2023-05-13T18:27:54-05:00 2022-06-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2021-07-01 463123178 OUR LADY OF THE ANGELS HOSPITAL INC OURL 9857306700 4200 ESSEN LANE BATON ROUGE LA 70809 JENNIFER CLOWERS REGIONAL CFO 9857306700 2023-05-12 1 JENNIFER CLOWERS XXX-XX-XXXX RYAN HOOKS P00746825 2253444000 2023-05-12 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z PAOLO ZAMBITO 4200 ESSEN LANE BATON ROUGE LA 70809 90025368 0 0928 X WWW.OLOAH.ORG X 2013 LA THE HOSPITAL'S PURPOSE IS TO PROVIDE CARE CARE FOR THE ILL, INJURED, OR DISABLED (SEE SCHEUDLE O) PERSONS & TO PROVIDE FOR RESEARCH, EDUCATION, & THE ENHANCEMENT OF HEALTH OF THOSE IN SOUTHEAST LOUISIANA. 11 9 611 9 0 0 8081604 3139361 76842347 84479037 36893 748592 0 0 84960844 88366990 2500 14395 0 0 33627795 36056639 0 0 0 35509131 39885187 69139426 75956221 15821418 12410769 64080884 62631558 32582389 23105553 31498495 39526005 X SEE SCHEDULE O 0 0 57477322 14395 84479037 OUR LADY OF THE ANGELS HOSPITAL, INC. PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES PRIMARILY TO RESIDENTS OF SOUTHEAST LOUISIANA. THE HOSPITAL IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE HOSPITAL HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. THE HOSPITAL PROVIDED 56 LICENSED BEDS, 9,428 INPATIENT DAYS AND 20,089 ER VISITS IN THE YEAR ENDED JUNE 30, 2022. 57477322 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 611 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 X AMANDA HYMEL 9857306700 5959 S SHERWOOD FOREST BLVD BATON ROUGE LA 70809 HENRY HARRISON BOARD MEMBER 2.00 0.00 X 0 0 0 ROBERT BURGEES RETIRED - PRESIDENT & CEO WCH 2.00 0.00 X 0 0 0 BERNIE CHASCIN BOARD MEMBER 2.00 0.00 X 0 0 0 ROGER KEESE BOARD MEMBER 2.00 0.00 X 0 0 0 LEO MICKENHEIM VICE CHAIR 2.00 0.00 X X 0 0 0 RENE RAGAS PRESIDENT AND CEO 2.00 51.00 X X 0 642468 109874 CRAIG ROBICHAUX CHAIR 2.00 0.00 X X 0 0 0 SR EILEEN ROWE BOARD MEMBER 2.00 2.50 X 0 0 0 CHRIS TREVINO MD BOARD MEMBER/PHYSICIAN 2.00 40.00 X 0 222058 12358 JUDITH WAMSLEY SECRETARY 2.00 0.00 X X 0 0 0 BRYAN MILLER VP CHIEF CLINICAL TRANSFORMATION 2.00 40.00 X X 0 399731 18099 WILLIAM WAINWRIGHT BOARD MEMBER 2.00 0.00 X 0 0 0 LOWELL E STANTON REGIONAL CFO 2.00 52.50 X 0 634011 42886 RALPH SERPAS VP, CNO 40.00 0.00 X 221740 0 37588 DEBBIE B WILLIAMS VP - OPERATIONS 40.00 0.00 X 203397 0 12300 HAMID HUSSAIN PHYSICIAN 40.00 0.00 X 600858 0 44898 GOLAM NOAZ PHYSICIAN 40.00 0.00 X 338534 0 24471 GERALD FORET HOSPITALIST NE 40.00 0.00 X 385291 0 45934 GARLAND ANDERSON PHYSICIAN 40.00 0.00 X 319796 0 40378 STEVEN OGDEN PHYSICIAN 40.00 0.00 X 339320 0 16615 JEFF LIMBOCKER FORMER CFO/CURRENT HS CFO 0.00 40.00 X 0 991087 185197 2408936 2889355 590598 43 1 1 0 FMOL HEALTH SYSTEM 4200 ESSEN LANE BATON ROUGE LA 70805 MANAGEMENT SERVICES 5825473 LSUHSC CLINICS 5825 AIRLINE HWY LSU UNIT BATON ROUGE LA 70805 PROF. MEDICAL SVCS 3167780 WASHINGTON PARISH EMERGENCY 5000 AMBASSADOR CAFFERY PKWY BLDG LAFAYETTE LA 70508 CONTRACT PROF. SVCS 1875958 LSUHSC-NEW ORLEANS 433 BOLIVAR ST NEW ORLEANS LA 70112 PROF. MEDICAL SVCS 1863193 MERCY SPECIALIZED BILLING SVCS 655 MARYVILLE CENTRE ST LOUIS MO 63141 BILLING SERVICES 1707059 31 3139361 3139361 PATIENT SERVICE REV 622110 82004082 82004082 PHARMACY 622110 1398231 1398231 OTHER REVENUE 900099 864820 864820 CAFETERIA SALES 622110 185597 185597 LAB 622110 13420 13420 12887 12887 84479037 139017 139017 2253353 14600 1658378 0 594975 14600 609575 609575 88366990 84479037 0 748592 14395 14395 412762 354705 58057 29539873 25384940 4154933 1141038 947062 193976 2917888 2421847 496041 2045078 1693916 351162 13753244 9615069 4138175 25213 25213 28884 11756 17128 4978977 2674318 2304659 147400 59993 87407 6620462 3575339 3045123 336885 137114 199771 6461675 5499868 961807 50043 20368 29675 2778 1131 1647 11286 11286 1042408 887248 155160 848627 69791 778836 MEDICAL SUPPLIES EXP 5577305 4108462 1468843 75956221 57477322 18478899 0 32512308 2802590 0 0 0 0 -3120082 2884795 0 0 0 0 0 0 560158 489880 5547537 5012471 19927546 2814047 19375414 17113499 0 0 0 22322336 0 0 0 113894 9205549 11892093 64080884 62631558 14752933 12107652 0 0 5013202 1994498 0 0 0 0 0 0 0 0 0 0 12816254 9003403 32582389 23105553 X 31498495 39526005 0 0 31498495 39526005 64080884 62631558 X 12410769 -3375328 -1007931 X 0 1 X 1 0 X 243762 243762 5413763 1145962 4267801 6014861 1668085 4346776 8255160 8255160 17113499 FMOL PORTFOLIO 22322336 F 22322336 DUE TO/FROM AFFILIATES 11892093 11892093 CAPITAL LEASE 3519906 ST OBLIGATION OPERATING LEASE 5253940 OTHER LIABILITIES 229557 9003403 X PART X, LINE 2: FMOLHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. 1 1 1 X 250.000000000000 0 1 1 1 0 1 1 1444018 1444018 24645747 24645747 26089765 26089765 0 0.00000 7592552 38801 7553751 0.09940 7592552 38801 7553751 0.09940 33682317 26128566 7553751 0.09940 0 4209850 7556422 9230564 -1674142 X 1 1 1 1 OUR LADY OF THE ANGELS HOSPITAL INC 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 WWW.OLOAH.ORG 2203781960 X X X X OUR LADY OF THE ANGELS HOSPITAL INC 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X SEE PART V SECTION B X 1 21 0 1 0 1 X 250.000000000000 0.000000000000 X X X X X 1 1 X X X 1 X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X X X X X X X 1 X 0 X X X X 1 X 0 0 OUR LADY OF THE ANGELS HOSPITAL, INC. PART V, SECTION B, LINE 5: THE ORGANIZATION ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS, A REGIONAL FOCUS GROUP, AND SURVEYS DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANNING PROCESS. OUR LADY OF ANGELS HOSPITAL (OLOAH) CONSIDERED INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH BY INTERVIEWING GINA LAGARDE, MD, MBA, REGIONAL MEDICAL DIRECTOR/ADMINISTRATOR, REGION 9, LOUISIANA OFFICE OF PUBLIC HEALTH, IN THE PROCESS OF CONDUCTING ITS COMMUNITY HEALTH NEEDS ASSESSMENT. ADDITIONALLY, OLOAH CONSIDERED INPUT FROM THOSE WHO REPRESENT BROAD INTERESTS IN THE COMMUNITY AND INCLUDED REPRESENTATIVES OF POPULATIONS IN CATEGORIES SUCH AS LOW-INCOME, MINORITY, MEDICALLY UNDERSERVED, AND THOSE EXPERIENCING BARRIERS DUE TO OTHER SOCIAL DETERMINANTS OF HEALTH. OUR LADY OF THE ANGELS HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS A JOINT CHNA CONDUCTED WITH OUR LADY OF THE LAKE SURGICAL HOSPITAL IN SLIDELL. OUR LADY OF THE ANGELS HOSPITAL, INC. PART V, SECTION B, LINE 11: OUR LADY OF THE ANGELS HOSPITAL (OLOAH), A MEMBER OF THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM (FMOLHS), CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021. THE SIGNIFICANT HEALTH NEEDS/PRIORITY AREAS IDENTIFIED DURING THE 2021 CHNA PROCESS WERE:1. ADDRESSING BARRIERS TO CARE2. IMPROVING HEALTH LITERACY CONCERNING ADDRESSING BARRIERS TO CARE AND INCREASING HEALTH LITERACY, OLOAH OFFERED COMMUNITY EDUCATION AND HEALTH SCREENINGS AT LOCAL HEALTH FAIRS, SCHOOLS, BUSINESSES AND COMMUNITY ORGANIZATIONS. THESE COMMUNITY EDUCATION SESSIONS OFFERED SERVICES TO OVER 1,490 INDIVIDUALS BETWEEN JUNE 2021 AND JULY 2022. OLOAH FACILITATED SERVICES AND HEALTH EDUCATION SESSIONS FOR SENIORS WITH MONTHLY EDUCATION PROGRAMS AND HEALTH SCREENINGS AT BOTH THE ST. TAMMANY AND WASHINGTON PARISH COUNCIL ON AGING FACILITIES AND WESTMINSTER WOODS APARTMENTS. OLOAH MADE HOME VISITS WITH BOTH NURSE PRACTITIONERS AND FAMILY MEDICINE RESIDENTS FROM THE LSU RURAL FAMILY MEDICINE RESIDENCY PROGRAM. IN ADDITION, OLOAH PROVIDED REGULAR COMMUNITY EDUCATION PROGRAMS IN AREA CHURCHES AND PUBLIC SCHOOLS. TOGETHER WITH THE LSU RURAL FAMILY MEDICINE RESIDENCY PROGRAM, OLOAH PERFORMED MORE THAN 500 PRO BONO STUDENT-ATHLETE SPORTS PHYSICALS AND HOSTED SEVERAL COMMUNITY HEALTH FAIRS EACH YEAR.OLOAH IS NOT ADDRESSING THE FOLLOWING NEEDS IDENTIFIED IN ITS CHNA: ECONOMY, EDUCATION, JOBS, MENTAL HEALTH, OBESITY, POVERTY, RACISM, SPECIALTY CARE, SUBSTANCE ABUSE AND TRANSPORTATION. EACH OF THESE NEEDS IS OUTSIDE OF THE SCOPE OF THE HOSPITAL OR IS BEING INDIRECTLY ADDRESSED AS OLOAH ADDRESSES ELIMINATING BARRIERS TO CARE AND IMPROVING HEALTH LITERACY OR THROUGH COLLABORATION WITH OTHER GROUPS. RECOGNIZING THAT TRANSPORTATION WAS A BARRIER TO CARE, OLOAH MADE SIGNIFICANT EFFORTS TO ADDRESS THE NEED THROUGH SUBSIDIZED TRANSPORTATION SERVICES FROM ITS SITE. IN FISCAL YEAR 2022, OLOAH PROVIDED APPROXIMATELY $15,000 IN TRANSPORTATION AID TO COMMUNITY MEMBERS. ANOTHER BARRIER TO CARE IS THE NEED FOR HOME OXYGEN THERAPY FOR MANY COMMUNITY MEMBERS. AS SUCH, THROUGH ITS COMMUNITY HEALTH SERVICES DEPARTMENT, IN FISCAL YEAR 2022, OLOAH COVERED THE COST OF HOME OXYGEN THERAPY FOR COMMUNITY MEMBERS FOR A TOTAL OF $3,000.IN ADDITION TO PROVIDING FISCAL AID FOR IDENTIFIED BARRIERS TO CARE, OLOAH ALSO INVESTED IN PROVIDING MATERIALS AND EDUCATION FOR AN IDENTIFIED POOL OF AT-RISK PATIENTS WITH HIGH BLOOD PRESSURE. OLOAH'S GOAL WAS TO PILOT A PROGRAM THAT WILL IMPROVE OVERALL BLOOD PRESSURE CONTROL IN A SELECT GROUP OF PATIENTS INCLUDING HIGHEST RISK PATIENTS WHO ARE BETTER SERVED OUTSIDE OF OLOAH'S CLINICS. THIS INVESTMENT OF MATERIALS AND EDUCATION WILL PROVIDE OLOAH WITH THE DATA TO BROADEN THE PROGRAM TO AID OUR HYPERSENSITIVE AND UNDER RESOURCED POPULATION. IN FISCAL YEAR 2022, THE PROGRAM WAS LAUNCHED BY DISTRIBUTING 20 BLOOD PRESSURE MONITORS TO COMMUNITY MEMBERS IN NEED. OLOAH ALSO HOSTED AN ONGOING TOBACCO CESSATION PROGRAM AND COLLABORATED WITH LOCAL, STATE AND COMMUNITY PARTNERS IN ORDER TO STUDY AND RESPOND TO THE OPIOID EPIDEMIC AND SUBSTANCE ABUSE ISSUES IN WASHINGTON PARISH. OLOAH SOCIAL SERVICES TEAM PARTICIPATES IN SEVERAL COMMUNITY EDUCATION OFFERINGS CONCERNING BEHAVIORAL HEALTH AND SUBSTANCE USE. IN FISCAL YEAR 2022, OLOAH SOCIAL SERVICES DEPARTMENT HAD A TOTAL OF 2673 CONTACTS WITH COMMUNITY MEMBERS, IN SETTINGS RANGING FROM LOCAL HEALTH FAIRS, COMMUNITY ORGANIZATION MEETINGS, TO COURT ORDERED SUBSTANCE ABUSE GROUPS. THROUGH ITS COMMUNITY IMPACT WORKGROUP, IN FISCAL YEAR 2022, OLOAH CONTINUED TO OPERATIONALIZE ITS COMMUNITY IMPACT GRANT PROGRAM. THROUGH THIS PROGRAM, OLOAH AWARDED A TOTAL OF APPROXIMATELY $15,000 IN FUNDING TO LOCAL ORGANIZATIONS WHOSE EFFORTS ADDRESS BARRIERS TO CARE, OR AID IN IMPROVING THE HEALTH LITERACY OF THE COMMUNITY. OUR LADY OF THE ANGELS HOSPITAL, INC. PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. THE PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2. STATE-FUNDED PRESCRIPTION PROGRAMS; 3. HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4. PATIENTS' CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5. PATIENT ELIGIBLE FOR FOOD STAMPS; 6. MEDICAID ELIGIBLE PATIENT; 7. PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8. PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY OUR LADY OF THE ANGELS HOSPITAL, INC. PART V, SECTION B, LINE 16J: REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW-INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. PART V, SECTION B, 16A, 16B & 16C: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE ALL AVAILABLE AT:HTTPS://FMOLHS.ORG/FINANCIAL-ASSISTANCE-POLICY/ PART V, SECTION B, LINE 7A: THE CHNA CAN BE LOCATED AT:HTTPS://OLOAH.ORG/ASSETS/DOCUMENTS/OLOAH-2021-CHNA.PDF PART I, LINE 3C: FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULLY DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. FULLY DISCOUNT CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS WHERE MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF INCOME AND ASSETS. PART I, LINE 7: THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINE 7A-7D AND WAS OBTAINED FROM THE HOSPITAL'S MEDICARE COST REPORT. PART III, LINE 2: AMOUNT REPRESENTS THE ACTUAL CUSTOMER AMOUNTS DUE TO OUR LADY OF THE ANGELS HOSPITAL THAT WERE WRITTEN OFF BECAUSE THEY WERE UNCOLLECTIBLE. PART III, LINE 4: THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. PART III, LINE 9B: PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, RESIDENCY, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR DISCOUNTED CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT: RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. AS SUCH, OUR LADY OF THE ANGELS HOSPITAL WORKS CLOSELY WITH CHARITABLE ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. OUR LADY OF THE ANGELS ADOPTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT BY JUNE 30, 2022 AND WILL CONTINUE TO USE COMMUNITY BASED DATA TO SUPPORT DECISIONS FOR OUTREACH IN THE COMMUNITY. PART VI, LINE 3: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE ANGELS HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE. PART VI, LINE 4: OUR LADY OF THE ANGELS HOSPITAL IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN BOGALUSA, LOUISIANA, THAT SERVES WASHINGTON PARISH AND PORTIONS OF THE SURROUNDING PARISHES. THE HOSPITAL'S PRIMARY SERVICE AREA IS WASHINGTON AND ST. TAMMANY PARISHES. BASED ON THE MOST RECENT CHNA, WASHINGTON PARISH HAS A POPULATION OF APPROXIMATELY 46,194, AND THE SENIOR POPULATION COMPRISES ABOUT 18.5% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $37,570, WHICH IS SIGNIFICANTLY LOWER THAN THE STATE AVERAGE. ST. TAMMANY PARISH HAS A POPULATION OF APPROXIMATELY 260,419 AND THE SENIOR POPULATION COMPRISES ABOUT 17.5% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $68,905 WHICH IS HIGHER THAN THE STATE AVERAGE. PART VI, LINE 5: OUR LADY OF THE ANGELS HOSPITAL PARTICIPATES IN COMMUNITY IMPROVEMENT ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY IMPROVEMENT ACTIVITIES INCLUDE THE FOLLOWING: OUR LADY OF THE ANGELS ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT MAY BE FOREGONE OR POSTPONED RESULTING IN MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE ANGELS PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE ANGELS HOSPITAL IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. OUR LADY OF THE ANGELS HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. PART VI, LINE 6: OUR LADY OF THE ANGELS HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE ANGELS HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA AND ONE IN MISSISSIPPI. OUR LADY OF THE ANGELS HOSPITAL SERVES THE COMMUNITY IN WASHINGTON PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: - OUR LADY OF THE LAKE HOSPITAL- OUR LADY OF LOURDES REGIONAL MEDICAL CENTER- ST. FRANCIS MEDICAL CENTER- OUR LADY OF THE LAKE ASSUMPTION HOSPITAL RELATED HOSPITAL IN MISSISSIPPI:ST. DOMINIC JACKSON MEMORIAL HOSPITAL 0 1 0 0 0 0 0 0 0 JEFF LIMBOCKER FORMER CFO/CURRENT HS CFO 0 670983 0 234110 0 85994 0 160910 0 24287 0 1176284 0 60058 RENE RAGAS PRESIDENT AND CEO 0 376418 0 264215 0 1835 0 83688 0 26186 0 752342 0 0 LOWELL E STANTON REGIONAL CFO 0 454544 0 176720 0 2747 0 14500 0 28386 0 676897 0 0 HAMID HUSSAIN PHYSICIAN 517641 0 80895 0 2322 0 14500 0 30398 0 645756 0 0 0 GERALD FORET HOSPITALIST NE 309295 0 74000 0 1996 0 14500 0 31434 0 431225 0 0 0 BRYAN MILLER VP CHIEF CLINICAL TRANSFORMATION 0 347009 0 51480 0 1242 0 14500 0 3599 0 417830 0 0 GOLAM NOAZ PHYSICIAN 237753 0 100345 0 436 0 14500 0 9971 0 363005 0 0 0 GARLAND ANDERSON PHYSICIAN 215720 0 103608 0 468 0 14500 0 25878 0 360174 0 0 0 STEVEN OGDEN PHYSICIAN 232816 0 106011 0 493 0 14500 0 2115 0 355935 0 0 0 RALPH SERPAS VP, CNO 168319 0 51586 0 1835 0 11497 0 26091 0 259328 0 0 0 CHRIS TREVINO MD BOARD MEMBER/PHYSICIAN 0 187318 0 33280 0 1460 0 10933 0 1425 0 234416 0 0 DEBBIE B WILLIAMS VP - OPERATIONS 155201 0 46361 0 1835 0 10084 0 2216 0 215697 0 0 0 PART I, QUESTION 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. PART 1, QUESTION 4A THE PRESIDENT AND REGIONAL CFO ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 18 MONTH. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE FORMER CFO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. PART 1, QUESTION 4B FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDED FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO THE APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. JEFF LIMBOCKER RECEIVED A PAYMENT OF $83,247, FROM THE PLANS IN THE CURRENT YEAR. FORM 990, PART III, LINE 1 INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. FORM 990, PART VI, SECTION A, LINE 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE ANGELS HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE ANGELS HOSPITAL, INC., RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE ANGELS HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B AFTER PREPARATION AND REVIEW BY KPMG, LLP, MANAGEMENT WILL REVIEW THE FORM 990. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OUR LADY OF THE ANGELS HOSPITAL, INC. HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY AND (D) UNDERSTANDS THAT OUR LADY OF THE ANGELS HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE ANGELS HOSPITAL, INC. PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION, AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT & CEO, AND REGIONAL CFO OF THIS ORGANIZATION ARE EMPLOYEES OF FMOL HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION, WHOSE SALARIES ARE DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION. SUCH PAY PRACTICES INCLUDE THE USE OF AN INDEPENDENT BOARD COMMITTEE WHICH REVIEWS COMPENSATION ANNUALLY AFTER OBTAINING AND RELYING UPON INDUSTRY WIDE COMPENSATION INFORMATION FROM OUTSIDE SOURCES. THE BOARD COMMITTEE APPROPRIATELY DOCUMENTS ITS DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PART VI, SECTION B, QUESTIONS 13 & 14 THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A DOCUMENT RETENTION POLICY AND A WHISTLEBLOWER POLICY IN PLACE ALTHOUGH THEY WERE NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS OR A COMMITTEE THEREOF BEFORE YEAR END. FORM 990, PART XI, LINE 9: CAPITAL TRANSFER -1,007,931. SECTION 1.263(A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE ANGELS HOSPITAL INC. DOES HAVE APPLICABLE FINANCIAL STATEMENTS FOR THE YEAR OF THE ELECTION, AND INTEND TO APPLY THE DEMINIMIS SAFE HARBOR ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(II). SECTION 1.263(A)-3(N) ELECTION- BOOK CONFORMITY ELECTION OUR LADY OF THE ANGELS HOSPITAL INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2022. 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