UNION GENERAL HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- UNION GENERAL HOSPITAL (EIN 72-0995809)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201141339349301534
- Schema version
- 2009v1.7
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T07:44:46-07:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Parrish Moody & Fikes PC | 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 | 2009-07-01 | 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) |
|---|---|---|
| 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 | Evalyn Ormond | Name |
| Title | CEO | Title |
| Date Signed | 2011-05-12 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carol S McIntosh CPA | Name |
| Phone | 2547768244 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11754332 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c | X | Organization501c |
| Web Site | uniongeneralhospital.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 | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 160 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 787580 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 321644 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10752300 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11349201 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1799 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13373 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 77027 | OtherRevenuePriorYear |
| Other Revenue Current Year | 70114 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11618706 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11754332 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4242615 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4589575 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7338165 | OtherExpensePriorYear |
| Other Expenses Current Year | 7299183 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11580780 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11888758 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 37926 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -134426 | RevenuesLessExpensesCY |
| Total Assets BOY | 6769533 | TotalAssetsBOY |
| Total Assets EOY | 6615550 | TotalAssetsEOY |
| Total Liabilities BOY | 1414622 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1200498 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5354911 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5415052 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide acute care hospital services in the Farmerville area. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 10305639 | Expense |
| Revenue | 11349201 | Revenue |
| Description | Provided acute care hospital services to individuals in the Farmerville area; individuals served amounted to 2,702 patient days and 5,372 emergency room visits. The laboratory performed 37,629 tests and 16,244 ECG, Radiology, Ultrasound, CT, OT, RT, ST and PT procedures were performed. The rural health clinics logged 11,488 visits. | Description |
| Total Program Service Expense | 10305639 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 | false | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 74 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 160 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| 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 |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | William Adcock CFO | NamePerson |
| Telephone Number | 3183687096 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 Hodge Watson Road | AddressLine1 |
| City | Calhoun | City |
| State | LA | State |
| ZIP Code | 71225 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| William E Adcock | |||||||
| CFO | 40.00 | X | 119965 | 0 | 3302 | ||
| Tim Tettleton | |||||||
| President | 0. | X | 0 | 0 | 0 | X | |
| Sheree Hicks | |||||||
| Pharmacist | 40.00 | 142148 | 0 | 7379 | X | ||
| Ralph Kelley | |||||||
| Board Member | 0. | 0 | 0 | 0 | X | ||
| Lynette Wade | |||||||
| Nurse Practitioner | 40.00 | 103690 | 0 | 8045 | X | ||
| John Ellis | |||||||
| Board Member | 0. | 0 | 0 | 0 | X | ||
| Evalyn Ormond | |||||||
| Contracted CEO | 40.00 | X | 167914 | 0 | 2339 | ||
| Eddie Jo Albritton | |||||||
| Board Member | 0. | 0 | 0 | 0 | X | ||
| Darra Jung | |||||||
| DON | 40.00 | X | 86957 | 0 | 5444 | ||
| Danny Smith | |||||||
| Board Member | 0. | 0 | 0 | 0 | X | ||
| Daniel Hunter | |||||||
| Board Member | 0. | 0 | 0 | 0 | X | ||
| Bessie Warren | |||||||
| Secretary | 0. | X | 0 | 0 | 0 | X | |
| Alice McDonald | |||||||
| Nurse Practitioner | 40.00 | 101140 | 0 | 7723 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 721814 | TotalReportableCompFromOrg |
| Total Other Compensation | 34232 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | 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 | |||||
| One Saint Mary Place | Shreveport | LA | 71101 | Lab Services | 1215903 |
| Lincoln Healthcare LLC | |||||
| PO Box 843 | Ruston | LA | 71273 | PT & OT Services | 358946 |
| Iasis Glenwood Regional Medical Center | |||||
| P O Box 35805 | West Monroe | LA | 712945805 | Consulting/CEO | 426836 |
| Healthland | |||||
| Dept Ch 17945 | Palatine | IL | 60055 | Comp Sftwre & Suppt | 282858 |
| Correct Care Inc | |||||
| P O Box 9146 | Mandeville | LA | 704709146 | ER Staffing | 810059 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Government Grants | 321644 | GovernmentGrants |
| Total Contributions | 321644 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient service fees | Description |
| Total Revenue Column | 11349201 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11349201 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11349201 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4026 | TotalRevenueColumn |
| Exclusion | $4,026 | 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 |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9347 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9347 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9347 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9347 | RelatedOrExemptFunctionIncome |
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 | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|
| Utility District Reimburs | 14904 | 14904 | |
| Other Miscellaneous | 12343 | 12343 | |
| Cafeteria sales | 22769 | $22,769 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20098 | TotalRevenueColumn |
| Exclusion | $20,098 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 70114 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11754332 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11385795 | RelatedOrExemptFunctionIncome |
| Exclusion | $46,893 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 385921 | Total |
| Management And General | 385921 | 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 | 3607058 | Total |
| Program Services | 3356469 | ProgramServices |
| Management And General | 250589 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 304554 | Total |
| Program Services | 266062 | ProgramServices |
| Management And General | 38492 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 292042 | Total |
| Program Services | 246172 | ProgramServices |
| Management And General | 45870 | 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 | 63393 | Total |
| Management And General | 63393 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 3337707 | Total |
| Program Services | 2919753 | ProgramServices |
| Management And General | 417954 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58950 | Total |
| Program Services | 2895 | ProgramServices |
| Management And General | 56055 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 951286 | Total |
| Program Services | 900998 | ProgramServices |
| Management And General | 50288 | 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 | 193009 | Total |
| Program Services | 137160 | ProgramServices |
| Management And General | 55849 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44511 | Total |
| Program Services | 40494 | ProgramServices |
| Management And General | 4017 | 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 | 53128 | Total |
| Program Services | 22522 | ProgramServices |
| Management And General | 30606 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31223 | Total |
| Program Services | 29973 | ProgramServices |
| Management And General | 1250 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 661591 | Total |
| Program Services | 661591 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208261 | Total |
| Program Services | 150840 | ProgramServices |
| Management And General | 57421 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Postage and Shipping | 17152 | 3657 | 13495 |
| Maintenance and repairs | 100622 | 89624 | 10998 |
| License & Dues | 50596 | 1367 | 49229 |
| Debt Collection | 23057 | 23057 | |
| Bad debts | 1476062 | 1476062 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28635 | Total |
| Management And General | 28635 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11888758 | Total |
| Program Services | 10305639 | ProgramServices |
| Management And General | 1583119 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1835038 | BOY |
| EOY | 2360269 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138762 | BOY |
| EOY | 138705 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1433978 | BOY |
| EOY | 1044794 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500851 | BOY |
| EOY | 548663 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144224 | BOY |
| EOY | 148118 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33825 | BOY |
| EOY | 36329 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8381417 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6042745 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2682855 | BOY |
| EOY | 2338672 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6769533 | BOY |
| EOY | 6615550 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 730418 | BOY |
| EOY | 729948 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 684204 | BOY |
| EOY | 470550 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1414622 | BOY |
| EOY | 1200498 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4739593 | BOY |
| EOY | 4889107 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 615318 | BOY |
| EOY | 525945 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5354911 | BOY |
| EOY | 5415052 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6769533 | BOY |
| EOY | 6615550 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | false | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 116247 | OtherCostOrOtherBasis |
| Book Value | 116247 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3995342 | OtherCostOrOtherBasis |
| Depreciation | 2776120 | Depreciation |
| Book Value | 1219222 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 74476 | OtherCostOrOtherBasis |
| Depreciation | 51645 | Depreciation |
| Book Value | 22831 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4195352 | OtherCostOrOtherBasis |
| Depreciation | 3214980 | Depreciation |
| Book Value | 980372 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2338672 | TotalOfBookValueLandBuildings |
| Total Revenue | 11754332 | TotalRevenue |
| Total Expenses | 11888758 | TotalExpenses |
| Excess Or Deficit For Year | -134426 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 194567 | NetUnrealizedGLOnInvestments |
| Other | $89,373 | OtherAmount |
| Total Adjustments | 283940 | TotalAdjustments |
| Excess Or Deficit Per FS | 149514 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 11754332 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 11754332 | RevenueSubtotal |
| Total Revenue Per Form990 | 11754332 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11888758 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 11888758 | ExpensesSubtotal |
| Total Expenses Per Form990 | 11888758 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XI, Line 8 | Identifier |
| Return Reference | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | ReturnReference |
| Explanation | Reclass of restricted assets $89373 | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12096 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12096 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1988901 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2092535 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2000997 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2092535 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12096 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 53373 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 53373 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14120 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12620 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 67493 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 65993 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2068490 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2094035 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 78089 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00660 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 118 | PersonsServed |
| Total Community Building Expense | 7080 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1770 | DirectOffsettingRevenue |
| Net Community Building Expense | 5310 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 250 | PersonsServed |
| Total Community Building Expense | 3000 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Net Community Building Expense | 1500 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 927 | PersonsServed |
| Total Community Building Expense | 14280 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 5790 | DirectOffsettingRevenue |
| Net Community Building Expense | 8490 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 8 | PersonsServed |
| Total Community Building Expense | 1980 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1980 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 1303 | PersonsServed |
| Total Community Building Expense | 26340 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 9060 | DirectOffsettingRevenue |
| Net Community Building Expense | 17280 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $916,061 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5650594 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 9376311 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3725717 | 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 | false | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
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 VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Excerpt from Audit Note 3: "Including bad debts and uncollected accounts, the total amount of uncompensated care was $6,221,951 and $6,953,115 in 2010 and 2009, respectively." Uncompensated care includes bad debt expense, charity care and contractual adjustments. | BadDebtFootnote |
| Debt Collection Policy | 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 aso informed that they may be eligible for the hospital's Charity Care program. | DebtCollectionPolicy |
| Number Of Facility Type Expln | The licensed hospital facility listed in Part V is the sole health care facility of the organization. | NumberOfFacilityTypeExpln |
| Needs Assessment | The hospital has worked with other community organizations to assess the healthcare needs of the community. The hospital plans to contract with North Louisiana AHEC to perform a more formal Needs Assessment every three years. It is currently in the process of working with North Louisiana AHEC to put the assessment criteria together. | NeedsAssessment |
| Patient Education Assistance | All patients without third party insurance receive information while at Union General Hospital 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. We also visit all inpatients without third party coverage during their hospital stay and send information letters to all Emergency Room patients without third party coverage. | PatientEducationAssistance |
| Community Information | 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. | CommunityInformation |
| Community Building Activities | 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. | CommunityBuildingActivities |
| Other Information | 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. We operate two rural health clinics, providing medical care and an indigent medicine program for over 10,000 patients, with a majority being Medicare and Medicaid recipients. We have a new physician office building that was built to help recruit new physicians to our area. UGH provides food and lodging for medical students who shadow local physicians, as well as provide office space for an AHEC employee that assists the community by taking Medicaid application at residents' homes. We also provide meeting space to our local Chamber of Commerce. | OtherInformation |
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 |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|
| William E Adcock | |||
| 119965 | 3302 | 123267 | |
| Evalyn Ormond | |||
| 164914 | 2339 | 170253 | 3000 |
| Darra Jung | |||
| 86957 | 5444 | 92401 | |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Tim Tettleton | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board President | Relationship |
| Amount Of Transaction | 2278370 | AmountOfTransaction |
| Description Of Transaction | Dir - Dep & Loan Bank | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents, conflict of interest policy and financial statements are made available to the public upon request. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | 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. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | All Board members are required to complete a conflict of interest statement annually. All employees are required to report any conflicts of interest. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | 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. |
| Form 990, Part VI, Line 3 | Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company | 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. During the current year, the CFO and DON are no longer a part of this agreement. |