2012-05-03T15:19:07-05:00 2011-06-30 BKD LLP 7901 Woodway Drive Suite 100 Waco TX 76712 990 2010-07-01 720995809 UNION GENERAL HOSPITAL UNIO 3183689751 PO BOX 398 FARMERVILLE LA 71241 EVALYN ORMOND 2012-05-15 true Carol S McIntosh 2547768244 2010 2016-02-24 21:20:13Z EVALYN ORMOND PO BOX 398 FARMERVILLE LA 71241 12747374 false X N/A X 1983 LA TO PROVIDE ACUTE CARE HOSPITAL SERVICES IN THE FARMERVILLE AREA. 7 6 159 7 0 0 321644 629525 11349201 12017765 13373 7673 70114 92411 11754332 12747374 0 0 4589575 4946476 0 0 7299183 7351641 11888758 12298117 -134426 449257 6615550 6613430 1200498 749121 5415052 5864309 TO PROVIDE ACUTE CARE HOSPITAL SERVICES IN THE FARMERVILLE AREA. false false 10657048 12028269 PROVIDED ACUTE CARE HOSPITAL SERVICES TO INDIVIDUALS IN THE FARMERVILLE AREA;INDIVIDUALS SERVED AMOUNTED TO 2,876 PATIENT DAYS AND 5,625 EMERGENCY ROOM VISITS. THE LABORATORY PERFORMED 38,954 TESTS AND 21,393 ECG, RADIOLOGY, ULTRASOUND, CT, OT, RT, ST, AND PT PROCEDURES WERE PERFORMED. THE RURAL HEALTH CLINICS LOGGED 12,117 VISITS. 10657048 true false false true false false false false false true false false false false false true false false false false false false false false false true true false false true false false false false false false false true false false false false false false false false false false true 75 0 true 159 true false false false false false false false false false false X 7 6 false true false false false false false true true false false false true true true true true true true false X X WILLIAM ADCOCK CFO 3183687096 115 HODGE WATSON RD CALHOUN LA 71225 TIM TETTLETON 1.0 X X 0 0 0 BESSIE WARREN 1.0 X X 0 0 0 JOHN ELLIS 1.0 X 0 0 0 EDDYE JO ALBRITTON 1.0 X 0 0 0 DANIEL HUNTER JR 1.0 X 0 0 0 RALPH KELLEY 1.0 X 0 0 0 DANNY SMITH 1.0 X 0 0 0 EVALYN ORMOND 40.0 X 149129 0 2016 WILLIAM E ADCOCK 40.0 X 121471 0 2255 DARRA JUNG 40.0 X 91879 0 2133 SHEREE HICKS 40.0 X 137122 0 781 499601 0 7185 4 false true true OMEGA DIAGNOSTICS LLC 2915 MISSOURI AVENUE SHREVEPORT LA 71109 LABORATORY SERVICES 1019562 CORRECT CARE INC 17438 HARD HAT DRIVE COVINGTON LA 70435 E. R. STAFFING 913348 LINCOLN HEALTHCARE LLC P O BOX 843 RUSTON LA 71273 THERAPY SERVICES 456843 LIFECARE MADISON LLC 84 MCGOWEN LANE RAYVILLE LA 71269 OUTPAT. PSYCH SERV 192500 IASIS GLENWOOD REGIONAL MEDICAL CEN 503 MCMILLAN ROAD WEST MONROE LA 71291 CONSULTANT SERVICES 149580 6 629525 629525 PATIENT SERVICE FEES 621110 12017765 12017765 12017765 7483 7483 0 0 190 190 190 190 0 0 0 UTILITY DISTRICT REIMBURSEMENT 900099 31473 31473 CAFETERIA AND VENDING SALES 711110 26453 26453 PHARMACY SALES 446110 11378 11378 23107 14662 8445 92411 12747374 12063900 53949 0 0 0 0 224359 224359 0 4091273 3605579 485694 0 38153 38153 268544 261975 6569 324147 271217 52930 0 97242 97242 27576 27576 0 0 0 3427558 3135146 292412 66743 5216 61527 859884 794437 65447 0 0 420461 366209 54252 58633 52504 6129 0 60679 23705 36974 20316 18472 1844 0 660627 660627 212671 126066 86605 BAD DEBT 1331942 1331942 LICENSES AND PERMITS 47321 3953 43368 PERSONAL PROPERTY TAXES 12789 12789 CONTRIBUTIONS 10180 10180 COLLECTIONS 30044 30044 6975 6975 12298117 10657048 1641069 0 2360269 2633741 138705 138648 1044794 1148397 548663 530245 148118 156855 36329 37927 8623280 6655663 2338672 1967617 6615550 6613430 729948 597889 470550 151232 1200498 749121 X 4889107 5417074 525945 447235 5415052 5864309 6615550 6613430 449257 X false true true X false X false false false false false false false false true 3172 3172 false OTHER ACTIVITIES DESCRIPTION PART II-B,LINE 1I HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING LHA DUES $7,844 22% $1,726 LA RURAL HOSP COALITION DUES $27,715 5% $1,386 NATIONAL RURAL HEALTH ASSOC DUES $1,200 5% $60 TOTAL $36,759 $3,172 146797 146797 4113291 2901125 1212166 4288716 3696459 592257 74476 58079 16397 1967617 12747374 12298117 449257 78710 78710 527967 12826084 78710 78710 12747374 12747374 12298117 12298117 12298117 FIN 48 Footnote Part X Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax postions to be recorded or disclosed in the financial statements. Other Changes in Net Assets Part XI, Line 8 Reclassification of restricted assets Reconciliation of Revenue Part XII, Line 4b Net assets released from restriction listed as revenue in financial statements but not in tax return. true true true X false false true false false 12299 12299 0.00100 2387940 2803522 2400239 2803522 12299 0.00100 65512 13114 40332 0.00330 11900 11900 0.00100 77412 13114 52232 0.00430 2477651 2816636 64531 0.00530 2465 17429 17429 0.00150 692 5948 5948 0.00050 719 15659 4874 10785 0.00100 474 22511 22511 0.00210 4350 61547 4874 56673 0.00510 true 806670 4290700 4290700 X true true 1 1 UNION GENERAL HOSPITAL

901 JAMES AVE FARMERVILLE LA 71241

X X X UNION GENERAL HOSPITAL 1 false true true 200. false true X X X true true X X true X X X true X X X X X X true X false true BAD DEBT EXPENSE PART III, LINE 4 EXCERPT FROM AUDIT NOTE 1: "The Hospital provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. ... Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account." COSTING METHODOLOGY PART III, LINE 4 TO DETERMINE BAD DEBT EXPENSE AT COST BAD DEBT EXPENSE WAS MULTIPLED TIMES THE COST-TO-CHARGE RATIO. PROVISIONS ON COLLECTION PRACTICES PART III, 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. BASIS FOR AMOUNTS CHARGED TO PATIENTS PART V, 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 PART V, LINE 13 DURING THE SCREENING PROCESS, PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOTIFIED OF THE POLICY. COLLECTION ACTIONS PERMITTED PART V, LINE 15 OTHER COLLECTION ACTIONS AGAINST A PATIENT PERMITTED UNDER THE HOSPITAL'S POLICIES ARE TURNING THE ACCOUNT OVER TO AN OUTSIDE COLLECTION AGENCY AND GARNISHMENT OF WAGES. COLLECTION ACTIONS ENGAGED PART V, LINE 16 THE HOSPITAL ENGAGED IN GARNISHMENT OF WAGES IN ADDITION TO REPORTING TO CREDIT AGENCIES AND LAWSUITS DURING THE YEAR. DETERMINATION OF AMOUNTS BILLED PART V, LINE 19 AND 21 GROSS CHARGES ARE BILLED TO ALL PATIENTS REGARDLESS OF AVAILABILITY OF INSURANCE COVERAGE. NEEDS ASSESSMENT PART VI THE HOSPITAL HAS WORKED WITH OTHER COMMUNITY ORGANIZATIONS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY. IT IS CURRENTLY IN THE PROCESS OF PERFORMING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT WITH ASSISTANCE FROM AN OUTSIDE FIRM. CNHA & IMPLEMENTATION STRATEGY SHOULD BE COMPLETED BY JUNE 30, 2012. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI 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 PART VI 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 poverty line. More than 50% of the population lives below 200% of 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 assocated with the rural underserved parish populations. PROMOTION OF COMMUNITY HEALTH PART VI 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 mammograms, 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 physicians.A new physician office building has been built to help recruit 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. BAD DEBT EXPENSE EXCLUDED IN CALCULATION OF PATIENT CARE COST TO CHARGES PART I, LINE 7, COLUMN F BAD DEBT EXPENSE IN THE AMOUNT OF $1,331,942 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. X X false false false false false false false false false EVALYN ORMOND 146129 0 3000 0 0 0 0 0 2016 0 151145 0 0 0 Tim Tettleton Board President 2568446 Dir- Deposit & Loan Bank false Business Transactions involving Interested Persons Schedule L, Part IV 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. DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON FORM 990, PART VI, Line 3 THE HOSPITAL HAS A CONTRACT WITH IASIS GLENWOOD REGIONAL MEDICAL CENTER TO PROVIDE PERSONNEL TO PERFORM DUTIES AS THE HOSPITAL ADMINISTRATOR. THIS CONTRACT AUTOMATICALLY RENEWS EACH YEAR. PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, QUESTION 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, QUESTION 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, QUESTION 15A 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. 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 2010 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. OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.