2015-05-15T16:04:30-05:00 2014-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2013-07-01 721470744 OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL % JEFF LIMBOCKER OURL 2256475000 1125 HIGHWAY 30 Suite GONZALES LA 70737 JEFF LIMBOCKER REGIONAL CFO 2256475000 2015-05-15 true RYAN HOOKS P00746825 2256475000 2015-05-15 2013 2016-02-25 16:41:14Z ST ELIZABETH HOSPITAL ROBERT BURGESS 1125 HIGHWAY 30 GONZALES LA 70737 95572091 false 0928 X www.steh.com X 2000 LA The purpose of the hospital is to provide of the ill, FOR THE CARE OF THE ILL, injured, or disabled persons and to enhance the health of those in the community through research and education. 17 12 927 36 6752 -21008 261396 138339 87392371 93089398 -189800 622454 465148 804154 87929115 94654345 87089 98725 0 0 48232311 49390408 0 0 0 36402452 39852849 84721852 89341982 3207263 5312363 100132176 103464954 35611550 34528380 64520626 68936574 X INSPIRED BT 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 THOSE 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. false false 39251718 98725 54628107 ST.ELIZABETH HOSPITAL PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. 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 THE NEEDY MEMBERS OF ITS COMMUNITIES. FOLLOWING THAT POLICY, HEALTH CARE SERVICES WERE PROVIDED WITHOUT CHARGE OR AT RATES WHICH ARE LESS THAN THE COST OF PROVIDING SUCH SERVICES. THE HOSPITAL PROVIDED INPATIENT AND OUTPATIENT MEDICAL SERVICES FOR 9,868 PATIENT DAYS AND 160,282 PHYSICIAN OFFICE VISITS. 9887931 13322985 THE HOSPITAL PROVIDES PATIENTS WITH SURGICAL CARE. 307,142 SURGICAL MINUTES WERE USED DURING THE YEAR. 7114929 25949171 THE HOSPITAL PROVIDES RADIOLOGY SERVICES TO ITS INPATIENTS AND OUTPATIENTS. DURING THE CURRENT YEAR, THE HOSPITAL PERFORMED 37,106 RADIOLOGY PROCEDURES. 56254578 true true false false false false false false false false true false false true true true false true false false true false false false true false true true true true true false false false false false false true false false false false false true true true true false false true 46 0 true 927 true true true false false false false true true false false false false X 17 12 true false false false true true true true true false false true true true true true true false true true true X JEFF LIMBOCKER 2256475071 1125 W HIGHWAY 30 GONZALES LA 70737 X ROBERT BURGESS PRESIDENT AND CEO 50.0 2.0 X X 0 337724 25564 CHRIS TREVINO MD BOARD MEMBER 2.0 0.0 X 0 0 0 ANTHONY NOBILE BOARD MEMBER-VICE CHAIR 2.0 0.0 X X 0 0 0 CARY PAUL AGUILLARD JR MD BOARD MEMBER 40.0 0.0 X 192930 0 31520 DAWN ZITMAN MD BOARD MEMBER 40.0 0.0 X 176343 0 25005 DEBORAH CAVALIER MD BOARD MEMBER 2.0 0.0 X 0 0 0 JAMES D'ANTONI MD CHIEF OF STAFF/BOARD MEMBER 40.0 0.0 X 190697 0 28921 JOHN F FRAICHE MD BOARD MEMBER 40.0 0.0 X 543598 0 12030 MARK K DEARMAN BOARD MEMBER 2.0 0.0 X 0 0 0 DONALD SONGY BOARD MEMBER 2.0 0.0 X 0 0 0 TESS STROMBERG BOARD MEMBER 2.0 0.0 X 0 0 0 RJ DAIGLE BOARD MEMBER 2.0 0.0 X ROGER KEESE BOARD MEMBER- SECRETARY 2.0 2.0 X X SCOTT PETRIE MD BOARD MEMBER 2.0 0.0 X SR HELEN CAHILL OSF BOARD MEMBER 1.0 4.0 X THE HONORABLE ALVIN TURNER JR BOARD MEMBER 2.0 0.0 X THE HONORABLE JOHN BERTHELOT BOARD MEMBER 2.0 0.0 X THE HONORABLE TERI CASSO BOARD MEMBER - CHAIR 2.0 2.0 X X Bill Martin Immediate Past Chairman 2.0 0.0 X X Gregory Brandao Ed D Board Member 2.0 0.0 X JEFFREY D LIMBOCKER CHIEF FINANCIAL OFFICER 2.0 65.5 X 0 425660 52899 SUE KNIGHT CHIEF OPERATING OFFICER 40.0 0.0 X 230849 0 55824 JILL LEE CNO 40.0 0.0 X 171739 0 25024 CRAIG A VITRANO MD CHIEF MEDICAL OFFICER 40.0 0.0 X 485441 0 65920 DAWN B SHARP MD STAFF PHYSICIAN 40.0 0.0 X 360483 0 36128 JOHN D KNAPP MD STAFF PHYSICIAN 40.0 0.0 X 323750 0 31886 RAHIL D SHAH MD STAFF PHYSICIAN 40.0 0.0 X 613940 0 10272 THOMAS EWING MD STAFF PHYSICIAN 40.0 0.0 X 451322 0 31640 Dolores N LeJeune RN CNA Former CEO/ Current Consultant 0.0 10.0 X 0 120885 1902 3741092 884269 434535 53 true true false FMOL Health System 4200 Essen Lane Baton Rouge LA 70809 Management Fees 7187482 MAJESTIC MEDICAL SOLUTIONS 207 W East Bank St Gonzales LA 70737 Equip. Maintenance 1483801 Our LAdy of the Lake RMC 5000 Hennessy Blvd Baton Rouge LA 70808 Management Fees 574327 CAPITAL AREA SHARED SERVICE 7301 Hennessy Blvd Suite D Baton Rouge LA 70808 Software Maintenance 546857 THEREX 341 Cool Springs Blvd Suite 450 Franklin TN 37067 PT Services 431210 37 X 23659 87656 27024 0 138339 Patient Service Revenue 900099 91720675 91720675 Cafeteria 900099 247226 247226 Purchase Discounts 900099 122728 122728 Outreach Lab 900099 109940 109940 Hearing and Balance 900099 99528 99528 789301 789301 93089398 256275 2811 253464 0 0 1068590 257725 810865 0 810865 810865 950412 60311 546374 98170 404038 -37859 366179 3941 362238 8766 23659 15477 -6711 -6711 0 0 0 94654345 93900263 6752 608991 77144 77144 17831 17831 3750 3750 0 1765493 1447704 317789 0 38929551 20308750 18620801 3131736 2053267 1078469 3019517 1998760 1020757 2544111 1528074 1016037 8378215 8378215 202201 202201 90745 90745 0 0 0 4566081 1093311 3472770 442401 2971 439430 3812550 1948005 1864545 1580639 807620 773019 0 2230097 1408636 821461 234532 83641 150891 0 28999 6578 22421 717761 399880 317881 0 3920110 2521795 1398315 1525001 1158079 366922 Medical Supplies Expense 9713307 9503526 209781 MAINTENANCE & SERVICE CONTRACT 2318798 1507041 811757 Special Events 91412 91412 89341982 56254578 33087404 0 X 0 0 18806620 18466763 0 0 13039515 15152420 0 0 0 0 0 0 1213415 1409913 1187092 949100 89199376 37588900 53549893 51610476 2179749 3223283 2874077 4243527 2755257 3006954 0 0 4526558 5402518 100132176 103464954 13805074 15489540 0 0 0 0 11720761 11720761 0 0 0 0 4358841 3769459 0 0 5726874 3548620 35611550 34528380 X 64197282 68728491 323344 208083 0 0 64520626 68936574 100132176 103464954 X 5312363 683239 -1579654 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3747277 3747277 58110275 17183672 40926603 918103 704372 213731 26419673 19700856 6718817 4048 4048 51610476 SELF-INSURANCE RECEIVABLE 1932698 DUE FROM AFFILIATES 2529369 LONG TERM PREPAIDS 853716 OTHER ASSETS 86735 5402518 0 SELF-INSURANCE LIABILITY 1932697 TAIL COVERAGE & NONREIMBURSEAB 281862 DUE TO/FROM AFFILIATES 1334061 3548620 X FIN 48 (ASC 740) FOOTNOTE 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 judgment occurs. No reserves for uncertain tax position have been recorded. Central America and the Caribbean Investments 2026535 2026535 2026535 true false true true true false Golf Tournament 32425 23659 8766 4799 7358 3320 0 32425 23659 8766 4799 7358 3320 15477 -6711 true true true X true X true true false true true 950274 950165 0.01060 8455722 4040800 4413944 0.04940 9405996 4040800 5364109 0.06000 501942 22427 479515 0.00540 402044 402044 0.00450 137098 137098 0.00150 1041084 22427 1018657 0.01140 10447080 4063227 6382766 0.07140 14553 13950 28503 false 18347099 24178308 22474617 1703691 true true ST ELIZABETH IMAGIN IMAGING SERVICES 0.51000 0.12250 0.36750 1 1 ST ELIZABETH HOSPITAL 1125 HIGHWAY 30 GONZALES LA 70737 WWW.FMOLHS.ORG/STEH 434 X X X ST ELIZABETH HOSPITAL true X X X X X X X X X 12 true false true X SEE PART V, SECTION C X X X X X false false true true 200. true 300. true X X X X true true X X X X X X true false X X X X true X false false PART V, LINE 14G REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICES. PART V, LINE 20D THE HOSPITAL OFFERS VARIOUS LEVELS OF DISCOUNTS WHICH ARE BASED ON A SLIDING SCALE USING THE FEDERAL POVERTY GUIDELINE FAMILY INCOME LEVELS AND OTHER FACTORS. SUCH OTHER FACTORS INCLUDE ASSET LEVELS, INCOME LEVELS, MEDICAL INDIGENCY, AND A PATIENT'S QUALIFICATION FOR MEDICARE OR MEDICAID. THE SLIDING SCALE IS DESIGNED SO THAT THE DISCOUNTS APPLIED BRING PATIENT CHARGES TO "BELOW THE AMOUNT" GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING EMERGENCY OR MEDICALLY NECESSARY SERVICES. TOGETHER THESE CRITERIA ARE USED TO SET THE MAXIMUM AMOUNT CHARGED. PART V, LINE 3 THE ORGANIZATION ENGAGED KEY COMMUNITY PARTNERS THROUGH PERSONAL INTERVIEWS. ST. ELIZABETH TOOK INTO ACCOUNT INPUT FROM THOSE WITH SPECIALIZED KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH BY WORKING WITH KENNY MATASSA, DIRECTOR OF THE ASCENSION PARISH HEALTH UNIT. ST. ELIZABETH INTERVIEWED BOTH COMMUNITY MEMBERS AND HEALTHCARE PROVIDERS. PART V, LINE 7 ALTHOUGH THE ST. ELIZABETH CHNA IDENTIFIED NINE HEALTH NEEDS OF THE COMMUNITY, THE IMPLEMENTATION STRATEGY FOCUSED ON THE FOUR HIGHEST NEED AREAS SINCE THEY POSED THE HIGHEST RISK TO THE COMMUNITY. THE IDENTIFIED NEEDS NOT CHOSEN AS AN AREA OF FOCUS INCLUDED: LOW INFANT BIRTH WEIGHT, RESPIRATORY DISEASES, MENTAL HEALTH, PHYSICAL ENVIRONMENT, AND TRANSPORTATION SERVICES. ST. ELIZABETH CHOSE NOT TO FOCUS ON THESE NEEDS EITHER BECAUSE OTHER ORGANIZATIONS IN THE COMMUNITY WERE ALREADY PROVIDING SERVICES TO ADDRESS THE NEEDS OR BECAUSE ST. ELIZABETH DOES NOT HAVE THE EXPERTISE TO PROVIDE THE SERVICE. PART V, LINE 5 THE CHNA CAN BE FOUND AT https://fmolhs.org/steh/Pages/About-us/Community-Health-Needs-Assessment.a spx 4 ST ELIZ-MARY BIRD PERKINS CANCER CENTER 4950 ESSEN LANE BATON ROUGE LA 70809 CANCER TREATMENT CENTER ST ELIZABETH IMAGING CENTER 1125 HIGHWAY 30 GONZALES LA 70737 IMAGING SERVICES COMMUNITY HEALTH CLINIC 1125 HIGHWAY 30 GONZALES LA 70737 LOW INCOME CLINIC LAKE URGENT CARE ASCENSION LLC 10313 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE 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 COST ACCOUNTING SYSTEM OF THE ORGANIZATION. 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. PART III, LINE 4 THE BAD DEBT FOOTNOTE IS ON PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 CMS REGULATIONS/GUIDELINES ARE USED IN COMPLETING THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS THE TOOL USED IN DETERMINING MEDICARE ALLOWABLE COSTS. 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 MISSION OF ST. ELIZABETH HOSPITAL. ST. ELIZABETH HOSPITAL IDENTIFIES THE COMMUNITY'S HEALTH NEEDS BY UTILIZING THE FOLLOWING INFORMATION GATHERING TECHNIQUES: COMMUNITY SURVEY: ON AN ANNUAL BASIS, ST. ELIZABETH HOSPITAL, ALONG WITH THE HELP OF STRATEGIC MARKETING AND RESEARCH, LLC, PERFORM A COMMUNITY SURVEY AIMED AT IDENTIFYING THE HEALTH CARE NEEDS AND PREFERENCES OF LOCAL RESIDENTS. THE SURVEY IS CONDUCTED VIA PHONE WHILE USING A RANDOM SAMPLE OF RESPONDENTS. THE FINDINGS FROM THIS RESEARCH SERVE AS A FOUNDATION FOR THE DEVELOPMENT OF FUTURE PROGRAMS FOR OFFERING HEALTHCARE IN ASCENSION PARISH. THE SURVEY ALSO IDENTIFIES THOSE SERVICES THAT ARE SOUGHT OUTSIDE OF ASCENSION PARISH, DUE TO SERVICES NOT BEING OFFERED OR NOT KNOWN TO BE OFFERED (PUBLIC AWARENESS). SUCH DATA HELPS ST. ELIZABETH HOSPITAL ASSESS WHETHER SPECIFIC MEDICAL NEEDS ARE UNDERSERVED. COMMUNITY EDUCATION SURVEY: EVERY TWO YEARS, THE COMMUNITY EDUCATION DEPARTMENT PREPARES A COMMUNITY EDUCATION SURVEY THAT IS GIVEN TO ASCENSION PARISH RESIDENTS WHO ATTEND LOCAL HEALTH SCREENINGS OR OTHER EDUCATIONAL EVENTS. THIS SURVEY IS DESIGNED TO IDENTIFY THE HEALTH EDUCATION NEEDS OF THE AREA RESIDENTS. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH ST. ELIZABETH HOSPITAL: 1. SCHEDULING (OUTPATIENT/SURGERY): DURING THE SCHEDULING OF PROCEDURES, A SCHEDULER INFORMS INDIVIDUALS OF THE VARIOUS TYPES OF FINANCIAL ASSISTANCE VIA PHONE. IF THE INDIVIDUAL IS INTERESTED, A FORM IS PROVIDED EITHER BY MAIL OR PICKUP TO COMPLETE AND RETURN TO THE HOSPITAL VIA PRE-PAID POSTAGE ENVELOPE. 2. THE POLICY IS PROVIDED, IN WRITING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY. 3. FINANCIAL COUNSELING: DURING FINANCIAL COUNSELING, THE INDIVIDUAL IS INFORMED OF THE VARIOUS TYPES OF FINANCIAL ASSISTANCE VIA PERSON TO PERSON CONVERSATION. IF THE INDIVIDUAL IS INTERESTED, A FORM IS PROVIDED AT THAT TIME FOR THE INDIVIDUAL TO COMPLETE AND RETURN TO THE HOSPITAL. ADDITIONALLY, CASHIERS HAVE POSTED NOTIFICATIONS OF THE FINANCIAL ASSISTANCE OPPORTUNITIES IN THE CASHIER'S OFFICE AND THE EMERGENCY ROOM COLLECTION DESK. 4. WEBSITE NOTIFICATION: ST. ELIZABETH HOSPITAL'S WEBSITE, LOCATED AT WWW.STEH.COM INCLUDES A PAGE CALLED "HELP FOR THE UNINSURED" WHICH PROVIDES INFORMATION CONCERNING ST. ELIZABETH HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A TELEPHONE NUMBER IS ALSO PROVIDED TO THOSE WHO ARE INTERESTED IN CONTACTING OUR FINANCIAL COUNSELORS FOR ADDITIONAL INFORMATION. 5. THE POLICY IS AVAILABLE UPON REQUEST. PART VI, LINE 4 COMMUNITY INFORMATION: ST. ELIZABETH HOSPITAL SERVES ASCENSION PARISH AND PORTIONS OF THE SURROUNDING PARISHES OF ASSUMPTION, IBERVILLE, EAST BATON ROUGE, AND ST. JAMES. THIS AREA HAS SEEN SIGNIFICANT GROWTH IN THE LAST DECADE. SPECIFICALLY, THE HISPANIC/LATINO POPULATION HAS MORE THAN DOUBLED IN SOME PORTIONS OF THE SERVICE AREA. THE NORTHERN PARTS OF THE SERVICE AREA TEND TO HAVE A MORE AFFLUENT POPULATION; WHEREAS, THE SOUTHERN TRACTS HAVE CONTINUED BARRIERS TO HEALTHCARE. PURSUANT TO THE HOSPITAL'S LAST CHNA, ST. ELIZABETH'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 107,215 AND IS CURRENTLY THE FASTEST GROWING PARISH IN THE STATE. THE AVERAGE PER CAPITA INCOME FOR THE SERVICE AREA IS $28,178 WITH 12.3% OF FAMILIES LIVING BELOW THE POVERTY LEVEL. IN ADDITION, 24% OF RESIDENTS DO NOT HAVE HEALTH INSURANCE. HEALTH STATISTICS THAT ARE ROUTINELY COLLECTED INDICATE THAT RESIDENTS OF THE SERVICE AREA EXPERIENCE MANY HEALTH PROBLEMS. SPECIFICALLY, THE POPULATION SUFFERS HIGHER RATES OF STROKE, OBESITY, CANCER, DIABETES AND HYPERTENSION THAN THE NATION AS A WHOLE. ST. ELIZABETH'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISH: ASCENSION PARISH PART II ST. ELIZABETH PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY BUILDING ACTIVITIES INCLUDE DEVOTING TIME TO NEIGHBORHOOD IMPROVEMENT AND REVITALIZATION PROJECTS, PARTICIPATING IN ECONOMIC DEVELOPMENT COUNCILS/CHAMBERS OF COMMERCE AND PARTICIPATING IN SCHOOL MENTORING PROGRAMS. ALL OF THESE PROGRAMS HELP DEVELOP THE GENERAL WELL-BEING OF THE COMMUNITY WHICH, IN TURN, PROMOTES THE HEALTH OF THE COMMUNITY ST. ELIZABETH SERVES. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE TIME DEVOTED TO FORMING COLLABORATIVE PARTNERSHIPS WITH VARIOUS ORGANIZATIONS SUCH AS THE DEPARTMENT OF HEALTH & HUMAN SERVICES, LOCAL SCHOOL BOARDS, AND OTHER LOCAL HOSPITALS TO IMPROVE THE GENERAL COMMUNITY HEALTH. ADDITIONALLY, ST. ELIZABETH PARTNERS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORKFORCE SHORTAGES. IT ALSO PARTICIPATES IN SCHOOL-BASED PROGRAMS RELATED TO HEALTH CARE CAREERS. OTHER INFORMATION SEE THE QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT REPORT ON SCHEDULE O. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: ST. ELIZABETH HOSPITAL 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. ELIZABETH IS PART OF THE FMOLHS HEALTH CARE SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. ST. ELIZABETH HOSPITAL SERVES THE COMMUNITY IN GONZALES, LA AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL ST. ELIZABETH HOSPITAL WORKS CLOSELY WITH OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER (A TAX-EXEMPT HOSPITAL AFFILIATE) TO PROVIDE COMPREHENSIVE MEDICAL SERVICES AS PART OF THE OVERALL HEALTHCARE PROVIDED TO THE COMMUNITY. PART III, LINE 2 THE ORGANIZATION ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF ACCOUNTS AND HISTORICAL COLLECTION HISTORY ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW OF THE COLLECTIONS TO DETERMINE THE APPROPRIATE COLLECTION PERCENTAGE TO USE IN ESTIMATING 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 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 OLOL; 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 VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE MAJORITY OF THE GOVERNING BODY OF ST. ELIZABETH HOSPITAL IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. ST. ELIZABETH HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN PATIENT CARE AREAS THROUGH INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. true River Parishes Community College Foundation Inc PO Box 10 Sorrento LA 70778 721465254 501(c)(3) 20500 GENERAL SUPPORT OUR LADY OF LAKE FOUNDATION 5000 Hennessy Blvd Baton Rouge LA 70808 721014324 501(c)(3) 8850 General Support GENERAL SUPPORT Volunteer Ascension PO Box 1564 Gonzales LA 70737 721376404 501(c)(3) 7525 General Support GENERAL SUPPORT 3 HARDSHIP ASSISTANCE 28 17831 PART I, QUESTION 2 All charitable donations are made to well-known charitable organizations or through referral from either a board or team member associated with the local/national charity. St. Elizabeth Hospital utilizes several resources to verify the integrity and authenticity of the charitable organization including, but not limited to, 1) Office of Inspector General Sanction List 2) General Services Administration Sanctions List 3) U.S Treasury Sanctions List 4) Internal Revenue Service's list of tax deductible charitable organizations or 5) Better Business Bureau Resource Library. Charitable recipients are asked to provide a donation letter explaining the intent for which the donation will be used. false true false false false false false true false JEFFREY D LIMBOCKER CHIEF FINANCIAL OFFICER 0 316496 0 80125 0 29039 0 28846 0 24053 0 478559 0 0 ROBERT BURGESS PRESIDENT AND CEO 0 240399 0 77925 0 19400 0 10200 0 15364 0 363288 0 0 CARY PAUL AGUILLARD JR MD BOARD MEMBER 181901 0 10929 0 100 0 8092 0 23428 0 224450 0 0 0 DAWN ZITMAN MD BOARD MEMBER 160966 0 15277 0 100 0 7377 0 17628 0 201348 0 0 0 JAMES D'ANTONI MD CHIEF OF STAFF/BOARD MEMBER 142373 0 48324 0 0 0 7932 0 20989 0 219618 0 0 0 JOHN F FRAICHE MD BOARD MEMBER 376300 0 47298 0 120000 0 10200 0 1830 0 555628 0 0 0 CRAIG A VITRANO MD CHIEF MEDICAL OFFICER 367007 0 91715 0 26719 0 47741 0 18179 0 551361 0 0 0 SUE KNIGHT CHIEF OPERATING OFFICER 190483 0 39650 0 716 0 46640 0 9184 0 286673 0 0 0 DAWN B SHARP MD STAFF PHYSICIAN 360483 0 0 0 0 0 10200 0 25928 0 396611 0 0 0 JOHN D KNAPP MD STAFF PHYSICIAN 292991 0 30759 0 0 0 10200 0 21686 0 355636 0 0 0 RAHIL D SHAH MD STAFF PHYSICIAN 463947 0 149993 0 0 0 10200 0 72 0 624212 0 0 0 THOMAS EWING MD STAFF PHYSICIAN 385038 0 66284 0 0 0 10200 0 21440 0 482962 0 0 0 Dolores N LeJeune RN CNA Former CEO/ Current Consultant 0 119471 0 0 0 1414 0 0 0 1902 0 122787 0 0 JILL LEE CNO 144932 0 26807 0 0 0 15457 0 9567 0 196763 0 0 Part I, Question 7 THE ORGANIZATION HAS PROVIDED LISTED PERSONS WITH INCENTIVE COMPENSATION WHICH IS BASED ON A FORMULA DERIVED FROM QUALITY, EFFICIENCY, AND OTHER PERFORMANCE MEASURES. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. Part I question 4a OTHER PERSONS LISTED ON PART VII, SECTION A ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT DUE TO REORGANIZATION OF HOSPITAL DEPARTMENTS, HOSPITAL FUNCTIONS OR DOWNSIZING ACTIVITY. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS OR HER BASE SALARY FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD RANGES FROM 4 WEEKS TO 4 MONTHS DEPENDING ON THE LENGTH OF SERVICE AND THE LEVEL OF SUCH EMPLOYEE. NO PAYMENTS WERE MADE TO PERSONS LISTED ON PART VII, SECTION A UNDER THE PLAN IN THE CURRENT YEAR. PART I, QUESTION 3 THE CEO AND CFO WERE 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 COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINED AND RELIED UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWED COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION WAS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION WAS DOCUMENTED BY THE COMPENSATION COMMITTEE. John F Fraiche MD Son Receives Compensation 161137 Compensation as a physician false PART VI, SECTION A, QUESTION 6 Question 8 FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL PART VI, SECTION A, QUESTION 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. ELIZABETH HOSPITAL Page 6, Part VI, Section B Question 12c St. Elizabeth Hospital 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 a 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 St. Elizabeth Hospital 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. Elizabeth Hospital 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 interest are reviewed and investigated by the Corporate Compliance Department and appropriate action is taken. Page 6, Part VI, Section B Question 15 THE BOARD OF DIRECTORS DESIGNATES THE EXECUTIVE COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR EXECUTIVES AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION FROM 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 PRESIDENT AND CEO OF ST. ELIZABETH HOSPITAL IS AN EMPLOYEE OF FMOL HEALTH SYSTEM, AND HIS SALARY IS DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION WHICH RESEMBLE THE ABOVE. Page 6, Part VI, Section C Question 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. 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 11 AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG, LLP, THE RETURN IS REVIEWED BY ONE OR MORE MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. Part VI, Section A Question 2 DR. CRAIG A. VITRANO AND DR. JOHN FRAICHE - BUSINESS RELATIONSHIP PROGRAM SERVICE ACCOMPLISHMENTS SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. ORGANIZATIONAL COMMITMENT TO PROVIDE COMMUNITY BENEFIT ST. ELIZABETH HOSPITAL OPERATES AS A MISSION OF THE FRANCISCAN MISSIONARIES OF OUR LADY, A CATHOLIC HEALTHCARE ORGANIZATION. ST. ELIZABETH HOSPITAL IS PART OF CHA (CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES). ST. ELIZABETH HOSPITAL IS LOCATED IN GONZALES, LOUISIANA IN THE PARISH OF ASCENSION. THE HOSPITAL SERVES THE ENTIRE ASCENSION PARISH COMMUNITY ALONG WITH PARTS OF IBERVILLE AND LIVINGSTON PARISHES. THE HOSPITAL IS LOCATED OFF OF INTERSTATE 10 AT 1125 WEST HIGHWAY 30, GONZALES, LOUISIANA. ST. ELIZABETH ACQUIRED ST. ELIZABETH PHYSICIANS, A WHOLLY OWNED SUBSIDIARY, ON JULY 1, 2007 AS PART OF ITS STRATEGIC PLAN. IN FISCAL YEAR 2010, THE PRACTICE CONTINUED TO RECRUIT SPECIALISTS TO THE UNDERSERVED AREA OF ASCENSION PARISH. ST. ELIZABETH PHYSICIANS MAINTAIN OFFICES IN PRAIRIEVILLE, GONZALES, DUTCHTOWN, AND DONALDSONVILLE, LOUISIANA. THE HOSPITAL SERVES AS THE ONLY ACUTE CARE ACCESS HOSPITAL IN ASCENSION PARISH WITH EMERGENCY ROOM SERVICES. THE HOSPITAL IS ABLE TO SUPPORT THE NEEDS OF ASCENSION PARISH AS WELL AS OUTLYING PARISHES. THE HOSPITAL'S PHILOSOPHY IS TO SERVE ITS COMMUNITY AND IN PARTICULAR THOSE MOST IN NEED. THE HOSPITAL SERVES THE NEEDS OF THE UNDERSERVED IN ITS COMMUNITY THROUGH ACCESS TO PRIMARY HEALTHCARE VIA ITS EMERGENCY DEPARTMENT AND COMMUNITY CLINIC AS WELL AS THROUGH ITS RELATIONSHIP WITH COMMUNITY PHYSICIANS. THE HOSPITAL'S EFFORTS TO EXPAND SERVICES TO THE COMMUNITY THROUGH OUTREACH INCLUDE THE FOLLOWING: - THE HOSPITAL AND PHYSICIAN PRACTICE PROVIDED FLU VACCINES TO THE EMPLOYEES OF THE FOLLOWING COMMUNITY ORGANIZATIONS IN ORDER TO PROMOTE WELLNESS AND HAVE AN ACTIVE ROLE IN INCREASING THE HEALTH OF THE COMMUNITY: 1. ASCENSION PARISH SCHOOL BOARD 2. ASCENSION PARISH SHERIFF'S OFFICE 3. EAST ASCENSION HIGH SCHOOL 4. ST. AMANT HIGH SCHOOL 5. DONALDSONVILLE HIGH SCHOOL 6. DUTCHTOWN HIGH SCHOOL 7. St. John's Church - THE HOSPITAL AND PHYSICIAN PRACTICE PARTICIPATES IN HEALTHCARE EDUCATION FOR THE PARISH THROUGH THE ST. ELIZABETH HOSPITAL ANNUAL HEALTH FAIR, KIDS FEST AND IN A COLLABORATIVE EFFORT WITH OTHER NOT FOR PROFIT ORGANIZATIONS INCLUDING: 1. CHAMBER OF COMMERCE 2. ROTARY CLUB OF EAST ASCENSION 3. AMERICAN CANCER SOCIETY 4. AMERICAN HEART ASSOCIATION 5. GONZALES ROTARY CLUB 6. ASCENSION BUSINESS NETWORK 7. MARCH OF DIMES 8. THE AMERICAN CANCER SOCIETY 9. VOLUNTEER ASCENSION 10. COMMUNITY ADVISORY PANEL 11. ALZHEIMER'S SERVICES OF THE CAPITOL AREA 12. GRIEF RECOVERY CENTER 13. CHILDREN'S ADVOCACY SERVICES 14. NATIONAL MS SOCIETY 15. CONCUSSION PREVENTION TO AREA HIGH SCHOOLS 16. RIVER PARISH COMMUNITY COLLEGE EDUCATIONAL OFFERINGS INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: 1. LOSS AND GRIEF EDUCATION AND SUPPORT 2. THRIVING WITH DIABETES 3. TOTAL JOINT REPLACEMENT EDUCATION CLASS 4. GROWING UP - PRETEEN CLASSES (THIS IS A FEE CLASS) 5. GIRLS DAY OUT (THIS IS A FEE CLASS) 6. EXTREME ESTEEM 7. HEALTHY COMMUNITY SERIES WITH FRAIS MARCHE' 8. ALZHEIMER'S LNL 9. ALZHEIMER'S CAREGIVER NETWORK 10. ALZHEIMER'S SHARING THE JOURNEY 11. ALZHEIMER'S LITERACY WORKSHOP 12. HEALTHY HEARTS LNL PROGRAMS 13. K.C MEN'S HEALTH 14. LOOK GOOD FEEL BETTER 15. MEDICARE UPDATE FOR 2015 16. FIT FOR A T 17. EXPERTS IN ARTHRITIS 18. EATEL HEALTH MINUTES 19. YOUR PERSONAL HEALTH INFORMATION: HOW TO ACCESS, MANAGE, AND PROTECT IT 20. ATRIAL FIBRILLATION 21. HISPANIC OUTREACH ACTIVITIES 22. LITERACY PROMOTION IN PRIMARY SCHOOLS - THE HOSPITAL PROVIDES THE FOLLOWING SCREENINGS FOR THE COMMUNITY: 1. SKIN CANCER 2. PROSTATE CANCER 3. GLUCOSE, CHOLESTEROL LEVELS AND PSA IF OVER 40 4. COLORECTAL CANCER 5. BLOOD PRESSURE 6. BMI 7. RESPIRATORY FUNCTION 8. PHYSICALS FOR LOCAL SCHOOL ATHLETIC TEAMS AND SPECIAL OLYMPICS PARTICIPANTS (STEP) - THE HOSPITAL HAS PARTNERED WITH MARY BIRD PERKINS CANCER CENTER TO PROVIDE CANCER TREATMENT SERVICES TO THE CITIZENS OF ASCENSION PARISH AND SURROUNDING AREAS. MARY BIRD PERKINS CANCER CENTER IS LOCATED ACROSS FROM ST. ELIZABETH HOSPITAL AND BEGAN SERVING PATIENTS IN FEBRUARY 2009. - THE HOSPITAL PARTICIPATES IN LEADERSHIP ASCENSION WHERE LEADERS FROM ST. ELIZABETH HOSPITAL AND ST. ELIZABETH PHYSICIANS LEARN ABOUT ASCENSION PARISH AND HOW TO MAKE A DIFFERENCE IN THE COMMUNITY THROUGH VOLUNTEERISM. - ST. ELIZABETH HOSPITAL SECURED GRANT FUNDING THROUGH FMOL FOR A COMMUNITY CLINIC. THE MISSION OF THIS CLINIC IS TO PROVIDE ACCESS TO CARE FOR THE UNINSURED AND UNDERINSURED RESIDENTS OF ASCENSION PARISH. SERVING THIS POPULATION OF ASCENSION PARISH RESIDENTS WILL ALLOW ST. ELIZABETH HOSPITAL TO POSITIVELY AFFECT THE FACE OF HEALTH CARE BY EDUCATING, TREATING AND MAINTAINING THE HEALTH STATUS OF ITS RESIDENTS. THE COMMUNITY CLINIC STAFF BEGIN TREATING PATIENTS IN APRIL 2009. - St. Elizabeth Physicians secured grant funding through FMOL to begin providing diabetic education to individuals with diabetes in Ascension Parish. The Diabetic Clinic began seeing patients in September 2011. - ST. ELIZABETH PHYSICIANS SECURED GRANT FUNDING THROUGH FMOL TO BEGIN PROVIDING A GERIATRIC SPECIALIST PHYSICIAN IN ASCENSION PARISH. DR. MOHAMMED SAEED BEGAN SEEING PATIENTS IN NOVEMBER 2012. - ST. ELIZABETH PHYSICIANS SECURED GRANT FUNDING THROUGH FMOL TO BEGIN PROVIDING A PEDIATRIC MEDICAID CLINIC IN ASCENSION PARISH. DR. CAMMIE HILLIARD BEGAN SEEING PATIENTS IN JANUARY 2014. - THE HOSPITAL AND PHYSICIAN PRACTICE PROVIDES FINANCIAL ASSISTANCE TO LOW INCOME PERSONS THROUGH ITS CHARITY CARE PROGRAM. IN ADDITION, THE HOSPITAL PROVIDES PROMPT PAY DISCOUNTS TO UNINSURED PATIENTS. THESE POLICIES ARE COMMUNICATED THROUGH FINANCIAL COUNSELORS EMPLOYED BY THE HOSPITAL. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAX THROUGH ITS 501(C)(3) DESIGNATION. TO FULFILL ITS MISSION, THE HOSPITAL: A. OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; B. GRANTS MEDICAL STAFF PRIVILEGES TO THOSE PHYSICIANS QUALIFIED TO PARTICIPATE IN THEIR PARTICULAR SPECIALTY. C. HAS A GOVERNING BODY THAT IS COMPRISED OF MEMBERS OF THE MEDICAL STAFF, COMMUNITY MEMBERS, MEMBERS OF THE HOSPITAL'S SPONSORING ORDER (FMOL), AND HOSPITAL EMPLOYEES. THE MAJORITY OF THE BOARD IS COMPOSED OF INDEPENDENT PEOPLE REPRESENTATIVE OF THE COMMUNITY. D. THE HOSPITAL IS AN EDUCATIONAL SITE FOR SEVERAL DIFFERENT PROFESSIONAL HEALTH CARE STUDENTS. ST. ELIZABETH HOSPITAL CLINICAL AND PROFESSIONAL STAFF PROVIDES OVER 10,861 HOURS OF HEALTH PROFESSIONS EDUCATION TO STUDENT IN SPECIALTIES SUCH AS: " NURSING " PHARMACY " LABORATORY " RADIOLOGY " CARDIOPULMONARY " FOOD AND NUTRITIONAL THERAPY E. ST. ELIZABETH HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS AS APPROPRIATE. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS A. ST. ELIZABETH HOSPITAL SPONSORS AN ANNUAL HEALTH FAIR FOR THE CITIZENS OF ASCENSION PARISH AS WELL AS OTHER PARISHES. THE ANNUAL HEALTH FAIR IS COMPRISED OF NUMEROUS BOOTHS PROVIDING HEALTH EDUCATION, SCREENING AND DIAGNOSTIC TESTING. THE FAIR IS STAFFED BY THE TEAM MEMBERS OF ST. ELIZABETH HOSPITAL ALONG WITH OTHER HEALTH CARE PROFESSIONALS AND BUSINESSES FROM ASCENSION PARISH. IN 2014, ST. ELIZABETH PARTNERED WITH ASCENSION PARISH TO PROVIDE THE HEALTH FAIR IN A LARGER ENCLOSED LOCATION. THE OVERALL GOAL OF THE ANNUAL HEALTH FAIR IS TO RAISE AWARENESS AND OFFER HEALTH EDUCATION AND SCREENINGS TO THE CITIZENS OF ASCENSION PARISH. PUBLIC AWARENESS REGARDING THE EVENT IS DELIVERED VIA EMAIL, RADIO, TELEVISION AND NEWSPAPER. THE ST. ELIZABETH HOSPITAL ANNUAL HEALTH FAIR HAS BEEN WELL RECEIVED BY THE COMMUNITY. OVER 650 PEOPLE ATTENDED IN 2014 WITH THE HELP OF OVER 200 VOLUNTEERS. B. ST. ELIZABETH HOSPITAL TEAM MEMBERS DONATED OVER 2,443 HOURS OF TIME FOR VARIOUS COMMUNITY BENEFIT ACTIVITIES. THESE ACTIVITIES INCLUDE CHARITY INVOLVEMENT IN SUCH NOT FOR PROFIT ORGANIZATIONS AS CHILD ADVOCACY SERVICES, ASCENSION CHAMBER OF COMMERCE, UNITED WAY, ARC OF EAST ASCENSION, ETC. AS AN EXPRESSION OF OUR MISSION AND CORE VALUES, THE TEAM MEMBERS OF ST. ELIZABETH HOSPITAL DONATE TIME TO COMMUNITY ACTIVITIES AS A WAY OF GIVING BACK TO THE COMMUNITY THAT WE SERVE. OUR GOAL IS TO REACH OUT TO THOSE WHO MAY NOT HAVE ACCESS TO THE SERVICES WE PROVIDE. DONATED HOURS ARE A WAY OF PROVIDING THAT ACCESS. SECTION 2 - QUANTIFIABLE COMMUNITY BENEFIT 1)CHARITY CARE - AT COST $ 1,010,985 2)MEDICAID SPONSORED HEALTHCARE - NET EXPENSE $ 6,722,103 3)COMMUNITY HEALTH SERVICES: COMMUNITY HEALTH EDUCATION $ 54,675 COMMUNITY BASED CLINICAL SERVICES $ 13,386 4) HEALTH PROFESSIONS EDUCATION TRAINING STAFF $ 402,044 5) FINANCIAL AND IN-KIND CONTRIBUTIONS: CASH DONATIONS $ 109,465 IN KIND DONATIONS $ 27,633 6) SUBSIDIZED HEALTH SERVICES COMMUNITY CLINIC LOSS $382,952 7) COMMUNITY BENEFIT OPERATIONS: DEDICATED STAFF $ 2,844 8) COMMUNITY BUILDING ACTIVITIES: IN KIND DONATIONS $ 28,503 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $8,754,590 Part XI, Question 9 Capital Transfers - $ (1,683,248) Income from Equity Investees - $ 103,594 St Elizabeth Physicians 2647 S ST ELIZABETH BLVD GONZALES LA 70737 721439296 HEALTHCARE LA 23319336 4820426 STEH ST BERNARD HEALTH FUND 4200 ESSEN LANE BATON ROUGE LA 70809 204685614 HEALTHCARE LA 501(C)(3) 11 TYPE 1 FMOL false HEALTH CARE CENTERS IN SCHOOLS 5000 HENNESSY BLVD BATON ROUGE LA 70808 721443935 HEALTHCARE LA 501(C)(3) 7 OLOL true HEART HOSPITAL OF ACADIANA LLC 1105 KALISTE SALOOM ROAD LAFAYETTE LA 70508 300442368 HEALTHCARE LA LOURDES N/A PERKINS PLAZA MEDICAL ARTS DEVELOPMENT 5000 HENNESSY BLVD SUITE 110 BATON ROUGE LA 70808 450516574 REAL ESTATE LA OLOL N/A PERKINS PLAZA IMAGING DEVELOPMENT LLC 5000 HENNESSY BOULEVARD PLAZA 2 S BATON ROUGE LA 70808 203894521 REAL ESTATE LA OLOL N/A NUCLEAR IMAGING LLC 5000 HENNESSY BLVD SUITE 110 BATON ROUGE LA 708084398 721470061 HEALTHCARE LA OLOL N/A P&S SURGERY CENTER LLC 312 GRAMMONT STREET MONROE LA 71201 721387312 HEALTHCARE LA SFMC N/A LOURDES IMAGING DEVELOPMENT LLC 4801 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 208326287 REAL ESTATE LA LOURDES N/A PARK PLACE SURGICAL CENTER LLC 901 WILSON STREET LAFAYETTE LA 70503 721404092 HEALTHCARE LA LOURDES N/A BRPT LAKE REHABILITATION CENTER LLC 530 SHADOWS LANE BATON ROUGE LA 70806 721404092 HEALTHCARE LA OLOL N/A CONVENIENT CARE LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 721439481 HEALTHCARE LA OLOL N/A PERKINS PLAZA AMBULATORY SURGERY CENTER 1400 N PORTLAND AVENUE SUITE 200 OKLAHOMA CITY LA 73134 481264699 HEALTHCARE LA OLOL N/A SURGICAL SPECIALTY CENTER OF BATON ROUGE 8080 BLUEBONNET BLVD BATON ROUGE LA 70810 233160962 HEALTHCARE LA OLOL N/A ST ELIZABETH-MARY BIRD PERKINS CANCER C 4950 ESSEN LANE BATON ROUGE LA 70809 260628752 HEALTHCARE LA STEH RELATED 142075 2998661 false 0 true 0.35000 REGIONAL EYE SURGERY CENTER LLC 7777 HENNESSY BLVD SUITE 4000 BATON ROUGE LA 70808 721484653 HEALTHCARE LA OLOL N/A ST MARYS IMAGING CENTER II LLC 4801 AMBASSADOR CAFFERY PKWY LAFAYETTE LA 70508 HEALTHCARE LA LOURDES IMAGING N/A NORTHEAST LA CANCER INSTITUTE LLC 411 CALYPSO STREET MONROE LA 71201 721329499 HEALTHCARE LA SFMC N/A LHCG-XIII LLC 420 WEST PINHOOK ROAD SUITE A LAFAYETTE LA 70503 208068308 HEALTHCARE LA LOURDES N/A LOURDES AFTER HOURS LLC 7777 HENNESSY BLVD SUITE 1004-202 BATON ROUGE LA 70809 201367299 HEALTHCARE LA LOURDES N/A ST ELIZABETH IMAGING CENTER LLC 8080 BLUEBONNET BLVD STE 1000 BATON ROUGE LA 70810 271470744 HEALTHCARE LA STEH RELATED -116975 181879 false true 0.51000 CAPITAL AREA SHARED SERVICES ORGANIZATIO 4200 ESSEN LANE BATON ROUGE LA 70809 275173212 HEALTHCARE LA STEP RELATED 31355 335188 false true 0.17000 CAPITAL AREA SHARED SERVICES ORG LLC 4200 ESSEN LANE BATON ROUGE LA 70809 275173212 HEALTHCARE LA OLOL PG N/A LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 352463092 HEALTHCARE LA STEH RELATED 971 76411 false true 0.20000 LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 352463092 HEALTHCARE LA OLOL N/A OLOL PONTCHARTRAIN SURGERY CENTER LLC 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 461379031 HEALTHCARE LA OLOLUSP N/A OLOLUSP SURGERY CENTER LLC 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 352457810 HEALTHCARE TX OLOL N/A ST FRANCIS INSURANCE AGENCY 309 JACKSON STREET MONROE LA 71201 721435136 INSURANCE LA SFMC C CORP HOSPITAL ASSISTANCE SERVICES PO BOX 4027-C LAFAYETTE LA 70502 721073486 HEALTHCARE LA LOURDES C CORP LOUISE INSURANCE COMPANY PO BOX 1051 CJ KY1-1102 INSURANCE CJ FMOL C CORP MONROE HEALTH SERVICES PO BOX 3187 MONROE LA 71210 721057820 HEALTHCARE LA AMBULATORY C CORP NORTHEAST LA HEALTH NETWORK 309 JACKSON STREET MONROE LA 71201 721294587 HEALTHCARE LA AMBULATORY C CORP CHARITABLE REMAINDER TRUST 4200 ESSEN LANE BATON ROUGE LA 70809 455492379 INVESTMENT LA OLOL FOUNDATION TRUST FRANCISICAN HEALTH & WELLNESS SERVICES I 4200 ESSEN LANE ROUGE LA 70809 455492379 HEALTHCARE LA FMOL C CORP FMOL HEALTH SYSTEM HOLDINGS INC 4200 ESSEN LANE ROUGE LA 70809 454405024 INVESTMENT LA FMOL C CORP false false true false false false false false true false false true false true true true true true