2017-05-15T16:09:14-05:00 2016-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2015-07-01 720423651 Our Lady of the Lake Hospital Inc % JEFF LIMBOCKER OURL 2257656565 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 JEFF LIMBOCKER REGIONAL CFO 2257656565 2017-05-14 true RYAN HOOKS P00746825 2253444000 2015 2021-01-29 14:40:06Z JEFF LIMBOCKER 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 1188313095 false 0928 X www.ololrmc.com X 1956 LA to provide for the care of the ill, injured, or disabled persons, and to provide for research, education, and for the enhancement of health of those in the community 17 14 8346 222 7549015 8141165 13064099 1052345581 1126616617 28772311 22211938 1631030 1819249 1090890087 1163711903 8553732 6317730 0 0 402085296 438721565 0 0 0 642503853 723878705 1053142881 1168918000 37747206 -5206097 1616056275 1628567652 691412672 783059908 924643603 845507744 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. false false 530131037 6317730 728635512 THE MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 185,823 PATIENT DAYS. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. ADDITIONAL COSTS WERE INCURRED FOR PARTICIPATION IN PROGRAMS WHICH, IN SOME CASES, PAY AMOUNTS LESS THAN THE COST OF PROVIDING SERVICES. 203896553 280244427 THE MEDICAL CENTER PROVIDES PATIENTS WITH BOTH INPATIENT AND OUTPATIENT SURGICAL CARE. DURING THE YEAR, 22,252 SURGICAL PROCEDURES WERE PERFORMED 81558621 112097770 THE MEDICAL CENTER PROVIDES PATIENTS WITH PHARMACEUTICALS IN THE COURSE OF THEIR MEDICAL CARE. IN THE CURRENT YEAR, THE HOSPITAL DISPENSED 18,490,294 UNIT DOSES 815586211 true true false false false false false false false false true true false true true true false true false false true true false false false false true true true true true false false false false false false false false false false false false true true true true false false true 338 0 true 8346 true true true false false false false false false false false false X 17 14 false false false false true true true true true false false true true true true false true false true true true X JEFF LIMBOCKER 2257656565 5000 HENNESSY BLVD BATON ROUGE LA 70808 X DR TIMOTHY ANDRUS BOARD MEMBER 2.0 0.0 X 0 0 0 DR JAMES CRAVEN BOARD MEMBER 40.0 0.0 X 207401 0 9966 DONALD DAIGLE BOARD MEMBER - SECRETARY 2.0 2.0 X X 0 3051 0 YOLANDA DIXON BOARD MEMBER 2.0 0.0 X 0 0 0 CHARLES FREEBURGH BOARD MEMBER 2.0 0.0 X 0 0 0 DR RICK KOUBEK BOARD MEMBER 2.0 0.0 X 0 0 0 LUTHER KISSAM BOARD MEMBER 2.0 0.0 X 0 0 0 SR LILLIAN LYNCH BOARD MEMBER 2.0 1.0 X 0 0 0 VAN MAYHALL JR BOARD MEMBER 2.0 0.0 X 0 0 0 JULIO MELARA BOARD MEMBER 2.0 0.5 X 0 0 0 DANIEL MONTELARO BOARD MEMBER - CHAIR 2.0 2.0 X X 0 0 0 DR BEN OUBRE BOARD MEMBER 2.0 0.0 X 0 0 0 JAMES RHORER MD BOARD MEMBER 2.0 0.0 X 0 0 0 SR EILEEN ROWE BOARD MEMBER 2.0 0.0 X 0 0 0 JOHN SELSER BOARD MEMBER - VICE CHAIR 2.0 2.0 X X 0 0 0 DR JOEL SILVERBURG BOARD MEMBER 2.0 0.0 X 0 0 0 DENZIL L MORAES Board Member 2.0 52.0 X 1322972 0 34782 kenneth wester CEO 2.0 58.0 X X 0 806424 66635 William Balhoff Board Member 2.0 2.0 X 0 0 0 Sr Helen Cahill board member 2.0 10.0 X 0 0 0 Henry Eiserloch MD board member 2.0 0.0 X 0 0 0 John Engquist board member 2.0 0.0 X 0 0 0 Harry J Philips JR board member 2.0 0.0 X 0 0 0 JEFFREY D LIMBOCKER CFO 2.0 58.0 X 0 519277 62312 TERRIE STERLING COO 60.0 0.0 X 528164 0 73762 DEBORAH FORD CNO 60.0 0.0 X 384708 0 10994 KENENTH C CIVELLO STAFF PHYSICIAN 60.0 0.0 X 1034849 0 33664 STEVEN T GREMILLION STAFF PHYSICIAN 60.0 0.0 X 992511 0 30542 ANDREW C SMITH STAFF PHYSICIAN 60.0 0.0 X 1231762 0 29632 NORMAN J DEUMITE STAFF PHYSICIAN 60.0 0.0 X 1012545 0 30742 JEFFREY HYDE STAFF PHYSICIAN 60.0 0.0 X 922322 0 32282 7637234 1328752 415313 417 false true false FMOL HEALTH SYSTEM 4200 Essen Lane Baton Rouge LA 70809 Management Fees 120362550 ANESTHESIOLOGY GROUP ASSOC 7777 Hennessy Blvd Baton Rouge LA 70808 MEDICAL SERVICES 11560854 CROTHALL HEALTHCARE INC 5000 Hennessy Blvd Baton Rouge LA 70808 MEDICAL SERVICES 11971095 LSUHSC-NEW ORLEANS 1901 Perdido St Box P3-1 New Orleans LA 70112 MEDICAL SERVICES 32973983 XTEND HEALTHCARE 500 W Main StreetSuite 14 HENDERSONVILLE TN 37075 Revenue Cycle Servic 9065357 404 474859 1884965 10704275 0 13064099 PATIENT SERVICE REVENUE 900099 1001528965 1001528965 OUTREACH LAB 900099 21010457 16018762 4991695 INCOME FROM EQUITY INVESTEES 900099 8985273 8952817 32456 CAFETERIA 900099 3057524 3057524 PHARMACY 900099 12953891 10591400 2362491 79080507 79008992 71515 1126616617 5678657 90858 5587799 17958 17958 0 15980702 14161452 1819250 0 1819249 1819249 26383564 571499 9553736 886004 16829828 -314505 16515323 16515323 0 0 0 0 1163711903 1120977709 7549015 22121080 6281730 6281730 24000 24000 12000 12000 0 2612553 1724285 888268 0 349695256 230798869 118896387 29438829 19429627 10009202 34029768 22459647 11570121 22945159 15143805 7801354 137592124 68796062 68796062 1023208 1023208 7304485 4820960 2483525 0 0 1677166 1677166 17628809 11635014 5993795 2941303 1941260 1000043 84286490 55629083 28657407 701206 701206 0 14141607 9333460 4808147 315576 208280 107296 0 1563314 1563314 10679032 7048161 3630871 0 41297301 27256219 14041082 12122971 8001161 4121810 Decrease in Accrued Pension 75421415 49778134 25643281 Medical Supplies Expense 195713729 195713729 PURCHASED SERVICES 93899376 61973588 31925788 EQUIPMENT AND MAINTENANCE 25109593 16572331 8537262 460000 303600 156400 1168918000 815586211 353331789 0 56365596 57313915 57826262 44577973 0 0 149600091 146018866 0 0 0 0 846800 513596 17704335 18202427 9400663 10757141 1080536035 488528520 609126224 592007515 258713723 246858906 341258372 354738767 25752499 38984250 30600380 31696686 58861330 86897610 1616056275 1628567652 153855339 145565680 0 0 0 0 295910025 306803406 0 0 0 0 0 0 0 0 241647308 330690822 691412672 783059908 X 906149292 819176673 18494311 26331071 0 0 924643603 845507744 1616056275 1628567652 X -5206097 -32896898 -41032864 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 74609409 74609409 628949187 227775781 401173406 5671923 2525436 3146487 349930124 246380703 103549421 21375391 11846599 9528792 592007515 FIXEED INCOME SECURITIES 149843527 F ALTERNATIVE INVESTMENTS 204895240 F 354738767 DUE FROM AFFILIATES 41990584 SELF INSURANCE RECEIVABLE 14743605 INT INC N/A OF FND 22635015 OTHER ASSETS 7528406 86897610 0 CAPITAL LEASE 2276852 ACCRUED PENSION COSTS 323671012 OTHER LIABILITIES 4446718 330394582 X FIN 48 (ASC 740 FOOTNOTE) Schedule D The Medical Center recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. No reserves for uncertain tax positions have been recorded. true Central America and the Caribbean Investments 182485986 182485986 182485986 Central America and the Caribbean MEDICAL SUPPLIES 12000 Check 1 true false true true true false true true X true X true X true true true false true true 128872743 108124771 20747972 0.01700 172206933 135299887 36907046 0.03020 301079676 243424658 57655018 0.04720 2143212 328202 1815010 0.00150 30237105 22227770 8009335 0.00660 671936 52148 619788 0.00050 715940 715940 0.00060 33768193 22608120 11160073 0.00920 334847869 266032778 68815091 0.05640 false 9360850 136372777 149235774 -12862997 X true true SURGICAL SPECIALTY SURGERY CENTER 0.49 0.51 PERKINS PLAZA ASC AMBULATORY SURGERY CENTER 0.6566 0.3434 REGIONAL EYE SURGERY IMAGING SERVICES 0.1275 0.8725 3 1 OUR LADY OF THE LAKE HOSPITAL 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 WWW.FMOLHS.ORG/OLOLRMC 132 X X X X 2 SURGICAL SPECIALTY CTR OF BATON ROUGE 8080 BLUEBONNET BLVD BATON ROUGE LA 70810 WWW.SSCBR.COM 645 X X 3 LAKE SURGICAL HOSPITAL (SLIDELL) LLC 1700 LINDBERG DR SLIDELL LA 70458 WWW.SSHLA.COM 2203782929 X X OUR LADY OF THE LAKE HOSPITAL 1 false false true X X X X X X X X X 15 true true false true X PART V, SECTION C 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 SURGICAL SPECIALTY CTR OF BATON ROUGE 2 false false true X X X X X X X X X 15 true true false true X PART V, SECTION C X true 15 false true false true X 150. 0. X X true true X X true X X X true X false X X X X true X false false Lake Surgical Hospital (Slidell) LLC 4 false true false false true X X X X X true true X X X X true X X true false X X X X true X false false PART V QUESTION 13H OUR LADY OF THE LAKE HOSPITAL: 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 V, QUESTION 22D OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER OF BATON ROUGE: The hospital facility determined the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care using the average of the bottom quarter lowest negotiated commercial insurance rates. PART V, SECTION B, QUESTION 5 OUR LADY OF THE LAKE HOSPITAL (OLOL) AND SURGICAL SPECIALTY CENTER (SSC) OF BATON ROUGE: OLOL & SSC JOINED THE MAYOR'S HEALTHY CITY INITIATIVE AND SITS AMONG OTHER LOCAL AREA HOSPITALS IN AN OPEN COLLABORATIVE EFFORT TO IMPROVE THE HEALTH OF THE BATON ROUGE COMMUNITY. THE MAYOR'S HEALTHY CITY INITIATIVE WORKED WITH HEALTHY BR AND MEDBR TO COMPLETE THE COMMUNITY NEEDS ASSESSMENT. AMONG THESE THREE GROUPS, THERE WERE REPRESENTATIVES FROM NUMEROUS BUSINESSES, HOSPITALS, GOVERNMENT ORGANIZATIONS, NONPROFIT ORGANIZATIONS AND SCHOOLS. THE LOCAL HOSPITALS PARTICIPATING WERE WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER, OUR LADY OF THE LAKE REGIIONAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, AND SURGICAL SPECIALTY CENTER OF BATON ROUGE. THE REPRESENTATIVES ALSO INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. ONE OF THESE INDIVIDUALS WAS MARILYN REYNAUD, MD, MPH, REGIONAL ADMINISTRATOR/MEDICAL DIRECTOR FOR THE DEPARTMENT OF HEALTH AND HOSPITALS, REGION 2 OFFICE OF PUBLIC HEALTH. PART V, SECTION B, QUESTION 6 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: A JOINT CHNA WAS CONDUCTED IN COLLABORATION WITH WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER AND LANE REGIONAL MEDICAL CENTER AND THE LOUISIANA HOSPITAL ASSOCIATION THROUGH THE MAYOR'S HEALTHY CITY INITIATIVE. PART V, SECTION B, QUESTION 7 OUR LADY OF THE LAKE HOSPITAL: THE CHNA CAN BE FOUND AT HTTPS://OLOLRMC.COM/PAGES/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX SURGICAL SPECIALTY CENTER OF BATON ROUGE: THE CHNA CAN BE FOUND AT WWW.SSCBR.COM. PART V, SECTION B, QUESTION 11 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER: In 2015 THE PARTICIPANTS IN THE JOINT CHNA IDENTIFIED FOUR SIGNIFICANT health needs in our community. OLOL WILL focus on ALL FOUR SIGNFICANT NEEDS IDENTIFIED-Obesity, HIV/AIDS AND OTHER STDS, OverUSE of the Emergency Department, and Mental HEALTH AND SUBSTANCE ABUSE. OLOL has done the following to help address the identified community needs: Obesity Health Care Centers in Schools (an affiliated tax-exempt organization which is funded by OLOL) and Baton Rouge Childrens Health Project both promoted the childhood obesity prevention message, 5210 +10 in 85 EBR Parish Schools. OLOL through its sponsorship of Go Noodle (a website designed to promote physical activity) provided 12,031,585 of minutes of physical activity to school children. OLOL also sponsored BREADA for $20,000 to create farmers market opportunities in low access neighborhoods. BREADA was able to provide five regular mobile market stops, including one on OLOLs LSUHBR North Clinic campus. OLOL also began participating in the USDA Summer Feeding Program providing 1925 meals during its first summer of feeding children at its Goodwood Pediatric Clinic. Also, a first for OLOL, we hosted the Amazing Half Marathon for 2088 participants in March 2015 And we added three new walking paths at LSUHBR Clinics. HIV/AIDS OLOL performed 7096 tests in three emergency departments and 1306 tests in two Urgent Care Centers. Approximately 20 new cases of HIV were identified at all five testing site. OLOL continues to offer community based screenings as well as education and awareness about HIV/AIDS resources and treatment options. OLOL also works with Healthy BR partners to decrease community stigma around HIV/AIDS and advocates for policy change that affects stigma and treatment. Mental/Behavioral Health OLOL worked with Healthy BR partners to create and utilize an electronically supported coordinated process to facilitate early identification, referrals and appropriate treatment of individuals with mental health and behavioral health conditions. OLOL also sponsored the NAMI conference for professionals treating and serving those with mental illness. Health Care Centers in Schools provided behavioral health encounters to 5290 students in FY16. HCCS continues to use the comprehensive risk assessment. Baton Rouge Childrens Health Project provided 529 behavioral encounters during the same fiscal year. Over Utilization of the Emergency Department The complex patient project (patients who have been to the Emergency department 5 or more times during a 6 month period) worked with 555 patients in FY16. We develop relationships with the patients to help them to identify and utilize medical resources other than the ED to get their medical needs met, so that they would not have to come to the ED as often. Our goal is to be sure that each patient gets the best evidenced-based medical care for their condition in the least restrictive setting. Patients who significantly reduced their admissions to the emergency department as a result of our interventions: 416 Patients who continued to be admitted to the emergency department the same number of times or more after our interventions: 139 For the 139 who did not improve, we developed a complex patient treatment planning team to address their complex needs, and that work has shown great promise for these patients. A total of 164,992 patients were seen in our Emergency Departments and another 52,784 patients were seen in our Urgent Care Clinics, and 147,857 patients were treated at Lake After Hours. SSC PROVIDED SERVICES TO THOSE WITH MEDICAID COVERAGE AND PROVIDES CHARITY CARE. THE EAR, NOSE & THROAT DOCTORS AT SSC ARE THE ONLY ENT DOCTORS IN EAST BATON ROUGE PARISH WHO ACCEPT MEDICAID. THEY ARE SENT REFERRALS FROM AREAS OUTSIDE OF EAST BATON ROUGE PARISH AS WELL. Surgical Specialty Center of Baton Rouge SURGICAL SPECIALTY CENTER WILL ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT ALONG WITH OUR LADY OF THE LAKE HOSPITAL. BECAUSE SSC DID NOT ADDRESS THESE NEEDS BEFORE THE ADOPTION OF THE JOINT CHNA DURING THIS TAX YEAR, A DISCUSSION OF HOW IT IS ADDRESSING THESE NEEDS WILL BE REPORTED IN THE HOSPITAL'S NEXT FORM 990. PART V, QUESTION 16I Our Lady of the Lake Hospital: Our Lady of the Lake Hospital also provides notification about the FAP, the FAP plain language summary, and the FAP application in its outpatient and urgent care clinics. PART V, QUESTION 2 Lake Surgical HOspital (Slidell) became subject to the 501(r) regulations in October 2015, WHEN IT BECAME A JOINT VENTURE OF OLOL. Based on the date the hospital became subject to the Community health needs assessment requirement, its first community health needs assessment WILL be adopted before December 31, 2017. 5 PERKINS PLAZA AMB SURGERY CENTER 7145 PERKINS ROAD BATON ROUGE LA 708084322 SURGERY CENTER CONVENIENT CARE LLC 7777 HENNESSY BOULEVARD BATON ROUGE LA 70808 URGENT CARE BRPT-LAKE REHABILITATION CENTERS LLC 530 SHADOWS LANE BATON ROUGE LA 70806 REHABILITATION LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE OLOL PONTCHARTRAIN SURGERY CENTER LLC 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 SURGERY CENTER PART I, LINE 7: As part of its mission to improve the lives and health of community members, OLOL has a cooperative endeavor agreement (CEA) with the State of Louisiana Department of Health and Hospitals (DHH) and Louisiana State University Health Sciences (LSU) that trains future physicians for our area and provides healthcare access to uninsured and under-insured residents. This public-private partnership has enabled positive healthcare transformation in Baton Rouge. Despite the closing of state-run hospitals and clinics, including Earl K. Long Medical Center in April 2013, and added challenges to the healthcare system created by the Baton Rouge Generals closure of its Mid-City Emergency Room (ER) in March 2015, recent data shows that this new model of care in Baton Rouge is working well. The benefits of the CEA to the community are visible in the following ways: Patient Care A. Uninsured and Medicaid patients have access to more than 20 specialty services, many of which were not available to the prior to the CEA. Local services now provided include Oncology, Neurology, Mental Health/Psych, Diabetes Care, Dermatology, Cardiology, and more, along with Pharmacy, Imaging, and Diagnostic Services. The increase in access to outpatient clinic visits has resulted in a 27% increase from 2012 (90,096 visits) to 2016 (114,840 visits). In 2016, patients were able to fill 78,645 prescriptions that helped treat both acute and chronic conditions such as hypertension, asthma, and diabetes. B. In coordination with LSU Health, OLOL operates two new urgent care clinics to cost-effectively treat a wide range of injuries and conditions including infections, flus and fevers, broken bones, and minor burns. Patients with these conditions typically seek treatment in ERs, which carry increased costs. Uninsured and Medicaid patients now have access to a more abundant and appropriate level of care for these healthcare needs through the LSU Health Urgent Care Centers and Lake After Hours. The total Medicaid and Uninsured visits for all locations was 69,778 in 2015, which represented a 157% increase in visits that were previously only available in Lake After Hours clinics in 2012. However, total urgent care visits in 2016 for these payer sources increased by 21% from 2015 and 210% from 2012 to surprising number of 81,886. C. Increasing capacity for emergency care has also been a priority for OLOL, especially in light of the growing need in North Baton Rouge and Mid City Area for this service. The recent renovations to OLOLs ER for adult, pediatric and trauma patients is continuing to attract an increasing number of uninsured and Medicaid patients. Total ER visits for this patient population has grown from 50,122 in FY2012 to 91,341 in FY2016 which represents a total growth rate of 82%. The uninsured category had a growth rate of 146% from FY2012 to FY2016 with Medicaid growing at 59% during this time period. D. OLOL manages and operates the Baton Rouge regions only designated trauma center, which cared for 1,711 patients in 2016, up from 862 in 2012. 26% of all trauma patients were uninsured in 2016 and 24% had Medicaid as their payment source. The trend of half of all trauma patients treated each year being uninsured or having Medicaid has been consistent since 2012. OLOL has achieved Level II Trauma Center designation and is pursuing the clinical research required for designation as a Level I Trauma Center. Graduate Medical Education A. Through the CEA, OLOL is training future generations of physicians in nearly all medical specialties and subspecialties as these clinicians commit to improve patient care in Baton Rouge. Equally important, academic medical centers such as OLOL are attracting the top physicians in the country, which helps advance medicine and deliver more comprehensive services in Baton Rouge, the surrounding parishes and the state. B. OLOL acts as a clinical teaching hospital for 24 residency and fellowship programs, including 17 through Louisiana State University School of Medicine, as well as programs offered through Tulane University School of Medicine (2), Baton Rouge General Medicine and Internal Medicine (3), OLOL(1) and a joint program between LSU and OLOL (1). LSU residents are provided with access to state of the art programs and facilities to further their education and to help them deliver the best patient care possible. C. OLOL has grown its graduate medical education (GME) program from 139 residents in 2012 to 192 residents in 2016. In addition to these improvements in the quality of care for uninsured and Medicaid patients in the area, OLOL has made capital investments that have benefitted families in the community and the region, including: 1. Dedicated heart/vascular center 2. Additional inpatient capacity and new ICU departments 3. Doubled the amount of ER capacity between two campuses, including trauma Through this innovative partnership, OLOL has increased its efforts and reaffirmed its focus to bring better, more accessible care to the residents of Baton Rouge, and the organization remains devoted to serving the health needs of this community well into the future. DHH provides payments under a reimbursement structure which are intended to compensate the hospital for incremental costs associated with higher Medicaid and uninsured patient volumes. Because of these reimbursements, which are considered direct offsetting revenue, the hospitals vital impact to the community in this effort is not directly reflected in the net community benefit percentage found at line 7k, column (f). The significant benefit to the community is better expressed as a percentage of total community benefit expense. PART I, LINE 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 OLOL; 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 7: THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION. FOR PART I LINES 7E, 7F, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. PART III, LINE 4: THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. PART III, LINE 9B: PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE 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, OUR LADY OF THE LAKE HOSPITAL JOINED the Mayors Healthy City Initiative taskforce in 2007. Still today, OLOL sits among other local area hospitals in an open collaborative effort to improve the health of the Baton Rouge community. The Community Health Needs Assessment is just one of many joint efforts that OLOL has participated in alongside other hospitals and organizations. In May of 2008, Baton Rouge Mayor-President Melvin L. "Kip" Holden commissioned the Mayors Healthy City Initiative to encourage Baton Rouge residents to adopt a healthier and more active lifestyle. The Mayor envisioned a program that would promote identify resources available in the community for residents to fight chronic diseases and childhood obesity. In Louisiana, almost half of our children are considered overweight or obese, putting them at a much greater risk of obesity-related health problems like diabetes, heart disease, stroke, cancer and asthma. Nationwide the number of children who are considered overweight or obese has nearly tripled over the past 30 years. To tackle this problem, the Mayor subdivided the Initiative into three separate but compatible parts: Healthy BR - a focus on healthier eating and a more active lifesyle MedBR - a focus on access to care and health outcomes Innovation Center - a focus on community efforts to address Childhood Obesity Each subgroup engages a variety of partner organizations in a cooperative effort between local and state governments, area hospitals, and local health organizations. OLOL is a major supporter and contributor of the Mayors Healthy City Initiative. the Mayors Healthy City Initiative served as a common platform, allowing for in-depth roundtable discussions among local area hospitals. The OLOL Community Advocacy team facilitated those discussions and processes for completing the CHNA report. OLOL ALSO WORKS SEPARATELY WITH COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY, PUBLIC HEALTH, AMERICAN HEART ASSOCIATION, ST. VINCENT DE PAUL AND MANY OTHER ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. FOR EXAMPLE, PARISH NURSING, HEALTH SCREENING FOR DIABETES, SKIN CANCER, PROSTATE CANCER AND BREAST CANCER ARE PROMOTED IN VARIOUS COMMUNITY SETTINGS TO IMPROVE OVERALL COMMUNITY HEALTH. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE LAKE HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. ADDITIONALLY, SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE. PART VI, LINE 4 COMMUNITY INFORMATION: OUR LADY OF THE LAKE HOSPITAL (OLOL) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN BATON ROUGE, LOUISIANA THAT SERVES EAST BATON ROUGE PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, EAST BATON ROUGE HAS A POPULATION OF APPROXIMATELY 445,227 RESIDENTS. THE POPULATION IS RELATIVELY YOUNG, WITH 23% OF RESIDENTS BELOW 18 YEARS OF AGE. THE SENIOR POPULATION COMPRISES ABOUT 12% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $47,770. 20.5% OF THE POPULATION IS LIVING BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS 5.8%. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR LADY OF THE LAKE HOSPITAL PARTICIPATES IN COMMUNITY IMPROVEMENT ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY IMPROVEMENT ACTIVITIES INCLUDE THE FOLLOWING: OUR LADY OF THE LAKE ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT WOULD BE FOREGONE OR POSTPONED THEREBY CREATING A COMMUNITY AREA WITH MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE LAKE PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. AFTER HURRICANE KATRINA, OUR LADY OF THE LAKE BECAME A TEACHING HOSPITAL THROUGH AFFILIATION WITH LOUISIANA STATE UNIVERSITY MEDICAL SCHOOL TO INSURE THE STATE OF LOUISIANA MAINTAIN AN ADEQUATE SUPPLY OF PHYSICIANS. IN 2011 OUR LADY OF THE LAKE RECEIVED ACCREDITATION APPROVAL FOR A PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAM. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. OLOL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. FOR MORE INFORMATION ON THE PROMOTION OF COMMUNITY HEALTH, PLEASE REFER TO THE PART VI SUPPLEMENTAL INFORMATION DESCRIPTION FOR PART 1 QUESTION 7. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: OUR LADY OF THE LAKE HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE LAKE HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF THE LAKE HOSPITAL SERVES THE COMMUNITY IN EAST BATON ROUGE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, QUESTION 2 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. true Boys & Girls Club 8281 Goodwood Blvd Ste H Baton Rouge LA 70806 720928014 501(C)(3) 6000 GENERAL SUPPORT General Support City Year Inc 287 Columbia Avenue Boston MA 02116 222882549 501(C)(3) 20000 GENERAL SUPPORT General Support Families Helping Families of Greater BR 2356 Drusilla Lane Baton Rouge LA 70809 721406289 501(C)(3) 10000 GENERAL SUPPORT General Support General Growth Properties 6401 Bluebonnet Blvd Ste 5050 Baton Rouge LA 70836 300247204 83330 PLAYGROUND EQUIPMENT Girls on the Run South LA 11408 Lake Sherwood Ave N Ste A Baton Rouge LA 70816 270832549 501(C)(3) 10000 GENERAL SUPPORT General Support Mary Bird Perkins Cancer Center P O Box 11407 Dept 1299 Birmingham AL 35246 237010520 501(C)(3) 15000 GENERAL SUPPORT Mayors Healthy City Initiative 222 St Louis Street Baton Rouge LA 70802 272515190 501(C)(3) 10000 GENERAL SUPPORT Mcmains Childrens Development Center 1805 college dr Baton Rouge LA 70808 720459036 501(C)(3) 10000 GENERAL SUPPORT General Support Our Lady of the Lake College 7434 Perkins Road Baton Rouge LA 70808 721173156 501(C)(3) 1500000 GENERAL SUPPORT General Support Our Lady of the Lake Foundation 5000 Hennessy Blvd Baton Rouge LA 70808 721014324 501(C)(3) 474859 GENERAL SUPPORT General Support Pennington Biomedical Research Foundation 6400 Perkins Road Baton Rouge LA 70808 581767810 501(C)(3) 17877 GENERAL SUPPORT Dreams Come True of Louisiana PO Box 1020 Prairieville LA 707691020 720954216 501(C)(3) 14500 GENERAL SUPPORT Louisiana Pediatric Cardiology Foundation 2137 A Quail Run Ste B Baton Rouge LA 70808 721476551 501(c)(3) 7500 GENERAL SUPPORT Tiger Athletic Foundation PO Box 711 Baton Rouge LA 70821 721004960 501(c)(3) 22100 GENERAL SUPPORT American Heart Association 7272 Greenville Avenue Dallas TX 752314596 135613797 501(c)(3) 15000 GENERAL SUPPORT Cardiovascular Research Foundation of LA 7777 Hennessy Blvd Ste 2007 Baton Rouge LA 70808 721490943 501(c)(3) 162900 GENERAL SUPPORT Knock Knock Children's Museum 2561 Citiplace Court Ste 750-260 Baton Rouge LA 70836 731701786 501(c)(3) 100000 GENERAL SUPPORT St Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 620646012 501(c)(3) 15000 GENERAL SUPPORT The Emerge Center 535 Roosevelt Street Baton Rouge LA 70802 465434705 501(c)(3) 10000 GENERAL SUPPORT Livingston Economic Development Council P O Box 809 Livingston LA 70754 720966247 501(c)(6) 15000 GENERAL SUPPORT Livingston Parish Chamber of Commerce 248 Veterans Blvd Denham Springs LA 70726 720632651 501(c)(6) 6375 GENERAL SUPPORT HEALTH CARE CENTERS IN SCHOOLS 4336 NORTH BOULEVARD BATON ROUGE LA 70806 721443935 501(C)(3) 3600000 GENERAL SUPPORT 19 3 medical care of needy individuals 2 24000 Monitoring grants FORMAL REQUESTS ARE RECEIVED BY THE BUSINESS PAYOR RELATIONS DEPARTMENT. THE REQUESTS ARE CHECKED FOR ALL APPROPRIATE INFORMATION AND DOCUMENTATION AND ARE PRESENTED TO EXECUTIVE ADMINISTRATION FOR APPROVAL. UPON APPROVAL THE REQUESTS ARE SUBMITTED TO ACCOUNTS PAYABLE FOR PAYMENT. true true false false false false false true false DR JAMES CRAVEN BOARD MEMBER 197201 0 10000 0 200 0 8291 0 1675 0 217367 0 0 0 KENENTH C CIVELLO STAFF PHYSICIAN 674123 0 342476 0 18250 0 10600 0 23064 0 1068513 0 0 0 STEVEN T GREMILLION STAFF PHYSICIAN 938174 0 45885 0 8452 0 10600 0 19942 0 1023053 0 0 0 JEFFREY D LIMBOCKER CFO 0 390537 0 111560 0 17180 0 38295 0 24017 0 581589 0 0 DENZIL L MORAES Board Member 849167 0 457693 0 16112 0 10600 0 24182 0 1357754 0 0 0 ANDREW C SMITH STAFF PHYSICIAN 772445 0 442268 0 17049 0 10600 0 19032 0 1261394 0 0 0 kenneth wester CEO 0 614511 0 171249 0 20664 0 38832 0 27803 0 873059 0 0 TERRIE STERLING COO 410960 0 116792 0 412 0 49959 0 23803 0 601926 0 0 0 DEBORAH FORD CNO 119466 0 0 0 265242 0 0 0 10994 0 395702 0 0 0 NORMAN J DEUMITE STAFF PHYSICIAN 667183 0 329415 0 15947 0 10600 0 20142 0 1043287 0 0 0 JEFFREY HYDE STAFF PHYSICIAN 595929 0 307543 0 18850 0 10600 0 21682 0 954604 0 0 0 PART 1, QUESTION 4A THE CEO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. One key employee is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason or due to change of control. If triggered, the employee would be paid his/her base salary and provided retirement and welfare benefits for an entitlement period. The entitlement period is 12 months. Deborah Ford recevied a severance payment in the amount of $265,013 in the current year. PART 1, QUESTION 4B FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLAN IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. NO ONE LISTED ON PART VII, SECTION A RECEIVED A PAYMENT FROM THE PLAN IN THE CURRENT YEAR. PART 1, QUESTION 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 1, QUESTION 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. MEMBERS PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO THE MEMBER ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION AND 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION CONFLICT OF INTEREST OUR LADY OF THE LAKE HOSPITAL, INC. HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY AND (D) UNDERSTANDS THAT OUR LADY OF THE LAKE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE LAKE HOSPITAL, INC. PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW OF THE FORM 990 BY KPMG, THE FORM 990 IS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE LAKE Hospital, Inc. DETERMINING COMPENSATION PART VI, SECTION B, QUESTION 15A & 15B OUR BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. THE COMPENSATION FOR THE CEO OF OUR LADY OF THE LAKE HOSPITAL, INC. IS SET BY THE COMPENSATION COMMITTEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE. Part XI, Line 9 Other Changes in net assets or fund balances: Capital Transfers FMOL (41,032,864) PART III, QUESTION 4D THE HOSPITAL PROVIDES VARIOUS OTHER PROGRAMS SUCH AS DIETARY, RESPIRATORY, PHARMACY AND SPECIAL PROCEDURES. SECTION 1.263(A)-3(N) - BOOK CONFORMITY ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2016. SECTION 1.263 (A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE LAKE HOSPITAL, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2016. 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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