OLLIE STEELE BURDEN MANOR INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- OLLIE STEELE BURDEN MANOR INC (EIN 72-0780429)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-13
- IRS object ID
- 202321339349302117
- Schema version
- 2021v4.2
- 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 | 2023-05-13T18:26:56-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | 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 | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720780429 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLLIE STEELE BURDEN MANOR INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OLLI | 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 | 2023-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JENNIFER | PersonFirstNm |
| Person Last | CLOWERS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MAXWELL BARLOW | PreparerPersonNm |
| PTIN | P01959439 | PTIN |
| Phone | 2253444000 | PhoneNum |
| Preparation | 2023-05-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JENNIFER CLOWERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 HENNESSY BLVD | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70808 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,041,659 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1963 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSE OF THE HOSPITAL IS TO PROVIDE CARE FOR THE ILL, INJURED OR DISABLED PERSONS, ESPECIALLY THE ELDERLY AND FOR THE ENHANCEMENT OF HEALTH OF THE ELDERLY IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 322 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,272,105 | PYContributionsGrantsAmt |
| CY Contributions Grants | $72,278 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,754,541 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,938,811 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,966 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,570 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $20,028,612 | PYTotalRevenueAmt |
| CY Total Revenue | $13,041,659 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,796 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,591 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,119,416 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,793,795 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,816,557 | PYOtherExpensesAmt |
| CY Other Expenses | $9,293,426 | CYOtherExpensesAmt |
| PY Total Expenses | $21,937,769 | PYTotalExpensesAmt |
| CY Total Expenses | $22,088,812 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,909,157 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$9,047,153 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,175,738 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,466,039 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,242,420 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,697,775 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$8,066,682 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,768,264 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,274,148 | ExpenseAmt |
| Grant | $1,591 | GrantAmt |
| Revenue | $12,938,811 | RevenueAmt |
| Desc | OLLIE STEELE BURDEN MANOR OPERATES TWO NURSING HOME FACILITIES SPECIALLY DESIGNED TO PROVIDE THE HIGHEST LEVEL OF CARE FOR THOSE SUFFERING WITH COMPLEX PHYSICAL HEALTH ISSUES INCLUDING ALZHEIMER'S DISEASE AND DEMENTIA. THE NURSING HOMES PROVIDE 24 HOUR NURSING CARE IN A REHABILITATIVE SETTING THAT MINISTERS TO THE NEEDS OF THE WHOLE PERSON. THE NURSING HOME PROVIDED CARE AND HOUSING FOR 55,604 RESIDENT DAYS. | Desc |
| Total Program Service Expenses | $17,274,148 | 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 | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | 0 | OperateHospitalInd |
| 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 |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 322 | 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 |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | 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 | 2259232701 | 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 | 70809 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 |
|---|---|---|---|---|---|---|---|---|---|
| KAREN B ALLEN | |||||||||
| PRESIDENT | 30.00 | 17.00 | Yes (X) | Yes (X) | $0 | $428,732 | $46,687 | ||
| MARY TAUZIN | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN CURRY | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ARTHUR LANDRY | |||||||||
| CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SR ANN CATHERINE NGUYEN | |||||||||
| BOARD MEMBER | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JEFF KUEHNY MD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DR LISA PEREZ | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| HUGH ELEY | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| NORMA RUTLEDGE | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| TRENT BOUDREAUX | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PHIL BRANTLEY PHD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH SCOTT WESTER | |||||||||
| BOARD MEMBER | 1.00 | 54.50 | Yes (X) | $0 | $1,128,872 | $240,484 | |||
| LOWELL E STANTON | |||||||||
| REGIONAL CFO | 1.00 | 54.00 | Yes (X) | $0 | $634,011 | $42,886 | |||
| JENNIFER L ANTOINE | |||||||||
| CLINICAL COORD RN | 40.00 | 0.00 | $103,997 | $0 | $8,214 | Yes (X) | |||
| HEATHER BAUDER | |||||||||
| SR. DIRECTOR ADMINISTRATOR | 40.00 | 0.00 | $151,175 | $0 | $22,151 | Yes (X) | |||
| PAMELA GASPARD | |||||||||
| DIRECTOR NURSING | 40.00 | 0.00 | $113,879 | $0 | $12,874 | Yes (X) | |||
| SHARON PALM | |||||||||
| CLINICAL COORDINATOR RN | 40.00 | 0.00 | $104,991 | $0 | $22,853 | Yes (X) | |||
| JEFF LIMBOCKER | |||||||||
| FORMER CFO / CURRENT HS CFO | 1.00 | 59.50 | $0 | $991,087 | $185,197 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $474,042 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,182,702 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $581,346 | 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 |
|---|---|---|---|---|---|
| AEGIS THERAPIES INC | |||||
| 7160 NORTH DALLAS PARKWAY SUITE 40 | PLANO | TX | 72902 | THERAPY SERVICES | $823,556 |
| SOUTHERN MEDICAL STAFFING | |||||
| 1247 MACAURTHUR DRIVE SUITE B | ALEXANDRIA | LA | 71302 | STAFFING SERVICES | $731,158 |
| BROUSSARD HEALTHCARE CONSULTING | |||||
| 127 W BROAD ST STE 700 | LAKE CHARLES | LA | 706014291 | HEALTHCARE SERVICES | $351,708 |
| LOUISIANA PAINTING INC | |||||
| 6727 OAK CLUSTER | GREENWELL SPRINGS | LA | 70739 | PAINTING SERVICES | $198,909 |
| DOYLE ELECTRIC | |||||
| 15035 JEFFERSON HWY | BATON ROUGE | LA | 70817 | ELECTRICAL SERVICES | $156,695 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $71,059 | GovernmentGrantsAmt |
| All Other Contributions | $1,219 | AllOtherContributionsAmt |
| Total Contributions | $72,278 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 623000 | $12,899,619 | $12,899,619 |
| OTHER PROGRAM REVENUE | 900099 | $32,243 | $32,243 |
| FRANCISCAN SISTER SERVICES | 623000 | $4,800 | $4,800 |
| VENDING REVENUE | 900099 | $2,149 | $2,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,938,811 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,731 | TotalRevenueColumnAmt |
| Exclusion | $4,731 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $25,839 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $25,839 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,839 | TotalRevenueColumnAmt |
| Exclusion | $25,839 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,041,659 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,938,811 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $30,570 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,591 | TotalAmt |
| Program Services | $1,591 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,888,832 | TotalAmt |
| Program Services | $8,549,234 | ProgramServicesAmt |
| Management And General | $1,339,598 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,084 | TotalAmt |
| Program Services | $474,076 | ProgramServicesAmt |
| Management And General | $74,008 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,651,999 | TotalAmt |
| Program Services | $1,427,911 | ProgramServicesAmt |
| Management And General | $224,088 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $704,880 | TotalAmt |
| Program Services | $609,699 | ProgramServicesAmt |
| Management And General | $95,181 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,803 | TotalAmt |
| Program Services | $36,308 | ProgramServicesAmt |
| Management And General | $10,495 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392 | TotalAmt |
| Management And General | $392 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,850,031 | TotalAmt |
| Program Services | $2,416,943 | ProgramServicesAmt |
| Management And General | $433,088 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,677 | TotalAmt |
| Program Services | $8,069 | ProgramServicesAmt |
| Management And General | $20,608 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,080,573 | TotalAmt |
| Program Services | $616,700 | ProgramServicesAmt |
| Management And General | $463,873 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,723 | TotalAmt |
| Program Services | $11,177 | ProgramServicesAmt |
| Management And General | $28,546 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824,263 | TotalAmt |
| Program Services | $700,650 | ProgramServicesAmt |
| Management And General | $123,613 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $534 | TotalAmt |
| Program Services | $150 | ProgramServicesAmt |
| Management And General | $384 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $950 | TotalAmt |
| Management And General | $950 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $980,713 | TotalAmt |
| Program Services | $833,636 | ProgramServicesAmt |
| Management And General | $147,077 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,655 | TotalAmt |
| Program Services | $20,355 | ProgramServicesAmt |
| Management And General | $131,300 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIR & MAINTANENCE | $1,340,475 | $458,798 | $881,677 |
| MEDICAL SUPPLIES EXPENS | $1,273,161 | $435,758 | $837,403 |
| PROVIDER FEES | $671,853 | $671,853 | |
| MISCELLANEOUS | $3,623 | $1,240 | $2,383 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,088,812 | TotalAmt |
| Program Services | $17,274,148 | ProgramServicesAmt |
| Management And General | $4,814,664 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,802,240 | BOYAmt |
| EOY | $6,037,289 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,147,234 | BOYAmt |
| EOY | $980,762 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,906 | BOYAmt |
| EOY | $62,403 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,154 | BOYAmt |
| EOY | $55,692 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,306,293 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,221,514 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,827,006 | BOYAmt |
| EOY | $11,084,779 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,198 | BOYAmt |
| EOY | $245,114 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,000 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,175,738 | BOYAmt |
| EOY | $18,466,039 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,546,378 | BOYAmt |
| EOY | $1,198,764 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $37,746 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,696,042 | BOYAmt |
| EOY | $10,461,265 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,242,420 | BOYAmt |
| EOY | $11,697,775 | 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 | -$8,070,113 | BOYAmt |
| EOY | $6,764,831 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,431 | BOYAmt |
| EOY | $3,433 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,066,682 | BOYAmt |
| EOY | $6,768,264 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,175,738 | BOYAmt |
| EOY | $18,466,039 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$9,047,153 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $23,882,099 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $905,168 | OtherCostOrOtherBasisAmt |
| Book Value | $905,168 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,413,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,632,276 | DepreciationAmt |
| Book Value | $8,781,525 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $815,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $563,121 | DepreciationAmt |
| Book Value | $252,310 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,171,893 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,026,117 | DepreciationAmt |
| Book Value | $1,145,776 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,084,779 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $10,459,065 |
| DEPOSITS | $2,200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,461,265 | 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 | 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 JUDGEMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. | ExplanationTxt |
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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH SCOTT WESTER | ||||||||||||||
| BOARD MEMBER | $0 | $690,598 | $0 | $254,965 | $0 | $183,309 | $0 | $210,730 | $0 | $29,754 | $0 | $1,369,356 | $0 | $125,808 |
| JEFF LIMBOCKER | ||||||||||||||
| FORMER CFO / CURRENT HS CFO | $0 | $670,983 | $0 | $234,110 | $0 | $85,994 | $0 | $160,910 | $0 | $24,287 | $0 | $1,176,284 | $0 | $60,058 |
| LOWELL E STANTON | ||||||||||||||
| REGIONAL CFO | $0 | $454,544 | $0 | $176,720 | $0 | $2,747 | $0 | $14,500 | $0 | $28,386 | $0 | $676,897 | $0 | $0 |
| KAREN B ALLEN | ||||||||||||||
| PRESIDENT | $0 | $299,282 | $0 | $124,423 | $0 | $5,027 | $0 | $26,100 | $0 | $20,587 | $0 | $475,419 | $0 | $0 |
| HEATHER BAUDER | ||||||||||||||
| SR. DIRECTOR ADMINISTRATOR | $119,065 | $0 | $31,985 | $0 | $125 | $0 | $7,465 | $0 | $14,686 | $0 | $173,326 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, QUESTION 3: | THE PRESIDENT IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE PRESIDENT'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. 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 4A: | A BOARD MEMBER AND THE FORMER CFO ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT GOOD CAUSE, FOR GOOD REASON, AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE PRESIDENT AND REGIONAL CFO ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, OR DUE TO 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 GENERALLY 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. |
| PART I, QUESTION 4B: | FMOLHS MAINTAINS THREE 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. THE FOLLOWING PEOPLE LISTED IN PART VII, SECTION A RECEIVED A PAYMENT FROM THE PLANS IN THE CURRENT YEAR: KENNETH SCOTT WESTER - $180,562 AND JEFF LIMBOCKER - $83,247. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI | FORM 990, PART VI, QUESTIONS 12-14 THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A CONFLICT OF INTEREST POLICY, DOCUMENT RETENTION POLICY, AND A WHISTLEBLOWER POLICY IN PLACE ALTHOUGH THEY WERE NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE JUNE 30, 2022. THE CONFLICT OF INTEREST POLICY AND THE DOCUMENT RETENTION POLICY HAVE, 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 A, LINE 6 | OUR LADY OF THE LAKE HOSPITAL, INC. (AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OLLIE STEELE BURDEN MANOR, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | OUR LADY OF THE LAKE HOSPITAL INC., AS THE SOLE MEMBER OF OLLIE STEELE BURDEN MANOR, INC., RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OLLIE STEELE BURDEN MANOR, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | OUR LADY OF THE LAKE HOSPITAL, AS THE SOLE MEMBER OF OLLIE STEELE BURDEN MANOR, INC. RESERVES THE FOLLOWING POWERS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES, PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL ARTICLES OF INCORPORATION AND BYLAWS OF CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION OR AFFILIATION, OR PARTICIPATE 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 IMMOVABLE PROPERTY ON BEHALF OF CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT FISCAL AUDITOR OF 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 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 12 | OLLIE STEELE BURDEN MANOR 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 OLLIE STEELE BURDEN MANOR 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, OLLIE STEELE BURDEN MANOR 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. |
| FORM 990, PART VI, SECTION B, LINE 15 | OTHER RELATED TAX EXEMPT ORGANIZATIONS SET THE COMPENSATION AND PAY THE EXECUTIVES. THAT BOARD OF DIRECTORS DESIGNATES THE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE COMPENSATION ANNUALLY OF EXECUTIVES. 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 | OLLIE STEELE BURDEN MANOR, INC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. SECTION 1.263(A)-3 (N) ELECTION - BOOK CONFORMITY ELECTION OLLIE STEELE BURDEN MANOR, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2022. SECTION 1.263(A)-1(F) ELECTION- DE MINIMIS SAFE HARBOR OLLIE STEELE BURDEN MANOR, INC. 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, 2022. TAXPAYER DOES HAVE 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 $5000 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)(II). |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR SERVICES: PROGRAM SERVICE EXPENSES 2,088,320. MANAGEMENT AND GENERAL EXPENSES 415,983. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,504,303. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 328,623. MANAGEMENT AND GENERAL EXPENSES 17,105. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 345,728. |
| FORM 990, PART XI, LINE 9: | CAPITAL TRANSFERS 23,882,099. |
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-I | FMOLHS | 0 |
| COMMUNITY HEALTH SERVICES - ST DOMINIC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640884870 | HEALTH PROGRAM | MS | 501(C)(3) | 10 | SDHS | 0 |
| ST DOMINIC - JACKSON MEMORIAL HOSPITAL | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640303091 | HOSPITAL | MS | 501(C)(3) | 3 | SDHS | 0 |
| ST DOMINIC - HEALTH SERVICES FOUNDATION | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 431992975 | FUNDRAISING | MS | 501(C)(3) | 7 | SDHS | 0 |
| ST CATHERINE'S VILLAGE INC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640714997 | RET HOME | MS | 501(C)(3) | 10 | SDHS | 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 (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|
| LOURDES IMAGING DEVELOPMENT LLC | ||||||||
| 4801 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 208326287 | REAL ESTATE | LA | 0 | 0 |
| PARK PLACE SURGERY CENTER LLC | ||||||||
| 4811 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 721404092 | HEALTHCARE | LA | 0 | 0 |
| BRPT LAKE REHABILITATION CENTERS LLC | ||||||||
| 175 S ENGLISH STATION RD STE 218 | LOUISVILLE | KY | 40245 | 721506100 | HEALTHCARE | LA | 0 | 0 |
| CONVENIENT CARE LLC | ||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 721439481 | HEALTHCARE | LA | 0 | 0 |
| CONVENIENT CARE LLC | ||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 721439481 | HEALTHCARE | LA | 0 | 0 |
| PERKINS PLAZA AMBULATORY SURGERY CENTER LLC | ||||||||
| 7145 PERKINS ROAD | BATON ROUGE | LA | 70808 | 481264699 | HEALTHCARE | LA | 0 | 0 |
| SURGICAL SPECIALTY CENTER OF BATON ROUGE LLC | ||||||||
| 8080 BLUEBONNET BLVD | BATON ROUGE | LA | 70810 | 263120962 | HEALTHCARE | LA | 0 | 0 |
| ST ELIZABETH-MARY BIRD PERKINS CANCER CENTER LLC | ||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 260628752 | HEALTHCARE | LA | 0 | 0 |
| NORTHEAST LA CANCER INSTITUTE LLC | ||||||||
| 411 CALYPSO STREET | MONROE | LA | 71201 | 721329499 | HEALTHCARE | LA | 0 | 0 |
| LHCG-XIII LLC DBA LOURDES HOME HEALTH | ||||||||
| 901 S HUGH WALLIS ROAD | LAFAYETTE | LA | 70508 | 208068308 | HEALTHCARE | LA | 0 | 0 |
| LOURDES AFTER HOURS LLC | ||||||||
| 7777 HENNESSY BLVD SUITE 1004-202 | BATON ROUGE | LA | 70809 | 201367299 | HEALTHCARE | LA | 0 | 0 |
| LAKE URGENT CARE ASCENSION LLC | ||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 352463092 | HEALTHCARE | LA | 0 | 0 |
| ST FRANCIS URGENT CARE LLC | ||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 474013731 | HEALTHCARE | LA | 0 | 0 |
| GAMMA KNIFE OF LOUISIANA LLC | ||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 811827194 | HEALTHCARE | LA | 0 | 0 |
| LHCG LXVII LLC | ||||||||
| 901 S HUGH WALLIS ROAD | LAFAYETTE | LA | 70508 | 474283509 | HEALTHCARE | LA | 0 | 0 |
| PINNACLE CARE HOLDINGS LLC | ||||||||
| 5627 S SHERWOOD FOREST BLVD | BATON ROUGE | LA | 70816 | 821637627 | HEALTHCARE | LA | 0 | 0 |
| LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | ||||||||
| 4801 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 943419282 | HEALTHCARE | LA | 0 | 0 |
| FREMAUX OFFICE MM LLC | ||||||||
| 3500 NORTH CAUSEWAY BOULEVARD STE 6 | METAIRIE | LA | 70002 | 843084552 | HEALTHCARE | LA | 0 | 0 |
| OLOL PONTCHARTRAIN SURGERY CENTER LLC | ||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 461379031 | HEALTHCARE | LA | 0 | 0 |
| LAKE SURGICAL HOSPITAL (SLIDELL) LLC | ||||||||
| 1700 LINDBERG DR | SLIDELL | LA | 70458 | 474228147 | HEALTHCARE | LA | 0 | 0 |
| PREMIER HEALTH HOLDINGS LLC | ||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 472665226 | HEALTHCARE | LA | 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | 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 | FMOL | 0 | ||||||
| FRANCISICAN HEALTH & WELLNESS SERVICES I | ||||||||||||
| HEALTHCARE | FMOL | 0 | 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 455492379 | LA | ||||
| FMOL HEALTH SYSTEM HOLDINGS INC | ||||||||||||
| INVESTMENT | FMOL | 0 | 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 454405024 | LA | ||||
| ST DOMINIC MADISON HEALTH SERVICES INC | ||||||||||||
| HEALTHCARE | SDHS | 0 | 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 202870254 | MS | ||||
| FIRST INTERMED CORPORATION | ||||||||||||
| MEDICAL SERVICES | SDHS | 0 | 308 CORPORATE DRIVE | RIDGELAND | MS | 39157 | 640824796 | MS | ||||
| ST DOMINIC INTEGRATED SERVICES INC | ||||||||||||
| INVESTMENTS | SDJMH | 0 | 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 271493623 | MS | ||||
| LAFAYETTE SURGICARE INC | ||||||||||||
| HEALTHCARE | LOURDES | 0 | C/O C T CORPORATION SYSTEM 3867 PLA | BATON ROUGE | LA | 70816 | 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 | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |