2017-06-20T09:45:13-05:00 2016-09-30 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2015-10-01 462605366 UNIVERSITY HOSPITAL & CLINICS INC UNIV 3372616004 2390 WEST CONGRESS LAFAYETTE LA 70506 KATHERINE D HEBERT VP CHIEF EXECUTIVE OFFICER 3372616004 2017-06-13 1 AMIE T WHITTINGTON CPA P01082167 6013261000 2017-05-24 2015 2021-01-29 14:40:06Z KATHERINE D HEBERT 2390 WEST CONGRESS LAFAYETTE LA 70506 145984978 0 X N/A X 2013 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. THE ORGANIZATION ALSO SERVES THE COMMUNITY BY OPERATING AS A TEACHING FACILITY. 4 2 847 30 2949575 -446250 16026275 269207 150069353 117758079 917 8749 7654924 27948943 173751469 145984978 4493 4673 0 0 41243180 43129546 0 0 0 137484240 127022064 178731913 170156283 -4980444 -24171305 47874338 54088070 15349179 28113710 32525159 25974360 X THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 132399763 4673 142757447 UNIVERSITY HOSPITAL AND CLINICS (UHC) WAS CREATED ON JUNE 24, 2013, AS A WHOLLY-OWNED SUBSIDIARY OF LAFAYETTE GENERAL HEALTH SYSTEM, AND WAS CREATED AS THE RESULT OF A COOPERATIVE ENDEAVOR AGREEMENT BETWEEN THE STATE OF LOUISIANA, LOUISIANA STATE UNIVERSITY, AND LAFAYETTE GENERAL HEALTH TO PROVIDE FOR THE OPERATION OF THE FORMER UNIVERSITY MEDICAL CENTER, ONE OF THE TEN (10) SAFETY-NET HOSPITALS PREVIOUSLY OPERATED BY LOUISIANA STATE UNIVERSITY THROUGH THEIR LSU HEALTH SYSTEM. UHC A GENERAL ACUTE CARE HOSPITAL PROVIDING THE NORMAL COMPLIMENT OF BOTH INPATIENT AND OUTPATIENT SERVICES, PROVIDING BOTH INPATIENT AND OUTPATIENT MEDICAL CARE, DIAGNOSTIC TESTING AND THERAPY SERVICES TO THOSE SEEKING CARE. HEALTHCARE SERVICES ARE PROVIDED ON A CONTINUOUS BASIS, TWENTY-FOUR HOURS PER DAY, SEVEN DAYS PER WEEK. TRADITIONALLY AND CURRENTLY, THIS FACILITY HAS BEEN THE MEDICAL CARE PROVIDER TO WHICH THOSE WHO WERE UNINSURED OR OTHERWISE UNABLE TO PAY FOR THEIR HEALTHCARE SERVICES TURNED TO FOR THOSE SERVICES. THROUGH AN AGREEMENT WITH THE LSU SCHOOL OF MEDICINE IN NEW ORLEANS, UHC ALSO PROVIDES GRADUATE MEDICAL EDUCATION THROUGH A NUMBER OF RESIDENCY PROGRAMS WHICH PROVIDE THE PHYSICIAN SERVICES FOR SEVERAL OUTPATIENT PRIMARY CARE AND SPECIALTY CARE CLINICS. THE ENTIRE PURPOSE OF THE ORGANIZATION IS TO PROVIDE INPATIENT AND OUTPATIENT MEDICAL CARE AND GRADUATE MEDICAL EDUCATION TO PROVIDE FOR THE MEDICAL NEEDS OF THE CITIZENS OF THE ACADIANA REGION OF SOUTH LOUISIANA. THE MAJORITY OF THE MEDICAL CARE PROVIDED AT UHC IS PROVIDED BY BOTH MEDICAL RESIDENTS AND STAFF PHYSICIANS. UHC EMPLOYS NURSING AND OTHER ANCILLARY PROFESSIONALS TO PROVIDE NON-PHYSICIAN HEALTHCARE SERVICES AND SUPPORT TO THE PATIENTS FOR WHOM WE PROVIDE CARE. ADDITIONALLY, UHC ALSO EMPLOYS SOME PHYSICIAN PROVIDERS, TO PROVIDE CARE DIRECTLY. UHC PROVIDES CARE FOR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, BASED UPON WRITTEN GUIDELINES WHICH ALLOWS UHC TO PROVIDE CARE TO PATIENTS WITH VARYING FINANCIAL MEANS TO PAY FOR THAT CARE. THROUGH THE AGREEMENT WITH THE STATE OF LOUISIANA, UHC RECEIVES SOME REIMBURSEMENT FOR PATIENTS WHO QUALIFY FOR "FREE CARE", WITH A MAXIMUM ON THE AMOUNT THAT THE STATE WILL REIMBURSE THE HOSPITAL. THE HOSPITAL HAS ALSO ENTERED INTO CONTRACTS AND AGREEMENTS WITH VARIOUS STATE AND FEDERAL HEALTHCARE REIMBURSEMENT PROGRAMS, SUCH AS MEDICAID AND MEDICARE, AS WELL AS PRIVATE INSURANCE PLANS TO REIMBURSE THE HOSPITAL FOR SERVICES PROVIDED TO THEIR BENEFICIARIES.IN ADDITION TO THE TRADITIONAL HOSPITAL SERVICES, UHC OPERATES SEVERAL CLINICS WHICH PROVIDE ONGOING MEDICAL CARE TO PATIENTS. THESE CLINICS OPERATE MONDAY THROUGH FRIDAY AND OPERATE JUST LIKE PRIVATE PHYSICIAN OFFICES. THEY ARE STAFFED BY NURSE PRACTITIONERS AND BY STAFF PHYSICIANS WHO SUPERVISE MEDICAL RESIDENTS, ALLOWING THEM TO GAIN VALUABLE CLINICAL EXPERIENCE AS PART OF THEIR MEDICAL RESIDENCY TRAINING. UHC HAS THREE "HOME-BASED" RESIDENCY PROGRAMS PROVIDING GRADUATE MEDICAL EDUCATION IN FAMILY MEDICINE, INTERNAL MEDICINE, AND A FELLOWSHIP PROGRAM IN GERIATRIC MEDICINE, OPERATED THROUGH THE FAMILY MEDICINE DEPARTMENT. IN ADDITION, UHC OPERATES SEVERAL ROTATING RESIDENCIES THAT ALLOWS RESIDENTS IN RESIDENCY PROGRAMS BASED IN NEW ORLEANS AT THE LSU SCHOOL OF MEDICINE TO SPEND PART OF THEIR RESIDENCY AT UHC PROVIDING CARE FOR OUR PATIENTS AND RECEIVING CLINICAL EXPERIENCE IN THEIR FIELD OF MEDICAL SPECIALTY. THESE RESIDENCIES ARE IN THE SPECIALTIES OF GENERAL SURGERY, OTORHINOLARYNGOLOGY, GYNECOLOGY, ORTHOPEDIC SURGERY, AND OPHTHALMOLOGY.UHC ALSO OPERATES A MEDICAL LIBRARY, STAFFED BY A DEGREED MEDICAL LIBRARIAN WHICH SERVES AS LEARNING RESOURCE CENTER FOR THE REGIONAL AREA HEALTH EDUCATION CENTER (AHEC) WHICH PROVIDES OUTREACH TO AREA HEALTH PROFESSIONALS AND POTENTIAL HEALTHCARE PROFESSIONALS, PROVIDING THEM TOOLS TO OBTAIN INFORMATION REGARDING HEALTHCARE CAREERS, AND RESEARCH ON SPECIFIC HEALTHCARE AND MEDICAL ISSUES.PROGRAM SERVICES STATISTICS RELATED TO PROVIDING COMMUNITY MEDICAL CARE FOR THE HOSPITAL DURING FYE 9/30/16 WERE: 13,684 TOTAL ACUTE PATIENT DAYS, 47,561 EMERGENCY ROOM VISITS AND 2,614 SURGERIES (INPATIENT AND OUTPATIENT).UNIVERSITY HOSPITAL & CLINICS HAS ACHIEVED STAGE 6 OF THE HIMSS ANALYTICS ELECTRONIC MEDICAL RECORD (EMR) ADOPTION MODEL. THIS DISTINCTION HONORS AN ORGANIZATION'S ACCOMPLISHMENTS TO IMPLEMENT TECHNOLOGY SOLUTIONS THAT HAVE THE ABILITY TO IMPROVE PATIENT SAFETY AND QUALITY OF CARE. CURRENTLY ONLY 29% (1,600) HOSPITALS IN THE UNITED STATES CARRY A STAGE 6 DESIGNATION. UNIVERSITY HOSPITALS & CLINICS IS A GREAT EXAMPLE OF HOW A VISION CAN BECOME REALITY IN THE WORLD OF HEALTHCARE INFORMATION TECHNOLOGY. IT TAKES COMMITMENT, SUPPORT AND A GREAT TEAM OF HEALTHCARE PROFESSIONALS TO ACHIEVE THIS PINNACLE LEVEL. UHC ALSO BECAME A PUBLIC MEDICAID ENROLLMENT CENTER. 132399763 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 83 0 1 847 1 1 1 0 0 0 0 0 0 0 X 4 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KATHERINE D HEBERT 3372616004 2390 WEST CONGRESS LAFAYETTE LA 70506 X JARED STARK CEO/VP - PART YEAR 40.00 X X 0 387332 73039 JAMES B FALTERMAN JR MD MEDICAL DIRECTOR 40.00 X 0 0 0 DAVID CALLECOD PRESIDENT/CEO 1.00 46.00 X X 0 1244305 238025 BETTY D BROWN TRUSTEE - NON VOTING 1.00 X 0 0 0 ALLEN J CELESTINE TRUSTEE - NON VOTING 1.00 X 0 0 0 JOBY JOHN TRUSTEE 1.00 2.00 X 0 0 0 ROSEMARY ST CLERGY MD SECRETARY - NON VOTING 1.00 X 0 0 0 DESIREE C AUZENNE TRUSTEE - NON VOTING 1.00 X 0 0 0 KATHERINE D HEBERT CEO/VP - PART YEAR 40.00 X X 0 298156 49954 LAURENCE VINCENT CNO 40.00 X 0 164499 3306 BRIAN KIRK CFO/VP 40.00 X 0 197799 30360 CHRISTY E LEE NURSE PRACTITIONER 43.70 X 0 167706 4122 TRUDI GAIL HOPPER LUQUETTE PHARMACIST 41.40 X 0 164913 0 WENDY DEAN-COLOMB PHYSICIAN 40.00 X 0 476609 5317 LAUREN S MYERS PHARMACIST 40.67 X 0 149167 1847 BLAIR CHISUM ERWIN PHARMACIST 40.13 X 0 143932 6183 0 3394418 412153 31 0 1 0 LSU HSC-NEW ORLEANS 433 BOLIVAR STREET NEW ORLEANS LA 70112 RESIDENTS AND FACULTY, TRANSITIONS SERVI 25613223 ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 60673 HOUSEKEEPING AND DIETARY 4011929 CONGRESS EMERGENCY GROUP LLC PO BOX 82368 LAFAYETTE LA 70598 ER PROVIDER 3494121 MEDICAL IMAGING ASSOCIATES OF LA PO BOX 60074 LAFAYETTE LA 70596 RADIOLOGIST PROVIDER 1625088 PARISH ANESTHESIA OF LAFAYETTE PO BOX 7250 METAIRIE LA 70010 ANESTHESIA PROVIDER 1358442 30 32240 236967 269207 PATIENT REVENUE 621990 117758079 117758079 117758079 8749 8749 OUTPATIENT LAB 621500 22945421 20667165 2278256 OTHER REVENUE 900099 2646752 1975433 671319 E.H.R REVENUE 900099 2356770 2356770 27948943 145984978 142757447 2949575 8749 4673 4673 1047786 1047786 35831509 32480315 3351194 563330 529549 33781 3093729 2819471 274258 2593192 2372760 220432 14197970 14197970 836 768 68 1502181 1350091 152090 17722718 1920622 15802096 75064 62648 12416 75841 52441 23400 812870 186935 625935 49205 49205 CONTRACT LABOR 39061126 37474890 1586236 BAD DEBT EXPENSE 30525459 30525459 MEDICAL SUPPLIES 18832727 18832727 EQUIPMENT RENTAL & MAIN 3911302 3544356 366946 254765 192853 61912 170156283 132399763 37756520 0 742511 5960 9140752 11408642 2134989 1957318 15790500 15790500 7032242 1686602 4385493 5345640 15680093 19580010 47874338 54088070 14053090 26739616 1296089 1374094 15349179 28113710 X 32525159 25974360 32525159 25974360 47874338 54088070 X -24171305 17620506 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 8668 195488 8668 195488 132391095 741511044 132399763 741706532 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 3000000 4500000 189962 174268 195488 559718 250000 250000 250000 750000 1125000 189962 174268 195488 559718 FORM 990, SCHEDULE C, PART II-A LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH THE LOUISIANA HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THIS ORGANIZATION ARE USED. ALSO, A MINIMAL AMOUNT WAS SPENT TO HAVE LUNCHES WITH VARIOUS LEGISLATURES. 858013 46776 811237 5493308 1639826 3853482 680921 680921 5345640 THIRD PARTY PAYABLE 19274352 DEPOSITS 116415 OTHER ASSETS 167117 INTERCOMPANY RECEIVABLES 22126 19580010 INTERCOMPANY PAYABLE 1374094 1374094 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 1 1 44150499 48881362 -4730863 0.00000 46083075 18856254 27226821 0.19500 90233574 67737616 22495958 0.19500 916 916 0.00000 4673 4673 0.00000 5589 5589 90239163 67737616 22501547 0.19500 1 30525459 17399512 13789742 16675704 -2885962 X 1 1 1 1 UNIVERSITY HOSPITAL & CLINIC INC 2390 WEST CONGRESS STREET LAFAYETTE LA 70506 X X X X X UNIVERSITY HOSPITAL & CLINICS INC 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS X 1 14 0 1 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_UHC_010416. X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FINANCIAL_ASSIS X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FINANCIAL_ASSIS X X X X X X 1 0 X X X X 1 X 0 0 UNIVERSITY HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY GATHERING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVICED BY THE HOSPITAL FACILITY, AS WELL AS INDIVIDUALS PROVIDING INPUT WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. IT IS MEANT TO PROVIDE DEPTH AND RICHNESS TO THE QUANTITATIVE DATA COLLECTED. ADDITIONALLY, FOCUS GROUPS WERE CONDUCTED TO ALLOW PARTICIPANTS TO PROVIDE INFORMATION ABOUT THEIR EXPERIENCES IN THE COMMUNITY AND WAYS IN WHICH THEY THINK THE SERVICES AND RESOURCES PROVIDED TO THE COMMUNITY CAN BE IMPROVED.COMMUNITY LEADER INTERVIEWEES:MANDI MITCHELL, DIRECTOR OF GOV. AFFAIRS, LA DEPT. OF ECONOMIC DEVELOPMENTREBECCA BENOIT, CHIEF NURSING OFFICER, LGMCDR. BRYAN SIBLEY, PEDIATRICIANCLAY ALLEN, CHAIRMAN OF THE BOARD OF TRUSTEES, UHCDAVID CALLECOD, PRESIDENT AND CEO, LAFAYETTE GENERAL HEALTHFLO MEADOWS, BOARD OF TRUSTEES MEMBER, UHCDR. GARY GUIDRY, PULMONOLOGIST AND BOARD OF TRUSTEES MEMBER, UHCJEANETTE ALCON, EXECUTIVE DIRECTOR, LAFAYETTE COMMUNITY HEALTHCARE CLINICJOEY DUREL, PRESIDENT, LAFAYETTE CITY-PARISHMARIA PLACER, EXECUTIVE DIRECTOR, 232-HELPPATRICK GANDY, COO, LGMCPAULA WALTERS, EXECUTIVE DIRECTOR, LAFAYETTE COUNCIL ON AGINGPHILIP GACHASSIN, BARIATRIC SURGEON, ACADIANA WEIGHT LOSS SURGERYRAYMOND HEBERT, EXECUTIVE DIRECTOR, COMMUNITY FOUNDATION OF ACADIANAZIAD ASHKAR, CHIEF MEDICAL OFFICER, UHCMARGARET TRAHAN, UNITED WAY OF ACADIANALOUIS HEBERT, HOSPICE FOUNDATION OF ACADIANA, INC.DR. PHILLIP CAILLOUET, PROFESSOR, UNIVERSITY OF LOUISIANA AT LAFAYETTEJARED STARK, CEO, UHCDR. LINDA OGE, FAMILY PRACTICE PHYSICIANLAURENCE VINCENT, CHIEF NURSING OFFICER, UHCDR. JOBY JOHN, DEAN AT COLLEGE OF BUSINESS, UNIVERSITY OF LA @ LAFAYETTECAROLYN HUVAL, VP, LAFAYETTE GENERAL MEDICAL CENTERMARGARET DURAND, CEO, SOUTHWEST LOUISIANA AREA HEALTH EDUCATION CENTERDR. JAMES FALTERMAN, JR., DESIGNATED INSTITUTIONAL OFFICE, UHCDR. ROSEMARY ST. CLERGY, UHC BOARD MEMBER; MEDICAL DIR. OF ACADIANA AMBULANCEVINCENT PIERRE, STATE REPRESENTATIVE UNIVERSITY HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: PLEASE SEE ATTACHED IMPLEMENTATION STRATEGY, ADOPTED AND EXECUTED BY THE HOSPITAL, FOR A DESCRIPTION OF HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.THE FOLLOWING NEEDS WERE NOT ADDRESSED FOR THE FOLLOWING REASONS:OVERWEIGHT AND OBESITY: UHC HAS CHOSEN TO ADDRESS THIS PRIORITY THROUGH IT BEHAVIORAL RISK FACTOR STRATEGIES. BOTH OF THE STRATEGIES AIMED AT IMPROVING HEALTH BEHAVIORS WILL ALSO HELP REDUCE OVERWEIGHT AND OBESITY RATES. HEALTHCARE ACCESS & AVAILABILITY: NOW UNDER THE DIRECTION OF LAFAYETTE GENERAL HEALTH, THE HOSPITAL IS FOCUSED ON REVIVING ITS SERVICE LINES AND OPERATING AT ITS FULL POTENTIAL. DESPITE ITS CURRENT STATE OF REJUVENATION, UHC STILL SERVES AS THE PRIMARY CHARITY HOSPITAL IN THE ACADIANA REGION. ONCE IT REACHES THE APPROPRIATE OPERATIONAL CAPACITY AND FUNCTION, UHC HOPES TO CREATE STRATEGIES FOR NEW WAYS TO SERVE THE COMMUNITY. UNIVERSITY HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 16I: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. 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 $ 30,525,459. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL OFFERS A VARIETY OF SPECIALISTS, AND CONTINUES TO RECRUIT PHYSICIANS TO OUR AREA TO ENSURE THAT THE HOSPITAL WILL CONTINUE TO BE THE FULL SERVICE HEALTHCARE PROVIDER THAT THE COMMUNITY EXPECTS. THE HOSPITAL JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS TO PROVIDE HEALTHCARE SCREENINGS AND TEST AT LOCAL EVENTS. PART 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 ORGANIZATION'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS REMAINED AT 99% OF SELF PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2016 AND 2015. 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.THE ORGANIZATION DID NOT CHANGE ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2016 OR 2015.BAD DEBT EXPENSE EQUALS THE BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS.THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BOTH CHARITY AND BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT 57% OF THE UNINSURED OUTPATIENT EMERGENCY ROOM VISITS THAT WERE ADJUSTED TO BAD DEBT MAY HAVE BEEN PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION.THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE ESTIMATED BASED ON PREVIOUS COST REPORTS FILED WHEN THE HOSPITAL WAS A GOVERNEMNT RUN HOSPITAL. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. PART III, LINE 9B: WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE, WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. PART III, LINES 2 & 3 BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT AT LEAST 57% OF THE TOTAL SELF PAY REVENUE IN BAD DEBT WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY. HOWEVER, SINCE NECESSARY DOCUMENTATION WAS NOT COMPLETED, THIS AMOUNT WAS INSTEAD WRITTEN OFF TO BAD DEBT. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. HOWEVER, HOSPITAL BELIEVES THAT THE COST OF THIS BAD DEBT IS A COMMUNITY BENEFIT BECAUSE BY CONTINUING TO TREAT PATIENTS THAT ARE UNABLE TO AFFORD CARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL CARE. PART VI, LINE 2: A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR YEAR ENDING 9/30/15. WE ENGAGED AN OUTSIDE CONSULTANT TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT DURING LATE 2014/EARLY 2015. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS. IN ADDITION, THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. PART VI, LINE 3: THE HOSPITAL COMPLIES WITH FEDERAL AND JACHO REQUIREMENTS OF POSTING NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS. HANDOUTS ARE INCLUDED WITH THE ADMISSION PACKAGE THAT INFORMS THE PATIENT OF CONTACT INFORMATION TO DISCUSS PAYMENT OPTIONS. THE HOSPITAL IS A MEDICAID ENROLLMENT FACILITY, AND AS SUCH, THE HOSPITAL OFFERS SCREENING SERVICES FOR ELIGIBILITY FOR MEDICAID AND POSSIBLE CHARITY CARE ASSISTANCE. PART VI, LINE 4: THE HOSPITAL SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED AS ACADIANA AS THE LARGEST, FULL SERVICE, ACUTE CARE MEDICAL CENTER. APPROXIMATELY ONE THIRD OF THE HOSPITAL'S DISCHARGES COME FROM LAFAYETTE PARSIH. THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE WITHOUT REGARD TO THEIR ABILITY TO PAY. PART VI, LINE 5: THE MAJORITY OF UHC'S BOARD IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. ONLY 2 ARE EMPLOYEES. UHC, SINCE INCEPTION HAS NEVER MADE A SURPLUS AND BY CEA DESIGN, NEVER WILL MAKE A SURPLUS. UHC TAKES CARE OF THE POOR AND INDIGENT IN OUR COMMUNITY AND RECEIVES A COST REPORT SUBSIDY THAT ONLY COVERS ALLOWABLE COSTS. LGH SYSTEM INVESTED MORE THAN $4 MILLION ON AN ELECTRONIC MEDICAL RECORD TO IMPROVE PATIENT SAFETY, SATISFACTION, AND EFFICIENCY. UHC IS A TEACHING HOSPITAL WHICH TRAINS HUNDREDS OF RESIDENTS IN VARIOUS PROGRAMS TO HELP THEM BECOME DOCTORS. UHC EXEMPLIFIED COMMUNITY OUTREACH BY OFFERING FREE MAMMOGRAMS, BREAST SCREENING AND FOLLOW UP CARE TO ELIGIBLE PATIENTS BY WORKING WITH SUSAN G. KOMEN, INC. AND THE LOUISIANA BREAST & CERVICAL HEALTH PROGRAM. LOUISIANA EXCEEDS THE NATIONAL AVERAGE IN BREAST CANCER DEATHS, LARGELY DUE TO LATE OR INCURABLE-STAGE DIAGNOSIS, AND UHC IS NOW HELPING COMBAT THAT. 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. PART VI, LINE 7, REPORTS FILED WITH STATES LA X X X X 1 0 X X X X X 1 1 0 0 0 1 1 0 0 JARED STARK CEO/VP - PART YEAR 0 310679 0 64078 0 12575 0 65400 0 7639 0 460371 0 0 DAVID CALLECOD PRESIDENT/CEO 0 835637 0 344735 0 63933 0 231626 0 6399 0 1482330 0 0 KATHERINE D HEBERT CEO/VP - PART YEAR 0 244635 0 40158 0 13363 0 42572 0 7382 0 348110 0 0 LAURENCE VINCENT CNO 0 146341 0 18158 0 0 0 3306 0 0 0 167805 0 0 BRIAN KIRK CFO/VP 0 175873 0 21926 0 0 0 25513 0 4847 0 228159 0 0 CHRISTY E LEE NURSE PRACTITIONER 0 167293 0 413 0 0 0 3386 0 736 0 171828 0 0 TRUDI GAIL HOPPER LUQUETTE PHARMACIST 0 164500 0 413 0 0 0 0 0 0 0 164913 0 0 WENDY DEAN-COLOMB PHYSICIAN 0 400000 0 50306 0 26303 0 0 0 5317 0 481926 0 0 LAUREN S MYERS PHARMACIST 0 148754 0 413 0 0 0 1847 0 0 0 151014 0 0 BLAIR CHISUM ERWIN PHARMACIST 0 143519 0 413 0 0 0 2958 0 3225 0 150115 0 0 PART I, LINE 1A THE ORGANIZATION DOES ALLOW FOR SPOUSAL TRAVEL FOR THE TRUSTEES AND OFFICERS. SUCH EXPENSES ARE REPORTED ON THEIR W-2'S OR 1099'S. SOCIAL CLUB DUES AND HOUSING ALLOWANCE WAS PAID FOR THE CEO/VP AND WAS INCLUDED AS COMPENSATION ON HIS W-2. PART I, LINES 4A-B THE FOLLOWING EMPLOYEES RECEIVED SEVERANCE PAYMENTS DURING 9/30/16 - IN TOTAL THE PAYMENTS WERE, AS FOLLOWS, AND WERE INCLUDED IN THEIR W-2S FOR 2016 AND 2017. BRIAN KIRK - $79,843 JARED STARK - $300,000 A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED EFFECTIVE JANUARY 01,2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WAS $349,200. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE DAVID CALLECOD, CHAIRMAN, BRIAN KIRK, CFO, JARED STARK, CEO, AND KATHERINE HEBERT, COO. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2015 W-2 WAGES, TOTALLED $85,833. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2015 W-2 WAGES: DAVID CALLECOD, PRESIDENT/CEO-LGHS & KATHERINE D HEBERT, COO PART I, LINE 6 THE ORGANIZATION DOES HAVE AN INCENTIVE PLAN FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS', AS LISTED ON PART VII OF FORM 990, CALCULATION OF INCENTIVE PLAN PAYMENTS ARE IN PART BASED ON THE CONSOLIDATED NET EARNINGS. 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 11 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. PART VII, SECTION B, INDEPENDENT CONTRACTORS LAFAYETTE GENERAL HEALTH SYSTEMS, INC. (LGHS), A RELATED ORGANIZATION, PAID ALL CONTRACTORS ON BEHALF OF UNIVERSITY HOSPITAL AND CLINICS (UHC), AND UHC REIMBURSED LGHS FOR THESE PAYMENTS. ALL 1099S WERE ISSUED BY LGHS. THE INFORMATION LISTED REFLECTS THE TOTALS THAT WOULD HAVE BEEN REPORTED HAD UHC MADE THE PAYMENTS THEMSELVES. FORM 990, PART XI, LINE 9: FORGIVENESS OF DEBT BY PARENT COMPANY 17,620,506. FORM 990, PART XII, LINE 2C THE PROCESS FOR OVERSIGHT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR. ST MARTIN HOSPITAL INC 210 CHAMPAGNE BOULEVARD BREAUX BRIDGE LA 70517 264626264 HOSPITAL LA 501(C)(3) 170(B)(1)(A)(III) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 LAFAYETTE GENERAL HEALTH SYSTEMS INC 1214 COOLIDGE STREET LAFAYETTE LA 70503 383646817 HEALTHCARE SUPPORT LA 501(C)(3) 509(A)(3) 0 LAFAYETTE HEALTH VENTURES INC PO BOX 53092 LAFAYETTE LA 70503 721006966 PHYSICIAN PRACTICES LA 501(C)(3) 509(A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 LAFAYETTE GENERAL MEDICAL CENTER INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 720535375 HOSPITAL LA 501(C)(3) 170(B)(1)(A)(III) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 464958152 HOSPITAL LA 501(C)(3) 170(B)(1)(A)(III) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 LAFAYETTE GENERAL FOUNDATION INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 371766778 FOUNDATION LA 501(C)(3) 509(A)(3) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 KAPLAN GENERAL HOSPITAL DBA ABROM KAPLAN MEMORIAL HOSPITAL 1214 COOLIDGE BLVD LAFAYETTE LA 70503 472540179 HOSPITAL LA 501(C)(3) 170(B)(1)(A)(III) LAFAYETTE GENERAL HEALTH SYSTEMS INC 0 LAFAYETTE INVESTMENT GROUP LLC 1000 W PINHOOK SUITE 206 LAFAYETTE LA 70503 421594593 MANAGEMENT LA N/A LAFAYETTE GENERAL SURGICAL HOSPITAL LLC 1000 W PINHOOK LAFAYETTE LA 70503 481300080 SURGICAL HOSPITAL LA N/A OIL CENTER SURGICAL PLAZA LLC 1000 W PINHOOK STE 204 LAFAYETTE LA 70503 464090110 SURGERY CENTER LA N/A ACADIANA RADIATION THERAPY LLC 104 WOODMONT BLVD STE 500 NASHVILLE TN 37205 471752607 RADIATION CENTER TN N/A 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 1 LAFAYETTE GENERAL MEDICAL CENTER 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 720535375 X 0 0 0 451173960 451173960 1000000 250000 0 0 0 ST MARTIN HOSPITAL 210 CHAMPAGNE BOULEVARD BREAUX BRIDGE LA 70517 264626264 X 4019 0 4019 17780620 17784639 1000000 250000 0 0 0 UNIVERSITY HOSPITAL AND CLINICS INC 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 462605366 X 8668 0 8668 132391095 132399763 1000000 250000 0 0 0 ACADIA GENERAL HOSPITAL INC 1305 CROWLEY RAYNE HWY CROWLEY LA 70526 464958152 X 7056 0 7056 37281667 37288723 1000000 250000 0 0 0 LAFAYETTE GENERAL HEALTH SYSTEMS INC 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 383646817 X 174280 0 174280 89588644 89762924 1000000 250000 0 0 0 LAFAYETTE GENERAL FOUNDATION 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 371766778 X 0 0 0 527246 527246 104087 26022 0 0 0 KAPLAN GENERAL HOSPITAL 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 472540179 X 1465 0 1465 12767812 12769277 788464 197116 0 0 0