2021-06-02T16:39:49-05:00 2020-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2019-07-01 720423635 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC % AMANDA HYMEL OURL 2259232701 4200 ESSEN LANE BATON ROUGE LA 70809 JENNIFER CLOWERS CFO/EVP 3374702000 2021-06-01 true BRITTANY ELLISER P01284594 2253444000 2021-05-17 2019 2022-09-23 18:48:47Z X W BRYAN LEE 4200 ESSEN LANE BATON ROUGE LA 70809 429649932 false X LOURDESRMC.COM X 1957 LA To provide for the care of the ill, injured, or disabled persons and to provide for research, education, and the enhancement of health of those in the community. 17 15 2729 196 1583061 -729056 2560423 9159761 325581998 402518366 5836514 3966886 2530962 3631413 336509897 419276426 61301 1497818 0 0 119408075 171163969 0 0 0 205760416 254319145 325229792 426980932 11280105 -7704506 396956240 491856825 333110711 453733840 63845529 38122985 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. EXTENDS THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. CALLS FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING-WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. false false 281538778 1497818 380401597 HOSPITAL AND MEDICAL SERVICES PRIMARILY TO RESIDENTS OF SOUTH LOUISIANA. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. THE MEDICAL CENTER PROVIDED SERVICES FOR 92,845 PATIENT DAYS, 19,366 INPATIENT DISCHARGES, AND 76,345 EMERGENCY ROOM VISITS IN THE YEAR ENDED JUNE 30, 2020. SEE SCHEDULE O FOR FURTHER EXPLANATION. 31297286 22116769 OUR LADY OF LOURDES RMC'S PHYSICIAN PRACTICE PROVIDES CARE TO THE NEEDY MEMBERS OF ITS COMMUNITIES. 312836064 true true false false false false false false false false true false false false true true false true false false true true false false false false true true true false true false false false false false false false false false false false false true true true true false false true 59 0 true 2729 true true true false false false false false false false false false false false X 17 15 false false false false true true true true true false false true true true true false true true false true true X AMANDA HYMEL 2257658496 5959 SSHERWOOD FOREST BLVD BATON ROUGE LA 70809 JEFF LIMBOCKER CFO/EVP 2.0 58.5 X 0 898795 161397 W BRYAN LEE CEO& President 0.5 50.0 X X 0 613195 104355 KENNETH FALTERMAN STAFF PHYSICIAN 40.0 0.0 X 607407 0 31871 DEIADRA J GARRETT STAFF PHYSICIAN 40.0 0.0 X 600624 0 19733 ANTHONY P BLALOCK CMO 40.0 1.0 X 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Professional Service 835000 20 3103033 5281879 774849 9159761 PATIENT SERVICE REVENUE 621400 400672300 400672300 OUTREACH LAB 621500 4282368 2768319 1514049 Income from equity investees 900099 -12496383 -12565395 69012 Food Service 900099 1614268 1614268 HEART HOSPITAL MANAGEMENT FEES 900099 996680 996680 7449133 7449133 402518366 1568933 1568933 266 266 0 3631413 3631413 0 3631413 3631413 2525476 10245717 1079109 9294397 1446367 951320 2397687 2397687 0 0 0 0 0 0 0 0 0 0 419276426 400935305 1583061 7598299 1485818 1485818 0 12000 12000 0 2621211 2265699 355512 0 137123949 118525956 18597993 9499074 7924277 1574797 12415848 10370351 2045497 9503887 7928293 1575594 68119516 30336370 37783146 243900 243900 17623 17623 0 0 50605 50605 9345026 3560432 5784594 874461 207611 666850 28585949 15276004 13309945 299187 71032 228155 0 13835607 8740519 5095088 207214 49196 158018 0 50536 11998 38538 8697126 94728 8602398 0 13598947 8591011 5007936 4689922 406892 4283030 MEDICAL SUPPLIES EXPENSE 84315142 77314703 7000439 0 OTHER EXPENSE 3376454 3096117 280337 DECREASE IN ACCRUED PENSION 18011930 16516452 1495478 426980932 312836064 114144868 0 25461258 116149693 6730939 8210237 0 0 46271786 43951204 0 0 0 0 733144 465135 6933424 8448923 3058306 2786670 407302150 152779036 236130283 254523114 100000 100000 20336391 20443121 20731942 -989169 20572162 20572162 9896605 17195735 396956240 491856825 67779036 61908717 0 0 0 40505506 165809236 223540713 0 0 0 0 0 0 0 0 99522439 127778904 333110711 453733840 X 56581211 28509465 7264318 9613520 63845529 38122985 396956240 491856825 X -7704506 -1418098 -16599940 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 42107120 42107120 226749221 52200309 174548912 4969706 3198397 1771309 94654723 63293462 31361261 38821380 34086868 4734512 254523114 0 ACCRUED PENSION COST 118258015 OTHER LONG TERM OBLIGATIONS 7334948 DUE TO/FROM AFFILIATES 2185941 127778904 X FIN 48 FOOTNOTE (ASC 740) SCHEDULE D, PART XIV THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. true Central America and the Caribbean Grantmaking 12000 12000 12000 Central America and the Caribbean HAITI MISSION 12000 CHECK 1 false false false false false false Line 2 THE HOSPITAL GIVES GRANTS TO ORGANIZATIONS WITH WHICH IT HAS A HISTORY OF GIVING. THE HOSPITAL FOLLOWS UP WITH GRANT RECIPIENTS IF THERE IS AN INDICATION OR POTENTIAL THAT THE FUNDS ARE NOT BEING USED FOR CHARITABLE PURPOSES. true true X true X 250. false true true true false true true 779222 779222 0 0.00000 58528441 53323208 5205233 0.01220 59307663 54102430 5205233 0.01220 971177 185358 785819 0.00180 65270 65270 0.00020 1064927 349366 715561 0.00170 62919 62919 0.00010 2164293 534724 1629569 0.00380 61471956 54637154 6834802 0.01600 69005 69005 0.00020 69005 69005 0.00020 true 3800432 90875791 86567941 4307850 X true true LOURDES IMAGING DEV LEASOR OF IMAGING PROP & EQUI 0.46466 0.16706 0.36828 HEART HOSP OF LAFAYE SPECIALTY HOSPITAL 0.6 0.2052 PARK PLACE SURGICAL SPECIALTY SURGERY CENTER 0.45 0.0521 0.4979 LAFAYETTE SURGICARE AMBULATORY SURGERY CENTER 0.5533 0.4467 3 1 OUR LADY OF LOURDES RMC 4801 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 WWW.LOURDESRMC.COM X X X 2 HEART HOSPITAL OF ACADIANA LLC 1105 KALISTE SALOOM ROAD LAFAYETTE LA 70508 www.hearthospitallaf.net X X X 3 PARK PLACE SURGICAL HOSPITAL 4811 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 www.parkplacesurgery.com X X SURGERY CENTER OUR LADY OF LOURDES RMC 1 false false true X X X X X X X X X 18 true true false true X SEE PART V, SECTION C X true 19 false true false true X 250. 0. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false HEART HOSPITAL OF ACADIANA LLC 2 false false true X X X X X X X X X 18 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 19 false true false true X 250. 0. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false PARK PLACE SURGERY CENTER LLC 3 false false true X X X X X X X X X 18 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 19 false true false true X 250. 0. X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 OUR LADY OF LOURDES RMC, HEART HOSPITAL OF ACADIANA, & PARK PLACE SURGERY: THE HOSPITALS GATHERED INFORMATION BY CONDUCTING 45 INTERVIEWS WITH INDIVIDUALS REPRESENTING COMMUNITY HEALTH AND PUBLIC SERVICE ORGANIZATION, MEDICAL PROFESSIONALS, HOSPITAL ADMINISTRATION AND OTHER HOSPITAL STAFF MEMBERS. INTERVIEWEES REPRESENTED NUMEROUS ORGANIZATIONS IN THE COMMUNITY INCLUDING LAFAYETTE GENERAL HEALTH, OUR LADY OF LOURDES, THE DIOCESE OF LAFAYETTE, MILES PERRET CANCER SERVICES, LOUISIANA DEPARTMENT OF HEALTH AND THE REGIONAL MEDICAL DIRECTOR OF REGION 4 OFFICE OF PUBLIC HEALTH. THE HOSPITAL ALSO HELD 5 FOCUS GROUPS THROUGHOUT THE SERVICE AREA AND RECEIVED 363 PAPER SURVEYS COMPLETED BY COMMUNITY MEMBERS WITHIN THE SERVICE AREA. PART V, SECTION B, LINE 6 LOURDES REGIONAL MEDICAL CENTER ADOPTED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WITH HEART HOSPITAL OF LAFAYETTE AND PARK PLACE SURGICAL HOSPITAL. PART V, SECTION B, LINE 7A OUR LADY OF LOURDES REGIONAL MEDICAL CENTER: THE CHNA CAN BE FOUND AT lourdesrmc.com/community-health/community-health-needs-assessment HEART HOSPITAL OF ACADIANA: THE CHNA CAN BE FOUND AT lourdesrmc.com/community-health/community-health-needs-assessment PARK PLACE SURGICAL HOSPITAL: THE CHNA CAN BE FOUND AT lourdesrmc.com/community-health/community-health-needs-assessment PART V, SECTION B, LINE 11 DURING THE CURRENT YEAR, OUR LADY OF LOURDES REGIONAL MEDICAL CENTER (INCLUDES LOURDES WOMEN'S AND CHILDREN'S HOSPITAL, HEART HOSPITAL OF LAFAYETTE AND PARK PLACE SURGICAL HOSPITAL) WORKED TO CONDUCT AN UPDATED JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WHICH IDENTIFIED NINE SIGNIFICANT HEALTH NEEDS: ACCESS TO CARE, CANCER, HEALTH LITERACY, HEART DISEASE & STROKE, NUTRITION & WEIGHT STATUS, MENTAL HEALTH/BEHAVIORAL HEALTH, PHYSICAL ACTIVITY, MATERNAL & CHILD HEALTH, AND DIABETES. THE HOSPITALS DECIDED THEY WOULD ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS IDENTIFIED DURING THE CURRENT CHNA: MENTAL HEALTH, CANCER, HEART DISEASE, ACCESS TO HEALTH CARE, NUTRITION & WEIGHT STATUS, MATERNAL & CHILD HEALTH. LOURDES CHOSE NOT TO ADDRESS HEALTH LITERACY, PHYSICAL ACTIVITY & DIABETES SINCE THESE COMMUNITY NEEDS WILL BE ADDRESSED THROUGH COMMUNITY PARTNERSHIPS OR INDIRECTLY THROUGH OTHER COMMUNITY HEALTH NEEDS THAT WILL BE ADDRESSED (NURTRITION & WEIGHT STATUS, HEART DISEASE, ETC.) OUR LADY OF LOURDES REGIONAL MEDICAL DURING THE CURRENT YEAR TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS OF HEART DISEASE & STROKE, CANCER, MENTAL/BEHAVIORAL HEALTH, ACCESS TO HEALTH CARE, NUTRITION & WEIGHT STATUS AND MATERNAL & CHILD HEALTH, THE HOSPITALS DID THE FOLLOWING: HEART DISEASE & STROKE LOURDES' ST. BERNADETTE'S CLINIC (SBC)FOR THE HOMELESS AND UNINSURED, AS PART OF THE TRIAGE OF NEW PATIENTS, CONTINUED TO SCREEN OVER 50% OF ALL PATIENTS FOR ABNORMAL GLUCOSE AND CHOLESTEROL LEVELS. HIGH RISK PATIENTS WERE REFERRED TO THEIR PRIMARY CARE PHYSICIAN. HEART HOSPITAL OF LAFAYETTE (HHL) CONTINUED TO OFFER FREE OR DISCOUNTED CARDIAC SCREENINGS FOR 50-75 LOW-INCOME, UNINSURED, OR MEDICAID PATIENTS ANNUALLY. HHL AND SBC CONTINUED THEIR PARTNERSHIP AND OFFERED (20) FREE CAROTID SCREENINGS QUARTERLY TO THE UNINSURED/UNDER-INSURED POPULATION WE SERVE. PARK PLACE SURGICAL HOSPITAL(PPSH) CONTINUED TO FUND A FULL-TIME NURSE PRACTITIONER AT SBC WHO PROVIDES SERVICE TO THE INDIGENT, UNINSURED AND UNDER-RESOURCED POPULATION. SBC PROVIDED OVER 3,500 MEDICAL VISITS FOR FISCAL YEAR. CANCER LOURDES' SBC TO PROVIDE EARLY DETECTION, SBC SCREENED FOR CANCER AND PROVIDED TOBACCO SCREENINGS TO OVER 90% OF ALL PATIENTS. ANTI-CRAVING MEDICATIONS WERE PROVIDED TO 90% OF THOSE PATIENTS THAT WERE NOT REFERRED TO A SMOKING CESSATION PROGRAM. SBC ALSO DID TB SKIN TESTS AND PROVIDED MAMMOGRAMS AND PAP SMEARS TO HOMELESS WOMEN, SOME OF WHOM HAD NEVER HAD THESE SERVICES. CONGREGATIONAL HEALTH SERVICES (CHS) CONTINUED TO DISTRIBUTE CANCER PREVENTION/AWARENESS INFORMATION AT ALL CHURCH EVENTS (26 CHURCH PARTNERS IN FIVE LA PARISHES) I.E. HEALTH FAIRS, ANNUAL AWARENESS DAYS (BREAST, COLON, PROSTATE, ETC.). NUTRITION & WEIGHT STATUS LOURDES' SBC REFERRED 50% OF ALL IDENTIFIED PATIENTS WITH A BMI OF 30 AND ABOVE TO OUR NUTRITIONIST FOR COUNSELING AND EDUCATION. THE REFERRALS FOR THOSE PATIENTS WERE NOTED IN THE PATIENTS' CHARTS AT SBC. EVERY PATIENT AT LOURDES' NORTHSIDE SCHOOL- BASED HEALTH CENTER (NSBHC) WAS SCREENED FOR BMI, IDENTIFYING THOSE STUDENTS WITH A BMI AT OR ABOVE THE 90TH PERCENTILE OF THE SAME AGE AND SEX; THOSE STUDENTS WERE ALSO REFERRED TO THE COMMUNITY SERVICES DIETITIAN AT SBC FOR WEIGHT COUNSELING. NSBHC CONTINUED EDUCATION AND COUNSELING TO 50% OF ALL STUDENTS IDENTIFIED AT OR ABOVE THE 90TH PERCENTILE OF BMI FOR THE SAME AGE AND SEX. CHS CONTINUED TO OFFER WEEKLY EXERCISE CLASSES AT THREE CHURCH PARTNERS, WITH QUARTERLY WEIGH-INS AND WEIGHT CHALLENGES. THE KID'S HEALTHY HEART PROGRAM WAS CONTINUED AT ONE CHURCH PARTNER THAT EMPHASIZES THE 3-E'S (EXERCISE, EDUCATION, AND EATING HABITS), SERVING AN AVERAGE OF 50-75 YOUTHS PER MONTH AND OVER 300 YOUTHS DURING THE SUMMER. SBC'S COLLABORATION WITH ST. JOSEPH'S DINER (SOUP KITCHEN) CONTINUED THE NUTRITION PROGRAM PROVIDING MEALS USING THE HEALTHY MEAL PLANS PREPARED BY OUR DIETITIAN AT SBC; OVER 60,000 HEALTHY MEALS WERE AND PREPARED AND SERVED TO THE HOMELESS POPULATION FOR THE FISCAL YEAR. MENTAL/BEHAVIORAL HEALTH: LOURDES' SBC COMMUNITY PARTNERSHIPS WITH 232-HELP AND THE FAMILY TREE TO CREATE COMMUNITY CRISIS CONNECTION (CCC) TO PROVIDE TELEPHONIC AND IN-PERSON MENTAL AND BEHAVIORAL HEALTH SERVICES TO THE HOMELESS AND UNINSURED POPULATION THROUGH AN FMF GRANT. ALSO, AT-RISK PATIENTS WERE SCREENED AT SBC FOR MENTAL/BEHAVIORAL HEALTH ISSUES AND REFERRED FOR FURTHER DIAGNOSES TO CCC. AT LOURDES' NSBHC, THE CLINIC'S SOCIAL WORKER CONDUCTED OVER 20 GROUP SESSIONS/PRESENTATIONS DURING THE SCHOOL YEAR ON WARNING SIGNS AND CRISIS INTERVENTIONS TO HELP A PERSON AT RISK. ALSO, AS PART OF OFFICE OF PUBLIC HEALTH (OPH) REQUIREMENTS, ALL STUDENTS SEEN AT THE NHS HEALTH CENTER HAD A RISK ASSESSMENT DONE BY NURSING PERSONNEL AND WERE REFERRED TO NSBHC'S LICENSED CLINICAL SOCIAL WORKER. CHS ALSO PROVIDED EDUCATIONAL INFORMATION AT ALL CHURCH HEALTH FAIRS (26 CHURCH PARTNERS - DURING THE YEAR) TO IMPROVE COMMUNITY KNOWLEDGE AND INCREASE AWARENESS ON COMMUNITY RESOURCES FOR MENTAL/BEHAVIORAL HEALTH. MATERNAL & CHILD HEALTH OUR LADY OF LOURDES - WOMEN'S & CHILDREN'S HOSPITAL (WCC) THERE IS STRONG EVIDENCE THAT BREASTFEEDING PROMOTION PROGRAMS INCREASE INITIATION, DURATION AND EXCLUSIVITY OF BREASTFEEDING. WCC PROMOTED AND FACILITATED BREASTFEEDING PROMOTION PROGRAMS TO THE COMMUNITY AND TO THEIR PATIENTS, MANY OF WHICH ARE LOW-INCOME AND ARE 80% MEDICAID. WITHIN THIS POPULATION, HIGH RISK INDIVIDUALS AT BOTH THE MATERNAL AND NEONATAL/PEDIATRIC POPULATION EXIST. UNDERSERVED CHILDREN, INCLUDING UNDER-REPRESENTED MINORITIES, ARE MORE LIKELY TO EXPERIENCE HIGH INTENSITY END-OF-LIFE CARE, INCLUDING IN-HOSPITAL DEATH. WCC INDENTIFIED A NEED FOR A PEDIATRIC PALLIATIVE NURSE PRACTITIONER (NP) TO ASSIST PARENTS AND SIBLINGS WITH RESOURCES, EDUCATION AND SUPPORT IN HELPING WITH POTENTIAL DEATH OR LONG-TERM CARE DECISIONS. WCC APPLIED AND RECEIVED A FMF GRANT TO FUND A PEDIATRIC PALLIATIVE NURSE PRACTITIONER TO HELP THESE LOW-INCOME FAMILIES WITH THE BENEFIT OF PALLIATIVE CARE TO THESE FAMILIES WITH INDIVIDUALIZED SYMPTOM MANAGEMENT, IMPROVED COMMUNICATION AND SUPPORT IN MAKING THESE DIFFICULT DECISIONS. WCC ALSO PROVIDED THE NECESSITY SPECIAL FORMULA SUPPORT AND SPECIALIZED TRANSPORTATION BEDS; WHEN OTHER OPTIONS ARE UNAVAILABLE OR NOT IN PLACE AT TIME OF DISCHARGE IT IS DETRIMENTAL IN THE OVERALL HEALTH AND WELFARE OF THE NEONATE/INFANT/CHILD. LACK OF PROPER NUTRITION AND APPROPRIATE SPECIALIZED EQUIPMENT UTILIZED FOR TRANSPORTATION FOR THE NEONATE/INFANT INCREASES THE RISK OF MALNUTRITION, FUTURE HEALTH ISSUES AND POSSIBLY DEATH. SPECIALIZED CAR BEDS FOR NEWBORNS ARE UTILIZED WHEN THEY CANNOT TOLERATE A CAR SEAT UPON DISCHARGE AND CAN CAUSE AN INCREASED RISK OF SUFFOCATION. IN FY 2020, WCC ASSISTED 362 NEWBORNS AND THEIR FAMILIES (OFTEN FROM DISCHARGE TO WIC APPOINTMENTS FOR THEIR SUPPORT). 606 CANS OF FORMULA WERE ALSO DISTRIBUTED AND 120 OF THE SPECIALIZED TRANSPORTATION BEDS WERE GIVEN OUT TO LOW-INCOME FAMILIES. ACCESS TO HEALTH CARE AT THE VERY ONSET OF THE CORONAVIRUS PANDEMIC, OUR LADY OF LOURDES RMC PARTNERED WITH LAFAYETTE GENERAL MEDICAL CENTER AND LAFAYETTE CONSOLIDATED GOVERNMENT-LCG(MAYOR'S OFFICE) TO ESTABLISH A COMMUNITY COVID-19 SCREENING CLINIC AT A CENTRALIZED LOCATION (LAFAYETTE CAJUNDOME)TO GIVE THE COMMUNITY EASY ACCESS TO COVID-19 TESTING. OVER 5,000 COVID SCREENINGS/TESTS WERE ADMINISTERED, AND OVER 5,000 MASKS/FACE COVERINGS WERE DISTRIBUTED. LOURDES DIRECTOR OF COMMUNITY SERVICES WAS SELECTED AND CURRENTLY SERVES AS A MEMBER OF THE LCG HEALTH EQUITY TASK FORCE TO CONTINUE TO PROVIDE COVID-19 TESTING SITES IN THE COMMUNITY, STUDY THE ADVERSE EFFECTS OF THE CORONAVIRUS ON LOW-INCOME/MINORITY POPULATIONS AND TO LOOK INTO THE SOCIAL DETERMINANTS OF HEALTH (SDOH)AFFECTING POOR HEALTH OUTCOMES IN TARGETED LOW-INCOME POPULATIONS IN THE COMMUNITY. LOURDES SBC APPLIED AND BECAME A MEDICAID ENROLLMENT CENTER FOR EASIER ACCESS TO MEDICAID APPLICATIONS FOR THE LOW-INCOME POPULATION NEAR THE CLINIC WITH LITTLE MEANS OF TRANSPORTATION. LOURDES SBC BECAME A COVID-19 TESTING SITE TO SERVE AS A CENTRAL LOCATION FOR THE HOMELESS POPULATION AND THOSE WITH LITTLE OR NO ACCESS TO TRANSPORTATION. CITY BUS PASSES ARE PROVIDED TO THE HOMELESS PATIENTS TO GET TO/FROM CLINIC, GET THEIR MEDICATIONS AND OTHER MEDICAL APPOINTMENTS. A MEN'S VETERAN HOMELESS SHELTER IS ADJACENT TO THE SBC THAT USES THE CLINIC FOR THEIR HEALTH NEEDS (MEDICAL, VISION, DENTAL EXTRACTIONS - DENTURES). SBC DOES NOT BILL FOR ANY OF THEIR SERVICES TO THE HOMELESS, UNINSURED, UNDER-RESOURCED POPULATION. PART V, SECTION B, LINE 13H OUR LADY OF LOURDES RMC: FULLY DISCOUNTED CARE IS ALSO AVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY. PART V, SECTION B, LINE 16A,B&C OUR LADY OF LOURDES RMC: The financial assistance policy (FAP), FAP application form, and a plain-language summary of the FAP are available at: https://fmolhs.org/financial-assistance-policy/ PARK PLACE SURGERY: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: HTTPS://WWW.PARKPLACESURGERY.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE HEART HOSPITAL OF LAFAYETTE: THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT: https://fmolhs.org/financial-assistance-policy/ PART V, SECTION B, LINE 16J OUR LADY OF LOURDES RMC, HEART HOSPITAL OF ACADIANA, PARK PLACE SURGERY CENTER, LAFAYETTE GENERAL MEDICAL CENTER: REGISTRATION PERSONNEL REFER UNINSURED, UNDERINSURED, AND LOW-INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. 5 LOURDES IMAGING NETWORK LLC 4809 AMBASSADOR CAFFERY SUITE 350 LAFAYETTE LA 70506 IMAGING CENTER LOURDES AFTER HOURS LLC 2130 KALISTE SALOOM ROAD LAFAYETTE LA 70508 HEALTHCARE CLINIC LHCG-XIII LLC 601 WEST ST MARY BLVD SUITE 309 LAFAYETTE LA 70506 HOME HEALTH AGENCY LHCG LXVII LLC 901 S HUGH WALLIS ROAD LAFAYETTE LA 70508 HOME HEALTH AGENCY LAFAYETTE SURGICARE 4630 Ambassador Caffery Pkwy LAFAYETTE LA 70508 AMBULATORY SURGICAL FACILITY PART I LINE 3C Financial assistance is available for individuals who are uninsured, underinsured, ineligible for any government health care benefit program, and who are unable to pay for their care. Fully-discounted care is available if income and assets meet certain federal poverty guideline levels. Fully-discounted care is also available for those patients with catastrophic medical bills if medical bills exceed a certain percentage of income and assets. Fully discounted care is also available where the patient or other sources can provide sufficient evidence of presumptive eligibility. Presumptive eligibility may be determined on the basis of individual life circumstances that may include: 1) patient receiving free care from a community clinic and is referred to the hospital; 2) State-funded prescription programs; 3) homeless, indigent, or homeless clinic patient; 4) patient's children who qualify for other financial assistance programs; 5) patient eligible for food stamps; 6) Medicaid eligible patient; 7) patient is deceased with no known responsible party; 8) patient is incarcerated and has no other responsible party. PART I LINE 7G OUR LADY OF LOURDES PROVIDES SUBSIDIZED HEALTH SERVICES INCLUDING HEALTH CARE CLINICS. ST. BERNADETTE'S CLINIC, WHICH PROVIDES FREE MEDICAL CARE TO THE HOMELESS AND UNINSURED POPULATION, IS INCLUDED. THE COSTING METHODOLOGY USED FOR SUBSIDIZED HEALTH SERVICES WAS ACTUAL EXPENSES INCURRED IN PROVIDING THE SERVICES LESS DIRECT OFFSETTING REVENUE. St. Bernadette Clinic $784,023. PART I LINE 7 THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE JUNE 30, 2019 MEDICARE COST REPORT DATA. FOR PART I LINES 7E, 7F, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. FOR PART I LINE 7G, COST FIGURES WERE CALCULATED FROM DEPARTMENTAL COSTS LESS DIRECT OFFSETTING REVENUE. PART III, SECTION A, LINE 2 THIS AMOUNT REPRESENTS THE ACTUAL CUSTOMER AMOUNTS DUE TO OUR LADY OF LOURDES REGIONAL MEDICAL CENTER THAT WERE WRITTEN OFF BECAUSE THEY WERE UNCOLLECTIBLE. PART III LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENT AND GUIDELINES. THE MEDICARE COST REPORT (MCR) is an annual report required of all institutions participating in the Medicare program. The MCR records each institution's total costs and charges associated with providing services to all patients, the portion of those costs and charges allocated to Medicare patients, and the Medicare payments received. PART III LINE 9B PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOPSITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI LINE 2 NEEDS ASSESSMENT THE COMMUNITY SERVICES DEPARTMENT AT OUR LADY OF LOURDES REGIONAL MEDICAL CENTER WAS FORMED NUMEROUS YEARS AGO TO ASSESS THE COMMUNITY NEEDS. IT HAS GROWN INTO 5 DISTINCT SERVICE AREAS WHICH PROVIDES HEALTHCARE TO NEEDY RESIDENTS IN THE ACADIANA AREA. IN TAKING "HEALTHCARE TO THE HIGHEST POWER", THE DEPARTMENT REACHES OUT TO THOSE MOST IN NEED, SPECIFICALLY, THE UNINSURED AND UNDERINSURED. IN PURSUING THE MISSION TO IMPROVE THE HEALTH STATUS OF ACADIANA'S POOREST RESIDENTS, THE DEPARTMENT HAS STRATEGICALLY PLACED ACCESSIBLE SERVICES THROUGHOUT THE COMMUNITY. COMMUNITY SERVICES' CATHOLIC IDENTITY IS MADE TANGIBLE IN THE COMMUNITY THROUGH THESE UNIQUE SERVICES. THE DEPARTMENT STEWARDS ITS RESOURCES BY ENGAGING COMMUNITY MEMBERS, FORMING PARTNERSHIPS, AND ESTABLISHING COLLABORATIVE RELATIONSHIPS. THESE UNIQUE SERVICES CLEARLY DISTINGUISH OUR LADY OF LOURDES FROM OTHER HEALTHCARE FACILITIES IN ACADIANA. THE MEDICAL CENTER DOES EXTENSIVE RESEARCH REGARDING COMMUNITY ISSUES AND NEEDS WITHIN ITS SERVICE AREAS. THE RESEARCH IS CONDUCTED IN AN EFFORT TO DETERMINE IF ITS COMMUNITY BENEFIT PROGRAMS ARE STILL APPROPRIATE AND TO DETERMINE IF OTHER PROGRAMS ARE NEEDED. THE SENIOR EXECUTIVE TEAM DETERMINES THE FOCUS GROUPS TO BETTER UNDERSTAND WHAT THE PEOPLE WITHIN THE REGION CONSIDER TO BE THE MAJOR COMMUNITY NEEDS. THE FOCUS GROUP INCLUDES COMMUNITY LEADERS, RELIGIOUS LEADERS, COMMUNITY SERVICE EMPLOYEES, LOW WAGE EMPLOYEES AND CLIENTS FROM CLINICS. SOME OF THE RESULTS OF THE MEDICAL CENTER'S NEEDS ASSESSMENT INCLUDE: ST. CLARE'S CLINIC ST. BERNADETTE'S COMMUNITY CLINIC NORTHSIDE HIGH SCHOOL BASED HEALTH CENTER CONGREGATIONAL HEALTH SERVICES PART VI LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE GIVEN THE MEDICAL CENTER'S PATIENT HANDBOOK WHERE THEY ARE REFERRED TO THE SECTION ENTITLED "FINANCIAL INFORMATION - WHAT TO EXPECT". FINANCIAL COUNSELORS ALSO MEET WITH THE PATIENTS AND EDUCATE THEM ABOUT THE ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND ALSO THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM. FOR THE CONVENIENCE OF THE PATIENTS, THE MEDICAL CENTER ALSO OPERATES A MEDICAID ENROLLMENT CENTER TO ASSIST PATIENTS INTERESTED IN APPLYING FOR MEDICAID BENEFITS. THIS OFFICE IS OPEN MONDAY - FRIDAY FROM 8:00 A.M. - 4:00 P.M. A TELEPHONE NUMBER IS ALSO PROVIDED IN THE HANDBOOK. PART VI LINE 4 COMMUNITY INFORMATION OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS A COMMUNITY BASED, NOT-FOR-PROFIT HOSPITAL THAT TREATS PATIENTS FROM ACROSS THE ACADIANA REGION. PURSUANT TO THE HOSPITAL'S LAST CHNA, OUR LADY OF LOURDES' PRIMARY AND SECONDARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 716,583. IT IS ESTIMATED THAT 18.1% OF THE POPULATION AND 21.6% OF THE CHILDREN OF LAFAYETTE PARISH (THE PRIMARY SERVICE AREA) IS LIVING IN POVERTY. THE PRIMARY SERVICE ARE INCLUDES THE FOLLOWING PARISH: LAFAYETTE PARISH THE SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: ACADIA PARISH EVANGELINE PARISH IBERIA PARISH JEFFERSON DAVID PARISH ST. LANDRY PARISH ST. MARTIN PARISH ST. MARY PARISH VERMILLION PARISH PART VI LINE 5 PROMOTION OF COMMUNITY HEALTH: THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS COMPRISED OF INDIVIDUALS WITH A BROAD CROSS-SECTION OF HEALTH CARE AND BUSINESS EXPERIENCE. OUR LADY OF LOURDES REGIONAL MEDICAL CENTER EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. PART VI LINE 6 AFFILIATED HEALTH CARE SYSTEM OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS NOT-FOR-PROFIT, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC.(FMOL HEALTH SYSTEM)IS THE SOLE MEMBER. OUR LADY OF LOURDES IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF LOURDES RMC SERVES THE COMMUNITY IN LAFAYETTE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER, ST. FRANCIS MEDICAL CENTER, ST. ELIZABETH HOSPITAL, OUR LADY OF THE LAKE ASSUMPTION HOSPITAL, AND OUR LADY OF THE ANGELS HOSPITAL. AS OF JUNE 1, 2019, ST. DOMINIC JACKSON MEMORIAL HOSPITAL IN MISSISSIPPI IS ALSO A RELATED HOSPITAL, DUE TO A SHARED MISSION AGREEMENT BETWEEN FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM AND ST. DOMINIC HEALTH SYSTEM. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGES 14-16 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART I, LINE 7F FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE. true AMERICAN CANCER SOCIETY 4633 North Blvd BATON ROUGE LA 70809 131788491 501(C)(3) 10000 GENERAL SUPPORT ACADIANA REGIONAL COALITION ON HOMELESSNESS AND HO PO Box 3936 LAFAYETTE LA 70502 721311299 501(C)(3) 350000 GENERAL SUPPORT One Acadiana Inc (FKA Greater Lafayette Chamber) 804 East St Mary Blvd LAFAYETTE LA 70503 720232780 501(C)(6) 50000 SEE PART IV LAFAYETTE CENTRAL PARK INC 2901 Johnston Street Ste 304 LAFAYETTE LA 70503 462552778 501(c)(3) 1000000 WATER PARK CONSTR. MILES PERRET CANCER SERVICES 230 Kaliste Saloom LAFAYETTE LA 70508 753023211 501(C)(3) 28462 FMV Donated Food GENERAL SUPPORT BEACON COMMUNITY CONNECTIONS 2600 Johnston St 330 LAFAYETTE LA 70503 831455134 501(C)(3) 45112 GENERAL SUPPORT FRANCISCAN MISSIONARIES OF OUR LADY UNIVERSITY 4200 ESSEN LANE BATON ROUGE LA 70809 721173156 501(C)(3) 10000 SCHOLARSHIPS 7 1 MONITORING GRANTS FORMAL REQUESTS ARE RECEIVED BY THE BUSINESS PAYOR RELATIONS DEPARTMENT, ARE CHECKED FOR ALL APPROPRIATE INFORMATION, AND ARE PRESENTED TO THE EXECUTIVE ADMINISTRATION FOR APPROVAL. THE HOSPITAL GIVES GRANTS TO ORGANIZATIONS WELL-KNOWN IN THE COMMUNITY, OR WHICH IT HAS A HISTORY OF GIVING TO. THE HOSPITAL FOLLOWS UP WITH GRANT RECIPIENTS IF THERE IS AN INDICATION OF POTENTIAL THAT THE FUNDS ARE NOT BEING USED FOR CHARITABLE PURPOSES. PART II, COLUMN H, PURPOSE OF GRANT OR ASSISTANCE ONE ACADIANA INC. - INVESTMENT IN ACADIANA ONE CAMPAIGN false true false false false false false false false DONNA F LANDRY COO 295046 74508 31000 43707 10556 454817 24032 DANNA M CRAIN HEART SERVICE/COO HHL 221202 57907 2060 69971 24956 376096 ANTHONY P BLALOCK CMO 379880 89165 52608 43798 2886 568337 43948 KELLY T CAHILL JR MD BOARD MEMBER/PHYSICIAN 343804 160429 519 11200 23571 539523 W BRYAN LEE CEO& President 447931 164255 1009 77788 26567 717550 JEFF LIMBOCKER CFO/EVP 550613 293047 55135 135652 25745 1060192 45920 GILBERT HUMBERT CNO 251461 41600 13848 23576 330485 JENNIFER J CLOWERS CFO & VP OF FINANCE 238631 58151 586 11200 25549 334117 DUKE WALKER VP ORTHO/NEURO SVCS 161262 32135 800 7982 22969 225148 TRACY DELHOMME VP ONCOLOGY 141953 29104 799 7283 26925 206064 KENNETH FALTERMAN STAFF PHYSICIAN 577144 26270 3993 11200 20671 639278 DEIADRA J GARRETT STAFF PHYSICIAN 574511 25110 1003 11200 8533 620357 SAROSH ZAFAR STAFF PHYSICIAN 507690 325 467 2646 511128 ANN MARIE FLANNERY STAFF PHYSICIAN 494557 0 5539 11200 22345 533641 Elpidia H Balbastro BOARD MEMBER 443277 0 3427 0 19370 466074 SCHEDULE J, PART I, LINE 4B FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDE FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURANCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. JEFF LIMBOCKER RECEIVED A PAYMENT OF $52,976 FROM THE PLAN DURING THE YEAR. ANTHONY BLALOCK RECEIVED A PAYMENT OF $51,532 FROM THE PLAN DURING THE YEAR. DONNA LANDRY RECEIVED A PAYMENT OF $27,905 FROM THE PLAN IN THE CURRENT YEAR. SCHEDULE J, PART I, LINE 4A THE CFO/EVP IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. AN OFFICER AND A BOARD MEMBER ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, OR DUE TO A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 12 MONTHS. SCHEDULE J, PART I, LINE 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. PART VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW OF THE FORM 990 BY KPMG, THE FORM 990 IS REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION B, QUESTION 12C OUR LADY OF LOURDES REGIONAL MEDICAL CENTER HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF LOURDES REGIONAL MEDICAL CENTER PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION, AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS OF POSSIBLE CONFLICTS OF INTERESTS ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VI, SECTION A, QUESTION 7a FMOL HEALTH SYSTEM INC., AS THE SOLE MEMBER OF THE MEDICAL CENTER, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER. PART VI, SECTION B, QUESTION 15A & 15B THE PRESIDENT AND CEO OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS AN EMPLOYEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) WHOSE SALARY IS DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION. SUCH PAY PRACTICES INCLUDE THE USE OF AN INDEPENDENT BOARD COMMITTEE WHICH REVIEWS COMPENSATION ANNUALLY AFTER OBTAINING AND RELYING UPON INDUSTRY-WIDE COMPENSATION INFORMATION FROM AN OUTSIDE CONSULTING FIRM. THE BOARD COMMITTEE APPROPRIATELY DOCUMENTS ITS DECISIONS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE CEO AND AN EXECUTIVE COMMITTEE. THE CEO AND EXECUTIVE COMMITTEE IS PROVIDED COMPENSATION RANGES DEVELOPED BY FMOL HEALTH SYSTEM FROM INDUSTRY-WIDE DATA. THE CEO AND EXECUTIVE COMMITTEE THEN USES THAT DATA TO DETERMINE THE APPROPRIATE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES AND DOCUMENTS THE HUMAN RESOURCE FILES. PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS : 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHANGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION. PART VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER. PART XI, LINE 9 CAPITAL TRANSFERS ($16,599,940) Section 1.263(a)-1(f) - De Minimis Safe Harbor Election OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. does have Applicable Financial Statements for the year of the election, and intend to apply the de minimis safe harbor election. This election permits the taxpayer to deduct for tax purposes any item deducted under its book policy that does not exceed $5,000 per invoice (or per item as substantiated by the invoice) or items having an economic useful life of twelve months or less as described in Section 1.263(a)-1(f)(1)(ii). SECTION 1.263(A)-3(N) ELECTION- BOOK CONFORMITY ELECTION OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. is making the election under Treas. Reg. 1.263(a)-3(n) to capitalize those repair and maintenance costs that it treats as capital improvements on its books and records for the tax year ended JUNE 30, 2020. 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