2017-11-15T15:26:41-06:00 2016-12-31 990 2016-01-01 943480131 LOUISIANA CHILDREN'S MEDICAL CENTER LOUI 5048969388 200 HENRY CLAY AVENUE NEW ORLEANS LA 701185720 SUZANNE HAGGARD CHIEF FINANCIAL OFFICER 5048969388 2017-11-15 208.252.122.3 2017-11-15 13:41:57 CS P 868CE60CDFAAF137F5E7EC93B64BBE84E51E476E 868CE60CDFAAF137F5E7EC93B64BBE84E51E476E 2016 2017-02-10 21:41:12Z GREGORY C FEIRN 200 HENRY CLAY AVENUE NEW ORLEANS LA 701185720 294875351 0 X WWWW.LCMCHEALTH.ORG X 2009 LA THE PRIMARY PURPOSE OF LCMC IS TO CREATE, MAINTAIN, AND GROW HEALTH CARE SERVICES IN THE GREATER NEW ORLEANS AREA CONSITENT WITH ITS OPERATION OF WEST JEFFERSON MEDICAL CENTER AND THE CHARITABLE MISSION OF THE LCMC AFFILIATES. LCMC PROVIDES SUPPORT AND MANAGEMENT SERVICES TO THE SYSTEM ENTITIES SO THAT THE ENTITIES IN TURN CAN FOCUS THEIR EFFORTS ON CARRYING OUT THEIR EXEMPT PURPOSES. 28 26 2191 120 0 0 7327939 6805777 86597282 286649330 0 0 217106 1420244 94142327 294875351 135000 117518 0 0 35963741 117389176 0 0 0 62363168 180209994 98461909 297716688 -4319582 -2841337 1822366042 1812600599 560268629 475535058 1262097413 1337065541 X SEE SCHEDULE O 0 0 117518 117518 55894177 LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC) IS A LOUISIANA NON-STOCK NOT-FOR-PROFIT CORPORATION THAT WAS INCORPORATED IN 2009, WITH ITS FOUNDING MEMBER BEING CHILDREN'S HOSPITAL (CHILDREN'S). THROUGH A HEALTH CARE SYSTEM AGREEMENT (SYSTEM AGREEMENT) BETWEEN LCMC, CHILDREN'S, TOURO INFIRMARY AND ITS SUBSIDIARIES (TOURO), AND COOPERATIVE ENDEAVOR AGREEMENTS (CEAS) WITH UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION (UMCMC) AND WEST JEFFERSON HOLDINGS, LLC (WEST JEFFERSON), THESE PARTIES HAVE DETERMINED THAT TOGETHER THEY CAN PROVIDE A MULTI-HOSPITAL, NOT-FOR-PROFIT COMMUNITY-BASED, SYSTEM THAT WILL PROVIDE A CONTINUUM OF CARE TO THE FAMILIES OF THE GULF SOUTH REGION. LCMC, CHILDREN'S, TOURO, UMCMC, AND WEST JEFFERSON ARE HEREINAFTER COLLECTIVELY REFERRED TO AS THE SYSTEM. LCMC FUNCTIONS AS THE SYSTEM PARENT WITH RESERVE POWERS TO BE EXERCISED TO PROMOTE THE BEST INTERESTS OF THE SYSTEM AND ITS AFFILIATES. ALL CORPORATE POWERS OF THE SYSTEM ARE VESTED IN THE BOARD OF TRUSTEES OF LCMC. CHILDREN'S PROVIDES COMPREHENSIVE PEDIATRIC HEALTHCARE THAT MEETS THE SPECIAL NEEDS OF CHILDREN THROUGH EXCELLENCE AND CONTINUOUS IMPROVEMENT OF PATIENT CARE, EDUCATION, AND RESEARCH. TOURO, FORMED IN 1852, SERVES THE GREATER NEW ORLEANS COMMUNITY AS A PREMIER, DIVERSE, MULTI-SPECIALTY HOSPITAL, CARING FOR THE SICK REGARDLESS OF RACE, COLOR, CREED, RELIGIOUS AFFILIATION, OR ABILITY TO PAY. UMCMC OPERATES UNIVERSITY MEDICAL CENTER IN NEW ORLEANS (UMC). UMCMC IS A PROVIDER OF CHARITY CARE FOR THE UNINSURED AND PLAYS A VITAL ROLE AS A STATEWIDE REFERRAL CENTER FOR PATIENTS IN NEED OF TERTIARY CARE. UMCMC ALSO PROVIDES MEDICAL AND ALLIED HEALTH TRAINING THROUGH ITS AFFILIATION WITH ACADEMIC INSTITUTIONS TO STRENGTHEN AND ENHANCE OPPORTUNITIES TO ACHIEVE THE STATE'S MEDICAL EDUCATION, CLINICAL CARE,AND RESEARCH GOALS.IN TAX YEAR 2016, LCMC AND ITS AFFILIATES PROVIDED TOTAL COMMUNITY BENEFIT EXPENSE OF $648.3 MILLION. THIS AMOUNT REPRESENTED 48 PERCENT OF THE AFFILIATES COMBINED TOTAL EXPENSE. LCMC AND ITS AFFILIATES PROVIDE SERVICES TO MANY LOW-INCOME RESIDENTS OF THE GREATER NEW ORELANS AREA. IN 2016, $421.7 MILLION IN EXPENSE (31 PERCENT OF THE AFFILIATES COMBINED TOTAL EXPENSE) WAS INCURRED IN PROVIDING SERVICES FOR MEDICAID RECIPIENTS AND IN PROVIDING FINANCIAL ASSISTANCE. TOURO AND CHILDREN'S AND OTHER HEALTH CARE PROVIDERS IN LOUISIANA HAVE COLLABORATED WITH THE STATE AND UNITS OF LOCAL GOVERNMENT IN LOUISIANA, TO MORE FULLY FUND THE MEDICAID PROGRAM AND ENSURE THE AVAILABILITY OF QUALITY HEALTHCARE SERVICES FOR THE LOW INCOME AND NEEDY RESIDENTS IN THE COMMUNITY POPULATION. THE PROVISION FOR THIS CHARITY CARE DIRECTLY TO LOW INCOME AND NEEDY PATIENTS WILL RESULT IN THE ALLEVIATION OF THE EXPENSE OF PUBLIC FUNDS THE GOVERNMENTAL ENTITIES PREVIOUSLY EXPENDED ON SUCH CARE, THEREBY ALLOWING THE GOVERNMENTAL ENTITIES TO INCREASE SUPPORT FOR THE STATE MEDICAID PROGRAM UP TO THE FEDERAL MEDICAID UPPER PAYMENT LIMITS (UPL). EACH STATE'S METHODOLOGY MUST COMPLY WITH ITS STATE PLAN AND BE APPROVED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS). FEDERAL MATCHING FUNDS ARE NOT AVAILABLE FOR MEDICAID PAYMENTS THAT EXCEED UPLS. IN TAX YEAR 2016, TOURO AND CHILDREN'S RECEIVED UPL PAYMENTS OF APPROXIMATELY $44.5 MILLION AND $103 MILLION RESPECTIVELY, WHICH ARE INCLUDED IN DIRECT OFFSETTING REVENUE ON PART I, LINE 7B IN SCHEDULE H F THE RESPECTIVE HOSPITAL'S 990S. IN TAX YEAR 2016, WEST JEFFERSON INCLUDED APPROXIMATELY $9 MILLION OF ITS UPL RECEIPTS AS DIRECT OFFSETTING REVENUE ON PART I, LINE 7B IN SCHEDULE H OF THE RESPECTIVE 990. 180984185 229943424 THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND CRITICAL CARE, HOME HEALTH, AND REHABILITATION SERVICES. THE HOSPITAL HAS A TOTAL OF 435 LICENSED PATIENT BEDS. THE HOSPITAL TREATED 11,767 INPATIENTS AND HAD 211,724 OUTPATIENT VISITS DURING 2016. THERE WERE 9,166 SURGERIES (INPATIENT, OUTPATIENT, AND AMBULATORY SURGERY CENTER), 58,075 EMERGENCY DEPARTMENT VISITS AND 1,203 BABIES DELIVERED. 5457007 2231973 COMMUNITY HEALTH SERVICES AND COMMUNITY BENEFIT OPERATIONS PROVIDE FREE HEALTH EDUCATION PROGRAMS AND SCREENINGS TO THE COMMUNITY. THESE PROGRAMS ARE DESIGNED TO FOCUS ON SOME OF THE MOST PREVALENT DISEASES WITHING THE COMMUNITY, SUCH AS DIABETES, HEART DISEASE AND CANCER. THESE PROGRAMS ADDRESS PREVENTION, EARLY DETECTION, TREATMENT, AND MAINTAINING HEALTHY LIFESTYLES. 186558710 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 99 0 2191 1 0 0 0 0 0 0 0 0 X 28 26 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X JESSICA CAHILL 5048969388 200 HENRY CLAY AVENUE NEW ORLEANS LA 70118 WILLIAM L MIMELES BOARD CHAIRMAN 1.00 X 0 0 0 KATIE ANDRY CROSBY BOARD VICE CHAIR 1.00 X 0 0 0 LEON J REYMOND BOARD SECRETARY/TREASURER 1.00 X 0 0 0 JULIE LIVAUDAIS GEORGE BOARD PAST CHAIRMAN 1.00 X 0 0 0 MICHAEL ADINOLFI MD BOARD MEMBER 1.00 X 0 0 0 BRIAN BARKEMEYER MD BOARD MEMBER 1.00 X 0 0 0 DARRYL D BERGER BOARD MEMBER 1.00 X 0 0 0 ALLAN BISSINGER BOARD MEMBER 1.00 X 0 0 0 RALPH O BRENNAN BOARD MEMBER 1.00 X 0 0 0 CHIP CAHILL BOARD MEMBER 1.00 X 0 0 0 ELWOOD F CAHILL BOARD MEMBER 1.00 X 0 0 0 DAMON DIETRICH BOARD MEMBER 1.00 X 321585 0 0 FANK DIVENCENTI MD BOARD MEMBER 1.00 X 0 0 0 LOU GOOD BOARD MEMBER 1.00 X 0 0 0 STEPHEN HALES MD BOARD MEMBER 1.00 X 0 0 0 JOHN HEATON MD BOARD MEMBER 1.00 X 0 0 0 A WHITFIELD HUGULEY IV BOARD MEMBER 1.00 X 0 0 0 RUTH KULLMAN BOARD MEMBER 1.00 X 0 0 0 STEPHEN KUPPERMAN BOARD MEMBER 1.00 X 0 0 0 THEODORE LE CLERGQ BOARD MEMBER 1.00 X 0 0 0 HUGH W LONG PHD BOARD MEMBER 1.00 X 0 0 0 ROBERT MAUPIN MD BOARD MEMBER 1.00 X 0 0 0 ANTHONEY RECASNER PHD BOARD MEMBER 1.00 X 0 0 0 STEPHEN SONTHEIMER BOARD MEMBER 1.00 X 0 0 0 MRS GEORGE VILLERE BOARD MEMBER 1.00 X 0 0 0 KNIGHT WORLEY MD BOARD MEMBER 1.00 X 0 0 0 ROYCE YOUNT JR MD BOARD MEMBER 1.00 X 0 0 0 GREGORY C FEIRN BOARD MEMBER, CEO 40.00 15.00 X X 0 1199475 242578 JIM MONTGOMERY PRESIDENT & COO 40.00 15.00 X 0 1241071 40408 SUZZANE HAGGARD CHIEF FINANCIAL OFFICER 40.00 15.00 X 0 648998 39494 RICK GUEVARA CHIEF LEGAL OFFICER 40.00 15.00 X 0 495862 36796 PAOLO ZAMBITO EVP - STRATEGY 40.00 15.00 X 0 446868 21127 NANCY R CASSAGNE CEO - WEST JEFFERSON HOLDINGS, LLC 55.00 X 600101 0 21636 SCOTT C LANDRY SVP - FACILITIES MGMT 55.00 X 0 278039 25993 CHAD COURREGE SVP - HUMAN RESOURCES 55.00 X 0 378382 34423 CHRISTINE ALBERT VP - MARKETING & COMMUNICATIONS 55.00 X 0 207122 14028 LISA GORE CHIEF CLINICAL EXCELLENCE OFFICER 55.00 X 0 536425 16623 TANYA TOWNSEND CHIEF INFORMATION OFFICER 55.00 X 0 385030 27790 RICHARD G HELMAN JR PHYSICIAN 55.00 X 415853 0 11767 CHARLES J BALLAY II PHYSICIAN 55.00 X 414248 0 24218 CLIFTON S NICHOLSON-UHL PHYSICIAN 55.00 X 383309 0 12008 ANGELA W GREENER COO - WEST JEFFERSON HOLDINGS, LLC 55.00 X 325103 0 20647 DANIEL C LUCIO PHYSICIAN 55.00 X 287563 0 19502 2747762 5817272 609038 79 0 1 0 LABORATORY MANAGEMENT SERVICES 2915 MISSOURI AVENUE SHREVEPORT LA 71109 OUTSOURCED LABORATORY SERVICES 6926368 SODEXO INC 1101 MEDICAL CENTER BLVD MARRERO LA 70072 ENVIRONMENTAL & DIETARY SERVICES 6755986 REHABCARE GROUP PO BOX 502096 ST LOUIS MO 63150 OUTSOURCED REHAB SERVICES 4881914 EPIC 1979 MILKY WAY VERONA WA 53593 IT SERVICES 3843915 CERNER HEALTH SERVICES PO BOX 959167 ST LOUIS MO 63195 IT SERVICES 2372499 82 6667000 138777 6667000 6805777 WEST JEFFERSON PATIENT SERVICE 621110 209417301 209417301 LCMC MANAGEMENT FEE 561000 55894177 55894177 WEST JEFFERSON NON-PATIENT SERVIC 621400 21337852 21337852 286649330 WEST JEFFERSON MRI K-1 900099 895154 895154 WEST JEFFERSON INDUSTRIAL MED 900099 259921 259921 WEST JEFFERSON CT SCAN K-1 900099 145169 145169 120000 120000 1420244 294875351 288069574 0 0 X 117518 117518 6938269 6938269 92225818 75548907 16676911 1391691 613058 778633 9990745 7127642 2863103 6842653 5429592 1413061 23690765 10973128 12717637 1155920 1155920 240546 240546 256404 256404 44688337 26540257 18148080 845595 31343 814252 3041714 390696 2651018 27888431 355947 27532484 7026865 1270112 5756753 230739 79264 151475 123530 123530 2301359 2301359 790218 790218 2623001 1686601 936400 MEDICAL SUPPLIES 49772445 49147997 624448 REPAIRS & MAINTENANCE 6209810 935618 5274192 ALL OTHER EXPENSES 4666123 2951998 1714125 LEASED FACILITIES & EQU 4658192 3359032 1299160 297716688 186558710 111157978 0 15885610 89764009 37240193 32036527 274928631 102094037 6798015 6711584 210907137 202880839 32551393 1113872 4590544 31437521 1270474326 1346042592 1541586 1633490 1822366042 1812600599 23415640 31533993 63183 41972 200000000 536789806 243959093 560268629 475535058 X 1262097413 1337065541 1262097413 1337065541 1822366042 1812600599 X -2841337 77809465 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54883 201521 256404 297658536 297914940 1000000 250000 0 0 1000000 1000000 1500000 256404 256404 250000 250000 375000 54883 54883 1370024 177871 1192153 511149 28609 482540 7518828 806907 6711921 23151392 100485 23050907 31437521 OTHER INVESTMENTS 160024 C INVESTMENTS IN JOINT VENTURES -432114 C INVESTMENTS IN SUBSIDIARIES 1344226454 C INVESTMENT IN PREMIER CLASS A 2088228 F 1346042592 BOND INTEREST 157333 EMPLOYEE BENEFITS 298187 LT LIABILITY 7257170 CURRENT LIABILITIES 10146705 SELF-INSURANCE RESERVES 1722425 DUE TO/FROM RELATED ENTITIES 223405778 COST REPORT LIABILITIES 971495 243959093 X PART X, LINE 2: PER THE CONSOLIDATED AUDITED FINANCIALS: LCMC, CHILDREN'S, UMCMC, TOURO INFIRMARY, AND CERTAIN OF THEIR RESPECTIVE SUBSIDIARIES ARE NOT-FOR-PROFIT ENTITIES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXATION. WEST JEFFERSON IS CONSIDERED A DISREGARDED ENTITY FOR FEDERAL AND STATE INCOME TAX PURPOSES. WEST JEFFERSON'S PROFITS AND LOSSES ARE ALLOCATED TO LCMC. ONE SUBSIDIARY OF TOURO AND ONE SUBSIDIARY OF WEST JEFFERSON ARE FOR-PROFIT ENTITIES. THE OPERATIONS OF THESE SUBSIDIARIES HAVE RESULTED IN COMBINED CUMULATIVE NET OPERATING LOSSES FOR FEDERAL INCOME TAX PURPOSES AT DECEMBER 31, 2016 AND 2015, OF APPROXIMATELY $43,782,000 AND 42,943,000 RESPECTIVELY. THESE NET OPERATING LOSS CARRYFORWARDS EXPIRE IN VARYING AMOUNTS BEGINNING IN 2018 THROUGH 2036. NO TAX BENEFITS RELATED TO THESE OPERATING LOSSES HAVE BEEN RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. CHILDREN'S, UMCMC, AND TOURO INFIRMARY ARE SEPARATE NON-PROFIT ORGANIZATIONS WHO FILE THEIR OWN TAX FORM 990. 1 1 1 X 1 X 1 1 0 0 18786266 12621809 6164457 0.02070 43651976 25535515 18116461 0.06090 62438242 38157324 24280918 0.08160 2608370 1040484 1567886 0.00530 2496442 1191489 1304953 0.00440 167520 167520 0.00060 5272332 2231973 3040359 0.01030 67710574 40389297 27321277 0.09190 184675 184675 0.00060 184675 184675 0.00060 0 7819000 46036860 47004088 -967228 X 1 1 1 CRESCENT CITY RESEARCH CONSORTIUM LLC CLINICAL TRIALS 0.50000 0.50000 2 WEST JEFFERSON INDUSTRIAL MEDICINE LLC PHYSICIAN PRACTICE 0.50000 0.50000 3 WEST JEFFERSON CT SCAN LLC OUTPATIENT IMAGING FACILITY 0.50000 0.50000 4 WEST JEFFERSON MRI LLC OUTPATIENT IMAGING FACILITY 0.50000 0.50000 1 1 WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD MARRERO LA 70072 WWW.WJMC.ORG 1982090742 X X X WEST JEFFERSON MEDICAL CENTER 1 0 1 1 X X X X X X X X 15 1 0 0 0 1 15 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.WJMC.ORG/DOCS/WJMC-FINANCIAL-ASSISTANCE X WWW.WJMC.ORG/DOCS/WJMC-FINANCIAL-ASSISTANCE X X X 1 X 0 X 1 X 0 0 WEST JEFFERSON MEDICAL CENTER PART V, SECTION B, LINE 5: WEST JEFFERSON MEDICAL CENTER (WJMC) JOINED WITH ELEVEN MEMBERS OF THE METROPOLITAN HOSPITAL COUNCIL OF NEW ORLEANS (MHCNO), A NON-PROFIT, REGIONAL MEMBERSHIP AND SERVICE ORGANIZATION REPRESENTING HOSPITALS AND HEALTHCARE ORGANIZATIONS IN THE GREATER NEW ORLEANS METROPOLITAN AREA TO INITIATE THE PROCESS OF CONDUCTING A COMPREHENSIVE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE COLLABORATIVE STUDY LAID THE FOUNDATION FOR INDIVIDUAL HOSPITAL CHNA'S (INDIVIDUAL-LEVEL CHNA REPORTS REQUIRED BY THE IRS EVERY THREE YEARS), SUCH AS WJMC'S CHNA. SPECIFICALLY, THE COLLABORATIVE EFFORT PLAYED AN IMPORTANT ROLE WITH OBTAINING INPUT THROUGH CONDUCTING OVER 100 KEY STAKEHOLDER CALLS IN THE GREATER NEW ORLEANS REGION AND FACILITATING 14 FOCUS GROUPS WITH OVER 200 RESIDENTS. A SERIES OF APPROXIMATELY 18 INTERVIEWS WERE COMPLETED WITH KEY STAKEHOLDERS IN THE GREATER NEW ORLEANS METROPOLITAN AREA AS FOLLOWS: 1 METHODIST HEALTH FOUNDATION, RICK HENAULT, EXECUTIVE VICE PRESIDENT; 2 BAPTIST COMMUNITY MINISTRIES, LIZ SCHEER, HEALTH GRANTS PROGRAM DIRECTOR; 3 AGENDA FOR CHILDREN, DR. ANTHONY RECASNER, CEO; 4 ACADIAN AMBULANCE, STEVE KUIPER, VP - OPERATIONS; 5 LSUHSC, DR. RICARDO SORENSON, CHAIR - DEPT OF PEDIATRICS; 6 CHILDREN'S SPECIAL HEALTH SERVICES, DR. SUSAN BERRY, DIRECTOR; 7 BLUE CROSS BLUE SHIELD, SHANNON TAYLOR, DIRECTOR - NETWORK DEVELOPMENT; 8 ST. BERNARD SCHOOLS, DORIS VOLTIER, SUPERINTENDENT; 9 VOA - NEW ORLEANS, JIM LEBLANC, PRESIDENT/CEO; 10 UNITED WAY FOR THE GNO AREA, GARY OSTROSKE, PRESIDENT; 11 CATHOLIC CHARITIES, GORDON WADGE, CEO/PRESIDENT; 12 EXECUTIVE DIRECTOR, STACY HORN KOCH, COVENANT HOUSE NEW ORLEANS; 13 PRESIDENT & CEO, NATALIE JAYROE, SECOND HARVEST FOOD BANK; 14 LA CHAPTER - AAP, ASHLEY POLITZ, LMSW, DIRECTOR; 15A CITY OF NEW ORLEANS, LUCAS DIAZ, DIRECTOR - OFFICE OF NEIGHBORHOOD ENGAGEMENT; 15B CITY OF NEW ORLEANS, DR. KAREN DISALVO, HEALTH COMMISSIONER; 16 KINGSLEY HOUSE, KEITH LEIDERMAN, P.H.D. CEO; 17 URBAN LEAGUE OF GNO, NOLAN ROLLINS, PRESIDENT/CEO; 18 DELGADO-CHARITY SCHOOL OF NURSING, CHERYL E. MYERS, PH.D, R.N., EXECUTIVE DEAN & DEAN OF NURSING. NEEDS IDENTIFIED INCLUDE (NOT LISTED IN ANY SPECIFIC ORDER) 1) ACCESS TO HEALTH SERVICES; 2) BEHAVIORAL HEALTH AND SUBSTANCE ABUSE; 3) RESOURCE AWARENESS AND HEALTH LITERACY; 4) ACCESS TO HEALTHY OPTIONS; AND 5) BEHAVIORS THAT IMPACT HEALTH. WEST JEFFERSON MEDICAL CENTER PART V, SECTION B, LINE 2: IN NOVEMBER 2014, WEST JEFFERSON HOLDINGS, LLC (COMPANY) WAS FORMED PURSUANT TO AN OPERATING AGREEMENT WITH LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC), WITH LCMC BEING THE SOLE MEMBER OF THE COMPANY. THE COMPANY WAS FORMED FOR THE PURPOSE OF OPERATING ASSETS LEASED TO IT BY JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 1, PARISH OF JEFFERSON, STATE OF LOUISIANA, D/B/A WEST JEFFERSON MEDICAL CENTER (THE DISTRICT) UNDER THE TERMS OF A COOPERATIVE ENDEAVOR AGREEMENT AND A MASTER HOSPITAL LEASE. THE COMPANY BEGAN OPERATING THE ASSETS LEASED TO IT BY THE DISTRICT EFFECTIVE OCTOBER 1, 2015. WEST JEFFERSON MEDICAL CENTER PART V, SECTION B, LINE 11: WEST JEFFERSON MEDICAL CENTER IS A 435-BED NOT-FOR-PROFIT ACUTE CARE COMMUNITY HOSPITAL LOCATED IN MARRERO, LOUISIANA, OPERATED BY THE NONPROFIT LCMC HEALTH SYSTEM. WJMC PROUDLY JOINED LCMC HEALTH SYSTEM ON OCTOBER 1, 2015. IN RESPONSE TO ITS COMMUNITY COMMITMENT, WEST JEFFERSON MEDICAL CENTER CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BETWEEN MARCH 2015 AND OCTOBER 2015 (SEE THE WEST JEFFERSON MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE FULL REPORT). THIS REPORT IS THE FOLLOW-UP IMPLEMENTATION PLAN THAT FULFILLS THE REQUIREMENTS OF THE INTERNAL REVENUE CODE 501(R)(3); A STATUTE ESTABLISHED WITHIN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) REQUIRING THAT NON-PROFIT HOSPITALS DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED IN THREE-YEAR INTERVALS. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANNING PROCESS UNDERTAKEN BY WEST JEFFERSON MEDICAL CENTER, WITH PROJECT MANAGEMENT AND CONSULTATION BY TRIPP UMBACH, INCLUDED EXTENSIVE INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH ISSUES. TRIPP UMBACH WORKED CLOSELY WITH LEADERSHIP FROM WEST JEFFERSON MEDICAL CENTER AND A PROJECT OVERSIGHT COMMITTEE, TO ACCOMPLISH THE ASSESSMENT AND IMPLEMENTATION PLAN. THIS IMPLEMENTATION PLAN INCLUDES STRATEGIES TO ADDRESS THE COMMUNITY HEALTH PRIORITIES WHICH WERE IDENTIFIED AND PRIORITIZED BASED ON THE INPUT OF COMMUNITY LEADERS REPRESENTING THE COMMUNITIES SERVED BY WEST JEFFERSON MEDICAL CENTER. THOSE PRIORITIES ARE: 1) ACCESS TO HEALTH SERVICES; 2) BEHAVIORAL HEALTH AND SUBSTANCE ABUSE; 3) RESOURCE AWARENESS AND HEALTH LITERACY; 4) ACCESS TO HEALTHY OPTIONS; AND 5) BEHAVIORS THAT IMPACT HEALTH. AS A NON-PROFIT HOSPITAL, WEST JEFFERSON MEDICAL CENTER PROVIDES CARE AND SERVICES TO RESIDENTS OF VULNERABLE POPULATIONS.TRIPP UMBACH FACILITATED AND MANAGED AN IMPLEMENTATION PLANNING PROCESS ON BEHALF OF WEST JEFFERSON MEDICAL CENTER, RESULTING INT HE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY AND PLA TO ADDRESS THE NEEDS IDENTIFIED IN THEIR COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED IN 2015 ( WEST JEFFERSON MEDICAL CENTER PART V, SECTION B, LINE 13B: THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR AN INDIGENT CARE DISCOUNT, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH EXTERNAL DATA SOURCES THAT COULD SUPPLY SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH ASSISTANCE.EXTERNAL DATA SOURCES: IN THE EVEN THAT THERE IS NO WRITTEN DOCUMENTATION TO SUPPORT A PATIENT'S ELIGIBILITY, WJMC MAY USE OUTSIDE SOURCES FOR ESTIMATING FAMILY INCOME AND POTENTIAL DISCOUNTS SUCH AS THE PATIENT'S ELIGIBILITY FOR THE FOLLOWING PROGRAMS IN CONJUNCTION WITH CHARITY PROBABILITY SCORING DATA:1. STATE-FUNDED PRESCRIPTION PROGRAMS2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC3. PARTICIPATION IN WOMEN, INFANTS, AND CHILDRENS PROGRAM (WIC)4. FOOD STAMP ELIGIBILITY5. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN)6. PATIENT IS DECEASED WITH NO KNOWN ESTATE OR RESPONSIBLE PARTY7. PATIENTS WHO ARE INCARCERATED MAY BE CONSIDERED ELIGIBLE IN THE EVENT THE STATE AND PARISH HAS MADE A DETERMINATION THAT THE STATE AND PARISH ARE NOT RESPONSIBLE FOR CHARGES AND THE INMATE/PATIENT IS RESPONSIBLE FOR THE BILL. WEST JEFFERSON MEDICAL CENTER PART V, SECTION B, LINE 13H: SEE EXPLANATION FOR LINE 13B PART V, SECTION B, LINE 22 WJMC SELF PAY DISCOUNT POLICY WAS AS FOLLOWS:OUTPATIENT SERVICES - 50% DISCOUNT OFF OF TOTAL CHARGES OR LESSOR OF MEDICARE CMS REIMBURSEMENT AS PAYMENT IN FULL WITHIN 10 DAYS OR SET THE ACCOUNT UP ON THE APPROPRIATE SHORT TERM PAYMENT ARRANGEMENT LISTED WITH THE SAME DISCOUNT.INPATIENT SERVICES - MEDICARE CMS DRG RATE IS OFFERED TO THE PATIENT AS PAYMENT IN FULL WITHIN 10 DAYS OR SET THE APPROPRIATE SHORT TERM PAYMENT ARRANGEMENT LISE ABOVE WITH THE SAME DISCOUNT.% OF POVERTY GUIDELINES DISCOUNT %:101% - 125% 80% OF BILLED CHARGES126% - 150% 65% OF BILLED CHARGES151% - 175% 50% OF BILLED CHARGES176% - 200% 40% OF BILLED CHARGES 1 1 - NEW ORLEANS PHYSICIANS SERVICES INC 1101 MEDICAL CENTER BLVD MARRERO LA 70072 PHYSICIAN PRACTICE PART I, LINE 7: WEST JEFFERSON IS COSTING SERVICES USING A RATIO OF COST TO CHARGES (RCC) OF ADJUSTED TOTAL EXPENSE AS A RATIO OF GROSS PATIENT CHARGES. WE APPLY THE RATIO TO GROSS CHARGES OF THE POPULATION BEING MEASURED IN ORDER TO ESTIMATE COST. ADJUSTED TOTAL EXPENSE IS WEST JEFFERSON'S TOTAL EXPENSE LESS NON-PATIENT REVENUE AND REMOVING DIRECT COMMUNITY BENEFIT COST DISCLOSED ON SCHEDULE H LINE 7J(C). WEST JEFFERSON USES THE RATIO OF ADJUSTED COST TO GROSS PATIENT CHARGES, USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. PART III, LINE 2: PART III, LINE 2 AND LINE 4. THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBES BAD DEBT EXPENSE AND ADDITIONALLY DESCRIBES, IN BRIEF, THE METHOD USED, IN ACCORDANCE WITH GAAP, TO ESTIMATE THE BAD DEBT EXPENSE OF THE HOSPITAL FOR THE FISCAL YEAR. PART III, LINE 4: PART III, LINE 2 AND LINE 4. THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBES BAD DEBT EXPENSE AND ADDITIONALLY DESCRIBES, IN BRIEF, THE METHOD USED, IN ACCORDANCE WITH GAAP, TO ESTIMATE THE BAD DEBT EXPENSE OF THE HOSPITAL FOR THE FISCAL YEAR. THE SYSTEM MAINTAINS ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM A PAYOR'S INABILITY TO MAKE PAYMENTS ON ACCOUNTS. THE SYSTEM USES A BALANCE SHEET APPROACH TO VALUE THE ALLOWANCE ACCOUNT BASED ON HISTORICAL WRITE-OFFS AND AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED. MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS ITS ALLOWANCES ASSOCIATED WITH ITS RECEIVABLES. PART III, LINE 8: THE TOTAL AMOUNT OF THE SHORTFALL REPORTED ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT.WEST JEFFERSON IS COSTING SERVICES USING A RATIO OF COST TO CHARGES (RCC) OF ADJUSTED TOTAL EXPENSE AS A RATIO OF GROSS PATIENT CHARGES. WE APPLY THE RATIO TO GROSS CHARGES OF THE POPULATION BEING MEASURED IN ORDER TO ESTIMATE COST. ADJUSTED TOTAL EXPENSE IS WEST JEFFERSON'S TOTAL EXPENSE LESS NON-PATIENT REVENUE AND REMOVING DIRECT COMMUNITY BENEFIT COST DISCLOSED ON SCHEDULE H LINE 7J(C). WEST JEFFERSON USES THE RATIO OF ADJUSTED COST TO GROSS PATIENT CHARGES, USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. PART III, LINE 9B: CHARITY CARE IS OFFERED TO PERSONS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. PART VI, LINE 2: WEST JEFFERSON HOLDINGS PARTICIPATED IN A COMPREHENSIVE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT RESULTING IN THE IDENTIFICATION OF THE TOP COMMUNITY HEALTH NEEDS. THE ASSESSMENT PROCESS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITIES SERVED BY THE HOSPITAL FACILITIES, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF THE PUBLIC HEALTH ISSUES AND THE UNDERSERVED COMMUNITY. THE ASSESSMENT PROCESS INCLUDED:COMMUNITY HEALTH ASSESSMENT PLANNING: A SERIES OF CONFERENCE CALLS WERE FACILITATED BY THE CONSULTANTS AND THE PROJECT TEAM.SECONDARY DATA: THE HEALTH OF A COMMUNITY IS LARGELY RELATED TO THE CHARACTERISTICS OF ITS RESIDENTS. AN INDIVIDUAL'S AGE, RACE, GENDER, EDUCATION, AND ETHNICITY OFTEN DIRECTLY OR INDIRECTLY IMPACT HEALTH STATUS AND ACCESS TO CARE. A COMPREHENSIVE ANALYSIS WAS COMPLETED OF HEALTH STATUS AND SOCIO-ECONOMIC ENVIRONMENTAL FACTORS RELATED TO THE HEALTH OF RESIDENTS IN THE DEFINED PROJECT AREA FROM EXISTING DATA SOURCES SUCH AS STATE AND PARISH PUBLIC HEALTH AGENCIES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER ADDITIONAL DATA SOURCES.INTERVIEW WITH KEY COMMUNITY STAKEHOLDERS: LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE AND/OR EXPERTISE IN PUBLIC HEALTH WERE IDENTIFIED. SUCH PERSONS WERE INTERVIEWED AS PART OF THE REGIONAL NEEDS ASSESSMENT PLANNING PROCESS. A SERIES OF APPROXIMATLEY 100 INTERVIEWS WERE COMPLETED WITH KEY STAKEHOLDERS IN THE GREATER NEW ORLEANS METROPOLITAN AREA.FOCUS GROUPS WITH COMMUNITY RESIDENTS: THE OVERSIGHT COMMITTEE ASSURED THAT COMMUNITY MEMBERS, INCLUDING UNDER-REPRESENTED RESIDENTS, WERE INCLUDED IN THE NEEDS ASSESSMENT PLANNING PROCESS VIA TWO FOCUS GROUPS. FOCUS GROUP AUDIENCES WERE DEFINED BY THE OVERSIGHT COMMITTEE UTILIZING SECONDARY DATA TO IDENTIFY HEALTH NEEDS AND DEFICITS IN TARGET POPULATIONS. THE FOCUS GROUP AUDIENCES INCLUDED WOMEN OF CHILDBEARING AGE AND SENIOR POPULATION (INDEPENDENT LIVING).IDENTIFICATION OF TOP REGIONAL COMMUNITY HEALTH NEEDS: TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUP INPUT. THE ANALYSIS PROCESS IDENTIFIED IN THE ASSESSMENT WERE SUPPORTD BY SECONDARY DATA (WHERE AVAILABLE) AND STRONG CONSENSUS WAS PROVIDED BY KEY COMMUNITY STAKEHOLDERS AND FOCUS GROUPS. AN INDEPENDENT REVIEW OF EXISTING DATA AND IN-DEPTH INTERVIEWS WITH STAKEHOLDERS REPRESENTING A CROSS-SECTION OF AGENCIES AND FOCUS GROUP INPUT RESULTED IN THE IDENTIFICATION OF THREE KEY HEALTH NEEDS IN THE WEST JEFFERSON SERVICE AREA THAT ARE SUPPORTED BY SECONDARY AND/OR PRIMARY DATA:1)ACCESS TO HEALTHCARE AND MEDICAL SERVICES (I.E., PRIMARY, SPECIALTY, PREVENTIVE, AND MENTAL).2)ACCESS TO COMMUNITY/SUPPORT SERVICES TO SUSTAIN A HEALTHY AND SAFE ENVIRONMENT.3)PROMOTION OF HEALTHY LIFESTYLES AND BEHAVIORS (SPECIFIC FOCUS ON CHRONIC DISEASES).THE WEST JEFFERSON COMMUNITY IS DIVERSE. THE HEALTH RISKS ASSOCIATED WITH CHRONIC DISEASE LIKE DIABETES AND OBESITY ARE PARTICULARLY HIGH AMONG OUR GROWING, MEDCIALLY UNDERSERVED AFRICAN-AMERICAN, HISPANIC, AND VIETNAMESE POPULATIONS. WEST JEFFERSON PERFORMS COMMUNITY OUTREACH TO THESE GROUPS THROUGH CHURCHES, LOCAL COMMUNITY ORGANIZATIONS, AND OTHER GRASSROOTS EFFORTS. WEST JEFFERSON'S GOAL IS TO HELP RESIDENTS LEARN HOW TO ACCESS THE CARE THEY NEED AND TO HELP THEM LEARN TO MANAGE THEIR HEALTH CONDITIONS AND LIVE HEALTHIER LIVES. PART VI, LINE 3: PRIOR TO RECEIPT OF SERVICES, PATIENTS ARE PROVIDED THE HOSPITAL'S "PATIENT RIGHTS BOOKLET", WHICH CLEARLY OUTLINES THE HOSPITAL'S PAYMENT EXPECTATIONS. IT ALSO STATES THAT FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE UPON REQUEST.WJMC OPERATES AN APPLICATION CENTER THAT SCREENS PATIENTS FOR POSSIBLE COVERAGE WITH MEDICAID AND DISABILITY PRORGRAMS. THE APPLICATION CENTER ALSO PROVIDES INFORMATION REGARDING FREE PRGORAM SERVICES WITHIN THE METROPOLITAN AREA.IN-HOUSE SELF-PAY PATIENTS ARE VISITED BY A FINANCIAL COUNSELOR AND/OR A DECO (ELIGIBILITY MANAGEMENT SEVICE) REPRESENTATIVE TO ASSIST IN SCREENING FOR POSSIBLE COVERAGE, INCLUDING FINANCIAL ASSISTANCE APPLICATIONS IF THE PATIENT DOES NOT QUALIFY FOR GOVERNMENT SPONSORED OR THIRD PARTY PROGRAMS. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT AND DETERMINES HIS/HER ABILITY TO PAY AND DISCUSSES THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ALL EMERGENCY ROOM PATIENTS ARE ALSO SCREENED FOR POSSIBLE THIRD PARTY COVERAGE AND/OR FINANCIAL ASSISTANCE. ALL SELF-PAY PATIENTS WHO ARE NOT SCREENED PRIOR TO BEING DISCHARGED RECEIVE A NOTICE FROM DECO THAT THE HOSPITAL, THROUGH ITS MEDICAL ELIGIBILITY ASSISTANCE PROGRAM (M.E.A.P.), ASSISTS PATIENTS AT WEST JEFFERSON TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE PROGRAMS, WHICH MAY ALSO PAY FOR HOPSITAL AND PHYSICIAN SERVICES. THIS IS A COMMUNITY SERVICE PROVIDED BY THE HOSPITAL AT NO CHARGE TO ITS PATIENTS. DECO STAFF, REGISTRATION STAFF, FINANCIAL COUNSELORS, CUSTOMER SERVICE REPRESENTATIVES, AND OTHER HOSPITAL STAFF ARE PROVIDED ONGOING TRAINING REGARDING THE ELIGIBILITY CRITERIA AND PROGRAMS THAT ARE AVAILABLE THROUGH VARIOUS LOCAL, STATE, AND FEDERAL AGENCIES TO ENSURE THAT DESERVING PATIENTS ARE REFERRED TO APPROPRIATE THIRD PARTIES AND/OR PROVIDED FINANCIAL ASSISTANCE, DEPENDING ON THE PATIENTS' INDIVIDUAL CIRCUMSTANCES. PART VI, LINE 4: GEOGRAPHIC SERVICE AREA: THE WEST JEFFERSON COMMUNITY INCLUDES SEVEN ZIP CODE AREAS (70072, 70058, 70094, 70056, 70053, 70131, AND 70114) IN TWO PARISHES (5 IN JEFFERSON; 2 IN ORLEANS). THESE AREAS PROVIDED 74% OF INPATIENT ADMISSIONS IN 2016.DEMOGRAPHIC SERVICE AREA:THE TOTAL POPULATION ESTIMATE FOR JEFFERSON PARISH FOR 2016 WAS 436,523 (SOURCE: JULY 1, 2016 US CENSUS BUREAU QUICK FACTS)RACE/ETHNICITYJEFFERSON PARISH: WHITE/NON HISPANIC = 53.2%(232,230); BLACK/NON HISPANIC = 27.5% (120,044); HISPANIC = 14.5% (63,296); ASIAN/ISL = 4.3% (18,770); ALL OTHER = 0.5% (2,183).JEFFERSON PARISH POPULATION OF CHILDREN (AGES 0-17) = 21.9% (95,599)JEFFERSON PARISH MEDIAN HOUSEHOLD INCOME (2011-2015 IN 2015 DOLLARS) COMPARED TO THE STATE: LOUISIANA = $45,047; JEFFERSON PARISH = $47,947PERCENT OF PEOPLE LIVING BELOW THE POVERTY LEVEL (2011-2015) WAS 20.2% FOR LOUISIANA; 16.3% FOR JEFFERSON PARISH.CHILD POVERTY RATES IN 2013 WERE 28.0% FOR LOUISIANA; 25.7% FOR JEFFERSON PARISH (SOURCE: UNITED STATES DEPARTMENT OF AGRICULTURE, PERCENT OF TOTAL POPULATION IN POVERTY, 2014).LOUISIANA RANKS 47TH IN THE NATION FOR THE PERCENT OF CHILDREN IN POVERTY; 49TH AMONG STATES IN PERCENT OF BABIES BORN AT LOW BIRTHWEIGHT; 48TH AMONG STATES IN ITS INFANT MORTALITY RATE. (SOURCE: KAISER FAMILY FOUNDATION, 2011-2013; AMERICA'S HEALTH RANKING UNITED HEALTH FOUNDATION, STATISTICS AS OF 2015)PERCENT OF UNINSURED ADULTS UNDER AGE 65 IN 2015 WAS 21% FOR JEFFERSON PARISH.PERCENT OF UNINSURED CHILDREN UNDER 19 IN 2013 WAS 5.3% (SOURCE: LOUISIANA HEALTH INSURANCE SURVEY, 2013 (SPONSORED BY DHH)).LOUISIANA'S UNINSURED RATE DROPPED FROM 21.7% IN 2013 TO 14.77% IN 2014 AFTER THE AFFORDABLE CARE ACT TOOK EFFECT AT THE BEGINNING OF 2014, ACCORDING TO A SURVEY CONDUCTED BY THE GALLUP ORGANIZATION. HOWEVER, THE PERCENTAGE OF LOUISIANA RESIDENTS WITHOUT HEALTH INSURANCE WAS LOWER THAN ONLY THREE STATES: TEXAS, WYMONG, AND OKLAHOMA, GIVING LOUISIANA THE 4TH HIGHEST PERCENTAGE OF UNINSURED RESIDENTS IN THE UNITED STATES.HEALTH OUTCOMES: JEFFERSON PARISH RANKED AS FOLLOW OUT OF 64 PARISHES IN THE STATE OF LOUISIANA:OUTCOMES RANK - 11THLENGTH OF LIFE - 17TH QUALITY OF LIFE - 17THHEALTHY BEHAVIORS - 5THTHE PERCENTAGE OF POPULATION IN JEFFERSON PARISH THAT SMOKES IS 19%.IN LOUISIANA, OBESITY IS MORE PREVALENT AMONG NON-HISPANIC BLACK AT 43.4% THAN NON-HISPANIC WHITES AT 31.3% AND HISPANICS AT 32.9% (SOURCE: HTTP://WWW.AMERICASHEALTHRANKINGS.ORG/LA)32% OF JEFFERSON PARISH WAS CONSIDERED OBESE.DIABETES VARIES BY RACE AND ETHNICITY IN THE STATE; 12.9% OF NON-HISPANIC BLACKS HAVE DIABETES COMPARED TO 9.2% OF NON-HISPANIC WHITES AND 8.1% OF HISPANICS. LOUISIANA HAS THE 7TH HIGHEST DIABETES MORTALITY RATE IN THE NATION. DIABETES IS THE 6TH LEADING CAUSE FOR DEATHS AMONG LOUISIANA RESIDENTS.LOUISIANA RANKS 46TH FOR CARDIOVASCULAR DEATH (SOURCE: AMERICA'S HEALTH RANKINGS BY THE UNITED HEALTH FOUNDATION HTTP://WWW.AMERICASHEALTHRANKINGS.ORG/LA). REDUCING DEATHS FROM CIRCULATORY SYSTEM DISEASES IS ANOTHER COMMUNITY NEED. WEST JEFFERSON IS WORKING TO DELIVER CRITICAL CARDIAC CARE AND STROKE SERVICES TO THESE PATIENTS.CANCER RATES: LOUISIANA RANKS 47TH IN CANCER DEATHS AND HAS CONSISTENTLY HAD ONE OF THE HIGHEST CANCER INCIDENCE RATE AND HIGHEST CANCER MORTALITY RATE IN THE COUNTRY (SOURCE: AMERICA'S HEALTH RANKINGS BY THE UNITED HEALTH FOUNDATION HTTP://WWW.AMERICASHEALTHRANKINGS.ORG/LA). WEST JEFFERSON'S CANCER CENTER PROVIDES A COMPREHENSIVE CANCER CARE PROGRAM.INFANT MORTALITY: THE STATE OF LOUISIANA CURRENTLY RANKS 48TH AMONG STATE IN ITS INFANT MORTALITY RATE (SOURCE: AMERICA'S HEALTH RANKINGS BY THE UNITED HEALTH FOUNDATION HTTP://WWW.AMERICASHEALTHRANKINGS.ORG/LA). THE OTHER ACUTE CARE HOSPITALS SERVING THE GREATER NEW ORLEANS COMMUNITY ARE: CHILDREN'S HOSPITAL, OCHSNER HOSPITAL, TULANE MEDICAL CENTER, UNIVERSITY MEDICAL CENTER, EAST JEFFERSON GENERAL HOSPITAL, TOURO INFIRMARY, AND ST. BERNARD PARISH HOSPITAL. PART VI, LINE 5: WEST JEFFERSON MEDICAL CENTER FURTHER PROMOTED THE HEALTH OF THE COMMUNITY, IN KEEPING WITH IT CHARITABLE MISSION, THROUGH EDUCATIONAL OFFERINGS AND SERVCIES FOR PATIENTS, THEIR LOVED ONES, AND MEMBERS OF THE COMMUNITY PROVIDED BY SEVERAL AREAS INCLUDING THE CANCER CENTER, STROKE CENTER, THE CARDIOVASCULAR PROGRAM, DIABETES SERVICES, COMMUNITY RELATIONS, THE FITNESS CENTERS, FAMILY DOCTORS, AND THE FAMILY BIRTH PLACE. THE HOSPITAL ALSO FURTHERED THE HEALTH OF THE COMMUNITY BY WAY OF PUBLIC OUTREACH AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY, CAMPUS-BASED HEALTH EVENTS AND SUPPORT GROUPS FOR PATIENTS AND THE PUBLIC, SMOKING CESSATION CLASSES, CONTINUITY OF CARE CLASSES FOR PERSONS WITH CONGESTIVE HEART FAILURE, STROKE SURVIVORS AND DIABETES AND IN THE OPERATIONS OF THE TWO FITNESS CENTERS OF THE MEDICAL CENTER PROVIDING NUTRITIONAL, WELLNESS, AND PREVENTITIVE HEALTH EDUCATION OFFERINGS.THE CLASSES PROVIDED TO YOUNG FAMILIES AT NO CHARGE INCLUDED PARENTING CLASSES, BREASTFEEDING CLASSES, NEWBORN CARE, SIBLING CLASS FOR NEW SIBLINGS, AND INFANT SAFETY AND FIRST AID CLASSES AS WELL AS CAR SEAT CHECK-UPS.IN THE INPATIENT SETTING, PATIENTS AND THEIR FAMILIES HAVE ACCESS IN THE ROOMS AT WEST JEFFERSON TO THE FREE GET WELL NETWORK WITH A HOST OF HEALTH TOPICS RELATING TO THEIR CONDITIONS AND DISEASE MANAGEMENT. PATIENT NAVIGATORS HELPED PATIENTS AND THEIR FAMILIES TO OVERCOME BARRIERS TO MAKING INFORMED CHOICES IN CARE. IN THE CANCER CENTER, NAVIGATORS HELPED PROMOTE THE TIMELINESS OF CARE AND ARE PART OF A LARGER TEAM FURTHERING EFFICIENT CARE AND PROMOTING HEALTH ON THE CANCER JOURNEY. NAVIGATOR SERVICES ARE AVALABLE TO PATIENTS AT NO CHARGE.COMMUNITY BENEFITS INCLUDED DONATION OF SPACE FOR COMMUNITY ORGANIZATIONS INCLUDING THE LOCAL CIVIC COALITION COMPRISED OF MULTIPLE NEIGHBORHOOD GROUPS, PROVISION OF EMERGENCY MEDICAL AND AMBULANCE SERVICES AT HIGH SCHOOL FOOTBALL GAMES, HEALTH PROFESSIONALS EXHIBITING AND SPEAKING AT AREA SENIOR CENTERS, AND ENGAGEMENT IN VARIED EVENTS OPEN TO THE PUBLIC WHERE TEAM MEMBERS PROVIDED VITAL HEALTH INFORMATION ON DISEASE PREVENTION AND EARLY INTERVENTION INCLUDING TOPICS OF HYPERTENSION AND STROKE AWARENESS. EXAMPLES OF SPEAKING AND EXHIBIT VENUES THIS YEAR INCLUDE THE NIGHT OUT AGAINST CRIME HELD IN MULTIPLE NEIGHBORHOODS ACROSS THE COMMUNITY. WEST JEFFERSON MEDICAL CENTER HEALTH PROFESSIONALS AND ITS EMERGENCY MEDICAL SERVICES AMBULANCE UNITS TOOK PART IN THESE NEIGHBORHOOD EVENTS. THE FAMILY DOCTORS PRIMARY CARE STAFF CONDUCTED BLOOD PRESSURE SCREENINGS DURING THE NIGHT OUTS. THESE EVENTS WERE FREE AND OPEN TO THE PUBLIC. THE PUBLIC EDUCATION AND PREVENTITIVE SCREENINGS INCLUDED THOSE OFFERED AND DEVELOPED BY THE COMMUNITY CANCER PROGRAM AT WEST JEFFERSON MEDICAL CENTER. GOALS WERE ESTABLISHED USING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS AN IMPORTANT GUIDE FOR IMPLEMENTING AND MONITORING THE EFFECTIVENESS OF THE OFFERINGS. IN THE CANCER CENTER, WEST JEFFERSON ENHANCED PATIENT NAVIGATION AND RELATED SERVICES TO HELP PATIENTS AND FAMILIES BEYOND DISCHARGE IN THEIR CANCER JOURNEY. WIG CLINICS FOR PATIENTS FOLLOWING CHEMOTHERAPY AND RADIATION TREATMENT WERE CONDUCTED AND COOKING CLASSES WERE HELD TO HELP PATIENTS' IMMUNE SYSTEMS FIGHT DISEASE. CANCER TOPICS WERE ALSO PRESENTED AND DISCUSSED IN A VARIETY OF SETTINGS INCLUDING ROTARY CLUBS, COMMUNITY CENTERS, AND SENIOR CITIZEN PROGRAMS. THE SPEAKER'S BUREAU AND RELATED SERVICES WERE OFFERED AT NO CHARGE. EDUCATIONAL MATERIALS WERE PROVIDED IN OTHER LANGUAGES IN KEEPING WITH THE NEED IDENTIFIED IN THE CHNA WHICH FEATURED COMMUNITY FOCUS GROUPS. A HISPANICS HEALTH FAIR WAS CONDUCTED AT ONE LOCATION OF A LOCAL GROCERY ESPECIALLY FOR THE HISPANIC POPULATION. ANOTHER LOCATION OF THE GROCERY SERVED AS A SECOND LOCATION FOR WELLNESS CLASSES AND TALKS IN ENGLISH WITH LANGUAGE TRANSLATION AVAILABLE WHERE NEEDED. THESE TOPICS FOCUSED ON NUTRITION, EXERCISE, AND CHRONIC DISEASE MANAGEMENT, AND WERE OFFERED BY DIETITIANS, EXERCISE SPECIALISTS, ALLIED HEALTH PROFESSIONALS, AND NURSES OF THE MEDICAL CENTER. THESE SERVICES WERE PROVIDED FREE OF CHARGE AS WERE SPEAKERS PROVIDED ON HEALTH TOPICS WHO PARTICIPATED IN OUTREACHES WITH THE LOCAL VIETNAMESE SENIOR CITIZEN GROUP. ARTICLES WERE DISSEMINATED IN ENGLISH AND VIETNAMESE DURING THOSE ACTIVITIES.IN THE UNDERSERVED COMMUNITIES OF THE REGION, WEST JEFFERSON TOOK PART IN RENEW NEIGHBORHOOD INITIATIVES FOR HEALTHIER COMMUNITIES AND SAFER COMMUNITIES VIA HEALTH FAIRS. TEAM MEMBERS ALSO PROVIDED HEALTHY COOKING RECIPES FOR THE LOCAL THANKSGIVING BASKET DISTRIBUTIONS. IN THE AFRICAN-AMERICAN/HIGH-RISK POPULATIONS IN THE AREA OF PROSTATE CANCER AWARENESS, TEAM MEMBERS TOOK ADVANTAGE OF SECURING OPPORTUNITIES TO SPEAK ABOUT IMPORTANCE OF COMMUNICATION AND SHARED DECISIONS MAKING WITH ONE'S PHYSICIAN. STAFF PROVIDED THE LATEST IN PROSTATE CANCER DETECTION GUIDELINES AND RESOURCES.IN THE AREA OF EMPLOYEE HEALTH, WEST JEFFERSON TOOK PART IN A MYRIAD OF EMPLOYER SPONSORED HEALTH EVENTS WITH LOCAL BUSINESSES. COMMUNITY RELATIONS TEAM MEMBERS DISTRIBUTED HEALTH INFORMATION, PREVENTITIVE HEALTH FACT SHEETS, AND BULLETINS FROM A VARIETY OF SOURCES INCLUDING THE AMERICAN HEART ASSOCIATION, THE AMERICAN STROKE ASSOCIATION, THE AMERICAN CANCER SOCIETY, THE SUSAN G. KOMEN FOUNDATION, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION AT MEETINGS AND EVENTS OF THE AREA BUSINESS AND INDUSTRY ASSOCIATION. THIS PARTICIPATION WAS PROVIDED FREE OF CHARGE TO FURTHER COMMUNITY HEALTH. WEST JEFFERSON ALSO PROVIDED CPR AND HEIMLICH MANEUVER DEMONSTRATIONS DURING OUTREACH INCLUDING TO A LOCAL CAFE PROVIDING TRAINING FOR AT-RISK YOUTH. THIS WAS ALSO CONDUCTED AT NO CHARGE. ON-CAMPUS SUPPORT GROUPS HOSTED BY STAFF OF THE MEDICAL CENTER INCLUDED A BARRIATRIC SUPPORT GROUP, THE BOSOM BUDDIES SUPPORT GROUP FOR BREAST CANCER SURVIVORS, A BRAIN AND SPINAL CORD INJURY SUPPORT GROUP, THE CANCER SURVIVORSHIP SUPPORT GROUP, THE CHRONIC OBSTRUCTIVE PULMONARY DISEASE SUPPORT GROUP, A COURAGE CAPS CANCER SUPPORT GROUP, THE LOOK GOOD FEEL BETTER PROGRAM FOR CANCER SURVIVORS, A LYPHEDEMA SUPPORT GROUP, A SMOKING CESSATION SUPPORT GROUP AND A STROKE SUPPORT GROUP. THE MEDICAL CENTER ALSO PROVIDED SPACE FOR A LOCAL GRIEF GROUP AND GRIEF RESOURCE CENTER TO MEET. THE SUPPORT GROUPS ARE PROVIDED FREE OF CHARGE WITH WJ PROVIDING STAFFING, HEALTH EDUCATION MATERIALS, AND PROMOTIONAL ASSISTANCE WITH SUPPORT AIDED BY THE HOSPITAL FOUNDATION FOR REFRESHMENTS.WEST JEFFERSON ALSO TOOK PART IN ADVANCING YOUTH INTERESTS IN HEALTH AWARENESS AND THE HEALTH PROFESSIONS WORKING CLOSELY WITH ITS AUXILIARY IN WELCOMING YOUTH VISITORS AND YOUTH VOLUNTEERS AND PROVIDING HEALTH EDUCATION HANDOUTS ON DISEASE PREVENTION AND HEALTH CAREERS TO AREA HIGH SCHOOL STUDENTS.PLASMA SCREENS ACROSS THE ORGANIZATION AT WEST JEFFERSON ARE UTILIZED TO PROMOTE MESSAGES OF HEALTH AND DISEASE PREVENTION WHICH ARE SEEN BY PATIENTS, THEIR LOVED ONES, VISITORS, AND THE PUBLIC. TOPICS INCLUDED MELANOMA, PROSTATE CANCER, SMOKING CESSATION, CARDIOVASCULAR DISEASE AWARENESS, UV SAFETY, BREAST HEALTH, AND MEN'S HEALTH. OUTDOOR ELECTRONIC BILLBOARDS ALSO AID THE HOSPITAL IN HEALTH PROMOTION AND HEALTH OBSERVANCES. THE HOSPITAL IS ALSO A SATELLITE NEWS SITE FOR A LOCAL TELEVISION STATION AND WEEKLY HEALTH EDUCATION AND DISEASE PREVENTION MESSAGES ARE OFFERED. THIS SERVICE IS PROVIDED AT NO CHARGE AND ENGAGES PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN THE HEALTH AWARENESS MESSAGES. THE HOSPITAL ALSO USES A LOCAL MEDICAL MINUTE RADIO FEATURE TO DISSEMINATE HEALTH INFORMATION. PART VI, LINE 6: WEST JEFFERSON HOLDING, LLC IS A LOUISIANA LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC). LCMC IS ALSO THE PARENT ORGANIZATION OF TOURO INFIRMARY, CHILDREN'S HOSPITAL, AND UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION.LCMC IS A LOUISIANA NON-STOCK, NOT-FOR-PROFIT CORPORATION THAT WAS INCORPORATED IN 2009. LCMC, THE SOLE MEMBER OF CHILDREN'S HOSPITAL INC. ("CHILDREN'S") ALSO BECAME THE SOLE MEMBER OF TOURO INFIRMARY ("TOURO") IN 2009 TO CREATE A TWO-HOSPITAL MEDICAL SYSTEM PROVIDING A COMPLETE CONTINUUM OF CARE FROM BIRTH TO GERIATRICS. CHILDREN'S PROVIDES COMPREHENSIVE PEDIATRIC HEALTHCARE THAT MEETS THE SPECIAL NEEDS OF CHILDREN THROUGH EXCELLENCE AND CONTINUOUS IMPROVEMENT OF PATIENT CARE, EDUCATION, AND RESEARCH. TOURO, FOUNDED IN 1852, SERVES THE GREATER NEW ORLEANS COMMUNITY AS A PREMIER, DIVERSE, MULTI-SPECIALTY HOSPITAL, CARING FOR THE SICK REGARDLESS OF RACE, COLOR, CREED, RELIGIOUS AFFILIATION, OR ABILITY TO PAY.IN TAX YEAR 2013, FOLLOWING STATE BUDGET REDUCTIONS THAT CAUSED SEVERE CUTS TO THE LOUISIANA PUBLIC HOSPITAL SYSTEM, AND AT THE REQUEST OF STATE OFFICIALS, LCMC EMBARKED ON A COOPERATIVE ENDEAVOR WITH THE STATE OF LOUISIANA ("STATE") FOR THE PURPOSE OF CREATING AN ACADEMIC MEDICAL CENTER (1) TO SERVE THE STATE AND ITS CITIZENS AS A PREMIER SITE FOR GRADUATE MEDICAL EDUCATION AND (2) TO FULFILL THE STATE'S HISTORICAL MISSION OF ASSURING ACCESS TO SAFETY NET SERVICES FOR ALL CITIZENS OF THE STATE, INCLUDING ITS MEDICALLY INDIGENT, HIGH-RISK MEDICAID, AND STATE INMATE POPULATIONS. UNDER THIS AGREEMENT, LCMC AGREED TO ASSUME RESPONSIBILITY FOR THE MANAGEMENT AND OPERATIONS OF THE INTERIM LSU PUBLIC HOSPITAL (ILH) AND THE UNIVERSITY MEDICAL CENTER. THROUGH THIS ENDEAVOR, LCMC AND ITS AFFILIATES ARE FULFILLING THEIR MISSIONS TO ENHANCE THE HEALTH OF THE GREATER NEW ORLEANS COMMUNITY BY DELIVERING HIGH QUALITY HEALTH CARE SERVICES TO ALL PATIENTS THROUGH A COMMITMENT TO CLINICAL EXCELLENCE, EDUCATION, TECHNOLOGY, RESEARCH, AND COMMUNITY OUTREACH.IN TAX YEAR 2015, LCMC AND WEST JEFFERSON HOLDINGS ENTERED INTO A COOPERATIVE ENDEAVOR WITH JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 1 TO LEASE AND OPERATE THE FACILITY KNOWN AS WEST JEFFERSON MEDICAL CENTER ("FACILITY"). THIS WAS DONE TO (1) TRANSFORM THE HEALTH CARE DELIVERY LANDSCAPE IN NEW ORLEANS THROUGH THE CREATION OF AN INTEGRATED HEALTHCARE DELIVERY NETWORK, (2) ALLOW FOR AN ENHANCED INTEGRATED DELIVERY SYSTEM WELL-POSITIONED FOR THE CHALLENGES OF HEALTHCARE REFORM AND POPULATION HEALTH MANAGEMENT IN THE FUTURE, (3) ENHANCE PHYSICIAN RECRUITMENT AND ENGAGEMENT AT THE FACILITY THROUGH DEVELOPMENT OF HIGH-QUALITY, OPEN MEDICAL STAFFS WITH SIGNIFICANT COMMUNITY INVOLVEMENT, A COMMITMENT TO MEDICAL RESEARCH AND EDUCATION, THE ESTABLISHMENT OF A PHYSICIAN NETWORK THAT MAY PARTICIPATE IN CLINICAL INTEGRATION, AND A COMMITMENT TO PLURALISTIC PHYSICIAN ALIGNMENT MODELS, AND (4) ACHIEVE FOR THE FACILITY THE BENEFITS OF SCALE ACHIEVED BY A LARGER HEALTH SYSTEM BY PROVIDING FOR GREATER STANDARDIZATION AND COST EFFICIENCY, ALLOWING FOR THE ABILITY TO LEVERAGE BEST PRACTICES AND GENERATE OPERATIONAL EFFICIENCIES. PART VI, LINE 7 FILING OF A COMMUNITY BENEFIT REPORT IS NOT REQUIEED IN THE STATE OF LOUISIANA. 1 CHILDREN'S HOSPITAL 200 HENRY CLAY AVENUE NEW ORLEANS LA 70118 720467503 501(C)(3) 46259 COKE SALES COMMISSIONS GO DIRECTLY TO THE LA REHAB WORK (BLIND PROGRAM). TOURO INFIRMARY 1401 FOUCHER STREET NEW ORLEANS LA 70115 720423689 501(C)(3) 46259 COKE SALES COMMISSIONS GO DIRECTLY TO THE LA REHAB WORK (BLIND PROGRAM). BATON ROUGE AREA FOUNDATION 100 NORTH STREET SUITE 900 BATON ROUGE LA 70802 726030391 501(C)(3) 25000 DONATION WAS INTO THE LOUISIANA FLOOD RELIEF FUND TO BENEFIT VICTIMS OF THE 2016 FLOOD IN THE SOUTH LOUISIANA AREA. 3 PART I, LINE 2: SINCE GRANTS WERE GIVEN TO RELATED PARTIES OF WHICH LCMC IS THE PARENT ORGANIZATION,EFFECTIVE OVERSIGHT IS MAINTAINED. X X X 0 0 0 0 0 0 0 0 0 DAMON DIETRICH BOARD MEMBER 321585 0 0 0 0 0 0 0 0 0 321585 0 0 0 GREGORY C FEIRN BOARD MEMBER, CEO 0 922823 0 240652 0 36000 0 214494 0 28084 0 1442053 0 0 JIM MONTGOMERY PRESIDENT & COO 0 1052516 0 179519 0 9036 0 23763 0 16645 0 1281479 0 760000 SUZZANE HAGGARD CHIEF FINANCIAL OFFICER 0 517413 0 125048 0 6537 0 30798 0 8696 0 688492 0 0 RICK GUEVARA CHIEF LEGAL OFFICER 0 367060 0 86802 0 42000 0 17225 0 19571 0 532658 0 0 PAOLO ZAMBITO EVP - STRATEGY 0 335634 0 76234 0 35000 0 10600 0 10527 0 467995 0 0 NANCY R CASSAGNE CEO - WEST JEFFERSON HOLDINGS, LLC 547752 0 49219 0 3130 0 7420 0 14216 0 621737 0 130189 0 SCOTT C LANDRY SVP - FACILITIES MGMT 0 225724 0 49860 0 2455 0 8399 0 17594 0 304032 0 0 CHAD COURREGE SVP - HUMAN RESOURCES 0 310492 0 65297 0 2593 0 12737 0 21686 0 412805 0 0 CHRISTINE ALBERT VP - MARKETING & COMMUNICATIONS 0 205898 0 0 0 1224 0 8075 0 5953 0 221150 0 0 LISA GORE CHIEF CLINICAL EXCELLENCE OFFICER 0 383116 0 147208 0 6101 0 10827 0 5796 0 553048 0 0 TANYA TOWNSEND CHIEF INFORMATION OFFICER 0 314241 0 68707 0 2082 0 10827 0 16963 0 412820 0 0 RICHARD G HELMAN JR PHYSICIAN 299220 0 114894 0 1739 0 6454 0 5313 0 427620 0 0 0 CHARLES J BALLAY II PHYSICIAN 317989 0 94375 0 1884 0 6550 0 17668 0 438466 0 0 0 CLIFTON S NICHOLSON-UHL PHYSICIAN 293866 0 87632 0 1811 0 6454 0 5554 0 395317 0 0 0 ANGELA W GREENER COO - WEST JEFFERSON HOLDINGS, LLC 300618 0 22500 0 1985 0 5904 0 14743 0 345750 0 0 0 DANIEL C LUCIO PHYSICIAN 144633 0 142024 0 906 0 6004 0 13498 0 307065 0 0 0 PART I, LINE 3 BASE COMPENSATION, INCENTIVE COMPENSATION AND ALL OTHER REPORTABLE AND NON-REPORTABLE COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE IS A SUBSET OF THE BOARD OF TRUSTEES. DECISIONS MADE BY THE EXECUTIVE COMMITTEE ARE DOCUMENTED AND REPORTED IN SUMMARY TO THE FULL BOARD OF TRUSTEES. IN ADDITION TO BOARD REVIEW, THIRD-PARTY CONSULTANTS PERIODICALLY REVIEW COMPENSATION AND INCENTIVE AMOUNTS TO ENSURE MARKET REASONABLENESS AND COMPETITIVENESS. THIRD-PARTY PREPARED COMPENSATION AND INCENTIVE REVIEW IS PRESENTED TO THE EXECUTIVE COMMITTEE. A LOUISIANA PUBLIC FACILITIES AUTHORITY 720895871 546395N67 2016-10-21 200000000 REFINANCE PORTION OF INTERIM TAXABLE DEBT AND FINANCE NEW CAPITAL EXPENDITUR 0 1 0 A 200000000 2571 5307003 194692997 2016 1 0 0 1 A 0 1 1 0 0 0.04200 0.00000 0.04200 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 11 OTHER SPENT PROCEEDS REPRESENT AMOUNTS PAID TO REFUND THE SERIES 2015A TAXABLE BONDS AND REFINANCE AMOUNTS AS TAX-EXEMPT. X VARIOUS ASSETS 1 6667000 COST 0 0 0 PART I, COLUMN (B): IN NOVEMBER 2014, WEST JEFFERSON HOLDINGS, LLC (THE COMPANY) WAS FORMED PURSUANT TO AN OPERATING AGREEMENT WITH LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC) WITH LCMC BEING THE SOLE MEMBER OF THE COMPANY. THE COMPANY WAS FORMED FOR THE PURPOSE OF OPERATING ASSETS LEASED TO IT BY JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 1, PARISH OF JEFFERSON, STATE OF LOUISIANA, D/B/A WEST JEFFERSON MEDICAL CENTER (THE DISTRICT UNDER THE TERMS OF A COOPERATIVE ENDEAVOR AGREEMENT (CEA) AND A MASTER HOSPITAL LEASE. THE COMPANY BEGAN OPERATING THE ASSETS LEASED TO IT BY THE DISTRICT EFFECTIVE OCTOBER 1, 2015. THE DISTRICT ASSIGNED THE BUSINESS, CONTROLS AND OPERATION OF THE HOSPITAL FACILITIES (THE FACILITIES) TO THE COMPANY, INCLUDING ALL RIGHT, TITLE AND INTEREST OF THE DISTRICT IN ALL ASSETS, PROPERTIES, CONTRACTS AND BUSINESSES USED OR HELD FOR USE IN, OR OTHERWISE CONSTITUTING OR RELATING TO, THE OPERATING OF THE FACILITIES. TEH VALUE OF TEH ASSETS LESS ANY LIABILITIES RECORDED WAS $7,192,939, AND WAS RECORDED AS A NON-CASH CONTRIBUTION IN THE 2015 FINANCIAL STATEMENTS. AS PART OF THAT CONTRIBUTION, A LIABILITY FOR POTENTIAL PAYMENTS UNDER ESTABLISHED PERFORMANCE CONSIDERATION WAS RECORDED. THE PERFORMANCE CONSIDERATION IS TO BE PAID TO THE DISTRICT FOR FORESEEABLE STEADY FINANCIAL PERFORMANCE OF THE HOSPITAL BUSINESS, WITH PAYMENT OF $6,667,000 PER YEAR FOR EACH OF THE FIRST THREE YEARS OF THE TERM WITH THE PAYMENT DUE NO LATER THAN 90 DAYS FOLLOWING THE LAST DAY OF SUCH PERFORMANCE YEAR. THESE AMOUNTS ARE RECORDED ON THE CONSOLIDATED BALANCE SHEETS WITH $6,667,000 CLASSIFIED AS CURRENT WITHIN OTHER CURRENT LIABILITIES, AND THE LONG-TERM PORTION TOTALING $6,667,000 WITHIN OTHER LONG-TERM LIABILITIES. THE SYSTEM'S PAYMENT MAY BE REDUCED SHOULD THE OPERATING EBIDA, AS DEFINED, OF WEST JEFFERSON BE LESS THAN 7.5% OF THE PERFORMANCE CONSIDERATION FOR THAT PERFORMANCE YEAR. IN THAT EVENT, THE PERFORMANCE CONSIDERATION MAY BE OFFSET, AT THE DISCRETION OF WEST JEFFERSON, BY THE INDIGENT COSTS FOR SUCH PERFORMANCE YEAR, UP TO A MAXIMUM OFFSET OF $20,000,000 IN THE AGGREGATE FOR THE FIRST THREE YEARS OF THE TERM OF THE WJ CEA. WEST JEFFERSON CONCLUDED THAT IT HAD NOT MET THE FINANCIAL PERFORMANCE REQUIREMENT AS OUTLINED ABOVE FOR THE PERFORMANCE YEAR ENDING DECEMBER 31, 2016. AS A RESULT, $6,667,000 OF THE ACCRUED PERFORMANCE CONSIDERATION HAS BEEN RECOGNIZED WITHIN OTHER NON-OPERATING REVENUES. PART III, LINE 1 THE PRIMARY PURPOSE OF LCMC IS TO CREATE, MAINTAIN, AND GROW HEALTH CARE SERVICES IN THE GREATER NEW ORLEANS AREA CONSITENT WITH ITS OPERATION OF WEST JEFFERSON MEDICAL CENTER AND THE CHARITABLE MISSION OF THE LCMC AFFILIATES. LCMC PROVIDES SUPPORT AND MANAGEMENT SERVICES TO THE SYSTEM ENTITIES SO THAT THE ENTITIES IN TURN CAN FOCUS THEIR EFFORTS ON CARRYING OUT THEIR EXEMPT PURPOSES. TO THAT END, THE EXECUTIVE MANAGEMENT OF THE SYSTEM AND THEIR SUPPORT STAFF AND SYSTEMS ARE CENTRALIZED AT LCMC. THE REVENUE OF LCMC IS DERIVED FROM PROVIDING PATIENT SERVICES AT WEST JEFFERSON MEDICAL CENTER AND FROM MANAGEMENT FEES RECEIVED FROM THE SYSTEM ENTITIES. CHILDREN'S HOSPITAL AND ITS SUBSIDIARIES, TOURO INFIRMARY AND ITS SUBSIDIARIES, UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION (UMCMC), AND WEST JEFFERSON HOLDINGS, LLC AND ITS SUBSIDIARIES ARE MEMBERS OF THE SYSTEM (LCMC). WHILE CHILDREN'S, TOURO, AND UMCMC ARE TAX-EXEMPT ORGANIZATIONS, SOME OF THE AFFILIATES AND/OR SUBSIDIARIES OF CHILDREN'S AND TOURO ARE FOR-PROFIT ENTITIES. ANY SERVICES PROVIDED TO SUCH ENTITIES WILL BE AT THE EXPRESS DIRECTION AND FOR THE BENEFIT OF CHILDREN'S AND TOURO. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990S ARE PREPARED AND REVIEWED IN DETAIL BY THE ORGANIZATION'S CONTROLLER AND THE RESPECTIVE ACCOUNTING STAFF. THE CFO/SENIOR VICE-PRESIDENT REVIEWS THE 990 IN FINAL DRAFT FORMAT, INCLUDING SUPPORTING WORK PAPERS AND RECONCILIATIONS. THE CFO THEN REVIEWS THE COMPLETED 990 WITH THE ORGANIZATIONS'S CEO , CHAIRPERSON OF THE BOARD OF TRUSTEES AND CHAIRPERSON OF THE FINANCE/AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. THE 990S ARE THEN DISTRIBUTED TO THE FULL BOARD FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C AT THE TIME OF HIRE, EACH EMPLOYEE REVIEWS THE CONFLICT OF INTEREST FORM, HAS AN OPPORTUNITY TO ASK QUESTIONS ABOUT THE POLICY, AND SIGNS A DOCUMENT STATING THAT THEY HAVE REVIEWED AND UNDERSTAND THE POLICY. THIS IS A PART OF THE EMPLOYEE'S PERMANENT RECORD, AND APPLIES TO ALL EMPLOYEES. SENIOR MANAGEMENT (DIRECTORS, VICE PRESIDENTS, CEO) AND MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE CORPORATION RELIES ON COMPARABLE DATA FROM UNRELATED ENTITIES TO DETERMINE THE AMOUNT OF COMPENSATION FOR ITS EXECUTIVES, AND DOCUMENTATION IS MAINTAINED REGARDING THE DETERMINATION OF THESE AMOUNTS. THE FINAL DECISION REGARDING THE AMOUNT OF COMPENSATION IS SUBJECT TO APPROVAL BY THE LCMC EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 15,726,482. MANAGEMENT AND GENERAL EXPENSES 7,431,961. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,158,443. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 9,698,691. MANAGEMENT AND GENERAL EXPENSES 71,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,769,876. OTHER CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 9,168,999. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,168,999. DUES & MEMBERSHIPS: PROGRAM SERVICE EXPENSES 311,149. MANAGEMENT AND GENERAL EXPENSES 669,220. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 980,369. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 800,095. MANAGEMENT AND GENERAL EXPENSES 337,601. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,137,696. OTHER CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 3,840. MANAGEMENT AND GENERAL EXPENSES 469,114. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 472,954. FORM 990, PART XI, LINE 9: EARNINGS FROM EQUITY INVESTMENTS IN RELATED TAX-EXEMPT HOSPITALS 77,809,465. FORM 990, PART XIII, LINE 2C THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. FORM 990, PART VI, QUESTION 16B SEE SCHEDULE M DETAIL. AMONGST THE ASSETS ACQUIRED ON 10/1/15 FROM THE DISTRICT WERE 5 PARTNERSHIPS; THEREFORE, LCMC IS NOW INVESTED IN THESE JOINT VENTURES. THE ORGANIZATION IS IN THE PROCESS OF FORMALIZING A POLICY TO SAFEGUARD THE ORGANIZATION'S TAX-EXEMPT STATUS. 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