2019-05-15T10:34:04-05:00 2018-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2017-07-01 720408970 ST FRANCIS MEDICAL CENTER % AMANDA HYMEL STFR 3189664000 PO Box 1901 Monroe LA 71210 JEFF LIMBOCKER CFO 3189664000 2019-05-07 true BRITTANY ELLISER P01284594 2253444000 2019-05-14 167.68.102.5 72049520191355000002 2019-05-15 P 90A2C092697DC1C99C73C628271EC53DA4745AB0 EB850E1BCF32CA73DDA849DEBA9ACC48FFFF1BCD 2017 2019-02-21 02:37:17Z Jeff Limbocker PO Box 1901 Monroe LA 71210 279087031 false 0928 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. 18 15 1930 93 1022544 -2301112 390981 900640 247342981 244061200 2866745 8181583 15480586 7912353 266081293 261055776 10262 18148 0 0 116730527 108113572 0 0 0 143049531 154870182 259790320 263001902 6290973 -1946126 305374843 271917014 249662526 244696420 55712317 27220594 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 177927120 18148 251973553 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, $1,320,445 were provided without charge. The Medical Center provided 345 licensed beds, 71,635 inpatient days, 220,969 outpatient visits, and 52,221 ER visits in the year ended June 30, 2018. 177927120 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 false false false false false true true true true false false true 134 0 true 1930 true true true false false false false false false false false false X 18 15 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 R KEITH WHITE MD DIRECTOR/PHYSICIAN 40.0 0.0 X 858984 0 30953 THOMAS J GULLATT MD DIRECTOR/PHYSICIAN 40.0 0.0 X 522356 0 61033 KRISTIN WOLKART President/CEO 2.0 58.0 X X 0 413819 71908 ROLF MORSTEAD MD Ex-Officio/Chief of Staff 2.0 0.0 X 0 0 0 SIDNEY BAILEY MD Director 1.0 0.0 X 0 0 0 NICK J BRUNO PH D Director 1.0 0.0 X 0 0 0 SR HELEN CAHILL Director 1.0 11.0 X 0 0 0 WILLIAM CHEEK CHAIRMAN 1.0 0.0 X X 0 0 0 BISHOP MICHAEL G DUCA Director 1.0 0.0 X 0 0 0 HILL HINKLE MD Director 1.0 0.0 X 0 0 0 SUSAN HOFFMAN DIRECTOR 1.0 0.0 X 0 0 0 SR MARY ANN SEPULVADO OSF Director 1.0 1.0 X 0 0 0 REV LARRY STAFFORD VICE CHAIRMAN 1.0 1.0 X X 0 0 0 JOHN REA DIRECTOR 1.0 0.0 X 0 0 0 LJ HOLLAND BOARD SECRETARY 1.0 0.0 X X 0 0 0 REV EVERETT SLACK DIRECTOR 1.0 0.0 X 0 0 0 JANET DURDEN DIRECTOR 1.0 0.0 X 0 0 0 Tonya Hunter MD DIRECTOR 1.0 0.0 X 0 0 0 JEFF LIMBOCKER REGIONAL CFO 2.0 58.0 X 0 552329 131623 DAN MACKSOOD CONTRACT CFO 40.0 0.0 X 0 0 0 Tyler Felt COO 40.0 0.0 X 0 0 0 Fred Tolbert VP Ancillary Services 40.0 0.0 X 0 0 0 KAYLA JOHNSON VP Patient Care Services 40.0 0.0 X 228624 0 58953 SABRINA HOGAN VP Physician Services 40.0 0.0 X 242452 0 67902 KEVIN M MEYER Physician 40.0 0.0 X 455213 0 24847 FRANK B SARTOR Physician 40.0 0.0 X 481786 0 25288 MICHAEL LANGIULLI PHYSICIAN 40.0 0.0 X 776023 0 23715 John Califano Physician 40.0 0.0 X 504483 0 27609 JOHN D BRUCHHAUS PHYSICIAN 40.0 0.0 X 456255 0 25552 RONALD E HOGAN FORMER Regional CFO 0.0 0.0 X 0 210339 0 4526176 1176487 549383 127 true true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Management Services 27289135 MORRISON MGMT SPECIALISTS 5801 Peachtree Dunwoody Rd Atlanta GA 30342 Dietary Services 5219044 Parish Anesthesia of Monroe 3510 North Causeway Blvd Suite 404 Metarie LA 70002 Anesthesia Services 2845497 Crothall Healthcare Inc 5000 Hennessy Blvd Baton Rouge LA 70808 PURCHASED SERVICE 3317256 TRIMEDX INC 5451 Lakeview Parkway S Dr Indianapolis IN 46268 Maintenance Services 3586273 126 900640 900640 PATIENT SERVICE REVENUE 621500 230174445 229209033 965412 CAFETERIA 900099 1942168 1942168 MANAGEMENT CONSULTING FEES 900099 1895795 1895795 INCOME FROM EQUITY INVESTMENTS 900099 870229 813097 57132 OTHER 900099 9178563 9178563 244061200 1325840 1325840 0 0 4020910 4020910 0 4020910 4020910 24023554 863445 17156938 874317 6866616 -10872 6855743 6855743 0 0 0 0 0 0 0 0 0 INCREASE IN ACCRUED PENSION 3891443 3891443 3891443 261055776 250951009 1022544 8181583 18148 18148 0 0 0 932963 573546 359417 0 86130196 52949206 33180990 5930980 3646116 2284864 9310576 5723749 3586827 5808857 3571040 2237817 42853096 26344273 16508823 404458 248644 155814 0 0 0 203721 203721 20908575 12853709 8054866 349767 215022 134745 24305851 14942211 9363640 565647 347736 217911 0 8040658 4943057 3097601 662367 407195 255172 0 0 5167559 5167559 0 10949255 6731139 4218116 3152453 1937995 1214458 MEDICAL SUPPLIES EXPENSE 37276726 37276726 Equity Investments 49 49 OTHER 30000 30000 263001902 177927120 85074782 0 40561295 26970251 3656959 0 0 0 28838994 32799186 0 0 0 0 142419 115000 5571610 5903892 3565803 2434707 375513016 275482193 106570162 100030823 36796793 0 51399865 90456046 14311790 0 3736701 3736701 10222452 9470408 305374843 271917014 40681285 36467276 0 0 0 0 126473557 121705457 0 0 0 0 0 0 0 0 82507684 86523687 249662526 244696420 X 55122979 26221506 589338 999088 0 0 55712317 27220594 305374843 271917014 X -1946126 -2124969 -24420628 X false true X true true true X 15041313 15041313 205068210 138046220 67021990 2296581 1446096 850485 150299138 133776029 16523109 2807774 2213848 593926 100030823 CAPITAL RESERVE INVESTMENTS 90456046 F 90456046 0 ACCRUED PENSION COSTS 66143804 GENERAL & PROFESSIONAL LIABILI 5098059 OTHER LIABILITIES 2035516 DUE TO RELATED PARTIES 13246308 86523687 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 355277 355277 0 0.00000 51743733 44995791 6747942 0.02420 52099010 45351068 6747942 0.02420 12366 12366 49818 49818 0.00020 1766828 681375 1085453 0.00390 45670 45670 0.00020 1874682 681375 1193307 0.00430 53973692 46032443 7941249 0.02850 48465 48465 0.00020 12730 12730 3587 3587 64782 64782 0.00020 true 10851354 65299141 74999629 -9700488 X true true P&S SURGICAL HOSPITA MEDICAL SERVICES 0.5 0.0389 0.3748 2 1 ST FRANCIS MEDICAL CENTER PO BOX 1901 MONROE LA 71210 www.fmolhs.org/stfran X X X 2 P&S SURGERY CENTER LLC 312 GRAMMONT STREET MONROE LA 71201 www.pssurgery.com X X ST FRANCIS MEDICAL CENTER 1 false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 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 true X X X true X false false P&S SURGERY CENTER LLC 2 false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 false true false true X 150. 0. X X X X true true X X X true X SEE PART V, SECTION C SEE PART V, SECTION C X X X X X X true X false X X false X X X false false PART V, SECTION B, LINE 5 ST. FRANCIS MEDICAL CENTER (SFMC) AND P&S SURGICAL HOSPITAL: 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 DR. SHELLEY JONES, WHO IS THE REGIONAL MEDICAL DIRECTOR/ADMINISTRATOR WITH THE OFFICE OF PUBLIC HEALTH. ADDITIONALLY, SFMC ALSO TOOK INTO ACCOUNT INPUT FROM THOSE WHO REPRESENT A BROAD INTEREST IN THE COMMUNITY BY ATTENDING A PRIORITY AREA PRESENTATION BY DR. MONTEIC SIZER, EXECUTIVE DIRECTOR OF NORTHEAST DELTA HUMAN SERVICES AUTHORITY, WHERE THERE WAS A DISCUSSION REGARDING EMERGING THEMES IN BEHAVIORAL HEALTH, MENTAL HEALTH, AND SUBSTANCE ABUSE. 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 P&S SURGERY CENTER, LLC: THE CHNA CAN BE FOUND AT HTTPS://STFRAN.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINE 11 DURING THE CURRENT YEAR, SFMC FOCUSED ON IDENTIFIED COMMUNITY NEEDS OF OBESITY/SEDENTARY LIFESTYLES, HEART ATTACK/STROKE, CHRONIC DISEASE MANAGEMENT, AND TOBACCO USE (SUBSTANCE ABUSE). WHILE IT IDENTIFIED NINE HEALTH NEEDS, IT CHOSE NOT TO FOCUS ON ACCESS TO CARE, CARE FOR THE ELDERLY, MENTAL HEALTH, COMMUNICABLE/INFECTIOUS DISEASE, AND NUTRITION/HEALTHY EATING. HOWEVER, SINCE THERE ARE LINKAGES AMONG ALL OF THESE AREAS, SFMC ANTICIPATES THAT THE OUTCOMES OF THE NON FOCUS AREAS WILL IMPROVE DUE TO THE TIE-INS THAT EXIST. FOR EXAMPLE, WHILE WE DID NOT CHOOSE TO FOCUS ON NUTRITION/HEALTHY EATING, WE DID SELECT OBESITY/SEDENTARY LIFESTYLES WHICH WILL HAVE TIE-INS TO HOW PEOPLE EAT. ADDITIONALLY CARE FOR THE ELDERLY WILL BE IMPROVED AS A COMPONENT OF IMPROVING HEALTH IN OUR FOCUS AREAS. THE OTHER UNSELECTED HEalTH NEEDS WILL NOT GO UNADDRESSED SINCE WORK IS CURRENTLY BEING DONE BY OUR OWN RESOURCES AND/OR BY THE PROGRAMMING OF OTHER COMMUNITY ORGANIZATIONS. ST. FRANCIS MEDICAL CENTER DID THE FOLLOWING: OBESITY/SEDENTARY LIFESTYLES: SFMC ESTABLISHED GOALS REGARDING THE NUMBER OF PATIENTS RECEIVING LACTATION COUNSELING, THE IMPLEMENTATION OF A SCREENING TOOL TO GAUGE UNDERSTANDING OF MATERIALS AND INITIATION OF BREASTFEEDING, AND THE DISTRIBUTION OF INFORMATION TO PROVIDERS AND NEW PARENTS SHOWING BREASTFEEDING AS AN EVIDENCE-BASED STRATEGY TO COMBAT OBESITY. THE HOSPITAL MET OR EXCEEDED ALL OF THESE GOALS. THE HOSPITAL ALSO INCREASED THE PERCENTAGE OF PATIENTS RECEIVING BREASTFEEDING EDUCATION AS THEIR PRIMARY SOURCE OF INFORMATION ABOUT NEWBORN NUTRITION. THE HOSPITAL ALSO HAS FOCUSED ON RETAINING TWO CERTIFIED LACTATION COUNSELORS. THE HOSPITAL IS FOCUSING ON BETTER TRACKING OF ADULTS RECEIVING BMI SCREEINGS AND FOLLOW-UP EDUCATION. HEART ATTACK/STROKE: THE HOSPITAL MET ITS GOALS DURING THE FISCAL YEAR WITH REGARDS TO INCREASING THE PERCENTAGE OF ST. FRANCIS MEDICAL GROUP PATIENTS RECEIVING EFFECTIVE CLINICAL CARE FOR CORONARY ARTERY DISEASE THROUGH ANTIPLATELET THERAPY; PRESENTING INFORMATION TO AT LEAST ONE OF EACH OF THE FOLLOWING: FIRST RESPONDER, WOMEN'S GROUPS, COMMUNITY ORGANIZATION, SCHOOL, BUSINESS, HEALTHCARE PROFESSIONALS; IMPROVING TIME FROM HOSPITAL ARRIVAL TO PERCUTANEOUS INTERVENTION (PCI) FOR ELIGIBLE PATIENTS WITH HEART ATTACKS; AND PROVIDING EDUCATION TO AT LEAST 90% OF SFMC ORIENTATION SESSIONS. CHRONIC DISEASE MANAGEMENT: THE HOSPITAL HAS FOCUSED ON DEVELOPING A BUSINESS PLAN WITH GOALS AND STRATEGIES FOR REDUCING READMISSIONS. WORK HAS ALSO BEEN DONE TOWARD CREATING A SPEAKERS' BUREAU TO HELP POSITION ST. FRANCIS MEDICAL CENTER AS A RESOURCE IN THE COMMUNITY THAT CAN BE CALLED UPON WHEN COMMUNITY PARTNERS NEED EDUCATION ABOUT A TOPIC RELATED TO CHRONIC DISEASE MANAGEMENT. SUBSTANCE ABUSE/TOBACCO USE: THE HOSPITAL MET ITS GOALS REGARDING INCREASING THE NUMBER OF NEW PATIENTS WHO ATTEND AN INTAKE SESSION AND AT LEAST ONE GROUP SESSION; AND ESTABLISHING TOBACCO CESSATION SUPPORT GROUPS. P&S SURGICAL HOSPITAL (P&S): DURING THE CURRENT YEAR, P&S FOCUSED ON IDENTIFIED COMMUNITY NEEDS OF ACCESS TO DENTAL CARE AND OBESITY. WHILE IT IDENTIFIED NINE HEALTH NEEDS DURING ITS LAST CHNA, IT CHOSE NOT TO FOCUS ON CHRONIC DISEASE MANAGEMENT, CARE FOR THE ELDERLY, SUBSTANCE ABUSE, MENTAL HEALTH, HEART ATTACK/STROKE, COMMUNICABLE/INFECTIOUS DISEASE, AND NUTRITION/HEALTHY EATING. EACH NEED NOT ADDRESSED IS EITHER BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY OR P&S IS NOT EQUIPPED TO ADDRESS THE NEED. P&S DID THE FOLLOWING: ACCESS TO DENTAL CARE: P&S IS PROVIDING DENTAL CARE TO INDIVIDUALS WHO MIGHT NOT OTHERWISE HAVE ACCESS TO SUCH CARE. LAST YEAR, 270 CASES WERE HANDLED. IN THE CURRENT YEAR, 320 CASES WERE HANDLED. OBESITY: P&S HAS MET ALL ITS GOALS RELATED TO OBESITY: EMPLOYMENT/RETENTION OF ONE DIETITION; RETAINING CENTER OF EXCELLENCE DESIGNATION; RETAINING CENTER OF DISTINCTION DESIGNATION; PROVIDING A SUPPORT GROUP. PART V, SECTION B, LINE 16J St. Francis Medical Center and P&S SURGERY CENTER, LLC 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 IT WAS DISCOVERED IN MAY 2018 THAT WHILE P&S DID HAVE ITS FAP, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION AVAILABLE TO PATIENTS, IT ONLY HAD ITS FINANCIAL ASSISTANCE APPLICATION POSTED ON THE WEBSITE. THE HOSPITAL FACILITY HAS SINCE BEEN FULLY ACQUIRED BY SFMC. AS SUCH IT HAS BEEN FULLY INTEGRATED INTO SFMC'S FULLY COMPLIANT 501(R) POLICIES, PLS, AND WEBSITE POSTINGS. 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/ P&S SURGERY CENTER, LLC: THE FINANCIAL ASSISTANCE POLICY, FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT: HTTPS://FMOLHS.ORG/FINANCIAL-ASSISTANCE-POLICY/ PART V, SECTION B, LINE 16I ST. FRANCIS MEDICAL CENTER WIDELY PUBLICIZES ITS FAP, IN PART, BY INCLUDING ON ITS WEBSITE LANGUAGE TRANSLATIONS OF ITS FINANCIAL ASSISTANCE POLICY AND ASSOCIATED DOCUMENTS. P&S SURGICAL HOSPITAL, A SMALLER ASSOCIATED HOSPITAL, ALSO WIDELY PUBLICIZES THE FAP IN MANY WAYS. HOWEVER, IT WAS DISCOVERED IN MAY 2018 THAT P&S WAS MISSING THE NEEDED TRANSLATIONS OF THE FINANCIAL ASSISTANCE POLICIES AND ASSOCIATED DOCUMENTS ON ITS WEBSITE. P&S WAS FULLY ACQUIRED BY ST. FRANCIS MEDICAL CENTER AND HAS NOW ADOPTED ALL OF ST. FRANCIS'S POLICES. SINCE P&S NO LONGER EXISTS AS A SEPARATE HOSPITAL FACILITY, THE NEEDED TRANSLATIONS AS POSTED ON ST. FRANCIS'S WEBSITE WILL SERVE TO MEET 501(R) REQUIREMENTS. THE WEBSITE CONTINUES TO BE ROUTINELY MONITORED TO ENSURE THE NEEDED TRANSLATED DOCUMENTS REMAIN AVAILABLE TO THE PUBLIC. PART V, SECTION B, LINE 21 WHILE ST. FRANCIS MEDICAL CENTER HAS A COMPLIANT EMERGENCY CARE POLICY, IT WAS DISCOVERED THAT ITS SMALL AFFILIATED HOSPITAL, P&S SURGICAL HOSPITAL, HAD AN EMERGENCY CARE POLICY THAT WAS NOT FULLY IN COMPLIANCE WITH IRC REGULATION 1.501(R)-(C) DUE TO A SMALL AMOUNT OF MISSING LANGUAGE. P&S DOES NOT HAVE AN EMERGENCY DEPARTMENT, BUT OTHERWISE OPERATED IN COMPLIANCE WITH EMTALA REGULATIONS. P&S DID NOT DISCRIMINATE AGAINST ANY PATIENT WITH AN EMERGENCY CONDITION. P&S WAS FULLY ACQUIRED BY ST. FRANCIS AND HAS ADOPTED ST. FRANCIS'S EMERGENCY CARE POLICY THAT INCLUDES ALL REQUIRED LANGUAGE. PART V, SECTION B, LINE 20A ST. FRANCIS MEDICAL CENTER: SFMC HAS A FINANCIAL ASSISTANCE POLICES DESIGNED TO ASSIST PATIENTS WITH LOW INCOME AND NO HEALTH INSURANCE. FOR THOSE WHO FALL OUTSIDE OF THIS FINANCIAL ASSISTANCE POLICY, SFMC WILL INITIATE EXTRAORDINARY COLLECTION ACTIONS (ECAS) IN AN EFFORT TO COLLECT PAYMENT FOR SERVICES PROVIDED. IRC REGULATION 1.501(R)-6(C)(4)(A) REQUIRES THAT SFMC SEND TO ALL PATIENTS (EVEN NON-QUALIFYING PATIENTS WITH HEALTH INSURANCE) A PLAIN LANGUAGE SUMMARY OF THE FAP AND A COMPLIANT LETTER PRIOR TO INITIATING THE ECA. IT WAS DISCOVERED IN MAY 2018 THAT TWO COLLECTION VENDORS OF SFMC DID NOT FULLY COMPLY WITH MAKING REASONABLE EFFORTS IN ACCORDANCE WITH IRC 1.501(R)-6(C)(4) DESPITE THE HOSPITAL GIVING THEM DETAILED INSTRUCTIONS TO DO SO. UPON DISCOVERY, THE HOSPITAL TOOK IMMEDIATE ACTION AND CORRECTED THE COLLECTION VENDORS' PROCESSES. FOR PATIENTS POTENTIALLY AFFECTED, THE COLLECTION VENDORS WILL NOT PERFORM ECAS AND WILL PROCESS FINANCIAL ASSISTANCE APPLICATIONS REGARDLESS OF TIMEFRAMES. BEFORE THE FISCAL YEAR ENDED, THE HOSPITAL INSTITUTED NEW PROCEDURES AND NEW TECHNOLOGY TO PREVENT THIS FROM REOCCURRING. P&S SURGERY CENTER, LLC: P&S SURGERY CENTER LLC INITIATES VERY FEW ECAS. OF THOSE INITIATED, P&S WAITED MORE THAN 240 DAYS BEFORE INITIATING ECAS IN COMPLIANCE WITH THE IRC 501(R) REGULATIONS. P&S ALSO SENT LETTERS NOTIFYING THE PATIENTS OF THE UPCOMING ECA. HOWEVER, THE LANGUAGE IN SUCH LETTER WAS NOT FULLY COMPLIANT WITH IRC 501(R) REGULATIONS AND P&S CANNOT PROVE WHETHER ORAL NOTIFICATIONS WERE OR WERE NOT MADE WITHIN REGULATION TIMEFRAMES. SHORTLY AFTER DISCOVERY OF THIS PROBLEM IN MAY, 2018, P&S SURGERY CENTER LLC WAS FULLY ACQUIRED BY ST. FRANCIS MEDICAL CENTER. UPON ACQUISITION, BILLING AND COLLECTION PRACTICES WERE FULLY INTEGRATED INTO ST. FRANCIS MEDICAL CENTER'S PRACTICES. SUPPLEMENTAL INFORMATION P&S SURGERY CENTER WAS ACQUIRED BY ST. FRANCIS MEDICAL CENTER IN SEPTEMBER OF 2018, SO ALL LINKS TO P&S DOCUMENTS WILL BE TO ST. FRANCIS MEDICAL CENTER'S WEBSITE. 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 JUNE 30, 2018 MEDICARE COST REPORT DATA. 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. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 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 2015 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. PURSUANT TO THE HOSPITAL'S LAST CHNA, SFMC'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 205,192 AND THE SENIOR POPULATION COMPRISES ABOUT 13.48% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $39,309 AND 20.09% OF THE PARISH'S RESIDENTS LIVE BELOW THE POVERTY LEVEL. ST. FRANCIS MEDICAL CENTER PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: OUACHITA PARISH LINCOLN PARISH ST. FRANCIS MEDICAL CENTER SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: CALDWELL PARISH EAST CARROLL PARISH FRANKLIN PARISH JACKSON PARISH MADISON PARISH MOREHOUSE PARISH RICHLAND PARISH TENSAS PARISH UNION PARISH WEST CARROLL PARISH 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 heatlh 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 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. 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 true true false false false false false false false R KEITH WHITE MD DIRECTOR/PHYSICIAN 651846 0 203720 0 3418 0 6750 0 24203 0 889937 0 0 0 THOMAS J GULLATT MD DIRECTOR/PHYSICIAN 456938 0 62000 0 3418 0 42495 0 18538 0 583389 0 0 0 KRISTIN WOLKART President/CEO 0 325831 0 73413 0 14575 0 47765 0 24143 0 485727 0 0 RONALD E HOGAN FORMER Regional CFO 0 0 0 0 0 210339 0 0 0 0 0 210339 0 0 KEVIN M MEYER Physician 369252 0 83093 0 2868 0 6750 0 18097 0 480060 0 0 0 KAYLA JOHNSON VP Patient Care Services 195378 0 31912 0 1334 0 35039 0 23914 0 287577 0 0 0 FRANK B SARTOR Physician 438435 0 39243 0 4108 0 6750 0 18538 0 507074 0 0 0 SABRINA HOGAN VP Physician Services 209420 0 32217 0 815 0 42495 0 25407 0 310354 0 0 0 MICHAEL LANGIULLI PHYSICIAN 594732 0 178863 0 2428 0 6750 0 16965 0 799738 0 0 0 John Califano Physician 462001 0 40453 0 2029 0 6750 0 20859 0 532092 0 0 0 JEFF LIMBOCKER REGIONAL CFO 0 427364 0 110390 0 14575 0 107606 0 24017 0 683952 0 0 JOHN D BRUCHHAUS PHYSICIAN 379933 0 62000 0 14322 0 0 0 25552 0 481807 0 0 0 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. No one listed on Part VII, Section A received a payment from the plans in the current year. PART I, QUESTION 4A Two officers 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 12 months. No payments were made under the plan in the current year. Ronald Hogan received a severance payment of $210,339 during the current year. PART I, QUESTION 1A TWO OFFICERS LISTED ON PART VII RECEIVED A HOUSING ALLOWANCE DURING THE YEAR. THE HOUSING ALLOWANCES WERE INCLUDED AS TAXABLE COMPENSATION TO THE INDIVIDUALS. 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 $(24,420,628) 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, 2018. 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, 2018. 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). PART VI, SECTION A, QUESTION 3 SUMMIT TALENT GROUP, LLC WAS HIRED TO PROVIDE CFO SERVICES DURING AN INTERIM PERIOD FOR ST. FRANCIS MEDICAL CENTER. 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