2021-06-02T15:26:47-05:00 2020-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2019-07-01 720408970 ST FRANCIS MEDICAL CENTER % AMANDA HYMEL STFR 2259232701 4200 ESSEN LANE BATON ROUGE LA 70809 JEREMY ROGERS COO/CFO 3189664000 2021-05-17 true BRITTANY ELLISER P01284594 2253444000 2021-05-17 2019 2022-09-23 18:48:47Z X JEREMY ROGERS 4200 ESSEN LANE BATON ROUGE LA 70809 342667436 false X www.stfran.com X 1913 LA TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS AND TO PROVIDE FOR THE RESEARCH,EDUCATION AND THE ENHANCEMENT OF HEALTH OF THOSE IN NORTHEAST LOUISIANA. 16 13 1955 82 1269021 875975 1846469 4956246 307647774 313754505 5892562 2347315 3673278 3664493 319060083 324722559 19029 24590 0 0 115836645 119634516 0 0 1892 201851994 209877300 317707668 329536406 1352415 -4813847 260641986 301207678 241021855 292628917 19620131 8578761 X 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. false false 207575120 24590 286646732 ST. FRANCIS MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES PRIMARILY TO RESIDENTS OF NORTHEAST LOUISIANA. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. 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. FOLLOWING THAT POLICY, HEALTH CARE SERVICES COSTING APPROXIMATELY, $2,352,976 WERE PROVIDED WITHOUT CHARGE. THE MEDICAL CENTER PROVIDED 359 LICENSED BEDS, 77,685 INPATIENT DAYS, 12,711 INPATIENT DISCHARGES, AND 44,877 ER VISITS IN THE YEAR ENDED JUNE 30, 2020 . 25031340 27107773 ST. FRANCIS MEDICAL CENTER'S PHYSICIAN PRACTICE PROVIDES CARE TO THE NEEDY MEMBERS OF ITS COMMUNITIES. 232606460 true true false false false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false true false false false false true true true true false false true 31 0 true 1955 true true true false false false false false false false false false false false X 16 13 false true false false false true true true true false false true true true true true true false true true true X AMANDA HYMEL 2257658496 5959 S SHERWOOD FOREST BLVD BATON ROUGE LA 70809 X JEFF LIMBOCKER REGIONAL CFO/EVP 1.0 59.5 X 0 898795 161397 SARAH AHMAD STAFF PHYSICIAN 40.0 0.0 X 738753 0 17244 THOMAS J GULLATT MD BOARD MEMBER/PHYSICIAN 40.0 0.0 X 622742 0 67846 JAMES G SMITH HOSPITALIST 40.0 0.0 X 606057 0 58890 DARSHAN PATEL STAFF PHYSICIAN 40.0 0.0 X 621086 0 32509 Frank B Sartor STAFF PHYSICIAN 40.0 0.0 X 618859 0 26456 JOHN D BRUCHHAUS STAFF PHYSICIAN 40.0 0.0 X 605374 0 28050 KRISTIN WOLKART EX-OFFICIO, PRES/CEO SFMC 1.0 51.0 X X 0 536900 82289 SABRINA HOGAN VP Physician Services 40.0 0.0 X 287081 0 62603 KAYLA JOHNSON VP Patient Care Services 40.0 0.0 X 264652 0 67091 JEREMY ROGERS VP, Finance/CFO SFMC 1.0 41.0 X 0 294941 25852 JOHN KAHL VP, OPS AND PHYSICIAN SVCS 40.0 0.0 X 151119 0 21797 ROLF MORSTEAD MD EX-OFFICIO/CHIEF OF STAFF 1.0 0.0 X 0 0 0 SIDNEY BAILEY MD BOARD MEMBER 1.0 0.0 X 0 0 0 NICK J BRUNO PH D BOARD MEMBER 1.0 0.0 X 0 0 0 SR HELEN CAHILL BOARD MEMBER 1.0 10.0 X 0 0 0 WILLIAM CHEEK CHAIR 1.0 0.0 X X 0 0 0 HILL HINKLE MD BOARD MEMBER 1.0 0.0 X 0 0 0 SUSAN HOFFMAN BOARD MEMBER 1.0 1.0 X 0 0 0 SR MARY ANN SEPULVADO OSF BOARD MEMBER 1.0 1.0 X 0 0 0 REV LARRY STAFFORD Board Member 1.0 1.0 X 0 0 0 JOHN REA BOARD MEMBER 1.0 0.0 X 0 0 0 LJ HOLLAND VICE CHAIR 1.0 0.0 X X 0 0 0 REV EVERETT SLACK BOARD MEMBER 1.0 0.0 X 0 0 0 CARRIE BAKER BOARD MEMBER 1.0 0.0 X 0 0 0 JANET DURDEN SECRETARY 1.0 0.0 X X 0 0 0 JOHN JONES BOARD MEMBER 1.0 0.0 X 0 0 0 REV BRIAN MERCER BOARD MEMBER 1.0 0.0 X 0 0 0 WILLIAM SMART BOARD MEMBER 1.0 0.0 X 0 0 0 4515723 1730636 652024 129 false true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Management Services 31588740 MORRISON MGMT SPECIALISTS 5801 Peachtree Dunwoody Rd Atlanta GA 30342 Dietary Services 5463064 SPECIALTY MGMT SER OF OUACHITA 101 Catalpa St Monroe LA 71201 Contract Labor Servi 15176814 Crothall Healthcare Inc 5000 Hennessy Blvd Baton Rouge LA 70808 Housekeeping Service 3777324 TRIMEDX INC 5451 Lakeview Parkway S Dr Indianapolis IN 46268 Maintenance Services 4299737 82 101012 4024265 830969 4956246 PATIENT SERVICE REVENUE 621500 294022278 294022278 Cafeteria 722514 1634625 1634625 OUTREACH LAB 621500 1179728 1179728 Income from Equity Investees 523000 850821 761528 89293 Other 900099 16067053 16067053 313754505 750355 750355 1111 1111 0 3664493 3664493 0 3664493 3664493 5675641 13865085 4112797 13832080 1562844 33005 1595849 1595849 0 0 0 0 0 0 0 0 0 0 324722559 316149977 1269021 2347315 24590 24590 0 0 0 1857659 1715215 142444 0 94487808 87242550 7245258 6563153 5891330 671823 9835028 8838752 996276 6890868 6185498 705370 51355755 24864494 26490456 805 168897 153184 15713 0 0 0 195818 195818 26296342 18300366 7995752 224 1227790 377009 850753 28 25673431 12379440 13293559 432 391886 120334 271543 9 0 7036126 1871062 5165064 441068 135435 305621 12 0 101553 31183 70367 3 5035982 108619 4927363 0 11587477 11587477 3668149 268190 3399959 MEDICAL SUPPLIES EXPENSE 60962102 50948814 10012986 302 PENSION RELATED CHANGES 11944154 9982275 1961820 59 Repairs 3726547 3114446 612083 18 Other Expenses 64029 53512 10517 194 162 32 329536406 232606460 96928054 1892 10740536 63700732 0 0 0 0 34237783 34482187 0 0 0 0 115000 0 6430114 6973006 2914284 3433362 352215026 249306643 98229374 102908383 0 0 82534327 76143400 0 0 3736701 3736701 21703867 9829907 260641986 301207678 37912590 36864554 0 0 0 37347049 116370258 117714677 0 0 0 0 0 0 0 0 86739007 100702637 241021855 292628917 X 19344801 8301999 275330 276762 19620131 8578761 260641986 301207678 X -4813847 -1529196 -4698327 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13975184 13975184 183605813 125696108 57909705 3234341 2581767 652574 148520905 119610616 28910289 2878783 1418152 1460631 102908383 INVESTMENTS HELD AT FMOLHS 76143400 F 76143400 0 OTHER LIABILITIES 4829558 DUE TO/FROM RELATED PARTIES 4361576 ACCRUED PENSION COST 91511503 100702637 X FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART XIII "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." true true X true X 250. false true true false true true 597936 597936 0.00000 57082595 56414080 668515 0.00200 57680531 57012016 668515 0.00200 53166 719 52447 0.00020 335686 295765 39921 0.00010 1676184 196149 1480036 0.00450 130338 130338 0.00040 2195374 492633 1702742 0.00520 59875905 57504649 2371257 0.00720 42446 42446 2663 2663 45109 45109 true 331392 75315980 83714190 -8398210 X true true 1 1 ST FRANCIS MEDICAL CENTER PO BOX 1901 MONROE LA 71210 www.fmolhs.org/stfran X X X ST FRANCIS MEDICAL CENTER 1 false false true X X X X X X X X X 19 true false false true X SEE PART V, SECTION C X true 19 false true false true X 200. 0. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X true X false false PART V, SECTION B, LINE 5 ST. FRANCIS MEDICAL CENTER (SFMC) THE ORGANIZATIONS ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS. SFMC TOOK INTO ACCOUNT INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH BY INTERVIEWING SHEILA HUTSON, WHO IS AN RN AT THE OFFICE OF PUBLIC HEALTH. ADDITIONALLY, SFMC ALSO TOOK INTO ACCOUNT INPUT FROM THOSE WHO REPRESENT A BROAD INTEREST IN THE COMMUNITY BY CONDUCTING AN ONLINE SURVEY. THE PARTICIPANTS WERE ASKED TO SELECT FOUR HEALTH ISSUES. PART V, SECTION B, LINE 7A ST. FRANCIS MEDICAL CENTER: THE CHNA CAN BE FOUND AT HTTPS://STFRAN.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINE 11 ST. FRANCIS MEDICAL CENTER SFMCs current Community Health Needs Assessment (CHNA) identified nine Priority Areas: Chronic Disease Management, Obesity / Sedentary Lifestyles, Substance Abuse, Mental Health, Cancer, Access To Care, Heart Disease / Stroke, Care for the Elderly, and Preventable Hospital Stays. From these nine identified significant health issues, SFMC chose the following five Priority Areas to address in its 2019 CHNA implementation plan: Chronic Disease Management, Obesity/Sedentary Lifestyles, Substance Abuse, Access to Care, and Care for the Elderly. However, since there are linkages among all the Priority Areas, SFMC anticipates that the outcomes of the non-focus areas could improve due to the tie-ins that exist. For example, while SFMC did not choose to address Mental Health as a Priority Area, SFMC did choose Substance Abuse and Access to Care, which could have tie-ins with Mental Health. Additionally. SFMC did not address Cancer as a Priority Area, but work done in the Priority Areas of Access to Care and Care for the Elderly may connect patients with cancer-related care and services. During the current year, SFMC shifted its focus from the original implementation plan goals and objectives to a focus on addressing COVID-19 in the community. SFMCs patient population was affected across all socioeconomic classes by the virus; however, the most vulnerable populations were often affected to the highest degree with issues related to access to care, economic distress, and other immediate needs. In doing so, SFMC still met some of the original CHNA implementation plan goals while expanding the focus to meet the more immediate COVID-19 needs as well. Chronic Disease Management: FMOLHS Senior Services hosted an online meeting via WebEx for Region 8 nursing homes, home health agencies, and hospice agencies attended by 30 providers in spring 2020. The meetings purpose was to discuss chronic disease management in the post-acute care setting. Obesity/Sedentary Lifestyles: SFMC piloted the Ideal Protein ketogenic weight loss program with team members to determine effectiveness and usability in the broader community. The St. Francis Medical Group, in collaboration with the Health Leaders Network, increased the measurement of and education regarding Body Mass Index (BMI) among its patients (baseline = 55.35% in FY 19; final FY 20 result = 62.75%). Additionally, 100% of mothers giving birth at SFMC were given information about breastfeeding as a best practice in feeding their baby as a strategy to combat obesity. Substance Abuse: The SFMC Tobacco Cessation Program implemented telehealth in FY 20 and has begun working on reducing the no-show rate to improve patient outcomes (goal associated with FY 21). The program participated in the planning and promotion of the Ouachita Youth Leadership Summit in collaboration with the Childrens Coalition for Northeast Louisiana. The summit was attended by 528 participants (240 adults; 288 students). Rebecca Mixon, SFMC Tobacco Cessation program manager, presented the one-hour program 'Tobacco Today: A Persistent Epidemic, The Advent of Vaping Among Youth.' To assist patients whose insurance does not cover nicotine replacement therapy for tobacco cessation, the SFMC Tobacco Cessation Program works with patients to connect them with programs such as the Pfizer Assistance Program, and SFMC allows patients to utilize their team member discount for NRT at RXOne, SFMCs outpatient pharmacy. The SFMC Tobacco Cessation Program has increased the number of new patients seen in the program and number of patients connected with the free counseling and NRT provided by the Smoking Cessation Trust. Access to Care: In the current year, St. Francis Medical Group clinics and the SFMC Tobacco Cessation Program began giving out prescription cards to assist patients with medication costs. SFMC provided space at no charge for the St. Vincent DePaul Pharmacy and referred patients in need of prescription assistance. SFMC hosted United Way 2-1-1 at an informational table to introduce team members and visitors to a way to access services and programs in the community in February 2020. COVID-19 prevented repeating the outreach in FY 20; however, requests for emergency assistance and programming are referred to United Way 2-1-1. SFMC improved access to its CHNA by locating multiple copies at its front desk and in its Administrative offices as well as conducting regular audits to ensure links remained live on the SFMC website. The SFMC CHNA contains a section of information related to accessing services in the community, which was shared with the regional Office of Public Health for use in their community outreach as well. In FY 20, Senior Services completed an update of Freedom of Choice documents based on Louisiana Department of Health information/criteria for case managers to use when assisting patients to be discharged to appropriate levels of care. Care for the Elderly: SFMC provided 7,334 meals to Meals on Wheels in FY 20 in collaboration with the Ouachita Council on Aging. PART V, SECTION B, LINE 16J St. Francis Medical Center Registration personnel refer patients that may have difficulty paying for their medical care to financial counselors to discuss qualifications for fully discounted care. PART V, SECTION B, LINE 13H St. Francis Medical Center: Presumptive eligibility may be determined on the basis of individual life circumstances that may include: 1. The patient receiving free care from a community clinic and is referred to the hospital; 2. State-funded prescription programs; 3. Homeless, indigent, or homeless clinic patient; 4. Patients children who qualify for other financial assistance programs; 5. Patient eligible for food stamps; 6. Medicaid eligible patient; 7. Patient is deceased with no known responsible party; 8. Patient is incarcerated and has no other responsible party PART V, SECTION B, LINE 16 PART V, SECTION B, LINE 16A, 16B 16C ST. FRANCIS MEDICAL CENTER: THE FINANCIAL ASSISTANCE POLICY, FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT: HTTPS://FMOLHS.ORG/FINANCIAL-ASSISTANCE-POLICY/ 4 COMMUNITY HEALTH CENTER 2600 TOWER DRIVE MONROE LA 71201 VARIOUS OUTPATIENT SERVICES NORTHEAST LA CANCER INSTITUTE 411 CALYPSO STREET MONROE LA 71210 CANCER TREATMENT AND IMAGING CENTER Monroe MRI Center 501 Catalpa Street Monroe LA 71201 MRI SERVICES ST FRANCIS PET IMAGING OF MONROE PO BOX 1851 Monroe LA 71201 PET IMAGING SERVICES PART I, LINE 3C FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULL AND PARTIAL DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. DISCOUNTED CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS AND IS AVAILABLE IF 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 MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY. PART I, LINE 7G ST. FRANCIS MEDICAL CENTER PROVIDES SUBSIDIZED HEALTH SERVICES, INCLUDING SERVICES THAT PROVIDE PEDIATRIC NEUROLOGY, PEDIATRIC NEUROSURGERY, AND ADULT NEUROLOGY. THESE SPECIALIZED SERVICES ARE SUBSIDIZED BY ST. FRANCIS MEDICAL CENTER SINCE THESE ARE UNDER-SERVED SPECIALTY AREAS. PART I, LINE 7 THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION. FOR PART I LINES 7E, 7F, 7G, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENT 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 4 THE BAD DEBT FOOTNOTE IS ON PAGES 14-16 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 ORGANIZATION CURRENTLY DOES NOT BELIEVE THAT ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. 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 CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2 NEEDS ASSESSMENT: Responding to the health needs of our community, especially to those most in need, is primary to the hospital's mission. As such, St. Francis Medical Center, Inc. works to conduct health care needs assessments. They work closely with Families helping Families, The Wellspring, The Children's Coalition, YMCA and many other organizations to define community needs and to consolidate efforts to meet those community needs. For example, a school-based health center and a diabetes and nutrition center was initiated after a health care assessment identified the need. The hospital conducted an updated community based needs assessment in tax year 2018 and will continue to use community based data to support decisions for outreach in the community. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: Patients are informed through a patient handbook that contains information on the financial policies of St. Francis Medical Center. Additionally, signs are posted in the Admissions areas that Financial Counseling is available upon request. Systems and tools are utilized to conduct high level financial screening to assist in identifying patients eligible for financial assistance. Financial counselors work closely with patients to assist with enrollment for those who are eligible for Medicaid as well as assist those who are eligible for HOSPITAL FINANCIAL ASSISTANCE in determining eligibility. PART VI, LINE 4 COMMUNITY INFORMATION: ST. FRANCIS MEDICAL CENTER (SFMC) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN MONROE, LOUISIANA THAT SERVES OUACHITA PARISH AND PORTIONS OF THE SURROUNDING PARISHES. FOR THE PURPOSE OF THE CHNA, SFMC DEFINES ITS PRIMARY SERVICE AREA AS LINCOLN AND OUACHITA PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, SFMC'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 205,383 AND THE SENIOR POPULATION COMPRISES ABOUT 13.48% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $40,167 IN OUACHITA PARISH AND $37,842 IN LINCOLN PARISH. APPROXIMATELY 19% OF THE PARISH'S RESIDENTS LIVE BELOW THE POVERTY LEVEL. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: St. Francis Medical Center participates in community improvement activities because it understands that improvements to a community have a direct link to the improved health of community residents. Community improvement activities include the following: SFMC provides occupancy and utilities free of charge to St. Vincent DePaul charitable pharmacy so that the poorest individuals in the community have access to prescription drugs. SFMC also provides occupancy free of charge to a primary health care clinic located in one of the poorest areas of Monroe. These activities allow the recipient organizations to spend their available funds on activities that have more direct impact on those in need. SFMC provides management oversight of community programs and activities, including Meals on Wheels, taxi and medication provided to the needy, and community benefit salary dollars. SMFC proudly serves as the designated regional hospital for Region 8 and provides leadership and coordination for emergency preparedness activities. SFMC provides leadership development and training for Roman Catholic Priests to serve in the SFMC Community. SFMC improves access to public health through its financial support of an adult day health care facility and a school based health center. SFMC has many programs designed to promote leadership development and provide exposure to various careers in health care. Such programs include health information management, sports medicine program, AHEC (area health education center) program, Carroll High School Housekeeping Program and the Jr. Volunteer Program. A majority of the governing body of SFMC is comprised of individuals from a broad cross-section of the community who reside in the primary service area and who are neither employees nor contractors of the organization. SFMC extends medical staff privileges to all qualified physicians in the community for some or all of the departments, as needed. SFMC applies surplus funds to improvements in patient care through investment in Clinical technology, medical information technology, and continued training of clinical staff. PART VI, LINE 6 St. Francis Medical Center is a not-for-profit hospital, non-stock member corporation of which Franciscan Missionaries of Our Lady Health System, Inc. (FMOL Health System) is the sole member. St. Francis Medical Center is part of the FMOL Health System which includes several hospitals and tax-exempt affiliates throughout the state of Louisiana. St. Francis Medical Center serves the community in Northeastern Louisiana and Southern Arkansas. Other related hospitals in Louisiana include: Our Lady of Lourdes Regional Medical Center Our Lady of the Lake Hospital St. Elizabeth Hospital Our Lady of the Lake Assumption Hospital OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, LINE 2 AMOUNTS REPRESENT THE ACTUAL CUSTOMER AMOUNTS DUE TO ST. FRANCIS MEDICAL CENTER THAT WERE WRITTEN OFF BECAUSE THEY WERE UNCOLLECTIBLE. PART I, LINE 7F FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE. X X true true false true false false false false false false false THOMAS J GULLATT MD BOARD MEMBER/PHYSICIAN 483854 132968 5920 48390 19456 690588 KRISTIN WOLKART EX-OFFICIO, PRES/CEO SFMC 393832 140909 2159 56373 25916 619189 KAYLA JOHNSON VP Patient Care Services 211690 50852 2110 41521 25570 331743 Frank B Sartor STAFF PHYSICIAN 572022 41042 5795 7000 19456 645315 SABRINA HOGAN VP Physician Services 226494 58791 1796 38184 24419 349684 JEFF LIMBOCKER REGIONAL CFO/EVP 550613 293047 55135 135652 25745 1060192 45920 JOHN D BRUCHHAUS STAFF PHYSICIAN 573941 27934 3499 0 28050 633424 JAMES G SMITH HOSPITALIST 570203 30059 5795 48390 10500 664947 DARSHAN PATEL STAFF PHYSICIAN 553007 65328 2751 7000 25509 653595 JEREMY ROGERS VP, Finance/CFO SFMC 234130 52494 8317 0 25852 320793 JOHN KAHL VP, OPS AND PHYSICIAN SVCS 127043 23730 346 3943 17854 172916 SARAH AHMAD STAFF PHYSICIAN 723560 12495 2698 0 17244 755997 PART I, QUESTION 3 THE CEO 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 CEO'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. THE CEO ALSO SIGNS A WRITTEN EMPLOYMENT AGREEMENT. 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. Jeff Limbocker received a payment of $52,976 from the plan during the current year. PART I, QUESTION 4A The REGIONAL CFO is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason or due to change of control. If triggered, the executive would be paid his/her base salary 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 CFO AND CEO 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 12 months. No payments were made under the plan in the current year. PART I, QUESTION 1A CHARTER TRAVEL WAS USED BY A BOARD MEMBER, THREE KEY EMPLOYEES AND ONE HIGHEST COMPENSATED EMPLOYEE WHEN IT WAS DEEMED THE MOST EFFICIENT METHOD OF TRAVEL BETWEEN RELATED AND SUBSIDIARY HOSPITALS THROUGHOUT THE STATE OF LOUISIANA. THESE AMOUNTS WERE NOT INCLUDED IN EMPLOYEE COMPENSATION BECAUSE THE FLIGHTS WERE STRICTLY FOR BUSINESS PURPOSES. ST. FRANCIS MEDICAL CENTER PROVIDED SPOUSAL TRAVEL TO ONE OFFICER. THE BENEFIT WAS NOT TAXABLE COMPENSATION DUE TO THE BUSINESS PURPOSE OF THE TRIP AND BECAUSE NO ADDITIONAL COSTS WERE INCURRED TO PROVIDE THE BENEFIT. OUACHITA REHAB ASSOCIATES LLC ENTITY MORE THAN 35% OWNED BY ROLF MORSTEAD, BOARD MEMBER 216681 PERFORMANCE OF SERVICES false Part VI, Section A, Question 6 FMOL Health System, Inc. (an IRC Section 501(C)(3) organization) is the sole member of the medical center. PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, INC. AS THE SOLE MEMBER OF THE MEDICAL CENTER, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. FRANCIS MEDICAL CENTER. PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: i. To change philosophy, objectives and purposes of corporation. ii. To appoint or remove the Members of the Board of Trustees and Officers of the corporation. iii. To amend, alter, modify or repeal the Articles of Incorporation and Bylaws of the corporation. iv. To authorize merger, consolidation, or affiliation, or participate in joint ventures. v. To dissolve and to distribute assets of the corporation. vi. To appoint and/or terminate with or without cause the Chief Executive Officer of the corporation. vii. To acquire, purchase, sell, lease, transfer, or encumber any immovable property on behalf of the corporation. viii. To add to or incur long-term debt in excess of $5 million by the Corporation. ix. To appoint the fiscal auditor for the corporation. x. 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. xi. To approve the annual operating and capital budgets of the corporation. xii. To approve a strategic business plan of the corporation. Part VI, Section A, Question 11A AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG LLP, THE TAXPAYER'S TAX ADVISORS, ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEWS THE RETURN. ST. FRANCIS MEDICAL CENTER'S GOVERNING BODY IS PROVIDED A COPY OF THE RETURN ELECTRONICALLY PRIOR TO THE FILING DATE AND IS GIVEN AN OPPORTUNITY TO REVIEW AND PROVIDE COMMENTS TO MANAGEMENT. PART VI, SECTION B, QUESTION 12C St. Francis Medical Center 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 she/he (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 St. Francis Medical Center 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, St. Francis Medical Center 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 15A & 15B Our Board of Directors designates an executive committee made up of independent board members to review and set the compensation annually of our officers and key employees. The executive committee obtains and relies upon comparable data including industry-wide compensation information provided by an outside consulting firm. The executive committee reviews compensation packages and appropriate compensation is determined and approved. The basis for determination is then documented by the executive committee. The compensation for the CEO of St. Francis Medical Center is set by the compensation committee of FMOL Health System (a related tax-exempt organization) according to their pay practices which are similar to those described above. GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 The organization makes its governing documents, conflict of interest policy and financial statements available upon request. PART XI, QUESTION 9 CAPITAL TRANSFERS $(4,698,327) SECTION 1.263(A)-3(N) ELECTION-BOOK CONFORMITY ELECTION ST. FRANCIS MEDICAL CENTER 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, 2020. SECTION 1.263 (A)-1(F)- ELECTION- DE MINIMIS SAFE HARBOR ELECTION ST. FRANCIS MEDICAL CENTER 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, 2020. 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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