2018-08-03T08:38:31-05:00 2017-09-30 720506596 COLE EVANS & PETERSON POST OFFICE DRAWER 1768 SHREVEPORT LA 711661768 990 2016-10-01 720400933 WILLIS-KNIGHTON MEDICAL CENTER WILL 3182124000 POST OFFICE BOX 32600 SHREVEPORT LA 711302600 JAMES K ELROD PRESIDENT 3182124000 2018-08-03 1 BARRY S SHIPP P00024584 3182228367 2016 2022-09-23 18:48:47Z JAMES K ELROD POST OFFICE BOX 32600 SHREVEPORT LA 711302600 1109442331 0 X WWW.WKHS.COM X 1949 LA THE MEDICAL CENTER PROVIDES A FULL-RANGE OF HEALTH CARE SERVICES TO THE GENERAL PUBLIC. 13 11 7869 211 4664816 0 196119 17450 1102485980 1093646052 2553641 3488779 4835251 7461229 1110070991 1104613510 2022946 1659170 0 0 438206039 463805513 0 0 0 576190204 621325194 1016419189 1086789877 93651802 17823633 1273828819 1280621148 420403063 310643881 853425756 969977267 X TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. 0 0 905133829 1659170 1091764160 WILLIS-KNIGHTON MEDICAL CENTER STRIVES TO PROVIDE HIGH QUALITY, COST-EFFECTIVE MEDICAL CARE TO THE COMMUNITIES OF NORTHWEST LOUISIANA, NORTHEAST TEXAS, AND SOUTHWEST ARKANSAS. THE MEDICAL CENTER OFFERS SOPHISTICATED TECHNOLOGY AND PROCEDURES THAT MAKE IT A TERTIARY CARE REFERRAL CENTER. GENERAL THE MEDICAL CENTER PROVIDES 24-HOUR EMERGENCY CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, AT ITS FOUR HOSPITALS. THE MEDICAL CENTER PROVIDES AN ORGAN TRANSPLANT PROGRAM, OBSTETRICS, COMPREHENSIVE HEART AND CANCER PROGRAMS, EXTENSIVE SURGICAL OPTIONS, LEADING-EDGE DIAGNOSTICS AS WELL AS A BROAD NETWORK OF PHYSICIANS ENCOMPASSING MOST SPECIALTIES AND SUBSPECIALTIES. THE MEDICAL CENTER PROVIDES THESE SERVICES WITHOUT DISCRIMINATION OF ANY SORT. THE MEDICAL CENTER HAD 55,318 ADMITTANCES DURING THE YEAR ENDED SEPTEMBER 30, 2017 WITH A TOTAL OF 219,620 PATIENT DAYS AND 3,272 BIRTHS. THE MEDICAL CENTER PARTICIPATES IN THE MEDICAID PROGRAM AND ADMINISTERS A CHARITY CARE POLICY WHEREBY FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO QUALIFIED INDIVIDUALS WITH LIMITED FINANCIAL MEANS. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER PROVIDED AN ESTIMATED $25,100,000 IN UNREIMBURSED COSTS ATTRIBUTABLE TO CHARITY CARE (EXCLUDING PROJECT NEIGHBORHEALTH) AND AN ESTIMATED $59,563,000 IN UNREIMBURSED COSTS ATTRIBUTABLE TO MEDICAID PATIENTS. THESE ESTIMATES ARE BASED ON THE MEDICAL CENTER'S OVERALL COST-TO-CHARGE RATIO. IN ADDITION TO THESE SERVICES, WILLIS-KNIGHTON PROJECT NEIGHBORHEALTH OPERATES FOUR CLINICS IN COMMUNITIES THAT ARE ECONOMICALLY DISTRESSED AND/OR DESIGNATED AS MEDICALLY UNDER-SERVED AREAS WITH HEALTH PROFESSIONAL SHORTAGES. SEE SCHEDULE H FOR DETAILED INFORMATION REGARDING PROJECT NEIGHBORHEALTH. REGIONAL TRANSPLANT CENTER THE MEDICAL CENTER OPERATES THE JOHN C. MCDONALD REGIONAL TRANSPLANT CENTER AT WILLIS-KNIGHTON MEDICAL CENTER. ALL TRANSPLANT PATIENTS RECEIVE TRANSPLANTS WITHOUT REGARD TO THEIR ECONOMIC STATUS. THE REGIONAL TRANSPLANT CENTER PROVIDES KIDNEY, PANCREAS, AND LIVER TRANSPLANTS. SUBSTANTIALLY ALL THE COSTS OF OPERATING THE REGIONAL TRANSPLANT CENTER ARE BORNE BY WILLIS-KNIGHTON MEDICAL CENTER. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017, 91 PATIENTS RECEIVED ORGAN TRANSPLANTS, CONSISTING OF 71 KIDNEYS (11 OF THOSE PATIENTS ALSO HAD A PANCREAS TRANSPLANT, AND 2 OF THOSE PATIENTS ALSO HAD A LIVER TRANSPLANT) AND 20 LIVERS. OF THE 91 TRANSPLANT SURGERIES PERFORMED AT THE MEDICAL CENTER DURING THE YEAR ENDED SEPTEMBER 30, 2017, 58 PATIENTS WERE BENEFICIARIES OF THE MEDICARE PROGRAM. AS SUCH, THESE TRANSPLANTS WERE PERFORMED AT VERY LITTLE, IF ANY, COST TO THE PATIENTS.EMERGENCY CARE THE MEDICAL CENTER PROVIDES EMERGENCY SERVICES AT FOUR LOCATIONS ON A 24-HOUR BASIS STAFFED BY FULL-TIME EMERGENCY ROOM PHYSICIANS. EMERGENCY PATIENTS ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER'S EMERGENCY ROOMS WERE VISITED BY 178,910 PATIENTS, OF WHOM 21,125 WERE ADMITTED TO THE HOSPITAL FOR FURTHER TREATMENT.WOMEN AND CHILDREN'S HEALTH THE MEDICAL CENTER PROVIDES A VARIETY OF MEDICAL SERVICES FOR WOMEN AND CHILDREN, INCLUDING OBSTETRICS, GYNECOLOGY, NEONATOLOGY, MATERNAL/FETAL HEALTH SERVICES FOR HIGH RISK PREGNANCY, PEDIATRIC INTENSIVE CARE AND PEDIATRIC SUPPORT SERVICES SUCH AS PEDIATRIC GASTROENTEROLOGY, SURGERY, AND PULMONOLOGY. THESE SERVICES INCLUDE BOTH HIGH-RISK AND LOW-RISK OBSTETRICS. MATERNAL TRANSPORTS ARE ACCEPTED. THE LABOR AND DELIVERY (L&D) UNITS ARE DIRECTED BY BOARD CERTIFIED OB-GYN PHYSICIANS AND THE MAJORITY OF THE NURSES ARE CERTIFIED BY THE ASSOCIATION OF WOMEN'S HEALTH, OBSTETRIC & NEONATAL NURSES (AWHON). THERE WERE 3,272 BIRTHS; 10,382 OBSTETRICAL VISITS TO THE L&D UNITS; AND 3,084 OBSTETRICAL AND GYNECOLOGICAL INPATIENTS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017.HEALTH AND WELLNESS CENTERS THE MEDICAL CENTER HAS SIX MEDICALLY-SUPERVISED HEALTH AND WELLNESS CENTERS DEDICATED TO THE PREVENTION OF HEALTH PROBLEMS, FOUR IN SHREVEPORT, ONE IN BOSSIER CITY, AND ONE IN HOMER WITH A TOTAL MEMBER ENROLLMENT AT SEPTEMBER 30, 2017 OF 5,473. THE CENTERS ARE LOCATED ON EACH OF THE FOUR HOSPITAL CAMPUSES, IN THE WK PIERRE AVENUE COMMUNITY CENTER, AND IN THE WK CLAIBORNE REGIONAL HEALTH CENTER. A MEDICAL EVALUATION, INCLUDING A BLOOD CHEMISTRY WORK-UP, IS REQUIRED FOR MEMBERSHIP. THE CENTERS SERVE PULMONARY AND CARDIAC REHABILITATION PATIENTS AND PROVIDE HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE LOCATED. NEONATAL INTENSIVE CARE UNIT WILLIS-KNIGHTON'S CENTER FOR WOMEN'S HEALTH HOUSES A 42-BED LEVEL III REGIONAL OBSTETRICAL AND NEONATAL UNIT. THIS UNIT ACCEPTS REFERRALS FROM THE ARK-LA-TEX AREA AND IS SERVICED BY BOTH AIR AND GROUND EMERGENCY TRANSPORT ON A 24-HOUR BASIS. THIS UNIT IS DIRECTED BY A BOARD CERTIFIED NEONATOLOGIST. THE MAJORITY OF THE NURSING STAFF IS CERTIFIED BY AWHON. THE AVERAGE LENGTH OF STAY PER ADMIT IS 19.8 DAYS.HOSPICE HOSPICE OF LOUISIANA IS A DEPARTMENT OF WILLIS-KNIGHTON MEDICAL CENTER THAT PROVIDES COMPREHENSIVE END-OF-LIFE CARE INCLUDING SKILLED AND SUPPORTIVE SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. THE HOSPICE TEAM, UNDER THE GUIDANCE OF THE ATTENDING PHYSICIAN, FOCUSES ON THE ALLEVIATION OF THE PAIN AND DISCOMFORT CONNECTED WITH LIFE-ENDING ILLNESS. QUALITY OF LIFE, EMOTIONAL AND SPIRITUAL BALANCE, SYMPTOM MANAGEMENT, AND PAIN CONTROL ARE THE GOALS THAT TEAM MEMBERS STRIVE FOR AS THEY ASSIST DYING PATIENTS AND THEIR FAMILIES. BEREAVEMENT SUPPORT FOR THE IMMEDIATE FAMILY AND COMPANIONS IS PROVIDED FOR AT LEAST ONE YEAR FOLLOWING THE PATIENT'S DEATH. FOR THE YEAR ENDED SEPTEMBER 30, 2017, HOSPICE OF LOUISIANA SERVED 198 PATIENTS AND THEIR FAMILIES AS DIRECT ADMITS, NOT INCLUDING VISITATION AND COUNSELING PROVIDED THROUGH PRE-ADMIT AND/OR BEREAVEMENT SERVICES. THE TEAM INCLUDES: REGISTERED NURSES, CERTIFIED NURSING ASSISTANTS, SOCIAL WORKERS, CHAPLAINS, VOLUNTEERS, ATTENDING PHYSICIANS, AND MEDICAL DIRECTOR.BEHAVIORAL MEDICINE CENTER THE BEHAVIORAL MEDICINE CENTER AT THE WK REHABILITATION INSTITUTE OFFERS INPATIENT AND OUTPATIENT SERVICES TO INDIVIDUALS IN NEED OF MENTAL HEALTH CARE. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE BEHAVIORAL MEDICINE CENTER SPONSORED NUMEROUS INFORMATION SESSIONS FOR VARIOUS GROUPS IN THE SHREVEPORT/BOSSIER AND NORTHWEST LOUISIANA AREAS. SUCH SESSIONS AMOUNTED TO APPROXIMATELY 36 HOURS AND WERE ATTENDED BY APPROXIMATELY 600 PEOPLE. TOPICS INCLUDED:MARRIAGE/FAMILY - DEVELOPMENT OF SKILLS TO ENRICH MARRIAGE AND FAMILY LIFE.SELF-ESTEEM - CONCENTRATES ON HOW GOOD SELF-ESTEEM CAN ENHANCE AN INDIVIDUAL'S QUALITY OF LIFE. PARENTING - FOCUSES ON APPROPRIATE PARENTING SKILLS AT VARIOUS DEVELOPMENTAL STAGES. STRESS MANAGEMENT - DEVELOPING SKILLS TO COPE WITH EVERYDAY STRESSES IN LIFE.PERSONAL ENRICHMENT - EMPOWERING OURSELVES TO REACH MAXIMUM POTENTIAL.MOTIVATION/ATTITUDE - HOW ATTITUDE AFFECTS OUR MENTAL AND PHYSICAL HEALTH.COUNSELING ISSUES/TECHNIQUES - ISSUES CONCERNING PROFESSIONAL DEVELOPMENT FOR COUNSELORS/THERAPISTS.AGING - DEVELOPMENT OF A POSITIVE ATTITUDE TO DEAL WITH ISSUES OF AGING.DEPRESSION/SUICIDE - ASSESSMENT OF DEPRESSION AND SUICIDE, AND LEGAL AND ETHICAL ISSUES SURROUNDING SUICIDE. 10151234 4550431 THE MEDICAL CENTER PROVIDES HOUSING, HEALTHCARE, AND RELATED SERVICES TO THE ELDERLY THROUGH THE OAKS OF LOUISIANA. THE OAKS OF LOUISIANA IS A RESIDENTIAL COMMUNITY DESIGNED SPECIFICALLY FOR ADULTS AGED 55 AND OVER. THIS RESIDENTIAL COMMUNITY PROVIDES SECURE, MAINTENANCE-FREE LIVING AND PROMOTES AN ACTIVE, HEALTHY LIFESTYLE. THE CAMPUS OF THE OAKS OF LOUISIANA INCLUDES THE TOWER AT THE OAKS, A RESIDENTIAL COMMUNITY, AND SAVANNAH AT THE OAKS, AN ASSISTED LIVING FACILITY. 915285063 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 582 0 1 7869 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MR JAMES K ELROD 3182124000 2600 GREENWOOD ROAD SHREVEPORT LA 711033908 JAMES K ELROD PRESIDENT/CEO/TRUSTEE 53.00 X X 1653767 6000 6825 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 40.00 X 226704 0 8778 PHILLIP A ROZEMAN MD TRUSTEE/PHYSICIAN 20.00 X 52465 0 1604 FRANK B HUGHES MD TRUSTEE/CHAIRMAN 4.00 X 0 0 0 RAND H FALBAUM TRUSTEE 4.00 X 0 0 0 WILLIS L MEADOWS JR TRUSTEE 4.00 X 0 0 0 SAM J TALBOT MD TRUSTEE 4.00 X 0 0 0 VINCENT MARSALA PHD TRUSTEE 4.00 X 0 0 0 JOHN C MICIOTTO MD TRUSTEE 4.00 X 0 0 0 GILBERT R SHANLEY CPA TRUSTEE 4.00 X 0 0 0 WILLIAM J COLE CPA TRUSTEE/TREASURER 8.00 X X 0 0 0 RICHARD SALE TRUSTEE/ SECRETARY 4.00 X X 0 0 0 EUGENE W BRYSON JR TRUSTEE 4.00 X 0 0 0 ELAINE SIMPKINS PHD TRUSTEE 4.00 X 0 0 0 MARY JANE WARD SR VICE PRESIDENT OF FINANCE 40.00 X 252337 0 27187 CHARLES D DAIGLE SR VP OF OPERATIONS & COO 40.00 X 693815 0 30330 STEPHEN R RANDALL SR VP-SPECIAL OPERATIONS 40.00 X 348161 0 27937 MARGARET G ELROD SR VP/IND WELLNESS/COMMUN 40.00 X 193808 0 9472 JERRY A FIELDER II VP/ADMINISTRATOR WKMC 40.00 X 203394 0 30377 CLIFFORD M BROUSSARD VP/ADMIN WK BOSSIER/QUALIT 40.00 X 193101 0 21835 JANET K ELROD VP/ADMIN WK SOUTH 40.00 X 191019 0 9111 IRA L MOSS VP/ADMIN WK PIERREMONT 40.00 X 223175 0 23938 JILL K ELROD VP OF LEGAL AFFAIRS 40.00 X 247955 0 11569 PEGGY J GAVIN SR VP OF PHYSICIAN SERVICE 40.00 X 193514 0 10749 DEBORAH D OLDS CHIEF NURSING OFFICER 40.00 X 156756 0 23632 DANIEL J MOLLER JR MD CHIEF-MEDICAL AFFAIRS-WKMC 40.00 X 530042 0 20860 CHARLES A POWERS MD CHIEF-MED. AFFAIRS-WKB 40.00 X 428467 0 21855 RANDALL P BREWER MD PHYSICIAN 40.00 X 1444705 0 23272 MILAN G MODY MD PHYSICIAN 40.00 X 2366649 0 28203 CHRISTOPHER L SHELBY MD PHYSICIAN 40.00 X 1471771 0 28199 JOHN GRAY NOLES MD PHYSICIAN 40.00 X 1605762 0 28197 SARAH GLORIOSO MD PHYSICIAN 40.00 X 1511624 0 27243 14188991 6000 421173 608 0 1 0 LSU HEALTH SCIENCES CENTER PO BOX 33932 SHREVEPORT LA 71130 MEDICAL STAFFING 7452349 AMN HEALTHCARE 8840 CYPRESS WATERS BOULEVARD SUIT DALLAS TX 75019 MEDICAL STAFFING 4981838 RED RIVER CARDIOVASCULAR 2751 ALBERT BICKNELL DR SUITE 5C SHREVEPORT LA 71103 PHYSICIAN SERVICES 3720544 SHREVEPORT ANESTHESIA SERVICE 2600 GREENWOOD ROAD SHREVEPORT LA 71103 PHYSICIAN SERVICES 3075000 RADIATION ONCOLOGY SERVICES APMC 2600 KINGS HIGHWAY SHREVEPORT LA 71103 MEDICAL STAFFING 3025732 125 17450 17450 HOSPITAL SERVICES 900099 1089316286 1089316286 RESIDENTIAL COMMUNITY 900099 4329766 4329766 1093646052 3616653 3616653 3082556 2587649 494907 494907 494907 1689138 424160 1696600 544572 -7462 -120412 -127874 -127874 LABORATORY REVENUE 621500 4061145 4061145 (LOSS) FROM SUBSIDIARY - MULTI-FA 623000 195194 195194 (LOSS) FROM SUBSIDIARY - VIRGINIA 623000 24239 24239 2685744 2082073 603671 6966322 1104613510 1096314591 4664816 3616653 1659170 1659170 6976810 6976810 332422604 294051579 38371025 30247656 26206206 4041450 64714644 56067991 8646653 29443799 18192086 11251713 4176774 4176774 2069696 2069696 2804256 1725124 1079132 12449994 12449994 1680952 1680952 65070912 34866912 30204000 8027634 8027634 DIRECT DEPARTMENTAL EXP 480296852 480296852 TAXES & LICENSES 13077746 13077746 BUSINESS OFFICE 4962050 4962050 26708328 2219143 24489185 1086789877 915285063 171504814 0 29060099 18524743 296642687 308293539 172672544 189178054 2929233 3108146 24913786 25869728 5522922 11005564 1332917848 693196977 632398053 639720871 95689254 70867382 12192921 12388115 1006272 843192 801048 821814 1273828819 1280621148 113935247 121465863 136773037 122339024 19523752 12076021 150171027 54762973 420403063 310643881 X 853425756 969977267 853425756 969977267 1273828819 1280621148 X 17823633 6548074 92179804 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 77307 77307 0 PART II-B, LINE 1: DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER PAID DUES TOTALING $54,250 TO THE LOUISIANA STATE MEDICAL SOCIETY ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $13,563, WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER PAID DUES TOTALING $7,980 TO THE AMERICAN MEDICAL ASSOCIATION ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $4,788, WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER PAID DUES TOTALING $280,745 TO THE LOUISIANA HOSPITAL ASSOCIATION FOR THE MEDICAL CENTER'S MEMBERSHIP IN THE ASSOCIATION AND ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $58,956, WAS RELATED TO LOBBYING ACTIVITIES. HEALTHCARE POLICY IS CRITICAL TO THE MISSION OF THE MEDICAL CENTER, AND ITS MANAGEMENT BELIEVES THAT HEALTHCARE PROVIDERS SHOULD PARTICIPATE IN FORMING HEALTHCARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFFS, WHEN POSSIBLE, TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTHCARE ISSUES. THE MEDICAL CENTER'S MANAGEMENT IS AVAILABLE TO LAWMAKERS, GOVERNMENT OFFICIALS, AND THEIR STAFF MEMBERS, FOR INFORMATION AND OCCASIONALLY RESPONDS TO QUESTIONS AND INITIATES COMMUNICATIONS ABOUT HOW PROPOSED LAWS, POLICIES, REGULATIONS, ETC. MIGHT AFFECT THE MEDICAL CENTER'S ABILITY TO DELIVER COST-EFFECTIVE, QUALITY HEALTHCARE. THE AMOUNT OF TIME AND MONEY RESOURCES INVOLVED IN THESE ACTIVITIES IS INSUBSTANTIAL. THE MEDICAL CENTER HAS NOT AND DOES NOT INTERVENE IN ANY POLITICAL CAMPAIGN. 998567 52158458 53157025 8877070 756401732 401536090 363742712 1843572 1508970 334602 430184471 272720300 157464171 82453978 17431617 65022361 639720871 INVESTMENT IN SUB. - VIRGINIA HALL, INC. 4547548 LIABILITY FOR PENSION BENEFITS 50215425 54762973 1130077762 6548074 6548074 1123529688 -18916178 -18916178 1104613510 1013526251 -73263626 -73263626 1086789877 0 1086789877 PART XI, LINE 4B - OTHER ADJUSTMENTS: UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSING, LAUNDRY SUBSIDIARIES EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARIES INCOME/EXPENSE UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSNG, LAUNDRY FASB ASC 715-30 PENSION FORM 990, SCHEDULE D, PART XI, LINE 4D AND PART XII, LINE 2D PART XI, LINE 4B UNRELATED BUSINESS GROSS INCOME: DATA PROCESSING 323,630 HOUSEKEEPING 81,174 LAUNDRY 191,248 SUBSIDIARIES EXPENSES (19,512,230) TOTAL (18,916,178) PART XII, LINE 2D UNRELATED BUSINESS GROSS INCOME: DATA PROCESSING (323,630) HOUSEKEEPING (81,174) LAUNDRY (191,248) SUBSIDIARIES EXPENSES 19,512,230 PENSION RELATED CHANGES (92,179,804) TOTAL 73,263,626 1 1 X 1 X 1 X 1 1 1 0 1 1 25135942 25135942 0.02310 157824847 98261514 59563333 0.05480 182960789 98261514 84699275 0.07790 3524920 3524920 0.00320 10255906 10255906 0.00940 2348516 675090 1673426 0.00150 1659170 1659170 0.00150 17788512 675090 17113422 0.01560 200749301 98936604 101812697 0.09350 1 13157850 0 260766353 281178201 -20411848 X 1 1 4 1 WILLIS-KNIGHTON MEDICAL CENTER 2600 GREENWOOD ROAD SHREVEPORT LA 71103 232 X X X X REHAB CTR, SNF, PHYSICIAN CLINICS A 2 WK PIERREMONT HEALTH CENTER 8001 YOUREE DRIVE SHREVEPORT LA 71115 232-C X X X X PHYSICIAN CLINICS A 3 WK BOSSIER HEALTH CENTER 2400 HOSPITAL DRIVE BOSSIER CITY LA 71111 387 X X X PHYSICIAN CLINICS A 4 WILLIS-KNIGHTON SOUTH 2510 BERT KOUNS INDUSTRIAL LOOP SHREVEPORT LA 71118 232-A X X X X PHYSICIAN CLINICS A WILLIS-KNIGHTON HEALTH SYSTEM 0 0 1 X X X X X X X X 15 1 1 0 1 X WWW.WKHS.COM 1 15 1 WWW.WKHS.COM 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X 1 X WWW.WKHS.COM X WWW.WKHS.COM X WWW.WKHS.COM X X X X 1 X 1 X X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: WILLIS-KNIGHTON MEDICAL CENTER, - FACILITY 4: WILLIS-KNIGHTON SOUTH, - FACILITY 3: WK BOSSIER HEALTH CENTER, - FACILITY 2: WK PIERREMONT HEALTH CENTER GROUP A-FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 5: CONDUCTED 11 INTERVIEWS (LIST OF INTERVIEWEES FOLLOWS) WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52.DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. GATHERED BACKGROUND INFORMATION, INCLUDING CREDENTIALS, ON EACH INTERVIEWEE.SHERRI BUFFINGTON, COMMUNITY LEADER; FORMER STATE SENATOR DISTRICT 38(CADDO AND DESOTO PARISH); FORMER VICE CHAIR HEALTH & WELFAREWILLIE BRADFORD, WILLIS-KNIGHTON DIRECTOR OF PROJECT NEIGHBORHEALTH; SHREVEPORT CITY COUNCILMAN (DISTRICT A)MARTHA MARAK, DIRECTOR OF THE FOOD BANK OF NORTHWEST LOUISIANADR. CHARLES POWERS, CMO - WILLIS-KNIGHTON BOSSIER HOSPITALTIM WILCOX, DIRECTOR OF WILLIS-KNIGHTON BEHAVIORAL MEDICINE DEPARTMENTDR. PHILLIP ROZEMAN, CARDIOLOGIST; COMMUNITY LEADERJERRY BOWMAN, SHREVEPORT CITY COUNCILMAN (DISTRICT G)KATHERINE LASTER, CADDO PARISH SCHOOL BOARD NURSING SUPERVISORDR. ELAINE SIMPKINS, COMMUNITY LEADER; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBERJANET MARTIN, EXECUTIVE DIRECTOR-INTERFAITH PHARMACYDR. PAUL CRAWFORD, OBSTETRICIAN & GYNECOLOGIST; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBER GROUP A-FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 6A: WK PIERREMONT HEALTH CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 5: CONDUCTED 11 INTERVIEWS (LIST OF INTERVIEWEES FOLLOWS) WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52.DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. GATHERED BACKGROUND INFORMATION, INCLUDING CREDENTIALS, ON EACH INTERVIEWEE.SHERRI BUFFINGTON, COMMUNITY LEADER; FORMER STATE SENATOR DISTRICT 38(CADDO AND DESOTO PARISH); FORMER VICE CHAIR HEALTH & WELFAREWILLIE BRADFORD, WILLIS-KNIGHTON DIRECTOR OF PROJECT NEIGHBORHEALTH; SHREVEPORT CITY COUNCILMAN (DISTRICT A)MARTHA MARAK, DIRECTOR OF THE FOOD BANK OF NORTHWEST LOUISIANADR. CHARLES POWERS, CMO - WILLIS-KNIGHTON BOSSIER HOSPITALTIM WILCOX, DIRECTOR OF WILLIS-KNIGHTON BEHAVIORAL MEDICINE DEPARTMENTDR. PHILLIP ROZEMAN, CARDIOLOGIST; COMMUNITY LEADERJERRY BOWMAN, SHREVEPORT CITY COUNCILMAN (DISTRICT G)KATHERINE LASTER, CADDO PARISH SCHOOL BOARD NURSING SUPERVISORDR. ELAINE SIMPKINS, COMMUNITY LEADER; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBERJANET MARTIN, EXECUTIVE DIRECTOR-INTERFAITH PHARMACYDR. PAUL CRAWFORD, OBSTETRICIAN & GYNECOLOGIST; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBER GROUP A-FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 5: CONDUCTED 11 INTERVIEWS (LIST OF INTERVIEWEES FOLLOWS) WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52.DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. GATHERED BACKGROUND INFORMATION, INCLUDING CREDENTIALS, ON EACH INTERVIEWEE.SHERRI BUFFINGTON, COMMUNITY LEADER; FORMER STATE SENATOR DISTRICT 38(CADDO AND DESOTO PARISH); FORMER VICE CHAIR HEALTH & WELFAREWILLIE BRADFORD, WILLIS-KNIGHTON DIRECTOR OF PROJECT NEIGHBORHEALTH; SHREVEPORT CITY COUNCILMAN (DISTRICT A)MARTHA MARAK, DIRECTOR OF THE FOOD BANK OF NORTHWEST LOUISIANADR. CHARLES POWERS, CMO - WILLIS-KNIGHTON BOSSIER HOSPITALTIM WILCOX, DIRECTOR OF WILLIS-KNIGHTON BEHAVIORAL MEDICINE DEPARTMENTDR. PHILLIP ROZEMAN, CARDIOLOGIST; COMMUNITY LEADERJERRY BOWMAN, SHREVEPORT CITY COUNCILMAN (DISTRICT G)KATHERINE LASTER, CADDO PARISH SCHOOL BOARD NURSING SUPERVISORDR. ELAINE SIMPKINS, COMMUNITY LEADER; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBERJANET MARTIN, EXECUTIVE DIRECTOR-INTERFAITH PHARMACYDR. PAUL CRAWFORD, OBSTETRICIAN & GYNECOLOGIST; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBER GROUP A-FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK PIERREMONT HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 5: CONDUCTED 11 INTERVIEWS (LIST OF INTERVIEWEES FOLLOWS) WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52.DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. GATHERED BACKGROUND INFORMATION, INCLUDING CREDENTIALS, ON EACH INTERVIEWEE.SHERRI BUFFINGTON, COMMUNITY LEADER; FORMER STATE SENATOR DISTRICT 38(CADDO AND DESOTO PARISH); FORMER VICE CHAIR HEALTH & WELFAREWILLIE BRADFORD, WILLIS-KNIGHTON DIRECTOR OF PROJECT NEIGHBORHEALTH; SHREVEPORT CITY COUNCILMAN (DISTRICT A)MARTHA MARAK, DIRECTOR OF THE FOOD BANK OF NORTHWEST LOUISIANADR. CHARLES POWERS, CMO - WILLIS-KNIGHTON BOSSIER HOSPITALTIM WILCOX, DIRECTOR OF WILLIS-KNIGHTON BEHAVIORAL MEDICINE DEPARTMENTDR. PHILLIP ROZEMAN, CARDIOLOGIST; COMMUNITY LEADERJERRY BOWMAN, SHREVEPORT CITY COUNCILMAN (DISTRICT G)KATHERINE LASTER, CADDO PARISH SCHOOL BOARD NURSING SUPERVISORDR. ELAINE SIMPKINS, COMMUNITY LEADER; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBERJANET MARTIN, EXECUTIVE DIRECTOR-INTERFAITH PHARMACYDR. PAUL CRAWFORD, OBSTETRICIAN & GYNECOLOGIST; WILLIS-KNIGHTON HEALTH SYSTEM BOARD MEMBER GROUP A-FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWK PIERREMONT HEALTH CENTER 5 1 - OUTPATIENT CLINICS VARIOUS LOCATIONS SHREVEPORT LA 71130 OUTPATIENT CLINICS 2 - THE OAKS OF LOUISIANA 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 RESIDENTIAL COMMUNITY FOR ADULTS AGE 55 AND OVER 3 - SAVANNAH AT THE OAKS 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 ASSISTED LIVING FACILITY 4 - EXTENDED CARE CENTER 2550 KINGS HIGHWAY SHREVEPORT LA 71103 SUBACUTE REHABILITATION 5 - WILLIS-KNIGHTON REHABILITATION INSTITUTE 1111 LINE AVENUE SHREVEPORT LA 71101 PHYSICAL REHABILITATION AND BEHAVIORAL REHABILITATION PART I, LINE 7: ALL ITEMS IN THE TABLE, EXCEPT FOR LINE 7G, USE THE COST-TO-CHARGE RATIO COSTING METHOD. PROJECT NEIGHBORHEALTH, WHICH IS INCLUDED ON LINE 7G, USES THE ACTUAL COST METHOD. PART III, LINE 4: THE MEDICAL CENTER MAINTAINS AN ALLOWANCE FOR DOUBTFUL PATIENT ACCOUNTS RECEIVABLE BASED ON MANAGEMENT'S ASSESSMENT OF COLLECTABILITY, CURRENT ECONOMIC CONDITIONS, AND PRIOR EXPERIENCE. AS MANAGEMENT DETERMINES THE COLLECTION OF SPECIFIC PATIENT ACCOUNTS TO BE DOUBTFUL, SUCH ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE. BASED ON THIS ANALYSIS, BAD DEBT EXPENSE AS A PERCENTAGE OF GROSS PATIENT BILLINGS (EXCLUDING MEDICARE CHARGES, MEDICAID CHARGES, AND CHARITY CARE) WAS 3.6 PERCENT AND 6.4 PERCENT FOR THE YEARS ENDED SEPTEMBER 30, 2017 AND SEPTEMBER 30, 2016, RESPECTIVELY. PART III, LINE 8: THE MEDICAL CENTER HAS NOT TO DATE INCLUDED MEDICARE SHORTFALLS IN ANY PUBLIC REPRESENTATION OF ITS COMMUNITY BENEFITS. THE MEDICAL CENTER IS AWARE OF THE VARIOUS ARGUMENTS CIRCULATING WITH REGARDS TO WHETHER THE SO CALLED MEDICARE SHORTFALL SHOULD BE IN WHOLE OR PART TREATED AS A COMMUNITY BENEFIT. THE MOST COMPELLING OF THE PROPONENTS' ARGUMENTS IS THAT BECAUSE TAX EXEMPT HOSPITALS MUST SERVE MEDICARE BENEFICIARIES AT NONNEGOTIABLE RATES SET BY THE GOVERNMENT, SHORTFALLS RESULT FROM UNDERPAYMENTS AND AS SUCH ARE UNAVOIDABLE COMMUNITY BENEFITS. OPPONENTS ARGUE SHORTFALLS ARE RELATED TO EFFICIENCY. THE MEDICAL CENTER IS CONFIDENT THAT ITS MEDICARE SHORTFALL IS NOT ATTRIBUTABLE TO INEFFICIENCIES BUT INSTEAD TO UNDERPAYMENTS FOR COSTS OF PROVIDING HIGH QUALITY MEDICAL CARE AND PATIENT SERVICES BY AN APPROPRIATE NUMBER OF COMPETENT STAFF IN HIGH QUALITY WELL EQUIPPED FACILITIES.THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. PART III, LINE 9B: 1. MONTHLY STATEMENTS ARE GENERATED AND MAILED BY THE MEDICAL CENTER TO PATIENTS/GUARANTORS TO MAKE THEM AWARE OF OUTSTANDING BALANCES.2. THE ACCOUNTS RECEIVABLE FILE IS REVIEWED MONTHLY FOR ACCOUNTS THAT HAVE AN OUTSTANDING BALANCE SHOWN TO BE THE PATIENT/GUARANTOR'S RESPONSIBILITY. AN ACCOUNT IS CONSIDERED TO BE IN THE EARLY STAGES OF DELINQUENCY AT A MINIMUM OF 136 DAYS FROM THE FIRST STATEMENT DATE, AT LEAST 3 STATEMENTS HAVE BEEN GENERATED FROM THE MEDICAL CENTER AND IT HAS BEEN GREATER THAN 45 DAYS SINCE THE LAST PAYMENT WAS RECEIVED FROM INSURANCE OR THE PATIENT/GUARANTOR.3. ACCOUNTS MEETING THE ABOVE CRITERIA ARE REFERRED TO AN EARLY OUT AGENCY FOR COLLECTION. THE EARLY OUT AGENCY WILL ATTEMPT TO COLLECT THE OUTSTANDING BALANCE FOR A PERIOD OF 90 DAYS. THE EARLY OUT COLLECTION EFFORTS WILL INCLUDE BOTH PHONE AND WRITTEN COMMUNICATIONS. PAYMENTS AND PATIENT CORRESPONDENCE WILL BE DIRECTED TO THE MEDICAL CENTER, NOT THE EARLY OUT AGENCY.4. THE EARLY OUT AGENCY WILL RETURN FILES TO THE MEDICAL CENTER AT THE END OF THE 90 DAY PERIOD WITH STATUS INFORMATION AS FOLLOWS:A. RETURNED WITH A PAYMENT ARRANGEMENT - ACCOUNTS ARE MAINTAINED IN-HOUSE AND MONITORED BY THE BUSINESSS OFFICE. THE BAD DEBT AGENCY IS CHANGED TO WK-REG. STATEMENTS ARE GENERATED AND MAILED TO THE PATIENT/GUARANTOR MONTHLY. ACCOUNTS ARE MONITORED MONTHLY. IF THE PATIENT DEFAULTS ON THE PAYMENT ARRANGEMENT, THE MEDICAL CENTER WILL MAIL NOTIFICATION CONCERNING THE WILLIS-KNIGHTON HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY AND A FINANCIAL ASSISTANCE APPLICATION AND ALLOW A MINIMUM OF 30 DAYS FOR RESPONSE. APPLICATIONS RECEIVED WILL BE PROCESSED AND NOTIFICATION WILL BE SENT TO THE PATIENT. ACCOUNTS WILL NOT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY UNLESS THE PATIENT FAILS TO RESPOND OR DOES NOT MEET THE FINANCIAL REQUIREMENTS FOR FINANCIAL ASSISTANCE.B. RETURNED WITH NO PAYMENT ARRANGEMENT - THE MEDICAL CENTER WILL MAIL NOTIFICATION CONCERNING THE WILLIS-KNIGHTON HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY AND A FINANCIAL ASSISTANCE APPLICATION AND ALLOW A MINIMUM OF 30 DAYS FOR RESPONSE. APPLICATIONS RECEIVED WILL BE PROCESSED AND NOTIFICATION WILL BE SENT TO THE PATIENT. ACCOUNTS WILL NOT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY UNLESS THE PATIENT FAILS TO RESPOND OR DOES NOT MEET THE FINANCIAL REQUIREMENTS FOR FINANCIAL ASSISTANCE. 5. THE BUSINESS OFFICE DIRECTOR WILL HAVE THE FINAL AUTHORITY FOR DETERMINING THAT THE MEDICAL CENTER HAS MADE REASONABLE EFFORTS TO DETERMINE THAT A PATIENT IS NOT FINANCIAL ASSISTANCE ELIGIBLE AND MAY THEREFORE ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS AGAINST THE PATIENT. COLLECTION EFFORTS MAY INCLUDE REPORTING TO CREDIT AGENCIES, LAWSUITS OR WAGE GARNISHMENT. PART VI, LINE 2: WILLIS-KNIGHTON MEDICAL CENTER OPERATES THROUGHOUT SHREVEPORT, BOSSIER CITY AND NEARBY PARISHES AND PROVIDES FOUR HOSPITALS, NUMEROUS SATELLITE CLINICS, A SKILLED NURSING FACILITY, A RETIREMENT COMMUNITY, AND AN ASSISTED LIVING FACILITY. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES THAT IT SERVES BY STAYING INFORMED ABOUT THE RELEVANT TRENDS OCCURRING IN THE AREAS IN WHICH IT OPERATES. PART VI, LINE 3: WILLIS-KNIGHTON HEALTH SYSTEM IS COMMITTED TO PROVIDING CHARITY CARE TO PERSONS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE. CONSISTENT WITH ITS MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTHCARE SERVICES AND TO BE AN ADVOCATE FOR THOSE WHO ARE MOST IN NEED, WILLIS-KNIGHTON HEALTH SYSTEM STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. PATIENTS ARE EXPECTED TO COOPERATE WITH WILLIS-KNIGHTON HEALTH SYSTEM'S PROCEDURES FOR OBTAINING CHARITY OR OTHER FORMS OF PAYMENT OR FINANCIAL ASSISTANCE, AND TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR INDIVIDUAL ABILITY TO PAY. PART VI, LINE 4: WILLIS-KNIGHTON'S PRIMARY SERVICE AREA COVERS AN APPROXIMATE 35 MILE RADIUS OF SHREVEPORT, COVERING THE LOUISIANA PARISHES OF CADDO, BOSSIER, WEBSTER, CLAIBORNE, RED RIVER, DESOTO AND BIENVILLE, AND WHICH HAD A 2016 ESTIMATED POPULATION OF APPROXIMATELY 441,767 PERSONS. THE MEDIAN HOUSEHOLD INCOME ACCORDING TO THE 2016 U.S. CENSUS DATA FOR SHREVEPORT IS $38,497. THE MEDIAN HOUSEHOLD INCOME ACCORDING TO THE 2016 U.S. CENSUS DATA FOR BOSSIER PARISH IS $46,322. PART VI, LINE 5: OTHER COMMUNITY BENEFITS:PROJECT NEIGHBORHEALTH - OVERVIEWDURING 1995, THE MEDICAL CENTER BEGAN A PROGRAM KNOWN AS "PROJECT NEIGHBORHEALTH." THE PROGRAM'S PURPOSE IS TO PROMOTE HEALTH AND WELL-BEING IN COMMUNITIES THAT ARE ECONOMICALLY DISTRESSED AND/OR DESIGNATED AS MEDICALLY UNDER-SERVED, HEALTH-PROFESSIONAL-SHORTAGE AREAS. THE PROGRAM PROVIDES FREE COMMUNITY PROGRAMS INCLUDING ANTI-DRUG/GANG PROGRAMS, LIFE SKILLS TRAINING, MENTORING PROGRAMS, NUTRITIONAL COUNSELING, POLICE COMMUNITY FORUMS, AND OTHER COMMUNITY-RELATED PROGRAMS. AS PART OF PROJECT NEIGHBORHEALTH, THE MEDICAL CENTER OPERATES THE FOLLOWING CLINICS: SIMPKINS COMMUNITY HEALTH & EDUCATION CENTER, WK PIERRE AVENUE HEALTH & WELLNESS CENTER, AND WK BRADLEY MEDICAL CLINIC.SIMPKINS COMMUNITY HEALTH PROJECT NEIGHBORHEALTH: ON SEPTEMBER 1, 1995, AT A COST OF APPROXIMATELY $1,300,000, THE MEDICAL CENTER OPENED A 6,463 SQUARE FOOT, FEDERALLY DESIGNATED INDIGENT CARE MEDICAL CLINIC ON HILRY HUCKABY AVENUE IN SHREVEPORT, LOUISIANA. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THESE FACILITIES ARE CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. THE LOCATION OF THE CLINIC (CENSUS TRACT 246 IN THE DR. MARTIN LUTHER KING DRIVE AREA IN CADDO PARISH) WAS DESIGNATED BY THE DEPARTMENT OF HEALTH AND HOSPITALS AS A HEALTH-PROFESSIONAL-SHORTAGE AREA AND AS A MEDICALLY UNDER-SERVED AREA. PRIOR TO THE CLINIC'S OPENING, THIS AREA WAS THE SECOND LARGEST CONTIGUOUS POPULATION OF MEDICALLY UNDER-SERVED PEOPLE IN THE UNITED STATES. THE CLINIC HAS AN EMERGENCY AND SPECIAL PROCEDURES ROOM, AN X-RAY DEPARTMENT, AND A FULLY EQUIPPED LABORATORY AND DENTAL FACILITY. PREVENTATIVE CARE PROGRAMS INCLUDE BLOOD PRESSURE CHECKS, HEALTH SCREENINGS, IMMUNIZATIONS, AND DIABETES COUNSELING. THE CLINIC'S STAFF INCLUDES A FAMILY PRACTICE PHYSICIAN SPECIALIST, A NURSE PRACTITIONER, AND SUPPORT STAFF. THE CLINIC HAD 2,614 MEDICAL PATIENT VISITS DURING THE YEAR ENDED SEPTEMBER 30, 2017. WK PIERRE AVENUE COMMUNITY HEALTH & WELLNESS CENTERPROJECT NEIGHBORHEALTH: ON AUGUST 1, 1998, THE MEDICAL CENTER OPENED A 15,062 SQUARE FOOT MEDICAL CLINIC KNOWN AS THE "WK PIERRE AVENUE COMMUNITY CENTER" ON PIERRE AVENUE IN SHREVEPORT AT A COST OF APPROXIMATELY $1,375,000. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THIS FACILITY IS CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. THIS FACILITY ALSO CONTAINS A HEALTH AND FITNESS CENTER. THE MEDICAL CENTER PROVIDES EQUIPMENT AND MEDICAL STAFF FOR THE CLINIC. THE CLINIC'S STAFF INCLUDES A FAMILY PRACTICE PHYSICIAN SPECIALIST, A NURSE PRACTITIONER, AND SUPPORT STAFF. THE CLINIC HAD 2,299 MEDICAL PATIENTS DURING THE YEAR ENDED SEPTEMBER 30, 2017. WK BRADLEY MEDICAL CLINIC ON AUGUST 24, 1998, THE MEDICAL CENTER OPENED A 3,915 SQUARE FOOT MEDICAL CLINIC KNOWN AS THE "WK BRADLEY MEDICAL CLINIC" IN BRADLEY, ARKANSAS AT A COST OF APPROXIMATELY $140,000. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THIS FACILITY IS CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. THE MEDICAL CENTER PROVIDES EQUIPMENT AND MEDICAL STAFF FOR THE CLINIC. THE CLINIC'S STAFF INCLUDES A NURSE PRACTITIONER WITH A SUPERVISING FAMILY PRACTICE PHYSICIAN AND VARIOUS SUPPORT STAFF. THE CLINIC HAD 1,811 MEDICAL PATIENTS DURING THE YEAR ENDED SEPTEMBER 30, 2017. PROJECT NEIGHBORHEALTH: DURING THE YEAR ENDED SEPTEMBER 30, 2017, UNDER PROJECT NEIGHBORHEALTH, THE MEDICAL CENTER PROVIDED OVER 170 HOURS TO COMMUNITY SERVICES/PROJECTS AT NO COST TO THE RECIPIENTS BY 1 PART-TIME EMPLOYEE AND VOLUNTEERS IN ADDITION TO HOURS PROVIDED BY VARIOUS DEPARTMENTS WITHIN THE MEDICAL CENTER.OTHER COMMUNITY SERVICESTHE MEDICAL CENTER MAKES AVAILABLE, FREE-OF-CHARGE, MEETING SPACE TO OUTSIDE COMMUNITY OUTREACH ORGANIZATIONS SUCH AS BOSSIER MEDICAL SOCIETY, CADDO PARISH SHERIFF'S OFFICE, ICE (INNER CITY ENTREPRENEUR), NORTH LOUISIANA AHEC, LIFESHARE BLOOD CENTER, LSU PSYCHIATRY PROGRAM, TEXAS WESLEYAN UNIVERSITY CRNA PROGRAM, NORTHWEST LOUISIANA COALITION FOR WOMEN AND CHILDREN, NORTHWEST LOUISIANA INTERFAITH PHARMACY, VOLUNTEERS FOR YOUTH JUSTICE, UNITED WAY, ALLIANCE FOR EDUCATION, NORTHWEST LOUISIANA FAMILY JUSTICE CENTER, CADDO COUNCIL ON AGING, COMMON GROUND COMMUNITY AND OTHER CHARITABLE AND GOVERNMENTAL ORGANIZATIONS. ROOMS ARE ALSO PROVIDED FOR OFF CAMPUS CLASSES TAUGHT BY BOSSIER PARISH COMMUNITY COLLEGE AT WK TRAINING AND DEVELOPMENT.THE MEDICAL CENTER OFFERS EXTENSIVE ONLINE HEALTH INFORMATION ON ITS WEB SITE. FREE HEALTH INFORMATION IS AVAILABLE, TARGETED TO BOTH ADULTS AND CHILDREN. INFORMATION FOR ADULTS INCLUDES A HEALTH LIBRARY, DRUG INTERACTION CHECKER, NUTRITION AND WELLNESS INFORMATION AND DESCRIPTION OF PROCEDURES, WRITTEN BY HEALTH PROFESSIONALS AND REVIEWED AND UPDATED REGULARLY. THE MEDICAL CENTER ALSO PARTNERS WITH THE NEMOURS FOUNDATION TO OFFER KIDSHEALTH, A HEALTH AND WELLNESS INFORMATION SITE TARGETED TO CHILDREN, TEENS AND THEIR PARENTS. THE WILLIS-KNIGHTON CANCER CENTER WEB SITE OFFERS INFORMATION ON VARIOUS TYPES OF CANCER AND TREATMENTS AS WELL AS AN UPDATED LIST OF CLINICAL TRIALS. DURING THE PAST YEAR THE MEDICAL CENTER'S ON-LINE HEALTH LIBRARY ATTRACTED 781,000 VISITS FROM A TOTAL OF 543,000 VISITORS. KIDSHEALTH ATTRACTED OVER 9,417 VISITS.IMMUNIZATIONS FOR CHILDREN WILLIS-KNIGHTON PROVIDES A MOBILE UNIT THAT OFFERS "SHOTS FOR TOTS". USING ITS MOBILE VAN AND STAFF, VACCINES ARE TAKEN TO VARIOUS NEIGHBORHOODS TO MAKE THEM CONVENIENT FOR PARENTS. UNDER THIS PROGRAM, ANY CHILD MAY RECEIVE IMMUNIZATION SHOTS, FREE OF CHARGE, FOR MEASLES, MUMPS, RUBELLA, DIPHTHERIA, PERTUSSIS, TETANUS, HEPATITIS B, POLIO, MENINGITIS, FLU, AND CHICKEN POX. THE MEDICAL CENTER SUBSIDIZES ALL EXPENSES OF THE PROGRAM EXCEPT THE VACCINE, WHICH IS PROVIDED BY THE LOUISIANA DEPARTMENT OF PUBLIC HEALTH. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE MEDICAL CENTER IMMUNIZED 2,343 PATIENTS UNDER THIS PROGRAM.HEALTH PROFESSIONS EDUCATIONTHE MEDICAL CENTER PROVIDES VARIOUS EDUCATION PROGRAMS THAT RESULT IN HEALTHCARE PROFESSIONALS RECEIVING DEGREES, CERTIFICATES OR TRAINING THAT IS NECESSARY TO BE LICENSED TO PRACTICE AS HEALTHCARE PROFESSIONALS. WHILE THE MEDICAL CENTER ALSO PROVIDES A VARIETY OF EDUCATION, TRAINING AND STIPEND PROGRAMS THAT ARE EXCLUSIVE TO THE MEDICAL CENTER'S EMPLOYEES AND MEDICAL STAFF, THOSE COSTS ARE NOT INCLUDED IN THIS CATEGORY. THE MEDICAL CENTER MAINTAINS AN ASSOCIATION WITH LSU HEALTH SCIENCES CENTER (A PUBLIC TEACHING, RESEARCH, AND INDIGENT CARE FACILITY) BY PROVIDING GRANTS, ASSISTANCE WITH RESIDENTS AND FELLOWS, ALONG WITH UNDERWRITING THE COST OF CLINICAL SETTINGS FOR TRAINING AND INTERNSHIPS FOR A VARIETY OF OTHER HEALTH PROFESSIONALS.SPORTS MEDICINESPORTS MEDICINE EXPERTS AT WILLIS-KNIGHTON SPORTS MEDICINE WORK WITH ATHLETES ON THE PREVENTION AND TREATMENT OF SPORTS-RELATED INJURIES, HELPING THEM TO MAINTAIN A HEALTHY LIFESTYLE. THIS SERVICE IS OFFERED TO VARIOUS SCHOOLS AND PROGRAMS THROUGHOUT THE LOCAL AREA. THE MEDICAL CENTER SPONSORS A FREE ATHLETIC PHYSICAL DAY FOR YOUNG ATHLETES, STAFFED BY SPORTS MEDICINE PHYSICIANS AND STAFF. 1 ALLIANCE FOR EDUCATION 820 JORDAN STREET SHREVEPORT LA 71101 721466587 501(C)(3) 15000 DONATION FOR OPERATIONS BOSSIER CHAMBER OF COMMERCE 710 BENTON ROAD BOSSIER CITY LA 71111 720382231 501(C)(6) 13200 DONATION FOR PATRIOT AWARENESS CADDO BOSSIER SOCCER ASSOCIATION 1780 EAST BERT KOUNS SUITE 901 SHREVEPORT LA 71105 581652966 501(C)(3) 25000 SPONSORSHIP CADDO-BOSSIER CANCER FOUNDATION 3300 ALBERT BICKNELL DRIVE SHREVEPORT LA 71103 453188641 501(C)(3) 10000 DONATION FOR OPERATIONS CADDO PARISH SCHOOL BOARD 1961 MIDWAY AVENUE SHREVEPORT LA 71130 726000224 GOVERNMENT 11000 SPONSORSHIP CHILDREN AND ARTHRITIS 2751 ALBERT BICKNELL DRIVE SUITE 2E 2E SHREVEPORT LA 71103 721170530 501(C)(3) 15000 SPONSORSHIP COUNCIL ON ALCOHOLISM & DRUG ABUSE 2000 FAIRFIELD AVENUE SHREVEPORT LA 71104 720544581 501(C)(3) 25000 DONATION FOR OPERATIONS DESOTO HOSPITAL ASSOCIATION INC 207 JEFFERSON STREET MANSFIELD LA 71052 720500565 501(C)(3) 179916 DONATION FOR OPERATIONS FRIENDS OF LOUISIANA STATE EXHIBIT MUSEUM INC PO BOX 38356 SHREVEPORT LA 71133 720960820 501(C)(3) 35000 DONATION FOR OPERATIONS SHREVEPORT CHAMBER OF COMMERCE 400 EDWARDS STREET SHREVEPORT LA 71101 720315700 501(C)(6) 100000 DONATION FOR OPERATIONS HOLY ANGELS RESIDENTIAL FACILITY INC 10450 ELLERBE ROAD SHREVEPORT LA 71106 720628035 501(C)(3) 60000 DONATION FOR OPERATIONS INDEPENDENCE BOWL FOUNDATION PO BOX 1723 SHREVEPORT LA 71166 720297228 501(C)(3) 27750 SPONSORSHIP INNER CITY ENTREPRENEUR INSTITUTE 820 JORDAN STREET SUITE 360 SHREVEPORT LA 71101 721418314 501(C)(3) 20000 SPONSORSHIP INSTITUTE FOR GLOBAL OUTREACH 1024 PIERRE AVENUE ROOM B SHREVEPORT LA 71103 331180777 501(C)(3) 37000 DONATION FOR OPERATIONS JUNIOR ACHIEVEMENT 3003 KNIGHT STREET SHREVEPORT LA 71105 720595081 501(C)(3) 18000 DONATION FOR OPERATIONS LOUISIANA TECH UNIVERSITY FOUNDATION PO BOX 3046 RUSTON LA 71272 726021176 501(C)(3) 92250 SPONSORSHIP LA TROOPER FOUNDATION PO BOX 65076 BATON ROUGE LA 70896 742918404 501(C)(3) 25000 DONATION FOR OPERATIONS LAKESHORE ELEMENTARY 1807 SAN JACINTO STREET SHREVEPORT LA 71109 726000224 GOVERNMENT 6523 SCHOOL SIGN LOUISIANA HERO'S PROJECT 2515 VANCE AVENUE ALEXANDRIA LA 71301 462720419 501(C)(3) 21821 DONATION FOR OPERATIONS LSUHSC PO BOX 31650 SHREVEPORT LA 71115 721402222 GOVERNMENT 170000 DONATION FOR OPERATIONS AND SPONSORSHIP NEW CARDIOVASCULAR HORIZONS 3639 AMBASSADOR CAFFERY PARKWAY SUITE 605 LAFAYETTE LA 70503 463186713 501(C)(3) 7500 SUPPORT FOR ACCREDITED CARDIOVASCULAR CONFERENCE NORTH SHREVEPORT BUSINESS ASSOCIATION PO BOX 7957 SHREVEPORT LA 71137 272205837 501(C)(3) 11837 DONATION FOR OPERATIONS NORTHWEST LOUISIANA FOOD BANK 2307 TEXAS AVENUE SHREVEPORT LA 71103 721328890 501(C)(3) 25702 DONATION FOR OPERATIONS NORTHWESTERN FOUNDATION UNIVERSITY PARKWAY NATCHITOCHES LA 71497 726021495 501(C)(3) 60000 DONATION FOR OPERATIONS SHREVEPORT-BOSSIER RESCUE MISSION 2033 TEXAS AVENUE SHREVEPORT LA 71103 237050551 501(C)(3) 55018 HEALTH INSURANCE FOR RESCUE MISSION EMPLOYEES AND DONATION FOR OPERATIONS SHREVEPORT LITTLE THEATRE 812 MARGARET PLACE SHREVEPORT LA 71101 720363143 501(C)(3) 10000 SPONSORSHIP SHREVEPORT OPERA 212 TEXAS STREET NO 1 SHREVEPORT LA 71101 726021455 501(C)(3) 10250 DONATION FOR OPERATIONS SHREVEPORT SYMPHONY 619 LOUISIANA AVENUE SHREVEPORT LA 71101 726001334 501(C)(3) 92040 DONATION FOR OPERATIONS ST LUKE'S EPISCOPAL MOBILE MINISTRY INC PO BOX 53074 SHREVEPORT LA 71135 453786377 501(C)(3) 10000 DONATION FOR OPERATIONS ST JUDE'S CHILDREN'S RESEARCH HOSPITAL PO BOX 810 MEMPHIS TN 38101 620646012 501(C)(3) 20000 DONATION FOR OPERATIONS SUSAN G KOMEN BREAST CANCER FOUNDATION 2015 FAIRFIELD AVENUE SUITE 2C SHREVEPORT LA 71104 752844653 501(C)(3) 10000 DONATION FOR OPERATIONS UNIVERSITY OF LOUISIANA AT MONROE FOUNDATION 3601 DESIARD STREET MONROE LA 71209 726028527 501(C)(3) 60000 DONATION FOR PROFESSORSHIP - SCHOOL OF NURSING VOLUNTEERS FOR YOUTH JUSTICE 900 JORDAN STREET SHREVEPORT LA 71101 721057695 501(C)(3) 225000 DONATION FOR OPERATIONS YMCA 400 MCNEIL SHREVEPORT LA 71101 720408997 501(C)(3) 39900 DONATION FOR OPERATIONS 29 5 PART I, LINE 2: THE MEDICAL CENTER HAS A CONTRIBUTION COMMITTEE THAT APPROVES SUBSTANTIALLY ALL CONTRIBUTIONS. THE CONTRIBUTION COMMITTEE REQUESTS THAT THE ORGANIZATION REQUESTING THE DONATION COMPLETE A CONTRIBUTION REQUEST FORM THAT IS AVAILABLE ON THE MEDICAL CENTER'S WEBSITE. BEFORE THE MEDICAL CENTER'S CONTRIBUTION COMMITTEE WILL APPROVE THE CONTRIBUTIONS THE PURPOSE OF THE CONTRIBUTION MUST BE STATED ON THE CONTRIBUTION REQUEST FORM. THE MEDICAL CENTER CONRIBUTIONS ARE USUALLY PROVIDED TO ORGANIZATIONS FOR GENERAL OPERATIONS AND ARE NOT MONITORED. X 0 1 X X X X X 1 1 0 1 0 0 0 0 0 JAMES K ELROD PRESIDENT/CEO/TRUSTEE 1388127 6000 0 0 265640 0 0 0 6825 0 1660592 6000 0 0 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 199998 0 3920 0 22786 0 1953 0 6825 0 235482 0 0 0 MARY JANE WARD SR VICE PRESIDENT OF FINANCE 231248 0 0 0 21089 0 4706 0 22481 0 279524 0 0 0 CHARLES D DAIGLE SR VP OF OPERATIONS & COO 592804 0 0 0 101011 0 1642 0 28688 0 724145 0 0 0 STEPHEN R RANDALL SR VP-SPECIAL OPERATIONS 322766 0 0 0 25395 0 1646 0 26291 0 376098 0 0 0 MARGARET G ELROD SR VP/IND WELLNESS/COMMUN 167420 0 0 0 26388 0 1847 0 7625 0 203280 0 0 0 JERRY A FIELDER II VP/ADMINISTRATOR WKMC 183638 0 0 0 19756 0 2592 0 27785 0 233771 0 0 0 CLIFFORD M BROUSSARD VP/ADMIN WK BOSSIER/QUALIT 188031 0 0 0 5070 0 1798 0 20037 0 214936 0 0 0 JANET K ELROD VP/ADMIN WK SOUTH 167983 0 0 0 23036 0 2196 0 6915 0 200130 0 0 0 IRA L MOSS VP/ADMIN WK PIERREMONT 197670 0 0 0 25505 0 2452 0 21486 0 247113 0 0 0 JILL K ELROD VP OF LEGAL AFFAIRS 222060 0 0 0 25895 0 2244 0 9325 0 259524 0 0 0 PEGGY J GAVIN SR VP OF PHYSICIAN SERVICE 166692 0 0 0 26822 0 2406 0 8343 0 204263 0 0 0 DEBORAH D OLDS CHIEF NURSING OFFICER 150714 0 0 0 6042 0 4646 0 18986 0 180388 0 0 0 DANIEL J MOLLER JR MD CHIEF-MEDICAL AFFAIRS-WKMC 499995 0 5770 0 24277 0 1874 0 18986 0 550902 0 0 0 CHARLES A POWERS MD CHIEF-MED. AFFAIRS-WKB 399996 0 4615 0 23856 0 1873 0 19982 0 450322 0 0 0 RANDALL P BREWER MD PHYSICIAN 974990 0 475181 0 -5466 0 1657 0 21615 0 1467977 0 0 0 MILAN G MODY MD PHYSICIAN 1199989 0 1170741 0 -4081 0 1638 0 26565 0 2394852 0 0 0 CHRISTOPHER L SHELBY MD PHYSICIAN 679993 0 795855 0 -4077 0 1638 0 26561 0 1499970 0 0 0 JOHN GRAY NOLES MD PHYSICIAN 862491 0 748671 0 -5400 0 1633 0 26564 0 1633959 0 0 0 SARAH GLORIOSO MD PHYSICIAN 719993 0 794769 0 -3138 0 1621 0 25622 0 1538867 0 0 0 FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) EXPLANATION OF PART II, COLUMN (B)(III) OTHER COMPENSATION JAMES K. ELROD UNUSED SICK PAY-$32,034 VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$856 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$16,068 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN CONTRIBUTION-$200,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,518) TOTAL--$265,640 MARY JANE WARD UNUSED SICK PAY-$5,769 VALUE ADDED FOR HEALTH & FITNESS USAGE-$880 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,643 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,203) TOTAL--$21,089 CHARLES D. DAIGLE UNUSED SICK PAY-$14,690 VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$645 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$834 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(8,358) SEVERANCE PAY-$75,000** TOTAL--$101,011 **THE INCREASE IN GROSS SEVERANCE BENEFIT, TO BE PAID TO MR. DAIGLE ON TERMINATION OF EMPLOYMENT (AS ADDITIONAL COMPENSATION FOR EACH OF HIS YEARS OF SERVICE TO WILLIS-KNIGHTON MEDICAL CENTER), WAS TAXABLE DURING 2016, AND ACCORDINGLY, WAS INCLUDED IN HIS 2016 FORM W-2. WILLIS-KNIGHTON DISBURSED TO THE INTERNAL REVENUE SERVICE AND TO THE LOUISIANA DEPARTMENT OF REVENUE THE REQUIRED TAX WITHHOLDING. WILLIS-KNIGHTON DID NOT PAY MR. DAIGLE THE NET-OF-TAX AMOUNT OF THIS COMPENSATION, BUT, UNDER THE TERMS OF THE AGREEMENT, THE MEDICAL CENTER IS RETAINING THE NET-OF-TAX AMOUNT UNTIL HIS EMPLOYMENT TERMINATES. ACCORDINGLY, THERE WAS NO CURRENT DISBURSEMENT TO MR. DAIGLE FOR SEVERANCE PAY. STEPHEN R. RANDALL UNUSED SICK PAY-$8,077 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 VALUE ADDED FOR CELL PHONE USAGE-$1,287 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$831 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 VALUE ADDED FOR CABLE/INTERNET- $1,838 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,958) TOTAL--$25,395 MARGARET G. ELROD UNUSED SICK PAY-$4,063 VALUE ADDED FOR CELL PHONE USAGE-$1,126 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$5,517 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(2,318) TOTAL--$26,388 JERRY A. FIELDER,II UNUSED SICK PAY-$4,375 VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$1,230 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$734 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,458) VALUE ADDED FOR CABLE/INTERNET- $1,355 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 TOTAL--$19,756 CLIFFORD M. BROUSSARD UNUSED SICK PAY-$4,500 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 VALUE ADDED FOR CELL PHONE USAGE-$643 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,366 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,759) TOTAL--$5,070 JANET K. ELROD UNUSED SICK PAY-$4,077 VALUE ADDED FOR HEALTH & FITNESS USAGE-$720 VALUE ADDED FOR CELL PHONE USAGE-$1,104 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$653 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,518) TOTAL--$23,036 IRA L. MOSS UNUSED SICK PAY-$4,730 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 VALUE ADDED FOR CELL PHONE USAGE-$646 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,843 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,208) PERSONAL USE OF EMPLOYER VEHICLES-$174 TOTAL--$25,505 JILL K. ELROD UNUSED SICK PAY-$5,314 VALUE ADDED FOR HEALTH & FITNESS USAGE-$720 VALUE ADDED FOR CELL PHONE USAGE-$3,099 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,242 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,018) VALUE ADDED FOR CABLE/INTERNET- $1,355 PERSONAL USE OF EMPLOYER VEHICLES-$183 TOTAL--$25,895 PEGGY J. GAVIN UNUSED SICK PAY-$4,045 VALUE ADDED FOR CELL PHONE USAGE-$1,123 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$5,487 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,036) PERSONAL USE OF EMPLOYER VEHICLES-$1,203 TOTAL--$26,822 DEBORAH D. OLDS UNUSED SICK PAY-$3,607 VALUE ADDED FOR HEALTH & FITNESS USAGE-$720 VALUE ADDED FOR CELL PHONE USAGE-$348 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$5,075 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,708) TOTAL--$6,042 DANIEL J. MOLLER, JR., M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$9,985 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,708) TOTAL--$24,277 CHARLES A. POWERS, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 VALUE ADDED FOR CELL PHONE USAGE-$1,467 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$7,772 SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,703) TOTAL--$23,856 PIERRE V. BLANCHARD,IV, M.D. SECTION 457(B) DEFERRED COMPENSATION PLAN-$18,000 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,304 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,518) TOTAL--$22,786 RANDALL P. BREWER, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$720 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$825 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,011) TOTAL--($5,466) MILAN G. MODY, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$557 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,958) TOTAL--($4,081) JOHN G. NOLES, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$558 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,958) TOTAL--($5,400) CHRISTOPHER SHELBY, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$561 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,958) TOTAL--($4,077) SARAH GLORIOSO, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$504 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,320 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,962) TOTAL--($3,138) EXPLANATION OF PART II, COLUMN (C) DEFERRED COMPENSATION THIS EMPLOYEE PARTICIPATES IN A DEFINED BENEFIT PENSION PLAN, THE CONTRIBUTIONS TO WHICH ARE ACTUARIALLY DETERMINED. THE AMOUNT SHOWN IS THE INCREASE IN THE ANNUAL VESTED BENEFIT AT NORMAL RETIREMENT FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2017 (NOT DISCOUNTED TO PRESENT VALUE) (NORMAL RETIREMENT IS AGE 65 WITH 5 YEARS OF PARTICIPATION). MR. ELROD HAS REACHED THE MAXIMUM BENEFIT UNDER THE PLAN. EXPLANATION OF PART II, COLUMN (D) NONTAXABLE BENEFITS INCLUDED IN THIS COLUMN IS THE COST OF THE FOLLOWING NONTAXABLE BENEFITS: LONG-TERM DISABILITY INCOME INSURANCE PLAN, GROUP TERM-LIFE INSURANCE, AND THE ESTIMATED COST OF SELF-FUNDED HEALTH INSURANCE PLAN. FRANK B HUGHES MD TRUSTEE 124616 RENT-BUILDING 0 PHILLIP A ROZEMAN MD TRUSTEE 6637 RENT-BUILDING 0 GREGORY J GAVIN FAMILY MEMBER OF PEGGY GAVIN, OFFICER 228389 EMPLOYMENT 0 CHARLES E MULLINS FAMILY MEMBER OF PEGGY GAVIN, OFFICER 96139 EMPLOYMENT 0 SHARLENE A BROUSSARD FAMILY MEMBER OF CLIFFORD BROUSSARD, OFFICER 55898 EMPLOYMENT 0 TODD J BLANCHARD FAMILY MEMBER OF PIERRE BLANCHARD, M.D., TRUSTEE 143818 EMPLOYMENT 0 PIERRE V BLANCHARD MD TRUSTEE 3644541 RENT-BUILDING, PURCHASED SERVICE AGREEMENT WITH LIFECARE HOSPITALS, INC., FOR WHICH PIERRE BLANCHARD, M.D. IS THE MEDICAL DIRECTOR 0 WILLIAM J COLE CPA TRUSTEE 2176183 ACCOUNTING, PAYROLL AND CONSULTING SERVICES PAID TO COLE, EVANS & PETERSON FOR WHICH WILLIAM J. COLE IS THE MANAGING PARTNER. 0 ARIEN WARD PYSD FAMILY MEMBER OF MARY JANE WARD, OFFICER 105737 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 1. FAMILY RELATIONSHIPS WITH JAMES K. ELROD - PRESIDENT, CEO, AND TRUSTEE MARGARET ELROD, SPOUSE - VP-MARKETING, LIVE OAK RETIREMENT COMMUNITY, QUICK CARE, OCCUPATIONAL MEDICINE, AND WELLNESS CENTERS JILL K. ELROD, DAUGHTER - VP OF LEGAL AFFAIRS JANET K. ELROD, DAUGHTER - VP AND ADMINISTRATOR OF WK SOUTH HOSPITAL FORM 990, PART VI, SECTION B, LINE 11B THE MEDICAL CENTER'S CPA FIRM PREPARES THE FORM 990 WITH THE ASSISTANCE OF SEVERAL OF THE MEDICAL CENTER'S EMPLOYEES. THE FORM 990 IS THEN REVIEWED BY THE MEDICAL CENTER'S PRESIDENT. AFTER THIS REVIEW, A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES, AND THE PRESIDENT, VICE-PRESIDENT AND CPA FIRM REVIEW AND DISCUSS THE FORM 990 WITH THE TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICTS OF INTEREST POLICY COVERS ALL "INTERESTED PERSONS." AN "INTERESTED PERSON" IS DEFINED AS ANY TRUSTEE, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN AN ENTITY WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A COMPENSATION ARRANGEMENT WITH THE MEDICAL CENTER OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. INTERESTED PERSONS HAVE A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST AND ALL MATERIAL FACTS RELATED TO THE PROPOSED TRANSACTION OR ARRANGEMENT TO THE TRUSTEES AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. THE INTERESTED PERSON IS ALLOWED TO MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION THE INTERESTED PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. IF THE BOARD OR COMMITTEE BELIEVES A MEMBER HAS VIOLATED THE CONFLICTS OF INTEREST POLICY, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE. IF THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. PERIODIC REVIEWS ARE CONDUCTED WHICH, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING. 2. WHETHER ACQUISITIONS OF GOODS OR SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 3. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 4. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION OF THE CEO OF THE MEDICAL CENTER. A SECOND COMPENSATION COMMITTEE DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEES STUDY DATA FROM INDEPENDENT SALARY SURVEYS (SUCH AS "MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS," WHICH IS AN ANNUAL SURVEY PREPARED BY SULLIVAN COTTER) TO UNDERSTAND COMPENSATION PAID TO SIMILARLY QUALIFIED INDIVIDUALS IN COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE COMPENSATION COMMITTEES ALSO COMPILE DATA FROM OTHER TAX-EXEMPT HEALTH SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AND USE THAT INFORMATION AS COMPARATIVE COMPENSATION. THE COMMITTEES USE THE INFORMATION FROM THESE SOURCES AS BENCHMARKS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION. THE COMMITTEES ALSO CONSIDER OTHER FACTORS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION, SUCH AS LENGTH OF EMPLOYMENT AND THEIR RESPONSIBILITIES. THE EXECUTIVE COMPENSATION COMMITTEE PERIODICALLY HIRES INDEPENDENT CONSULTANTS FOR ANALYSIS OF THE COMPENSATION OF THE MEDICAL CENTER'S CEO. THE COMMITTEES MAINTAIN CONTEMPORANEOUS DOCUMENTATION OF THE BASIS FOR THEIR DECISIONS REGARDING COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 WILLIS-KNIGHTON MEDICAL CENTER'S GOVERNING DOCUMENTS AND ITS CONFLICT OF INTEREST POLICY ARE AVAILABLE ON ITS WEBSITE: WWW.WKHS.COM. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.EMMA.MSRB.ORG. FORM 990, PART XI, LINE 9: FASB ASC 715-30 PENSION 92,179,804. FORM 990, PART XII, LINE 2C WILLIS-KNIGHTON MEDICAL CENTER DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DUING THE YEAR ENDED 9/30/17. 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