2016-05-02T16:11:39-05:00 2015-06-30 BKD LLP 14241 DALLAS PKWY SUITE 1100 DALLAS TX 75254 990 2014-07-01 720995809 Union General Hospital % WILLIAM ADCOCK UNIO 3183689751 PO Box 398 Farmerville LA 71241 WILLIAM ADCOCK CFO 3183689751 2016-05-16 true Jeanette Verrelli P00742631 9727028262 2014 2016-08-17 19:52:53Z EVALYN ORMOND PO BOX 398 FARMERVILLE LA 71241 15204007 false X WWW.UNIONGEN.ORG X 1983 LA TO PROVIDE ACUTE CARE HOSPITAL SERVICES IN THE FARMERVILLE AREA. 7 7 161 7 0 0 2964086 1635972 11765978 13476629 7623 -10500 69010 82517 14806697 15184618 17056 51173 0 0 5528879 5621082 0 0 0 8266113 8887099 13812048 14559354 994649 625264 10175742 11027080 1284140 1562809 8891602 9464271 IT IS THE MISSION OF UNION GENERAL HOSPITAL TO DELIVER THE BEST POSSIBLE HEALTH CARE AVAILABLE AND SERVE THE DEDICATED PEOPLE OF UNION PARISH AND THE SURROUNDING AREAS. false false 12369317 51173 13517071 PROVIDED ACUTE CARE HOSPITAL SERVICES TO INDIVIDUALS IN THE FARMERVILLE AREA; INDIVIDUALS SERVED AMOUNTED TO 2,731 PATIENT DAYS AND 5,865 EMERGENCY ROOM VISITS. THE LABORATORY PERFORMED 36,374 TESTS AND 36,863 ECG, RADIOLOGY, ULTRASOUND, CT, OT, RT, ST, AND PT PROCEDURES WERE PERFORMED. THE RURAL HEALTH CLINICS LOGGED 12,115 VISITS. 12369317 true true false true false false false false false false true false false true true false true false false false false false false false false false true true true false true false false false false false false false false false false false false false false false false false true 106 0 true 161 true false false false false false false false false false false X 7 7 false true false false false false false true true false false false true true true true true true true false X X WILLIAM ADCOCK 3183687096 901 JAMES AVE FARMERVILLE LA 71241 X TIM TETTLETON PRESIDENT 1.0 0.0 X X 0 0 0 BESSIE WARREN SECRETARY 1.0 0.0 X X 0 0 0 JOHN ELLIS DIRECTOR 1.0 0.0 X 0 0 0 EDDYE JO ALBRITTON DIRECTOR 1.0 0.0 X 0 0 0 DANIEL HUNTER JR VICE PRESIDENT 1.0 0.0 X X 0 0 0 RALPH KELLEY DIRECTOR 1.0 0.0 X 0 0 0 DANNY SMITH DIRECTOR 1.0 0.0 X 0 0 0 DIANNE DAVIDSON COO 40.0 0.0 X 90306 0 3607 EVALYN ORMOND CONTRACTED CEO 40.0 0.0 X 0 0 1644 WILLIAM ADCOCK CFO 40.0 0.0 X 156973 0 6221 DARRA JUNG DIRECTOR OF NURSING 40.0 0.0 X 115440 0 5253 HOLLY CORLEY MD PHYSICIAN 40.0 0.0 X 228916 0 6729 SHEREE HICKS PHARMACIST 40.0 0.0 X 176748 0 4100 LYNETTE WADE NP NURSE PRACTITIONER 40.0 0.0 X 106822 0 4134 LISA POST PHYSICIAN 20.0 0.0 X 103513 0 219 978718 0 31907 6 false true false Correct Care Inc 17438 Hardhat Drive COVINGTON LA 70435 E.R. STAFFING 1054473 Omega Diagnostics LLC 2915 Missouri Ave SHREVEPORT LA 71109 LABORATORY 975388 Lincoln Healthcare Inc 1817 Northpointe Lane RUSTON LA 71273 THERAPY SERVICES 937613 Medhost of Tennessee Inc 6550 Carothers Pkwy 100 FRANKLIN TN 37067 IT SERVICES 324918 IASIS Glenwood Regional Medical Cen 503 McMillan Road WEST MONROE LA 71291 ADMIN SERVICES 207636 7 1583377 52595 1635972 NET PATIENT SERVICE REVENUE 621110 13419509 13419509 E.H.R. Incentive Revenue 900099 16464 16464 PHARMACY REVENUE 446110 40656 40656 13476629 6114 6114 0 0 0 0 0 2775 19389 -16614 -16614 -16614 0 0 0 CAFETERIA AND VENDING SALES 722514 42075 42075 MEDICAL RECORDS 561000 8125 8125 UTILITIES DISTRICT REIMBURSEMENT 900099 1390 1390 30927 30927 82517 15184618 13517071 31575 X 51173 51173 0 0 0 380770 303450 77320 0 4439438 3630169 809269 42662 0 42662 420892 341435 79457 337320 273640 63680 0 7874 7874 59232 59232 0 0 0 4032719 3673578 359141 81931 7139 74792 261394 93290 168104 195582 195582 0 286498 248433 38065 61739 48465 13274 0 91741 26503 65238 2431 2431 0 1085626 1085626 129923 69861 60062 BAD DEBT EXPENSE 1673381 1673381 MEDICAL SUPPLIES 819560 819560 DUES & SUBSCRIPTIONS 38418 10386 28032 COLLECTIONS 42472 63 42409 16578 13165 3413 14559354 12369317 2190037 0 3495040 4171517 387755 1389965 0 0 783722 1338735 0 0 0 0 0 0 178494 196649 81676 98390 12527470 9406550 3855414 3120920 0 0 0 0 0 0 0 0 1393641 710904 10175742 11027080 814452 858417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469688 704392 1284140 1562809 X 8602152 8227416 289450 1236855 0 0 8891602 9464271 10175742 11027080 X 625264 -52595 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 2640 false false false 2640 false SCHEDULE C, PART II-B, LINE 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES: THE HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING RURAL HOSPITAL COALITION $8,587 7% $601 LA HOSPITAL ASSOCIATION 9,887 20% 1,978 NATIONAL RURAL HEALTH ASSOC 1,225 5% 61 LA RURAL HEALTH ASSOC 700 0% 0 -------------------------------------- TOTAL $20,399 $2,640 146797 146797 4777813 3413233 1364580 7429716 5894205 1535511 173144 99112 74032 3120920 Due from 3rd Party Payer 543148 OTHER RECEIVABLES 121937 EMPLOYEE RECEIVABLES 7580 DUE FROM CARD HEALTHCARE 36000 DUE FROM HOSP SERV DISTRICT 294 UTILITY DEPOSITS 1945 710904 0 CAPITAL LEASE OBLIGATION 97955 ESTIMATED AMOUNTS DUE TO 3RD PARTY PAYER 580687 ESTIMATED SELF-INSURANCE COSTS 25750 704392 X 12530626 -1673381 -1673381 14204007 980611 980611 15184618 12905362 19389 19389 12885973 1673381 1673381 14559354 SCHEDULE D, PART X, LINE 2 LIABILITY FOR UNCERTAIN TAX POSITIONS: THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2012. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $(1,673,381) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $1,673,381 SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: ADDITIONAL DISTRICT CONTRIBUTION RECEIVED $1,000,000 LOSS ON DISPOSAL OF PROPERTY & EQUIPMENT (19,389) ----------------- TOTAL $980,611 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: LOSS ON DISPOSAL OF PROPERTY & EQUIPMENT $19,389 true true X true X true X true true false true true 22511 22511 0.00170 2551137 3591163 0.00000 2573648 3591163 22511 0.00170 3115 40418 40418 0.00310 2396 26978 26978 0.00210 5511 67396 67396 0.00520 5511 2641044 3591163 89907 0.00690 459 2766 2766 0.00020 812 6872 2634 4238 0.00030 35 31503 31503 0.00240 1306 41141 2634 38507 0.00290 true 1673381 5564837 5656848 -92011 X true true 1 1 Union General Hospital 901 James Ave Farmerville LA 71241 WWW.UNIONGEN.ORG 146 X X X Union General Hospital 1 false false true X X X X X X X X 14 true false false true X SEE PART V, SECTION C X true 14 true SEE PART V, SECTION C false false true X 200. 200. X X true true X X true X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 REPRESENTATIVES FROM THE COMMUNITY: THE CHNA HOSPITAL STEERING COMMITTEE (CHSC) IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. THE HOSPITAL IDENTIFIED 10 KEY STAKEHOLDERS FOR INDIVIDUAL INTERVIEWS WHO REPRESENTED MEDICALLY UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES. THESE INDIVIDUALS INCLUDED: THE SUPERINTENDENT OF THE UNION PARISH SCHOOL SYSTEM, THE MAYOR OF THE CITY, A PRIEST FROM OUR LADY PERPETUAL HEALTH CATHOLIC CHURCH, A CANCER CONTROL OFFICER FROM AHEC, A MINISTER FROM BLOOMING GROVE BAPTIST CHURCH, A NURSE FROM THE UNION PARISH HEALTH UNIT, A DIRECTOR ON THE COUNCIL OF AGING, A CHILD SAFETY COORDINATOR FROM THE CHILDREN'S COALITION, A PHYSICIAN FROM THE HOSPITAL AND A BUSINESS OWNER ON UNION GENERAL'S BOARD OF DIRECTORS. DURING THE INTERVIEW PROCESS, STAKEHOLDERS WERE ASKED QUESTIONS RELATED TO BOTH HEALTH AND ECONOMIC ISSUES WITHIN THE COMMUNITY. THEY WERE THEN ASKED TO RANK CERTAIN ISSUES IN ORDER OF IMPORTANCE FOR THE PURPOSE OF INCLUDING THEIR VOTES IN THE COMMUNITY'S HEALTH PRIORITIES. ADDITIONALLY, THE UNION GENERAL COMMUNITY HEALTH NEEDS SURVEY OBTAINED INPUT FROM VARIOUS MEMBERS OF THE COMMUNITY IN FOCUS GROUP MEETINGS. SCHEDULE H, PART V, SECTION B, LINE 7 COMMUNITY HEALTH NEEDS ASSESSMENT: THE HOSPITAL'S CHNA IS AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: http://www.uniongen.org/2015%20CHNA%20Report_Union%20General.pdf SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF AMOUNTS BILLED: GROSS CHARGES ARE BILLED TO ALL PATIENTS REGARDLESS OF AVAILABILITY OF INSURANCE COVERAGE, BUT PATIENTS ELIGIBLE UNDER FAP WILL RECEIVE DISCOUNT OF CHARGES TO ZERO. PATIENTS ELIGIBLE UNDER FAP WILL THEREFORE NEVER BE CHARGED MORE THAN RATES CHARGED TO THOSE WITH INSURANCE. SCHEDULE H, PART V, SECTION B, LINE 11 IDENTIFIED NEEDS ADDRESSED AND NOT ADDRESSED: THE FOLLOWING PRIORITY NEEDS WERE IDENTIFIED BY THE COMMUNITY AND THE CHNA STEERING COMMITTEE: -CANCER: THE HOSPITAL WILL PROVIDE TESTING, EDUCATION, AND REFERRAL SERVICES FOR MULTIPLE TYPES OF CANCER IN POSSIBLE COLLABORATION WITH THE FOLLOWING: THE HEALTH DEPARTMENT, HEALTHCARE PROVIDERS, ULM CERVICAL CANCER EDUCATION PROGRAM, AND LSU PARTNERS IN WELLNESS. -ADOLESCENT BEHAVIORS (TEEN PREGNANCY, BULLYING, ALCOHOL AND DRUG USE): HOSPITAL STAFF WILL AIM TO ENHANCE EDUCATIONAL PROGRAMS. TO ADDRESS THE ISSUE OF PREVENTION AMONG ADOLESCENTS, UNION GENERAL HOSPITAL IN COLLABORATION WITH THE DISTRICT ATTORNEYS OFFICE, LAW ENFORCEMENT, AND SCHOOL BOARD IS PUTTING TOGETHER COURT MANDATED TEEN AA MEETINGS AT UNION GENERAL HOSPITAL OFFERED ONE EVENING A WEEK YEAR-ROUND. MEETINGS WILL BE CONDUCTED WITH UNION GENERAL STAFF AND HELD ON THE CAMPUS OF UNION GENERAL HOSPITAL. STAFF INCLUDES TWO LICENSED PROFESSIONAL COUNSELORS AND ONE BOARD CERTIFIED MENTAL HEALTH AND PSYCHIATRIC NURSE. -CARDIOVASCULAR: THE HOSPITAL WILL PROVIDE INCREASED ACCESS TO EDUCATION AND AWARENESS FOR EARLY PREVENTION OF HEART DISEASE AND STROKE IN POSSIBLE COLLABORATION WITH THE OCHSNER HEALTH SYSTEM, HEALTH UNIT, ST. FRANCES HOSPITAL, AND CHILDREN'S COALITION. -OBESITY AND DIABETES: THE HOSPITAL WILL HOST A MOVE MORE, EAT HEALTHY BACK TO SCHOOL HEALTH FAIR TO BETTER PREPARE THE COMMUNITY FOR STARTING A HEALTHY SCHOOL YEAR. THEY WILL ALSO AIM TO PROVIDE INCREASED ACCESS TO PLACES OR RESOURCES FOR PHYSICAL ACTIVITY. THE FOLLOWING ARE HEALTH NEEDS WITHOUT SPECIFIC IMPLEMENTATION STRATEGIES: -DENTAL AND ORAL HEALTH: IT IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES TO OFFER DENTAL CARE. A FEDERALLY QUALIFIED HEALTHCARE CENTER (FQHC) IN MARION OFFERS DENTAL SERVICES TO THE UNINSURED OR UNDERINSURED ON A SLIDING FEE SCALE. THE HOSPITAL AND RURAL HEALTH CLINIC WILL EDUCATE AND REFER PATIENTS TO MOREHOUSE COMMUNITY MEDICAL CENTER (MCMC) OF MARION. -SEXUAL HEALTH: SEXUAL HEALTH WILL BE ADDRESSED THROUGH ANOTHER HEALTH PRIORITY "ADOLESCENT BEHAVIORS." UGH WILL DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS TEEN LIFESTYLE ISSUES WHICH INCLUDE SEXUAL HEALTH. ADDITIONALLY, PUBLIC HEALTH FACILITIES WILL BE IDENTIFIED AS RESOURCES COMMUNITY MEMBERS CAN CONTACT REGARDING SEXUAL HEALTH AND STD PREVENTION AND TREATMENT. -MENTAL HEALTH: MENTAL HEALTH SERVICES ARE BEYOND THE SCOPE OF THE SERVICES PROVIDED AT THE HOSPITAL. UGH WILL HELP IDENTIFY MENTAL HEALTH RESOURCES WITHIN ITS RESOURCE DIRECTORY. -RESPIRATORY AND ASTHMA: AFTER FURTHER REVIEW OF THIS HEALTH PRIORITY, THE SOURCE OF THE PRIORITY NEED WAS FROM THE SELF-REPORTED SURVEY THAT ASKED ABOUT ONE'S HEALTH CHALLENGES. THERE WAS NO OTHER EVIDENCE TO SUPPORT THIS AS A MAJOR HEALTH ISSUE. THE HOSPITAL WILL CONTINUE TO MONITOR THIS HEALTH CONDITION TO DETERMINE IF IT IS A SUBSTANTIAL HEALTH ISSUE IN THE FUTURE. ADDITIONALLY, THE HOSPITAL WILL HELP IDENTIFY RESPIRATORY SERVICES WITHIN ITS RESOURCE DIRECTORY. UNION GENERAL HOSPITAL WILL CONTINUE TO OFFER AN ANNUAL FLU SHOT DRIVE TO THE COMMUNITY AND EMPLOYEES TO REDUCE RESPIRATORY ILLNESSES. -ALCOHOL AND DRUG USE (ADULTS): ALCOHOL AND DRUG USE AMONG ADULTS WILL NOT BE ADDRESSED AT THIS TIME. SUBSTANCE ABUSE TREATMENT IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES. UGH WILL CONTINUE TO REFER PATIENTS TO OTHER ORGANIZATIONS THAT ADDRESS THIS ISSUE. -ACCESS TO CARE (TRANSPORTATION, PHYSICIANS, JOB OPPORTUNITIES, AND WELLNESS): ACCESS TO WELLNESS SERVICES WILL BE ADDRESSED THROUGH THE OBESITY AND DIABETES HEALTH PRIORITY. ACCESS TO CARE RELATED TO SPECIALTY PHYSICIANS, LACK OF TRANSPORTATION, AND LACK OF JOB OPPORTUNITIES IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES TO THE COMMUNITY. THE HOSPITAL WILL HELP IDENTIFY THESE TYPES OF SERVICES WITHIN ITS RESOURCE DIRECTORY. WELLNESS CARE IS CURRENTLY AVAILABLE IN ALL LOCAL PHYSICIAN OFFICES AS WELL AS AT MCMC OF MARION WHICH OFFERS SERVICES TO INDIGENT AND UNDERINSURED AT REDUCED RATES OR FREE THROUGH SLIDING FEE SCALES. THE HOSPITAL BELIEVES THAT RESPONDENTS TO SURVEY MAY NOT HAVE BEEN AWARE OF ALL WELLNESS SERVICES OFFERED BY CURRENT HEALTHCARE PROVIDERS OR MAY HAVE BEEN REFERRING TO A HEALTH CLUB TYPE FACILITY WHICH IS OUTSIDE THE SCOPE OF HOSPITAL SERVICES. -JOINT AND BACK PAIN: AFTER FURTHER REVIEW OF THIS HEALTH PRIORITY, THE SOURCE OF THIS PRIORITY WAS FROM THE SELF-REPORTED SURVEY THAT ASKED ABOUT ONE'S HEALTH CHALLENGES. THE HOSPITAL WILL CONTINUE TO MONITOR THIS HEALTH CONDITION TO DETERMINE IF THIS IS A SUBSTANTIAL HEALTH ISSUE IN THE FUTURE. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE: 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 10A IMPLEMENTATION STRATEGY: THE HOSPITAL'S IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: http://www.uniongen.org/2015%20IMPLEMENTATION%20STRATEGY%20UNION%20GENERAL %20HOSPITAL%20FINAL.pdf 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 V, SECTION B, LINE 16I NOTIFICATION OF FINANCIAL ASSISTANCE POLICY: DURING THE SCREENING PROCESS, PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOTIFIED OF THE POLICY. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE BAD DEBT EXPENSE OF $1,673,381 ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED FROM THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 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, SECTION A, LINE 4 BAD DEBT FOOTNOTE: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospitals allowance for doubtful accounts was approximately 87% of self-pay patients receivable at June 30, 2015 and 2014. In addition, the Hospitals write-offs decreased approximately $991,000 from approximately $2,312,000 for the year ended June 30, 2014, to approximately $1,321,000 for the year ended June 30, 2015. The decrease in the write-offs is primarily the result of positive changes in the age and payer mix of accounts receivable at June 30, 2015 as compared to June 30, 2014. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY & 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, SECTION C, LINE 9B 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 200% 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 VI, LINE 2 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: 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: UNION GENERAL IS LOCATED IN UNION PARISH, A LARGE SPRAWLING RURAL COMMUNITY MADE UP OF 876.99 SQUARE MILES OF ROLLING HILLS AND TALL PINE TREES. 27.9% OF THE POPULATION IS BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. THERE IS NO PUBLIC TRANSPORTATION IN THE PARISH AND THE TOTAL PARISH POPULATION IS 22,721 (US CENSUS 2010). UNION PARISH IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA (MUA) AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $35,828 (CENSUS 2010). THE COMMUNITY'S MORTALITY RATE IS NEARLY TWICE THE NATIONAL RATE DUE TO THE LACK OF EDUCATION PROGRAMS, THE HIGH RATE OF UNDIAGNOSED DISEASE, AS WELL AS POVERTY AND ISOLATION ASSOCIATED WITH THE RURAL UNDERSERVED PARISH POPULATIONS. SCHEDULE H, PART VI, LINE 5 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 PARTNERS WITH THE ADVANCED HEALTH EDUCATION CENTER (AHEC) TO ENCOURAGE LOCAL YOUTH TO PURSUE HEALTHCARE CAREERS. UGH IS INVOLVED WITH LOCAL BUSINESSES TO BRING HEALTH AWARENESS AND SCREENING TO THE PUBLIC THROUGH RELAY FOR LIFE, AHA'S GO RED CAMPAIGN, UNITED WAY FUNDRAISER AND BY HOSTING AN ANNUAL BREAST CANCER AWARENESS DAY FOR THE COMMUNITY. UNION GENERAL PROMOTES BETTER HEALTH THROUGH AN EMPLOYEE WELLNESS PROGRAM THAT WILL BE EXPANDED TO LOCAL EMPLOYERS. UGH PARTNERS WITH LSU MAMMO VAN TO PROVIDE FREE MAMMOGRAMS, PELVIC EXAMS, PAP SMEARS AND COLON SCREENING FOR THE SERVICE AREA. THE HOSPITAL PROVIDED HAND WASHING INSTRUCTION FOR ELEMENTARY SCHOOL KIDS AND FOR NURSING HOME STAFF AND RESIDENTS, AS WELL AS PROVIDED BLOOD SUGAR AND BLOOD PRESSURE SCREENING FOR LOCAL BUSINESSES. UGH PARTICIPATED IN THE TOWN OF FARMERVILLE'S TOY DRIVE FOR NEEDY CHILDREN, ALONG WITH SPONSORED LOCAL 4-H PROJECTS. UGH EMPLOYEES ARE VERY INVOLVED WITH LOCAL ORGANIZATIONS, SUCH AS AN ALZHEIMER'S SUPPORT GROUP, COUNCIL ON AGING, NURSING HOME COUNCILS AND OTHERS. ALL PROPERTY OWNED BY UNION GENERAL IS DESIGNATED TOBACCO-FREE. UGH OPERATES UNDER A BOARD OF DIRECTORS, WHICH IS COMPRISED OF REPRESENTATIVE MEMBERS OF THE COMMUNITY. IT MAINTAINS AN OPEN MEDICAL STAFF AND OPERATES A 24/7 EMERGENCY ROOM STAFFED WITH ON-SITE PHYSICIANS. A NEW PHYSICIAN OFFICE BUILDING WAS BUILT TO HELP RECRUIT NEW PHYSICIANS TO THE AREA. UGH PROVIDES FOOD AND LODGING FOR MEDICAL STUDENTS WHO SHADOW LOCAL PHYSICIANS, AS WELL AS PROVIDES AN EMPLOYEE THAT ASSISTS THE COMMUNITY BY TAKING MEDICAID APPLICATIONS TO RESIDENT'S HOMES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: LOUISIANA SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $1,673,381 WAS INCLUDED ON FORM 990, PART IX LINE 25 IN TOTAL EXPENSES. HOWEVER, THIS AMOUNT WAS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF PATIENT CARE COST TO CHARGES. false Town of Farmerville 407 South Main Street Farmerville LA 71241 091984971 GOVT 7500 LA Watermelon Festival 1 SCHEDULE I, PART I, LINE 2 PROCESS FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: UNION GENERAL HOSPITAL RARELY GIVES LARGE DONATIONS DURING THE TAX YEAR. THE FESTIVAL MENTIONED ABOVE HAD ONE OF ITS LONG-TIME PHYSICIANS IN THE HONORARY SPOT FOR THE LARGEST FESTIVAL IN THE PARISH, SO THE HOSPITAL MADE THE DECISION TO BE THE TITLE SPONSOR FOR THE YEAR. THE HOSPITAL CREATES A BUDGET FOR THE TOTAL AMOUNT OF FUNDS DESIGNATED FOR GENERAL MARKETING/PUBLIC RELATIONS AND DONATIONS. THERE IS NO FORMAL PROCESS IN PLACE TO MONITOR THE FUNDS DONATED. X X false false false false false false false false false HOLLY CORLEY MD PHYSICIAN 228916 0 0 0 0 0 4620 0 2109 0 235645 0 SHEREE HICKS PHARMACIST 176748 0 0 0 0 0 3326 0 774 0 180848 0 WILLIAM ADCOCK CFO 156973 0 0 0 0 0 4382 0 1839 0 163194 0 FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF CONTROL OVER MANAGEMENT DUTIES: THE HOSPITAL HAS ENTERED INTO A CONTRACT FOR ADMINISTRATIVE SERVICES WITH IASIS GLENWOOD REGIONAL MEDICAL CENTER, WHICH AUTOMATICALLY RENEWS EACH YEAR. THIS CONTRACT REQUIRES THAT THE MANAGEMENT COMPANY PROVIDE PERSONNEL TO PERFORM DUTIES AS THE HOSPITAL ADMINISTRATOR. FEES PAID TO IASIS WERE $207,636. PER IRS GUIDANCE, NO COMPENSATION PAID BY IASIS IS SHOWN ON PART VII FOR THIS INDIVIDUAL: EVALYN ORMOND $194,851 FORM 990, PART VI, SECTION B, LINE 11B 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 PROVIDE A COPY TO THE PRESIDENT OF THE BOARD PRIOR TO FILING. THE RETURN WILL BE MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS AT THE FIRST BOARD MEETING AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C 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. FORM 990, PART VI, SECTION B, LINE 15A & 15B REVIEW OF CEO AND CFO OFFICIAL COMPENSATION: INFORMATION WAS OBTAINED FROM THE 2014 LA SALARY SURVEY DONE BY THE GREATER NEW ORLEANS SOCIETY FOR H/R ADMIN 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. All other employees (including other officers) receive merit increases based on their annual employee evaluation scores ever February. The CEO & CFO set the maximum increases for Department Managers, and maximum percentage increases for all other employees. Each employee receives a prorata 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 employees supervisor. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A CONTRACTED CEO POSITION: THE POSITION OF CEO IS CONTRACTED THROUGH IASIS GLENWOOD REGIONAL MEDICAL CENTER, AN UNRELATED ORGANIZATION. UNION GENERAL HOSPITAL REIMBURSES GLENWOOD FOR THE CEO'S SALARY. THIS INDIVIDUAL IS LISTED ON PART VII, SECTION A OF FORM 990, ALONG WITH THE AMOUNT OF BENEFITS PAID DIRECTLY BY UNION GENERAL. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: NET ASSETS RELEASED FROM RESTRICTION $(52,595) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:2797515 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:1032699 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE AGREEMENTS TOTAL FEES:184198 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN RECRUITING TOTAL FEES:12734 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:3061 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE TESTING TOTAL FEES:2512