2015-11-13T13:49:08-06:00 2014-12-31 721088864 LAPORTE APAC 111 VETERANS MEMORIAL BLVD SUITE 600 METAIRIE LA 700054958 990 2014-01-01 720417281 AMERICAN LEGION HOSPITAL AMER 3372504047 PO BOX 1507 CROWLEY LA 70527 MICHAEL MCBRIDE SECRETARY, BOARD OF DIRECTORS 3377886406 2015-11-13 1 BONNIE M WYLLIE JD LLM P00540011 5048355522 2014 2016-03-07 17:11:31Z X TERRY OSBORNE 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 11051295 0 X WWW.ALH.ORG X 1951 LA PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, AND CHARITY HEALTHCARE SERVICES FOR RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. 8 5 412 46 0 0 1259 18734 30385851 10811124 171460 -6863269 384642 167843 30943212 4134432 0 0 0 0 16569128 6799315 0 0 0 17962383 9807140 34531511 16606455 -3588299 -12472023 32551512 16147338 9772408 5901584 22779104 10245754 X THE MISSION OF AMERICAN LEGION HOSPITAL IS TO BE A COMMUNITY HEALTH CENTER PROVIDING A SPECTRUM OF HIGH QUALITY HEALTH SERVICES, PROMOTING EDUCATION WITHIN THE ORGANIZATION, EMPHASIZING SERVICE AND EXCELLENCE,AND CONTINUALLY IMPROVING THE QUALITY MANAGEMENT SYSTEM. 0 1 10875390 3601426 THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. TOTAL HOSPITAL (ACUTE AND ICU) PATIENT DAYS TOTALED 4,672; AVERAGE LENGTH OF STAY WAS 4.5 DAYS; TOTAL PSYCHIATRIC DAYS TOTALED 1,463; AVERAGE LENGTH OF STAY WAS 9.7 DAYS, OUTPATIENT REGISTRATIONS TOTALED 17,893 FOR THE YEAR. CARE PROVIDED TO MEDICARE AND MEDICAID AND MEDICAID MANAGED CARE BENEFICIARIES TOTALED 44% AND 21%, RESPECTIVELY, OF TOTAL GROSS REVENUE. 2817124 364583 AMERICAN LEGION HOSPITAL ("ALH") ENTERED INTO A SPECIAL SERVICES LEASE AGREEMENT WITH ACADIA GENERAL HOSPITAL, INC. ("AGH") A LOUISIANA NON-PROFIT CORPORATION, WHICH IS A WHOLLY OWNED SUBSIDIARY OF LAFAYETTE GENERAL HEALTH SYSTEM, INC. ("LGH") A LOUISIANA NONPROFIT CORPORATION. AGH SEAMLESSLY CONTINUED THE MISSION OF ALH BY ASSUMING THE MANAGEMENT AND OPERATIONS OF ALH'S HOSPITAL ON JUNE 1, 2014. THIS MADE THE HOSPITAL PART OF LGH'S REGIONAL NETWORK OF FACILITIES.AGH'S ROLE IN THIS AGREEMENT IS TO PROVIDE HIGH QUALITY MEDICAL SERVICES USING THE EXPANDED RESOURCES, TECHNOLOGY, PURCHASING POWER AND CLINICAL PROTOCOL ALIGNMENT OF LGH. THE INTENT OF THIS ARRANGEMENT WAS TO PROVIDE FINANCIAL STABILITY AND LONG-TERM VIABILITY OF THE HOSPITAL FOR THE BENEFIT OF THE RESIDENTS OF THE CITY OF CROWLEY AND ACADIA PARISH. THIS WOULD ENABLE BETTER CARE TO BE DELIVERED EFFICIENTLY AND COST-EFFECTIVELY, AND IT WOULD ENSURE CONTINUED OPERATIONS AND ACCESS TO HOSPITAL AND EMERGENCY CARE.ALH LEASED TO AGH THE HOSPITAL BUILDINGS AND FIXTURES. THE LEASE INCLUDED ALL THE MOVABLE PROPERTY, SUCH AS EQUIPMENT, MACHINERY, COMPUTERS AND SOFTWARE EQUIPMENT. IT ALSO INCLUDED ALL INVENTORY, SUPPLIES, AND PHARMACEUTICALS. THE INITIAL TERM OF THE LEASE WILL BE TEN YEARS WITH FOUR OPPORTUNITIES TO RENEW THE LEASE FOR FIVE YEAR PERIODS. AT THE TERMINATION OF THE LEASE THE MOVABLE PROPERTY WILL REVERT TO ALH.AS PART OF THIS LEASE AGREEMENT ALH ASSIGNED TO AGH ITS CONTRACTS, LEASES, PERMITS, AND LICENSES SO THAT AGH COULD OPERATE THE FACILITY. ALH ALSO ASSIGNED TO AGH ITS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED IN ORDER TO FACILITATE THE COLLECTION OF THE BILLS. AGH ALSO ASSUMED THE ACCOUNTS PAYABLE FOR MATERIALS, SERVICES, AND SUPPLIES. THERE IS NO ISSUE WITH PRIVATE INUREMENT SINCE AGH IS A NONPROFIT HOSPITAL CONTINUING THE SAME MISSION. THE HOSPITAL PROVIDED SERVICE TO THE COMMUNITY:-SPONSORED COMMUNITY BLOOD DRIVES.-PARTICIPATED AS A CLINIC OBSERVATION SITE FOR LOCAL COLLEGES AND UNIVERSITIES.-PARTICIPATED IN EVERY CHOICE COMES WITH A PRICE (CAMPAIGN AGAINST IMPAIRED AND DISTRACTED DRIVING AMONG HIGH SCHOOL STUDENTS) WITH THE ACADIA PARISH SHERIFF'S OFFICE & LAW ENFORCEMENT PARTNERS. THE FILM CREW PRESENTED THE ER WITH 3 MOCK PATIENTS. -9 EMPLOYEES PARTICIPATED IN THE ACADIA PARISH CAREER EXPO AND 115 KIDS STOPPED AT THE HOSPITAL BOOTH.-DONATED 1/2 TON OF FOOD TO THE CROWLEY CHRISTIAN CARE CENTER.-AWARDED AS SAFE-SLEEP CHAMPION HOSPITAL BY THE LOUISIANA OFFICE OF PUBLIC HEALTH. THE HOSPITAL INCREASED AWARENESS OF INFANT MORTALITY BY UPDATING POLICIES, ESTABLISHING CONTRACTS WITH MOTHERS OF NEWBORNS, AND EDUCATING PARENTS ABOUT SAFE SLEEP ENVIRONMENTS. 13692514 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 52 0 1 412 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X TERRY OSBORNE 3372504047 806 N AVE K CROWLEY LA 70526 BC DELAHOUSSAYE MD BOARD OF DIRECTORS, CHAIRM 0.50 X 0 0 0 MICHAEL MCBRIDE BD OF DIRECTORS, SECR/TREA 0.50 X 0 0 0 RALPH COWEN BOARD OF DIRECTORS 0.50 X 0 0 0 LAWRENCE HABETZ BOARD OF DIRECTORS 0.50 X 0 0 0 STEPHEN STEFANSKI BOARD OF DIRECTORS 0.50 X 0 0 0 P DALE LELEUX JR MD BOARD OF DIRECTORS, VICE C 0.50 X 0 0 0 ROBERT LEE WRIGHT BOARD OF DIRECTORS 0.50 X 0 0 0 WILLIAM G NEVITT BOARD OF DIRECTORS 0.50 X 0 0 0 TERRY OSBORNE CEO 40.00 X 293552 0 5485 CHARMAINE VIDRINE CFO 40.00 X 59878 0 0 353430 0 5485 1 0 1 0 PROFESSIONAL ANESTHESIA SERVICES OF SWLA 1309 HILLCROFT DRIVE LAKE CHARLES LA 70605 CRNA ANESTHESIA SERVICES 508333 EMCARE 18167 US HIGHWAY 19 NORTH SUITE 65 CLEARWATER FL 33764 ER PHYSICIAN SERVICES 297439 ACADIANA WOUNDCARE AND HYPERBARICS 1325 WRIGHT AVE STEC CROWLEY LA 70526 CONTRACT WC/HYPERBARIC 225203 ARSHAVIR MICHAEL APMC PO BOX 2403 CROWLEY LA 70527 ANESTHESIA SERVICES 195833 SUPERIOR IMAGING AND DIAGNOSTICS LLC 101 SETTLERS TRACE BLVD LAFAYETTE LA 70508 RADIOLOGY SERVICES 168950 8 18734 18734 PATIENT SERVICES 621990 10446541 10446541 BUILDING AND EQUIPMENT RENTAL 532000 364583 364583 10811124 53594 53594 60392 0 60392 60392 60392 6916863 -6916863 -6916863 -6916863 JOINT VENTURE-OPEN AIR MRI 621400 81358 81358 CAFETERIA REVENUE 722210 66473 66473 JOINT VENTURE-C. CARDIAC WELLNESS 621400 -70002 -70002 29622 29622 107451 4134432 3966009 0 149689 X 403626 403626 5482158 4525003 957155 135210 113576 21634 778321 650289 128032 217591 217591 97882 97882 1444450 1301685 142765 7537 7537 616296 422112 194184 29232 24555 4677 298394 207717 90677 44061 39839 4222 8545 3792 4753 282423 282398 25 1970352 1517171 453181 190144 190144 PATIENT SUPPLIES/DRUGS 3585149 3585149 REPAIRS AND MAINTENANCE 777900 598930 178970 PHYSICIAN RECRUITMENT 98606 98606 COLLECTION EXPENSES 25779 25779 112799 105769 7030 16606455 13692514 2913941 0 2125 1873000 1454081 3419905 8000878 185522 1231941 906550 266883 35518317 27263453 10494399 8254864 335925 285574 142088 28879 9983525 1832711 32551512 16147338 3143984 160097 6466428 5583042 161996 158445 9772408 5901584 X 22505587 9972237 273517 273517 22779104 10245754 32551512 16147338 -12472023 -61327 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 608863 608863 12652463 9512537 3139926 21621301 17156158 4465143 635690 594758 40932 8254864 RESTRICTED CASH AND INVESTMENTS 125000 DEPOSITS FOR HEALTH INSURANCE ADMINISTRATOR 556826 TRUST INVESTMENT 260644 COST REPORT SETTLEMENT RECEIVABLE 829023 MALPRACTICE DEPOSITS 61218 1832711 COST REPORT SETTLEMENT PAYABLE 158445 158445 X 4643000 519924 519924 4123076 11356 11356 4134432 17043000 436545 436545 16606455 0 16606455 PART X, LINE 2: TEXT FROM FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS. UNCERTAINTY IN INCOME TAXES: THE AUTHORITATIVE GUIDANCE IN ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF THIS GUIDANCE, TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AS OF DECEMBER 31, 2014 AND 2013. PART XI, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY INCOME $ 519,924 - AUDITED FINANCIAL STMTS WERE CONSOLIDATED PART XI, LINE 4B - OTHER ADJUSTMENTS: JOINT VENTURE INCOME -- OPEN AIR MRI, LLC 81,358 JOINT VENTURE INCOME -- ADVANCED CARDIOLOGY CENTER LLC -16,078 JOINT VENTURE INCOME -- CROWLEY CARDIAC WELLNESS -53,924 PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSE $436,545 (AUDITED FINANCIAL STMTS WERE CONSOLIDATED) 1 1 X 1 X 1 X 1 0 0 15945 15945 0.00100 1418551 1236478 182073 0.01100 1434496 1236478 198018 0.01200 1434496 1236478 198018 0.01200 98606 98606 0.00590 98606 98606 0.00590 0 1318537 15945 6029481 6029481 X 1 1 1 OPEN AIR MRI PROVIDE OPEN AIR MRI 0.51000 2 OF ACADIANA LLC SERVICES TO RESIDENTS 3 OF ACADIA PARISH AND 4 SURROUNDING AREA 5 ADVANCED PROVIDE CARDIAC 0.30000 0.04000 0.36000 6 CARDIOLOGY SCREENING SERVICES 7 CENTER LLC TO RESIDENTS OF 8 ACADIA PARISH AND 9 SURROUNDING AREA 10 ALH HEALTH PARTIAL OWNER OF 1.00000 11 VENTURES LLC CROWLEY CARDIAC 12 WELLNESS, LLC & 13 ADVANCED CARDIOLOGY 14 CENTER, LLC 15 CROWLEY CARDIAC PROVIDE CARDIAC 0.30000 0.04000 0.36000 16 WELLNESS LLC SCREENING & 17 NUCLEAR MEDICINE 18 DIAGNOSTIC TESTING 19 TO RESIDENTS OF 20 ACADIA PARISH AND 21 SURROUNDING AREA 1 1 AMERICAN LEGION HOSPITAL 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 WWW.ALH.ORG X X X INCLUDES OFFSITE PSYCHIATRIC CAMPUS AMERICAN LEGION HOSPITAL 1 0 0 1 X X X X X X X X 13 1 0 0 1 X WWW.ALH.ORG 0 0 1 X 100.000000000000 200.000000000000 X 1 1 1 X X 1 0 X 1 X 0 0 AMERICAN LEGION HOSPITAL PART V, SECTION B, LINE 11: AMERICAN LEGION HOSPITAL CEASED OPERATIONS OF ITS HOSPITAL ON MAY 31, 2014. ACADIA GENERAL HOSPITAL TOOK OVER THE MANAGEMENT AND OPERATIONS OF THE HOSPITAL ON JUNE 1, 2014. AMERICAN LEGION HOSPITAL PART V, SECTION B, LINE 16I: THE HOSPITAL INCLUDES ON ALL INVOICE STATEMENTS A MESSAGE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. IT INFORMS PATIENTS TO CONTACT A CUSTOMER SERVICE REPRESENTATIVE TO REQUEST AN APPLICATION. AMERICAN LEGION HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL NOTIFIES PATIENTS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION AND IN COMMUNICATIONS WITH PATIENTS REGARDING THE PATIENTS' BILLS. THIS IS DONE BEFORE MAKING ANY REASONABLE COLLECTION EFFORTS. 3 OPEN AIR MRI OF ACADIANA LLC 1305 CROWLEY-RAYNE HWY SUITE A CROWLEY LA 70526 PROVIDES OPEN AIR MRI SERVICES ADVANCED CARDIOLOGY CENTER LLC 1113 EAST NORTHERN AVENUE SUITE B CROWLEY LA 70526 PROVIDES CARDIAC SCREENING SERVICES CROWLEY CARDIAC WELLNESS LLC 1113 EAST NORTHERN AVENUE SUITE B CROWLEY LA 70526 PROVIDES CARDIAC SCREENING SERVICES & NUCLEAR MEDICINE DIAGNOSTIC TESTING PART I, LINE 7: PERCENT OF TOTAL COMMUNITY BENEFIT EXPENSE TO TOTAL EXPENSE IS 9.0%. THE HOSPITAL USED TOTAL COMMUNITY BENEFIT EXPENSE (1,434,496) OVER TOTAL EXPENSES FROM PART IX ($16,606,455) TO COMPUTE THIS PERCENTAGE. SCHEDULE H: DISCOUNTIUANCE OF OPERATIONS AMERICAN LEGION HOSPITAL ("ALH") ENTERED INTO A SPECIAL SERVICES LEASE AGREEMENT WITH ACADIA GENERAL HOSPITAL, INC. ("AGH") A LOUISIANA NON-PROFIT CORPORATION, WHICH IS A WHOLLY OWNED SUBSIDIARY OF LAFAYETTE GENERAL HEALTH SYSTEM, INC. ("LGH") A LOUISIANA NONPROFIT CORPORATION. AGH SEAMLESSLY CONTINUED THE MISSION OF ALH BY ASSUMING THE MANAGEMENT AND OPERATIONS OF ALH'S HOSPITAL ON JUNE 1, 2014. THIS MADE THE HOSPITAL PART OF LGH'S REGIONAL NETWORK OF FACILITIES.AGH'S ROLE IN THIS AGREEMENT IS TO PROVIDE HIGH QUALITY MEDICAL SERVICES USING THE EXPANDED RESOURCES, TECHNOLOGY, PURCHASING POWER AND CLINICAL PROTOCOL ALIGNMENT OF LGH. THE INTENT OF THIS ARRANGEMENT WAS TO PROVIDE FINANCIAL STABILITY AND LONG-TERM VIABILITY OF THE HOSPITAL FOR THE BENEFIT OF THE RESIDENTS OF THE CITY OF CROWLEY AND ACADIA PARISH. THIS WOULD ENABLE BETTER CARE TO BE DELIVERED EFFICIENTLY AND COST-EFFECTIVELY, AND IT WOULD ENSURE CONTINUED OPERATIONS AND ACCESS TO HOSPITAL AND EMERGENCY CARE.ALH LEASED TO AGH THE HOSPITAL BUILDINGS AND FIXTURES. THE LEASE INCLUDED ALL THE MOVABLE PROPERTY, SUCH AS EQUIPMENT, MACHINERY, COMPUTERS AND SOFTWARE EQUIPMENT. IT ALSO INCLUDED ALL INVENTORY, SUPPLIES, AND PHARMACEUTICALS. THE INITIAL TERM OF THE LEASE WILL BE TEN YEARS WITH FOUR OPPORTUNITIES TO RENEW THE LEASE FOR FIVE YEAR PERIODS. AT THE TERMINATION OF THE LEASE THE MOVABLE PROPERTY WILL REVERT TO ALH.AS PART OF THIS LEASE AGREEMENT ALH ASSIGNED TO AGH ITS CONTRACTS, LEASES, PERMITS, AND LICENSES SO THAT AGH COULD OPERATE THE FACILITY. ALH ALSO ASSIGNED TO AGH ITS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED IN ORDER TO FACILITATE THE COLLECTION OF THE BILLS. AGH ALSO ASSUMED THE ACCOUNTS PAYABLE FOR MATERIALS, SERVICES, AND SUPPLIES. THERE IS NO ISSUE WITH PRIVATE INUREMENT SINCE AGH IS A NONPROFIT HOSPITAL CONTINUING THE SAME MISSION. PART II, COMMUNITY BUILDING ACTIVITIES: LINE 8 COMMUNITY BUILDING ACTIVITIES: OUR AREA FALLS INTO THE HEALTHCARE PHYSICIAN SHORTAGE AREA (HPSA); AS A RESULT, OUR HOSPITAL HAS TO RECRUIT PHYSICIANS TO OUR AREA TO ENSURE A FULL ARRAY OF PHYSICIAN SERVICES IS AVAILABLE FOR THE RESIDENTS OF OUR PARISH AND SURROUNDING AREAS. PHYSICIAN RECRUITMENT IN THE CURRENT YEAR AMOUNTED TO $98,606. WE ALSO OFFERED AN ONGOING INCENTIVE FOR OUR CURRENT NURSING STAFF FOR REIMBURSEMENT OF STUDENT LOANS; THIS INCENTIVE WAS MADE TO COMPETE WITH OTHER HOSPITALS IN THE AREA. PART III, LINE 2 AND 3:THE HOSPITAL USED THE SAME COSTING METHODOLOGY USED AND RECOMMENDED IN THE IRS WORKSHEET 2 FOR SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, FOR PART III, LINES 2 AND 3. FOR LINE 3, THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION. APPROXIMATELY SIXTY-NINE PERCENT OF OUR BAD DEBTS WERE UNINSURED. THUS, THE HOSPITAL ASSUMED THAT FIFTY PERCENT OF THOSE WOULD PROBABLY QUALIFY FOR CHARITY BUT FAILED TO PROVIDE THE APPROPRIATE DOCUMENTATION. FOR THE OTHER THIRTY-ONE PERCENT OF OUR BAD DEBT POPULATION IT WAS ASSUMED THAT A FOURTH OF THOSE WOULD QUALIFY BUT DID NOT PRESENT THE APPROPRIATE DOCUMENTATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 4: FOOTNOTE IN FINANCIAL STATEMENTS FOR BAD DEBTS FROM NOTE 1 OF NOTES TO CONSOLIDATED FINANCIAL STATEMENTS:PATIENT ACCOUNTS RECEIVABLES ARE CARRIED AT THE ORIGINAL BILLED AMOUNT LESS DEDUCTIONS FOR CONTRACTUALS AND OTHER DISCOUNTS AS WELL AS AN ESTIMATE FOR UNCOLLECTIBLE ACCOUNTS BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLES ARE WRITTEN-OFF WHEN DEEMED UNCOLLECTIBLE WHICH OCCURS AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLES PREVIOUSLY WRITTEN-OFF ARE RECORDED WHEN RECEIVED. THE HOSPITAL DOES NOT HAVE A POLICY OF CHARGING INTEREST ON PAST DUE BALANCES IN PATIENT ACCOUNTS RECEIVABLE.FROM NOTE 2 OF NOTES TO CONSOLIDATED FINANCIAL STATEMENTS.ACCOUNTS RECEIVABLE ARE ALSO REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN DISCOUNTED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS TOTALED $14,000 AND $2,686,000 AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 62% AND 47% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2014 AND 2013. OVERALL, THE TOTAL OF SELF-PAY DISCOUNTS AND WRITE-OFFS HAS NOT CHANGED SIGNIFICANTLY FOR THE YEAR ENDED DECEMBER 31, 2014. THE HOSPITAL HAS NOT EXPERIENCED SIGNIFICANT CHANGE IN WRITE-OFF TRENDS EVEN THOUGH THE HOSPITAL HAS CHANGED ITS CHARITY CARE POLICY EFFECTIVE FOR 2011 TO COMPLY WITH THE AFFORDABLE CARE ACT AND INTERNAL REVENUE CODE SECTION 501(R)(5) WHICH LIMITS THE AMOUNTS CHARGED TO THOSE WHO QUALIFY FOR FINANCIAL ASSISTANCE TO THE BEST INSURANCE RATE OR MEDICARE RATE FOR SERVICE. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 IS THE STANDARD MEDICARE COST REPORT COSTING SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITAL'S FILED 2014 COST REPORT FOR THE PERIOD ENDING 5/31/2014; THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE AMOUNTS REPORTED INCLUDE THOSE RELATED TO MEDICARE PART A INPATIENT SERVICES (BOTH ACUTE AND PSYCHIATRIC) AND MEDICARE PART B HOSPITAL-RELATED OUTPATIENT SERVICES; IT EXCLUDES THE MEDICARE HOSPITAL OUTPATIENT LABORATORY CHARGES WHICH WERE REIMBURSED ON A FEE SCHEDULE AND, THUS, NOT REQUIRED TO BE REPORTED ON THE COST REPORT. ADDITIONALLY, THESE AMOUNTS EXCLUDE THE REIMBURSEMENT AND COSTS ASSOCIATED WITH OUR ANESTHESIA HOSPITAL BASED PRACTICE AS WELL AS OUR PHYSICIAN OFFICE. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY ADDRESSES THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. OUR HOSPITAL PRACTICE INCLUDES SENDING STATEMENTS WITH GRADUATED MESSAGES TO PATIENTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT; AT THIS TIME, THEY ARE INFORMED OF THE FINANCIAL ASSISTANCE PRACTICE AND ARE ENCOURAGED TO CONTACT THE HOSPITAL IF THEY FEEL THAT THEY WOULD QUALIFY. AT ANY TIME, ANY PATIENT MAY REQUEST A CHARITY CARE APPLICATION FORM. PART VI, LINE 2: NEEDS ASSESSMENTAMERICAN LEGION HOSPITAL (ALH) IS THE ONLY ACUTE CARE HOSPITAL IN ACADIA PARISH AND THE SURROUNDING AREA, AND IT MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE COMMUNITY, AND THEY ARE AWARE OF THE HEALTH NEEDS IN THE COMMUNITY. FOR THESE NEEDS IDENTIFIED BY THE BOARD AND MEDICAL STAFF, ALH USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE HOSPITAL COMPLIES WITH FEDERAL REQUIREMENTS OF NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS, SUCH AS MEDICARE. IN THE ADMISSIONS PROCESS, THE HOSPITAL MAKES AVAILABLE SCREENING SERVICES ONSITE TO HELP INPATIENTS WHO QUALIFY FOR MEDICARE AND/OR MEDICAID ASSISTANCE APPLY FOR BENEFITS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN THE HANDBOOK PROVIDED TO PATIENTS UPON ADMISSION. ADDITIONALLY, UPON ORIGINAL BILL FOR SERVICES, ALL PATIENTS WITHOUT INSURANCE ARE REMINDED OF THE CHARITY DISCOUNT WITH INFORMATION ON HOW TO APPLY. A PROMPT PAY DISCOUNT IS OFFERED TO ALL PATIENTS WITHOUT INSURANCE. PART VI, LINE 4: COMMUNITY INFORMATIONTHE HOSPITAL SERVES THE RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. AS THE ONLY ACUTE HOSPITAL IN THE PARISH, THE HOSPITAL PROVIDES HEALTHCARE SERVICES TWENTY-FOUR HOURS A DAY. THE HOSPITAL STRIVES TO MAINTAIN A WELL CONDITIONED PLANT AND MODERN TECHNOLOGY TO BETTER SERVE THE CITIZENS OF OUR COMMUNITY; ADDITIONALLY, THE HOSPITAL STRIVES TO MAINTAIN A KNOWLEDGEABLE AND FRIENDLY STAFF TO PROVIDE PATIENT CARE TO THE RESIDENTS IN THE SURROUNDING AREA. ACADIA PARISH COVERS 655.12 SQUARE MILES IN SOUTHWEST LOUISIANA. THE ESTIMATED POPULATION FOR 2013 WAS AROUND 62,204 RESIDENTS. ACADIA PARISH'S POPULATION CONSISTS OF 13.2% OF PERSONS WHO ARE SIXTY-FIVE OR OLDER (SLIGHTLY LESS THAN THE STATE'S OVERALL PERCENTAGE OF 13.3%).ACCORDING TO THE 2008-2012 AMERICAN COMMUNITY SURVEY OF THE U.S. CENSUS BUREAU, THE MEDIAN HOUSEHOLD INCOME FOR ACADIA PARISH WAS $38,686. HOWEVER, FOR LOUISIANA IT WAS $44,673 AND FOR THE U.S. IT WAS $53,046. THIS SURVEY ALSO SHOWS THE PERCENT OF PEOPLE LIVING BELOW THE POVERTY LEVEL DURING 2009-2011 IN ACADIA PARISH TO BE 21.2%. HOWEVER, DURING 2008-2012 IN LOUISIANA IT WAS 18.7%, AND IN THE U.S. IT WAS 14.9%. THUS, ACADIA PARISH'S POPULATION IS POORER THAN THE REST OF LOUISIANA AND THE NATION. PART VI, LINE 5: THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL PROVIDES CARE FOR ALL PERSONS IN THE COMMUNITY OTHERWISE ABLE TO PAY THE COST MEDICAL SERVICES EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE LOCAL COMMUNITY AND USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. ADDITIONALLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF.BY MAINTAINING AN OPEN MEDICAL STAFF, THE HOSPITAL CAN OFFER A VARIETY OF SPECIALISTS TO AN OTHERWISE RURAL PARISH, THEREBY INCREASING AVAILABLE RESOURCES FOR THE BEST PATIENT CARE. THE HOSPITAL ALSO MAINTAINS A BOARD OF DIRECTORS COMPRISED OF MEMBERS FROM THE COMMUNITY; BY INCORPORATING MEMBERS OF THE COMMUNITY, THE BOARD CAN ENSURE THE LONG-TERM VIABILITY OF THE HOSPITAL TO BE ABLE TO CONTINUE TO SERVE THE COMMUNITY FOR GENERATIONS TO COME. THE HOSPITAL DILIGENTLY STRIVES TO MAINTAIN A SURPLUS OF REVENUE OVER EXPENSES TO CONTINUE TO UPDATE THE HOSPITAL'S PLANT AND EQUIPMENT WITH THE RAPID CHANGING TECHNOLOGY IN TODAY'S MEDICAL WORLD TO BETTER MEET THE CHANGING NEEDS OF OUR COMMUNITY. THE HOSPITAL IS THE SECOND LARGEST EMPLOYER IN THE PARISH, SECOND TO ONLY THE LOCAL SCHOOL BOARD. THE HOSPITAL IS A LARGE GENERATOR OF SALES TAX TO THE PARISH AS WELL. THE HOSPITAL CONTRIBUTED ALMOST $2,400,000 TO THE LOCAL ECONOMY IN ANNUAL EXPENDITURES, EXCLUDING PAYROLL. AS A RESULT, THE HOSPITAL'S PRESENCE SERVES AS A LARGE ECONOMIC FORCE IN OUR LOCAL COMMUNITY; TO ENSURE THAT WE CAN CONTINUE TO SERVE THE RESIDENTS OF OUR COMMUNITY, WE MUST CONTINUE TO MONITOR THE CURRENT CONDITIONS OF OUR WORKFORCE AND THE AVAILABILITY OF PHYSICIANS IN OUR AREA. THE HOSPITAL RECRUITS PHYSICIANS, INCLUDING SPECIALISTS, TO OUR AREA TO ENSURE THAT WE CAN CONTINUE TO BE THE HEALTHCARE PROVIDER OF THE FUTURE AS WELL. THE HOSPITAL ALSO JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS AND COMPANIES TO PROVIDE HEALTHCARE SCREENINGS AT LOCAL EVENTS AS WELL AS PROVIDE INFORMATION TO PROMOTE A HEALTHIER, SAFER COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE HOSPITAL IS NOT AFFILIATED WITH ANY OTHER HEALTH CARE SYSTEM.PART VI LINE 7 COMMUNITY BENEFIT REPORTCURRENTLY, LOUISIANA DOES NOT REQUIRE THE HOSPITAL TO ISSUE A COMMUNITY BENEFIT REPORT; HOWEVER, THE LOCAL NEWSPAPER DOES ON OCCASION RUN AN ARTICLE ON THE HOSPITAL WHERE THE HOSPITAL DOES MAKE THE PUBLIC AWARE OF THE HUGE ECONOMIC IMPACT IT HAS ON THE LOCAL ECONOMY, BOTH AS AN EMPLOYER AS WELL AS A PURCHASER OF SUPPLIES WHICH GENERATES SALES TAXES FOR THE LOCAL ECONOMY. X X X 0 0 0 0 0 1 0 1 0 TERRY OSBORNE CEO 285023 0 0 0 8529 0 0 0 5485 0 299037 0 0 0 PART I, LINE 3 THE PROCESS FOR DETERMINING COMPENSATION OF THE HOSPITAL'S CEO IS BASED ON SURVEY DATA OF HOSPITALS SIMILAR TO AMERICAN LEGION HOSPITAL IN RESPECT TO REVENUES, BEDS, REGION AND FTES. ALL CONTRACTUAL CHANGES, INCLUDING INCREASES IN SALARY OF THE HOSPITAL'S CEO, ARE REVIEWED BY THE HOSPITAL'S AUDIT AND OVERSIGHT COMMITTEE. A RECOMMENDATION IS MADE FROM THE AUDIT AND OVERSIGHT COMMITTEE TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY. THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE ALSO EVALUATES THE CEO'S PERFORMANCE ANNUALLY. PART I, LINE 6 THE HOSPITAL EMPLOYED ONE PHYSICIAN; THE CONTRACT STATES THAT HIS COMPENSATION SHALL CONSIST OF THE NET RECEIPTS OF HIS OFFICE PRACTICE LESS EXPENSES ASSOCIATED WITH RUNNING SUCH PRACTICE, INCLUDING PRACTICE-RELATED BAD DEBTS. THUS, HIS BASE COMPENSATION EQUALS HIS PRACTICE'S NET EARNINGS. HIS COMPENSATION IS NOT BASED ON ANY EARNINGS OF THE HOSPITAL AS A WHOLE. MICHAEL MCBRIDE SEE PART V 0 SEE PART V 0 0 0 STEPHEN STEFANSKI SEE PART V 38100 SEE PART V;LISTTOTAL 0 0 0 P DALE LELEUX JR MD SEE PART V SEE PART V;LISTTOTAL 0 0 FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS (A) NAME OF PERSON: STEPHEN STEFANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND FATHER OF INSURANCE AGENT, STEPHEN STEFANSKI, JR., OF LOCAL INSURANCE COMPANY.(C) AMOUNT OF TRANSACTION: $0(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL PAID $312,517 FOR WORKERS COMPENSATION INSURANCE AND $89,026 FOR PROPERTY INSURANCE. THE COST OF THE INSURANCE POLICIES WAS THE LOWEST PROPOSAL RECEIVED FROM THE VARIOUS INSURANCE COMPANIES; THE BOARD DECIDED ON THESE PARTICULAR POLICIES. THE BOARD MEMBER AT ISSUE (FATHER) HAS REFRAINED FROM VOTING ON ANY RELATED ISSUES. NEITHER FATHER NOR SON WAS COMPENSATED BY THE HOSPITAL, AND THE SON IS NOT AN OWNER OF THE LOCAL INSURANCE COMPANY. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS (A) NAME OF PERSON: STEPHEN STEFANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND FATHER OF PARTIAL OWNER OF SECURITY COMPANY, BRETT STEFANSKI(C) AMOUNT OF TRANSACTION: $38,100(D) DESCRIPTION OF TRANSACTION: DURING 2014, THE HOSPITAL PAID $38,100 TO A LOCAL SECURITY COMPANY OF WHICH IS PARTIALLY OWNED BY THE BOARD MEMBER'S SON. THE HOSPITAL HAS USED THE PARTICULAR SECURITY COMPANY FOR YEARS PRIOR TO HIS ACQUISITION. THE BOARD MEMBER HAS NOT VOTED ON ANY RELATED MATTER FOR THE SECURITY COMPANY SINCE THE BOARD MEMBER'S SON'S ACQUISITION. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS (A) NAME OF PERSON: MICHAEL MCBRIDE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND REGIONAL PRESIDENT OF EVANGELINE BANK AND TRUST COMPANY(C) AMOUNT OF TRANSACTION : $0(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE BANKING AND INVESTMENT MANAGEMENT SERVICES PROVIDED BY EVANGELINE BANK. IN 2014, THE HOSPITAL ALSO HAD AN OUTSTANDING LOAN FROM THIS PARTICULAR FINANCIAL INSTITUTION. MR. MCBRIDE IS NOT COMPENSATED BY AMERICAN LEGION HOSPITAL. THIS ARRANGEMENT WAS REVIEWED AND APPROVED BY THE BOARD OF AMERICAN LEGION HOSPITAL. THE SERVICES PROVIDED BY EVANGELINE BANK ARE COMPARABLE TO SERVICES AVAILABLE AT OTHER LOCAL FINANCIAL INSTITUTIONS. THE BOARD MEMBER REFRAINS FROM VOTING ON ANY RELATED BANKING ISSUES. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS (A) NAME OF PERSON: P. DALE LELEUX, JR. MD(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL AND PARTIAL OWNER OF JOINT VENTURES.(C) AMOUNT OF TRANSACTION: $0(D) DESCRIPTION OF TRANSACTION: IN 2011, THE HOSPITAL FORMED A 100% OWNED SUBSIDIARY NAMED ALH HEALTH VENTURES, LLC. IN 2011, THE PHYSICIAN/BOARD MEMBER BECAME A PARTIAL OWNER OF LOUISIANA CARDIAC WELLNESS, LLC. BOTH OF THESE ENTITIES ARE MEMBERS OF CROWLEY CARDIAC WELLNESS, LLC. IN 2013, ALH HEALTH VENTURES, LLC AND LOUISIANA CARDIAC WELLNESS ALONG WITH ANOTHER PARTY FORMED ACADIANA CARDIOLOGY CENTER, LLC. THE BOARD MEMBER ABSTAINS FROM VOTING ON ANY RELATED MATTERS. MANAGEMENT AND PROFIT/ LOSS SHARING PERCENTAGES FOLLOW THE POLICIES AND PROCEDURES OUTLINED IN THE OPERATING AGREEMENT. FORM 990, PART III, LINE 3 AMERICAN LEGION HOSPITAL ("ALH") ENTERED INTO A SPECIAL SERVICES LEASE AGREEMENT WITH ACADIA GENERAL HOSPITAL, INC. ("AGH") A LOUISIANA NON-PROFIT CORPORATION, WHICH IS A WHOLLY OWNED SUBSIDIARY OF LAFAYETTE GENERAL HEALTH SYSTEM, INC. ("LGH") A LOUISIANA NONPROFIT CORPORATION. AGH WILL CONTINUE THE MISSION OF ALH BY ASSUMING THE MANAGEMENT AND OPERATIONS OF ALH'S HOSPITAL ON JUNE 1, 2014. AS OF MAY 31, 2014 ALH CEASED THE PROGRAM SERVICES LISTED ON LINES 4A AND 4B. AGH'S ROLE IN THIS AGREEMENT IS TO BE THE PROVIDER OF HIGH QUALITY MEDICAL SERVICES USING THE EXPANDED RESOURCES, TECHNOLOGY, PURCHASING POWER AND CLINICAL PROTOCOL ALIGNMENT OF LGH. THE INTENT OF THIS ARRANGEMENT WAS TO PROVIDE FINANCIAL STABILITY AND LONG-TERM VIABILITY OF THE HOSPITAL FOR THE BENEFIT OF THE RESIDENTS OF THE CITY OF CROWLEY AND ACADIA PARISH. THIS WILL ENABLE BETTER CARE TO BE DELIVERED EFFICIENTLY AND COST-EFFECTIVELY, AND IT WILL ENSURE CONTINUED OPERATIONS AND ACCESS TO HOSPITAL AND EMERGENCY CARE. ALH LEASED TO AGH THE HOSPITAL BUILDINGS AND FIXTURES. THE LEASE INCLUDED ALL THE MOVABLE PROPERTY, SUCH AS EQUIPMENT, MACHINERY, COMPUTERS AND SOFTWARE EQUIPMENT. IT ALSO INCLUDED ALL INVENTORY, SUPPLIES, AND PHARMACEUTICALS. THE INITIAL TERM OF THE LEASE WILL BE TEN YEARS WITH FOUR OPPORTUNITIES TO RENEW THE LEASE FOR FIVE YEAR PERIODS. AT THE TERMINATION OF THE LEASE THE MOVABLE PROPERTY WILL REVERT TO ALH. AS PART OF THIS LEASE AGREEMENT ALH ASSIGNED TO AGH ITS CONTRACTS, LEASES, PERMITS, AND LICENSES SO THAT AGH COULD OPERATE THE FACILITY. ALH ALSO ASSIGNED TO AGH ITS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED IN ORDER TO FACILITATE THE COLLECTION OF THE BILLS. AGH ALSO ASSUMED THE ACCOUNTS PAYABLE FOR MATERIALS, SERVICES, AND SUPPLIES. THERE IS NO ISSUE WITH PRIVATE INUREMENT SINCE AGH IS A NONPROFIT HOSPITAL CONTINUING THE SAME MISSION. FORM 990, PART VI, SECTION A, LINE 6 AMERICAN LEGION HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION. MEMBERS OF THE AMERICAN LEGION POST # 15 ARE AUTOMATICALLY MEMBERS OF THE AMERICAN LEGION HOSPITAL CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE AMERICAN LEGION HOSPITAL CORPORATION ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 THE FULL COPY WAS PRESENTED TO THE BOARD OF DIRECTORS. THE FORM AND ITS CONTENTS WERE DISCUSSED WITH THE BOARD BY THE HOSPITAL'S CEO BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE TRANSACTIONS ARE ALL ENTERED INTO AT FAIR MARKET VALUE WITH THE CORRESPONDING BOARD MEMBERS ABSTAINING FROM VOTING ON ITEMS FOR WHICH A CONFLICT OF INTEREST EXISTS. THE HOSPITAL'S ADMINISTRATION REVIEWS ALL TRANSACTIONS TO EVALUATE WHETHER CONFLICTS OF INTEREST EXIST AND TAKES APPROPRIATE ACTION WHEN NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE HOSPITAL'S CEO IS BASED ON SURVEY DATA OF HOSPITALS SIMILAR TO AMERICAN LEGION HOSPITAL IN RESPECT TO REVENUES, BEDS, REGION AND FTES. ALL CONTRACTUAL CHANGES, INCLUDING INCREASES IN SALARY OF THE HOSPITAL'S CEO, ARE REVIEWED BY THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE. A RECOMMENDATION IS MADE FROM THE AUDIT & OVERSIGHT COMMITTEE TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY. THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE ALSO EVALUATES THE CEO'S PERFORMANCE ANNUALLY. LINE 15B: THE PROCESS FOR DETERMINING COMPENSATION OF THE HOSPITAL'S CFO IS BASED ON SURVEY DATA OF HOSPITALS SIMILAR TO AMERICAN LEGION HOSPITAL IN RESPECT TO REVENUES, BEDS, REGION AND FTES. ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY OF THE HOSPITAL'S CFO, ARE INITIATED BY THE CEO AND REVIEWED BY THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE. A RECOMMENDATION IS MADE FROM THE AUDIT & OVERSIGHT COMMITTEE TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY. THE HOSPITAL'S CEO ALSO EVALUATES THE CFO'S PERFORMANCE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO ANYONE WHO REQUESTS SUCH WITHIN THE TERMS OF THE LAW. FORM 990, PART IX, LINE 11G: THIS LINE INCLUDES ALL OTHER CONTRACT SERVICES AS DESCRIBED BELOW: PHYSICIANS AND OTHER ALLIED HEALTH CARE PROVIDERS----1,202,979 MEDICAL SERVICES (PATIENT CARE)---67,609 OTHER SERVICES---173,862 TOTAL---1,444,450 ALH HEALTH VENTURES LLC 1113 EAST NORTHERN AVENUE CROWLEY LA 70526 352409152 PROV CARDIAC HLTH SCREENS LA -50351 23295 ALH OPEN AIR MRI OF ACADIANA LLC PO BOX 2207 LAKE CHARLES LA 706022207 721510626 OPEN AIR MRI SERVICES LA AMERICAN LEGION HOSPITAL RELATED HEALTHCARE 81358 107725 0 0 0.51000 PROFESSIONAL ARTS CENTER INC PO BOX 852 CROWLEY LA 705270852 720701822 RENTAL OF MEDICAL OFFICES LA N/A C 31495 98979 0.67000 1 CROWLEY PROFESSIONAL MED CORP 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 721142948 MAINTAIN MEDICAL OFFICE SPACE LA N/A C 4830 21401 0.48300 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 OPEN AIR MRI OF ACADIANA LLC A 13500 CASH OPEN AIR MRI OF ACADIANA LLC F 16406 CASH FORM 990, SCHEDULE R, PART V, LINE 1A: THE RENTAL TO OPEN AIR MRI OF ACADIANA, LLC IS SUBSTANTIALLY RELATED TO AMERICAN LEGION HOSPITAL'S EXEMPT PURPOSE OF PROVIDING MEDICAL CARE. AMERICAN LEGION HOSPITAL DOES NOT HAVE ANY UNRELATED TRADE OR BUSINESS INCOME TO REPORT ON FORM 990-T.