2021-08-16T12:34:12-05:00 2020-09-30 721202445 POSTLETHWAITE & NETTERVILLE 8550 UNITED PLAZA BLVD SUITE 1001 BATON ROUGE LA 70809 990 2019-10-01 720652905 WOMAN'S HOSPITAL FOUNDATION D/B/A WOMAN'S HEALTH FOUNDATION WOMA 2259248107 P O BOX 95009 BATON ROUGE LA 70895 STEPHANIE ANDERSON EXECUTIVE VP/ CAO 2259248107 2021-08-11 1 MEGAN COURTNEY P01571790 2259224600 2019 2022-09-23 18:48:47Z BARBARA GRIFFITH 100 WOMANS WAY BATON ROUGE LA 708959009 616427885 0 X WWW.WOMANS.ORG X 1968 LA TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. 13 8 2403 140 27026040 48783 2165040 1549619 533549703 546046861 9070695 1763115 9372053 8780634 554157491 558140229 33000 32350 0 0 157206224 162606139 0 0 1899267 374875762 385587617 532114986 548226106 22042505 9914123 848940512 880343770 334200200 337775909 514740312 542567861 TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. 0 0 441434923 32350 504097642 THE MISSION OF WOMAN'S HOSPITAL IS TO IMPROVE THE HEALTH OF WOMEN AND INFANTS. WE RESPOND TO THE SPECIFIC NEEDS OF THE COMMUNITY AND SURROUNDING AREA'S NEEDS BY PROVIDING QUALITY MEDICAL AND EDUCATIONAL SERVICES WITHOUT DISTINCTION AS TO THE MEANS OF THE PERSON, HIS/HER RACE, OR DOMICILE. WOMAN'S PROVIDES MANY IMPORTANT HEALTH CARE SERVICES THAT ARE NOT AVAILABLE BY ANY OTHER ENTITY IN OUR SERVICE AREA. (115,712 LIVES TOUCHED) 12694000 58090 WOMAN'S HOSPITAL EDUCATES THE COMMUNITY BY SPONSORING PROGRAMS AND EVENTS, AND DISTRIBUTES LITERATURE ON HEALTH TOPICS OF INTEREST TO WOMEN INCLUDING CHILDBIRTH, MENOPAUSE, HEART HEALTH, DRUG ABUSE, AGING, AND SEXUALITY (360 EDUCATION PROGRAMS). WE ALSO PROVIDE COMMUNITY SERVICE BY ABSORBING VARIOUS COSTS ESSENTIAL TO THE INDIGENT POPULATION, INCLUDING EMERGENCY AND PRENATAL CARE. 433379 300170 WOMEN'S HEALTH RESEARCH INSTITUTE CONCENTRATES ITS SCIENTIFIC RESEARCH ON THE UNIQUE HEALTH CONDITIONS OF VITAL IMPORTANCE TO WOMEN'S HEALTH. ONGOING RESEARCH INCLUDES STUDIES ON MENOPAUSE, HORMONES, OSTEOPOROSIS, BREAST CANCER, MATERNAL-FETAL MEDICINE, NEONATAL MEDICINE, AND GENETICS (18 NEW PROTOCOLS REVIEWED AND APPROXIMATELY 20 ACTIVE STUDIES). 454562302 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 0 1 520 0 1 2403 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X APRIL F CHAISSON 2259248107 100 WOMANS WAY BATON ROUGE LA 70817 BEN MARMANDE SECRETARY/TREASURER 4.00 X X 0 0 0 CHRISTEL SLAUGHTER PHD DIRECTOR 4.00 X 0 0 0 FRANK BREAUX MD DIRECTOR 4.00 X 0 0 0 GREG GELPI MD DIRECTOR 4.00 X 0 0 0 PATRICK SEITER DIRECTOR (10/1/19 - 3/3/20) 4.00 X 0 0 0 ROSE HUDSON DIRECTOR 4.00 X 0 0 0 EDWARD SCHWARTZENBURG MD DIRECTOR 4.00 X 0 0 0 TOM HAWKINS JR DIRECTOR 4.00 X 0 0 0 KIRK FISHER DIRECTOR 4.00 X 0 0 0 DONNA FRAICHE 2020 CHAIR 4.00 X X 0 0 0 STEVEN FEIGLEY MD 2020 CHAIR ELECT 4.00 X X 0 0 0 RENEE HARRIS MD DIRECTOR 4.00 X 0 0 0 ROBERT L BURGESS JR (10/1/19 - 10/21/19) INTERIM PRESIDENT/CEO 65.00 X X 388340 0 1834 CHEREE SCHWARTZENBURG MD DIRECTOR 4.00 X 0 0 0 CHRIS CIESIELSKI DIRECTOR (6/23/20 - PRESENT) 4.00 X 0 0 0 MICHAEL PERNICIARO MD DIRECTOR 4.00 X 0 0 0 TERRIE THOMAS MD SECRETARY/TREASURER 65.00 X X 0 0 0 DR BARBARA GRIFFITH (10/21/19 - 9/30/20) PRESIDENT/CEO 65.00 2.00 X X 284072 0 74398 STEPHANIE ANDERSON EXECUTIVE VP/CAO 65.00 X 584727 0 52035 CHERI JOHNSON SR VP, CNO 65.00 X 267261 0 16656 DONNA BODIN VP, HUMAN RESOURCES (10/1/19/ - 4/21/20) 65.00 X 297881 0 58181 MARY C MAHER-GRIFFITHS VP, QUALITY 65.00 X 191563 0 33737 PAUL KIRK VP, INFORMATION SYSTEMS/CI 65.00 X 321400 0 24670 KURT SCOTT SR VP, COO 65.00 X 269889 0 28064 WILLIAM D BINDER MD CMO (10/1/19-7/25/20) 65.00 X 356565 0 18956 APRIL CHAISSON VP, FINANCE 65.00 X 214011 0 36006 STANLEY F SHELTON SR VP, CHIEF STRATEGIC SERVICES (10/1/18-7/16/19) 65.00 X 248983 0 20289 PATRICIA R JOHNSON SR. VP, CNO (FORMER) 65.00 X 162757 0 16098 ROBERT MOORE MD MEDICAL DIRECTOR 40.00 X 635798 0 15937 MARSHALL ST AMANT MD MEDICAL DIRECTOR 40.00 X 638141 0 48503 EDWARD W VEILLON JR MD PHYSICIAN 40.00 X 526745 0 45621 MINDY W BOWIE MD MEDICAL DIRECTOR 40.00 X 467238 0 29602 ALBERT L DIKET MD PHYSICIAN 40.00 X 511654 0 43358 TERI G FONTENTOT PRESIDENT/CEO EMERITUS (10/1/18- 3/27/19) 65.00 X 1107712 0 18997 7474737 0 582942 125 1 1 0 LSUHSC OFFICE OF SPONSORED PROJECTS 433 BOLIVAR STREET NEW ORLEANS LA 70112 MEDICAL SERVICES 5675535 MARY BIRD PERKINS CANCER CENTER 4950 ESSEN LANE BATON ROUGE LA 70809 MEDICAL SERVICES 3226622 VAN METER AND ASSOCIATES 1816 INDUSTRIAL BLVD HARVEY LA 70058 MEDICAL SERVICES 1645745 PATHOLOGY GROUP OF LOUISIANA 5339 ODONOVAN DRIVE BATON ROUGE LA 70808 MEDICAL SERVICES 1471262 OUR LADY OF THE LAKE 5000 HENNESSY BLVD BATON ROUGE LA 70809 MEDICAL SERVICES 1199782 54 1277228 272391 1549619 HOSPITAL SERVICES 541900 536863893 517033108 19830785 PHARMACY OUTSIDE SALES 446110 3701645 3701645 FITNESS CENTER 713940 2163640 564261 1599379 CAFETERIA 722210 2074514 2028159 46355 CHILD CARE 624410 1239907 589060 650847 3262 3262 546046861 4550644 33093 4517551 3418016 4562831 -1144815 -1144815 -3945 -1140870 50684929 52957119 515339 -2272190 -515339 -2787529 -2787529 490122 252367 237755 237755 OTHER OPERATING REVENUE 900099 9687694 8519813 1167881 9687694 558140229 528737663 27026040 826907 32350 32350 3749216 2924851 824365 124800288 97359625 27440663 25255027 19702038 5552989 8801608 6792227 2009381 459139 328402 130700 37 104089 74451 29630 8 216667 154972 61677 18 1217407 565085 652322 2183232 1139847 1043385 1285130 1262924 22206 219078 129388 89690 11638469 11638469 19325934 6595762 12730172 CONTRACTUAL ADJUSTMENTS 255051433 255051433 PURCHASED SERVICES 30014774 21468259 8544078 2437 PATIENT RELATED SUPPLIE 28977673 28977673 REPAIRS & MAINTENANCE 11072385 4397017 5531888 1143480 23822207 7605998 15462922 753287 548226106 454562302 91764537 1899267 121192064 136172880 26750693 27492032 42670003 41774045 5160183 5692977 538426788 165797691 383269754 372629097 2192715 2138679 6444222 6444222 261260878 287999838 848940512 880343770 30926326 31510609 199800 199800 302853262 295674343 220812 10391157 334200200 337775909 X 510760600 538724205 3979712 3843656 514740312 542567861 848940512 880343770 X 9914123 17915209 -1783 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 0 1 240417 240417 0 PART II-B, LINE 1: ALL OF THE FOLLOWING MEMBERSHIP DUES AMOUNTS RELATE TO THE LOBBYING EXPENSE PORTION OF THE DUES: 1. $643 FOR MEMBERSHIP DUES TO 340B HEALTH (FORMERLY SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS). 2. $18,796 FOR MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION. 3. $914 FOR MEMBERSHIP DUES TO THE AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACIST. 4. $216,667 TO JUDY EWELL DAY FOR GOVERNMENTAL RELATIONS. 5. $5 FOR MEMBERSHIP DUES TO THE AMERICAN COLLEGE OF HEALTHCARE EXEUCTIVES. 6. $12 FOR MEMBERSHIP DUES TO THE AMERICAN SOCIETY OF METABOLIC AND BARIATRIC SURGERY. 7. $2,4000 FOR MEMBERSHIP DUES TO THE BATON ROUGE AREA CHAMBER. 8. $4 FOR MEMBERSHIP DUES TO THE HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY. 9. $500 FOR MEMBERSHIP DUES TO THE LOUISIANA STATE MEDICAL SOCIETY. 10. $400 FOR MEMBERSHIP DUES TO THE PUBLIC AFFAIRS RESEARCH COUNCIL OF LOUISIANA. 11. $76 FOR MEMBERSHIP DUES TO THE AMERICAN COLLEGE OF OBSTETRICIANS & GYNECOLOGISTS. 16000 X 0 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1250000 1.00000 0 0 13464813 13464813 409748393 87902339 321846054 110097981 77895352 32202629 5115601 5115601 372629097 OTHER RECEIVABLES 17958638 BONDS HELD BY TRUSTEE 10374107 DEFERRED FINANCING CHARGES 1334386 RESTRICTED DONATIONS - OTHERS 9887796 RESTRICTED DONATIONS - CAP ONE CD 766521 DEPRECIATION RESERVE 263771996 OTHER ASSETS 6021122 ESTIMATED THIRD PARTY SETTLEMENTS 454665 UNAMORTIZED BOND DISCOUNT -22569393 287999838 OTHER LIABILITIES 20812 DHH PROVIDER RELIEF FUND 10370345 10391157 X PART III, LINE 4: PERMANENT INSTALLMENT OF 32 GICLEES OF WORLD RENOWNED FOLK ART DONATED IN A PRIOR YEAR AS PART OF THE HEALING ARTS PROGRAM. THE ARTWORK IS DISPLAYED IN A PROMINENT AREA OF THE HOSPITAL, FOR ALL PATIENTS AND VISITORS TO ENJOY. PART V, LINE 4: THE FOUNDATION HOLDS AN ENDOWMENT FUND IN THE AMOUNT OF $1,250,000 FROM THE HELEN BARNES TRUST. THIS AMOUNT IS PERMANENTLY RESTRICTED BUT THE ANNUAL EARNINGS FROM THIS ENDOWMENT MAYBE USED BY THE FOUNDATION. THE INCOME IS REPORTED ON THE CORE FORM 990, BUT THE BALANCE ON THIS ENDOWMENT DOES NOT CHANGE FROM YEAR TO YEAR SINCE ONLY THE $1,250,000 IS RESTRICTED. PART X, LINE 2: THE HOSPITAL APPLIES THE ACCOUNTING GUIDANCE RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH SETS OUT A CONSISTENT FRAMEWORK TO DETERMINE THE APPROPRIATE LEVEL OF TAX RESERVES TO MAINTAIN FOR UNCERTAIN TAX POSITIONS. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE RECORDED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN THE RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE HOSPITAL HAS EVALUATED ITS POSITION REGARDING THE ACCOUNTING FOR UNCERTAIN INCOME TAX POSITIONS AND DOES NOT BELIEVE THAT IT HAS ANY MATERIAL UNCERTAIN TAX POSITIONS. 1 1 X 1 X 1 X 1 1 0 1 1 3383660 3383660 0.00620 35511317 35511317 0.06480 8544724 8544724 0.01560 47439701 47439701 0.08660 461776 461776 0.00080 0 8785102 8785102 0.01600 433379 433379 0.00080 63638 63638 0.00010 9743895 9743895 0.01770 57183596 57183596 0.10430 1 3703966 11209 5552281 6027481 -475200 X 1 1 1 WOMAN'S RETAIL VENTURES LLC HOSPITAL GIFT SHOP 0.74750 0.04040 0.19190 2 STUMBERG LAND LLC LAND MANAGEMENT 0.64400 0.00000 0.35600 1 1 WOMAN'S HOSPITAL FOUNDATION PO BOX 95009 BATON ROUGE LA 70895 WWW.WOMANS.ORG X WOMAN'S HOSPITAL FOUNDATION 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X HTTP://WWW.HEALTHYBR.COM/ 1 18 1 HTTP://WWW.HEALTHYBR.COM/ 0 1 X 200.000000000000 300.000000000000 1 1 X X X X 1 X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X HTTP://WWW.WOMANS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE X X X X X X 1 X 0 X X X 1 X 0 0 WOMAN'S HOSPITAL FOUNDATION PART V, SECTION B, LINE 5: WOMAN'S DEVELOPED ITS COMMUNITY HEALTH ASSESSMENT IN COLLABORATION WITH OTHER AREA PROVIDERS AND THE MAYOR-PRESIDENT'S HEALTHY CITY INITIATIVE (MHCI). THE TEAM OF HEALTH CARE LEADERS DEVELOPED A LIST OF BATON ROUGE'S 10 HEALTH PRIORITIES, WHICH WAS REVIEWED AND APPROVED BY ALL MHCI PARTNERS WOMAN'S HOSPITAL FOUNDATION PART V, SECTION B, LINE 6A: REPRESENTATIVES FROM WOMAN'S HOSPITAL, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, BATON ROUGE GENERAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, SURGICAL SPECIALTY CENTER OF BATON ROUGE, AND OCHSNER MEDICAL CENTER OF BATON ROUGE MET TO DISCUSS AN ASSESSMENT OF COMMUNITY HEALTH. WOMAN'S HOSPITAL FOUNDATION PART V, SECTION B, LINE 6B: AARP, AMERICAN DIABETES ASSOCIATION, AMERICAN HEART ASSOCIATION, BATON ROUGE CITY COUNCIL, BATON ROUGE GENERAL MEDICAL CENTER, BATON ROUGE HEALTH DISTRICT, BOCO MEDICAL, LLC, CAPITAL AREA AGENCY ON AGING, CAPITAL AREA UNITED WAY, CAPITAL AREA HUMAN SERVICES DISTRICT, CARESOUTH MEDICAL AND DENTAL, CENTER FOR PLANNING EXCELLENCE, CITY OF BATON ROUGE, CITY OF BATON ROUGE - HUMAN DEVELOPMENT AND SERVICES, CITY OF BATON ROUGE, OFFICE OF SOCIAL SERVICES, COMMUNITY ADVOCATE, CRISIS INTERVENTION CENTER, DIRECTOR/DREAM TRUE BUSINESS SOLUTIONS, HEALTHY BR, HIGHERPOWER/VARSITY SPORTS, HUMANA, HUMANA HEALTH, INC, LA ACTION COALITION, FUTURE OF NURSING, LA ASSOCIATION OF HEALTH, PHYSICAL EDUCATION, RECREATION AND DANCE, LA DEPARTMENT OF HEALTH , LA DEPT. OF HEALTH -OFFICE OF BEHAVIORAL HEALTH, LA DEPT. OF HEALTH, OFFICE OF PRIMARY CARE AND RURAL HEALTH , LA DEPT. OF HEALTH, OFFICE OF PUBLIC HEALTH, LA EMERGENCY RESPONSE NETWORK, LA DEPT. OF HEALTH, LANE REGIONAL MEDICAL CENTER, LEXLEE'S KIDS, LOUISIANA CENTER FOR HEALTH EQUITY, LOUISIANA HEALTH CARE QUALITY FORUM, LOUISIANA PRIMARY CARE ASSOCIATION, LOUISIANA PUBLIC HEALTH INSTITUTE, LOUISIANA CENTER FOR NURSING LSBN, LSU, LSU STUDENT, LSU HEALTH, MARCH OF DIMES LOUISIANA, MARY BIRD PERKINS CANCER CENTER, MERCK, MID-CITY REDEVELOPMENT ALLIANCE , MLK COMMUNITY CENTER, NEONATAL TRANSPORT TEAM, NOVO NORDISK, OCHSNER BATON ROUGE MEDICAL CENTER, OUR LADY OF THE LAKE CHILDREN'S HOSPITAL, OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, PENNINGTON BIOMEDICAL RESEARCH CENTER, SMOKING CESSATION TRUST, SOUTH BURBANK CRIME PREVENTION AND DEVELOPMENT DISTRICT, SOUTHERN UNIVERSITY AGRICULTURAL LAND-GRANT CAMPUS, ST. JAMES PLACE, STUDENT VISITING FROM HAITI, SUSAN G. KOMEN BATON ROUGE, THE BATON ROUGE CLINIC, AMC, VETERAN AFFAIRS , VOLUNTEER OF AMERICA , WELL-AHEAD LA, LA DEPT. OF HEALTH, OFFICE OF PUBLIC HEALTH, WOMAN'S HOSPITAL, YMCA OF THE CAPITAL AREA WOMAN'S HOSPITAL FOUNDATION PART V, SECTION B, LINE 11: THE GOALS AND STRATEGIES ESTABLISHED TO MEET THE SIGNIFICANT NEEDS IDENTIFIED IN WOMAN'S HOSPITAL'S (MOST RECENT) CHNA ARE OUTLINED BELOW. FOUR PRIORITIES WERE DEVELOPED AND THE HOSPITAL PARTICIPATES IN THE FOLLOWING:ACCESS TO CARE: WOMAN'S HOSPITAL PHYSICAL/OCCUPATIONAL THERAPY, AUDIOLOGY AND NUTRITIONAL COUNSELING CARE COSTS ARE SUBSIDIZED BY GRANT FUNDS. WOMAN'S HOSPITAL ALSO EMPLOYS SOCIAL WORKERS WHO ASSESS FOR BARRIERS TO CARE IN INPATIENT AND OUTPUT SETTING. WOMAN'S PROVIDES REFERRALS TO INTERNAL AND EXTERNAL RESOURCES TO MITIGATE BARRIERS. WOMAN'S PROVIDES INTEGRATED CARE IN OBSTETRICS OFFICES TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES. WOMAN'S ALSO SUPPORTS TRANSPORTATION NEEDS WITH LYFT SERVICES WHEN APPROPRIATE, AIDS WITH MEDICATION COSTS OR COPAYS, AND PROVIDES CAFE GIFT CARDS FOR FOOD NEEDS.BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE): THE GUIDING RECOVERY AND CREATING EMPOWERMENT (GRACE) PROGRAM AT WOMAN'S HOSPITAL LAUNCHED IN THE FALL OF 2018, GRACE IS A CARE COORDINATION PROGRAM FOR PREGNANT WOMEN WITH OPIOID USE DISORDER THAT CONNECTS THEM TO RESOURCES IN THE COMMUNITY TO PROVIDE TREATMENT AND SUPPORT. FUNDED BY A GRANT FROM THE UNITED HEALTH FOUNDATION, IT IS THE ONLY PROGRAM OF ITS KIND IN LOUISIANA AND ONE OF FEW IN THE NATION. WOMEN ENROLLED IN THIS PROGRAM RECEIVE SUPPORT THROUGHOUT PREGNANCY AND FOR SIX WEEKS AFTER GIVING BIRTH. THIS MULTI-DISCIPLINARY CASE-MANAGEMENT IS DESIGNED TO IMPROVE OUTCOMES FOR MOTHER AND BABY AND LEAD TO ADDICTION RECOVERY. HEALTHY LIVING: WOMAN'S OFFERS A VARIETY OF SERVICES TO SUPPORT HEALTH AND WELLNESS. THE WOMAN'S CENTER FOR WELLNESS OFFERS A TRADEMARKED WEIGHT AND LIFESTYLE MANAGEMENT PROGRAM TO LOCAL EMPLOYERS AND OFFERS COMPLIMENTARY FITNESS CLASSES AND EDUCATIONAL SEMINARS, INCLUDING COOKING DEMONSTRATIONS. THE CENTER IS CURRENTLY THE AREA'S ONLY MEDICAL FITNESS FACILITY, DESIGNATED BY THE MEDICAL FITNESS ASSOCIATION. ADDITIONALLY, WOMAN'S OPERATES A METABOLIC AND WEIGHT LOSS CLINIC, OFFERS BARIATRIC SURGERY AND RUNS ONE OF THE TWO ACCREDITED DIABETES PREVENTION PROGRAMS IN LOUISIANA. WOMAN'S RESEARCH DEPARTMENT CONDUCTS CLINICAL STUDIES RELATED TO TREATING GESTATIONAL DIABETES, TYPE II DIABETES AND POLYCYSTIC OVARIAN SYNDROME. WOMAN'S CAFE OFFERS A WIDE VARIETY OF HEALTHY CHOICES FOR A LOWER COST. THE EMPLOYEE WELLNESS PROGRAM AT WOMAN'S OFFERS PREMIUM DISCOUNTS AND CASH INCENTIVES FOR PARTICIPATION AND, THROUGH A COMIBNATION OF EFFORTS, HAS RESULTED IN A REDUCTION OF DRUG CLAIMS IN ITS HEALTH INSURANCE PROGRAM.SEXUALLY TRANSMITTED INFECTIONS/HIV: WOMAN'S CONTINUES TO OPERATE THE MOTHER-TO-CHILD TRANSMISSION PROGRAM, WHICH OFFERS VOLUNTARY TESTING, CASE MANAGEMENT, FREE MEDICATION AND TREATMENT FOR MOM AND BABY. VOLUNTARY TESTING FOR HIV/STDS IS OFFERED TO ALL PATIENTS IN THE ASSESSMENT CENTER. PART V, SECTION B, LINE 4 WOMAN'S HOSPITAL FOUNDATION CONDUCTED ITS THIRD COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN FISCAL YEAR 2019 TO COVER THE PERIOD 2018-2020 (TAX YEARS 2017-2019). PART I, LINE 3C: WOMAN'S OFFERS A 20% DISCOUNT TO ALL UNINSURED PATIENTS REGARDLESS OF INCOME. DISCOUNTS ARE NOT APPLIED TO COSMETIC PROCEDURES. IN ADDITION, WOMAN'S OFFERS SPECIAL PRICING PACKAGES FOR SPECIFIC SERVICES, I.E. DELIVERY AND BARIATRIC SURGERY, AS WELL AS MATCHING PHYSICIAN DISCOUNTS UP TO 50% REGARDLESS OF INCOME. PART III, LINE 3: THE HOSPITAL MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN ASSESSMENT OF COLLECTABILITY, CURRENT ECONOMIC CONDITIONS, AND PRIOR EXPERIENCE. THE HOSPITAL DETERMINES IF PATIENT ACCOUNTS RECEIVABLE ARE PAST-DUE BASED ON THE SERVICE/DISCHARGE DATE; HOWEVER, THE HOSPITAL DOES NOT CHARGE INTEREST ON PAST-DUE ACCOUNTS. THE HOSPITAL WRITES OFF PATIENT ACCOUNTS RECEIVABLE IF MANAGEMENT CONSIDERS THE COLLECTION OF THE OUTSTANDING BALANCES TO BE DOUBTFUL. THIS IS ONLY AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN FOLLOWED AS OUTLINED IN OUR COLLECTION POLICY. BAD DEBT EXPENSE OF $3,703,966 IS A COMBINATION OF ACTUAL ACCOUNTS WRITTEN OFF AND ADJUSTMENTS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BASED ON A REVIEW OF ALL ACCOUNTS IN WHICH WE WERE UNABLE TO FULLY DETERMINE ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (BECAUSE THE FINANCIAL ASSISTANCE APPLICATION WAS INCOMPLETE), WE IDENTIFIED $11,209 OF CHARGES THAT WERE WRITTEN OFF AS BAD DEBT (AFTER ALL REASONABLE COLLECTION EFFORTS WERE FOLLOWED AS OUTLINED IN OUR COLLECTION POLICY). PART III, LINE 8: 100% OF THE SHORTFALL IS TREATED AS COMMUNITY BENEFIT. THE METHOD USED TO DETERMINE THE MEDICARE ALLOWABLE COST OF CARE IS COST TO CHARGE RATIO. PART III, LINE 9B: WE MAKE REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY AND QUALIFY A PATIENT FOR FINANCIAL ASSISTANCE BEFORE WE TAKE ANY ACTION TO COLLECT. WE NOTIFY PATIENTS OF OUR FINANCIAL ASSISTANCE POLICY UPON ADMISSION. PATIENTS ARE REFERRED TO A FINANCIAL COUNSELOR TO DISCUSS OUR FINANCIAL ASSISTANCE POLICY IN DETAIL. WE DOCUMENT AND TRACK WHEN AN APPLICATION IS PROVIDED TO A PATIENT/GUARANTOR; WHEN AN APPLICATION IS RECEIVED FROM A PATIENT/GUARANTOR (WHETHER COMPLETE OR INCOMPLETE); AND ALL COMMUNICATION WITH THE PATIENT/GUARANTOR WHILE THE APPLICATION IS INCOMPLETE. WE DOCUMENT IF THE APPLICATION IS APPROVED OR DENIED AND THE NOTIFICATION OF APPROVAL OR DENIAL TO THE PATIENT/GUARANTOR. IF WE ARE UNABLE TO FULLY DETERMINE ELIGIBILITY OR QUALIFY A PATIENT FOR FINANCIAL ASSISTANCE, WE FOLLOW ALL REASONABLE COLLECTION EFFORTS AS OUTLINED IN OUR COLLECTION POLICY. 0 AMERICAN HEART ASSOCIATION PO BOX 4002900 DES MOINS IA 503402900 135613797 20450 CASH CASH GRANT ORGANIZATIONAL DONATION KARNIVAL KREWE DE LOUISIANE PO BOX 82680 BATON ROUGE LA 708842680 721474904 6000 CASH CASH GRANT CANCER EVENT SPONSHORSHIP LOUISIANA NURSES FOUNDATION 543 SPANISH TOWN ROAD BATON ROUGE LA 70802 581697506 5900 CASH CASH GRANT NIGHTINGALE AWARDS GALA SPONSORSHIP 3 PART I, LINE 2: GRANTS ARE GIVEN TO ORGANIZATIONS FOR SPECIFIC PURPOSES AND ARE NOT MONITORED FURTHER. X X X X 1 1 X X X X X 1 1 0 0 0 1 0 0 0 ROBERT L BURGESS JR (10/1/19 - 10/21/19) INTERIM PRESIDE 375695 0 0 0 12645 0 0 0 1834 0 390174 0 0 0 DR BARBARA GRIFFITH (10/21/19 - 9/30/20) PRESIDENT/CEO 98018 0 112365 0 73689 0 68999 0 5399 0 358470 0 0 0 STEPHANIE ANDERSON EXECUTIVE VP/CAO 377423 0 202790 0 4514 0 38300 0 13735 0 636762 0 0 0 CHERI JOHNSON SR VP, CNO 212995 0 53227 0 1039 0 15473 0 1183 0 283917 0 0 0 DONNA BODIN VP, HUMAN RESOURCES (10/1/19/ - 4/21 223833 0 72901 0 1147 0 30725 0 27456 0 356062 0 0 0 MARY C MAHER-GRIFFITHS VP, QUALITY 151714 0 37687 0 2162 0 6616 0 27121 0 225300 0 0 0 PAUL KIRK VP, INFORMATION SYSTEMS/CI 252712 0 60238 0 8450 0 23268 0 1402 0 346070 0 0 0 KURT SCOTT SR VP, COO 213881 0 52645 0 3363 0 2083 0 25981 0 297953 0 0 0 WILLIAM D BINDER MD CMO (10/1/19-7/25/20) 284715 0 67494 0 4356 0 0 0 18956 0 375521 0 0 0 APRIL CHAISSON VP, FINANCE 170035 0 43116 0 860 0 7687 0 28319 0 250017 0 0 0 STANLEY F SHELTON SR VP, CHIEF STRATEGIC SERVICES (10/ 128726 0 600 0 119657 0 7682 0 12607 0 269272 0 0 0 PATRICIA R JOHNSON SR. VP, CNO (FORMER) 135339 0 24117 0 3301 0 5924 0 10174 0 178855 0 0 0 ROBERT MOORE MD MEDICAL DIRECTOR 562896 0 46984 0 25918 0 1900 0 14037 0 651735 0 0 0 MARSHALL ST AMANT MD MEDICAL DIRECTOR 610522 0 750 0 26869 0 22300 0 26203 0 686644 0 0 0 EDWARD W VEILLON JR MD PHYSICIAN 517648 0 750 0 8347 0 15327 0 30294 0 572366 0 0 0 MINDY W BOWIE MD MEDICAL DIRECTOR 431193 0 20000 0 16045 0 1823 0 27779 0 496840 0 0 0 ALBERT L DIKET MD PHYSICIAN 499420 0 750 0 11484 0 20200 0 23158 0 555012 0 0 0 TERI G FONTENTOT PRESIDENT/CEO EMERITUS (10/1/18- 3/2 179843 0 39250 0 888619 0 13300 0 5697 0 1126709 0 180964 0 PART I, LINE 1A ON 1 INSTANCE, MOVING EXPENSES REIMBURSED TO DR. BARBARA GRIFFITH WERE GROSSED UP BEFORE BEING REIMBURSED THRU PAYROLL. ON 1 INSTACE, MEMBERSHIP DUES WERE GROSSED UP BEFORE BEING REIMBURSED TO TERI FONTENOT. ON 1 INSTANCE, WOMAN'S HOSPITAL PROVIDED PAYMENTS OF $9,000 FOR HOUSING ALLOWANCE AND WERE INCLUDED IN THE ABOVE AMOUNT REIMBURSED AS MOVING EXPENSES FOR DR. BARBARA GRIFFITH. ON 1 INSTANCE, WOMAN'S HOSPITAL PROVIDED MONTHLY DUES TOTALING $8,206 TO THE COUNTRY CLUB OF LOUISIANA AND WERE REIMBURSED TO TERI FONTENOT WHILE SHE WAS CEO. ON 1 INSTANCE, THE COSTS OF A FINANCIAL ADVISOR WERE PAID BY THE HOSPITAL FOR THE FORMER CEO TERI FONTENOT. ON PART I, LINES 4A-B TERI FONTENOT - SERP DISTRIBUTION IN THE AMOUNT OF $180,964 STANLEY SHELTON - SEVERANCE PAYMENT IN THE AMOUNT OF $98,609.35 DR. BARBARA GRIFFITH- SERP CONTRIBUTION IN THE AMOUNT OF #68,999 THERE ARE TWO SUPPLEMENTAL DEFERRED COMPENSATION PLANS, THE EXECUTIVE DC PLAN AND THE SUPPLEMENTAL EXECUTIVE DEFERRED COMPENSATION PLAN (SERP). THE EXECUTIVE DC PLAN PROVIDES RESTORATION ACCRUALS APPLICABLE TO THE CASH BALANCE RETIREMENT PLAN, THE 403(B) PLAN AND THE 401(A) PLAN. THE RESTORATION ACCRUALS ARE EQUAL TO THE AMOUNTS THAT WOULD HAVE BEEN ADDED TO THE PLANS (BASED ON THE PERCENTAGE OF SALARY AND YEARS OF SERVICE) IF THE ANNUAL PENSION COMPENSATION LIMITS HAD NOT BEEN IN PLACE. THE NORMAL RETIREMENT AGE (NRA) FOR THE EXECUTIVE DC PLAN IS AT AGE 60. UPON ATTAINMENT OF NRA IN THE PLAN, PARTICIPANTS EXPERIENCE A "PAYMENT EVENT." THE SUPPLEMENTAL EXECUTIVE DEFERRED COMPENSATION RETIREMENT PLAN (SERP) PROVIDES ANNUAL CREDITS THAT, WHEN ACCUMULATED TO AGE 65, PROVIDE THE EXECUTIVE WITH A TARGET LIFETIME ANNUITY OF 55% OF FIVE-YEAR AVERAGE BASE NET PAY (OFFSET) OF SS AND OTHER HOSPITAL-PROVIDED BENEFITS. NORMAL RETIREMENT AGE (NRA) FOR THE SERP PLAN IS AT AGE 62. UPON ATTAINMENT OF NRA IN THE SERP, PARTICIPANTS BECOME FULLY VESTED AND EXPERIENCE A "PAYMENT EVENT." PART I, LINE 6 WOMAN'S HOSPITAL'S MANAGEMENT INCENTIVE PLAN PROVIDES FOR COMPENSATION IF CERTAIN GOALS/TARGETS ARE ACHIEVED, ONE BEING NET INCOME FROM OPERATIONS. A LCDA HOSPREV REF NOTE (WOMAN'S) SERIES 2015 721416168 2015-10-19 63605000 REFINANCE SERIES 2010B HOSPITAL REVENUE BONDS 0 0 0 B LCDA HOSP REF REV BONDS (WOMAN'S) SERIES 2017A 721416168 54628CAU6 2017-06-28 251867391 REFUND OUTSTANDING SERIES 2010A AND 2010B BONDS 0 0 0 A 63605000 1 0 1 1 B 251867391 2106164 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 0 B 0 DR EDWARD SCHWARTZENBURG DR. EDWARD SCHWARTZENBURG IS A DIRECTOR OF THE FOUNDATION 223978 SCHWARTZENBURG, LAFRANCA, AND GUIDRY RENTS OFFICE SPACE FROM THE FOUNDATION. DR. EDWARD SCHWARTZENBURG IS A MEMBER OF THIS GROUP. 0 DR FRANK BREAUX DR. FRANK BREAUX IS A DIRECTOR OF THE FOUNDATION 1287115 LWHA RENTS OFFICE SPACE FROM THE FOUNDATION. DR. FRANK BREAUX IS A MEMBER OF THIS GROUP. 0 DR RENEE HARRIS DR. RENEE HARRIS IS A DIRECTOR OF THE FOUNDATION 319059 ASSOCIATES IN WOMEN'S HEALTH RENTS OFFICE SPACE FROM THE FOUNDATION. DR RENEE HARRIS IS A MEMBER OF THIS GROUP. 0 DR STEVEN FEIGLEY DR. STEVEN FEIGLEY IS AN OFFICER OF THE FOUNDATION 1287115 LWHA RENTS OFFICE SPACE FROM THE FOUNDATION. DR. STEVEN FEIGLEY IS A MEMBER OF THIS GROUP. 0 DR TERRY THOMAS DR. TERRY THOMAS IS AN OFFICER OF THE FOUNDATION 319059 ASSOCIATES IN WOMEN'S HEALTH RENTS OFFICE SPACE FROM THE FOUNDATION. DR TERRY THOMAS IS A MEMBER OF THIS GROUP. 0 DR MICHAEL PERNICAIRO DR. MICHAEL PERNICAIRO IS A DIRECTOR OF THE FOUNDATION 1287115 LWHA RENTS OFFICE SPACE FROM THE FOUNDATION. DR. MICHAEL PERNICAIRO IS A MEMBER OF THIS GROUP. 0 DRCHEREE SCHWARTZENBURG DR. CHEREE SCWARTZENBURG IS A DIRECTOR OF THE FOUNDATION 223978 SCHWARTZENBURG, LAFRANCA, AND GUIDRY RENTS OFFICE SPACE FROM THE FOUNDATION. DR. EDWARD SCHWARTZENBURG IS A MEMBER OF THIS GROUP. 0 FORM 990, PART VI, SECTION A, LINE 2 DR. STEVEN FEIGLEY, DR. FRANK BREAUX, AND DR. MICHAEL PERNICAIRO ARE MEMBERS OF LOUISIANA WOMEN'S HEALTHCARE (LWHA). FORM 990, PART VI, SECTION A, LINE 6 BOARD MEMBERS ARE ELECTED BY FOUNDATION MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE ELECTED BY FOUNDATION MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS MADE BY THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. THE FOUNDATION CAN VOTE SEPARATELY FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A SUMMARY OF FORM 990 WAS PRESENTED TO THE BOARD PRIOR TO FILING. ALL BOARD MEMBERS WERE ALSO GIVEN THE OPTION TO REVIEW THE FORM 990 IN ITS ENTIRETY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A LETTER AND QUESTIONNAIRE ARE SENT TO EACH BOARD MEMBER ANNUALLY WITH A LIST OF OFFICERS, DIRECTORS, AND KEY PERSONNEL TO USE FOR REFERENCE IN REPORTING ANY POSSIBLE CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 A MARKET COMPARISON AND RESULTING RECOMMENDATIONS FOR TOTAL COMPENSATION AND MANAGEMENT INCENTIVE PLANS ARE CONDUCTED BY A CONSULTING FIRM AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S TAX DOCUMENTS ARE AVAILABLE UPON REQUEST. THE FORM 990 IS ALSO UPLOADED ONTO GUIDESTAR'S WEBSITE WHERE IT CAN BE VIEWED BY THE GENERAL PUBLIC. THE FOUNDATION'S ANNUAL REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE. THE FOUNDATION ALSO ISSUES QUARTERLY BOND DISCLOSURE REQUIREMENTS TO BONDHOLDERS AND RATING AGENCIES. FORM 990, PART XI, LINE 9: CHANGE IN AUXILIARY ACCOUNT -1,783. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S PROCESS HAS NOT CHANGED FROM THE FILING OF THE PREVIOUS FORM 990. STUMBERG HOLDING LLC 100 WOMANS WAY BATON ROUGE LA 70817 464133824 LAND MANAGEMENT LA WOMAN'S HOSPITAL FOUNDATION WOMAN'S MATERRA INVESTMENT COMPANY LLC 100 WOMANS WAY BATON ROUGE LA 70817 844017773 LAND MANAGEMENT LA WOMAN'S HOSPITAL FOUNDATION FOUNDATION FOR WOMAN'S 100 WOMANS WAY BATON ROUGE LA 70895 471970335 TO PROMOTE THE WELFARE OF WOMAN'S HOSPITAL FOUNDATION D/B/A WOMAN'S HOSPITAL LA 501(C)(3) LINE 12B, II WOMAN'S HOSPITAL FOUNDATION 0 WOMAN'S RETAIL VENTURES LLC 100 WOMANS WAY BATON ROUGE LA 70817 043845778 GIFT SHOP RETAIL LA 111182 701079 0 0 0.74750 STUMBERG LAND LLC 100 WOMANS WAY BATON ROUGE LA 70817 464150615 LAND MANAGEMENT LA -13025 1486964 0 0 0.64400 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 1 FOUNDATION FOR WOMANS C 1277228 CASH FOUNDATION FOR WOMANS P 854195 CASH FOUNDATION FOR WOMANS O 461828 CASH FOUNDATION FOR WOMANS O 83303 CASH FOUNDATION FOR WOMANS N 17602 CASH FOUNDATION FOR WOMANS B 149553 CASH WOMAN'S RETAIL VENTURES LLC S 160638 CASH WOMAN'S RETAIL VENTURES LLC J 84962 CASH FORM 990, SCHEDULE R, PART I & PART III STUMBERG HOLDING, LLC, A DISREGARDED ENTITY FOR TAX PURPOSES, IS OWNED 100% BY WOMAN'S HOSPITAL FOUNDATION. STUMBERG HOLDING, LLC IS A 64.40% MEMBER IN STUMBERG LAND, LLC.