2019-05-15T13:06:59-05:00 2018-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2017-07-01 721470744 OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL % AMANDA HYMEL OURL 2256475000 1125 HIGHWAY 30 GONZALES LA 70737 JEFF LIMBOCKER CFO 2256475071 2019-05-07 true BRITTANY ELLISER P01284594 2253444000 2019-05-14 167.68.102.5 72049520191355000010 2019-05-15 P 53C1C64467A110CFCB3C567BD5AEFD0F6F397324 EB850E1BCF32CA73DDA849DEBA9ACC48FFFF1BCD 2017 2019-02-21 02:37:17Z ST ELIZABETH HOSPITAL ROBERT BURGESS 1125 HIGHWAY 30 GONZALES LA 70737 116221043 false 0928 X WWW.STEH.COM X 2000 LA The purpose of the hospital is to provide FOR THE CARE OF THE ILL, injured, or disabled persons and to enhance the health of those in the community through research and education. 17 12 989 19 0 -38119 156985 11917 101008984 113708168 279479 627142 551200 534381 101996648 114881608 111622 76076 0 0 58188907 60822021 0 0 0 43503297 45295236 101803826 106193333 192822 8688275 96102927 95673135 36614115 29578688 59488812 66094447 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH THOSE 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. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. false false 43768770 76076 45372174 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 THE NEEDY MEMBERS OF ITS COMMUNITIES. FOLLOWING THAT POLICY, HEALTH CARE SERVICES WERE PROVIDED WITHOUT CHARGE OR AT RATES WHICH ARE LESS THAN THE COST OF PROVIDING SUCH SERVICES. THE HOSPITAL PROVIDED INPATIENT AND OUTPATIENT MEDICAL SERVICES FOR 13,167 PATIENT DAYS AND 220,883 PHYSICIAN OFFICE VISITS. 12282405 30407151 THE HOSPITAL PROVIDES PATIENTS WITH SURGICAL CARE. 351,021 SURGICAL MINUTES WERE USED DURING THE YEAR. 23753701 38454026 THE HOSPITAL PROVIDES RADIOLOGY SERVICES TO ITS INPATIENTS AND OUTPATIENTS. DURING THE CURRENT YEAR, THE HOSPITAL PERFORMED 36,935 RADIOLOGY PROCEDURES. 79804876 true true false false false false false false false false true true false false true true false true false false false false 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 43 0 true 989 true true true false false false false true true false false false false X 17 12 false false false false true true true true true false false true true true true true true false true true true X AMANDA HYMEL 2259232701 5959 S SHERWOOD FOREST BLVD BATON ROUGE LA 70809 X SR MARTHA ANN ABSHIRE BOARD MEMBER 2.0 2.0 X 0 0 0 ROBERT BURGESS PRESIDENT AND CEO 50.0 2.0 X X 0 389803 57587 JOHN F FRAICHE MD PRES STEPG 40.0 0.0 X 557133 0 12318 MARK K DEARMAN BOARD MEMBER 2.0 0.0 X 0 0 0 THE HONORABLE TESS STROMBERG BOARD MEMBER 2.0 0.0 X 0 0 0 RJ DAIGLE BOARD MEMBER 2.0 0.0 X 0 0 0 ROGER KEESE SECRETARY 2.0 2.0 X X 0 0 0 THE HONORABLE ALVIN TURNER JR BOARD MEMBER 2.0 0.0 X 0 0 0 THE HONORABLE TERI CASSO CHAIR 2.0 0.0 X X 0 0 0 STACEY CHIASSON BOARD MEMBER 2.0 0.0 X 0 0 0 DENZIL MORAES MD BOARD MEMBER/PHYSICIAN 40.0 0.0 X 1273990 0 32482 SR VERNOLA LYONS BOARD MEMBER 2.0 0.0 X 0 0 0 ROBERT SCHUTTE MD CHIEF OF STAFF 1-12/2017 40.0 0.0 X 0 0 0 DAWN B SHARP MD CHIEF OF STAFF 1-12/2018 40.0 0.0 X 413004 0 37339 Paul C Aguillard MD BOARD MEMBER/PHYSICIAN 40.0 0.0 X 484673 0 32339 DAVID ALEXANDER BOARD MEMBER 2.0 0.0 X 0 0 0 DALE HYMEL BOARD MEMBER 2.0 0.0 X 0 0 0 KENNETH CAMPBELL BOARD MEMBER 2.0 0.0 X 0 0 0 SUE KNIGHT COO 40.0 0.0 X 274784 0 82119 JEFFREY LIMBOCKER REGIONAL CFO 0.0 60.0 X 0 552329 131623 YVONNE PELLERIN CNO 40.0 0.0 X 195498 0 15166 RAHIL D SHAH STAFF PHYSICIAN 40.0 0.0 X 574487 0 10872 Michael Bodin STAFF PHYSICIAN 40.0 0.0 X 496097 0 35383 Michael A Goodier Staff Physician 40.0 0.0 X 440317 0 32339 John D Knapp STAFF Physician 40.0 0.0 X 437884 0 32934 ELIZABETH BOLLINGER STAFF PHYSICIAN 40.0 0.0 X 422524 0 72057 5570391 942132 584558 72 false true false Trimedx 5451 Lakeview Parkway S Drive INDIANAPOLIS IN 46268 Clinical Maintenance 1296005 Stuart Company General Contractor 4320 Jeffrey Dr BATON ROUGE LA 70816 Construction 652780 Crothall Healthcare Inc 1500 Liberty Ridge Dr Suite 210 WAYNE PA 19087 ENVIRONMENTAL SVCS 593528 FMOL HEALTH SYSTEM 4200 ESSEN LANE BATON ROUGE LA 70809 MANAGEMENT FEES 10377404 OUR LADY OF THE LAKE HOSPITAL INC 5000 HENNESSY BLVD BATON ROUGE LA 70808 MANAGEMENT FEES 11427210 43 X 11917 11917 Patient Service Revenue 621500 111845816 111845816 OUTREACH LAB 900099 500520 500520 CAFETERIA 900099 154745 154745 OTHER 900099 1207087 1207087 113708168 105495 105495 0 0 525183 525183 0 525183 525183 1851300 7650 1322146 15157 529154 -7507 521647 521647 0 0 0 11330 2132 9198 9198 0 0 0 0 114881608 114233351 636340 76076 76076 0 0 0 2375996 1696831 679165 0 46438217 33395515 13042702 4297418 3089397 1208021 4726178 3397631 1328547 2984212 2145338 838874 11520451 8282007 3238444 59596 42843 16753 74514 53568 20946 0 0 15538 11170 4368 7306351 5252507 2053844 452367 325205 127162 3131626 2251314 880312 997237 716910 280327 0 1911939 1423630 488309 130044 93488 36556 0 24480 17599 6881 574282 412849 161433 0 4132733 3219176 913557 1453682 1045046 408636 REPAIRS & MAINTENANCE 2250845 1618124 632721 Medical Supplies Expense 11185205 11185205 Special Events 63396 45575 17821 MEMBERSHIP DUES 10950 7872 3078 106193333 79804876 26388457 0 0 0 14795479 17852669 0 0 16410887 12590999 0 0 0 0 0 0 1539740 1435296 514238 768428 98247290 48028578 50532523 50218712 2797189 0 3896159 7407631 3624883 3501792 0 0 1991829 1897608 96102927 95673135 18552607 13936739 0 0 0 0 11865508 11801568 0 0 0 0 2034264 1927849 0 0 4161736 1912532 36614115 29578688 X 59289412 65873484 199400 220963 0 0 59488812 66094447 96102927 95673135 X 8688275 -169060 -1913580 X false true X true false X 3747277 3747277 60094342 24758427 35335915 2362150 1069425 1292725 31768031 22200726 9567305 275490 0 275490 50218712 INVESTMENT IN CAPITAL RESERVE 7407631 F 7407631 0 SELF-INSURANCE LIABILITY 1459446 TAIL COVERAGE & NONREIMBURSABL 272068 DUE FROM AFFILIATES 181018 1912532 X FIN 48 (ASC 740) FOOTNOTE 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 judgment occurs. No reserves for uncertain tax position have been recorded. true true true X 250. false true true false true true 467328 467328 0.00440 22068410 12978828 9089582 0.08560 22535738 12978828 9556910 0.09000 54708 54708 0.00050 175557 175557 0.00170 673726 673726 0.00630 39393 39393 0.00030 943384 943384 0.00880 23479122 12978828 10500294 0.09880 3595 3595 0.00010 3595 3595 0.00010 false 10018276 9629810 10056088 -426278 X true true 1 1 ST ELIZABETH HOSPITAL 1125 HIGHWAY 30 GONZALES LA 70737 WWW.FMOLHS.ORG/STEH X X X ST ELIZABETH HOSPITAL false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 false true false true X 250. 0. X X X X X true true X X X true X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X SEE SUPPLEMENT AT PART V X X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 16I REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE CARE. THE POLICY IS ALSO POSTED AT THE HOSPITAL ADMISSION AREAS. PART V, SECTION B, LINE 5 THE ORGANIZATION ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS. ST. ELIZABETH HOSPITAL TOOK INTO ACCOUNT INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH BY WORKING WITH GONZALES MENTAL HEALTH, COMMUNITY CLINICS, AND THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS. ST. ELIZABETH HOSPITAL ALSO INTERVIEWED COMMUNITY ORGANIZATIONS, HEALTHCARE PROVIDERS, AND RELIGIOUS ORGANIZATIONS. PART V, SECTION B, LINE 11 ST. ELIZABETH HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR TAX YEAR 2015. THE CHNA IDENTIFIED THREE SIGNIFICANT COMMUNITY HEALTH NEEDS: OBESITY, CANCER, AND MENTAL HEALTH/SUBSTANCE ABUSE. THE FOLLOWING INITIATIVES HAVE BEEN IMPLEMENTED TO ADDRESS THOSE NEEDS FOR THE FISCAL YEAR ENDED JUNE 30, 2018. OBESITY AND RELATED CHRONIC DISEASES: ST. ELIZABETH HOSPITAL MAINTAINS THE ST. ELIZABETH PHYSICIAN WELLNESS CLINIC IN ASCENSION, WHICH SPECIFICALLY TARGETS AND ADDRESSES NUTRIENT ACTIVITY AND MEDICAL COUNSELLING FOR THIS PATIENT POPULATION AS IDENTIFIED IN THE CHNA. ST. ELIZABETH CONTINUES TO OPERATE AND FUND THE ST. ELIZABETH PHYSICIAN DIABETES MANAGEMENT PROGRAM (DMP). THE DMP PROGRAM PROVIDED DIABETES EDUCATION, SCREENINGS, AND ACCESS TO MEDICAL TREATMENT FOR DIABETES. IN FY 2018 THE ST. ELIZABETH PHYSICIAN PRACTICE CLINICS MET THE RECOMMENDED GOAL IN MAINTAINING THE ESTABLISHED OUTCOMES FOR DIABETES AND HIGH BLOOD PRESSURE ADEQUATE CONTROLS. THE FY 2018 AMBULATORY PERFORMANCE SCORE FOR THE ST. ELIZABETH PHYSICIAN PRACTICE WAS AT 93.4% OUT OF A POSSIBLE 100%. THE NUMBER OF ST. ELIZABETH HOSPITAL OBESITY AND CHRONIC DISEASE RELATED COMMUNITY EDUCATION OFFERINGS WAS A PRIMARY FOCUS FOR FY 2018. CANCER: ST. ELIZABETH HOSPITAL CONTINUED TO FOCUS ON PROVIDING CANCER RELATED SCREENINGS, EVALUATION AND EDUCATION ON THE FOLLOWING TYPES OF CANCER AS IDENTIFIED THROUGH THE CHNA. THE ANNUAL ST. ELIZABETH FAMILY HEALTH FEAST BRINGS VARIOUS PROVIDERS AND COMMUNITY PARTNERS TO PROVIDE SCREENINGS AND OTHER EDUCATIONAL RESOURCES ON VARIOUS TYPES OF CANCERS. - SKIN CANCER EVALUATIONS - COLON CANCER EVALUATION AND SCREENINGS - PROSTATE CANCER COMMUNITY SCREENINGS, EVALUATION, AND EDUCATION THROUGH MARY BIRD PERKINS CANCER CENTER IN THE AREAS OF WELLNESS AND PREVENTION ST. ELIZABETH PHYSICIAN PRACTICE CLINICS MET AND EXCEEDED THE ESTABLISHED GOALS FOR COLON AND BREAST CANCER SCREENINGS. IN COLLABORATION WITH OUR LADY OF THE LAKE MEDICAL CENTER, ST. ELIZABETH HOSPITAL CONTINUES TO SUPPORT A TOBACCO CESSATION PROGRAM TO REDUCE THE NUMBER OF CANCER RELATED DISEASES CAUSED BY TOBACCO USE. MENTAL HEALTH & SUBSTANCE ABUSE: ST. ELIZABETH HOSPITAL CONTINUES TO SUPPORT MENTAL HEALTH RELATED COMMUNITY EDUCATION EVENTS. ST. ELIZABETH HOSPITAL MAINTAINS A FULL-TIME CLINICAL PSYCHOLOGIST ON CAMPUS AVAILABLE TO PROVIDE INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES. ST. ELIZABETH HOSPITAL AND PHYSICIAN PRACTICE CLINICS CONTINUES TO COLLABORATE WITH OTHER COMMUNITY PARTNERS SUCH AS ASCENSION CONSULTING CENTER, AN OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CENTER, GONZALES MENTAL HEALTH AND ALZHEIMER'S SERVICES OF GREATER BATON ROUGE TO MEET THE MENTAL HEALTH NEEDS OF ASCENSION PARISH. PART V, SECTION B, LINE 7 The CHNA can be found at https://ololrmc.com/assets/documents/st-elizabeth-chna-2016_lr.pdf PART V, SECTION B, QUESTION 13H 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 THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION, AND PLAIN-LANGUAGE SUMMARY OF THE FAP WERE AVAILABLE AT: HTTPS://FMOLHS.ORG/PAGES/FINANCIAL-ASSISTANCE-POLICY.ASPX 3 ST ELIZ-MARY BIRD PERKINS CANCER CENTER 4950 ESSEN LANE BATON ROUGE LA 70809 CANCER TREATMENT CENTER COMMUNITY HEALTH CLINIC 1125 HIGHWAY 30 GONZALES LA 70737 LOW INCOME CLINIC LAKE URGENT CARE ASCENSION LLC 10313 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE PART I, LINE 7 THE COST-TO-CHARGE RATIO, AS CALCULATED USING IRS WORKSHEET 2, IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE AMOUNTS REPORTED IN PART 1, LINES 7A-G. 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. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 CMS REGULATIONS/GUIDELINES ARE USED IN COMPLETING THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS THE TOOL USED IN DETERMINING MEDICARE ALLOWABLE COSTS. 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 HOSPITAL'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: RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED IS PRIMARY TO THE MISSION OF ST. ELIZABETH HOSPITAL. ST. ELIZABETH HOSPITAL IDENTIFIES THE COMMUNITY'S HEALTH NEEDS BY UTILIZING THE FOLLOWING INFORMATION GATHERING TECHNIQUES: COMMUNITY SURVEY: ON AN ANNUAL BASIS, ST. ELIZABETH HOSPITAL, ALONG WITH THE HELP OF STRATEGIC MARKETING AND RESEARCH, LLC, PERFORM A COMMUNITY SURVEY AIMED AT IDENTIFYING THE HEALTH CARE NEEDS AND PREFERENCES OF LOCAL RESIDENTS. THE SURVEY IS CONDUCTED VIA PHONE WHILE USING A RANDOM SAMPLE OF RESPONDENTS. THE FINDINGS FROM THIS RESEARCH SERVE AS A FOUNDATION FOR THE DEVELOPMENT OF FUTURE PROGRAMS FOR OFFERING HEALTHCARE IN ASCENSION PARISH. THE SURVEY ALSO IDENTIFIES THOSE SERVICES THAT ARE SOUGHT OUTSIDE OF ASCENSION PARISH, DUE TO SERVICES NOT BEING OFFERED OR NOT KNOWN TO BE OFFERED (PUBLIC AWARENESS). SUCH DATA HELPS ST. ELIZABETH HOSPITAL ASSESS WHETHER SPECIFIC MEDICAL NEEDS ARE UNDERSERVED. COMMUNITY EDUCATION SURVEY: EVERY TWO YEARS, THE COMMUNITY EDUCATION DEPARTMENT PREPARES A COMMUNITY EDUCATION SURVEY THAT IS GIVEN TO ASCENSION PARISH RESIDENTS WHO ATTEND LOCAL HEALTH SCREENINGS OR OTHER EDUCATIONAL EVENTS. THIS SURVEY IS DESIGNED TO IDENTIFY THE HEALTH EDUCATION NEEDS OF THE AREA RESIDENTS. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INIDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH ST. ELIZABETH HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIALS POLICIES OF THE HOSPITAL. ADDITIONALLY, SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THSOE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE. PART VI, LINE 4 COMMUNITY INFORMATION: ST. ELIZABETH HOSPITAL SERVES ASCENSION PARISH AND PORTIONS OF THE SURROUNDING PARISHES OF ASSUMPTION, IBERVILLE, EAST BATON ROUGE, AND ST. JAMES. THIS AREA HAS HAD SIGNIFICANT GROWTH IN THE LAST DECADE. SPECIFICALLY, THE HISPANIC/LATINO POPULATION HAS MORE THAN DOUBLED IN SOME PORTIONS OF THE SERVICE AREA. THE NORTHERN PARTS OF THE SERVICE AREA TEND TO HAVE A MORE AFFLUENT POPULATION; WHEREAS, THE SOUTHERN TRACTS HAVE CONTINUED BARRIERS TO HEALTHCARE. PURSUANT TO THE HOSPITAL'S LAST CHNA, ST. ELIZABETH'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 117,694 AND IS ONE OF THE FASTEST GROWING PARISHES IN THE STATE. DESPITE THE GROWTH, 9.6% OF FAMILIES LIVE BELOW THE POVERTY LEVEL AND 15% OF RESIDENTS DO NOT HAVE HEALTH INSURANCE. HEALTH STATISTICS THAT ARE ROUTINELY COLLECTED INDICATE THAT RESIDENTS OF THE SERVICE AREA EXPERIENCE MANY HEALTH PROBLEMS. THE POPULATION SUFFERS HIGHER RATES OF STROKE, OBESITY, CANCER, DIABETES AND HYPERTENSION THAN THE NATION AS A WHOLE. ST. ELIZABETH'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: ASCENSION PARISH PART II ST. ELIZABETH PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY BUILDING ACTIVITIES INCLUDE DEVOTING TIME TO NEIGHBORHOOD IMPROVEMENT AND REVITALIZATION PROJECTS, PARTICIPATING IN ECONOMIC DEVELOPMENT COUNCILS/CHAMBERS OF COMMERCE AND PARTICIPATING IN SCHOOL MENTORING PROGRAMS. ALL OF THESE PROGRAMS HELP DEVELOP THE GENERAL WELL-BEING OF THE COMMUNITY WHICH, IN TURN, PROMOTES THE HEALTH OF THE COMMUNITY ST. ELIZABETH SERVES. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE TIME DEVOTED TO FORMING COLLABORATIVE PARTNERSHIPS WITH VARIOUS ORGANIZATIONS SUCH AS THE DEPARTMENT OF HEALTH & HUMAN SERVICES, LOCAL SCHOOL BOARDS, AND OTHER HOSPITALS TO IMPROVE THE GENERAL COMMUNITY HEALTH. ADDITIONALLY, ST. ELIZABETH PARTNERS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORKFORCE SHORTAGES. IT ALSO PARTICIPATES IN SCHOOL-BASED PROGRAMS RELATED TO HEALTH CARE CAREERS. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: ST. ELIZABETH HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE-MEMBER. ST. ELIZABETH IS PART OF THE FMOLHS HEALTH CARE SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. ST. ELIZABETH HOSPITAL SERVES THE COMMUNITY IN GONZALES, LA AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL ST. ELIZABETH HOSPITAL WORKS CLOSELY WITH OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER (A TAX-EXEMPT HOSPITAL AFFILIATE) TO PROVIDE COMPREHENSIVE MEDICAL SERVICES AS PART OF THE OVERALL HEALTHCARE PROVIDED TO THE COMMUNITY. PART III, LINE 2 THE ORGANIZATION ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF ACCOUNTS AND HISTORICAL COLLECTION HISTORY ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW OF THE COLLECTIONS TO DETERMINE THE APPROPRIATE COLLECTION PERCENTAGE TO USE IN ESTIMATING BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE MAJORITY OF THE GOVERNING BODY OF ST. ELIZABETH HOSPITAL IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. ST. ELIZABETH HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL 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. true Volunteer Ascension PO Box 1564 Gonzales LA 70737 721376404 501(c)(3) 5175 GENERAL SUPPORT BATON ROUGE AREA FOUNDATION 402 N FOURTH STREET BATON ROUGE LA 70802 726030391 501(c)(3) 10000 GENERAL SUPPORT BATON ROUGE AREA CHAMBER 564 Laurel Street Baton Rouge LA 70801 720126959 501(c)(6) 10000 GENERAL SUPPORT 2 1 PART I, QUESTION 2 ALL CHARITABLE DONATIONS ARE MADE TO WELL-KNOWN CHARITABLE ORGANIZATIONS OR THROUGH REFERRAL FROM EITHER A BOARD OR TEAM MEMBER ASSOCIATED WITH THE LOCAL/NATIONAL CHARITY. ST. ELIZABETH HOSPITAL UTILIZES SEVERAL RESOURCES TO VERIFY THE INTEGRITY AND AUTHENTICITY OF THE CHARITABLE ORGANIZATION INCLUDING, BUT NOT LIMITED TO, 1) OFFICE OF INSPECTOR GENERAL SANCTION LIST 2) GENERAL SERVICES ADMINISTRATION SANCTIONS LIST 3) U.S. TREASURY SANCTIONS LIST 4) INTERNAL REVENUE SERVICE'S LIST OF TAX DEDUCTIBLE CHARITABLE ORGANIZATIONS OR 5) BETTER BUSINESS BUREAU RESOURCE LIBRARY. CHARITABLE RECIPIENTS ARE ASKED TO PROVIDE A DONATION LETTER EXPLAINING THE INTENT FOR WHICH THE DONATION WILL BE USED. false true false false false false false false false ROBERT BURGESS PRESIDENT AND CEO 0 297802 0 75666 0 16335 0 47652 0 9935 0 447390 0 0 JOHN F FRAICHE MD PRES STEPG 488032 0 69101 0 0 10216 0 2102 0 569451 0 0 0 DENZIL MORAES MD BOARD MEMBER/PHYSICIAN 858978 0 414736 0 276 0 10800 0 21682 0 1306472 0 0 0 RAHIL D SHAH STAFF PHYSICIAN 486766 0 87721 0 0 0 10800 0 72 0 585359 0 0 0 DAWN B SHARP MD CHIEF OF STAFF 1-12/2018 413004 0 0 0 0 0 10800 0 26539 0 450343 0 0 0 SUE KNIGHT COO 234769 0 39098 0 917 0 72782 0 9337 0 356903 0 0 0 JEFFREY LIMBOCKER REGIONAL CFO 0 427364 0 110390 0 14575 0 107606 0 24017 0 683952 0 0 YVONNE PELLERIN CNO 169368 0 25729 0 401 0 7814 0 7352 0 210664 0 0 0 Paul C Aguillard MD BOARD MEMBER/PHYSICIAN 310701 0 173972 0 0 0 10800 0 21539 0 517012 0 0 0 Michael Bodin STAFF PHYSICIAN 345643 0 150454 0 0 0 10800 0 24583 0 531480 0 0 0 Michael A Goodier Staff Physician 392537 0 47780 0 0 0 10800 0 21539 0 472656 0 0 0 John D Knapp STAFF Physician 305732 0 132152 0 0 0 10800 0 22134 0 470818 0 0 0 ELIZABETH BOLLINGER STAFF PHYSICIAN 421843 681 0 0 71985 0 72 0 494581 0 0 0 Part I question 4a The President & CEO is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason or due to change of control. If triggered, the employee would be paid his/her base salary 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. The regional CFO is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason, or due to change of control. If triggered, the employee would be paid his/her base salary and provided retirement and welfare benefits for an entitlement period. The entitlement period is 12 months. No payments were made under the plan in the current year. PART I, QUESTION 3 THE CEO AND CFO WERE 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 COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINED AND RELIED UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWED COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION WAS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION WAS DOCUMENTED BY THE COMPENSATION COMMITTEE. PART I, QUESTION 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 occurrence 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. No one listed on Part VII, Section A received a payment from the plan in the current year. PART VI, SECTION A, QUESTION 6 Question 8 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. ELIZABETH HOSPITAL Page 6, Part VI, Section B Question 12c St. Elizabeth Hospital 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 a 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 St. Elizabeth Hospital 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, St. Elizabeth Hospital 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 interest are reviewed and investigated by the Corporate Compliance Department and appropriate action is taken. Page 6, Part VI, Section B Question 15 THE BOARD OF DIRECTORS DESIGNATES THE EXECUTIVE COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR EXECUTIVES AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION FROM AN OUTSIDE CONSULTING FIRM. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE EXECUTIVE COMMITTEE. THE PRESIDENT AND CEO OF ST. ELIZABETH HOSPITAL IS AN EMPLOYEE OF FMOL HEALTH SYSTEM, AND HIS SALARY IS DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION WHICH RESEMBLE THE ABOVE. Page 6, Part VI, Section C Question 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. 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 11 AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG, LLP, THE RETURN IS REVIEWED BY ONE OR MORE MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. Part XI, Question 9 Capital Transfers - $ (1,913,580) SECTION 1.263(A)-3(N) - BOOK CONFORMITY ELECTION ST. ELIZABETH HOSPITAL IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2018. SECTION 1.263 (A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION ST. ELIZABETH HOSPITAL HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2018. TAXPAYER HAS AN APPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE 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)(I). 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