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OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC (EIN 72-1495500)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-07-15
IRS object ID
202031979349304703
Schema version
2018v3.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-07-15T12:59:00-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1301 Main Street Suite 2150AddressLine1Txt
CityBaton RougeCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70801ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN721495500EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OUR LADY OF THE LAKE ASSUMPTIONBusinessNameLine1Txt
Business Name Line2COMMUNITY HOSPITALBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% AMANDA HYMELInCareOfNm
Business Name ControlOURLBusinessNameControlTxt
Phone2257657709PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15000 Hennesy BoulevardAddressLine1Txt
CityBaton RougeCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70808ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFF LIMBOCKERPersonNm
Person TitleCFO/EVPPersonTitleTxt
Phone2257656565PhoneNum
Signature2020-06-25SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN HOOKSPreparerPersonNm
PTINP00746825PTIN
Phone2253444000PhoneNum
Preparation2020-06-23PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.206.0.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id72049520201975000012FederalOriginalSubmissionId
Federal Original Submission Id2020-07-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEB850E1BCF32CA73DDA849DEBA9ACC48FFFF1BCDAtSubmissionCreationDeviceId
At Submission Filing Device Id606B868638B351F0DD3B21299E8CEABE66140F96AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHRISTINA HOCKADAYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15000 HENNESSY BOULEVARDAddressLine1Txt
CityBATON ROUGECityNm
State AbbreviationLAStateAbbreviationCd
ZIP70808ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,208,381GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateLALegalDomicileStateCd
Activity Or MissionTHE PURPOSE OF THE HOSPITAL IS TO PROVIDE FOR THE CARE OF ILL, INJURED AND DISABLED PERSONS AND TO ENHANCE THE HEALTH OF THOSE IN THE COMMUNITY THROUGH RESEARCH AND EDUCATION.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee59TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$14,617PYContributionsGrantsAmt
CY Contributions Grants$30,000CYContributionsGrantsAmt
PY Program Service Revenue$7,829,587PYProgramServiceRevenueAmt
CY Program Service Revenue$6,638,912CYProgramServiceRevenueAmt
PY Investment Income$474,114PYInvestmentIncomeAmt
CY Investment Income$366,139CYInvestmentIncomeAmt
PY Other Revenue$28,417PYOtherRevenueAmt
CY Other Revenue$28,417CYOtherRevenueAmt
PY Total Revenue$8,346,735PYTotalRevenueAmt
CY Total Revenue$7,063,468CYTotalRevenueAmt
PY Grants And Similar Paid$4,138PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,018CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,138,779PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,078,768CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,378,242PYOtherExpensesAmt
CY Other Expenses$3,510,949CYOtherExpensesAmt
PY Total Expenses$6,521,159PYTotalExpensesAmt
CY Total Expenses$6,592,735CYTotalExpensesAmt
PY Revenues Less Expenses$1,825,576PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$470,733CYRevenuesLessExpensesAmt
Total Assets BOY$15,092,651TotalAssetsBOYAmt
Total Assets EOY$16,049,358TotalAssetsEOYAmt
Total Liabilities BOY$3,977,562TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,645,435TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,115,089NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,403,923NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$5,112,253ExpenseAmt
Grant$3,018GrantAmt
Revenue$6,638,912RevenueAmt
DescOUR LADY OF THE LAKE ASSUMPTION PROVIDES TWENTY-FOUR HOUR HEALTHCARE SERVICES FOR PATIENTS IN THE SURROUNDING RURAL COMMUNITIES. THE HOSPITAL HAD 5,917 EMERGENCY ROOM VISITS THIS YEAR. THE HOSPITAL'S EMERGENCY ROOM IS OPEN TO EVERYONE, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL ALSO PROVIDED 25,390 LAB TESTS, OVER 3,000 OUTPATIENT CLINIC VISITS AND 110 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.Desc
Total Program Service Expenses$5,112,253TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee59EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAMANDA HYMELPersonNm
Phone2257656565PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15000 HENNESSY BOULEVARDAddressLine1Txt
CityBATON ROUGECityNm
State AbbreviationLAStateAbbreviationCd
ZIP70808ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Jeffrey D Limbocker
CFO2.058.0Yes (X)Yes (X)$0$696,323$138,768
Kenneth Wester
Board Member2.055.5Yes (X)$0$1,115,252$204,346
John Selser
chair2.02.0Yes (X)Yes (X)$0$0$0
William E Balhoff
Chair2.00.0Yes (X)Yes (X)$0$0$0
Charles P Bolotte MD
Board member10.00.0Yes (X)$35,698$0$0
Christy Hockaday
CEO2.048.0Yes (X)Yes (X)$0$245,030$28,633
Yolanda Dixon
Secretary2.02.0Yes (X)Yes (X)$0$0$0
Harry J Philips Jr
Vice Chair2.00.0Yes (X)Yes (X)$0$0$0
Stephanie Manson
Board Member2.040.0Yes (X)$0$469,495$68,312
Brian F Tripode
Supervisor-Pharmacy40.00.0$159,182$0$29,270Yes (X)
Donna M Mullings
Director - nursing 140.00.0$102,333$0$41,465Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$297,213TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,526,100TotReportableCompRltdOrgAmt
Total Other Compensation$510,794TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OLOLRMC Laboratory Services
7777 Hennessy Blvd Suite 804Baton RougeLA70898Lab Services$1,066,081
Correct Care Inc
229 Saint John LaneCOVINGTONLA704333276Director of ER Fees$1,264,787
FMOL HEALTH SYSTEM
4200 ESSEN LANEBATON ROUGELA70809LAB MANAGEMENT FEES$111,745
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$30,000AllOtherContributionsAmt
Total Contributions$30,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue900099$6,623,529$6,623,529
Purchase Discounts900099$3,288$3,288
Medical Records900099$598$598
Outreach Lab900099$5,988$5,988
All other Program Service Revenue900099$5,509$5,509
FieldValueIRS element (for citing)
Total Program Service Revenue$6,638,912TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,456TotalRevenueColumnAmt
Exclusion$58,456ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$28,417RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$28,417RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,417TotalRevenueColumnAmt
Related Or Exempt Func Income$28,417RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,452,596SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,144,913SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$307,683SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$307,683TotalRevenueColumnAmt
Exclusion$307,683ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,063,468TotalRevenueColumnAmt
Related Or Exempt Func Income$6,667,329RelatedOrExemptFuncIncomeAmt
Exclusion$366,139ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,018TotalAmt
Program Services$3,018ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,307,893TotalAmt
Program Services$1,813,942ProgramServicesAmt
Management And General$493,951ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$265,470TotalAmt
Program Services$208,651ProgramServicesAmt
Management And General$56,819ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$348,612TotalAmt
Program Services$262,047ProgramServicesAmt
Management And General$86,565ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$156,793TotalAmt
Program Services$124,304ProgramServicesAmt
Management And General$32,489ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,462,685TotalAmt
Program Services$1,164,013ProgramServicesAmt
Management And General$298,672ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,450TotalAmt
Program Services$5,450ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13,743TotalAmt
Management And General$13,743ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,085,386TotalAmt
Program Services$871,944ProgramServicesAmt
Management And General$213,442ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$136TotalAmt
Program Services$88ProgramServicesAmt
Management And General$48ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$263,029TotalAmt
Program Services$97,973ProgramServicesAmt
Management And General$165,056ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$40,741TotalAmt
Program Services$40,741ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$235,623TotalAmt
Program Services$201,624ProgramServicesAmt
Management And General$33,999ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,290TotalAmt
Program Services$16,726ProgramServicesAmt
Management And General$7,564ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$189,530TotalAmt
Program Services$162,182ProgramServicesAmt
Management And General$27,348ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$41,578TotalAmt
Management And General$41,578ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies Expense$146,730$137,648$9,082$0
SALES TAX EXPENSE$2,028$1,902$126$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,592,735TotalAmt
Program Services$5,112,253ProgramServicesAmt
Management And General$1,480,482ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,119,523BOYAmt
EOY$8,327,145EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,488BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,550BOYAmt
EOY$265,779EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$802,508BOYAmt
EOY$499,527EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$14,673BOYAmt
EOY$14,702EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,963,037LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,921,357LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,194,448BOYAmt
EOY$1,041,680EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$5,730,042BOYAmt
EOY$5,900,525EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$212,419BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$15,092,651BOYAmt
EOY$16,049,358EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,573,770BOYAmt
EOY$2,908,032EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,403,792BOYAmt
EOY$1,737,403EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,977,562BOYAmt
EOY$4,645,435EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,109,251BOYAmt
EOY$11,403,923EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,838BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,115,089BOYAmt
EOY$11,403,923EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,092,651BOYAmt
EOY$16,049,358EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$470,733ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$181,899NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$55,461OtherCostOrOtherBasisAmt
Book Value$55,461BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$855,835OtherCostOrOtherBasisAmt
Depreciation$666,505DepreciationAmt
Book Value$189,330BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$82,115OtherCostOrOtherBasisAmt
Depreciation$44,845DepreciationAmt
Book Value$37,270BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,969,626OtherCostOrOtherBasisAmt
Depreciation$2,210,007DepreciationAmt
Book Value$759,619BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$1,041,680TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp
Total Book Value Securities$0TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
RETIREMENT PAYABLE LONG TERM$1,366,941
DUE TO/FROM RELATED ENTITIES$370,462
FieldValueIRS element (for citing)
Total Liability$1,737,403TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFIN 48 (ASC 740) FOOTNOTEFormAndLineReferenceDesc
ExplanationFMOLHS 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.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$175,763TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$175,763NetCommunityBenefitExpnsAmt
Total Expense0.03460TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,634,639TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,634,639DirectOffsettingRevenueAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,810,402TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,634,639DirectOffsettingRevenueAmt
Net Community Benefit Expns$175,763NetCommunityBenefitExpnsAmt
Total Expense0.03460TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,255TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$35,255NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,255TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$35,255NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,845,657TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,634,639DirectOffsettingRevenueAmt
Net Community Benefit Expns$211,018NetCommunityBenefitExpnsAmt
Total Expense0.03460TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$64,827BadDebtExpenseAmt
Reimbursed By Medicare$1,788,282ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$1,812,543CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$24,261MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Assumption Community HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 HIGHWAY 402AddressLine1Txt
CityNAPOLEONVILLECityNm
State AbbreviationLAStateAbbreviationCd
ZIP70390ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherRural Health ClinicOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Assumption Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SUPPLEMENT AT PART VFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SUPPLEMENT AT PART VFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SUPPLEMENT AT PART VFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 5THE 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 PARISH 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.
PART V, SECTION B, QUESTION 7THE CHNA CAN BE FOUND AT HTTPS://OLOLRMC.COM/PAGES/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX
PART V, SECTION B, QUESTION 11Assumption 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 2018-2019 fiscal year, ACH served over 2,000 parishioners. ACH partnered with Assumption's Council of Aging for The Council of Aging Community Health Fair which targeted senior citizen audience of Assumption Parish. ACH administered free flu vaccines, blood pressure and glucose screenings, cholesterol screenings, and weight and BMI checks. ACH purchased healthy snacks that were distributed to the seniors. There were approximately 125 attendees at the Fair. ACH participated in the Assumption Head Start Health Fair. ACH administered free flu vaccines, blood pressure and glucose screenings, and weight and BMI checks. ACH purchased Healthy Food Choices coloring books and crayons that were given to the parents and grandparents to take home for their children and grandchildren. Approximately 30 people attended. ACH representatives also attended 3 parent meetings to introduce the Get Fit Program. ACH administered flu vaccines to the Assumption Retarded Center citizens and their staff. Assumption Parish Sheriff's Department held an in-house health fair. ACH offered blood pressure screenings and BMI screenings to all of their employees. ACH performed a full-scale exercise for Active Shooter which involved our parish sheriff's department, our volunteer fire department, Acadian, Policy Jury and Nursing Home. This exercise provided education and confidence to our parishioners that ACH would be prepared for an active shooter in addition to showing that agencies can work together for the safety of the parish. A Nutritional Program was offered through our clinic to teach children about healthier food choices. Recognizing the program could be expanded and enhanced, ACH reached out to the public school nurses for their suggestions. ACH was then introduced to the LSU Ag Center Agent. After months of sharing suggestions and planning ACH created the Get-Fit-Ba-You program. Assumption collaborated with the parish LSU Ag Center to begin the Get-Fit-Ba-You program which was taught to 1100 5th - 8th graders in our parish public school system. LSU Ag Center, with the help of LSU, designed a nutritional three week program. This introduced students to healthy choices they can make for themselves. ACH provides the staff to cook food tasting samples for the 1100 students. Through a series of pre and post tests given to the students that participated through their physical education classes, ACH determined that there was a 35% increase in knowledge of nutrition because of the program. ACH created a walking path under four beautiful oak trees. Benches, planters and trashcans were added to continue to add to the beauty of the walking path. ACH estimates that 25 to 30 parishioners a day use our walking path. Mary Bird Perkins and Woman's Hospital Mobile Unit have partnered with us to provide breast exams and skin and prostate cancer screenings between three to four times a year, completing 88 breast exams.
PART V, SECTION B, QUESTION 13HPRESUMPTIVE 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 ASSITANCE 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 V, SECTION B, QUESTION 16JREGISTRATION 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 ASSITANCE POLICY. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICE AND AT ALL REGISTRATION LOCATIONS.
PART V, SECTION B, QUESTION 16A, B, & CThe Financial Assistance Policy (FAP), FAP application form, and a plain-language summary of the FAP are available at: https://fmolhs.org/financial-assistance-policy/

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3CFINANCIAL 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 ASSITANCE 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 7THE 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 IRS WORKSHEET 2.
PART III, SECTION A, QUESTION 2PART III, SECTION A, QUESTION 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 4THE BAD DEBT FOOTNOTE IS ON PAGE 19 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8THE 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 9BPATIENTS 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 2NEEDS 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 EDUCTION PROGRAMS.
PART VI, LINE 3PATIENT 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 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. 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 INFORMATION THE 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 CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE ANGELS HOSPITAL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Jeffrey D Limbocker
CFO$0$535,092$0$160,416$0$815$0$114,181$0$24,587$0$835,091$0$0
Kenneth Wester
Board Member$0$741,977$0$372,460$0$815$0$175,987$0$28,359$0$1,319,598$0$0
Brian F Tripode
Supervisor-Pharmacy$159,057$0$0$125$0$6,717$0$22,553$0$188,452$0$0$0
Christy Hockaday
CEO$0$208,231$0$35,984$0$815$0$10,039$0$18,594$0$273,663$0$0
Stephanie Manson
Board Member$0$399,671$0$69,249$0$575$0$41,046$0$27,266$0$537,807$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I QUESTION 4AA BOARD MEMBER AND THE CFO LISTED IN PART VII 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. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE CEO 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 GENERALLY 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR.
PART I QUESTION 4BFMOLHS 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. No one listed on Part VII, Section A received a payment from the plans in the current year.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, QUESTION 1 - ORGANIZATION'S MISSIONINSPIRED 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.
PART VI, SECTION A, QUESTION 6OUR 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.
PART VI, SECTION A, QUESTION 7AOUR 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.
PART VI, SECTION A, QUESTION 7BOUR 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
PART VI, SECTION A, QUESTION 11AFTER 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.
PART VI, SECTION B, QUESTION 12COLOL 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 13Throughout 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, 2019. 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).
PART VI, SECTION B, QUESTION 15A & 15BOTHER 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.
PART VI, SECTION C, QUESTION 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
SECTION 1.263(A)-3(N) ELECTION-BOOK CONFORMITY ELECTIONOUR 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, 2019.
SECTION 1.263 (A)-1(F) - ELECTION- DE MINIMIS SAFE HARBOR ELECTIONOUR 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, 2019. 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).
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACT LABOR TOTAL FEES:139587
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICES TOTAL FEES:141403
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL PURCHASED SVC TOTAL FEES:802558
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING TOTAL FEES:1838

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ST BERNARD HEALTH FUND
4200 ESSEN LANEBATON ROUGELA70809204685614HEALTHCARELA501(C)(3)11 TYPE 1FMOLfalse
HEALTH CARE CENTERS IN SCHOOLS
5000 HENNESSY BLVDBATON ROUGELA70808721443935HEALTHCARELA501(C)(3)7OLOLfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
HEART HOSPITAL OF ACADIANA LLC
1105 KALISTE SALOOM ROADLAFAYETTELA70508300442368HEALTHCARELALOURDESN/A
PERKINS PLAZA IMAGING DEVELOPMENT LLC
5000 HENNESSY BLVD PLAZA 2 SUITEBATON ROUGELA70808203894521REAL ESTATELAOLOLN/A
P&S SURGERY CENTER LLC
312 GRAMMONT STREETMONROELA71201721387870HEALTHCARELASFMCN/A
LOURDES IMAGING DEVELOPMENT LLC
4801 AMBASSADOR CAFFERY PKWYLAFAYETTELA70508208326287REAL ESTATELALOURDESN/A
PARK PLACE SURGERY CENTER LLC
4811 AMBASSADOR CAFFERY PKWYLAFAYETTELA70508721404092HEALTHCARELALOURDESN/A
BRPT LAKE REHABILITATION CENTERS LLC
5222 BRITTANY DRIVEBATON ROUGELA70808721506100HEALTHCARELAOLOLN/A
CONVENIENT CARE LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809721439481HEALTHCARELAOLOLN/A
SURGICAL SPECIALTY CENTER OF BATON ROUGE
8080 BLUEBONNET BLVDBATON ROUGELA70810263160962HEALTHCARELAOLOLN/A
ST ELIZABETH-MARY BIRD PERKINS CANCER C
4950 ESSEN LANEBATON ROUGELA70809260628752HEALTHCARELAOLOLN/A
NORTHEAST LA CANCER INSTITUTE LLC
411 CALYPSO STREETMONROELA71201721329499HEALTHCARELASFMCN/A
LHCG-XIII LLC
901 S HUGH WALLIS ROADLAFAYETTELA70508208068308HEALTHCARELALOURDESN/A
LOURDES AFTER HOURS LLC
7777 HENNESSY BLVD SUITE 1004-202BATON ROUGELA70809201367299HEALTHCARELALOURDESN/A
LAKE URGENT CARE ASCENSION LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809352463092HEALTHCARELAOLOLN/A
OLOLUSP SURGERY CENTER LLC
15305 DALLAS PKWY STE 1600 LB 28ADDISONTX75001352457810HEALTHCARETXOLOLN/A
ST FRANCIS URGENT CARE LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809474013731HEALTHCARELASFMCN/A
GAMMA KNIFE OF LOUISIANA LLC
4950 ESSEN LANEBATON ROUGELA70809811827194HEALTHCARELAOLOLN/A
LHCG LXVII LLC
901 S HUGH WALLIS ROADLAFAYETTELA70508474283509HEALTHCARELALOURDESN/A
PREMIER HEALTH HOLDINGS LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809472665226HEALTHCARELAOLOLN/A
PINNACLE CARE HOLDINGS LLC
5627 S SHERWOOD FOREST BLVDBATON ROUGELA70816720423651HEALTHCARELAOLOLN/A
LAFAYETTE SURGERY CENTER LTD PSHIP
C/O C T CORP SYSTEM 3867 PLAZA TOWBATON ROUGELA70816HEALTHCARELALOURDESN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
HOSPITAL ASSISTANCE SERVICES
PO BOX 4027-CLAFAYETTELA70502721073486HEALTHCARELALOURDESC CORP
LOUISE INSURANCE COMPANY
INSURANCEFMOLC CORPPO BOX 1051 KY1-1102CAYMAN ISLANDSCJCJ
FRANCISICAN HEALTH & WELLNESS SERVICES
4200 ESSEN LANEBATON ROUGELA70809455492379HEALTHCARELAFMOLC CORP
FMOL HEALTH SYSTEM HOLDINGS INC
4200 ESSEN LANEBATON ROUGELA70809454405024INVESTMENTLAFMOLC CORP
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd