SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
ACADIA GENERAL HOSPITAL INC
 
Employer identification number

46-4958152
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    135,959   135,959 0.370 %
b Medicaid (from Worksheet 3, column a) . . . . .     7,417,386 4,522,751 2,894,635 7.870 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     7,553,345 4,522,751 3,030,594 8.240 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     5,245   5,245 0.010 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     9,200   9,200 0.030 %
j Total. Other Benefits . .     14,445   14,445 0.040 %
k Total. Add lines 7d and 7j .     7,567,790 4,522,751 3,045,039 8.280 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
7,832,048
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
135,237
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
14,377,735
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
36,457,504
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-22,079,769
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 ACADIA GENERAL HOSPITAL INC
1305 CROWLEY RAYNE HWY
CROWLEY,LA70526
X X         X      
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ACADIA GENERAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ACADIA GENERAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/AGH_FAP_12715.P
b
HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/AGH_FINANCIAL_A
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

ACADIA GENERAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 5: THE SOURCES USED FOR AGH'S CHNA ARE PROVIDED IN THE REFERENCES AND APPENDIX B: COMMUNITY LEADER INTERVIEWWS. INFORMATION WAS GATHERED BY CONDUCTING INTERVIEWS WITH INDIVIDUALS REPRESENTING COMMUNITY HEALTH AND PUBLIC SERVICE ORGANIZATIONS, MEDICAL PROFESSIONALS, HOSPITAL ADMINISTRATION, AND OTHER HOSPITAL STAFF MEMBERS. THE CHNA CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF
ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: AGH, FORMERLY AMERICAN LEGION HOSPITAL, WAS ACQUIRED BY LAFAYETTE GENERAL HEALTH(LGH) ON JUNE 1, 2014. BECAUSE THIS ACQUISITION OCCURRED AFTER THE 2013 CHNA REPORT WAS COMPLETED BY AMERICAN LEGION HOSPITAL, AGH HAS CHOSEN TO UTILIZE THE RESULTS FROM THIS 2016 CHNA REPORT TO DEVISE A NEW IMPLEMENTATION STRATEGY THAT IS CONSISTENT WITH THE CURRENT FINDINGS AND AVAILABLE RESOURCES WITHIN THE LGH SYSTEM. THE CHNA CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF
ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 11: ALL SIGNIFICAT NEEDS IDENTIFIED IN THE CHNA HAVE BEEN ADDRESSED. THE HOSPITAL IS PRIORITIZING HEALTH NEEDS IN ITS COMMMUNITY AND PRIORITIZING SERVICES THAT THE HOSPITAL WILL UNDERTAIKE TO MEET THESE NEEDS. PLEASE SEE INFORMATION CONTAINED IN THE HOSPITAL'S IMPLEMENTATION STRATEGY. IT CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/AGH-CHNA-IMPLEMENTATIONSTRATEGY-FINAL.PDF
ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 16I: THE HOSPITAL INCLUDES ON ALL INVOICE STATEMENTS A MESSAGE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. IT INFORMS PATIENTS TO CONTACT A CUSTOMER SERVICE REPRESENTATIVE TO REQUEST AN APPLICATION.
ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 20E: MONTHLY STATEMENTS ARE SENT TO THE PATIENTS PRIOR TO SENDING COLLECTIONS AFTER 120 DAYS OF NON-PAYMENT.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Page 8
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
Page 9
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 7: THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,932,048.
PART 1, LINE 7, COLUMN F THE HOSPITAL USED THE SAME COSTING METHODOLOGY USED AND RECOMMENDED IN THE IRS WORKSHEET 2 FOR SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, FOR PART III, LINES 2 AND 3. FOR LINE 3, THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS.
PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE ORGANIZATION'S MAJOR PAYOR 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 ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, IF NECESSARY (E.G., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR 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, THOSE WITH NO THIRD-PARTY COVERAGE, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE ORGANIZATION'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS REMAINED AT 99% OF SELF PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2016 AND 2015. THE ORGANIZATION CONTINUES TO EXPERIENCE HIGH LEVELS OF CHARITY CARE AND BAD DEBT WRITE-OFFS AS A RESULT OF RISING PATIENT RESPONSIBILITIES DUE IN PART TO HIGH DEDUCTIBLE AND HIGH CO-PAY INSURANCE PLANS.BAD DEBT EXPENSE EQUALS THE BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS.
PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 IS THE STANDARD MEDICARE COST REPORT COSTING SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITAL'S FILED 2015 COST REPORT; THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE AMOUNTS REPORTED INCLUDE THOSE RELATED TO MEDICARE PART A INPATIENT SERVICES (BOTH ACUTE AND PSYCHIATRIC) AND MEDICARE PART B HOSPITAL-RELATED OUTPATIENT SERVICES; IT EXCLUDES THE MEDICARE HOSPITAL OUTPATIENT LABORATORY CHARGES WHICH WERE REIMBURSED ON A FEE SCHEDULE AND, THUS, NOT REQUIRED TO BE REPORTED ON THE COST REPORT. ADDITIONALLY, THESE AMOUNTS EXCLUDE THE REIMBURSEMENT AND COSTS ASSOCIATED WITH OUR ANESTHESIA HOSPITAL BASED PRACTICE AS WELL AS OUR PHYSICIAN OFFICE.
PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY ADDRESSES THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. OUR HOSPITAL PRACTICE INCLUDES SENDING STATEMENTS WITH GRADUATED MESSAGES TO PATIENTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT; AT THIS TIME, THEY ARE INFORMED OF THE FINANCIAL ASSISTANCE PRACTICE AND ARE ENCOURAGED TO CONTACT THE HOSPITAL IF THEY FEEL THAT THEY WOULD QUALIFY. AT ANY TIME, ANY PATIENT MAY REQUEST A CHARITY CARE APPLICATION FORM.
PART VI, LINE 2: ACADIA GENERAL HOSPITAL (AGH) IS THE ONLY ACUTE CARE HOSPITAL IN ACADIA PARISH AND THE SURROUNDING AREA, AND IT MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE COMMUNITY, AND THEY ARE AWARE OF THE HEALTH NEEDS IN THE COMMUNITY. FOR THESE NEEDS IDENTIFIED BY THE BOARD AND MEDICAL STAFF, AGH USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. A FORMAL NEEDS ASSESSMENT UNDERTAKEN FOR YEAR ENDING 9/30/16 - IT CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF
PART VI, LINE 3: THE HOSPITAL COMPLIES WITH FEDERAL REQUIREMENTS OF NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS, SUCH AS MEDICARE. IN THE ADMISSIONS PROCESS, THE HOSPITAL MAKES AVAILABLE SCREENING SERVICES ONSITE TO HELP INPATIENTS WHO QUALIFY FOR MEDICARE AND/OR MEDICAID ASSISTANCE APPLY FOR BENEFITS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN THE HANDBOOK PROVIDED TO PATIENTS UPON ADMISSION. ADDITIONALLY, UPON ORIGINAL BILL FOR SERVICES, ALL PATIENTS WITHOUT INSURANCE ARE REMINDED OF THE CHARITY DISCOUNT WITH INFORMATION ON HOW TO APPLY. A PROMPT PAY DISCOUNT IS OFFERED TO ALL PATIENTS WITHOUT INSURANCE.
PART VI, LINE 4: THE HOSPITAL SERVES THE RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. AS THE ONLY ACUTE HOSPITAL IN THE PARISH, THE HOSPITAL PROVIDES HEALTHCARE SERVICES TWENTY-FOUR HOURS A DAY. THE HOSPITAL STRIVES TO MAINTAIN A WELL CONDITIONED PLANT AND MODERN TECHNOLOGY TO BETTER SERVE THE CITIZENS OF OUR COMMUNITY; ADDITIONALLY, THE HOSPITAL STRIVES TO MAINTAIN A KNOWLEDGEABLE AND FRIENDLY STAFF TO PROVIDE PATIENT CARE TO THE RESIDENTS IN THE SURROUNDING AREA. ACADIA PARISH COVERS 655.12 SQUARE MILES IN SOUTHWEST LOUISIANA. THE ESTIMATED POPULATION FOR 2014 WAS AROUND 62,000 RESIDENTS. ACADIA PARISH'S POPULATION CONSISTS OF 13.2% OF PERSONS WHO ARE SIXTY-FIVE OR OLDER (SLIGHTLY LOWER THAN THE STATE'S OVERALL PERCENTAGE OF 13.3%). ACCORDING TO THE U.S. CENSUS BUREAU FROM MUNINET GUIDE.COM, THE MEDIAN HOUSEHOLD INCOME FOR ACADIA PARISH WAS $38,161. HOWEVER, FOR LOUISIANA IT WAS $48,725 AND FOR THE U.S. IT WAS $54,130. THUS, ACADIA PARISH'S POPULATION IS POORER THAN THE REST OF LOUISIANA AND THE NATION.
PART VI, LINE 5: THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL PROVIDES CARE FOR ALL PERSONS IN THE COMMUNITY OTHERWISE ABLE TO PAY THE COST MEDICAL SERVICES EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE LOCAL COMMUNITY AND USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. ADDITIONALLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF.BY MAINTAINING AN OPEN MEDICAL STAFF, THE HOSPITAL CAN OFFER A VARIETY OF SPECIALISTS TO AN OTHERWISE RURAL PARISH, THEREBY INCREASING AVAILABLE RESOURCES FOR THE BEST PATIENT CARE. THE HOSPITAL ALSO MAINTAINS A BOARD OF DIRECTORS COMPRISED OF MEMBERS FROM THE COMMUNITY; BY INCORPORATING MEMBERS OF THE COMMUNITY, THE BOARD CAN ENSURE THE LONG-TERM VIABILITY OF THE HOSPITAL TO BE ABLE TO CONTINUE TO SERVE THE COMMUNITY FOR GENERATIONS TO COME. THE HOSPITAL DILIGENTLY STRIVES TO MAINTAIN A SURPLUS OF REVENUE OVER EXPENSES TO CONTINUE TO UPDATE THE HOSPITAL'S PLANT AND EQUIPMENT WITH THE RAPID CHANGING TECHNOLOGY IN TODAY'S MEDICAL WORLD TO BETTER MEET THE CHANGING NEEDS OF OUR COMMUNITY. IN THE CURRENT YEAR THE HOSPITAL HAD A CAPITAL OUTLAY OF OVER $182,244 MOSTLY CLINICAL PURCHASES.THE HOSPITAL IS THE SECOND LARGEST EMPLOYER IN THE PARISH, SECOND TO ONLY THE LOCAL SCHOOL BOARD. THE HOSPITAL IS A LARGE GENERATOR OF SALES TAX TO THE PARISH AS WELL. THE HOSPITAL'S PRESENCE SERVES AS A LARGE ECONOMIC FORCE IN OUR LOCAL COMMUNITY; TO ENSURE THAT WE CAN CONTINUE TO SERVE THE RESIDENTS OF OUR COMMUNITY, WE MUST CONTINUE TO MONITOR THE CURRENT CONDITIONS OF OUR WORKFORCE AND THE AVAILABILITY OF PHYSICIANS IN OUR AREA. THE HOSPITAL RECRUITS PHYSICIANS, INCLUDING SPECIALISTS, TO OUR AREA TO ENSURE THAT WE CAN CONTINUE TO BE THE HEALTHCARE PROVIDER OF THE FUTURE AS WELL. THE HOSPITAL ALSO JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS AND COMPANIES TO PROVIDE HEALTHCARE SCREENINGS AT LOCAL EVENTS AS WELL AS PROVIDE INFORMATION TO PROMOTE A HEALTHIER, SAFER COMMUNITY.
PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH OTHER HEALTHCARE ORGANIZATIONS. SEE FORM 990 SCHEDULE R FOR A COMPLETE LISTING. ALL OF THE ORGANIZATIONS ARE LOCAL HEALTHCARE ORGANIZATIONS WITH THE SAME PURPOSE AS THE HOSPITAL.
Schedule H (Form 990) 2015
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