2015-05-15T15:31:36-05:00 2014-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2013-07-01 720423651 Our Lady of the Lake Hospital Inc % JEFF LIMBOCKER OURL 2257657709 5000 HENNESSY BOULEVARD Suite BATON ROUGE LA 70808 JEFF LIMBOCKER REGIONAL CFO 2257657709 2015-05-15 true KPMG LLP P00746825 2257657709 2013 2016-04-25 22:37:26Z Our Lady of the Lake RMC K SCOTT WESTER 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 1002688525 false 0928 X www.ololrmc.com X 1956 LA to provide for the care of the ill, injured, or disabled persons, and to provide for research, education, and for the enhancement of health of those in the community 15 12 7063 287 8560034 0 7712549 7570361 768245581 904821828 19589685 35738106 45125383 -1677555 840673198 946452740 10127484 4149614 0 0 321077522 373653674 0 0 0 397136104 511658079 728341110 889461367 112332088 56991373 1498370068 1556258719 660438993 633641094 837931075 922617625 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. false false 331495120 428012001 THE MEDICAL CENTER PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 167,310 PATIENT DAYS. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. ADDITIONAL COSTS WERE INCURRED FOR PARTICIPATION IN PROGRAMS WHICH, IN SOME CASES, PAY AMOUNTS LESS THAN THE COST OF PROVIDING SERVICES. SEE SCHEDULE O FOR FURTHER EXPLANATION. 131535954 169833471 THE MEDICAL CENTER PROVIDES PATIENTS WITH BOTH INPATIENT AND OUTPATIENT SURGICAL CARE. DURING THE YEAR, 19,686 SURGICAL PROCEDURES WERE PERFORMED 50446350 65134121 THE MEDICAL CENTER PROVIDES PATIENTS WITH PHARMACEUTICALS IN THE COURSE OF THEIR MEDICAL CARE. IN THE CURRENT YEAR, THE HOSPITAL DISPENSED 14,746,114 UNIT DOSES 181092210 4121814 233818341 694569634 true true false false false false false false false false true true false false true true false true false false true true false false false false true true true true true false false false false false false false true false false false false true true true true false false true 274 0 true 7063 true true true false false false false false false false false false X 15 12 false false false false true true true true true false false true true true true false true false true true true X JEFF LIMBOCKER 2257656565 5000 HENNESSY BLVD BATON ROUGE LA 70808 X DR TIMOTHY ANDRUS BOARD MEMBER 2.0 0.0 X DR JAMES CRAVEN BOARD MEMBER 2.0 0.0 X DONALD DAIGLE BOARD MEMBER - CHAIR 2.0 4.0 X X YOLANDA DIXON BOARD MEMBER 2.0 0.0 X CHARLES FREEBURGH BOARD MEMBER - Past Chair 2.0 2.0 X X RENEE FURR BOARD MEMBER - Past Secretary 2.0 0.0 X X DR DAVID HANSON BOARD MEMBER 2.0 0.0 X LUTHER KISSAM BOARD MEMBER 2.0 0.0 X SR LILLIAN LYNCH BOARD MEMBER 2.0 0.0 X VAN MAYHALL JR BOARD MEMBER 2.0 0.0 X DR JOHN MCCLELLAND BOARD MEMBER 42.0 0.0 X 530059 24592 DANIEL MONTELARO BOARD MEMBER - VICE CHAIR 2.0 2.0 X X DR BEN OUBRE BOARD MEMBER 2.0 0.0 X DR DAVID POPE BOARD MEMBER 2.0 0.0 X SR EILEEN ROWE BOARD MEMBER 2.0 0.0 X JOHN SELSER BOARD MEMBER - SECRETARY 2.0 2.0 X X DR JOEL SILVERBURG BOARD MEMBER 2.0 0.0 X KENNETH WESTER CEO 2.0 55.5 X X 735113 98810 JEFFREY D LIMBOCKER CFO 2.0 55.0 X 425660 52898 TERRIE P STERLING COO 50.0 0.0 X 449877 0 50102 DEBORAH FORD CNO 50.0 0.0 X 280056 0 46164 KENNETH C CIVELLO STAFF PHYSICIAN 60.0 0.0 X 961957 33654 STEVEN T GREMILLION STAFF PHYSICIAN 60.0 0.0 X 1046744 31087 JEFFREY D HYDE STAFF PHYSICIAN 60.0 0.0 X 865257 28511 DENZIL L MORAES STAFF PHYSICIAN 60.0 0.0 X 1194762 34773 ANDREW C SMITH STAFF PHYSICIAN 60.0 0.0 X 1013444 29991 6342156 1160773 430582 289 false true false FMOL HEALTH SYSTEM 4200 Essen Lane Baton Rouge LA 70809 Management Services 84419346 ANESTHESIOLOGY GROUP ASSOC 7777 Hennessy Blvd Baton Rouge LA 70808 Physician Services 9636707 CROTHALL HEALTHCARE INC 5000 Hennessy Blvd Baton Rouge LA 70808 Healthcare Serivces 8891791 LSUHSC-NEW ORLEANS 1901 Perdido St Box P3-1 New Orleans LA 70112 Medical Services 7219610 HEMATOLOGY ONCOLOGY ASSC OF BR 4950 Essen Lane Ste 500 Baton Rouge LA 70809 Medical Services 7090610 145 4139607 2278626 1152128 0 7570361 PATIENT SERVICE REVENUE 900099 844898139 844898139 OUTREACH LABORATORY 900099 23958324 18801842 5156482 INCOME FROM EQUITY INVESTEES 900099 9964243 9690002 274241 PHARMACY 900099 4323610 1730439 2593171 CAFETERIA SALES 900099 2746385 2746385 18931127 18931127 904821828 5086368 223229 4863139 18858 18858 0 11688923 13366478 -1677555 0 -1677555 -1677555 73500264 1923 42820898 48409 30679366 -46486 30632880 312911 30319969 0 0 0 0 946452740 895120379 8560034 35201966 4121814 4121814 15800 15800 12000 12000 0 1576601 1345493 231108 0 296926063 253439123 43486940 22385530 17041845 5343685 33158808 29041643 4117165 19606672 16275839 3330833 78028379 38712074 39316305 1708900 1993 1706907 4640072 20496 4619576 0 0 1664611 1664611 34544560 29469562 5074998 4577960 776255 3801705 24197982 19204192 4993790 701237 284212 417025 0 13461028 11044189 2416839 224817 174115 50702 0 1472948 887261 585687 12729705 10438358 2291347 0 32944394 27106078 5838316 10331441 5041780 5289661 DECREASE IN ACCRUED PENSION 14705864 2560731 12145133 MEDICAL SUPPLIES EXPENSE 158261326 158261326 PURCHASED SERVICES 97167995 63794601 33373394 EQUIPMENT & MAINTENANCE 20014384 5498854 14515530 280476 280476 889461367 694569634 194891733 0 X 51211713 31219758 71117095 44862269 0 0 145949083 128234874 0 0 0 0 0 41781 14389326 16075053 14659880 8607499 1036865448 399362230 582956842 637503218 220486055 251014803 281775375 327784564 42096434 21115632 11950328 30600379 61777937 59198889 1498370068 1556258719 166841123 133370821 0 0 0 0 300832430 293758991 0 0 0 0 0 0 0 0 192765440 206511282 660438993 633641094 X 825226388 906430753 12704687 16186872 0 0 837931075 922617625 1498370068 1556258719 X 56991373 53447073 -25751896 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 74610347 74610347 618671466 183489631 435181835 1653907 1054891 599016 320822402 204345134 116477268 21107326 10472574 10634752 637503218 FIXED INCOME SECURITIES 116007759 F ALTERNATIVE INVESTMENTS 211776805 F 327784564 0 OTHER LIABILITIES 27435233 ACCRUED PENSION COSTS 179076049 206511282 X FIN 48 (ASC 740 FOOTNOTE) Schedule D 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 positions have been recorded. true Central America and the Caribbean Investments 160913397 160913397 160913397 Central America and the Caribbean Haiti Mission 12000 Check 1 true false true true true false true true X true X true X true true true false true true 83004465 74534027 8470439 0.00940 100733084 86126787 14606297 0.01620 183737549 160660814 23076736 0.02560 2036229 343951 1692278 0.00190 36847548 26757107 10090441 0.01120 939450 95403 844047 0.00090 931819 931819 0.00100 40755046 27196461 13558585 0.01500 224492595 187857275 36635321 0.04060 false 138747338 115429424 145489589 -30060165 true true SURGICAL SPECIALTY SURGERY CENTER 0.49000 0.51000 PERKINS PLAZA ASC AMBULATORY SURGERY CENTER 0.65660 0.34340 REGIONAL EYE SURGERY IMAGING SERVICES 0.12750 0.87250 2 1 OUR LADY OF THE LAKE HOSPITAL 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 WWW.FMOLHS.ORG/OLOLRMC State License: 132 X X X X 2 SURGICAL SPECIALTY CTR OF BATON ROUGE 8080 BLUEBONNET BLVD BATON ROUGE LA 70810 WWW.SSCBR.COM State License: 645 X X OUR LADY OF THE LAKE HOSPITAL 1 true X X X X X X X X X 12 true true true X See Part V, SEction C X X 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 SURGICAL SPECIALTY CTR OF BATON ROUGE 2 true X X X X X X X X X 12 true true true X SEE PART V, SECTION C X X X X X false false true true 150. false 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 OUR LADY OF THE LAKE HOSPITAL: REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. THE POLICY IS ALSO POSTED AT THE HOSPITAL BUSINESS OFFICES AND AT THE HOSPITAL'S URGENT CARE CENTERS. SURGICAL SPECIALTY CENTER OF BATON ROUGE: FOR PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE, FINANCIAL COUNSELORS ARE AVAILABLE TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. PART V, QUESTION 20D OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER OF BATON ROUGE: 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. TOGETHER THESE CRITERIA ARE USED TO SET THE MAXIMUM AMOUNT CHARGED. 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 OTHER MEDICALLY NECESSARY SERVICES. PART V, SECTION B, QUESTION 3 OUR LADY OF THE LAKE HOSPITAL AND SURGICAL SPECIALTY CENTER OF BATON ROUGE: OLOL JOINED THE MAYOR'S HEALTHY CITY INITIATIVE AND SITS AMONG OTHER LOCAL AREA HOSPITALS IN AN OPEN COLLABORATIVE EFFORT TO IMPROVE THE HEALTH OF THE BATON ROUGE COMMUNITY. THE MAYOR'S HEALTHY CITY INITIATIVE WORKED WITH HEALTHYBR AND MEDBR TO COMPLETE THE COMMUNITY NEEDS ASSESSMENT. AMONG THESE THREE GROUPS, THERE WERE REPRESENTATIVES FROM NUMEROUS BUSINESSES, HOSPITALS, GOVERNMENT ORGANIZATIONS, NONPROFIT ORGANIZATIONS AND SCHOOLS. THE LOCAL HOSPITALS PARTICIPATING WERE WOMAN'S HOSPITAL, BATON ROUGE GENERAL, OCHSNER MEDICAL CENTER, LSU HEALTH SCIENCES, LANE REGIONAL MEDICAL CENTER, AND EARL K. LONG/LSU HEALTH. THE REPRESENTATIVES ALSO INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THESE INDIVIDUALS WERE JIMMY GUIDRY, MD, STATE HEALTH OFFICER OF LOUISIANA AND DHH'S MEDICAL DIRECTOR; PAM ROMERO, RD, LDN, CDE, REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; AND MARILYN REYNAUD, MD, MPH, REGIONAL ADMINISTRATOR/MEDICAL DIRECTOR FOR THE DEPARTMENT OF HEALTH AND HOSPITALS, REGION 2 OFFICE OF PUBLIC HEALTH. PART V, SECTION B, QUESTION 4 OUR LADY OF THE LAKE HOSPITAL: THE CHNA WAS CONDUCTED IN COLLABORATION WITH WOMAN'S HOSPITAL, BATON ROUGE GENERAL MEDICAL CENTER, LANE REGIONAL MEDICAL CENTER, AND LSU HEALTH/EARL K. LONG MEDICAL CENTER AND THE LOUISIANA HOSPITAL ASSOCIATION THROUGH THE MAYOR'S HEALTHY CITY INITIATIVE. SURGICAL SPECIALTY CENTER OF BATON ROUGE: SURGICAL SPECIALTY CENTER OF BATON ROUGE FORMALLY ADOPTED THE COMMUNITY HEALTH NEEDS ASSESSMENT OF OUR LADY OF THE LAKE HOSPITAL , AN AFFILIATED ENTITY. SSC AND OLOL SHARE THE SAME DEMOGRAPHIC COMMUNITY SO SSC FELT THAT THE NEEDS IDENTIFIED BY THE MAYOR'S HEALTHY CITY INITIATIVE WERE REPRESENTATIVE OF ITS COMMUNITY'S NEEDS AS WELL. PART V, SECTION B, QUESTION 5 OUR LADY OF THE LAKE HOSPITAL: THE CHNA CAN BE FOUND AT HTTPS://FMOLHS.ORG/OLOLRMC/PAGES/QUALITY/COMMUNITY-HEALTH-ASSESSMENT.ASPX SURGICAL SPECIALTY CENTER OF BATON ROUGE: THE CHNA CAN BE FOUND AT WWW.SSCBR.COM. PART V, SECTION B, QUESTION 7 OUR LADY OF THE LAKE HOSPITAL: ALTHOUGH OUR LADY OF THE LAKE HOSPITAL CHNA IDENTIFIED 10 HEALTH NEEDS OF THE COMMUNITY, THE IMPLEMENTATION STRATEGY FOCUSED ON THE 4 HIGHEST NEED AREAS SINCE THEY POSED THE HIGHEST RISK TO THE COMMUNITY. THE IDENTIFIED NEEDS NOT CHOSEN AS AN AREA OF FOCUS INCLUDED HEART DISEASE/HIGH BLOOD PRESSURE/STROKE; CANCER; DIABETES; CHILD AND ADOLESCENT HEALTH; LIFESTYLE ISSUES; AND BARRIERS. WHLIE NOT CHOSEN AS AN AREA OF FOCUS, OLOL CURRENTLY CONDUCTS AND WILL CONTINUE TO CONDUCT PROGRAMS AND/OR PROVIDE SERVICES THAT HELP ADDRESS THOSE NEEDS. SURGICAL SPECIALTY CENTER OF BATON ROUGE: SURGICAL SPECIALTY CENTER OF BATON ROUGE (SSC) DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. IT CHOSE NOT TO ADDRESS OBESITY, HIV/AIDS, CHILDREN & ADOLESCENT HEALTH, HEART DISEASE/HIGH BLOOD PRESSURE/STROKE BECAUSE OUR LADY OF THE LAKE HOSPITAL (AN AFFILIATED ENTITY) AND OTHERS HAVE SELECTED THESE ISSUES TO ADDRESS. SSC WILL ASSIST OTHER LOCAL HOSPITALS AND ORGANIZATIONS IN THE COMMUNITY IF REQUESTED AND WHERE APPROPRIATE. SSC ALSO CHOSE NOT TO ADDRESS MENTAL AND BEHAVIORAL HEALTH, HIV/AIDS, AND OVER UTILIZATION OF EMERGENCY DEPARTMENT BECAUSE SSC IS A SPECIALTY HOSPITAL NOT EQUIPPED TO ADDRESS SUCH ISSUES. 5 PERKINS PLAZA AMB SURGERY CENTER 7145 PERKINS ROAD BATON ROUGE LA 708084322 SURGERY CENTER CONVENIENT CARE LLC 7777 HENNESSY BOULEVARD BATON ROUGE LA 70808 URGENT CARE BRPT-LAKE REHABILITATION CENTERS LLC 530 SHADOWS LANE BATON ROUGE LA 70806 REHABILITATION OLOL PONCHARTRAIN SURGERY CENTER LLC 15305 DALLAS PKWYSTE 1600 LB 28 ADDISON TX 75001 SURGERY CENTER LAKE URGENT CARE ASCENSION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 URGENT CARE PART I, LINE 7: As part of its mission to improve the lives and health of community members, Our Lady of the Lake has a cooperative endeavor agreement (CEA) with the State of Louisiana Department of Health and Hospitals (DHH) and Louisiana State University Health Sciences (LSU) that trains future physicians for our area and provides healthcare access to uninsured and under-insured residents. This public-private partnership has enabled positive healthcare transformation in Baton Rouge. Despite the closing of state-run hospitals and clinics, including Earl K. Long Medical Center in April 2013, and added challenges to the healthcare system created by the Baton Rouge General's closure of its Mid City Emergency Room (ER) in March 2015, recent data shows that this new model of care in Baton Rouge is working well. The benefits of the CEA to the community are visible in the following ways: Patient Care a. Uninsured and Medicaid patients have access to more than 20 specialty services, many of which were not available to them prior to the CEA. Local services now provided include oncology, neurology, mental health/psych, diabetes care, dermatology, cardiology, and more, along with pharmacy, imaging, and diagnostic services. This expansion of services has resulted in a 47 percent increase in clinic visits for these patients from 2012 to 2014. In the first year alone, patients were able to fill nearly 70,000 prescriptions that helped treat both acute and chronic conditions such as hypertension, asthma and diabetes. b. In coordination with LSU Health, Our Lady of the Lake operates two urgent care clinics to cost-effectively treat a wide range of injuries and conditions including infections, flus and fevers, broken bones, and minor burns. Patients with these conditions typically seek treatment in ERs, which carry increased costs. Uninsured and Medicaid patients now have access to a more abundant and appropriate level of care for these healthcare needs. There were 57,969 urgent care visits for uninsured and Medicaid patients in 2014, which represents a 212 percent increase in visits as compared to visits in 2012. c. Increasing capacity for emergency care has also been a priority for Our Lady of the Lake, especially in light of the growing need in the north Baton Rouge and Mid City area for this service. Thanks to recent renovations, Our Lady of the Lake also now has expanded dedicated Adult, Pediatric and Trauma areas in its ERs, and in 2014 alone, 81,373 uninsured and Medicaid patients received emergency care at the Lake, representing a 62 percent increase over 2012. d. Our Lady of the Lake manages and operates the Baton Rouge region's only designated Trauma Center, which cared for 1,110 patients in 2014, up from 859 in 2012. Nearly half of all trauma patients each year are uninsured or have Medicaid. Our Lady of the Lake has achieved Level II Trauma Center designation and is pursuing the clinical research required for designation as a Level I Trauma Center. Graduate Medical Education a. Through the CEA Our Lady of the Lake is training future generations of physicians in nearly all medical specialties and subspecialties as these clinicians commit to improve patient care in Baton Rouge. Equally important, academic medical centers such as Our Lady of the Lake are attracting the top physicians in the country, which helps advance medicine and deliver more comprehensive services in Baton Rouge, the surrounding parishes and the State. b. Our Lady of the Lake acts as a clinical teaching hospital for 21 residency and fellowship programs, including 15 through Louisiana State University School of Medicine, as well as programs offered through Tulane University School of Medicine and directly through Our Lady of the Lake. LSU residents are provided with access to state of the art programs and facilities to further their education and to help them deliver the best patient care possible. c. The Lake has grown its graduate medical education (GME) program from 139 residents in 2012 to 188 residents in 2014. In addition to these improvements in the quality of care for uninsured and Medicaid patients in the area, Our Lady of the Lake has made capital investments that have benefited families in the community and the region, including: 1. Dedicated Heart/Vascular center 2. Additional inpatient capacity and new ICU departments 3. Doubled the amount of ER capacity between two campuses, including Trauma Through this innovative partnership, Our Lady of the Lake has increased its efforts and reaffirmed its focus to bring better, more accessible care to the residents of Baton Rouge, and the organization remains devoted to serving the health needs of this community well into the future. DHH provides payments under a reimbursement structure which are intended to compensate the Hospital for incremental costs associated with higher Medicaid and uninsured patient volumes. Because of these reimbursements, which are considered direct offsetting revenue, the hospital's vital impact to the community in this effort is not directly reflected in the net community benefit percentage found at line 7K, column (F). The significant benefit to the community is better expressed as a percentage of total community benefit expense. Such total community benefit expense for the fiscal year is $224,492,595 which is 24.85% of total hospital expenses. 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 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: 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: PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON INCOME, ASSETS, AND MEDICAL EXPENSES AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE FULLY DISCOUNTED BASED ON A PRESUMPTIVE CHARITY SCORING SYSTEM WHICH IS SIMILAR TO CREDIT SCORING. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THESE PROCESSES HELP IDENTIFY (EARLY IN THE PROCESS) PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS HELPS KEEP QUALIFYING PATIENTS OUT OF THE HOSPITAL'S COLLECTION PROCESSES BECAUSE AMOUNTS COVERED BY FINANCIAL ASSISTANCE ARE NOT SUBJECT TO THE HOSPITAL'S COLLECTION PRACTICES. HOWEVER, IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE DISCOUNTED AMOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTIONS PROCESS. PART VI, LINE 2: NEEDS ASSESSMENT: RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. AS SUCH, OUR LADY OF THE LAKE HOSPITAL JOINED the Mayors Healthy City Initiative taskforce in 2007. Still today, OLOL sits among other local area hospitals in an open collaborative effort to improve the health of the Baton Rouge community. The Community Health Needs Assessment is just one of many joint efforts that OLOL has participated in alongside other hospitals and organizations. In May of 2008, Baton Rouge Mayor-President Melvin L. "Kip" Holden commissioned the Mayors Healthy City Initiative to encourage Baton Rouge residents to adopt a healthier and more active lifestyle. The Mayor envisioned a program that would promote identify resources available in the community for residents to fight chronic diseases and childhood obesity. In Louisiana, almost half of our children are considered overweight or obese, putting them at a much greater risk of obesity-related health problems like diabetes, heart disease, stroke, cancer and asthma. Nationwide the number of children who are considered overweight or obese has nearly tripled over the past 30 years. To tackle this problem, the Mayor subdivided the Initiative into three separate but compatible parts: HealthyBR - a focus on healthier eating and a more active lifesyle MedBR - a focus on access to care and health outcomes Innovation Center - a focus on community efforts to address Childhood Obesity Each subgroup engages a variety of partner organizations in a cooperative effort between local and state governments, area hospitals, and local health organizations. OLOL is a major supporter and contributor of the Mayors Healthy City Initiative. the Mayors Healthy City Initiative served as a common platform, allowing for in-depth roundtable discussions among local area hospitals. The OLOL Community Advocacy team facilitated those discussions and processes for completing the CHNA report. OLOL ALSO WORKS SEPARATELY WITH COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY,PUBLIC HEALTH, AMERICAN HEART ASSOCIATION, ST. VINCENT DE PAUL AND MANY OTHER ORGANIZATIONS TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. FOR EXAMPLE,PARISH NURSING, HEALTH SCREENING FOR DIABETES, SKIN CANCER, PROSTATE CANCER AND BREAST CANCER ARE PROMOTED IN VARIOUS COMMUNITY SETTINGS TO IMPROVE OVERALL COMMUNITY HEALTH. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE LAKE HOSPITAL. PATIENTS ARE INFORMED THROUGH A PATIENT HANDBOOK THAT CONTAINS INFORMATION ON THE FINANCIAL POLICIES OF THE HOSPITAL. ADDITIONALLY, SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHEN AND WHERE APPROPRIATE, FINANCIAL COUNSELORS VISIT PATIENTS AT THE TIME OF THE ENCOUNTER AND EXPLAIN THE ASSISTANCE OPTIONS AVAILABLE. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR HOSPITAL FINANCIAL ASSISTANCE. PART VI, LINE 4 COMMUNITY INFORMATION: OUR LADY OF THE LAKE HOSPITAL (OLOL) IS A COMMUNITY-BASED, NOT-FOR-PROFIT HOSPITAL LOCATED IN BATON ROUGE, LOUISIANA THAT SERVES EAST BATON ROUGE PARISH AND PORTIONS OF THE SURROUNDING PARISHES. PURSUANT TO THE HOSPITAL'S LAST CHNA, OLOL'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 669,874 AND 263,676 HOUSEHOLDS. THE MEDIAN AGE IS 35 YEARS, THE SENIOR POPULATION COMPRISES ABOUT 11.7% OF THE TOTAL POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $46,563, 25.6% HOUSEHOLDS HAVE INCOMES BELOW $25,000, PER CAPITA INCOME IS $24,673 AND UNEMPLOYMENT RATE IS 6.2%. OLOL'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: EAST BATON ROUGE PARISH LIVINGSTON PARISH ASCENSION PARISH OLOL'S SECONDARY SERVICE AREA INCLUDES THE FOLLOWING PARISHES: ASSUMPTION PARISH EAST FELICIANA PARISH IBERVILLE PARISH POINTE COUPEE PARISH ST. HELENA PARISH TANGIPAHOA PARISH WEST BATON ROUGE PARISH WEST FELICIANA PARISH PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR LADY OF THE LAKE HOSPITAL PARTICIPATES IN COMMUNITY IMPROVEMENT ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY IMPROVEMENT ACTIVITIES INCLUDE THE FOLLOWING: OUR LADY OF THE LAKE ESTABLISHED CLINICS LOCATED IN AREAS WITHIN UNDER-INSURED/LOW INCOME AREAS. THIS ALLOWS INDIVIDUALS TO ACCESS HEALTH CARE SERVICE THAT WOULD BE FOREGONE OR POSTPONED THEREBY CREATING A COMMUNITY AREA WITH MORE INTENSE HEALTH ISSUES/PROBLEMS. OUR LADY OF THE LAKE PROVIDES OVERSIGHT OF COMMUNITY PROGRAMS AND ACTIVITIES AND COORDINATED HEALTH CARE SCREENING FOR VARIOUS HEALTH ISSUES. AFTER HURRICANE KATRINA, OUR LADY OF THE LAKE BECAME A TEACHING HOSPITAL THROUGH AFFILIATION WITH LOUISIANA STATE UNIVERSITY MEDICAL SCHOOL TO INSURE THE STATE OF LOUISIANA MAINTAIN AN ADEQUATE SUPPLY OF PHYSICIANS. IN 2011 OUR LADY OF THE LAKE RECEIVED ACCREDITATION APPROVAL FOR A PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAM. THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE IS COMPRISED OF INDIVIDUALS FROM A BROAD CROSS-SECTION OF THE COMMUNITY WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. OLOL 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. FOR MORE INFORMATION ON THE PROMOTION OF COMMUNITY HEALTH, PLEASE REFER TO THE PART VI SUPPLEMENTAL INFORMATION DESCRIPTION FOR PART 1 QUESTION 7. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: OUR LADY OF THE LAKE HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL, NON-STOCK, MEMBER CORPORATION OF WHICH FRANCISCIAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOL HEALTH SYSTEM) IS THE SOLE MEMBER. OUR LADY OF THE LAKE HOSPITAL IS PART OF THE FMOL HEALTH SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE OF LOUISIANA. OUR LADY OF THE LAKE HOSPITAL SERVES THE COMMUNITY IN EAST BATON ROUGE PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL OUR LADY OF THE LAKE ASSUMPTION HOSPITAL OUR LADY OF THE ANGELS HOSPITAL PART III, SECTION A, QUESTION 2 THE HOSPITAL ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF THE ACCOUNTS AND BASED ON THE HISTORICAL COLLECTION ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW TO DETERMINE THE APPROPRIATENESS OF THE COLLECTION PERCENTAGES UTILIZED IN ESTIMATED BAD DEBT EXPENSE. CHARITY AND DISCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS RECEIVED ON ACCOUNTS SUBSEQUENT TO BEING CONSIDERED BAD DEBT ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE. true Alliance Safety Council 10099 North Reiger Road Baton Rouge LA 70809 720702946 501(C)(3) 70000 GENERAL SUPPORT General Support Baton Rouge Speech and Hearing Foundation 535 W Roosevelt Street Baton Rouge LA 70802 720542134 501(c)(3) 45000 General Support Boys & Girls Club 8281 Goodwood Blvd Ste H Baton Rouge LA 70806 720928014 501(C)(3) 6000 GENERAL SUPPORT General Support BREADA P O Box 3976 Baton Rouge LA 70821 721332566 501(C)(3) 20000 GENERAL SUPPORT General Support Cancer Services of Baton Rouge 550 Lobdell Avenue Baton Rouge LA 70806 720517180 501(C)(3) 15000 GENERAL SUPPORT General Support Capital Area United Way 700 Laurel Street Baton Rouge LA 70802 274059300 501(C)(3) 23042 GENERAL SUPPORT General Support Child Life Council 11821 Parklawn Drive Rockville NC 20852 521799846 501(C)(3) 10000 GENERAL SUPPORT General Support City Year Inc 287 Columbia Avenue Boston MA 02116 222882549 501(C)(3) 20000 GENERAL SUPPORT General Support Epilepsy Foundation of LA 8301 Professional Place East Landover MD 20785 720824847 501(C)(3) 10000 GENERAL SUPPORT General Support F Jefferson Liner JR MD and Dorothy A Lewis PTRS P O Box 2308 Hammond LA 70404 720955002 15723 SEE PART IV Families Helping Families of Greater Baton Rouge 2356 Drusilla Lane Baton Rouge LA 70809 721406289 501(C)(6) 7500 GENERAL SUPPORT General Support Fore Kids Foundation 11005 Lapalco Blvd Avondale LA 70094 581940111 501(C)(3) 30000 GENERAL SUPPORT community General Support General Growth Properties 6401 Bluebonnet Blvd Ste 5050 Baton Rouge LA 70836 300247204 96000 PLAYGROUND EQUIPMENT Girls on the Run South LA 11408 Lake Sherwood Ave N Ste A Baton Rouge LA 70816 270832549 501(C)(3) 20000 GENERAL SUPPORT General Support Istrouma Area Council Boy Scouts of America P O Box 66676 Baton Rouge LA 70896 720411324 501(C)(3) 10500 GENERAL SUPPORT General Support LSUHSC Clinics 5825 Airline Hwy LSU Unit Baton Rouge LA 70805 721304948 501(C)(3) 174820 GENERAL SUPPORT General Support Mary Bird Perkins Cancer Center P O Box 11407 Dept 1299 Birmingham AL 35246 237010520 501(C)(3) 15000 GENERAL SUPPORT General Support Mayor's Healthy City Initiative 222 St Louis Street Baton Rouge LA 70802 272515190 501(C)(3) 10000 GENERAL SUPPORT McCains Childrens Development 9047 Airline Hwy Baton Rouge LA 70815 720459036 501(C)(3) 60654 GENERAL SUPPORT Metromorphosis 1400 N Foster Drive Baton Rouge LA 70802 455102759 501(C)(3) 7550 GENERAL SUPPORT General Support Our Lady of the Lake College 7434 Perkins Road Baton Rouge LA 70808 721173156 501(C)(3) 2371529 GENERAL SUPPORT Our Lady of the Lake Foundation 5000 Hennessy Blvd Baton Rouge LA 70808 721014324 501(C)(3) 5521 GENERAL SUPPORT General Support Project Fit America P O Box 308 Boyes Hot Springs CA 95416 363730823 501(C)(3) 71200 GENERAL SUPPORT General Support 21 2 MEDICAL CARE FOR NEEDY INDIVIDUALS 1 15800 Monitoring grants FORMAL REQUESTS ARE RECEIVED BY THE BUSINESS PAYOR RELATIONS DEPARTMENT. THE REQUESTS ARE CHECKED FOR ALL APPROPRIATE INFORMATION AND DOCUMENTATION AND ARE PRESENTED TO EXECUTIVE ADMINISTRATION FOR APPROVAL. UPON APPROVAL THE REQUESTS ARE SUBMITTED TO ACCOUNTS PAYABLE FOR PAYMENT. PART II, PAGE 3, LINE 10 THE PURPOSE OF THE GRANT TO F JEFFERSON LINER JR., MD AND DOROTHY A. LEWIS PTRS WAS FOR SURGICAL SERVICES PROVIDED TO CHARITY HOSPITAL FOR NEEDY PATIENTS FREE OF CHARGE. false true false false false false false true false DR JOHN MCCLELLAND BOARD MEMBER 369370 112918 47771 10200 14392 554651 KENNETH C CIVELLO STAFF PHYSICIAN 574856 340001 47100 10200 23454 995611 STEVEN T GREMILLION STAFF PHYSICIAN 658418 283128 105198 10200 20887 1077831 JEFFREY D HYDE STAFF PHYSICIAN 523414 294743 47100 10200 18311 893768 JEFFREY D LIMBOCKER CFO 316496 80125 29039 28846 24053 478559 DENZIL L MORAES STAFF PHYSICIAN 761853 385625 47284 10200 24573 1229535 ANDREW C SMITH STAFF PHYSICIAN 668625 297719 47100 10200 19791 1043435 KENNETH WESTER CEO 517525 169825 47763 69982 28828 833923 TERRIE P STERLING COO 369376 0 80125 0 376 0 39864 0 10238 0 499979 0 0 0 DEBORAH FORD CNO 227955 0 51825 0 276 0 10200 0 35964 0 326220 0 0 0 PART 1, QUESTION 4A THE CEO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. PART 1, QUESTION 4B FMOLHS MAINTAINS AN UNFUNDED DEFERRED COMPENSATION PLAN WHICH MEETS THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLAN IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. NO ONE LISTED ON PART VII, SECTION A RECEIVED A PAYMENT FROM THE PLAN IN THE CURRENT YEAR. PART 1, QUESTION 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART 1, QUESTION 3 THE CEO IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. SURGICAL MANAGEMENT SERVICES LLC 1 BOARD MEMBER IS OWNER 2086765 PROVIDED MANAGEMENT SERVICES false CVT VASCULAR LAB INC 1 BOARD MEMBER IS OWNER 995054 PROVIDED MEDICAL SERVICES false CVT SURGICAL CENTER 1 BOARD MEMBER IS OWNER 375234 PROVIDED MEDICAL SERVICES false GOVERNING DOCUMENTS PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART VI, SECTION A, QUESTION 6 FMOL HEALTH SYSTEM (AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. MEMBERS PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO THE MEMBER 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 AND 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION PART VI, SECTION B, QUESTION 12C OUR LADY OF THE LAKE HOSPITAL, INC. HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY AND (D) UNDERSTANDS THAT OUR LADY OF THE LAKE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OUR LADY OF THE LAKE HOSPITAL, INC. PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW OF THE FORM 990 BY KPMG, THE FORM 990 IS REVIEWED BY 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 7A FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE HOSPITAL, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OUR LADY OF THE LAKE Hospital, Inc. DETERMINING COMPENSATION PART VI, SECTION B, QUESTION 15A & 15B OUR BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. THE COMPENSATION FOR THE CEO OF OUR LADY OF THE LAKE HOSPITAL, INC. IS SET BY THE COMPENSATION COMMITTEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE. COMMUNITY BENEFIT STATEMENT FORM 990 PART III THE MEDICAL CENTER PARTICIPATES IN GOVERNMENT PROGRAMS, INCLUDING MEDICARE, MEDICAID, AND THE TRICARE PROGRAM. UNDER THESE PROGRAMS, THE MEDICAL CENTER PROVIDES CARE TO PATIENTS AT PAYMENT RATES THAT ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF ACTUAL COST. IN SOME CASES, THESE PROGRAMS PAY THE MEDICAL CENTER AT AMOUNTS THAT ARE LESS THAN ITS COST OF PROVIDING SERVICES. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ALLOWANCES) AND THE ESTIMATED LOSSES INCURRED BY THE MEDICAL CENTER DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR CHARITY FOR THE YEAR END JUNE 30, 2014. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY THE MEDICAL CENTER UNDER MANAGED CARE OR OTHER SUCH ARRANGEMENTS. THE BELOW FIGURES USE A SLIGHTLY DIFFERENT ASSUMPTION FROM SCHEDULE H AND THEREFORE AMOUNTS MAY VARY. CHARITY CARE AND MEANS TESTED PROGRAMS: JUNE 30, 2014 CHARGES FOREGONE NET COMMUNITY BENEFIT EXPENSE CHARITY CARE $74,545,000 $28,981,000 UNREIMBURSED MEDICAID 12,394,000 4,970,000 UNREIMBURSED MEDICARE 332,641,000 30,060,000 TOTAL $419,580,000 $64,011,000 IN ADDITION TO COMMUNITY SERVICES DIRECTLY ASSOCIATED WITH PROVIDING HOSPITAL BASED CARE, THE MEDICAL CENTER SERVES THE COMMUNITY IN NUMEROUS OTHER WAYS. COMMUNITY HEALTH IMPROVEMENT SERVICES IMMUNOLOGICAL SUPPORT THE MEDICAL CENTER ORGANIZED, OWNS AND OPERATES A HOME WHICH IS DESIGNED TO HELP THE MEMBERS OF OUR COMMUNITY WHO HAVE CONTRACTED ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) TO DEAL WITH THE VERY DEBILITATING PHYSICAL, SOCIAL, AND PSYCHOLOGICAL PROBLEMS ASSOCIATED WITH THE DISEASE. PARISH NURSE PROGRAM TO ASSIST IN EDUCATING THE COMMUNITY REGARDING HEALTH RELATED ISSUES, THE MEDICAL CENTER PARTICIPATES IN NUMEROUS HEALTH FAIRS AND SPONSORS TALKS TO VARIOUS SCHOOLS AND INDUSTRY GROUPS REGARDING SUCH ISSUES AS DRUG ABUSE AND SAFETY IN THE WORKPLACE. LAKELINE DIRECT THE MEDICAL CENTER OPERATES A NURSE CALL CENTER, LAKELINE DIRECT, OFFERING COMPLIMENTARY 24 HOUR NURSE ADVICE, HEALTH INFORMATION AID, AND PHYSICIAN REFERRAL SERVICE TO THE COMMUNITY. ST. MARTHA ACTIVITY CENTER THE MEDICAL CENTER PROVIDES AN ACTIVITY CENTER LOCATED AT THE ELDERLY HOUSING FACILITY FOR THE RESIDENTS OF THE HOUSING FACILITY AS WELL AS OTHER ELDERLY COMMUNITY MEETINGS. ELDERLY SERVICES THE MEDICAL CENTER SPONSORS AND INCURS THE SALARY OF THE DIRECTOR OF THE HUD HOUSING FACILITY, PASTORAL CARE ASSOCIATE AND MEDICAL DIRECTOR OF ELDERLY SERVICES. ELDERLY HOUSING OLLIE STEELE BURDEN MANOR, A SUBSIDIARY OF THE MEDICAL CENTER, OPERATES ST. CLARE MANOR WHICH HAS 216 TOTAL BEDS, OF WHICH 120 ARE MEDICAID LICENSED. HEALTH CARE PROFESSIONAL'S EDUCATION OLOL COLLEGE IN AN EFFORT TO ENSURE THAT AN ADEQUATE SUPPLY OF NURSES ARE AVAILABLE FOR THE BATON ROUGE COMMUNITY, THE MEDICAL CENTER FOUNDED AND ORGANIZED OUR LADY OF THE LAKE COLLEGE, INC. THE MEDICAL CENTER SUBSIDIZES THE OPERATIONS OF THE COLLEGE WITH GRANTS. INTERNS AND RESIDENTS THE MEDICAL CENTER PARTICIPATES IN MEDICARE'S GRADUATE MEDICAL EDUCATION THROUGH AFFILIATION WITH LOUISIANA MEDICAL SCHOOL AND MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS TO CONTINUE TO SUPPORT AVAILABILITY OF PHYSICIANS IN FUTURE YEARS. SUBSIDIZED HEALTH SERVICES FAMILY EDUCATION THE MEDICAL CENTER PROMOTES A HEALTHY ENVIRONMENT FOR THE FAMILY THROUGH ITS PEDIATRIC PROGRAMS, WHICH INCLUDE KID-MED CLINIC, PEDIATRIC ASSESSMENT CENTER AND CHILD LIFE PROGRAMS. COPE THE MEDICAL CENTER PROVIDES CRISIS ORIENTED PSYCHIATRIC EVALUATION (COPE) TO THE COMMUNITY. PALLIATIVE CARE THE MEDICAL CENTER PROVIDES PALLIATIVE CARE SERVICE FOR PATIENTS IN THE FINAL STATE OF LIFE AND THEIR FAMILY MEMBERS. RESEARCH CLINICAL RESEARCH THE MEDICAL CENTER PARTICIPATES IN CLINICAL RESEARCH PROJECTS TO IMPROVE THE HEALTH AND CARE OF PATIENTS AND COMMUNITY MEMBERS. FINANCIAL CONTRIBUTIONS CASH CONTRIBUTIONS THE MEDICAL CENTER ALSO ORGANIZES EMPLOYEE PARTICIPATION IN FUND RAISING FOR ORGANIZATIONS SUCH AS CAPITAL AREA UNITED WAY, MARCH OF DIMES OF AMERICA, JUNIOR ACHIEVEMENT, CYSTIC FIBROSIS AND THE COMMUNITY FUND FOR THE ARTS. THE MEDICAL CENTER ALSO MAKES CORPORATE DONATIONS TO VARIOUS AREA COMMUNITY SERVICE ORGANIZATIONS. COMMUNITY BUILDING ACTIVITIES ELDERLY HOUSING COMPLEX THE MEDICAL CENTER OPERATES FOUR ELDERLY HOUSING PROJECTS: VILLA ST. FRANCIS, INC., ASSISI VILLAGE, INC., CALAIS HOUSE, INC., AND CHATEAU LOUISE, INC. THESE PROJECTS ARE DESIGNED TO PROMOTE THE HEALTH, SECURITY, AND HAPPINESS OF THE ELDERLY AND HANDICAPPED PERSONS OF THE GREATER BATON ROUGE AREA. MARY BIRD PERKINS THE MEDICAL CENTER ALSO SPONSORS THE CHARITABLE ACTIVITIES OF OTHER NOT-FOR-PROFIT ORGANIZATIONS IN BATON ROUGE. THE MEDICAL CENTER PROVIDES LAND ADJOINING THE MEDICAL CENTER TO THE MARY BIRD PERKINS CANCER CENTER FOR ITS OPERATIONS AND FORGOES ALL RENTAL INCOME FOR THE USE OF THIS LAND. COMMUNITY CLINIC THE MEDICAL CENTER PROVIDES A BUILDING THAT SPONSORS A COMMUNITY CLINIC AND FOREGOES ALL RENTAL INCOME RELATED TO THE USE OF THE BUILDING. Part XI, Line 9 Other Changes in net assets or fund balances: Paid in Capital - NUCLEAR IMAGING 869,187 Capital Transfers FMOL 24,882,709 Total Other Adj. to FB 25,751,896 PART III, QUESTION 4D THE HOSPITAL PROVIDES VARIOUS OTHER PROGRAMS SUCH AS DIETARY, RESPIRATORY, PHARMACY AND SPECIAL PROCEDURES. 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