2021-11-10T16:00:11-06:00 2020-12-31 201941244 HORNE LLP 661 SUNNYBROOK ROAD STE 100 RIDGELAND MS 39157 990 2020-10-01 264626264 ST MARTIN HOSPITAL INC STMA 3375071201 210 CHAMPAGNE BLVD BREAUX BRIDGE LA 70517 GLENN DAILEY CEO 3375071201 2021-11-10 1 GLENN DAILEY 999009999 AMIE T WHITTINGTON CPA P01082167 6013261000 2021-11-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z GLENN DAILEY 1214 COOLIDGE BLVD LAFAYETTE LA 70503 6586620 0 X WWW.STMARTINHOSPITAL.ORG X 2009 LA THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. 3 1 217 4 5420 2727 5301502 4314 30228236 5652098 30 0 1379417 930208 36909185 6586620 7438 8000 0 0 9368424 2395097 0 0 0 14006041 3961053 23381903 6364150 13527282 222470 40198956 43049986 8037065 8916201 32161891 34133785 ST. MARTIN HOSPITAL'S MISSION IS TO IMPROVE, MAINTAIN AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 4655967 8000 6576886 COMMUNITY MEDICAL CARE PROVIDER. THE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE PARISH REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SERVICES INCLUDE INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION.PROGRAM SERVICE STATISTICS RELATED TO PROVIDING MEDICAL CARE FOR THE HOSPITAL: TOTAL PATIENT DAYS WERE 1,086, TOTAL EMERGENCY ROOM VISITS WERE 4,206, AND TOTAL REHAB UNITS WERE 3,980. 4655967 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 57 0 1 217 1 1 1 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 3375071201 210 CHAMPAGNE BLVD BREAUX BRIDGE LA 70517 ALLEN STELLY BOARD MEMBER - NON-VOTING 1.00 0.00 X 0 0 0 BECKY PATIN BOARD MEMBER - NON-VOTING 1.00 0.00 X 0 0 0 BURTON DUPUIS BOARD MEMBER 1.00 0.00 X 0 0 0 CHESTER CEDARS BOARD MEMBER - NON-VOTING 1.00 0.00 X 0 0 0 DR WARREN DEGATUR BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK GANDY SMH BOARD CHAIRMAN 1.00 44.00 X X 0 898658 125871 GLENN DAILEY CEO 40.00 0.00 X 0 238719 4998 FELECIE LANDRY RN 40.00 0.00 X 0 129563 7811 JACQUELINE NED RN 40.00 0.00 X 0 118397 18221 KAREN MCFAUEL QUALITY CLINICAL ANALYST S 40.00 0.00 X 0 133339 8298 KIM COLLIGAN RN SPECIALTY EMERGENCY 40.00 0.00 X 0 147236 3174 THERESA ACOSTA RN SPECIALTY TEAM LEAD EME 40.00 0.00 X 0 149092 8675 KAREN WYBLE FORMER CEO 40.00 0.00 X 0 272493 15069 0 2087497 192117 9 1 1 0 ADVANTAGE MEDICAL PROFESSIONAL 3340 SEVERN AVE SUITE 320 METAIRIE LA 70002 NURSING SERVICES 751921 CARDIOVASCULAR INSTITUTE OF THE SOUTH 225 DUNN STREET HOUMA LA 70360 CARDIOLOGY DIAGNOSTIC SERVICES 417015 K & M MEDICAL CONSULTANTS LLC 1233 WAYNE GILMORE CIRCLE STE 250B OPELOUSAS LA 70570 CONTRACT LABOR - PHARMACISTS 226400 COMPREHENSIVE PHARMACY SERVICES PO BOX 638316 CINCINATTI OH 45263 PHARMACY MANAGEMENT SERVICES 201735 COL IMAGING LLC PO BOX 2207 LAKE CHARLES LA 706022207 MRI MAINTENANCE CONTRACT 192000 8 4314 4314 PATIENT SERVICE REVENU 621990 5652098 5652098 5652098 OTHER REVENUE 900099 924593 919173 5420 DIETARY REVENUE 722210 5615 5615 930208 6586620 6576886 5420 0 8000 8000 2024672 1673179 351493 35137 29504 5633 187888 147213 40675 147400 122701 24699 4324 228 4096 54325 32264 22061 330245 173473 156772 355 201 154 3040 655 2385 58676 58676 130853 130853 1026 1026 CONTRACT LABOR 981148 923962 57186 MEDICAL SUPPLIES 905550 846591 58959 OVERHEAD ALLOCATION 834976 834976 BAD DEBT 552014 552014 104521 15129 89392 6364150 4655967 1708183 0 35627 20688 4821321 5497507 587148 584374 12060 459644 5750167 130853 2958699 5619314 31784101 30868459 40198956 43049986 1327547 3636605 1733167 0 4976351 5279596 8037065 8916201 X 32161891 34133785 32161891 34133785 40198956 43049986 X 222470 1749424 X X 0 1 X 1 0 X X 1050 46181 1050 46181 4654917 219609567 4655967 219655748 382798 1000000 95700 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 150830 210264 207488 46181 614763 250000 250000 250000 250000 1000000 1500000 150830 210264 207488 46181 614763 FORM 990, SCHEDULE C, PART II-A, LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH LOUISIANA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. 3295195 63769 3231426 337300 12358 324942 968000 54726 913274 1149672 1149672 5619314 OTHER ASSETS 36766 RELATED PARTY RECEIVABLES 29935469 NET RIGHT OF USE OPERATING LEASE ASSET 896224 30868459 OTHER ACCOUNTS PAYABLE 1462011 CAPITAL LEASE OBLIGATION 2921805 CURRENT PORTION OF RIGHT OF USE ASSET 300953 LONG TERM PORTION OF RIGHT OF USE ASSET 594827 5279596 X PART X, LINE 2: THE MAJORITY OF OCHSNER 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 2017 THROUGH 2020 IN OCHSNER'S MAIN TAX JURISDICTIONS. 1 1 1 X 1 X 1 0 0 763 763 0.00010 1365259 1625998 0 0.00000 1366022 1625998 763 0.00010 8000 8000 0.00140 8000 8000 0.00140 1374022 1625998 8763 0.00150 1 552014 276007 6999637 2467576 4532061 X 1 1 1 1 ST MARTIN HOSPITAL INC 210 CHAMPAGNE BLVD BREAUX BRIDGE LA 70517 X X X ST MARTIN HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPT X 1 19 1 SEE SUPPLEMENTAL SCHEDULE FOR FULL WEB ADDRESS 0 1 X 200.000000000000 200.000000000000 X 1 1 X X X 1 X HTTPS://OCHSNERLG.ORG/FINANCIAL-ASSISTANCE-POLICIES X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20FINANCIAL%20ASSISTANCE%20AP X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20PLAIN%20LANGUAGE%20SUMMARY% X X X X X X X 1 0 X X 1 X 0 0 ST. MARTIN HOSPITAL PART V, SECTION B, LINE 5: THE SOURCES USED FOR SMH'S CHNA ARE PROVIDED IN THE REFERENCES AND APPENDIX B: COMMUNITY LEADER INTERVIEWWS. INFORMATION WAS GATHERED BY CONDUCTING INTERVIEWS WITH INDIVIDUALSREPRESENTING COMMUNITY HEALTH AND PUBLIC SERVICE ORGANIZATIONS, MEDICAL PROFESSIONALS, HOSPITAL ADMINISTRATION, AND OTHER HOSPITAL STAFF MEMBERS. TWELVE INTERVIEWS WERE CONDUCTED FROM JULY 2 THROUGH AUGUST 21, 2019. INTERVIEWS REQUIRED APPROXIMATELY 30 MINUTES TO COMPLETE. INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY.THE CHNA CAN BE ACCESSED AT: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDF ST. MARTIN HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL HAS ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY. THE HOSPITAL ALSO HAS INCLUDED A COMMUNITY BENEFIT SECTION IN ITS OPERATIONAL PLANS AND ADOPTED A BUDGET FOR PROVISION OF SERVICES THAT ADDRESSES THE NEEDS IDENTIFIED IN THE CHNA. THE HOSPITAL IS PRIORITIZING THE HELATH NEEDS OF THE COMMUNITY AND THE SERVICES THAT THE HOPSITAL WILL UNDERTAKE TO MEET THE HEALTH NEEDS OF THE COMMUNITY, AS DETAILED IN THE CHNA AND ITS IMPLEMENTATION STRATEGY.PLEASE SEE IMPLEMENTATION STRATEGY FOR FURTHER INFORMATION. IMPLEMENTATION STARTEGY CAN BE FOUND AT: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-05/CHNA%20IMPLEMENTATION%20STRATEGY%20FOR%20SMH%20FINAL%201.28.20.PDF ST. MARTIN HOSPITAL PART V, SECTION B, LINE 16J: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. PART V, QUESTIONS 7A & 10A: WEB ADDRESS OF CHNA AND IMPLEMENTATION STRATEGY HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDFHTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-05/CHNA%20IMPLEMENTATION%20STRATEGY%20FOR%20SMH%20FINAL%201.28.20.PDF PART I, LINE 7: THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H.PART I, LINE 7B, MEDICAID: SMH IS A MEMBER OF THE RURAL HEALTH CARE COALITION. THESE RURAL HOSPITALS ARE PROTECTED STATUTORILY BY STATE LEGISLATION. THE STATE PROVIDES SUPPLEMENTAL MEDICAID PAYMENTS TO HELP OFFSET THE UNCOMPENSATED COST OF SERVICES PROVIDED TO BOTH MEDICAID AND UNINSURED PATIENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 552,014. PART II, COMMUNITY BUILDING ACTIVITIES: WE PROVIDE HEALTH SCREENINGS, WHICH INCLUDE BLOOD PRESSURE CHECKS, GLUCOSE SCREENING AND EKGS. WE ALSO PROVIDE EDUCATIONAL PROGRAMS WITHIN OUR COMMUNITY. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEPT EXPENSE IS ON PAGE 17 OF THE ATTACHED AUDITED FINANCIALS STATEMENTS. PLEASE NOTE THAT BAD DEBT EXPENSE IS NOW REFERRED TO AS IMPLICIT PRICE CONCESSIONS.BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE REFLECTED ON THE ORGANIZATION'S TRIAL BALANCE AND CLASSIFIED AS IMPLICIT PRICE CONCESSIONS IN THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BOTH CHARITY AND BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT AT LEAST 50% OF THE PATIENTS THAT WERE ADJUSTED TO BAD DEBT ARE LIKELY PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT OR ARE UNWILLING TO INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. HOWEVER, HOSPITAL BELIEVES THAT THE COST OF THIS BAD DEBT IS A COMMUNITY BENEFIT BECAUSE BY CONTINUING TO TREAT PATIENTS THAT ARE UNABLE TO AFFORD CARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL CARE. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITALS FILED COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. PART III, LINE 9B: WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE ,WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. PART VI, LINE 2: THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATI0N. THE H0SPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR YEAR ENDING 9/30/19. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS COMPLETED IN SEPTEMBER OF 2019. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS.THE CHNA CAN BE ACCESSED AT: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDFAND THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT:HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-05/CHNA%20IMPLEMENTATION%20STRATEGY%20FOR%20SMH%20FINAL%201.28.20.PDF PART VI, LINE 3: WE POST A NOTICE THAT WE HAVE A CHARITY POLICY THAT PROVIDES FOR FINANCIAL ASSISTANCE TO THOSE THAT MEET SPECIFIC CRITERIA IN THE RECEPTION AREA OF THE HOSPITAL. PART VI, LINE 4: WE ARE LOCATED IN A RURAL PARISH IN LOUISIANA. ST. MARTIN PARISH IS AN AGRICULTURAL COMMUNITY WITH COMMERCIAL FISHING. WE ARE THE ONLY HOSPITAL IN OUR PARISH (ST. MARTIN). WE ALSO HAVE BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA.THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING GEOGRAPHIC AND DEMOGRAPHIC AREAS, IS ADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED DURING 2019. THE CHNA CAN BE ACCESSED AT:HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDF PART VI, LINE 5: OUR BOARD OF TRUSTEES IS COMPRISED OF MEMBERS FROM OUR COMMUNITY, WHICH MAKE UP OUR PRIMARY SERVICE AREA. ST. MARTIN HOSPITAL EXTENDS PRIVILEGES TO PRIMARY CARE PHYSICIANS IN OUR COMMUNITY. SURPLUS FUNDS ARE USED TO PROVIDE CAPITAL IMPROVEMENTS TO OUR HOSPITAL TO ENRICH THE QUALITY CARE THAT WE PROVIDE. WE ALSO RECRUIT PHYSICIANS INTO OUR COMMUNITY, ORGANIZE FUND-RAISERS FOR CANCER RESEARCH THROUGH OUR PARTICIPATION IN THE RELAY FOR LIFE. WE ALSO PROVIDE SUPPORT TO THE UNITED WAY OF ACADIANA BY HAVING A FUND-RAISING CAMPAIGN AND HAVING MEMBERS OF OUR STAFF ON THEIR BOARD AND COMMITTEES. PART VI, LINE 6: THE HOSPITAL IS OWNED BY LAFAYETTE GENERAL HEALTH SYSTEMS. THIS ALLIANCE HAS ALLOWED THE HOSPITAL TO EXTEND ITS OUTREACH TO ALL THE CITIZENS OF ST. MARTIN PARISH. THE HOSPITAL WAS ABLE TO EXPAND ITS OUTPATIENT AND EMERGENCY SERVICES. THE HOSPITAL WAS ALSO ABLE TO ENRICH ITS INPATIENT SERVICES BY IMPLEMENTING A HOSPITALIST PROGRAM. 1 LAFAYETTE PARISH SCHOOL SYSTEM -ON TRACK BY 5 ALLIANCE 326 GAUTHIER ROAD LAFAYETTE LA 70501 726000625 GOV'T 5000 DONATION 1 0 PART I, LINE 2: CHARITABLE DONATIONS ARE MADE TO LOCAL NON-PROFIT ORGANIZATIONS THAT PARALLEL OUR HEALTHCARE MISSION IN THE COMMUNITY. 0 1 0 0 0 1 1 0 0 PATRICK GANDY SMH BOARD CHAIRMAN 0 538501 0 264087 0 96070 0 110100 0 15771 0 1024529 0 0 KAREN WYBLE FORMER CEO 0 216492 0 33421 0 22580 0 4730 0 10339 0 287562 0 0 GLENN DAILEY CEO 0 198286 0 27084 0 13349 0 4765 0 233 0 243717 0 0 THERESA ACOSTA RN SPECIALTY TEAM LEAD EME 0 145465 0 500 0 3127 0 3081 0 5594 0 157767 0 0 KIM COLLIGAN RN SPECIALTY EMERGENCY 0 140218 0 500 0 6518 0 2964 0 210 0 150410 0 0 PART I, LINE 3 AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, 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 A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED BY LAFAYETTE GENERAL MEDICAL CENTER, THE SOLE MEMBER OF ST. MARTIN HOSPITAL, 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 WAS $104,400, WHICH INCLUDES BOTH LAFAYETTE GENERAL MEDICAL CENTER AND ST. MARTIN HOSPITAL EMPLOYEES. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE PATRICK GANDY, SMH BOARD CHAIRMAN. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2020 W-2 WAGES, TOTALLED $ 69,948. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2020 W-2 WAGES: PATRICK GANDY, SMH BOARD CHAIRMAN. PART I, LINE 6 THE ORGANIZATION DOES HAVE AN INCENTIVE PLAN FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS, AS LISTED ON PART VII OF FORM 990, CALCULATION OF INCENTIVE PLAN PAYMENTS ARE IN PART BASED ON THE CONSOLIDATED NET EARNINGS. WARREN J DEGATOR JR MD INC WARREN DEGATUR, BOARD MEMBER, IS SOLE OWNER OF WARREN J DEGATOR JR MD INC. 30500 DR. DEGATUR'S PRACTICE WAS ISSUED A FORM 1099 IN THE AMOUNT OF $30,500. THE $30,500 WAS FOR MEDICAL DIRECTOR PAY. 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-STOCK NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS RATIFY THE SELECTION OF THE INDIVIDUALS THAT SERVE ON THE BOARD OF TRUSTEES (GOVERNING BODY) AFTER THOSE INDIVIDUALS HAVE BEEN SELECTED AS A TRUSTEE BY THE BOARD OF TRUSTEES FORM 990, PART VI, SECTION A, LINE 7B YES, 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 THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S ACCOUNTING STAFF THE COMPLETED FORMS ARE REVIEWED BY THE OFFICERS AND THEN PRESENTED TO THE BOARD FOR REVIEW, COMMENT AND CORRECTIONS IF NEEDED BEFORE FILING WITH THE IRS. 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 GOVERNANCE 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 15A 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 ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. FORM 990, PART VI, SECTION C, LINE 19 OTHER DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY/LEGAL AUTHORITIES. FORM 990, PART XI, LINE 9: OTHER CHANGE IN NET ASSETS 1,749,424. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PREVIOUS YEAR LAFAYETTE GENERAL MEDICAL CENTER INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 720535375 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE HEALTH VENTURES INC PO BOX 53092 LAFAYETTE LA 70503 721006966 PHYSICIAN PRACTICES LA 501(C)(3) 509 (A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE GENERAL HEALTH SYSTEMS INC 920 W PINHOOK LAFAYETTE LA 70503 383646817 HEALTHCARE SUPPORT LA 501(C)(3) 509 (A)(3) N/A 0 UNIVERSITY HOSPITAL & CLINICS INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 462605366 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 464958152 HEALTHCARE SUPPORT LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE GENERAL FOUNDATION INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 371766778 FOUNDATION LA 501(C)(3) 509 (A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS 0 KAPLAN GENERAL HOSPITAL DBA ABROM KAPLAN MEMORIAL HOSPITAL 1214 COOLIDGE BLVD LAFAYETTE LA 70503 472540179 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 OCHSNER CLINIC FOUNDATION 1514 JEFFERSON HIGHWAY NEW ORLEANS LA 70121 720502505 PATIENT CARE LA 501(C)(3) LINE 3 N/A 0 BRENT HOUSE CORPORATION 1512 JEFFERSON HIGHWAY NEW ORLEANS LA 70121 720872457 RENTS HOTEL ROOMS TO PATIENTS/GUESTS OF OCHSNER FACILITIES. 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