2022-05-13T17:25:55-05:00 2021-06-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2020-07-01 721495500 OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL OURL 2257657709 4200 ESSEN LANE BATON ROUGE LA 70809 LOWELL STANTON REGIONAL CFO 2257657709 2022-05-13 1 LOWELL STANTON 999009999 MAXWELL BARLOW P01959439 2253444000 2022-05-10 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z KEVIN GUIDRY 4200 ESSEN LANE BATON ROUGE LA 70809 10500345 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. 8 4 62 4 0 0 458276 1509044 6909939 7013132 184455 716902 28417 25986 7581087 9265064 0 814 0 0 2943066 3159757 0 0 0 4105502 4061117 7048568 7221688 532519 2043376 20367089 20816779 8559788 5429389 11807301 15387390 X SEE SCHEDULE O. 0 0 5997884 814 7039118 OUR LADY OF THE LAKE ASSUMPTION PROVIDES TWENTY-FOUR HOUR HEALTHCARE SERVICES FOR PATIENTS IN THE SURROUNDING RURAL COMMUNITIES. THE HOSPITAL HAD 4,515 EMERGENCY ROOM VISITS THIS YEAR. THE HOSPITAL'S EMERGENCY ROOM IS OPEN TO EVERYONE, REGARDLESS OF ABILITY TO PAY.THE HOSPITAL ALSO PROVIDED 14,028 LAB TESTS AND 14 INPATIENT DAYS DURING THE YEAR. 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 MEMBERS OF ITS COMMUNITIES. 5997884 1 0 0 0 0 0 0 0 0 0 1 1 0 0 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 1 62 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 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 WENDY GAUDET INTERIM CEO 2.00 40.00 X X 0 179098 22231 STEPHANIE G MANSON BOARD MEMBER 2.00 40.00 X 0 502460 87112 LOWELL E STANTON REGIONAL CFO 2.00 52.50 X X 0 561274 24388 KENNETH WESTER BOARD MEMBER 2.00 53.50 X 0 1046740 258135 WILLIAM E BALHOFF CHAIR 2.00 2.00 X X 0 0 0 CHARLES P BOLOTTE MD BOARD MEMBER 10.00 0.00 X 0 0 0 YOLANDA DIXON SECRETARY 2.00 2.00 X X 0 0 0 HARRY J PHILIPS JR VICE CHAIR 2.00 2.00 X X 0 0 0 KEVIN GUIDRY CEO 2.00 40.00 X 0 266142 93611 DONNA M MULLINGS DIR. NURSING 40.00 0.00 X 110580 0 50191 BRIAN F TRIPODE SUPV PHARMACY 40.00 0.00 X 179655 0 22549 CHRISTINA HOCKADAY FORMER CEO 0.00 0.00 X 0 118314 6375 JEFF LIMBOCKER FORMER CFO 0.00 60.50 X 0 971153 196661 290235 3645181 761253 2 1 1 0 FMOL HEALTH SYSTEM 4200 ESSEN LANE BATON ROUGE LA 70809 LAB MANAGEMENT FEES 1538421 CORRECT CARE INC 17438 HARD HAT DRIVE COVINGTON LA 70435 MEDICAL SERVICES 1340718 GIFTED NURSES 2748 METAIRIE LAWN DRIVE STE B METAIRIE LA 70002 LABOR SERVICES 157654 3 1509044 1509044 PATIENT SERVICE REVENUE 622110 6997431 6997431 MISCELLANEOUS 900099 11681 11681 OUTREACH LAB 621500 3663 3663 MEDICAL RECORDS 561110 357 357 7013132 60068 60068 25986 0 25986 25986 25986 1437921 454194 1189855 45426 248066 408768 656834 656834 9265064 7039118 0 716902 814 814 2533806 2292886 240920 149520 134618 14902 303989 273706 30283 172442 155256 17186 1515486 1360819 154667 55 55 15798 15798 311369 42433 268936 62431 46847 15584 404348 296763 107585 11600 8704 2896 184445 184445 8754 6569 2185 7060 5298 1762 257971 257971 39916 5354 34562 MEDICAL SUPPLIES EXPENS 1157009 862156 294853 EQUIPMENT & MAINTENANCE 84875 63245 21630 7221688 5997884 1223804 0 12847104 10623907 0 0 0 0 626386 1286643 0 0 0 0 0 0 0 0 16363 22315 4437363 3308699 945743 1128664 0 0 5931493 7755250 0 0 0 0 0 0 20367089 20816779 3768667 3466787 0 0 3164032 450981 0 0 0 0 0 0 0 0 0 0 1627089 1511621 8559788 5429389 X 11807301 15287390 0 100000 11807301 15387390 20367089 20816779 2043376 1536713 0 X 0 1 X 1 1 1 X 55461 55461 861569 707070 154499 82115 52212 29903 3438218 2549417 888801 1128664 INVESTMENT IN CAP RESERVE 7755250 F 7755250 DUE TO/FROM RELATED ENTITIES 1511621 1511621 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 1 1 464444 464444 0.06430 2655065 2655065 3119509 2655065 464444 0.06430 2797 2797 0.00040 2797 2797 0.00040 3122306 2655065 467241 0.06470 1 36376 1413713 1366302 47411 X 1 1 1 1 ASSUMPTION COMMUNITY HOSPITAL 135 HIGHWAY 402 NAPOLEONVILLE LA 70390 X X X X RURAL HEALTH CLINIC ASSUMPTION COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V SECTION B X X 1 18 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: THE HOSPITAL HELD A FOCUS GROUP DISCUSSION WITH VARIOUS COMMUNITY GROUPS IN ORDER TO DISCUSS AND VALIDATE STATISTICAL DATA OBTAINED FROM THE HEALTH COMMUNITIES INSTITUTE. THE FOCUS GROUP WAS ABLE TO HELP IDENTIFY THE COMMUNITY'S CHALLENGES AND THE ISSUES WITH THE GREATEST POTENTIAL FOR SUCCESS. IT MET WITH REPRESENTATIVES FROM ASSUMPTION PARISH COUNCIL ON AGING, ASSUMPTION PARISH LIBRARY, ASSUMPTION PARISH SCHOOLS, ASSUMPTION PARISH HEAD START, ACADIAN AMBULANCE SERVICE, LSU AG CENTER, ASSUMPTION HEALTHCARE AND REHAB, ASSUMPTION ASSOCIATION FOR RETARDED CITIZENS, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, ASSUMPTION PRIMARY CARE, ASSUMPTION PARISH SHERIFF'S OFFICE, ASSUMPTION POLICE JURY, AND REGION III OFFICE OF EMERGENCY PREPAREDNESS. ONE PARTICIPANT WITH SPECIALIZED KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH WAS DEBRA GONZALES, DHH/OFFICE OF PUBLIC HEALTH FOR REGION III. ASSUMPTION COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA CAN BE FOUND ATHTTPS://OLOLRMC.COM/PAGES/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX ASSUMPTION COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: ASSUMPTION COMMUNITY HOSPITAL (ACH), A CRITICAL ACCESS HOSPITAL, AN AFFILIATE OF OUR LADY OF THE LAKE HOSPITAL AND A MEMBER OF THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, CONDUCTED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT IN 2018. THE SIGNIFICANT HEALTH NEEDS IDENTIFIED DURING THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT WERE: MENTAL HEALTH SERVICES, OBESITY, DIABETES, AND ACCESS TO CANCER SCREENING. THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2015 WERE ACCESS TO PRIMARY CARE, CHILDHOOD OBESITY, DIABETES, AND HEALTH EDUCATION FOR SENIORS.DURING THE 2020-2021 FISCAL YEAR, ACH SERVED OVER 2,800 PARISHIONERS.HEALTH FAIRS WERE CANCELLED FOR THIS YEAR DUE TO THE COVID-19 PANDEMIC AND CONCERNS FOR THE COMMUNITY'S SAFETY. ACH PARTNERSHIPS ARE STILL STRONG WITH ASSUMPTION'S COUNCIL OF AGING, ASSUMPTION HEAD START PROGRAM, AND THE ASSUMPTION ASSOCIATION FOR RETARDED CITIZENS, INC. THE ACH STAFF AND ALL THE AGENCIES ACH HAS WORKED WITH IN THE PAST ARE LOOKING FORWARD TO WORKING TOGETHER SOON TO CONTINUE THE PARISH'S HEALTH FAIRS.ACH'S COLLABORATION WITH THE ASSUMPTION PARISH LSU AG CENTER HAS CHANGED DUE TO A RETIREMENT IN THE AGENCY'S MANAGEMENT. MONTHLY ZOOM MEETINGS BEGAN WITH SEVERAL DIFFERENT AGENCIES WITHIN THE PARISH. TOPICS THAT WERE DISCUSSED INCLUDED CLEANING UP PARKS, STARTING FARMER'S MARKETS, ADDING SIDEWALKS TO CERTAIN AREAS OF THE PARISH, AND IMPROVING PARISH PARKS. ALL PLANS CENTERED ON GIVING RESIDENTS A PLACE TO EXERCISE AND CHOICES FOR HEALTHIER LIFESTYLES. ACH PLANS TO CONTINUE THE GET-FIT-BAYOU PROGRAM WHEN PUBLIC GROUPS ARE ALLOWED BACK IN SCHOOLS.ACH WALKING PATH USAGE DOUBLED, PARTIALLY DUE TO COVID-19. ACH WAS ABLE TO PROVIDE A SAFE PLACE FOR PEOPLE TO GET EXERCISE AND IMPROVE THEIR MENTAL HEALTH DURING THE SOCIAL DISTANCING OF THE COVID-19 PANDEMIC. MARY BIRD PERKINS AND THE WOMAN'S HOSPITAL MOBILE UNIT PARTNERED WITH ACH TO PROVIDE BREAST EXAMS AND SKIN AND PROSTATE CANCER SCREENINGS BETWEEN 8 AND 10 TIMES A YEAR, COMPLETING APPROXIMATELY 160 EXAMS. THE NUMBER OF THE WOMAN'S MOBILE VISITS CONTINUE TO INCREASE SIGNIFICANTLY EACH YEAR. ACH FOLLOWED THE LEAD OF FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM AND IMPLEMENTED ALL RECOMMENDATIONS AND REQUIREMENTS OF THE CDC WITH REGARD TO COVID-19 SAFETY. AT BOTH ACH PUBLIC ENTRANCES, FRONT LOBBY, AND ER ENTRANCE, STAFF AND SECURITY GUARDS SCREENED ER PATIENTS, OUTPATIENTS AND VISITORS FOR COVID-19 SYMPTOMS. IN JANUARY 2021, COVID-19 VACCINE DEMANDS BEGAN. AN INFLUX OF PHONE CALLS FLOODED THE HOSPITAL AND CLINIC PHONE LINES. STAFF MEMBERS FROM BOTH FACILITIES HANDLED ALL THE QUESTIONS, PLACING PEOPLE ON CALLBACK WAITING LISTS TO SCHEDULE THEIR VACCINE APPOINTMENTS. THE CLINIC SCHEDULED A DAY TO GIVE 100 VACCINES TO HANDLE THE DEMAND. HOSPITAL STAFF WAS STAGED AT THE CLINIC TO ASSIST. TWICE A WEEK THE CLINIC CLEARED THE AFTERNOON SCHEDULES TO HANDLE THE VACCINE DEMAND. ACH WILL CONTINUE TO WORK WITH ITS COMMUNITY PARTNERS TO DEVELOP PROGRAMS THAT ADDRESS THE NEEDS OF THE PEOPLE OF ASSUMPTION PARISH, ESPECIALLY ITS VULNERABLE POPULATIONS, WITH THE GOAL OF BEING A PRIMARY ENTRY POINT FOR HEALTHCARE IN THE AREA. BECAUSE THE PANDEMIC TOOK PLACE DURING A SIGNIFICANT PART OF THE 2018 CHNA MEASUREMENT PERIOD, SOME OF THE INITIAL IMPLEMENTATION STRATEGY TARGETS WERE NOT ACHIEVED. HOWEVER, THERE WAS SIGNIFICANT WORK WITH THE COMMUNITY REGARDING COVID-19 AND MEETING THE NEEDS OF PEOPLE IN CRISIS. ACH ADMINISTERED MORE THAN 2,200 FIRST AND SECOND COVID-19 VACCINE DOSES TO COMMUNITY MEMBERS THROUGH THE ASSUMPTION PRIMARY CARE CLINIC AND PARTNERED WITH ASSUMPTION PARISH SCHOOLS, THIBODAUX REGIONAL FAMILY PRACTICE, AND THE ASSUMPTION PARISH OFFICE OF EMERGENCY PREPAREDNESS TO PROVIDE AND ADMINISTER MORE THAN 600 VACCINES TO THE FACULTY OF THE ASSUMPTION PARISH SCHOOL BOARD. THE INITIAL BEHAVIORAL HEALTH PROGRAM THAT WAS IMPLEMENTED DURING THE CHNA MEASUREMENT PERIOD DID NOT CONTINUE DUE TO PROVIDER CONSTRAINTS. A NEW PROGRAM WITH TWO PROVIDERS AND A LICENSED COUNSELOR WHO SEE PATIENTS IN PERSON AND THROUGH VIRTUAL VISITS HAS SINCE BEEN ESTABLISHED AT THE ASSUMPTION PRIMARY CLINIC. THE BEHAVIORAL HEALTH PROVIDER ALSO PROVIDES CONSULTATIONS WHEN ACH EMERGENCY DEPARTMENT HAS PHYSICIAN'S EMERGENCY CERTIFICATE (PEC) PATIENTS. DAILY, ACH COMMUNICATED AND WORKED WITH ASSUMPTION PARISH, REGION III, AND STATE EMERGENCY PREPAREDNESS AGENCIES. IN 2021, THERE WERE A RECORD NUMBER OF HURRICANES THAT THREATENED OUR AREA. WHEN THE HURRICANES THREATENED OUR AREA, ACH STAFF REMAINED ON CAMPUS EVEN THOUGH THE CODE GRAY WAS NOT CALLED BY FMOLHS. IN FEBRUARY, A MAJOR WINTER STORM CLOSED DOWN MOST OF THE STATE. ACH STAFF WORKED WITH LOCAL LEPC AND FMOLHS DURING THIS CODE GRAY EVENT.THE STATE'S EFS-8 PORTAL HAS BEEN USED TO SUBMIT THE HOSPITAL'S PREVIOUS DAY'S TOTALS. TOTALS SUCH AS COVID-19 NUMBERS, NUMBER OF ER PATIENTS, STAFFING OUTAGES, TOTAL OF PPE SUPPLIES, ETC. ARE REPORTED DAILY. 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 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. THE HOSPITAL DOES NOT HAVE A FORMAL COMMUNITY BENEFIT REPORT BUT IS CONSOLIDATED WITH THE SOLE MEMBER, OUR LADY OF THE LAKE HOSPITAL, INC.PART I, LINE 7, COLUMN FFOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE.PART I, LINE 7THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-D AND IS BASED ON THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION. FOR PART I LINES 7E, 7F, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. FOR PART I LINE 7G, COST FIGURES WERE CALCULATED FROM DEPARTMENTAL COSTS LESS DIRECT OFFSETTING REVENUE. 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 17 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 THE HOSPITAL WORKED WITH THE ASSUMPTION RURAL HEALTH CLINIC COMMUNITY, THE ASSUMPTION COUNCIL ON AGING, THE ASSUMPTION PARISH SCHOOL NURSES, DEPARTMENT OF HEALTH AND HOSPITALS/OFFICE OF PUBLIC HEALTH, AND OTHER COMMUNITY AND BUSINESS LEADERS TO IDENTIFY THE COMMUNITY'S HEALTH CARE NEEDS. THE IDENTIFIED NEEDS WILL CONTINUE TO BE ADDRESSED THROUGH CONTINUED DIALOGUE AND COLLABORATION WITH SPECIFIC GROUPS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. IN ADDITION TO WORKING WITH SPECIFIC GROUPS TO ADDRESS THE COMMUNITY'S HEALTH CARE NEEDS, THE HOSPITAL AND THE RURAL HEALTH CARE CLINIC PROVIDE VARIOUS OUTREACH PROGRAMS SUCH AS AN ANNUAL HEALTH FAIR, PERIODIC SMOKING CESSATION CLASSES, AND PERIODIC DIABETES EDUCATION PROGRAMS. 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 4COMMUNITY INFORMATION ASSUMPTION PARISH IS A VERY RURAL AREA WITH ONLY ONE INCORPORATED COMMUNITY OF APPROXIMATELY 700 RESIDENTS KNOWN AS THE VILLAGE OF NAPOLEONVILLE. ASSUMPTION PARISH IS A COMMUNITY HEAVILY DEPENDENT ON AGRICULTURE (PRIMARILY SUGAR CANE PRODUCTION) AND HAS ONLY A FEW LARGE EMPLOYERS SUCH AS THE ASSUMPTION PARISH SCHOOL SYSTEM AND A LOCAL MARINE SHIPYARD. BASED ON THE MOST RECENT CHNA, THE MEDIAN HOUSEHOLD INCOME FOR THE PARISH FOR 2018 WAS $45,457. OTHER SMALL COMMUNITIES LOCATED IN THE PARISH INCLUDE, LABADIEVILLE, PAINCOURTVILLE, PLATTENVILLE, BERTRANDVILLE, BELLE ROSE, PIERRE PART AND BAYOU L'OURSE. 13.93% OF FAMILIES LIVE BELOW THE POVERTY LINE. 29% OF THE ASSUMPTION PARISH POPULATION DID NOT GRADUATE HIGH SCHOOL. THE MAJORITY OF ASSUMPTION PARISH SPEAKS ONLY ENGLISH, BUT 13% SPEAK INDO-EUROPEAN LANGUAGES.PART VI, LINE 5OTHER INFORMATIONTHE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS COMPRISED OF INDIVIDUALS WITH A BROAD CROSS-SECTION OF HEALTH CARE AND BUSINESS EXPERIENCE. OUR LADY OF THE LAKE ASSUMPTION HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF.PART VI, LINE 6AFFILIATED 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 HOSPITAL 0 1 0 0 0 0 0 0 0 KENNETH WESTER BOARD MEMBER 0 663937 0 210990 0 171813 0 228388 0 29747 0 1304875 0 124160 JEFF LIMBOCKER FORMER CFO 0 594289 0 299775 0 77089 0 170677 0 25984 0 1167814 0 54592 STEPHANIE G MANSON BOARD MEMBER 0 380045 0 120580 0 1835 0 61009 0 26103 0 589572 0 0 LOWELL E STANTON REGIONAL CFO 0 410291 0 136397 0 14586 0 0 0 24388 0 585662 0 0 KEVIN GUIDRY CEO 0 221437 0 44580 0 125 0 77955 0 15656 0 359753 0 0 BRIAN F TRIPODE SUPV PHARMACY 178530 0 1000 0 125 0 7406 0 15143 0 202204 0 0 0 WENDY GAUDET INTERIM CEO 0 168490 0 10483 0 125 0 7372 0 14859 0 201329 0 0 DONNA M MULLINGS DIR. NURSING 104450 0 6005 0 125 0 30180 0 20011 0 160771 0 0 0 CHRISTINA HOCKADAY FORMER CEO 0 116351 0 450 0 1513 0 0 0 6375 0 124689 0 0 PART I QUESTION 4A THE 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. A BOARD MEMBER IS 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 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. 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 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. TH ENTITLEMENT PERIOD IS 24 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. KENNETH SCOTT WESTER RECEIVED A PAYMENT OF $169,066 AND JEFFREY LIMBOCKER RECEIVED A PAYMENT OF $74,342 FROM THE PLANS IN THE CURRENT YEAR. FORM 990, PART III, LINE 1 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 WAS NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE JUNE 30, 2021. 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, 2021. 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, 2021. 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). 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