THIBODAUX REGIONAL HEALTH SYSTEM INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- THIBODAUX REGIONAL HEALTH SYSTEM INC (EIN 84-2046902)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-02
- IRS object ID
- 202212149349301246
- Schema version
- 2020v4.2
- 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 C
- Schedule D
- Schedule F
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-02T20:42:21-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 201941244 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HORNE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 661 SUNNYBROOK ROAD STE 100 | AddressLine1Txt |
| City | RIDGELAND | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 842046902 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THIB | BusinessNameControlTxt |
| Phone | 9854475500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 N ACADIA ROAD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MORGAN BOURGEOIS | PersonNm |
| Person Title | CONTROLLER | PersonTitleTxt |
| Phone | 9854475500 | PhoneNum |
| Signature | 2022-07-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MORGAN | PersonFirstNm |
| Person Last | BOURGEOIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMIE T WHITTINGTON CPA | PreparerPersonNm |
| PTIN | P01082167 | PTIN |
| Phone | 6013261000 | PhoneNum |
| Preparation | 2022-07-25 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREG STOCK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 NORTH ACADIA ROAD | AddressLine1Txt |
| City | THIBIDAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $298,145,164 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.THIBODAUX.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2019 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1566 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $2,076,668 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $56,380,367 | PYContributionsGrantsAmt |
| CY Contributions Grants | $49,378,454 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $207,766,764 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $240,848,537 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,403,174 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,950,168 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,938,698 | PYOtherRevenueAmt |
| CY Other Revenue | $5,967,978 | CYOtherRevenueAmt |
| PY Total Revenue | $272,489,003 | PYTotalRevenueAmt |
| CY Total Revenue | $298,145,137 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $493 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,076 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $90,460,888 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $105,145,497 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $131,201,955 | PYOtherExpensesAmt |
| CY Other Expenses | $146,852,634 | CYOtherExpensesAmt |
| PY Total Expenses | $221,663,336 | PYTotalExpensesAmt |
| CY Total Expenses | $252,004,207 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $50,825,667 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $46,140,930 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $409,488,284 | TotalAssetsBOYAmt |
| Total Assets EOY | $473,318,062 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $356,550,570 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $374,658,321 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $52,937,714 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $98,659,741 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $187,028,151 | ExpenseAmt |
| Grant | $6,076 | GrantAmt |
| Revenue | $243,527,973 | RevenueAmt |
| Desc | 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 9/30/2021 INCLUDE: 2021 LEAPFROG GROUP PATIENT SAFTEY SCORE "A" FOR FALL 2021 HEALTHGRADES PATIENT SAFETY EXCELLENCE AWARD 2021 HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD 2021 50 TOP CARDIOVASCULAR HOPSITAL BY IBM WATSON HEALTH 2021 LEAPFROG GROUP PATIENT SAFETY SCORE "A" FOR SPRING 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST HOSPITAL 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST PLACE TO WORK 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST EMERGENCY ROOM/URGENT CARE 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST MINOR EMERGENCY ROOM/AFTER HOURS CLINIC 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST FITNESS CENTER/GYM 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST PAIN MANAGEMENT CLINIC 2021 THE COURIER/DAILY COMET BAYOU'S BEST OF THE BEST BEST PHSYICAL THERAPISTTOTAL INPATIENT DAYS 32,084AVERAGE DAILY CENSUS 87.9INPATIENT ADMISSIONS 7,038AVERAGE LOS (ACUTE) 3.84OBSERVATION PATIENTS 2,358REHAB DAYS 3,246DELIVERIES 1,063OUTPATIENT VISITS 150,727E/R VISITS 37,226HOME HEALTH ADMISSIONS 1,275ADJUSTED PATIENT DAYS 111,126SURGERY CASES 8,213 | Desc |
| Total Program Service Expenses | $187,028,151 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | Yes (1) | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 101 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1566 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9854475500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 NORTH ACADIA ROAD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| GREG K STOCK | |||||||
| CEO AND BOARD SEC. - NONVOTING | 40.00 | Yes (X) | Yes (X) | $987,311 | $0 | $32,210 | |
| JAKE GIARDINA | |||||||
| BOARD CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANCIS RICHARD | |||||||
| BOARD VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR CLEVELAND HILL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR DAVID ELIAS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR RAJA TALLURI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR CHRIS RODRIGUE | |||||||
| CHIEF OF STAFF - NON-VOTING | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN C GAUBERT | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $299,970 | $0 | $19,787 | ||
| THEUNETTE ANTILL | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $76,005 | $0 | $3,926 | ||
| BLAIN ARTHURS | |||||||
| STAFF PHYSICIAN | 40.00 | $1,073,139 | $0 | $28,262 | Yes (X) | ||
| CARLOS R GIMENEZ | |||||||
| STAFF PHYSICIAN | 40.00 | $809,497 | $0 | $21,680 | Yes (X) | ||
| JARED GILMORE | |||||||
| STAFF PHYSICIAN | 40.00 | $863,002 | $0 | $40,493 | Yes (X) | ||
| DEEPAK AWASTHI | |||||||
| STAFF PHYSICIAN | 40.00 | $770,875 | $0 | $43,447 | Yes (X) | ||
| THOMAS R DONNER | |||||||
| STAFF PHYSICIAN | 40.00 | $744,481 | $0 | $43,447 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,624,280 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $233,252 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 93 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTH CATALYST | |||||
| 3165 MILLROCK DRIVE SUITE 400 | SALT LAKE CITY | UT | 84121 | DATA ANALYTICS SERVICES | $1,596,672 |
| POWER WELLNESS MANAGEMENT | |||||
| 851 OAK CREEK DR | LOMBARD | IL | 60148 | FITNESS CENTER ADMIN SERVICES | $1,590,458 |
| MEDDATA | |||||
| 120 INNWOOD DR | COVINGTON | LA | 70433 | AMBULATORY BILLING/COLLECTION/OTHER SERV | $1,425,954 |
| CARDIOVASCULAR INSTITUTE OF THE SOUTH | |||||
| 225 DUNN STREET | HOUMA | LA | 70360 | EKG READS/MANAGEMENT SERVICES | $946,958 |
| THIBODAUX EMERGENCY PHYSICIAN GROUP | |||||
| 5000 AMBASSADOR CAFFERY PKWY BLDG 1 | LAFAYETTE | LA | 70508 | ER PHYSICIANS SERVICES | $801,340 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,944,489 | GovernmentGrantsAmt |
| All Other Contributions | $47,433,965 | AllOtherContributionsAmt |
| Total Contributions | $49,378,454 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $240,848,537 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $240,848,537 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $240,848,537 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,947,626 | TotalRevenueColumnAmt |
| Exclusion | $1,947,626 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,929,402 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,929,402 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,929,402 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,929,402 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,569 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $27 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,542 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,542 | TotalRevenueColumnAmt |
| Exclusion | $2,542 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| FITNESS CENTER REVENUE | 713940 | $2,243,108 | $2,076,668 | $166,440 | |
| CAFETERIA AND VENDING | 722514 | $817,073 | $817,073 | ||
| EQUITY IN EARNINGS OF SUBSIDIARY | 900099 | $401,628 | $401,628 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $576,767 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $348,406 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $228,361 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,038,576 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $298,145,137 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $243,527,973 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,076,668 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,162,042 | ExclusionAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,076 | TotalAmt |
| Program Services | $6,076 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,309,856 | TotalAmt |
| Program Services | $71,575,841 | ProgramServicesAmt |
| Management And General | $16,734,015 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,088,795 | TotalAmt |
| Program Services | $1,694,013 | ProgramServicesAmt |
| Management And General | $394,782 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,407,068 | TotalAmt |
| Program Services | $7,619,999 | ProgramServicesAmt |
| Management And General | $1,787,069 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,339,778 | TotalAmt |
| Program Services | $4,446,843 | ProgramServicesAmt |
| Management And General | $892,935 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,986,569 | TotalAmt |
| Program Services | $23,886 | ProgramServicesAmt |
| Management And General | $4,962,683 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,602,630 | TotalAmt |
| Program Services | $182,060 | ProgramServicesAmt |
| Management And General | $4,420,570 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,250,098 | TotalAmt |
| Program Services | $1,926,356 | ProgramServicesAmt |
| Management And General | $2,323,742 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,440 | TotalAmt |
| Program Services | $203,781 | ProgramServicesAmt |
| Management And General | $19,659 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,963 | TotalAmt |
| Program Services | $35,077 | ProgramServicesAmt |
| Management And General | $1,886 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,688,324 | TotalAmt |
| Management And General | $14,688,324 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,102,933 | TotalAmt |
| Program Services | $12,537,538 | ProgramServicesAmt |
| Management And General | $4,565,395 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,905,386 | TotalAmt |
| Management And General | $1,905,386 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $54,420,691 | $54,420,691 | |
| PURCHASED SERVICES | $20,959,553 | $13,580,184 | $7,379,369 |
| BAD DEBTS | $13,189,783 | $13,189,783 | |
| EQUIPMENT RENTAL AND MA | $8,848,913 | $5,586,023 | $3,262,890 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,637,351 | TotalAmt |
| Management And General | $1,637,351 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $252,004,207 | TotalAmt |
| Program Services | $187,028,151 | ProgramServicesAmt |
| Management And General | $64,976,056 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,091,978 | BOYAmt |
| EOY | $13,672,146 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,161,525 | BOYAmt |
| EOY | $2,163,715 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,989,709 | BOYAmt |
| EOY | $38,696,024 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,137,376 | BOYAmt |
| EOY | $4,031,061 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,264,737 | BOYAmt |
| EOY | $63,175,263 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,876,861 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,050,600 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,768,331 | BOYAmt |
| EOY | $32,826,261 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,091,069 | BOYAmt |
| EOY | $117,158,541 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,983,559 | BOYAmt |
| EOY | $201,595,051 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,488,284 | BOYAmt |
| EOY | $473,318,062 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,285,708 | BOYAmt |
| EOY | $22,854,336 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,264,862 | BOYAmt |
| EOY | $351,803,985 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,550,570 | BOYAmt |
| EOY | $374,658,321 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,937,714 | BOYAmt |
| EOY | $98,659,741 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,937,714 | BOYAmt |
| EOY | $98,659,741 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,488,284 | BOYAmt |
| EOY | $473,318,062 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $46,140,930 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,418,903 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $2,000,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
Total Grassroots Lobbying TotalGrassrootsLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $45,860 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $45,860 | FilingOrganizationsTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $186,982,291 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $187,028,151 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $1,000,000 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $250,000 | FilingOrganizationsTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | $1,000,000 | CurrentYearMinus1Amt |
| Current Year | $1,000,000 | CurrentYearAmt |
| Total | $2,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $3,000,000 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | $48,883 | CurrentYearMinus1Amt |
| Current Year | $45,860 | CurrentYearAmt |
| Total | $94,743 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | $250,000 | CurrentYearMinus1Amt |
| Current Year | $250,000 | CurrentYearAmt |
| Total | $500,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $750,000 | GrassrootsCeilingAmt |
Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | $48,883 | CurrentYearMinus1Amt |
| Current Year | $45,860 | CurrentYearAmt |
| Total | $94,743 | TotalAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-A, LINE 1A | FormAndLineReferenceDesc |
| Explanation | $32,400 IS FOR PAYMENTS TO HAYNIE AND ASSOCIATES FOR LOBBYING RELATED SERVICES. $3,544 IS FOR THE PORTION OF DUES TO AHA THAT HAS BEEN DEEMED FOR LOBBYING, AND $9,916 IS FOR THE PORTION OF DUES TO LHA THAT HAS BEEN DEEMED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,861 | OtherCostOrOtherBasisAmt |
| Book Value | $82,861 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,006,333 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,474,565 | DepreciationAmt |
| Book Value | $9,531,768 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,549,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,782,502 | DepreciationAmt |
| Book Value | $9,767,060 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,238,105 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,793,533 | DepreciationAmt |
| Book Value | $13,444,572 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,826,261 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| INVESTMENT FUNDS | $117,030,853 | C |
| OTHER INVESTMENTS | $127,688 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $117,158,541 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $2,738,185 |
| CAPITAL LEASE | $191,479,621 |
| INVESTMENT IN THIB REG SURGICAL | $3,545,890 |
| INVESTMENT IN JV IMAGING CENTER | $3,332,000 |
| DEFERRED COMPENSATION PLAN | $499,355 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $201,595,051 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| COST REPORT RECEIVABLE MEDICAID | $3,436,823 |
| TRMC LEASE | $133,095,297 |
| CAPITAL LEASES | $187,947,516 |
| COST REPORT RECEIVABLE MEDICARE | -$66,926 |
| ACCRUED INTEREST | $12,109,043 |
| INSURANCE LIABILITY | $5,282,232 |
| AMOUNTS DUE TO HSD | $10,000,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $351,803,985 | TotalLiabilityAmt |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $0 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $0 | TotalSpentAmt |
Foreign Individuals Grants ForeignIndividualsGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Assistance | DISTRIBUTION OF MEDICAL SUPPLIES | TypeOfAssistanceTxt |
| Region | SOUTH ASIA | RegionTxt |
| Recipient | 350 | RecipientCnt |
| Non Cash Assistance | $6,076 | NonCashAssistanceAmt |
| Description Of Non Cash Asst | DISTRIBUTION OF MEDICAL SUPPLIES | DescriptionOfNonCashAsstTxt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III ACCOUNTING METHOD: | FormAndLineReferenceDesc |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 325.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,079,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,079,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,300,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,164,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,135,275 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,379,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,164,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,214,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01760 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,379,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,164,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,214,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01760 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $13,189,783 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $659,489 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $46,367,473 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $43,313,397 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,054,076 | MedicareSurplusOrShortfallAmt |
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 TIC JV LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SUBLEASE OF IMAGING CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.84730 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.15270 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL HEALTH SYSTEM INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 NORTH ACADIA ROAD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Other | INPATIENT REHAB AND INPATIENT PSYCH | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 325.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.THIBODAUX.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.THIBODAUX.COM/DOCUMENTS/FINANCIAL-HARDSHIP-APPLICATION-6-2016.PDF | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.THIBODAUX.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | THIBODAUX REGIONAL HEALTH SYSTEM, INC. | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 2: HOSPITAL BEGAN OPERATIONS ON OCTOBER 1, 2019, AS A TAX-EXEMPT HOSPITAL | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 18 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 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 UROLOGY CLINIC | ||||
| 504 N ACADIA RD | THIBODAUX | LA | 70301 | UROLOGY |
| 4 - THIBODAUX REGIONAL PAIN MANAGEMENT CLINI | ||||
| 726 N ACADIA RD STE 2400 | THIBODAUX | LA | 70301 | PAIN MANAGEMENT |
| 5 - THIBODAUX REGIONAL PULMONOLOGY CLINIC | ||||
| 604 N ACADIA RD STE 411 | THIBODAUX | LA | 70301 | PULMONOLOGY |
| 6 - THIBODAUX REGIONAL BRAIN & SPINE CLINIC | ||||
| 726 N ACADIA RD STE 2100 | THIBODAUX | LA | 70301 | BRAIN & SPINE |
| 7 - THIBODAUX REGIONAL NEUROLOGY CLINIC | ||||
| 726 N ACADIA RD STE 2300 | THIBODAUX | LA | 70301 | NEUROLOGY |
| 8 - THIBODAUX REGIONAL PEDIATRIC CLINIC | ||||
| 807 RIDGEFIELD RD | THIBODAUX | LA | 70301 | PEDIATRICS |
| 9 - THIBODAUX REGIONAL RHEUMATOLOGY CLINIC | ||||
| 726 N ACADIA RD STE 3400 | THIBODAUX | LA | 70301 | RHEUMATOLOGY |
| 10 - THIBODAUX REGIONAL FAMILY MEDICINE CLINI | ||||
| 114 HIGHWAY 403 | PAINCOURTVILLE | LA | 70391 | FAMILY MEDICINE |
| 11 - THIBODAUX REGIONAL INTERNAL MEDICINE CLI | ||||
| 506 N ACADIA RD | THIBODAUX | LA | 70301 | INTERNAL MEDICINE |
| 12 - THIBODAUX REGIONAL ENDOCRINOLOGY CLINIC | ||||
| 726 N ACADIA RD STE 3300 | THIBODAUX | LA | 70301 | ENDOCRINOLOGY |
| 13 - THIBODAUX REGIONAL CARDIOVASCULAR CLINIC | ||||
| 604 N ACADIA RD STE 409 | THIBODAUX | LA | 70301 | CARDIOVASCULAR |
| 14 - THIBODAUX REGIONAL PODIATRY CLINIC | ||||
| 726 N ACADIA RD STE 1700 | THIBODAUX | LA | 70301 | PODIATRY |
| 15 - THIBODAUX REGIONAL FAMILY MEDICINE CLINI | ||||
| 3928 HIGHWAY 70 SOUTH | PIERRE PART | LA | 70339 | FAMILY MEDICINE |
| 16 - THIBODAUX REGIONAL PLASTIC & RECONSTRUCT | ||||
| 604 N ACADIA RD ST 410 | THIBODAUX | LA | 70301 | PLASTIC SURGERY |
| 17 - THIBODAUX REGIONAL RACELAND MULTISPECIAL | ||||
| 4560 HIGHWAY 1 STE 3 | RACELAND | LA | 70394 | MULTI-SPECIALTY |
| 18 - THIBODAUX REGIONAL PHYSICAL MEDICINE AND | ||||
| 1107 AUDUBON AVE B | THIBODAUX | LA | 70301 | PHYSICAL MEDICINE |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 13,189,783. |
| 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 22 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PLEASE NOTE THAT BAD DEBT EXPENSE IS NOW REFERRED TO AS IMPLICIT PRICE CONCESSIONS, AS DESCRIBED ON PAGE 22 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 2020 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 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLAIN ARTHURS | ||||||||||||||
| STAFF PHYSICIAN | $1,073,139 | $0 | $0 | $0 | $0 | $0 | $12,001 | $0 | $16,261 | $0 | $1,101,401 | $0 | $0 | $0 |
| GREG K STOCK | ||||||||||||||
| CEO AND BOARD SEC. - NONVOTING | $987,311 | $0 | $0 | $0 | $0 | $0 | $22,531 | $0 | $9,679 | $0 | $1,019,521 | $0 | $0 | $0 |
| JARED GILMORE | ||||||||||||||
| STAFF PHYSICIAN | $863,002 | $0 | $0 | $0 | $0 | $0 | $30,900 | $0 | $9,593 | $0 | $903,495 | $0 | $0 | $0 |
| CARLOS R GIMENEZ | ||||||||||||||
| STAFF PHYSICIAN | $809,497 | $0 | $0 | $0 | $0 | $0 | $12,001 | $0 | $9,679 | $0 | $831,177 | $0 | $0 | $0 |
| DEEPAK AWASTHI | ||||||||||||||
| STAFF PHYSICIAN | $770,875 | $0 | $0 | $0 | $0 | $0 | $28,000 | $0 | $15,447 | $0 | $814,322 | $0 | $0 | $0 |
| THOMAS R DONNER | ||||||||||||||
| STAFF PHYSICIAN | $744,481 | $0 | $0 | $0 | $0 | $0 | $28,000 | $0 | $15,447 | $0 | $787,928 | $0 | $0 | $0 |
| STEVEN C GAUBERT | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $299,970 | $0 | $0 | $0 | $0 | $0 | $10,108 | $0 | $9,679 | $0 | $319,757 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ORTHO LA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DR. ELIAS, BOARD MEMBER, IS A 16.67% OWNER IN ORTHO LA | RelationshipDescriptionTxt |
| Transaction | $729,644 | TransactionAmt |
| Transaction | ORTHO LA AND THE HOSPITAL PARTICIPATE IN A CO-MANAGEMENT AGREEMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS JAKE GIARDINA AND DR. CLEVELAND HILL BOTH SERVE ON THE BOARD FOR THE HOSPITAL SERVICE DISTRICT #3. |
| 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 XII, LINE 2C | THE PROCESS FOR SELECTION AND OVERSIGHT OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR. BOARD APPROVAL IS REQUIRED. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt |
|---|---|---|---|---|---|---|---|---|
| THIBODAUX REGIONAL PHYSICIAN PARTNERS LLC | ||||||||
| 602 N ACADIA RD | THIBODAUX | LA | 70301 | 850884025 | CIN | LA | $0 | $0 |
| TRPP-ACO LLC | ||||||||
| 602 N ACADIA RD | THIBODAUX | LA | 70301 | 850903901 | ACO | LA | $0 | $0 |
| THIBODAUX REGIONAL URGENT CARE LLC | ||||||||
| 602 N ACADIA RD | THIBODAUX | LA | 70301 | 872256339 | URGENT CARE | LA | $0 | $0 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL MEDICAL CENTER EMPLOYEE RELIEF FUND INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 NORTH ACADIA RD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273160403 | EIN |
| Primary Activities | EMPLOYEE RELIEF | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 170(B)(1)(A)(VI) | PublicCharityStatusTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIC JV LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 N ACADIA ROAD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 814256937 | EIN |
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $377,940 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $3,370,796 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 N ACADIA ROAD | AddressLine1Txt |
| City | THIBODAUX | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721335958 | EIN |
| Primary Activities | HEALTHCARE AND BILLING | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THIBODAUX REGIONAL HEALTH SYTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIC JV LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $224,276 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments