SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC (EIN 72-0551963)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-09
- IRS object ID
- 201223149349301017
- Schema version
- 2011v1.2
- 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 B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-09T09:42:42-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721202445 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POSTLETHWAITE & NETTERVILLE | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8550 UNITED PLAZA BLVD SUITE 1001 | AddressLine1 |
| City | BATON ROUGE | City |
| State | LA | State |
| ZIP Code | 70809 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720551963 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Business Name Line2 | D/B/A LAKE CHARLES MEMORIAL HOSPITAL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 3374943202 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1701 OAK PARK BOULEVARD | AddressLine1 |
| City | LAKE CHARLES | City |
| State | LA | State |
| ZIP Code | 70601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHARLES WHITSON | Name |
| Title | PRESIDENT AND CEO | Title |
| Phone | 3374943204 | Phone |
| Date Signed | 2012-11-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM S SANDAHL | Name |
| PTIN | P00295075 | PTIN |
| Phone | 2259224600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY GRAHAM | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1701 OAK PARK BOULEVARD | AddressLine1 |
| City | LAKE CHARLES | City |
| State | LA | State |
| ZIP Code | 70601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 208216615 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LCMH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2157 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1194764 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 310377 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 193621946 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 206200722 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 423389 | InvestmentIncomePriorYear |
| Investment Income Current Year | 585096 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2475437 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1107658 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 197715536 | TotalRevenuePriorYear |
| Total Revenue Current Year | 208203853 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 65000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 15000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 73501805 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 78988111 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 494753 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 109112527 | OtherExpensePriorYear |
| Other Expenses Current Year | 112841727 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 182679332 | TotalExpensesPriorYear |
| Total Expenses Current Year | 191844838 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 15036204 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 16359015 | RevenuesLessExpensesCY |
| Total Assets BOY | 192852578 | TotalAssetsBOY |
| Total Assets EOY | 202568931 | TotalAssetsEOY |
| Total Liabilities BOY | 121040608 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 122421634 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 71811970 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 80147297 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE 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 Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5023135 | Expense |
| Grants | 15000 | Grants |
| Revenue | 2366624 | Revenue |
| Description | LAKE CHARLES MEMORIAL HOSPITAL2011 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 2011, MEMORIAL HOSPITAL PROVIDED $12,403,280 IN UN-REIMBURSED MEDICAID COSTS AND $3,439,454 IN CHARITY CARE COSTS. COMMUNITY BENEFIT-$15,842,734SPORTS MEDICINETHE SPORTS MEDICINE ALLIANCE PROVIDED $254,284 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:$254,284III. HEALTH PROFESSIONALS EDUCATIONLAKE CHARLES MEMORIAL INVESTS IN MEDICAL EDUCATION IN AN EFFORT OF PROVIDE THE AREA WITH QUALIFIED PROFESSIONALS. IN 2011, LCMH SPENT $2,402,227 FOR THE LOUISIANA STATE UNIVERSITY HEALTH SERVICES CENTER-FAMILY PRACTICE RESIDENCY PROGRAM.COMMUNITY BENEFIT:$2,402,227CHARITABLE DONATIONSLCMH MAKES NUMEROUS MONETARY DONATIONS TO A VARIETY OF NON-PROFIT AGENCIES.COMMUNITY BENEFIT:$21,460COMMUNITY 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 $33,375 IN SPECIAL EVENTS AND SEMINARS.COMMUNITY BENEFIT:$33,375MEMORIAL'S TOTAL 2011 NET COMMUNITY CONTRIBUTIONS - $18,554,280 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 34620842 | Expense |
| Revenue | 21434619 | Revenue |
| Description | THE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 145048360 | Expense |
| Revenue | 183120375 | Revenue |
| Description | THE 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 184692337 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 156 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2157 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES WHITSON CHIEF FINANCIAL OF | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3374943202 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1701 OAK PARK BLVD | AddressLine1 |
| City | LAKE CHARLES | City |
| State | LA | State |
| ZIP Code | 706018911 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER THOMPSON | |||||||||
| PHYSICIAN / ACTIVE TRUSTEE | 40.00 | X | 927381 | 0 | 11025 | ||||
| GLENN PUMPELLY | |||||||||
| PAST CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |||
| ULYSSES GENE THIBODEAUX | |||||||||
| CHAIRMAN ELECT / SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |||
| LOUIS M TODD SR | |||||||||
| ACTIVE TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| DAVID WALLACE MD | |||||||||
| ACTIVE TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| CHARLES WHITSON CPA | |||||||||
| SR.VICE PRESIDENT OF FINAN | 40.00 | X | 246429 | 0 | 9169 | X | |||
| PHILIP EARHART | |||||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |||
| LARRY GRAHAM | |||||||||
| PRESIDENT/CEO & ASST SECRE | 40.00 | X | 657014 | 0 | 11025 | X | |||
| THOMAS C STRONG MD | |||||||||
| PAST MEDICAL STAFF PRESIDENT | 40.00 | X | 387002 | 0 | 10621 | ||||
| DENISE EMERSON RAU | |||||||||
| ACTIVE TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| THOMAS SHEARMAN | |||||||||
| ACTIVE TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| BRIAN CLEMENTS MD | |||||||||
| MEDICAL STAFF PRESIDENT | 40.00 | X | 451077 | 0 | 11025 | ||||
| JOE MILLER | |||||||||
| ACTIVE TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| GERALD W MOUTON | |||||||||
| ACTIVE TRUSTEE | 40.00 | X | 309040 | 0 | 3675 | ||||
| MARILYN MCSWAIN RN | |||||||||
| SR.VICE PRESIDENT OF NURSI | 40.00 | 199341 | 0 | 7225 | X | ||||
| DAVID B USHER | |||||||||
| SR.VICE PRES OF BUSINESS D | 40.00 | 203249 | 0 | 7728 | X | ||||
| TIM COFFEY | |||||||||
| SR.VICE PRES OF OPERATIONS | 40.00 | 248952 | 0 | 8890 | X | ||||
| DONNA SHIELDS | |||||||||
| ASST VICE PRES NURSING | 40.00 | 187889 | 0 | 7564 | X | ||||
| TODD DELAHOUSSAYE | |||||||||
| SR.VICE PRES OF PHYSICIAN | 40.00 | 165689 | 0 | 6452 | X | ||||
| KATHLEEN DEROUEN | |||||||||
| SR.VICE PRES OF MARKETING | 40.00 | 157101 | 0 | 6323 | X | ||||
| KEVIN MOCKLIN | |||||||||
| MEDICAL DIRECTOR | 40.00 | 230006 | 0 | 8743 | X | ||||
| NATHAN COHEN | |||||||||
| PHYSICIAN | 40.00 | 900001 | 0 | 0 | X | ||||
| LEROY FREDERICKS | |||||||||
| PHYSICIAN | 40.00 | 853688 | 0 | 7350 | X | ||||
| JAMES GAHARAN | |||||||||
| PHYSICIAN | 40.00 | 834208 | 0 | 7350 | X | ||||
| BRET CASCIO | |||||||||
| PHYSICIAN | 40.00 | 1498006 | 0 | 7350 | X | ||||
| MICHAEL BROUSSARD MD | |||||||||
| PHYSICIAN | 40.00 | 832008 | 0 | 7350 | X | ||||
| MANLEY M JORDAN MD | |||||||||
| ACTIVE TRUSTEE (FORMER) | 40.00 | 449247 | 0 | 11025 | X | ||||
| WILLIAM CONDOS | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 658243 | 0 | 0 | X | ||||
| DAVID DREZ | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 581542 | 0 | 0 | X | ||||
| WILLIAM MOSS | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 424005 | 0 | 7350 | X | ||||
| BEN THOMPSON | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 509663 | 0 | 7350 | X | ||||
| GARY KOHLER | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 477614 | 0 | 7350 | X | ||||
| ROBERT BROUSSARD | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 463766 | 0 | 7350 | X | ||||
| DENNIS WALKER | |||||||||
| PHYSICIAN (FORMER HIGHEST | 40.00 | 539750 | 0 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 13391911 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 179290 | TotalOtherCompensation |
| Number Individuals GT100 K | 95 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| LEWING CONSTRUCTION INC | |||||
| PO BOX 5216 | LAKE CHARLES | LA | 706065216 | CONTRUCTION/CONTRACTOR | 3225316 |
| INSTITUTE FOR NEUROPSYCHIATRY APMC | |||||
| 2829 4TH AVENUE | LAKE CHARLES | LA | 70601 | PSYCH SERVICES | 1192383 |
| LA COMMERCIAL LAUNDRY LLC | |||||
| PO BOX 503 | SCOTT | LA | 705830503 | LAUNDRY/LINEN SERVICE | 1191600 |
| EMERGENCY MEDICAL SPECIALIST APMC | |||||
| PO BOX 95385 | NEW ORLEANS | LA | 701959385 | ER/PSYCH TRIAGE SERVICES | 791672 |
| LC ANESTHESIOLOGY APMC | |||||
| 751 BAYOU PINES | LAKE CHARLES | LA | 70601 | ANESTHESIA SERVICE | 773626 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 126 | NumberOfContractorsGT100K |
| Government Grants | 305491 | GovernmentGrants |
| All Other Contributions | 4886 | AllOtherContributions |
| Total Contributions | 310377 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 900099 | 200019922 | 200019922 |
| MISC. PATIENT REVENUE | 900099 | 4920228 | 4920228 |
| CAFETERIA | 900099 | 1260572 | 1260572 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 206200722 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 586808 | TotalRevenueColumn |
| Exclusion | $586,808 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 384404 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 384404 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 384404 | TotalRevenueColumn |
| Exclusion | $384,404 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11050 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 12762 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -1712 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1712 | TotalRevenueColumn |
| Related Or Exempt Function Income | -1712 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| INCOME FROM SECOND AVE | 621990 | 680597 | 680597 |
| INCOME FROM LA PET/CT | 621990 | 37311 | 37311 |
| NET INCOME FROM GIFT S | 453220 | 5346 | 5346 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 723254 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 208203853 | TotalRevenueColumn |
| Related Or Exempt Function Income | 206922264 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $971,212 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Program Services | 15000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2695327 | Total |
| Program Services | 943364 | ProgramServices |
| Management And General | 1563290 | ManagementAndGeneral |
| Fundraising | 188673 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59265448 | Total |
| Program Services | 58376466 | ProgramServices |
| Management And General | 888982 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1216700 | Total |
| Program Services | 1164841 | ProgramServices |
| Management And General | 48154 | ManagementAndGeneral |
| Fundraising | 3705 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11702273 | Total |
| Program Services | 11203489 | ProgramServices |
| Management And General | 463150 | ManagementAndGeneral |
| Fundraising | 35634 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4108363 | Total |
| Program Services | 3933253 | ProgramServices |
| Management And General | 162600 | ManagementAndGeneral |
| Fundraising | 12510 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1186121 | Total |
| Program Services | 1148164 | ProgramServices |
| Management And General | 34991 | ManagementAndGeneral |
| Fundraising | 2966 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 583730 | Total |
| Program Services | 565051 | ProgramServices |
| Management And General | 17220 | ManagementAndGeneral |
| Fundraising | 1459 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2836051 | Total |
| Program Services | 2745297 | ProgramServices |
| Management And General | 83664 | ManagementAndGeneral |
| Fundraising | 7090 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1040942 | Total |
| Program Services | 863982 | ProgramServices |
| Management And General | 93685 | ManagementAndGeneral |
| Fundraising | 83275 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37965 | Total |
| Program Services | 36750 | ProgramServices |
| Management And General | 1025 | ManagementAndGeneral |
| Fundraising | 190 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229465 | Total |
| Program Services | 222123 | ProgramServices |
| Management And General | 6195 | ManagementAndGeneral |
| Fundraising | 1147 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5992121 | Total |
| Program Services | 5752436 | ProgramServices |
| Management And General | 239685 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11263112 | Total |
| Program Services | 10474694 | ProgramServices |
| Management And General | 788418 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3509161 | Total |
| Program Services | 3263520 | ProgramServices |
| Management And General | 245641 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| SUPPLIES | 39526441 | 38261595 | 1166030 | 98816 |
| BAD DEBT | 18394148 | 18394148 | ||
| PURCHASED SERVICES | 15821694 | 15315400 | 466740 | 39554 |
| SERVICE CONTRACTS | 4113028 | 3981412 | 121334 | 10282 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8307748 | Total |
| Program Services | 8031352 | ProgramServices |
| Management And General | 266944 | ManagementAndGeneral |
| Fundraising | 9452 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191844838 | Total |
| Program Services | 184692337 | ProgramServices |
| Management And General | 6657748 | ManagementAndGeneral |
| Fundraising | 494753 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1443425 | BOY |
| EOY | 14230375 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20227161 | BOY |
| EOY | 14776693 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28868819 | BOY |
| EOY | 25038213 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3254078 | BOY |
| EOY | 3487210 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2251787 | BOY |
| EOY | 2098358 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 258898261 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 185693412 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73066012 | BOY |
| EOY | 73204849 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 221926 | BOY |
| EOY | 54461450 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63519370 | BOY |
| EOY | 15271783 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192852578 | BOY |
| EOY | 202568931 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25301081 | BOY |
| EOY | 28318913 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90375000 | BOY |
| EOY | 87540000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3752834 | BOY |
| EOY | 4207702 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1611693 | BOY |
| EOY | 2355019 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121040608 | BOY |
| EOY | 122421634 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71811970 | BOY |
| EOY | 80147297 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71811970 | BOY |
| EOY | 80147297 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192852578 | BOY |
| EOY | 202568931 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 16359015 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -8023688 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3422429 | OtherCostOrOtherBasis |
| Book Value | 3422429 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 126355815 | OtherCostOrOtherBasis |
| Depreciation | 90476338 | Depreciation |
| Book Value | 35879477 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1322876 | OtherCostOrOtherBasis |
| Depreciation | 1322876 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 116221822 | OtherCostOrOtherBasis |
| Depreciation | 86956734 | Depreciation |
| Book Value | 29265088 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11575319 | OtherCostOrOtherBasis |
| Depreciation | 6937464 | Depreciation |
| Book Value | 4637855 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 73204849 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT - LA PET IMAGING | 124759 | C |
| INVESTMENT-CORPORATE SHARE LCCC | 12000 | C |
| INVESTMENTS-VHA-E | 82786 | C |
| INVESTMENTS-LAKE CHARLES HEALTH PLANS | 37500 | C |
| INVESTMENT - SWLHS, INC. | 54204405 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 54461450 | TotalOfBookValueSecurities |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INTERCOMPANY RECEIVABLES | 1128502 |
| ASSETS WHOSE USE IS LIMITED | 11392982 |
| DEFERRED FINANCING COSTS | 2094899 |
| OTHER RECEIVABLES | 552895 |
| OTHER ASSET-MSO | 102505 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 15271783 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| BOND PREMIUM | $38,319 |
| INVESTMENT-AMRI | $2,316,700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2355019 | TotalOfAmounts |
| Total Revenue | 208203853 | TotalRevenue |
| Total Expenses | 191844838 | TotalExpenses |
| Excess Or Deficit For Year | 16359015 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 40264 | NetUnrealizedGLOnInvestments |
| Other | -$663,136 | OtherAmount |
| Total Adjustments | -622872 | TotalAdjustments |
| Excess Or Deficit Per FS | 15736143 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 209120396 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 40264 | NetUnrealizedGainsInvestments |
| Other Revenues | 1599533 | OtherRevenues |
| Revenue Not Rptd F990 | 1639797 | RevenueNotRptdF990 |
| Revenue Subtotal | 207480599 | RevenueSubtotal |
| Other Revenues Not Included | 723254 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 723254 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 208203853 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 198115808 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 6270970 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 6270970 | ExpensesNotRptdF990 |
| Expenses Subtotal | 191844838 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 191844838 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE SYSTEM HAS EVALUATED ITS POSITION REGARDING THE ACCOUNTING FOR UNCERTAIN INCOME TAX POSITIONS. 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. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | BOOK/TAX DIFFERENCE - LA PET/CT IMAGING LAKE CHARLES LLC -2,192. BOOK/TAX DIFFERENCE - GIFT SHOP 19,654. BOOK/TAX DIFFERENCE - 2ND AVENUE MRI, LLC -680,597. ROUNDING -1. TOTAL TO SCHEDULE D, PART XI, LINE 8: -663,136. | |
| PART XIII, LINE 2D: THE ENTITY ALLOCATES OVERHEAD TO ITS TAXABLE ENTITIES $4,625,711 EXPENSES REPORTED ON SOUTHWEST LA HOSPITAL FOUNDATION $ 335,313 INTERCOMPANY RENT INCOME OFFSET AGAINST RENT EXPENSES $1,309,945 ROUNDING $ 1 ---------- TOTAL $6,270,970 PART XII, LINE 4B: BOOK/TAX DIFFERENCES INCLUDE: K-1 LA PET/CT IMAGING LAKE CHARLES $ 37,311 K-1 2ND AVENUE MRI $ 680,597 HOSPITAL AUXILIARY GIFT SHOP $ 5,346 --------- TOTAL $ 723,254 PART XII, LINE 2D: BOOK/TAX DIFFERENCES INCLUDE: REVENUE REPORTED ON SOUTHWEST LA HOSPITAL FOUNDATION $ 229,469 DISTRIBUTION FROM GIFT SHOP AUXILIARY $ 25,000 BOOK INCOME-LA PET/CI IMAGING $ 35,119 INTERCOMPANY RENT INCOME OFFSET AGAINST RENT EXPENSE $1,309,945 --------- TOTAL $1,599,533 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5855141 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5072198 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 782943 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 28765701 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16362421 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12403280 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34620842 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21434619 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13186223 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06040 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4535960 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2133733 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2402227 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01100 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 487175 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 232891 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 254284 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5023135 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2366624 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2656511 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01220 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39643977 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 23801243 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15842734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07260 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,906,665 | BadDebtExpenseAmount |
| Amount Attributable To | 3543999 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 56122817 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 81958562 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -25835745 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|
| 1 SECOND AVENUE MRI LLC | ||
| IMAGING | 0.51000 | 0.49000 |
| 2 LA PET IMAGING | ||
| IMAGING | 0.24500 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE CHARLES MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1701 OAK PARK BLVD | AddressLine1 |
| City | LAKE CHARLES | City |
| State | LA | State |
| ZIP Code | 70601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE CHARLES MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| 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 11H: ALL PATIENTS ARE CHARGED THE SAME. THE DISCOUNT IS DETERMINED BASED ON THESE GUIDELINES. | LAKE CHARLES MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 13G: THE FINANCIAL ASSISTANCE POLICY IS OFFERED BY FINANCIAL COUNSELORS. | LAKE CHARLES MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 21: 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| NATIONAL LUNG CANCER PARTNERSHIP | |||||||
| 222 NORTH MIDVALE BLVD 6 | MADISON | WI | 53705 | 450505050 | 501(C)(3) | 5000 | SPONSORSHIP |
| SWLA CENTER FOR HEALTH SERVICES | |||||||
| PO BOX 19010 | LAKE CHARLES | LA | 706169010 | 721015384 | 501(C)(3) | 5000 | SPONSORSHIP |
| THE WHISTLE STOP | |||||||
| 1518 18TH STREET | LAKE CHARLES | LA | 70601 | 020693757 | 501(C)(3) | 5000 | SPONSORSHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER THOMPSON | |||||||||||||
| 700003 | 0 | 227378 | 0 | 0 | 0 | 11025 | 0 | 0 | 0 | 938406 | 0 | 0 | 0 |
| CHARLES WHITSON CPA | |||||||||||||
| 246429 | 0 | 0 | 0 | 0 | 0 | 9169 | 0 | 0 | 0 | 255598 | 0 | 0 | 0 |
| LARRY GRAHAM | |||||||||||||
| 542267 | 0 | 106999 | 0 | 7748 | 0 | 11025 | 0 | 0 | 0 | 668039 | 0 | 0 | 0 |
| THOMAS C STRONG MD | |||||||||||||
| 387002 | 0 | 0 | 0 | 0 | 0 | 10621 | 0 | 0 | 0 | 397623 | 0 | 0 | 0 |
| BRIAN CLEMENTS MD | |||||||||||||
| 323532 | 0 | 127545 | 0 | 0 | 0 | 11025 | 0 | 0 | 0 | 462102 | 0 | 0 | 0 |
| GERALD W MOUTON | |||||||||||||
| 272000 | 0 | 37040 | 0 | 0 | 0 | 3675 | 0 | 0 | 0 | 312715 | 0 | 0 | 0 |
| MARILYN MCSWAIN RN | |||||||||||||
| 199341 | 0 | 0 | 0 | 0 | 0 | 7225 | 0 | 0 | 0 | 206566 | 0 | 0 | 0 |
| DAVID B USHER | |||||||||||||
| 203249 | 0 | 0 | 0 | 0 | 0 | 7728 | 0 | 0 | 0 | 210977 | 0 | 0 | 0 |
| TIM COFFEY | |||||||||||||
| 248952 | 0 | 0 | 0 | 0 | 0 | 8890 | 0 | 0 | 0 | 257842 | 0 | 0 | 0 |
| DONNA SHIELDS | |||||||||||||
| 187889 | 0 | 0 | 0 | 0 | 0 | 7564 | 0 | 0 | 0 | 195453 | 0 | 0 | 0 |
| TODD DELAHOUSSAYE | |||||||||||||
| 165689 | 0 | 0 | 0 | 0 | 0 | 6452 | 0 | 0 | 0 | 172141 | 0 | 0 | 0 |
| KATHLEEN DEROUEN | |||||||||||||
| 157101 | 0 | 0 | 0 | 0 | 0 | 6323 | 0 | 0 | 0 | 163424 | 0 | 0 | 0 |
| KEVIN MOCKLIN | |||||||||||||
| 230006 | 0 | 0 | 0 | 0 | 0 | 8743 | 0 | 0 | 0 | 238749 | 0 | 0 | 0 |
| NATHAN COHEN | |||||||||||||
| 900001 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 900001 | 0 | 0 | 0 |
| LEROY FREDERICKS | |||||||||||||
| 853688 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 861038 | 0 | 0 | 0 |
| JAMES GAHARAN | |||||||||||||
| 834208 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 841558 | 0 | 0 | 0 |
| BRET CASCIO | |||||||||||||
| 1498006 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 1505356 | 0 | 0 | 0 |
| MICHAEL BROUSSARD MD | |||||||||||||
| 832008 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 839358 | 0 | 0 | 0 |
| MANLEY M JORDAN MD | |||||||||||||
| 449247 | 0 | 0 | 0 | 0 | 0 | 11025 | 0 | 0 | 0 | 460272 | 0 | 0 | 0 |
| WILLIAM CONDOS | |||||||||||||
| 658243 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 658243 | 0 | 0 | 0 |
| DAVID DREZ | |||||||||||||
| 581542 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 581542 | 0 | 0 | 0 |
| WILLIAM MOSS | |||||||||||||
| 424005 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 431355 | 0 | 0 | 0 |
| BEN THOMPSON | |||||||||||||
| 509663 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 517013 | 0 | 0 | 0 |
| GARY KOHLER | |||||||||||||
| 477614 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 484964 | 0 | 0 | 0 |
| ROBERT BROUSSARD | |||||||||||||
| 463766 | 0 | 0 | 0 | 0 | 0 | 7350 | 0 | 0 | 0 | 471116 | 0 | 0 | 0 |
| DENNIS WALKER | |||||||||||||
| 539750 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 539750 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE 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 6 | WILLIAM 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 7 | LARRY 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
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOUISIANA PUBLIC FACILITIES AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 720895871 | IssuerEIN |
| CUSIP Number | 546395D84 | CUSIPNumber |
| Date Issued | 2007-11-01 | DateIssued |
| Issue Price | 69199000 | IssuePrice |
| Description Of Purpose | BOND REFUNDING, FACILITY AND EQUIPMENT UPGRADE AND RESERVES | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 2840000 | AmountRetired |
| Total Proceeds | 69371392 | TotalProceeds |
| Amount In Reserve Fund | 6641478 | AmountInReserveFund |
| Refunding Escrow | 67707398 | RefundingEscrow |
| Issuance Costs From Proceeds | 1363276 | IssuanceCostsFromProceeds |
| Capital Expenditures | 917627 | CapitalExpenditures |
| Year Of Subst Completion | 2007 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 1 | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIXIS FUNDING | BusinessNameLine1 |
| Business Name Line2 | CORP | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of GIC | 12.000000000000 | TermOfGIC |
| Regulatory Safe Harbor Satisfied | 1 | RegulatorySafeHarborSatisfied |
| Gross Proceeds Invested | 1 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| THOMAS SHEARMAN | |||
| THOMAS SHEARMAN IS A MEMBER OF THE BOARD & EMPLOYED BY LC AMERICAN PRESS | 103421 | LC AMERICAN PRESS PROVIDES ADVERTISING FOR THE HOSPITAL. | 0 |
| LOUIS TODD | |||
| LOUIS TODD IS A MEMBER OF THE BOARD & IS SELF-EMPLOYED (TODD & ASSOCIATES) | 240124 | TODD & 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 CLINIC | 194767 | CHILDREN CLINIC PROVIDES MEDICAL DIRECTORSHIP OF THE PEDIATRIC NURSERY, NEONATAL INTENSIVE CARE UNIT AND PEDIATRIC INTENSIVE CARE UNIT PROGRAMS AT THE HOSPITAL | 0 |
| RICHARD MARTINEZ MD | |||
| FORMER BD MEMBER, PARTNER SWLA IMAGING INVEST. WHICH OWNS 25.5% PET IMAGING | 35119 | THE HOSPITAL OWNS 24.5% OF PET IMAGING JOINT VENTURE. | 0 |
| RICHARD MARTINEZ MD | |||
| FORMER BD MEMBER, PARTNER RADIOLOGY ASSOC. OF SWLA WHICH OWNS 49% AMRI | 408236 | THE HOSPITAL OWNS 51% OF SECOND AVENUE MRI ('AMRI') | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOME HEALTH AGENCY, PHARMACY, AND WOUND CARE FACILITY HAVE BEEN OUTSOURCED TO MANAGEMENT COMPANIES. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ENTITY HAS BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THEY ELECT BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | BOARD MEMBERS WILL BE PROVIDED A COPY OF THE 990 FOR REVIEW PRIOR TO SUBMISSION TO THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | COMPLIANCE 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 15 | COMPARISON 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 19 | IN 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 5: | NET UNREALIZED GAINS ON INVESTMENTS: 40,264. BOOK/TAX DIFFERENCE - LA PET/CT IMAGING LAKE CHARLES LLC -2,192. BOOK/TAX DIFFERENCE - GIFT SHOP 19,654. BOOK/TAX DIFFERENCE - 2ND AVENUE MRI, LLC -680,597. REORGANIZATION - GAAP ADJUSTMENT 34,569. ROUNDING -1. FORGIVENESS OF DEBT - LAKE CHARLES MEDICAL PLAZA SOUTH -7,435,385. TOTAL TO FORM 990, PART XI, LINE 5: -8,023,688. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990 PART XII LINE 2C | THE ORGANIZATION'S PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHWEST LOUISIANA HEALTH CARE SYSTEM INC | |||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 721103255 | SUPPORT OF LAKE CHARLES MEMORIAL HOSPITAL | LA | 501(C)(3) | PUBLIC CHARITY | N/A | 0 | |
| SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC | |||||||||||
| PO BOX 2900 | LAKE CHARLES | LA | 70602 | 270833927 | SUPPORT OF LAKE CHARLES MEMORIAL HOSPITAL | LA | 501(C)(3) | PUBLIC CHARITY | 0 | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Share Of Total IncomeShareOfTotalIncome | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKE CHARLES MEDICAL PLAZA SOUTH | ||||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 621447910 | REAL ESTATE MANAGEMENT | LA | SWLHS INC | RELATED | 663 | 0 | 0 | 0.01000 | ||
| SECOND AVENUE MRI LLC | ||||||||||||||
| 2800 SECOND AVE SUITE C | LAKE CHARLES | LA | 70601 | 202226374 | IMAGING SERVICES | LA | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | RELATED | 258488 | 0 | 0 | 0.51000 | 680597 | |
| LA PETCT IMAGING LAKE CHARLES LLC | ||||||||||||||
| 920 PIERREMONT ROAD SUITE 411 | SHREVEPORT | LA | 71106 | 721474363 | IMAGING SERVICES | LA | RELATED | 118475 | 0 | 0 | 0.24500 | 37311 | ||
| THE DIGESTIVE HEALTH CENTER OF SWLA LLC | ||||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 272663607 | MEDICAL SERVICES | LA | N/A | |||||||
| LAKE CHARLES PHARM & MED EQUIP SUPPLY CO LLC | ||||||||||||||
| 7000 CARDINAL PLACE | DUBLIN | OH | 43017 | 721300617 | MEDICAL SERVICES | OH | N/A | |||||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WLW PROPERTIES INC | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 721023846 | REAL ESTATE / EQUITY | LA | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | C | 87535 | 267637 | 1.00000 | |
| LAKE CHARLES MEDICAL SERVICES INC | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 721285200 | MEDICAL SERVICES | LA | C | N/A | ||||
| SWLHS INC | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 721103283 | MEDICAL SERVICES | LA | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | C | -8754778 | 5276829 | 1.00000 | |
| SWLHS ONCOLOGY INC | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 201541727 | MEDICAL SERVICES-ONCOLOGY | LA | C | N/A | ||||
| LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER INC | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 721381266 | MEDICAL SERVICES | LA | C | N/A | ||||
| LAKE CHARLES MEMORIAL PHO | ||||||||||||
| 1701 OAK PARK BLVD | LAKE CHARLES | LA | 70601 | 726013916 | HEALTHCARE SERVICES | LA | SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION | C | 1.00000 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (23 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| LAKE CHARLES MEDICAL SERVICES INC | ||
| I | 535293 | FAIR MARKET VALUE |
| SWLHS INC | ||
| A | 208812 | FAIR MARKET VALUE |
| SWLHS ONCOLOGY INC | ||
| I | 76351 | FAIR MARKET VALUE |
| LAKE CHARLES HEART & VASCULAR INC | ||
| I | 161327 | FAIR MARKET VALUE |
| WLW PROPERTIES INC | ||
| J | 34284 | FAIR MARKET VALUE |
| (no name) | ||
| FAIR MARKET VALUE | ||
| (no name) | ||
| FAIR MARKET VALUE | ||
| (no name) | ||
| FAIR MARKET VALUE | ||
| SECOND AVENUE MRI LLC | ||
| I | 94203 | FAIR MARKET VALUE |
| SECOND AVENUE MRI LLC | ||
| P | 404662 | CASH |
| SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC | ||
| N | 181358 | CASH |
| SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION FOUNDATION INC | ||
| M | 6182 | CASH |
| SWLHS INC | ||
| B | 16935215 | CASH |
| LAKE CHARLES MEDICAL SERVICES INC | ||
| B | 27324663 | CASH |
| SWLHS ONCOLOGY INC | ||
| B | 5758572 | CASH |
| LAKE CHARLES HEART & VASCULAR INC | ||
| B | 4185955 | CASH |
| SWLHS INC | ||
| B | 37269190 | CONT OF SUBSIDIARY STOCK-COST |
| LAKE CHARLES MEDICAL PLAZA SOUTH | ||
| Q | 7435385 | CASH/DEBT FORGIVENESS |
| SWLHS INC | ||
| P | 1108300 | CASH |
| LAKE CHARLES HEART & VASCULAR INC | ||
| P | 870126 | CASH |
| LAKE CHARLES MEDICAL SERVICES INC | ||
| P | 2210044 | CASH |
| SWLHS ONCOLOGY INC | ||
| P | 437241 | CASH |
| SOUTHWEST LOUISIANA HEALTHCARE SYSTEM INC | ||
| H | 0 | CASH |