2016-05-16T10:17:06-05:00 2015-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2014-07-01 720408970 ST FRANCIS MEDICAL CENTER % MR RONALD E HOGAN STFR 3189664000 PO Box 1901 Monroe LA 71210 RONALD HOGAN REGIONAL CFO 3189664000 2016-05-13 true RYAN HOOKS P00746825 2253444000 2014 2016-08-17 19:52:53Z KRISTIN WOLKART PO BOX 1901 MONROE LA 71210 247476888 false 0928 X www.stfran.com X 1913 LA TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS AND TO PROVIDE FOR THE RESEARCH,EDUCATION AND THE ENHANCEMENT OF HEALTH OF THOSE IN NORTHEAST LOUISIANA. 17 12 2421 113 3345196 540026 801773 1693614 233820808 232522237 10648141 6740353 3193256 2383605 248463978 243339809 351197 320778 0 0 132131068 122955285 0 0 0 135920079 140878841 268402344 264154904 -19938366 -20815095 375845852 332510177 231131509 231193750 144714343 101316427 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH 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. PRIVILEGED TO SERVE. false false 192126910 232522237 St. Francis Medical Center provides quality hospital and medical services primarily to residents of Northeast Louisiana. The Medical Center is an active, caring member of the communities it serves. In carrying out its mission of meeting the healthcare needs of the people of God, the Medical Center has established a policy under which it provides care to needy members of its communities. Following that policy, health care services costing approximately, $5,347,354 were provided without charge. The Medical Center provided 545 licensed beds, 77,221 inpatient days, 216,961 outpatient visits, and 62,867 ER visits in the year ended June 30, 2015. See Schedule O for further explanation. 192126910 true true false false false false false false false false true true false false true true false true false false true true false false false false true true true false true false false false false false false false true false false false false true true true true false false true 123 0 true 2421 true true true false false false false false false false false false X 17 12 true false false false false true true true true false false true true true true true true false true true true X MR RONALD E HOGAN 3189664000 309 JACKSON ST MONROE LA 71201 X R KEITH WHITE MD DIRECTOR 50.0 0.0 X 791778 0 29885 THOMAS J GULLATT MD DIRECTOR 50.0 0.0 X 511942 0 51660 LOUIS BREMER Ex-Officio/President/ CEO 2.0 52.0 X X 0 559390 28834 KRISTIN WOLKART President/CEO 2.0 58.0 X X 0 266783 44624 K SCOTT WESTER Interim CEO 1.0 57.5 X X 0 784733 64461 ROLF MORSTEAD MD Ex-Officio/Chief of Staff 2.0 0.0 X 21387 0 0 JUDY BELL SECRETARY 1.0 0.5 X X 0 0 0 SIDNEY BAILEY MD DIRECTOR 1.0 0.0 X 1800 0 0 NICK J BRUNO PHD DIRECTOR 1.0 0.0 X 0 0 0 SR HELEN CAHILL DIRECTOR 1.0 10.0 X 0 0 0 WILLIAM CHEEK DIRECTOR 1.0 0.0 X 0 0 0 BISHOP MICHAEL G DUCA DIRECTOR 1.0 0.0 X 0 0 0 HILL HINKLE MD DIRECTOR 1.0 0.0 X 0 0 0 SUSAN HOFFMANN VICE CHAIRMAN 1.0 0.0 X X 0 0 0 J STEWART GENTRY CHAIRMAN 1.0 0.0 X X 0 0 0 TERRY KING MD DIRECTOR 1.0 0.0 X 0 0 0 JOHN LUFFEY JR ESQ DIRECTOR 1.0 1.0 X 0 0 0 SR MARY ANN SEPULVADO OSF DIRECTOR 1.0 1.0 X 0 0 0 TONYA SHEPPARD MD DIRECTOR 1.0 0.0 X 0 0 0 REV LARRY STAFFORD DIRECTOR 1.0 1.0 X 0 0 0 RONALD E HOGAN REGIONAL CFO 2.0 58.0 X 0 381170 52227 KAYLA JOHNSON VP Patient Care Services 40.0 0.0 X 225616 0 41363 FRED TOLBERT VP Ancillary Services 40.0 0.0 X 216683 0 47440 MICHAEL LANGIULLI Physician 40.0 0.0 X 733167 0 30435 KEVIN M MEYER Physician 40.0 0.0 X 586740 0 24776 DAVID M MCCOY Physician 40.0 0.0 X 505788 0 26729 JAMES G SMITH Physician 40.0 0.0 X 433966 0 42115 JOHN D BRUCHHAUS Physician 40.0 0.0 X 426472 0 36103 4455339 1992076 520652 126 false true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Management Services 22045878 Lincoln Builders 1910 Farmerville Hwy Ruston LA 712730400 Building Contractor 13560140 MAYO CLINIC LABORATORIES PO BOX 4100 ROCHESTER MN 559034100 LAB TESTING 1126514 PARISH ANESTHESIA OF MONROE 3510 NORTH CAUSEWAY BLVD SUITE 404 METARIE LA 70002 ANESTHESIA SERVICES 4427870 DVA Renal Healthcare Inc PO Box 8500-1607 Philadelphia PA 191781607 Dialysis Services 1109303 45 1173000 194548 326066 1693614 PATIENT SERVICE REVENUE 621500 225165537 221923036 3242501 CAFETERIA 900099 2100333 2100333 OTHER PROGRAM SERVICE 900099 6364517 6364517 INCOME FROM EQUITY INVESTEES 900099 -1108150 -1098959 -9191 232522237 1015178 48067 967111 0 0 2383605 2383605 0 2383605 2383605 9862254 4141429 -4350 5720825 4350 5725175 63819 5661356 0 0 0 0 243339809 231672532 3345196 6628467 X 310627 310627 0 10151 10151 0 0 0 1798845 1473813 325032 99161805 81244356 17917449 6413254 5202203 1211051 8820284 7154700 1665584 6761097 5483250 1277847 30851221 20616105 10235116 1147327 748104 399223 52872 34475 18397 0 0 439908 439908 16662986 10291778 6371208 586013 404381 181632 12233088 8003631 4229457 46634 46634 0 7299544 1088453 6211091 548199 365323 182876 0 0 5499055 5499055 0 10911282 9685414 1225868 4238550 2041182 2197368 MEDICAL SUPPLIES EXPENSE 41040859 26783914 14256945 DECREASE IN ACCRUED PENSION 9321303 5685995 3635308 264154904 192126910 72027994 0 X 24165950 26767813 13541469 8837915 0 0 36307207 42984986 0 0 0 0 1155995 1720224 5653165 5809216 5055635 3162822 355705332 239615660 109378685 116089672 71610867 49016269 94207958 65098800 2244473 340032 5749347 5749348 6775101 6933080 375845852 332510177 28674445 28311387 0 0 0 0 132470104 132525589 0 0 0 0 0 0 0 0 69986960 70356774 231131509 231193750 X 143468464 100484754 1245879 831673 0 0 144714343 101316427 375845852 332510177 X -20815095 -6040059 -16542762 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14740717 14740717 193730406 121224647 72505759 2316857 1582026 734831 142168415 115438435 26729980 0 2748937 1370552 1378385 116089672 -22972 F FIXED INCOME SECURITIES 23317991 F ALTERNATIVE INVESTMENTS 41803781 F 65098800 0 DUE TO RELATED PARTIES 92145 OTHER LIABILITIES 1848541 ACCRUED PENSION COST 62428148 GENERAL AND PROFESSIONAL LIABI 5987940 70356774 X FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART XIII "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 judgement occurs. No reserves for uncertain tax positions have been recorded." true Central America and the Caribbean Investments 47156968 47156968 47156968 Central America and the Caribbean Medical Needs 10151 Cash 1 true false true true true false true true X true X true X true true false true true 3897253 3897253 0.01370 36498248 22678467 13819781 0.04630 721952 637877 84075 0.00030 41117453 23316344 17801109 0.06030 173533 86982 86552 0.00030 251459 251459 0.00090 1756308 607086 1149222 0.00410 10650 10650 2191950 694068 1497883 0.00530 43309403 24010412 19298992 0.06560 43957 43957 0.00020 176664 176664 0.00060 1000 1000 184992 184992 0.00070 10000 10000 416613 416613 0.00150 false 19848425 104975732 138286803 -33311071 X true true P&S Surgical Hospita MEDICAL SERVICES 0.50000 0.03340 0.44000 3 1 ST FRANCIS MEDICAL CENTER PO BOX 1901 MONROE LA 71210 www.fmolhs.org/stfran License: 157 X X X A 2 P&S SURGERY CENTER LLC 312 GRAMMONT STREET MONROE LA 71201 www.pssurgery.com License: 490 X X 3 ST FRANCIS NORTH HOSPITAL PO BOX 1901 MONROE LA 71201 www.fmolhs.org/stfran License: 157-I X X X A Group A 13 false false true X X X X X X X X X 12 true true false true X SEE PART V, SECTION C X true 12 false true false true X 200. 300. X X X true true X X true X X X X X true X false X X X X true X false false P&S SURGERY CENTER LLC 2 false false true X X X X X X X X X 12 true true false true X SEE PART V, SECTION C X true 12 false true false true X 150. 262. X X X X true true X X X X true X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 ST. FRANCIS MEDICAL CENTER, ST. FRANCIS NORTH HOSPITAL AND P&S SURGICAL HOSPITAL: THE ORGANIZATIONS ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS. SFMC TOOK INTO ACCOUNT INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH BY INTERVIEWING SHELLEY JONES, MD, MPH, WHO IS THE REGIONAL MEDICAL DIRECTOR WITH DHH/LOUISIANA OFFICE OF PUBLIC HEALTH. SFMC ALSO TOOK INTO ACCOUNT INPUT FROM THOSE WHO REPRESENT A BROAD INTEREST OF THE COMMUNITY BY INTERVIEWING LINDSEY MURRAY, HEALTHCARE DIRECTOR AT THE CHILDREN'S COALITION OF NORTHEAST LOUISIANA, DR. JAN CORDER PZYNER, FORMER EXECUTIVE DIRECTOR OF THE LIVING WELL FOUNDATION, RENE STANSBURY, THE TOBACCO CONTROL COORDINATOR AT SOUTHWEST LOUISIANA AREA HEALTH EDUCATION CENTER AND JENNIFER HANELINE, REGION VIII TFL COORDINATOR AT TOBACCO FREE LIVING. PART V, SECTION B, LINE 6a P&S SURGICAL HOSPITAL AND ST. FRANCIS NORTH FORMALLY ADOPTED THE COMMUNITY HEALTH NEEDS ASSESSMENT OF ST. FRANCIS MEDICAL CENTER, AN AFFILIATED ENTITY. ST. FRANCIS MEDICAL CENTER, P&S SURGICAL HOSPITAL, AND ST. FRANCIS NORTH ALL SHARE THE SAME DEMOGRAPHIC COMMUNITY SO P&S SURGICAL HOSPITAL AND ST. FRANCIS NORTH FELT THAT THE NEEDS IDENTIFIED BY ST. FRANCIS MEDICAL CENTER WERE REPRESENTATIVE OF ITS COMMUNITY'S NEEDS AS WELL. PART V, SECTION B, LINE 11 During the current year, SFMC focused on identified community needs of Obesity, Diabetes, and Tobacco Use. While it identified eleven health needs during its last CHNA, it chose not to focus on adolescent health, immunizations, premature birth, domestic violence, mental health and lack of a medical home/barriers to care. Each need not addressed is either being addressed by other organizations in the community or it is not equipped to address the need. SFMC did the following during the year: Obesity: In order to increase the percentage of women who initiate breastfeeding during postpartum hospitalization, SFMC revised parenting and prenatal classes to present breastfeeding as the norm rather than the exception and purchased updated prenatal instruction videos including a section on successful breastfeeding. Diabetes: SFMC provided twenty-one diabetes educational opportunities for all school nurses employed by Monroe City Schools and Ouachita Parish School Board. SFMC also increased the number of people receiving foot exams at the Diabetes & Nutrition Center. SFMC extended an invitation to school nurses to provide diabetes education at small group meetings and at multiple times and provided more than 20 consults for school nurses throughout the school year. Tobacco Use: In January 2015, SFMC and SFN opened the St. Francis Tobacco Cessation Program, a comprehensive, evidence-based program addressing tobacco use and nicotine addiction. The program had an average of 62.5 client visits each month. SFMC provided educational tobacco avoidance presentations to two local elementary schools. SFMC also strengthened its own Tobacco Use policy. P&S Surgical Hospital (P&S): During the current year, P&S focused on identified community needs of Adolescent Health and Immunizations. While it identified eleven health needs during its last CHNA, it chose not to focus on obesity, diabetes, premature birth, domestic violence, mental health, lack of a medical home/barriers to care, tobacco use, asthma, and care for the aging. Each need not addressed is either being addressed by other organizations in the community or it is not equipped to address the need. P&S did the following during the year: Adolescent health: In order to decrease the barriers to dental care for low-income pediatric patients, P&S provided 1,137 dental visits to low-income pediatric patients. Immunizations: P&S provided 184 pediatric immunizations during the year in order to help maintain childhood immunization rates. This program was eliminated at the end of the year due to the State of Louisiana pushing to have immunizations done in the primary care offices. St. Francis North Hospital (SFN): During the current year, SFN focused on identified community needs of Tobacco Use and Adolescent Health. While it identified eleven health needs during its last CHNA, it chose not to focus on obesity, diabetes, premature birth, domestic violence, mental health, lack of a medical home/barriers to care, immunizations, asthma, and care for the aging. Each need not addressed is either being addressed by other organizations in the community or it is not equipped to address the need. SFN did the following during the year: Tobacco Use: In January 2015, SFN and SFMC opened the St. Francis Tobacco Cessation Program, a comprehensive, evidence-based program addressing tobacco use and nicotine addiction. The program had an average of 62.5 client visits each month. SFN also partnered with Monroe Housing Authority (MHA) to provide on-site enrollment and counseling sessions to assist residents as MHA moved to tobacco-free campuses at two of their locations. Adolescent health: SFN provided eight educational sessions to adolescents on lifestyle health risks. These sessions were provided by the school-based health clinic at Carroll Junior High School. PART V, SECTION B, LINE 7 ST. FRANCIS MEDICAL CENTER, ST. FRANCIS MEDICAL CENTER - NORTH & P&S SURGICAL HOSPITAL: THE CHNA CAN BE FOUND AT HTTPS://FMOLHS.ORG/STFRAN/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX ST. FRANCIS NORTH HOSPITAL PART V, LINE 16I ST. FRANCIS MEDICAL CENTER, ST. FRANCIS NORTH HOSPITAL AND P&S SURGICAL HOSPITAL: REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. PART V, LINE 13H ST. FRANCIS MEDICAL CENTER, ST. FRANCIS NORTH HOSPITAL AND P&S SURGICAL HOSPITAL: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY. PART V, QUESTION 22D P&S SURGICAL HOSPITAL: THE HOSPITAL FACILITY DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR MOTHER MEDICALLY NECESSARY CARE USING THE AVERAGE OF THE BOTTOM QUARTER LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. 5 COMMUNITY HEALTH CENTER 920 OLIVER ROAD MONROE LA 71201 VARIOUS OUTPATIENT SERVICES NORTHEAST LA CANCER INSTITUTE 411 CALYPSO STREET MONROE LA 71210 CANCER TREATMENT AND IMAGING CENTER Monroe MRI Center 501 Catalpa Street Monroe LA 71201 MRI SERVICES ST FRANCIS PET IMAGING OF MONROE PO BOX 1851 Monroe LA 71201 PET IMAGING SERVICES ST FRANCIS PEDIATRIC AFTER HOURS PO BOX 207 MONROE LA 71201 AFTER HOURS CLINIC FOR CHILDREN 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 AND PARTIAL 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. FULLY DISCOUNTED CARE IS ALSO AVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO THE HOSPITAL; 2) STATE-FUNDED PRESCRIPTION PROGRAMS; 3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT; 4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCE PROGRAMS; 5) PATIENT ELIGIBLE FOR FOOD STAMPS; 6) MEDICAID ELIGIBLE PATIENT; 7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY; 8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY. PART I, LINE 7G ST. FRANCIS MEDICAL CENTER PROVIDES SUBSIDIZED HEALTH SERVICES, INCLUDING SERVICES THAT PROVIDE PEDIATRIC NEUROLOGY, PEDIATRIC NEUROSURGERY, AND ADULT NEUROLOGY. THESE SPECIALIZED SERVICES ARE SUBSIDIZED BY ST. FRANCIS MEDICAL CENTER SINCE THESE ARE UNDER-SERVED SPECIALTY AREAS. PART I, LINE 7 THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I LINES 7A-7D AND IS BASED ON THE JUNE 30, 2015 MEDICARE COST REPORT DATA. FOR PART I LINES 7E, 7F, 7G, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENT AND THE MEDICARE COST REPORT WHERE APPLICABLE. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. THE ORGANIZATION CURRENTLY DOES NOT BELIEVE THAT ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2 NEEDS ASSESSMENT: Responding to the health needs of our community, especially to those most in need, is primary to the hospital's mission. As such, St. Francis Medical Center, Inc. works to conduct health care needs assessments. They work closely with Families helping Families, The Wellspring, The Children's Coalition, YMCA and many other organizations to define community needs and to consolidate efforts to meet those community needs. For example, a school-based health center and a diabetes and nutrition center was initiated after a health care assessment identified the need. The hospital conducted a formal community based needs assessment in 2011 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: Patients are informed through a patient handbook that contains information on the financial policies of St. Francis Medical Center. Additionally, signs are posted in the Admissions areas that Financial Counseling is available upon request. Systems and tools are utilized to conduct high level financial screening to assist in identifying patients eligible for financial assistance. Financial counselors work closely with patients to assist with enrollment for those who are eligible for Medicaid as well as assist those who are eligible for HOSPITAL FINANCIAL ASSISTANCE in determining eligibility. PART VI, LINE 4 COMMUNITY INFORMATION: ST. FRANCIS MEDICAL CENTER (SFMC) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN MONROE, LOUISIANA THAT SERVES OUACHITA PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, SFMC'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 150,862 AND THE SENIOR POPULATION COMPRISES ABOUT 12.6% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $37,298 AND 20.8% OF THE PARISH'S RESIDENTS LIVE BELOW THE POVERTY LEVEL. ST. FRANCIS MEDICAL CENTER PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: OUACHITA PARISH ST. FRANCIS MEDICAL CENTER SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: CALDWELL PARISH EAST CARROLL PARISH FRANKLIN PARISH JACKSON PARISH LINCOLN PARISH MADISON PARISH MOREHOUSE PARISH RICHLAND PARISH TENSAS PARISH UNION PARISH WEST CARROLL PARISH PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: St. Francis Medical Center 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: SFMC provides occupancy and utilities free of charge to St. Vincent DePaul charitable pharmacy so that the poorest individuals in the community have access to prescription drugs. SFMC also provides occupancy free of charge to a primary health care clinic located in one of the poorest areas of Monroe. These activities allow the recipient organizations to spend their available funds on activities that have more direct impact on those in need. SFMC provides management oversight of community programs and activities, including Meals on Wheels, taxi and medication provided to the needy, and community benefit salary dollars. SMFC proudly serves as the designated regional hospital for Region 8 and provides leadership and coordination for emergency preparedness activities. SFMC provides leadership development and training for Roman Catholic Priests to serve in the SFMC Community. SFMC improves access to public health through its financial support of an adult day health care facility and a school based health center. SFMC has many programs designed to promote leadership development and provide exposure to various careers in heatlh care. Such programs include health information management, sports medicine program, AHEC (area health education center) program, Carroll High School Housekeeping Program and the Jr. Volunteer Program. A majority of the governing body of SFMC 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. SFMC extends medical staff privileges to all qualified physicians in the community for some or all of the departments, as needed. SFMC applies surplus funds to improvements in patient care through investment in clinical technology, medical information technology, and continued training of clinical staff. PART VI, LINE 6 St. Francis Medical Center is a not-for-profit hospital, non-stock member corporation of which Franciscan Missionaries of Our Lady Health System, Inc. (FMOL Health System) is the sole member. St. Francis Medical Center is part of the FMOL Health System which includes several hospitals and tax-exempt affiliates throughout the state of Louisiana. St. Francis Medical Center serves the community in Northeastern Louisiana and Southern Arkansas. Other related hospitals in Louisiana include: Our Lady of Lourdes Regional Medical Center Our Lady of the Lake Hospital St. Elizabeth Hospital Our Lady of the Lake Assumption Hospital OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, LINE 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 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. true ULM Foundation School of Nursing Building Fund 700 University Avenue Monroe LA 71209 726028527 501c(3) 50000 DONATION TO NURSING PROGRAM 1 PART I, LINE 2 ST. FRANCIS MEDICAL CENTER REQUESTS AN ACKNOWLEDGEMENT LETTER FROM EACH ORGANIZATION TO WHICH WE GIVE $5,000 OR MORE IN A CALENDAR YEAR. ORGANIZATIONS ARE REQUESTED TO IDENTIFY WHEN THE FUNDS WERE RECEIVED, HOW MUCH WAS RECEIVED, HOW THE FUNDS WERE USED AND WHAT THE OUTCOMES WERE OF THE PROJECT OR PROGRAM FOR WHICH THE FUNDS WERE REQUESTED. true true false false false false false true false R KEITH WHITE MD DIRECTOR 500011 0 288256 0 3511 0 6500 0 23385 0 821663 0 0 0 THOMAS J GULLATT MD DIRECTOR 317688 0 190816 0 3438 0 32326 0 19334 0 563602 0 0 0 LOUIS BREMER Ex-Officio/President/ CEO 0 317733 0 0 0 241657 0 10400 0 18434 0 588224 0 78266 KRISTIN WOLKART President/CEO 0 208841 0 50000 0 7942 0 23362 0 21262 0 311407 0 0 RONALD E HOGAN REGIONAL CFO 0 276204 0 87803 0 17163 0 26518 0 25709 0 433397 0 0 MICHAEL LANGIULLI Physician 675013 0 55683 0 2471 0 6500 0 23935 0 763602 0 0 0 KEVIN M MEYER Physician 343881 0 240238 0 2621 0 6500 0 18276 0 611516 0 0 0 DAVID M MCCOY Physician 357664 0 144971 0 3153 0 6500 0 20229 0 532517 0 0 0 JAMES G SMITH Physician 319245 0 111283 0 3438 0 32326 0 9789 0 476081 0 0 0 JOHN D BRUCHHAUS Physician 318568 0 105283 0 2621 0 24235 0 11868 0 462575 0 0 0 K SCOTT WESTER Interim CEO 0 583808 0 180278 0 20647 0 37476 0 26985 0 849194 0 0 KAYLA JOHNSON VP Patient Care Services 190216 0 34500 0 900 0 18049 0 23314 0 266979 0 0 0 FRED TOLBERT VP Ancillary Services 184591 0 30700 0 1392 0 24061 0 23379 0 264123 0 0 0 PART I, 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 DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. THE CEO ALSO SIGNS A WRITTEN EMPLOYMENT AGREEMENT. PART I, LINE 4A The CEO and interim CEO are entitled to a severance benefit. The payout of such benefit is remote as it is effective only for termination of employment without cause for good reason. If triggered, the executive would be paid his/her base salary and an annual incentive at target and provided retirement and welfare benefits for an entitlement period. Louis Bremer received a severance payment in the amount of $143,121 during the current year. An officer is entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment without cause, for good reason or due to change of control. If triggered, the employee would be paid his/her base salary and provided retirement and welfare benefits for an entitlement period. The entitlement period is 12 months. No payments were made under the plan in the current year. PART I, QUESTION 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. PART I, QUESTION 4B FMOLHS maintains two unfunded deferred compensation plans which meet the requirements of IRC Section 457(f) and IRC Section 409A. The plans provide for compensation to be deferred and paid upon the occurrence of certain events such as termination without cause, disability, death or attainment of a specific payment date. Participation in the plans is limited to certain executives and is subject to approval of FMOLHS board of directors or a designated committee of such board. Louis Bremer received a payment in the amount of $84,190 in the current year. OUACHITA REHAB ASSOCIATION BOARD MEMBER IS OWNER 137716 MEDICAL DIRECTOR PAYMENTS false EMILY BYRD DAUGHTER OF DIRECTOR 7251 COMPENSATION false TERRY KING APMC BOARD MEMBER IS OWNER 390837 SFMC PAYS FOR MEDICAL SERVICES false STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990 PART III The Medical Center is an active, caring member of the communities it serves. In carrying out its mission of meeting the health needs of the people of God, the Board of Directors has established a policy under which the Medical Center provides care to needy members of its communities. Following that policy, health care services costing $5,347,354 were provided without charge during the year ended June 30, 2015. Gross charges foregone, based on established rates, totaled approximately $17,946,000 for the year ended June 30, 2015. The Medical Center also participates in government programs including Medicare, Medicaid and TriCare programs. Under these programs, the Medical Center provides care to patients at payment rates that are determined by the federal and state governments, regardless of actual cost. In some cases, these programs pay the Medical Center at amounts which are less than its cost of providing services. The following table summarizes the amounts of charges foregone (i.e., contractual allowances) and the estimated unreimbursed costs incurred by the Medical Center due to inadequate payments by these programs and for charity for the year ended June 30, 2015. June 30, 2015 Charity Care and means-tested programs: CHARGES FOREGONE Medicare: $322,608,305 Medicaid: $133,003,989 Charity: $17,946,000 Other: $2,288,053 Total: $475,846,347 Estimated Unreimbursed Charges: Medicare: $32,709,884 Medicaid: $20,226,076 Charity: $5,347,354 Other: $84,182 Total: $58,367,496 In addition to community services directly associated with providing hospital-based care, the Medical Center serves the community in numerous other ways. For example: The Medical Center provides Health Professionals Education in a clinical setting for undergraduate, vocational training, internships, clerkships, and residencies. This program includes registered nurse recruitment activities and collaboration with local colleges for supervision and clinical training in pharmacy, respiratory therapy, health information management and medical technology. The costs incurred for these programs totaled approximately $249,840 during the year ended June 30, 2015. The Medical Center provides subsidized health services which provide a discount, at cost, to all patients that have no form of insurance coverage. The costs incurred for these programs totaled approximately $668,021 during the year ended June 30, 2015. The Medical Center provides cash and in-kind contributions to community groups which include donations to Families Helping Families, Children's Coalition, Wellspring, Haiti Project, Prevent Child Abuse, Alzheimer's Foundation, YMCA, and Komen Foundation. This program also includes employee costs associated with board and community involvement of rural hospitals. The costs incurred for these programs totaled approximately $7,800 during the year ended June 30, 2015. The Medical Center provides occupancy and utilities to St. Vincent DePaul charitable pharmacy. The costs incurred for these programs totaled approximately $43,957 during the year ended June 30, 2015. The Medical Center provides community health education classes on breast feeding, childbirth basics, sibling class and abc's of childcare. This also includes sponsorship of Think First, a national injury prevention organization. The Medical Center provides free depression and anxiety screenings to the community. The costs incurred for these programs totaled approximately $10,131 during the year ended June 30, 2015. The Medical Center provides community support which includes staff costs of management oversight of community benefit programs and activities, including Meals on Wheels, taxi and medication provided to the needy, Bayou Jamb (an annual football jamboree for area high school teams), and community benefit salary dollars. The costs incurred for these programs totaled approximately $169,568 during the year ended June 30, 2015. The Medical Center provides community based clinical services including community based health screenings including behavior health, discounted services provided to Louisiana Baptist Children's home, Veteran's Administration, rural hospitals, ULM athletic department, MDA, Wellspring, and handicap children. The costs incurred for these programs totaled approximately $262,483 during the year ended June 30, 2015. The Medical Center provides leadership development and training for community members. St. Francis serves as the designated regional hospital for Region 8 and provides leadership and coordination for emergency preparedness activities. The costs incurred for these programs totaled approximately $57,833 during the year ended June 30, 2015. The Medical Center provides community health improvement advocacy which includes the unreimbursed costs of the Adult Day Health Care Facility and the school based health center. The costs incurred for these programs totaled approximately $184,992 during the year ended June 30, 2015. The Medical Center provides workforce development designed to promote leadership development and provided exposure to various careers in health care including: sports medicine program, AHEC (Area Health Education Center Program), Carroll High School housekeeping program and junior volunteer program. The costs incurred for these programs totaled approximately $6,500 during the year ended June 30, 2015. Part VI, Section A, Question 2 KRISTEN WOLKART, SCOTT WESTER, Ron Hogan, Louis Bremer, and J. Stewart Gentry have a business relationship with each other solely because they all serve as directors of other organizations which are related to St. Francis Medical Center. Part VI, Section A, Question 6 FMOL Health System, Inc. (an IRC Section 501(C)(3) organization) is the sole member of the medical center. PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, INC. AS THE SOLE MEMBER OF THE MEDICAL CENTER, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. FRANCIS MEDICAL CENTER. PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: i. To change philosophy, objectives and purposes of corporation. ii. To appoint or remove the Members of the Board of Trustees and Officers of the corporation. iii. To amend, alter, modify or repeal the Articles of Incorporation and Bylaws of the corporation. iv. To authorize merger, consolidation, or affiliation, or participate in joint ventures. v. To dissolve and to distribute assets of the corporation. vi. To appoint and/or terminate with or without cause the Chief Executive Officer of the corporation. vii. To acquire, purchase, sell, lease, transfer, or encumber any immovable property on behalf of the corporation. viii. To add to or incur long-term debt in excess of $5 million by the Corporation. ix. To appoint the fiscal auditor for the corporation. x. 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. xi. To approve the annual operating and capital budgets of the corporation. xii. To approve a strategic business plan of the corporation. Part VI, Section A, Question 11A AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG LLP, THE TAXPAYER'S TAX ADVISORS, ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEWS THE RETURN. ST. FRANCIS MEDICAL CENTER'S GOVERNING BODY IS PROVIDED A COPY OF THE RETURN ELECTRONICALLY PRIOR TO THE FILING DATE AND IS GIVEN AN OPPORTUNITY TO REVIEW AND PROVIDE COMMENTS TO MANAGEMENT. PART VI, SECTION B, QUESTION 12C St. Francis Medical Center 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 she/he (a) has received a copy of the conflict of interest policy; (b) has read and understands the policy; (c) has agreed to comply with the policy; and (d) understands that St. Francis Medical Center is a charitable organization and that, in order to maintain its Federal tax exemption, it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. In addition to the above, St. Francis Medical Center 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, QUESTION 15A & 15B Our Board of Directors designates an executive committee made up of independent board members to review and set the compensation annually of our officers and key employees. The executive committee obtains and relies upon comparable data including industry-wide compensation information provided by an outside consulting firm. The executive committee reviews compensation packages and appropriate compensation is determined and approved. The basis for determination is then documented by the executive committee. The compensation for the CEO of St. Francis Medical Center is set by the compensation committee of FMOL Health System (a related tax-exempt organization) according to their pay practices which are similar to those described above. GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 The organization makes its governing documents, conflict of interest policy and financial statements available upon request. PART XI, QUESTION 9 CAPITAL TRANSFER PER FMOL $(16,542,762) SECTION 1.263(A)-3(N) ELECTION-BOOK CONFORMITY ELECTION ST. FRANCIS MEDICAL CENTER 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, 2015. SECTION 1.263 (A)-1(F)- ELECTION- DE MINIMIS SAFE HARBOR ELECTION ST. FRANCIS MEDICAL CENTER hereby makes the de minimis safe harbor election under Section 1.263(a)-1(f) of the Treasury Regulations, effective only for the tax year ending June 30, 2015. Taxpayer has an Applicable Financial Statement for the year of the election. This election permits the taxpayer to deduct for tax purposes any item deducted under its book policy that does not exceed $5,000 per invoice (or per item, as substantiated by the invoice) or items having an economic useful life of twelve months or less as described in Section 1.263(a)-1(f)(1)(i). 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