JENNINGS AMERICAN LEGION HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- JENNINGS AMERICAN LEGION HOSPITAL INC (EIN 72-0445607)
- Tax period
- 2016-12-01 to 2017-11-30
- Filed
- 2018-07-17
- IRS object ID
- 201841989349300509
- Schema version
- 2016v3.0
- 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 | 2018-07-17T07:42:52-07:00 | ReturnTs |
| Tax Period End | 2017-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lester Miller & Wells | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 Bayou Rapides | AddressLine1Txt |
| City | Alexandria | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720445607 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennings American Legion Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JENN | BusinessNameControlTxt |
| Phone | 3376167100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 Elton Road | AddressLine1Txt |
| City | Jennings | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70546 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dana D Williams | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2018-07-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Robert G Miller | PreparerPersonNm |
| PTIN | P00523509 | PTIN |
| Phone | 3184871450 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,204,840 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Formation | 1952 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | Healthcare services | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 564 | TotalEmployeeCnt |
| Total Volunteers | 52 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,514,374 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,655,711 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,334,100 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,474,783 | CYProgramServiceRevenueAmt |
| PY Investment Income | $62,285 | PYInvestmentIncomeAmt |
| CY Investment Income | $74,346 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $39,910,759 | PYTotalRevenueAmt |
| CY Total Revenue | $42,204,840 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $22,110,591 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,193,618 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,119,343 | PYOtherExpensesAmt |
| CY Other Expenses | $19,773,821 | CYOtherExpensesAmt |
| PY Total Expenses | $41,229,934 | PYTotalExpensesAmt |
| CY Total Expenses | $43,967,439 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,319,175 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,762,599 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,202,434 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,612,651 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,178,032 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,350,848 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,024,402 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,261,803 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Healthcare services | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $29,326,011 | ExpenseAmt |
| Revenue | $42,204,840 | RevenueAmt |
| Desc | JENNINGS AMERICAN LEGION HOSPITALS (JALH) OPERATES A 49 BED ACUTE CARE HOSPITAL. JALH PROVIDES INPATIENT AND OUTPATIENT SERVICES, THREE LICENSED RURAL HEALTH CLINICS, AND OPERATES A 24-HOUR EMERGENCY ROOM. JALH PROVIDES THESE SERVICES REGARDLESS OF RACE, COLOR, CREED, RELIGION, GENDER, NATIONAL ORIGION, DISABILITY, AGE, OR ABILITY TO PAY. THE HOSPITAL PROVIDED THE FOLLOWING INPATIENT DAYS OF CARE DURING FY 2016: MEDICARE MEDICAID TOTALACUTE 5,666 2,411 11,181JALH IS VERY ACTIVE IN THE COMMUNITY. JALH HOSTS A NUMBER OF HEALTH FAIRS FOR THE COMMUNITY. THE HEALTH FAIRS OFFER THE COMMUNITY ACCESS TO A NUMBER OF FREE HEALTH SCREENINGS AND ACCESS TO VENDORS FOR THEIR HEALTH. JALH PARTICIPATES IN THE MEDICAID PROGRAM AND ADMINISTERS A CHARITY CARE POLICY WHEREBY FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO QUALIFIED FINANCIALLY TROUBLED INDIVIDUALS. JALH FOREGONE $1,590,813 OF CHARGES FOR THE YEAR ENDED NOVEMBER 30, 2017. | Desc |
| Total Program Service Expenses | $29,326,011 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 88 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 564 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| 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 |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (true) | 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 | false | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tammy Benoit | PersonNm |
| Phone | 3376167040 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 Elton Road | AddressLine1Txt |
| City | Jennings | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 705463614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Richard Oustalet | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,800 | $0 | $0 | ||
| JOHN SEGURA | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,900 | $0 | $0 | ||
| GLEN MCFARLAIN | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | ||
| CHRISTOPHER ACHEE | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $12,600 | $0 | $0 | ||
| DALE LANDRY | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $12,600 | $0 | $0 | ||
| HOARCE NAQUIN JR | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | ||
| ELLA DARTEZ | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | ||
| DARRELL LANDRY | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,700 | $0 | $0 | ||
| JAMES RICHERT JR | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,800 | $0 | $0 | ||
| RICHARD ARCENEAUX | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $12,300 | $0 | $0 | ||
| ARTHUR D MATTE CPA | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $12,600 | $0 | $0 | ||
| JOHN LOUVIERE JR | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | ||
| LAWRENCE BENOIT | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | ||
| JULIE BERRY | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,300 | $0 | $0 | ||
| CARL BENOIT | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,900 | $0 | $0 | ||
| KEVIN BERKEN | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,400 | $0 | $0 | ||
| RONNIE PETREE | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $5,800 | $0 | $0 | ||
| DANA WILLIAMS | ||||||||
| CEO | 40.00 | 0.00 | $248,506 | $0 | $25,780 | Yes (X) | ||
| CHRIS KOHLENBERG | ||||||||
| CFO | 40.00 | 0.00 | $179,424 | $0 | $5,849 | Yes (X) | ||
| DARIN DOUMITE | ||||||||
| MD | 40.00 | 0.00 | $405,167 | $0 | $22,704 | Yes (X) | ||
| JOEL BAILEY | ||||||||
| MD | 40.00 | 0.00 | $353,274 | $0 | $21,838 | Yes (X) | ||
| KRYSTLE BAKER | ||||||||
| MD | 40.00 | 0.00 | $304,000 | $0 | $10,337 | Yes (X) | ||
| AMANDA ELLINGTON | ||||||||
| MD | 40.00 | 0.00 | $324,500 | $0 | $5,600 | Yes (X) | ||
| GEORGE BAILEY JR | ||||||||
| MD | 40.00 | 0.00 | $246,000 | $0 | $21,442 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,186,571 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $113,550 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | 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 |
|---|---|---|---|---|---|
| CPS Inc | |||||
| PO Box 638316 | CINCINNATI | OH | 452638316 | PHARMACY MGMT FEE | $2,514,083 |
| CPSI INC | |||||
| 6600 WALL STREET | MOBILE | AL | 36695 | TECH SUPPORT | $505,526 |
| JEFFERSON DAVIS PHYSICIAN SERVICE | |||||
| PO BOX 677979 | DALLAS | TX | 75260 | CONTRACT SERVICE | $341,784 |
| PATHOLOGY LABORATORY INC | |||||
| 830 W BAYOU PINES | LAKE CHARLES | LA | 70601 | LAB SERVICES | $313,287 |
| JEFFERSON DAVIS EMERGENCY GROUP | |||||
| PO BOX 82368 | LAFAYETTE | LA | 70598 | ER PHYSICIAN FEES | $272,156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,608,502 | GovernmentGrantsAmt |
| All Other Contributions | $47,209 | AllOtherContributionsAmt |
| Total Contributions | $1,655,711 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| NET PATIENT SERVICE REV | $38,302,841 | $38,302,841 |
| OTHER OPERATING REVENUE | $2,171,942 | $2,171,942 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $40,474,783 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,910 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $64,910 | RelatedOrExemptFuncIncomeAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,436 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,436 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,436 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,436 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,204,840 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,549,129 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,759 | TotalAmt |
| Management And General | $578,759 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,476,265 | TotalAmt |
| Program Services | $11,666,283 | ProgramServicesAmt |
| Management And General | $7,809,982 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,035 | TotalAmt |
| Program Services | $310,902 | ProgramServicesAmt |
| Management And General | $208,133 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,289,153 | TotalAmt |
| Program Services | $1,371,203 | ProgramServicesAmt |
| Management And General | $917,950 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,330,406 | TotalAmt |
| Program Services | $796,913 | ProgramServicesAmt |
| Management And General | $533,493 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,049 | TotalAmt |
| Program Services | $23,989 | ProgramServicesAmt |
| Management And General | $16,060 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,700 | TotalAmt |
| Program Services | $26,775 | ProgramServicesAmt |
| Management And General | $17,925 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,167,691 | TotalAmt |
| Program Services | $699,447 | ProgramServicesAmt |
| Management And General | $468,244 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,862 | TotalAmt |
| Program Services | $19,684 | ProgramServicesAmt |
| Management And General | $13,178 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,432 | TotalAmt |
| Program Services | $30,209 | ProgramServicesAmt |
| Management And General | $20,223 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,735 | TotalAmt |
| Program Services | $7,628 | ProgramServicesAmt |
| Management And General | $5,107 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,682 | TotalAmt |
| Program Services | $61,507 | ProgramServicesAmt |
| Management And General | $41,175 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,108,064 | TotalAmt |
| Program Services | $1,262,730 | ProgramServicesAmt |
| Management And General | $845,334 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,395 | TotalAmt |
| Program Services | $424,928 | ProgramServicesAmt |
| Management And General | $284,467 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies and Drugs | $6,484,061 | $6,363,329 | $120,732 |
| PROFESSIONAL FEES | $3,210,383 | $2,779,835 | $430,548 |
| REPAIRS AND MAINTENANCE | $1,647,729 | $986,990 | $660,739 |
| SALES TAX | $739,531 | $442,979 | $296,552 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,423,507 | TotalAmt |
| Program Services | $2,050,680 | ProgramServicesAmt |
| Management And General | $1,372,827 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,967,439 | TotalAmt |
| Program Services | $29,326,011 | ProgramServicesAmt |
| Management And General | $14,641,428 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,242 | BOYAmt |
| EOY | $1,723,987 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,888,356 | BOYAmt |
| EOY | $3,399,282 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,155 | BOYAmt |
| EOY | $1,079,795 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $961,599 | BOYAmt |
| EOY | $746,476 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,585,308 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $34,848,084 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,102,479 | BOYAmt |
| EOY | $14,737,224 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,174,603 | BOYAmt |
| EOY | $7,925,887 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,202,434 | BOYAmt |
| EOY | $29,612,651 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,071,649 | BOYAmt |
| EOY | $3,575,433 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,106,383 | BOYAmt |
| EOY | $1,775,415 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,178,032 | BOYAmt |
| EOY | $5,350,848 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,024,402 | BOYAmt |
| EOY | $24,261,803 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,024,402 | BOYAmt |
| EOY | $24,261,803 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,202,434 | BOYAmt |
| EOY | $29,612,651 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,762,599 | ReconcilationRevenueExpnssAmt |
| 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 | false | FederalGrantAuditRequiredInd |
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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,526,338 | OtherCostOrOtherBasisAmt |
| Book Value | $1,526,338 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,244,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,811,309 | DepreciationAmt |
| Book Value | $8,433,304 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $702,993 | OtherCostOrOtherBasisAmt |
| Depreciation | $628,748 | DepreciationAmt |
| Book Value | $74,245 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,094,558 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,408,027 | DepreciationAmt |
| Book Value | $4,686,531 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,806 | OtherCostOrOtherBasisAmt |
| Book Value | $16,806 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,737,224 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED 3RD PARTY PAYOR SETTLEMENTS | $1,919,642 |
| GUARANTEE RECEIVABLE | $932,883 |
| INVESTMENTS RESTRICTED | $4,429,668 |
| OTHER RECEIVABLE | $643,694 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,925,887 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $42,204,840 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $42,204,840 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $42,204,840 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $43,967,439 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $43,967,439 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $43,967,439 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | NOTE 17- INCOME TAXESAccounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Hospital and recognize a tax liability if the organization has taken an uncertain position that more likely than not would be sustained upon examination by the Internal Revenue Service. Management has concluded that there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Hospital is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any periods in progress. Hospital management believes it is no longer subject to income tax examinations for periods ending prior to December 1, 2012. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
| Report Publically Available | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,137,198 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,215,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$78,302 | NetCommunityBenefitExpnsAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,016,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,337,484 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $678,768 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,153,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,552,984 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $600,466 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $9,990 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $681,754 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $618,976 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $62,778 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,898 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $696,642 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $618,976 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $77,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $12,850,092 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,171,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $678,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,484,326 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $34,547 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,087,995 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,265,084 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,177,089 | 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 | false | 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 | JENNINGS AMERICAN LEGION HOSP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 ELTON RD | AddressLine1Txt |
| City | JENNINGS | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | JALH.COM | WebsiteAddressTxt |
| State License | 1720071 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNINGS AMERICAN LEGION HOSP | 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 | 16 | 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 | JALH.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | JALH.COM | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| 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 | 200.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | false | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | JALH.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 5 - Account Input from Persons Who Represent the Community | + An evaluation of the impact of actions taken to address the significant health needs identified in the November 2013 CHNA to understand the effectiveness of JALH's current strategies and programs.+Community input was provided through 19 key informant interviewees and any comments received providing feedback on the previous assessment and implementation strategy. |
| Part V, Line 16i - Other Means Hospital Facility Publicized the Policy | MAILED LETTER AND APPLICATION TO OUTPATIENT ER PRIVATE PAY PATIENTS |
| Part V, Line 18d - Other Collection Actions Against a Patient | LIENS FILED ON THIRD-PARTY AUTO LIABILITY PLANS ONLY |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) | DISCOUNTED CARE IS DETERMINED BY 300% OF FPG - FREE CARE IS AT 200% |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | THE HOSPITAL ESTIMATES APPROXIMATELY 1.39% OF THE AMOUNTS WRITTEN OFF TO BAD DEBTS ARE RELATED TO PATIENTS WHO COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THIS ESTIMATE IS BASED ON A REVIEW MADE MONTHLY ON THE LIST OF PATIENTS TURNED OVER TO COLLECTIONS. THE HOSPITAL DETERMINES THIS BASED ON THE PATIENT'S BILLING ADDRESS, SUCH AS A PATIENT LIVING IN A LOW INCOME HOUSING LOCATION OR PATIENT PROVIDING A FALSE ADDRESS. ANOTHER DETERMINING FACTOR IS WHETHER A PATIENT EVENTUALLY QUALIFIES FOR MEDICAID COVERAGE UNDER THE MEDICAID SPEND DOWN PROGRAM DUE TO LARGE MEDICAL BILLS. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | THE HOSPITAL CONTENDS THAT THE MAJORITY, IF NOT ALL, OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE HOSPITAL OFFERS QUALITY HEALTHCARE TO ALL PATIENTS REGARDLESS OF PAYMENT OR REIMBURSEMENT EXPECTATION. RESOURCES FOR MEDICARE PATIENTS VERSUS ALL OTHER PATIENTS ARE IDENTICAL BASED ON TREATMENT. |
| Part VI - Needs Assessment | Please see the attached PDF JALH 2016 CHNA |
| Part VI - Patient Education of Eligibility for Assistance | Jennings American Legion Hospital is committed to patients first. As part of this commitment, Jennings American Legion Hospital's vision is to provide the highest quality healthcare at the lowest possible cost to all people in the hospital's service area. The hospital's charity care program supports patients who have demonstrated financial need and require medically necessary medical services. Jennings American Legion's Financial Counselor visits with all physicians on staff and keeps her business cards in their offices for patients that need assistance. On a daily basis the Financial Counselor runs reports of all private pay patients. She then visits all the private pay patients that are Inpatient to screen for assistance. For the patients that have been through outpatient departments, including the ER the Financial Counselor mails a financial assistance package . Follow-up phone calls are also made by the financial counselor to aide in return packets.The Financial Counselor obtains the following information to determine a patient's need for charity care: household income, family size, assets, and availability of alternative sources of payments. Finally, a thorough review is completed and the following services are provided:- Assist patients with a governmental assistance application when applicable.- Help patients determine if a third party is liable.- Provide medical services at reduced rates or at no cost.- Provide individualized plans based on the patient's ability to pay.- Use fair and consistent collection practices. |
| Part VI - Community Information | Jennings American Legion Hospital is currently licensed to operate 49 beds and is accredited by The Joint Commission. For fiscal year 2017, patient volumes included 3,050 admissions and 16,392 emergency department visits.JENNINGS, is a small town of approximately 11,400 located on Interstate 10 about halfway between two major cities in Louisiana, Lafayette and Lake Charles. It is also halfway between Houston Texas and New Orleans Louisiana. Jennings is the seat of Jefferson Davis Parish.Jennings American Legion Hospital services all of Jefferson Davis Parish, parts of Allen Parish, Acadia Parish, Calcasieu Parish and Evangeline Parish. Jefferson Davis Parish population was approximately 32,000. The average income in Jefferson Davis Parish was $22,665. The percentage of Jefferson Davis Parish residents living below the poverty line was 19.3%. Jennings American Legion Hospital is the only hospital to serve Jefferson Davis Parish.The portion of the population under the age of 65 in Jefferson Davis Parish with a disability is 15%. The percentage of the population who were female was 51.2%. The population classified as white was 80.02%, African American 16.7%, Asian .3%, two or more races 2.0% and Hispanic or Latino 2.4%. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|---|---|---|
| AMANDA ELLINGTON | ||||||
| MD | $297,000 | $27,500 | $5,600 | $330,100 | ||
| CHRIS KOHLENBERG | ||||||
| CFO | $176,434 | $590 | $185,273 | $2,400 | $5,849 | |
| DANA WILLIAMS | ||||||
| CEO | $235,384 | $890 | $9,936 | $274,286 | $12,232 | $15,844 |
| DARIN DOUMITE | ||||||
| MD | $377,667 | $27,500 | $6,998 | $427,871 | $15,706 | |
| GEORGE BAILEY JR | ||||||
| MD | $234,000 | $9,856 | $267,442 | $12,000 | $11,586 | |
| JOEL BAILEY | ||||||
| MD | $349,274 | $4,000 | $10,600 | $375,112 | $11,238 | |
| KRYSTLE BAKER | ||||||
| MD | $300,000 | $4,000 | $10,289 | $314,337 | $48 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | No review was or will be conducted. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE BOARD. WHENEVER CONFLICT EXISTS, THE BOARDMEMBER MUST ABSTAIN FROM VOTING ON ANY MATTERS AFFECTED BY THE CONFLICT. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | A COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND APPROVES THE CEO'S SALARY ON AN ANNUAL BASIS. THE APPROVAL PROCESS INCLUDES COMPARISON TO COMPENSATION SURVEYS MADE BY THE HOSPITAL ASSOCIATION AND OTHER TRADE ORGANIZATIONS. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | No documents available to the public. |
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