UNION GENERAL HOSPITAL: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- UNION GENERAL HOSPITAL (EIN 72-0995809)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-04-18
- IRS object ID
- 202401099349301315
- Schema version
- 2022v5.0
- 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) |
|---|---|---|
| Return | 2024-04-18T12:24:58+00:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720995809 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIO | BusinessNameControlTxt |
| Phone | 3183689751 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 398 | AddressLine1Txt |
| City | FARMERVILLE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71241 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EVALYN ORMOND | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2024-04-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEANETTE VERRELLI | PreparerPersonNm |
| PTIN | P00742631 | PTIN |
| Phone | 9727028262 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVALYN ORMOND | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 398 | AddressLine1Txt |
| City | FARMERVILLE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71241 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,653,224 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNIONGEN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACUTE CARE HOSPITAL SERVICES IN THE FARMERVILLE AREA. IT IS OUR GOAL TO DELIVER THE BEST POSSIBLE HEALTH CARE AVAILABLE AND SERVE THE DEDICATED PEOPLE OF UNION PARISH AND THE SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 175 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,984,103 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,546,891 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,870,177 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,813,295 | CYProgramServiceRevenueAmt |
| PY Investment Income | $17,705 | PYInvestmentIncomeAmt |
| CY Investment Income | $209,361 | CYInvestmentIncomeAmt |
| PY Other Revenue | $180,577 | PYOtherRevenueAmt |
| CY Other Revenue | $83,677 | CYOtherRevenueAmt |
| PY Total Revenue | $23,052,562 | PYTotalRevenueAmt |
| CY Total Revenue | $21,653,224 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $37,250 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $32,181 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,292,430 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,064,927 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,281,633 | PYOtherExpensesAmt |
| CY Other Expenses | $9,899,270 | CYOtherExpensesAmt |
| PY Total Expenses | $17,611,313 | PYTotalExpensesAmt |
| CY Total Expenses | $18,996,378 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,441,249 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,656,846 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,411,557 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,239,904 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,868,184 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,039,685 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,543,373 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,200,219 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IT IS THE MISSION OF UNION GENERAL HOSPITAL TO PROVIDE QUALITY SERVICE WITH COMPASSIONATE CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,676,586 | ExpenseAmt |
| Grant | $32,181 | GrantAmt |
| Revenue | $19,860,883 | RevenueAmt |
| Desc | PROVIDED ACUTE CARE HOSPITAL SERVICES TO INDIVIDUALS IN THE FARMERVILLE AREA; INDIVIDUALS SERVED AMOUNTED TO 1,964 PATIENT DAYS AND 6,617 EMERGENCY ROOM VISITS. THE LABORATORY PERFORMED 50,083 TESTS AND 31,667 ENDOSCOPIC, RADIOLOGY, ULTRASOUND, CT, OT, RT, ST, AND PT PROCEDURES WERE PERFORMED. THE RURAL HEALTH CLINIC LOGGED 9,295 VISITS. WE CONTINUE TO PROVIDE TELEHEALTH IN OUR CLINIC (72 VISITS) AND INTENSIVE OUTPATIENT PSYCHIATRIC PROGRAM (1,699 VISITS), IN ORDER TO PROVIDE NEEDED SERVICES FOR THOSE PATIENTS AS WELL. UGH HAS CONTINUED TO PROVIDE NECESSARY TESTING FOR OUR COMMUNITY IN A SAFE ENVIRONMENT UNDER STATE AND FEDERAL GUIDELINES FOR THE COVID-19 VIRUS. WE SET UP NEGATIVE PRESSURE ROOMS IN OUR EMERGENCY ROOM AND NURSING AREA, IN ORDER TO PROVIDE ADDITIONAL CARE NEEDED BY OUR COVID PATIENTS. | Desc |
| Total Program Service Expenses | $14,676,586 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 161 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 175 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRAD ADCOCK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3183687096 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 JAMES AVE | AddressLine1Txt |
| City | FARMERVILLE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71241 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ALLYSON CROW | ||||||||
| SECRETARY | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DANIEL HUNTER JR | ||||||||
| VICE PRESIDENT | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM TETTLETON | ||||||||
| PRESIDENT | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BESSIE WARREN | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTY FINE | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| DANNY SMITH | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| DEBRA JAMES | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| DARRA JUNG | ||||||||
| DIRECTOR OF NURSING | 40.0 | 0 | Yes (X) | $159,080 | $0 | $5,078 | ||
| DIANNE DAVIDSON | ||||||||
| COO | 40.0 | 0 | Yes (X) | $139,387 | $0 | $2,447 | ||
| EVALYN ORMOND | ||||||||
| CEO | 40.0 | 0 | Yes (X) | $298,215 | $0 | $5,332 | ||
| WILLIAM ADCOCK | ||||||||
| CFO | 40.0 | 0 | Yes (X) | $254,502 | $0 | $4,616 | ||
| Connie Booth | ||||||||
| Physician | 40.0 | 0 | $159,149 | $0 | $10,599 | Yes (X) | ||
| DEANNA NEAL | ||||||||
| NP | 40.0 | 0 | $123,274 | $0 | $1,244 | Yes (X) | ||
| KATE COOK | ||||||||
| PHARMACY DIRECTOR | 40.0 | 0 | $146,694 | $0 | $4,173 | Yes (X) | ||
| LYNETTE WADE | ||||||||
| NP | 40.0 | 0 | $126,011 | $0 | $2,420 | Yes (X) | ||
| NICOLE LEBLANC | ||||||||
| RN | 40.0 | 0 | $147,791 | $0 | $6,270 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,554,103 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $42,179 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| OMEGA DIAGNOSTICS LLC | ||||||
| 1000 E PRESTON AVENUE | SHREVEPORT | LA | 711052704 | LAB SERVICES | $1,475,280 | |
| CORRECT CARE INC | ||||||
| 229 SAINT JOHN LANE | COVINGTON | LA | 70433 | EMERGENCY ROOM PHYSICIANS | $1,153,976 | |
| LINCOLN HEALTHCARE LLC DBA LEGACY REHABILITATION | ||||||
| P O BOX 843 | RUSTON | LA | 71273 | PHYSICAL, OCCUPATIONAL & SPEECH THERAPY CONTRACT LABOR | $956,717 | |
| EMERGENCY STAFFING SOLUTIONS INC | ||||||
| 17304 PRESTON ROAD | DALLAS | TX | 75252 | EMERGENCY ROOM PHYSICIANS | $447,593 | SUITE 1400 |
| MEDHOST OF TENNESSEE INC | ||||||
| 2739 MOMENTUM PLACE | CHICAGO | IL | 606895327 | HEALTHCARE SOFTWARE/I.T. SERVICES | $346,007 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $833,393 | GovernmentGrantsAmt |
| All Other Contributions | $713,498 | AllOtherContributionsAmt |
| Total Contributions | $1,546,891 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE FEES | 621110 | $19,332,588 | $19,332,588 |
| OTHER OPERATING REVENUE | 621110 | $52,854 | $52,854 |
| PHARMACY REVENUE | 446110 | $427,853 | $427,853 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,813,295 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $206,161 | TotalRevenueColumnAmt |
| Exclusion | $206,161 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,200 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $3,200 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,200 | TotalRevenueColumnAmt |
| Exclusion | $3,200 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA AND VENDING MACHINE | 722514 | $36,089 | $0 | $36,089 |
| MEDICAL RECORDS | 561000 | $6,161 | $6,161 | |
| UTILITY DISTRICT REIMBURSEMENT | 900099 | $2,461 | $2,461 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,966 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,966 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $83,677 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,653,224 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,860,883 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $245,450 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,181 | TotalAmt |
| Program Services | $32,181 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $868,657 | TotalAmt |
| Program Services | $688,701 | ProgramServicesAmt |
| Management And General | $179,956 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,976,119 | TotalAmt |
| Program Services | $5,527,679 | ProgramServicesAmt |
| Management And General | $1,448,440 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,238 | TotalAmt |
| Program Services | $58,084 | ProgramServicesAmt |
| Management And General | $13,154 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,711 | TotalAmt |
| Program Services | $470,219 | ProgramServicesAmt |
| Management And General | $106,492 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,202 | TotalAmt |
| Program Services | $466,543 | ProgramServicesAmt |
| Management And General | $105,659 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,698 | TotalAmt |
| Management And General | $78,698 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,586 | TotalAmt |
| Management And General | $191,586 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,179,851 | TotalAmt |
| Program Services | $5,074,070 | ProgramServicesAmt |
| Management And General | $1,105,781 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,166 | TotalAmt |
| Program Services | $13,558 | ProgramServicesAmt |
| Management And General | $81,608 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,367 | TotalAmt |
| Program Services | $174,984 | ProgramServicesAmt |
| Management And General | $232,383 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,763 | TotalAmt |
| Management And General | $297,763 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,905 | TotalAmt |
| Program Services | $212,991 | ProgramServicesAmt |
| Management And General | $55,914 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,743 | TotalAmt |
| Program Services | $60,364 | ProgramServicesAmt |
| Management And General | $6,379 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,573 | TotalAmt |
| Program Services | $31,564 | ProgramServicesAmt |
| Management And General | $63,009 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $885,029 | TotalAmt |
| Program Services | $697,463 | ProgramServicesAmt |
| Management And General | $187,566 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,120 | TotalAmt |
| Program Services | $64,470 | ProgramServicesAmt |
| Management And General | $70,650 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COVID EXPENSES | $14,489 | $11,316 | $3,173 |
| MEDICAL SUPPLIES | $950,298 | $950,298 | |
| DUES & SUBSCRIPTIONS | $71,615 | $24,356 | $47,259 |
| COLLECTIONS | $36,551 | $735 | $35,816 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,516 | TotalAmt |
| Program Services | $117,010 | ProgramServicesAmt |
| Management And General | $8,506 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,996,378 | TotalAmt |
| Program Services | $14,676,586 | ProgramServicesAmt |
| Management And General | $4,319,792 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,993,814 | BOYAmt |
| EOY | $10,272,852 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $769,573 | BOYAmt |
| EOY | $8,707,912 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,218 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,934,015 | BOYAmt |
| EOY | $2,008,692 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $248,047 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,471 | BOYAmt |
| EOY | $226,110 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $347,434 | BOYAmt |
| EOY | $124,253 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,541,268 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,783,366 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,067,516 | BOYAmt |
| EOY | $5,757,902 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,996,516 | BOYAmt |
| EOY | $894,136 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,411,557 | BOYAmt |
| EOY | $28,239,904 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $949,579 | BOYAmt |
| EOY | $948,077 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $826,997 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,608 | BOYAmt |
| EOY | $91,608 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,868,184 | BOYAmt |
| EOY | $1,039,685 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,893,373 | BOYAmt |
| EOY | $25,900,219 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650,000 | BOYAmt |
| EOY | $1,300,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,543,373 | BOYAmt |
| EOY | $27,200,219 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,411,557 | BOYAmt |
| EOY | $28,239,904 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,656,846 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $5,290 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,290 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1i OTHER ACTIVITIES FOR LOBBYING PURPOSES: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAID DUES TO THE FOLLOWING ORGANIZATIONS: AMERICAN HOSPITAL ASSOCIATION LA HOSPITAL ASSOCIATION CAH COALITION LA RURAL HOSPITAL COALITION NATIONAL RURAL HEALTH ASSOCIATION A PORTION OF THESE DUES ARE DESIGNATED FOR LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $317,472 | OtherCostOrOtherBasisAmt |
| Book Value | $317,472 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,633,452 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,214,141 | DepreciationAmt |
| Book Value | $419,311 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,680,325 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,775,156 | DepreciationAmt |
| Book Value | $3,905,169 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,778,732 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,794,069 | DepreciationAmt |
| Book Value | $984,663 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $131,287 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $131,287 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,757,902 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED SELF-INSURANCE COSTS | Desc |
| Amt | $91,608 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $91,608 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $20,762,608 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,762,608 | RevenueSubtotalAmt |
| Other Revenues Not Included | $890,616 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $890,616 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,653,224 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,996,378 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,996,378 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,996,378 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 | ASC 740 FOOTNOTE: 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 POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements | CONTRIBUTION FOR ACQUISITION OF PROPERTY AND EQUIPMENT - 34455 CONTRIBUTIONS RECEIVED W/ DONOR RESTRICTIONS - 650000 INVESTMENT INCOME - 206161 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,818 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0008 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,066,755 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,001,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,082,573 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,001,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0008 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17662 | PersonsServedCnt |
| Total Community Benefit Expns | $44,015 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $44,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0023 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 129299 | PersonsServedCnt |
| Total Community Benefit Expns | $100,445 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $100,445 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0053 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 146961 | PersonsServedCnt |
| Total Community Benefit Expns | $144,460 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $144,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0076 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 146961 | PersonsServedCnt |
| Total Community Benefit Expns | $7,227,033 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,001,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $160,278 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0084 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 39876 | PersonsServedCnt |
| Total Community Benefit Expns | $16,951 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 34051 | PersonsServedCnt |
| Total Community Benefit Expns | $23,291 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,291 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 73927 | PersonsServedCnt |
| Total Community Benefit Expns | $40,242 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $40,242 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0021 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $884,119 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,271,178 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,357,597 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$86,419 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 JAMES AVE | AddressLine1Txt |
| City | FARMERVILLE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71241 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UNIONGEN.ORG | WebsiteAddressTxt |
| State License | 146 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://UNIONGEN.ORG/MEDIA/1209/UNIONCHNAFINAL.PDF | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://UNIONGEN.ORG/MEDIA/1209/UNIONCHNAFINAL.PDF | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.0 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - UNION GENERAL HOSPITAL. REPRESENTATIVES FROM THE COMMUNITY: THE HOSPITAL GATHERED INFORMATION FROM COMMUNITY MEETINGS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA, TO PRIORITIZE THE HEALTH NEEDS OF THE POPULATION. THE HOSPITAL'S CHIEF EXECUTIVE OFFICER DEVELOPED A HOSPITAL STEERING COMMITTEE. THE CEO APPOINTED THE FOLLOWING INDIVIDUALS AS PARTICIPANTS ON THIS COMMITTEE: EVALYN ORMOND - CHIEF EXECUTIVE OFFICER DIANNE DAVIDSON - CHIEF OPERATING OFFICER WILLIAM ADCOCK - CHIEF FINANCIAL OFFICER JULIE DUTY - COMPLIANCE/HIPAA OFFICER CLAUDIA WADE - COMMUNITY DEVELOPMENT MANAGER, GRANT WRITER BRITTANY SMITH - DIETARY DIRECTOR THE COMMITTEE IDENTIFIED 8 STAKEHOLDERS FOR INDIVIDUAL INTERVIEWS. BELOW IS A LIST OF THE ORGANIZATIONS REPRESENTED BY THE KEY STAKEHOLDERS. GAZETTE NEWSPAPER - UNION PARISH POLICE JURY BANNER NEWSPAPER - TOWN OF MARION UNION GENERAL HOSPITAL - UNION EMERGENCY PREPAREDNESS TOWN OF FARMERVILLE - FARMERVILLE FIRST BAPTIST CHURCH UNION COUNCIL ON AGING - DOWNSVILLE CHARTER SCHOOL UNION PARISH SHERIFF'S DEPARTMENT - UNION PARISH LIBRARY CHILDREN'S COALITION - UNION PARISH CHAMBER OF COMMERCE |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - UNION GENERAL HOSPITAL. FOLLOWING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IT HAS BEEN NOTED THAT SEVERAL NEEDS IDENTIFIED IN THE 2018 CHNA CONTINUE TO BE A PRIORITY. THE STEERING COMMITTEE HAS HIGHLIGHTED THE FOLLOWING AREAS: CANCER: IN AN ONGOING EFFORT, THE HOSPITAL HAS BEEN CONDUCTING BREAST CANCER EDUCATION SESSIONS, SPECIFICALLY TARGETING THE PARTICIPANTS OF THE "IT'S A GIRL THING" PROGRAM, IN COLLABORATION WITH THE SCHOOL DISTRICT. ADOLESCENT BEHAVIORS: OUR PARTNERSHIP WITH THE SCHOOL DISTRICT REMAINS STRONG, FOCUSING ON PROGRAMS LIKE "IT'S A GIRL THING "MAKING PROUD CHOICES." THIS INCLUDES A COMPREHENSIVE STD/HIV AND PREGNANCY PREVENTION PROGRAM. WE'VE SEEN AN INCREASE IN PARTICIPATION AND PARENTAL INTEREST, WITH OVER 64 MEETINGS HELD AT VARIOUS LOCATIONS, INCLUDING SCHOOLS AND VIA ZOOM, TOTALING 582 SINCE THE PROGRAM'S INCEPTION IN 2013. ADDITIONALLY, IN COLLABORATION WITH THE FOOD BANK OF NORTHEAST LOUISIANA, PARTICIPANTS RECEIVE A 40-POUND FOOD BOX MONTHLY, ADDRESSING FOOD SECURITY CONCERNS. MENTAL HEALTH AND SUBSTANCE ABUSE PREVENTION: THE HOSPITAL CONTINUES TO EMPHASIZE MENTAL HEALTH, ALCOHOL AND DRUG PREVENTION, AND SUICIDE PREVENTION THROUGH OUR ADOLESCENT HEALTH PROGRAMS. OUR COLLABORATIVE EFFORTS HAVE EXPANDED OUR NETWORK AND GARNERED RECOGNITION. WE'VE ALSO BEEN PROACTIVE IN ANTI-BULLYING INITIATIVES, REACHING OVER 3,000 STUDENTS ACROSS UNION PARISH, SIGNIFICANTLY REDUCING BULLYING INCIDENTS AND SUICIDE ATTEMPTS. TEEN DRUG PREVENTION: OUR TEEN DRUG AND ALCOHOL PREVENTION PROGRAM, LAUNCHED IN 2018, HAS BEEN RECOGNIZED WITH THE OUTSTANDING RURAL HEALTH PROGRAM OF THE YEAR AWARD. THIS PROGRAM, OFFERED IN SCHOOLS AND THROUGH HOSPITAL INITIATIVES, HAS SHOWN A SIGNIFICANT IMPACT ON THE COMMUNITY. TEEN MENTAL HEALTH EDUCATION: OUR EFFORTS IN TEACHING ABOUT SUICIDE AND ANTI-BULLYING HAVE CONTRIBUTED TO A REDUCTION IN SUICIDE RATES. THE HOSPITAL MAINTAINS STRONG COLLABORATIONS WITH VARIOUS COMMUNITY ORGANIZATIONS TO ADDRESS SUBSTANCE ABUSE AND ITS CONSEQUENCES. CARDIOVASCULAR HEALTH: IN PARTNERSHIP WITH OCHSNER HEALTH SYSTEM, UNION GENERAL HOSPITAL HAS BECOME AN EMERGENCY LEVEL 3 STROKE CENTER. WE'VE FOCUSED ON INCREASING EDUCATION AND AWARENESS ABOUT EARLY PREVENTION OF HEART DISEASE AND STROKE. OUR PARTNERSHIP WITH OCHSNER CLINIC FOUNDATION HAS ENHANCED PATIENT ACCESS TO SPECIALIZED CARE. ADDITIONALLY, HEALTH FAIRS AND NUTRITION CLASSES PROMOTE HEALTHY HABITS. OBESITY AND DIABETES: WE ACTIVELY PARTICIPATE IN HEALTH FAIRS AND COMMUNITY EVENTS, COLLABORATING WITH LOCAL ORGANIZATIONS. INITIATIVES LIKE THE BIGGEST LOSER PROGRAM AND NUTRITION EDUCATION, OFFERED IN PARTNERSHIP WITH LSU AGCENTER, ARE STEPS TOWARDS FOSTERING A HEALTH-CONSCIOUS COMMUNITY. THESE EFFORTS REFLECT OUR ONGOING COMMITMENT TO ADDRESSING THE HEALTH NEEDS OF OUR COMMUNITY AS IDENTIFIED IN THE CHNA. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - UNION GENERAL HOSPITAL. ANY PATIENTS WITH MEDICAID COVERAGE THAT HAVE NON-COVERED CHARGES WILL NOT REQUIRE ANY ADDITIONAL SCREENING TO QUALIFY FOR FINANCIAL ASSISTANCE. |
| Schedule H, Part V, Section B, Line 16 Facility , 1 | Facility , 1 - UNION GENERAL HOSPITAL. NOTIFICATION OF FINANCIAL ASSISTANCE POLICY: DURING THE SCREENING PROCESS, PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOTIFIED OF THE POLICY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (19 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 20d PRESUMPTIVE ELIGIBILITY DETERMINATIONS | PRESUMPTIVE ELIGIBILITY DETERMINATIONS: THE HOSPITAL DOES NOT MAKE PRESUMPTIVE ELIGIBILITY DETERMINATIONS AS DESCRIBED UNDER SECTION 501(R) AS THEY REQUIRE ALL PATIENTS TO COMPLETE AN APPLICATION. HOWEVER, IF A PATIENT IS FOUND TO QUALIFY FOR MEDICAID, THEY WILL ALSO QUALIFY FOR FINANCIAL ASSISTANCE WITH NO FURTHER SCREENING REQUIRED. |
| Schedule H, Part V, Section B LINES 18, 19, & 20 | ACTIONS FOR NON-PAYMENT: 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. |
| Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM | AFFILIATED HEALTH CARE SYSTEM: N/A |
| Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT | STATE FILING OF COMMUNITY BENEFIT REPORT: N/A |
| Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care | FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: -UNDERINSURANCE STATUS -INSURANCE STATUS -MEDICAID COVERAGE |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. THE COSTS COMPUTED ON IRS WORKSHEET 4 WERE COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT. THE COSTS COMPUTED ON WORKSHEET 8 WERE FROM THE HOSPITAL'S INCOME STATEMENT. |
| Schedule H, Part II Community Building Activities | COMMUNITY BUILDING ACTIVITIES: A TEEN DRUG PREVENTION PROGRAM WAS ESTABLISHED AT TWO OF OUR LOCAL SCHOOLS TO MEET WITH 6TH-12TH GRADE STUDENTS TWICE A WEEK TO DISCUSS WAYS TO DEAL WITH DRUGS AND SUBSTANCE ABUSE. THAT PROGRAM CONTINUES, WITH OVER 300 STUDENTS ENROLLED IN THE PROGRAM. THE HOSPITAL CONTINUES ITS PARTNERSHIP WITH THE LOCAL SCHOOL DISTRICT AND OFFERS IT'S A GIRL THING, MAKING PROUD CHOICES, "THE HOSPITAL'S STD/HIV PREGNANCY PREVENTION PROGRAM. THE HOSPITAL EDUCATES 6TH THROUGH 12TH GRADE GIRLS EVERY WEEK FOR AN HOUR. WE HAVE CONTINUED WITH THE ANTI BULLYING PROGRAM: UNION PARISH "TOGETHER, WE CAN BE BULLY FREE, HAVE EXPANDED THE PROGRAM TO INCLUDE 3RD AND 4TH GRADERS. WE NOW HAVE OVER 1,000 STUDENTS PARTICIPATING IN THE PROGRAM. IN PARTNERSHIP WITH OMEGA LABS, THE HOSPITAL IS OFFERING FREE COLON CANCER SCREENINGS TO THE COMMUNITY. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | BAD DEBT EXPENSE: WE USE AN AGING APPROACH TO RESERVE AMOUNTS FOR BAD DEBT BY FINANCIAL CLASS. WHEN AN ACCOUNT REACHES THE STATUS THAT WE'VE DETERMINED THEM TO BE UNCOLLECTIBLE, THE ACCOUNT IS WRITTEN OFF AS A BAD DEBT. ALL APPROPRIATE DISCOUNTS AND PAYMENTS ARE APPLIED TO AN ACCOUNT, WHICH REDUCES ANY BAD DEBT WRITE-OFFS FOR THAT ACCOUNT. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | BAD DEBT AS A COMMUNITY BENEFIT: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | COSTING METHODOLOGY AND MEDICARE SHORTFALL: THE HOSPITAL USED MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICAID OR MEDICARE DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. IN ADDITION, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT; THEREFORE, COSTS TO PROVIDE CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT TO THE EXTENT COSTS EXCEED MEDICARE REIMBURSEMENT. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | PROVISIONS ON COLLECTION PRACTICES: ONCE A PATIENT IS BELIEVED TO BE INDIGENT, THEY MUST COMPLETE AN APPLICATION FOR CHARITY CARE ASSISTANCE FOR UGH TO DETERMINE THE PATIENT'S ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. TO BE ELIGIBLE, A PATIENT/FAMILY'S INCOME SHALL BE COMPARED TO 250% OF THE FEDERAL POVERTY GUIDELINES. THEIR INCOME MUST BE AT OR BELOW THE CORRESPONDING AMOUNT BASED ON FAMILY SIZE. IF A PATIENT WITH MEDICAID COVERAGE HAS NON-COVERED CHARGES, NO ADDITIONAL SCREENING WILL BE REQUIRED TO QUALIFY FOR CHARITY CARE. THE HOSPITAL MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. THE SCREENING PROCESS TO DETERMINE A PATIENT'S ELIGIBILITY FOR THE HOSPITAL'S CHARITY CARE PROGRAM WILL BEGIN AS SOON AS POSSIBLE FOLLOWING ADMISSION TO UGH. ONCE A PATIENT HAS BEEN DETERMINED TO QUALIFY FOR UGH'S CHARITY CARE PROGRAM, NO ADDITIONAL COLLECTION EFFORTS WILL BE MADE ON THAT ACCOUNT. |
| Schedule H, Part V, Section B, Line 16a FAP website | - UNION GENERAL HOSPITAL: Line 16a URL: HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - UNION GENERAL HOSPITAL: Line 16b URL: HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - UNION GENERAL HOSPITAL: Line 16c URL: HTTP://UNIONGEN.ORG/PATIENT-INFO/FINANCIAL-ASSISTANCE/; |
| Schedule H, Part VI, Line 2 Needs assessment | NEEDS ASSESSMENT: 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. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: 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. |
| Schedule H, Part VI, Line 4 Community information | COMMUNITY INFORMATION: UNION GENERAL IS LOCATED IN UNION PARISH, A LARGE SPRAWLING RURAL COMMUNITY MADE UP OF 905 SQUARE MILES OF ROLLING HILLS AND TALL PINE TREES. 19.4% OF THE POPULATION IS BELOW 100% OF THE FEDERAL POVERTY GUIDELINES. THERE IS NO PUBLIC TRANSPORTATION IN THE PARISH AND THE TOTAL PARISH POPULATION IS 22,108 (2019 ESTIMATE). UNION PARISH IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA (MUA) AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). PER CAPITA INCOME IS APPROXIMATELY $24,030 (2019 ESTIMATE). 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 UNDER SERVED PARISH POPULATIONS. |
| Schedule H, Part VI, Line 5 Promotion of community health | PROMOTION OF COMMUNITY HEALTH: UNION GENERAL HOSPITAL 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. UGH IS INVOLVED WITH LOCAL BUSINESSES AND CHURCHES TO BRING AWARENESS AND SCREENING TO THE PUBLIC THROUGH RELAY FOR LIFE, AHA'S GO RED CAMPAIGN, UNITED WAY FUNDRAISER, SUSAN G KOMEN FUNDRAISER AND RACE FOR THE CURE, AND BY HOSTING AN ANNUAL BREAST CANCER AWARENESS DAY FOR THE COMMUNITY. UGH PARTNERS WITH SUSAN G KOMEN TO PROVIDE FREE MAMMOGRAMS AND OMEGA DIAGNOSTICS, LLC TO OFFER FREE COLON SCREENINGS FOR THE SERVICE AREA. THE HOSPITAL BUILT A WALKING TRAIL ON CAMPUS TO ENCOURAGE EXERCISE IN THE COMMUNITY, AS WELL AS PROVIDED NUTRITION WORKSHOPS, AND BLOOD SUGAR AND BLOOD PRESSURE SCREENING FOR THE COMMUNITY. UGH PROVIDED ANTI BULLYING, TEEN DRUG PREVENTION AND TEEN PREGNANCY PREVENTION SESSIONS AT THE HOSPITAL AND ALL THE SCHOOLS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DARRA JUNG | ||||||||||||||
| DIRECTOR OF NURSING | $158,798 | $0 | $0 | $0 | $282 | $0 | $3,024 | $0 | $2,054 | $0 | $164,158 | $0 | $0 | $0 |
| WILLIAM ADCOCK | ||||||||||||||
| CFO | $230,097 | $0 | $23,889 | $0 | $516 | $0 | $4,003 | $0 | $613 | $0 | $259,118 | $0 | $0 | $0 |
| EVALYN ORMOND | ||||||||||||||
| CEO | $264,958 | $0 | $25,000 | $0 | $8,257 | $0 | $5,332 | $0 | $0 | $0 | $303,547 | $0 | $0 | $0 |
| KATE COOK | ||||||||||||||
| PHARMACY DIRECTOR | $146,144 | $0 | $0 | $0 | $550 | $0 | $2,978 | $0 | $1,195 | $0 | $150,867 | $0 | $0 | $0 |
| NICOLE LEBLANC | ||||||||||||||
| RN | $132,782 | $0 | $15,000 | $0 | $9 | $0 | $0 | $0 | $6,270 | $0 | $154,061 | $0 | $0 | $0 |
| Connie Booth | ||||||||||||||
| Physician | $158,787 | $0 | $162 | $0 | $200 | $0 | $3,266 | $0 | $7,333 | $0 | $169,748 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 7 Non-fixed payments | FormAndLineReferenceDesc |
| Explanation | DETERMINATION OF BONUSES: THE AMOUNT OF THE CEO'S BONUS IS DETERMINED BY THE BOARD DURING AN EXECUTIVE SESSION AT THE NOVEMBER MEETING. THE CFO'S BONUS IS BASED OFF A PERCENTAGE OF ANNUAL SALARY DETERMINED BY THE CEO. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b Review of form 990 by governing body | PROCESS TO REVIEW THE FORM 990: 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, AND THE RETURN IS THEN MADE AVAILABLE TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FULL BOARD WILL REVIEW A COPY OF THE 990 WITH RECOMMENDATIONS FROM THE FINANCE COMMITTEE PRIOR TO FILING WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY CONFLICTS OF INTEREST. IN THE EVENT OF A CONFLICT, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. |
| Form 990, Part VI, Line 19 Required documents available to the public | AVAILABILITY OF DOCUMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | - Total Revenue: 38966, Related or Exempt Function Revenue: 38966, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part IX, Line 11g Other Fees | PURCHASED MEDICAL SERVICES - Total Expense: 4333883, Program Service Expense: 3574466, Management and General Expenses: 759417, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 1497009, Program Service Expense: 1497009, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE AGREEMENTS - Total Expense: 193821, Program Service Expense: 2032, Management and General Expenses: 191789, Fundraising Expenses: ; PHYSICIAN RECRUITING - Total Expense: 75, Program Service Expense: , Management and General Expenses: 75, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 155063, Program Service Expense: 563, Management and General Expenses: 154500, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS TO ESTABLISH COMPENSATION | REVIEW OF OFFICER COMPENSATION: INFORMATION WAS OBTAINED FROM MODERN HEALTHCARE ARTICLES REGARDING SALARY COMPENSATION FOR THE CEO & CFO, IN THE TIMEFRAME OF 2020-2021, 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 DURING THE EXECUTIVE SESSION. DOCUMENTATION OF THE REVIEW IS KEPT IN THE EXECUTIVE SESSION'S MINUTES. ALL OTHER EMPLOYEES (INCLUDING OTHER OFFICERS) RECEIVE MERIT INCREASES BASED ON THEIR ANNUAL EMPLOYEE EVALUATION SCORES EVERY FEBRUARY OR MARCH. THE CEO AND CFO SET THE MAXIMUM INCREASES FOR DEPARTMENT MANAGERS, AND MAXIMUM PERCENTAGE INCREASES FOR ALL OTHER EMPLOYEES. EACH EMPLOYEE RECEIVES A PRO RATA PERCENTAGE OF THE MAXIMUM PERCENTAGE, BASED ON THEIR ACTUAL EVALUATION SCORE COMPARED TO THE MAXIMUM SCORE POSSIBLE ON THE EVALUATION. THE EVALUATIONS ARE COMPLETED BY THE EMPLOYEE'S SUPERVISOR. |
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