2019-08-15T11:20:32-05:00 2018-09-30 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2017-10-01 464958152 ACADIA GENERAL HOSPITAL INC ACAD 3377886402 1305 CROWLEY RAYNE HIGHWAY CROWLEY LA 70526 JOSEPH MITCHELL CEO CEO 3377886402 2019-08-13 1 AMIE T WHITTINGTON CPA P01082167 6013261000 2019-08-12 66.175.140.26 2019-08-13 13:53:16 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BC619A55C3BD57EEB00F545ADEF2BCC560AB27BE 2017 2019-02-21 02:37:17Z JOSEPH MITCHELL 1305 CROWLEY RAYNE HIGHWAY CROWLEY LA 70526 40133799 0 X WWW.LAFAYETTEGENERAL.COM X 2014 LA THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. 3 1 301 21 0 5604 13996 9078 44130112 40012920 2492 5311 189811 104519 44336411 40131828 8116 9775 0 0 15691004 16737862 0 0 0 27002197 24966991 42701317 41714628 1635094 -1582800 11518614 11423561 5332576 6820320 6186038 4603241 X THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 35724249 9775 40119410 ACADIA GENERAL HOSPITAL PROVIDES A WIDE RANGE OF HEALTHCARE AND MEDICAL SERVICES TO INDIVIDUALS. AS A GENERAL ACUTE CARE HOSPITAL, ACADIA GENERAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SERVICES FOR PATIENTS. ACADIA GENERAL HOSPITAL PROVIDES MEDICAL SPECIALTIES OF FAMILY MEDICINE, INTERNAL MEDICINE, NEPHROLOGY, CARDIOLOGY, GASTROENTEROLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY, UROLOGY, OTOLARYNGOLOGY (ENT), GYNECOLOGY, ONCOLOGY, PEDIATRICS, AND OPHTHALMOLOGY. THE HOSPITAL PROVIDES GENERAL MEDICAL/SURGICAL INPATIENT BEDS, INTENSIVE CARE UNIT INPATIENT SERVICES, AND INPATIENT GYNECOLOGY SERVICES. IN ADDITION TO ITS INPATIENT SERVICES, ACADIA GENERAL HOSPITAL PROVIDES A VARIETY OF OUTPATIENT SERVICES, DIAGNOSTIC TESTING, AND THERAPY SERVICES. MANY OF THESE SERVICES ALSO PROVIDE SERVICES TO PATIENTS RECEIVING CARE IN OUR INPATIENT UNITS. ACADIA GENERAL HOSPITAL PROVIDES SURGERY SERVICES, A FULL-SERVICE LABORATORY AND PATHOLOGY SERVICES, A WIDE RANGE OF RADIOLOGICAL SERVICES (INCLUDING GENERAL DIAGNOSTIC, MAMMOGRAPHY, ULTRASOUND, COMPUTED TOMOGRAPHY (CT), NUCLEAR MEDICINE, MAGNETIC RESONANCE IMAGING, ECHOCARDIOGRAPHY, AND BONE DENSITY), RESPIRATORY THERAPY, CARDIOLOGY (INCLUDING ELECTROCARDIOLOGY (EKG) AND STRESS EKG), ELECTROENCEPHALOGRAPHY (EEG), AUDIOLOGY SERVICES, SPEECH THERAPY SERVICES, PHYSICAL THERAPY SERVICES, WOUND CARE AND HYPERBARIC, VEIN THERAPY, AND CHEMOTHERAPY AND OTHER INFUSION THERAPY SERVICES. ACADIA GENERAL HOSPITAL HAS A 24-HOUR EMERGENCY DEPARTMENT PROVIDING ACUTE AND NON-ACUTE SERVICES TO THE RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. FROM OCTOBER 1, 2017 TO SEPTEMBER 30, 2018, ACADIA GENERAL HOSPITAL HAD 9,375 ACUTE PATIENT DAYS. THE EMERGENCY DEPARTMENT SERVICED 20,983 VISITS. OTHER SIGNIFICANT HEALTHCARE SERVICES PROVIDED INCLUDED 563 INPATIENT SURGERIES AND 2,273 OUTPATIENT SURGERIES. 35724249 1 0 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 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 50 0 1 301 1 1 1 0 0 0 0 0 0 0 X 3 1 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 3377886402 1305 CROWLEY RAYNE HIGHWAY CROWLEY LA 70526 DAVID CALLECOD PRESIDENT/CEO-LGMC 1.00 44.00 X 0 904458 240655 STEPHEN A STEFANSKI SECRETARY-TREASURER 1.00 X 0 0 0 CARSON DE LA HOUSSAYE JR MD DIRECTOR 1.00 X 0 0 0 JOSEPH MITCHELL CEO AND NONVOTING BOARD 40.00 X X 0 139068 8140 MAX TRAHAN MD CHIEF OF STAFF AND NONVOTING BOARD 40.00 X 0 630428 6016 CAROLINE G MARCEAUX CNO 40.00 X 0 139319 18612 JOSEPH CRAIG BRIGNAC PHARMACIST 40.00 X 0 138079 13128 HOPE ROSINSKI PHARMACIST 40.00 X 0 130515 12956 GLENN EDWARD DAILEY ASSOCIATE ADMINISTRATOR 40.00 X 0 127460 2865 SCOTT ISTRE DIRECTOR OF PERIOP SERVICES 40.00 X 0 103237 0 0 2312564 302372 16 0 1 0 ADVANTAGE NURSING SERVICES LLC 25271 NETWORK PLACE CHICAGO IL 60673 CLINICAL CONTRACT LABOR 800401 ARAMARK CORPORATION 1307 CROWLEY RAYNE HWY SUITE D CROWLEY LA 70526 HOUSEKEEPING AND DIETARY 731840 HUB CITY PHYSICIAN GROUP LLC PO BOX 677979 DALLAS TX 75267 CLINICAL OUTSOURCED SERVICES-HOSPITALIST 561092 CROWLEY EMERGENCY GROUP LLC PO BOX 677679 DALLAS TX 75267 PHYSICIAN CLINICAL SERVICES_EMERGENCY ME 464516 PARISH ANESTHESIA OF LAFAYETTE 3900 N CAUSEWAY BOULEVARD SUITE 625 METAIRIE LA 70002 ANESTHESIA COVERAGE 449958 12 9078 9078 PATIENT REVENUE 621990 40012920 40012920 40012920 5311 5311 40086 0 40086 40086 40086 0 9078 1971 -1971 -1971 OTHER REVENUE 900099 66404 66404 66404 40131828 40119410 0 3340 9775 9775 769496 769496 13288371 12124880 1163491 248736 214882 33854 1403549 1138736 264813 1027710 890213 137497 232138 168021 64117 62577 623 61954 491806 389796 102010 614535 88018 526517 10531 1620 8911 3870 2771 1099 43933 43933 221468 207091 14377 MEDICAL SUPPLIES 11018130 11018130 CONTRACT LABOR 5233224 4996448 236776 BAD DEBT 3075468 3075468 EQUIPMENT REPAIR AND RE 2083287 1212821 870466 1876024 141023 1735001 41714628 35724249 5990379 0 80230 31376 5289512 5469919 271089 455521 1481240 1532531 279493 471303 2482666 803563 1023048 1679103 3094002 1783808 11518614 11423561 5090638 6631169 139276 42317 102662 146834 5332576 6820320 X 6186038 4596134 7107 6186038 4603241 11518614 11423561 X -1582800 3 X X 0 1 X 1 0 X X 5281 150830 5281 150830 35718968 762190798 35724249 762341628 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 2000000 3000000 222980 150830 373810 250000 250000 500000 750000 222980 150830 373810 FORM 990, SCHEDULE C, PART II-A, LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH LOUISIANA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THIS ORGANIZATION IS USED. 99162 35641 63521 1858818 767922 1090896 524686 524686 1679103 INTERCOMPANY RECEIVABLES 1795742 INVESTMENT IN OBSEQUIO -11934 1783808 INTERCOMPANY PAYABLE 146834 146834 X PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740. FASB ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR FINANCIAL STATEMENT RECOGNITION OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE INTERPRETATION ALSO PROVIDES GUIDANCE ON RECOGNITION, DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE ORGANIZATION'S VARIOUS FEDERAL INCOME TAX AND EXEMPT ORGANIZATION INCOME TAX RETURNS (IRS FORMS 1065, 1120, AND 990), WHETHER FILED ON A CALENDAR OR FISCAL YEAR BASIS, ARE SUBJECT TO EXAMINATION BY THE IRS. THE INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED. 1 1 1 X 1 X 1 1 1 0 0 44995 44995 0.00120 9507567 5085722 4421845 0.11440 9552562 5085722 4466840 0.11560 11494 11494 0.00030 9775 9775 0.00030 21269 21269 0.00060 9573831 5085722 4488109 0.11620 1 3075468 53570 18521972 17705621 816351 X 1 1 1 1 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 X X X ACADIA GENERAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMEND X 1 15 1 HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS 0 1 X 200.000000000000 200.000000000000 X 1 1 X X X 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/AGH_FAP_12715.P X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/AGH_FINANCIAL_A X HTTP://WWW.LAFAYETTEGENERAL.COM/UPLOADS/FILES/DOWNLOADS/AGH_FINANCIAL_ASSIS X X X X X X X 1 0 X X X X 1 X 0 0 ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 5: THE SOURCES USED FOR AGH'S CHNA ARE PROVIDED IN THE REFERENCES AND APPENDIX B: COMMUNITY LEADER INTERVIEWWS. INFORMATION WAS GATHERED BY CONDUCTING INTERVIEWS WITH INDIVIDUALS REPRESENTING COMMUNITY HEALTH AND PUBLIC SERVICE ORGANIZATIONS, MEDICAL PROFESSIONALS, HOSPITAL ADMINISTRATION, AND OTHER HOSPITAL STAFF MEMBERS. THE CHNA CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: AGH, FORMERLY AMERICAN LEGION HOSPITAL, WAS ACQUIRED BY LAFAYETTE GENERAL HEALTH(LGH) ON JUNE 1, 2014. BECAUSE THIS ACQUISITION OCCURRED AFTER THE 2013 CHNA REPORT WAS COMPLETED BY AMERICAN LEGION HOSPITAL, AGH HAS CHOSEN TO UTILIZE THE RESULTS FROM THIS 2016 CHNA REPORT TO DEVISE A NEW IMPLEMENTATION STRATEGY THAT IS CONSISTENT WITH THE CURRENT FINDINGS AND AVAILABLE RESOURCES WITHIN THE LGH SYSTEM. THE CHNA CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 11: ALL SIGNIFICAT NEEDS IDENTIFIED IN THE CHNA HAVE BEEN ADDRESSED. THE HOSPITAL IS PRIORITIZING HEALTH NEEDS IN ITS COMMMUNITY AND PRIORITIZING SERVICES THAT THE HOSPITAL WILL UNDERTAIKE TO MEET THESE NEEDS. PLEASE SEE INFORMATION CONTAINED IN THE HOSPITAL'S IMPLEMENTATION STRATEGY. IT CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/AGH-CHNA-IMPLEMENTATIONSTRATEGY-FINAL.PDF ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 16J: THE HOSPITAL INCLUDES ON ALL INVOICE STATEMENTS A MESSAGE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. IT INFORMS PATIENTS TO CONTACT A CUSTOMER SERVICE REPRESENTATIVE TO REQUEST AN APPLICATION. ACADIA GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 20E: MONTHLY STATEMENTS ARE SENT TO THE PATIENTS PRIOR TO SENDING COLLECTIONS AFTER 120 DAYS OF NON-PAYMENT. 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 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 $ 3,075,468. PART 1, LINE 7, COLUMN F THE HOSPITAL USED THE SAME COSTING METHODOLOGY USED AND RECOMMENDED IN THE IRS WORKSHEET 2 FOR SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, FOR PART III, LINES 2 AND 3. FOR LINE 3, THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE ORGANIZATION'S MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, IF NECESSARY (E.G., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THOSE WITH NO THIRD-PARTY COVERAGE, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE ORGANIZATION'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS REMAINED AT 99% OF SELF PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2018 AND 2017. THE ORGANIZATION CONTINUES TO EXPERIENCE HIGH LEVELS OF CHARITY CARE AND BAD DEBT WRITE-OFFS AS A RESULT OF RISING PATIENT RESPONSIBILITIES DUE IN PART TO HIGH DEDUCTIBLE AND HIGH CO-PAY INSURANCE PLANS.BAD DEBT EXPENSE EQUALS THE BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 IS THE STANDARD MEDICARE COST REPORT COSTING SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITAL'S FILED 2017 COST REPORT; THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE AMOUNTS REPORTED INCLUDE THOSE RELATED TO MEDICARE PART A INPATIENT SERVICES (BOTH ACUTE AND PSYCHIATRIC) AND MEDICARE PART B HOSPITAL-RELATED OUTPATIENT SERVICES; IT EXCLUDES THE MEDICARE HOSPITAL OUTPATIENT LABORATORY CHARGES WHICH WERE REIMBURSED ON A FEE SCHEDULE AND, THUS, NOT REQUIRED TO BE REPORTED ON THE COST REPORT. ADDITIONALLY, THESE AMOUNTS EXCLUDE THE REIMBURSEMENT AND COSTS ASSOCIATED WITH OUR ANESTHESIA HOSPITAL BASED PRACTICE AS WELL AS OUR PHYSICIAN OFFICE. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY ADDRESSES THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. OUR HOSPITAL PRACTICE INCLUDES SENDING STATEMENTS WITH GRADUATED MESSAGES TO PATIENTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT; AT THIS TIME, THEY ARE INFORMED OF THE FINANCIAL ASSISTANCE PRACTICE AND ARE ENCOURAGED TO CONTACT THE HOSPITAL IF THEY FEEL THAT THEY WOULD QUALIFY. AT ANY TIME, ANY PATIENT MAY REQUEST A CHARITY CARE APPLICATION FORM. PART VI, LINE 2: ACADIA GENERAL HOSPITAL (AGH) IS THE ONLY ACUTE CARE HOSPITAL IN ACADIA PARISH AND THE SURROUNDING AREA, AND IT MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE COMMUNITY, AND THEY ARE AWARE OF THE HEALTH NEEDS IN THE COMMUNITY. FOR THESE NEEDS IDENTIFIED BY THE BOARD AND MEDICAL STAFF, AGH USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. A FORMAL NEEDS ASSESSMENT UNDERTAKEN FOR YEAR ENDING 9/30/16 - IT CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/DOWNLOADS/AGH-AMENDED_FINAL_CHNA-16.PDF PART VI, LINE 3: THE HOSPITAL COMPLIES WITH FEDERAL REQUIREMENTS OF NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS, SUCH AS MEDICARE. IN THE ADMISSIONS PROCESS, THE HOSPITAL MAKES AVAILABLE SCREENING SERVICES ONSITE TO HELP INPATIENTS WHO QUALIFY FOR MEDICARE AND/OR MEDICAID ASSISTANCE APPLY FOR BENEFITS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN THE HANDBOOK PROVIDED TO PATIENTS UPON ADMISSION. ADDITIONALLY, UPON ORIGINAL BILL FOR SERVICES, ALL PATIENTS WITHOUT INSURANCE ARE REMINDED OF THE CHARITY DISCOUNT WITH INFORMATION ON HOW TO APPLY. A PROMPT PAY DISCOUNT IS OFFERED TO ALL PATIENTS WITHOUT INSURANCE. PART VI, LINE 4: THE HOSPITAL SERVES THE RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. AS THE ONLY ACUTE HOSPITAL IN THE PARISH, THE HOSPITAL PROVIDES HEALTHCARE SERVICES TWENTY-FOUR HOURS A DAY. THE HOSPITAL STRIVES TO MAINTAIN A WELL CONDITIONED PLANT AND MODERN TECHNOLOGY TO BETTER SERVE THE CITIZENS OF OUR COMMUNITY; ADDITIONALLY, THE HOSPITAL STRIVES TO MAINTAIN A KNOWLEDGEABLE AND FRIENDLY STAFF TO PROVIDE PATIENT CARE TO THE RESIDENTS IN THE SURROUNDING AREA. ACADIA PARISH COVERS 655.12 SQUARE MILES IN SOUTHWEST LOUISIANA. THE ESTIMATED POPULATION FOR 2014 WAS AROUND 62,000 RESIDENTS. ACADIA PARISH'S POPULATION CONSISTS OF 13.2% OF PERSONS WHO ARE SIXTY-FIVE OR OLDER (SLIGHTLY LOWER THAN THE STATE'S OVERALL PERCENTAGE OF 13.3%). ACCORDING TO THE U.S. CENSUS BUREAU FROM MUNINET GUIDE.COM, THE MEDIAN HOUSEHOLD INCOME FOR ACADIA PARISH WAS $38,161. HOWEVER, FOR LOUISIANA IT WAS $48,725 AND FOR THE U.S. IT WAS $54,130. THUS, ACADIA PARISH'S POPULATION IS POORER THAN THE REST OF LOUISIANA AND THE NATION. PART VI, LINE 5: THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD OF ABILITY TO PAY. THE HOSPITAL PROVIDES CARE FOR ALL PERSONS IN THE COMMUNITY OTHERWISE ABLE TO PAY THE COST MEDICAL SERVICES EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE LOCAL COMMUNITY AND USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. ADDITIONALLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF.BY MAINTAINING AN OPEN MEDICAL STAFF, THE HOSPITAL CAN OFFER A VARIETY OF SPECIALISTS TO AN OTHERWISE RURAL PARISH, THEREBY INCREASING AVAILABLE RESOURCES FOR THE BEST PATIENT CARE. THE HOSPITAL ALSO MAINTAINS A BOARD OF DIRECTORS COMPRISED OF MEMBERS FROM THE COMMUNITY; BY INCORPORATING MEMBERS OF THE COMMUNITY, THE BOARD CAN ENSURE THE LONG-TERM VIABILITY OF THE HOSPITAL TO BE ABLE TO CONTINUE TO SERVE THE COMMUNITY FOR GENERATIONS TO COME. THE HOSPITAL DILIGENTLY STRIVES TO MAINTAIN A SURPLUS OF REVENUE OVER EXPENSES TO CONTINUE TO UPDATE THE HOSPITAL'S PLANT AND EQUIPMENT WITH THE RAPID CHANGING TECHNOLOGY IN TODAY'S MEDICAL WORLD TO BETTER MEET THE CHANGING NEEDS OF OUR COMMUNITY. IN THE CURRENT YEAR THE HOSPITAL HAD A CAPITAL OUTLAY OF OVER $280,435 MOSTLY CLINICAL PURCHASES.THE HOSPITAL IS THE SECOND LARGEST EMPLOYER IN THE PARISH, SECOND TO ONLY THE LOCAL SCHOOL BOARD. THE HOSPITAL IS A LARGE GENERATOR OF SALES TAX TO THE PARISH AS WELL. THE HOSPITAL'S PRESENCE SERVES AS A LARGE ECONOMIC FORCE IN OUR LOCAL COMMUNITY; TO ENSURE THAT WE CAN CONTINUE TO SERVE THE RESIDENTS OF OUR COMMUNITY, WE MUST CONTINUE TO MONITOR THE CURRENT CONDITIONS OF OUR WORKFORCE AND THE AVAILABILITY OF PHYSICIANS IN OUR AREA. THE HOSPITAL RECRUITS PHYSICIANS, INCLUDING SPECIALISTS, TO OUR AREA TO ENSURE THAT WE CAN CONTINUE TO BE THE HEALTHCARE PROVIDER OF THE FUTURE AS WELL. THE HOSPITAL ALSO JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS AND COMPANIES TO PROVIDE HEALTHCARE SCREENINGS AT LOCAL EVENTS AS WELL AS PROVIDE INFORMATION TO PROMOTE A HEALTHIER, SAFER COMMUNITY. 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. X X X X X 1 1 0 0 0 1 1 0 0 DAVID CALLECOD PRESIDENT/CEO-LGMC 0 814626 0 0 0 89832 0 223618 0 17037 0 1145113 0 0 MAX TRAHAN MD CHIEF OF STAFF AND NONVOTING BOARD 0 332598 0 283685 0 14145 0 5427 0 589 0 636444 0 0 CAROLINE G MARCEAUX CNO 0 138331 0 0 0 988 0 2983 0 15629 0 157931 0 0 JOSEPH CRAIG BRIGNAC PHARMACIST 0 138079 0 0 0 0 0 2888 0 10240 0 151207 0 0 PART I, LINE 3 AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY A RELATED ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THIS RELATED ORGANIZATION'S COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. PART I, LINES 4A-B DR. MAX TRAHAN CEASED EMPLOYMENT WITH HOSPITAL SYSTEM ON 1/18/17 AND WAS PAID OUT FOR THE REMAINDER ON HIS EMPLOYMENT CONTRACT UPON SEPARATION, THIS AMOUNT IS INCLUDED IN HIS W-2 WAGES FOR 2017. 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 $220,000. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS INCLUDED DAVID CALLECOD, PRESIDENT/CEO-LGHS. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2017 W-2 WAGES, TOTALLED $72,600. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN HIS 2017 W-2 WAGES: DAVID CALLECOD, PRESIDENT/CEO-LGHS. 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; 15% EMPLOYEES, 20% SERVICE, 30% QUALITY, 25% 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. SOUTHERN SECURITY BOARD MEMBER STEPHEN STEFANSKI'S SON IS 40% OWNER OF SOUTHERN SECURITY 123942 THE COMPANY PROVIDES SECURITY SERVICES TO THE HOSPITAL. 0 TRAHAN CONSLUTING GROUP BOARD MEMBER (NONVOTING)/CHIEF OF STAFF MAX TRAHAN OWNS TRAHAN CONSULTING G 58000 TRAHAN CONSULTING GROUP PROVIDES CONSULTING SERVICES TO THE HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS STEPHEN STEFANSKI AND DR. CASON DE LA HOUSSAYE BOTH ALSO SERVE ON THE BOARD AMERICAN LEGION HOSPITAL, AN ENTITY UNRELATED TO ACADIA GENERAL HOSPITAL. 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 GOVERNANCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE. THEREAFTER THE CHAIRPERSON OF THE GOVERNANCE COMMITIEE 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 MAYBE 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 TO THE PRESIDENT'S COMPENSATION THEREAFTER. 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 XI, LINE 9: ROUNDING 3. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. 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