2015-05-11T15:39:24-05:00 2014-09-30 720506596 COLE EVANS & PETERSON POST OFFICE DRAWER 1768 SHREVEPORT LA 711661768 990 2013-10-01 720400933 WILLIS-KNIGHTON MEDICAL CENTER WILL 3182124000 POST OFFICE BOX 32600 SHREVEPORT LA 711302600 JAMES K ELROD PRESIDENT 3182124000 2015-05-11 1 C WILLIAM GERARDY JR P00024591 3182228367 2013 2016-02-25 16:41:14Z WILLIS-KNIGHTON HEALTH SYSTEM JAMES K ELROD POST OFFICE BOX 32600 SHREVEPORT LA 711302600 977195482 0 X WWW.WKHS.COM X 1949 LA THE MEDICAL CENTER PROVIDES A FULL-RANGE OF HEALTH CARE SERVICES TO THE GENERAL PUBLIC. 13 10 7083 272 1188569 0 12857 12100 891166400 927927793 283508 1181510 4132928 5884289 895595693 935005692 1841191 1776850 0 0 375192529 373219732 0 0 0 444496160 476822688 821529880 851819270 74065813 83186422 1006411418 1094232338 280746051 320919969 725665367 773312369 X TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. 0 0 717010023 1776850 928421233 WILLIS-KNIGHTON MEDICAL CENTER STRIVES TO PROVIDE HIGH QUALITY, COST-EFFECTIVE MEDICAL CARE TO THE COMMUNITIES OF NORTHWEST LOUISIANA, NORTHEAST TEXAS, AND SOUTHWEST ARKANSAS. THE MEDICAL CENTER OFFERS SOPHISTICATED TECHNOLOGY AND PROCEDURES THAT MAKE IT A TERTIARY CARE REFERRAL CENTER. GENERAL THE MEDICAL CENTER PROVIDES 24-HOUR EMERGENCY CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, AT ITS FOUR HOSPITALS. THE MEDICAL CENTER PROVIDES AN ORGAN TRANSPLANT PROGRAM, OBSTETRICS, COMPREHENSIVE HEART AND CANCER PROGRAMS, EXTENSIVE SURGICAL OPTIONS, LEADING-EDGE DIAGNOSTICS AS WELL AS A BROAD NETWORK OF PHYSICIANS ENCOMPASSING MOST SPECIALTIES AND SUBSPECIALTIES. THE MEDICAL CENTER PROVIDES THESE SERVICES REGARDLESS OF RACE, COLOR, CREED, RELIGION, GENDER, NATIONAL ORIGIN, DISABILITY OR AGE. THE MEDICAL CENTER HAD 53,253 ADMITTANCES DURING THE YEAR ENDED SEPTEMBER 30, 2014 WITH A TOTAL OF 211,347 PATIENT DAYS AND 3,429 BIRTHS. THE MEDICAL CENTER PARTICIPATES IN THE MEDICAID PROGRAM AND ADMINISTERS A CHARITY CARE POLICY WHEREBY FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO QUALIFIED INDIVIDUALS WITH LIMITED FINANCIAL MEANS. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER PROVIDED AN ESTIMATED $21,500,000 IN UNREIMBURSED COSTS ATTRIBUTABLE TO CHARITY CARE (EXCLUDING PROJECT NEIGHBORHEALTH) AND AN ESTIMATED $26,600,000 IN UNREIMBURSED COSTS ATTRIBUTABLE TO MEDICAID PATIENTS. THESE ESTIMATES ARE BASED ON THE MEDICAL CENTER'S OVERALL COST-TO-CHARGE RATIO. IN ADDITION TO THESE SERVICES, WILLIS-KNIGHTON PROJECT NEIGHBORHEALTH OPERATES FOUR CLINICS IN COMMUNITIES THAT ARE ECONOMICALLY DISTRESSED AND/OR DESIGNATED AS MEDICALLY UNDER-SERVED AREAS WITH HEALTH PROFESSIONAL SHORTAGES. SEE SCHEDULE H FOR DETAILED INFORMATION REGARDING PROJECT NEIGHBORHEALTH. REGIONAL TRANSPLANT CENTER THE MEDICAL CENTER OPERATES THE JOHN C. MCDONALD REGIONAL TRANSPLANT CENTER AT WILLIS-KNIGHTON MEDICAL CENTER. ALL TRANSPLANT PATIENTS RECEIVE TRANSPLANTS WITHOUT REGARD TO THEIR ECONOMIC STATUS. THE REGIONAL TRANSPLANT CENTER PROVIDES KIDNEY, PANCREAS, AND LIVER TRANSPLANTS. SUBSTANTIALLY ALL THE COSTS OF OPERATING THE REGIONAL TRANSPLANT CENTER ARE BORNE BY WILLIS-KNIGHTON MEDICAL CENTER. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014, 46 PATIENTS RECEIVED ORGAN TRANSPLANTS, CONSISTING OF 38 KIDNEYS (7 OF THOSE PATIENTS ALSO HAD A PANCREAS TRANSPLANT) AND 8 LIVERS. OF THE 46 TRANSPLANT SURGERIES PERFORMED AT THE MEDICAL CENTER DURING THE YEAR ENDED SEPTEMBER 30, 2014, 35 PATIENTS WERE BENEFICIARIES OF THE MEDICARE PROGRAM. AS SUCH, THESE TRANSPLANTS WERE PERFORMED AT VERY LITTLE, IF ANY, COST TO THE PATIENTS.EMERGENCY CARE THE MEDICAL CENTER PROVIDES EMERGENCY SERVICES AT FOUR LOCATIONS ON A 24-HOUR BASIS STAFFED BY FULL-TIME EMERGENCY ROOM PHYSICIANS. EMERGENCY PATIENTS ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER'S EMERGENCY ROOMS WERE VISITED BY 179,554 PATIENTS, OF WHOM 21,385 WERE ADMITTED TO THE HOSPITAL FOR FURTHER TREATMENT.WOMEN AND CHILDREN'S HEALTH THE MEDICAL CENTER PROVIDES A VARIETY OF MEDICAL SERVICES FOR WOMEN AND CHILDREN, INCLUDING OBSTETRICS, GYNECOLOGY, NEONATOLOGY, MATERNAL/FETAL HEALTH SERVICES FOR HIGH RISK PREGNANCY, PEDIATRIC INTENSIVE CARE AND PEDIATRIC SUPPORT SERVICES SUCH AS PEDIATRIC GASTROENTEROLOGY AND PEDIATRIC SURGERY. THESE SERVICES INCLUDE BOTH HIGH-RISK AND LOW-RISK OBSTETRICS. MATERNAL TRANSPORTS ARE ACCEPTED. THE LABOR AND DELIVERY (L&D) UNITS ARE DIRECTED BY BOARD CERTIFIED OB-GYN PHYSICIANS AND THE MAJORITY OF THE NURSES ARE CERTIFIED BY THE ASSOCIATION OF WOMEN'S HEALTH, OBSTETRIC & NEONATAL NURSES (AWHON). THERE WERE 3,429 BIRTHS; 9,724 OBSTETRICAL VISITS TO THE L&D UNITS; AND 3,280 OBSTETRICAL AND GYNECOLOGICAL INPATIENTS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014HEALTH AND WELLNESS CENTERS THE MEDICAL CENTER HAS SIX MEDICALLY-SUPERVISED HEALTH AND WELLNESS CENTERS DEDICATED TO THE PREVENTION OF HEALTH PROBLEMS, FOUR IN SHREVEPORT, ONE IN BOSSIER CITY, AND ONE IN HOMER WITH A TOTAL MEMBER ENROLLMENT AT SEPTEMBER 30, 2014 OF 5,939. THE CENTERS ARE LOCATED ON EACH OF THE FOUR HOSPITAL CAMPUSES, IN THE WK PIERRE AVENUE COMMUNITY CENTER, AND IN THE WK CLAIBORNE REGIONAL HEALTH CENTER. A MEDICAL EVALUATION, INCLUDING A BLOOD CHEMISTRY WORK-UP, IS REQUIRED FOR MEMBERSHIP. THE CENTERS SERVE PULMONARY AND CARDIAC REHABILITATION PATIENTS AND PROVIDE HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE LOCATED. NEONATAL INTENSIVE CARE UNIT WILLIS-KNIGHTON'S CENTER FOR WOMEN'S HEALTH HOUSES A 42-BED LEVEL III REGIONAL OBSTETRICAL AND NEONATAL UNIT. THIS UNIT ACCEPTS REFERRALS FROM THE ARK-LA-TEX AREA AND IS SERVICED BY BOTH AIR AND GROUND EMERGENCY TRANSPORT ON A 24-HOUR BASIS. THIS UNIT IS DIRECTED BY A BOARD CERTIFIED NEONATOLOGIST. THE MAJORITY OF THE NURSING STAFF IS CERTIFIED BY AWHON. THE AVERAGE LENGTH OF STAY PER ADMIT IS 20.7 DAYS.HOSPICE HOSPICE OF LOUISIANA IS A DEPARTMENT OF WILLIS-KNIGHTON MEDICAL CENTER THAT PROVIDES COMPREHENSIVE END-OF-LIFE CARE INCLUDING SKILLED AND SUPPORTIVE SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. THE HOSPICE TEAM, UNDER THE GUIDANCE OF THE ATTENDING PHYSICIAN, FOCUSES ON THE ALLEVIATION OF THE PAIN AND DISCOMFORT CONNECTED WITH LIFE-ENDING ILLNESS. QUALITY OF LIFE, EMOTIONAL AND SPIRITUAL BALANCE, SYMPTOM MANAGEMENT, AND PAIN CONTROL ARE THE GOALS THAT TEAM MEMBERS STRIVE FOR AS THEY ASSIST DYING PATIENTS AND THEIR FAMILIES. BEREAVEMENT SUPPORT FOR THE IMMEDIATE FAMILY AND COMPANIONS IS PROVIDED FOR AT LEAST ONE YEAR FOLLOWING THE PATIENT'S DEATH. FOR THE YEAR ENDED SEPTEMBER 30, 2014, HOSPICE OF LOUISIANA SERVED 259 PATIENTS AND THEIR FAMILIES AS DIRECT ADMITS, NOT INCLUDING VISITATION AND COUNSELING PROVIDED THROUGH PRE-ADMIT AND/OR BEREAVEMENT SERVICES. THE TEAM INCLUDES: REGISTERED NURSES, CERTIFIED NURSING ASSISTANTS, SOCIAL WORKERS, CHAPLAINS, VOLUNTEERS, ATTENDING PHYSICIANS, AND MEDICAL DIRECTOR.BEHAVIORAL MEDICINE CENTER THE BEHAVIORAL MEDICINE CENTER AT WILLIS-KNIGHTON MEDICAL CENTER OFFERS INPATIENT AND OUTPATIENT SERVICES TO INDIVIDUALS IN NEED OF MENTAL HEALTH CARE. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE BEHAVIORAL MEDICINE CENTER SPONSORED NUMEROUS INFORMATION SESSIONS FOR VARIOUS GROUPS IN THE SHREVEPORT/BOSSIER AND NORTHWEST LOUISIANA AREAS. SUCH SESSIONS AMOUNTED TO APPROXIMATELY 556 HOURS AND WERE ATTENDED BY APPROXIMATELY 3,850 PEOPLE. TOPICS INCLUDED:MARRIAGE/FAMILY - DEVELOPMENT OF SKILLS TO ENRICH MARRIAGE AND FAMILY LIFE.SELF-ESTEEM - CONCENTRATES ON HOW GOOD SELF-ESTEEM CAN ENHANCE AN INDIVIDUAL'S QUALITY OF LIFE. PARENTING - FOCUSES ON APPROPRIATE PARENTING SKILLS AT VARIOUS DEVELOPMENTAL STAGES. STRESS MANAGEMENT - DEVELOPING SKILLS TO COPE WITH EVERYDAY STRESSES IN LIFE.PERSONAL ENRICHMENT - EMPOWERING OURSELVES TO REACH MAXIMUM POTENTIAL.MOTIVATION/ATTITUDE - HOW ATTITUDE AFFECTS OUR MENTAL AND PHYSICAL HEALTH.COUNSELING ISSUES/TECHNIQUES - ISSUES CONCERNING PROFESSIONAL DEVELOPMENT FOR COUNSELORS/THERAPISTS.AGING - DEVELOPMENT OF A POSITIVE ATTITUDE TO DEAL WITH ISSUES OF AGING.DEPRESSION/SUICIDE - ASSESSMENT OF DEPRESSION AND SUICIDE, AND LEGAL AND ETHICAL ISSUES SURROUNDING SUICIDE. 11427877 4270693 THE MEDICAL CENTER PROVIDES HOUSING, HEALTHCARE, AND RELATED SERVICES TO THE ELDERLY THROUGH THE OAKS OF LOUISIANA. THE OAKS OF LOUISIANA IS A RESIDENTIAL COMMUNITY DESIGNED SPECIFICALLY FOR ADULTS AGED 55 AND OVER. THIS RESIDENTIAL COMMUNITY PROVIDES SECURE, MAINTENANCE-FREE LIVING AND PROMOTES AN ACTIVE, HEALTHY LIFESTYLE. THE CAMPUS OF THE OAKS OF LOUISIANA INCLUDES THE TOWER AT THE OAKS, A RESIDENTIAL COMMUNITY, AND SAVANNAH AT THE OAKS, AN ASSISTED LIVING FACILITY. 728437900 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 499 0 1 7083 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 10 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X MR JAMES K ELROD 3182124000 2611 GREENWOOD ROAD SHREVEPORT LA 711033908 JAMES K ELROD PRESIDENT/CEO/TRUSTEE 53.00 X X 1356085 6000 14847 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 40.00 X 205174 0 7225 PHILLIP A ROZEMAN MD TRUSTEE 4.00 X 0 0 0 TIGNER A WALKER TRUSTEE 4.00 X 0 0 0 FRANK B HUGHES MD TRUSTEE/CHAIRMAN 4.00 X 0 0 0 RAND H FALBAUM TRUSTEE 4.00 X 0 0 0 TWAIN K GIDDENS JR TRUSTEE/SECRETARY 4.00 X X 0 0 0 WILLIS L MEADOWS JR TRUSTEE 4.00 X 0 0 0 SAM J TALBOT MD TRUSTEE 4.00 X 0 0 0 VINCENT MARSALA PHD TRUSTEE 4.00 X 0 0 0 JOHN C MICIOTTO MD TRUSTEE 4.00 X 0 0 0 GILBERT R SHANLEY CPA TRUSTEE 4.00 X 0 0 0 WILLIAM J COLE CPA TRUSTEE/TREASURER 4.00 X X 0 0 0 RICHARD H SALE TRUSTEE 4.00 X 0 0 0 EUGENE W BRYSON JR TRUSTEE 4.00 X 0 0 0 CHARLES D DAIGLE SR VP OF OPERATIONS & COO 40.00 X 993825 0 23057 STEPHEN R RANDALL SR VP-SPECIAL OPERATIONS 40.00 X 320091 0 22086 MARGARET G ELROD VP/IND WELLNESS/COMMUNITY 40.00 X 179382 0 9364 JERRY A FIELDER II VP/ADMINISTRATOR WKMC 40.00 X 170607 0 23691 CLIFFORD M BROUSSARD VP/ADMIN WK BOSSIER 40.00 X 182896 0 15388 JANET K ELROD VP/ADMIN WK SOUTH 40.00 X 179194 0 9479 IRA L MOSS VP/ADMIN WK PIERREMONT 40.00 X 212201 0 17587 JILL K ELROD VP OF LEGAL AFFAIRS 40.00 X 235978 0 10106 PEGGY J GAVIN VP OF PHYSICIAN SERVICES 40.00 X 181335 0 9269 DEBORAH D OLDS VP OF NURSING 40.00 X 139780 0 17011 RAMONA D FRYER TERM 82514 VP OF REV/QUALITY/COMPLIAN 40.00 X 262007 0 18396 DANIEL J MOLLER JR MD CHIEF-MEDICAL AFFAIRS-WKMC 40.00 X 359468 0 14851 CHARLES A POWERS MD CHIEF-MED. AFFAIRS-WKB 40.00 X 340058 0 15611 RANDALL P BREWER MD PHYSICIAN 40.00 X 1531563 0 22693 MILAN G MODY MD PHYSICIAN 40.00 X 1654467 0 20637 CHRISTIAN M BRIERY MD PHYSICIAN 40.00 X 1469046 0 20366 CHRISTOPHER L SHELBY MD PHYSICIAN 40.00 X 1116495 0 20595 CLINT M CORMIER MD PHYSICIAN 40.00 X 1368946 0 19717 ROBERT D HUIE FORMER EXECUTIVE VP & CFO 52.00 X 857164 0 11097 13315762 6000 343073 497 1 1 0 TEG ARCHITECTS LLC 903 SPRING STREET JEFFERSONVILLE IN 47130 ARCHITECTUAL FEES 4801502 LSU HEALTH SCIENCES CENTER PO BOX 33932 SHREVEPORT LA 71130 MEDICAL STAFFING 4771615 SHREVEPORT ANESTHESIA SERVICE 2600 GREENWOOD ROAD SHREVEPORT LA 71103 PHYSICIAN SERVICES 4632428 RED RIVER CARDIOVASCULAR SURGEONS 2751 ALBERT BICKNELL DR SUITE 5C SHREVEPORT LA 71103 PHYSICIAN SERVICES 3464780 MAYO MEDICAL LABORATORIES PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY TESTING SERVICES 2616100 118 12100 12100 HOSPITAL SERVICES 900099 923657100 923657100 RESIDENTIAL COMMUNITY 900099 4270693 4270693 927927793 1113097 1113097 2165486 1895821 269665 269665 269665 40362382 40273797 20172 88585 -20172 68413 68413 LABORATORY REVENUE 621500 472623 472623 (LOSS) FROM SUBSIDIARY - VIRGINIA 623000 -129139 -129139 (LOSS) FROM SUBSIDIARY - MULTI-FA 623000 -512876 -512876 5784016 5068070 715946 5614624 935005692 932691926 1188569 1113097 1775475 1775475 1375 1375 5296107 5296107 277023494 243591066 33432428 13348541 11517391 1831150 53744875 46372166 7372709 23806715 20540916 3265799 493097 493097 2063450 2063450 2447771 1166575 1281196 7649529 7649529 464966 464966 46361676 24138154 22223522 5419981 5419981 DIRECT DEPARTMENTAL EXP 377434492 377434492 TAXES & LICENSES 8403353 8403353 BUSINESS OFFICE 4767676 4767676 21316697 1900290 19416407 851819270 728437900 123381370 0 5326613 5813034 118581569 164779181 141524578 132883301 7798107 4871535 21296159 21626553 3864762 4236493 1145842085 578746331 527278672 567095754 165730061 178520552 12754760 12241757 1443318 1370819 812819 793359 1006411418 1094232338 92060255 102674340 164265868 154586270 22748604 24419928 40910755 280746051 320919969 X 725665367 773312369 725665367 773312369 1006411418 1094232338 X 83186422 -116930 -35422490 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 69880 69880 0 PART II-B, LINE 1: DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER PAID DUES TOTALING $49,225 TO THE LOUISIANA STATE MEDICAL SOCIETY ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $10,571 WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER PAID DUES TOTALING $4,900 TO THE AMERICAN MEDICAL ASSOCIATION ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $2,695 WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER PAID DUES TOTALING $269,591 TO THE LOUISIANA HOSPITAL ASSOCIATION FOR THE MEDICAL CENTER'S MEMBERSHIP IN THE ASSOCIATION AND ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $56,614 WAS RELATED TO LOBBYING ACTIVITIES. HEALTHCARE POLICY IS CRITICAL TO THE MISSION OF THE MEDICAL CENTER, AND ITS MANAGEMENT BELIEVES THAT HEALTHCARE PROVIDERS SHOULD PARTICIPATE IN FORMING HEALTHCARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFFS, WHEN POSSIBLE, TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTHCARE ISSUES. THE MEDICAL CENTER'S MANAGEMENT IS AVAILABLE TO LAWMAKERS, GOVERNMENT OFFICIALS, AND THEIR STAFF MEMBERS, FOR INFORMATION AND OCCASIONALLY RESPONDS TO QUESTIONS AND INITIATES COMMUNICATIONS ABOUT HOW PROPOSED LAWS, POLICIES, REGULATIONS, ETC. MIGHT AFFECT THE MEDICAL CENTER'S ABILITY TO DELIVER COST-EFFECTIVE, QUALITY HEALTHCARE. THE AMOUNT OF TIME AND MONEY RESOURCES INVOLVED IN THESE ACTIVITIES IS INSUBSTANTIAL. THE MEDICAL CENTER HAS NOT AND DOES NOT INTERVENE IN ANY POLITICAL CAMPAIGN. 1099490 49157484 50256974 9146727 658767696 324434010 343480413 1912688 1328120 584568 353069927 237837033 115232894 72688073 15147168 57540905 567095754 CAPITAL LEASE OBLIGATIONS 1785022 INVESTMENT IN SUB. - VIRGINIA HALL, INC. 3711822 LIABILITY FOR PENSION BENEFITS 35413911 40910755 952226452 -116930 -116930 952343382 -17337690 -17337690 935005692 904579450 52760180 52760180 851819270 0 851819270 PART XI, LINE 4B - OTHER ADJUSTMENTS: UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSING, LAUNDRY SUBSIDIARIES EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARIES INCOME/EXPENSE UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSNG, LAUNDRY FASB ASC 715-30 PENSION FORM 990, SCHEDULE D, PART XI, LINE 4B AND PART XII, LINE 2D PART XI, LINE 4B UNRELATED BUSINESS GROSS INCOME: DATA PROCESSING 472,608 HOUSEKEEPING 81,338 LAUNDRY 266,817 SUBSIDIARIES EXPENSES (18,158,453) TOTAL (17,337,690) PART XII, LINE 2D UNRELATED BUSINESS GROSS INCOME: DATA PROCESSING (472,608) HOUSEKEEPING (81,338) LAUNDRY (266,817) SUBSIDIARIES EXPENSES 18,158,453 PENSION RELATED CHANGES 35,422,490 TOTAL 52,760,180 1 1 X 1 X 1 X 1 1 1 0 1 1 21528864 21528864 0.02530 83423585 56766980 26656605 0.03130 104952449 56766980 48185469 0.05660 3236176 3236176 0.00380 4955527 4955527 0.00580 2330722 872985 1457737 0.00170 1775475 1775475 0.00210 12297900 872985 11424915 0.01340 117250349 57639965 59610384 0.07000 1 20574407 0 234639493 245919576 -11280083 X 1 1 4 1 WILLIS-KNIGHTON MEDICAL CENTER 2600 GREENWOOD ROAD SHREVEPORT LA 71103 232 X X X X REHAB CTR, SNF, PHYSICIAN CLINICS A 2 WK PIERREMONT HEALTH CENTER 8001 YOUREE DRIVE SHREVEPORT LA 71115 232-C X X X X PHYSICIAN CLINICS A 3 WK BOSSIER HEALTH CENTER 2400 HOSPITAL DRIVE BOSSIER CITY LA 71111 387 X X X PHYSICIAN CLINICS A 4 WILLIS-KNIGHTON SOUTH 2510 BERT KOUNS INDUSTRIAL LOOP SHREVEPORT LA 71118 232-A X X X X PHYSICIAN CLINICS/BEHAVIORAL MEDICINE A WILLIS-KNIGHTON HEALTH SYSTEM 1 X X X X X X X X 12 1 1 1 X X X X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X 1 X 1 X X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: WILLIS-KNIGHTON MEDICAL CENTER, - FACILITY 4: WILLIS-KNIGHTON SOUTH, - FACILITY 3: WK BOSSIER HEALTH CENTER, - FACILITY 2: WK PIERREMONT HEALTH CENTER FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 3: CONDUCTED 17 INTERVIEWS (LIST OF INTERVIEWEES FOLLOWS) WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52.DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. GATHERED BACKGROUND INFORMATION, INCLUDING CREDENTIALS, ON EACH INTERVIEWEE.SHERRI BUFFINGTON, STATE SENATOR DISTRICT 38(CADDO AND DESOTO PARISH); VICE CHAIR HEALTH & WELFAREBARROW PEACOCK, STATE SENATOR DISTICT 37 (SHREVEPORT AND BOSSIER PARISH)WILLIS BRADFORD, WILLIS-KNIGHTON DIRECTOR OF PROJECT NEIGHBORHEALTHMARTHA MARAK, DIRECTOR OF THE FOOD BANK OF NORTHWEST LOUISIANADR. DAN MOLLER, CMO, WILLIS-KNIGHTON HEALTH SYSTEMDR. ANIL NANDA, NEUROSURGEON, LSU HEALTH - SHREVEPORTDR. CHARLES POWERS, CMO - WILLIS-KNIGHTON BOSSIER HOSPITALRON WEBB, CITY COUNCILMAN, DISTRICT E, CITY OF SHREVEPORTDR. MARTHA WHYTE, DIRECTOR - DEPARTMENT OF PUBLIC HEALTH REGION 7BRIDGET CAUSEY, RN, BSN, NURSING SUPERVISOR, CADDO PARISH PUBLIC SCHOOLSWILLIE WHITE, CEO OF DAVID RAINES COMMUNITY HEALTH CENTERSDR. JOHN MICIOTTO, RETIRED OB/GYN, FORMER MEDICAL DIRECTOR, NORTHWEST LOUISIANA DEPT. OF HEALTHANTHONY MARTIN, DIRECTOR - WILLIS-KNIGHTON HOME HEALTH/HOSPICETIM WILCOX, DIRECTOR - WILLIS-KNIGHTON BEHAVIORAL HEALTHC.O. SIMPKINS, SR., DDS - COMMUNITY LEADER, EX-CITY COUNCILMANBRUCE WILSON, DIRECTOR - UNITED WAY OF NORTHWEST LOUISIANADR. PHILLIP ROZEMAN, CARDIOLOGIST, COMMUNITY LEADER FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 4: WK PIERREMONT HEALTH CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 3: SAME AS FOR FACILITY 1 - WILLIS-KNIGHTON MEDICAL CENTER FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 4: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 3: SAME AS FOR FACILITY 1 - WILLIS-KNIGHTON MEDICAL CENTER FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 4: WILLIS-KNIGHTON MEDICAL CENTERWK PIERREMONT HEALTH CENTERWILLIS-KNIGHTON SOUTH FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 3: SAME AS FOR FACILITY 1 - WILLIS-KNIGHTON MEDICAL CENTER FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 4: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWK PIERREMONT HEALTH CENTER 4 OUTPATIENT CLINICS VARIOUS LOCATIONS SHREVEPORT LA 71130 OUTPATIENT CLINICS THE OAKS OF LOUISIANA 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 RESIDENTIAL COMMUNITY FOR ADULTS AGE 55 AND OVER SAVANNAH AT THE OAKS 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 ASSISTED LIVING FACILITY EXTENDED CARE CENTER 2550 KINGS HIGHWAY SHREVEPORT LA 71103 SUBACUTE REHABILITATION PART I, LINE 7: ALL ITEMS IN THE TABLE, EXCEPT FOR LINE 7G, USE THE COST-TO-CHARGE RATIO COSTING METHOD. PROJECT NEIGHBORHEALTH, WHICH IS INCLUDED ON LINE 7G, USES THE ACTUAL COST METHOD. PART III, LINE 4: THE MEDICAL CENTER MAINTAINS AN ALLOWANCE FOR DOUBTFUL PATIENT ACCOUNTS RECEIVABLE BASED ON MANAGEMENT'S ASSESSMENT OF COLLECTABILITY, CURRENT ECONOMIC CONDITIONS, AND PRIOR EXPERIENCE. AS MANAGEMENT DETERMINES THE COLLECTION OF SPECIFIC PATIENT ACCOUNTS TO BE DOUBTFUL, SUCH ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE. BASED ON THIS ANALYSIS, BAD DEBT EXPENSE AS A PERCENTAGE OF GROSS PATIENT BILLINGS (EXCLUDING MEDICARE CHARGES, MEDICAID CHARGES, AND CHARITY CARE) WAS 6.3 PERCENT AND 5.8 PERCENT FOR THE YEARS ENDED SEPTEMBER 30, 2014 AND SEPTEMBER 30, 2013, RESPECTIVELY. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. PART III, LINE 9B: 1. MONTHLY STATEMENTS ARE GENERATED AND MAILED BY THE MEDICAL CENTER TO KEEP PATIENTS/GUARANTORS INFORMED OF OUTSTANDING ACCOUNT BALANCES. STATEMENT MESSAGES ARE GENERATED FOR EACH ACCOUNT THAT LET THE PATIENT/GUARANTOR KNOW IF THE BALANCE IS PENDING PAYMENT FROM THEIR INSURANCE CARRIER OR DEEMED TO BE THE PATIENT'S RESPONSIBILITY.2. THE ACCOUNTS RECEIVABLE FILE IS REVIEWED MONTHLY FOR ACCOUNTS THAT HAVE AN OUTSTANDING BALANCE SHOWN TO BE THE PATIENT/GUARANTOR'S RESPONSIBILITY. AN ACCOUNT IS CONSIDERED TO BE IN THE EARLY STAGES OF DELINQUENCY ONCE IT BECOMES 90 DAYS OLD, RECEIVED AT LEAST THREE STATEMENTS FROM THE HEALTH SYSTEM AND IT HAS BEEN GREATER THAN 45 DAYS SINCE THE LAST PAYMENT WAS RECEIVED FROM INSURANCE OR THE PATIENT/GUARANTOR.3. ACCOUNTS MEETING THE ABOVE CRITERIA ARE REFERRED FOR COLLECTION TO HEALTHCARE REVENUE RECOVERY, LLC FOR FOLLOW UP WITH THE PATIENT/GUARANTOR. HEALTHCARE REVENUE RECOVERY, LLC WILL ATTEMPT TO COLLECT THE OUTSTANDING BALANCE FOR A PERIOD OF 75 DAYS. HEALTHCARE REVENUE RECOVERY, LLC COLLECTION EFFORTS WILL INCLUDE BOTH PHONE AND WRITTEN COMMUNICATIONS. PAYMENTS AND PATIENT CORRESPONDENCE WILL BE DIRECTED TO WILLIS-KNIGHTON HEALTH SYSTEM, NOT HEALTHCARE REVENUE RECOVERY, LLC.4. HEALTHCARE REVENUE RECOVERY, LLC WILL RETURN FILES TO WILLIS-KNIGHTON HEALTH SYSTEM AT THE END OF THE 75 DAY PERIOD WITH STATUS INFORMATION AS FOLLOWS:A. RETURNED WITH A PAYMENT ARRANGEMENT - ACCOUNTS ARE MAINTAINED IN HOUSE AND MONITORED BY THE BUSINESS OFFICE. THE BAD DEBT AGENCY IS CHANGED FROM SP-HCRR TO WK-REG. STATEMENTS ARE GENERATED AND MAILED TO THE PATIENT/GUARANTOR MONTHLY. ACCOUNTS ARE MONITORED MONTHLY AND WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY IF THE PATIENT/GUARANTOR DEFAULTS ON THE PAYMENT AGREEMENT.B. RETURNED WITH NO PAYMENT ARRANGEMENT - ACCOUNTS ARE REFERRED TO THE CREDIT BUREAU FOR BAD DEBT COLLECTIONS REGARDLESS OF THE PAYER CLASS. PART VI, LINE 2: WILLIS-KNIGHTON MEDICAL CENTER OPERATES THROUGHOUT SHREVEPORT, BOSSIER CITY AND NEARBY PARISHES AND PROVIDES FOUR HOSPITALS, NUMEROUS SATELLITE CLINICS, A SKILLED NURSING FACILITY, A RETIREMENT COMMUNITY, AND AN ASSISTED LIVING FACILITY. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES THAT IT SERVES BY STAYING INFORMED ABOUT THE RELEVANT TRENDS OCCURRING IN THE AREAS IN WHICH IT OPERATES. PART VI, LINE 3: WILLIS-KNIGHTON HEALTH SYSTEM IS COMMITTED TO PROVIDING CHARITY CARE TO PERSONS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE. CONSISTENT WITH ITS MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTHCARE SERVICES AND TO BE AN ADVOCATE FOR THOSE WHO ARE MOST IN NEED, WILLIS-KNIGHTON HEALTH SYSTEM STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. PATIENTS ARE EXPECTED TO COOPERATE WITH WILLIS-KNIGHTON HEALTH SYSTEM'S PROCEDURES FOR OBTAINING CHARITY OR OTHER FORMS OF PAYMENT OR FINANCIAL ASSISTANCE, AND TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR INDIVIDUAL ABILITY TO PAY. PART VI, LINE 4: WILLIS-KNIGHTON'S PRIMARY SERVICE AREA COVERS AN APPROXIMATE 35 MILE RADIUS OF SHREVEPORT, COVERING THE LOUISIANA PARISHES OF CADDO, BOSSIER, WEBSTER, CLAIBORNE, RED RIVER, DESOTO AND BIENVILLE, AND WHICH HAD A 2013 ESTIMATED POPULATION OF APPROXIMATELY 486,000 PERSONS. THE MEDIAN HOUSEHOLD INCOME ACCORDING TO THE 2013 U.S. CENSUS PROJECTION DATA FOR SHREVEPORT IS $38,465. THE MEDIAN HOUSEHOLD INCOME ACCORDING TO THE 2013 U.S. CENSUS PROJECTION DATA FOR BOSSIER PARISH IS $47,290. PART VI, LINE 5: OTHER COMMUNITY BENEFITS:PROJECT NEIGHBORHEALTH - OVERVIEWDURING 1995, THE MEDICAL CENTER BEGAN A PROGRAM KNOWN AS "PROJECT NEIGHBORHEALTH." THE PROGRAM'S PURPOSE IS TO PROMOTE HEALTH AND WELL-BEING IN COMMUNITIES THAT ARE ECONOMICALLY DISTRESSED AND/OR DESIGNATED AS MEDICALLY UNDER-SERVED, HEALTH-PROFESSIONAL-SHORTAGE AREAS. THE PROGRAM PROVIDES FREE COMMUNITY PROGRAMS INCLUDING ANTI-DRUG/GANG PROGRAMS, LIFE SKILLS TRAINING, MENTORING PROGRAMS, NUTRITIONAL COUNSELING, POLICE COMMUNITY FORUMS, AND OTHER COMMUNITY-RELATED PROGRAMS. AS PART OF PROJECT NEIGHBORHEALTH, THE MEDICAL CENTER OPERATES THE FOLLOWING CLINICS: SIMPKINS COMMUNITY HEALTH & EDUCATION CENTER, WK PIERRE AVENUE HEALTH & WELLNESS CENTER, WK BRADLEY MEDICAL CLINIC, AND THE CHILDREN'S DENTAL CLINIC AND WK COMMUNITY EDUCATION CENTER.SIMPKINS COMMUNITY HEALTH & EDUCATION CENTERPROJECT NEIGHBORHEALTH: ON SEPTEMBER 1, 1995, AT A COST OF APPROXIMATELY $1,300,000, THE MEDICAL CENTER OPENED A 6,463 SQUARE FOOT, FEDERALLY DESIGNATED INDIGENT CARE MEDICAL CLINIC AND A 3,914 SQUARE FOOT COMMUNITY EDUCATION BUILDING ON SHREVEPORT-BLANCHARD ROAD AT DR. MARTIN LUTHER KING DRIVE IN SHREVEPORT, LOUISIANA. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THESE FACILITIES ARE CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. THE LOCATION OF THE CLINIC (CENSUS TRACT 246 IN THE DR. MARTIN LUTHER KING DRIVE AREA IN CADDO PARISH) WAS DESIGNATED BY THE DEPARTMENT OF HEALTH AND HOSPITALS AS A HEALTH-PROFESSIONAL-SHORTAGE AREA AND AS A MEDICALLY UNDER-SERVED AREA. PRIOR TO THE CLINIC'S OPENING, THIS AREA WAS THE SECOND LARGEST CONTIGUOUS POPULATION OF MEDICALLY UNDER-SERVED PEOPLE IN THE UNITED STATES. THE CLINIC HAS AN EMERGENCY AND SPECIAL PROCEDURES ROOM, AN X-RAY DEPARTMENT, AND A FULLY EQUIPPED LABORATORY AND DENTAL FACILITY. PREVENTATIVE CARE PROGRAMS INCLUDE BLOOD PRESSURE CHECKS, HEALTH SCREENINGS, IMMUNIZATIONS, AND DIABETES COUNSELING. THE CLINIC'S STAFF INCLUDES 2 PART-TIME FAMILY PRACTICE PHYSICIANS, A PART-TIME NURSE PRACTITIONER, AND SUPPORT STAFF. THE CLINIC HAD 4,240 MEDICAL PATIENT VISITS DURING THE YEAR ENDED SEPTEMBER 30, 2014. THE EDUCATION FACILITY HOUSES CLASSROOMS, AN AUDITORIUM, A NURSERY, A CONFERENCE ROOM, AND A LIBRARY WITH STUDY AREAS.WK COMMUNITY HEALTH & WELLNESS CENTER SHREVEPORT-BLANCHARD ROADPROJECT NEIGHBORHEALTH: ON AUGUST 1, 1998, THE MEDICAL CENTER OPENED A 15,062 SQUARE FOOT MEDICAL CLINIC KNOWN AS THE "WK COMMUNITY HEALTH & WELLNESS CENTER SHREVEPORT-BLANCHARD ROAD" ON HILRY HUCKABY III AVENUE IN SHREVEPORT AT A COST OF APPROXIMATELY $1,375,000. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THIS FACILITY IS CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. THIS FACILITY ALSO CONTAINS A HEALTH AND FITNESS CENTER. THE MEDICAL CENTER PROVIDES EQUIPMENT AND MEDICAL STAFF FOR THE CLINIC. THE CLINIC'S STAFF INCLUDES 2 PART-TIME FAMILY PRACTICE PHYSICIANS, A PART-TIME PHYSICIAN ASSISTANT, AND SUPPORT STAFF. THE CLINIC HAD 3,828 MEDICAL PATIENTS DURING THE YEAR ENDED SEPTEMBER 30, 2014. WK BRADLEY MEDICAL CLINIC ON AUGUST 24, 1998, THE MEDICAL CENTER OPENED A 3,915 SQUARE FOOT MEDICAL CLINIC KNOWN AS THE "WK BRADLEY MEDICAL CLINIC" IN BRADLEY, ARKANSAS AT A COST OF APPROXIMATELY $140,000. LOCATED IN AN ECONOMICALLY DISTRESSED COMMUNITY, THIS FACILITY IS CONVENIENT TO AND PRIMARILY FOR THE BENEFIT OF THE PEOPLE IN THAT COMMUNITY. THE MEDICAL CENTER PROVIDES EQUIPMENT AND MEDICAL STAFF FOR THE CLINIC. THE CLINIC'S STAFF INCLUDES A NURSE PRACTITIONER AND VARIOUS SUPPORT STAFF. THE CLINIC HAD 1,862 MEDICAL PATIENTS DURING THE YEAR ENDED SEPTEMBER 30, 2014. PROJECT NEIGHBORHEALTH: DURING THE YEAR ENDED SEPTEMBER 30, 2014, UNDER PROJECT NEIGHBORHEALTH, THE MEDICAL CENTER PROVIDED OVER 3,000 HOURS TO COMMUNITY SERVICES/PROJECTS AT NO COST TO THE RECIPIENTS BY 3 FULL-TIME EMPLOYEES, 1 PART-TIME EMPLOYEE, AND VOLUNTEERS IN ADDITION TO HOURS PROVIDED BY VARIOUS DEPARTMENTS WITHIN THE MEDICAL CENTER.OTHER COMMUNITY SERVICESTHE MEDICAL CENTER MAKES AVAILABLE, FREE-OF-CHARGE, MEETING SPACE TO OUTSIDE COMMUNITY OUTREACH ORGANIZATIONS SUCH AS QUEENSBOROUGH NEIGHBORHOOD ASSOCIATION, BOSSIER MEDICAL SOCIETY, CADDO PARISH SHERIFF'S OFFICE, ICE (INNER CITY ENTREPRENEUR), NORTH LOUISIANA AHEC, LIFESHARE BLOOD CENTER, LSU PSYCHIATRY PROGRAM, TEXAS WESLEYAN UNIVERSITY CRNA PROGRAM, NORTHWEST LOUISIANA COALITION FOR WOMEN AND CHILDREN, NORTHWEST LOUISIANA INTERFAITH PHARMACY, VOLUNTEERS FOR YOUTH JUSTICE, UNITED WAY, ALLIANCE FOR EDUCATION AND OTHER CHARITABLE AND GOVERNMENTAL ORGANIZATIONS. ROOMS ARE ALSO PROVIDED FOR OFF CAMPUS CLASSES TAUGHT BY BOSSIER PARISH COMMUNITY COLLEGE AT THE WK CAREER INSTITUTE.THE MEDICAL CENTER OFFERS EXTENSIVE ONLINE HEALTH INFORMATION ON ITS WEB SITE. FREE HEALTH INFORMATION IS AVAILABLE, TARGETED TO BOTH ADULTS AND CHILDREN. INFORMATION FOR ADULTS INCLUDES A HEALTH LIBRARY, DRUG INTERACTION CHECKER, NUTRITION AND WELLNESS INFORMATION AND DESCRIPTION OF PROCEDURES, WRITTEN BY HEALTH PROFESSIONALS AND REVIEWED AND UPDATED REGULARLY. THE MEDICAL CENTER ALSO PARTNERS WITH THE NEMOURS FOUNDATION TO OFFER KIDSHEALTH, A HEALTH AND WELLNESS INFORMATION SITE TARGETED TO CHILDREN, TEENS AND THEIR PARENTS. THE WILLIS-KNIGHTON CANCER CENTER WEB SITE OFFERS INFORMATION ON VARIOUS TYPES OF CANCER AND TREATMENTS AS WELL AS AN UPDATED LIST OF CLINICAL TRIALS. DURING THE PAST YEAR THE MEDICAL CENTER'S ON-LINE HEALTH LIBRARY ATTRACTED 471,200 VISITS FROM A TOTAL OF 260,000 VISITORS. KIDSHEALTH ATTRACTED 287,491 VISITS.IMMUNIZATIONS FOR CHILDREN WILLIS-KNIGHTON PROVIDES A MOBILE UNIT THAT OFFERS "SHOTS FOR TOTS". USING ITS MOBILE VAN AND STAFF, VACCINES ARE TAKEN TO VARIOUS NEIGHBORHOODS TO MAKE THEM CONVENIENT FOR PARENTS. UNDER THIS PROGRAM, ANY CHILD MAY RECEIVE IMMUNIZATION SHOTS, FREE OF CHARGE, FOR MEASLES, MUMPS, RUBELLA, DIPHTHERIA, PERTUSSIS, TETANUS, HEPATITIS B, POLIO, MENINGITIS, FLU, AND CHICKEN POX. THE MEDICAL CENTER SUBSIDIZES ALL EXPENSES OF THE PROGRAM EXCEPT THE VACCINE, WHICH IS PROVIDED BY THE LOUISIANA DEPARTMENT OF PUBLIC HEALTH. DURING THE YEAR ENDED SEPTEMBER 30, 2014, THE MEDICAL CENTER IMMUNIZED 3,039 PATIENTS UNDER THIS PROGRAM.HEALTH PROFESSIONS EDUCATIONTHE MEDICAL CENTER PROVIDES VARIOUS EDUCATION PROGRAMS THAT RESULT IN HEALTH CARE PROFESSIONALS RECEIVING DEGREES, CERTIFICATES OR TRAINING THAT IS NECESSARY TO BE LICENSED TO PRACTICE AS HEALTH CARE PROFESSIONALS. WHILE THE MEDICAL CENTER ALSO PROVIDES A VARIETY OF EDUCATION, TRAINING AND STIPEND PROGRAMS THAT ARE EXCLUSIVE TO THE MEDICAL CENTER'S EMPLOYEES AND MEDICAL STAFF, THOSE COSTS ARE NOT INCLUDED IN THIS CATEGORY. THE MEDICAL CENTER MAINTAINS AN ASSOCIATION WITH LSU HEALTH SCIENCES CENTER (A PUBLIC TEACHING, RESEARCH, AND INDIGENT CARE FACILITY) BY PROVIDING GRANTS, ASSISTANCE WITH RESIDENTS AND FELLOWS, ALONG WITH UNDERWRITING THE COST OF CLINICAL SETTINGS FOR TRAINING AND INTERSHIPS FOR A VARIETY OF OTHER HEALTH PROFESSIONALS.SPORTS MEDICINESPORTS MEDICINE EXPERTS AT WILLIS-KNIGHTON SPORTS MEDICINE WORK WITH ATHLETES ON THE PREVENTION AND TREATMENT OF SPORTS-RELATED INJURIES, HELPING THEM TO MAINTAIN A HEALTHY LIFESTYLE. THIS SERVICE IS OFFERED TO VARIOUS SCHOOLS AND PROGRAMS THROUGHOUT THE LOCAL AREA.WK INNOVATION CENTER ON MAY 4, 2014, THE MEDICAL CENTER OPENED THE WK INNOVATION CENTER. THE CENTER INCLUDES A VIRTUAL HOSPITAL, WHICH IS ONE OF THE LARGEST VIRTUAL HOSPITALS IN THE NATION COMPLETE WITH 22 PATIENT ROOMS, TWO OPERATING SUITES, RECOVERY AND A LABOR AND DELIVERY SUITE. THIS STATE-OF-THE-ART VIRTUAL HOSPITAL USES THE LATEST HIGH-FIDELITY SIMULATORS TO RECREATE REAL-LIFE SITUATIONS FOR NURSING STUDENTS TO HONE THEIR SKILLS. IT HAS A REAL ICU ENVIRONMENT COMPLETE WITH A VARIETY OF ADVANCE PATIENT SIMULATORS, WHICH CAN HAVE SEIZURES, BLEED, SWEAT, TALK AND MUCH MORE. NINE NURSING SCHOOLS THROUGHOUT LOUISIANA AND EAST TEXAS, AS WELL AS THE LSU SCHOOL OF MEDICINE IN SHREVEPORT, WILL USE THE FACILITY TO TRAIN HEALTH PROFESSIONALS.TALBOT MEDICAL MUSEUM THE TALBOT MEDICAL MUSEUM PRESERVES, REVEALS, AND INTERPRETS THE HISTORY OF MODERN MEDICINE OVER THE PAST CENTURY AND A HALF. SPECIAL EMPHASIS IS PLACED ON THOSE PEOPLE, PLACES AND EVENTS THAT HAVE SHAPED MEDICINE IN OUR REGION. 1 ALLIANCE FOR EDUCATION 820 JORDAN STREET SHREVEPORT LA 71101 721466587 501(C)(3) 25000 DONATION FOR PATHWAY TO EXCELLENCE AMERICAN CANCER SOCIETY 920 PIERREMONT SUITE 300 SHREVEPORT LA 71106 237040934 501(C)(3) 15000 DONATION FOR BARON BALL ARC OF CADDO-BOSSIER 351 JORDAN STREET SHREVEPORT LA 71101 720482891 501(C)(3) 20000 DONATION FOR OPERATIONS BOSSIER CHAMBER OF COMMERCE 710 BENTON ROAD BOSSIER CITY LA 71111 720382231 501(C)(6) 10000 DONATION FOR OPERATIONS CADDO-BOSSIER CANCER FOUNDATION LEAGUE INC 3300 ALBERT BICKNELL DRIVE SHREVEPORT LA 71103 453188641 501(C)(3) 5250 DONATION FOR OPERATIONS CADDO BOSSIER SOCCER ASSOCIATION 1780 EAST BERT KOUNS SUITE 901 SHREVEPORT LA 71105 581652966 501(C)(3) 18000 SPONSORSHIP CALVARY ACADEMY 9333 LINWOOD AVENUE SHREVEPORT LA 71106 720482882 501(C)(3) 6000 SPONSORSHIP CHILDREN AND ARTHRITIS 2751 ALBERT BICKNELL DRIVE SUITE 2E 2E SHREVEPORT LA 71103 721170530 501(C)(3) 15000 DONATION FOR OPERATIONS COUNCIL FOR A BETTER LOUISIANA PO BOX 4308 BATON ROUGE LA 70821 720570930 501(C)(6) 10000 DONATION FOR OPERATIONS FORENSIC NURSE EXAMINERS PO BOX 44466 SHREVEPORT LA 71134 352262163 501(C)(3) 15000 DONATION FOR OPERATIONS FRIENDS OF THE MANSFIELD FEMALE COLLEGE MUSEUM INC 101 MONROE STREET MANSFIELD LA 71052 432100668 501(C)(3) 10000 DONATION FOR OPERATIONS HOLY ANGELS RESIDENTIAL FACILITY INC 10450 ELLERBE ROAD SHREVEPORT LA 71106 720628035 501(C)(3) 49714 DONATION FOR OPERATIONS INDEPENDENCE BOWL FOUNDATION PO BOX 1723 SHREVEPORT LA 71166 720297228 501(C)(3) 46250 SPONSORSHIP INNER CITY ENTREPRENEUR INSTITUTE 820 JORDAN STREET SUITE 360 SHREVEPORT LA 71101 721418314 501(C)(3) 20000 BIZCAMP SPONSOR INSTITUTE FOR GLOBAL OUTREACH 1024 PIERRE AVENUE ROOM B SHREVEPORT LA 71103 331180777 501(C)(3) 25000 DONATION FOR OPERATIONS JUNIOR ACHIEVEMENT 3003 KNIGHT STREET SHREVEPORT LA 71105 720595081 501(C)(3) 33600 DONATION FOR OPERATIONS LOUISIANA TECH UNIVERSITY FOUNDATION PO BOX 3046 RUSTON LA 71272 726021176 501(C)(3) 67000 SPONSORSHIP LOUISIANA TROOPER FOUNDATION PO BOX 65076 BATON ROUGE LA 70896 742918404 501(C)(3) 10000 DONATION FOR OPERATIONS LOYOLA EDUCATIONAL CORPORATION OF SHREVEPORT 921 JORDAN STREET SHREVEPORT LA 71101 720679392 501(C)(3) 7000 DONATION FOR OPERATIONS LSUHSC PO BOX 31650 SHREVEPORT LA 71115 721402222 GOVERNMENT 220000 DONATION FOR OPERATIONS MARCH OF DIMES FOUNDATION 1120 SOUTH POINTE PARKWAY BLDG D SHREVEPORT LA 71105 131846366 501(C)(3) 43500 DONATION FOR OPERATIONS MARTIN LUTHER KING HEALTH CENTER PO BOX 393 SHREVEPORT LA 71162 721079721 501(C)(3) 50000 DONATION FOR OPERATIONS NORTH AMERICA IAPB INC 137 HAMPTON ROAD SHREVEPORT LA 11968 043796216 501(C)(3) 50000 DONATION FOR OPERATIONS NORTH CADDO MEDICAL CENTER FOUNDATION POST OFFICE BOX 792 VIVIAN LA 71082 320275128 501(C)(3) 51464 DONATION FOR OPERATIONS NORTH LOUISIANA ECONOMIC PARTNERSHIP INC 415 TEXAS STREET SHREVEPORT LA 71101 720936419 501(C)(3) 40150 DONATION FOR OPERATIONS NORTHWEST LOUISIANA FOOD BANK 2307 TEXAS AVENUE SHREVEPORT LA 71103 721328890 501(C)(3) 55000 DONATION FOR OPERATIONS NORTHWEST LOUISIANA INTERFAITH PHARMACY INC 909 OLIVE STREET SHREVEPORT LA 71104 721479289 501(C)(3) 10000 DONATION FOR OPERATIONS NORTHWESTERN FOUNDATION UNIVERSITY PARKWAY NATCHITOCHES LA 71497 726021495 501(C)(3) 90000 DONATION FOR OPERATIONS OAKWOOD HOME FOR WOMEN INC 1700 HIGHLAND AVENUE SHREVEPORT LA 71101 237368054 501(C)(3) 10000 DONATION FOR OPERATIONS THE ODYSSEY FOUNDATION 401 TEXAS STREET SHREVEPORT LA 71101 331055253 501(C)(6) 10000 DONATION FOR WALKING FOR AUTISM FUNDRAISER PROVIDENCE HOUSE 814 COTTON STREET SHREVEPORT LA 71101 721205164 501(C)(3) 50000 DONATION FOR OPERATIONS RED RIVER REVEL ARTS FESTIVAL 101 CROCKET STREET SUITE C SHREVEPORT LA 71101 720953274 501(C)(3) 25000 SPONSORSHIP OF REGIONAL CULTURAL EVENT SAMARITAN COUNSELING CENTER 1525 STEPHENS AVENUE SHREVEPORT LA 71101 721014069 501(C)(3) 10000 DONATION FOR OPERATIONS AFRICAN-AMERICAN CHAMBER OF COMMERCE 1315 MILAM STREET SHREVEPORT LA 71101 726028366 501(C)(3) 7500 SPONSORSHIP SHREVEPORT-BOSSIER RESCUE MISSION 2033 TEXAS AVENUE SHREVEPORT LA 71103 237050551 501(C)(3) 95359 HEALTH INSURANCE FOR RESCUE MISSION EMPLOYEES SHREVEPORT OPERA 212 TEXAS STREET NO 1 SHREVEPORT LA 71101 726021455 501(C)(3) 10000 DONATION FOR OPERATIONS SHREVEPORT POLICE SPECIAL RESPONSE TEAM CITIZENS SUPPORT GROUP 710 MILAM STREET SHREVEPORT LA 71101 271836049 501(C)(3) 39090 DONATION FOR EQUIPMENT SHREVEPORT SYMPHONY 619 LOUISIANA AVENUE SHREVEPORT LA 71101 726001334 501(C)(3) 93000 DONATION FOR OPERATIONS SPRINGHILL MEDICAL SERVICES INC 2001 DOCTORS DRIVE SPRINGHILL LA 71075 721479692 501(C)(3) 203335 DONATION FOR OPERATIONS ST JUDE'S CHILDREN'S RESEARCH HOSPITAL PO BOX 810 MEMPHIS TN 38101 620646012 501(C)(3) 25000 DREAM HOME DONATION ST LUKE'S EPISCOPAL MOBILE MINISTRY INC PO BOX 53074 SHREVEPORT LA 71135 453786377 501(C)(3) 6000 DONATION FOR MEDICAL RV VOLUNTEERS OF AMERICA 360 JORDAN STREET SHREVEPORT LA 71101 720506820 501(C)(3) 10000 DONATION FOR OPERATIONS YMCA 400 MCNEIL SHREVEPORT LA 71101 720408997 501(C)(3) 40800 SPONSORSHIP WESTWOOD ELEMENTARY 3201 LINE AVENUE SHREVEPORT LA 71103 726000224 GOVERNMENT 6933 DONATION FOR SIGN 39 5 PART I, LINE 2: THE MEDICAL CENTER HAS A CONTRIBUTION COMMITTEE THAT APPROVES SUBSTANTIALLY ALL CONTRIBUTIONS. THE CONTRIBUTION COMMITTEE REQUESTS THAT THE ORGANIZATION REQUESTING THE DONATION COMPLETE A CONTRIBUTION REQUEST FORM THAT IS AVAILABLE ON THE MEDICAL CENTER'S WEBSITE. BEFORE THE MEDICAL CENTER'S CONTRIBUTION COMMITTEE WILL APPROVE THE CONTRIBUTIONS THE PURPOSE OF THE CONTRIBUTION MUST BE STATED ON THE CONTRIBUTION REQUEST FORM. X 0 1 X X X X X 1 1 0 1 0 0 0 0 0 JAMES K ELROD PRESIDENT/CEO/TRUSTEE 1133175 6000 0 0 222910 0 0 0 14847 0 1370932 6000 0 0 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 200000 0 0 0 5174 0 1953 0 5272 0 212399 0 0 0 CHARLES D DAIGLE SR VP OF OPERATIONS & COO 454939 0 0 0 538886 0 1592 0 21465 0 1016882 0 0 0 STEPHEN R RANDALL SR VP-SPECIAL OPERATIONS 298754 0 0 0 21337 0 1521 0 20565 0 342177 0 0 0 MARGARET G ELROD VP/IND WELLNESS/COMMUNITY 155807 0 0 0 23575 0 2482 0 6882 0 188746 0 0 0 JERRY A FIELDER II VP/ADMINISTRATOR WKMC 167840 0 0 0 2767 0 3938 0 19753 0 194298 0 0 0 CLIFFORD M BROUSSARD VP/ADMIN WK BOSSIER 176868 0 0 0 6028 0 1791 0 13597 0 198284 0 0 0 JANET K ELROD VP/ADMIN WK SOUTH 157234 0 0 0 21960 0 2591 0 6888 0 188673 0 0 0 IRA L MOSS VP/ADMIN WK PIERREMONT 185934 0 0 0 26267 0 2425 0 15162 0 229788 0 0 0 JILL K ELROD VP OF LEGAL AFFAIRS 207977 0 0 0 28001 0 2071 0 8035 0 246084 0 0 0 PEGGY J GAVIN VP OF PHYSICIAN SERVICES 155126 0 0 0 26209 0 3390 0 5879 0 190604 0 0 0 DEBORAH D OLDS VP OF NURSING 135322 0 0 0 4458 0 4540 0 12471 0 156791 0 0 0 RAMONA D FRYER TERM 82514 VP OF REV/QUALITY/COMPLIAN 241190 0 0 0 20817 0 2325 0 16071 0 280403 0 0 0 DANIEL J MOLLER JR MD CHIEF-MEDICAL AFFAIRS-WKMC 333624 0 0 0 25844 0 1865 0 12986 0 374319 0 0 0 CHARLES A POWERS MD CHIEF-MED. AFFAIRS-WKB 315000 0 0 0 25058 0 1866 0 13745 0 355669 0 0 0 RANDALL P BREWER MD PHYSICIAN 975000 0 562021 0 -5458 0 1577 0 21116 0 1554256 0 0 0 MILAN G MODY MD PHYSICIAN 675000 0 982248 0 -2781 0 1572 0 19065 0 1675104 0 0 0 CHRISTIAN M BRIERY MD PHYSICIAN 700000 0 772052 0 -3006 0 1609 0 18757 0 1489412 0 0 0 CHRISTOPHER L SHELBY MD PHYSICIAN 640000 0 479269 0 -2774 0 1530 0 19065 0 1137090 0 0 0 CLINT M CORMIER MD PHYSICIAN 700000 0 671351 0 -2405 0 1619 0 18098 0 1388663 0 0 0 ROBERT D HUIE FORMER EXECUTIVE VP & CFO 490722 0 0 0 366442 0 0 0 11097 0 868261 0 58229 0 PART I, LINE 1A THE VALUE OF EACH PERSON'S FREE MEMBERSHIP IN THE MEDICAL CENTER'S HEALTH & WELLNESS CENTERS IS ADDED TO THE EMPLOYEE'S W-2 WAGES. PART I, LINE 3 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION OF THE TOP TWO EXECUTIVES (CEO AND CFO) OF THE MEDICAL CENTER. A SECOND COMPENSATION COMMITTEE, CONSISTING OF THE CEO AND CFO, DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEES STUDY DATA FROM INDEPENDENT SALARY SURVEYS. OFFICERS AND OTHER KEY EMPLOYEES ARE PROVIDED WITH A WRITTEN EMPLOYMENT CONTRACT BEFORE EMPLOYMENT COMMENCES. PART I, LINES 4A-B CERTAIN OFFICERS INCLUDED IN FORM 990, PART VII, SECTION A, LINE 1A, PARTICIPATE IN A SECTION 457(B) DEFERRED COMPENSATION PLAN. PART I, LINE 5 PHYSICIANS INCLUDED IN FORM 990, PART VII, SECTION A, LINE 1A, ARE COMPENSATED BASED ON THEIR OWN PERSONAL PRODUCTIVITY. THE PHYSICIANS ARE PAID A PERCENTAGE OF THEIR INDIVIDUAL COLLECTIONS BASED ON THE CONDITIONS OF EACH PHYSICIAN CONTACT. FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) EXPLANATION OF PART II, COLUMN (B)(III) OTHER COMPENSATION JAMES K. ELROD UNUSED VACATION PAY-$161,261 UNUSED SICK PAY-$26,151 VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$1,535 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$16,099 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,155) CABLE/INTERNET-$1,319 TOTAL--$222,910 ROBERT D. HUIE VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$928 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$4,333 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,928) NONQUALIFIED DEFERRED COMPENSATION PLAN-$364,909 (PLEASE SEE EXPLANATION FOLLOWING) TOTAL--$366,442 CHARLES D. DAIGLE UNUSED SICK PAY-$11,220 VALUE ADDED FOR CELL PHONE USAGE-$1,119 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$558 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,936) BONUS CHECK-$30,300 GIFT CERTIFICATE-$125 SEVERANCE PAY-$485,000** TOTAL--$538,886 **THE GROSS SEVERANCE BENEFIT, TO BE PAID TO MR. DAIGLE ON TERMINATION OF EMPLOYMENT (AS ADDITIONAL COMPENSATION FOR EACH OF HIS YEARS OF SERVICE TO WILLIS-KNIGHTON MEDICAL CENTER), WAS TAXABLE DURING 2013, AND, ACCORDINGLY, WAS INCLUDED IN HIS 2013 FORM W-2. WILLIS-KNIGHTON DISBURSED TO THE INTERNAL REVENUE SERVICE AND TO THE LOUISIANA DEPARTMENT OF REVENUE THE REQUIRED TAX WITHHOLDING. WILLIS-KNIGHTON DID NOT PAY MR. DAIGLE THE NET-OF-TAX AMOUNT OF THIS COMPENSATION, BUT, UNDER THE TERMS OF THE AGREEMENT, THE MEDICAL CENTER IS RETAINING THE NET-OF-TAX AMOUNT UNTIL HIS EMPLOYMENT TERMINATES. ACCORDINGLY, THERE WAS NO CURRENT DISBURSEMENT TO MR. DAIGLE FOR SEVERANCE PAY. STEPHEN R. RANDALL UNUSED SICK PAY-$6,894 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 VALUE ADDED FOR CELL PHONE USAGE-$1,092 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$562 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 GIFT CERTIFICATE-$125 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,036) TOTAL--$21,337 MARGARET G. ELROD UNUSED SICK PAY-$3,616 VALUE ADDED FOR CELL PHONE USAGE-$1,911 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,684 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(2,654) PERSONAL USE OF EMPLOYER VEHICLES-$393 GIFT CERTIFICATE-$125 TOTAL--$23,575 JERRY A. FIELDER,II UNUSED SICK PAY-$3,894 VALUE ADDED FOR CELL PHONE USAGE-$1,384 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$686 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,336) VALUE ADDED FOR CABLE/INTERNET- $1,319 VALUE ADDED FOR HEALTH & FITNESS USAGE-$695 GIFT CERTIFICATE-$125 TOTAL--$2,767 CLIFFORD M. BROUSSARD UNUSED SICK PAY-$4,082 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 VALUE ADDED FOR CELL PHONE USAGE-$849 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,164 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,392) GIFT CERTIFICATE-$125 TOTAL--$6,028 JANET K. ELROD UNUSED SICK PAY-$3,628 VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 VALUE ADDED FOR CELL PHONE USAGE-$2,082 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$619 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(2,654) GIFT CERTIFICATE-$125 TOTAL--$21,960 IRA L. MOSS UNUSED SICK PAY-$4,291 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 VALUE ADDED FOR CELL PHONE USAGE-$1,091 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,478 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,926) PERSONAL USE OF EMPLOYER VEHICLES-$508 GIFT CERTIFICATE-$125 TOTAL--$26,267 JILL K. ELROD UNUSED SICK PAY-$4,820 VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 VALUE ADDED FOR CELL PHONE USAGE-$3,337 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,242 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,655) VALUE ADDED FOR CABLE/INTERNET- $1,319 PERSONAL USE OF EMPLOYER VEHICLES-$2,653 GIFT CERTIFICATE-$125 TOTAL--$28,001 PEGGY J. GAVIN UNUSED SICK PAY-$3,600 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 VALUE ADDED FOR CELL PHONE USAGE-$938 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,677 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,654) PERSONAL USE OF EMPLOYER VEHICLES-$1,823 GIFT CERTIFICATE-$125 TOTAL--$26,209 RAMONA D. FRYER UNUSED SICK PAY-$6,346 VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 VALUE ADDED FOR CELL PHONE USAGE-$1,028 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,050 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,892) GIFT CERTIFICATE-$125 TOTAL--$20,817 DEBORAH D. OLDS UNUSED SICK PAY-$1,561 VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 VALUE ADDED FOR CELL PHONE USAGE-$2,216 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,447 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(2,426) TOTAL--$4,458 DANIEL J. MOLLER, JR., M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$9,985 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(2,426) GIFT CERTIFICATE-$125 TOTAL--$25,844 CHARLES A. POWERS, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 VALUE ADDED FOR CELL PHONE USAGE-$1,978 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$7,772 SECTION 457(B) DEFERRED COMPENSATION PLAN-$17,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,392) TOTAL--$25,058 PIERRE V. BLANCHARD,IV, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,329 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,155) TOTAL--$5,174 RANDALL P. BREWER, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$822 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,940) TOTAL--($5,458) MILAN G. MODY, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$555 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,536) TOTAL--($2,781) CHRISTIAN M. BRIERY, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$562 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,228) TOTAL--($3,006) CLINT M. CORMIER, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$504 VALUE ADDED FOR HEALTH & FITNESS USAGE-$660 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,569) TOTAL--($2,405) CHRISTOPHER L. SHELBY, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$562 VALUE ADDED FOR HEALTH & FITNESS USAGE-$1,200 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,536) TOTAL--($2,774) EXPLANATION OF PART II, COLUMN (B)(III) OTHER COMPENSATION THE AMOUNT CONTRIBUTED FOR MR. HUIE'S SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IS INCLUDED IN THE DETAILS FOR PART II, COLUMN (B)(III). UPON MR. HUIE'S DEATH, THERE WAS A TECHNICAL TERMINATION OF THE TRUST; THEREFORE, THE FUNDS WERE PAID DIRECTLY TO THE SUCCESSION OF ROBERT D. HUIE. EXPLANATION OF PART II, COLUMN (C) DEFERRED COMPENSATION THIS EMPLOYEE PARTICIPATES IN A DEFINED BENEFIT PENSION PLAN, THE CONTRIBUTIONS TO WHICH ARE ACTUARIALLY DETERMINED. THE AMOUNT SHOWN IS THE INCREASE IN THE ANNUAL VESTED BENEFIT AT NORMAL RETIREMENT FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 (NOT DISCOUNTED TO PRESENT VALUE) (NORMAL RETIREMENT IS AGE 65 WITH 5 YEARS OF PARTICIPATION). MR. ELROD HAS REACHED THE MAXIMUM BENEFIT UNDER THE PLAN. EXPLANATION OF PART II, COLUMN (D) NONTAXABLE BENEFITS INCLUDED IN THIS COLUMN IS THE COST OF THE FOLLOWING NONTAXABLE BENEFITS: LONG-TERM DISABILITY INCOME INSURANCE PLAN, GROUP TERM-LIFE INSURANCE, AND THE ESTIMATED COST OF SELF-FUNDED HEALTH INSURANCE PLAN. FRANK B HUGHES MD TRUSTEE 124616 RENT-BUILDING 0 PHILLIP A ROZEMAN MD TRUSTEE 79641 RENT-BUILDING 0 GREGORY J GAVIN FAMILY MEMBER OF PEGGY GAVIN, OFFICER 194495 EMPLOYMENT 0 KIMBERLY M MULLINS FAMILY MEMBER OF PEGGY GAVIN, OFFICER 58165 EMPLOYMENT 0 CHARLES E MULLINS FAMILY MEMBER OF PEGGY GAVIN, OFFICER 83515 EMPLOYMENT 0 SHARLENE A BROUSSARD FAMILY MEMBER OF CLIFFORD BROUSSARD, OFFICER 58852 EMPLOYMENT 0 TODD J BLANCHARD FAMILY MEMBER OF PIERRE BLANCHARD, M.D., TRUSTEE 136376 EMPLOYMENT 0 PIERRE V BLANCHARD MD TRUSTEE 5012922 RENT-BUILDING, PURCHASED SERVICE AGREEMENT WITH LIFECARE HOSPITALS, INC., FOR WHICH PIERRE BLANCHARD, M.D. IS THE MEDICAL DIRECTOR 0 SARAH GLORIOSO MD FAMILY MEMBER OF TWAIN K. GIDDENS, JR., TRUSTEE 1176456 EMPLOYMENT 0 WILLIAM J COLE CPA TRUSTEE 1974382 FEES PAID TO COLE, EVANS & PETERSON, FOR WHICH WILLIAM J. COLE IS THE MANAGING PARTNER, FOR CONTINUOUS EXECUTIVE LEVEL ASSISTANCE IN THE ACCOUNTING AND FINANCE DEPARTMENTS, ROUTINE SERVICES TO PERSONNEL, PAYROLL PROCESSING AND ADMINISTRATION, PREPARATION OF QUARTERLY AND ANNUAL FINANCIAL STATEMENTS, AND A WIDE RANGE OF FINANCIAL AND NONFINANCIAL SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 2 1. FAMILY RELATIONSHIPS WITH JAMES K. ELROD - PRESIDENT, CEO, AND TRUSTEE MARGARET ELROD, SPOUSE - VP-MARKETING, LIVE OAK RETIREMENT COMMUNITY, QUICK CARE, OCCUPATIONAL MEDICINE, AND WELLNESS CENTERS JILL K. ELROD, DAUGHTER - VP OF LEGAL AFFAIRS JANET K. ELROD, DAUGHTER - VP AND ADMINISTRATOR OF WK SOUTH HOSPITAL FORM 990, PART VI, SECTION B, LINE 11 THE MEDICAL CENTER'S CPA FIRM PREPARES THE FORM 990 WITH THE ASSISTANCE OF SEVERAL OF THE MEDICAL CENTER'S EMPLOYEES. THE FORM 990 IS THEN REVIEWED BY THE MEDICAL CENTER'S PRESIDENT. AFTER THIS REVIEW, A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES, AND THE PRESIDENT, VICE-PRESIDENT AND CPA FIRM REVIEW AND DISCUSS THE FORM 990 WITH THE TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICTS OF INTEREST POLICY COVERS ALL "INTERESTED PERSONS." AN "INTERESTED PERSON" IS DEFINED AS ANY TRUSTEE, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN AN ENTITY WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A COMPENSATION ARRANGEMENT WITH THE MEDICAL CENTER OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. INTERESTED PERSONS HAVE A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST AND ALL MATERIAL FACTS RELATED TO THE PROPOSED TRANSACTION OR ARRANGEMENT TO THE TRUSTEES AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. THE INTERESTED PERSON IS ALLOWED TO MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION THE INTERESTED PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. IF THE BOARD OR COMMITTEE BELIEVES A MEMBER HAS VIOLATED THE CONFLICTS OF INTEREST POLICY, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE. IF THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. PERIODIC REVIEWS ARE CONDUCTED WHICH, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING. 2. WHETHER ACQUISITIONS OF GOODS OR SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 3. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 4. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION OF THE TOP TWO EXECUTIVES (CEO AND CFO) OF THE MEDICAL CENTER. A SECOND COMPENSATION COMMITTEE, CONSISTING OF THE CEO AND CFO, DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEES STUDY DATA FROM INDEPENDENT SALARY SURVEYS (SUCH AS "MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS," WHICH IS AN ANNUAL SURVEY PREPARED BY SULLIVAN COTTER) TO UNDERSTAND COMPENSATION PAID TO SIMILARLY QUALIFIED INDIVIDUALS IN COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE COMPENSATION COMMITTEES ALSO COMPILE DATA FROM OTHER TAX-EXEMPT HEALTH SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AND USE THAT INFORMATION AS COMPARATIVE COMPENSATION. THE COMMITTEES USE THE INFORMATION FROM THESE SOURCES AS BENCHMARKS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION. THE COMMITTEES ALSO CONSIDER OTHER FACTORS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION, SUCH AS LENGTH OF EMPLOYMENT AND THEIR RESPONSIBILITIES. THE EXECUTIVE COMPENSATION COMMITTEE PERIODICALLY HIRES INDEPENDENT CONSULTANTS FOR ANALYSIS OF THE COMPENSATION OF THE MEDICAL CENTER'S TOP TWO EXECUTIVES (CEO AND CFO). THE COMMITTEES MAINTAIN CONTEMPORANEOUS DOCUMENTATION OF THE BASIS FOR THEIR DECISIONS REGARDING COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 WILLIS-KNIGHTON MEDICAL CENTER'S GOVERNING DOCUMENTS AND ITS CONFLICT OF INTEREST POLICY ARE AVAILABLE ON ITS WEBSITE: WWW.WKHS.COM. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.EMMA.MSRB.ORG. FORM 990, PART XI, LINE 9: FASB ASC 715-30 PENSION CHANGES OTHER THAN THE NET PERIODIC PENSION COST -35,422,490. FORM 990, PART XII, LINE 2C WILLIS-KNIGHTON MEDICAL CENTER DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DUING THE YEAR ENDED 9/30/14. 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