2022-08-15T14:48:18-05:00 2021-09-30 721202445 POSTLETHWAITE & NETTERVILLE 8550 UNITED PLAZA BLVD SUITE 1001 BATON ROUGE LA 70809 990 2020-10-01 720652905 WOMAN'S HOSPITAL FOUNDATION D/B/A WOMAN'S HEALTH FOUNDATION WOMA 2259248107 100 WOMANS WAY BATON ROUGE LA 70817 APRIL CHAISSON SENIOR VP/CFO 2259248107 2022-08-11 1 APRIL CHAISSON 999009999 MEGAN COURTNEY P01571790 2259224600 2022-08-10 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z BARBARA GRIFFITH 100 WOMANS WAY BATON ROUGE LA 70817 924134015 0 X WWW.WOMANS.ORG X 1968 LA TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. 11 8 2436 100 14820658 1058007 1549619 2005762 546046861 625896555 1763115 85940373 8780634 31210622 558140229 745053312 32350 821820 0 0 162606139 179543191 0 0 0 385587617 452755170 548226106 633120181 9914123 111933131 880343770 955522065 337775909 327805163 542567861 627716902 TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. 0 0 519815928 821820 625069030 THE MISSION OF WOMAN'S HOSPITAL IS TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. WE RESPOND TO THE SPECIFIC NEEDS OF THE COMMUNITY AND SURROUNDING AREA'S NEEDS BY PROVIDING QUALITY MEDICAL AND EDUCATIONAL SERVICES WITHOUT DISTINCTION AS TO THE MEANS OF THE PERSON, HIS/HER RACE, OR DOMICILE. WOMAN'S PROVIDES MANY IMPORTANT HEALTH CARE SERVICES THAT ARE NOT AVAILABLE BY ANY OTHER ENTITY IN OUR SERVICE AREA. (118,525 LIVES TOUCHED IN FY2021) 16904000 32950 WOMAN'S HOSPITAL EDUCATES THE COMMUNITY BY SPONSORING PROGRAMS AND EVENTS, AND DISTRIBUTES LITERATURE ON HEALTH TOPICS OF INTEREST TO WOMEN INCLUDING CHILDBIRTH, MENOPAUSE, HEART HEALTH, DRUG ABUSE, AGING, AND SEXUALITY (263 EDUCATION PROGRAMS WITH 1,292 ATTENDEES ). WE ALSO PROVIDE COMMUNITY SERVICE BY ABSORBING VARIOUS COSTS ESSENTIAL TO THE INDIGENT POPULATION, INCLUDING EMERGENCY AND PRENATAL CARE. 669138 794575 WOMAN'S HOSPITAL RESEARCH CENTER CONCENTRATES ITS SCIENTIFIC RESEARCH ON THE UNIQUE HEALTH CONDITIONS OF VITAL IMPORTANCE TO WOMEN'S HEALTH. ONGOING RESEARCH INCLUDES STUDIES ON MENOPAUSE, HORMONES, OSTEOPOROSIS, BREAST CANCER, MATERNAL-FETAL MEDICINE, NEONATAL MEDICINE, AND GENETICS (17 NEW PROTOCOLS REVIEWED AND APPROXIMATELY 29 ACTIVE STUDIES). 537389066 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 386 0 1 2436 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X APRIL F CHAISSON 2259248107 100 WOMANS WAY BATON ROUGE LA 70817 BEN MARMANDE 2021 CHAIR 4.00 X X 0 0 0 CHEREE SCHWARTZENBURG MD DIRECTOR 4.00 X 0 0 0 CHRIS CIESIELSKI DIRECTOR 4.00 X 0 0 0 CHRISTEL SLAUGHTER PHD DIRECTOR 4.00 X 0 0 0 DONNA FRAICHE DIRECTOR 4.00 X 0 0 0 GREG GELPI MD DIRECTOR 4.00 X 0 0 0 JANET OLSON DIRECTOR 4.00 X 0 0 0 KIRK FISHER DIRECTOR 4.00 X 0 0 0 MICHAEL PERNICIARO MD DIRECTOR 4.00 X 0 0 0 NICK SPEYRER DIRECTOR 4.00 X 0 0 0 ROSE HUDSON SECRETARY/TREASURER 4.00 X X 0 0 0 STEVEN FEIGLEY MD 2020 CHAIR 4.00 X X 0 0 0 TERRIE THOMAS MD CHAIR ELECT 4.00 X X 0 0 0 TOM HAWKINS JR DIRECTOR 4.00 X 0 0 0 WHITNEY BREAUX DIRECTOR 4.00 X 0 0 0 BARBARA GRIFFITH MD PRESIDENT/CEO 65.00 X 845715 0 130244 APRIL CHAISSON VP, FINANCE 65.00 X 215565 0 81121 CHERI JOHNSON SR VP/CNO 65.00 X 288776 0 60991 DONNA BODIN VP, EMPLOYEE/WELLNESS SERV 65.00 X 310255 0 26105 ED HALPHEN VP, HUMAN RESOURCES 65.00 X 171971 0 0 KURT SCOTT SR VP/COO 65.00 X 302506 0 100015 MARY MAHER- GRIFFITHS VP, QUALITY 65.00 X 187096 0 63357 PATRICK SEITER IN-HOUSE GENERAL COUNSEL 4.00 X 225978 0 72341 PAUL KIRK VP, INFORMATION SYSTEMS/CI 65.00 X 314239 0 67173 ROBERT MOORE MD CHIEF MEDICAL OFFICER 65.00 X 594086 0 55508 STEPHANIE ANDERSON EXECUTIVE VP/CAO 65.00 X 654351 0 127813 WILLIAM D BINDER MD CHIEF MEDICAL OFFICER (1/6 65.00 X 194430 0 13102 ANTHONY C EVANS JR MD PHYSICIAN 40.00 X 653516 0 78242 EDWARD W VEILLON MD PHYSICIAN 40.00 X 496331 0 88163 LAUREL KING MD PHYSICIAN 40.00 X 487419 0 59392 MARSHALL ST AMANT MD PHYSICIAN 40.00 X 608940 0 100788 PAMELA SIMMONS MD PHYSICIAN 40.00 X 492315 0 68396 STANLEY SHELTON SR VP/CHIEF STRATEGIC SERVICES 0.00 X 138053 0 0 7181542 0 1192751 127 1 1 0 TRANSFORMYX LLC 6867 BLUEBONNET BLVD BATON ROUGE LA 70810 IT SERVICES 1836289 WHELAN SECURITY CO 1699 SOUTH HANLEY ROD SUITE 350 ST LOUIS MO 63144 SECURITY 1456643 HEALTH SYSTEMS IMPROVEMENT LLC 500 RUE DE LA VIE SUITE 474 BATON ROUGE LA 70817 MANAGEMENT SERVICES 734500 THE CHARTIS GROUP LLC DEPARTMENT 5925 CAROL STREAM IL 60122 CONSULTING SERVICES 720000 LANGUAGE LINE SERVICES PO BOX 202564 DALLAS TX 75320 LANGUAGE INTERPRETATION 687146 35 1230618 775144 2005762 HOSPITAL SERVICES 541900 616159885 609875900 6283985 PHARMACY OUTSIDE SALES 446110 5820448 5820448 CAFETERIA 722210 1978994 1978994 FITNESS CENTER 713940 1934541 652235 1282306 PATIENT EDUCATION 611710 2687 2687 625896555 3437849 -5207 3443056 3566576 3482853 83723 83723 77898 5825 255531709 2225757 174244409 1010533 81287300 1215224 82502524 82502524 661217 342908 318309 318309 OTHER OPERATING REVENUE 900099 13148616 11787388 1361228 CARES ACT PROVIDER RELIEF FUND 900099 10370345 10370345 UPL EXCESS OF UPL PAYMENT 900099 7289629 7289629 30808590 745053312 641957178 14820658 86269714 821820 821820 4561947 3583078 978869 136659993 107336487 29323506 28889873 22690895 6198978 9431378 7285159 2146219 414636 301093 113543 77209 56066 21143 59794 43420 16374 1272896 549874 723022 2306990 1143957 1163033 1438871 1419324 19547 176626 105125 71501 11146409 11146409 19100699 6880835 12219864 OTHER EXPENSES 176096211 167520825 8575386 CONTRACTUAL ADJUSTMENTS 137368715 137368715 PATIENT RELATED SUPPLIE 39528029 39528029 PURCHASED SERVICES 35216061 25572560 9643501 28552024 15181804 13370220 633120181 537389066 95731115 0 136172880 155128087 27492032 41774045 46450735 5692977 6508131 541877475 183153946 372629097 358723529 2138679 4309633 6444222 6444222 287999838 377957728 880343770 955522065 31510609 39197291 199800 199800 295674343 288387346 10391157 20726 337775909 327805163 X 538724205 623074491 3843656 4642411 542567861 627716902 880343770 955522065 X 111933131 -26799693 15603 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 0 1 0 1 59794 59794 0 PART II-B, LINE 1: ALL OF THE FOLLOWING AMOUNTS RELATE TO THE LOBBYING EXPENSE PORTION OF THE PAYMENT: 1. $37,500 FOR CONSULTING FEES TO SOUTHERN STRATEGY GROUP OF LOUISIANA LLC. 2. $7,405 FOR MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION. 3. $2,400 FOR MEMBERSHIP DUES TO THE BATON ROUGE AREA CHAMBER. 4. $12,489 FOR MEMBERSHIP DUES TO THE LOUISIANA HOSPITAL ASSOCIATION. 16000 X 0 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1.00000 0 0 13463306 13463306 411411739 99497429 311914310 112418828 83656517 28762311 4583602 4583602 358723529 OTHER RECEIVABLES 28575086 BONDS HELD BY TRUSTEE 10406232 DEFERRED FINANCING CHARGES 1220643 RESTRCITED DONATIONS - OTHERS 12754020 RESTRICTED DONATIONS - CAP ONE CD 773974 DEPRECIATION RESERVE 344680449 OTHER ASSETS 699003 ESTIMATED THIRD PARTY SETTELMENTS 491181 UNAMORTIZED BOND DISCOUNT -21642860 377957728 OTHER LIABILITIES 20726 20726 X PART III, LINE 4: PERMANENT INSTALLMENT OF 32 GICLEES OF WORLD RENOWNED FOLK ART DONATED IN A PRIOR YEAR AS PART OF THE HEALING ARTS PROGRAM. THE ARTWORK IS DISPLAYED IN A PROMINENT AREA OF THE HOSPITAL, FOR ALL PATIENTS AND VISITORS TO ENJOY. PART V, LINE 4: THE FOUNDATION HOLDS AN ENDOWMENT FUND IN THE AMOUNT OF $1,250,000 FROM THE HELEN BARNES TRUST. THIS AMOUNT IS PERMANENTLY RESTRICTED BUT THE ANNUAL EARNINGS FROM THIS ENDOWMENT MAYBE USED BY THE FOUNDATION. THE INCOME IS REPORTED ON THE CORE FORM 990, BUT THE BALANCE ON THIS ENDOWMENT DOES NOT CHANGE FROM YEAR TO YEAR SINCE ONLY THE $1,250,000 IS RESTRICTED. PART X, LINE 2: THE HOSPITAL APPLIES THE ACCOUNTING GUIDANCE RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH SETS OUT A CONSISTENT FRAMEWORK TO DETERMINE THE APPROPRIATE LEVEL OF TAX RESERVES TO MAINTAIN FOR UNCERTAIN TAX POSITIONS. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE RECORDED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN THE RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE HOSPITAL HAS EVALUATED ITS POSITION REGARDING THE ACCOUNTING FOR UNCERTAIN INCOME TAX POSITIONS AND DOES NOT BELIEVE THAT IT HAS ANY MATERIAL UNCERTAIN TAX POSITIONS. 1 1 X 1 X 1 X 1 1 0 1 1 3606920 3606920 0.00570 39872046 39872046 0.06300 10442803 10442803 0.01650 53921769 53921769 0.08520 601358 601358 0.00090 0 12571493 12571493 0.01990 103519 103519 0.00020 123867 123867 0.00020 13400237 13400237 0.02120 67322006 67322006 0.10640 1 7620334 33629 5703966 6561290 -857324 X 1 1 1 WOMAN'S RETAIL VENTURES LLC HOSPITAL GIFT SHOP 0.74750 0.02020 0.23230 2 STUMBERG LAND LLC LAND MANAGEMENT 0.64400 0.00000 0.35600 1 1 WOMAN'S HOSPITAL 100 WOMANS WAY BATON ROUGE LA 70817 WWW.WOMANS.ORG X WOMAN'S HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X HTTP://WWW.HEALTHYBR.COM/ 1 20 1 HTTP://WWW.HEALTHYBR.COM/ 0 1 X 200.000000000000 300.000000000000 1 1 X X X X 1 X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X X X X X X 1 X 0 X X X 1 X 0 0 WOMAN'S HOSPITAL PART V, SECTION B, LINE 5: WOMAN'S DEVELOPED ITS COMMUNITY HEALTH ASSESSMENT IN COLLABORATION WITH OTHER AREA PROVIDERS AND THE MAYOR-PRESIDENT'S HEALTHY CITY INITIATIVE (MHCI). THE TEAM OF HEALTH CARE LEADERS DEVELOPED A LIST OF BATON ROUGE'S 10 HEALTH PRIORITIES, WHICH WAS REVIEWED AND APPROVED BY ALL MHCI PARTNERS WOMAN'S HOSPITAL PART V, SECTION B, LINE 6A: REPRESENTATIVES FROM WOMAN'S HOSPITAL, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, BATON ROUGE GENERAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, SURGICAL SPECIALTY CENTER OF BATON ROUGE, AND OCHSNER MEDICAL CENTER OF BATON ROUGE MET TO DISCUSS AN ASSESSMENT OF COMMUNITY HEALTH. WOMAN'S HOSPITAL PART V, SECTION B, LINE 6B: PENNINGTON BIOMEDICAL RESEARCH CENTER, THE BATON ROUGE CLINIC, BLUE CROSS BLUE SHIELD OF LOUISIANA, LOUISIANA DEPARTMENT OF HEALTH, EAST BATON ROUGE PARISH SCHOOL SYSTEM, AMERICAN HEART ASSOCIATION, CAPITAL AREA REENTRY PROGRAM, THE BRIDGE CENTER FOR HOPE, GILEADFOCUS INITIATIVE, NIKKY SCOTT INC., IMPACT NURSE CONSULTING, LOUISIANA CHAPTER OF POSITIVE WOMEN'S NETWORK, AND COMMUNITY RESIDENTS. WOMAN'S HOSPITAL PART V, SECTION B, LINE 11: BEHAVIORAL HEALTH: THE GUIDING RECOVERY AND CREATING EMPOWERMENT (GRACE) PROGRAM AT WOMAN'S HOSPITAL IS A CARE COORDINATION PROGRAM FOR PREGNANT WOMEN WITH OPIOID, ALCOHOL OR TOBACCO USE ADDICTION THAT CONNECTS THEM TO RESOURCES IN THE COMMUNITY TO PROVIDE TREATMENT AND SUPPORT. IT IS THE ONLY PROGRAM OF ITS KIND IN LOUISIANA AND ONE OF FEW IN THE NATION. WOMEN ENROLLED IN THIS PROGRAM RECEIVE SUPPORT THROUGHOUT PREGNANCY AND FOR SIX WEEKS AFTER GIVING BIRTH. THIS MULTI-DISCIPLINARY CASE-MANAGEMENT IS DESIGNED TO IMPROVE OUTCOMES FOR MOTHER AND BABY AND LEAD TO ADDICTION RECOVERY. WOMAN'S ALSO ADDED DR. AMBER PARDEN, A BOARD-CERTIFIED PSYCHIATRIST WITH A PASSION FOR PERINATAL MENTAL HEALTH, TO ITS STAFF. SHE PROVIDES TREATMENT FOR PERIPARTUM AND POSTPARTUM ANXIETY AND DEPRESSION, FOCUSING ON MEDICATION MANAGEMENT AND PSYCHOTHERAPY TREATMENT PLANS, ALONG WITH INPATIENT AND OUTPATIENT CONSULTATIONS FOR MENTAL HEALTH SUPPORT, BARIATRIC SURGERY PATIENTS AND THOSE UNDERGOING CANCER TREATMENTS.CHRONIC DISEASE: TO HELP ADDRESS THE HIGH INCIDENCE OF DIABETES ON OUR COMMUNITY, WOMAN'S OPERATES A METABOLIC WEIGHT MANAGEMENT CLINIC AND RUNS ONE OF THE TWO ACCREDITED DIABETES PREVENTION PROGRAMS IN LOUISIANA. WOMAN'S HOSPITAL RESEARCH CENTER CONDUCTS CLINICAL STUDIES RELATED TO TREATING GESTATIONAL DIABETES, TYPE 2 DIABETES AND POLYCYSTIC OVARIAN SYNDROME. WOMAN'S IS ALSO ADDRESSING HYPERTENSION IN PREGNANCY THROUGH ASSIGNING CASE MANAGERS WHO CAN MONITOR A PATIENT'S BLOOD PRESSURE THROUGHOUT PREGNANCY, INCLUDING USING AT-HOME BLOOD PRESSURE CUFFS.HEALTH EQUITY AND RACIAL DISPARITIES: IN 2020, WOMAN'S HIRED A DE&I CONSULTANT AND LAUNCHED AN INCLUSIVE EXCELLENCE ACTION COMMITTEE (IEAC) TO PROMOTE DIVERSITY, EQUITY, INCLUSION AND BELONGING AT WOMAN'S HOSPITAL. THE COMMITTEE WORKS DIRECTLY WITH LEADERSHIP TO LISTEN, LEARN, LEAD, GUIDE AND SHEPHERD THE HOSPITAL'S COMMITMENT TOWARD INCLUSIVE EXCELLENCE AND DIVERSITY. THE HOSPITAL HAS ALSO INVESTED IN TRAINING FOR EMPLOYEES TO HELP ADDRESS UNCONSCIOUS BIAS AND TO IMPROVE INCLUSIVE PRACTICES THAT IMPROVE HEALTH OUTCOMES FOR ALL.HEALTHY LIVING/LIFESTYLE: THE WOMAN'S CENTER FOR WELLNESS, CURRENTLY THE AREA'S ONLY MEDICAL FITNESS FACILITY DESIGNATED BY THE MEDICAL FITNESS ASSOCIATION, OFFERS A VARIETY OF FITNESS CLASSES AND NUTRITION PROGRAMS AND RESOURCES FOR PATIENTS AND COMMUNITY MEMBERS. THE EMPLOYEE WELLNESS PROGRAM AT WOMAN'S OFFERS PREMIUM DISCOUNTS AND CASH INCENTIVES FOR EMPLOYEES WHO COMPLETE HEALTH AND WELLNESS CHALLENGES.MATERNAL AND INFANT HEALTH: RECENTLY NAMED ONE THE WORLD'S BEST HOSPITALS BY NEWSWEEK FOR GYNECOLOGY AND MATERNITY CARE, WOMAN'S HAS ALSO RECEIVED A BIRTH READY+ DESIGNATION FROM THE LOUISIANA DEPARTMENT OF HEALTH FOR ITS EFFORTS IN PROMOTING SAFE, EQUITABLE, AND DIGNIFIED BIRTH FOR ALL BIRTHING PERSONS IN LOUISIANA -- ONE OF ONLY EIGHT FACILITIES IN THE STATE TO EARN THIS DISTINCTION. THROUGH ITS WORK WITH THE LOUISIANA PERINATAL QUALITY COLLABORATIVE, WOMAN'S HAS ADOPTED SAFETY BUNDLES TO REDUCE THE RISKS OF HEMORRHAGE AND HYPERTENSION. THEY HAVE ALSO FORMED WORK GROUPS TO ADDRESS SEVERAL OF THE MAIN DRIVERS FOR PREMATURITY INCLUDING HYPERTENSION, DRUG USE, AND INCOMPETENT CERVIX AND IMPLEMENTED EVIDENCE-BASED STRATEGIES TO EFFECT CHANGE IN THESE AREAS. ADDITIONALLY, WOMAN'S HAS MATERNAL-FETAL MEDICINE SPECIALISTS TO CARE FOR HIGH-RISK PREGNANCIES AND OPERATES A LEVEL III-S NEONATAL INTENSIVE CARE UNIT, A DESIGNATION WHICH ALLOWS THEM TO CARE FOR INFANTS WHO ARE EXTREMELY PREMATURE, ARE CRITICALLY ILL OR REQUIRE SURGICAL INTERVENTION. PART V, SECTION B, LINE 4 WOMAN'S HOSPITAL FOUNDATION CONDUCTED ITS FOURTH COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN FISCAL YEAR 2021 TO COVER THE PERIOD 2021-2023 (TAX YEARS 2020-2022) PART I, LINE 3C: WOMAN'S OFFERS A 20% DISCOUNT TO ALL UNINSURED PATIENTS REGARDLESS OF INCOME. DISCOUNTS ARE NOT APPLIED TO COSMETIC PROCEDURES. IN ADDITION, WOMAN'S OFFERS SPECIAL PRICING PACKAGES FOR SPECIFIC SERVICES, I.E. DELIVERY AND BARIATRIC SURGERY, AS WELL AS MATCHING PHYSICIAN DISCOUNTS UP TO 50% REGARDLESS OF INCOME. PART III, LINE 3: THE HOSPITAL MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN ASSESSMENT OF COLLECTABILITY, CURRENT ECONOMIC CONDITIONS, AND PRIOR EXPERIENCE. THE HOSPITAL DETERMINES IF PATIENT ACCOUNTS RECEIVABLE ARE PAST-DUE BASED ON THE SERVICE/DISCHARGE DATE; HOWEVER, THE HOSPITAL DOES NOT CHARGE INTEREST ON PAST-DUE ACCOUNTS. THE HOSPITAL WRITES OFF PATIENT ACCOUNTS RECEIVABLE IF MANAGEMENT CONSIDERS THE COLLECTION OF THE OUTSTANDING BALANCES TO BE DOUBTFUL. THIS IS ONLY AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN FOLLOWED AS OUTLINED IN OUR COLLECTION POLICY. BAD DEBT EXPENSE OF $6,393,998 IS A COMBINATION OF ACTUAL ACCOUNTS WRITTEN OFF AND ADJUSTMENTS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BASED ON A REVIEW OF ALL ACCOUNTS IN WHICH WE WERE UNABLE TO FULLY DETERMINE ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (BECAUSE THE FINANCIAL ASSISTANCE APPLICATION WAS INCOMPLETE), WE IDENTIFIED $33,629 OF CHARGES THAT WERE WRITTEN OFF AS BAD DEBT (AFTER ALL REASONABLE COLLECTION EFFORTS WERE FOLLOWED AS OUTLINED IN OUR COLLECTION POLICY). PART III, LINE 8: 100% OF THE SHORTFALL IS TREATED AS COMMUNITY BENEFIT. THE METHOD USED TO DETERMINE THE MEDICARE ALLOWABLE COST OF CARE IS COST TO CHARGE RATIO. PART III, LINE 9B: REASONABLE EFFORTS ARE MADE TO DETERMINE A PATIENT'S ELIGIBILITY AND QUALIFY THEM FOR FINANCIAL ASSISTANCE PRIOR TO ANY ACTION BEING TAKEN TO COLLECT. PATIENTS ARE NOTIFIED OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND ARE REFERRED TO A FINANCIAL COUNSELOR TO DISCUSS THE POLICY IN DETAIL. FINANCIAL ASSISTANCE APPLICATIONS ARE DOCUMENTED AND TRACKED WHEN PROVIDED TO A PATIENT/GUARANTOR AND WHEN THE APPLICATION IS RETURNED (WHETHER COMPLETE OR INCOMPLETE). ALL COMMUNICATION WITH THE PATIENT/GUARANTOR IS DOCUMENTED WHILE THE APPLICATION IS INCOMPLETE. THE APPLICATION IS NOTATED AS APPROVED OR DENIED ALONG WITH NOTIFICATION OF APPROVAL OR DENIAL TO THE PATIENT/GUARDIAN. IF ELIGIBILITY FOR FINANCIAL ASSISTANCE IS NOT ABLE TO BE FULLY DETERMINED, ALL REASONABLE COLLECTION EFFORTS ARE FOLLOWED AS OUTLINED IN THE HOSPITAL'S COLLECTION POLICY. 0 MARCH OF DIMES FOUNDATION (LOUISIANA CHAPTER) 12015 JUSTICE AVE BATON ROUGE LA 70816 131846366 501(C)(3) 10000 CASH GRANT SIGNATURE CHEF AUCTION SPONSORSHIP BATON ROUGE AREA CHAMBER 564 LAUREL STREET BATON ROUGE LA 70801 720126959 501(C)(3) 20000 CASH GRANT BRAC 2020 "THINK BIGGER" REGIONAL STRATEGIC PLAN BATON ROUGE HEALTH DISTRICT 6400 PERKINS ROAD BATON ROUGE LA 70808 472593574 501(C)(3) 75000 CASH GRANT ANNUAL CONTRIBUTION AMERICAN HEART ASSOCIATION PO BOX 4002900 DES MOINES IA 50340 135613797 501(C)(3) 10000 CASH GRANT ANNUAL PLEDGE ANNA'S GRACE FOUNDATION 11770 S HARRELLS FERRY ROAD SUITE C C BATON ROUGE LA 70816 463434365 501(C)(3) 5000 CASH GRANT 2021 IMPACT SCHOLARSHIP FOUNDATION FOR WOMANS 100 WOMANS WAY BATON ROUGE LA 70817 471970335 501(C)(3) 701820 CASH GRANT OFFSET OPERATING EXPENSES 6 0 PART I, LINE 2: GRANTS ARE GIVEN TO ORGANIZATIONS FOR SPECIFIC PURPOSES AND ARE NOT MONITORED FURTHER. X X 1 1 X X X X X 1 1 0 0 0 1 0 0 0 BARBARA GRIFFITH MD PRESIDENT/CEO 540457 0 269873 0 35385 0 71070 0 59174 0 975959 0 0 0 STEPHANIE ANDERSON EXECUTIVE VP/CAO 348613 0 283295 0 22443 0 67679 0 60134 0 782164 0 0 0 ANTHONY C EVANS JR MD PHYSICIAN 573861 0 750 0 78905 0 769 0 77473 0 731758 0 0 0 MARSHALL ST AMANT MD PHYSICIAN 556706 0 750 0 51484 0 27290 0 73498 0 709728 0 0 0 ROBERT MOORE MD CHIEF MEDICAL OFFICER 506392 0 750 0 86944 0 1950 0 53558 0 649594 0 0 0 EDWARD W VEILLON MD PHYSICIAN 460626 0 750 0 34955 0 17138 0 71025 0 584494 0 0 0 PAMELA SIMMONS MD PHYSICIAN 452811 0 750 0 38754 0 388 0 68008 0 560711 0 0 0 LAUREL KING MD PHYSICIAN 455715 0 635 0 31069 0 0 0 59392 0 546811 0 0 0 KURT SCOTT SR VP/COO 215870 0 79138 0 7498 0 30912 0 69103 0 402521 0 0 0 PAUL KIRK VP, INFORMATION SYSTEMS/CI 236125 0 69368 0 8746 0 39719 0 27454 0 381412 0 0 0 CHERI JOHNSON SR VP/CNO 210609 0 77001 0 1166 0 33681 0 27310 0 349767 0 0 0 DONNA BODIN VP, EMPLOYEE/WELLNESS SERV 61027 0 42000 0 207228 0 13357 0 12748 0 336360 0 0 0 PATRICK SEITER IN-HOUSE GENERAL COUNSEL 222575 0 0 0 3403 0 43430 0 28911 0 298319 0 0 0 APRIL CHAISSON VP, FINANCE 163135 0 51498 0 932 0 31575 0 49546 0 296686 0 0 0 MARY MAHER- GRIFFITHS VP, QUALITY 138868 0 45971 0 2257 0 15773 0 47584 0 250453 0 0 0 WILLIAM D BINDER MD CHIEF MEDICAL OFFICER (1/6 169330 0 649 0 24451 0 0 0 13102 0 207532 0 0 0 ED HALPHEN VP, HUMAN RESOURCES 0 0 0 0 171971 0 0 0 0 0 171971 0 0 0 STANLEY SHELTON SR VP/CHIEF STRATEGIC SERVICES 0 0 0 0 138053 0 0 0 0 0 138053 0 0 0 PART I, LINE 1A DR. GRIFFITH'S REIMBURSEMENTS FOR MOVING EXPENSES WERE GROSSED UP TO $30,762.28 AND INCLUDED A TEMPORARY HOUSING ALLOWANCE. PART I, LINES 4A-B THE EXECUTIVE DC PLAN PROVIDES RESTORATION ACCRUALS APPLICABLE TO THE CASH BALANCE RETIREMENT PLAN, THE 403(B) PLAN AND THE 401(A) PLAN. THE RESTORATION ACCRUALS ARE EQUAL TO THE AMOUNTS THAT WOULD HAVE BEEN ADDED TO THE PLANS (BASED ON THE PERCENTAGE OF SALARY AND YEARS OF SERVICE) IF THE ANNUAL PENSION COMPENSATION LIMITS HAD NOT BEEN IN PLACE. THE NORMAL RETIREMENT AGE (NRA) FOR THE EXECUTIVE DC PLAN IS AT AGE 60. UPON ATTAINMENT OF NRA IN THE PLAN, PARTICIPANTS EXPERIENCE A "PAYMENT EVENT." DONNA BODIN WAS PAID A SEVERANCE OF $139,363.43. STANLEY SHELTON WAS PAID A SEVERANCE OF $138,053.09. STEPHANIE ANDERSON RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $26,716.30. APRIL CHAISSON RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $5,250. BARBARA GRIFFITH MD RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $71,070. CHERI JOHNSON RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $17,174.30. PAUL KIRK RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $15,544.67. MARY MAHER-GRIFFITHS RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $8,239.30. KURT SCOTT RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $26,516.88. PATRICK SEITER RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $43,430.40. KEILA STOVALL RECEIVED A 457(F) CONTRIBUTION IN THE AMOUNT OF $10,503.17. PART I, LINE 6 WOMAN'S HOSPITAL'S MANAGEMENT INCENTIVE PLAN PROVIDES FOR COMPENSATION IF CERTAIN GOALS/TARGETS ARE ACHIEVED, ONE BEING NET INCOME FROM OPERATIONS. A LCDA HOSPREV REF NOTE (WOMAN'S) SERIES 2015 721416168 2015-10-19 63605000 REFINANCE SERIES 2010B HOSPITAL REVENUE BONDS 0 0 0 B LCDA HOSP REF REV BONDS (WOMAN'S) SERIES 2017A 721416168 54628CAU6 2017-06-28 251867391 REFUND OUTSTANDING SERIES 2010A AND 2010B BONDS 0 0 0 A 63605000 1 0 1 1 B 251867391 2106164 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 0 B 0 STEVEN FEIGLEY MD MEMBER OF LWHA/LWCA 1670619 RENTAL PAYMENTS FOR SPACE IN PHYSICIAN'S OFFICE BUILDING 0 MICHAEL PERNICIARO MD MEMBER OF LWHA/LWCA 1670619 RENTAL PAYMENTS FOR SPACE IN PHYSICIAN'S OFFICE BUILDING 0 STEVEN FEIGLEY MD MEMBER OF LWHA/LWCA 141064 PRINCIPAL PAYMENTS ON LOAN FOR RENOVATED OFFICE SPACE 0 MICHAEL PERNICIARO MD MEMBER OF LWHA/LWCA 141064 PRINCIPAL PAYMENTS ON LOAN FOR RENOVATED OFFICE SPACE 0 TERRIE THOMAS MD MEMBER OF AWH 319059 RENTAL PAYMENTS FOR SPACE IN PHYSICIAN'S OFFICE BUILDING 0 CHEREE SCWARTZENBERG MD MEMBER OF SLG 243451 RENTAL PAYMENTS FOR SPACE IN PHYSICIAN'S OFFICE BUILDING 0 FORM 990, PART VI, SECTION A, LINE 2 DR. STEVEN FEIGLEY AND DR. MICHAEL PERNICIARO ARE MEMBERS OF LOUISIANA WOMEN'S HEALTHCARE (LWHA). FORM 990, PART VI, SECTION A, LINE 6 BOARD MEMBERS ARE ELECTED BY FOUNDATION MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE ELECTED BY FOUNDATION MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS MADE BY THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. THE FOUNDATION CAN VOTE SEPARATELY FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A SUMMARY OF FORM 990 WAS PRESENTED TO THE BOARD PRIOR TO FILING. ALL BOARD MEMBERS WERE ALSO GIVEN THE OPTION TO REVIEW THE FORM 990 IN ITS ENTIRETY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A LETTER AND QUESTIONNAIRE ARE SENT TO EACH BOARD MEMBER ANNUALLY WITH A LIST OF OFFICERS, DIRECTORS, AND KEY PERSONNEL TO USE FOR REFERENCE IN REPORTING ANY POSSIBLE CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 A MARKET COMPARISON AND RESULTING RECOMMENDATIONS FOR TOTAL COMPENSATION AND MANAGEMENT INCENTIVE PLANS ARE CONDUCTED BY A CONSULTING FIRM AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S TAX DOCUMENTS ARE AVAILABLE UPON REQUEST. THE FORM 990 IS ALSO UPLOADED ONTO GUIDESTAR'S WEBSITE WHERE IT CAN BE VIEWED BY THE GENERAL PUBLIC. THE FOUNDATION'S ANNUAL REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE. THE FOUNDATION ALSO ISSUES QUARTERLY BOND DISCLOSURE REQUIREMENTS TO BONDHOLDERS AND RATING AGENCIES. FORM 990, PART XI, LINE 9: CHANGE IN AUXILLARY ACCOUNT 15,603. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S PROCESS HAS NOT CHANGED FROM THE FILING OF THE PREVIOUS FORM 990. FORM 990, PART XII, LINE 3B: SINGLE AUDIT FOR CARES ACT PROVIDER RELIEF FUNDS WILL BE CONDUCTED IN FY 2022. STUMBERG HOLDING LLC 100 WOMANS WAY BATON ROUGE LA 70817 464133824 LAND MANAGEMENT LA WOMAN'S HOSPITAL FOUNDATION WOMAN'S MATERRA INVESTMENT COMPANY LLC 100 WOMANS WAY BATON ROUGE LA 70817 844017773 LAND MANAGEMENT LA 1709893 2580635 WOMAN'S HOSPITAL FOUNDATION FOUNDATION FOR WOMAN'S 100 WOMANS WAY BATON ROUGE LA 70895 471970335 TO PROMOTE THE WELFARE OF WOMAN'S HOSPITAL FOUNDATION D/B/A WOMAN'S HOSPITAL LA 501(C)(3) LINE 12B, II WOMAN'S HOSPITAL FOUNDATION 0 WOMAN'S RETAIL VENTURES LLC 9000 AIRLINE HWY STE 330 BATON ROUGE LA 70895 043845778 GIFT SHOP RETAIL LA 83352 709479 0 0 0.74750 STUMBERG LAND LLC 100 WOMANS WAY BATON ROUGE LA 70817 464150615 LAND MANAGEMENT LA -5317 1486964 0 0 0.64400 MATERRA DEVELOPMENT LLC 402 N FOURTH ST BATON ROUGE LA 70802 822503975 LAND MANAGEMENT LA 424310 3231910 0 0 0.50000 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 FOUNDATION FOR WOMANS C 1230618 CASH FOUNDATION FOR WOMANS B 701820 CASH FOUNDATION FOR WOMANS N 21393 CASH FOUNDATION FOR WOMANS O 562502 CASH FOUNDATION FOR WOMANS Q 115135 CASH WOMAN'S RETAIL VENTURES LLC S 74000 CASH WOMAN'S RETAIL VENTURES LLC J 86253 CASH FORM 990, SCHEDULE R, PART I & PART III STUMBERG HOLDING, LLC, A DISREGARDED ENTITY FOR TAX PURPOSES, IS OWNED 100% BY WOMAN'S HOSPITAL FOUNDATION. STUMBERG HOLDING, LLC IS A 64.40% MEMBER IN STUMBERG LAND, LLC.