Our Lady of Lourdes Hospital at Pasco: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Our Lady of Lourdes Hospital at Pasco (EIN 91-0349750)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201401349349302045
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T09:32:27-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1250 East Fifth Street Suite 1900AddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910349750EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Our Lady of Lourdes Hospital at PascoBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOURLNameControl
Phone5095477704Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1520 North 4th AvenueAddressLine1
CityPascoCity
StateWAState
ZIP Code993012568ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFrank R BeckerName
TitleVP Finance/CFOTitle
Phone5095462282Phone
Date Signed2014-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRebecca LyonsName
PTINP01487105PTIN
Phone5137847100Phone
Date Prepared2014-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Lourdes Health NetworkBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn SerleNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1520 North 4th AvenueAddressLine1
CityPascoCity
StateWAState
ZIP Code993012568ZIPCode
FieldValueIRS element (for citing)
Gross Receipts103766591GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.lourdeshealth.netWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionRespond to the healthcare needs of the Mid-Columbia area in a Christian spirit.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees913TotalNbrEmployees
Total Nbr Volunteers167TotalNbrVolunteers
Total Gross UBI346525TotalGrossUBI
Net Unrelated Business Txbl Income341298NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year721530ContributionsGrantsPriorYear
Contributions Grants Current Year256709ContributionsGrantsCurrentYear
Program Service Revenue Prior Year109179571ProgramServiceRevenuePriorYear
Program Service Revenue CY102106610ProgramServiceRevenueCY
Investment Income Prior Year714348InvestmentIncomePriorYear
Investment Income Current Year868805InvestmentIncomeCurrentYear
Other Revenue Prior Year787936OtherRevenuePriorYear
Other Revenue Current Year137999OtherRevenueCurrentYear
Total Revenue Prior Year111403385TotalRevenuePriorYear
Total Revenue Current Year103370123TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year250463GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY254749GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year57114336SalariesEtcPriorYear
Salaries Etc Current Year57787513SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year54236296OtherExpensePriorYear
Other Expenses Current Year44445494OtherExpensesCurrentYear
Total Expenses Prior Year111601095TotalExpensesPriorYear
Total Expenses Current Year102487756TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-197710RevenuesLessExpensesPriorYear
Revenues Less Expenses CY882367RevenuesLessExpensesCY
Total Assets BOY71828166TotalAssetsBOY
Total Assets EOY72806536TotalAssetsEOY
Total Liabilities BOY28131375TotalLiabilitiesBOY
Total Liabilities EOY28970017TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY43696791NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY43836519NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Our Lady of Lourdes Hospital at Pasco is an extension of the healing ministry of Jesus. We are called to serve our community, our patients, their loved ones and our co-workers with respect, compassion and care. We respond to the health care needs in a Christian spirit. We strive for excellence in all we do. Our Catholic health ministry is dedicated to spiritually centered, holistic care, which sustains and improves the health of individuals and communities. In furtherance of its mission and in an effort to reduce the government's financial burden, Our Lady of Lourdes Hospital at Pasco provides essential health care services, such as inpatient acute care, emergency and ambulatory services, behavioral health care, and outpatient clinics as well as community services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense41052490Expense
Revenue46692296Revenue
DescriptionOur Lady of Lourdes Hospital at Pasco provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 34% of the value of services rendered were to elderly patients under the Medicare program and approximately 19% of services were provided to patients who were deemed indigent under state, county, or Hospital guidelines. In the spirit of principles adopted by Ascension Health, Our Lady of Lourdes Hospital at Pasco has taken proactive steps to address those issues that will affect the accessibility, the financing, and the delivery of healthcare to all persons especially the uninsured, the underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated cost of services provided to the elderly, the uninsured, and the underinsured totaled $8,333,668, including $2,149,652 cost for charity care and $1,385,235 in bad debts attributable to the uninsured and underinsured, $808,443 in services to the general community, and $4,582,354 in unpaid cost of public programs.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10864735Expense
Grants254749Grants
Revenue12357336Revenue
DescriptionCommunity benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, Our Lady of Lourdes Hospital at Pasco has made available the following programs to the community: physical fitness activities, community health programs, medical education, cancer screening programs, support groups and educational classes, CPR and first aid classes, health screening, flu shot clinic, nutrition and weight loss management.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense37856270Expense
Revenue43056978Revenue
DescriptionOur Lady of Lourdes Hospital at Pasco provides the following inpatient and outpatient medical services to the community: emergency care services, flight care, laboratory services, orthopedic services, pain management, primary care physicians, radiology services, rehabilitation services, sleep studies, maternity, physical therapy, occupational therapy, speech therapy, respiratory therapy, surgery, pediatrics, imaging, inpatient and outpatient alcohol and substance abuse, and inpatient and outpatient behavioral health services. Some of these services, such as rehab therapies, primary care physicians, behavioral health and maternity operate at a loss in order to ensure that all services are available to meet community health care needs. During the fiscal year ending June 30, 2013, Our Lady of Lourdes Hospital at Pasco treated 2,623 inpatient adults and children in the community for a total of 12,956 patient days of service. Our Lady of Lourdes Hospital at Pasco also provided services to 239,644 outpatients, including 2,055 outpatient surgical patients, 21,925 emergency room visits, 7,554 behavioral health and rehab therapy visits and 138,143 clinic and urgent care visits.Description
FieldValueIRS element (for citing)
Total Program Service Expense89773495TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096210NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees913NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Roberta WittorfBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5095423044TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1520 North 4th AvenueAddressLine1
CityPascoCity
StateWAState
ZIP Code993012568ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Ernest Parra
Chair1.000.00XX000
Bart Gallant
Vice Chair1.000.00XX000
Charles Graves
Vice President1.000.00XX000
Sr Mary Williams
Secretary1.000.00XX000
Greg Garcia
Treasurer1.000.00XX000
Dr Laurie Evans
Member1.000.00X000
Julie Killian
Member1.000.00X000
Sr Ann Patricia O'Connor
Member1.000.00X000
Sr Adrienne Clare Pereira
Member1.000.00X000
Jeff Petersen
Member1.000.00X000
Dr Venkataraman Sambasivan
Member1.000.00X000
Randy Shoop
Member1.000.00X000
Sr Mary Catherine Siminski
Member1.000.00X000
John Serle
President/CEO48.002.00X754461046707
Frank Becker
VP Finance/CFO48.002.00X351178055515
Sr Esther Polacci Sch O
VP Mission50.000.00X000
Barbara Blood
HR Executive Director50.000.00X17470807972
Denise Clapp
Chief Nursing Officer50.000.00X151731016163
Barbara Mead
VP Behavioral Health & Clinics50.000.00X251024025149
James I Bucher MD
Physician50.000.00396147015363X
Michael J Hannan MD
Anesthesiogist50.000.00416577033960X
James T Go MD
Physician50.000.00373994020755X
Benjamin D Pe MD
Physician50.000.00392586036979X
John Michael Roach MD
Physician50.000.00472352033495X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3734758TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation292058TotalOtherCompensation
Number Individuals GT100 K86NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Tri Cities Laboratory LLC
110 West Cliff AvenueSpokaneWA99204Laboratory Services2785672
Northwest Emergency Physicians Inc
PO Box 634850CincinnatiOH452634850Emergency Physicians2451227
Specialized Physicals
1365 Beet RoadWalla WallaWA99362Physician Services824003
TriMedx LLC
PO Box 636129CincinnatiOH452636129Equipment Servicing607328
Nuance Communications
1 Wayside RoadBurlingtonMA01803Technology Services526615
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Related Organizations160592RelatedOrganizations
All Other Contributions96117AllOtherContributions
Noncash Contributions2822NoncashContributions
Total Contributions256709TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Services6219905465103754651037
Medicare Patient Rev.6219902859393428593934
Medicaid Patient Rev.6219901809836218098362

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column763277TotalRevenueColumn
Related Or Exempt Function Income763277RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue102106610TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column859323TotalRevenueColumn
Exclusion$859,323ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real287018Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real335639Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-48621Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-48621TotalRevenueColumn
Exclusion-$48,621ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other70311Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other60829Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other9482Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column9482TotalRevenueColumn
Exclusion$9,482ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Cafeteria and Vending722212294640$294,640
Pharmacy44611076597$76,597
Inv in Uncon. Entities523000-284619-$631,144346525

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column100002TotalRevenueColumn
Exclusion$100,002ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue186620TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column103370123TotalRevenueColumn
Related Or Exempt Function Income102106610RelatedOrExemptFunctionIncome
Unrelated Business Revenue346525UnrelatedBusinessRevenue
Exclusion$660,279ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total254749Total
Program Services254749ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1683102Total
Program Services558136ProgramServices
Management And General1124966ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total42932604Total
Program Services38973098ProgramServices
Management And General3959506ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2422583Total
Program Services2155576ProgramServices
Management And General267007ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7654216Total
Program Services6620096ProgramServices
Management And General1034120ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3095008Total
Program Services2724891ProgramServices
Management And General370117ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total217741Total
Program Services456888ProgramServices
Management And General-239147ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total219624Total
Management And General219624ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total185054Total
Management And General185054ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total21557Total
Management And General21557ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6505142Total
Program Services4994872ProgramServices
Management And General1510270ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total706585Total
Management And General706585ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total732238Total
Program Services700154ProgramServices
Management And General32084ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4617570Total
Program Services4045453ProgramServices
Management And General572117ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3526059Total
Program Services3366512ProgramServices
Management And General159547ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total308908Total
Program Services243269ProgramServices
Management And General65639ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total425013Total
Program Services372517ProgramServices
Management And General52496ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3099235Total
Program Services2713632ProgramServices
Management And General385603ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total311178Total
Program Services272623ProgramServices
Management And General38555ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical & Food Supplies131173981304628671112
Professional Fees5167187510514262045
Other Minor Equipment43012640707623050
Dues and Subscriptions17953076109103421

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4675349Total
Program Services2686416ProgramServices
Management And General1988933ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total102487756Total
Program Services89773495ProgramServices
Management And General12714261ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7029773BOY
EOY69257EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY16286677BOY
EOY13796186EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1432341BOY
EOY1543678EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1358330BOY
EOY1479935EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis27269571LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8560826LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY20747390BOY
EOY18708745EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY54880BOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY217375BOY
EOY1940889EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY24701400BOY
EOY35267846EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY71828166BOY
EOY72806536EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11707147BOY
EOY11604904EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY213233BOY
EOY577658EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16210995BOY
EOY16787455EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY28131375BOY
EOY28970017EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY43636732BOY
EOY43765978EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY60059BOY
EOY70541EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY43696791BOY
EOY43836519EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY71828166BOY
EOY72806536EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses882367ReconcilationRevenueExpenses
Reconciliation Unrealized Invest499637ReconciliationUnrealizedInvest
Reconcilation Other Changes-1242276ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$21,557OtherActivitiesAmount
Total Lobbying Expenditures IIB21557TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationLobbying expenses represent the portion of dues paid to national and state hospital associations that are specially allocable to lobbying. Our Lady of Lourdes Hospital at Pasco does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1334397OtherCostOrOtherBasis
Book Value1334397BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16550724OtherCostOrOtherBasis
Depreciation4587597Depreciation
Book Value11963127BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis758154OtherCostOrOtherBasis
Depreciation323942Depreciation
Book Value434212BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7576891OtherCostOrOtherBasis
Depreciation3649287Depreciation
Book Value3927604BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1049405OtherCostOrOtherBasis
Book Value1049405BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18708745TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
Interest in Investment held by Ascension Health Alliance24762553
Investments in Tri-Cities Cancer Center5239898
Investments in Tri-Cities Lab.2185744
Deferred Compensation Asset1824175
Third Party Receivables1012490
Investment in BLT, LLC114289
Other Miscellaneous Receivables71185
Physician Guarantees Asset57512
FieldValueIRS element (for citing)
Total Book Value Other Assets35267846TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Intercompany Debt to Ascension Health Alliance$12,190,557
Deferred Compensation Liability$1,824,175
Estimated Settlement to Third Party Payors$1,354,823
Other Long-Term Debt$1,109,242
Self Insurance Liability$308,658
FieldValueIRS element (for citing)
Total Of Amounts16787455TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
ExplanationFrom the consolidated audited financial statements of Our Lady of Lourdes Hospital at Pasco d/b/a Lourdes Health Network ("Health Network"): The member health care entities of the Health Network are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). The Health Network accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2149652TotalCommunityBenefitExpense
Net Community Benefit Expense2149652NetCommunityBenefitExpense
Percent Of Total Expense0.02080PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense34323936TotalCommunityBenefitExpense
Direct Offsetting Revenue29741582DirectOffsettingRevenue
Net Community Benefit Expense4582354NetCommunityBenefitExpense
Percent Of Total Expense0.04440PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense36473588TotalCommunityBenefitExpense
Direct Offsetting Revenue29741582DirectOffsettingRevenue
Net Community Benefit Expense6732006NetCommunityBenefitExpense
Percent Of Total Expense0.06520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense146000TotalCommunityBenefitExpense
Net Community Benefit Expense146000NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense201521TotalCommunityBenefitExpense
Net Community Benefit Expense201521NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2552073TotalCommunityBenefitExpense
Direct Offsetting Revenue2037095DirectOffsettingRevenue
Net Community Benefit Expense514978NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense91944TotalCommunityBenefitExpense
Net Community Benefit Expense91944NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2991538TotalCommunityBenefitExpense
Direct Offsetting Revenue2037095DirectOffsettingRevenue
Net Community Benefit Expense954443NetCommunityBenefitExpense
Percent Of Total Expense0.00930PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense39465126TotalCommunityBenefitExpense
Direct Offsetting Revenue31778677DirectOffsettingRevenue
Net Community Benefit Expense7686449NetCommunityBenefitExpense
Percent Of Total Expense0.07450PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2150TotalCommunityBuildingExpense
Net Community Building Expense2150NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense45391TotalCommunityBuildingExpense
Net Community Building Expense45391NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense788TotalCommunityBuildingExpense
Net Community Building Expense788NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense48329TotalCommunityBuildingExpense
Net Community Building Expense48329NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,385,235BadDebtExpenseAmount
Amount Reimbursed By Medicare16316196AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17403414CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1087218MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroupOtherOther
Lourdes Medical Center
1520 North 4th AvenuePascoWA99301www.lourdeshealth.netXXXXA
Lourdes Counseling Center
21175 Carondelet DriveRichlandWA99352www.lourdeshealth.netXABehavioral Health Services

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Facility Reporting Group - ABusinessNameLine1
FieldValueIRS element (for citing)
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Lourdes Columbia Point
112 Columbia Point Drive Suite 103RichlandWA99352Physician Clinic
Lourdes Surgical Associates
1200 N 14th Avenue Suite 400PascoWA99301Surgical Services
Lourdes Women's Health at 14th Avenue
1200 N 14th Avenue Suite 255PascoWA99301Women's Health Care (Closed October 2013)
Lourdes Ear Nose and Throat Assoc
1200 N 14th Avenue Suite 220PascoWA99301Ear, Nose and Throat Care
Lourdes Family Health Center
650 S Columbia AvenueConnellWA99326Family Health Care Clinic
Lourdes Urgent Care
5304 N Road 68PascoWA99301Urgent Care Clinic
Lourdes Occupational Hlth & Phys Med
9915 Sandifur ParkwayPascoWA99301Occupational Health and Physical Medicine
Lourdes Riverview Medical Group
4403 W Court Street Suite BPascoWA99301Physician Clinic
Lourdes West Pasco
7425 Wrigley DrivePascoWA99301Women's Hlth, Family Med., Pediatrics, Gastroenterology & Diagnostic Imaging
Lourdes Cullum House
208 Cullum AvenueRichlandWA99352Behavioral Health Residential Support

Form990 Schedule H Part VI Form990ScheduleHPartVI (25 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost-to-charge ratio that addresses all patient segments (for example: inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self-pay). The best available data was used to calculate the amounts reported in the table.
Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services.
Part II: Lourdes Health Network ("Lourdes") provided the following community building activities:- CHILDHOOD OBESITY - To support healthy activities and prevention of childhood obesity, Lourdes sponsored three fun runs in local schools, provided "healthy snack" education to three local schools, and sponsored America on the Move through the YMCA. Without the support of Lourdes, the schools and organizations would not have been able to offer these activities that are designed to help young children learn healthy habits. Lourdes also supports many youth sports activities, such as Kennewick Youth Baseball, little league basketball teams and soccer teams to further our work to encourage children to be active.- PRENATAL OUTREACH - Lourdes provides free prenatal classes to anyone in the community, regardless of hospital of delivery. Classes include: Prenatal education in English and Spanish, Infant CPR classes, and refresher courses. In addition, a postpartum clinic is available free of charge for any new mother and baby post discharge. A positive educational program is also provided to high-risk teen mothers via the New Horizons High School and the Pasco School District. This program provides self esteem, parenting skills, and pre and post natal education.- COMMUNITY EDUCATION - For 95 years, Lourdes has been active providing community education throughout the region. A few examples: - Lourdes Health Network Nutritional Counselors are guest speakers at nursing homes, assisted living facilities, schools, volunteer groups and churches presenting healthy eating and diabetes prevention information provided by Lourdes, but at no cost to attendees. - Lourdes Health Network's Infection Control nurse actively educated children in schools and the community at many community events about proper hand washing and flu prevention at no cost to attendees and funded by Lourdes. In addition, Lourdes spearheaded an internal and external hand washing campaign and provided the largest community event - the Benton Franklin Fair and Rodeo - with posters, hand wipes, and hand sanitizers. - Dr. Benjamin Pe, Lourdes board certified child psychiatrist, provides educational sessions to local elementary schools about signs and symptoms of childhood mental illness provided by Lourdes at no cost to the school district. - Blood Drives - Lourdes works in close partnership with the Red Cross and promotes and hosts blood drives in many of our facilities. Having an adequate community blood supply is essential to our community's health. Lourdes is proud to offer these blood drives at no cost to participants or to the Red Cross. - Scholarships - Lourdes Auxiliary provides outstanding local students wanting to enter the healthcare field with $1,500 scholarships to pursue their education. This is one way that we can contribute to fighting the healthcare worker shortage and further the education of our community's brightest students.
Part III, Line 4: The organization is a part of the Our Lady of Lourdes Hospital at Pasco consolidated audit. The footnote that references bad debt expense in the June 30, 2013 consolidated audit is as follows: The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of allowance for doubtful accounts based upon historical write-off experience by payer category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Network follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Network's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. During fiscal 2013, the Health Network brought substantially all of the patient billing functions in-house. This change resulted in a substantial improvement in patient accounts receivable collection efforts in 2013. The Health Network has not experienced material changes in write-off trends and has not materially changed its charity care policy since June 30, 2012.The organization's share of bad debt expense in 2012 was $3,477,722 atcharges ($1,385,235 at cost).
Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply.
Part VI, Line 2: Lourdes Health Network ("Lourdes") is a collaborative community partner. During year ended June 30, 2013, Lourdes collaborated with Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors to complete the Community Health Needs Assessment for Benton and Franklin Counties ("CHNA"). Through data and community perception, a CHNA is a systematic examination of the health status within a given population to help identify key problems and assets in a community. The CHNA highlights the findings through a culmination of our health status, community themes and strengths, forces of change, and local public health systems. A complete copy of the organizations CHNA can be accessed at http://www.bfcha.org/.
Part VI, Line 3: Financial counselors are trained to discuss our financial assistance policy and assist those needing assistance with the application. In addition, they have knowledge of other assistance programs that patients may qualify for and assist patients in finding that information. During the pre-registration, registration, admission and discharge processes, Lourdes attempts to identify patients who may be eligible for charity or discounted care via the charity care policy. A financial counselor is provided to all patients. Lourdes charity care policy is posted in all admitting areas, the emergency room and the information desk with information about our financial assistance program and how to access it if needed. On the website is the full application available for download as well as information about the policy. A written summary and contact information is provided in all communications with patients regarding bills and account status.
Part VI, Line 4: Lourdes Health Network ("Lourdes") primarily serves those residing in Franklin and Benton Counties. Lourdes offers the only acute hospital in Franklin County and provides a clinic in North Franklin County. Lourdes also offers the region's only inpatient mental health hospital in Benton & Franklin Counties. In fiscal year ending June 30, 2013, Lourdes Health Network provided more than $8.9 million calculated using CHA guidelines in charity and uncompensated care to members of our community. The demographic makeup of the community we serves is as follows:FRANKLIN COUNTY - Total Population (Est. as of July 2012) - 85,845- 69.6% are high school educated or above - Median Household Income - $51,770- 21.5% of individuals below poverty level - 51.0% Hispanic or LatinoBENTON COUNTY- Total Population (Est. as of July 2012) - 182,398- 88.9% are high school educated or above- Median Household Income - $60,300- 12.9% of individuals below poverty level- 18.5% Hispanic or LatinoThe Health Status of the Mid-Columbia region trends with the health of the nation. However, our area has a higher prevalence of childhood obesity and diabetes, which then adds to other issues, such as heart disease and stroke. Other areas rated unfavorable compared to peer counties include:- Births to women under 18- Births to unmarried women- No care in first trimester- Mortality- Homicide- Lung Cancer- Stroke- Suicide- Colon CancerLourdes Health Network works diligently to provide healthy lifestyle education to the community in multiple ways such as a community newsletter, a web-based health information library, community events and educational forums and formalized relationships with schools.
Part VI, Line 5: Our Lady of Lourdes Hospital at Pasco ("Lourdes") seeks to improve the physical, mental, social, and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, Our Lady of Lourdes Hospital at Pasco has developed programs to help achieve its mission. Lourdes has provided significant support in the form of job shadow hours for classes at a local college, an employment service, and other organizations with the purpose of creating new employment opportunities for members of the community. Lourdes has also participated in other community-building coalitions in an effort to address health and safety concerns in the community.Lourdes allows educated staff with specific expertise to provide community education. For instance, the Infection Control nurse provides hand hygiene education to schools, at community events, and to teachers. Lourdes' board-certified child psychiatrist provides education to local teachers about signs and symptoms of children's common mental health issues. Certified dieticians provide education to school children and through the YMCA about healthy after-school snacks and overall healthy eating habits. It is estimated that over 2,000 school children and staff have attended sessions in the last year. Partnership with City of Pasco for Pasco Safety Improvements - Lourdes Medical Center is located on 4th Avenue in Pasco. 4th Avenue is a major arterial with 4 lanes of traffic. There have been several deaths and many injuries as people attempt to cross 4th Avenue to enter the hospital. As a proactive community leader, Lourdes has partnered with the City on a safety assessment and plan to improve 4th Avenue. This partnership included a monetary donation to the City for the assessment. The safety of our community and our patients is of utmost concern for Lourdes. - Other Non-profits: American Cancer Society, American Diabetes Association, American Red Cross, Boys and Girls Clubs, YMCA.
Part VI, Line 6: Our Lady of Lourdes Hospital at Pasco, d/b/a Lourdes Health Network ("Health Network") is a member of Ascension Health. In December 2011, Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of not-for-profit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health Alliance, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System.Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, theCongregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province American Province and the Sisters of Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province.Our Lady of Lourdes Hospital at Pasco d/b/a Lourdes Health Network, located in Pasco Washington, is a not-for-profit acute care hospital. The Health Network consists of two separately licensed not-for-profit health care providers and a foundation: Lourdes Medical Center ("MedicalCenter") located in Pasco, Washington; Lourdes Counseling Center ("Counseling Center") in Richland, Washington; and Lourdes Foundation ("Foundation"). The Medical Center and Counseling Center provide inpatient, outpatient and emergency care services for the residents ofPasco and its surrounding communities. Admitting physicians are primarily practitioners in the local area. The Foundation supports the Medical Center and the Counseling Center. The Health Network is related to Ascension Health's other sponsored organizations through common control.Substantially all expenses of Ascension Health are related to providing health care services.The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. Inaccordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS).The amount of traditional charity care provided, determined on the basis of cost, was approximately $2,091 and $1,747 for the years ended June 30, 2013 and 2012, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying other information.
WAReports Filed With StatesPart VI, Line 7
OUR LADY OF LOURDES HOSPITAL AT PASCOCOMMUNITY BENEFIT REPORTFOR THE YEAR ENDED JUNE 30, 2013This report illustrates the significant degree to which Our Lady of Lourdes Hospital at Pasco (dba and referred to throughout this document as Lourdes Health Network) contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest not-for-profit healthcare system, Lourdes Health Network continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of Lourdes Health Network is to perpetuate the healing mission of Jesus. Lourdes Health Network furthers this goal through delivery of patient services at the beginning of life, the end of life and each step in between with care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical and mental health services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay in a compassionate spirit. In order to portray the full breadth of our contribution, our community benefit information is described below: ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFITLourdes Health Network consists of Lourdes Medical Center, a 25-bed Acute Critical Access Hospital with an additional 10-bed inpatient rehabilitation unit and Lourdes Counseling Center, a stand alone 32-bed Psychiatric Hospital offering both inpatient and outpatient behavioral health services and a network of physician clinics caring for families in Southeastern Washington.In June of 2013, Lourdes Health Network's Volunteer Board of Directors approved the Community Health Improvement Plan based on community needs as identified in the Community Health Needs Assessment. Areas of focus for Lourdes Health Network include but are not limited to obesity and behavioral health. Lourdes Health Network primarily serves the Benton & Franklin Counties of Washington State an area with a population of nearly 250,000 total population. Our Lady of Lourdes Hospital at Pasco seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, Lourdes Health Network has developed the following programs to help achieve its mission:EXPANDING AWARENESS, EDUCATION, AND HEALTH PROMOTIONLourdes Health Network believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. Lourdes Health Network has invested significantly in unique, top quality health education and materials relating to first aid, health and wellness and more in order to accomplish its goals.BodyWorks - Lourdes Health Network provides, at no charge, children struggling with obesity a course called BodyWorks. This five week, five session program is designed to help children and their entire family make healthier nutrition choices. Registered dieticians work directly with them and also provide coaching for grocery shopping. Lourdes Health Network also offers a series called, "Lunch and Learn" free and open to anyone on various health care topics monthly. Medical Education - Lourdes Health Network believes in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Healthcare professionals are therefore encouraged to attend the "Lunch and Learn" sessions provided onsite. In addition, Lourdes Health Network provides healthcare professionals education in the following job specific areas on a routine basis:- BLS = Basic Life Support (i.e. cardiopulmonary resuscitation CPR)- ACLS = Advance Cardiac Life Support- TNCC = Trauma Nurse Core Curriculum- PALS = Pediatric Advanced Life Support- STABLE = Advanced Neonatal Resuscitation- Advanced Rehab Documentation and FIM scoring- Advanced Solution Wound Care- CPT Coding E/M Documentation guidelines- Emergency Severity index: 5 level triage- PICC Line Insertion class- Prophylaxis and Management of Asthma- Radiation Safety Training- SBAR Communication- Providing Holistic, Reverent CareIn the spirit of principles adopted by Ascension Health, Lourdes Health Network has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $8,333,668 with an additional $2,149,652 in charity care delivered.Lourdes Medical Center provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 34% of the values of services rendered were to elderly patients under the Medicare program, and approximately 19% of the services were provided to patients who were deemed indigent under state guidelines (Medicaid).Lourdes Counseling Center also provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 22% of the values of its services rendered were to elderly patients under the Medicare program, and approximately 46% of the services were provided to patients who were deemed indigent under state guidelines (Medicaid).LOURDES MEDICAL CENTER- Operates an emergency room that is open to all persons regardless of ability to pay; - Has an open medical staff with privileges available to all qualified physicians in the area; - Has a volunteer-based governing body in which independent persons representative of the community comprise a majority;- Engages in the training and education of health care professionals; and- Participates in Medicaid, Medicare, CHAMPUS, Tricare, and/or other government-sponsored health care programs.PATIENT SERVICESLourdes Health Network provides the following in-patient and out-patient medical services to the community:- ICU- Acute Care- Chemical Dependency and Rehabilitation- Physical Rehabilitation- Surgery- Same-Day Surgery- Gastroenterology Lab- Laboratory- Diagnostic Imaging- Diagnostic Therapeutic- Adult and Child Psychiatry- Renal- Emergency- Clinic Services (Occupational Health, Primary Care, Pediatrics, Gastroenterology, Urgent Care, Pediatric Urgent Care, OB/GYN, ENT, Urology, Neurology, Pulmonology, General Surgery, and Internal Medicine)- Ambulatory- Sleep Lab- Ear, Nose and Throat- Therapies (Physical, Occupational, and Speech)- Diabetic & Nutritional Education and Counseling- Inpatient Adult Psychiatric- Outpatient Counseling and Behavioral Health Treatment- Intensive Outpatient Behavioral Health- Supported Living Programs for Behavioral Health- PATH Program for the Homeless PopulationSome of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs, such as the PATH Program.During the fiscal year ending June 30, 2013, Lourdes Health Network treated 2,623 adults and children in the community for a total of 12,956 patient days of service. The Medical Center also provided services to 239,644 outpatients, including 2,055 outpatient surgery patients, 21,925 emergency room visits, 7,554 behavioral health and rehab therapy visits, and 138,143 clinic and urgent care visits.FINANCIAL INFORMATIONThe financial information presented below was prepared in accordance with the Catholic Health Association's (CHA) community benefit reporting guidelines. These guidelines recommend the following:- Report care of the poor at cost, not charges.- Do not include bad debt, contractual allowances, and quick pay discounts as part of care of the poor expense.- Do not count Medicare shortfall as a community benefit.- Report the net expense for community benefit services, i.e., the total community benefit expense minus any associated revenue from patients, payers, and other external sources.The CHA reporting guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the reporting guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health.
For fiscal year ended June 30, 20131. Care of the poor (at cost) = $2,149,6522. Government sponsored health care (net expense) = $4,582,354(unpaid cost of public indigent care programs includes Medicaid, SCHIP, other safety net programs; does not include Medicare shortfall)3. Community Benefit Programs (net expense) = $808,4434. Bad debt (at cost) = $1,385,235
See belowPart V, Line 8 Facility Reporting Group A
Throughout the assessment process members of the steering committee provided specific presentations in their field of expertise. The steering committee learned about previous assessments, current health statistics, the economy, spirituality, and many other topics relevant to understanding the sub-populations and health trends of the community. In addition, WSU-Tri-Cities students assisted the steering committee by presenting assessments on six population groups: uninsured elementary students, middle school adolescents, young adults with mental illness, agricultural workers, the Hanford workforce, and seniors aged 65+. Two Masters of Public Health (MPH) students helped with compiling data and statistical analysis. Students from Columbia Basin College helped conduct a community oral health survey.Facility 1 -- Lourdes Medical CenterPart V, Section B, line 3:
The assessment and report were compiled through collaboration between the Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, Lourdes Health Network, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors. For a complete list of entities included in the Community Health Needs Assessment see:http://www.lourdeshealth.net/assets-lhn/pdf/brochures/CHNA-2013-Executive- Summary.pdfFacility 1 -- Lourdes Medical CenterPart V, Section B, line 4:
Lourdes Medical Center does not intend to address the following community health needs identifited in the Community Health Needs Assessment: - Affordability while we continue to contain costs and maintain our generous charity care policy, we will not specifically address this need as the issue is much larger and difficult to address. - Lack of Insurance we will not directly address this issue as many of those without health insurance will have health insurance with the Affordable Care Act.Facility 1 -- Lourdes Medical CenterPart V, Section B, line 7:
Signs are posted in emergency rooms, in waiting rooms, and at the admissions offices to notify patients that the hospital has a financial assistance policy. In addition, every billing statement and the Hospital's website include information regarding the financial assistance policy. The policy is provided at the request of the patient.Facility 1 -- Lourdes Medical CenterPart V, Section B, line 14g:
Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of Our Lady of Lourdes Hospital at Pasco does not allow a hospital to engage in extraordinary collection actions before the organization made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy. Reasonable efforts taken include but are not limited to:- Notifying individuals of the financial assistance policy on admission- Notifying individuals of the financial assistance policy prior to discharge- Notifying individuals of the financial assistance policy incommunications with the patients regarding the patients' bills- Documenting its determination of whether patients were eligible forfinancial assistance under the hospital facility's financial assistancepolicyFacility 1 -- Lourdes Medical CenterPart V, Section B, line 18e:
Throughout the assessment process members of the steering committee provided specific presentations in their field of expertise. The steering committee learned about previous assessments, current health statistics, the economy, spirituality, and many other topics relevant to understanding the sub-populations and health trends of the community. In addition, WSU-Tri-Cities students assisted the steering committee by presenting assessments on six population groups: uninsured elementary students, middle school adolescents, young adults with mental illness, agricultural workers, the Hanford workforce, and seniors aged 65+. Two Masters of Public Health (MPH) students helped with compiling data and statistical analysis. Students from Columbia Basin College helped conduct a community oral health survey.Facility 2 -- Lourdes Counseling CenterPart V, Section B, line 3:
The assessment and report were compiled through collaboration between the Benton-Franklin Community Health Alliance, Kadlec Regional Medical Center, Kennewick General Hospital, Lourdes Health Network, PMH Medical Center, Group Health Cooperative, the Benton-Franklin Health District, and many other key partners and time contributors. For a complete list of entities included in the Community Health Needs Assessment see:http://www.lourdeshealth.net/assets-lhn/pdf/brochures/CHNA-2013-Executive- Summary.pdfFacility 2 -- Lourdes Counseling CenterPart V, Section B, line 4:
Lourdes Counseling Center does not intend to address the following community health needs identifited in the Community Health Needs Assessment: - Affordability while we continue to contain costs and maintain our generous charity care policy, we will not specifically address this need as the issue is much larger and difficult to address. - Lack of Insurance we will not directly address this issue as many of those without health insurance will have health insurance with the Affordable Care Act.Facility 2 -- Lourdes Counseling CenterPart V, Section B, line 7:
Signs are posted in emergency rooms, in waiting rooms, and at the admissions offices to notify patients that the hospital has a financial assistance policy. In addition, every billing statement and the Hospital's website include information regarding the financial assistance policy. The policy is provided at the request of the patient.Facility 2 -- Lourdes Counseling CenterPart V, Section B, line 14g:
Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of Our Lady of Lourdes Hospital at Pasco does not allow a hospital to engage in extraordinary collection actions before the organization made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy. Reasonable efforts taken include but are not limited to:- Notifying individuals of the financial assistance policy on admission- Notifying individuals of the financial assistance policy prior to discharge- Notifying individuals of the financial assistance policy incommunications with the patients regarding the patients' bills- Documenting its determination of whether patients were eligible forfinancial assistance under the hospital facility's financial assistancepolicyFacility 2 -- Lourdes Counseling CenterPart V, Section B, line 18e:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Lourdes Foundation
520 North 4th AvenuePascoWA99301911528577Section 501(c)(3)200393General Support
Washington State University Foundation
255 E Main St Suite 301PullmanWA991641925911075542Section 501(c)(3)30000Tri Cities Nursing Partnership Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Our Lady of Lourdes Hospital at Pasco provided donations to Lourdes Foundation to assist in daily operations. Lourdes Foundation's operations are closely monitored through shared leadership and goverance to ensure monies given are used as intended. In addition, Our Lady of Lourdes Hospital at Pasco donated to Benton Franklin Community Health Alliance in support of its access to care goals in the local community. The use of these funds is monitored through access to care successes and break throughs in the community.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John Serle
President/CEO30371803677500829930220040247030801168000
Frank Becker
VP Finance/CFO20733308275606108903100002451504066930184350
Barbara Blood
HR Executive Director153987020611011000079720182680000
Denise Clapp
Chief Nursing Officer1361100847907142060800100830167894000
Barbara Mead
VP Behavioral Health & Clinics1839460287180383600150090101400276173000
James I Bucher MD
Physician3947710001376000153630411510000
Michael J Hannan MD
Anesthesiogist396389000201880125000214600450537000
James T Go MD
Physician34677701940907808000207550394749000
Benjamin D Pe MD
Physician20729801578880274000125000244790429565000
John Michael Roach MD
Physician670004485490171030125000209950505847000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aAn officer is allowed to receive companion travel reimbursement for one companion on two business trips. The companion fees are reimbursable according to the standard travel reimbursement policy. These reimbursements are considered taxable income to the officer and are included in taxable wages. Gross up payments are made to all employees of Our Lady of Lourdes Hospital at Pasco for gifts received from the employer such as Christmas gift cards and special recognition awards. An officer receives payments for tax preparation services. These reimbursements are considered taxable income to the officer and are included in taxable wages.
Part I, Line 4bEligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, are entirely dependent on the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision there is not guarantee that these executives will evere receive any benefit under the program. Any amount ultimately paid under the program to executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individual receive payment from the supplemental nonqualified retirement plan in the amount as noted: Frank Becker - $18,435 The following individuals made contributions to the supplemental nonqualified retirement plan in the amounts as noted: John Serle - $17,004 Frank Becker - $26,000 Barbara Mead - $10,400

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Changes in Program ServicesForm 990, Part III, line 3During fiscal year ending June 30, 2013, Our Lady of Lourdes Hospital at Pasco discontinued its labor/delivery and nursery service lines and closed its Connell clinic location.
Form 990, Part VI, Section A, line 6Our Lady of Lourdes Hospital at Pasco has a single corporate member, Ascension Health.
Form 990, Part VI, Section A, line 7aOur Lady of Lourdes Hospital at Pasco has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Our Lady of Lourdes Hospital at Pasco.
Form 990, Part VI, Section A, line 7bAscension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
Form 990, Part VI, Section B, line 11Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions.
Form 990, Part VI, Section B, line 12cThe organization regulary and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Section B, line 15In determing the compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substatntion of the deliberation and decision. The Audit Committee reviewed and approved the compensation. In the review of the compensation, the other officers of the organization were compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
Form 990, Part VI, Section C, line 19The organization will provide any documents open to public inspection upon request.
Form 990, Part VII, Section A:Sister Esther Polacci is paid directly from LA Province of the Sisters of St. Joseph Carondelet.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Transfer to Sponsor -106,175. Transfer to Affiliates -1,132,056. Release from Restriction -4,045.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Ascension Health
PO Box 45998St LouisMO63145311662309National Health SystemMOSection 501(c)(3)Schedule A, Line 11aAscension Health Alliance0
Lourdes Foundation
520 North 4th AvenuePascoWA99301911528577FundraisingWASection 501(c)(3)Schedule A, Line 11aOur Lady of Lourdes Hospital at Pasco1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Physicians of Pasco Condominiums AssocBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1520 North 4th AvenueAddressLine1
CityPascoCity
StateWAState
ZIP Code99301ZIPCode
FieldValueIRS element (for citing)
EIN453691641EIN
Primary ActivityProperty ManagementPrimaryActivity
Legal Domicile StateWALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Lourdes Health NetworkBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income-72943ShareOfTotalIncome
Share Of EOY Assets4267ShareOfEOYAssets
Percentage Ownership0.78540PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Lourdes Foundation
B200393Actual Amount Paid
Lourdes Foundation
C160592Actual Amount Paid
Lourdes Foundation
Q81214Actual Amount Paid
Ascension Health
P10045882Actual Amount Paid
Ascension Health
R860807Actual Amount Paid
Ascension Health
S501542Actual Amount Paid

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