2017-05-15T15:42:21-05:00 2016-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2015-07-01 463123178 OUR LADY OF THE ANGELS HOSPITAL INC % JEFF LIMBOCKER OURL 9857306700 5000 Hennessy Boulevard Baton Rouge LA 70808 JEFF LIMBOCKER REGIONAL CFO 2257656565 2017-05-14 true RYAN HOOKS P00746825 2253444000 2015 2021-01-29 14:40:06Z RENE RAGAS 433 PLAZA STREET BOGALUSA LA 70427 67387681 false 0928 X N/A X 2013 LA TO PROVIDE FOR THE CARE OF THE ILL, INJURED OR DISABLED PERSONS & TO PROVIDE FOR RESEARCH, EDUCATION, & ENHANCEMENT OF THOSE IN & SURROUNDING WASHINGTON PARISH 11 9 593 13 0 115291 1242958 51509747 66142462 0 2261 0 0 51625038 67387681 2900 0 0 0 24206040 29312940 0 0 0 33308820 31394893 57517760 60707833 -5892722 6679848 13397957 25742711 7578815 18763639 5819142 6979072 X SEE Schedule O false false 33389308 66142462 OUR LADY OF THE ANGELS HOSPITAL, INC. PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES PRIMARILY TO RESIDENTS OF SOUTHEAST LOUISIANA. THE HOSPITAL IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE HOSPITAL HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. THE HOSPITAL PROVIDED 98 LICENSED BEDS AND 9,164 INPATIENT DAYS IN THE YEAR ENDED JUNE 30, 2016. 33389308 true true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 22 0 true 593 true false false false false false false false false false false X 11 9 false false false false true true true true true false false true true true true false false false false false X JEFF LIMBOCKER 2257656565 5000 HENNESSY BLVD BATON ROUGE LA 70808 X JOHN FINAN JR CHAIRMAN 2.0 50.5 X X 0 2180808 69464 SENATOR BEN NEVERS DIRECTOR 2.0 0.0 X 0 0 0 CHARLES MIZELL DIRECTOR 2.0 0.0 X 0 0 0 REV BOB ADAMS CHAIRMAN 2.0 0.0 X 0 0 0 ROGER KEESE SECRETARY 2.0 2.0 X 0 0 0 BERNIE CHASCIN DIRECTOR 2.0 0.0 X 0 0 0 CRAIG ROBICHAUX DIRECTOR 2.0 0.0 X 0 0 0 CHRIS TREVINO MD DIRECTOR 2.0 0.0 X 0 0 0 SR MARGARIDA VASQUES DIRECTOR 2.0 3.5 X 0 0 0 SR UYEN VU DIRECTOR 2.0 0.5 X 0 0 0 RENE RAGAS PRESIDENT & CEO 2.0 48.0 X X 0 339206 53054 SR EILEEN ROWE BOARD MEMBER 2.0 2.5 X 0 0 0 JUDITH WAMSLEY BOARD MEMBER 2.0 0.0 X 0 0 0 JEFF LIMBOCKER CFO 2.0 58.0 X 0 519277 65898 RALPH SERPAS CNO 40.0 0.0 X 161024 0 30251 HAMID HUSSAIN PHYSICIAN 40.0 0.0 X 216223 0 18724 Christopher FRITZSCHE PHYSICIAN 40.0 0.0 X 175680 0 19710 JOSEPH C BRUNO PHYSICIAN 40.0 0.0 X 135221 0 12560 MARIA CHRIST BEUNAFLOR PHYSICIAN 40.0 0.0 X 130767 0 7877 GARLAND ANDERSON PHYSICIAN 40.0 0.0 X 204960 0 30940 1023875 3039291 308478 25 false true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Mangement Fees 2118337 Trimedex 5451 Lakeview Parkway S Drive Indianapolis IN 46268 Clinical Maintenance 652000 Regional Radiology LLC PO Box 1608 Kenner LA 700631608 Radiologist Services 650000 Van Meter Emergency Physicians PO Box 636343 Cincinnati OH 452636343 ER Physician Service 612500 Acadiana Computer System Inc 324 Dulles Drive Lafayette LA 70506 Billing Services 420534 13 1065672 114803 62483 1242958 PATIENT SERVICE REVENUE 900099 65147897 65147897 PHARMACY SALES 900099 741868 741868 CAFETERIA SALES 900099 145564 145564 PURCHASE DISCOUNTS 900099 45561 45561 GIFT SHOP 900099 25509 25509 36063 36063 66142462 2261 2261 0 0 0 0 0 0 0 0 0 0 67387681 66142462 2261 X 0 0 0 0 159848 87916 71932 0 24510307 13480669 11029638 814606 448033 366573 2079301 1143616 935685 1748878 961883 786995 7119679 3915824 3203855 91947 50571 41376 0 0 0 0 8966065 4931336 4034729 674 371 303 5535254 3044390 2490864 1630 896 734 0 5358052 2946928 2411124 55868 30727 25141 0 0 0 0 59549 32752 26797 633920 348656 285264 Medical Supplies Expense 3572255 1964740 1607515 60707833 33389308 27318525 0 369047 7473126 0 0 0 0 6194246 9981054 0 0 0 0 0 0 701475 726813 5474589 5580676 2048081 81661 658048 1966420 0 0 0 0 0 0 0 0 552 14622 13397957 25742711 5927372 4718370 0 0 25000 0 0 0 0 0 0 0 0 0 0 0 1626443 14045269 7578815 18763639 X 5818791 6660792 351 318280 0 0 5819142 6979072 13397957 25742711 X 6679848 -5519918 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 125000 125000 730857 31132 699725 293226 50529 242697 898998 898998 1966420 0 DUE TO AFFILIATES 12136365 DEFINED CONTRIBUTION PAYABLE 461301 OTHER LIABILITIES 1447603 14045269 X FIN 48 (ASC 740) FOOTNOTE Form Sch D Part X Line 2 FMOLHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. true true true X false true true true false false 14514974 14514974 0.00000 11536432 11536432 26051406 26051406 0.00000 4935167 45253 4889914 0.08050 4935167 45253 4889914 0.08050 30986573 26096659 4889914 0.08050 false 10355863 7491863 11005262 -3513399 X true true 1 1 OUR LADY OF THE ANGELS HOSPITAL INC 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 WWW.OLOAH.ORG 2203781960 X X X X OUR LADY OF THE ANGELS HOSPITAL INC 1 false false true X X X X X X X X X 15 true false false true X See supplemental information true 15 false true false true X 200. 0. X X X true true X X true X X X X X X true X false X X X X true X false false Part V, Line 5 THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM THE COMMUNITY BY CONDUCTING EIGHT FOCUS GROUP SESSIONS AS WELL AS CONDUCTING SEMI-STRUCTURED INTERVIEWS WITH VARIOUS INDIVIDUALS REPRESENTING ORGANIZATIONS ACTIVE IN THE COMMUNITY. THE SEMI-STRUCTURED INTERVIEWS INCLUDED THE FOLLOWING INDIVIDUALS WITH SPECIALIZED KNOWLEDGE IN PUBLIC HEALTH: GINA LAGARDE, MD, REGIONAL ADMINISTRATOR/MEDICAL DIRECTOR, OFFICE OF PUBLIC HEALTH, REGION IX, DEPARTMENT OF HEALTH & HOSPITALS DIANE LEWIS, RN, NURSE SUPERVISOR, WASHINGTON PARISH HEALTH UNIT PART V, LINE 11 OUR LADY OF THE ANGELS HOSPITAL INC. IDENTIFIED OVERCOMING BARRIERS TO GOOD HEALTH, HEART DISEASE & STROKE, OLDER ADULTS & AGING, OTHER CHRONIC DISEASES, AND MENTAL HEALTH & MENTAL DISORDERS AS SIGNIFICANT COMMUNITY HEALTH NEEDS. THEY HAVE CHOSEN TO FOCUS ON OVERCOMING BARRIERS TO GOOD HEALTH, OLDER ADULTS & AGING, AND MENTAL HEALTH & SUBSTANCE ABUSE. BECAUSE THE HOSPITAL'S FIRST CHNA WAS ADOPTED ON THE LAST DAY OF THIS TAXABLE YEAR, DISCUSSION OF HOW IT IS ADDRESSING THOSE NEEDS WILL BE REPORTED IN THE HOSPITAL'S NEXT FORM 990. PART V, LINE 7A THE CHNA CAN BE LOCATED AT HTTP://WWW.OLOAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTML PART V, LINE 16I REGISTRATION PERSONNEL AND FINANCIAL COUNSELORS REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE CARE. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICE AND AT ALL OUTPATIENT REGISTRATION LOCATIONS. PART V, LINE 22D THE HOSPITAL FACILITY DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE USING THE AVERAGE OF THE BOTTOM QUARTER LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. PART V, LINE 15E ANY PATIENTS WITHOUT INSURANCE ARE ASKED QUESTIONS UPON ADMISSION THAT WOULD QUALIFY THE PATIENT FOR FINANCIAL ASSISTANCE. IF QUALIFIED, PATIENTS ARE ASKED TO PROVIDE SUPORT FOR ALL QUALIFYING INFORMATION, I.E. PROOF OF INCOME, PROOF OF RESIDENCY, ETC. PART I, LINE 3C: Financial assistance is available for individuals who are uninsured, underinsured, ineligible for any government health care benefit program, and who are unable to pay for their care. Full discounted care is available if income and assets meet certain federal poverty guideline levels. Discounted care is also available for those patients with catastrophic medical bills and is available if medical bills exceed a certain percentage of income and assets. PART I, LINE 7F: FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE. PART I, LINE 7: THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINE 7A-7D AND WAS OBTAINED FROM THE HOSPITAL'S MEDICARE COST REPORT. PART III, SECTION A, QUESTION 2 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. PART III, LINE 4: THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: 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: PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, RESIDENCY, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR DISCOUNTED CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT: RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. AS SUCH, OUR LADY OF THE ANGELS HOSPITAL WORKS CLOSELY WITH CHARITABLE ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. OUR LADY OF THE ANGELS ADOPTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT BY JUNE 30, 2016 AND WILL CONTINUE TO USE COMMUNITY BASED DATA TO SUPPORT DECISIONS FOR OUTREACH IN THE COMMUNITY. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE ANGELS HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE. PART VI, LINE 4 COMMUNITY INFORMATION: Our Lady of the Angels Hospital is a community-based, not-for-profit hospital located in Bogalusa, Louisiana, that serves Washington Parish and portions of the surrounding parishes. Washington Parish has a population of approximately 45,997 and 17,761 households. The Senior population compromises about 15.9% of the total population. The median household income is $31,750, and 20.14% of households have income below the poverty level. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR LADY OF THE ANGELS HOSPITAL PARTICIPATES IN COMMUNITY IMPROVEMENT ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY IMPROVEMENT ACTIVITIES INCLUDE THE FOLLOWING: OUR LADY OF THE ANGELS ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT MAY BE FOREGONE OR POSTPONED RESULTING IN MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE ANGELS PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE ANGELS HOSPITAL IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. OUR LADY OF THE ANGELS HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: OUR LADY OF THE ANGELS HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE ANGELS HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF THE ANGELS HOSPITAL SERVES THE COMMUNITY IN WASHINGTON PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE HOSPITAL OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE LAKE ASSUMPTION HOSPITAL false true false false false false false true false JEFF LIMBOCKER CFO 0 390537 0 111560 0 17180 0 41881 0 24017 0 585175 0 0 JOHN FINAN JR CHAIRMAN 0 955613 0 1188957 0 36238 0 46704 0 22760 0 2250272 0 0 RENE RAGAS PRESIDENT & CEO 0 228056 0 60775 0 50375 0 28961 0 24093 0 392260 0 0 HAMID HUSSAIN PHYSICIAN 203745 0 12353 0 125 0 8798 0 9926 0 234947 0 0 0 Christopher FRITZSCHE PHYSICIAN 152555 0 23000 0 125 0 7156 0 12554 0 195390 0 0 0 RALPH SERPAS CNO 141212 0 19578 0 234 0 6764 0 23487 0 191275 0 0 0 GARLAND ANDERSON PHYSICIAN 204835 0 125 8528 22412 0 235900 0 0 PART 1, QUESTION 3 The CEO is paid by FMOL Health System, a related tax exempt organization. The FMOLHS board of directors designates a compensation committee, made up of independent board members, to review and set the CEO's compensation annually. The compensation committee obtains and relies upon comparable data including a compensation study/survey from an independent compensation consultant. The compensation committee reviews compensation packages and appropriate compensation is determined and approved. The basis for making such determination is documented by the compensation committee. PART 1, QUESTION 4A The CEO is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for termination of employment without cause. If triggered, the executive would be paid 75% of his base salary and 75% of his incentive payment determined at target and provided retirement and welfare benefits for an entitlement period. The entitlement period is 24 months. No payments were made under the plan in the current year. PART 1, QUESTION 4B FMOLHS maintains three unfunded deferred compensation plans which meet the requirements of IRC Section 457(f) and IRC Section 409A. The plans provide for compensation to be deferred and paid upon the occurrence of certain events such as termination without cause, disability, death or attainment of a specific payment date. Participation in the plans is limited to certain executives and is subject to the approval of FMOLHS Board of directors or a designated committee of such board. No one listed on Part VII, Section A received a payment from the plans in the current year. PART I, QUESTION 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART III, LINE 1 INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. Form 990 Part VI Line 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE ANGELS HOSPITAL, INC. Form 990 Part VI Line 7a FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE ANGELS HOSPITAL, INC., RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE ANGELS HOSPITAL, INC. Form 990 Part VI Line 7b THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION. Form 990 Part VI Line 11b AFTER PREPARATION AND REVIEW BY KPMG, LLP, MANAGEMENT WILL REVIEW THE FORM 990. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION B, QUESTION 12 OUR LADY OF THE ANGELS HOSPITAL, INC. HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY AND (D) UNDERSTANDS THAT OUR LADY OF THE ANGELS HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE ANGELS HOSPITAL, INC. PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION B, QUESTIONS 13 & 14 THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A DOCUMENT RETENTION POLICY AND A WHISTLEBLOWER POLICY IN PLACE ALTHOUGH THEY WERE NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS OR A COMMITTEE THEREOF BEFORE JUNE 30, 2016. PART VI, SECTION B, QUESTION 15A & 15B THE PRESIDENT & CEO, AND CFO OF THIS ORGANIZATION ARE EMPLOYEES OF FMOL HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION, WHOSE SALARIES ARE DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION. SUCH PAY PRACTICES INCLUDE THE USE OF AN INDEPENDENT BOARD COMMITTEE WHICH REVIEWS COMPENSATION ANNUALLY AFTER OBTAINING AND RELYING UPON INDUSTRY WIDE COMPENSATION INFORMATION FROM OUTSIDE SOURCES. THE BOARD COMMITTEE APPROPRIATELY DOCUMENTS ITS DECISIONS. Form 990 Part VI Line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. Part XI Line 9 CAPITAL TRANSFER 5,519,918 SECTION 1.263(A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION OUR LADY OF THE ANGELS HOSPITAL INC. DOES HAVE APPLICABLE FINANCIAL STATEMENTS FOR THE YEAR OF THE ELECTION, AND INTEND TO APPLY THE DE MINIMIS SAFE HARBOR ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(II). SECTION 1.263(A)-3(N) ELECTION- BOOK CONFORMITY ELECTION OUR LADY OF THE ANGELS HOSPITAL INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2016. 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