2016-05-16T13:59:53-05:00 2015-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2014-07-01 720423635 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC % RONALD E HOGAN OURL 3374702000 4801 ambassador caffery parkway Lafayette LA 70508 RONALD HOGAN REGIONAL CFO 3374702000 2016-05-15 true KPMG LLP P00746825 2253444000 2014 2016-08-17 19:52:53Z WILLIAM BARROW 4801 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 231057236 false 0928 X www.fmolhs.org/lourdesrmc X 1957 LA TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS AND TO PROVIDE FOR RESEARCH, EDUCATION, AND THE ENHANCEMENT OF HEALTH OF THOSE IN THE COMMUNITY. 17 15 1867 110 1179336 125853 1254380 1091343 209017522 221972643 4510536 -22239140 227580 1362914 215010018 202187760 266396 358025 0 0 82929136 86841563 0 0 0 123500996 144081130 206696528 231280718 8313490 -29092958 363608000 374165009 235748834 279771737 127859166 94393272 X OF THE ROMAN CATHOLIC CHURCH, OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. EXTENDS THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC. CALLS 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. false false 180477799 358025 221421508 HOSPITAL AND MEDICAL SERVICES PRIMARILY TO RESIDENTS OF SOUTH 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. THE MEDICAL CENTER PROVIDED SERVICES FOR 55,029 PATIENT DAYS, 96,495 OUTPATIENT VISITS, AND 36,241 EMERGENCY ROOM VISITS IN THE YEAR ENDED JUNE 30, 2015. SEE SCHEDULE O FOR FURTHER EXPLANATION. 180477799 true true false false false false false false false false true false true 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 false false false false false true true true true false false true 274 0 true 1867 true true true false false false false false false false false false X 17 15 true false false false true true true true true false false true true true true false true true false true false X RONALD E HOGAN 3374702000 4801 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 WF BUD BARROW PRESIDENT AND CEO 2.0 58.0 X X 0 514365 73214 DR KENNETH ODINET BOARD MEMBER 2.5 0.0 X 46500 0 0 D WAYNE ELMORE VICE CHAIR 0.5 0.0 X X 0 0 0 FR CHESTER ARCENEAUX BOARD MEMBER 0.5 0.0 X 0 0 0 PAUL BREAUX III MD BOARD MEMBER 0.5 0.5 X 0 0 0 DR RICHARD BROUSSARD BOARD MEMBER 0.5 0.0 X 0 0 0 DR KELLY T CAHILL JR BOARD MEMBER 40.0 0.0 X 320687 0 30597 DR CHANCELLOR DONALD BOARD MEMBER 0.5 0.0 X 0 0 0 CHARLES T GOODSON BOARD MEMBER 0.5 0.0 X 0 0 0 KENNETH L HIX SECRETARY 0.5 0.0 X X 0 0 0 JOHN L INDEST CHAIR 0.5 0.0 X X 0 0 0 DR HENRY J KAUFMAN BOARD MEMBER 2.5 0.0 X 30505 0 0 SR VERNOLA LYONS BOARD MEMBER 0.5 0.0 X 0 0 0 SR BETTY LYONS BOARD MEMBER 0.5 0.0 X 0 0 0 IAN MACDONALD BOARD MEMBER 0.5 0.5 X 0 0 0 ROBERT MAHTOOK JR BOARD MEMBER 0.5 0.0 X 0 0 0 DR THOMAS MONTGOMERY BOARD MEMBER 0.5 0.0 X 0 0 0 KEVIN MOODY BOARD MEMBER 0.5 0.0 X 0 0 0 JAMES MWATIBO MD BOARD MEMBER 40.0 0.0 X 227354 0 29528 GAIL ROMERO BOARD MEMBER 0.5 0.0 X 0 0 0 DR MICHAEL VANDERLICK BOARD MEMBER 40.0 0.0 X 279496 0 23719 DR CLINTON YOUNG BOARD MEMBER 0.5 0.0 X 0 0 0 RON HOGAN REGIONAL CFO 2.0 58.0 X 0 381170 52227 DONNA LANDRY COO 40.0 0.0 X 306189 0 28021 DANNA M CRAIN CNO 40.0 0.0 X 230742 0 60168 RICHARD FEI STAFF PHYSICIAN 40.0 0.0 X 503921 0 32762 ANTHONY P BLALOCK VP MEDICAL AFFAIRS 50.0 0.0 X 375718 0 13667 WARTELLE J CASTILLE STAFF PHYSICIAN 40.0 0.0 X 352203 0 34898 MARIA D MARTINEZ STAFF PHYSICIAN 40.0 0.0 X 299511 0 12279 FRANK W COURMIER STAFF PHYSICIAN 40.0 0.0 X 299386 0 33088 3272212 895535 424168 83 false true false FMOL HEALTH SYSTEM INC 4200 ESSEN LANE BATON ROUGHE LA 70809 MANAGEMENT SERVICES 19927185 SODEXO INC AFFILIATES 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 MANAGEMENT SERVICES 2672038 GE HEALTHCARE INFORMATION BIN 265 MILWAUKEE WI 532880256 LEASE OF EQUIPMENT 1552321 LOURDES IMAGING DEVELOPMENT 4801 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 LEASE OF EQUIPMENT 2418151 THE LEMOINE COMPANY LLC 214 JEFFERSON STREET SUITE 200 LAFAYETTE LA 70501 CONSTRUCT. SERVICES 1762756 99 959517 124963 6863 0 1091343 PATIENT SERVICE REVENUE 900099 209742770 209742770 OUTREACH LAB REVENUE 900099 4500325 3367143 1133182 OTHER REVENUE 900099 2993177 2993177 INCOME FROM EQUITY INVESTEES 900099 2008928 1975353 33575 HEART HOSPITAL MANAGEMENT FEE 900099 1483204 1483204 1244239 1244239 221972643 5503272 0 5404 5497868 0 0 1362914 1362914 0 1362914 582047 780867 1124564 2500 472235 28397241 652329 -28394741 -27742412 7175 -27749587 0 0 0 0 202187760 221387933 1179336 -21470852 340025 340025 0 0 18000 18000 0 1402685 601237 801448 0 0 69312954 51680320 17632634 4446003 3314977 1131026 6894613 6405345 489268 4785308 4445725 339583 27668992 24329627 3339365 511130 511130 26939 156 26783 0 0 45379 45379 4770640 1657837 3112803 661034 38049 622985 22146910 11087863 11059047 975 975 0 10053683 7007093 3046590 476628 121791 354837 0 0 6129057 3125819 3003238 0 12669196 9501897 3167299 2137029 358224 1778805 MEDICAL SUPPLIES EXPENSE 42411975 42071276 340699 PENSION RELATED CHANGES 14371563 14371563 231280718 180477799 50802919 0 20542241 22458815 5564789 5213631 0 0 28643282 28561379 0 0 0 0 5148744 1328184 3885504 3909525 1103951 1684127 333326212 98409095 237988708 234917117 5513709 7656630 7258924 10031779 26528751 26211531 20572163 20572162 857234 11620129 363608000 374165009 31179596 31763367 0 0 0 0 145943452 173431889 0 0 0 0 0 0 0 0 58625786 74576481 235748834 279771737 X 127859166 94273272 0 120000 0 0 127859166 94393272 363608000 374165009 X -29092958 604668 -4977604 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26626341 26626341 200302929 21648476 178654453 3287381 1075781 2211600 62822295 43942183 18880112 40287266 31742655 8544611 234917117 INVESTMENT IN PARK PLACE 5363893 F INVEST IN LOURDES AFTER HOURS 303517 F INVEST IN LHC GROUP 384877 F INVESTMENT IN HHL 19200853 F INVESTMENT IN LID 958391 F 26211531 0 CAPITAL LEASE 311137 ACCRUED PENSION COST 74265344 74576481 X FIN 48 FOOTNOTE (ASC 740) SCHEDULE D, PART XIV THE MEDICAL CENTER 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 5301394 5301394 5301394 Central America and the Caribbean HAITI MISSION 18000 CHECK 1 true false true true true false true true X true X true X true true true false true true 5870281 5870281 0.02250 16009785 6989472 9020313 0.03450 21880066 6989472 14890594 0.05700 517289 245373 279081 0.00110 123107 123107 0.00050 932781 592728 340053 0.00130 368078 368078 0.00140 1941255 838101 1110319 0.00430 23821321 7827573 16000913 0.06130 54677 7051 47626 0.00010 54677 7051 47626 0.00010 true 10271671 70377480 73238673 -2861193 X true true LOURDES IMAGING DEV LEASOR OF IMAGING PROP & EQUI 0.24723 0.05126 0.70151 HEART HOSP OF LAFAYE SPECIALTY HOSPITAL 0.60000 0.33240 PARK PLACE SURGICAL AMBULATORY SURGICAL CENTER 0.45000 0.07410 0.35930 3 1 OUR LADY OF LOURDES RMC 4801 AMBASSADOR CAFFERY PARKWAY LAFAYETTE LA 70508 www.fmolhs.org/lourdesrmc 697 X X X 2 HEART HOSPITAL OF ACADIANA LLC 1105 KALISTE SALOOM ROAD LAFAYETTE LA 70508 www.hearthospitallaf.net 631 X X X 3 PARK PLACE SURGERY CENTER LLC 4811 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 www.parkplacesurgery.com 505 X SURGERY CENTER OUR LADY OF LOURDES RMC 1 false false true X X X X X X X X X 12 true false 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 X true X X X X X true X false X X X X true X false false HEART HOSPITAL OF ACADIANA LLC 2 false false true X X X X X X X X X 12 true true false true X PART V, SECTION C X true 12 false true false true X 200. 300. X X true true X X X true X X X X true X false X X X X true X false false PARK PLACE SURGERY CENTER LLC 3 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 X true X X X X true X false X X X X true X false false PART V, LINE 5 OUR LADY OF LOURDES RMC, HEART HOSPITAL OF ACADIANA, & PARK PLACE SURGERY: INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES OF THE COMMUNITY, INCLUDING CHURCH LEADERS, LOURDES EMPLOYEES, CIVIC LEADERS, LOCAL GOVERNMENT OFFICIALS, PHYSICIANS, STATE AND LOCAL HEALTH DEPARTMENTS, AND VOLUNTEERS. THEIR INPUT AND EXPERTISE WAS HEAVILY RELIED UPON FOR INTERPRETATION OF DATA AND TRENDS IN HEALTHCARE IN LOUISIANA AND LAFAYETTE PARISH. THE HOSPITAL CONSULTED WITH DR. TINA STEFANSKI, REGION IV MEDICAL DIRECTOR FOR THE LOUISIANA DEPARTMENT OF HEALTH & HOSPITALS; IRIS MALONE, NURSE PRACTITIONER IN THE SCHOOL-BASED HEALTH CENTER; SHANON MCLAUGHLIN, SUPERVISOR OF THE SCHOOL-BASED HEALTH CENTER; CHRIS MARTIN, EXECUTIVE DIRECTOR OF BOYS & GIRLS CLIB OF ACADIANA; JAN SWIFT, EXECUTIVE DIRECTOR OF UPPER LAFAYETTE; AND CHIEF JIM CRAFT, LAFAYETTE POLICE DEPARTMENT. PART V, LINE 6 HEART HOSPITAL OF ACADIANA AND PARK PLACE SURGERY CENTER FORMALLY ADOPTED THE COMMUNITY HEALTH NEEDS ASSESSMENT OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, AN AFFILIATED ENTITY. HEART HOSPITAL OF ACADIANA, PARK PLACE SURGERY CENTER, AND OUR LADY OF LOURDES SHARE THE SAME DEMOGRAPHIC COMMUNITY SO HEART HOSPIAL OF ACADIANA AND PARK PLACE SURGERY CENTER FELT THAT THE NEEDS IDENTIFIED BY OUR LADY OF LOURDES WERE REPRESENTATIVE OF ITS COMMUNITY'S NEEDS AS WELL. PART V, LINE 7 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER: THE CHNA CAN BE FOUND AT HTTPS://FMOLHS.ORG/LOURDESRMC/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX HEART HOSPITAL OF LAFAYETTE: THE CHNA CAN BE FOUND AT HTTP://WWW.HEARTHOSPITALOFLAFAYETTE.COM/COMMUNITY/OUTREACH.HTML PARK PLACE SURGICAL HOSPITAL: THE CHNA CAN BE FOUND AT HTTP://WWW.PARKPLACESURGERY.COM/DOCS/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_PAR K_PLACE_SURGICAL_HL.PDF PART V, LINE 11 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER: In 2012 Our Lady of Lourdes identified six health needs in our community. As part of the Implementation Plan Phase of the Affordable Care Act, we focused on obesity, diabetes, cancer and heart disease. The areas identified with the least access to health care was 70501 and 70507 zip code areas. It was in these areas that goals and outcomes were set. The identified needs not chosen as an area of focus included mental health and alcoholism/drug addiction. We decided those needs were outside of the scope of our practice and there were other community agencies, such as the Extra Mile, Lafayette Community Healthcare Clinic and University Medical, that were better suited to provide the services. Obesity The goal was to increase the number of individuals with a healthy Body Mass Index, (less than 25) and to provide education on healthier eating habits. At St. Bernadette Community Clinic, an outreach clinic of Our Lady of Lourdes Community Services Department, patients saw an overall decrease in BMI by 7.14% in 2015. Congregational Health Services, another Community Services Department outreach program of Our Lady of Lourdes, provided BMI checks at several churches and handed out brochures on women's and men's health issues. Diabetes The goal was to decrease the risk of complications and morbidity related to diabetes. Congregational Health Services provided increased access to diabetes medications and screenings while promoting healthy eating and preventive health for diabetic patients. Data is not yet available to determine what difference these activities have made in these patients. Cancer The goal was to increase the number of individuals screened for cancer and to afford early detection of cancer in these patients. Screenings for breast, colon and prostate cancer were made available to these residents through St. Bernadette Community Clinic and Lourdes Primary Care physician practices. St. Bernadette saw an increase of 60% in appointments for preventative health care testing, such as mammograms, prostate exams and colonoscopies. As a result of the breast cancer screenings, St. Bernadette found 3% with positive diagnoses, none of which would likely have been caught until the advance stages of the disease. Heart Disease The goal was to improve cardiovascular health and provide early detection of individuals at risk for heart disease. Congregational Health Services increased access to heart medication for the poor and increased access to expert heart healthy knowledge and education. Heart Hospital partnered with St. Bernadette to conduct Carotid screening for their patients. HEART HOSPITAL OF LAFAYETTE: In 2012 Heart Hospital of Lafayette identified six health needs in our community. As part of the Implementation Plan Phase of the Affordable Care Act, we focused on obesity, diabetes, and heart disease. The areas identified with the least access to health care was 70501 and 70507 zip code areas. The identified needs not chosen as an area of focus included mental health, alcoholism/drug addiction, and cancer. We decided those needs were outside the scope of our practice and there were sufficient programs and services provided by Our Lady of Lourdes Regional Medical Center and other community outreach clinics and agencies in those areas. We partnered with St. Bernadette Clinic to offer Carotid screenings for their patients and sponsored a part-time dietician. We sponsored a full-time registered nurse for the Northside High School Clinic, serving students primarily in the 70501 zip code area. We also provide support in outreach programs with Our Lady of Lourdes Congregational Health Services. PARK PLACE SURGERY: Park Place Surgery, as a partner with Our Lady of Lourdes Medical Center, participates in the Implementation Plan Phase of the Affordable Care Act. As a Tier 2 Hospital that specializes in surgical services, Park Place's administration works closely with the Our Lady of the Lourdes team to help identify ways to most effectively impact the system's overall mission and plan. Park Place's objective is to support those system needs in fulfilling their goals. Park Place's administration, with the direction of Our Lady of Lourdes, has done the following to help address the identified community needs: Park Place Surgery funds a full time Nurse Practitioner at St Bernadette's Clinic servicing the indigent of the community. This program provides access to care for a population of people who otherwise would be unserved. Park Place Surgery provides support both financially and through volunteer time to the Miles Perret Cancer Center. The center is focused on the support of cancer patients in several phases of cancer care. Many patients serviced by this organization were Park Place patients. These support services include counseling services for family and patients, nutritional services, treatment items and supplies, and patient health system navigation and support. Park Place Surgery contributes to the Lafayette Community Healthcare Clinic. This organization aids the underserved in the community who are not eligible for Medicare or Medicaid, but do not have the economic resources for traditional health insurance. Park Place Surgery provides access to care for the patients of Acadiana and beyond through its physician partners and the cases these physicians refer to the facility. Of those served at Park Place, 10% of all services are provided to patients in the two zip codes which are identified by the Community Health Needs Assessment as underserved. The identified needs not chosen as an area of focus included mental health and alcoholism/drug addiction since that is outside of Park Place Surgery's scope of practice. However, mental health issues and addictions are diagnosed and referred by their community outreach clinics to other community agencies such as the Extra Mile, Lafayette Community Health Clinic, and University Medical Center. PART V, LINE 16I OUR LADY OF LOURDES RMC, HEART HOSPITAL OF ACADIANA, & PARK PLACE SURGERY: 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 OUR LADY OF LOURDES RMC, HEART HOSPITAL OF LAFAYETTE & PARK PLACE SURGERY: 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. 3 LOURDES IMAGING NETWORK LLC 4809 AMBASSADOR CAFFERY SUITE 350 LAFAYETTE LA 70506 IMAGING CENTER LOURDES AFTER HOURS LLC 2130 KALISTE SALOOM ROAD LAFAYETTE LA 70508 HEALTHCARE CLINIC LHCG-XIII LLC 601 WEST ST MARY BLVD SUITE 309 LAFAYETTE LA 70506 HOME HEALTH AGENCY 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 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 OUR LADY OF LOURDES PROVIDES SUBSIDIZED HEALTH SERVICES INCLUDING HEALTH CARE CLINICS. THESE PROGRAMS SUCH AS SCOTT FAMILY CLINIC, ST. CLARE CLINIC, WHICH SERVE THE UNDERINSURED OR UNINSURED, AND ST. BERNADETTE'S CLINIC, WHICH PROVIDES FREE MEDICAL CARE TO THE HOMELESS AND UNINSURED POPULATION, ARE INCLUDED. THE COSTING METHODOLOGY USED FOR SUBSIDIZED HEALTH SERVICES WAS ACTUAL EXPENSES INCURRED IN PROVIDING THE SERVICES LESS DIRECT OFFSETTING REVENUE. SCOTT CLINIC $22,573 ST. BERNADETTE CLINIC $206,686 ST. CLARE CLINIC $110,793 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, 7H AND 7I, DIRECT COSTS WERE CAPTURED FROM THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND THE MEDICARE COST REPORT WHERE APPLICABLE. FOR PART I LINE 7G, COST FIGURES WERE CALCULATED FROM DEPARTMENTAL COSTS LESS DIRECT OFFSETTING REVENUE. 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 III LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENT AND GUIDELINES. THE MEDICARE COST REPORT (MCR) is an annual report required of all institutions participating in the Medicare program. The MCR records each institution's total costs and charges associated with providing services to all patients, the portion of those costs and charges allocated to Medicare patients, and the Medicare payments received. 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 HOPSITAL'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 THE COMMUNITY SERVICES DEPARTMENT AT OUR LADY OF LOURDES REGIONAL MEDICAL CENTER WAS FORMED NEARLY 10 YEARS AGO TO ASSESS THE COMMUNITY NEEDS. IT HAS GROWN INTO 5 DISTINCT SERVICE AREAS WHICH PROVIDES HEALTHCARE TO NEEDY RESIDENTS IN THE ACADIANA AREA. IN TAKING "HEALTHCARE TO THE HIGHEST POWER", THE DEPARTMENT REACHES OUT TO THOSE MOST IN NEED, SPECIFICALLY, THE UNINSURED AND UNDERINSURED. IN PURSUING THE MISSION TO IMPROVE THE HEALTH STATUS OF ACADIANA'S POOREST RESIDENTS, THE DEPARTMENT HAS STRATEGICALLY PLACED ACCESSIBLE SERVICES THROUGHOUT THE COMMUNITY. COMMUNITY SERVICES' CATHOLIC IDENTITY IS MADE TANGIBLE IN THE COMMUNITY THROUGH THESE UNIQUE SERVICES. THE DEPARTMENT STEWARDS ITS RESOURCES BY ENGAGING COMMUNITY MEMBERS, FORMING PARTNERSHIPS, AND ESTABLISHING COLLABORATIVE RELATIONSHIPS. THESE UNIQUE SERVICES CLEARLY DISTINGUISH OUR LADY OF LOURDES FROM OTHER HEALTHCARE FACILITIES IN ACADIANA. THE MEDICAL CENTER DOES EXTENSIVE RESEARCH REGARDING COMMUNITY ISSUES AND NEEDS WITHIN ITS SERVICE AREAS. THE RESEARCH IS CONDUCTED IN AN EFFORT TO DETERMINE IF ITS COMMUNITY BENEFIT PROGRAMS ARE STILL APPROPRIATE AND TO DETERMINE IF OTHER PROGRAMS ARE NEEDED. THE SENIOR EXECUTIVE TEAM DETERMINES THE FOCUS GROUPS TO BETTER UNDERSTAND WHAT THE PEOPLE WITHIN THE REGION CONSIDER TO BE THE MAJOR COMMUNITY NEEDS. THE FOCUS GROUP INCLUDES COMMUNITY LEADERS, RELIGIOUS LEADERS, COMMUNITY SERVICE EMPLOYEES, LOW WAGE EMPLOYEES AND CLIENTS FROM CLINICS. SOME OF THE RESULTS OF THE MEDICAL CENTER'S NEEDS ASSESSMENT INCLUDE: ST. CLARE'S CLINIC ST. BERNADETTE'S COMMUNITY CLINIC NORTHSIDE HIGH SCHOOL BASED HEALTH CENTER SCOTT FAMILY CLINIC CONGREGATIONAL HEALTH SERVICES PART VI LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE GIVEN THE MEDICAL CENTER'S PATIENT HANDBOOK WHERE THEY ARE REFERRED TO THE SECTION ENTITLED "FINANCIAL INFORMATION - WHAT TO EXPECT". FINANCIAL COUNSELORS ALSO MEET WITH THE PATIENTS AND EDUCATE THEM ABOUT THE ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND ALSO THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM. FOR THE CONVENIENCE OF THE PATIENTS, THE MEDICAL CENTER ALSO OPERATES A MEDICAID ENROLLMENT CENTER TO ASSIST PATIENTS INTERESTED IN APPLYING FOR MEDICAID BENEFITS. THIS OFFICE IS OPEN MONDAY - FRIDAY FROM 8:00 A.M. - 4:00 P.M. A TELEPHONE NUMBER IS ALSO PROVIDED IN THE HANDBOOK. PART VI LINE 4 COMMUNITY INFORMATION OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN LAFAYETTE, LOUISIANA THAT SERVES LAFAYETTE PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, OUR LADY OF LOURDES' PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 221,578 AND 13.7% OF ITS POPULATION IS LIVING IN POVERTY. OUR LADY OF LOURDES' PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: LAFAYETTE PARISH OUR LADY OF LOURDES' SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: ACADIA PARISH EVANGELINE PARISH IBERIA PARISH JEFFERSON DAVIS PARISH ST. LANDRY PARISH ST. MARTIN PARISH ST. MARY PARISH VERMILION PARISH PART VI LINE 5 PROMOTION OF COMMUNITY HEALTH: THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS COMPRISED OF INDIVIDUALS WITH A BROAD CROSS-SECTION OF HEALTH CARE AND BUSINESS EXPERIENCE. OUR LADY OF LOURDES REGIONAL MEDICAL CENTER EXTENDS MEDICAL STAFF PRIVILEGES TO 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. ALSO, SEE THE QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT REPORT ON SCHEDULE O. PART VI LINE 6 AFFILIATED HEALTH CARE SYSTEM OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS NOT-FOR-PROFIT, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEATLH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF LOURDES IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF LOURDES RMC SERVES THE COMMUNITY IN LAFAYETTE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. 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 SOUTHWEST LA EDUCATION & REFERRAL CENTER 1005 JEFFERSON AVENUE LAFAYETTE LA 70501 720628109 501(C)(3) 20000 DENTURE PROGRAM MILES PERRET CANCER SERVICES PO DRAWER 3408 LAFAYETTE LA 70501 721394708 501(C)(3) 25000 GENERAL SUPPORT UNITED WAY OF ACADIANA 215 EAST PINHOOK LAFAYETTE LA 70501 720513639 501(C)(3) 25000 COMMUNITY PROGRAM SUPPORT SOUTH LA COMMUNITY COLLEGE 320 DEVALCOURT STREET LAFAYETTE LA 70506 721425264 501(C)(3) 75000 RN PROGRAM LAFAYETTE CATHOLIC SERVICE CENTERS INC PO BOX 3177 LAFAYETTE LA 70502 720977497 501(C)(3) 10000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 8600 GENERAL SUPPORT BOY SCOUTS OF AMERICA EVANGELINE AREA COUNCIL PO BOX 80115 LAFAYETTE LA 70598 720423617 501(C)(3) 15000 GENERAL SUPPORT 7 Schedule I, Part I, Line 2 ACCORDING TO THE LEVELS OF AUTHORIZATION'S POLICIES AND PROCEDURES, ALL CHARITABLE CONTRIBUTIONS ARE APPROVED BY THE CEO OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER. false true false false false false false true false WF BUD BARROW PRESIDENT AND CEO 0 379481 0 107000 0 27884 0 53779 0 19435 0 587579 0 0 DR KELLY T CAHILL JR BOARD MEMBER 241990 0 78697 0 0 0 10400 0 20197 0 351284 0 0 0 JAMES MWATIBO MD BOARD MEMBER 208079 0 19275 0 0 0 9263 0 20265 0 256882 0 0 0 DR MICHAEL VANDERLICK BOARD MEMBER 232637 0 46859 0 0 0 10400 0 13319 0 303215 0 0 0 RON HOGAN REGIONAL CFO 0 276204 0 87803 0 17163 0 26518 0 25709 0 433397 0 0 DONNA LANDRY COO 245600 0 49708 0 10881 0 12823 0 15198 0 334210 0 0 0 DANNA M CRAIN CNO 185381 0 38315 0 7046 0 35668 0 24500 0 290910 0 0 0 RICHARD FEI STAFF PHYSICIAN 501246 0 2125 0 550 0 10400 0 22362 0 536683 0 0 0 ANTHONY P BLALOCK VP MEDICAL AFFAIRS 325362 0 49625 0 731 0 10400 0 3267 0 389385 0 0 0 WARTELLE J CASTILLE STAFF PHYSICIAN 168070 0 144081 0 40052 0 10400 0 24498 0 387101 0 0 0 MARIA D MARTINEZ STAFF PHYSICIAN 235000 0 64511 0 0 0 10400 0 1879 0 311790 0 0 0 FRANK W COURMIER STAFF PHYSICIAN 297261 0 2125 0 0 0 10400 0 22688 0 332474 0 0 0 SCHEDULE J, PART I, LINE 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. No one listed on Part VII, Section A received a payment from the plans in the current year. SCHEDULE J, PART I, LINE 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO. SCHEDULE J, PART I, LINE 4A THE CEO 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. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD RANGES FROM 18 TO 36 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE CFO 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 OR 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. SCHEDULE J, PART I, LINE 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 VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW BY KPMG LLP, THE FORM 990 IS REVIEWED BY ONE OR MORE MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS, AND COMMENTS ARE SOLICITED. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE MEDICAL CENTER'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION B, QUESTION 12C OUR LADY OF LOURDES REGIONAL 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 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 LOURDES REGIONAL 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, OUR LADY OF LOURDES REGIONAL 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 OF POSSIBLE CONFLICTS OF INTERESTS ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER. PART VI, SECTION B, QUESTION 15A & 15B THE PRESIDENT AND CEO OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IS AN EMPLOYEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) WHOSE SALARY IS 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 AN OUTSIDE CONSULTING FIRM. THE BOARD COMMITTEE APPROPRIATELY DOCUMENTS ITS DECISIONS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE CEO AND AN EXECUTIVE COMMITTEE. THE CEO AND EXECUTIVE COMMITTEE IS PROVIDED COMPENSATION RANGES DEVELOPED BY FMOL HEALTH SYSTEM FROM INDUSTRY-WIDE DATA. THE CEO AND EXECUTIVE COMMITTEE THEN USES THAT DATA TO DETERMINE THE APPROPRIATE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES AND DOCUMENTS THE HUMAN RESOURCE FILES. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990 PART III OUR LADY OF LOURDES REGIONAL MEDICAL CENTER SERVICE TO THE COMMUNITY - JUNE 30, 2015 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. THE MEDICAL CENTER ALSO PARTICIPATES IN GOVERNMENT PROGRAMS INCLUDING MEDICARE, MEDICAID, AND THE TRICARE PROGRAM. UNDER THESE PROGRAMS, THE MEDICAL CENTER PROVIDES CARE TO PATIENTS AT PAYMENT RATES WHICH 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 CHARITY CARE AND MEANS-TESTED PROGRAMS FOR THE YEAR ENDED JUNE 30, 2015. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY THE MEDICAL CENTER UNDER MANAGED CARE AND OTHER SUCH AGREEMENTS. THE BELOW FIGURES USE SLIGHTLY DIFFERENT ASSUMPTIONS FROM SCHEDULE H AND THEREFORE AMOUNTS MAY VARY. 2015 CHARGES FOREGONE MEDICARE $249,195,000 MEDICAID 53,875,000 CHARITY 18,100,000 TOTAL 321,170,000 ESTIMATED UNREIMBURSED COSTS MEDICARE $8,708,000 MEDICAID 12,935,000 CHARITY 5,689,000 TOTAL 27,332,000 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 SPONSORS THE ST. BERNADETTE'S CLINIC. ST. BERNADETTE'S PROVIDES FREE MEDICAL CARE TO THE HOMELESS AND UNINSURED POPULATION IN THE ACADIANA AREA. LOURDES PROVIDES THE SERVICES OF A NURSE PRACTITIONER AND REGISTERED NURSE. THE COST ASSOCIATED WITH THE CLINIC APPROXIMATED $256,294 FOR THE YEAR ENDED JUNE 30, 2015. DURING 1996, THE MEDICAL CENTER BEGAN OPERATING THE NORTHSIDE HIGH SCHOOL HEALTH CENTER. THE CENTER IS COMMITTED TO PROVIDING EXEMPLARY COMPREHENSIVE HEALTH CARE TO THE STUDENTS AT NORTHSIDE HIGH SCHOOL. PHYSICAL AND PSYCHOSOCIAL SERVICES ARE PROVIDED BY A DEDICATED STAFF IN AN INFORMAL AND CONFIDENTIAL ATMOSPHERE THAT IS EASILY ACCESSIBLE TO ALL STUDENTS. EMPHASIS IS PLACED ON WELLNESS, AVOIDING HIGH RISK BEHAVIORS, AND MEETING THE INDIVIDUAL MEDICAL, EMOTIONAL AND SOCIAL NEEDS OF ADOLESCENTS AT NO COST TO THE STUDENTS. THE ESTIMATED COSTS ASSOCIATED WITH THE HEALTH CENTER APPROXIMATED $151,885 FOR THE YEAR ENDED JUNE 30, 2015. CONGREGATIONAL HEALTH SERVICES BEGAN MARCH 2001 AT IMMACULATE HEART OF MARY CHURCH AND THEN EXPANDED TO PROGRESSIVE BAPTIST CHURCH, WHICH ARE CHURCHES IN THE LAFAYETTE AREA. CURRENTLY, THERE ARE TWO PART-TIME NURSES AND ONE NURSE PRACTITIONER WHO COORDINATE THE PROGRAM. THE NURSES HAVE SPECIALIZED TRAINING AS HEALTH EDUCATORS, REFERRAL SOURCES, HEALTH COUNSELORS, HEALTH ADVOCATES AND VOLUNTEER COORDINATORS. THE ESTIMATED COSTS ASSOCIATED WITH THESE ACTIVITIES APPROXIMATED $125,257 FOR THE YEAR ENDED JUNE 30, 2015. THE MEDICAL CENTER HAS PURCHASED THE "CAMP BLUEBIRD" FRANCHISE, A CAMP FOR ADULT CANCER PATIENTS, PROVIDING SUCH PATIENTS A SECURE AND MEDICALLY SUPERVISED ENVIRONMENT, AND OFFERING THERAPEUTIC SHARING OPPORTUNITIES AS WELL AS INFORMATION REGARDING THE EDUCATIONAL, MEDICAL AND PSYCHOLOGICAL CONCERNS OF THE CAMPERS. THE ESTIMATED COSTS ASSOCIATED WITH THESE ACTIVITIES APPROXIMATED $67,461 FOR THE YEAR ENDED JUNE 30, 2015. THE MEDICAL CENTER SPONSORS THE SCOTT FAMILY CENTER (THE CENTER), WHICH BEGAN IN 1998 AS A PEDIATRIC CLINIC AND KIDMED (A STATE-SPONSORED HEALTH PROGRAM) AND HAS NOW EVOLVED INTO A FAMILY CLINIC WITH KIDMED SERVICES. A PEDIATRIC NURSE PRACTITIONER, FAMILY NURSE PRACTITIONER AND CLERICAL STAFF OPERATE THE FACILITY. THE CENTER SERVES UNDERINSURED, UNINSURED, AND LACHIP (A STATE-SPONSORED HEALTH PROGRAM) ENROLLMENT. THE FACILITY IS A MAJOR PROVIDER OF IMMUNIZATIONS AS AN ALTERNATE SOURCE TO THE LAFAYETTE PARISH HEALTH UNIT. THE ESTIMATED COSTS ASSOCIATED WITH THESE ACTIVITIES APPROXIMATED $18,921 FOR THE YEAR ENDED JUNE 30, 2015. THE MEDICAL CENTER DONATES THE SERVICES OF ONE FULL-TIME REGISTERED NURSE TO THE LAFAYETTE COMMUNITY HEALTH CARE CLINIC (THE CLINIC). THE CLINIC TARGETS INDIVIDUALS AND FAMILIES WHO ARE EMPLOYED OR TEMPORARILY UNEMPLOYED AND UNINSURED. PHYSICIANS, DENTISTS, NURSES, AND PHARMACISTS ARE ON HAND TO TREAT PATIENTS. THE ESTIMATED COSTS ASSOCIATED WITH THE CLINIC APPROXIMATED $18,954 FOR THE YEAR ENDED JUNE 30, 2015. THE MEDICAL CENTER ALSO HAD ESTIMATED COSTS OF $45,564 ASSOCIATED WITH EMERGENCY PREPAREDNESS AND $120,202 ASSOCIATED WITH HEALTH PROFESSIONS EDUCATION FOR THE YEAR ENDED JUNE 30, 2015. THE FOLLOWING TABLE SUMMARIZES ESTIMATED COSTS OF THE COMMUNITY SERVICES NOTED ABOVE FOR THE YEAR ENDED JUNE 30, 2015: 2015 ST. BERNADETTE'S $256,294 NORTHSIDE HIGH SCHOOL HEALTH CENTER 151,885 CONGREGATIONAL HEALTH SERVICES 125,257 SCOTT FAMILY CENTER 18,921 LAFAYETTE COMMUNITY HEALTH CARE CLINIC 18,954 HEALTH PROFESSIONS EDUCATION 120,202 EMERGENCY PREPAREDNESS 45,564 ------------- TOTAL $737,007 ALTHOUGH THE MEDICAL CENTER HAS ESTIMATED THE COST OF THESE EFFORTS TO SERVE THE ACADIANA COMMUNITY, MANAGEMENT AND THE BOARD OF DIRECTORS BELIEVE THAT SUCH COSTS REPRESENT ONLY ONE FACET OF THE MANY WAYS THAT THE MEDICAL CENTER AND ITS RELATED ORGANIZATIONS SERVE THE ACADIANA AREA. PART VI, SECTION A, QUESTION 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. PART VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF LOURDES REGIONAL MEDICAL CENTER. PART XI, LINE 9 CAPITAL TRANSFERS (4,977,604) PART VI, SECTION B, QUESTION 16A & 16B THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A JOINT VENTURE POLICY IN PLACE ALTHOUGH IT WAS NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE JUNE 30, 2015. THE ORGANIZATION INTENDS TO HAVE THE POLICIES APPROVED BY OUR LADY OF LOURDES REGIONAL MEDICAL CENTER'S BOARD OF DIRECTORS OR COMMITTEE THEREOF. Section 1.263(a)-1(f) - De Minimis Safe Harbor Election OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, 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 LOURDES REGIONAL MEDICAL CENTER, 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, 2015. 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