2016-05-16T13:46:36-05:00 2015-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2014-07-01 720423651 Our Lady of the Lake Hospital Inc % JEFF LIMBOCKER OURL 2257657709 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 JEFF LIMBOCKER REGIONAL CFO 2257657709 2016-05-15 true KPMG LLP P00746825 2253444000 2014 2016-08-17 19:52:53Z K SCOTT WESTER 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 1122131270 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 19 17 7668 222 8835059 0 7570361 8141165 904821828 1052345581 35738106 28772311 -1677555 1631030 946452740 1090890087 4149614 8553732 0 0 373653674 402085296 0 0 0 511658079 642503853 889461367 1053142881 56991373 37747206 1556258719 1616056275 633641094 691412672 922617625 924643603 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 478310889 683621793 THE MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 167,310 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. SEE SCHEDULE O FOR FURTHER EXPLANATION. 183965727 262931459 THE MEDICAL CENTER PROVIDES PATIENTS WITH BOTH INPATIENT AND OUTPATIENT SURGICAL CARE. DURING THE YEAR, 19,686 SURGICAL PROCEDURES WERE PERFORMED 73586291 105172584 THE MEDICAL CENTER PROVIDES PATIENTS WITH PHARMACEUTICALS IN THE COURSE OF THEIR MEDICAL CARE. IN THE CURRENT YEAR, THE HOSPITAL DISPENSED 14,746,114 UNIT DOSES 735862907 true true false false false false false false false false true true false false true true false true false false true true false false false false true true true false true false false false false false false false false false false false false true true true true false false true 317 0 true 7668 true true true false false false false false false false false false X 19 17 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 JULIO MELARA BOARD MEMBER 2.0 5.0 X 0 0 0 DR TIMOTHY ANDRUS BOARD MEMBER 2.0 0.0 X 0 0 0 DR JAMES CRAVEN BOARD MEMBER 2.0 2.0 X 0 0 0 DONALD DAIGLE BOARD MEMBER - SECRETARY 2.0 4.0 X X 0 0 0 YOLANDA DIXON BOARD MEMBER 2.0 0.0 X 0 0 0 CHARLES FREEBURGH BOARD MEMBER 2.0 2.0 X 0 0 0 DR RICK KOUBEK BOARD MEMBER 2.0 0.0 X 0 0 0 William E Balhoff BOARD MEMBER 2.0 2.0 X 0 0 0 LUTHER KISSAM BOARD MEMBER 2.0 0.0 X 0 0 0 SR LILLIAN LYNCH BOARD MEMBER 2.0 0.0 X 0 0 0 VAN MAYHALL JR BOARD MEMBER 2.0 0.0 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 KENNETH WESTER CEO 2.0 58.0 X X 0 784733 64461 DR DAVID HANSON BOARD MEMBER 2.0 0.0 X 8795 0 0 JEFFREY D LIMBOCKER CFO 2.0 58.0 X 0 474458 59003 TERRIE STERLING COO 60.0 0.0 X 526203 0 62657 DEBORAH FORD CNO 60.0 0.0 X 293604 0 35529 KENENTH C CIVELLO STAFF PHYSICIAN 60.0 0.0 X 955242 0 32645 STEVEN T GREMILLION STAFF PHYSICIAN 60.0 0.0 X 1110118 0 29783 DENZIL L MORAES STAFF PHYSICIAN 60.0 0.0 X 1344164 0 33763 NORMAN J DEUMITE STAFF PHYSICIAN 60.0 0.0 X 901722 0 29783 CHARLES A SMITH STAFF PHYSICIAN 60.0 0.0 X 1136012 0 30190 6275860 1259191 377814 342 false true false FMOL HEALTH SYSTEM 4200 Essen Lane Baton Rouge LA 70809 Management Fees 97581646 ANESTHESIOLOGY GROUP ASSOC 7777 Hennessy Blvd Baton Rouge LA 70808 PHYSICIAN SERVICES 11571515 CROTHALL HEALTHCARE INC 5000 Hennessy Blvd Baton Rouge LA 70808 MEDICAL SERVICES 9568326 LSUHSC-NEW ORLEANS 1901 Perdido St Box P3-1 New Orleans LA 70112 MEDICAL SERVICES 34728995 Milton J Womack Inc 8400 Jefferson Hwy Baton Rouge LA 70809 Construction Service 10085891 149 2027104 2344745 3769316 0 8141165 PATIENT SERVICE REVENUE 900099 948234847 948234847 OUTREACH LABORATORY 900099 24187941 18985892 5202049 INCOME FROM EQUITY INVESTEES 900099 2415872 2163022 252850 PHARMACY 900099 10368459 7448791 2919668 CAFETERIA SALES 900099 2910423 2910423 64228039 64228039 1052345581 5686823 0 197831 5488992 13799 0 13799 0 15493472 13862442 1631030 0 1631030 1631030 40200695 249735 16877097 501644 23323598 -251909 23071689 0 262661 22809028 0 0 0 0 1090890087 1045602044 8835059 28311819 8537232 8537232 4500 4500 12000 12000 0 1079611 712543 367068 0 326728158 215640584 111087574 23234690 15334895 7899795 29450539 19437356 10013183 21592298 14250917 7341381 123334914 61667457 61667457 1778845 1778845 3748191 2473806 1274385 0 0 1770102 1770102 16274590 10741229 5533361 3104495 2048967 1055528 71349340 47090564 24258776 659645 435366 224279 0 14648052 9667714 4980338 281500 185790 95710 0 1400959 924633 476326 11322737 7473006 3849731 0 38410784 25351117 13059667 11779622 7774551 4005071 Decrease in Accrued Pension 40253427 26567262 13686165 Medical Supplies Expense 176341851 176341851 PURCHASED SERVICES 100750215 66495142 34255073 EQUIPMENT & MAINTENANCE 24864584 16410625 8453959 430000 283800 146200 1053142881 735862907 317279974 0 X 31219758 56365596 44862269 57826262 0 0 128234874 149600091 0 0 0 0 41781 846800 16075053 17704335 8607499 9400663 1053848130 444721906 637503218 609126224 251014803 258713723 327784564 341258372 21115632 25752499 30600379 30600380 59198889 58861330 1556258719 1616056275 133370821 153855339 0 0 0 0 293758991 295910025 0 0 0 0 0 0 0 0 206511282 241647308 633641094 691412672 X 906430753 906149292 16186872 18494311 0 0 922617625 924643603 1556258719 1616056275 X 37747206 -21816525 -13904703 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 74607345 74607345 616743616 205608403 411135213 5280989 1780078 3500911 335840789 226522147 109318642 21375391 10811278 10564113 609126224 FIXED INCOME SECURITIES 122193539 F ALTERNATIVE INVESTMENTS 219064833 F 341258372 0 OTHER LIABILITIES 4527127 ACCRUED PENSION COSTS 233988670 CAPITAL LEASES 3131511 241647308 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 194085632 194085632 194085632 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 127138391 107544508 19593883 0.01840 155745568 115469968 40275600 0.03780 282883959 223014476 59869483 0.05620 2028613 342056 1686557 0.00160 41381218 21145094 20236124 0.01900 582505 3672 578833 0.00050 744839 744839 0.00070 44737175 21490822 23246353 0.02180 327621134 244505298 83115836 0.07800 false 72146357 128349309 140479247 -12129938 X true true SURGICAL SPECIALTY SURGERY CENTER 0.49000 0.51000 PERKINS PLAZA ASC AMBULATORY SURGERY CENTER 0.65660 0.34340 REGIONAL EYE SURGERY IMAGING SERVICES 0.12750 0.87250 2 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 OUR LADY OF THE LAKE HOSPITAL 1 false false true X X X X X X X X X 12 true true false true X PART V, SECTION C X true 12 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 12 true true false true X PART V, SECTION C X true 12 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 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 AND SURGICAL SPECIALTY CENTER OF BATON ROUGE: OLOL 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 HEALTHYBR 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, OCHSNER MEDICAL CENTER, LSU HEALTH SCIENCES, LANE REGIONAL MEDICAL CENTER, AND NOW CLOSED EARL K. LONG/LSU HEALTH. THE REPRESENTATIVES ALSO INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THESE INDIVIDUALS WERE JIMMY GUIDRY, MD, STATE HEALTH OFFICER OF LOUISIANA AND DHH'S MEDICAL DIRECTOR; PAM ROMERO, RD, LDN, CDE, REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; AND 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: THE CHNA WAS CONDUCTED IN COLLABORATION WITH WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, AND LSU HEALTH/EARL K. LONG MEDICAL CENTER AND THE LOUISIANA HOSPITAL ASSOCIATION THROUGH THE MAYOR'S HEALTHY CITY INITIATIVE. SURGICAL SPECIALTY CENTER OF BATON ROUGE: Surgical Specialty Center of Baton Rouge formally adopted the Community Health Needs Assessment of Our Lady of the Lake Hospital, an affiliated entity. SSC and OLOL share the same demographic community so SSC felt that the needs identified by the Mayor's Healthy City Initiative were representative of its community's needs as well. PART V, SECTION B, QUESTION 7 OUR LADY OF THE LAKE HOSPITAL: THE CHNA CAN BE FOUND AT HTTPS://FMOLHS.ORG/OLOLRMC/PAGES/QUALITY/COMMUNITY-HEALTH-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: In 2012 Our Lady of the Lake identified ten health needs in our community. Our Implementation Strategy focused on the 4 highest need areas since they posed the highest risk to the community. The identified needs not chosen as an area of focus include heart disease/high blood pressure/stroke; diabetes; child and adolescent health; lifestyle issues; and barriers to care. While not chosen as an area of focus, OLOL currently conducts and will continue to conduct programs and/or provide services that help address those needs. OLOL chose to focus on Obesity, HIV/AIDS, Over Utilization of the Emergency Department, and Mental/Behavioral Health. During the past year, OLOL has done the following to help address the identified community needs: Obesity Health Care Center in Schools (an affiliated tax-exempt organization) and Baton Rouge Children's Health Project both promoted the childhood obesity prevention message 5210+10 in 46 schools and 167 school-based personnel were trained in the program. OLOL provided 12,630,461 minutes of GoNoodle (a website designed to promote physical activity) to school based children in 2015. OLOL also sponsored BREADA and together created the Farm Fresh for Better Health program, signing up 423 patients. 205 of these patients signed up for the SNAP rewards program and 619 vouchers were redeemed at market locations. HIV/AIDS OLOL provided 20,000 tests in three emergency departments and 2,822 tests in two urgent care centers. 66 new cases of HIV and 18 acute infections were identified. Mental/Behavioral Health Health Care Centers in School (an affiliate tax-exempt organization) offered 5,583 behavioral health patient encounters and continued to provide services which included the use of a comprehensive risk assessment. Baton Rouge Children's Health Project offered 669 behavioral health encounters. Over Utilization of the Emergency Department In October 2015, the Emergency Department case manager put in place a program to refer and schedule follow-up appointments for patients. OLOL expanded the hours at our Mid City Urgent Care Clinic and Lake After Hours served 41, 598 patients. SURGICAL SPECIALTY CENTER OF BATON ROUGE: In 2012, Surgical Specialty Center of Baton Rouge identified the health needs in the community. The Implementation Strategy focused on the Cancer and Barriers to Care. They did not focus on heart disease/high blood pressure/stroke; child and adolescent health; lifestyle issues; obesity, HIV/AIDs, over utilization of the emergency department; and diabetes because either OLOL and others organization have selected these issues to address or SSC is a specialty hospital and is not equipped to address such issues. However, SSC will assist other local hospitals and organization in the community if requested and where appropriate. The following was done in our community during the year to address Cancer and Barrier to Care: Cancer: SSC provided prostate screenings in 2015 and referred 5 individuals for follow-up with the Urologist based on the results of the screening. Barriers to Care: SSC provided services to those with Medicare and Medicaid coverage and provides charity care. The Ear, Nose & Throat doctors at SSC are the only ENT doctors in East Baton Rouge parish who accept Medicaid. They are sent referrals from areas outside of East Baton Rouge parish as well. PART V, QUESTION 16I Our Lady of the Lake Hospital: Our Lady of the Lake Hospital also provides notification about the FAP, the FAP, and the FAP application in its outpatient and urgent care clinics. REGISTRATION PERSONNEL AND FINANCIAL COUNSELORS REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICE AND AT ALL OUTPATIENT REGISTRATION LOCATIONS. 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 OLOL PONCHARTRAIN SURGERY CENTER LLC 15305 DALLAS PKWYSTE 1600 LB 28 ADDISON TX 75001 SURGERY CENTER LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE 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 General's 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 clinics has resulted in a 10% increase from 2012 (90,096 visits) to 2015 (99,287 visits). In 2015, patients were able to fill 76,228 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. There were 69,778 urgent care visits for uninsured and Medicaid patients combined for all of these locations in 2015, which represents a 157 percent increase in visits compared to visits that were only available in Lake After Hours clinic in 2012. 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 OLOL's ER for adult, pediatric and trauma patients is continuing to attract an increasing number of uninsured and Medicaid patients. Total ER visits in 2014 grew by 62 percent from 2012; however, 2015 Total ER visits surpassed this growth by adding another 15 percent to achieve a total growth rate of 77 percent with the Total ER uninsured and Medicaid visits at 88,703. D.OLOL manages and operates the Baton Rouge region's only designated trauma center, which cared for 1307 patients in 2015, up from 862 in 2012. 31 percent of all trauma patients were uninsured in 2015 and 19% 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 21 residency and fellowship programs, including 15 through Louisiana State University School of Medicine, as well as programs offered through Tulane University School of Medicine and directly through OLOL. 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 2015. 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 hospital's 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. Such total community benefit expense for the fiscal year is $327,621,134 which is 30.72% of total hospital expenses. 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: HealthyBR - 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, OLOL'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 669,874 AND 263,676 HOUSEHOLDS. THE MEDIAN AGE IS 35 YEARS, THE SENIOR POPULATION COMPRISES ABOUT 11.7% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $46,563, 25.6% HOUSEHOLDS HAVE INCOMES BELOW $25,000, PER CAPITA INCOME IS $24,673 AND UNEMPLOYMENT RATE IS 6.2%. OLOL'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: EAST BATON ROUGE PARISH LIVINGSTON PARISH ASCENSION PARISH OLOL'S SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: ASSUMPTION PARISH EAST FELICIANA PARISH IBERVILLE PARISH POINTE COUPEE PARISH ST. HELENA PARISH TANGIPAHOA PARISH WEST BATON ROUGE PARISH WEST FELICIANA PARISH 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 Cancer Services of Baton Rouge 550 Lobdell Avenue Baton Rouge LA 70806 720517180 501(C)(3) 15000 General Support Capital Area United Way 700 Laurel Street Baton Rouge LA 70802 720447100 501(C)(3) 5150 General Support ForeKids Foundation 11005 Lapalco Blvd Avondale LA 70094 581940111 501(C)(3) 29000 General Support General Growth Properties 6401 Bluebonnet Blvd Ste 5050 Baton Rouge LA 70836 300247204 116670 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 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 Our Lady of the Lake College 7434 Perkins Road Baton Rouge LA 70808 721173156 501(C)(3) 1966509 General Support Our Lady of the Lake Foundation 5000 Hennessy Blvd Baton Rouge LA 70808 721014324 501(C)(3) 2031054 GENERAL SUPPORT LASM PO Box 3373 Baton Rouge LA 708213373 720542138 501(C)(3) 5500 GENERAL SUPPORT Junior Achievement 7809 Jefferson Hwy Ste D4 Baton Rouge LA 70809 720485727 501(C)(3) 5500 GENERAL SUPPORT Baton Rouge Sickel Cell Anemia Foundation 2301 North Blvd Baton Rouge LA 70806 720774464 501(C)(3) 6000 GENERAL SUPPORT Baton Rouge Basketball and Volleyball 7122 Perkins Road Baton Rouge LA 70808 453232829 501(C)(3) 7500 GENERAL SUPPORT Dreams Come True of Louisiana PO Box 1020 Prairieville LA 707691020 720954216 501(C)(3) 8000 GENERAL SUPPORT School Based Health Alliance 1010 Vermont Ave Ste 600 Washington DC 20005 541752058 501(C)(3) 10000 GENERAL SUPPORT LOUISIANA STATE UNIVERSITY 3838 W LAKESHORE DR Baton Rouge LA 70808 726020969 501(C)(3) 10000 GENERAL SUPPORT Louisiana Pediatric Cardiology Foundation 2137 A Quail Run Ste B Baton Rouge LA 70808 721476551 501(C)(3) 10000 GENERAL SUPPORT Louisiana 4-H Foundation PO Box 25100 Baton Rouge LA 70894 721367519 501(C)(3) 10000 GENERAL SUPPORT Volunteer Health Corps 4655 Sherwood Common Blvd Baton Rouge LA 70816 204852337 501(C)(3) 10000 GENERAL SUPPORT Tiger Athletic Foundation PO Box 711 Baton Rouge LA 70821 721004960 501(C)(3) 22100 GENERAL SUPPORT Baton Rouge Children's Advocacy Center PO Box 64740 Baton Rouge LA 70896 260028918 501(C)(3) 30000 GENERAL SUPPORT The Emerge Center 535 Roosevelt Street Baton Rouge LA 70802 455434705 501(C)(3) 45000 GENERAL SUPPORT American Heart Association 7272 Greenville Avenue Dallas TX 752314596 135613797 501(C)(3) 50000 GENERAL SUPPORT Cardiovascular Research Foundation of Louisiana 7777 Hennessy Blvd Ste 2007 Baton Rouge LA 70808 721490943 501(C)(3) 50000 GENERAL SUPPORT The Cerebral Palsy & Childrens Development Center 1805 College Drive Baton Rouge LA 70808 237447804 501(C)(3) 65292 GENERAL SUPPORT Knock Knock Children's Museum 2561 Citiplace Court Ste 750-260 Baton Rouge LA 70836 731701786 501(C)(3) 100000 GENERAL SUPPORT HEALTH CARE CENTERS IN SCHOOLS 4336 NORTH BOULEVARD BATON ROUGE LA 70806 721443935 501(C)(3) 3600000 GENERAL SUPPORT 27 1 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. false true false false false false false true false KENENTH C CIVELLO STAFF PHYSICIAN 638438 0 304559 0 12245 0 10400 0 22245 0 987887 0 0 0 STEVEN T GREMILLION STAFF PHYSICIAN 822828 0 274889 0 12401 0 10400 0 19383 0 1139901 0 0 0 JEFFREY D LIMBOCKER CFO 0 354015 0 103280 0 17163 0 35804 0 23199 0 533461 0 0 DENZIL L MORAES STAFF PHYSICIAN 810297 0 517562 0 16305 0 10400 0 23363 0 1377927 0 0 0 KENNETH WESTER CEO 0 583808 0 180278 0 20647 0 37476 0 26985 0 849194 0 0 TERRIE STERLING COO 398152 0 127550 0 501 0 47059 0 15598 0 588860 0 0 0 DEBORAH FORD CNO 242353 0 50850 0 401 0 10400 0 25129 0 329133 0 0 0 NORMAN J DEUMITE STAFF PHYSICIAN 661738 0 221078 0 18906 0 10400 0 19383 0 931505 0 0 0 CHARLES A SMITH STAFF PHYSICIAN 731217 0 386550 0 18245 0 10400 0 19790 0 1166202 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 termination of employment without cause for good reason. 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. The CFO is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason or due to change 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. No payments were made under the plan in the current year. PART 1, QUESTION 4B FMOLHS maintains two 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. 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. COMMUNITY BENEFIT STATEMENT FORM 990 PART III THE MEDICAL CENTER PARTICIPATES IN GOVERNMENT PROGRAMS, INCLUDING MEDICARE, MEDICAID, AND THE TRICARE PROGRAM. UNDER THESE PROGRAMS, THE MEDICAL CENTER PROVIDES CARE TO PATIENTS AT PAYMENT RATES THAT ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF ACTUAL COST. IN SOME CASES, THESE PROGRAMS PAY THE MEDICAL CENTER AT AMOUNTS THAT ARE LESS THAN ITS COST OF PROVIDING SERVICES. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ALLOWANCES) AND THE ESTIMATED LOSSES INCURRED BY THE MEDICAL CENTER DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR CHARITY FOR THE YEAR END JUNE 30, 2015. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY THE MEDICAL CENTER UNDER MANAGED CARE OR OTHER SUCH ARRANGEMENTS. THE BELOW FIGURES USE A SLIGHTLY DIFFERENT ASSUMPTION FROM SCHEDULE H AND THEREFORE AMOUNTS MAY VARY. CHARITY CARE AND MEANS TESTED PROGRAMS: JUNE 30, 2015 CHARGES FOREGONE NET COMMUNITY BENEFIT EXPENSE CHARITY CARE $194,951,000 $9,036,000 UNREIMBURSED MEDICAID 235,885,000 22,000,000 UNREIMBURSED MEDICARE 540,902,000 54,566,000 OTHER 7,561,000 619,000 TOTAL $979,299,000 $86,221,000 IN ADDITION TO COMMUNITY SERVICES DIRECTLY ASSOCIATED WITH PROVIDING HOSPITAL BASED CARE, THE MEDICAL CENTER SERVES THE COMMUNITY IN NUMEROUS OTHER WAYS. COMMUNITY HEALTH IMPROVEMENT SERVICES IMMUNOLOGICAL SUPPORT THE MEDICAL CENTER ORGANIZED, OWNS AND OPERATES A HOME WHICH IS DESIGNED TO HELP THE MEMBERS OF OUR COMMUNITY WHO HAVE CONTRACTED ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) TO DEAL WITH THE VERY DEBILITATING PHYSICAL, SOCIAL, AND PSYCHOLOGICAL PROBLEMS ASSOCIATED WITH THE DISEASE. PARISH NURSE PROGRAM TO ASSIST IN EDUCATING THE COMMUNITY REGARDING HEALTH RELATED ISSUES, THE MEDICAL CENTER PARTICIPATES IN NUMEROUS HEALTH FAIRS AND SPONSORS TALKS TO VARIOUS SCHOOLS AND INDUSTRY GROUPS REGARDING SUCH ISSUES AS DRUG ABUSE AND SAFETY IN THE WORKPLACE. LAKELINE DIRECT THE MEDICAL CENTER OPERATES A NURSE CALL CENTER, LAKELINE DIRECT, OFFERING COMPLIMENTARY 24 HOUR NURSE ADVICE, HEALTH INFORMATION AID, AND PHYSICIAN REFERRAL SERVICE TO THE COMMUNITY. ST. MARTHA ACTIVITY CENTER THE MEDICAL CENTER PROVIDES AN ACTIVITY CENTER LOCATED AT THE ELDERLY HOUSING FACILITY FOR THE RESIDENTS OF THE HOUSING FACILITY AS WELL AS OTHER ELDERLY COMMUNITY MEETINGS. ELDERLY SERVICES THE MEDICAL CENTER SPONSORS AND INCURS THE SALARY OF THE DIRECTOR OF THE HUD HOUSING FACILITY, PASTORAL CARE ASSOCIATE AND MEDICAL DIRECTOR OF ELDERLY SERVICES. ELDERLY HOUSING OLLIE STEELE BURDEN MANOR, A SUBSIDIARY OF THE MEDICAL CENTER, OPERATES ST. CLARE MANOR WHICH HAS 216 TOTAL BEDS, OF WHICH 120 ARE MEDICAID LICENSED. HEALTH CARE PROFESSIONAL'S EDUCATION OLOL COLLEGE IN AN EFFORT TO ENSURE THAT AN ADEQUATE SUPPLY OF NURSES ARE AVAILABLE FOR THE BATON ROUGE COMMUNITY, THE MEDICAL CENTER FOUNDED AND ORGANIZED OUR LADY OF THE LAKE COLLEGE, INC. THE MEDICAL CENTER SUBSIDIZES THE OPERATIONS OF THE COLLEGE WITH GRANTS. INTERNS AND RESIDENTS THE MEDICAL CENTER PARTICIPATES IN MEDICARE'S GRADUATE MEDICAL EDUCATION THROUGH AFFILIATION WITH LOUISIANA MEDICAL SCHOOL AND MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS TO CONTINUE TO SUPPORT AVAILABILITY OF PHYSICIANS IN FUTURE YEARS. SUBSIDIZED HEALTH SERVICES FAMILY EDUCATION THE MEDICAL CENTER PROMOTES A HEALTHY ENVIRONMENT FOR THE FAMILY THROUGH ITS PEDIATRIC PROGRAMS, WHICH INCLUDE KID-MED CLINIC, PEDIATRIC ASSESSMENT CENTER AND CHILD LIFE PROGRAMS. COPE THE MEDICAL CENTER PROVIDES CRISIS ORIENTED PSYCHIATRIC EVALUATION (COPE) TO THE COMMUNITY. PALLIATIVE CARE THE MEDICAL CENTER PROVIDES PALLIATIVE CARE SERVICE FOR PATIENTS IN THE FINAL STATE OF LIFE AND THEIR FAMILY MEMBERS. RESEARCH CLINICAL RESEARCH THE MEDICAL CENTER PARTICIPATES IN CLINICAL RESEARCH PROJECTS TO IMPROVE THE HEALTH AND CARE OF PATIENTS AND COMMUNITY MEMBERS. FINANCIAL CONTRIBUTIONS CASH CONTRIBUTIONS THE MEDICAL CENTER ALSO ORGANIZES EMPLOYEE PARTICIPATION IN FUND RAISING FOR ORGANIZATIONS SUCH AS CAPITAL AREA UNITED WAY, MARCH OF DIMES OF AMERICA, JUNIOR ACHIEVEMENT, CYSTIC FIBROSIS AND THE COMMUNITY FUND FOR THE ARTS. THE MEDICAL CENTER ALSO MAKES CORPORATE DONATIONS TO VARIOUS AREA COMMUNITY SERVICE ORGANIZATIONS. COMMUNITY BUILDING ACTIVITIES ELDERLY HOUSING COMPLEX THE MEDICAL CENTER OPERATES FOUR ELDERLY HOUSING PROJECTS: VILLA ST. FRANCIS, INC., ASSISI VILLAGE, INC., CALAIS HOUSE, INC., AND CHATEAU LOUISE, INC. THESE PROJECTS ARE DESIGNED TO PROMOTE THE HEALTH, SECURITY, AND HAPPINESS OF THE ELDERLY AND HANDICAPPED PERSONS OF THE GREATER BATON ROUGE AREA. MARY BIRD PERKINS THE MEDICAL CENTER ALSO SPONSORS THE CHARITABLE ACTIVITIES OF OTHER NOT-FOR-PROFIT ORGANIZATIONS IN BATON ROUGE. THE MEDICAL CENTER PROVIDES LAND ADJOINING THE MEDICAL CENTER TO THE MARY BIRD PERKINS CANCER CENTER FOR ITS OPERATIONS AND FORGOES ALL RENTAL INCOME FOR THE USE OF THIS LAND. COMMUNITY CLINIC THE MEDICAL CENTER PROVIDES A BUILDING THAT SPONSORS A COMMUNITY CLINIC AND FOREGOES ALL RENTAL INCOME RELATED TO THE USE OF THE BUILDING. Part XI, Line 9 Other Changes in net assets or fund balances: Capital Transfers FMOL 13,904,703 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, 2015. 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, 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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