2017-06-22T08:32:07-05:00 2016-09-30 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2015-10-01 720535375 LAFAYETTE GENERAL MEDICAL CENTER INC LAFA 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 ROGER MATTKE CFO 3372898125 2017-06-13 1 AMIE T WHITTINGTON CPA P01082167 6013261000 2017-05-24 2015 2021-01-29 14:40:06Z DAVID CALLECOD 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 535321814 0 X WWW.LAFAYETTEGENERAL.COM X 1911 LA LAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 22 15 2515 144 3387786 -1968291 223744 0 428275814 523492642 8079017 1468661 12350514 10360511 448929089 535321814 799588 556758 0 0 103893735 134594707 0 0 0 282162461 350639978 386855784 485791443 62073305 49530371 395964202 397218835 86160004 36682415 309804198 360536420 X LAFALAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 451173960 556758 530394687 PROGRAM SERVICES STATISTICS RELATED TO PROVIDING COMMUNITY MEDICAL CARE FOR THE HOSPITAL: TOTAL ACUTE PATIENT DAYS WERE 102,141, TOTAL NURSERY DAYS WERE 6,176, TOTAL REHAB DAYS WERE 3,330 AND TOTAL MENTAL HEALTH DAYS WERE 8,307. OTHER SIGNIFICANT HEALTHCARE SERVICES PROVIDED INCLUDED 88,263 EMERGENCY ROOM VISITS, 19,235 SURGERIES (INPATIENT AND OUTPATIENT), AND 3,034 DELIVERIES.THE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY. SERVICES INCLUDED INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION. THE REVENUES FORM THESE SERVICES ARE $1,178,685,347 AND $753,225,216, RESPECTIVELY. THERE WERE ACUTE AND SKILLED CARE SERVICES NOT FULLY COMPENSATED. THESE INCLUDED MEDICARE / MEDICAID CONTRACTUALS WITH $996,569,538 OF UNCOMPENSATED SERVICES, OTHER CONTRACTUALS WITH $411,557,340 OF UNCOMPENSATED SERVICES, AND BAD DEBTS OF $69,049,756. THE NET REVENUES OF THE SERVICES PROVIDED WERE $454,733,929.LAFAYETTE GENERAL MEDICAL CENTER (LGMC) SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED ACADIANA WITH 481 STAFFED BEDS (INCLUDING 26 NURSERY BEDS) AND 2,342 EMPLOYEES. LGMC REMAINS THE AREA'S LARGEST, FULL SERVICE, ACUTE-CARE MEDICAL CENTER.OUR HOSPITAL MISSION IN THE COMMUNITIES THAT WE SERVE IS TO RESTORE, MAINTAIN, AND IMPROVE HEALTH. WE ARE A COMMUNITY-OWNED AND LOCALLY MANAGED HOSPITAL THAT STAYS TRUE TO OUR MISSION BY DEDICATING SIGNIFICANT RESOURCES TO COMPENSATE A COMPASSIONATE, HIGHLY SKILLED STAFF; ACQUIRE ADVANCED TECHNOLOGY; AND DEVELOP SERVICE IMPROVEMENTS EACH YEAR.IN LINE WITH OUR GOAL OF BUILDING A REGIONAL HEALTH CARE SYSTEM, LAFAYETTE GENERAL HAS ESTABLISHED CLINICAL AFFILIATIONS WITH OUTLYING HOSPITALS, EXTENDING OUR BEST PRACTICES IN CANCER TREATMENTS, CARDIOLOGY, AND NEUROSCIENCE SUPPORT TO OUTLYING PARISHES. WE ALSO ENABLED PATIENTS TO PARTICIPATE MORE IN THEIR HEALTH CARE BY OFFERING AN ONLINE PATIENT PORTAL.ON JULY 1, 2013, AFTER LAFAYETTE GENERAL HEALTH TOOK OVER MANAGEMENT OF UNIVERSITY HOSPITAL & CLINICS (FORMERLY UNIVERSITY MEDICAL CENTER) WHEN IT WAS RUN BY THE STATE OF LOUISIANA, THE RESIDENCY PROGRAM WAS EXPANDED TO LAFAYETTE GENERAL MEDICAL CENTER. THESE TWO HOSPITALS SHARE IN A SYNERGISTIC RELATION, WHERE RESIDENTS BASED OUT OF LSU'S NEW ORLEANS AND BATON ROUGE CAMPUSES ROTATE THROUGHOUT EACH OF THESE HOSPITALS. THESE RESIDENTS SPAN A WIDE RANGE OF SERVICE LINES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, OTOLARYNGOLOGY (EAR, NOSE AND THROAT), OPHTHALMOLOGY, GENERAL SURGERY, OBSTETRICS, ANESTHESIOLOGY AND ORTHOPEDICS. FELLOWSHIPS (SPECIFIC MEDICAL TRAINING AVAILABLE TO THOSE WHO HAVE COMPLETED A RESIDENCY PROGRAM) ARE AVAILABLE IN CARDIOLOGY, GERIATRICS, RETINA AND UROGYNECOLOGY.LAFAYETTE GENERAL HEALTH ALSO EXPANDED EDUCATION OPPORTUNITIES OFFERED TO OTHER HEALTHCARE PROFESSIONALS IN ACADIANA BY STARTING THE FIRST EVIDENCE-BASED CURRICULUM NURSE RESIDENCY PROGRAM (NRP) IN LOUISIANA. LAFAYETTE GENERAL HEALTH RECOGNIZED THE NURSING SHORTAGE AFFECTING HOSPITALS ACROSS THE COUNTRY, ESPECIALLY IN ACADIANA. THE NURSE RESIDENCY PROGRAM (NRP) HELPS TRAIN GRADUATE NURSES ENTERING THEIR PROFESSIONAL FIELD. THE ONE-YEAR PROGRAM FOCUSES ON PATIENT OUTCOMES, LEADERSHIP AND QUALITY. LGMC'S FIRST NRP COHORT IN JANUARY 2016 CONSISTED OF 11 NURSES AND GREW BY 400% WITH THE NEXT CLASS. THE SECOND COHORT CONSISTED OF 50 NURSE RESIDENTS WHO BEGAN THE PROGRAM IN AUGUST.LAFAYETTE GENERAL CONTINUES TO EXPAND ITS SERVICES AND FACILITIES IN ORDER TO MEET THE GROWING NEEDS OF OUR COMMUNITY. THREE OF THE MORE RECENT RENOVATIONS AND EXPANSION TO OUR FACILITIES ARE DETAILED BELOW.LAFAYETTE GENERAL MEDICAL CENTER COMPLETED A $52.5 MILLION EMERGENCY DEPARTMENT AND OPERATING ROOM EXPANSION AND RENOVATION PROJECT. THE EXPANSION INCREASED THE EMERGENCY DEPARTMENT BED CAPACITY FROM 31 BEDS TO 45 AND ADDED TWO NEW TRAUMA ROOMS. A NEW TRAUMA ELEVATOR ADDED DIRECT ACCESS FROM THE EMERGENCY HELIPAD LANDING AREA TO THE ER, ICU, AND SURGERY AREAS BELOW. THIS EXPANSION ALSO INCLUDED A 343 SPACE PARKING GARAGE. LAFAYETTE GENERAL SOUTHWEST (LGSW) IS THE NEWEST ADDITION TO LAFAYETTE GENERAL HEALTH (LGH).AN AGREEMENT WAS REACHED ON NOVEMBER 6, 2015 FOR LGSW TO JOIN THE LGH FAMILY. LGSW SERVES AS AN EXTENSION OF LAFAYETTE GENERAL MEDICAL CENTER'S MAIN CAMPUS IN THE OIL CENTER. LGSW IS A FULL-SERVICE, ACUTE CARE HOSPITAL. THE ADDITION OF BEDS AND AN EMERGENCY DEPARTMENT ALLOWED LGH TO EXPAND SERVICES AND SERVE MORE PEOPLE IN AND AROUND THE LAFAYETTE COMMUNITY. THE ADDITION HELPED EASE LGMC'S INTAKE OF TRANSFERRED PATIENTS. WITH THE ACQUISITION OF THE NEW HOSPITAL, LGSW UNDERWENT UPDATES AND A SMALL RENOVATION.THE FOURTH FLOOR OF LGSW RECEIVED A TOTAL MAKEOVER TO TRANSFER THE INPATIENT REHABILITATION DEPARTMENT FROMLGMC. THE MOVE RESULTED IN MORE REHABILITATION BEDS FOR LAFAYETTE GENERAL PATIENTS THAN EVER BEFORE.IN MARCH 2016 LGMC ADDED 19 NEW BEDS AND AN EXTRA 11,000 SQUARE FEET TO LABOR & DELIVERY, MOTHER/BABY AND THE NEONATAL INTENSIVE CARE UNIT (NICU).LAFAYETTE GENERAL MEDICAL CENTER (LGMC) IS CURRENTLY CLASSIFIED AS A LEVEL II TRAUMA PROGRAM AND IS WORKING TO BECOME AN ACS VERIFIED ADULT LEVEL II TRAUMA CENTER. THIS DESIGNATION ELEVATES LGMC AS THE REGION'S REFERREDDESTINATION FOR TRAUMA PATIENTS, PROVIDING RESOURCES AND STAFFING TO HANDLE MAJOR EMERGENCIES.OUR ACCOLADES AND ACCREDITATIONS GROW EACH YEAR. IN OUR FISCAL YEAR 2016 WE RECEIVED THE FOLLOWING: LGMC EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL AS A CERTIFIED ORTHOPEDIC JOINT REPLACEMENT PROGRAM FOR SHOULDER REPLACEMENT. THIS PUT LGMC AMONG A RARE AND ELITE GROUP OF HOSPITALS WITH CERTIFICATIONS IN KNEE, HIP AND SHOULDER REPLACEMENT. WE WERE NAMED A "GREAT PLACE TO WORK IN HEALTHCARE" BY BECKER'S HOSPITALREVIEW AND AMONG THE "BEST PLACE TO WORK IN INFORMATION TECHNOLOGY" BY INTERNATIONAL DATA CORPORATION. WE ALSO ADDED MORE TECHNOLOGY, SUCH AS A NEW MINIATURIZED, WIRELESS HEART MONITOR CALLED THE CARDIOMEMS SYSTEM, AND MEDTRONIC'S PIPELINE FLEX EMBOLIZATION DEVICE TO TREAT BRAIN ANEURYSMS THROUGH OUR NEUROSCIENCE CENTER. LGMC GARNERED NUMEROUS AWARDS FOR ITS USE OF GROUNDBREAKING TECHNOLOGY, AS WELL AS PATIENT SAFETY AND SATISFACTION. WITH AN ACCREDITED CANCER PROGRAM, ADVANCED CERTIFIED PRIMARY STROKE CENTER, ACCREDITED CENTER FOR METABOLIC AND BARIATRIC SURGERY, BREAST IMAGING CENTER OF EXCELLENCE AND A BCBS BLUE DISTINCTION CENTER+ (PLUS) IN MATERNITY CARE, LGMC CONTINUED MEETING THE HEALTHCARE CHALLENGES OF ACADIANA.WE ALSO WAS NAMED A 2015/2016 CONSUMER CHOICE AWARD WINNER FOR THE 11TH TIME BY NATIONAL RESEARCH CORPORATION. LGMC WAS RECOGNIZED AS A 2014 TOP PERFORMER ON KEY QUALITY MEASURES BY THE JOINT COMMISSION. LGMC RECEIVED THE 2016 WOMEN'S CHOICE AWARD AS ONE OF AMERICA'S BEST HOSPITALS FOR PATIENT EXPERIENCE, OBSTETRICS, CANCER CARE, PATIENT SAFETY, STROKE CENTERS, BARIATRIC (WEIGHT LOSS) SURGERY AND ORTHOPEDICS. LGSW EARNED A WOMEN'S CHOICE AWARD FOR EMERGENCY CARE AND PATIENT SAFETY. LGMC RECEIVED AMERICAN HEART ASSOCIATION'S MISSION: LIFELINE BRONZE RECEIVING QUALITY ACHIEVEMENT AWARD FOR IMPLEMENTING SPECIFIC MEASURES OUTLINED FOR TREATING PATIENTS SUFFERING SEVERE HEART ATTACKS. LGMC AND UNIVERSITY HOSPITAL & CLINICS (UHC) EARNED QUALITY RESPIRATORY CARE RECOGNITION (QRCR) BY THE AMERICAN ASSOCIATION FOR RESPIRATORY CARE. LAFAYETTE GENERAL MEDICAL CENTER ASSUMES THE ROLE OF A COMMUNITY PARTNER IN A VARIETY OF WAYS. THROUGH FINANCIAL CONTRIBUTIONS WE WORK TO PRESERVE THE PROSPERITY OF OUR COMMUNITY, FURTHER MEDICAL EDUCATION AND RESEARCH AND HELP OUR CONSTITUENTS ACCESS THE MEDICAL CARE THEY NEED. WE COORDINATE EVENTS AND SCREENINGS FREE OF CHARGE TO MAINTAIN THE HEALTH OF THE LOCAL PUBLIC, INCLUDING FREE EKG SCREENINGS, FREE EDUCATIONAL SEMINARS AND FREE COLORECTAL SCREENING KITS. WE ALSO EXTEND OUR WORKFORCE BEYOND THEIR DAILY RESPONSIBILITIES TO PARTICIPATE IN ACTIVITIES THAT PROVIDE FOR THE SAFETY AND BETTERMENT OF OUR COMMUNITY. 451173960 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 476 0 1 2515 1 1 1 0 0 0 0 0 0 0 X 22 15 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 X CLAY ALLEN CHAIRMAN 3.00 1.00 X 0 0 0 MARTIN BECH SECRETARY 1.00 1.00 X 0 0 0 BRADLEY J CHASTANT MD TRUSTEE 8.00 1.00 X 9100 0 0 BRADEN DESPOT TRUSTEE 1.00 1.00 X 0 0 0 BENJAMIN DOGA MD TRUSEE AND VICE CHAIR - PART YEAR 3.50 1.00 X 18720 0 0 JULIE FALGOUT TRUSTEE 1.00 1.00 X 0 0 0 WILLIAM H FENSTERMAKER PAST CHAIRMAN 1.00 2.00 X 0 0 0 PHILIP GACHASSIN MD TRUSTEE 8.50 1.00 X 94600 0 0 ROBERT GILES TRUSTEE 1.00 1.00 X 0 0 0 JOBY JOHN PHD TRUSTEE 1.00 2.00 X 0 0 0 FLO MEADOWS TREASURER 1.00 1.00 X 0 0 0 DAVID CALHOUN TRUSTEE 1.00 1.00 X 0 0 0 MANDI MITCHELL TRUSTEE 1.00 1.00 X 0 0 0 GARY SALMON TRUSTEE 1.00 1.00 X 0 0 0 SAMUEL SHUFFLER MD TRUSTEE 1.00 1.00 X 0 0 0 DAVID WILSON CHAIR ELECT 1.00 1.00 X 0 0 0 JOSEPH ZANCO TRUSTEE 1.00 1.00 X 0 0 0 BRAD BROUSSARD MD TRUSTEE 5.00 1.00 X 56000 0 0 JOHN SCHUTTE MD TRUSTEE 21.00 41.00 X 23200 1374315 20298 DENNIS ESCHETE MD CHIEF OF STAFF 9.00 1.00 X 121000 0 0 PEGGY GIGLIO TRUSTEE 1.00 1.00 X 0 0 0 RICKEY MINIEX TRUSTEE 1.00 1.00 X 0 0 0 EDWARD KRAMPKE VICE CHAIR - PART YEAR 1.00 2.00 X 0 0 0 DAVID CALLECOD PRESIDENT/CEO - LGHS 1.00 46.00 X 0 1244305 238025 PATRICK W GANDY JR EVP-LGH/CEO - LGMC 1.00 40.00 X 0 637362 95311 ROGER MATTKE SVP/CFO- LGH 1.00 40.00 X 0 591525 116566 REBECCA F BENOIT VP/CNO 40.00 X 0 327900 47991 GORDON E ROUNTREE JR SVP/GENERAL COUNSEL 1.00 40.00 X 0 517808 88577 LANA ADAMS VP/CFO 40.00 X 0 135190 4717 DEBORAH F JOHNSON MD PHYSICIAN 40.00 X 0 746980 4566 MICHAEL CAIN MD PHYSICIAN 40.00 1.00 X 37440 720124 11052 SALMAN MALAD MD PHYSICIAN 40.00 X 0 701084 5451 RICKY L OWERS MD PHYSICIAN 40.00 X 0 477901 8182 VICTORIA PANELLI-RAMERY PHYSICIAN 40.00 X 0 461563 5075 360060 7936057 645811 55 0 1 0 ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 60673 HOUSEKEEPING AND DIETARY 13292441 ACADIANA RADIATION THERAPY LLC 104 WOODMONT BLVD STE 500 NASHVILLE TN 37205 RADIATION THERAPY 4139500 PARISH ANESTHESIA OF LAFAYETTE 3510 N CAUSEWAY BOULEVARD METAIRIE LA 70002 ANESTHESIA SERVICES 2771027 CARDIOVASCULAR INSTITUTE OF THE SOUTH AP 225 DUNN STREET HOUMA LA 703604413 CARDIOLOGY SERVICES 2651874 FASTAFF LLC PO BOX 11407 BIRMINGHAM AL 352462334 AGENCY NURSING STAFF 2296860 80 PATIENT REVENUE 621990 523492642 523492642 523492642 1468661 1468661 1 1 69153 0 69153 69153 69153 1526 0 1526 1526 OTHER REVENUE 900099 10289831 6902045 3387786 10289831 535321814 530394687 3387786 1539341 X 556758 556758 322620 322620 113911622 106932251 6979371 1760157 1649992 110165 10585453 9586251 999202 8014855 7441381 573474 2124990 1768785 356205 19560 19222 338 17350815 16196174 1154641 4416 4276 140 4449171 995103 3454068 241400 193611 47789 61118 61118 65977018 65977018 4547461 4160755 386706 94667 94667 MEDICAL SUPPLIES 97931195 85043075 12888120 BAD DEBT 69049756 69049756 EQUIPMENT RENTAL AND MA 20314020 16430910 3883110 PHYSICIAN CLINICAL SERV 19011881 18933631 78250 49462510 46079226 3383284 485791443 451173960 34617483 0 5077 5351 20320527 18816365 43623741 77381284 18968440 17641354 9456922 13982197 987885 736928 96624284 73968119 19601105 22656165 9778 9778 9765390 11927236 1333333 1448740 271892004 232613437 395964202 397218835 29876732 36682415 390273 55892999 0 86160004 36682415 X 309804198 360536420 309804198 360536420 395964202 397218835 49530371 1201851 0 X X 0 1 X 1 0 X X 0 195488 0 195488 451173960 741511044 451173960 741706532 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 24586 189962 174268 195488 584304 250000 250000 250000 250000 1000000 1500000 24586 189962 174268 195488 584304 SCHEDULE C PART II-A, LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH THE AMERICAN HOSPITAL ASSOCIATION AND THE LOUISIANA HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. 5358388 2120943 3237445 1725511 1313907 411604 88641282 70464193 18177089 899103 69076 830027 22656165 BOND FUNDS 11 DEPOSITS 6753 CSV OF EXEC/KEY LIFE INSURANCE 395578 UNINVESTED VALUE OF SERP 4849212 DUE FROM RELATED PARTY 227361883 232613437 X PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740. FASB ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR FINANCIAL STATEMENT RECOGNITION OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE INTERPRETATION ALSO PROVIDES GUIDANCE ON RECOGNITION, DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE ORGANIZATION'S VARIOUS FEDERAL INCOME TAX AND EXEMPT ORGANIZATION INCOME TAX RETURNS (IRS FORMS 1065, 1120, AND 990), WHETHER FILED ON A CALENDAR OR FISCAL YEAR BASIS, ARE SUBJECT TO EXAMINATION BY THE IRS. THE INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED. 1 1 X 1 X 1 X 1 1 1 0 1 1 1517195 1517195 0.00310 64347566 94455478 -30107912 0.00000 65864761 94455478 -28590717 0.00310 3864998 3864998 0.00800 3094920 780834 2314086 0.00480 356758 356758 0.00070 7316676 780834 6535842 0.01350 73181437 95236312 -22054875 0.01660 1 60049756 3125088 136236287 143199920 -6963633 X 1 1 2 1 LAFAYETTE GENERAL MEDICAL CENTER INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 X X X X A 2 LAFAYETTE GENERAL MEDICAL CENTER INC 2810 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70506 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 15 1 0 0 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/LGMC-FINA X 1 15 1 HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS 0 0 1 X 100.000000000000 200.000000000000 1 1 X X X 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/LGMC_FINANCIAL_ X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 X X X X X X 1 0 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: LAFAYETTE GENERAL MEDICAL CENTER INC., - FACILITY 2: LAFAYETTE GENERAL MEDICAL CENTER INC. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY GATHERING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVICED BY THE HOSPITAL FACILITY, AS WELL AS INDIVIDUALS PROVIDING INPUT WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. IT IS MEANT TO PROVIDE DEPTH AND RICHNESS TO THE QUANTITATIVE DATA COLLECTED. ADDITIONALLY, FOCUS GROUPS WERE CONDUCTED TO ALLOW PARTICIPANTS TO PROVIDE INFORMATION ABOUT THEIR EXPERIENCES IN THE COMMUNITY AND WAYS IN WHICH THEY THINK THE SERVICES AND RESOURCES PROVIDED TO THE COMMUNITY CAN BE IMPROVED.ORGANIZATIONS PROVIDING INPUT INCLUDE:BOARD OF TRUSTEES - HOSPITAL LEADERSHIPUNITED WAY OF ACADIANA - PUBLIC SERVICE ORGANIZATIONLAFAYETTE GENERAL HEALTH - HOSPITAL LEADERSHIPLAFAYETTE GENERAL MEDICAL CENTER - HOSPITAL LEADERSHIPCOMMUNITY PHYSICIAN (PEDIATRICIAN) - HEALTHCARE PROVIDEROFFICE OF PUBLIC HEALTH - PUBLIC HEALTH EXPERTACADIANA WEIGHT LOSS SURGERY - HEALTHCARE PROVIDERSWLA CENTER FOR HEALTH SERVICES PUBLIC SERVICE ORGANIZATIONLGMC CANCER CENTER - HEALTHCARE PROVIDERSW LOUISIANA AREA HEALTH EDUCATION CENTER - PUBLIC SERVICE ORGANIZATION FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED NEEDS ASSESSMENT BY:-ADOPTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THE HEALTH NEEDS OF THE HOSPITAL FACILITY'S COMMUNITY-EXECUTION OF THE IMPLEMENTATION STRATEGY-PARTICIPATION IN THE DEVELOPMENT OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-PARTICIPATION IN THE EXECUTION OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS-ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT-PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY-PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITYPLEASE SEE ATTACHED IMPLEMENTATION STRATEGY FOR FURTHER INFORMATION. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16I: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. PART I, LINE 6A: THE ANNUAL COMMUNITY BENEFIT REPORT INCLUDED ALL OF THE HEALTHCARE FACILITIES THAT LAFAYETTE GENERAL MEDICAL CENTER, INC IS AFFILIATED WITH. THE COMMUNITY BENEFIT REPORT INCLUDED LAFAYETTE GENERAL HEALTH SYSTEM, UNIVERSITY HOSPITAL & CLINICS, ACADIA GENERAL HOSPITAL, KAPLAN GENERAL HOSPITAL, DBA ABROM KAPLAN MEMORIAL HOSPITAL, LAFAYETTE GENERAL SURGICAL HOSPITAL, OIL CENTER SURGIAL PLAZA, ST. MARTIN HOSPITAL, LAFAYETTE HEALTH VENTURES, AND LAFAYETTE GENERAL FOUNDATION. PART I, LINE 7: THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H.PART I, LINE 7B, MEDICAID: LGMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS TO ASSIST IN OFFSETTING THE COSTS OF PROVIDING GRADUATE MEDICAL EDUCATION PROGRAMS AT BOTH LGMC AND UNIVERSITY HOSPITAL AND CLINICS. THE PAYMENTS ARE PROVIDED THROUGH A COLLABORATIVE ENDEAVOR AGREEMENT CREATING A PUBLIC PRIVATE PARTNERSHIP WITH LGMC, UHC, LOUISIANA STATE UNIVERSITY AND THE STATE OF LOUISIANA. PART 1, LINE 7, COLUMN F THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25 WHICH EXCLUDED BAD DEBT EXPENSE A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7 THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE ORGANIZATION'S MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, IF NECESSARY (E.G., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THOSE WITH NO THIRD-PARTY COVERAGE, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THEAMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED,IS WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE ORGANIZATION'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS REMAINED AT 99% OF SELF PAYACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2016 AND 2015. THE ORGANIZATION CONTINUES TO EXPERIENCE HIGH LEVELS OF CHARITY CARE AND BAD DEBT WRITE-OFFS AS A RESULT OF RISING PATIENT RESPONSIBILITIES DUE IN PART TO HIGH DEDUCTIBLE AND HIGH CO-PAY INSURANCE PLANS. BAD DEBT EXPENSE EQUALS THE BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BOTH CHARITY AND BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT 44% OF THE UNINSURED OUTPATIENT EMERGENCY ROOM VISITS THAT WERE ADJUSTED TO BAD DEBT MAY HAVE BEEN PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION.THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITALS FILED 2016 COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. PART III, LINE 9B: WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE ,WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. PART VI, LINE 2: A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR THE YEAR ENDING 09/30/16. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE OUR COMMUNITY HEALTH NEEDS ASSESSMENT DURING 2016. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS. IN ADDITION, THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATION. THE HOSPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/LGMC-FINAL%20CHNA-16.PDFTHE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/LGMC-CHNA-IMPLEMENTATIONSTRATEGY-FINAL.PDF PART VI, LINE 3: THE HOSPITAL COMPLIES WITH FEDERAL AND JACHO REQUIREMENTS OF POSTING NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS. HANDOUTS ARE INCLUDED WITH THE ADMISSION PACKAGE THAT INFORMS THE PATIENT OF CONTACT INFORMATION TO DISCUSS PAYMENT OPTIONS. THE HOSPITAL IS A MEDICAID ENROLLMENT FACILITY, AND AS SUCH, THE HOSPITAL OFFERS SCREENING SERVICES FOR ELIGIBILITY FOR MEDICAID AND POSSIBLE CHARITY CARE ASSISTANCE. HOSPITAL PERSONNEL ALSO SCREEN LARGER ACCOUNTS AFTER THE ORIGINAL BILL IS ISSUED, AND CONTACT THE PATIENT TO DETERMINE QUALIFICATIONS FOR CHARITY CARE POLICY. PART VI, LINE 4: THE HOSPITAL SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED AS ACADIANA AS THE LARGEST, FULL SERVICE, ACUTE CARE MEDICAL CENTER. APPROXIMATELY ONE THIRD OF THE HOSPITAL'S DISCHARGES COME FROM LAFAYETTE PARISH. THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE. PART VI, LINE 5: THE HOSPITAL DOES MAINTAIN AN OPEN MEDICAL STAFF THUS ALLOWING IT TO OFFER A VARIETY OF SPECIALISTS, AND CONTINUES TO RECRUIT PHYSICIANS TO OUR AREA TO ENSURE THAT THE HOSPITAL WILL CONTINUE TO BE THE FULL SERVICE HEALTHCARE PROVIDER THAT THE COMMUNITY EXPECTS. THE HOSPITAL JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS TO PROVIDE HEALTHCARE SCREENINGS AND TEST AT LOCAL EVENTS. PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH OTHER HEALTHCARE ORGANIZATIONS. SEE FORM 990 SCHEDULE R FOR A COMPLETE LISTING. ALL OF THE ORGANIZATIONS ARE LOCAL HEALTHCARE ORGANIZATIONS WITH THE SAME PURPOSE AS THE HOSPITAL. 1 CAMP BON COEUR 405 W MAIN ST LAFAYETTE LA 70501 581710741 501(C)(3) 10000 DONATION LAFAYETTE COMMUNITY HEALTHCARE CLINIC 1317 JEFFERSON STREET LAFAYETTE LA 70501 721221982 501(C)(3) 1000 8264 FEE SCHEDULE LAB SERVICES DONATION; REFERENCE LAB SERVICES LAFAYETTE GENERAL FOUNDATION 1214 COOLIDGE BLVD LAFAYETTE LA 70503 371766778 501(C)(3) 207820 DONATION MILES PERRET CANCER CENTER 2130 KALISTE SALOAM RD 200 LAFAYETTE LA 70508 753023211 501(C)(3) 13182 DONATION 4 0 PART I, LINE 2: CHARITABLE DONATIONS ARE MADE TO LOCAL NON-PROFIT ORGINIZATIONS THAT PARALLEL OUR HEALTHCARE MISSION IN THE COMMUNITY. X X X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 JOHN SCHUTTE MD TRUSTEE 0 1226944 0 147371 23200 0 0 12060 0 8238 23200 1394613 0 0 DAVID CALLECOD PRESIDENT/CEO - LGHS 0 835637 0 344735 0 63933 0 231626 0 6399 0 1482330 0 0 PATRICK W GANDY JR EVP-LGH/CEO - LGMC 0 451960 0 156836 0 28566 0 87860 0 7451 0 732673 0 0 ROGER MATTKE SVP/CFO- LGH 0 423201 0 147322 0 21002 0 105127 0 11439 0 708091 0 0 REBECCA F BENOIT VP/CNO 0 244612 0 71153 0 12135 0 45336 0 2655 0 375891 0 0 GORDON E ROUNTREE JR SVP/GENERAL COUNSEL 0 368279 0 132063 0 17466 0 78576 0 10001 0 606385 0 0 DEBORAH F JOHNSON MD PHYSICIAN 0 746154 0 0 0 826 0 2248 0 2318 0 751546 0 0 MICHAEL CAIN MD PHYSICIAN 0 720124 0 0 37440 0 0 4496 0 6556 37440 731176 0 0 SALMAN MALAD MD PHYSICIAN 0 643839 0 57245 0 0 0 3154 0 2297 0 706535 0 0 RICKY L OWERS MD PHYSICIAN 0 315501 0 162400 0 0 0 5977 0 2205 0 486083 0 0 VICTORIA PANELLI-RAMERY PHYSICIAN 0 461563 0 0 0 0 0 0 0 5075 0 466638 0 0 PART I, LINE 1A THE ORGANIZATION DOES ALLOW FOR SPOUSAL TRAVEL FOR THE TRUSTEES AND OFFICERS. SUCH EXPENSES ARE REPORTED ON THEIR W-2'S OR 1099'S. SOCIAL CLUB DUES WERE PAID FOR THE PRESIDENT/CEO-LGHS AND THE EVP/CEO-LGMC AND WERE INCLUDED AS WELL AS COMPENSATION ON THEIR W-2'S. PART I, LINE 4B A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED EFFECTIVE JANUARY 01,2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WAS $498,900. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE DAVID CALLECOD, PRESIDENT/CEO-LGHS, PATRICK GANDY, EVP/COO-LGMC, ROGER MATTKE, SVP/CFO, REBECCA BENOIT, VP/CNO, AND GORDON ROUNTREE, GENERAL COUNSEL. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2015 W-2 WAGES, TOTALLED $151,338. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2015 W-2 WAGES: DAVID CALLECOD, PRESIDENT/CEO-LGHS, PATRICK GANDY, EVP/COO-LGMC, ROGER MATTKE, SVP/CFO, AND GORDON ROUNTREE, GENERAL COUNSEL. PART I, LINE 6 THE ORGANIZATION DOES HAVE AN INCENTIVE PLAN FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS', AS LISTED ON PART VII OF FORM 990, CALCULATION OF INCENTIVE PLAN PAYMENTS ARE IN PART BASED ON THE CONSOLIDATED NET EARNINGS. SURGICAL HOSPITAL MANAGEMENT SYSTEM PHILIP GACHASSIN, M.D. IS A TRUSTEE OF LGMC AND IS A MEMBER OF SHMS, LLC. 1470000 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE ACUTE CARE SURGICALIST SERVICES. 0 STREAMLINE ORTHOPEDIC SERVICES APMLLC JOHN SCHUTTE, MD IS A TRUSTEE OF LGMC AND IS A MEMBER OF SOS, APMLLC 854364 LAFAYETTE GENERAL MEDICAL CENTER, INC HAS ENTERED INTO A CONTRACT WITH STREAMLINE ORTHOPEDIC SERVICES, APMLLC TO PROVIDE MEDICAL DIRECTOR SERVICES AND OVERSIGHT OF THE ORTHOPEDIC SERVICES PRODUCT LINE. 0 LAFAYETTE UROLOGY CALL LLC DR. SAMUEL SHUFFLER IS A TRUSTEE OF LGMC AND IS A MEMBER OF LUC, LLC 408000 LAFAYETTE GENERAL MEDICAL CENTER, INC HAS ENTERED INTO A CONTRACT WITH LAFAYETTE UROLOGY CALL, LLC TO ER CALL COVERAGE. 0 ACADIANA WEIGHT LOSS SURGERY LLC PHILIP GACHASSIN, M.D. IS A TRUSTEE OF LGMC AND IS A MEMBER AWLS, LLC. 83333 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE MANAGEMENT SERVICES AND MEDICAL DIRECTION SERVICES FOR BARIATRIC SERVICE LINE. 0 FORM 990, PART III, LINE 4A CONTINUED COMMUNITY OUTREACH & HEALTH CARE ACCESS CONTRIBUTIONS: LAFAYETTE GENERAL MEDIAL CENTER MAINTAINS A PROACTIVE APPROACH TO EDUCATION AND WELLNESS IN OUR COMMUNITY. ANNUALLY LGMC PROVIDES A MULTITUDE OF EDUCATIONAL SEMINARS AIMED AT EDUCATING THE PUBLIC ON PREVENTATIVE CARE AND MAINTAINING A HEALTHY LIFESTYLE. SOME OF THESE ACTIVITIES AND PROGRAMS INCLUDE: DONATED $8,264 IN DIAGNOSTIC SERVICES AS PART OF A PARTNERSHIP WITH THE LAFAYETTE COMMUNITY HEALTH CARE CLINIC. WOMEN'S AND CHILDREN'S SERVICES CURRENTLY OFFERS CLASSES WHICH INCLUDE NEWBORN CARE, LABOR AND DELIVERY PROCESS, SIBLING RELATIONSHIPS,BREASTFEEDING YOUR INFANT AND INFANT CPR. FREE MEETINGS PROVIDE COMFORT AND CONFIDENCE TO THOSE DEALING WITH STROKE SURVIVAL, WEIGHT-LOSS SURGERY, MULTIPLE BIRTHS, KIDNEY DISEASE AND INTESTINAL OR URINARY DIVERSIONS. LGMC ALSO PROVIDES FREE TRANSPORTATION FOR PATIENTS WITH SPECIAL NEEDS, IN ORDER TO ALLOW THEM ACCESS TO MEDICAL CARE AT THE HOSPITAL. TO IMPROVE HEALTH CARE ACCESS FOR THOSE UNINSURED WORKERS LIVING AT OR BELOW POVERTY LEVEL, LGMC MAINTAINS A REFERRAL AGREEMENT WITH THE LOCAL "LAFAYETTE COMMUNITY HEALTHCARE CLINIC" TO PROVIDE DIAGNOSTIC TESTING TO THEIR PATIENT POPULATION. LAFAYETTE GENERAL MEDICAL CENTER IS TRULY A COMMUNITY OWNED HOSPITAL CARING FOR THE NEEDS OF THE COMMUNITY AND INVESTING IN THE FUTURE WELLNESS OF OUR NEIGHBORS. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES, CLAY ALLEN AND ROBERT GILES, ARE INVOLVED IN SEPARATE BUSINESS VENTURES TOGETHER THAT ARE WHOLLY UNRELATED TO THE ORGANIZATION. THE FOLLOWING TRUSTEES ALL HAVE OWNERSHIP IN LAFAYETTE GENERAL SURGICAL HOSPITAL: DR. SCHUTTE, DR. CHASTANT, DR. SHUFFLER AND DR. GACHASSIN. PHILIP GACHASSIN, M.D. AND DENNIS ESCHETE, M.D. ARE PARTNERS IN A GENERAL SURGERY OFFICE PRACTICE AND SHARE OFFICE SPACE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-STOCK NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS RATIFY THE SELECTION OF THE INDIVIDUALS THAT SERVE ON THE BOARD OF TRUSTEES (GOVERNING BODY) AFTER THOSE INDIVIDUALS HAVE BEEN SELECTED AS A TRUSTEE BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B YES, THE INDIVIDUALS OF THE TRUSTEES (GOVERNING BODY) AND THE MEMBERS MUST BE APPROVED BY THE MEMBERSHIP BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S ACCOUNTING STAFF AND A CPA FIRM. THE COMPLETED FORMS ARE REVIEWED BY THE OFFICERS AND THEN PRESENTED TO THE BOARD FOR REVIEW, COMMENT AND CORRECTIONS IF NEEDED BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL SURVEY IS SENT TO THE BOARD MEMBERS AND OFFICERS REQUIRING THEM TO DISCLOSE CONFLICTS OF INTEREST. AFTER RECEIPT OF THESE SURVEYS, THE GOVERENCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE. THEREAFTER THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE AND THE ORGANIZATION'S GENERAL COUNCIL (WHO ATTENDS ALL BOARD MEETINGS) INSURES THAT ALL CONFLICTS ARE TIMELY DISCLOSED AND APPROPRIATE RECUSALS ARE MADE ON BUSINESS MATTERS THAT MAY BE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEOS COMPENSATION THEREAFTER. THIS SAME PROCESS IS FOLLOWED FOR THE FOLLOWING SENIOR EXECUTIVES OF THE ORGANIZATION: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER AND GENERAL COUNSEL. FORM 990, PART VI, SECTION C, LINE 19 BASIC FINANCIAL INFORMATION IS MADE AVAILABLE AND SENT OUT TO THE COMMUNITY BY MEANS OF THE ORGANIZATION'S ANNUAL REPORT. OTHER DOCUMENTS AND MORE DETAILED FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY / LEGAL AUTHORITIES. FORM 990, PART VII, SECTION A, LINE A PAYMENTS TO THE PHYSICIANS THAT SERVE AS TRUSTEES WERE REPORTED ON 1099 MISC BOX 6 FOR SUCH SERVICES AS PROVIDING CALL COVERAGE IN OUR EMERGENCY ROOM, OR SERVING AS MEDICAL DIRECTORS FOR VARIOUS HOSPITAL DEPARTMENTS. NO PAYMENTS WERE MADE IN THEIR CAPACITY AS TRUSTEE. FORM 990, PART IX, LINE 24E NONCLINICAL CONTRACT LABOR: PROGRAM SERVICE EXPENSES 17,792,842. MANAGEMENT AND GENERAL EXPENSES 546,904. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,339,746. CLINICAL CONTRACT LABOR: PROGRAM SERVICE EXPENSES 14,125,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,125,855. FOOD SUPPLIES: PROGRAM SERVICE EXPENSES 3,822,429. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,822,429. MEDICAL DIRECTORSHIPS: PROGRAM SERVICE EXPENSES 3,716,565. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,716,565. COMMUNITY PHYSICIAN RELATIONS: PROGRAM SERVICE EXPENSES 3,430,070. MANAGEMENT AND GENERAL EXPENSES 25,751. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,455,821. RECRUITING: PROGRAM SERVICE EXPENSES 94,637. MANAGEMENT AND GENERAL EXPENSES 2,168,474. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,263,111. OTHER NONCLINICAL SERVICES: PROGRAM SERVICE EXPENSES 1,112,387. MANAGEMENT AND GENERAL EXPENSES 472,295. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,584,682. LAUNDRY: PROGRAM SERVICE EXPENSES 1,363,746. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,363,746. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 195,719. MANAGEMENT AND GENERAL EXPENSES 98,973. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 294,692. TAXES & LICENSES: PROGRAM SERVICE EXPENSES 128,395. MANAGEMENT AND GENERAL EXPENSES 43,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,999. BANK CHARGES: PROGRAM SERVICE EXPENSES 136,588. MANAGEMENT AND GENERAL EXPENSES 790. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,378. EMPLOYEE ACTIVITIES: PROGRAM SERVICE EXPENSES 61,121. MANAGEMENT AND GENERAL EXPENSES 18,647. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,768. TELEPHONE: PROGRAM SERVICE EXPENSES 51,930. MANAGEMENT AND GENERAL EXPENSES 648. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,578. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 32,214. MANAGEMENT AND GENERAL EXPENSES 7,198. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,412. OTHER COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 13,228. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,228. BOND FUND EXPENSE: PROGRAM SERVICE EXPENSES 1,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,500. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANED FROM THE PREVIOUS YEAR. ST MARTIN HOSPITAL INC 210 CHAMPAGNE BOULEVARD BREAUX BRIDGE LA 70517 264626264 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE HEALTH VENTURES INC 1211 COOLIDGE STREET LAFAYETTE LA 70503 721006966 PHYSICIAN PRACTICES LA 501(C)(3) 509(A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE GENERAL HEALTH SYSTEMS INC 1214 COOLIDGE STREET LAFAYETTE LA 70503 383646817 HEALTHCARE SUPPORT LA 501(C)(3) 509(A)(3) 0 UNIVERSITY HOSPITAL & CLINICS INC 1211 COOLIDGE STREET LAFAYETTE LA 70503 462605366 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 464958152 HEALTHCARE SUPPORT LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE GENERAL FOUNDATION INC 1214 COOLIDGE STREET LAFAYETTE LA 70503 371766778 FOUNDATION LA 501(C)(3) 509(A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS 0 KAPLAN GENERAL HOSPITAL DBA ABROM KAPLAN MEMORIAL HOSPITAL 1211 COOLIDGE STREET LAFAYETTE LA 70503 472540179 HOSPITAL LA 501(C)(3) 170(B)(1)(A) (III) LAFAYETTE GENERAL HEALTH SYSTEMS 0 LAFAYETTE INVESTMENT GROUP LLC 1000 WEST PINHOOK ROAD STE 206 LAFAYETTE LA 70503 421594593 MANAGEMENT LA LAFAYETTE GENERAL MEDICAL CENTER RELATED 183507 2088883 0 0 0.51720 LAFAYETTE GENERAL SURGICAL HOSPITAL LLC 1000 WEST PINHOOK ROAD LAFAYETTE LA 70503 481360080 SURGICAL HOSPITAL LA LAFAYETTE GENERAL MEDICAL CENTER RELATED 1896947 2532903 0 0 0.50000 OIL CENTER SURGICAL PLAZA LLC 1000 WEST PINHOOK ROAD STE 204 LAFAYETTE LA 70503 464090110 SURGERY CENTER LA LAFAYETTE GENERAL MEDICAL CENTER RELATED 189370 1811061 0 0 0.50000 ACADIANA RADIATION THERAPY LLC 104 WOODMONT BLVD STE 500 NASHVILLE TN 37205 471752607 RADIATION CENTER TN LAFAYETTE GENERAL MEDICAL CENTER RELATED 317955 4312699 0 0 0.50000 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 OIL CENTER SURGICAL PLAZA LLC L 42888 COST OIL CENTER SURGICAL PLAZA LLC Q 1032790 COST OIL CENTER SURGICAL PLAZA LLC R 996499 COST OIL CENTER SURGICAL PLAZA LLC S 1261 COST LAFAYETTE GENERAL SURGICAL HOSPITAL LLC Q 1879943 COST LAFAYETTE GENERAL SURGICAL HOSPITAL LLC S 2300424 COST LAFAYETTE GENERAL SURGICAL HOSPITAL LLC R 4231923 COST LAFAYETTE INVESTMENT GROUP LLC Q 54583 COST LAFAYETTE INVESTMENT GROUP LLC R 40156 COST LAFAYETTE GENERAL MEDICAL CENTER 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 720535375 X 0 0 0 451173960 451173960 1000000 250000 0 0 0 ST MARTIN HOSPITAL 210 CHAMPAGNE BOULEVARD BREAUX BRIDGE LA 70517 264626264 X 4019 0 4019 17780620 17784639 1000000 250000 0 0 0 UNIVERSITY HOSPITAL AND CLINICS INC 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 462605366 X 8668 0 8668 132391095 132399763 1000000 250000 0 0 0 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 464958152 X 7056 0 7056 37281667 37288723 1000000 250000 0 0 0 LAFAYETTE GENERAL HEALTH SYSTEMS 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 383646817 X 174280 0 174280 89588644 89762924 1000000 250000 0 0 0 LAFAYETTE GENERAL FOUNDATION 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 371766778 X 0 0 0 527246 527246 104087 26022 0 0 0 KAPLAN GENERAL HOSPITAL 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 472540179 X 1465 0 1465 12767812 12769277 788464 197116 0 0 0