIONS. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance THE AMOUNT CALCULATED AS BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS WAS DETERMINED USING STATISTICAL DATA BASED UPON THE PERCENT OF APPROVED FAP APPLICATIONS TO RETURNED FAP APPLICATIONS. Part I, Line 7 - Explanation of Costing Methodology SPRINGHILL MEDICAL SERVICES INC (SMC) USED A CALCULATED COST TO CHARGE RATIO PER WORKSHEET 2 IN THE INSTRUCTIONS FOR FORM 990 SCHEDULE H PUBLISHED BY THE INTERNAL REVENUE SERVICE FOR (A), (B), (C), AND (G). ACTUAL COST INCURRED WAS USED FOR (E) AND (F). Part I, Line 7, Column F - Explanation of Bad Debt Expense SMC RECORDS BAD DEBT AT GROSS CHARGES LEFT UNPAID AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. THE COST OF THE BAD DEBT REPORTED WAS DETERMINED BASED UPON THE COST TO CHARGE RATIO. CALCULATED FROM WORSHEET 2. SMC ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY USING STATISTICAL DATA COLLECTED OVER SIX MONTHS THAT INCLUDED THE PERCENT OF APPROVED APPLICATIONS TO RETURNED APPLICATIONS. THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT IS RELATED TO BAD DEBT STATES "TRADE RECEIVABLES ARE CARRIED AT THE ORIGINAL BILLED AMOUNT LESS AN ESTIMATE MADE FOR UNCOLLECTIBLE ACCOUNTS BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY USING HISTORICAL EXPERIENCES APPLIED TO AN AGING OF ACCOUNTS. TRADE RECEIVABLES ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. THE RATIONALE FOR INCLUDING ANY PORTION OF BAD DEBT AS COMMUNITY BENEFIT IS PRIMARILY DUE TO SMCS RURAL LOCATION AND PROVIDING ACCESS TO PATIENTS EVEN THOUGH THEY ARE UNWILLING TO PAY OR IN THE EVENT THEY ARE UNABLE TO PAY BUT UNWILLING TO FOLLOW OUR FINANCIAL ASSISTANCE PROGRAM. BY NOT BLOCKING ACCESS TO CARE, SMC KEEPS THE COMMUNITY HEALTHY. Part VI - Needs Assessment SMC ASSESSES THE NEEDS OF THE COMMUNITY THROUGH A COLLABORATION BETWEEN PHYSICIANS, CASE MANAGERS, AND OUTREACH COORDINATORS WHO SPEND TIME IN THE COMMUNITY PROVIDING EDUCATION, WELLNESS TESTS, AND ASSESSMENTS OF PATIENTS WITH CERTAIN DIAGNOSIS. NEEDS ASSESSMENT IS ALSO ACCOMPLISHED THROUGH PARTICIPATION IN SPRINGHILL COMMUNITY NETWORK AND THE FRIENDS 50+ COMMUNITY GROUP. Part VI - Patient Education of Eligibility for Assistance SMC STRIVES TO INFORM AND EDUCATE ALL OF OUR UNINSURED PATIENTS THAT PRESENT TO OUR FACILITIES ABOUT OUR FINANCIAL ASSISTANCE POLICY. UNINSURED PATIENTS ARE EDUCATED ON MEDICAID AND OUR CHARITY CARE PROGRAM WHEN THEY PRESENT TO OUR FACILITY AS EMERGENCY, OUTPATIENT, OR INPATIENT. WE HAVE SEVERAL MEDICAID APPLICATION REPRESENTATIVES AT OUR FACILITY THAT CAN TAKE APPLICATIONS FOR MEDICAID AND PATIENTS ARE GIVEN INFORMATION ON HOW TO APPLY. PATIENTS ARE ALSO GIVEN A FINANCIAL ACCEPTANCE APPLICATION THAT CONTAINS INSTRUCTIONS AND CONTACT INFORMATION. ALL OF OUR INITIAL BILLING STATEMENTS TELL THE PATIENTS THAT IF THEY FEEL THEY MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE TO CONTACT THE BUSINESS OFFICE. Part VI - Community Information SMC SERVES THE RURAL COMMUNITY OF NORTH WEBSTER PARISH IN LOUISIANA AND SOUTH COLUMBIA COUNTY IN ARKANSAS. THE POPULATION OF THE COMMUNITY IS APPROXIMATELY 20,000. THE AVERAGE INCOME IS APPROXIMATELY $24,000 PER YEAR AND ABOUT 12% OF THE COMMUNITY HAS INCOME BELOW THE FEDERAL POVERTY GUIDELINES. THE PATIENT MIX OF UNINSURED AND MEDICAID IS 12% AND 16%. Part VI - Community Building Activities THROUGH THE CLEANUP AND MAINTENANCE OF COMMUNITY PARKS, SMC MAKES ENVIRONMENTAL IMPROVEMENTS BY REMOVING TRASH AS WELL AS PROMOTES PHYSICAL ACTIVITY. Part VI - Additional Information PART 1, LINE 6A: COMMUNITY BENEFIT REPORT: SEE ATTACHED CHNA PART III, LINE 2: THE COST OF THE BAD DEBT REPORTED WAS CALCULATED BY APPLYING THE COST TO CHARGE RATIO FROM WORKSHEET 2 TO BAD DEBT GROSS CHARGES THAT HAVE BEEN DEEMED UNCOLLECTIBLE AFTER REASONABLE COLLECTION EFFORTS. PART III, LINE 3: THE AMOUNT CALCULATED AS BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS WAS DETERMINED USING STATISTICAL DATA BASED UPON THE PERCENT OF APPROVED FAP APPLICATIONS TO RETURNED FAP APPLICATIONS. PART III, LINE 4: THE FOOTNOTE IN THE ORGANIZATIONS FINANCIAL STATEMENTS RELATED TO BAD DEBT IS NOTE 1 ON PAGE 8. PART III, LINE 8: THE AMOUNT REPORTED IN PART III, LINE 6 COMES DIRECTLY FROM THE MOST RECENTLY FILED MEDICARE COST REPORT. PART III, LINE 9B: THE COLLECTION PRACTICE FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FAP IS TO ASSIST THEM WITH AN APPLICATION TO THE STATE MEDICAID PROGRAM AND IF THE PATIENT IS NOT ELIGIBLE THEN THEIR CHARGES ARE REDUCED BY A PERCENTAGE USING INCOME AND THE FEDERAL POVERTY GUIDELINES. PART VI #2: NEEDS ASSESSMENTS OTHER THAN THROUGH A CHNA INCLUDE A COLLABORATION BETWEEN PHYSICIANS, CASE MANAGERS, AND OUTREACH COODINATORS WHO SPEND TIME IN THE COMMUNITY PROVIDING EDUCATION AND WELLNESS TESTS. PART VI # 4: SEE ATTACHED CHNA. X X false false false false false false false false false false DAVID W LAW MD-FAMILY PRACTICE 201734 9034 210768 JENNIFER RANZ MD-FAMILY PRACTICE 186825 13229 200054 JERRY WAYNE SESSIONS MD-FAMILY PRACTICE 192168 11883 204051 MICHELLE PARDUE MD-FAMILY PRACTICE 203547 9802 213349 VINCENT LOCOCO MD-FAMILY PRACTICE 394334 18558 412892 VINCENT R SEDMINIK CEO 145000 32422 177422 Form 990, Part VI, Line 11b: Form 990 Review Process THE BOARD REVIEWS THE 990 DRART COMPLETED BY THE CPA. THE BOARD APPROVES THE RETURN THEN THE FORM 8879-EO IS SIGNED AND RETURNED TO CPA FIRM AUTHORIZING THE CPA TO FILE ELECTRONICALLY. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees COMPENSATION AND ADJUSTMENTS TO COMPENSATION OF TOP MANAGEMENT AND PHYSICIANS MUST BE REVIEWED AND APPROVED BY THE BOARD. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available ALL GOVERNING DOCUMENTS AND WRITTEN POLICIES ARE AVAILABLE UPON REQUEST.