JENNINGS AMERICAN LEGION HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- JENNINGS AMERICAN LEGION HOSPITAL INC (EIN 72-0445607)
- Tax period
- 2011-12-01 to 2012-11-30
- Filed
- 2013-07-15
- IRS object ID
- 201321969349301657
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-15T14:45:44-07:00 | Timestamp |
| Tax Period End Date | 2012-11-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lester Miller & Wells | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 Bayou Rapides | AddressLine1 |
| City | Alexandria | City |
| State | LA | State |
| ZIP Code | 71303 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-12-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720445607 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennings American Legion Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JENN | NameControl |
| Phone | 3376167100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 Elton Road | AddressLine1 |
| City | Jennings | City |
| State | LA | State |
| ZIP Code | 70546 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dana D Williams | Name |
| Title | CEO | Title |
| Date Signed | 2013-07-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Robert G Miller | Name |
| Phone | 3184871450 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 38454426 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | Healthcare services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 537 | TotalNbrEmployees |
| Total Nbr Volunteers | 52 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 10002 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 11000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 39283955 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 38240744 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 175014 | InvestmentIncomePriorYear |
| Investment Income Current Year | 202682 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 39468971 | TotalRevenuePriorYear |
| Total Revenue Current Year | 38454426 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17456548 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 18149994 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 19144321 | OtherExpensePriorYear |
| Other Expenses Current Year | 18585076 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36600869 | TotalExpensesPriorYear |
| Total Expenses Current Year | 36735070 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2868102 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1719356 | RevenuesLessExpensesCY |
| Total Assets BOY | 39588886 | TotalAssetsBOY |
| Total Assets EOY | 39292473 | TotalAssetsEOY |
| Total Liabilities BOY | 13442201 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11426432 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 26146685 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 27866041 | NetAssetsOrFundBalancesEOY |
| Mission Description | Healthcare services | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 16352893 | Expense |
| Revenue | 38454426 | Revenue |
| Description | Jennings AMERICAN LEGION HOSPITALS (JALH) OPERATES A 60 BED ACUTE CARE HOSPITAL. JALH PROVIDES INPATIENT AND OUTPATIENT SERVICES, 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 2012: MEDICARE MEDICAID TOTALACUTE 6,091 1,799 12,638JALH 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 DISTRIBUTES A QUARTERLY COMMUNITY NEWSLETTER. THIS NEWSLETTER INCLUDES TIMELY HEALTHCARE TOPICS INCLUDING SMOKING CESSATION, DIABETIC AWARENESS, CONTROLLING BLOOD PRESSURE, ETC.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 $1,807,075 OF CHARGES FOR THE YEAR ENDED NOVEMBER 30, 2012. | Description |
| Total Program Service Expense | 16352893 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | true | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | false | ScheduleORequired |
| Number Forms Transmitted With1096 | 68 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 537 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Pam Primeaux CFO | NamePerson |
| Telephone Number | 3376167032 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 Elton Road | AddressLine1 |
| City | Jennings | City |
| State | LA | State |
| ZIP Code | 705463614 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|
| RONNIE PETREE | |||||
| Director | 0.00 | 2000 | 0 | 0 | |
| DR JAMES MCNALLY | |||||
| Director | 0.00 | 5800 | 0 | 0 | |
| KEVIN BERKEN | |||||
| Director | 0.00 | 2000 | 0 | 0 | |
| CARL BENOIT | |||||
| Director | 0.00 | 2000 | 0 | 0 | |
| JULIE BERRY | |||||
| Director | 0.00 | 6000 | 0 | 0 | |
| GORDON HAYES | |||||
| Director | 0.00 | 6000 | 0 | 0 | |
| LARRY BENOIT | |||||
| Director | 0.00 | 6100 | 0 | 0 | |
| JOHN LOUVIERE JR | |||||
| Director | 0.00 | 6000 | 0 | 0 | |
| ARTHUR D MATTE CPA | |||||
| Director | 0.00 | 11550 | 0 | 0 | |
| RICHARD ARCENEAUX | |||||
| Director | 0.00 | 8750 | 0 | 0 | |
| JAMES RICHERT JR | |||||
| Director | 0.00 | 6100 | 0 | 0 | |
| DARRELL LANDRY | |||||
| Director | 0.00 | 5900 | 0 | 0 | |
| ALLEN MEDUS | |||||
| Director | 0.00 | 12600 | 0 | 0 | |
| ELLA DARTEZ | |||||
| Director | 0.00 | 6000 | 0 | 0 | |
| JOHNNIE LANDRY | |||||
| Director | 0.00 | 3650 | 0 | 0 | |
| DALE LANDRY | |||||
| Director | 0.00 | 5900 | 0 | 0 | |
| DOUGLAS DAIGLE | |||||
| Director | 0.00 | 7450 | 0 | 0 | |
| TED COX | |||||
| Director | 0.00 | 4250 | 0 | 0 | |
| G VINCENT BAILEY MD | |||||
| Director | 0.00 | 4700 | 0 | 0 | |
| Richard Oustalet | |||||
| Director | 0.00 | 5900 | 0 | 0 | |
| LAM NGUYEN | |||||
| DOCTOR | 40.00 | 178329 | 0 | 0 | X |
| DANA D WILLIAMS | |||||
| CEO | 40.00 | 253351 | 0 | 0 | X |
| PAMELA PRIMEAUX | |||||
| CFO | 40.00 | 184491 | 0 | 0 | X |
| KEITH SIMPSON | |||||
| COO | 40.00 | 133651 | 0 | 0 | X |
| THERESA WOODS | |||||
| CNO | 40.00 | 132351 | 0 | 0 | X |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1000823 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SIEMENS HEALTHCARE | |||||
| PO BOX 121102 | DALLAS | TX | 753121102 | MEDICAL SUPPLIES | 380188 |
| OWENS & MINOR INC | |||||
| PO BOX 841420 | DALLAS | TX | 75284 | MEDICAL SUPPLIES | 1264175 |
| DUPUY ORTHOPAEDICS INC | |||||
| PO BOX 406663 | ATLANTA | GA | 303846663 | MEDICAL SUPPLIES | 501859 |
| CPSI | |||||
| 6600 WALL STREET | MOBILE | AL | 36685 | COMPUTER SERVICES | 378383 |
| CPS Inc | |||||
| PO Box 116474 | ATLANTA | GA | 303686474 | PHARMACY MGMT FEE | 2221496 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 32 | NumberOfContractorsGT100K |
| All Other Contributions | 11000 | AllOtherContributions |
| Total Contributions | 11000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| OTHER OPERATING REVENUE | 3621687 | 3621687 |
| NET PATIENT SERVICE REV | 34619057 | 34619057 |
| COMPREHENSIVE INCOME |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 38240744 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 202682 | TotalRevenueColumn |
| Related Or Exempt Function Income | 202682 | RelatedOrExemptFunctionIncome |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38454426 | TotalRevenueColumn |
| Related Or Exempt Function Income | 38443426 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118650 | Total |
| Management And General | 118650 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14846728 | Total |
| Program Services | 6630549 | ProgramServices |
| Management And General | 8216179 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348177 | Total |
| Program Services | 155496 | ProgramServices |
| Management And General | 192681 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1789694 | Total |
| Program Services | 799277 | ProgramServices |
| Management And General | 990417 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1046745 | Total |
| Program Services | 467476 | ProgramServices |
| Management And General | 579269 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40513 | Total |
| Program Services | 18093 | ProgramServices |
| Management And General | 22420 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42290 | Total |
| Program Services | 18887 | ProgramServices |
| Management And General | 23403 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21737 | Total |
| Program Services | 9708 | ProgramServices |
| Management And General | 12029 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241529 | Total |
| Program Services | 107867 | ProgramServices |
| Management And General | 133662 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2168255 | Total |
| Program Services | 968343 | ProgramServices |
| Management And General | 1199912 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 545433 | Total |
| Program Services | 243590 | ProgramServices |
| Management And General | 301843 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | 1099327 | 490959 | 608368 |
| BAD DEBTS | 2987418 | 1334181 | 1653237 |
| PURCHASED SERVICES | 4574624 | 2043027 | 2531597 |
| SUPPLIES | 4995642 | 2231054 | 2764588 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1868308 | Total |
| Program Services | 834386 | ProgramServices |
| Management And General | 1033922 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36735070 | Total |
| Program Services | 16352893 | ProgramServices |
| Management And General | 20382177 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 875432 | BOY |
| EOY | 1276334 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5256649 | BOY |
| EOY | 6348777 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1078092 | BOY |
| EOY | 1138849 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 682263 | BOY |
| EOY | 740873 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 42663381 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 25679046 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18388026 | BOY |
| EOY | 16984335 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13308424 | BOY |
| EOY | 12803305 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39588886 | BOY |
| EOY | 39292473 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2620880 | BOY |
| EOY | 2257023 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10115305 | BOY |
| EOY | 9139509 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 706016 | BOY |
| EOY | 29900 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13442201 | BOY |
| EOY | 11426432 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26146685 | BOY |
| EOY | 27866041 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26146685 | BOY |
| EOY | 27866041 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39588886 | BOY |
| EOY | 39292473 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1719356 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Protection Of Natural Habitat | X | ProtectionOfNaturalHabitat |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1391339 | OtherCostOrOtherBasis |
| Book Value | 1391339 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26944122 | OtherCostOrOtherBasis |
| Depreciation | 15621555 | Depreciation |
| Book Value | 11322567 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 683095 | OtherCostOrOtherBasis |
| Depreciation | 463870 | Depreciation |
| Book Value | 219225 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13585658 | OtherCostOrOtherBasis |
| Depreciation | 9593621 | Depreciation |
| Book Value | 3992037 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 59167 | OtherCostOrOtherBasis |
| Book Value | 59167 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16984335 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLE | 486080 |
| INVESTMENTS RESTRICTED BY BOARD | 10548202 |
| GUARANTEES RECEIVABLE | 1769023 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 12803305 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| provision for advances received | $858,802 |
| estimates 3rd party payor settlements | -$828,902 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 29900 | TotalOfAmounts |
| Total Revenue | 38454426 | TotalRevenue |
| Total Expenses | 36735070 | TotalExpenses |
| Excess Or Deficit For Year | 1719356 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 1719356 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 38454426 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 38454426 | RevenueSubtotal |
| Total Revenue Per Form990 | 38454426 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 36735070 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 36735070 | ExpensesSubtotal |
| Total Expenses Per Form990 | 36735070 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1580994 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1476293 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 104701 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4947863 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4698789 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 249074 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6528857 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6175082 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 353775 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12079 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 300703 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 300703 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00820 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 991612 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 384002 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 607610 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01650 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3556 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3556 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1307950 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 384002 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 923948 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02510 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7836807 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6559084 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1277723 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03480 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,987,418 | BadDebtExpenseAmount |
| Amount Attributable To | 1045596 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 13905378 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14413203 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -507825 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | jennings american legion | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1634 elton road | AddressLine1 |
| City | jennings | City |
| State | LA | State |
| ZIP Code | 70546 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | jennings american legion | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - Community Information | Jennings American Legion Hospital is currently licensed to operate 60 beds and is accredited by The Joint Commission. For fiscal year 2012, patient volumes included more then 3,471 admission and 15,027 emergency department visits.JENNINGS, is a small town of approximately 10,986 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 31,097 in 2009. The average income in 2008 in Jefferson Davis Parish was $38,577. The percentage of Jefferson Davis Parish residents living in poverty in 2008 was 16.7%. In the city of Jennings the percentage of residents living in poverty in 2009 was 22.8% (15.4% for White Non-hispanic, 37.0% for black residents, 73.9% for Hispanic or Latino, 50.6% for other race residents, and 43.0% for two or more race residents). Jennings American Legion Hospital is the only hospital to serve Jefferson Davis Parish.The number of people in Jefferson Davis Parish with a disability is 6,539. The percentage of the population who were female in 2009 was 51.6%. The population classified as white was 80.8%, black 17.2%, Asian .3%, two or more races 1.2% and Hispanic or Latino 1.5%. In 2009 35.1% of the population is less than eighteen years old and 13.7% of the residents were over the age of sixty-five. | |
| 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 V, Line 19d - Other Billing Determination of Individuals Without Insurance | BY FEDERAL POVERTY GUIDELINES | Number of Hospital Faciltiy - 0 |
| Part V, Line 15e - Other Collection Actions Against a Patient | LIENS FILED ON THIRD-PARTY AUTO LIABILITY PLANS ONLY | Number of Hospital Faciltiy - 0 |
| Part V, Line 13g - Other Means Hospital Facility Publicized the Policy | MAILED LETTER AND APPLICATION TO OUTPATIENT ER PRIVATE PAY PATIENTS | Number of Hospital Faciltiy - 0 |
| 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 III, Line 4 - Bad Debt Expense | THE HOSPITAL ESTIMATES APPROXIMATELY 35% 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 ESTIAMTE 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 I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) | DISCOUNTED CARE IS DETERMINED BY 300% OF FPG - FREE CARE IS AT 200% |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|
| PAMELA PRIMEAUX | |
| 184491 | 184491 |
| LAM NGUYEN | |
| 178329 | 178329 |
| DANA D WILLIAMS | |
| 253351 | 253351 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | No documents available to the public. |
| Form 990, Part VI, Line 12c | 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 11 | Form 990, Part VI, Line 11: Form 990 Review Process | No review was or will be conducted. |