2020-07-14T15:32:30-05:00 2019-06-30 346565596 ERNST & YOUNG US LLP 425 HOUSTON STREET SUITE 600 FORT WORTH TX 761027427 990 2018-07-01 364774713 LSU Health Sciences Center Shreveport Faculty Group Practice LSUH 3186758533 1431 Dalzell Street Shreveport LA 71103 VERNON MOORE CFO,TREASURER 2020-07-14 true MELVA SCOTT P01207335 8173351900 2018 2020-09-22 18:59:49Z X Ochsner LSU Physician Group CHARLES FOX III MD 1431 Dalzell Street Shreveport LA 71103 92672150 false X N/A X 2013 LA LSU HEALTH SCIENCES CENTER-SHREVEPORT FACULTY GROUP PRACTICE PROVIDES HEALTHCARE TO THE GENERAL PUBLIC, INCLUDING BUT NOT LIMITED TO, THE DELIVERY OF PHYSICIAN MEDICAL SERVICES AND OTHER HEALTHCARE SERVICES TO INDIVIDUALS 8 7 2 0 0 0 0 0 70037535 92672150 0 0 0 0 70037535 92672150 0 0 0 0 0 358947 0 0 0 69040739 89924701 69040739 90283648 996796 2388502 15479777 29891350 5437342 17832816 10042435 12058534 No Board Approved Mission Statement false false 90283648 92672150 LSU HEALTH SCIENCES CENTER-SHREVEPORT FACULTY GROUP PRACTICE PROVIDES HEALTHCARE TO THE GENERAL PUBLIC, INCLUDING, BUT NOT LIMITED TO, THE DELIVERY OF PHYSICIAN MEDICAL SERVICES AND OTHER HEALTHCARE SERVICES TO INDIVIDUALS. THE FGP RECEIVES COMPENSATION FOR THESE SERVICES FROM THE MEDICARE AND MEDICAID PROGRAMS, CERTAIN COMMERCIAL INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS, PREFERRED PROVIDER ORGANIZATIONS AND DIRECTLY FROM PATIENTS. 90283648 true false false false false false false false false true false false true false true false true false false false false false false false false false false false false false false false false false false false false false false false false false true false false false true 7 0 true 2 true false false false false false false true false false false false X 8 7 false true true false true false true true true false false true true true true true true true true false X VERNON MOORE 3188629977 1431 Dalzell Street SHREVEPORT LA 71103 CHARLES J FOX III MD PRESIDENT/CHIEF EXECUTIVE OFFICER/BOARD CHAIR 50.0 0 X X 0 0 0 VERNON H MOORE III CHIEF FINANCIAL OFFICER/TREASURER 10.0 40.0 X X 0 87518 3439 DAVID F LEWIS MD MBA DIRECTOR 1.0 49.0 X 0 0 0 W JEFF REYNOLDS DIRECTOR 1.0 5.0 X 0 0 0 GE GHALI DDS MD FACS FRCS(ED) DIRECTOR 1.0 5.0 X 0 0 0 PETER NOVEMBER DIRECTOR 1.0 5.0 X 0 0 0 VINCENT ADOLPH MD DIRECTOR 1.0 0 X 0 0 0 CHARLES D DAIGLE DIRECTOR 1.0 49.0 X 0 0 0 WILLIAM COMEGYS III DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 HORATIO D'AGOSTINO MD DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 LARRY FERDINAND DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 ALEXANDER GOMELSKY MD DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 RAYMOND LASSEIGNE DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 GLENN MILLS MD DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 ASHLEY MORRIS DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 VALENCIA SARPY JONES DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 JONATHON RENOLDS DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 MARY SMITH DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 DEANO THORNTON DIRECTOR - END 09/30/18 1.0 0 X 0 0 0 STEPHEN RANDALL CHIEF ADMINISTRATIVE OFFICER 10.0 40.0 X 0 0 0 SHELLEY SULLIVAN TYNAN SECRETARY 1.0 5.0 X 0 0 0 PATRICK BICKNELL EXECUTIVE DIRECTOR 50.0 0 X 73723 0 785 73723 87518 4224 0 false false false LSUHSC - SHREVEPORT 1501 KINGS HIGHWAY SHREVEPORT LA 71103 PHYSCIAN SERVICES 28551769 ACADIANA COMPUTER SYSTEMS 324 DULLES DRIVE LAFAYETTE LA 70506 BILLING MANAGEMENT 4241182 OCHSNER CLINIC FOUNDATION 1514 JEFFERSON HIGHWAY NEW ORLEANS LA 70121 MANAGEMENT COMPANY 774903 HEALTH MANAGEMENT ASSOCIATES ONE MICHIGAN AVENUE BUILDING 120 NORTH WASHINGTON SQUARE LANSING MI 48933 INTERIM ADMINSTRATIVE SUPPORT 346813 BRUCE SOLOMON CONSULTING LLC PO BOX 331 FORT WORTH TX 76101 CONSULTING SERVICES 228000 6 0 PATIENT SERVICE REVENUE 621110 92672150 92672150 0 0 0 0 92672150 0 0 0 0 0 0 0 0 0 92672150 92672150 0 0 74508 74508 239937 239937 25116 25116 19386 19386 65093655 65093655 9020130 9020130 0 0 420 420 171727 171727 230952 230952 1363 1363 3444 3444 175939 175939 LSU HSC 15086458 15086458 LICENSE FEES 72475 72475 SUPPLIES 52465 52465 15673 15673 0 0 90283648 90283648 0 0 6633708 17624888 8245294 9929906 0 0 0 13954 36665 544773 133891 586821 410882 0 0 0 1889009 15479777 29891350 5437342 17832816 0 0 0 5437342 17832816 X 10042435 12058534 10042435 12058534 15479777 29891350 2388502 -372403 0 X false true X true false X 0 70037535 92597150 162634685 0 0 0 0 0 0 70037535 92597150 162634685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162634685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70037535 92597150 162634685 1 1.0 0 0.0 X 393940 109234 284706 150833 24657 126176 410882 DUE FROM OLHS-NL 1889009 1889009 0 0 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE TEXT OF THE FOOTNOTE TO THE CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE LIABILITY FOR UNCERTAIN TAX POSITIONS IS AS FOLLOWS: OLHS-NL QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, EXCEPT FOR UNRELATED BUSINESS INCOME, IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. PURSUANT TO LOUISIANA LAW, THIS EXEMPTION ALSO APPLIES TO LOUISIANA STATE INCOME AND FRANCHISE TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION ON THE ACCOMPANYING CONSOLIDATED BALANCE SHEET. THE TAX CUTS AND JOBS ACT (THE ACT) WAS ENACTED ON DECEMBER 22, 2017. THE PROVISIONS OF THE ACT DID NOT HAVE A MATERIAL TAX EFFECT ON OLHS-NL'S CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT WILL CONTINUE TO EVALUATE THE IMPACT OF THE ACT AND MAY RECORD ADJUSTMENTS AS ADDITIONAL INFORMATION AND GUIDANCE ARE RELEASED FROM THE INTERNAL REVENUE SERVICE (IRS). Form 990, Part VI, Line 3 Delegation of management duties Ochsner Clinic Foundation entered into a management agreement to provide management services, billing and collection services and administrative support for certain hospital and healthcare operations in Shreveport and Monroe. Also, Ochsner acquired the Electronic Health Records licenses and fully manages the Information Services function. The Directors appointed to the board that are employed as Executives and Physicians by Ochsner Clinic Foundation did not receive any additional compensation by the management company for their duties. The following individuals were compensated as executives and physicians by the management company: 1. PETER NOVEMBER - $0 2. VINCENT ADOLPH MD - $0 3. SHELLEY SULLIVAN TYNAN - $0 4. CHARLES DAIGLE - $459,317 5. VERNON MOORE - $0 6. STEPHEN RANDALL - $282,730 Form 990, Part VI, Line 4 Significant changes to organizational documents Below is a summary of the Significant Changes: a. Composition of Board - The board is made of the Joint Management Committee, 4 LSU Designated Directors & 4 Ochsner Designated Directors, with the Chair of the Board changing every 2 years between the LSU & Ochsner Designated Directors. All directors serve an indefinite term. b. Officers - Appointed by the CEO instead of by the Board, apart from the CEO who is appointed by the Chancellor of LSU Health Sciences Center. Also, the CEO must be a Physician at LSU Health Sciences Center - Shreveport. c. Stockholders - Sole owned by OLHS-NL d. Amend Documents/Bylaws - The bylaws were amended after the acquisition by OLHS-NL on October 1, 2018. e. Voting Approval Requirement - A 2/3 Majority of Each of the Designated Director Groups. In The event of a deadlock, the subject being voted upon will be brought before the Member, OLHS-NL, and its board to final determination on the matter. f. Policies - The Board adopted a Conflicts of Interest Policy in the updated bylaws. g. Committee - Since the corporation is solely owned by OLHS-NL, then it is under the authority of their Audit Committee. At a future time, the corporation may elect to have committees, but at this time does not have any. Form 990, Part VI, Line 6 Classes of members or stockholders LSU-Health Sciences Center- Shreveport Faculty Group Practice is a wholly owned subsidiary of Ochsner LSU Health System of North Louisiana, a related 501(c)(3) organization, and a supported organization. LSU-Health Sciences Center- Shreveport Faculty Group Practice is organized on a non-stock membership basis, and as of October 1, 2018 the sole Member of the Corporation is Ochsner LSU Health System of North Louisiana. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders In the event of a final vote that results in a deadlock, the Directors may bring the matter before the Member and the board of directors of the Member will make the final determination on the matter, consistent with Section 4.14N of these Bylaws. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ORGANIZATION PROVIDES A COPY OF THE FORM 990 TO THE FULL BOARD OF DIRECTORS ONCE REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM, ERNST & YOUNG U.S. LLP Form 990, Part VI, Line 12c Conflict of interest policy OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES OF OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA AND ITS SUBSIDIARIES AND AFFILIATES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY, OR WITHIN 40 DAYS OF BECOMING AN EMPLOYEE, OR IF A CURRENT EMPLOYEE HAS A CHANGE IN BUSINESS CIRCUMSTANCES NOT PREVIOUSLY DISCLOSED. THE CONFLICT OF INTEREST PROGRAM ADMINISTRATOR REVIEWS DISCLOSURES AND DETERMINES WHETHER ACTION IS NECESSARY OR IF THE DISCLOSURE NEEDS TO BE REVIEWED BY THE CONFLICT OF INTEREST STEERING COMMITTEE. THE CONFLICT OF INTEREST PROGRAM ADMINISTRATOR, IN CONJUNCTION WITH THE CONFLICT OF INTEREST STEERING COMMITTEE, WILL MAKE MITIGATION RECOMMENDATIONS, INCLUDING, BUT NOT LIMITED TO, DIVESTITURE AND TERMINATION OF BUSINESS RELATIONSHIPS. OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA REQUIRES ANNUAL CERTIFICATION THAT THE RELATIONSHIPS DISCLOSED DURING A PRECEDING CALENDAR YEAR ARE COMPLETE AND ACCURATE. Form 990, Part VI, Line 15a Process to establish compensation of top management official ALL OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA CEO AND OFFICER COMPENSATION AND BENEFITS ARRANGEMENTS, INCLUDING SALARY AND BONUS INCENTIVE PLANS, ARE REVIEWED BY OCHSNER CLINIC FOUNDATION'S EXECUTIVE TEAM UNDER ITS AGREEMENT TO PROVIDE MANAGEMENT SERVICES. OCHSNER CLINIC FOUNDATION'S EXECUTIVE TEAM IS WITHOUT CONFLICTS OF INTEREST AND USES AN INDEPENDENT EXTERNAL CONSULTANT. APPROPRIATE DATA IS APPLIED TO DETERMINE THE COMPARABILITY OF FAIR MARKET VALUE PAY AND ALL ACTIONS ARE APPROPRIATELY DOCUMENTED. Form 990, Part VI, Line 15b Process to establish compensation of other employees Management jobs are assigned to pay ranges where the midpoint is aligned to the 50th percentile of salary survey data. Upon hire, management salaries are based upon applicable skills and experience relevant to the job and pay range. Merit increases are awarded annually thereafter based upon performance. Off-cycle adjustments may be provided due to market movement to ensure alignment with the competitive market. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST Form 990, Part XII, Line 2c Change in Oversight Process or Selection Process The organization became a wholly owned subsidiary of OLHS-NL, and is included in the Consolidated Audit. The oversight process of these financial statement is the Audit Committee of OLHS-NL. This change in the oversight process resulted in the change of the Auditor of the Financial Statements and Reviewer of the Tax Return from Carr Riggs & Ingram LLC to Ernst & Young U.S. LLP. OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA 1431 DALZELL STREET SHREVEPORT LA 71103 831605004 PATIENT CARE LA 501(c)(3) 3 NA false LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER-SHREVEPORT 1501 KINGS HIGHWAY SHREVEPORT LA 71103 720702002 MEDICAL FACILITY LA 501(c)(3) 3 NA false false false false false false false false false false false false true true false false false false false true OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA L 16500000 INTERCOMPANY BILLINGS - MKT VALUE OCHSNER LSU HEALTH SYSTEM OF NORTH LOUISIANA S 1889009 INTERCOMPANY BILLINGS - MKT VALUE LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER-SHREVEPORT M 28551769 MKT VALUE Schedule R, Part V, Line 2 LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER-SHREVEPORT LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER-SHREVEPORT, (LSUHSC-S), AND LSU HEALTH SCIENCES CENTER - SHREVEPORT FACULTY GROUP PRACTICE , (LSU FGP), WERE RELATED ORGANIZATIONS DURING FISCAL YEAR ENDED JUNE 30, 2019. HOWEVER, THIS RELATIONSHIP ENDED ON OCTOBER 1, 2018 AND LSUHSC-S AND LSU FGP ARE NO LONGER RELATED. HENCE, NEITHER ENTITY WILL BE REPORTED AS SUCH ON EITHER OF THE ORGANIZATIONS 2019 FORM 990'S FOR THE FISCAL YEAR ENDING JUNE 30, 2020.