ST MARTIN HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ST MARTIN HOSPITAL INC (EIN 26-4626264)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-07-31
- IRS object ID
- 201512129349300601
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
- Affiliated Group Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-07-31T08:18:26-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 201941244 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HORNE LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1020 HIGHLAND COLONY PKWY STE 400 | AddressLine1 |
| City | RIDGELAND | City |
| State | MS | State |
| ZIP Code | 39157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264626264 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 3375071201 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRYAN LAPEROUSE | PersonNm |
| Person Title | INTERIM ADMINISTRATOR | PersonTitleTxt |
| Phone | 3375071201 | PhoneNum |
| Signature | 2015-07-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARSHA H DIECKMAN CPA | PreparerPersonNm |
| PTIN | P00246741 | PTIN |
| Phone | 6013261000 | PhoneNum |
| Preparation | 2015-07-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID CALLECOD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1214 COOLIDGE BLVD | AddressLine1 |
| City | LAFAYETTE | City |
| State | LA | State |
| ZIP Code | 70503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,743,847 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STMARTINHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 178 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $40 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,795 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,428,076 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,534,903 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $498 | CYInvestmentIncomeAmt |
| PY Other Revenue | $154,866 | PYOtherRevenueAmt |
| CY Other Revenue | $201,651 | CYOtherRevenueAmt |
| PY Total Revenue | $16,582,982 | PYTotalRevenueAmt |
| CY Total Revenue | $20,743,847 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,596 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,235 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,583,701 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,261,652 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,297,441 | PYOtherExpensesAmt |
| CY Other Expenses | $11,956,113 | CYOtherExpensesAmt |
| PY Total Expenses | $17,884,738 | PYTotalExpensesAmt |
| CY Total Expenses | $19,221,000 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,301,756 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,522,847 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,335,156 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,101,325 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,816,822 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,060,144 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,518,334 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,041,181 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ST. MARTIN HOSPITAL'S MISSION IS TO IMPROVE, MAINTAIN AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,233,791 | ExpenseAmt |
| Grant | $3,235 | GrantAmt |
| Revenue | $20,708,404 | RevenueAmt |
| Desc | COMMUNITY MEDICAL CARE PROVIDER. THE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE PARISH REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SERVICES INCLUDE INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION.PROGRAM SERVICE STATISTICS RELATED TO PROVIDING MEDICAL CARE FOR THE HOSPITAL: TOTAL PATIENT DAYS WERE 4,284, TOTAL EMERGENCY ROOM VISITS WERE 17,310, AND TOTAL REHAB VISITS WERE 19,461. | Desc |
| Total Program Service Expenses | $15,233,791 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 178 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3375071201 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID CALLECOD | ||||||||
| CHAIRMAN/CEO - LGHS | 1.00 | 44.00 | Yes (X) | Yes (X) | $0 | $1,232,869 | $142,939 | |
| KATHERINE D HEBERT | ||||||||
| CEO/SECRETARY | 40.00 | 1.00 | Yes (X) | Yes (X) | $0 | $283,489 | $10,427 | |
| ED KRAMPE | ||||||||
| VICE CHAIRMAN | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR WARREN DEGATUR | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BURTON DUPUIS | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DOLLIE HAMNER | ||||||||
| PHARMACIST | 40.00 | 0.00 | $115,684 | $0 | $6,054 | Yes (X) | ||
| DEBORAH K HIGGINBOTHAM | ||||||||
| RN | 53.00 | 0.00 | $123,065 | $0 | $5,317 | Yes (X) | ||
| CATHIE A BOUDREAUX | ||||||||
| RN | 40.00 | 0.00 | $115,857 | $0 | $11,289 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $354,606 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,516,358 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $176,026 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SOUTHWEST CONTRACTORS LLC | |||||
| 100 CENTRAL STREET STE 100 | LAFAYETTE | LA | 70501 | CONSTRUCTION CONTRACTORS | $1,991,723 |
| REHABCARE GROUP INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 631502096 | CONTRACTED REHAB DEPT | $717,715 |
| CARDIOVASCULAR INSTITUTE OF THE SOUTH | |||||
| 225 DUNN STREET | HOUMA | LA | 70360 | CARDIOLOGY DIAGNOSTIC SERVICES | $609,328 |
| CORRECT CARE INC | |||||
| PO BOX 9146 | MANDEVILLE | LA | 70470 | ER PHYSICIAN SERVICES | $158,639 |
| WARREN J DEGATUR MD | |||||
| 206 CHAMPAGNE BLVD | BREAUX BRIDGE | LA | 70517 | INCOME GUARANTEE PHYSICIAN SERVICES | $122,204 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $6,795 | AllOtherContributionsAmt |
| Total Contributions | $6,795 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $20,534,903 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,534,903 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,534,903 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $498 | TotalRevenueColumnAmt |
| Exclusion | $498 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,150 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,150 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,150 | TotalRevenueColumnAmt |
| Exclusion | $28,150 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER REVENUE | 900099 | $147,473 | $147,473 |
| DIETARY REVENUE | 722210 | $26,028 | $26,028 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $173,501 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,743,847 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,708,404 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,648 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,235 | TotalAmt |
| Program Services | $3,235 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,223,633 | TotalAmt |
| Program Services | $5,374,729 | ProgramServicesAmt |
| Management And General | $848,904 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,626 | TotalAmt |
| Program Services | $49,704 | ProgramServicesAmt |
| Management And General | $15,922 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,599 | TotalAmt |
| Program Services | $422,858 | ProgramServicesAmt |
| Management And General | $103,741 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,794 | TotalAmt |
| Program Services | $375,670 | ProgramServicesAmt |
| Management And General | $70,124 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,602 | TotalAmt |
| Management And General | $278,602 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,914 | TotalAmt |
| Program Services | $1,428 | ProgramServicesAmt |
| Management And General | $50,486 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,967 | TotalAmt |
| Program Services | $158,038 | ProgramServicesAmt |
| Management And General | $19,929 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,339 | TotalAmt |
| Program Services | $183,560 | ProgramServicesAmt |
| Management And General | $89,779 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,495 | TotalAmt |
| Program Services | $6,307 | ProgramServicesAmt |
| Management And General | $3,188 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,813 | TotalAmt |
| Program Services | $2,536 | ProgramServicesAmt |
| Management And General | $5,277 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,865 | TotalAmt |
| Program Services | $1,895 | ProgramServicesAmt |
| Management And General | $286,970 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,107 | TotalAmt |
| Program Services | $330,107 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,368 | TotalAmt |
| Management And General | $48,368 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $3,964,357 | $3,964,357 | |
| CONTRACT LABOR | $3,701,849 | $2,089,445 | $1,612,404 |
| MEDICAL SUPPLIES | $1,541,181 | $1,541,181 | |
| EQUIP. RENTAL & REPAIR | $858,450 | $490,093 | $368,357 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,806 | TotalAmt |
| Program Services | $238,648 | ProgramServicesAmt |
| Management And General | $185,158 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,221,000 | TotalAmt |
| Program Services | $15,233,791 | ProgramServicesAmt |
| Management And General | $3,987,209 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $462,248 | BOYAmt |
| EOY | $377,610 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,901,143 | BOYAmt |
| EOY | $2,563,726 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,245 | BOYAmt |
| EOY | $504,738 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,487 | BOYAmt |
| EOY | $13,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,643,486 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $919,222 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,926,213 | BOYAmt |
| EOY | $3,724,264 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $625,820 | BOYAmt |
| EOY | $2,917,274 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,335,156 | BOYAmt |
| EOY | $10,101,325 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $854,635 | BOYAmt |
| EOY | $1,006,766 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,962,187 | BOYAmt |
| EOY | $6,053,378 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,816,822 | BOYAmt |
| EOY | $7,060,144 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,518,334 | BOYAmt |
| EOY | $3,041,181 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,518,334 | BOYAmt |
| EOY | $3,041,181 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,335,156 | BOYAmt |
| EOY | $10,101,325 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,522,847 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Belongs Afflt Grp | Yes (X) | OrganizationBelongsAffltGrpInd |
Total Grassroots Lobbying TotalGrassrootsLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $5,889 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $189,962 | AffiliatedGroupTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $5,889 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $189,962 | AffiliatedGroupTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $15,227,902 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $550,741,154 | AffiliatedGroupTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $15,233,791 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $550,931,116 | AffiliatedGroupTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $911,690 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $1,000,000 | AffiliatedGroupTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $227,923 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $250,000 | AffiliatedGroupTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $0 | AffiliatedGroupTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $0 | AffiliatedGroupTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $826,841 | CurrentYearMinus2Amt |
| Current Year Minus1 | $881,274 | CurrentYearMinus1Amt |
| Current Year | $1,000,000 | CurrentYearAmt |
| Total | $2,708,115 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $4,062,173 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $1,821 | CurrentYearMinus2Amt |
| Current Year Minus1 | $3,249 | CurrentYearMinus1Amt |
| Current Year | $189,962 | CurrentYearAmt |
| Total | $195,032 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $206,710 | CurrentYearMinus2Amt |
| Current Year Minus1 | $220,319 | CurrentYearMinus1Amt |
| Current Year | $250,000 | CurrentYearAmt |
| Total | $677,029 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,015,544 | GrassrootsCeilingAmt |
Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $1,821 | CurrentYearMinus2Amt |
| Current Year Minus1 | $3,249 | CurrentYearMinus1Amt |
| Current Year | $189,962 | CurrentYearAmt |
| Total | $195,032 | TotalAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE C, PART II-A, LINE 1A | FormAndLineReferenceDesc |
| Explanation | ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH LOUISIANA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,147,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $408,963 | DepreciationAmt |
| Book Value | $2,738,447 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $632,739 | OtherCostOrOtherBasisAmt |
| Depreciation | $82,194 | DepreciationAmt |
| Book Value | $550,545 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $824,188 | OtherCostOrOtherBasisAmt |
| Depreciation | $428,065 | DepreciationAmt |
| Book Value | $396,123 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,149 | OtherCostOrOtherBasisAmt |
| Book Value | $39,149 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,724,264 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $26,854 |
| OTHER ACCOUNTS RECEIVABLE | $115,920 |
| RELATED PARTY RECEIVABLES | $2,774,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,917,274 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER ACCOUNTS PAYABLE | $2,404,643 |
| RELATED PARTY PAYABLES | $149,972 |
| CAPITAL LEASE OBLIGATION | $3,498,763 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,053,378 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACS 740. FASB ACS 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR FINANCIAL STATEMENT RECOGNITION OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE INTERPRETATION ALSO PROVIDES GUIDANCE ON RECOGNITION, DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE ORGANIZATION'S VARIOUS FEDERAL INCOME TAX AND EXEMPT ORGANIZATION INCOME TAX RETURNS (IRS FORMS 1065, 1120, AND 990), WHETHER FILED ON A CALENDAR OR FISCAL YEAR BASIS, ARE SUBJECT TO EXAMINATION BY THE IRS. THE INCOME TAX RETURNS FOR YEARS 2010 THROUGH 2012 ARE SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,144 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,911,660 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$2,898,516 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,745,746 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,511,060 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,234,686 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,758,890 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,422,720 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$1,663,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08090 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,173,630 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $769,620 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $404,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02650 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,235 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,235 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,176,865 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $769,620 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $407,245 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,935,755 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,192,340 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$1,256,585 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10760 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,964,357 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,171,486 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,261,771 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,985,652 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $276,119 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW | OwnWebsiteURLTxt |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. MARTIN HOSPITAL | PART V, SECTION B, LINE 1J: CHNA ALSO DESCRIBES THE INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND THE FOCUS GROUPS USED IN ORDER TO OBTAIN DATA. |
| ST. MARTIN HOSPITAL | PART V, SECTION B, LINE 3: INTERVIEW METHODOLOGYEIGHT INTERVIEWS WERE CONDUCTED IN-PERSON FROM NOVEMBER 13-14, 2012. INTERVIEWS REQUIRED APPROXIMATELY 30 MINUTES TO COMPLETE. INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY. ADDITIONALLY, THE FOLLOWING COMMUNITY-FOCUSED QUESTIONS WERE USED AS THE BASIS FOR DISCUSSION:-INTERVIEWEE'S NAME-INTERVIEWEE'S TITLE-INTERVIEWEE'S ORGANIZATION-OVERVIEW INFORMATION ABOUT THE INTERVIEWEE'S ORGANIZATION-WHAT ARE THE TOP THREE STRENGTHS OF THE COMMUNITY?-WHAT ARE THE TOP THREE HEALTH CONCERNS OF THE COMMUNITY?-WHAT ARE THE HEALTH ASSETS AND RESOURCES AVAILABLE IN THE COMMUNITY?-WHAT ARE THE HEALTH ASSETS OR RESOURCES THAT THE COMMUNITY LACKS?-WHAT ASSETS OR RESOURCES IN THE COMMUNITY ARE NOT BEING USED TO THEIR FULL CAPACITY?-WHAT ARE THE BARRIERS TO OBTAINING HEALTH SERVICES IN THE COMMUNITY?-WHAT IS THE SINGLE MOST IMPORTANT THING THAT COULD BE DONE TO IMPROVE THE HEALTH IN THE COMMUNITY?-WHAT CHANGES OR TRENDS IN THE COMMUNITY DO YOU EXPECT OVER THE NEXT FIVE YEARS?-WHAT OTHER INFORMATION CAN BE PROVIDED ABOUT THE COMMUNITY THAT HAS NOT ALREADY BEEN DISCUSSED?THESE INTERVIEWS WERE CONDCUTED WITH THE FOLLOWING COMMUNITY LEADERS:JODY WEST,COORDINATOR, ST. MARTIN PARISH SCHOOL-BASED HEALTH CENTER, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONJACK DALE DELHOMME, MAYOR-CITY OF BREAUX BRIDGE, AREA REPRESENTED: ELECTED OFFICIALDR. GUS INGRALDI, CARDIOLOGIST-CARDIOVASCULAR INSTITUTE OF THE SOUTH, AREA REPRESENTED: PHYSICIANSTACEY SAVOY, COMMUNITY HEALTH SERVICES COORDINATOR-ST. MARTIN HEALTH UNIT, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONFRANCINE GUILLORY, PSYCHOTHERAPIST/WELLNESS COUNSELOR, AREA REPRESENTED: MENTAL HEALTHAIMEE GUIDRY, NURSE PRACTITIONER-PARTNERS IN HEALTH CARE, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONDIANE SANT, ACADIANA HOME HEALTH, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONTEDDY THOMAS, CLERK/NUTRITION EDUCATOR-ST. MARTIN HEALTH UNIT AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONIN ADDITION TO INTERVIEWS WITH COMMUNITY LEADERS, FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED TO ALLOW PARTICIPANTS TO PROVIDE INFORMATION ABOUT THEIR EXPERIENCES IN THE COMMUNITY AND WAYS IN WHICH THEY THINK THE SERVICES AND RESOURCES PROVIDED TO THE COMMUNITY CAN BE IMPROVED. PARTICIPANTS COMPLETED A DEMOGRAPHIC QUESTIONNAIRE AND A CONSENT FORM AGREEING TO PARTICIPATE IN THE FOCUS GROUP. THE REQUESTED INFORMATION INCLUDED: -GENDER-AGE -ZIP CODE -ETHNICITY -RACE -EDUCATION LEVEL -EMPLOYMENT STATUS -HOUSEHOLD INCOME -HEALTH INSURANCE STATUS |
| ST. MARTIN HOSPITAL | PART V, SECTION B, LINE 7: UNADDRESSED PRIORITIES INCLUDED:COMMUNICABLE DISEASE: INTERVIEWEES EXPRESSED CONCERN MOSTLY RELATING TO PEDIATRIC IMMUNIZATION RATES. ST. MARTIN HOSPITAL DOES NOT OFFER WOMEN'S OR PEDIATRIC HEALTH SERVICES, AND DOES NOT ADVERTISE LABOR AND DELIVERY SERVICES TO THE COMMUNITY. NOT ONLY ARE RESOURCES LIMITED TO ACCOMODATE THE NEED, ST. MARTIN HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS PEDIATRIC HEALTHCONCERNS AMONG ITS PHYSICIANS AS THEIR COMPETENCIES ARE FOCUSED ON OTHER AREAS OF MEDICINE.MENTAL HEALTH: ST. MARTIN HOSPITAL DOES NOT HAVE A BEHAVIORAL HEALTH UNIT. THEY DO NOT HAVE THE RESOURCES OR EXPERTISE TO CONTINUOUSLY REMAIN ACTIVE IN THE SEARCH FOR ENHANCEMENT IN MENTALHEALTH SERVICES. THE HOSPITAL'S FOCUS IS TO ENHANCE MEDICAL SERVICES IN THE COMMUNITY TO MEET OTHER HEALTH NEEDS MORE WITHIN THEIR SCOPE OF CARE AND COMPETENCY.SUBSTANCE ABUSE: ST. MARTIN HOSPITAL DOES NOT HAVE A BEHAVIORAL HEALTH OR ACUTE SUBSTANCE ABUSE TREATMENT UNIT. THE HOSPITAL DOES NOT HAVE THE RESOURCES OR EXPERTISE TO CONTINUOUSLY REMAINACTIVE IN THE SEARCH FOR ENHANCEMENT IN SUBSTANCE ABUSE SERVICES. THE HOSPITAL'S FOCUS IS TO ENHANCE MEDICAL SERVICES IN THE COMMUNITY TO MEET OTHER HEALTH NEEDS MORE WITHIN THEIR SCOPE OF CARE AND COMPETENCY. |
| ST. MARTIN HOSPITAL | PART V, SECTION B, LINE 14G: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,964,357. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WE PROVIDE HEALTH SCREENINGS, WHICH INCLUDE BLOOD PRESSURE CHECKS, GLUCOSE SCREENING AND EKGS. WE ALSO PROVIDE EDUCATIONAL PROGRAMS WITHIN OUR COMMUNITY. |
| PART III, LINE 4: | THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: THE ORGANIZATION REPORTS ACCOUNTS RECEIVABLE NET OF ESTIMATED ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS AND ADJUSTMENTS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE ORGANIZATION ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING AMOUNT OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE AMOUNT CHARGED TO THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON THE ORGANIZATION'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, AND TRENDS IN GOVERNMENT REIMBURSEMENT. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN OFF WHEN THE ORGANIZATION HAS DETERMINED THE ACCOUNT WILL NOT BE COLLECTED.BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BOTH CHARITY AND BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT AT LEAST 80% OF THE PATIENTS THAT WERE ADJUSTED TO BAD DEBT ARE LIKELY PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT OR ARE UNWILLING TO INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. HOWEVER, HOSPITAL BELIEVES THAT THE COST OF THIS BAD DEBT IS A COMMUNITY BENEFIT BECAUSE BY CONTINUING TO TREAT PATIENTS THAT ARE UNABLE TO AFFORD CARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL CARE. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITALS FILED 2014 COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. |
| PART III, LINE 9B: | WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE ,WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. |
| PART VI, LINE 2: | THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATI0N. THE H0SPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR YEAR ENDING 9/30/13. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS COMPLETED IN JUNE OF 2013. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS.THE CHNA CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/ST-MARTIN-COMMUNITY-NEEDS-ASSESSMENT.PDF |
| PART VI, LINE 3: | WE POST A NOTICE THAT WE HAVE A CHARITY POLICY THAT PROVIDES FOR FINANCIAL ASSISTANCE TO THOSE THAT MEET SPECIFIC CRITERIA IN THE RECEPTION AREA OF THE HOSPITAL. |
| PART VI, LINE 4: | WE ARE LOCATED IN A RURAL PARISH IN LOUISIANA. ST. MARTIN PARISH IS AN AGRICULTURAL COMMUNITY WITH COMMERCIAL FISHING. WE ARE THE ONLY HOSPITAL IN OUR PARISH (ST. MARTIN). WE ALSO HAVE BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA.THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING GEOGRAPHIC AND DEMOGRAPHIC AREAS, IS ADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED DURING 2013. THE CHNA CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/ST-MARTIN-COMMUNITY-NEEDS-ASSESSMENT.PDF |
| PART VI, LINE 5: | OUR BOARD OF TRUSTEES IS COMPRISED OF MEMBERS FROM OUR COMMUNITY, WHICH MAKE UP OUR PRIMARY SERVICE AREA. ST. MARTIN HOSPITAL EXTENDS PRIVILEGES TO PRIMARY CARE PHYSICIANS IN OUR COMMUNITY. SURPLUS FUNDS ARE USED TO PROVIDE CAPITAL IMPROVEMENTS TO OUR HOSPITAL TO ENRICH THE QUALITY CARE THAT WE PROVIDE. WE ALSO RECRUIT PHYSICIANS INTO OUR COMMUNITY, ORGANIZE FUND-RAISERS FOR CANCER RESEARCH THROUGH OUR PARTICIPATION IN THE RELAY FOR LIFE. WE ALSO PROVIDE SUPPORT TO THE UNITED WAY OF ACADIANA BY HAVING A FUND-RAISING CAMPAIGN AND HAVING MEMBERS OF OUR STAFF ON THEIR BOARD AND COMMITTEES. |
| PART VI, LINE 6: | THE HOSPITAL IS OWNED BY LAFAYETTE GENERAL HEALTH SYSTEMS. THIS ALLIANCE HAS ALLOWED THE HOSPITAL TO EXTEND ITS OUTREACH TO ALL THE CITIZENS OF ST. MARTIN PARISH. THE HOSPITAL WAS ABLE TO EXPAND ITS OUTPATIENT AND EMERGENCY SERVICES. THE HOSPITAL WAS ALSO ABLE TO ENRICH ITS INPATIENT SERVICES BY IMPLEMENTING A HOSPITALIST PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID CALLECOD | ||||||||||||||
| CHAIRMAN/CEO - LGHS | $0 | $744,400 | $0 | $291,805 | $0 | $196,664 | $0 | $133,617 | $0 | $9,322 | $0 | $1,375,808 | $0 | $0 |
| KATHERINE D HEBERT | ||||||||||||||
| CEO/SECRETARY | $0 | $205,544 | $0 | $40,288 | $0 | $37,657 | $0 | $3,297 | $0 | $7,130 | $0 | $293,916 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY A RELATED ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THIS RELATED ORGANIZATION'S COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. |
| PART I, LINE 4B | A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED BY LAFAYETTE GENERAL MEDICAL CENTER, THE SOLE MEMBER OF ST. MARTIN HOSPITAL, EFFECTIVE JANUARY 01, 2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WAS $228,600, WHICH INCLUDES BOTH LAFAYETTE GENERAL MEDICAL CENTER AND ST. MARTIN HOSPITAL EMPLOYEES. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE DAVID CALLECOD, CEO OF LAFAYETTE GENERAL HEALTH SYSTEMS AND KATHERINE D. HEBERT, CEO OF ST. MARTIN HOSPITAL. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2013 W-2 WAGES, TOTALLED $210,535. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2013 W-2 WAGES: DAVID CALLECOD, PRESIDENT/CEO-LGHS AND KATHERINE HEBERT, ADMINISTRATOR. |
| PART I, LINE 6 | THE ORGANIZATION DOES HAVE A PROFIT SHARING PLAN (SUCCESS SHARING) FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS, AS LISTED ON PART VII OF FORM 990, CALCULATION OF PROFIT SHARING IS IN PART BASED ON THE CONSOLIDATED NET EARNINGS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN J DEGATOR JR MD INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | WARREN DEGATUR, BOARD MEMBER, IS SOLE OWNER OF WARREN J DEGATOR JR MD INC. | RelationshipDescriptionTxt |
| Transaction | $122,204 | TransactionAmt |
| Transaction | DR. DEGATUR'S PRACTICE WAS ISSUED A FORM 1099 IN THE AMOUNT OF $122,203.60. OF THIS AMOUNT, 101,472.43 WAS FOR INCOME GUARANTEE PAYMENTS, UNDER AGREEMENT, BETWEEN THE PRACTICE AND THE HOSPITAL. $2,500 WAS FOR ON CALL PAY AND $6,000 WAS FOR MEDICAL DIRECTOR PAY. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS A NON-STOCK NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS RATIFY THE SELECTION OF THE INDIVIDUALS THAT SERVE ON THE BOARD OF TRUSTEES (GOVERNING BODY) AFTER THOSE INDIVIDUALS HAVE BEEN SELECTED AS A TRUSTEE BY THE BOARD OF TRUSTEES |
| FORM 990, PART VI, SECTION A, LINE 7B | YES, THE INDIVIDUALS OF THE TRUSTEES (GOVERNING BODY) AND THE MEMBERS MUST BE APPROVED BY THE MEMBERSHIP BODY |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S ACCOUNTING STAFF THE COMPLETED FORMS ARE REVIEWED BY THE OFFICERS AND THEN PRESENTED TO THE BOARD FOR REVIEW, COMMENT AND CORRECTIONS IF NEEDED BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL SURVEY IS SENT TO THE BOARD MEMBERS AND OFFICERS REQUIRING THEM TO DISCLOSE CONFLICTS OF INTEREST. AFTER RECEIPT OF THESE SURVEYS, THE GOVERNANCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE; THEREAFTER, THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE AND THE ORGANIZATION'S GENERAL COUNCIL (WHO ATTENDS ALL BOARD MEETINGS) INSURES THAT ALL CONFLICTS ARE TIMELY DISCLOSED AND APPROPRIATE RECUSALS ARE MADE ON BUSINESS MATTERS THAT MAY BE RELATED TO THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15A | AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | OTHER DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY/LEGAL AUTHORITIES. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM PREVIOUS YEAR |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAFAYETTE GENERAL MEDICAL CENTER INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 720535375 | HOSPITAL | LA | 501(C)(3) | 170(B)(1)(A) (III) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| LAFAYETTE HEALTH VENTURES INC | |||||||||||
| PO BOX 53092 | LAFAYETTE | LA | 70503 | 721006966 | PHYSICIAN PRACTICES | LA | 501(C)(3) | 509 (A)(3) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| LAFAYETTE GENERAL HEALTH SYSTEMS INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 383646817 | HEALTHCARE SUPPORT | LA | 501(C)(3) | 509 (A)(3) | 0 | N/A | |
| UNIVERSITY HOSPITAL & CLINICS INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 462605366 | HOSPITAL | LA | 501(C)(3) | 170(B)(1)(A) (III) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| ACADIA GENERAL HOSPITAL INC | |||||||||||
| 1305 CROWLEY RAYNE HWY | CROWLEY | LA | 70526 | 464958152 | HEALTHCARE SUPPORT | LA | PENDING 501(C)(3) | 170(B)(1)(A) (III) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| LAFAYETTE GENERAL FOUNDATION INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 371766778 | FOUNDATION | LA | PENDING 501(C)(3) | 509 (A)(3) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| LAFAYETTE INVESTMENT GROUP LLC | |||||||
| 1000 W PINHOOK SUITE 206 | LAFAYETTE | LA | 70503 | 421594593 | MANAGEMENT | LA | N/A |
| LAFAYETTE GENERAL SURGICAL HOSPITAL LLC | |||||||
| 1000 W PINHOOK | LAFAYETTE | LA | 70503 | 481300080 | SURGICAL HOSPITAL | LA | N/A |
| OIL CENTER SURGICAL PLAZA LLC | |||||||
| 1000 W PINHOOK STE 204 | LAFAYETTE | LA | 70503 | 464090110 | SURGERY CENTER | LA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER LAFAYETTE PHYSICIANS HOSPITAL ORG | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 AUDUBON BLVD | AddressLine1 |
| City | LAFAYETTE | City |
| State | LA | State |
| ZIP Code | 70503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721286969 | EIN |
| Primary Activities | SUPPORT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Affiliated Group Schedule AffiliatedGroupSchedule
Affiliated Schedule AffiliatedScheduleGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Electing OrganizationElectingOrganizationInd | Total Grassroots LobbyTotalGrassrootsLobbyAmt | Total Direct LobbyTotalDirectLobbyAmt | Total Lobby ExpenditureTotalLobbyExpenditureAmt | Other Exempt Purpose ExpendOtherExemptPurposeExpendAmt | Total Exempt Purpose ExpendTotalExemptPurposeExpendAmt | Lobby NontxLobbyNontxAmt | Grassroots NontxGrassrootsNontxAmt | Total Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmt | Tot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmt | Share Excess Lobby ExpendShareExcessLobbyExpendAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAFAYETTE GENERAL MEDICAL CENTER | |||||||||||||||
| 1214 COOLIDGE BOULEVARD | LAFAYETTE | LA | 705032621 | 720535375 | Yes (X) | $0 | $0 | $0 | $297,068,790 | $297,068,790 | $1,000,000 | $250,000 | $0 | $0 | $0 |
| ST MARTIN HOSPITAL | |||||||||||||||
| 210 CHAMPAGNE BOULEVARD | BREAUX BRIDGE | LA | 70517 | 264626264 | Yes (X) | $5,889 | $0 | $5,889 | $15,227,902 | $15,233,791 | $911,690 | $227,923 | $0 | $0 | $0 |
| UNIVERSITY HOSPITAL AND CLINICS INC | |||||||||||||||
| 1214 COOLIDGE BOULEVARD | LAFAYETTE | LA | 705032621 | 462605366 | Yes (X) | $7,246 | $0 | $7,246 | $138,358,132 | $138,365,378 | $1,000,000 | $250,000 | $0 | $0 | $0 |
| ACADIA GENERAL HOSPITAL INC | |||||||||||||||
| 1305 CROWLEY RAYNE HWY | CROWLEY | LA | 70526 | 464958152 | Yes (X) | $2,142 | $0 | $2,142 | $11,655,391 | $11,657,533 | $732,877 | $183,219 | $0 | $0 | $0 |
| LAFAYETTE GENERAL HEALTH SYSTEMS | |||||||||||||||
| 1214 COOLIDGE BOULEVARD | LAFAYETTE | LA | 705032621 | 383646817 | Yes (X) | $174,685 | $0 | $174,685 | $88,430,939 | $88,605,624 | $1,000,000 | $250,000 | $0 | $0 | $0 |