2016-05-12T12:46:26-05:00 2015-09-30 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2014-10-01 720535375 LAFAYETTE GENERAL MEDICAL CENTER INC LAFA 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 705032621 ROGER MATTKE CFO 3372898125 2016-05-11 1 AMIE T WHITTINGTON CPA P01082167 6013261000 2016-05-09 2014 2016-08-17 19:52:53Z DAVID CALLECOD 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 448929089 0 X WWW.LAFAYETTEGENERAL.COM X 1911 LA LAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 21 14 2001 122 3610697 -2002427 211434 223744 357497935 428275814 3556783 8079017 16349373 12350514 377615525 448929089 42435 799588 0 0 100374500 103893735 0 0 0 219583764 282162461 320000699 386855784 57614826 62073305 315475291 395964202 60503351 86160004 254971940 309804198 X LAFALAFAYETTE GENERAL MEDICAL CENTER'S MISSION IS TO RESTORE, MAINTAIN, ANDIMPROVE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 368724722 799588 436914515 PROGRAM SERVICES STATISTICS RELATED TO PROVIDING COMMUNITY MEDICAL CARE FOR THE HOSPITAL: TOTAL ACUTE PATIENT DAYS WERE 79,612, TOTAL NURSERY DAYS WERE 5,753, TOTAL REHAB DAYS WERE 3,204 AND TOTAL MENTAL HEALTH DAYS WERE 8,136. OTHER SIGNIFICANT HEALTHCARE SERVICES PROVIDED INCLUDED 65,223 EMERGENCY ROOM VISITS, 15,684 SURGERIES (INPATIENT AND OUTPATIENT), AND 2,875 DELIVERIES.THE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY. SERVICES INCLUDED INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION. THE REVENUES FORM THESE SERVICES ARE $805,566,348 AND $525,928,891, RESPECTIVELY. THERE WERE ACUTE AND SKILLED CARE SERVICES NOT FULLY COMPENSATED. THESE INCLUDED MEDICARE / MEDICAID CONTRACTUALS WITH $588,655,945 OF UNCOMPENSATED SERVICES, OTHER CONTRACTUALS WITH $313,848,296 OF UNCOMPENSATED SERVICES, AND BAD DEBTS OF $54,125,948. THE NET REVENUES OF THE SERVICES PROVIDED WERE $374,865,050.LAFAYETTE GENERAL MEDICAL CENTER (LGMC) SERVES THE NINE PARISHES IN LOUISIANA DESIGNATED ACADIANA WITH 365 STAFFED BEDS (INCLUDING 26 NURSERY BEDS) AND 2,001 EMPLOYEES. LGMC REMAINS THE AREA'S LARGEST, FULL SERVICE, ACUTE-CARE MEDICAL CENTER.OUR HOSPITAL MISSION IS TO RESTORE, MAINTAIN, AND IMPROVE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE. WE ARE A COMMUNITY-OWNED AND LOCALLY MANAGED HOSPITAL THAT STAYS TRUE TO OUR MISSION BY DEDICATING SIGNIFICANT RESOURCES TO COMPENSATE A COMPASSIONATE, HIGHLY SKILLED STAFF; ACQUIRE ADVANCED TECHNOLOGY; AND DEVELOP SERVICE IMPROVEMENTS EACH YEAR.IN LINE WITH OUR GOAL OF BUILDING A REGIONAL HEALTH CARE SYSTEM, LAFAYETTE GENERAL HAS ESTABLISHED CLINICAL AFFILIATIONS WITH OUTLYING HOSPITALS, EXTENDING OUR BEST PRACTICES IN CANCER TREATMENTS, CARDIOLOGY, AND NEUROSCIENCE SUPPORT TO OUTLYING PARISHES. WE ALSO ENABLED PATIENTS TO PARTICIPATE MORE IN THEIR HEALTH CARE BY OFFERING AN ONLINE PATIENT PORTAL.ON JULY 1, 2013, AFTER LAFAYETTE GENERAL HEALTH TOOK OVER MANAGEMENT OF UNIVERSITY HOSPITAL & CLINICS (FORMERLY UNIVERSITY MEDICAL CENTER) WHEN IT WAS RUN BY THE STATE OF LOUISIANA, THE RESIDENCY PROGRAM WAS EXPANDED TO LAFAYETTE GENERAL MEDICAL CENTER. THESE TWO HOSPITALS SHARE IN A SYNERGISTIC RELATION, WHERE RESIDENTS BASED OUT OF LSU'S NEW ORLEANS AND BATON ROUGE CAMPUSES ROTATE THROUGHOUT EACH OF THESE HOSPITALS. THESE RESIDENTS SPAN A WIDE RANGE OF SERVICE LINES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, OTOLARYNGOLOGY (EAR, NOSE AND THROAT), OPHTHALMOLOGY, GENERAL SURGERY, OBSTETRICS, ANESTHESIOLOGY AND ORTHOPEDICS. FELLOWSHIPS (SPECIFIC MEDICAL TRAINING AVAILABLE TO THOSE WHO HAVE COMPLETED A RESIDENCY PROGRAM) ARE AVAILABLE IN GERIATRICS AND UROGYNECOLOGY.LAFAYETTE GENERAL CONTINUES TO EXPAND ITS SERVICES AND FACILITIES IN ORDER TO MEET THE GROWING NEEDS OF OUR COMMUNITY. TWO OF THE MORE RECENT RENOVATIONS AND EXPANSION TO OUR FACILITIES ARE DETAILED BELOW.ORIGINALLY BUILT IN 1963, THE 10-STORY LAFAYETTE GENERAL MEDICAL CENTER MAIN BUILDING COMPLETED AN EXTERIOR AND INTERIOR DESIGN RENOVATION TO FOCUS ON PATIENT HEALTH CARE BY CREATING A HEALING-FOCUSED AND COMFORTABLE ENVIRONMENT. THE $70 MILLION RENOVATION PROJECT ADDED MORE THAN 65 SQUARE FEET OF SPACE TO PATIENT ROOMS AND MORE THAN 12,500 SQUARE FEET OF OVERALL SPACE WITH LARGER PATIENT BATHROOMS, SHOWERS AND A MODERNIZED PATIENT CARE INFRASTRUCTURE.LAFAYETTE GENERAL MEDICAL CENTER COMPLETED A $52.5 MILLION EMERGENCY DEPARTMENT AND OPERATING ROOM EXPANSION AND RENOVATION PROJECT. THE EXPANSION INCREASED THE EMERGENCY DEPARTMENT BED CAPACITY FROM 31 BEDS TO 45 AND ADDED TWO NEW TRAUMA ROOMS. A NEW TRAUMA ELEVATOR ADDED DIRECT ACCESS FROM THE EMERGENCY HELIPAD LANDING AREA TO THE ER, ICU, AND SURGERY AREAS BELOW. THIS EXPANSION ALSO INCLUDED A 343 SPACE PARKING GARAGE. LGMC WAS AMONG THE FIRST IN THE NATION USING A NEW SYSTEM TO TREAT CORONARY ARTERY DISEASE, AND TO USE A DRUGCOATED BALLOON CATHETER. LGMC INTRODUCED ACADIANA'S FIRST DA VINCI XI SURGICAL SYSTEM. LGMC WAS THE SECOND HOSPITAL IN THE WORLD TO PIONEER THE BRIGHTMATTER SERVO BRAIN SURGERY SYSTEM.OUR ACCOLADES AND ACCREDITATIONS GROW EACH YEAR. IN OUR FISCAL YEAR 2015 WE RECEIVED THE FOLLOWING: WE WERE ALSO NAMED AS A 2015 WOMEN'S CHOICE AWARD RECIPIENT FOR BEING ONE OF AMERICA'S BEST HOSPITALS FOR PATIENT SAFETY, OBSTETRICS, ORTHOPEDICS, CANCER CARE, STROKE AND PATIENT EXPERIENCE. THE HOSPITAL WAS ALSO RECOGNIZED AMONG THE NATIONS "MOST WIRED" BUY HOSPITALS & HEALTH NETWORKS MAGAZINE. THE HOSPITAL WAS AS RECOGNIZED AS A 2014/2015 CONSUMER CHOICE AWARD WINNER FOR THE TENTH-CONSECUTIVE TIME BY NATIONAL RESEARCH CORPORATION. THE CONSUMER CHOICE AWARD WINNERS ARE DETERMINED BY CONSUMER PERCEPTIONS ON MULTIPLE QUALITY AND IMAGE RATINGS COLLECTED IN NATIONAL RESEARCH'S MARKET INSIGHTS SURVEY, THE LARGEST ONLINE CONSUMER HEALTHCARE SURVEY IN THE COUNTRY. THE HOSPITAL RECEIVED THE 2014 PRESS GANEY GUARDIAN OF EXCELLENCE AWARD AND THE 2014 PRESS GANEY BEACON OF EXCELLENCE AWARD FOR PATIENT EXPERIENCE. THE PRESS GANEY AWARDS RECOGNIZE THE NATION'S TOP-PERFORMING HEALTH CARE FACILITIES THAT HAVE CONSISTENTLY ACHIEVED THE 95TH PERCENTILE IN PATIENT EXPERIENCE, AND HAVE CONSISTENTLY MAINTAINED A HIGH LEVEL OF EXCELLENCE FOR THREE CONSECUTIVE YEARS. LAFAYETTE GENERAL MEDICAL CENTER WAS NAMED A 2015 WOMEN'S CHOICE AWARD RECIPIENT FOR BEING ONE OF AMERICA'S BEST HOSPITALS FOR PATIENT SAFETY. THIS DISTINCTION IS THE ONLY EVIDENCE-BASED DESIGNATION THAT IDENTIFIES THE COUNTRY'S BEST HOSPITALS BASED ON ROBUST CRITERIA REGARDING PATIENT SAFETY, SPECIFICALLY WHAT WOMEN SAY THEY WANT FROM A HOSPITAL. THE 310 HOSPITALS SELECTED AS AMERICA'S BEST HOSPITALS FOR PATIENT SAFETY NATIONWIDE WERE IDENTIFIED BASED ON HAVING A LOW INCIDENCE OF PROBLEMS ARISING FROM SURGICAL ERRORS AND INFECTIONS. SOUTHERN EYE BANK (SEB) PRESENTED LGMC ITS 2014 "HOSPITAL OF THE YEAR" AWARD FOR BEING A LOCAL LEADER IN CORNEA DONATION. THIS IS THE FIFTH TIME LGMC HAS RECEIVED THE SEB AWARD.BOTH UNIVERSITY HOSPITAL & CLINICS (UHC) AND LAFAYETTE GENERAL MEDICAL CENTER (LGMC) EARNED QUALITY RESPIRATORY CARE RECOGNITION (QRCR) UNDER A NATIONAL PROGRAM AIMED AT HELPING PATIENTS AND FAMILIES MAKE INFORMED DECISIONS ABOUT THE QUALITY OF THE RESPIRATORY CARE SERVICES AVAILABLE IN HOSPITALS.LAFAYETTE GENERAL MEDICAL CENTER (LGMC) GARNERED THE LOUISIANA QUALITY FOUNDATION'S (LQF) HIGHEST AWARD, THE LOUISIANA PERFORMANCE EXCELLENCE AWARD (LPEA). THE LQF AWARDS PROGRAM RECOGNIZES PERFORMANCE EXCELLENCE LEADERSHIP IN BOTH PROFIT AND NON-PROFIT LOUISIANA ORGANIZATIONS IN THE AREAS OF MANUFACTURING, SERVICE, HEALTH CARE, EDUCATION AND THE PUBLIC SECTOR. LPEA RECIPIENTS HAVE SUCCESSFULLY ACHIEVED BENCHMARK CRITERIA IN ALIGNMENT WITH THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD. BALDRIGE, INITIATED IN 1987, IS AN INTERNATIONALLY RECOGNIZED STANDARD FOR PERFORMANCE EXCELLENCE IN BUSINESS, EDUCATION AND HEALTH CARE. THE BALDRIGE PROGRAM HELPS ORGANIZATIONS ACHIEVE BEST-IN-CLASS LEVELS OF PERFORMANCE BY IDENTIFYING ROLE MODEL ORGANIZATIONS AND SHARING BEST PRACTICES. LGMC'S APPLICATION, WHICH DETAILED PROCESSES THAT HAVE HELPED THE ORGANIZATION REACH AND SUSTAIN NATIONALLY RECOGNIZED LEVELS IN PATIENT CARE AND PATIENT SATISFACTION, WAS REVIEWED AT THE STATE LEVEL BY LQF. A PANEL OF EXAMINERS THEN CONDUCTED A SITE VISIT. LQF HAS THREE DIFFERENT AWARD WINNERS BASED ON SUBMISSION OF 1) ORGANIZATIONAL PROFILE 2) BALDRIGE CRITERIA 3) RESULTS. PERFORMANCE CHALLENGE AWARD WINNERS HAVE DEMONSTRATED EXCELLENCE IN THE ORGANIZATIONAL PROFILE, WHILE COMMITMENT TO PERFORMANCE AWARD WINNERS SHOW PROFICIENCY IN BOTH THE ORGANIZATIONAL PROFILE AND BALDRIGE CRITERIA. LPEA WINNERS EXCEL IN ALL THREE AREAS.LAFAYETTE GENERAL MEDICAL CENTER ASSUMES THE ROLE OF A COMMUNITY PARTNER IN A VARIETY OF WAYS. THROUGH FINANCIAL CONTRIBUTIONS WE WORK TO PRESERVE THE PROSPERITY OF OUR COMMUNITY, FURTHER MEDICAL EDUCATION AND RESEARCH AND HELP OUR CONSTITUENTS ACCESS THE MEDICAL CARE THEY NEED. WE COORDINATE EVENTS AND SCREENINGS FREE OF CHARGE TO MAINTAIN THE HEALTH OF THE LOCAL PUBLIC, INCLUDING FREE EKG SCREENINGS AT MONTHLY HEART FAIRS AND FREE COLORECTAL SCREENING KITS. WE ALSO EXTEND OUR WORKFORCE BEYOND THEIR DAILY RESPONSIBILITIES TO PARTICIPATE IN ACTIVITIES THAT PROVIDE FOR THE SAFETY AND BETTERMENT OF OUR COMMUNITY. 368724722 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 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 331 0 1 2001 1 1 1 0 0 0 0 0 0 0 X 21 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 3372898125 1214 COOLIDGE BOULEVARD LAFAYETTE LA 70503 X CLAY ALLEN CHAIRMAN 3.00 2.00 X 0 0 0 MARTIN BECH TRUSTEE 1.00 1.00 X 0 0 0 BRADLEY J CHASTANT MD TRUSTEE 8.00 1.00 X 7500 0 0 BRADEN DESPOT SECRETARY 1.00 2.00 X 0 0 0 BENJAMIN DOGA MD TRUSTEE 3.50 1.00 X 22600 0 0 JULIE FALGOUT TRUSTEE 1.00 1.00 X 0 0 0 WILLIAM H FENSTERMAKER PAST CHAIRMAN 1.00 2.00 X 0 0 0 PHILIP GACHASSIN MD TRUSTEE 8.50 1.00 X 97933 0 0 ROBERT GILES TRUSTEE 1.00 1.00 X 0 0 0 JOBY JOHN PHD TRUSTEE 1.00 3.00 X 0 0 0 EDWARD KRAMPE VICE CHAIRMAN - PART YEAR 1.00 2.00 X 0 0 0 FLO MEADOWS TREASURER 1.00 1.00 X 0 0 0 DAVID CALHOUN TRUSTEE 1.00 1.00 X 0 0 0 MANDI MITCHELL TRUSTEE 1.00 1.00 X 0 0 0 GARY SALMON TRUSTEE 1.00 1.00 X 0 0 0 SAMUEL SHUFFLER MD TRUSTEE 1.00 1.00 X 0 0 0 DAVID WILSON TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH ZANCO TRUSTEE 1.00 1.00 X 0 0 0 JUAN J PEREZ-RUIZ MD CHIEF OF STAFF - PART YEAR 1.00 41.00 X 0 271163 10667 BRAD BROUSSARD MD TRUSTEE - PART YEAR 5.00 41.00 X 54333 0 0 JOHN SCHUTTE MD TRUSTEE - PART YEAR 21.00 41.00 X 52000 1428105 19469 DENNIS ESCHETE MD CHIEF OF STAFF - PART YEAR 9.00 1.00 X 87800 0 0 DAVID CALLECOD PRESIDENT/CEO - LGHS 1.00 46.00 X 0 1177776 238614 PATRICK W GANDY JR EVP/CEO - LGMC 1.00 40.00 X 0 596096 94150 ROGER MATTKE SVP/CFO 1.00 40.00 X 0 549661 115044 REBECCA F BENOIT VP/CNO 1.00 40.00 X 0 307130 48652 GORDON E ROUNTREE JR SVP/GENERAL COUNSEL 1.00 40.00 X 0 480889 86033 DEBORAH F JOHNSON MD PHYSICIAN 40.00 0.00 X 0 806368 4009 MICHAEL CAIN MD PHYSICIAN 40.00 1.00 X 44928 782533 6062 SALMAN MALAD MD PHYSICIAN 40.00 0.00 X 0 753651 5145 ANGELA MAYEUX-HEBERT MD PHYSICIAN 40.00 0.00 X 56100 726812 10465 WILLIAM ROY JR MD PHYSICIAN 40.00 0.00 X 0 583051 9170 423194 8463235 647480 83 0 1 0 ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 60673 HOUSEKEEPING AND DIETARY 10661972 CARDIOVASCULAR INSTITUTE OF THE SOUTH AP 225 DUNN STREET HOUMA LA 703604413 CARDIOLOGY SERVICES 2927041 LSU HEALTH CARE SERVICES 433 BOLIVAR STREET NEW ORLEANS LA 70112 MEDICAL SCHOOL RESIDENTS 2242670 PARISH ANESTHESIA OF LAFAYETTE 3510 N CAUSEWAY BOULEVARD METAIRIE LA 70002 ANESTHESIA SERVICES 1796375 GBR LLC 155 HOSPITAL DRIVE SUITE 206 LAFAYETTE LA 70503 CRITICAL CARE SERVICES 1691538 56 45176 178568 223744 PATIENT REVENUE 621990 428275814 428275814 428275814 4816076 4816076 6 6 98751 0 98751 98751 98751 3262941 0 3262941 3262941 3262941 2359 0 2359 2359 OTHER REVENUE 900099 12249398 8638701 3610697 12249398 448929089 436914515 3610697 8180133 X 799588 799588 322166 322166 88442406 82273235 6169171 1157138 1089539 67599 7800151 7046339 753812 6171874 5720446 451428 1543623 1497089 46534 378201 378201 30768 24508 6260 5050414 4365870 684544 19752 18652 1100 3667308 945761 2721547 210228 177759 32469 47539 47539 62355108 62355108 4221796 3959144 262652 124582 112942 11640 MEDICAL SUPPLIES 78027560 77035407 992153 BAD DEBT 54125948 54125948 NONCLINICAL CONTRACT LA 17132582 16327111 805471 EQUIPMENT RENTAL AND MA 14408498 11243966 3164532 40818554 39180570 1637984 386855784 368724722 18131062 0 5073 5077 46943521 20320527 33668553 43623741 14665155 18968440 9478061 9456922 1030465 987885 89036399 69435294 34628363 19601105 83906002 9778 9778 8582421 9765390 1333333 1333333 81224566 271892004 315475291 395964202 37566383 29876732 9973361 3957634 390273 9005973 55892999 60503351 86160004 X 254971940 309804198 254971940 309804198 315475291 395964202 62073305 -7241047 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 174268 0 174268 368679545 636621767 368679545 636796035 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 23762 24586 189962 174268 412578 250000 250000 250000 250000 1000000 1500000 23762 24586 189962 174268 412578 SCHEDULE C PART II-A, LINE 1A ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH THE AMERICAN HOSPITAL ASSOCIATION AND THE LOUISIANA HOSPITAL ASSOCIATION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. 5401334 1874702 3526632 1728102 1213906 514196 80324220 66280649 14043571 1582743 66037 1516706 19601105 BOND FUNDS 5732109 DEPOSITS 7453 CSV OF EXEC/KEY LIFE INSURANCE 373846 UNINVESTED VALUE OF SERP 2795449 DUE FROM RELATED PARTY 262983147 271892004 DUE TO RELATED PARTY 55892999 55892999 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 1200198 1200198 0.00360 39843445 91660355 -51816910 0.00000 41043643 91660355 -50616712 0.00360 10883047 10883047 0.03270 3142570 684674 2457896 0.00740 78454 78454 0.00020 14104071 684674 13419397 0.04030 55147714 92345029 -37197315 0.04390 1 54125948 2816803 102772279 104307686 -1535407 X 1 1 1 1 LAFAYETTE GENERAL MEDICAL CENTER INC 1214 COOLIDGE BLVD LAFAYETTE LA 70503 X X X X LAFAYETTE GENERAL MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS X 1 12 0 0 0 1 X 100.000000000000 200.000000000000 1 1 X X X 1 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/LGMC_FINANCIAL_ X HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 X X X X X X 1 0 1 X 0 0 LAFAYETTE GENERAL MEDICAL CENTER 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.INDIVIDUALS PROVIDING INPUT:MANDI MITCHELL, DIRECTOR OF GOVERNMENTAL AFFAIRS -LOUISIANA DEPARTMENT OF ECONOMIC DEVELOPMENT; AREA REPRESENTED: GOVERNMENT OFFICIALREBECCA BENOIT, CHIEF NURSING OFFICER - LGMC; AREA REPRESENTED:HOSPITAL STAFFBOOTSIE DURAND, CHIEF EXECUTIVE OFFICER - SOUTHWEST LOUISIANA AREA HEALTH EDUCATION CENTER; AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVEDR. BRYAN SIBLEY, PEDIATRICIAN; AREA REPRESENTED: COMMUNITY PHYSICIANCLAY ALLEN, CHAIRMAN OF THE BOARD OF TRUSTEES - LGMC; AREA REPRESENTED: HOSPITAL ADMINISTRATIONDAVID CALLECOD, PRESIDENT AND CEO - LGMC; AREA REPRESENTED: HOSPITAL ADMINISTRATIONFLO MEADOWS, BOARD OF TRUSTEES MEMBER - LGMC AND REALTOR - COLDWELL BANKER PELICAN REAL ESTATE; AREA REPRESENTED: HOSPITAL ADMINISTRATIONDR. GARY GUIDRY, PULMONOLOGIST AND BOARD OF TRUSTEES MEMBER - LGMC; AREA REPRESENTED: HOSPITAL STAFFJEANETTE ALCON, EXECUTIVE DIRECTOR - LAFAYETTE COMMUNITY HEALTHCARE CLINIC; AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVEJOEY DUREL, PRESIDENT - LAFAYETTE CITY-PARISH; AREA REPRESENTED: GOVERNMENT OFFICIALMARIA PLACER, EXECUTIVE DIRECTOR - 232-HELP; AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVEPATRICK GANDY, CHIEF OPERATING OFFICER- LGMC; AREA REPRESENTED: HOSPITAL ADMINISTRATIONPAULA WALTERS, EXECUTIVE DIRECTOR - LAFAYETTE COUNCIL ON AGING; AREA REPRESENTED: MEDICALLY UNDERSERVED COMMUNITY ORGANIZATION REPRESENTATIVEPHILIP GACHASSIN, BARIATRIC SURGEON - ACADIANA WEIGHT LOSS SURGERY; AREA REPRESENTED: COMMUNITY PHYSICIANRAYMOND HEBERT, EXECUTIVE DIRECTOR - COMMUNITY FOUNDATION OF ACADIANA; AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVEZIAD ASHKAR, CHIEF MEDICAL OFFICER - LGMC; AREA REPRESENTED: HOSPITAL ADMINISTRATIONMARGARET TRAHAN, UNITED WAY OF ACADIANA, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVELOUIS HEBERT, HOSPICE FOUNDATION OF ACADIANA, INC.; AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATION REPRESENTATIVEDR. PHILLIP CAILLOUET, UNIVERSITY OF LOUISIANA AT LAFAYETTE, AREA REPRESENTED: HOSPITAL REPRESENTATIVE LAFAYETTE GENERAL MEDICAL CENTER INC. PART V, SECTION B, LINE 11: THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED NEEDS ASSESSMENT BY:-ADOPTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THE HEALTH NEEDS OF THE HOSPITAL FACILITY'S COMMUNITY-EXECUTION OF THE IMPLEMENTATION STRATEGY-PARTICIPATION IN THE DEVELOPMENT OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-PARTICIPATION IN THE EXECUTION OF A COMMUNITY-WIDE COMMUNITY BENEFIT PLAN-INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS-ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT-PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY-PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITYPLEASE SEE ATTACHED IMPLEMENTATION STRATEGY FOR FURTHER INFORMATION. LAFAYETTE GENERAL MEDICAL CENTER INC. PART V, SECTION B, LINE 16I: THE POLICY IS DESCRIBED IN OUR PATIENT INFORMATION PACKETS PROVIDED DURING THE ADMISSION PROCESS. PART V, SECTION B, LINE 7A - CHNA WEBSITE HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/LGMC-COMMUNITY-NEEDS-ASSESSMENT-FY2013.PDF PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY LAFAYETTE GENERAL MEDICAL CENTER INC. PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 LAFAYETTE GENERAL MEDICAL CENTER INC. PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/LGMC_FINANCIAL_ LAFAYETTE GENERAL MEDICAL CENTER INC. PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/FAP/FAP_LGMC_122815 PART I, LINE 6A: THE ANNUAL COMMUNITY BENEFIT REPORT INCLUDED ALL OF THE HEALTHCARE FACILITIES THAT LAFAYETTE GENERAL MEDICAL CENTER, INC IS AFFILIATED WITH. THE COMMUNITY BENEFIT REPORT INCLUDED LAFAYETTE GENERAL HEALTH SYSTEM, UNIVERSITY HOSPITAL & CLINICS, ACADIA GENERAL HOSPITAL, KAPLAN GENERAL HOSPITAL, DBA ABROM KAPLAN MEMORIAL HOSPITAL, LAFAYETTE GENERAL SURGICAL HOSPITAL, OIL CENTER SURGIAL PLAZA, ST. MARTIN HOSPITAL, LAFAYETTE HEALTH VENTURES, AND LAFAYETTE GENERAL FOUNDATION. 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 7B, MEDICAID: LGMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS TO ASSIST IN OFFSETTING THE COSTS OF PROVIDING GRADUATE MEDICAL EDUCATION PROGRAMS AT BOTH LGMC AND UNIVERSITY HOSPITAL AND CLINICS. THE PAYMENTS ARE PROVIDED THROUGH A COLLABORATIVE ENDEAVOR AGREEMENT CREATING A PUBLIC PRIVATE PARTNERSHIP WITH LGMC, UHC, LOUISIANA STATE UNIVERSITY AND THE STATE OF LOUISIANA. 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 $ 54,125,948. PART 1, LINE 7, COLUMN F THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25 WHICH EXCLUDED 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 III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE ORGANIZATION'S MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, IF NECESSARY (E.G., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THOSE WITH NO THIRD-PARTY COVERAGE, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THEAMOUNTS 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 PAYACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2015 AND 2014. THE ORGANIZATION HAS EXPERIENCED AN INCREASE IN 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, AND AN OVERALL INCREASE IN UNINSURED PATIENTS RESULTING FROM THE COLLABORATION WITH THE STATE TO OPERATE THE FORMER LSU TEACHING HOSPITAL IN LAFAYETTE WHICH SERVES A PREDOMINATELY MEDICAID AND UNINSURED POPULATION.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 44% 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 RECAPPED FROM THE HOSPITALS FILED 2015 COST REPORT. 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 VI, LINE 2: A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR THE YEAR ENDING 09/30/13. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE OUR COMMUNITY HEALTH NEEDS ASSESSMENT DURING 2013. 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. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATION. THE HOSPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/LGMC-COMMUNITY-NEEDS-ASSESSMENT-FY2013.PDF 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. HOSPITAL PERSONNEL ALSO SCREEN LARGER ACCOUNTS AFTER THE ORIGINAL BILL IS ISSUED, AND CONTACT THE PATIENT TO DETERMINE QUALIFICATIONS FOR CHARITY CARE POLICY. 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 PARISH. THE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE. PART VI, LINE 5: THE HOSPITAL DOES MAINTAIN AN OPEN MEDICAL STAFF THUS ALLOWING IT TO OFFER 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 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. 1 AMERICAN CANCER SOCIETY 1064 W PINHOOK RD STE 203 LAFAYETTE LA 70508 131788491 501(C)(3) 9000 DONATION CAMP BON COEUR 405 W MAIN ST LAFAYETTE LA 70501 581710741 501(C)(3) 10000 DONATION LAFAYETTE COMMUNITY HEALTHCARE CLINIC 1317 JEFFERSON STREET LAFAYETTE LA 70501 721221982 501(C)(3) 500 9941 FEE SCHEDULE LAB SERVICES DONATION; REFERENCE LAB SERVICES LAFAYETTE GENERAL FOUNDATION 1214 COOLIDGE BLVD LAFAYETTE LA 70503 371766778 501(C)(3) 730634 DONATION MILES PERRET CANCER CENTER 2130 KALISTE SALOAM RD 200 LAFAYETTE LA 70508 753023211 501(C)(3) 15000 DONATION NAMI ACADIANA 1001 W PINHOOK RD LAFAYETTE LA 70503 261801727 501(C)(3) 5000 DONATION UNIVERSITY OF LOUISIANA AT LAFAYETTE 104 E UNIVERSITY CIRCLE LAFAYETTE LA 70503 726023836 501(C)(3) 8283 DONATION 7 0 PART I, LINE 2: CHARITABLE DONATIONS ARE MADE TO LOCAL NON-PROFIT ORGINIZATIONS THAT PARALLEL OUR HEALTHCARE MISSION IN THE COMMUNITY. X X X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 JUAN J PEREZ-RUIZ MD CHIEF OF STAFF - PART YEAR 0 271163 0 0 0 0 0 3522 0 7145 0 281830 0 0 JOHN SCHUTTE MD TRUSTEE - PART YEAR 0 1274945 0 153160 52000 0 0 11725 0 7744 52000 1447574 0 0 DAVID CALLECOD PRESIDENT/CEO - LGHS 0 774176 0 309670 0 93930 0 228970 0 9644 0 1416390 0 0 PATRICK W GANDY JR EVP/CEO - LGMC 0 425620 0 127686 0 42790 0 87193 0 6957 0 690246 0 0 ROGER MATTKE SVP/CFO 0 393952 0 118186 0 37523 0 104281 0 10763 0 664705 0 0 REBECCA F BENOIT VP/CNO 0 236912 0 59228 0 10990 0 46105 0 2547 0 355782 0 0 GORDON E ROUNTREE JR SVP/GENERAL COUNSEL 0 345644 0 103693 0 31552 0 77922 0 8111 0 566922 0 0 DEBORAH F JOHNSON MD PHYSICIAN 0 806368 0 0 0 0 0 1782 0 2227 0 810377 0 0 MICHAEL CAIN MD PHYSICIAN 0 782533 0 0 44928 0 0 0 0 6062 44928 788595 0 0 SALMAN MALAD MD PHYSICIAN 0 730426 0 23225 0 0 0 2940 0 2205 0 758796 0 0 ANGELA MAYEUX-HEBERT MD PHYSICIAN 0 620555 0 106257 56100 0 0 6084 0 4381 56100 737277 0 0 WILLIAM ROY JR MD PHYSICIAN 0 583051 0 0 0 0 0 7115 0 2055 0 592221 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 WERE PAID FOR THE PRESIDENT/CEO-LGHS AND THE EVP/CEO-LGMC AND WERE INCLUDED AS WELL AS COMPENSATION ON THEIR W-2'S. PART I, LINE 4B 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 $498,900. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE DAVID CALLECOD, PRESIDENT/CEO-LGHS, PATRICK GANDY, EVP/COO-LGMC, ROGER MATTKE, SVP/CFO, GORDON ROUNTREE, GENERAL COUNSEL, AND REBECCA BENOIT, CNO. DISTRIBUTIONS FROM SERP PLAN, INCLUDED IN 2014 W-2 WAGES, TOTALLED $75,669. THE FOLLOWING RECEIVED DISTRIBUTIONS, INCLUDED IN THEIR 2014 W-2 WAGES: DAVID CALLECOD, PRESIDENT/CEO-LGHS, PATRICK GANDY, EVP/COO-LGMC, ROGER MATTKE, SVP/CFO, AND GORDON ROUNTREE, GENERAL COUNSEL. 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. SURGICAL HOSPITAL MANAGEMENT SYSTEM PHILIP GACHASSIN, M.D. IS A TRUSTEE OF LGMC AND IS A MEMBER OF SHMS, LLC. 1267500 LAFAYETTE GENERAL MEDICAL CENTER, INC. HAS ENTERED INTO A CONTRACT WITH INTERESTED PERSON TO PROVIDE ACUTE CARE SURGICALIST SERVICES. 0 STREAMLINE ORTHOPEDIC SERVICES APMLLC JOHN SCHUTTE, MD IS A TRUSTEE OF LGMC AND IS A MEMBER OF SOS, APMLLC 722727 LAFAYETTE GENERAL MEDICAL CENTER, INC HAS ENTERED INTO A CONTRACT WITH STREAMLINE ORTHOPEDIC SERVICES, APMLLC TO PROVIDE MEDICAL DIRECTOR SERVICES AND OVERSIGHT OF THE ORTHOPEDIC SERVICES PRODUCT LINE. 0 LAFAYETTE UROLOGY CALL LLC DR. SAMUEL SHUFFLER IS A TRUSTEE OF LGMC AND IS A MEMBER OF LUC, LLC 182500 LAFAYETTE GENERAL MEDICAL CENTER, INC HAS ENTERED INTO A CONTRACT WITH LAFAYETTE UROLOGY CALL, LLC TO ER CALL COVERAGE. 0 FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES, CLAY ALLEN AND ROBERT GILES, ARE INVOLVED IN SEPARATE BUSINESS VENTURES TOGETHER THAT ARE WHOLLY UNRELATED TO THE ORGANIZATION. ANGELA MAYEUX-HERBERT AND BRADLEY CHASTANT ARE PARTNERS IN LIG, WHICH LGMC IS ALSO A PARTNER IN. THE FOLLOWING TRUSTEES ALL HAVE OWNERSHIP IN LAFAYETTE GENERAL SURGICAL HOSPITAL: DR. SCHUTTE, DR. CHASTANT, DR. SHUFFLER AND DR. GACHASSIN. 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 GOVERENCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE. THEREAFTER THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE 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 MAY BE 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 THE PRESIDENT/CEOS COMPENSATION THEREAFTER. THIS SAME PROCESS IS FOLLOWED FOR THE FOLLOWING SENIOR EXECUTIVES OF THE ORGANIZATION: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER AND GENERAL COUNSEL. FORM 990, PART VI, SECTION C, LINE 19 BASIC FINANCIAL INFORMATION IS MADE AVAILABLE AND SENT OUT TO THE COMMUNITY BY MEANS OF THE ORGANIZATION'S ANNUAL REPORT. OTHER DOCUMENTS AND MORE DETAILED FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY / LEGAL AUTHORITIES. FORM 990, PART VII, SECTION A, LINE A PAYMENTS TO THE PHYSICIANS THAT SERVE AS TRUSTEES WERE REPORTED ON 1099 MISC BOX 6 FOR SUCH SERVICES AS PROVIDING CALL COVERAGE IN OUR EMERGENCY ROOM, OR SERVING AS MEDICAL DIRECTORS FOR VARIOUS HOSPITAL DEPARTMENTS. NO PAYMENTS WERE MADE IN THEIR CAPACITY AS TRUSTEE. FORM 990, PART IX, LINE 24E PHYSICIAN CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 11,996,979. MANAGEMENT AND GENERAL EXPENSES 74,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,071,479. COMMUNITY PHYSICIAN RELATIONS: PROGRAM SERVICE EXPENSES 10,459,545. MANAGEMENT AND GENERAL EXPENSES 12,491. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,472,036. CLINICAL CONTRACT LABOR: PROGRAM SERVICE EXPENSES 7,059,191. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,059,191. MEDICAL DIRECTORSHIPS: PROGRAM SERVICE EXPENSES 3,161,033. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,161,033. FOOD SUPPLIES: PROGRAM SERVICE EXPENSES 3,066,334. MANAGEMENT AND GENERAL EXPENSES 67. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,066,401. OTHER NONCLINICAL SERVICES: PROGRAM SERVICE EXPENSES 1,453,567. MANAGEMENT AND GENERAL EXPENSES 206,726. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,660,293. RECRUITING: PROGRAM SERVICE EXPENSES 57,033. MANAGEMENT AND GENERAL EXPENSES 1,203,893. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,260,926. LAUNDRY: PROGRAM SERVICE EXPENSES 745,497. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 745,497. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 658,947. MANAGEMENT AND GENERAL EXPENSES 32,836. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 691,783. TAXES & LICENSES: PROGRAM SERVICE EXPENSES 163,905. MANAGEMENT AND GENERAL EXPENSES 13,123. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 177,028. BANK CHARGES: PROGRAM SERVICE EXPENSES 132,970. MANAGEMENT AND GENERAL EXPENSES 34,072. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 167,042. TELEPHONE: PROGRAM SERVICE EXPENSES 83,330. MANAGEMENT AND GENERAL EXPENSES 21,028. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,358. EMPLOYEE ACTIVITIES: PROGRAM SERVICE EXPENSES 78,175. MANAGEMENT AND GENERAL EXPENSES 19,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 98,062. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 63,255. MANAGEMENT AND GENERAL EXPENSES 11,289. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 74,544. OTHER COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 309. MANAGEMENT AND GENERAL EXPENSES 8,072. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,381. BOND FUND EXPENSE: PROGRAM SERVICE EXPENSES 500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 500. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANED FROM THE PREVIOUS YEAR. FORM 990, PART III, LINE 4A - CONTINUED FINANCIAL CONTRIBUTIONS: IN 2015 WE DONATED OVER $78,000 SUPPORTING ORGANIZATIONS THAT PARALLEL OUR MISSION IN THE COMMUNITY, EMPLOYEES THROUGH CONTINUING EDUCATION, AND HELPING TO IMPROVE THE HEALTH OF THOSE WE SERVE. FROM OFFERING CLINICAL SUPPORT TO CAMP BON CEUR ATTENDEES TO SPONSORING EVENTS THAT RAISE RESEARCH MONEY AND AWARENESS FOR ILLNESSES LIKE BREAST CANCER, DIABETES AND HEART DISEASE. IN 2015 THESE MONIES WERE DONATED TO 13 DIFFERENT ORGANIZATIONS IN OUR COMMUNITY. COMMUNITY OUTREACH & HEALTH CARE ACCESS CONTRIBUTIONS: LAFAYETTE GENERAL MEDIAL CENTER MAINTAINS A PROACTIVE APPROACH TO EDUCATION AND WELLNESS IN OUR COMMUNITY. ANNUALLY LGMC PROVIDES A MULTITUDE OF EDUCATIONAL SEMINARS AIMED AT EDUCATING THE PUBLIC ON PREVENTATIVE CARE AND MAINTAINING A HEALTHY LIFESTYLE. SOME OF THESE ACTIVITIES AND PROGRAMS INCLUDE: DONATED $9,941 IN DIAGNOSTIC SERVICES AS PART OF A PARTNERSHIP WITH THE LAFAYETTE COMMUNITY HEALTH CARE CLINIC. WOMEN'S AND CHILDREN'S SERVICES CURRENTLY OFFERS CLASSES WHICH INCLUDE NEWBORN CARE, LABOR AND DELIVERY PROCESS, SIBLING RELATIONSHIPS, BREASTFEEDING YOUR INFANT AND INFANT CPR. FREE SUPPORT GROUPS ARE OPEN TO RESIDENTS DEALING WITH STROKE SURVIVAL, WEIGHT LOSS SURGERY, INFANT BEREAVEMENT, AND MULTIPLE BIRTHS. LGMC ALSO PROVIDES FREE TRANSPORTATION FOR PATIENTS WITH SPECIAL NEEDS, IN ORDER TO ALLOW THEM ACCESS TO MEDICAL CARE AT THE HOSPITAL. TO IMPROVE HEALTH CARE ACCESS FOR THOSE UNINSURED WORKERS LIVING AT OR BELOW POVERTY LEVEL, LGMC MAINTAINS A REFERRAL AGREEMENT WITH THE LOCAL "LAFAYETTE COMMUNITY HEALTHCARE CLINIC" TO PROVIDE DIAGNOSTIC TESTING TO THEIR PATIENT POPULATION. LAFAYETTE GENERAL MEDICAL CENTER IS TRULY A COMMUNITY OWNED HOSPITAL CARING FOR THE NEEDS OF THE COMMUNITY AND INVESTING IN THE FUTURE WELLNESS OF OUR NEIGHBORS. 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