Pocahontas Memorial Hospital has a $4 million problem-and it's not what some county residents might think.

Management at the financially ailing hospital is hoping to collect roughly four years of bad debt that amounts to about $500 for every single person who lives here. None of that is covered by private insurance, Medicare or Medicaid.

According to Steve Whited, the Minnie Hamilton Health Systems financial officer overseeing PMH's transition, the hospital is sending bills that date back as far as 2008 in hopes of recouping some of that loss.

Whited said PMH has several options for patients who may be in arrears.

One is Charity Care, also called Exoneration.

Anyone can apply for this option, regardless of income. But patients must prove they have applied for a medical card and been denied, provide personal financial information, including proof of income and expenses, and more. Once their debt to PMH is forgiven, then the state's Disproportionate Share Hospital payment, or DSH, will pay for their care.

"It's a safety net for those with too much income for a medical card, but [who don't have] health insurance," Whited said.

The hospital already receives a DSH payment each quarter and the annual amount comes to about $650,000.

Patients also may use a payment plan.

PMH will accept a payment plan for as little as $5 a month, Whited said. That could be some comfort to patients who see a large number at the end of the bill and don't think they can pay the full amount.

While the hospital management team has changed some internal policies, the collection policy is still the same-it's just being enforced differently.

Patients should receive a bill within the first 30 days after treatment, a second bill in 60 days and a third in 90. If the PMH business office sees no activity on the account in three months, then staffers will send a letter requesting a payment plan. The final step, if that letter remains unanswered, is to turn over the bill to a collection agency.

Whited said that step is a last resort and any good faith effort to pay during the initial 90+ day period will be acknowledged.

Timely billing has been a problem in the past, but Whited said the hospital has eight people now to do the billing in-house. They'll be ready to roll on November 1, when PMH's contract with HMS in Nashville, Tennessee, ends.

But whether or not patients can or will pay, Whited said PMH is firm in its mission to treat the sick or injured.

"Regardless, we're still providing service," he said.

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