UNION GENERAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- UNION GENERAL HOSPITAL (EIN 72-0995809)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-09
- IRS object ID
- 201301299349301215
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-09T10:43:35-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7901 Woodway Drive Suite 100 | AddressLine1 |
| City | Waco | City |
| State | TX | State |
| ZIP Code | 76712 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720995809 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % WILLIAM ADCOCK | InCareOfName |
| Name Control | UNIO | NameControl |
| Phone | 3183689751 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 398 | AddressLine1 |
| City | FARMERVILLE | City |
| State | LA | State |
| ZIP Code | 71241 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM ADCOCK | Name |
| Title | CFO | Title |
| Phone | 3183689751 | Phone |
| Date Signed | 2013-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Amanda Maya | Name |
| Phone | 2547768244 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | EVALYN ORMOND | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 398 | AddressLine1 |
| City | FARMERVILLE | City |
| State | LA | State |
| ZIP Code | 71241 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 13387787 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UNIONGEN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE ACUTE CARE HOSPITAL SERVICES IN THE FARMERVILLE AREA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 154 | TotalNbrEmployees |
| Total Nbr Volunteers | 7 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 629525 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1076714 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12017765 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12228955 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7673 | InvestmentIncomePriorYear |
| Investment Income Current Year | 12529 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 92411 | OtherRevenuePriorYear |
| Other Revenue Current Year | 69589 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12747374 | TotalRevenuePriorYear |
| Total Revenue Current Year | 13387787 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 13357 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4946476 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4997301 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7351641 | OtherExpensePriorYear |
| Other Expenses Current Year | 7112121 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12298117 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12122779 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 449257 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1265008 | RevenuesLessExpensesCY |
| Total Assets BOY | 6613430 | TotalAssetsBOY |
| Total Assets EOY | 7735673 | TotalAssetsEOY |
| Total Liabilities BOY | 749121 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 606356 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5864309 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7129317 | NetAssetsOrFundBalancesEOY |
| Mission Description | IT IS THE MISSION OF UGH TO DELIVER THE BEST POSSIBLE HEALTH CARE AVAILABLE AND SERVE THE DEDICATED PEOPLE OF UNION PARISH AND THE SURROUNDING AREAS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 10224429 | Expense |
| Grants | 13357 | Grants |
| Revenue | 12248726 | Revenue |
| Description | PROVIDED ACUTE CARE HOSPITAL SERVICES TO INDIVIDUALS IN THE FARMERVILLE AREA; INDIVIDUALS SERVED AMOUNTED TO 2,325 PATIENT DAYS AND 5,471 EMERGENCY ROOM VISITS. THE LABORATORY PERFORMED 36,904 TESTS AND 23,112 ECG, RADIOLOGY, ULTRASOUND, CT, OT, RT, ST, AND PT PROCEDURES WERE PERFORMED. THE RURAL HEALTH CLINICS LOGGED 13,168 VISITS. | Description |
| Total Program Service Expense | 10224429 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 70 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 154 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WILLIAM ADCOCK | NamePerson |
| Telephone Number | 3183687096 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 HODGE WATSON RD | AddressLine1 |
| City | CALHOUN | City |
| State | LA | State |
| ZIP Code | 71225 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| TIM TETTLETON | |||||||
| PRESIDENT | 1.0 | X | X | 0 | 0 | 0 | |
| BESSIE WARREN | |||||||
| SECRETARY | 1.0 | X | X | 0 | 0 | 0 | |
| JOHN ELLIS | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| EDDYE JO ALBRITTON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DANIEL HUNTER JR | |||||||
| VICE PRESIDENT | 1.0 | X | 0 | 0 | 0 | ||
| RALPH KELLEY | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DANNY SMITH | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| EVALYN ORMOND | |||||||
| CONTRACTED CEO | 40.0 | X | 0 | 0 | 2016 | ||
| WILLIAM E ADCOCK | |||||||
| CFO | 40.0 | X | 106950 | 0 | 2253 | ||
| DARRA JUNG | |||||||
| DON | 40.0 | X | 91552 | 0 | 2199 | ||
| SHEREE HICKS | |||||||
| PHARMACIST | 40.0 | 116270 | 0 | 781 | X | ||
| HOLLY CORLEY | |||||||
| PHYSICIAN | 40.0 | 200128 | 0 | 2322 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 514900 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 9571 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| OMEGA DIAGNOSTICS LLC | |||||
| 2915 MISSOURI AVE | SHREVEPORT | LA | 71109 | LABORATORY | 972174 |
| CORRECT CARE INC | |||||
| 17438 HARD HAT DRIVE | COVINGTON | LA | 70435 | E.R. STAFFING | 913607 |
| LINCOLN HEALTHCARE LLC | |||||
| 1817 NORTHPOINTE LANE | RUSTON | LA | 71273 | THERAPY SERVICES | 623827 |
| IASIS GLENWOOD HOSPITAL | |||||
| 503 MCMILLAN ROAD | WEST MONROE | LA | 71291 | ADMIN. CONSULTANT | 194355 |
| SULLIVAN STOLIER RESOR | |||||
| 909 POYDRAS STE 600 | NEW ORLEANS | LA | 70112 | LEGAL SERVICES | 127114 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Government Grants | 1070953 | GovernmentGrants |
| All Other Contributions | 5761 | AllOtherContributions |
| Noncash Contributions | 207525 | NoncashContributions |
| Total Contributions | 1076714 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT INCOME | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 12228955 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12228955 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12228955 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10439 | TotalRevenueColumn |
| Exclusion | $10,439 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2090 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2090 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2090 | TotalRevenueColumn |
| Exclusion | $2,090 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA AND VENDING SALES | 722100 | 40107 | $40,107 | |
| MEDICAL RECORDS | 722210 | 9614 | $9,614 | |
| UTILITIES DISTRICT REIMBURSEMENT | 900099 | 5868 | 5868 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14000 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13903 | RelatedOrExemptFunctionIncome |
| Exclusion | $97 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 69589 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13387787 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12248726 | RelatedOrExemptFunctionIncome |
| Exclusion | $62,347 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13357 | Total |
| Program Services | 13357 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269974 | Total |
| Program Services | 225511 | ProgramServices |
| Management And General | 44463 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4117407 | Total |
| Program Services | 3408656 | ProgramServices |
| Management And General | 708751 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40939 | Total |
| Management And General | 40939 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253159 | Total |
| Program Services | 211465 | ProgramServices |
| Management And General | 41694 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 315822 | Total |
| Program Services | 263808 | ProgramServices |
| Management And General | 52014 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28389 | Total |
| Management And General | 28389 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43533 | Total |
| Management And General | 43533 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3541032 | Total |
| Program Services | 3202502 | ProgramServices |
| Management And General | 338530 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78169 | Total |
| Program Services | 6101 | ProgramServices |
| Management And General | 72068 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 195761 | Total |
| Program Services | 49001 | ProgramServices |
| Management And General | 146760 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 466711 | Total |
| Program Services | 290487 | ProgramServices |
| Management And General | 176224 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71967 | Total |
| Program Services | 57655 | ProgramServices |
| Management And General | 14312 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73578 | Total |
| Program Services | 23587 | ProgramServices |
| Management And General | 49991 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5920 | Total |
| Program Services | 5763 | ProgramServices |
| Management And General | 157 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 421580 | Total |
| Program Services | 421580 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171816 | Total |
| Program Services | 117792 | ProgramServices |
| Management And General | 54024 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 1314626 | 1314626 | |
| MEDICAL SUPPLIES | 608512 | 608512 | |
| LICENSE AND PERMITS | 51798 | 4013 | 47785 |
| COLLECTIONS | 30433 | 13 | 30420 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8296 | Total |
| Management And General | 8296 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12122779 | Total |
| Program Services | 10224429 | ProgramServices |
| Management And General | 1898350 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2423056 | BOY |
| EOY | 2975923 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 349333 | BOY |
| EOY | 350104 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1148397 | BOY |
| EOY | 976189 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156855 | BOY |
| EOY | 166430 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37927 | BOY |
| EOY | 33179 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9182736 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7028886 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1967617 | BOY |
| EOY | 2153850 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 530245 | BOY |
| EOY | 1079998 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6613430 | BOY |
| EOY | 7735673 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 597889 | BOY |
| EOY | 606356 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 151232 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 749121 | BOY |
| EOY | 606356 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5417074 | BOY |
| EOY | 6734677 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 447235 | BOY |
| EOY | 394640 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5864309 | BOY |
| EOY | 7129317 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6613430 | BOY |
| EOY | 7735673 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1265008 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $2,105 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 2105 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER ACTIVITIES DESCRIPTION | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1F | ReturnReference |
| Explanation | HOSPITAL PAID DUES TO ORGANIZATIONS. A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING RURAL HOSPITAL COALITION $31,141 1% $311 LHA DUES $8,195 21% $1,721 NATIONAL RURAL HEALTH ASSOC DUES $1,200 5% $60 AMERICAN ACADEMY OF NURSE PRACT $125 10% $13 TOTAL $40,661 $2,105 | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 146797 | OtherCostOrOtherBasis |
| Book Value | 146797 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4205481 | OtherCostOrOtherBasis |
| Depreciation | 3014585 | Depreciation |
| Book Value | 1190896 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4757482 | OtherCostOrOtherBasis |
| Depreciation | 3951289 | Depreciation |
| Book Value | 806193 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 72976 | OtherCostOrOtherBasis |
| Depreciation | 63012 | Depreciation |
| Book Value | 9964 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2153850 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM MEDICAID | 1030615 |
| OTHER RECEIVABLES | 4233 |
| EMPLOYEE RECEIVABLES | 7445 |
| DUE FROM CARDINAL HEALTHCARE | 36000 |
| DUE FROM HOSPITAL DISTRICT | 0 |
| UTILITY DEPOSITS | 1705 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1079998 | TotalBookValueOtherAssets |
| Total Revenue | 13387787 | TotalRevenue |
| Total Expenses | 12122779 | TotalExpenses |
| Excess Or Deficit For Year | 1265008 | ExcessOrDeficitForYear |
| Other | $52,595 | OtherAmount |
| Total Adjustments | 52595 | TotalAdjustments |
| Excess Or Deficit Per FS | 1317603 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 13440382 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 52595 | OtherRevenues |
| Revenue Not Rptd F990 | 52595 | RevenueNotRptdF990 |
| Revenue Subtotal | 13387787 | RevenueSubtotal |
| Total Revenue Per Form990 | 13387787 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 12122779 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 12122779 | ExpensesSubtotal |
| Total Expenses Per Form990 | 12122779 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER CHANGES IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | NET ASSETS RELEASED FROM RESTRICTION $52,595 ---------------------------------------------------- TOTAL $52,595 |
| RECONCILIATION OF REVENUE | SCHEDULE D, PART XII, LINE 2D | NET ASSETS RELEASED FROM RESTRICTION LISTED AS REVENUE IN FINANCIAL STATEMENTS, BUT NOT IN TAX RETURN. NET ASSETS RELEASED FROM RESTRICTION $52,595 --------------------------------------------------- TOTAL $52,595 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18491 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18491 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2074962 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1317743 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 757220 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2093453 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1317743 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 775711 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07180 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 117176 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 117176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01080 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13357 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13357 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 130533 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 130533 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01200 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2223986 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1317743 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 906244 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08380 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1332 | PersonsServed |
| Total Community Building Expense | 16976 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 16976 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1313 | PersonsServed |
| Total Community Building Expense | 20912 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20912 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1514 | PersonsServed |
| Total Community Building Expense | 4472 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4472 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 253 | PersonsServed |
| Total Community Building Expense | 2672 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2672 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4412 | PersonsServed |
| Total Community Building Expense | 45032 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 45032 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,314,626 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5118839 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3311904 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1806935 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 JAMES AVE | AddressLine1 |
| City | FARMERVILLE | City |
| State | LA | State |
| ZIP Code | 71241 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | true | AllNeedsAddressed |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Insurance Status | X | InsuranceStatus |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| BAD DEBT EXPENSE, COSTING METHODOLOGY | SCHEDULE H, PART III, SECTION A, LINE 4 | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WITH THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE BAD DEBT EXPENSE OF $1,314,626 ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED FROM THE AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. |
| BAD DEBT EXPENSE EXCLUDED IN CALCULATION OF PATIENT CARE COST TO CHARGES | SCHEDULE H, PART I, LINE 7, COLUMN F | BAD DEBT EXPENSE OF $1,314,626 WAS INCLUDED ON FORM 990, PART VI LINE 25 IN TOTAL EXPENSES. HOWEVER, THIS AMOUNT WAS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF PATIENT CARE COST TO CHARGES. |
| MEDICARE | SCHEDULE H, PART III, SECTION B, LINE 8 | THE HOSPITAL USED MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. THE ORGANIZATION'S SHORTFALL LESSENS THE BURDEN OF THE GOVERNMENT. IN ADDITION, THE STATE OF LOUISIANA TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. |
| PROVISIONS ON COLLECTION PRACTICES | SCHEDULE H, PART III, SECTION C, LINE 9B | ALL PATIENTS WITHOUT THIRD PARTY INSURANCE RECEIVE INFORMATION WHILE AT UGH REGARDING GOVERNMENTAL ASSISTANCE AND ARE ADVISED TO MAKE AN APPOINTMENT WITH A CERTIFIED MEDICAID ENROLLMENT CENTER TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID ASSISTANCE. THOSE PATIENTS ARE ALSO INFORMED THAT THEY MAY BE ELIGIBLE FOR THE HOSPITAL'S CHARITY CARE PROGRAM. |
| INPUT FROM PERSONS REPRESENTING THE COMMUNITY | SCHEDULE H, PART V, SECTION B, LINE 3 | UNION GENERAL HOSPITAL USED INPUT FROM INTERVIEWS FROM THE FOLLOWING COMMUNITY REPRESENTATIVES: DR. GEORGE CANNON-SUPERINTENDENT OF UNION PARISH SCHOOL SYSTEM HOLLY CORLEY MD-INTERNAL MEDICINE/PEDIATRICS PHYSICIAN MS. BESSIE WARREN- UNION GENERAL HOSPITAL BOARD MEMBER, BUSINESS OWNER MS. MARY BARRIOS-CHILD SAFETY COORDINATOR, CHILDREN'S COALITION MS. LOUISE DENTON-DIRECTOR, COUNCIL ON AGING MS. LEAH BLYTHE-PATIENT ADVOCATE, UNITED HOME CARE REV. MICHAEL CALAHAN-MINISTER, BLOOMING GROVE BAPTIST CHURCH MS. DEANN POWELL-PUBLIC HEALTH NURSE, UNION PARISH HEALTH UNIT MS. MARANDA SCHOENBERGER-PROGRAM MANAGER, CANCER CONTROL OFFICER, AHEC FATHER AL JOIST-PRIEST, OUR LADY OF PERPETUAL HEALTH CATHOLIC CHURCH MR. STEIN BAUGHMAN-MAYOR, TOWN OF FARMERVILLE ADDITIONALLY, THE UNION GENERAL COMMUNITY HEALTH NEEDS SURVEY OBTAINED INPUT FROM VARIOUS MEMBERS OF THE COMMUNITY IN FOCUS GROUPS MEETINGS. |
| BASIS FOR AMOUNTS CHARGED TO PATIENTS | SCHEDULE H, PART V, SECTION B, LINE 11 | PATIENT MUST BE A RESIDENT OF UNION PARISH. FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS RECEIVING INPATIENT OR EMERGENCY CARE. |
| NOTIFICATION OF FINANCIAL ASSISTANCE POLICY | SCHEDULE H, PART V, SECTION B, LINE 13 | DURING THE SCREENING PROCESS, PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOTIFIED OF THE POLICY. |
| SCHEDULE H, PART V, SECTION B, LINE 15, 16 & 17 | NEITHER UNION GENERAL HOSPITAL, NOR THIRD PARTIES AUTHORIZED BY UGH, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. | |
| DETERMINATION OF AMOUNTS BILLED | SCHEDULE H, PART V, SECTION B, LINE 19 | GROSS CHARGES ARE BILLED TO ALL PATIENTS REGARDLESS OF AVAILABILITY OF INSURANCE COVERAGE, BUT PATIENTS ELIGIBLE UNDER FAP WILL RECEIVE DISCOUNT OF CHARGES TO ZERO. PATIENTS ELIGIBLE UNDER FAP WILL THEREFORE NEVER BE CHARGED MORE THAN RATES CHARGED TO THOSE WITH INSURANCE. |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | THE HOSPITAL HAS WORKED WITH OTHER COMMUNITY ORGANIZATIONS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY. THE HOSPITAL HAS COMPLETED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT WITH ASSISTANCE FROM AN OUTSIDE FIRM. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | ALL PATIENTS WITHOUT THIRD PARTY INSURANCE RECEIVE INFORMATION WHILE AT UGH REGARDING GOVERNMENTAL ASSISTANCE AND ARE ADVISED TO MAKE AN APPOINTMENT WITH A CERTIFIED MEDICAID ENROLLMENT CENTER TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID ASSISTANCE. THOSE PATIENTS ARE INFORMED THAT THEY MAY BE ELIGIBLE FOR THE HOSPITAL'S CHARITY CARE PROGRAM. ALSO, ALL INPATIENTS WITHOUT THIRD PARTY COVERAGE ARE VISITED DURING THEIR HOSPITAL STAY AND SENT INFORMATION. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | UNION GENERAL IS LOCATED IN UNION PARISH, A RURAL COMMUNITY OF 878 SQUARE MILES, AND PROVIDES MEDICAL SERVICES TO AN UNDERSERVED POPULATION OF 22,712 CITIZENS. MEDIAN HOUSEHOLD INCOME FOR THE PARISH IS APPROXIMATELY $29,061 WITH MEDIAN FAMILY INCOME OF $36,035. APPROXIMATELY 14.3% OF FAMILIES AND 18.6% OF THE TOTAL POPULATION ARE BELOW THE POVERTY LINE. MORE THAN 50% OF THE POPULATION LIVES BELOW 200% FEDERAL POVERTY GUIDELINES. APPROXIMATELY 71% OF THE POPULATION IS WHITE AND 27% IS AFRICAN AMERICAN WITH A GROWING HISPANIC POPULATION. IT IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA (MUA) AND HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). THE COMMUNITY'S MORTALITY RATE IS NEARLY TWICE THE NATIONAL RATE DUE TO THE LACK OF EDUCATION PROGRAMS, THE HIGH RATE OF UNDIAGNOSED DISEASE, AS WELL AS POVERTY AND ISOLATION ASSOCIATED WITH THE RURAL UNDERSERVED PARISH POPULATIONS. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | UGH SERVES AS A MEDICAID ENROLLMENT CENTER FOR UNION PARISH, PROVIDES FLU SHOT CLINICS TO THE COMMUNITY AND PARTICIPATES IN HEALTH FAIRS LOCALLY. THE HOSPITAL ALSO PARTICIPATES IN CAREER FAIRS AT LOCAL COLLEGES FOR HEALTHCARE STUDENTS, REACHING OVER 200 STUDENTS, AS WELL AS SERVING AS A CLINICAL SITE FOR LPNS, RADIOLOGY, PHLEBOTOMY AND NURSE PRACTITIONERS. WE PARTNER WITH AHEC TO ENCOURAGE LOCAL YOUTH TO PURSUE HEALTHCARE CAREERS. UGH IS INVOLVED WITH LOCAL BUSINESSES TO BRING HEALTH AWARENESS AND SCREENINGS TO THE PUBLIC THROUGH RELAY FOR LIFE, AHA'S GO RED CAMPAIGN, UNITED WAY FUNDRAISER AND BY HOSTING AN ANNUAL BREAST CANCER AWARENESS DAY FOR THE COMMUNITY. UNION GENERAL PROMOTES BETTER HEALTH THROUGH AN EMPLOYEE WELLNESS PROGRAM THAT WILL BE EXPANDED TO LOCAL EMPLOYERS. UGH PARTNERS WITH LSU MAMMO VAN TO PROVIDE FREE MANMMOGRAMS, PELVIC EXAMS, PAP SMEARS AND COLON SCREENINGS FOR OUR AREA. THE HOSPITAL PROVIDED HAND WASHING INSTRUCTION FOR ELEMENTARY SCHOOL KIDS AND FOR NURSING HOME STAFF AND RESIDENTS, AS WELL AS PROVIDE BLOOD SUGAR AND BLOOD PRESSURE SCREENINGS FOR LOCAL BUSINESSES. WE PARTICIPATED IN THE TOWN OF FARMERVILLE'S TOY DRIVE FOR NEEDY CHILDREN, ALONG WITH SPONSORING LOCAL 4-H PROJECTS. UGH EMPLOYEES ARE VERY INVOLVED WITH LOCAL ORGANIZATIONS, SUCH AS AN ALZHEIMER'S SUPPORT GROUP, COUNCIL ON AGING, NURSING HOME COUNCILS AND OTHERS. ALL PROPERTY OWNED BY UNION GENERAL IS DESIGNATED AS TOBACCO-FREE. UGH OPERATES UNDER A BOARD OF DIRECTORS, WHICH IS COMPRISED OF REPRESENTATIVE MEMBERS OF THE COMMUNITY. IT MAINTAINS AN OPEN MEDICAL STAFF AND OPERATES A 24/7 EMERGENCY ROOM STAFFED WITH ON-SITE PHYISCIANS. A NEW PHYSICIAN OFFICE BUILDING HAS BEEN BUILT TO HELP RECURIT NEW PHYSICIANS TO THE AREA. UGH PROVIDES FOOD AND LODGING FOR MEDICAL STUDENTS WHO SHADOW LOCAL PHYSICIANS, AS WELL AS PROVIDES OFFICE SPACE FOR AN AHEC EMPLOYEE THAT ASSISTS THE COMMUNITY BY TAKING MEDICAID APPLICATION AT RESIDENTS' HOMES. UGH ALSO PROVIDES MEETING SPACE TO THE LOCAL CHAMBER OF COMMERCE. |
| AFFILIATED HEALTHCARE SYSTEM | SCHEDULE H, PART VI, LINE 6 | N/A |
| STATE FILING OF COMMUNITY BENEFIT REPORT | SCHEDULE H, PART VI, LINE 7 | LOUISIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ORGANIZATION PROCEDURE FOR MONITORING USE OF GRANT FUNDS | Identifier |
| Return Reference | SCHEDULE I, PAT I, LINE 2 | ReturnReference |
| Explanation | ALL DONATIONS ARE APPROVED BY THE CEO. THE COMPTROLLER MONITORS DONATION AMOUNTS VERSUS BUDGETED AMOUNTS, AND INFORMS THE CEO OF ANY VARIANCES ON A REGULAR BASIS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | HOLLY CORLEY | NamePerson |
| Base Compensation Filing Org | 200128 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 2322 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 202450 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | COMMUNITY TRUST BANK | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SEE PART V | Relationship |
| Amount Of Transaction | 166882 | AmountOfTransaction |
| Description Of Transaction | DEPOSIT AND LOAN BANK | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV, LINE 1 | ReturnReference |
| Explanation | TIM TETTLETON IS ON THE BOARD OF DIRECTORS AT COMMUNITY TRUST BANK WHERE THE HOSPITAL MAINTAINS FUNDS AND HAS A LINE OF CREDIT. THE HOSPITAL HAS A CONFLICT OF INTEREST POLICY AND HE HAS FULLY DISCLOSED THIS RELATIONSHIP. | Explanation |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArt | |
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest | |
| Books And Publications | BooksAndPublications | |
| Clothing And Household Goods | ClothingAndHouseholdGoods | |
| Cars And Other Vehicles | CarsAndOtherVehicles | |
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential | |
| Real Estate Commercial | RealEstateCommercial | |
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory | |
| Drugs And Medical Supplies | DrugsAndMedicalSupplies | |
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts |
Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | Auto Doors | 1 | 6750 | FMV |
| X | Medicine Cabinets | 2 | 15000 | FMV |
| X | Generator | 1 | 30516 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON | FORM 990, PART VI, SECTION B, LINE 3 | THE HOSPITAL HAS ENTERED INTO A CONTRACT FOR ADMINISTRATIVE SERVICES WITH IASIS GLENWOOD REGIONAL MEDICAL CENTER, WHICH AUTOMATICALLY RENEWS EACH YEAR. THIS CONTRACT REQUIRES THAT THE MANAGEMENT COMPANY PROVIDE PERSONNEL TO PERFORM DUTIES AS THE HOSPITAL ADMINISTRATOR. FEES PAID APPROXIMATED $14,000 A MONTH. |
| PROCESS TO REVIEW THE FORM 990 | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM FOLLOWING THE COMPLETION OF AN AUDIT OF FINANCIAL STATEMENTS. BOTH THE CEO AND CFO REVIEW THE RETURN PRIOR TO FILING. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY CONFLICTS OF INTEREST. |
| REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15A AND 15B | SALARY SURVEY INFORMATION FOR THE POSITIONS OF CEO, CFO, CNO AND PHARMACY DIRECTOR WAS OBTAINED FROM THE LOUISIANA HOSPITAL ASSOCIATION AND PRESENTED TO THE UGH BOARD FOR REVIEW AND DISCUSSION. SALARIES FOR THESE POSITIONS WERE ADJUSTED BASED UPON RECOMMENDATION AND APPROVAL BY THE BOARD OF DIRECTORS. INITIAL REVIEW WAS FROM 2006 LHA SALARY SURVEY. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| CONTRACTED CEO POSITION | FORM 990, PART VII, SECTION A | THE POSITION OF CEO IS CONTRACTED THROUGH GLENWOOD REGIONAL MEDICAL CENTER, AN UNRELATED ORGANIZATION. UNION GENERAL HOSPITAL REIMBURSES GLENWOOD FOR THE CEO'S SALARY. THIS INDIVIDUAL IS LISTED AT PART VII, SECTION A OF FORM 990, ALONG WITH THE AMOUNT OF BENEFITS PAID DIRECTLY BY UNION GENERAL. THE AMOUNT OF SALARY PAID TO GLENWOOD, COMBINED WITH ANY 2011 W-2 WAGES FROM UNION GENERAL, IS ALSO LISTED AT PART VII, SECTION A OF FORM 990. THE TOTAL AMOUNT PAID TO GLENWOOD, INCLUDING THE CEO'S SALARY AND ADDITIONAL AMOUNTS FOR CONSULTING SERVICES, IS LISTED AT PART VII, SECTION B OF FORM 990. |