OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC (EIN 72-1495500)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-15
- IRS object ID
- 202501359349305640
- Schema version
- 2023v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-15T11:00:07-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 MAIN STREET SUITE 2150 | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721495500 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OUR LADY OF THE LAKE ASSUMPTION | BusinessNameLine1Txt |
| Business Name Line2 | COMMUNITY HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OURL | BusinessNameControlTxt |
| Phone | 2257657709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 ESSEN LANE | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70809 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER CLOWERS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2257657709 | PhoneNum |
| Signature | 2025-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN HOOKS | PreparerPersonNm |
| PTIN | P00746825 | PTIN |
| Phone | 2253444000 | PhoneNum |
| Preparation | 2025-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN TRIPODE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 ESSEN LANE | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70809 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,165,689 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSE OF THE HOSPITAL IS TO PROVIDE FOR THE CARE OF ILL, INJURED AND (SEE SCHEDULE O).DISABLED PERSONS AND TO ENHANCE THE HEALTH OF THOSE IN THE COMMUNITY THROUGH RESEARCH AND EDUCATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 64 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,185 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,581,840 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,923,061 | CYProgramServiceRevenueAmt |
| PY Investment Income | $268,845 | PYInvestmentIncomeAmt |
| CY Investment Income | $228,633 | CYInvestmentIncomeAmt |
| PY Other Revenue | $25,750 | PYOtherRevenueAmt |
| CY Other Revenue | $25,500 | CYOtherRevenueAmt |
| PY Total Revenue | $11,876,435 | PYTotalRevenueAmt |
| CY Total Revenue | $13,184,379 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,359 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $872 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,075,681 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,341,891 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,816,192 | PYOtherExpensesAmt |
| CY Other Expenses | $5,224,653 | CYOtherExpensesAmt |
| PY Total Expenses | $8,894,232 | PYTotalExpensesAmt |
| CY Total Expenses | $9,567,416 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,982,203 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,616,963 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,380,919 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,014,036 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,950,558 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,864,622 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,430,361 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,149,414 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,098,464 | ExpenseAmt |
| Grant | $872 | GrantAmt |
| Revenue | $12,948,561 | RevenueAmt |
| Desc | OUR LADY OF THE LAKE ASSUMPTION PROVIDES TWENTY-FOUR HOUR HEALTHCARE SERVICES FOR PATIENTS IN THE SURROUNDING RURAL COMMUNITIES. THE 14 OUTPATIENT BED HOSPITAL HAD 6,378 EMERGENCY ROOM VISITS THIS YEAR AND PROVIDED 18,740 LAB TESTS. THE HOSPITAL'S EMERGENCY ROOM IS OPEN TO EVERYONE, REGARDLESS OF ABILITY TO PAY. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMEBERS OF ITS COMMUNITIES. EFFECTIVE AUGUST 2023, ACH BECAME A RURAL EMERGENCY HOSPITAL. THE DESIGNATION ALLOWS IT TO FOCUS ON PROVIDING ESSENTIAL EMERGENCY AND OUTPATIENT SERVICES, PRIMARILY IN COMMUNITIES THAT CANNOT SUPPORT A FULL-SERVICE INPATIENT HOSPITAL OPERATION, EFFECTIVELY MAINTAINING ACCESS TO HEALTHCARE IN AREAS WITH LIMITED OPTIONS. | Desc |
| Total Program Service Expenses | $7,098,464 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 64 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMANDA HYMEL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2257656565 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5959 S SHERWOOD FOREST BLVD | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70816 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BRIAN F TRIPODE | |||||||||
| SENIOR DIRECTOR | 40.00 | 0.00 | Yes (X) | Yes (X) | $224,572 | $0 | $27,509 | ||
| CHARLES L SPICER | |||||||||
| PRESIDENT - OLOL | 2.00 | 42.00 | Yes (X) | Yes (X) | $0 | $926,102 | $129,969 | ||
| CHARLES P BOLOTTE MD | |||||||||
| BOARD MEMBER | 10.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GREG BOWSER | |||||||||
| SECRETARY | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| HARRY J PHILIPS JR | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JENNIFER CLOWERS | |||||||||
| REGIONAL CFO | 2.00 | 45.50 | Yes (X) | Yes (X) | $0 | $632,613 | $82,941 | ||
| JOHN FRAICHE MD | |||||||||
| PHYSICIAN | 2.00 | 40.00 | Yes (X) | $0 | $655,629 | $38,603 | |||
| LESLEY TILLEY | |||||||||
| VP REGIONAL OPERATIONS BR | 2.00 | 40.00 | Yes (X) | $0 | $412,765 | $47,997 | |||
| MICHAEL CRAPANZANO MD | |||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT N HENGSENS | |||||||||
| CHAIR | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN M TOUPS | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRITTANY WYGER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $281,720 | $0 | $15,846 | Yes (X) | |||
| DAMIAN RICHARD | |||||||||
| MRI TECHNOLOGIST | 40.00 | 0.00 | $111,364 | $0 | $9,466 | Yes (X) | |||
| DONNA M MULLINGS | |||||||||
| DIR. NURSING | 40.00 | 0.00 | $103,426 | $0 | $4,988 | Yes (X) | |||
| LOWELL STANTON | |||||||||
| FORMER REG CFO/ LOURDES CFO | 0.00 | 40.50 | $0 | $600,074 | $42,876 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $721,082 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,227,183 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $400,195 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CORRECT CARE INC | |||||
| 17438 HARD HAT DRIVE | COVINGTON | LA | 70435 | MEDICAL SERVICES | $1,126,423 |
| FMOL HEALTH SYSTEM | |||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | LAB MANAGEMENT FEES | $653,899 |
| CROTHALL HEALTHCARE INC | |||||
| 1500 LIBERTY RIDGE DR | WAYNE | PA | 19087 | HOUSEKEEPING SERVICES | $227,749 |
| TRIMEDX INC | |||||
| PO BOX 636129 | CINCINNATI | OH | 45263 | BIOMED SERVICES | $176,440 |
| INNER PARISH SECURITY CORP | |||||
| 43222 PECAN RIDGE DRIVE | HAMMOND | LA | 70403 | SECURITY | $174,322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $7,185 | AllOtherContributionsAmt |
| Total Contributions | $7,185 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $12,917,740 | $12,917,740 |
| OUTREACH LAB | 621500 | $4,318 | $4,318 |
| MISCELLANEOUS | 900099 | $1,003 | $1,003 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,923,061 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $247,246 | TotalRevenueColumnAmt |
| Exclusion | $247,246 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,500 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,500 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,500 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,500 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $962,697 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $981,310 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$18,613 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$18,613 | TotalRevenueColumnAmt |
| Exclusion | -$18,613 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,184,379 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,948,561 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $228,633 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $872 | TotalAmt |
| Program Services | $872 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,572 | TotalAmt |
| Program Services | $181,800 | ProgramServicesAmt |
| Management And General | $42,772 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,330,331 | TotalAmt |
| Program Services | $2,696,031 | ProgramServicesAmt |
| Management And General | $634,300 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,423 | TotalAmt |
| Program Services | $168,726 | ProgramServicesAmt |
| Management And General | $39,697 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,722 | TotalAmt |
| Program Services | $270,161 | ProgramServicesAmt |
| Management And General | $63,561 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,843 | TotalAmt |
| Program Services | $198,210 | ProgramServicesAmt |
| Management And General | $46,633 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,561,996 | TotalAmt |
| Program Services | $1,331,097 | ProgramServicesAmt |
| Management And General | $230,899 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,800 | TotalAmt |
| Management And General | $8,800 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,871 | TotalAmt |
| Management And General | $17,871 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,712 | TotalAmt |
| Program Services | $276,650 | ProgramServicesAmt |
| Management And General | $121,062 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,114 | TotalAmt |
| Program Services | $41,074 | ProgramServicesAmt |
| Management And General | $45,040 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,092,140 | TotalAmt |
| Program Services | $610,124 | ProgramServicesAmt |
| Management And General | $482,016 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,995 | TotalAmt |
| Program Services | $5,244 | ProgramServicesAmt |
| Management And General | $5,751 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,640 | TotalAmt |
| Program Services | $255,257 | ProgramServicesAmt |
| Management And General | $108,383 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,076 | TotalAmt |
| Program Services | $3,852 | ProgramServicesAmt |
| Management And General | $4,224 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,253 | TotalAmt |
| Program Services | $1,075 | ProgramServicesAmt |
| Management And General | $1,178 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,770 | TotalAmt |
| Program Services | $301,554 | ProgramServicesAmt |
| Management And General | $53,216 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,596 | TotalAmt |
| Program Services | $8,573 | ProgramServicesAmt |
| Management And General | $43,023 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $681,419 | $401,842 | $279,577 |
| MEDICAL SUPPLIES EXPENS | $394,618 | $232,712 | $161,906 |
| EQUIPMENT & MAINTENANCE | $192,653 | $113,610 | $79,043 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,567,416 | TotalAmt |
| Program Services | $7,098,464 | ProgramServicesAmt |
| Management And General | $2,468,952 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,797,286 | BOYAmt |
| EOY | $11,206,976 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,112,703 | BOYAmt |
| EOY | $302,078 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,076 | BOYAmt |
| EOY | $6,380 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,464,463 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,119,324 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,222,196 | BOYAmt |
| EOY | $2,345,139 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,812,712 | BOYAmt |
| EOY | $8,916,469 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,420,946 | BOYAmt |
| EOY | $11,236,994 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,380,919 | BOYAmt |
| EOY | $34,014,036 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,950,558 | BOYAmt |
| EOY | $3,589,327 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,275,295 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,950,558 | BOYAmt |
| EOY | $6,864,622 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,330,361 | BOYAmt |
| EOY | $27,149,414 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,430,361 | BOYAmt |
| EOY | $27,149,414 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,380,919 | BOYAmt |
| EOY | $34,014,036 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,616,963 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,045,115 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $56,975 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,461 | OtherCostOrOtherBasisAmt |
| Book Value | $55,461 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,266,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,003,214 | DepreciationAmt |
| Book Value | $1,263,447 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,547 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,228 | DepreciationAmt |
| Book Value | $57,319 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,949,181 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,048,238 | DepreciationAmt |
| Book Value | $900,943 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $120,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,644 | DepreciationAmt |
| Book Value | $67,969 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,345,139 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN CAPITAL RESERVE | Desc |
| Book Value | $8,916,469 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,916,469 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY RECEIVABLES | Desc |
| Book Value | $11,236,994 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,236,994 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS HELD AT FMOLHS | Desc |
| Amt | $3,275,295 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,275,295 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FIN 48 (ASC740) FOOTNOTE FMOLHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $244,703 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02560 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,636,840 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,636,840 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,881,543 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,636,840 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $244,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02560 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,351 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $70 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,281 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,886 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $70 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,167 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,884,780 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,636,910 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $247,870 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02590 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $451 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $451 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $451 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $451 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $194,181 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $160,337 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $36,175 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $124,162 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASSUMPTION COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 HIGHWAY 402 | AddressLine1Txt |
| City | NAPOLEONVILLE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70390 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL EMERGENCY HOSPITAL (AUG 2023) | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASSUMPTION COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SUPPLEMENT AT PART V | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SUPPLEMENT AT PART V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SUPPLEMENT AT PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SUPPLEMENT AT PART V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASSUMPTION COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: ASSUMPTION COMMUNITY HOSPITAL (ACH) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021. FOLLOWING THE RESULTS OF A COMMUNITY SURVEY CONDUCTED IN AUGUST 2021, PARTICIPANTS HAD AN OPPORTUNITY TO REVIEW THE RESULTS AND COMPARE THEM WITH THE DATA PRESENTED FROM THE US NEWS HEALTHIEST COMMUNITIES WEBSITE AND THEIR PERSONAL EXPERIENCES IN THE COMMUNITY TO PROVIDE TARGETED FEEDBACK ABOUT THE GREATEST AREAS OF NEED. DISCUSSIONS ALSO TOOK PLACE WITH ASSUMPTION PRIMARY CARE. THESE DISCUSSIONS REVEALED PROBLEMS FACING ASSUMPTION PARISH RESIDENTS, SUCH AS DIFFICULTY MAKING IT TO APPOINTMENTS AND BARRIERS TO ACCESSING MENTAL AND BEHAVIORAL HEALTH. ACCESS TO CANCER SCREENINGS CONTINUE TO BE A NEED AS WELL, EVEN THOUGH BREAST CANCER SCREENINGS HAVE INCREASED SINCE THE LAST CHNA MEASUREMENT PERIOD FROM FOUR VISITS A YEAR TO AN AVERAGE OF 10 VISITS PER YEAR DUE TO UTILIZATION OF THE WOMAN'S HOSPITAL MOBILE MAMMOGRAPHY UNIT. IN PREPARING THIS CHNA, ACH INTERVIEWED DEBRA GONZALES, RN, SUPERVISOR A, WITH THE LOUISIANA DEPARTMENT OF HEALTH / REGION 3 OFFICE OF PUBLIC HEALTH. MS. GONZALES HELPED ACH COMPARE THE RESULTS FROM ALL SURVEYS AND FEEDBACK RECEIVED TO-DATE TO THE CURRENT PRIORITY AREAS REGION 3 OPH FEELS ARE MOST GREATLY AFFECTING THE PEOPLE IT SERVES. MS. GONZALES ECHOED MUCH OF THE FEEDBACK THAT HAD BEEN RECEIVED REGARDING PATIENTS' STRUGGLES WITH ACCESS TO CARE, POVERTY, MENTAL / BEHAVIORAL HEALTH, AND OBESITY. ADDITIONALLY, ASSUMPTION COMMUNITY HOSPITAL CONSIDERED INPUT FROM THOSE WHO REPRESENT A BROAD INTEREST AND INCLUDED REPRESENTATIVES OF POPULATIONS IN CATEGORIES SUCH AS LOW-INCOME, MINORITY, MEDICALLY UNDERSERVED, AND THOSE EXPERIENCING BARRIERS DUE TO OTHER SOCIAL DETERMINANTS OF HEALTH. CONSIDERING ALL DATA ANALYSIS, STAKEHOLDER DISCUSSIONS, AND SURVEYS RESULTS, ACH DETERMINED THE TOP COMMUNITY NEEDS TO BE: MENTAL / BEHAVIORAL HEALTH CANCER SCREENINGS ACCESS TO CARE / TRANSPORTATION |
| ASSUMPTION COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: DURING THE CURRENT YEAR, ASSUMPTION COMMUNITY HOSPITAL CONTINUED TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS IDENTIFIED DURING THE PRIOR CHNA: MENTAL/BEHAVIORAL HEALTH, CANCER SCREENINGS, AND ACCESS TO CARE/TRANSPORTATION. THE HOSPITAL DID THE FOLLOWING:1) ASSUMPTION COMMUNITY HOSPITAL (ACH) CONTINUED TO WORK WITH THE BEHAVIORAL HEALTHCARE PROVIDER ADDED TO ASSUMPTION PRIMARY CARE AND WILL CONTINUE EXPANDING SERVICES BY ADDING ADDITIONAL PATIENT DAYS TO INCREASE ACCESS TO MENTAL/BEHAVIORAL HEALTH CARE IN THE COMMUNITY SERVED. 2) ACH ALSO PARTNERED WITH RELIANT ON CALL TO PROVIDE TRANSPORTATION FOR PATIENTS DISCHARGED FROM THE ACH EMERGENCY DEPARTMENT WHEN THE PATIENTS DO NOT HAVE ACCESS TO TRANSPORTATION OR DO NOT HAVE ACCESS TO A SAFE MODE OF TRANSPORTATION. 3) THROUGH A COLLABORATION WITH WOMAN'S HOSPITAL, ACH PROVIDED MAMMOGRAPHY SERVICES IN THE LOCAL COMMUNITY. ACH PARTICIPATES IN VARIOUS COMMUNITY EVENTS DESIGNED TO ACCOMPLISH THE CHNA GOALS AND ADDRESS COMMUNITY NEEDS, ESPECIALLY AMONG VULNERABLE POPULATIONS, SUCH AS COLLABORATING WITH LSU AG CENTER'S HEALTHY COMMUNITIES COALITION FOR EVENTS AND PROGRAMMING THROUGHOUT THE COMMUNITY SERVED. ACH ORGANIZED AND HELD A COLORECTAL CANCER SCREENING WHICH PROVIDED SERVICES TO 50 PARTICIPANTS AND PARTNERED WITH THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS / OFFICE OF PUBLIC HEALTH TO PROVIDE A CANCER SCREENING EVENT THAT PROVIDED SCREENINGS FOR 10 PARTICIPANTS. ADDITIONALLY, WOMAN'S HOSPITAL AND ACH PARTNER IN THE COMMUNITY TO PROVIDE MAMMOGRAPHY SCREENINGS THROUGH THE WOMAN'S HOSPITAL MOBILE UNIT ON THE ACH CAMPUS ONCE EACH MONTH, WHICH IS AN INCREASE IN THE FREQUENCY OF SERVICES PROVIDED. ACH ALSO PARTNERED WITH OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER TO PROVIDE ACLS, PALS, AND BLS TRAINING COURSES REGULARLY IN THE COMMUNITY.COMMUNITY EDUCATION EFFORTS INCLUDE ACTIVITIES SUCH AS STROKE EDUCATION AND CANCER OUTREACH AND "STOP THE BLEED" EDUCATION (DESIGNED BY THE AMERICAN COLLEGE OF SURGEONS TO TEACH PEOPLE HOW TO CONTROL BLEEDING IN AN EMERGENCY). |
| ASSUMPTION COMMUNITY HOSPITAL | PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY IS DETERMINED BASED ON INFORMATION THAT MAY BE OBTAINED FROM SOURCES OTHER THAN THE PATIENT, SUCH AS EVIDENCE THAT THE PATIENT IS PARTICIPATING IN ONE OR MORE OF THE FOLLOWING:1. STATE-FUNDING PRESCRIPTION PROGRAMS.2. LACHIP, SUBSIDIZED HOUSING, FREE OR REDUCED SCHOOL LUNCHES, ETC. FOR THE PATIENT'S/GUARANTOR'S CHILDREN.3. LOUISIANA FOOD STAMP PROGRAM.4. STATE MEDICARE PROGRAM. FOR PATIENTS WHO HAVE MEDICARE COVERAGE, THE FINANCIAL ASSISTANCE DETERMINATION WILL RELY ON INFORMATION FROM THE MEDICAID PROGRAM, INCLUDING EVIDENCE THAT:- PATIENT IS CURRENTLY ON MEDICAID, BUT HAS A PRIOR BALANCE WITHIN 12 MONTHS OF THE APPROVAL DATE- PATIENT CURRENTLY HAS MEDICAID WITH LIMITED BENEFITS (ONLY COVERS FAMILY PLANNING). -PATIENT IS IN A HOSPICE AND HAS MEDICAID ONLY-PATIENT HAS MEDICAID THROUGH A NON-CONTRACTED STATE-PATIENT QUALIFIES FOR MEDICAID WITH A "SPEND-DOWN REQUIREMENT"-PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (I.E. MEDICAID SPEND-DOWN)-PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY OR ESTATE. THE DUE DILIGENCE EFFORTS TO VERIFY THE ESTATE ARE TO BE DOCUMENTED VIA THE HOSPITAL APPROVED WEBSITE.ADDITIONALLY, A PATIENT MAY BE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THERE IS AN INDEPENDENT, QUALIFIED ATTESTATION THAT THE PATIENT IS HOMELESS. |
| ASSUMPTION COMMUNITY HOSPITAL | PART V, SECTION B, LINE 16J: REGISTRATION PERSONNEL AND FINANCIAL COUNSELORS REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FULLY-DISCOUNTED CARE UNDER THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICE AND AT ALL REGISTRATION LOCATIONS. |
| PART V, SECTION B, QUESTION 16A, B, & C: | THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTPS://FMOLHS.ORG/FINANCIAL-ASSISTANCE-POLICY/ |
| PART V, SECTION B, LINE 7B: | THE CHNA CAN BE FOUND AT HTTPS://WWW.FMOLHS.ORG/-/MEDIA/FILES/ASSUMPTION-COMMUNITY-HOSPITAL-2021-CHNA.ASHX |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE INSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULLY-DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. FULLY-DISCOUNTED CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS WHERE MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF INCOME AND ASSETS. FULLY DISCOUNTED CARE IS ALSO AVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY IS DETERMINED BASED ON INFORMATION THAT MAY BE OBTAINED FROM SOURCES OTHER THAN THE PATIENT, SUCH AS EVIDENCE THAT THE PATIENT IS PARTICIPATING IN ONE OR MORE OF THE FOLLOWING:1. STATE-FUNDED PRESCRIPTION PROGRAMS;2. LACHIP, SUBSIDIZED HOUSING, FREE OR REDUCED SCHOOL LUNCHES, ETC. FOR THE PATIENT/GUARANTOR'S CHILDREN;3. LOUISIANA FOOD STAMP PROGRAM;4. STATE MEDICAID PROGRAM. FOR PATIENTS THAT HAVE MEDICAID COVERAGE, THE FINANCIAL ASSISTANCE DETERMINATION WILL RELY ON INFORMATION FROM THE MEDICAID PROGRAM, INCLUDING EVIDENCE THAT: - PATIENT IS CURRENTLY ON MEDICAID, BUT HAS A PRIOR BALANCE WITHIN 12 MONTHS OF THE APPROVAL DATE - PATIENT CURRENTLY HAS MEDICAID WITH LIMITED BENEFITS (ONLY COVERS FAMILY PLANNING) - PATIENT IS IN A HOSPICE AND HAS MEDICAID ONLY - PATIENT HAS MEDICAID THROUGH A NON-CONTRACTED STATE - PATIENT QUALIFIES FOR MEDICAID WITH A "SPEND-DOWN REQUIREMENT" - PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (I.E., MEDICAID SPEND-DOWN); - PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY OR ESTATE. THE DUE DILIGENCE EFFORTS TO VERIFY THE ESTATE ASSETS ARE TO BE DOCUMENTED VIA THE HOSPITAL APPROVED WEBSITE.ADDITIONALLY, A PATIENT MAY BE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THERE IS AN INDEPENDENT, QUALIFIED ATTESTATION THAT THE PATIENT IS HOMELESS. |
| PART I, LINE 7: | THE OPERATION OF OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS A COMMUNITY BENEFIT IN ITSELF. OUR LADY OF THE LAKE ASSUMPTION IS LOCATED IN AN UNDER-INSURED/LOW INCOME AREA. THE HOSPITAL IS THE ONLY SOURCE OF EMERGENCY HEALTH SERVICES AVAILABLE IN THE IMMEDIATE AREA. EFFECTIVE JULY 1, 2022, THE LOUISIANA DEPARTMENT OF PUBLIC HEALTH IMPLEMENTED A NEW MEDICAID PAYMENT PROGRAM WHICH MATERIALLY INCREASED HOSPITAL MEDICAID FUNDING. THE NEW PAYMENT MODEL IS DESIGNED TO PAY HOSPITALS ABOVE COST BY PAYING AMOUNTS ROUGHLY EQUIVALENT TO RATES PAID BY COMMERCIAL INSURANCE COMPANIES. AS A RESULT, MEDICAID PAYMENTS FOR JUNE 30, 2024 EXCEEDED THE COST OF DELIVERING SERVICES TO MEDICAID PATIENTS. ACCORDINGLY, THERE HAS BEEN A SIGNIFICANT DECREASE IN COMMUNITY BENEFIT FOR THE MEDICAID PROGRAM SINCE.PART I, LINE 7:A COST TO CHARGE RATIO WAS USED TO CALCULATE PART I, LINE 7A AND 7B. THE COST TO CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. THE COST TO CHARGE RATIO IS APPLIED TO GROSS CHARGES RELATED TO CHARITY CARE AND CARE COVERED BY MEDICAID AND OTHER GOVERNMENT PROGRAMS. |
| PART III, LINE 2: | AMOUNT REPRESENTS THE ACTUAL CUSTOMER AMOUNTS DUE TO OUR LADY OF THE LAKE ASSUMPTION THAT WERE WRITTEN OFF BECAUSE THEY WERE UNCOLLECTIBLE. |
| PART III, LINE 4: | THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. THE AMOUNT ON PART III, LINE 6 REPRESENTS MEDICARE ALLOWABLE COSTS FROM THE COST REPORT. |
| PART III, LINE 9B: | PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR DISCOUNTED CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. |
| PART VI, LINE 2: | NEEDS ASSESSMENT RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. AS SUCH, ASSUMPTION COMMUNITY HOSPITAL WORKS TO CONDUCT HEALTH CARE NEEDS ASSESSMENTS. THE HOSPITAL WORKS CLOSELY WITH ASSUMPTION PARISH COUNCIL ON AGING, ASSUMPTION PARISH LIBRARY, ASSUMPTION PARISH SCHOOLS, ACADIAN AMBULANCE SERVICE, LOCAL MEDIA OUTLETS, ASSUMPTION PARISH HEAD START, DHH / OFFICE OF PUBLIC HEALTH REGION III, LOCAL CLERGY, LSU AG CENTER, ASSUMPTION HEALTHCARE AND REHABILITATION, ASSUMPTION ASSOCIATION FOR RETARDED CITIZENS, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, LOCAL HEALTHCARE PROVIDERS, ASSUMPTION PARISH SHERIFF'S OFFICE, POLICE JURY, REGION III OFFICE OF EMERGENCY PREPAREDNESS, ASSUMPTION PARISH DETENTION CENTER, AND OTHER COMMUNITY STAKEHOLDERS TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. FOR EXAMPLE, BEHAVIORAL HEALTH PROGRAMMING HAS BEEN EXPANDED AFTER THE NEED WAS IDENTIFIED IN THE COMMUNITY, AND A TRANSPORTATION PROGRAM HAS BEEN PUT IN PLACE TO HELP PATIENTS WITH IDENTIFIED BARRIERS TO CARE. THE HOSPITAL CONDUCTED AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT IN TAX YEAR 2021 AND WILL CONTINUE TO USE COMMUNITY-BASED DATA TO SUPPORT DECISIONS FOR OUTREACH IN THE COMMUNITY. |
| PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. ADDITIONALLY, SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE.PART VI, LINE 4:COMMUNITY INFORMATION ASSUMPTION COMMUNITY HOSPITAL IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN NAPOLEONVILLE, LOUISIANA, THAT SERVES ASSUMPTION PARISH AND PORTIONS OF THE SURROUNDING PARISHES. FOR PURPOSE OF THE CHNA, THE HOSPITAL DEFINES ITS PRIMARY SERVICE AREA AS ASSUMPTION PARISH. PURSUANT TO THE HOSPITAL'S MOST RECENT CHNA, ASSUMPTION'S PRIMARY SERVICE AREA HAS A 2021 POPULATION OF APPROXIMATELY OF 21,891, AND THE SENIOR POPULATION COMPRISES ABOUT 18.7% OF THE TOTAL POPULATION. THE PARISH'S MEDIAN HOUSEHOLD INCOME FOR 2021 IS $45,457, AND 13.93% OF FAMILIES LIVE BELOW THE POVERTY LINE.PART VI, LINE 5:ACH IS THE ONLY HOSPITAL IN ASSUMPTION PARISH AND PROVIDES EMERGENCY SERVICES THAT ARE CRITICAL TO THE PEOPLE WHO ARE SERVED IN THE AREA. IN ADDITION TO THE MANY COMMUNITY BENEFIT OUTREACH AND EDUCATIONAL OPPORTUNITIES THAT THE HOSPITAL PROVIDES TO HELP IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE IT IS PRIVILEGED TO SERVE, THE HOSPITAL SERVES AS A CRITICAL ACCESS POINT FOR PEOPLE WHO WOULD OTHERWISE HAVE TO DRIVE MILES OUT OF THEIR WAY TO RECEIVE IMMEDIATE CARE WHEN THEY NEED IT THE MOST. EFFECTIVE AUGUST 2023, ACH BECAME A RURAL EMERGENCY HOSPITAL. THE DESIGNATION ALLOWS IT TO FOCUS ON PROVIDING ESSENTIAL EMERGENCY AND OUTPATIENT SERVICES, PRIMARILY IN COMMUNITIES THAT CANNOT SUPPORT A FULL-SERVICE INPATIENT HOSPITAL OPERATION, EFFECTIVELY MAINTAINING ACCESS TO HEALTHCARE IN AREAS WITH LIMITED OPTIONS. ACH HAS BEEN RECOGNIZED AS ONE OF THE TOP 20 CRITICAL ACCESS HOSPITALS FOR BEST PRACTICE IN PATIENT SATISFACTION IN THE UNITED STATES. HOSPITAL SERVICES AVAILABLE IN THE RURAL EMERGENCY HOSPITAL INCLUDE: MODERN EMERGENCY DEPARTMENT STAFFED BY HIGHLY TRAINED AND EXPERIENCED PHYSICIANS 24 HOURS PER DAY, OUTPATIENT OBSERVATION SERVICES INCLUDING BLOOD TRANSFUSION, IV, FLUID, AND MEDICATION ADMINISTRATION, FULL RANGE OF DIAGNOSTIC CAPABILITIES, LABORATORY SERVICES, RADIOLOGY SERVICES (INCLUDING ULTRASOUND, X-RAY AND MAMMOGRAPHY), EKG AND 24-HOUR HOLTER MONITORING, RESPIRATORY SERVICES, PULSE OXIMETRY, ARTERIAL BLOOD GASES, AEROSOL DRUG THERAPY AND OXYGEN THERAPY, MEDICAL NUTRITION THERAPY, AND CT SERVICES. A MAJORITY OF THE GOVERNING BODY OF ACH IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILIEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OF THE DEPARTMENTS, AS NEEDED, AND APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF.PART VI, LINE 6:AFFILIATED HEALTH CARE SYSTEM OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS A NOT-FOR-PROFIT, NON-STOCK, MEMBER CORPORATION OF WHICH OUR LADY OF THE LAKE HOSPITAL, INC. IS THE SOLE MEMBER. OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS PART OF THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE. OUR LADY OF THE LAKE ASSUMPTION SERVES THE COMMUNITY IN LOUISIANA'S ASSUMPTION PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER OUR LADY OF LOURDES REGIONAL MEDICAL CENTERST. FRANCIS MEDICAL CENTER OUR LADY OF THE LAKE ASCENSIONOUR LADY OF THE ANGELS HOSPITALRELATED HOSPITAL IN MISSISSIPPI:ST. DOMINIC JACKSON MEMORIAL HOSPITAL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARLES L SPICER | ||||||||||||||
| PRESIDENT - OLOL | $0 | $716,043 | $0 | $163,924 | $0 | $46,135 | $0 | $104,500 | $0 | $25,469 | $0 | $1,056,071 | $0 | $0 |
| JENNIFER CLOWERS | ||||||||||||||
| REGIONAL CFO | $0 | $410,422 | $0 | $220,415 | $0 | $1,776 | $0 | $55,765 | $0 | $27,176 | $0 | $715,554 | $0 | $0 |
| JOHN FRAICHE MD | ||||||||||||||
| PHYSICIAN | $0 | $558,034 | $0 | $86,043 | $0 | $11,552 | $0 | $16,500 | $0 | $22,103 | $0 | $694,232 | $0 | $0 |
| LOWELL STANTON | ||||||||||||||
| FORMER REG CFO/ LOURDES CFO | $0 | $470,903 | $0 | $123,980 | $0 | $5,191 | $0 | $16,500 | $0 | $26,376 | $0 | $642,950 | $0 | $0 |
| LESLEY TILLEY | ||||||||||||||
| VP REGIONAL OPERATIONS BR | $0 | $272,780 | $0 | $132,204 | $0 | $7,781 | $0 | $16,500 | $0 | $31,497 | $0 | $460,762 | $0 | $0 |
| BRITTANY WYGER | ||||||||||||||
| PHYSICIAN | $281,215 | $0 | $0 | $0 | $505 | $0 | $14,061 | $0 | $1,785 | $0 | $297,566 | $0 | $0 | $0 |
| BRIAN F TRIPODE | ||||||||||||||
| SENIOR DIRECTOR | $200,246 | $0 | $24,226 | $0 | $100 | $0 | $11,534 | $0 | $15,975 | $0 | $252,081 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I QUESTION 4A: | THE REGIONAL CFO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. |
| PART I QUESTION 3 | OTHER RELATED ORGANIZATIONS SET THE COMPENSATION AND PAY FOR THE EXECUTIVES. THAT BOARD OF DIRECTORS DESIGNATES THE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. |
| PART I QUESTION 4B: | FMOLHS MAINTAINS TWO UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDE FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. NO PAYMENTS WERE MADE UNDER THE PLANS IN THE CURRENT YEAR. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: | INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING- WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. |
| FORM 990, PART VI, SECTION A, LINE 6 | OUR LADY OF THE LAKE HOSPITAL (AN IRC SECTION 501 (C) (3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | OUR LADY OF THE LAKE HOSPITAL, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS AND THE OFFICERS OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | OUR LADY OF THE LAKE HOSPITAL, INC. AS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL CAN MAKE THE DECISIONS AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES, AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF THE CORPORATION. 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION OR AFFILIATION, OR PARTICIPATION IN JOINT VENTURES 5. TO DISSOLVE AND DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY CORPORATION 9. TO APPOINT THE FISCAL AUDITOR OF THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHANGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION |
| FORM 990, PART VI, SECTION B, LINE 11B | AFTER PREPARATION OF THE FORM 990 BY KPMG LLP, MANAGEMENT REVIEWED THE FORM 990. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | OLOL ASSUMPTION COMMUNITY HOSPITAL HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT OLOL ASSUMPTION COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OLOL ASSUMPTION COMMUNITY HOSPITAL PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION, AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST, ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION B QUESTION 13 THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A WHISTLEBLOWER POLICY IN PLACE ALTHOUGH IT HAS NOT BEEN NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. THE WHISTLEBLOWER POLICY HAS, HOWEVER, BEEN APPROVED BY THE BOARD OF DIRECTORS OF OUR LADY OF THE LAKE HOSPITAL, INC. (THE ORGANIZATION'S SOLE-MEMBER). |
| FORM 990, PART VI, SECTION B, LINE 15A | OTHER RELATED ORGANIZATIONS SET THE COMPENSATION AND PAY FOR THE EXECUTIVES. THAT BOARD OF DIRECTORS DESIGNATES THE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. SECTION 1.263(A)-3(N) ELECTION-BOOK CONFORMITY ELECTION OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2024. SECTION 1.263 (A)-1(F) - ELECTION- DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2024. TAXPAYER HAS AN APPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM, AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I). |
| FORM 990, PART XI, LINE 9: | CAPITAL TRANSFER 56,975. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ST DOMINIC HEALTH SERVICES INC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640714999 | HOLDING CO | MS | 501(C)(3) | 12-III FI | FMOLHS | 0 |
| COMMUNITY HEALTH SERVICES - ST DOMINIC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640884870 | HEALTH PROGRAM | MS | 501(C)(3) | 10 | SDJMH | 0 |
| ST DOMINIC - JACKSON MEMORIAL HOSPITAL | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640303091 | HOSPITAL | MS | 501(C)(3) | 3 | FMOLHS | 0 |
| ST DOMINIC - HEALTH SERVICES FOUNDATION | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 431992975 | FUNDRAISING | MS | 501(C)(3) | 7 | SDJMH | 0 |
| ST CATHERINE'S VILLAGE INC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640714997 | RET HOME | MS | 501(C)(3) | 10 | SDJMH | 0 |
| HEALTH CARE CENTERS IN SCHOOLS | ||||||||||
| 5000 HENNESSY BLVD | BATON ROUGE | LA | 70808 | 721443935 | HEALTHCARE | LA | 501(C)(3) | 10 | OLOL | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| LOURDES IMAGING DEVELOPMENT LLC | ||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 208326287 | REAL ESTATE | LA | N/A | N/A | 0 | 0 |
| PARK PLACE SURGERY CENTER LLC | ||||||||||
| 4811 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 721404092 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| CONVENIENT CARE LLC | ||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 721439481 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| PERKINS PLAZA AMBULATORY SURGERY CENTER LLC | ||||||||||
| 7145 PERKINS ROAD | BATON ROUGE | LA | 70808 | 481264699 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| SURGICAL SPECIALTY CENTER OF BATON ROUGE LLC | ||||||||||
| 8080 BLUEBONNET BLVD | BATON ROUGE | LA | 70810 | 263120962 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| ST ELIZABETH-MARY BIRD PERKINS CANCER CENTER LLC | ||||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 260628752 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| NORTHEAST LA CANCER INSTITUTE LLC | ||||||||||
| 411 CALYPSO STREET | MONROE | LA | 71201 | 721329499 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| LHCG-XIII LLC DBA LOURDES HOME HEALTH | ||||||||||
| 901 S HUGH WALLIS ROAD | LAFAYETTE | LA | 70508 | 208068308 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| LOURDES AFTER HOURS LLC | ||||||||||
| 7777 HENNESSY BLVD SUITE 1004-202 | BATON ROUGE | LA | 70809 | 201367299 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| LAKE URGENT CARE ASCENSION LLC | ||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 352463092 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| ST FRANCIS URGENT CARE LLC | ||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 474013731 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| GAMMA KNIFE OF LOUISIANA LLC | ||||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 811827194 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| PINNACLE CARE HOLDINGS LLC | ||||||||||
| 5627 S SHERWOOD FOREST BLVD | BATON ROUGE | LA | 70816 | 821637627 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | ||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 943419282 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| FREMAUX OFFICE MM LLC | ||||||||||
| 3500 NORTH CAUSEWAY BOULEVARD STE 6 | METAIRIE | LA | 70002 | 843084552 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| OLOL PONTCHARTRAIN SURGERY CENTER LLC | ||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 461379031 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| LAKE SURGICAL HOSPITAL (SLIDELL) LLC | ||||||||||
| 1700 LINDBERG DR | SLIDELL | LA | 70458 | 474228147 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| PREMIER HEALTH HOLDINGS LLC | ||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 472665226 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| PERKINS PLAZA DEVELOPMENT LLC | ||||||||||
| 5000 HENNESSY BLVD | BATON ROUGE | LA | 70808 | HEALTHCARE | LA | N/A | N/A | 0 | 0 | |
| JACKSON HEART & VASCULAR CENTER LLC | ||||||||||
| 969 LAKELAND DR | JACKSON | MS | 39216 | 870947298 | HEALTHCARE | MS | N/A | N/A | 0 | 0 |
| CARDIOVASCULAR AND ARRYTHMIA CENTER LLC (CVAC) | ||||||||||
| PO BOX 82063 | BATON ROUGE | LA | 70884 | 861438331 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
| CARDIOVASCULAR AND ARRYTHMIA MANAGEMENT LLC (CVAM) | ||||||||||
| PO BOX 82063 | BATON ROUGE | LA | 70884 | HEALTHCARE | LA | N/A | N/A | 0 | 0 | |
| TRACTION SPORT MANAGEMENT LLC | ||||||||||
| 9222 BURBANK DRIVE | BATON ROUGE | LA | 70820 | 822247999 | HEALTHCARE | LA | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOUISE INSURANCE COMPANY | |||||||||||||
| PO BOX 1051 | CJ | KY1-1102 | INSURANCE | CJ | N/A | C | 0 | ||||||
| FRANCISICAN HEALTH & WELLNESS SERVICES I | |||||||||||||
| HEALTHCARE | N/A | C | 0 | 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 455492379 | LA | ||||
| FMOL HEALTH SYSTEM HOLDINGS INC | |||||||||||||
| INVESTMENT | N/A | C | 0 | 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 454405024 | LA | ||||
| ST DOMINIC MADISON HEALTH SERVICES INC | |||||||||||||
| HEALTHCARE | N/A | C | 0 | 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 202870254 | MS | ||||
| ST DOMINIC INTEGRATED SERVICES INC | |||||||||||||
| INVESTMENTS | N/A | C | 0 | 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 271493623 | MS | ||||
| LAFAYETTE SURGICARE INC | |||||||||||||
| HEALTHCARE | N/A | C | 0 | C/O C T CORPORATION SYSTEM 3867 PLA | BATON ROUGE | LA | 70816 | LA | |||||
| NMC OPERATING COMPANY LLC DBA SPINE HOSPITAL OF LOUISIANA | |||||||||||||
| HEALTHCARE | N/A | S | 0 | 10105 PARK ROWE CIRCLE STE 250 | BATON ROUGE | LA | 70810 | 270059959 | LA | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |