2019-05-22T14:18:43-05:00 2018-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2017-07-01 720423651 Our Lady of the Lake Hospital Inc % AMANDA HYMEL OURL 2257656565 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 JEFF LIMBOCKER REGIONAL CFO 2257656565 2019-05-07 true RYAN HOOKS P00746825 2253444000 2019-05-15 167.68.102.5 72049520191355000007 2019-05-15 P 744BF7D84084AC7DB780DAB75B741F6B51BD3729 EB850E1BCF32CA73DDA849DEBA9ACC48FFFF1BCD 2017 2019-02-21 02:37:17Z JEFF LIMBOCKER 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 1417469033 false 0928 X www.ololrmc.com X 1956 LA to provide for the care of the ill, injured, or disabled persons, and to provide for research, education, and for the enhancement of health of those in the community 16 13 7555 144 6242204 -1501828 11481251 13147896 1148893438 1167503418 22348091 65085995 44774992 32063189 1227497772 1277800498 5127101 5292661 0 0 448462178 455533467 0 0 0 691403727 673203674 1144993006 1134029802 82504766 143770696 1840968379 1924172030 913221418 892572014 927746961 1031600016 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 538552275 5302661 779718296 THE MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 182,492 PATIENT DAYS. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. ADDITIONAL COSTS WERE INCURRED FOR PARTICIPATION IN PROGRAMS WHICH, IN SOME CASES, PAY AMOUNTS LESS THAN THE COST OF PROVIDING SERVICES. 207135490 299891651 THE MEDICAL CENTER PROVIDES PATIENTS WITH BOTH INPATIENT AND OUTPATIENT SURGICAL CARE. DURING THE YEAR, 24,072 SURGICAL PROCEDURES WERE PERFORMED 82854196 119956660 THE MEDICAL CENTER PROVIDES PATIENTS WITH PHARMACEUTICALS IN THE COURSE OF THEIR MEDICAL CARE. IN THE CURRENT YEAR, THE HOSPITAL DISPENSED 17,719,132 UNIT DOSES 828541961 true true false true false false false false false false true true false false true true false true false false true true false false false false true true true false true false false false false false false false false false false false false true true true true false false true 311 0 true 7555 true true true false false false false false false false false false X 16 13 false false false false true true true true true false false true true true true false true false true true true X AMANDA HYMEL 2259232701 5959 S SHERWOOD BLVD BATON ROUGE LA 70809 X DR JAMES CRAVEN BOARD MEMBER/PHYSICIAN 40.0 0.0 X 197791 0 9579 YOLANDA DIXON Secretary 2.0 2.0 X X 0 0 0 DR RICK KOUBEK BOARD MEMBER 2.0 2.0 X 0 0 0 JULIO MELARA BOARD MEMBER 2.0 0.5 X 0 0 0 DR BEN OUBRE BOARD MEMBER 2.0 0.0 X 0 0 0 SR EILEEN ROWE BOARD MEMBER 2.0 2.5 X 0 0 0 JOHN SELSER Chair 2.0 2.0 X X 0 0 0 K SCOTT WESTER CEO 2.0 55.5 X X 0 760798 198983 William E Balhoff DIRECTOR 2.0 2.0 X 0 0 0 SR HELEN CAHILL BOARD MEMBER 2.0 10.0 X 0 0 0 HENRY EISERLOCH MD BOARD MEMBER 2.0 0.0 X 0 0 0 Scott N Hensgens BOARD MEMBER 2.0 0.0 X 0 0 0 Harry J Phillips Jr BOARD MEMBER 2.0 0.0 X 0 0 0 Michael Crapanzano BOARD MEMBER 2.0 0.0 X 0 0 0 John Engquist BOARD MEMBER 2.0 0.0 X 0 0 0 LOUIS BARFIELD MD BOARD MEMBER 40.0 0.0 X 480905 0 34789 GREG BOWSER BOARD MEMBER 2.0 0.0 X 0 0 0 JEFFREY D LIMBOCKER Regional CFO 2.0 58.0 X 0 552329 131623 TERRIE P STERLING COO 40.0 0.0 X 546367 0 141120 Nicole Telhiard VP Patient Care Services 40.0 0.5 X 306181 0 64943 KENNETH C CIVELLO STAFF PHYSICIAN 40.0 0.0 X 1035379 0 33864 STEVEN T GREMILLION STAFF PHYSICIAN 40.0 0.0 X 971626 0 30756 CHARLES A SMITH STAFF PHYSICIAN 40.0 0.0 X 1091031 0 29833 Paul M Dampf STAFF PHYSICIAN 40.0 0.0 X 953696 0 37289 Paul D Garrett Staff Physician 40.0 0.0 X 960612 0 32296 6543588 1313127 745075 398 false true false FMOL HEALTH SYSTEM 4200 Essen Lane BATON ROUGE LA 70809 Management Fees 62371510 LSUHSC-NEW ORLEANS 1901 Perdido St Box P3-1 NEW ORLEANS LA 70112 Medical Services 38599122 ANESTHESIOLOGY GROUP ASSOC 7777 Hennessy Blvd BATON ROUGE LA 70808 ANESTHESIOLOGY SVCS 12788178 MILTON J WOMACK INC 8440 JEFFERSON HWY BATON ROUGE LA 70809 Contractor Services 11161354 MORRISON MGMT SPECIALISTS 400 Northridge Road Suite 600 ATLANTA GA 30350 Cafeteria Services 11851689 389 10608303 1537575 1002018 13147896 PATIENT SERVICE REVENUE 900099 1113378518 1113378518 OUTREACH LABORATORY 900099 9855707 5427659 4428048 PHARMACY 900099 18717408 17773057 944351 MANAGEMENT FEES 900099 1102862 1102862 INCOME FROM EQUITY INVESTEES 900099 12195045 11325240 869805 12253878 12253878 1167503418 9792854 9792854 1204733 1204733 0 15039272 1241738 13797534 0 13797534 13797534 190141208 2373996 135793440 2633357 54347768 -259361 54088408 54088408 0 0 0 0 0 0 0 0 0 Increase in accrued pension 18265655 18265655 18265655 1277800498 1193324403 6242204 65085995 5280661 5280661 0 12000 12000 0 1183381 793242 390139 0 366735689 245829723 120905966 28731958 19259563 9472395 35108119 23533622 11574497 23774320 15936367 7837953 183347519 122901237 60446282 1305457 875072 430385 0 0 0 1622018 1622018 18204486 12202804 6001682 4401306 2959907 1441399 26555124 17800391 8754733 2542553 1704320 838233 0 14937186 10012672 4924514 363817 243873 119944 0 1471649 986474 485175 16616380 11138267 5478113 0 43385416 29082048 14303368 9954974 6673003 3281971 Medical Supplies Expense 205390776 205390776 0 Equipment & Maintenance 33017228 22132059 10885169 PURCHASED SERVICES 110063244 73777430 36285814 OTHER 24541 16450 8091 1134029802 828541961 305487841 0 72037829 93118004 179272811 94006592 0 0 116796849 92662198 0 0 0 0 454112 513753 19635661 17275188 12380585 8795143 1224707440 525528072 597730804 699179368 292842148 1472430 400461255 761139296 41202863 43175276 31696685 31696686 76456777 81138096 1840968379 1924172030 148294432 135323213 0 0 16777731 0 445032224 435819091 0 0 0 0 0 0 0 28927321 303117031 292502389 913221418 892572014 X 894662679 988115374 33084282 43484642 0 0 927746961 1031600016 1840968379 1924172030 X 143770696 -17363750 -22553891 X false true X true true true X false false false false false true 15000 false false false 15000 false false PART II-B LINE 1F PORTION OF DUES TO AN IRC SECTION 501(C)(6) ORGANIZATION THAT IS CONSIDERED LOBBYING 76181241 76181241 773269735 271152071 502117664 5643727 4241023 1402704 348248445 236238403 112010042 21364292 13896575 7467717 699179368 INVESTMENT IN REGIONAL EYE 324941 F INVESTMENT IN CAPITAL RESERVE 760814355 F 761139296 0 CAPITAL LEASE 18586 ACCRUED PENSION COSTS 287888660 OTHER LIABILITIES 4595143 292502389 X FIN 48 (ASC 740 FOOTNOTE) Schedule D The Medical Center 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. 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X X X X true true X X X true X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X X X X X X true X true X X X false X X X false false PART V, SECTION B, QUESTION 13H OUR LADY OF THE LAKE HOSPITAL: 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, QUESTION 5 OUR LADY OF THE LAKE HOSPITAL (OLOL) AND SURGICAL SPECIALTY CENTER (SSC) OF BATON ROUGE: OLOL & SSC JOINED THE MAYOR'S HEALTHY CITY INITIATIVE AND SITS AMONG OTHER LOCAL AREA HOSPITALS IN AN OPEN COLLABORATIVE EFFORT TO IMPROVE THE HEALTH OF THE BATON ROUGE COMMUNITY. THE MAYOR'S HEALTHY CITY INITIATIVE WORKED WITH HEALTHY BR AND MEDBR TO COMPLETE THE COMMUNITY NEEDS ASSESSMENT. AMONG THESE GROUPS, THERE WERE REPRESENTATIVES FROM NUMEROUS BUSINESSES, HOSPITALS, GOVERNMENT ORGANIZATIONS INCLUDING THE OFFICE OF PUBLIC HEALTH, NONPROFIT ORGANIZATIONS AND SCHOOLS. THE LOCAL HOSPITALS PARTICIPATING WERE WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, AND SURGICAL SPECIALTY CENTER OF BATON ROUGE. THE REPRESENTATIVES ALSO INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. MARILYN REYNAUD, MD, MPH, REGIONAL ADMINISTRATOR/MEDICAL DIRECTOR FOR THE DEPARTMENT OF HEALTH AND HOSPITALS, REGION 2 OFFICE OF PUBLIC HEALTH AND DR. JIMMY GUIDRY, STATE HEALTH OFFICER, PROVIDED INPUT AND GUIDANCE ON THE CHNA. LAKE SURGICAL HOSPITAL: LAKE SURGICAL HOSPITAL (SLIDELL) GATHERED INFORMATION FOR ITS CHNA USING SURVEYS, INTERVIEWS, AND PUBLISHED MATERIALS. THE HOSPITAL INTERVIEWED LEADERS FROM ORGANIZATION THAT INCLUDED PUBLIC HEALTH EXPERTISE, PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH RELATED DATA, AND REPRESENTATIVES OF UNDERSERVED POPULATIONS. ALLYSON VILLARS, ST. TAMMANY PARISH DIRECTOR OF HEALTH AND HUMAN SERVICES, AS WELL AS LEADERS FROM THE CHAMBER OF COMMERCE, COUNCIL ON AGING, COMFORCARE, HOME INSTEAD SENIOR CARE, AND FATHER PAT WATTIGNY PROVIDED INPUT AND GUIDANCE ON THE CHNA. PART V, SECTION B, QUESTION 6 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: A JOINT CHNA WAS CONDUCTED IN COLLABORATION WITH WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER AND LANE REGIONAL MEDICAL CENTER THROUGH THE MAYOR'S HEALTHY CITY INITIATIVE. PART V, SECTION B, QUESTION 7 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: THE JOINT CHNA CAN BE FOUND AT THE FOLLOWING WEBSITES: HTTPS://OLOLRMC.COM/PAGES/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX WWW.SSCBR.COM/USERFILES/FILE/CHNA_FINAL-062416.PDF HTTP://WWW.HEALTHYBR.COM/ASSETS/UPLOADS/DOCS/CHNA.FINAL.6.24.16.PDF PART V, SECTION B, QUESTION 11 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: IN 2015 THE PARTICIPANTS IN THE JOINT CHNA IDENTIFIED FOUR SIGNIFICANT HEALTH NEEDS IN OUR COMMUNITY. OLOL FOCUSES ON ALL FOUR SIGNIFICANT NEEDS IDENTIFIED - OBESITY, HIV/AIDS, OVERUSE OF THE EMERGENCY DEPARTMENT, AND MENTAL HEALTH AND BEHAVIORAL HEALTH. OLOL HAS DONE THE FOLLOWING TO HELP ADDRESS THE IDENTIFIED COMMUNITY NEEDS: OBESITY OLOL PHYSICIAN GROUP PHYSICIAN, DR. TYSON PROVIDES A CHILDHOOD OBESITY PROGRAM IN PARTNERSHIP WITH PENNINGTON RESEARCH CENTER. HEALTH CARE CENTERS IN SCHOOLS (AN AFFILIATED TAX-EXEMPT ORGANIZATION WHICH IS FUNDED BY OLOL) AND BATON ROUGE CHILDREN'S HEALTH PROJECT BOTH PROMOTED THE CHILDHOOD OBESITY PREVENTION MESSAGE, 5210+10 IN 85 EBR PARISH SCHOOLS. OLOL ALSO SPONSORED BREADA FOR $15,000 TO PROMOTE 5210+10 AT FARMERS MARKETS, RYAN ELEMENTARY SCHOOL, AND MAIN LIBRARY. 3,400 LIVES WERE IMPACTED. OLOL PARTNERED WITH CITY YEAR TO TRAIN MORE THAN 90 CORP MEMBERS IN 5210+10, CPR, AND TRAUMA PROGRAM STOP THE BLEED EFFORTS. COMMUNITY EDUCATION ON OBESITY PREVENTION WAS ALSO PROVIDED TO 1,707 PEOPLE. OLOL ALSO BEGAN PARTICIPATING IN THE USDA SUMMER FEEDING PROGRAM PROVIDING 2961 MEALS IN THE SUMMER OF 2017 AND 8001 MEALS IN THE SUMMER OF 2018 AT ITS GOODWOOD PEDIATRIC CLINIC. ALSO, WE HOSTED THE AMAZING HALF MARATHON FOR 2,000 PARTICIPANTS IN MARCH 2018. ANNUALLY OLOL PROVIDES TWO SEASONAL FARM TO WORK PROGRAMS (PRODUCE BOXES FROM LOCAL FARMERS ARE DELIVERED TO WORKSITE). OLOL PROVIDES SUBSIDIZED BOXES FOR TEAM MEMBERS WHO MAKE LESS THAN $15/HOUR, FOR $5,225. THE PROGRAM SERVED 544 PARTICIPANTS DURING FYE18. HIV/AIDS OLOL PERFORMED 3,375 TESTS IN THREE EMERGENCY DEPARTMENTS AND SCREENED 13,383 PATIENTS IN TWO URGENT CARE CENTERS. 85 NEW CASES OF HIV WERE IDENTIFIED AT ALL FIVE TESTING SITES. OLOL CONTINUES TO OFFER COMMUNITY BASED SCREENINGS AS WELL AS EDUCATION AND AWARENESS ABOUT HIV/AIDS RESOURCES AND TREATMENT OPTIONS. OLOL WORKED WITH OCHSNER HOSPITAL TO START HIV OPT-OUT TESTING IN THEIR EMERGENCY DEPARTMENTS. OLOL ALSO WORKS WITH HEALTHY BR PARTNERS TO DECREASE COMMUNITY STIGMA AROUND HIV/AIDS AND ADVOCATES FOR POLICY CHANGE THAT AFFECTS STIGMA AND TREATMENT, AND INCREASE COMMUNITY SCREENINGS. DURING ITS WORK WITH HEALTHY BR PARTNERS, COMMUNITY SCREENINGS INCREASED BY 7 AND, 213 INDIVIDUALS WERE SCREENED FOR HIV. MENTAL/BEHAVIORAL HEALTH THE JOINT LSU-OLOL PSYCHIATRY RESIDENCY PROGRAM TRAINED 25 PSYCHIATRY RESIDENTS DURING FYE 18. THE PHYSICIANS PROVIDED SERVICES AT OLOL HOSPITAL AND IN OUTPATIENT LOCATIONS ACROSS THE COMMUNITY. OLOL LAUNCHED A COLLABORATIVE CARE MODEL FOR MENTAL HEALTH, SUPPORTED BY A $300,000 GRANT. THE LSU-OLOL PSYCH PROGRAM INITIATED A SUICIDE PREVENTION ASSESSMENT. OVER UTILIZATION OF THE EMERGENCY DEPARTMENT THE COMPLEX PATIENT PROJECT (PATIENTS WHO HAVE BEEN TO THE EMERGENCY DEPARTMENT 5 OR MORE TIMES DURING A 6 MONTH PERIOD) WORKED WITH 796 PATIENTS IN FY18. WE DEVELOP RELATIONSHIPS WITH THE PATIENTS TO HELP THEM TO IDENTIFY AND UTILIZE MEDICAL RESOURCES OTHER THAN THE ED TO GET THEIR MEDICAL NEEDS MET, SO THAT THEY WOULD NOT HAVE TO COME TO THE ED AS OFTEN. OUR GOAL IS TO BE SURE THAT EACH PATIENT GETS THE BEST EVIDENCE-BASED MEDICAL CARE FOR THEIR CONDITION IN THE LEAST RESTRICTIVE SETTING. PATIENTS WHO SIGNIFICANTLY REDUCED THEIR ADMISSIONS TO THE EMERGENCY DEPARTMENT AS A RESULT OF OUR INTERVENTIONS: 594 PATIENTS WHO CONTINUED TO BE ADMITTED TO THE EMERGENCY DEPARTMENT THE SAME NUMBER OF TIMES OR MORE AFTER OUR INTERVENTIONS: 209 FOR THE 209 WHO DID NOT IMPROVE, WE DEVELOPED A COMPLEX PATIENT TREATMENT, MULTIDISCIPLINARY PLANNING TEAM LED BY EMERGENCY ROOM AND HOSPITALIST DOCTORS TO ADDRESS THEIR COMPLEX NEEDS. A TOTAL OF 125,675 PATIENTS WERE SEEN IN OUR EMERGENCY DEPARTMENTS. MEDICAID EXPANSION OLOL CENTER USES ID SUPPORT WITH MEDICAID OUTREACH SPECIALISTS ON SITE. SURGICAL SPECIALTY CENTER OF BATON ROUGE SURGICAL SPECIALTY CENTER WILL ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT ALONG WITH OUR LADY OF THE LAKE HOSPITAL. SSC PROVIDES SERVICES TO THOSE WITH MEDICAID COVERAGE AND PROVIDES CHARITY CARE. THE EAR, NOSE & THROAT DOCTORS AT SSC ARE THE ONLY ENT DOCTORS IN EAST BATON ROUGE PARISH WHO ACCEPT MEDICAID. THEY ARE SENT REFERRALS FROM AREAS OUTSIDE OF EAST BATON ROUGE PARISH AS WELL. PART V, SECTION B, QUESTION 16A, B, & C OUR LADY OF THE LAKE HOSPITAL: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTPS://FMOLHS.ORG/PAGES/FINANCIAL-ASSISTANCE-POLICY.ASPX SURGICAL SPECIALTY CENTER OF BATON ROUGE: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: WWW.SSCBR.COM/PAGE.PHP?PID=21 LAKE SURGICAL HOSPITAL (SLIDELL): THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN-LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: SSHLA.COM/ADDITIONAL-DOCUMENTS PART V, SECTION B, QUESTION 16J OUR LADY OF THE LAKE HOSPITAL, SURGICAL SPECIALTY CENTER OF BATON ROUGE, LAKE SURGICAL HOSPITAL (SLIDELL): REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW-INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. PART V, SECTION B, QUESTION 16I OUR LADY OF THE LAKE HOSPITAL WIDELY PUBLICIZES ITS FAP, IN PART, BY INCLUDING ON ITS WEBSITE LANGUAGE TRANSLATIONS OF ITS FINANCIAL ASSISTANCE POLICY AND ASSOCIATED DOCUMENTS. LAKE SURGICAL HOSPITAL AND SURGICAL SPECIALTY CENTER ARE SMALLER, ASSOCIATED HOSPITALS WHO ALSO WIDELY PUBLICIZE THE FAP IN MANY WAYS. HOWEVER, IT WAS DISCOVERED IN MAY 2018 THAT BOTH LAKE SURGICAL HOSPITAL AND SURGICAL SPECIALTY CENTER WERE MISSING THE NEEDED TRANSLATIONS OF THE FINANCIAL ASSISTANCE POLICIES AND ASSOCIATED DOCUMENTS ON THEIR WEBSITES. LAKE SURGICAL HOSPITAL CORRECTED THE ERROR BY POSTING THE NEEDED TRANSLATIONS TO ITS WEBSITE. THE WEBSITES ARE NOW BEING ROUTINELY MONITORED TO ENSURE THE NEEDED TRANSLATION DOCUMENTS REMAIN AVAILABLE TO THE PUBLIC. PART V, SECTION B, QUESTION 21 WHILE OUR LADY OF THE LAKE HOSPITAL HAS A COMPLIANT EMERGENCY CARE POLICY, IT WAS DISCOVERED THAT SMALL AFFILIATED HOSPITALS, SURGICAL SPECIALTY CENTER AND LAKE SURGICAL HOSPITAL, HAD AN EMERGENCY CARE POLICY THAT WAS NOT FULLY COMPLIANT WITH IRC REGULATION 1.501(R)-4(C) DUE TO A SMALL AMOUNT OF MISSING LANGUAGE. SURGICAL SPECIALTY CENTER AND LAKE SURGICAL HOSPITAL DO NOT HAVE AN EMERGENCY DEPARTMENT, BUT AT ALL TIMES ACTED IN COMPLIANCE WITH EMTALA REGULATIONS. THE FACILITIES DID NOT DISCRIMINATE AGAINST ANY PATIENT WITH AN EMERGENCY CONDITION AND BOTH NOW HAVE A WRITTEN POLICY CONTAINING ALL REQUIRED LANGUAGE. PART V, SECTION B, QUESTION 20A LAKE SURGICAL HOSPITAL (SLIDELL): LAKE SURGICAL HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY DESIGNED TO ASSIST PATIENTS WITH LOW INCOME AND NO HEALTH INSURANCE. FOR THOSE WHO FALL OUTSIDE OF THE FINANCIAL ASSISTANCE POLICY, LAKE SURGICAL HOSPITAL WILL INITIATE ECAS IN AN EFFORT TO COLLECT PAYMENT FOR SERVICES PROVIDED. IRC REGULATION 1.501(R)-6(C)(4)(A) REQUIRES THAT LAKE SURGICAL HOSPITAL 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 ECAS WERE INITIATED ON 29 PATIENTS WITH HEALTH INSURANCE BEFORE THE REQUIRED INFORMATION HAD BEEN MAILED TO THEM. SINCE THESE 29 PATIENTS WERE NOT ELIGIBLE UNDER THE FAP DUE TO THEIR INSURANCE STATUS, THEY WERE NOT NEGATIVELY IMPACTED FROM THE ERROR. THE TOTAL AMOUNT INVOLVED WAS $54,080. BEFORE THE FISCAL YEAR ENDED, LAKE SURGICAL HOSPITAL CHANGED ITS PROCEDURES SO THAT ALL PATIENTS RECEIVE A PLAIN LANGUAGE SUMMARY AND A COMPLIANCE LETTER PRIOR TO INITIATING ECAS REGARDLESS OF INSURANCE STATUS. SURGICAL SPECIALTY CENTER: SURGICAL SPECIALTY CENTER (SSC) HAS A FINANCIAL ASSISTANCE POLICY DESIGNED TO ASSIST PATIENTS WITH LOW INCOME AND NO HEALTH INSURANCE. FOR THOSE WHO FALL OUTSIDE OF THE FINANCIAL ASSISTANCE POLICY, SSC WILL INITIATE ECAS IN AN EFFORT TO COLLECT PAYMENT FOR SERVICES PROVIDED. IRC REGULATION 1.501(R)-6(C)(4)(A) REQUIRES THAT SSC 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 ECAS WERE INITIATED ON A FEW PATIENTS WITH HEALTH INSURANCE BEFORE THE REQUIRED INFORMATION HAD BEEN MAILED TO THEM. SINCE THESE PATIENTS WERE NOT ELIGIBLE UNDER THE FAP DUE TO THEIR INSURANCE STATUS, THEY WERE NOT NEGATIVELY IMPACTED FROM THE ERROR. PROCEDURAL CORRECTIONS ARE BEING MADE TO PREVENT THIS FROM RE-OCCURING IN THE FUTURE. 5 PERKINS PLAZA AMB SURGERY CENTER 7145 PERKINS ROAD BATON ROUGE LA 708084322 SURGERY CENTER CONVENIENT CARE LLC 7777 HENNESSY BOULEVARD BATON ROUGE LA 70808 URGENT CARE BRPT-LAKE REHABILITATION CENTERS LLC 530 SHADOWS LANE BATON ROUGE LA 70806 REHABILITATION LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE OLOL PONTCHARTRAIN SURGERY CENTER LLC 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 SURGERY CENTER PART I, LINE 7: As part of its mission to improve the lives and health of community members, OLOL has a cooperative endeavor agreement (CEA) with the State of Louisiana Department of Health, formerly known as DHH, and Louisiana State University Health Sciences (LSU) that trains future physicians for our area and provides healthcare access to uninsured and under-insured residents. This public-private partnership has enabled positive healthcare transformation in Baton Rouge. Despite the closing of state-run hospitals and clinics, including Earl K. Long Medical Center in April 2013, and added challenges to the healthcare system created by the Baton Rouge Generals closure of its Mid-City Emergency Room (ER) in March 2015, recent data shows that this new model of care in Baton Rouge is working well. The benefits of the CEA to the community are visible in the following ways: Patient Care A. Uninsured and Medicaid patients have access to more than 20 specialty services, many of which were not available to prior to the CEA. Local services now provided oncology, mental health/psych, mental health integration into primary care with the availability of a psychiatrist as a consultant, diabetes care, dermatology, cardiology and more, along with pharmacy, imaging and diagnostic services. With the 2016 Medicaid expansion in Louisiana, we have seen an increase across the board in clinic visits, up from 114,840 in 2016 to 197,939 in 2017. Those outpatient visits have more than doubled from 2012(90,096 visits) due to expanded insurance coverage and more opportunity to access care. Increased access to care also included access to pharmacy and urgent care services. Patients filled 83,135 prescriptions that helped treat both acute and chronic conditions such as hypertension, asthma, diabetes and HIV. B. In coordination with LSU Health, OLOL operates two urgent care clinics to cost-effectively treat a wide range of injuries and conditions including infections, flus and fevers, broken bones and minor burns. Patients with these conditions would typically seek treatment in EDs which carry increased costs. Uninsured and an increasing number of patients with Medicaid, now have access to a more abundant right place, right level of care for these healthcare needs through LSU Health Urgent Care Centers and Lake After Hours. LSU Health has encountered 50,908 patients via its two Urgent Care locations. C. Increasing capacity for Emergency care has also been a priority for OLOL, especially in light of being the only Emergency Department in a 20 mile radius of North Baton Rouge and Mid City. Through the CEA with support from the state of Louisiana, OLOL made the decision to expand access and open a stand-alone Emergency Department on the campus of LSU Health North Baton Rouge clinic and urgent care site. By being in such close proximity to the Urgent Care vs the ED, this care coordination allows for opportunities to educate patients on the appropriate use of the emergency department as well as allows those who truly are in need of emergent care to receive treatment in a timely manner. D. Our Lady of the Lake is the only designated trauma center in region 2, which cared for 2652 patients in 2017. 24.7% of all trauma patients were uninsured in 2017 and 31% had Medicaid as their payment source. The trend of half of all trauma patients treated each year being uninsured or having Medicaid has been consistent since 2012. Graduate Medical Education A. Through the CEA, OLOL is training future generations of physicians in nearly all medical specialties and subspecialties as these clinicians commit to improve patient care in Baton Rouge. Equally important, academic medical centers such as OLOL are attracting the top physicians in the country, which helps advance medicine and deliver more comprehensive services in Baton Rouge, the surrounding parishes and the state. B. OLOL serves as a clinical teaching site for 25 residency and fellowship programs, including 17 through Louisiana State University Health Sciences Center, Tulane University School of Medicine (2), OLOL (2), Baton Rouge General (3), and a joint program between OLOL and LSU (1). In addition to these improvements in the quality of care for uninsured and Medicaid patients in the area, OLOL has made capital investments that have benefitted families in the community and the region, including: 1. Groundbreaking on Children's Hospital in 2016 2. Opening of new North BR Emergency Room. Through this innovative partnership, OLOL has increased its efforts and reaffirmed its focus to bring better, more accessible care to the residents of Baton Rouge, and the organization remains devoted to serving the health needs of this community well into the future. LDH provides payments under a reimbursement structure which are intended to compensate the hospital for incremental costs associated with higher Medicaid and uninsured patient volumes. Because of these reimbursements, which are considered direct offsetting revenue, the hospitals vital impact to the community in this effort is not directly reflected in the net community benefit percentage found at line 7k, column (f). The significant benefit to the community is better expressed as a percentage of total community benefit expense. PART I, LINE 7: THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION. FOR PART I LINES 7E, 7F, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. FOR PART I LINE 7G, COST FIGURES WERE CALCULATED FROM DEPARTMENTAL COSTS LESS DIRECT OFFSETTING REVENUE. PART III, LINE 4: THE BAD DEBT FOOTNOTE IS ON 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. 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 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, OUR LADY OF THE LAKE HOSPITAL JOINED the Mayors Healthy City Initiative in 2007. Still today, OLOL sits among other local area hospitals in an open collaborative effort to improve the health of the Baton Rouge community. The Community Health Needs Assessment is just one of many joint efforts that OLOL has participated in alongside other hospitals and organizations. In May of 2008, Baton Rouge Mayor-President Melvin L. "Kip" Holden commissioned the Mayors Healthy City Initiative to encourage Baton Rouge residents to adopt a healthier and more active lifestyle. In 2017 there was a change in administration, and a new mayor was elected; Sharon Weston Broom committed to and continues the work of the Mayor's Healthy City Initiative. Both Mayors envision a program that would promote and identify resources available in the community for residents to live healthier lives free of chronic disease. In Louisiana, almost half of our children are considered overweight or obese, putting them at a much greater risk of obesity-related health problems like diabetes, heart disease, stroke, cancer and asthma. Nationwide the number of children who are considered overweight or obese has nearly tripled over the past 30 years. To tackle this problem, the Mayor subdivided the Initiative into 2 separate but compatible parts: Healthy BR - a focus on healthier eating and a more active lifesyle MedBR - a focus on access to care and health outcomes Each subgroup engages a variety of partner organizations in a cooperative effort between local and state governments, area hospitals, public health, and local health organizations and nonprofits. OLOL is a major supporter and contributor of the Mayors Healthy City Initiative. the Mayors Healthy City Initiative served as a common platform, allowing for in-depth roundtable discussions among local area hospitals. The OLOL Community Advocacy team facilitated those discussions and processes for completing the CHNA report. OLOL ALSO WORKS SEPARATELY WITH COMMUNITY ORGANIZATIONS (on the CHNA Implementation Plan) SUCH AS UNITED WAY, PUBLIC HEALTH, AMERICAN HEART ASSOCIATION, BREC, BRAC, AND MANY OTHER ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. FOR EXAMPLE, PARISH NURSING, HEALTH SCREENING FOR DIABETES, SKIN CANCER, PROSTATE CANCER AND BREAST CANCER ARE PROMOTED IN VARIOUS COMMUNITY SETTINGS TO IMPROVE OVERALL COMMUNITY HEALTH. OLOL HAS PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS THAT ADDRESS THE 4 SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA. PART VI, LINE 3 PATIENT 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 4 COMMUNITY INFORMATION: OUR LADY OF THE LAKE HOSPITAL (OLOL) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN BATON ROUGE, LOUISIANA THAT SERVES EAST BATON ROUGE PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, EAST BATON ROUGE HAS A POPULATION OF APPROXIMATELY 445,227 RESIDENTS. THE POPULATION IS RELATIVELY YOUNG, WITH 23% OF RESIDENTS BELOW 18 YEARS OF AGE. THE SENIOR POPULATION COMPRISES ABOUT 12% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $47,770. 20.5% OF THE POPULATION IS LIVING BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS 5.8%. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR LADY OF THE LAKE HOSPITAL 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: OUR LADY OF THE LAKE ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT WOULD BE FOREGONE OR POSTPONED THEREBY CREATING A COMMUNITY AREA WITH MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE LAKE PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. OUR LADY OF THE LAKE BECAME A TEACHING HOSPITAL THROUGH AFFILIATION WITH LOUISIANA STATE UNIVERSITY MEDICAL SCHOOL TO INSURE THE STATE OF LOUISIANA MAINTAIN AN ADEQUATE SUPPLY OF PHYSICIANS. IN 2011 OUR LADY OF THE LAKE RECEIVED ACCREDITATION APPROVAL FOR A PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAM. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE 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. OLOL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL 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. FOR MORE INFORMATION ON THE PROMOTION OF COMMUNITY HEALTH, PLEASE REFER TO THE PART VI SUPPLEMENTAL INFORMATION DESCRIPTION FOR PART 1 QUESTION 7. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: OUR LADY OF THE LAKE HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE LAKE HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF THE LAKE HOSPITAL SERVES THE COMMUNITY IN EAST BATON ROUGE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, QUESTION 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 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. 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 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 FORM A COMMUNITY CLINIC AND IS REFERRED TO THE HOPSITAL; 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. true City Year Inc 287 Columbia Avenue Boston ME 021165114 222882549 501(C)(3) 10000 General Support Mayors Healthy City Initiative 222 Saint Louis Street Baton Rouge LA 70802 272515190 501(C)(3) 10000 General Support Children's Miracle Network 205 West 700 South Salt Lake City UT 84101 870387205 501(C)(3) 6000 General Support Boys & Girls Club 8281 Goodwood Blvd Ste H Baton Rouge LA 70806 720928014 501(C)(3) 6000 General Support American Heart Association 7272 Greenville Avenue Dallas TX 752314596 135613797 501(C)(3) 65000 General Support McMains Childrens Development Center 1805 College Drive Baton Rouge LA 70808 720459036 501(C)(3) 10000 General Support Livingston Economic Development Council P O Box 809 Livingston LA 70754 720966247 501(C)(6) 15000 SEE PART IV Fore Kids Foundation 11005 Lapalco Blvd Avondale LA 70094 581940111 501(C)(3) 30000 General Support Louisiana Soccer Association 475 Gardere Ln Baton Rouge LA 70820 721067495 501(C)(3) 15000 General Support Baton Rouge Area Chamber 564 Laurel St Baton Rouge LA 70801 720126959 501(C)(6) 125000 SEE PART IV Louisiana Resource And DEVELOPMENT COUNCIL PO Box 44422 Baton Rouge LA 70804 581686563 501(C)(3) 6000 GENERAL SUPPORT Baton Rouge Health District 5246 Brittany Dr Baton Rouge LA 70808 472593574 501(C)(3) 150000 GENERAL SUPPORT Baton Rouge Speech and HEARING FOUNDATION 7784 Innovation Park Drive Baton Rouge LA 70820 720542134 501(C)(3) 10000 GENERAL SUPPORT Louisiana AAP Foundation PO Box 64629 Baton Rouge LA 70896 161629344 501(C)(3) 10000 GENERAL SUPPORT HEALTH CARE CENTERS IN SCHOOLS 4336 NORTH BOULEVARD BATON ROUGE LA 70806 721443935 501(C)(3) 2900000 GENERAL SUPPORT FRANCISCAN UNIVERSITY 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 721173156 501(C)(3) 1500000 GENERAL SUPPORT 14 2 Monitoring grants FORMAL REQUESTS ARE RECEIVED BY THE BUSINESS PAYOR RELATIONS DEPARTMENT, ARE CHECKED FOR ALL APPROPRIATE INFORMATION, AND ARE PRESENTED TO EXECUTIVE ADMINISTRATION FOR APPROVAL. THE HOSPITAL GIVES GRANTS TO ORGANIZATIONS WELL-KNOWN IN THE COMMUNITY, OR WHICH IT HAS A HISTORY OF GIVING TO. THE HOSPITAL FOLLOWS UP WITH GRANT RECIPIENTS IF THERE IS AN INDICATION OF POTENTIAL THAT THE FUNDS ARE NOT BEING USED FOR CHARITABLE PURPOSES. PURPOSE OF GRANT OR ASSISTANCE LIVINGSTON ECONOMIC DEVELOPMENT COUNCIL - TO SUPPORT "LIVINGSTON TOMORROW" BATON ROUGE AREA CHAMBER - TO SUPPORT "THINK BIGGER" REGIONAL STRATEGIC PLAN false true false false false false false false false DR JAMES CRAVEN BOARD MEMBER/PHYSICIAN 187536 0 10000 0 255 0 7904 0 1675 0 207370 0 0 0 KENNETH C CIVELLO STAFF PHYSICIAN 639073 0 392434 0 3872 0 10800 0 23064 0 1069243 0 0 0 STEVEN T GREMILLION STAFF PHYSICIAN 663330 0 307655 0 641 0 10800 0 19956 0 1002382 0 0 0 JEFFREY D LIMBOCKER Regional CFO 0 427364 0 110390 0 14575 0 107606 0 24017 0 683952 0 0 CHARLES A SMITH STAFF PHYSICIAN 734127 0 351186 0 5718 0 10800 0 19033 0 1120864 0 0 0 K SCOTT WESTER CEO 0 592086 0 153897 0 14815 0 171180 0 27803 0 959781 0 0 TERRIE P STERLING COO 425673 0 120053 0 641 0 122931 0 18189 0 687487 0 0 0 Nicole Telhiard VP Patient Care Services 262982 0 42894 0 305 0 41440 0 23503 0 371124 0 0 0 Paul M Dampf STAFF PHYSICIAN 383072 0 516453 0 54171 0 10800 0 26489 0 990985 0 0 0 Paul D Garrett Staff Physician 571078 0 389354 0 180 0 10800 0 21496 0 992908 0 0 0 LOUIS BARFIELD MD BOARD MEMBER 463138 0 17587 0 180 0 10800 0 23989 0 515694 0 0 0 PART 1, QUESTION 4B FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES 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 PLAN 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 PLAN IN THE CURRENT YEAR. PART 1, 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 MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. PART 1, QUESTION 4A THE CEO IS 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 CFO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE IN 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. 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 VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. MEMBERS PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO THE MEMBER ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO 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 THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR 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 AND 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION CONFLICT OF INTEREST OUR LADY OF THE LAKE HOSPITAL, INC. 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 OUR LADY OF THE LAKE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE LAKE HOSPITAL, INC. 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 A, QUESTION 11 AFTER PREPARATION AND REVIEW OF THE FORM 990 BY KPMG, THE FORM 990 IS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE LAKE Hospital, Inc. DETERMINING COMPENSATION PART VI, SECTION B, QUESTION 15A & 15B OUR BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. 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. THE COMPENSATION FOR THE CEO OF OUR LADY OF THE LAKE HOSPITAL, INC. 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. Part XI, Line 9 Other Changes in net assets or fund balances: Capital Transfers FMOL (22,553,891) PART III, QUESTION 4D THE HOSPITAL PROVIDES VARIOUS OTHER PROGRAMS SUCH AS DIETARY, RESPIRATORY, PHARMACY AND SPECIAL PROCEDURES. SECTION 1.263(A)-3(N) - BOOK CONFORMITY ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. 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, 2018. SECTION 1.263 (A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. 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). 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