2022-11-11T15:25:46-06:00 2021-12-31 201941244 HORNE LLP 661 SUNNYBROOK ROAD STE 100 RIDGELAND MS 39157 990 2021-01-01 721006966 LAFAYETTE HEALTH VENTURES INC LAFA 3372898951 PO BOX 53092 LAFAYETTE LA 70505 KIM DOOLEY CHIEF OPERATING OFFICER 3372898951 2022-11-11 KIM DOOLEY 999009999 AMIE T WHITTINGTON CPA P01082167 6013261000 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z KIM DOOLEY 115 AUDUBON BLVD LAFAYETTE LA 70503 48650948 0 X HTTPS://OCHSNERLG.ORG/LGMDPHYSICIANS X 1984 LA OPERATE BUSINESSES (PHYSICIAN PRACTICES) THAT RETURN VALUE IN SUPPORT OF THE MISSION OF LAFAYETTE GENERAL MEDICAL CENTER (LGMC). LGMC'S MISSION IS TO PROVIDE MEDICAL CARE TO RESTORE, MAINTAIN & IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITY WE SERVE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. 3 0 420 0 771 0 579686 163792 10531779 47551233 2061 953 1168320 933858 12281846 48649836 5000 15909 0 0 11971028 60622999 0 0 0 5033901 16217252 17009929 76856160 -4728083 -28206324 10029024 14637307 51471804 84286411 -41442780 -69649104 LHVI'S MISSION IS THAT WE "SHALL OPERATE BUSINESSES THAT RETURN VALUE IN SUPPORT OF THAT MISSION OF LAFAYETTE GENERAL MEDICAL CENTER." 0 0 65193383 15909 48484320 LHVI'S PROGRAM SERVICE IS AS A COMMUNITY MEDICAL CARE PROVIDER. LHVI OPERATES BUSINESSES THAT RETURN VALUE IN SUPPORT OF THE MISSION OF LAFAYETTE GENERAL MEDICAL CENTER, A NON-PROFIT HOSPITAL. LHVI HAS THE FOLLOWING SERVICE LINES: FAMILY MEDICINE, HEMATOLOGY/ONCOLOGY, INTERNAL MEDICINE, INTERVENTIONAL CARDIOLOGY, NEUROLOGY SERVICES, NEUROSURGERY, RADIATION ONCOLOGY, ORTHOPEADICS, TELEMEDICINE, AND URGENT CARE CLINICS. THROUGH THE PRACTICE OF THESE SERVICE LINES WE HELP TO RESTORE, MAINTAIN, AND IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES THAT WE SERVE; THIS IS LGMC'S MISSION WHICH WE FULLY SUPPORT. THE REVENUE FROM THESE SERVICES IS $190,365,093. SOME THESE SERVICES WERE NOT FULLY COMPENSATED. THESE INCLUDE MEDICAID/MEDICARE CONTRACTUALS WITH $73,380,371 OF UNCOMPENSATED SERVICES, OTHER CONTRACTUALS WITH $54,024,775 OF UNCOMPENSATED SERVICES AND BAD DEBTS OF $3,201,262. THE NET REVENUES OF THE SERVICES PROVIDED WERE $59,758,685. LHVI MAINTAINS A PROACTIVE APPROACH TO EDUCATION AND WELLNESS IN OUR COMMUNITY. ANNUALLY, LHVI PROVIDES SEVERAL EDUCATIONAL SEMINARS AIMED AT EDUCATING THE PUBLIC ON PREVENTATIVE CARE AND MAINTAINING A HEALTHY LIFESTYLE. SOME OF THESE ACTIVITIES INCLUDE: VOLUNTEERING FOR THE ZYDECO MARATHON, HELD COVID TESTING CLINICS (AS WELL AS FLU), AND HELPED STAFF THE COVID VACCINE CLINICS. 65193383 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 64 0 1 420 1 1 1 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KIM DOOLEY 3372898951 115 AUDUBON BLVD LAFAYETTE LA 70503 X KIMBERLY H DOOLEY CHIEF ADMINISTRATIVE OFFICER/BOARD MEMBER - NON VO 40.00 0.00 X 0 305582 41001 MICHAEL ALEXANDER MD BOARD MEMBER/EMPLOYED PHYSICIAN 41.00 0.00 X 0 365765 67467 MICHAEL S CAIN MD BOARD MEMBER/EMPLOYED PHYSICIAN 41.00 0.00 X 0 880114 53660 PATRICK W GANDY BOARD MEMBER/CHAIR 1.00 45.00 X X 0 1450683 57461 ROGER MATTKE BOARD MEMBER - NON VOTING 1.00 40.00 X 0 1225259 74215 BRIAN E ETIER JR PHYSICIAN 40.00 0.00 X 0 1075977 44738 JOHN P SCHUTTE MD PHYSICIAN 40.00 3.00 X 0 3500559 67657 MARCUS P SCHMITZ PHYSICIAN 40.00 0.00 X 0 1054401 46496 MOHAMAD A ALLAM PHYSICIAN 40.00 0.00 X 0 1298411 71417 VICTOR E TEDESCO PHYSICIAN 40.00 0.00 X 0 1599156 54511 AL J PATIN FORMER BOARD MEMBER 0.00 42.00 X 0 739284 70183 0 13495191 648806 142 1 1 0 HAYES LOCUMS LLC PO BOX 88122 CHICAGO IL 60680 PROVIDER SERVICES 720714 LOCUMTENENSCOM LLC PO BIX 405547 ATLANTA GA 30384 PROVIDER SERVICES 440908 KAREN BOWEN RODEN MD 109 SOUTHWARK DRIVE LAFAYETTE LA 70508 PHYSICIAN SERVICES 220023 DELTA LOCUM TENENS LLC PO BOX 202940 DALLAS TX 75320 PROVIDER SERVICES 197482 ANESTHESIA BUSINESS CONSULTANTS LLC PO BOX 1406 CAROL STREAM IL 60132 ANESTHESIA SERVICES 161457 7 163792 163792 MEDICAL PATIENT SERVICES 621990 47551233 47551233 47551233 953 953 1883 1112 771 771 INTERCOMPANY REVENUE 561000 933087 933087 933087 48649836 48484320 771 953 15909 15909 54043369 52481448 1561921 1324800 1300970 23830 2683430 2529952 153478 2571400 2459612 111788 8970582 8970582 1471934 1427433 44501 32549 27549 5000 408461 148003 260458 6409 6409 1176462 1107810 68652 117767 112384 5383 96375 76678 19697 128977 103139 25838 92485 -26120 118605 MED SUPPL, ORGANS, DRUG 1586079 1592404 -6325 MISC EXPENSES 1526394 1431880 94514 EDUCATION 228427 198271 30156 LICENSES AND TAXES 205043 44246 160797 169308 155406 13902 76856160 65193383 11662777 0 189118 380076 6470216 10359894 429524 13713 6410 636043 655007 1064829 122411 468286 942418 1803010 19114 2293502 10029024 14637307 4573115 3794905 1690008 613939 488963 45208681 79388604 51471804 84286411 X -41442780 -69649104 -41442780 -69649104 10029024 14637307 -28206324 0 X X 0 1 X 1 0 X X 1 LAFAYETTE GENERAL MEDICAL CENTER 720535375 3 1 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PAGE 4, SECTION A, LINE 6 LHVI SUPPORTS LAFAYETTE GENERAL MEDICAL CENTER. THE MISSION OF LGMC IS TO SUPPORT THE HEALTH AND WELLNESS OF THE COMMUNITIES SERVED BY THE HOSPITALS. IF DONATIONS ARE NOT MADE TO LGMC DIRECTLY, LHVI ENSURES THAT THESE DONATIONS ARE TO ORGANIZATIONS THAT PROVIDE SERVICES THAT BENEFIT THE COMMUNITIES SERVED BY LGMC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32050 13617 18433 413750 108794 304956 619029 619029 942418 COST REPORT ASSETS 971771 RIGHT OF USE ASSETS 1303736 DEPOSITS 17995 2293502 DUE TO RELATED ENTITIES 78567796 LEASE LIABILITY EQUIPMENT 820808 79388604 X PART X, LINE 2: THE MAJORITY OF OCHSNER CLINIC FOUNDATION AND ITS SUBSIDIARIES QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(A) AND ARE DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. ANY FEDERAL INCOME TAXES ASSOCIATED WITH THE FOR-PROFIT ENTITIES ARE NOT MATERIAL TO OCHSNER'S CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS. THE STATUTE OF LIMITATIONS REMAINS OPEN FOR TAX YEARS 2018 THROUGH 2021 IN OCHSNER'S MAIN TAX JURISDICTIONS. 1 MILES PERRET CENTER CANCER SERVICE 2130 KALISTED SALOOM RD STE 200 LAFAYETTE LA 70508 753023211 501(C)3 5454 0 CASH DONATION AMERICAN CANCEER SOCIETY INC 1604 WEST PINHOOK RD STE 203 LAFAYETTE LA 70508 131788491 501(C)3 5455 0 CASH DONATION 2 0 PART I, LINE 2: CHARITABLE DONATIONS ARE MADE TO LOCAL NON-PROFIT ORGINIZATIONS THAT PARALLEL OUR HEALTHCARE MISSION IN THE COMMUNITY. X X X X X 0 1 0 0 0 0 0 0 0 JOHN P SCHUTTE MD PHYSICIAN 0 990887 0 0 0 2509672 0 26000 0 41657 0 3568216 0 0 VICTOR E TEDESCO PHYSICIAN 0 1597572 0 0 0 1584 0 26000 0 28511 0 1653667 0 0 PATRICK W GANDY BOARD MEMBER/CHAIR 0 663163 0 67001 0 720519 0 24564 0 32897 0 1508144 0 0 MOHAMAD A ALLAM PHYSICIAN 0 1296324 0 0 0 2087 0 39000 0 32417 0 1369828 0 0 ROGER MATTKE BOARD MEMBER - NON VOTING 0 527318 0 36406 0 661535 0 44571 0 29644 0 1299474 0 0 BRIAN E ETIER JR PHYSICIAN 0 789062 0 0 0 286915 0 10556 0 34182 0 1120715 0 0 MARCUS P SCHMITZ PHYSICIAN 0 844391 0 0 0 210010 0 26000 0 20496 0 1100897 0 0 MICHAEL S CAIN MD BOARD MEMBER/EMPLOYED PHYSICIAN 0 815694 0 55000 0 9420 0 26000 0 27660 0 933774 0 0 AL J PATIN FORMER BOARD MEMBER 0 415166 0 36749 0 287369 0 39000 0 31183 0 809467 0 0 MICHAEL ALEXANDER MD BOARD MEMBER/EMPLOYED PHYSICIAN 0 261858 0 0 0 103907 0 45500 0 21967 0 433232 0 0 KIMBERLY H DOOLEY CHIEF ADMINISTRATIVE OFFICER/BOARD M 0 273453 0 9911 0 22218 0 12555 0 28446 0 346583 0 0 PART I, LINE 3 AN INDEPENDENT EXTERNAL CONSULTANT FIRM IS ENGAGED BY A RELATED ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THIS RELATED ORGANIZATION'S COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. PART I, LINE 4B SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED EFFECTIVE JANUARY 01, 2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WERE $0. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS INCLUDED DAVID CALLECOD, FORMER BOARD MEMBER, AL PATIN, BOARD MEMBER, ROGER MATTKE, AND PATRICK GANDY, BOARD MEMBER DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2021 W-2 WAGES, TOTALLED $3,127,036. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2021 W-2 WAGES: DAVID CALLECOD, FORMER BOARD MEMBER, AL PATIN, BOARD MEMBER, ROGER MATTKE, AND PATRICK GANDY, BOARD MEMBER FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7B THE INDIVIDUALS OF THE TRUSTEES (GOVERNING BODY) AND THE MEMBERS MUST BE APPROVED BY THE MEMBERSHIP BODY. FORM 990, PART VI, SECTION B, LINE 11B ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEW THE RETURN. THE RETURN IS ALSO REVIEWED BY HORNE, LLP, THE COMPANY'S TAX ADVISORS. A COPY OF THE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS ELECTRONICALLY AND COMMENTS ARE SOLICITED FROM THE ENTIRE BOARD. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL SURVEY IS SENT TO THE BOARD MEMBERS AND OFFICERS REQUIRING THEM TO DISCLOSE CONFLICTS OF INTEREST. AFTER RECEIPT OF THESE SURVEYS, THE GOVERENCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE. THEREAFTER THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE AND THE ORGANIZATION'S GENERAL COUNCIL (WHO ATTENDS ALL BOARD MEETINGS) INSURES THAT ALL CONFLICTS ARE TIMELY DISCLOSED AND APPROPRIATE RECUSALS ARE MADE ON BUSINESS MATTERS THAT MAY BE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENTS TO THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. THIS SAME PROCESS IS FOLLOWED FOR ALL THE KEY EMPLOYEES OF THE ORGANIZATION, INCLUDING THE CHIEF FINANCIAL OFFICER. THE PROCESS FOR DETERMINING COMPENSATION OF LHVI'S REMAINING EMPLOYEES AND PHYSICIANS IS DONE BY A REVIEW CONDUCTED BY LAFAYETTE GENERAL MEDICAL CENTER'S HUMAN RESOURCES DEPARTMENT. LOCAL, REGIONAL AND STATE MARKET COMPENSATION SURVEYS ARE USED. PHYSICIAN COMPENSATION IS DETERMINED THROUGH THE USE OF NATIONAL AND REGIONAL SURVEYS AND INDEPENDENT FAIR MARKET VALUE REVIEWS, IF NECESSARY. FORM 990, PART VI, SECTION C, LINE 19 BASIC FINANCIAL INFORMATION IS MADE AVAILABLE AND SENT OUT TO THE COMMUNITY BY MEANS OF THE ORGANIZATION'S ANNUAL REPORT. OTHER DOCUMENTS AND MORE DETAILED FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY / LEGAL AUTHORITIES. FORM 990, PART VII, SECTION A DRS. MICHAEL ALEXANDER AND MICHAEL CAIN ARE EMPLOYED PHYSICIANS OF LHVI. THEY ARE ALSO ON THE BOARD OF DIRECTORS FOR LHVI. THE COMPENSATION THAT THEY RECEIVE IS SOLELY BASED ON THEM BEING EMPLOYED PHYSICIANS. THEY DO NOT RECEIVE ANY FORM OF COMPENSATION FOR BEING BOARD MEMBERS. FORM 990, PART VII, SECTION B THE INDEPENDENT CONTRACTORS LISTED IN SECTION B PERFORM SERVICES SOLELY FOR LHVI IN THE AMOUNTS LISTED. HOWEVER, ALL INVOICES ARE PAID ON BEHALF OF LHVI BY LGMC. THEREFORE, THE 1099'S ISSUED TO THESE INDEPENDENT CONTRACTORS WERE ISSUED BY LGMC AND REPORTED BY LGMC. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. 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