STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC (EIN 72-0551963)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-06
IRS object ID
201333109349301808
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-06T14:50:04-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN721202445EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1POSTLETHWAITE & NETTERVILLEBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18550 UNITED PLAZA BLVD SUITE 1001AddressLine1
CityBATON ROUGECity
StateLAState
ZIP Code70809ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN720551963EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONBusinessNameLine1
Business Name Line2D/B/A LAKE CHARLES MEMORIAL HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone3374943202Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11701 OAK PARK BOULEVARDAddressLine1
CityLAKE CHARLESCity
StateLAState
ZIP Code70601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLARRY GRAHAMName
TitlePRESIDENT AND CEOTitle
Phone3374943204Phone
Date Signed2013-11-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGAIL H PITTMANName
PTINP01429086PTIN
Phone2259224600Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLARRY GRAHAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11701 OAK PARK BOULEVARDAddressLine1
CityLAKE CHARLESCity
StateLAState
ZIP Code70601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts219692693GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LCMH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1952YearFormation
State Legal DomicileLAStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTHCARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2241TotalNbrEmployees
Total Nbr Volunteers60TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year310377ContributionsGrantsPriorYear
Contributions Grants Current Year218807ContributionsGrantsCurrentYear
Program Service Revenue Prior Year206200722ProgramServiceRevenuePriorYear
Program Service Revenue CY217788512ProgramServiceRevenueCY
Investment Income Prior Year585096InvestmentIncomePriorYear
Investment Income Current Year468351InvestmentIncomeCurrentYear
Other Revenue Prior Year1107658OtherRevenuePriorYear
Other Revenue Current Year1201947OtherRevenueCurrentYear
Total Revenue Prior Year208203853TotalRevenuePriorYear
Total Revenue Current Year219677617TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year15000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY35000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year78988111SalariesEtcPriorYear
Salaries Etc Current Year87652049SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1634369TotalFundrsngExpCurrentYear
Other Expense Prior Year112841727OtherExpensePriorYear
Other Expenses Current Year110942088OtherExpensesCurrentYear
Total Expenses Prior Year191844838TotalExpensesPriorYear
Total Expenses Current Year198629137TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16359015RevenuesLessExpensesPriorYear
Revenues Less Expenses CY21048480RevenuesLessExpensesCY
Total Assets BOY202568931TotalAssetsBOY
Total Assets EOY186931118TotalAssetsEOY
Total Liabilities BOY122421634TotalLiabilitiesBOY
Total Liabilities EOY118337597TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY80147297NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY68593521NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF LAKE CHARLES MEMORIAL HOSPITAL IS TO IDENTIFY AND IMPROVE THE HEALTH OF THE PEOPLE OF SOUTH LOUISIANA AND EAST TEXAS BY PROVIDING A FULL SPECTRUM OF INNOVATIVE SERVICES-INCLUDING HEALTH EDUCATION, DISEASE PREVENTION, AND DIAGNOSTIC AND TREATMENT OPTIONS-IN A PERSONALIZED, CARING AND SAFE MANNER THROUGHOUT THE REGION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5485817Expense
Revenue2044265Revenue
DescriptionLAKE CHARLES MEMORIAL HOSPITAL2012 COMMUNITY BENEFITS SUMMARYI. INTRODUCTIONAS A COMMUNITY-BASED HOSPITAL, IT IS LAKE CHARLES MEMORIAL HOSPITAL'S MISSION TO HELP IMPROVE THE HEALTH AND WELLNESS OF THE SOUTHWEST LOUISIANA COMMUNITY. WHILE IT IS OUR LEGAL RESPONSIBILITY TO PROVIDE MEDICAL CARE TO ANYONE IN NEED REGARDLESS OF HIS OR HER ABILITY TO PAY, MEMORIAL ALSO PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY SERVICE PROGRAMS, INCLUDING EDUCATIONAL PROGRAMS AND HEALTH SCREENINGS, FREE OF CHARGE OR AT A GREATLY REDUCED COST TO THE CONSUMER.II. CHARITY CAREMEMORIAL PROVIDES MEDICAL CARE TO MEDICAID RECIPIENTS REGARDLESS OF THEIR ABILITY TO PAY, AND REGARDLESS OF MEDICAID REIMBURSEMENT. IN 2012, MEMORIAL HOSPITAL PROVIDED $12,978,482 IN UN-REIMBURSED MEDICAID COSTS AND $4,473,830 IN CHARITY CARE COSTS. COMMUNITY BENEFIT-$17,452,311SPORTS MEDICINETHE SPORTS MEDICINE ALLIANCE PROVIDED $403,601 IN PRE-PARTICIPATION PHYSICALS FOR AREA ATHLETES, ATHLETIC ASSESSMENTS, LECTURES, IN-SERVICES, WORKSHOPS, SPORTS CAMPS AND CLINICS, STUDENT TRAINER SCHOLARSHIPS, ATHLETIC TRAINER COVERAGE AT AREA SPORTING EVENTS, SPECIAL EVENTS AND MORE FREE OF CHARGE OR FOR A MINIMAL FEE TO THE PARTICIPANTS. COMMUNITY BENEFIT:$403,601III. HEALTH PROFESSIONALS EDUCATIONLAKE CHARLES MEMORIAL INVESTS IN MEDICAL EDUCATION IN AN EFFORT OF PROVIDE THE AREA WITH QUALIFIED PROFESSIONALS. IN 2012, LCMH SPENT $3,037,952 FOR THE LOUISIANA STATE UNIVERSITY HEALTH SERVICES CENTER-FAMILY PRACTICE RESIDENCY PROGRAM.COMMUNITY BENEFIT:$3,037,952CHARITABLE DONATIONSLCMH MAKES NUMEROUS MONETARY DONATIONS TO A VARIETY OF NON-PROFIT AGENCIES.COMMUNITY BENEFIT:$51,365COMMUNITY EVENTS AND SEMINARSEACH YEAR, LCMH PROVIDES FREE HEALTH SCREENINGS, EDUCATIONAL SEMINARS AND INFORMATIONAL BOOTHS AT A VARIETY OF COMMUNITY EVENTS. THE HOSPITAL ALSO PROVIDES FREE SPEAKERS TO CIVIC GROUPS AND OTHER ORGANIZATIONS. THIS COMMITMENT TO HEALTH AND WELLNESS EDUCATION TAKES MEMORIAL PROFESSIONALS INTO THE FIVE PARISH AREA TO STAFF INDUSTRIAL, CORPORATE AND SCHOOL HEALTH FAIRS. THE HOSPITAL CONTRIBUTED $54,151 IN SPECIAL EVENTS AND SEMINARS.COMMUNITY BENEFIT:$54,151MEMORIAL'S TOTAL 2012 NET COMMUNITY CONTRIBUTIONS - $20,999,380Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense36683158Expense
Revenue22672400Revenue
DescriptionTHE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUT- PATIENT SERVICES THROUGH A 29-BED LONG-TERM ACCUTE CARE FACILITY, A 339-BED ACUTE CARE FACILITY AND SATELLITE LOCATIONS. THE SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES WITHOUT CHARGE OR AT REDUCED RATES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense138962102Expense
Grants35000Grants
Revenue194019708Revenue
DescriptionTHE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES THROUGH A 29-BED LONG-TERM ACUTE CARE FACILITY, A 339-BED ACUTE CARE FACILITY AND SATELLITE LOCATIONS.Description
FieldValueIRS element (for citing)
Total Program Service Expense181131077TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096295NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2241NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Other WebsiteXOtherWebsite

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHARLES WHITSON CHIEF FINANCIAL OFBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3374943202TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11701 OAK PARK BLVDAddressLine1
CityLAKE CHARLESCity
StateLAState
ZIP Code706018911ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
CHRISTOPHER THOMPSON
PHYSICIAN / MEDICAL STAFF PRES40.00X85519207500
GLENN PUMPELLY
IMMED PAST CHAIRMAN1.00X000X
ULYSSES GENE THIBODEAUX
CHAIRMAN1.00X000X
LOUIS M TODD SR
ACTIVE TRUSTEE1.00X000
DAVID WALLACE MD
ACTIVE TRUSTEE1.00X000
CHARLES WHITSON CPA
SR.VICE PRESIDENT OF FINAN40.00X283618027116X
LARRY GRAHAM
PRESIDENT/CEO & ASST SECRE40.00X675177019212X
DENISE EMERSON RAU
CHAIRMAN-ELECT/VICE CHAIR/SEC1.00X000X
THOMAS SHEARMAN
ACTIVE TRUSTEE1.00X000
BRIAN CLEMENTS MD
MEDICAL STAFF PAST PRESIDENT40.00X428249027116
JOE MILLER
ACTIVE TRUSTEE1.00X000
GERALD W MOUTON
ACTIVE TRUSTEE40.00X269000014093
BRYAN BAROOTES MD
PHYSICIAN/MED STAFF PRESIDENT ELECT1.00X000
S MARK MCMURRY
ACTIVE TRUSTEE1.00X000
MARILYN MCSWAIN RN
SR.VICE PRESIDENT OF NURSI40.00219565019731X
DAVID B USHER
SR.VICE PRES OF BUSINESS D40.00207184021569X
TIM COFFEY
SR.VICE PRES OF OPERATIONS40.00281570015346X
DONNA SHIELDS
ASST VICE PRES NURSING40.00209061019340X
TODD DELAHOUSSAYE
SR.VICE PRES OF PHYSICIAN40.00189114013061X
KATHLEEN DEROUEN
SR.VICE PRES OF MARKETING40.00162822016098X
NATHAN COHEN
PHYSICIAN40.0091981800X
LEROY FREDERICKS
PHYSICIAN40.0089754607500X
BRETT CASCIO
PHYSICIAN40.00182997507500X
MICHAEL BROUSSARD MD
PHYSICIAN40.0089377607500X
FRANCISCO MARERRO
PHYSICIAN40.00100315407500X
MANLEY M JORDAN MD
ACTIVE TRUSTEE (FORMER)40.00429998027116X
THOMAS C STRONG MD
ACTIVE TRUSTEE (FORMER)40.00408711015548X
KEVIN MOCKLIN
ACTIVE TRUSTEE (FORMER)40.00239304020355X
WILLIAM CONDOS
PHYSICIAN (FORMER HIGHEST40.0026058304690X
WILLIAM MOSS
PHYSICIAN (FORMER HIGHEST40.00512954027116X
BEN THOMPSON
PHYSICIAN (FORMER HIGHEST40.00482911021593X
GARY KOHLER
PHYSICIAN (FORMER HIGHEST40.00454850027116X
ROBERT BROUSSARD
PHYSICIAN (FORMER HIGHEST40.00434213027116X
JAMES GAHARAN
PHYSICIAN (FORMER HIGHEST40.0083583907500X
DENNIS WALKER
PHYSICIAN (FORMER HIGHEST40.00428847025842X
GREGORY RUBINO MD
PHYSICIAN (FORMER HIGHEST40.0075000607500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org14563037TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation441674TotalOtherCompensation
Number Individuals GT100 K94NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LEWING CONSTRUCTION INC
PO BOX 5216LAKE CHARLESLA706065216CONTRUCTION/CONTRACTOR2027185
LA COMMERCIAL LAUNDRY LLC
PO BOX 503SCOTTLA705830503LAUNDRY/LINEN SERVICE1325296
INSTITUTE FOR NEUROPSYCHIATRY APMC
2829 4TH AVENUELAKE CHARLESLA70601PSYCH SERVICES1316597
EMERGENCY MEDICAL SPECIALIST APMC
PO BOX 95385NEW ORLEANSLA701959385ER/PSYCH TRIAGE SERVICES666672
COMPREHENSIVE PHARMACY SERVICE
P O BOX 116474ATLANTAGA303686474PHARMACY SERVICE649249
FieldValueIRS element (for citing)
Number Of Contractors GT100 K144NumberOfContractorsGT100K
Related Organizations112119RelatedOrganizations
Government Grants106688GovernmentGrants
Total Contributions218807TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENU900099211527448211527448
MISC. PATIENT REVENUE90009936218093621809
MEDICAID MANAGED CARE PAYMENTS90009913652751365275
CAFETERIA90009912739801273980
FieldValueIRS element (for citing)
Total Program Service Revenue217788512TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column462466TotalRevenueColumn
Exclusion$462,466ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real259971Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real259971Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column259971TotalRevenueColumn
Exclusion$259,971ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other20961Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other15076Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other5885Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column5885TotalRevenueColumn
Related Or Exempt Function Income5885RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INCOME FROM SECOND AVENUE MRI, LL621990823390823390
NET INCOME FROM GIFT SHOP4532206594065940
INCOME FROM LA PET/CT IMAGING LAK6219905264652646
FieldValueIRS element (for citing)
Total Other Revenue941976TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column219677617TotalRevenueColumn
Related Or Exempt Function Income218736373RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$722,437ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total35000Total
Program Services35000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total14563037Total
Program Services5097063ProgramServices
Management And General8446561ManagementAndGeneral
Fundraising1019413Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total51351696Total
Program Services50581421ProgramServices
Management And General770275ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1212834Total
Program Services1024487ProgramServices
Management And General169590ManagementAndGeneral
Fundraising18757Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16211856Total
Program Services13694231ProgramServices
Management And General2266899ManagementAndGeneral
Fundraising250726Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4312626Total
Program Services3642896ProgramServices
Management And General603033ManagementAndGeneral
Fundraising66697Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total774564Total
Program Services749778ProgramServices
Management And General22850ManagementAndGeneral
Fundraising1936Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total248828Total
Program Services240866ProgramServices
Management And General7340ManagementAndGeneral
Fundraising622Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2665484Total
Program Services2580188ProgramServices
Management And General78632ManagementAndGeneral
Fundraising6664Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1356906Total
Program Services1126232ProgramServices
Management And General122122ManagementAndGeneral
Fundraising108552Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total262236Total
Program Services253845ProgramServices
Management And General7080ManagementAndGeneral
Fundraising1311Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total5707938Total
Program Services5479620ProgramServices
Management And General228318ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11924089Total
Program Services11089403ProgramServices
Management And General834686ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4024986Total
Program Services3743237ProgramServices
Management And General281749ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES3924343637987646115768198109
PURCHASED SERVICES173952611683861351316043488
BAD DEBT1539218515392185
CONTRACT LABOR4316346423001986327

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7629829Total
Program Services7344347ProgramServices
Management And General267388ManagementAndGeneral
Fundraising18094Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total198629137Total
Program Services181131077ProgramServices
Management And General15863691ManagementAndGeneral
Fundraising1634369Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14230375BOY
EOY10578185EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14776693BOY
EOY14862985EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY25038213BOY
EOY24207133EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3487210BOY
EOY4156378EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2098358BOY
EOY2617752EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis265734715LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec196343512LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY73204849BOY
EOY69391203EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY54461450BOY
EOY43797209EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15271783BOY
EOY17320273EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY202568931BOY
EOY186931118EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28318913BOY
EOY27579755EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY87540000BOY
EOY84520000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4207702BOY
EOY3065397EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2355019BOY
EOY3172445EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY122421634BOY
EOY118337597EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY80147297BOY
EOY68593521EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY80147297BOY
EOY68593521EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY202568931BOY
EOY186931118EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses21048480ReconcilationRevenueExpenses
Reconcilation Other Changes-32602256ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3625824OtherCostOrOtherBasis
Book Value3625824BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis128668436OtherCostOrOtherBasis
Depreciation93685795Depreciation
Book Value34982641BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1322876OtherCostOrOtherBasis
Depreciation1322876Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis120413581OtherCostOrOtherBasis
Depreciation93801814Depreciation
Book Value26611767BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11703998OtherCostOrOtherBasis
Depreciation7533027Depreciation
Book Value4170971BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings69391203TotalOfBookValueLandBuildings

Other Securities OtherSecurities (5 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT - LA PET IMAGING176288C
INVESTMENT-CORPORATE SHARE LCCC12000C
INVESTMENTS-VHA-E82786C
INVESTMENTS-LAKE CHARLES HEALTH PLANS37500C
INVESTMENT - SWLHS, INC.43488635C
FieldValueIRS element (for citing)
Total Of Book Value Securities43797209TotalOfBookValueSecurities

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY RECEIVABLES1793229
ASSETS WHOSE USE IS LIMITED11419742
DEFERRED FINANCING COSTS1923326
OTHER RECEIVABLES2081471
OTHER ASSET-MSO102505
FieldValueIRS element (for citing)
Total Book Value Other Assets17320273TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
BOND PREMIUM$32,845
INVESTMENT-AMRI$3,139,600
FieldValueIRS element (for citing)
Total Of Amounts3172445TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE SYSTEM APPLIES THE ACCOUNTING GUIDANCE RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH SETS OUT A CONSISTENT FRAMEWORK TO DETERMINE THE APPROPRIATE LEVEL OF TAX RESERVES TO MAINTAIN FOR UNCERTAIN TAX POSITIOINS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE RECORDED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN THE RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM HAS EVALUATED ITS POSITION REGARDING THE ACCOUNTING FOR UNCERTAIN INCOME TAX POSITIONS AND DOES NOT BELIEVE THAT IT HAS ANY MATERIAL UNCERTAIN TAX POSITIONS. WITH FEW EXCEPTIONS, THE SYSTEM IS NO LONGER SUBJECT TO FEDERAL, STATE, OR LOCAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS ENDED BEFORE DECEMBER 31, 2009.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6069497TotalCommunityBenefitExpense
Direct Offsetting Revenue5037220DirectOffsettingRevenue
Net Community Benefit Expense1032277NetCommunityBenefitExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense30613662TotalCommunityBenefitExpense
Direct Offsetting Revenue17635180DirectOffsettingRevenue
Net Community Benefit Expense12978482NetCommunityBenefitExpense
Percent Of Total Expense0.06530PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense36683159TotalCommunityBenefitExpense
Direct Offsetting Revenue22672400DirectOffsettingRevenue
Net Community Benefit Expense14010759NetCommunityBenefitExpense
Percent Of Total Expense0.07050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense5078419TotalCommunityBenefitExpense
Direct Offsetting Revenue2040468DirectOffsettingRevenue
Net Community Benefit Expense3037951NetCommunityBenefitExpense
Percent Of Total Expense0.01530PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense407398TotalCommunityBenefitExpense
Direct Offsetting Revenue3797DirectOffsettingRevenue
Net Community Benefit Expense403601NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5485817TotalCommunityBenefitExpense
Direct Offsetting Revenue2044265DirectOffsettingRevenue
Net Community Benefit Expense3441552NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense42168976TotalCommunityBenefitExpense
Direct Offsetting Revenue24716665DirectOffsettingRevenue
Net Community Benefit Expense17452311NetCommunityBenefitExpense
Percent Of Total Expense0.08780PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,845,130BadDebtExpenseAmount
Amount Attributable To2907078AmountAttributableTo
Amount Reimbursed By Medicare62948280AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare90926804CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-27978524MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 SECOND AVENUE MRI LLC
IMAGING0.510000.49000
2 LA PET IMAGING
IMAGING0.24500
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1LAKE CHARLES MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11701 OAK PARK BLVDAddressLine1
CityLAKE CHARLESCity
StateLAState
ZIP Code70601ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LAKE CHARLES MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
PART II: N/A
PART III, LINE 4: THE FOLLOWING FOOTNOTE REGARDING BAD DEBT EXPENSE IS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS: "THE SYSTEM MAINTAINS ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS, DOUBTFUL ACCOUNTS, AND CHARITY CARE BASED ON MANAGEMENT'S ASSESSMENT OF COLLECTIBILITY, CURRENT ECONOMIC CONDITIONS, AND PRIOR EXPERIENCE. THE SYSTEM DETERMINES IF PATIENT ACCOUNTS RECEIVABLE ARE PAST-DUE BASED ON THE DISCHARGE DATE; HOWEVER, THE SYSTEM DOES NOT CHARGE INTEREST ON PAST-DUE ACCOUNTS. THE SYSTEM CHARGES OFF PATIENT ACCOUNTS RECEIVABLE IF MANAGEMENT CONSIDERS THE COLLECTON OF THE OUTSTANDING BALANCES TO BE DOUBTFUL."COSTING METHODOLOGY IS OPERATING EXPENSE (LESS BAD DEBT) TIMES PAYOR MIX TIMES ALLOWABLE PERCENT. THE SHORTFALL AS RELATES TO THIS QUESTION SHOULD BE TREATED AS A COMMUNITY BENEFIT IN THAT CARE IS PROVIDED TO MEMBERS OF OUR COMMUNITY AT LESS THAN THE ALLOWABLE COST.
PART III, LINE 8: COSTING METHODOLOGY USED FOR LINE 6 IS OPERATING EXPENSES (LESS BAD DEBT) TIMES PAYOR MIX TIMES 92% ALLOWABLE. THE SHORTFALL AS RELATES TO THIS QUESTION SHOULD BE TREATED AS A COMMUNITY BENEFIT IN THAT CARE IS PROVIDED TO MEMBERS OF OUR COMMUNITY AT LESS THAN THE ALLOWABLE COST.
PART III, LINE 9B: THE COLLECTION POLICY IS THE SAME AS FOR THOSE WHO DON'T QUALIFY. THOSE ENTITLED TO FREE CARE HAVE NO COLLECTION ACTIVITY AS THERE IS NO CHARGE FOR THEIR CARE. THOSE WHO QUALIFY FOR DISCOUNTED CARE WILL BE TREATED AS ANY OTHER PATIENT WHO HAS A BALANCE DUE THE HOSPITAL, JUST THAT THE BALANCE DUE WILL BE AT THE DISCOUNTED RATE FOR WHICH THEY QUALIFY.
PART V, SECTION B, LINE 12H: ALL PATIENTS ARE CHARGED THE SAME. THE DISCOUNT IS DETERMINED BASED ON THESE GUIDELINES.LAKE CHARLES MEMORIAL HOSPITAL
PART V, SECTION B, LINE 14G: THE FINANCIAL ASSISTANCE POLICY IS OFFERED BY FINANCIAL COUNSELORS.LAKE CHARLES MEMORIAL HOSPITAL
PART V, SECTION B, LINE 22: ALL PATIENTS ARE CHARGED THE SAME. DISCOUNTS ARE CALCULATED BASED ON FINANCIAL ASSISTANCE POLICY.LAKE CHARLES MEMORIAL HOSPITAL
PART VI, LINE 2: LCMH PROVIDES PROGRAMS & ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH & HEALING. THESE SCREENINGS, SEMINARS, CLASSES, ETC. RESPOND TO THE NEEDS OF PERSONS LIVING IN OUR COMMUNITY AND IMPROVES OVERALL COMMUNITY HEALTH. MEMORIAL HOSPITAL PROVIDES COMMUNITY HEALTH EDUCATION, COMMUNITY-BASED CLINICAL SERVICES, SUCH AS HEALTH SCREENINGS, SUPPORT GROUPS, SELF-HELP PROGRAMS, SUCH AS SMOKING CESSATION AND WEIGHT LOSS PROGRAMS, PASTORAL OUTREACH PROGRAMS AND SPIRITUAL CARE FOR THE WELL BEING OF OUR COMMUNITY.
PART VI, LINE 3: LCMH UTILIZES FINANCIAL COUNSELORS TO APPRISE OUR PATIENTS OF PROGRAMS AVAILABLE TO ASSIST THEM WITH THE COSTS ASSOCIATED WITH THEIR CARE.
PART VI, LINE 4: LCMH SERVICES A COMMUNITY WHICH IS APPROXIMATELY TWO HOURS EAST OF HOUSTON, TX AND TWO HOURS WEST OF BATON ROUGE, LA. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $44,826, WHICH IS SLIGHTLY ABOVE THE STATE AVERAGE. APPROXIMATELY 15.4% OF THE POPULATION LIVES BELOW THE POVERTY LEVEL, WHICH IS SLIGHTLY BELOW THE STATE AVERAGE.
PART VI, LINE 5: N/A

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
REALLIETY ATHLETIC PRODUCTIONS
2023 CHARVAISLAKE CHARLESLA70601461240215N/A5000SPONSORSHIP
SWLA CENTER FOR HEALTH SERVICES
PO BOX 19010LAKE CHARLESLA706169010721015384501(C)(3)5000SPONSORSHIP
VHA FOUNDATION INC
220 EAST LAS COLINAS BLVDIRVINGTX75039222710552501(C)(3)25000SPONSORSHIP
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: RECONCILIATION OF GRANTS ARE MONITORED MONTHLY BY AN ACCOUNTANT IN THE ACCOUNTING OFFICE AND REVEIWED BY THE CONTROLLER AND VICE PRESIDENT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (27 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHRISTOPHER THOMPSON
PHYSICIAN / MEDICAL STAFF PRES70000301551890007500000862692000
CHARLES WHITSON CPA
SR.VICE PRESIDENT OF FINAN2836180000075000196160310734000
LARRY GRAHAM
PRESIDENT/CEO & ASST SECRE560009010742007748075000117120694389000
BRIAN CLEMENTS MD
MEDICAL STAFF PAST PRESIDENT325780010246900075000196160455365000
GERALD W MOUTON
ACTIVE TRUSTEE2690000000000140930283093000
MARILYN MCSWAIN RN
SR.VICE PRESIDENT OF NURSI2195650000056620140690239296000
DAVID B USHER
SR.VICE PRES OF BUSINESS D2071840000075000140690228753000
TIM COFFEY
SR.VICE PRES OF OPERATIONS281570000007297080490296916000
DONNA SHIELDS
ASST VICE PRES NURSING2090610000052710140690228401000
TODD DELAHOUSSAYE
SR.VICE PRES OF PHYSICIAN189114000005012080490202175000
KATHLEEN DEROUEN
SR.VICE PRES OF MARKETING1628220000043860117120178920000
NATHAN COHEN
PHYSICIAN919818000000000919818000
LEROY FREDERICKS
PHYSICIAN897546000007500000905046000
BRETT CASCIO
PHYSICIAN18299750000075000001837475000
MICHAEL BROUSSARD MD
PHYSICIAN893776000007500000901276000
FRANCISCO MARERRO
PHYSICIAN10031540000075000001010654000
MANLEY M JORDAN MD
ACTIVE TRUSTEE (FORMER)4299980000075000196160457114000
THOMAS C STRONG MD
ACTIVE TRUSTEE (FORMER)3560020527090007500080480424259000
KEVIN MOCKLIN
ACTIVE TRUSTEE (FORMER)2393040000062860140690259659000
WILLIAM CONDOS
PHYSICIAN (FORMER HIGHEST260583000000046900265273000
WILLIAM MOSS
PHYSICIAN (FORMER HIGHEST5129540000075000196160540070000
BEN THOMPSON
PHYSICIAN (FORMER HIGHEST4829110000075000140930504504000
GARY KOHLER
PHYSICIAN (FORMER HIGHEST4548500000075000196160481966000
ROBERT BROUSSARD
PHYSICIAN (FORMER HIGHEST4342130000075000196160461329000
JAMES GAHARAN
PHYSICIAN (FORMER HIGHEST835839000007500000843339000
DENNIS WALKER
PHYSICIAN (FORMER HIGHEST4288470000000258420454689000
GREGORY RUBINO MD
PHYSICIAN (FORMER HIGHEST750006000007500000757506000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE HOSPITAL PAYS ANNUAL DUES TO THE PIONEER CLUB, A SOCIAL CLUB, FOR LARRY GRAHAM, PRESIDENT AND CEO IN THE AMOUNT OF $736.30 PER YEAR. ANY NONBUSINESS USE OF THE CLUB IS ACCOUNTED FOR AND INCLUDED AS COMPENSATION IN THE CEO W-2.
PART I, LINE 6WILLIAM MOSS, M.D., BEN THOMPSON, M.D., GARY KOHLER M.D., ROBERT BROUSSARD, M.D.,LUCIEN K. MOSS M.D. AND MANLEY JORDAN, M.D. ARE SUBJECT TO A BONUS STRUCTURE OF COLLECTIONS MINUS EXPENSES. 85% OF THE EXCESS IS PAID TO THE PHYSICIAN, BUT NOT TO EXCEED 85% OF THE PHYSICIAN BASE.
PART I, LINE 7LARRY GRAHAM, PRESIDENT AND CEO, IS SUBJECT TO AN INCENTIVE PAY BASED ON EMPLOYEE SUCCESS IN ACHIEVING GOALS ESTABLISHED BY THE BOARD. THE MAXIMUM AMOUNT TO BE PAID IN ANY ONE YEAR IS 25% OF HIS BASE PAY.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1LOUISIANA PUBLIC FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN720895871IssuerEIN
CUSIP Number546395D84CUSIPNumber
Date Issued2007-11-01DateIssued
Issue Price69371392IssuePrice
Description Of PurposeBOND REFUNDING, FACILITY AND EQUIPMENT UPGRADE AND RESERVESDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired690000AmountRetired
Total Proceeds69371392TotalProceeds
Amount In Reserve Fund6641478AmountInReserveFund
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due1NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC1GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line1NATIXIS FUNDINGBusinessNameLine1
Business Name Line2CORPBusinessNameLine2
FieldValueIRS element (for citing)
Term Of GIC12.000000000000TermOfGIC
Regulatory Safe Harbor Satisfied1RegulatorySafeHarborSatisfied
Gross Proceeds Invested1GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE K, PART IV, LINE 2C:Identifier
ExplanationBKD PERFORMED ARBITRAGE CALCULATION MAY 14, 2012 AND DETERMINED THAT NO REBATE WAS DUE ON THE BOND ISSUES.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
THOMAS SHEARMAN
THOMAS SHEARMAN IS A MEMBER OF THE BOARD & EMPLOYED BY LC AMERICAN PRESS111386LC AMERICAN PRESS PROVIDES ADVERTISING FOR THE HOSPITAL.0
LOUIS TODD
LOUIS TODD IS A MEMBER OF THE BOARD & IS SELF-EMPLOYED (TODD & ASSOCIATES)785743TODD & ASSOCIATES PROVIDES BROKERAGE SERVICES FOR MEDICAL MALPRACTICE INSURANCE FOR THE HOSPITAL'S EMPLOYED PHYSICIANS THROUGH LAMMICO. LOUIS TODD RECEIVES A COMMISSION FROM THE PREMIUMS THAT THE HOSPITAL PAYS TO LAMMICO.0
DAVID WALLACE MD
DAVID WALLACE IS A MEMBER OF THE BOARD, & A PHYSICIAN OF CHILDREN CLINIC136938CHILDREN CLINIC PROVIDES MEDICAL DIRECTORSHIP OF THE PEDIATRIC NURSERY, NEONATAL INTENSIVE CARE UNIT AND PEDIATRIC INTENSIVE CARE UNIT PROGRAMS AT THE HOSPITAL0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE HOME HEALTH AGENCY, PHARMACY, AND WOUND CARE FACILITY HAVE BEEN OUTSOURCED TO MANAGEMENT COMPANIES.
FORM 990, PART VI, SECTION A, LINE 6THE ENTITY HAS BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7ATHEY ELECT BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BBOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BOARD MEMBERS WILL BE PROVIDED A COPY OF THE 990 FOR REVIEW PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCOMPLIANCE IS MONITORED THROUGHOUT THE YEAR VIA MANUAL SIGNATURES BEING REQUIRED ON ALL AP CHECKS EXCEPT SMALL BALANCE PATIENT REFUNDS. THESE CHECKS HAVE AUTOMATED SIGNATURES, BUT ARE REVIEWED BEFORE MAILING. IN ADDITION LARGE CONSTRUCTION JOBS ARE REQUIRED TO BE BID OUT AND BIDS ARE RETURNED SEALED TO OUR ATTORNEYS. RELATIONSHIPS SUCH AS BANKING, INSURANCE AND OTHERS THAT HAVE BEEN DISCLOSED BY BOARD MEMBERS ARE SUBJECT TO DISCUSSION AT BOARD MEETINGS AND GENERALLY THE BOARD MEMBER WITHIN THAT RELATIONSHIP WILL EXCLUDE THEMSELVES FROM THE MEETING.
FORM 990, PART VI, SECTION B, LINE 15COMPARISON WITH VHA GULF STATES GREATER NEW ORLEANS SOCIETY OF HUMAN RESOURCES ASSN AND LHA DATA WAS DONE BY THE SALARY COMMITTEE OF THE BOARD OF TRUSTEES. MINUTES OF THE SALARY COMMITTEE WERE MAINTAINED.
FORM 990, PART VI, SECTION C, LINE 19IN ADDITION TO THE DOCUMENTS THAT ARE ON FILE WITH THE SECRETARY OF STATE THAT WERE REQUIRED TO ESTABLISH THE LEGAL ENTITY, THE GOVERNING DOCUMENTS (INCLUDING THE CONFLICT OF INTEREST POLICY) WILL BE PROVIDED TO THE PUBLIC UPON REQUEST AND SUBJECT TO OUR LEGAL COUNSEL'S APROVAL.
FORM 990, PART XI, LINE 9:BOOK/TAX DIFFERENCE - LA PET/CT IMAGING LAKE CHARLES LLC -1,117. BOOK/TAX DIFFERENCE - GIFT SHOP -65,940. BOOK/TAX DIFFERENCE - 2ND AVENUE MRI, LLC -823,390. GAAP ADJUSTMENT TO RECORD EQUITY IN SUBSIDIARIES -31,711,809.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990 PART XII LINE 2CTHE ORGANIZATION'S PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SOUTHWEST LOUISIANA HEALTH CARE SYSTEM INC
1701 OAK PARK BLVDLAKE CHARLESLA70601721103255SUPPORT OF LAKE CHARLES MEMORIAL HOSPITALLA501(C)(3)PUBLIC CHARITYN/A0
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC
PO BOX 2900LAKE CHARLESLA70602270833927SUPPORT OF LAKE CHARLES MEMORIAL HOSPITALLA501(C)(3)PUBLIC CHARITY0SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncomeDirect Controlling Entity NADirectControllingEntityNA
LAKE CHARLES MEDICAL PLAZA SOUTH
1701 OAK PARK BLVDLAKE CHARLESLA70601621447910REAL ESTATE MANAGEMENTLASWLHS INCRELATED1000.01000
SECOND AVENUE MRI LLC
2800 SECOND AVE SUITE CLAKE CHARLESLA70601202226374IMAGING SERVICESLASOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONRELATED108689000.51000823390
THE DIGESTIVE HEALTH CENTER OF SWLA LLC
1701 OAK PARK BLVDLAKE CHARLESLA70601272663607MEDICAL SERVICESLAN/A
LAKE CHARLES PHARM & MED EQUIP SUPPLY CO LLC
7000 CARDINAL PLACEDUBLINOH43017721300617MEDICAL SERVICESOHN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
WLW PROPERTIES INC
1701 OAK PARK BLVDLAKE CHARLESLA70601721023846REAL ESTATE / EQUITYLASOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONC574332622141.000000
LAKE CHARLES MEDICAL SERVICES INC
1701 OAK PARK BLVDLAKE CHARLESLA70601721285200MEDICAL SERVICESLAC0N/A
SWLHS INC
1701 OAK PARK BLVDLAKE CHARLESLA70601721103283MEDICAL SERVICESLASOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONC-1709302386208211.000000
SWLHS ONCOLOGY INC
1701 OAK PARK BLVDLAKE CHARLESLA70601201541727MEDICAL SERVICES-ONCOLOGYLAC0N/A
LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER INC
1701 OAK PARK BLVDLAKE CHARLESLA70601721381266MEDICAL SERVICESLAC0N/A
LAKE CHARLES MEMORIAL PHO
1701 OAK PARK BLVDLAKE CHARLESLA70601726013916PHYSICIAN NETWORK AND CONTRACTINGLASOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONC1.000000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (21 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LAKE CHARLES MEDICAL SERVICES INC
J535293FAIR MARKET VALUE
SWLHS INC
A208812FAIR MARKET VALUE
SWLHS ONCOLOGY INC
J76351FAIR MARKET VALUE
LAKE CHARLES HEART & VASCULAR INC
J161327FAIR MARKET VALUE
WLW PROPERTIES INC
K34284FAIR MARKET VALUE
(no name)
FAIR MARKET VALUE
(no name)
FAIR MARKET VALUE
(no name)
FAIR MARKET VALUE
SECOND AVENUE MRI LLC
J94203FAIR MARKET VALUE
SECOND AVENUE MRI LLC
Q402448CASH
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC
O146089CASH
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC
P42183CASH
SWLHS INC
Q1771116CASH
LAKE CHARLES HEART & VASCULAR INC
Q1225516CASH
LAKE CHARLES MEDICAL SERVICES INC
Q2927234CASH
SWLHS ONCOLOGY INC
Q343431CASH
LAKE CHARLES MEDICAL SERVICES INC
J262668FAIR MARKET VALUE
SWLHS INC
J43776FAIR MARKET VALUE
SWLHS ONCOLOGY INC
J2006FAIR MARKET VALUE
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC
R162702CASH
SWLHS INC
B20996039CASH