2024-08-12T09:22:06-05:00 2023-09-30 201941244 HORNE LLP 661 SUNNYBROOK ROAD STE 100 RIDGELAND MS 39157 990 2022-10-01 842046902 THIBODAUX REGIONAL HEALTH SYSTEM INC THIB 9854475500 602 N ACADIA ROAD THIBODAUX LA 70301 STEPHEN EAST CURRENT CFO 9854475500 2024-08-07 1 0 AMIE WHITTINGTON DEAN CPA P01082167 6013261000 2024-07-31 2022 2024-08-08 14:25:15Z GREG STOCK 602 NORTH ACADIA ROAD THIBIDAUX LA 70301 323307469 0 X HTTPS://WWW.THIBODAUX.COM/ X 2019 LA OPERATION OF THIBODAUX REGIONAL MEDICAL CENTER (THE HOSPITAL). THE MISSION OF THE HOSPITAL IS TO PROVIDE THE HIGHEST QUALITY, MOST COST-EFFECTIVE HEALTHCARE SERVICES POSSIBLE TO THE PEOPLE OF THIBODAUX AND SURROUNDING AREAS. 5 4 1772 17 3479014 0 59051301 31532919 260638158 280666027 1518854 2526143 7656952 8367628 328865265 323092717 68030 0 0 0 115647614 121173488 0 0 0 162297778 167514236 278013422 288687724 50851843 34404993 514056856 511252829 373250985 338668340 140805871 172584489 X THE MISSION OF THE HOSPITAL IS TO PROVIDE THE HIGHEST QUALITY, MOST COST-EFFECTIVE HEALTHCARE SERVICES POSSIBLE TO THE PEOPLE OF THIBODAUX AND SURROUNDING AREAS. THE HOSPITAL, IN RECOGNITION OF ITS MISSION, STRIVES TO ACHIEVE ITS VISION TO BE THE REGIONAL MEDICAL CENTER OF CHOICE FOR SELECTED HEALTHCARE SERVICES IN SOUTHEAST LOUISIANA THROUGH A COMMITMENT TO QUALITY IMPROVEMENT, BY PARTNERING WITH OTHER HEALTHCARE PROVIDERS, AND BY REMAINING FINANCIALLY VIABLE IN A COMPETITIVE ENVIRONMENT. TO ACHIEVE OUR VISION, WE PROMOTE THE FOLLOWING VALUES: RESPECT, INTEGRITY, INNOVATION, EXCELLENCE, ACCOUNTABILITY, AND PASSION. 0 0 217189240 283912018 THE MISSION OF THE HOSPITAL IS TO PROVIDE THE HIGHEST QUALITY, MOST COST-EFFECTIVE HEALTHCARE SERVICES POSSIBLE TO THE PEOPLE OF THIBODAUX AND SURROUNDING AREAS. THE HOSPITAL, IN RECOGNITION OF ITS MISSION, STRIVES TO ACHIEVE ITS VISION TO BE THE REGIONAL MEDICAL CENTER OF CHOICE FOR SELECTED HEALTHCARE SERVICES IN SOUTHEAST LOUISIANA THROUGH A COMMITMENT TO QUALITY IMPROVEMENT, BY PARTNERING WITH OTHER HEALTHCARE PROVIDERS, AND BY REMAINING FINANCIALLY VIABLE IN A COMPETITIVE ENVIRONMENT. TO ACHIEVE OUR VISION, WE PROMOTE THE FOLLOWING VALUES: RESPECT, INTEGRITY, INNOVATION, EXCELLENCE, ACCOUNTABILITY, AND PASSION.THE MEDICAL CENTER IS LICENSED FOR 180 BEDS AND OPERATES 140 INPATIENT BEDS INCLUDING INPATIENT REHAB AND INPATIENT BEHAVIORAL HEALTH. THE AVAILABLE STAFFED BED COMPLEMENT IS AS FOLLOWS:MEDICAL/SURGICAL 79LDRP/ANTE PARTAL 16INTENSIVE CARE 16STEPDOWN 10REHABILITATION 14BEHAVIORAL HEALTH 16THE MEDICAL CENTER HAS APPROXIMATELY 281 PHYSICIANS ON STAFF. THIS INCLUDES 112 ACTIVE STAFF PHYSICIANS, 11 ASSOCIATE STAFF PHYSICIANS, 38 COURTESY STAFF PHYSICIANS, 18 EMERGENCY DEPARTMENT PHYSICIANS, 17 CONSULTING STAFF PHYSICIANS, 7 COMMUNITY STAFF PHYSICIANS, 77 TELEMEDICINE PHYSICIANS, AND 1 HOUSE STAFF PHYSICIAN. THE MEDICAL STAFF SUPPORT SERVICES PROVIDED AT THE MAIN HOSPITAL, CANCER CENTER, MEDICAL OFFICE BUILDING, MEDICAL PLAZA AND WELLNESS CENTER AS APPROPRIATE TO THE SERVICES PROVIDED IN THOSE LOCATIONS.ALL SERVICES ARE PLANNED AND DESIGNED ON THE PATIENT POPULATION THE HOSPITAL SERVES, THE HOSPITAL'S MISSION AND VISION STATEMENT, KEY REQUIREMENTS OF OUR PATIENTS AND THEIR FAMILY MEMBERS, AND KEY REQUIREMENTS OF OTHER MAJOR STAKEHOLDERS. THE PROCESS OF PLANNING A SERVICE IS A COLLABORATIVE EFFORT. HOSPITAL STAFF THAT ARE MOST KNOWLEDGEABLE ABOUT THE PARTICULAR SERVICE BEING PLANNED ARE INVOLVED IN THE PLANNING PROCESS AS WELL AS PHYSICIANS AND COMMUNITY LEADERS WHERE APPROPRIATE. IN ACCORDANCE WITH FEDERAL AND STATE REGULATIONS, PROFESSIONAL PRACTICE STANDARDS AND CODES, TRMC PROVIDES THE COMMUNITY WITH AN EXTENSIVE RANGE OF GENERAL AND SPECIALTY MEDICAL SERVICES.SIGNIFICANT HOSPITAL ACHIEVEMENTS & KEY STATISTICS FOR FISCAL YEAR ENDED 9/30/2023 INCLUDE:2023 - THE JOINT COMMISSION AND AMERICAN HEART ASSOCIATION CERTIFIED PRIMARY STROKE CENTERFIRST HOSPITAL IN REGION2023 - COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES GENERAL REHABILITATION AND STROKE SPECIALTY PROGRAM11TH CONSECUTIVE 3-YEAR ACCREDITATION2023 - LABORATORY ACCREDITATION BY THE COLLEGE OF AMERICAN PATHOLOGISTACCREDITATION MAINTAINED SINCE 19712023 - AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION ACCREDITATION OF CARDIAC REHABILITATION PROGRAM2023 - DIABETES SELF-MANAGEMENT ACCREDITATION BY THE AMERICAN DIABETES ASSOCIATIONACCREDITED SINCE 19992023 - SLEEP CENTER ACCREDITATION BY THE AMERICAN ASSOCIATION OF SLEEP MEDICINE2023 - BLUE DISTINCTION CENTER+ FOR MATERNITY CARE2023 - BLUE DISTINCTION CENTER+ FOR KNEE AND HIP REPLACEMENT2023 - BIRTH READY DESIGNATION BY THE LOUISIANA DEPARTMENT OF HEALTH (LDH) AND THE LOUISIANA PERINATAL QUALITY COLLABORATIVE (LAPQC)2023 - INPATIENT REHABILITATION AND STROKE SPECIALTY PROGRAM RE- ACCREDITATION BY CARF (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES)2023 - MEDICAL EXCELLENCE AWARD - #1 HOSPITAL IN LOUISIANA FOR CARDIAC CARE BY CARECHEX2023 - POV PEOPLE'S CHOICE FAVORITE HOSPITAL2023 - POV PEOPLE'S CHOICE FAVORITE GYM/HEALTH & FITNESS CLUB2023 - POV PEOPLE'S CHOICE FAVORITE URGENT CARE2023 - POV PEOPLE'S CHOICE FAVORITE PLACE TO WORK2023 - THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST -BEST HOSPITAL2023 - THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST - FITNESS CENTER/GYMTOTAL INPATIENT DAYS 26,444AVERAGE DAILY CENSUS 72.4INPATIENT ADMISSIONS 6,020AVERAGE LOS (ACUTE) 4.1OBSERVATION PATIENTS 2,959REHAB DAYS 2,882DELIVERIES 939OUTPATIENT VISITS 157,608E/R VISITS 37,242HOME HEALTH ADMISSIONS 1,172ADJUSTED PATIENT DAYS 112,442SURGERY CASES 10,366CARECHEX AWARDS - HIGHLIGHTS:TOP 10% OVERALL HOSPITAL CARE FOR THE STATE AND #1 IN THE MARKET FOR MEDICAL EXCELLENCETOP 10% IN OVERALL MEDICAL CARE FOR THE, NATION, REGION AND STATE AND #1 IN THE MARKET FOR PATIENT SAFETYHEALTHGRADES: 5-STAR RATING FOR PACEMAKER PROCEDURES, HIP FRACTURE TREATMENT, WHICH HAS HELD THIS DESIGNATION FOR 3 YEARS IN A ROW, AND CAROTID PROCEDURES, WHICH HAS HELD THIS DESIGNATION FOR 10 YEARS IN A ROW. BLUE CROSS BLUE SHIELD:BLUE DISTINCTION CENTER+ SPINE SURGERYBLUE DISTINCTION CENTER+ FOR HIP AND KNEE REPLACEMENTBLUE DISTINCTION CENTER + MATERNITYLOUISIANA PERINATAL QUALITY COLLABORATIVE BIRTH READY DESIGNATIONLOUISIANA DEPARTMENT OF HEALTH THE GIFT DESIGNATION 217189240 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 120 1 1 1772 1 1 1 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 X THE ORGANIZATION 9854475500 602 NORTH ACADIA ROAD THIBODAUX LA 70301 GREG K STOCK CEO AND BOARD SEC. - NONVO 40.00 X X 814430 0 38262 JAKE GIARDINA BOARD CHAIRMAN 1.00 X 0 0 0 FRANCIS RICHARD BOARD VICE CHAIRMAN 1.00 X 0 0 0 DR CLEVELAND HILL BOARD MEMBER 1.00 X 0 0 0 DR DAVID ELIAS BOARD MEMBER 1.00 X 0 0 0 DR RAJA TALLURI BOARD MEMBER 1.00 X 0 0 0 DR CHRIS RODRIGUE CHIEF OF STAFF - NON-VOTIN 40.00 X 534421 0 20163 THEUNETTE ANTILL CHIEF FINANCIAL OFFICER/ PART YEAR 40.00 X 89644 0 9492 STEPHEN EAST CHIEF FINANCIAL OFFICER/ PART YEAR 40.00 X 0 0 0 BLAIN ARTHURS STAFF PHYSICIAN 40.00 X 1135445 0 43521 CARLOS R GIMENEZ STAFF PHYSICIAN 40.00 X 1080603 0 37431 SCOTT HEBERT STAFF PHYSICIAN 40.00 X 1367953 0 18000 GREGORY DOBARD STAFF PHYSICIAN 40.00 X 1043034 0 37431 LINDSAY LASSEIGNE STAFF PHYSICIAN 40.00 X 918702 0 16356 6984232 0 220656 125 0 1 0 HEALTH CATALYST 3165 MILLROCK DRIVE SUITE 400 SALT LAKE CITY UT 84121 INFORMATION TECHNOLOGY SERVICES/SUPPORT 5996713 MEDDATA 120 INNWOOD DR COVINGTON LA 70433 BILLING SERVICES 2464585 POWER WELLNESS MANAGEMENT 851 OAK CREEK DR LOMBARD IL 60148 FITNESS CENTER MANAGEMENT SERVICES 2004943 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 PHYSICIAN LOCUM PROVIDERS 1050337 CCMMA LA 224 WEST 18TH STREET APT 8A NEW YORK NY 10011 TELEHEALTH PROVIDER SERVICES 931480 30 31532919 31532919 PATIENT SERVICE REVENUE 621990 280666027 280666027 280666027 2526143 2526143 1642590 0 1642590 1642590 1642590 79937 214752 -134815 -134815 FITNESS CENTER REVENUE 713940 3262723 3097546 165177 CAFETERIA AND VENDING 722514 1213812 1213812 OTHER REVENUE 621990 1079341 697873 381468 1303977 905528 398449 6859853 323092717 283912018 3479014 4168766 1200598 1200598 99728205 81868128 17860077 2527679 2047420 480259 11761347 9476044 2285303 5955659 5023658 932001 5234296 37956 5196340 6109616 415736 5693880 4937521 2157849 2779672 244091 207248 36843 17477 6919 10558 13463177 13463177 16774421 12245327 4529094 1635551 1635551 MEDICAL SUPPLIES 65564967 65564967 PURCHASED SERVICES 30427028 22532175 7894853 BAD DEBTS 11375977 11375977 EQUIPMENT RENTAL AND MA 8022357 4229836 3792521 3707757 3707757 288687724 217189240 71498484 0 13343551 30781056 2168366 2202585 28643884 27484625 4119908 4022074 108640131 112058653 106446383 68795061 39261267 37651322 106006963 107942354 5426410 4823475 206446376 184286685 514056856 511252829 20433919 18680626 352817066 319987714 373250985 338668340 X 140805871 172584489 140805871 172584489 514056856 511252829 X 34404993 101660 -2728035 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 53960 53960 217135280 217189240 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 48883 45860 50648 53960 199351 250000 250000 250000 250000 1000000 1500000 48883 45860 50648 53960 199351 SCHEDULE C, PART II-A, LINE 1A $32,400 IS FOR PAYMENTS TO HAYNIE AND ASSOCIATES FOR LOBBYING RELATED SERVICES. $8,754.63 IS FOR THE PORTION OF DUES TO AHA THAT HAS BEEN DEEMED FOR LOBBYING, AND $12,805.40 IS FOR THE PORTION OF DUES TO LHA THAT HAS BEEN DEEMED FOR LOBBYING. 82861 82861 58377133 42104352 16272781 45928766 26490447 19438319 2057623 200262 1857361 37651322 INVESTMENT FUNDS 107817354 C OTHER INVESTMENTS 125000 C 107942354 OTHER RECEIVABLES 6100291 CAPITAL LEASE 170164357 INVESTMENT IN THIB REG SURGICAL 3953845 INVESTMENT IN JV IMAGING CENTER 3332000 DEFERRED COMPENSATION PLAN 736192 184286685 COST REPORT RECEIVABLE MEDICAID 1600099 TRMC LEASE 133095297 CAPITAL LEASES 147187653 COST REPORT RECEIVABLE MEDICARE -295370 ACCRUED INTEREST 25319772 INSURANCE LIABILITY 4705696 AMOUNTS DUE TO HSD 8374567 319987714 X PART X, LINE 2: THE HEALTH SYSTEM IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HEALTH SYSTEM IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HEALTH SYSTEM DID NOT INCUR FEDERAL INCOME TAX EXPENSE FOR THE YEARS ENDED SEPTEMBER 30, 2023 AND 2022. FESTIVAL OF HOPE 79937 79937 60196 154556 79937 79937 60196 154556 214752 -134815 1 1 1 X 1 X 325.000000000000 1 1 1 0 0 2812726 2812726 0.01010 28654855 28269168 385687 0.00140 31467581 28269168 3198413 0.01150 31467581 28269168 3198413 0.01150 1 11375977 1353741 45870929 43149250 2721679 1 1 1 TIC JV LLC SUBLEASE OF IMAGING CENTER 0.84730 0.00000 0.15270 1 1 THIBODAUX REGIONAL HEALTH SYSTEM INC 602 NORTH ACADIA ROAD THIBODAUX LA 70301 X X INPATIENT REHAB AND INPATIENT PSYCH THIBODAUX REGIONAL HEALTH SYSTEM INC 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.THIBODAUX.COM/DOCUMENTS/2022-COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 21 1 HTTPS://WWW.THIBODAUX.COM/DOCUMENTS/2022-CHNA-STRATEGY-AND-ACTION-PLAN.PDF 0 1 X 200.000000000000 325.000000000000 1 1 X X X 1 X HTTPS://WWW.THIBODAUX.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ X WWW.THIBODAUX.COM/DOCUMENTS/FINANCIAL-HARDSHIP-APPLICATION-6-2016.PDF X HTTPS://WWW.THIBODAUX.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X 1 X 0 0 THIBODAUX REGIONAL HEALTH SYSTEM, INC. PART V, SECTION B, LINE 5: PLEASE REFER TO THE CHNA, POSTED ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.THIBODAUX.COM/DOCUMENTS/2022-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF THIBODAUX REGIONAL HEALTH SYSTEM, INC. PART V, SECTION B, LINE 11: PLEASE SEE THE IMPLEMENTATION STRATEGY, POSTED ON HOSPITAL'S WEBSITE AT: HTTPS://WWW.THIBODAUX.COM/DOCUMENTS/2022-CHNA-STRATEGY-AND-ACTION-PLAN.PDF 23 1 - THIBODAUX REGIONAL WOMEN'S CLINIC 604 N ACADIA RD STE 500 THIBODAUX LA 70301 OB/GYN 2 - THIBODAUX REGIONAL CANCER CENTER 608 N ACADIA RD THIBODAUX LA 70301 CANCER CARE 3 - THIBODAUX REGIONAL URGENT CARE - THIB 2031 AUDUBON AVE THIBODAUX LA 70301 URGENT CARE 4 - THIBODAUX REGIONAL UROLOGY CLINIC 506 N ACADIA RD THIBODAUX LA 70301 UROLOGY 5 - THIBODAUX REGIONAL PEDIATRIC CLINIC 604 N ACADIA RD STE 100 THIBODAUX LA 70301 PEDIATRICS 6 - THIBODAUX REGIONAL URGENT CARE - HOUMA 1411 ST CHARLES ST HOUMA LA 70360 URGENT CARE 7 - THIBODAUX REGIONAL INTERNAL MEDICINE CLI 400 N ACADIA RD THIBODAUX LA 70301 INTERNAL MEDICINE 8 - THIBODAUX REGIONAL PAIN MANAGEMENT CLINI 726 N ACADIA RD STE 2400 THIBODAUX LA 70301 PAIN MANAGEMENT 9 - THIBODAUX REGIONAL PULMONOLOGY CLINIC 604 N ACADIA RD STE 411 THIBODAUX LA 70301 PULMONOLOGY 10 - THIBODAUX REGIONAL NEUROLOGY CLINIC 726 N ACADIA RD STE 2300 THIBODAUX LA 70301 NEUROLOGY 11 - THIBODAUX REGIONAL FAMILY MEDICINE CLINI 114 HIGHWAY 403 PAINCOURTVILLE LA 70391 FAMILY MEDICINE 12 - THIBODAUX REGIONAL FOOT & ANKLE CENTER 290 BOWIE RD THIBODAUX LA 70301 PODIATRY 13 - THIBODAUX REGIONAL RHEUMATOLOGY CLINIC 726 N ACADIA RD STE 3400 THIBODAUX LA 70301 RHEUMATOLOGY 14 - THIBODAUX REG MULTI-SPECIALTY CLINIC - H 1238 ST CHARLES ST HOUMA LA 70360 MULTI-SPECIALTY 15 - THIBODAUX REGIONAL ENDOCRINOLOGY CLINIC 726 N ACADIA RD STE 3300 THIBODAUX LA 70301 ENDOCRINOLOGY 16 - THIBODAUX REGIONAL FAMILY MEDICINE CLINI 3928 HIGHWAY 70 SOUTH PIERRE PART LA 70339 FAMILY MEDICINE 17 - THIBODAUX REGIONAL BRAIN & SPINE CLINIC 726 N ACADIA RD STE 2100 THIBODAUX LA 70301 BRAIN & SPINE 18 - THIBODAUX REGIONAL RACELAND MULTISPECIAL 4560 HIGHWAY 1 STE 3 RACELAND LA 70394 MULTI-SPECIALTY 19 - THIBODAUX REGIONAL PHYSICAL MEDICINE & R 726 N ACADIA RD STE 1700 THIBODAUX LA 70301 REHAB 20 - THIBODAUX REGIONAL CARDIOVASCULAR CLINIC 604 N ACADIA RD STE 409 THIBODAUX LA 70301 CARDIOVASCULAR 21 - THIBODAUX REGIONAL CARDIOLOGY CLINIC 2595 HWY 1 LABADIEVILLE LA 70372 CARDIOLOGY 22 - THIBODAUX REGIONAL PLASTIC & RECONSTRUCT 604 N ACADIA RD ST 410 THIBODAUX LA 70301 PLASTIC SURGERY 23 - THIBODAUX REGIONAL CARDIOLOGY CLINIC 602 NORTH ACADIA RD STE 101 THIBODAUX LA 70301 CARDIOLOGY PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 11,375,977. PART II, COMMUNITY BUILDING ACTIVITIES: N/A PART III, LINE 2: SEE EXPLANATION, BELOW, REFERENCING THE BAD DEBT EXPENSE AUDIT FOOTNOTE. PART III, LINE 3: NONE OF THE BAD DEBT EXPENSE HAS BEEN INCLUDED IN THE COMMUNITY BENEFIT CALCULATIONS. HOWEVER, HOSPITAL ESTIMATES THAT FIVE PERCENT OF BAD DEBTS COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THIS ESTIMATE IS BASED ON PATIENT DEMOGRAPHICS, BILLINGS, COLLECTIONS AND OTHER HISTORICAL DATA. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS ON PAGE 24 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PLEASE NOTE THAT BAD DEBT EXPENSE IS NOW REFERRED TO AS IMPLICIT PRICE CONCESSIONS, AS DESCRIBED ON PAGE 12 OF AUDITED FINANCIALS. BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE REFLECTED ON THE ORGANIZATION'S TRIAL BALANCE AND CLASSSIFIED AS IMPLICIT PRICE CONCESSIONS IN THE AUDITED FINANCIAL STATEMENTS.THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITALS FILED 2023 COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DOES NOT INCLUDE ANY MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. PART III, LINE 9B: THE POLICY OF THIBODAUX REGIONAL HEALTH SYSTEM, INC. ("TRHS") IS TO PROVIDE EMERGENCY CARE AND MEDICALLY NECESSARY CARE ON A NON-PROFIT BASIS TO PATIENTS WITHOUT REGARD TO RACE, CREED, OR ABILITY TO PAY. PATIENTS WHO DO NOT HAVE THE MEANS TO PAY FOR SERVICES PROVIDED AT TRHS FACILITIES MAY REQUEST FINANCIAL ASSISTANCE, WHICH WILL BE AWARDED SUBJECT TO TERMS AND CONDITIONS. THE ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY ARE INTENDED TO ENSURE THAT TRHS WILL HAVE THE FINANCIAL RESOURCES TO PROVIDE CARE TO PATIENTS WHO ARE IN THE GREATEST FINANCIAL NEED. THIS POLICY APPLIES TO THIBODAUX REGIONAL HEALTH SYSTEM (THE "HOSPITAL") AND ALL TRHS FACILITIES, INCLUDING ANY CARE PROVIDED WITHIN THE HOSPITAL BY A SUBSTANTIALLY-RELATED ORGANIZATION.IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ELIGIBLE AMOUNT IS WRITTEN OFF THE PATIENT ACCOUNT AND ANY PARTIAL REMAINING BALANCE, IF ANY, IS THEN BILLED IN ACCORDANCE WITH THE BILLING AND COLLECTION POLICY AS STATED BELOW. PART VI, LINE 2: HAVE USED PRC COMMUNITY HEALTH SURVEY TO STUDY AS WELL AS STATISTICS OTHER HEALTH-RELATED DATA FOR THE AREA. PART VI, LINE 3: DISPLAYED ON PATIENT STATEMENTS AS WELL AS LOCATED ON OUR WEBSITE. HOSPITAL ALSO HAS AN POLICY INTERNALLY. (PFS - CUSTOMER SERVICE- FINANCIAL HARDSHIP) PART VI, LINE 4: THE COMMUNITIES INCLUDE ASSUMPTION, LAFOURCHE, ST. JAMES, ST. MARY, AND TERREBONNE PARISHES WHICH IS BASED ON THE ZIP CODES OF RESIDENCE FOR RECENT PATIENTS. PART VI, LINE 5: THE GOVERNING BODY RESIDES IN THE ORGANIZATION'S PRIMARY SERVICE AREA, TRHS EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY, AND SURPLUS FUNDS ARE USED TO PURCHASE NEW EQUIPMENT WITH ADVANCED TECHNOLOGY, ALONG WITH FACILITY UPGRADES AND ADDITIONS (I.E. NEW CANCER CENTER BUILDING & NEW EQUIPMENT, ADDITIONAL WELLNESS CENTER PHASE II). PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES LA X X X 0 0 0 0 0 0 0 0 0 SCOTT HEBERT STAFF PHYSICIAN 1367953 0 0 0 0 0 18000 0 0 0 1385953 0 0 0 BLAIN ARTHURS STAFF PHYSICIAN 1135445 0 0 0 0 0 27500 0 16021 0 1178966 0 0 0 CARLOS R GIMENEZ STAFF PHYSICIAN 1080603 0 0 0 0 0 27500 0 9931 0 1118034 0 0 0 GREGORY DOBARD STAFF PHYSICIAN 1043034 0 0 0 0 0 27500 0 9931 0 1080465 0 0 0 LINDSAY LASSEIGNE STAFF PHYSICIAN 918702 0 0 0 0 0 0 0 16356 0 935058 0 0 0 GREG K STOCK CEO AND BOARD SEC. - NONVO 814430 0 0 0 0 0 28831 0 9431 0 852692 0 0 0 DR CHRIS RODRIGUE CHIEF OF STAFF - NON-VOTIN 534421 0 0 0 0 0 20163 0 0 0 554584 0 0 0 ORTHO LA DR. ELIAS, BOARD MEMBER, IS A 16.67% OWNER IN ORTHO LA 782885 ORTHO LA AND THE HOSPITAL PARTICIPATE IN A CO-MANAGEMENT AGREEMENT 0 ORTHO LA DR. ELIAS, BOARD MEMBER, IS A 16.67% OWNER IN ORTHO LA 278181 ORTHO LA RENTS SPACE FROM THE HOSPITAL. 0 KENEDI ANDERSON KENEDI ANDERSON IS THE GRAND-DAUGHTER OF OFFICER GREG STOCK 15000 CONTRACTED PERFORMER FOR FUNDRAISER 0 ANNE E RODRIGUE WIFE OF CHIEF OF STAFF, CHRIS RODRIGUE 621527 EMPLOYEE OF TRHS 0 FORM 990, PART VI, SECTION A, LINE 6 PER THE ARTICLES OF INCORPORATION, THE CORPORATION HAS ONE CLASS OF MEMBERSHIP, ALL DESIGNATED AS "MEMBERS." THE MEMBERS OF THE BOARD OF DIRECTORS FROM TIME TO TIME ARE AND SHALL BE THE ONLY MEMBERS OF THE CORPORATION. EACH MEMBER OF THE CORPORATION SHALL BE ENTITLED TO CAST ONE VATE AT ALL MEETING OF THE MEMBERS OF THE CORPORATION. THE ONLY RIGHTS PRIVILEGES, RESTRICTIONS, OR LIMIATION GRANTED TO IMPOSED UPON MEMBERS OF THE CORPORATION ARE THOSE IN THE ARTICLES, BYLAWS OR THE LNCL. FORM 990, PART VI, SECTION A, LINE 7A THIE INITIAL DIRECTORS OF THE CORPORATION WERE LISTED IN THE ARTICLES OF INCORPORATION. SUBSEQUENT DIRECTORS OF THE CORPORATION ARE ELECTED BY A MAJORITY VOTE OF THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS SHARED WITH THE BOARD AHEAD OF FILING AND IS REVIEWED IN DETAIL BY ACCOUNTING DEPARTMENT AHEAD OF FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO THE FOLLOWING INDIVIDUALS: DIRECTORS, OFFICERS, BOARD, OR MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS. ANNUALLY, THE BOARD OF DIRECTORS COMPLETE A CONFLICT OF INTEREST QUESTIONAIRE. ADDITIONALLY, THE BOARD MEMBERS ARE REQUIRED TO SELF DISCLOSE IN THE EVENT OF A POTENTIALK CONFLICT OF INTEREST IS IDENTIFIED OR SUSPECTED. THE BOARD THEN DETERMINES IF A CONFLICT OF INTEREST IS PRESENT. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION IS APPLIED UNIFORMLY TO ALL EMPLOYEES BASED ON POSITION OFFERED AND RELATED PRIOR EXPERIENCE. HR DEPARTMENT REVIEWS SURVEY DATA AND THE BOARD APPROVES OFFICER COMPENSATION AND MAKES CONTEMPORANEOUS SUBSTATION OF THE DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CUMMULATIVE ADJUSTMENT FOR ASC842 IMPLEMENTATION -2,728,035. FORM 990, PART XII, LINE 2C THE PROCESS FOR SELECTION AND OVERSIGHT OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR. BOARD APPROVAL IS REQUIRED. THIBODAUX REGIONAL PHYSICIAN PARTNERS LLC 602 N ACADIA RD THIBODAUX LA 70301 850884025 CIN LA 0 0 TRHS TRPP-ACO LLC 602 N ACADIA RD THIBODAUX LA 70301 850903901 ACO LA 0 0 TRHS THIBODAUX REGIONAL URGENT CARE LLC 602 N ACADIA RD THIBODAUX LA 70301 872256339 URGENT CARE LA 0 0 TRHS THIBODAUX REGIONAL MEDICAL CENTER EMPLOYEE RELIEF FUND INC 602 NORTH ACADIA RD THIBODAUX LA 70301 273160403 EMPLOYEE RELIEF LA 501(C)(3) 170(B)(1)(A)(VI) TRHS 1 TIC JV LLC 602 N ACADIA ROAD THIBODAUX LA 70301 814256937 RENTAL LA TRHS RELATED 377237 3393288 0 0 0.84730 THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION 602 N ACADIA ROAD THIBODAUX LA 70301 721335958 HEALTHCARE AND BILLING LA THIBODAUX REGIONAL HEALTH SYTEM INC C 38003896 1.00000 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 TIC JV LLC K 448552 CASH TIC JV LLC S 366300 CASH