2021-11-12T09:35:19-06:00 2020-12-31 201941244 HORNE LLP 661 SUNNYBROOK ROAD STE 100 RIDGELAND MS 39157 990 2020-10-01 720535375 LAFAYETTE GENERAL MEDICAL CENTER INC LAFA 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 ROGER MATTKE CFO 3372898125 2021-11-12 1 ROGER MATTKE 999009999 AMIE T WHITTINGTON CPA P01082167 6013261000 2021-11-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PATRICK GANDY 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 148104220 0 X WWW.LAFAYETTEGENERAL.COM X 1911 LA LAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 17 11 3438 11 1883214 143740 27361895 38164 546354044 143372122 441698 83432 10951147 4610502 585108784 148104220 39504 11455 0 0 158939724 40645218 0 0 0 370926981 90904569 529906209 131561242 55202575 16542978 663727826 680580313 126174998 127771247 537552828 552809066 X LAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 124547891 11455 146088910 PROGRAM SERVICES STATISTICS RELATED TO PROVIDING COMMUNITY MEDICAL CARE FOR THE HOSPITAL: TOTAL ACUTE PATIENT DAYS WERE 28,006, TOTAL NURSERY DAYS WERE 1,538, TOTAL REHAB DAYS WERE 1,369 AND TOTAL MENTAL HEALTH DAYS WERE 1,506. OTHER SIGNIFICANT HEALTHCARE SERVICES PROVIDED INCLUDED 716,688 EMERGENCY ROOM VISITS, 3,257 SURGERIES (INPATIENT AND OUTPATIENT), AND 811 DELIVERIES.DURING THE YEAR THE FOLOWING DESIGNATIONS WERE EARNED: OCHSNER LAFAYETTE GENERAL MEDICAL CENTER EARNS BLUE DISTINCTION CENTER DESIGNATION FOR QUALITY AND COST-EFFICIENCY IN KNEE AND HIP REPLACEMENT AND SPINE SURGERIES. OCHSNER LAFAYETTE GENERAL ORTHOPEDIC HOSPITAL EARNS BLUE DISTINCTION CENTER DESIGNATION FOR QUALITY IN KNEE AND HIP REPLACEMENT SURGERYTHE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY. SERVICES INCLUDED INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION. LAFAYETTE GENERAL MEDICAL CENTER (LGMC) SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED ACADIANA WITH 433 STAFFED BEDS (INCLUDING 25 NURSERY BEDS) AND 2,275 EMPLOYEES. LGMC REMAINS THE AREA'S LARGEST, FULL SERVICE, ACUTE-CARE MEDICAL CENTER.OUR HOSPITAL MISSION IN THE COMMUNITIES THAT WE SERVE IS TO RESTORE, MAINTAIN, AND IMPROVE HEALTH. WE ARE A COMMUNITY-OWNED AND LOCALLY MANAGED HOSPITAL THAT STAYS TRUE TO OUR MISSION BY DEDICATING SIGNIFICANT RESOURCES TO COMPENSATE A COMPASSIONATE, HIGHLY SKILLED STAFF; ACQUIRE ADVANCED TECHNOLOGY; AND DEVELOP SERVICE IMPROVEMENTS EACH YEAR.IN LINE WITH OUR GOAL OF BUILDING A REGIONAL HEALTH CARE SYSTEM, LAFAYETTE GENERAL MEDICAL CENTER HAS ESTABLISHED CLINICAL AFFILIATIONS WITH OUTLYING HOSPITALS, EXTENDING OUR BEST PRACTICES IN CANCER TREATMENTS, CARDIOLOGY, AND NEUROSCIENCE SUPPORT TO OUTLYING PARISHES. WE ALSO ENABLED PATIENTS TO PARTICIPATE MORE IN THEIR HEALTH CARE BY OFFERING AN ONLINE PATIENT PORTAL.ON JULY 1, 2013, AFTER LAFAYETTE GENERAL HEALTH TOOK OVER MANAGEMENT OF UNIVERSITY HOSPITAL & CLINICS (FORMERLY UNIVERSITY MEDICAL CENTER) WHEN IT WAS RUN BY THE STATE OF LOUISIANA, THE RESIDENCY PROGRAM WAS EXPANDED TO LAFAYETTE GENERAL MEDICAL CENTER. THESE TWO HOSPITALS SHARE IN A SYNERGISTIC RELATION, WHERE RESIDENTS BASED OUT OF LSU'S NEW ORLEANS AND BATON ROUGE CAMPUSES ROTATE THROUGHOUT EACH OF THESE HOSPITALS. THESE RESIDENTS SPAN A WIDE RANGE OF SERVICE LINES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, OTOLARYNGOLOGY (EAR, NOSE AND THROAT), OPHTHALMOLOGY, GENERAL SURGERY, OBSTETRICS/GYNECOLOGY, ANESTHESIOLOGY AND ORTHOPEDICS. FELLOWSHIPS (SPECIFIC MEDICAL TRAINING AVAILABLE TO THOSE WHO HAVE COMPLETED A RESIDENCY PROGRAM) ARE AVAILABLE IN CARDIOLOGY, GERIATRICS, RETINA AND UROGYNECOLOGY.LAFAYETTE GENERAL HEALTH ALSO EXPANDED EDUCATION OPPORTUNITIES OFFERED TO OTHER HEALTHCARE PROFESSIONALS IN ACADIANA BY STARTING THE FIRST EVIDENCE-BASED CURRICULUM NURSE RESIDENCY PROGRAM (NRP) IN LOUISIANA. LAFAYETTE GENERAL HEALTH RECOGNIZED THE NURSING SHORTAGE AFFECTING HOSPITALS ACROSS THE COUNTRY, ESPECIALLY IN ACADIANA. THE NURSE RESIDENCY PROGRAM (NRP) HELPS TRAIN GRADUATE NURSES ENTERING THEIR PROFESSIONAL FIELD. THE ONE-YEAR PROGRAM FOCUSES ON PATIENT OUTCOMES, LEADERSHIP AND QUALITY. LGMC'S FIRST NRP COHORT IN JANUARY 2016 CONSISTED OF 11 NURSES. THE THIRD AND FOURTH COHORTS STARTED IN FISCAL YEAR 2017 AND CONSISTED OF 34 AND 35 NURSE RESIDENTS RESPECTIVELY.LAFAYETTE GENERAL CONTINUES TO EXPAND ITS SERVICES AND FACILITIES IN ORDER TO MEET THE GROWING NEEDS OF OUR COMMUNITY. THREE OF THE MORE RECENT RENOVATIONS AND EXPANSION TO OUR FACILITIES ARE DETAILED BELOW.LAFAYETTE GENERAL MEDICAL CENTER COMPLETED A $52.5 MILLION EMERGENCY DEPARTMENT AND OPERATING ROOM EXPANSION AND RENOVATION PROJECT. THE EXPANSION INCREASED THE EMERGENCY DEPARTMENT BED CAPACITY FROM 31 BEDS TO 45 AND ADDED TWO NEW TRAUMA ROOMS. A NEW TRAUMA ELEVATOR ADDED DIRECT ACCESS FROM THE EMERGENCY HELIPAD LANDING AREA TO THE ER, ICU, AND SURGERY AREAS BELOW. THIS EXPANSION ALSO INCLUDED A 343 SPACE PARKING GARAGE. LAFAYETTE GENERAL SOUTHWEST (LGSW) IS THE NEWEST ADDITION IN NOVEMBER 2015 TO LAFAYETTE GENERAL HEALTH (LGH). LGSW SERVES AS AN EXTENSION OF LAFAYETTE GENERAL MEDICAL CENTER'S MAIN CAMPUS IN THE OIL CENTER. LGSW IS A FULL-SERVICE, ACUTE CARE HOSPITAL. THE ADDITION OF BEDS AND AN EMERGENCY DEPARTMENT ALLOWED LGH TO EXPAND SERVICES AND SERVE MORE PEOPLE IN AND AROUND THE LAFAYETTE COMMUNITY. THE ADDITION HELPED EASE LGMC'S INTAKE OF TRANSFERRED PATIENTS. WITH THE ACQUISITION OF THE NEW HOSPITAL, LGSW UNDERWENT UPDATES AND A SMALL RENOVATION. THE FOURTH FLOOR OF LGSW RECEIVED A TOTAL MAKEOVER TO TRANSFER THE INPATIENT REHABILITATION DEPARTMENT FROM LGMC. THE MOVE RESULTED IN MORE REHABILITATION BEDS FOR LAFAYETTE GENERAL PATIENTS THAN EVER BEFORE.IN MARCH 2016 LGMC ADDED 19 NEW BEDS AND AN EXTRA 11,000 SQUARE FEET TO LABOR & DELIVERY, MOTHER/BABY AND THE NEONATAL INTENSIVE CARE UNIT (NICU).LAFAYETTE GENERAL MEDICAL CENTER (LGMC) IS CURRENTLY CLASSIFIED AS A LEVEL II TRAUMA PROGRAM AND IS WORKING TO BECOME AN ACS VERIFIED ADULT LEVEL II TRAUMA CENTER. THIS DESIGNATION ELEVATES LGMC AS THE REGION'S REFERREDDESTINATION FOR TRAUMA PATIENTS, PROVIDING RESOURCES AND STAFFING TO HANDLE MAJOR EMERGENCIES.LAFAYETTE GENERAL MEDICAL CENTER ASSUMES THE ROLE OF A COMMUNITY PARTNER IN A VARIETY OF WAYS. THROUGH FINANCIAL CONTRIBUTIONS WE WORK TO PRESERVE THE PROSPERITY OF OUR COMMUNITY, FURTHER MEDICAL EDUCATION AND RESEARCH AND HELP OUR CONSTITUENTS ACCESS THE MEDICAL CARE THEY NEED. WE COORDINATE EVENTS AND SCREENINGS FREE OF CHARGE TO MAINTAIN THE HEALTH OF THE LOCAL PUBLIC, INCLUDING SUDDEN IMPACT, A PROGRAM TEACHING YOUNG DRIVERS THE HAZARDS OF IMPAIRED, DISTRACTED AND UNRESTRAINED DRIVING, AND DISTRIBUTED FREE COLORECTAL SCREENING KITS. WE ALSO EXTEND OUR WORKFORCE BEYOND THEIR DAILY RESPONSIBILITIES TO PARTICIPATE IN ACTIVITIES THAT PROVIDE FOR THE SAFETY AND BETTERMENT OF OUR COMMUNITY. 124547891 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 307 0 1 3438 1 1 1 0 0 0 0 0 0 0 0 0 X 17 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 X BRAD BROUSSARD MD TRUSTEE 1.00 1.00 X 0 36666 0 CLAY ALLEN TRUSTEE 1.00 1.00 X 0 0 0 DAVID WILSON CHAIRMAN 1.00 1.00 X 0 0 0 DR TONI LEONI CHIEF OF STAFF 40.00 1.00 X 0 0 0 FRANK WALKER TRUSTEE 1.00 1.00 X 0 0 0 JARED QUOYESER TRUSTEE 1.00 2.00 X 0 0 0 JOHN SCHUTTE MD TRUSTEE 1.00 41.00 X 0 993898 21536 JOSEPH ZANCO TRUSTEE 1.00 1.00 X 0 0 0 MANDI MITCHELL TRUSTEE 1.00 1.00 X 0 0 0 MARTIN BECH SECRETARY 1.00 1.00 X 0 0 0 MARY ELLEN HENRY TRUSTEE 1.00 1.00 X 0 0 0 MICHAEL HULEFELD TRUSTEE 1.00 51.00 X 0 1891907 290941 MOLLY THOMAS MD PHYSICIAN/TRUSTEE 41.00 1.00 X 0 609927 13827 PEGGY GIGLIO TRUSTEE 1.00 2.00 X 0 0 0 RICKEY MINIEX TRUSTEE 1.00 1.00 X 0 0 0 ROBERT HART MD TRUSTEE 1.00 51.00 X 0 1450751 28311 WARNER THOMAS TRUSTEE 1.00 51.00 X 0 6050128 771684 WILLIAM H FENSTERMAKER EMERITUS TRUSTEE NON-VOTIN 1.00 2.00 X 0 0 0 AL PATIN SVP-COO LGMC 40.00 1.00 X 0 466696 89023 KIM HEBERT CFO 40.00 0.00 X 0 205756 3732 PATRICK W GANDY JR EVP-LGH/CEO-LGMC 40.00 5.00 X 0 898658 125871 MEGAN DAIGLE PHYSICIAN 40.00 0.00 X 0 584624 10136 MICHAEL S CAIN PHYSICIAN 40.00 1.00 X 0 879970 21851 PHILIPPE PROUET PHYSICIAN 40.00 0.00 X 0 620259 21813 STEVEN SACCARO PHYSICIAN 40.00 0.00 X 0 577946 0 VICTORIA E PANELLIE-RAMERY PHYSICIAN 40.00 0.00 X 0 608612 16419 DENIS ESCHETE FORMER BOARD MEMBER 0.00 0.00 X 0 108000 0 PHILLIP GACHASSIN FORMER BOARD MEMBER 0.00 0.00 X 0 36666 0 REBECCA BENOIT FORMER VP/CNO 0.00 0.00 X 0 482718 38660 0 16503182 1453804 176 1 1 0 ACADIANA RADIATION THERAPY LLC 104 WOODMONT BLVD STE 500 NASHVILLE TN 37205 RADIATION THERAPY 7113394 PARISH ANESTHESIA OF LAFAYETTE PO BOX 7250 METAIRIE LA 70010 ANESTHESIA SERVICES 6933696 GIFTED NURSES LLC PO BOX 202056 DALLAS TX 75320 NURSING SERVICES 4681054 CARDIOVASCULAR INSTITUTE OF THE SOUTH AP 225 DUNN STREET HOUMA LA 70360 CARDIOLOGY SERVICES 4355965 ADVANTAGE MEDICAL PROFESSIONAL 3340 SEVERN AVE SUITE 320 METAIRIE LA 70002 NURSING SERVICES 3066049 47 15000 23164 38164 PATIENT REVENUE 621990 143372122 143372122 143372122 83432 83432 10500 0 10500 10500 10500 OTHER REVENUE 900099 4600002 2716788 1883214 4600002 148104220 146088910 1883214 93932 11455 11455 34567134 32285507 2281627 591444 551285 40159 3047949 2779570 268379 2438691 2266045 172646 13276 13276 1171957 833598 338359 4423542 3323895 1099647 21743 20873 870 1865 10 1855 20694549 20639820 54729 1842772 1275494 567278 51385 974 50411 MEDICAL SUPPLIES 36721781 36236464 485317 CLINICAL CONTRACT LABOR 12291046 12284866 6180 BAD DEBT 7546999 7546999 EQUIPMENT RENTAL AND MA 2314897 1762019 552878 3808757 2729017 1079740 131561242 124547891 7013351 0 9760 0 -339987 0 68302153 93219490 8879403 4190567 16461505 18028167 453226 699962 28268857 1842772 19505395 26426085 13699850 14918823 10751716 1333334 526004805 521763885 663727826 680580313 41755220 40283385 64518363 64518363 126525 126525 19774890 22842974 126174998 127771247 X 537552828 552809066 537552828 552809066 663727826 680580313 X 16542978 641345 -1928085 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 46181 0 0 46181 124547891 219609567 124547891 219655748 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 150830 210264 207488 46181 614763 250000 250000 250000 250000 1000000 1500000 150830 210264 207488 46181 614763 SCHEDULE C PART II-A, LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH THE AMERICAN HOSPITAL ASSOCIATION AND THE LOUISIANA HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. 41000 4854 36146 136400 5106 131294 26141640 1832812 24308828 1949817 1949817 26426085 DUE FROM RELATED PARTY 499179948 NET RIGHT OF USE OF OPERATING LEASE ASSETS 22583937 521763885 CURRENT PORTION OF RIGHT OF USE ASSET 5349392 CURRENT PORTION RIGHT OF USE EMBEDDED LEASE ASSETS 75546 DUE TO RELATED PARTY 219009 LONG TERM PORTION OF RIGHT OF USE ASSET 17146919 RECOURSE RESERVE 52108 22842974 X PART X, LINE 2: THE MAJORITY OF OCHSNER AND ITS SUBSIDIARIES QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(A) AND ARE DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. ANY FEDERAL INCOME TAXES ASSOCIATED WITH THE FOR-PROFIT ENTITIES ARE NOT MATERIAL TO OCHSNER'S CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS. THE STATUTE OF LIMITATIONS REMAINS OPEN FOR TAX YEARS 2017 THROUGH 2020 IN OCHSNER'S MAIN TAX JURISDICTIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 30146 30146 0.00020 24331799 29649726 0 0.00000 24361945 29649726 30146 0.00020 93845 93845 0.00080 851747 851747 0.00690 5000 5000 0.00000 950592 950592 0.00770 25312537 29649726 980738 0.00790 1 7547000 646015 51298992 52656279 -1357287 X 1 1 3 1 LAFAYETTE GENERAL MEDICAL CENTER INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 X X X X A 2 LAFAYETTE GENERAL ORTHOPEDIC HOSPITAL 2810 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70506 X X X A 3 LAFAYETTE GENERAL SURGICAL HOSPITAL LLC 1000 W PINHOOK ROAD LAFAYETTE LA 70503 X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 19 1 1 0 1 X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/LAFAYETTEJOINTCHNA-FINALR X 1 19 1 HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-02/DRAFT%20IMPLEMENTATION%20 0 1 X 200.000000000000 200.000000000000 X 1 1 X X X 1 X HTTPS://OCHSNERLG.ORG/FINANCIAL-ASSISTANCE-POLICIES X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20FINANCIAL%20ASSISTANCE%20AP X HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20PLAIN%20LANGUAGE%20SUMMARY% X X X X X X X 1 0 X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: LAFAYETTE GENERAL MEDICAL CENTER INC., - FACILITY 2: LAFAYETTE GENERAL ORTHOPEDIC HOSPITAL, - FACILITY 3: LAFAYETTE GENERAL SURGICAL HOSPITAL, LLC FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY GATHERING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVICED BY THE HOSPITAL FACILITY, AS WELL AS INDIVIDUALS PROVIDING INPUT WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. IT IS MEANT TO PROVIDE DEPTH AND RICHNESS TO THE QUANTITATIVE DATA COLLECTED. ADDITIONALLY, FOCUS GROUPS WERE CONDUCTED TO ALLOW PARTICIPANTS TO PROVIDE INFORMATION ABOUT THEIR EXPERIENCES IN THE COMMUNITY AND WAYS IN WHICH THEY THINK THE SERVICES AND RESOURCES PROVIDED TO THE COMMUNITY CAN BE IMPROVED.ORGANIZATIONS PROVIDING INPUT CAN BE FOUND IN THE CHNA, LOCATED AT: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDF FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: JOINT COMMUNITY HEALTH NEEDS ASSESSMENT FOR LAFAYETTE GENERAL MEDICAL CENTER, OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, HEART HOSPITAL OF LAFAYETTE AND PARK PLACE SURGICAL HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED NEEDS ASSESSMENT BY:-ADOPTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THE HEALTH NEEDS OF THE HOSPITAL FACILITY'S COMMUNITY-EXECUTION OF THE IMPLEMENTATION STRATEGY-PARTICIPATION IN THE DEVELOPMENT OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-PARTICIPATION IN THE EXECUTION OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS-ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT-PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY-PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITYPLEASE SEE ATTACHED IMPLEMENTATION STRATEGY FOR FURTHER INFORMATION: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-05/CHNA%20IMPLEMENTATION%20STRATEGY%20FOR%20SMH%20FINAL%201.28.20.PDF FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16J: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. FINANCIAL ASSISTANCE POLICY WEBSITES: HTTPS://OCHSNERLG.ORG/FINANCIAL-ASSISTANCE-POLICIESHTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20FINANCIAL%20ASSISTANCE%20APP%20FNL.PDFHTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/OLG%20PLAIN%20LANGUAGE%20SUMMARY%20FNL.PDF PART I, LINE 6A: THE ANNUAL COMMUNITY BENEFIT REPORT INCLUDED ALL OF THE HEALTHCARE FACILITIES THAT LAFAYETTE GENERAL MEDICAL CENTER, INC IS AFFILIATED WITH. THE COMMUNITY BENEFIT REPORT INCLUDED LAFAYETTE GENERAL HEALTH SYSTEM, UNIVERSITY HOSPITAL & CLINICS, ACADIA GENERAL HOSPITAL, KAPLAN GENERAL HOSPITAL, DBA ABROM KAPLAN MEMORIAL HOSPITAL, LAFAYETTE GENERAL SURGICAL HOSPITAL, OIL CENTER SURGIAL PLAZA, ST. MARTIN HOSPITAL, LAFAYETTE HEALTH VENTURES, AND LAFAYETTE GENERAL FOUNDATION. PART I, LINE 7: THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H.PART I, LINE 7B, MEDICAID: LGMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS TO ASSIST IN OFFSETTING THE COSTS OF PROVIDING GRADUATE MEDICAL EDUCATION PROGRAMS AT BOTH LGMC AND UNIVERSITY HOSPITAL AND CLINICS. THE PAYMENTS ARE PROVIDED THROUGH A COLLABORATIVE ENDEAVOR AGREEMENT CREATING A PUBLIC PRIVATE PARTNERSHIP WITH LGMC, UHC, LOUISIANA STATE UNIVERSITY AND THE STATE OF LOUISIANA. 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 $ 7,547,000. PART 1, LINE 7, COLUMN F THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25 WHICH EXCLUDED BAD DEBT EXPENSE A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7 THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEPT EXPENSE IS ON PAGES 17 OF THE ATTACHED AUDITED FINANCIALS STATEMENTS. PLEASE NOTE THAT BAD DEBT EXPENSE IS NOW REFERRED TO AS IMPLICIT PRICE CONCESSIONS.BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE REFLECTED ON THE ORGANIZATION'S TRIAL BALANCE AND CLASSIFIED AS IMPLICIT PRICE CONCESSIONS IN THE AUDITED FINANCIAL STATEMENTS. IT WAS ESTIMATED THAT 28% OF THE UNINSURED OUTPATIENT EMERGENCY ROOM VISITS THAT WERE ADJUSTED TO BAD DEBT MAY HAVE BEEN PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION.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 2019 COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. PART III, LINE 9B: WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE ,WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. PART VI, LINE 2: A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR THE YEAR ENDING 09/30/19. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE OUR COMMUNITY HEALTH NEEDS ASSESSMENT DURING 2019. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS. IN ADDITION, THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATION. THE HOSPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED AT:HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2019-09/SP3727-LGH-SMH-CHNA-ADOPTED-9.17.19.PDFTHE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT: HTTPS://OCHSNERLG.ORG/SITES/DEFAULT/FILES/2020-05/CHNA%20IMPLEMENTATION%20STRATEGY%20FOR%20SMH%20FINAL%201.28.20.PDF PART VI, LINE 3: THE HOSPITAL COMPLIES WITH FEDERAL AND JACHO REQUIREMENTS OF POSTING NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS. HANDOUTS ARE INCLUDED WITH THE ADMISSION PACKAGE THAT INFORMS THE PATIENT OF CONTACT INFORMATION TO DISCUSS PAYMENT OPTIONS. THE HOSPITAL IS A MEDICAID ENROLLMENT FACILITY, AND AS SUCH, THE HOSPITAL OFFERS SCREENING SERVICES FOR ELIGIBILITY FOR MEDICAID AND POSSIBLE CHARITY CARE ASSISTANCE. HOSPITAL PERSONNEL ALSO SCREEN LARGER ACCOUNTS AFTER THE ORIGINAL BILL IS ISSUED, AND CONTACT THE PATIENT TO DETERMINE QUALIFICATIONS FOR CHARITY CARE POLICY. PART VI, LINE 4: THE HOSPITAL SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED AS ACADIANA AS THE LARGEST, FULL SERVICE, ACUTE CARE MEDICAL CENTER. APPROXIMATELY ONE THIRD OF THE HOSPITAL'S DISCHARGES COME FROM LAFAYETTE PARISH. THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE. PART VI, LINE 5: THE HOSPITAL DOES MAINTAIN AN OPEN MEDICAL STAFF THUS ALLOWING IT TO OFFER A VARIETY OF SPECIALISTS, AND CONTINUES TO RECRUIT PHYSICIANS TO OUR AREA TO ENSURE THAT THE HOSPITAL WILL CONTINUE TO BE THE FULL SERVICE HEALTHCARE PROVIDER THAT THE COMMUNITY EXPECTS. THE HOSPITAL JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS TO PROVIDE HEALTHCARE SCREENINGS AND TEST AT LOCAL EVENTS. PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH OTHER HEALTHCARE ORGANIZATIONS. SEE FORM 990 SCHEDULE R FOR A COMPLETE LISTING. ALL OF THE ORGANIZATIONS ARE LOCAL HEALTHCARE ORGANIZATIONS WITH THE SAME PURPOSE AS THE HOSPITAL. 1 LAFAYETTE PARISH SCHOOL SYSTEM -ON TRACK BY 5 ALLIANCE 326 GAUTHIER ROAD LAFAYETTE LA 70501 726000625 GOV'T 5000 DONATION 1 0 PART I, LINE 2: CHARITABLE DONATIONS ARE MADE TO LOCAL NON-PROFIT ORGINIZATIONS THAT PARALLEL OUR HEALTHCARE MISSION IN THE COMMUNITY. X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 WARNER THOMAS TRUSTEE 0 1839909 0 4151250 0 58969 0 750745 0 20939 0 6821812 0 0 MICHAEL HULEFELD TRUSTEE 0 961687 0 900000 0 30220 0 261249 0 29692 0 2182848 0 0 ROBERT HART MD TRUSTEE 0 820063 0 600000 0 30688 0 6800 0 21511 0 1479062 0 0 PATRICK W GANDY JR EVP-LGH/CEO-LGMC 0 538501 0 264087 0 96070 0 110100 0 15771 0 1024529 0 0 JOHN SCHUTTE MD TRUSTEE 0 990850 0 0 0 3048 0 5385 0 16151 0 1015434 0 0 MICHAEL S CAIN PHYSICIAN 0 822738 0 0 0 57232 0 5700 0 16151 0 901821 0 0 PHILIPPE PROUET PHYSICIAN 0 401501 0 217458 0 1300 0 5662 0 16151 0 642072 0 0 VICTORIA E PANELLIE-RAMERY PHYSICIAN 0 594401 0 11979 0 2232 0 5700 0 10719 0 625031 0 0 MOLLY THOMAS MD PHYSICIAN/TRUSTEE 0 573229 0 8455 0 28243 0 0 0 13827 0 623754 0 0 MEGAN DAIGLE PHYSICIAN 0 534897 0 10449 0 39278 0 4158 0 5978 0 594760 0 0 STEVEN SACCARO PHYSICIAN 0 577946 0 0 0 0 0 0 0 0 0 577946 0 0 AL PATIN SVP-COO LGMC 0 342192 0 87760 0 36744 0 73252 0 15771 0 555719 0 0 REBECCA BENOIT FORMER VP/CNO 0 215155 0 0 0 267563 0 35000 0 3660 0 521378 0 0 KIM HEBERT CFO 0 177318 0 26252 0 2186 0 3507 0 225 0 209488 0 0 DENIS ESCHETE FORMER BOARD MEMBER 0 108000 0 0 0 0 0 0 0 0 0 108000 0 0 PHILLIP GACHASSIN FORMER BOARD MEMBER 0 36666 0 0 0 0 0 0 0 0 0 36666 0 0 PART I, LINE 1A A SMALL GROSS UP PAYMENT IS MADE FOR EXECUTIVE DISABILITY INSURANCE. PART I, LINE 4B A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED EFFECTIVE JANUARY 01,2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WAS $207,400. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE PATRICK GANDY, EVP/COO-LGMC, AL PATIN, SVP/COO AND REBECCA BENOIT, FORMER VP/CNO. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2020 W-2 WAGES, TOTALLED $ 357,410.55. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 20120 W-2 WAGES: PATRICK GANDY, EVP/COO-LGMC, AL PATIN, SVP/COO AND REBECCA BENOIT, FORMER VP/CNO. PART I, LINE 6 THE ORGANIZATION DOES HAVE AN INCENTIVE PLAN FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS', AS LISTED ON PART VII OF FORM 990, CALCULATION OF INCENTIVE PLAN PAYMENTS ARE IN PART BASED ON THE CONSOLIDATED NET EARNINGS. STREAMLINE ORTHOPEDIC SERVICES APMLLC JOHN SCHUTTE, MD IS A TRUSTEE OF LGMC AND IS A MEMBER OF SOS, APMLLC 685500 LAFAYETTE GENERAL MEDICAL CENTER, INC HAS ENTERED INTO A CONTRACT WITH STREAMLINE ORTHOPEDIC SERVICES, APMLLC TO PROVIDE MEDICAL DIRECTOR SERVICES AND OVERSIGHT OF THE ORTHOPEDIC SERVICES PRODUCT LINE. 0 GBR LLC CHIEF OF STAFF, BRAD BROUSSARD IS AN OWNER OF GBR LLC 2587197 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE INTESIVISTS SERVICES, LUNG MASS CLINIC MANAGEMENT SERVICES, PULMONARY COVERAGE SERVICES AND TO PROVIDE FACULATY FOR GRADUATE MEDICAL EDUCATION PROGRAM 0 SURGICAL HOSPITAL MANAGEMENT SYSTEM PHILIP GACHASSIN, M.D. IS A FORMER TRUSTEE AND IS A MEMBER OF SHMS, LLC. 1648750 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE ACUTE CARE SURGICALIST SERVICES. 0 ACADIANA WEIGHT LOSS SURGERY LLC PHILIP GACHASSIN, M.D. IS A FORMER TRUSTEE AND IS A MEMBER AWLS, LLC. 312000 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE SERVICES. 0 ACADIANA ORTHOPEDIC PROPERTIES LLC JOHN SCHUTTE MD IS A TRUSTEE OF LGHS AND IS A MEMBER OF AOP, LLC 20318 LAFAYETTE MEDICAL CENTER, INC HAS ENTERED INTO A LEASE AGREEMENT WITH INTERESTED PERSON TO PROVIDE OFFICE BUILDING SPACE. 0 FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES, CLAY ALLEN AND DAVID WILSON ARE INVOLVED IN SEPARATE BUSINESS VENTURES TOGETHER THAT ARE WHOLLY UNRELATED TO THE ORGANIZATION. THE FOLLOWING TRUSTEES ALL HAVE OWNERSHIP IN LAFAYETTE GENERAL SURGICAL HOSPITAL: DR. SCHUTTE AND DR. GACHASSIN, BOTH FORMER BOARD MEMBERS. PHILIP GACHASSIN, M.D. AND DENNIS ESCHETE, M.D. (FORMER BOARD MEMBERS) ARE PARTNERS IN A GENERAL SURGERY OFFICE PRACTICE AND SHARE OFFICE SPACE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-STOCK NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS RATIFY THE SELECTION OF THE INDIVIDUALS THAT SERVE ON THE BOARD OF TRUSTEES (GOVERNING BODY) AFTER THOSE INDIVIDUALS HAVE BEEN SELECTED AS A TRUSTEE BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B YES, THE INDIVIDUALS OF THE TRUSTEES (GOVERNING BODY) AND THE MEMBERS MUST BE APPROVED BY THE MEMBERSHIP BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S ACCOUNTING STAFF AND A CPA FIRM. THE COMPLETED FORMS ARE REVIEWED BY THE OFFICERS AND THEN PRESENTED TO THE BOARD FOR REVIEW, COMMENT AND CORRECTIONS IF NEEDED BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL SURVEY IS SENT TO THE BOARD MEMBERS AND OFFICERS REQUIRING THEM TO DISCLOSE CONFLICTS OF INTEREST. AFTER RECEIPT OF THESE SURVEYS, THE GOVERENCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE. THEREAFTER THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE AND THE ORGANIZATION'S GENERAL COUNCIL (WHO ATTENDS ALL BOARD MEETINGS) INSURES THAT ALL CONFLICTS ARE TIMELY DISCLOSED AND APPROPRIATE RECUSALS ARE MADE ON BUSINESS MATTERS THAT MAY BE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO?S COMPENSATION THEREAFTER. THIS SAME PROCESS IS FOLLOWED FOR THE FOLLOWING SENIOR EXECUTIVES OF THE ORGANIZATION: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER AND GENERAL COUNSEL. FORM 990, PART VI, SECTION C, LINE 19 BASIC FINANCIAL INFORMATION IS MADE AVAILABLE AND SENT OUT TO THE COMMUNITY BY MEANS OF THE ORGANIZATION'S ANNUAL REPORT. OTHER DOCUMENTS AND MORE DETAILED FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY / LEGAL AUTHORITIES. FORM 990, PART VII, SECTION A, LINE A PAYMENTS TO THE PHYSICIANS THAT SERVE AS TRUSTEES WERE REPORTED ON 1099 MISC BOX 6 FOR SUCH SERVICES AS PROVIDING CALL COVERAGE IN OUR EMERGENCY ROOM, OR SERVING AS MEDICAL DIRECTORS FOR VARIOUS HOSPITAL DEPARTMENTS. NO PAYMENTS WERE MADE IN THEIR CAPACITY AS TRUSTEE. FORM 990, PART XI, LINE 9: OTHER CHANGE IN NET ASSETS -1,928,085. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANED FROM THE PREVIOUS YEAR. 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