2025-05-15T11:00:07-05:00 2024-06-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2023-07-01 721495500 OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL OURL 2257657709 4200 ESSEN LANE BATON ROUGE LA 70809 JENNIFER CLOWERS CFO 2257657709 2025-05-12 1 0 RYAN HOOKS P00746825 2253444000 2025-05-08 2023 2025-03-06 01:10:19Z BRIAN TRIPODE 4200 ESSEN LANE BATON ROUGE LA 70809 14165689 0 X N/A X 2001 LA 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. 11 6 64 5 0 0 0 7185 11581840 12923061 268845 228633 25750 25500 11876435 13184379 2359 872 0 0 4075681 4341891 0 0 0 4816192 5224653 8894232 9567416 2982203 3616963 25380919 34014036 2950558 6864622 22430361 27149414 X SEE SCHEDULE O. 0 0 7098464 872 12948561 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. 7098464 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 64 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 0 0 X AMANDA HYMEL 2257656565 5959 S SHERWOOD FOREST BLVD BATON ROUGE LA 70816 BRIAN F TRIPODE SENIOR DIRECTOR 40.00 0.00 X X 224572 0 27509 CHARLES L SPICER PRESIDENT - OLOL 2.00 42.00 X X 0 926102 129969 CHARLES P BOLOTTE MD BOARD MEMBER 10.00 0.00 X 0 0 0 GREG BOWSER SECRETARY 2.00 2.00 X X 0 0 0 HARRY J PHILIPS JR BOARD MEMBER 2.00 2.00 X 0 0 0 JENNIFER CLOWERS REGIONAL CFO 2.00 45.50 X X 0 632613 82941 JOHN FRAICHE MD PHYSICIAN 2.00 40.00 X 0 655629 38603 LESLEY TILLEY VP REGIONAL OPERATIONS BR 2.00 40.00 X 0 412765 47997 MICHAEL CRAPANZANO MD BOARD MEMBER 2.00 2.00 X 0 0 0 SCOTT N HENGSENS CHAIR 2.00 2.00 X X 0 0 0 STEPHEN M TOUPS VICE CHAIR 2.00 0.00 X X 0 0 0 BRITTANY WYGER PHYSICIAN 40.00 0.00 X 281720 0 15846 DAMIAN RICHARD MRI TECHNOLOGIST 40.00 0.00 X 111364 0 9466 DONNA M MULLINGS DIR. NURSING 40.00 0.00 X 103426 0 4988 LOWELL STANTON FORMER REG CFO/ LOURDES CFO 0.00 40.50 X 0 600074 42876 721082 3227183 400195 4 1 1 0 CORRECT CARE INC 17438 HARD HAT DRIVE COVINGTON LA 70435 MEDICAL SERVICES 1126423 FMOL HEALTH SYSTEM 4200 ESSEN LANE BATON ROUGE LA 70809 LAB MANAGEMENT FEES 653899 CROTHALL HEALTHCARE INC 1500 LIBERTY RIDGE DR WAYNE PA 19087 HOUSEKEEPING SERVICES 227749 TRIMEDX INC PO BOX 636129 CINCINNATI OH 45263 BIOMED SERVICES 176440 INNER PARISH SECURITY CORP 43222 PECAN RIDGE DRIVE HAMMOND LA 70403 SECURITY 174322 5 7185 7185 PATIENT SERVICE REVENUE 622110 12917740 12917740 OUTREACH LAB 621500 4318 4318 MISCELLANEOUS 900099 1003 1003 12923061 247246 247246 25500 0 25500 25500 25500 962697 981310 -18613 -18613 -18613 13184379 12948561 0 228633 872 872 224572 181800 42772 3330331 2696031 634300 208423 168726 39697 333722 270161 63561 244843 198210 46633 1561996 1331097 230899 8800 8800 17871 17871 397712 276650 121062 86114 41074 45040 1092140 610124 482016 10995 5244 5751 363640 255257 108383 8076 3852 4224 2253 1075 1178 354770 301554 53216 51596 8573 43023 PURCHASED SERVICES 681419 401842 279577 MEDICAL SUPPLIES EXPENS 394618 232712 161906 EQUIPMENT & MAINTENANCE 192653 113610 79043 9567416 7098464 2468952 0 10797286 11206976 0 0 0 0 1112703 302078 0 0 0 0 0 0 0 0 15076 6380 6464463 4119324 2222196 2345139 0 0 7812712 8916469 0 0 0 0 3420946 11236994 25380919 34014036 2950558 3589327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3275295 2950558 6864622 X 22330361 27149414 100000 0 22430361 27149414 25380919 34014036 X 3616963 1045115 56975 X 0 1 X 1 0 X 55461 55461 2266661 1003214 1263447 72547 15228 57319 3949181 3048238 900943 120613 52644 67969 2345139 INVESTMENT IN CAPITAL RESERVE 8916469 F 8916469 INTERCOMPANY RECEIVABLES 11236994 11236994 INVESTMENTS HELD AT FMOLHS 3275295 3275295 X PART X, LINE 2: 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. 1 1 1 X 250.000000000000 0 1 1 1 0 0 244703 244703 0.02560 3636840 3636840 3881543 3636840 244703 0.02560 1351 70 1281 0.00010 1886 1886 0.00020 3237 70 3167 0.00030 3884780 3636910 247870 0.02590 451 451 0.00000 451 451 0.00000 1 194181 160337 36175 124162 X 1 1 1 1 ASSUMPTION COMMUNITY HOSPITAL 135 HIGHWAY 402 NAPOLEONVILLE LA 70390 X X X X RURAL EMERGENCY HOSPITAL (AUG 2023) ASSUMPTION COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE SUPPLEMENT AT PART V X 1 21 0 1 0 1 X 250.000000000000 0.000000000000 X X X X X 1 1 X X X 1 X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X X X X X X X 1 X 0 X X X X 1 X 0 0 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 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 0 1 0 0 0 0 0 0 0 CHARLES L SPICER PRESIDENT - OLOL 0 716043 0 163924 0 46135 0 104500 0 25469 0 1056071 0 0 JENNIFER CLOWERS REGIONAL CFO 0 410422 0 220415 0 1776 0 55765 0 27176 0 715554 0 0 JOHN FRAICHE MD PHYSICIAN 0 558034 0 86043 0 11552 0 16500 0 22103 0 694232 0 0 LOWELL STANTON FORMER REG CFO/ LOURDES CFO 0 470903 0 123980 0 5191 0 16500 0 26376 0 642950 0 0 LESLEY TILLEY VP REGIONAL OPERATIONS BR 0 272780 0 132204 0 7781 0 16500 0 31497 0 460762 0 0 BRITTANY WYGER PHYSICIAN 281215 0 0 0 505 0 14061 0 1785 0 297566 0 0 0 BRIAN F TRIPODE SENIOR DIRECTOR 200246 0 24226 0 100 0 11534 0 15975 0 252081 0 0 0 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. 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. 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