2017-05-15T15:58:12-05:00 2016-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2015-07-01 720408970 ST FRANCIS MEDICAL CENTER % AMANDA HYMEL STFR 3189664000 PO Box 1901 Monroe LA 71210 JEFF LIMBOCKER OFFICER 3189664000 2017-05-15 true BRITTANY ELLISER P01284594 2253444000 2015 2021-01-29 14:40:06Z KRISTIN WOLKART PO BOX 1901 MONROE LA 71210 242881858 false 0928 X www.stfran.com X 1913 LA TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS AND TO PROVIDE FOR THE RESEARCH,EDUCATION AND THE ENHANCEMENT OF HEALTH OF THOSE IN NORTHEAST LOUISIANA. 16 11 2344 92 3509533 176324 1693614 1173969 232522237 233025307 6740353 4148925 2383605 2737118 243339809 241085319 320778 67563 0 0 122955285 120531485 0 0 0 140878841 160249833 264154904 280848881 -20815095 -39763562 332510177 308730912 231193750 266268775 101316427 42462137 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. PRIVILEGED TO SERVE. false false 215668329 233025307 St. Francis Medical Center provides quality hospital and medical services primarily to residents of Northeast Louisiana. The Medical Center is an active, caring member of the communities it serves. In carrying out its mission of meeting the healthcare needs of the people of God, the Medical Center has established a policy under which it provides care to needy members of its communities. Following that policy, health care services costing approximately, $7,626,446 were provided without charge. The Medical Center provided 545 licensed beds, 73,767 inpatient days, 227,275 outpatient visits, and 58,470 ER visits in the year ended June 30, 2016. See Schedule O for further explanation. 215668329 true true false false false false false false false false true true false false true true false true false false true false false false false false true true true false true false false false false false false false false true false false false true true true true false false true 111 0 true 2344 true true true false false false false false false false false false X 16 11 true false false false false true true true true false false true true true true true true false true true true X AMANDA HYMEL 2257658496 PO BOX 1901 MONROE LA 71210 X R KEITH WHITE MD DIRECTOR 40.0 0.0 X 839205 0 30828 THOMAS J GULLATT MD DIRECTOR 40.0 0.0 X 489745 0 18470 KRISTIN WOLKART President/CEO 2.0 58.0 X X 0 366497 61836 ROLF MORSTEAD MD Ex-Officio/Chief of Staff 40.0 0.0 X 59100 0 0 SIDNEY BAILEY MD Director 40.0 0.0 X 1000 0 0 JUDY BELL PAST Secretary 1.0 0.0 X X 0 0 0 NICK J BRUNO PH D Director 1.0 0.0 X 0 0 0 SR HELEN CAHILL Director 1.0 11.0 X 0 0 0 WILLIAM CHEEK VICE CHAIR 1.0 0.0 X X 0 0 0 BISHOP MICHAEL G DUCA Director 1.0 0.0 X 0 0 0 HILL HINKLE MD Director 1.0 0.0 X 0 0 0 SUSAN HOFFMAN Chairman 1.0 0.0 X X 0 0 0 J STEWART GENTRY PAST Chairman 1.0 0.0 X X 0 0 0 JOHN LUFFEY JR ESQ Director 1.0 1.0 X 0 0 0 SR MARY ANN SEPULVADO OSF Director 1.0 1.0 X 0 0 0 TONYA HUNTER MD Director 1.0 0.0 X 0 0 0 REV LARRY STAFFORD SECRETARY 1.0 1.0 X X 0 0 0 JOHN REA DIRECTOR 1.0 0.0 X 0 0 0 LJ HOLLAND DIRECTOR 1.0 0.0 X 0 0 0 REV EVERETT SLACK DIRECTOR 1.0 0.0 X 0 0 0 RONALD E HOGAN Regional CFO 2.0 58.0 X 0 398259 55728 KAYLA JOHNSON VP Patient Care Services 40.0 0.0 X 236994 0 52690 FRED TOLBERT VP Ancillary Services 40.0 0.0 X 206838 0 44846 SABRINA HOGAN VP Physician Services 40.0 0.0 X 238970 0 36894 KEVIN M MEYER Physician 40.0 0.0 X 598875 0 25422 DAVID M MCCOY Physician 40.0 0.0 X 744461 0 33328 Homan David J Physician 40.0 0.0 X 680027 0 33142 Sartor Frank B Physician 40.0 0.0 X 512829 0 22855 MICHAEL LANGIULLI PHYSICIAN 40.0 0.0 X 801138 0 24498 LOUIS BREMER FORMER PRESIDENT/CEO 0.0 0.0 X 0 406022 15802 5409182 1170778 456339 173 true true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Management Services 23045001 Parish Anesthesia of Monroe 3510 North Causeway Blvd Suite 404 METARIE LA 70002 Anesthesia Services 3738365 TRIMEDX INC 5451 Lakeview Parkway S Dr Indianapolis IN 46268 Maintenance Services 3634945 Lincoln Builders 1910 Farmerville HWY Ruston LA 712730400 Building Contractor 2648127 INTUITIVE SURGICAL INC 1020 KIFER ROAD SUNNYVALE CA 94086 DAVINCI ROBOT 2356383 158 X 0 129027 1044942 385000 1173969 PATIENT SERVICE REVENUE 621500 224409744 220947500 3462244 OUTREACH LAB 900099 2080650 2080650 OTHER PROGRAM SERVICE REVENUE 900099 12581266 12581266 INCOME FROM EQUITY INVESTEES 900099 -8300821 -8366903 66082 340B DRUG REVENUE 900099 2254468 2254468 233025307 1129355 -4030 1133385 0 0 2737118 2737118 0 2737118 2772540 -35422 4816109 1737050 59489 3079059 -59489 3019570 20659 2998911 0 0 0 0 241085319 232269521 3509533 4132296 67563 67563 0 0 0 0 3143778 2550121 593657 0 92248426 75580149 16668277 8467058 6868176 1598882 10430837 8461123 1969714 6241386 5061764 1179622 30152134 20148945 10003189 491943 320767 171176 2340 1526 814 0 0 303025 303025 23048211 14235568 8812643 169681 117089 52592 14733898 9639813 5094085 12169 12169 0 6657951 992783 5665168 611485 407497 203988 0 0 5029458 5029458 0 12015070 10665193 1349877 4169772 2008060 2161712 MEDICAL SUPPLIES EXPENSE 44220425 44220425 PENSION RELATED CHANGES 15197760 9270634 5927126 IMPAIRMENT 3412836 3412836 OTHER EXPENSE 21675 21675 280848881 215668329 65180552 0 X 26767813 24836517 8837915 2563479 0 0 42984986 35645119 0 0 0 0 1720224 182333 5809216 6038839 3162822 3392293 360848061 251044188 116089672 109803873 49016269 47167598 65098800 65987104 340032 -110587 5749348 3743789 6933080 9480555 332510177 308730912 28311387 30051667 0 0 0 0 132525589 129613401 0 0 0 0 0 0 0 0 70356774 106603707 231193750 266268775 X 100484754 41579291 831673 882844 0 0 101316427 42462137 332510177 308730912 X -39763562 -6050593 -13040135 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15041313 15041313 200408924 126939410 73469514 2296581 1153993 1142588 140352305 120887528 19464777 2748939 2063258 685681 109803873 FIXED INCOME SECURITIES 25205541 F ALTERNATIVE INVESTMENTS 40781563 F 65987104 0 DUE TO RELATED PARTIES 18844301 ACCRUED PENSION COSTS 80780628 GENERAL & PROFESSIONAL LIABILITY 5037810 OTHER LIABILITIES 1940968 106603707 X FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART XIII "FMOLHS recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgement occurs. No reserves for uncertain tax positions have been recorded." true Central America and the Caribbean Investments 34479116 34479116 34479116 true false true true true false true true X true X true X true true false true true 3194514 3194514 0.01130 34573152 25712652 8860500 0.03120 871372 646191 225181 0.00080 38639038 26358843 12280195 0.04330 787536 186773 600763 0.00210 478359 478359 0.00170 1694163 482002 1212161 0.00430 18702 18702 0.00010 2978760 668775 2309985 0.00820 41617798 27027618 14590180 0.05150 55135 55135 0.00020 1898 1898 7453 7453 64486 64486 0.00020 true 21530716 93935552 108016234 -14080682 X true true P&S Surgical Hospita MEDICAL SERVICES 0.5 0.034 0.4406 2 1 ST FRANCIS MEDICAL CENTER PO BOX 1901 MONROE LA 71210 www.fmolhs.org/stfran X X X 2 P&S SURGERY CENTER LLC 312 GRAMMONT STREET MONROE LA 71201 www.pssurgery.com X X ST FRANCIS MEDICAL CENTER 1 false false true X X X X X X X X X 15 true false false true X SEE SUPPLEMENTAL INFORMATION X true 15 false true false true X 200. 300. X X X true true X X true X X X X X true X false X X X X true X false false P&S SURGERY CENTER LLC 2 false false true X X X X X X X X X 15 true false false true X SEE SUPPLEMENTAL INFORMATION X true 15 false true false true X 150. 262. X X X X true true X X X X true X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 ST. FRANCIS MEDICAL CENTER (SFMC) AND P&S SURGICAL HOSPITAL: THE ORGANIZATIONS ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS. SFMC TOOK INTO ACCOUNT INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH BY INTERVIEWING DR. SHELLEY JONES, WHO IS THE REGIONAL MEDICAL DIRECTOR/ADMINISTRATOR WITH THE OFFICE OF PUBLIC HEALTH. ADDITIONALLY, SFMC ALSO TOOK INTO ACCOUNT INPUT FROM THOSE WHO REPRESENT A BROAD INTEREST IN THE COMMUNITY BY ATTENDING A PRIORITY AREA PRESENTATION BY DR. MONTEIC SIZER, EXECUTIVE DIRECTOR OF NORTHEAST DELTA HUMAN SERVICES AUTHORITY, WHERE THERE WAS A DISCUSSION REGARDING EMERGING THEMES IN BEHAVIORAL HEALTH, MENTAL HEALTH, AND SUBSTANCE ABUSE. PART V, SECTION B, LINE 7A ST. FRANCIS MEDICAL CENTER: THE CHNA CAN BE FOUND AT HTTPS://STFRAN.COM/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX P&S SURGERY CENTER, LLC: THE CHNA CAN BE FOUND AT HTTPS://PSSURGERY.COM/2016-COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B, LINE 11 DURING THE CURRENT YEAR, SFMC FOCUSED ON IDENTIFIED COMMUNITY NEEDS OF OBESITY/SEDENTARY LIFESTYLES, HEART ATTACK/STROKE, CHRONIC DISEASE MANAGEMENT, AND TOBACCO USE (SUBSTANCE ABUSE). WHILE IT IDENTIFIED NINE HEALTH NEEDS, IT CHOSE NOT TO FOCUS ON ACCESS TO CARE, CARE FOR THE ELDERLY, MENTAL HEALTH, COMMUNICABLE/INFECTIOUS DISEASE, AND NUTRITION/HEALTHY EATING. HOWEVER, SINCE THERE ARE LINKAGES AMONG ALL OF THESE AREAS, SFMC ANTICIPATES THAT THE OUTCOMES OF THE NON FOCUS AREAS WILL IMPROVE DUE TO THE TIE-INS THAT EXIST. FOR EXAMPLE, WHILE WE DID NOT CHOOSE TO FOCUS ON NUTRITION/HEALTHY EATING, WE DID SELECT OBESITY/SEDENTARY LIFESTYLES WHICH WILL HAVE TIE-INS TO HOW PEOPLE EAT. ADDITIONALLY CARE FOR THE ELDERLY WILL BE IMPROVED AS A COMPONENT OF IMPROVING HEALTH IN OUR FOCUS AREAS. THE OTHER UNSELECTED HELATH NEEDS WILL NOT GO UNADDRESSED SINCE WORK IS CURRENTLY BEING DONE BY OUR OWN RESOURCES AND/OR BY THE PROGRAMMING OF OTHER COMMUNITY ORGANIZATIONS. ST. FRANCIS MEDICAL CENTER DID THE FOLLOWING: OBESITY/SEDENTARY LIFESTYLIES: SFMC CONTINUED ITS EFFORTS TO INCREASE THE PERCENTAGE OF WOMEN WHO INITIATE BREASTFEEDING DURING POSTPARTUM HOSPITILIZATION. THE ST. FRANCIS WIC CLINIC HAS TRAINED AND RETAINED THREE ADDITIONAL CERTIFIED LACTATION COUNSELORS. HEART ATTACK/STROKE: SFMC ASSIGNED EARLY HEART ATTACK WARNING COMPUTER-BASED LEARNING EDUCATION TO ALL TEAM MEMBERS. TO DATE, 94.14% OF SFMC TEAM MEMBERS (1,559) HAVE SUCCESSFULLY COMPLETED THE EDUCATION. SFMC ALSO PRESENTED HEART ATTACK/STROKE EDUCATION SESSIONS TO FIRST RESPONDERS THROUGHOUT THE REGION. CHRONIC DISEASE MANAGEMENT: THE SFMC SCHOOL-BASED HEALTH CENTER COMPLETED ITS WELLNESS INTERVENTION NETWORK AND PRESENTED FINDINGS AT A REGIONAL MEETING OF 200+ COMMUNITY STAKEHOLDERS. THE PROGRAM FOCUSED ON POSITIVE HEALTH OUTCOMES IN 5 AREAS FOR STUDENTS AND FAMILIES, INCLUDING HEALTH EDUCATION, MENTAL HEALTH, PARENT ENGAGEMENT, YOUTH ROLE MODELS, AND DENTAL HYGIENE. SUBSTANCE ABUSE/TOBACCO USE: IN THE MOST RECENT FISCAL YEAR, ST. FRANCIS PROVIDED 1579 TOBACCO CESSATION COUNSELING SESSIONS AND CONNECTED 226 PATIENTS WITH FREE COUNSELING AND NICOTINE REPLACEMENT THERAPY TO HELP THEM QUIT USING TOBACCO PRODUCTS THROUGH THE SERVICES OF THE SMOKING CESSATION TRUST. A SUPPORT GROUP WAS ESTABLISHED TO PROVIDE AN ADDITIONAL LAYER OF SUPPORT DURING AND AFTER THE CESSATION PROGRAM. P&S SURGICAL HOSPITAL (P&S): DURING THE CURRENT YEAR, P&S FOCUSED ON IDENTIFIED COMMUNITY NEEDS OF ACCESS TO DENTAL CARE AND OBESITY. WHILE IT IDENTIFIED NINE HEALTH NEEDS DURING ITS LAST CHNA, IT CHOSE NOT TO FOCUS ON CHRONIC DISEASE MANAGEMENT, CARE FOR THE ELDERLY, SUBSTANCE ABUSE, MENTAL HEALTH, HEART ATTACK/STROKE, COMMUNICABLE/INFECTIOUS DISEASE, AND NUTRITION/HEALTHY EATING. EACH NEED NOT ADDRESSED IS EITHER BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY OR P&S IS NOT EQUIPPED TO ADDRESS THE NEED. P&S DID THE FOLLOWING: ACCESS TO DENTAL CARE: IN ORDER TO DECREASE THE BARRIERS TO DENTAL CARE FOR LOW-INCOME PEDIATRIC PATIENTS, P&S PROVIDED 316 DENTAL VISITS TO LOW-INCOME PEDIATRIC PATIENTS. OBESITY: P&S PROVIDED PRE-SURGERY NUTRITIONAL COUNSELING VISITS TO 69 PATIENTS, AND MAINTAINED ABOVE-AVERAGE CLINICAL QUALITY SCORES IN THE MBSAQIP DATABASE FOR ALL MEASURES. AN ONLINE SUPPORT GROUP IS PROVIDED THROUGH FACEBOOK TO CONNECT PATIENTS WITH INFORMATION AND SOCIAL SUPPORT. PART V, LINE 16I St. Francis Medical Center and P&S Surgical Hospital: Registration personnel refer patients that may have difficulty paying for their medical care to financial counselors to discuss qualifications for free or discounted care. PART V, LINE 13H St. Francis Medical Center and P&S Surgical 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 4 COMMUNITY HEALTH CENTER 2600 TOWER DRIVE MONROE LA 71201 VARIOUS OUTPATIENT SERVICES NORTHEAST LA CANCER INSTITUTE 411 CALYPSO STREET MONROE LA 71210 CANCER TREATMENT AND IMAGING CENTER Monroe MRI Center 501 Catalpa Street Monroe LA 71201 MRI SERVICES ST FRANCIS PET IMAGING OF MONROE PO BOX 1851 Monroe LA 71201 PET IMAGING SERVICES PART I, LINE 3C FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULL AND PARTIAL DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. DISCOUNTED CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS AND IS AVAILABLE IF MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF INCOME AND ASSETS. FULLY DISCOUNTED CARE IS ALSO AVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY. PART I, LINE 7G ST. FRANCIS MEDICAL CENTER PROVIDES SUBSIDIZED HEALTH SERVICES, INCLUDING SERVICES THAT PROVIDE PEDIATRIC NEUROLOGY, PEDIATRIC NEUROSURGERY, AND ADULT NEUROLOGY. THESE SPECIALIZED SERVICES ARE SUBSIDIZED BY ST. FRANCIS MEDICAL CENTER SINCE THESE ARE UNDER-SERVED SPECIALTY AREAS. PART I, LINE 7 THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE JUNE 30, 2016 MEDICARE COST REPORT DATA. FOR PART I LINES 7E, 7F, 7G, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENT AND THE MEDICARE COST REPORT WHERE APPLICABLE. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. THE ORGANIZATION CURRENTLY DOES NOT BELIEVE THAT ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2 NEEDS ASSESSMENT: Responding to the health needs of our community, especially to those most in need, is primary to the hospital's mission. As such, St. Francis Medical Center, Inc. works to conduct health care needs assessments. They work closely with Families helping Families, The Wellspring, The Children's Coalition, YMCA and many other organizations to define community needs and to consolidate efforts to meet those community needs. For example, a school-based health center and a diabetes and nutrition center was initiated after a health care assessment identified the need. The hospital conducted an updated community based needs assessment in tax year 2015 and will continue to use community based data to support decisions for outreach in the community. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: Patients are informed through a patient handbook that contains information on the financial policies of St. Francis Medical Center. Additionally, signs are posted in the Admissions areas that Financial Counseling is available upon request. Systems and tools are utilized to conduct high level financial screening to assist in identifying patients eligible for financial assistance. Financial counselors work closely with patients to assist with enrollment for those who are eligible for Medicaid as well as assist those who are eligible for HOSPITAL FINANCIAL ASSISTANCE in determining eligibility. PART VI, LINE 4 COMMUNITY INFORMATION: ST. FRANCIS MEDICAL CENTER (SFMC) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN MONROE, LOUISIANA THAT SERVES OUACHITA PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, SFMC'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 205,192 AND THE SENIOR POPULATION COMPRISES ABOUT 13.48% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $39,309 AND 20.09% OF THE PARISH'S RESIDENTS LIVE BELOW THE POVERTY LEVEL. ST. FRANCIS MEDICAL CENTER PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: OUACHITA PARISH LINCOLN PARISH ST. FRANCIS MEDICAL CENTER SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: CALDWELL PARISH EAST CARROLL PARISH FRANKLIN PARISH JACKSON PARISH MADISON PARISH MOREHOUSE PARISH RICHLAND PARISH TENSAS PARISH UNION PARISH WEST CARROLL PARISH PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: St. Francis Medical Center participates in community improvement activities because it understands that improvements to a community have a direct link to the improved health of community residents. Community improvement activities include the following: SFMC provides occupancy and utilities free of charge to St. Vincent DePaul charitable pharmacy so that the poorest individuals in the community have access to prescription drugs. SFMC also provides occupancy free of charge to a primary health care clinic located in one of the poorest areas of Monroe. These activities allow the recipient organizations to spend their available funds on activities that have more direct impact on those in need. SFMC provides management oversight of community programs and activities, including Meals on Wheels, taxi and medication provided to the needy, and community benefit salary dollars. SMFC proudly serves as the designated regional hospital for Region 8 and provides leadership and coordination for emergency preparedness activities. SFMC provides leadership development and training for Roman Catholic Priests to serve in the SFMC Community. SFMC improves access to public health through its financial support of an adult day health care facility and a school based health center. SFMC has many programs designed to promote leadership development and provide exposure to various careers in heatlh care. Such programs include health information management, sports medicine program, AHEC (area health education center) program, Carroll High School Housekeeping Program and the Jr. Volunteer Program. A majority of the governing body of SFMC is comprised of individuals from a broad cross-section of the community who reside in the primary service area and who are neither employees nor contractors of the organization. SFMC extends medical staff privileges to all qualified physicians in the community for some or all of the departments, as needed. SFMC applies surplus funds to improvements in patient care through investment in clinical technology, medical information technology, and continued training of clinical staff. PART VI, LINE 6 St. Francis Medical Center is a not-for-profit hospital, non-stock member corporation of which Franciscan Missionaries of Our Lady Health System, Inc. (FMOL Health System) is the sole member. St. Francis Medical Center is part of the FMOL Health System which includes several hospitals and tax-exempt affiliates throughout the state of Louisiana. St. Francis Medical Center serves the community in Northeastern Louisiana and Southern Arkansas. Other related hospitals in Louisiana include: Our Lady of Lourdes Regional Medical Center Our Lady of the Lake Hospital St. Elizabeth Hospital Our Lady of the Lake Assumption Hospital OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, LINE 2 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. PART I, LINE 7F FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE. true St Francis Medical Center Foundation 309 Jackson Street Monroe LA 71201 720408970 501(C)(3) 53000 GENERAL SUPPORT 1 PART I, LINE 2 ST. FRANCIS MEDICAL CENTER REQUESTS AN ACKNOWLEDGEMENT LETTER FROM EACH ORGANIZATION TO WHICH WE GIVE $5,000 OR MORE IN A CALENDAR YEAR. ORGANIZATIONS ARE REQUESTED TO IDENTIFY WHEN THE FUNDS WERE RECEIVED, HOW MUCH WAS RECEIVED, HOW THE FUNDS WERE USED AND WHAT THE OUTCOMES WERE OF THE PROJECT OR PROGRAM FOR WHICH THE FUNDS WERE REQUESTED. true true false false false false false true false R KEITH WHITE MD DIRECTOR 643501 0 124037 0 71667 0 6625 0 24203 0 870033 0 0 0 THOMAS J GULLATT MD DIRECTOR 324827 0 70711 0 94207 0 0 0 18470 0 508215 0 0 0 LOUIS BREMER FORMER PRESIDENT/CEO 0 0 0 0 0 406022 0 0 0 15802 0 421824 0 0 KRISTIN WOLKART President/CEO 0 288041 0 53940 0 24516 0 37868 0 23968 0 428333 0 0 RONALD E HOGAN Regional CFO 0 297952 0 83127 0 17180 0 36881 0 18847 0 453987 0 0 KEVIN M MEYER Physician 376252 0 219788 0 2835 0 6625 0 18797 0 624297 0 0 0 DAVID M MCCOY Physician 633743 0 107250 0 3468 0 6625 0 26703 0 777789 0 0 0 KAYLA JOHNSON VP Patient Care Services 200139 0 36014 0 841 0 29256 0 23434 0 289684 0 0 0 FRED TOLBERT VP Ancillary Services 173516 0 31858 0 1464 0 28332 0 16514 0 251684 0 0 0 Homan David J Physician 608311 0 69675 0 2041 0 6625 0 26517 0 713169 0 0 0 Sartor Frank B Physician 372814 0 114397 0 25618 0 6625 0 16230 0 535684 0 0 0 SABRINA HOGAN VP Physician Services 202132 0 35996 0 842 0 26551 0 10343 0 275864 0 0 0 MICHAEL LANGIULLI PHYSICIAN 649259 0 149440 0 2439 0 6625 0 17873 0 825636 0 0 0 PART I, QUESTION 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. THE CEO ALSO SIGNS A WRITTEN EMPLOYMENT AGREEMENT. PART I, LINE 4A The FORMER 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. Louis Bremer received a severance payment in the amount of $421,824 during the current year. PART I, QUESTION 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART I, QUESTION 4B FMOLHS maintains three unfunded deferred compensation plans which meet the requirements of IRC Section 457(f) and IRC Section 409A. The plans provide for compensation to be deferred and paid upon the occurrence of certain events such as termination without cause, disability, death or attainment of a specific payment date. Participation in the plans is limited to certain executives and is subject to approval of FMOLHS board of directors or a designated committee of such board. No one listed on Part VII, Section A received a payment from the plans in the current year. X 1 385000 FMV 1 false false false Part VI, Section A, Question 2 Ron Hogan, KRISTIN WOLKART, and J. Stewart Gentry have a business relationship with each other solely because they all serve as directors of other organizations which are related to St. Francis Medical Center. RON HOGAN AND SABRINA HOGAN HAVE A FAMILY RELATIONSHIP. Part VI, Section A, Question 6 FMOL Health System, Inc. (an IRC Section 501(C)(3) organization) is the sole member of the medical center. PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, INC. AS THE SOLE MEMBER OF THE MEDICAL CENTER, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. FRANCIS MEDICAL CENTER. PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: i. To change philosophy, objectives and purposes of corporation. ii. To appoint or remove the Members of the Board of Trustees and Officers of the corporation. iii. To amend, alter, modify or repeal the Articles of Incorporation and Bylaws of the corporation. iv. To authorize merger, consolidation, or affiliation, or participate in joint ventures. v. To dissolve and to distribute assets of the corporation. vi. To appoint and/or terminate with or without cause the Chief Executive Officer of the corporation. vii. To acquire, purchase, sell, lease, transfer, or encumber any immovable property on behalf of the corporation. viii. To add to or incur long-term debt in excess of $5 million by the Corporation. ix. To appoint the fiscal auditor for the corporation. x. To approve any increment or addition to the capital debt or efforts to renegotiate, modify or charge the existing capital debt obligations of the corporation. xi. To approve the annual operating and capital budgets of the corporation. xii. To approve a strategic business plan of the corporation. Part VI, Section A, Question 11A AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG LLP, THE TAXPAYER'S TAX ADVISORS, ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEWS THE RETURN. ST. FRANCIS MEDICAL CENTER'S GOVERNING BODY IS PROVIDED A COPY OF THE RETURN ELECTRONICALLY PRIOR TO THE FILING DATE AND IS GIVEN AN OPPORTUNITY TO REVIEW AND PROVIDE COMMENTS TO MANAGEMENT. PART VI, SECTION B, QUESTION 12C St. Francis Medical Center has a comprehensive conflict of interest policy that requires each officer, trustee, board committee member and employee to complete a conflict of interest disclosure statement annually. Completed disclosure forms are reviewed and maintained by the Chief Compliance Officer. If any trustee, Board committee member or senior manager has a potential conflict, the Executive Committee of the Board determines whether action needs to be taken and communicates any such action to the individual. A potential conflict of any other employee is reviewed by the CEO or his designee. The Executive Committee, CEO or designee, as applicable, determines if a conflict of interest exists or creates the appearance of impropriety. If such a determination is made, the individual will be excused from participating in the business decision. During the year, any change to the information in the disclosure statement must be disclosed promptly to the Chief Compliance Officer, who takes appropriate action. The process also requires affirmation from each individual that she/he (a) has received a copy of the conflict of interest policy; (b) has read and understands the policy; (c) has agreed to comply with the policy; and (d) understands that St. Francis Medical Center is a charitable organization and that, in order to maintain its Federal tax exemption, it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. In addition to the above, St. Francis Medical Center provides mechanisms for confidential reporting of compliance issues. These mechanisms include an anonymous hotline and Web site where individuals may raise issues, seek clarification, and report possible conflicts of interest or other concerns. These reports, including reports of possible conflicts of interest, are reviewed and investigated by the Corporate Compliance Department and appropriate action is taken. PART VI, SECTION B, QUESTION 15A & 15B Our Board of Directors designates an executive committee made up of independent board members to review and set the compensation annually of our officers and key employees. The executive committee obtains and relies upon comparable data including industry-wide compensation information provided by an outside consulting firm. The executive committee reviews compensation packages and appropriate compensation is determined and approved. The basis for determination is then documented by the executive committee. The compensation for the CEO of St. Francis Medical Center is set by the compensation committee of FMOL Health System (a related tax-exempt organization) according to their pay practices which are similar to those described above. GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 The organization makes its governing documents, conflict of interest policy and financial statements available upon request. PART XI, QUESTION 9 CAPITAL TRANSFER PER FMOL $(13,040,135) SECTION 1.263(A)-3(N) ELECTION-BOOK CONFORMITY ELECTION ST. FRANCIS MEDICAL CENTER is making the election under Treas. Reg. 1.263(a)-3(n) to capitalize those repair and maintenance costs that it treats as capital improvements on its books and records for the tax year ended JUNE 30, 2016. SECTION 1.263 (A)-1(F)- ELECTION- DE MINIMIS SAFE HARBOR ELECTION ST. FRANCIS MEDICAL CENTER hereby makes the de minimis safe harbor election under Section 1.263(a)-1(f) of the Treasury Regulations, effective only for the tax year ending June 30, 2015. 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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