2014-08-14T09:57:15-05:00 2013-09-30 721202445 POSTLETHWAITE & NETTERVILLE 8550 UNITED PLAZA BLVD SUITE 1001 BATON ROUGE LA 70809 990 2012-10-01 721025017 BATON ROUGE GENERAL MEDICAL CENTER BATO 2252371547 8490 PICARDY AVENEUE NO 300-B BATON ROUGE LA 70809 KENDALL JOHNSON 2252371547 2014-08-14 1 RALPH STEPHENS P00638118 2259224600 2012 2015-11-30 17:44:51Z MARK SLYTER 8490 PICARDY AVENEUE NO 300-B BATON ROUGE LA 70809 385368686 0 X WWW.BRGENERAL.ORG X 1983 LA TO PROVIDE HIGH QUALITY HEALTHCARE TO THE BATON ROUGE AREA, REGARDLESS OF PATIENT RACE, CREED, SEX, NATIONAL ORIGIN, AGE OR ABILITY TO PAY AND TO PROMOTE THE OVERALL HEALTH OF THE COMMUNITY VIA WELLNESS PROGRAMS AND MEDICAL EDUCATION ACTIVITIES. 18 11 0 400 479672 -108788 890637 1031435 321633161 368192959 1787045 1028478 9315378 12605329 333626221 382858201 926314 1047456 0 0 120699077 133938118 0 0 0 203754359 241146535 325379750 376132109 8246471 6726092 305581130 298665555 239615809 227058237 65965321 71607318 TO PROVIDE HIGH QUALITY HEALTHCARE TO THE BATON ROUGE AREA, REGARDLESS OF PATIENT RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY AND TO PROMOTE THE OVERALL HEALTH OF THE COMMUNITY VIA WELLNESS PROGRAMS AND MEDICAL EDUCATION ACTIVITIES. 0 0 266316392 1047456 231796622 BATON ROUGE GENERAL (BRG) PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL TO THE OPERATIONS AND STABILITY OF BRG, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS HAVE THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. IN KEEPING WITH BRG'S COMMITMENT TO SERVING THE COMMUNITY, BRG PROVIDED $37,338,752 OF FREE AND/OR SUBSIDIZED CARE, $290,130,422 OF CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AS WELL AS HEALTH ACTIVITIES AND EDUCATION PROGRAMS. DURING FY 2013, BRG RECORDED 20,131 ADMITS, 196,897 OUTPATIENT CASES/PROCEDURES, 112,218 PATIENT DAYS, 100,005 EMERGENCY ROOM VISITS, DISPENSED 2,500,000 PHARMACY UNIT DOSES AND 11,450 INPATIENT/OUTPATIENT SURGERIES. 35566280 84396196 BRG OFFERS A FULL RANGE OF INPATIENT AND OUTPATIENT SURGICAL SERVICES TO THE GREATER BATON ROUGE AREA INCLUDING, BUT NOT LIMITED TO, GENERAL, ORTHOPEDIC, CARDIOVASCULAR, AND NEUROSURGERIES. BRG IS HOME TO THE AREA'S FINEST GENERAL AND ORTHOPEDIC SPECIALISTS AND OFFERS THE LATEST TECHNOLOGY AND CLINICALLY COMPETENT SUPPORT STAFF IN THE AREA. BRG COMPLETED 11,450 SURGERIES DURING THE FISCAL YEAR. 27190441 52000141 THE BRG INPATIENT/OUTPATIENT PHARMACIES PROVIDE OUR PATIENTS WITH THE MOST CURRENT AND EFFECTIVE PHARMACEUTICALS ON THE MARKET. PHARMACY IS AN INTEGRAL PART OF PATIENT THERAPY AND RECOVERY. DURING THE YEAR, THE INPATIENT/OUTPATIENT PHARMACIES DISPENSED 2,500,000 UNIT DOSES. 329073113 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 X 92 0 1 0 0 0 0 0 0 0 0 0 0 0 X 18 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GLENN SMITH CPA 2252371547 8490 PICARDY AVE 300B BATON ROUGE LA 70809 X VENKAT BANDA MD 3.00 X 0 748535 64910 PETER BOSTICK MD 3.00 X 0 0 0 GREG BOWSER 3.00 X 0 0 0 SUE ANNE COX 3.00 X 0 0 0 PERRY FRANKLIN 3.00 X 0 0 0 GARY GRAPHIA 3.00 X 0 0 0 MARGARET HART 3.00 X 0 0 0 EVELYN HAYES MD BOARD CHAIR 50.00 X X 0 111512 40528 LESLIE HERPIN MARX 3.00 X 0 0 0 JOE JUBAN 3.00 X 0 0 0 ROY KADAIR MD 3.00 X 0 0 0 JAMES LLORENS PHD 3.00 X 0 0 0 ANDREW OLINDE MD 3.00 X 34332 0 0 JANICE PELLAR 3.00 X 0 0 0 GOV CHARLES BUDDY ROEMER 3.00 X 0 0 0 ELAINE VALLETTE DRPH 3.00 X 0 0 0 REV RONNIE WILLIAMS 3.00 X 0 0 0 WILLIAM HOLMAN 50.00 X X 0 1179992 56553 DIONNE E VIATOR CPA 50.00 X 0 491822 48245 EDGARDO TENREIRO 50.00 X 0 419716 97627 FLOYD ROBERTS MD 50.00 X 0 788468 39201 KENDALL JOHNSON CPA 50.00 X 0 301972 62646 ANNA CAZES DNS 50.00 X 0 232720 80242 PAUL DOUGLAS 50.00 X 0 261910 51532 DONALD SHAW 50.00 X 0 201622 49573 PEYTON GRANT 50.00 X 0 194072 61308 GEORGE BELL 50.00 X 0 291259 47684 WILLIAM J HUBBARD MD 50.00 X 0 825315 64272 ROBERT N MOUKARZEL MD 50.00 X 0 792298 58424 GERALD W MOLLOY MD 50.00 X 0 627818 54910 DHAVAL V ADHVARYU MD 50.00 X 0 600736 40664 EDWARD C FACUNDUS MD 50.00 X 0 351438 18760 34332 8421205 937079 55 0 1 0 GENERAL HEALTH SYSTEM 8490 PICARDY AVE BATON ROUGE LA 70809 MANAGEMENT & GOVERNANCE 48914559 PARISH ANESTHESIA OF BR 3510 N CAUSEWAY BLVD METAIRIE LA 70002 MEDICAL SERVICES 4084145 LSU HEALTH SCIENCES CTR 433 BOLIVAR ST NEW ORLEANS LA 70112 MEDICAL SERVICES 2735983 HOSPITAL HOUSEKEEPING SVCS PO BOX 826 SAN ANTONIO TX 78293 HOUSEKEEPING SERVICES 2599222 HMG PHYSICIANS LLC 3600 FLORIDA BLVD BATON ROUGE LA 70806 MEDICAL SERVICES 1890000 47 1019135 12300 1031435 NET PATIENT REVENUES 621990 368192959 368192959 368192959 1078321 1078321 2904583 0 2904583 2904583 2904583 2448771 11871 2510485 0 -61714 11871 -49843 -49843 CAFETERIA REVENUE 722210 3281378 479672 2801706 PURCHASE REBATES 900099 1179066 1179066 SUPPORT REV -LTAC 900099 684634 684634 4555668 4555668 9700746 382858201 371097542 479672 10249552 1044630 1044630 2826 2826 34332 34332 114959755 113637688 1322067 10348857 10319222 29635 8595174 8492426 102748 54716568 13863680 40852888 1300 1300 55150 55150 31388506 28891671 2496835 1974253 1966285 7968 83476352 83331109 145243 247257 247257 4913730 4543629 370101 284840 266587 18253 6874988 6187489 687499 11796277 11221395 574882 502574 502574 BAD DEBT EXPENSES 25065607 25065607 LOSS ON BOND REFINANCE 10547457 10547457 EQUIPMENT RENTALS/REPAI 7811161 7509102 302059 PATIENT RELATIONS EXPEN 694589 694589 795926 648408 147518 376132109 329073113 47058996 0 15703593 21973168 72556538 49798248 36104393 38286248 1507800 1707602 32375562 33873645 1367126 1044357 325424945 183598095 140605341 141826850 5360777 10155437 305581130 298665555 51303379 55556599 188312430 171501638 239615809 227058237 X 65965321 71607318 65965321 71607318 305581130 298665555 6726092 -1084095 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 50 1 0 1 100 0 1 55000 55150 0 PART IV, SUPPLEMENTAL INFORMATION: PART II-B, LINE 1D & 1E INTERNAL COMMUNICATIONS ONLY, INVOLVING LITTLE OR NO DIRECT COST. PART II-B, LINE G COSTS WERE LIMITED TO IN-TOWN TRAVEL AT MINIMAL DIRECT COST. PART II-B, LINE I LOBBYING FIRM ENGAGED TO ASSIST IN LEGISLATIVE EFFORTS ONLY. 9755209 9755209 207433065 110502713 96930352 8110033 6713861 1396172 93513590 66381521 27132069 6613048 6613048 141826850 356708497 -26149704 -26149704 382858201 0 382858201 351066502 0 351066502 25065607 25065607 376132109 PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED HOLDING LOSSES -1,084,097. BAD DEBTS EXPENSE -25,065,607. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS EXPENSE 25,065,607. PART X, LINE 2 - FIN 48/ASC FOOTNOTE: "THE COMPANY ADOPTED THE PROVISIONS OF THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES TOPIC OF THE FASB ASC. THE COMPANY RECOGNIZES A THRESHOLD AND MEASUREMENT PROCESS FOR FINANCIAL STATEMENT RECOGNITION OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE INTERPRETATION ALSO PROVIDES GUIDANCE ON RECOGNITION, DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE COMPANY'S TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE COMPANY'S OPEN AUDIT PERIODS ARE YEARS ENDED SEPTEMBER 30, 2010 THROUGH SEPTEMBER 30, 2012. THERE ARE CURRENTLY NO RETURNS UNDER EXAMINATION. MANAGEMENT EVALUATED THE COMPANY'S TAX POSITIONS AND CONSIDERED THAT THE COMPANY HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE." 1 1 X 1 X 1 X 1 0 1 1 12471143 67949 12403194 0.03530 42325002 25006238 17318764 0.04930 54796145 25074187 29721958 0.08460 6614 546531 0 546531 0.00160 7 726 9159253 3116623 6042630 0.01720 3 97270 28496749 24213577 4283172 0.01220 447175 16802 430373 0.00120 883714 0 883714 0.00250 10 104610 39533422 27347002 12186420 0.03470 10 104610 94329567 52421189 41908378 0.11930 12500 0 12500 0.00000 12500 0 12500 0.00000 25000 25000 0 8371913 96452972 87590234 8862738 X 1 1 1 1 BRGMC - MID CITY AND BLUEBONNET CAMPUS

8490 PICARDY AVENUE BATON ROUGE LA 70809

X X X X A BRGMC - MID CITY CAMPUS 1 X X X X X X X X 12 1 1 1 X X X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 0 1 1 X X X X X 1 X X X 1 X X X X X X X 1 X 0 1 9 FAMILY HEALTH CENTER

3801 NORTH BLVD BATON ROUGE LA 70806

CLINICAL LOCATION FAMILY HEALTH CENTER-SOUTH

333 LEE DRIVE SUITE B BATON ROUGE LA 70806

CLINICAL LOCATION BRG SURGICAL ASSOCIATES

3600 FLORIDA BLVD BATON ROUGE LA 70806

CLINICAL LOCATION BRG SURGICAL ASSOCIATES-BLUEBONNET

8595 PICARDY AVENUE SUITE 235 BATON ROUGE LA 70809

CLINICAL LOCATION BRG ORTHOPEDIC ASSOCIATES

8595 PICARDY AVENUE SUITE 235 BATON ROUGE LA 70809

CLINICAL LOCATION BRG GASTROENTEROLOGY CENTER

6615 PERKINS ROAD BATON ROUGE LA 70808

CLINICAL LOCATION BRG NEUROLOGY ASSOCIATES

3600 FLORIDA BLVD BATON ROUGE LA 70806

CLINICAL LOCATION MATERNAL-FETAL MEDICINE OF BATON ROUGE

8595 PICARDY AVENUE SUITE 305 BATON ROUGE LA 70809

CLINICAL LOCATION WOMACK HEART CENTER-VALVE CENTER

8888 SUMMA AVE BATON ROUGE LA 70809

CLINICAL LOCATION PART III, LINE 9B: THE TAXPAYER'S COLLECTION PROCESS POLICY STATES THAT IF A PATIENT CANNOT PAY ANY REMAINING PATIENT ACCOUNT BALANCES IN FULL, THE COLLECTOR IS TO UTILIZE THE PAYMENT ARRANGEMENT GUIDELINES IN OUR CHARITY CARE POLICY TO APPLY FOR FINANCIAL ASSISTANCE. APPROVAL FOR ASSISTANCE WILL BE BASED ON INCOME, ABILITY TO PAY AND ACCOUNT BALANCE, AMONG OTHER FACTORS. PART III, LINE 2 BAD DEBT AT COST WAS CALCULATED USING THE ABOVE-REFERENCED COST-TO-CHARGE RATIO FROM PART I, WORKSHEET 2. NO AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION PERFORMS ANNUAL REVIEWS OF ITS COLLECTION HISTORIES TO DETERMINE THE ACCURACY OF ITS ESTIMATIONS OF BAD DEBT ALLOWANCE AMOUNTS. PART V, LINE 1 THE ORGANIZATION PARTICIPATES IN A PARISH-WIDE COMMUNITY BENEFIT REPORT WHICH SUMMARIZES ITS EFFORTS TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF THE GREATER BATON ROUGE AREA. SAID REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON AN AS-REQUESTED BASIS. THE COST-TO-CHARGE RATIO, AS CALCULATED ON THE TAXPAYER'S MEDICARE COST REPORT, IS USED AS THE BASIS FOR CALCULATING THE AMOUNTS REPORTED IN PART I, LINES 7A-7D. ACTUAL, DIRECT COSTS WERE USED IN THE CALCULATIONS OF THE VARIOUS AMOUNTS IN PART I, LINES 7E-7I. NO ADDITION OF UNALLOCATED OVERHEAD COSTS WERE USED ALTHOUGH THE ORGANIZATION FEELS THAT SUCH AN ADDITION WOULD BE JUSTIFIED. PART VI, LINE 2: THE BATON ROUGE GENERAL MEDICAL CENTER (BRGMC) SERVES THE NEEDS OF THE COMMUNITY THROUGH ITS COMMITMENT TO EXCEPTIONAL PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. IN ORDER TO IDENTIFY THE HEALTH AND WELLNESS NEEDS OF THE BATON ROUGE AREA, BRGMC PARTICIPATED IN THE MAYOR'S HEALTHY CITY INITIATIVE TO ENCOURAGE BATON ROUGE AREA RESIDENTS TO ADOPT A HEALTHIER AND MORE ACTIVE LIFESTYLE. PARTICIPATING IN THE INITIATIVE INCLUDED, BUT WERE NOT LIMITED TO, BRGMC, THE OFFICE OF MAYOR-PRESIDENT KIP HOLDEN, BLUE CROSS/BLUE SHIELD OF LOUISIANA, THE OFFICE OF US SENATOR MARY LANDRIEU, EBR PARISH PUBLIC SCHOOL SYSTEM, LSU HEALTH SCIENCES CENTER, LA. PRIMARY CARE ASSOCIATION, AMERICAN HEART ASSOCIATION, LSU PENNINGTON BIOMEDICAL RESEARCH CENTER AMONG A GROUP OF 25 MAJOR COMMUNITY GROUPS IN THE AREA. COORDINATION AMONG THESE GROUPS SERVED TO COORDINATE THE ASSESSMENT AND AVOID DUPLICATE EFFORTS TO INCREASE THE VALUE OF WHAT WE COLLECTIVELY BRING TO THE COMMUNITY HEALTHCARE NEEDS. PART VI, LINE 3: EACH AND EVERY PATIENT IS SCREENED BY PATIENT FINANCIAL SERVICES PERSONNEL, LICENSED SOCIAL WORKERS AND OTHER HEALTH CARE PROFESSIONALS TO DETERMINE IF ELIGIBLE FOR STATE AND/OR FEDERAL HEALTH CARE ASSISTANCE. SAID ASSISTANCE AS WELL AS ELIGIBILITY FOR BRGMC CHARITY CARE IS ASSESSED WITH THE PATIENT OR THEIR FAMILY MEMBER OR REPRESENTATIVE. OF PRIMARY IMPORTANCE IS THE HEALTH, RECUPERATION AND WELL-BEING OF OUR PATIENTS. PART VI, LINE 4: BRGMC IS THE ONLY COMMUNITY-OWNED, NON-PROFIT HOSPITAL LOCATED IN THE BATON ROUGE AREA. IT CONSISTS OF 2 HOSPITAL CAMPUSES, MID CITY AND BLUEBONNET. MID CITY SERVES THE DOWNTOWN AND SURROUNDING URBAN AREAS OF BATON ROUGE AS WELL AS THE SURROUNDING WEST BATON ROUGE, IBERVILLE, THE FELICIANAS, ST HELENA AND POINTE COUPEE PARISH AREAS. THE BLUEBONNET CAMPUS SERVES THE SOUTHERN AREA OF BATON ROUGE, AS WELL AS THE SURROUNDING ASCENSION, LIVINGSTON AND TANGIPAHOA PARISH AREAS WHICH HAVE SEEN ENORMOUS GROWTH IN POPULATION OVER THE LAST 30 YEARS. PART VI, LINE 6: BRGMC IS AN IRC SEC. 501(C)(3) ORGANIZATION, OWNED BY ITS COMMUNITY-OWNED 501(C)(3) PARENT COMPANY, GENERAL HEALTH SYSTEM (GHS) #72-0475545. THE GHS BOARD OF DIRECTORS ALSO SERVES AS THE BOARD FOR BRGMC. THE BOARD CONSISTS OF VARIOUS COMMUNITY LEADERS FROM THE BUSINESS, GOVERNMENTAL, PHILANTHROPIC AND MEDICAL COMMUNITIES IN THE BATON ROUGE AREA, SERVE WITHOUT COMPENSATION AND PROVIDE A VERY BROAD BASE OF KNOWLEDGE AND EXPERTISE TO THE GOVERNANCE AND MANAGEMENT OF BRGMC. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE GREATER BATON ROUGE AREA WHO WISH TO PROVIDE THEIR PATIENTS WITH THE FINEST CARE AND MEDICAL TECHNOLOGY AT THEIR DISPOSAL. IN FURTHERANCE OF ITS COMMITMENT TO PROVIDE THE BEST MEDICAL EDUCATION IN BATON ROUGE, BRGMC ENTERED INTO AN AFFILIATION AGREEMENT WITH TULANE UNIVERSITY SCHOOL OF MEDICINE TO CREATE A SATELLITE TRIANING CAMPUS FOR ITS MEDICAL STUDENTS. IN MAY 2013, 12 SELECTED STUDENTS (IN MAY 2012, 12 STUDENTS) BEGAN THE PROGRAM DURING WHICH THEY WILL SPEND THEIR 3RD AND 4TH YEAR CLINICAL ROTATIONS AT THE MID CITY CAMPUS. THE BRG PHYSICIANS WILL BE SERVING AS THE STUDENTS' TEACHERS AND MENTORS. THE PROGRAM TITLED "LEAD (LEADERSHIP, EDUCATION, ADVOCACY AND DISCOVERY) ACADEMY" SIGNIFIES THE FIRST TIME TULANE UNIVERSITY SCHOOL OF MEDICINE HAS OPENED A TRAINING FACILITY OUTSIDE OF NEW ORLEANS, LOUISIANA. 1 GENERAL HEALTH SYSTEM FOUNDATION 8490 PICARDY AVE BATON ROUGE LA 70809 740801335 501C3 871714 CHARITY EFFORTS VOLUNTEER HEALTH CORPS 4655 SHERWOOD COMMON BLVD BATON ROUGE LA 70810 204852337 501C3 15000 CHARITY EFFORTS AMERICAN CANCER SOCIETY 10528 KENTSHIRE COURT BATON ROUGE LA 70810 131788491 501C3 10000 CHARITY EFFORTS AMERICAN HEART ASSOCIATION 2644 S SHERWOOD FOREST BLVD BATON ROUGE LA 70816 135613797 501C3 108500 CHARITY EFFORTS BATON ROUGE SYMPHONY ORCHESTRA 7330 HIGHLAND RD BATON ROUGE LA 70808 030469605 501C3 5000 CHARITY EFFORTS FRIENDS OF BATON ROUGE ZOO P O BOX 60 BAKER LA 70704 721094494 501C3 6000 CHARITY EFFORTS PENNINGTON BIOMEDICAL RESEARCH 6400 PERKINS RD BATON ROUGE LA 70808 581767810 501C3 5000 CHARITY EFFORTS 7 0 PART I, LINE 2 - THE GRANT RECIPIENT (GENERAL HEALTH SYSTEM FOUNDATION)IS RELATED TO THE TAXPAYER AND IS A 501C3 ORGANIZATION. BECAUSE OF CENTRALIZED MANGAGEMENT, GOVERNANCE AND ACCOUNTING, THE USE OF GRANT PROCEEDS ARE MONITORED BY THE TAXPAYER ON A DAY-TO-DAY, MONTH-TO-MONTH BASIS TO ENSURE THAT SAID PROCEEDS ARE USED TO FURTHER THE RECIPIENTS' EXEMPT PURPOSE. X X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 VENKAT BANDA MD 0 225000 0 296702 0 226833 0 44000 0 20910 0 813445 0 0 EVELYN HAYES MD BOARD CHAIR 0 111512 0 0 0 0 0 39472 0 1056 0 152040 0 0 WILLIAM HOLMAN 0 657179 0 241706 0 281107 0 39500 0 17053 0 1236545 0 0 DIONNE E VIATOR CPA 0 397009 0 94813 0 0 0 26985 0 21260 0 540067 0 0 EDGARDO TENREIRO 0 376192 0 43524 0 0 0 81746 0 15881 0 517343 0 0 FLOYD ROBERTS MD 0 352937 0 46955 0 388576 0 22500 0 16701 0 827669 0 0 KENDALL JOHNSON CPA 0 267038 0 28050 0 6884 0 51425 0 11221 0 364618 0 0 ANNA CAZES DNS 0 199784 0 22000 0 10936 0 61000 0 19242 0 312962 0 0 PAUL DOUGLAS 0 216949 0 34694 0 10267 0 34831 0 16701 0 313442 0 0 DONALD SHAW 0 177764 0 19538 0 4320 0 40979 0 8594 0 251195 0 0 PEYTON GRANT 0 162339 0 25968 0 5765 0 41395 0 19913 0 255380 0 0 GEORGE BELL 0 244771 0 34229 0 12259 0 32783 0 14901 0 338943 0 0 WILLIAM J HUBBARD MD 0 790577 0 30000 0 4738 0 45750 0 18522 0 889587 0 0 ROBERT N MOUKARZEL MD 0 790577 0 0 0 1721 0 40250 0 18174 0 850722 0 0 GERALD W MOLLOY MD 0 450000 0 0 0 177818 0 34000 0 20910 0 682728 0 0 DHAVAL V ADHVARYU MD 0 119995 0 291042 0 189699 0 33164 0 7500 0 641400 0 0 EDWARD C FACUNDUS MD 0 265000 0 38993 0 47445 0 5000 0 13760 0 370198 0 0 PART I, LINE 1A CERTAIN EMPLOYEE BENEFITS THAT WERE PROVIDED TO THE PRESIDENT/CEO WERE GROSSED UP TO COVER THE TAX IMPACT AND INCLUDED ON FORM W-2 AS COMPENSATION. THE PRESIDENT/CEO TRAVELS OCCASIONALLY FIRST CLASS ON TAXPAYER-RELATED BUSINESS TRAVEL. WHEN THE STRATEGIC PLANNING RETREAT IS SCHEDULED AT AN OUT-OF-TOWN VENUE, CERTAIN DIRECTORS' AND SENIOR EXECUTIVES' GUESTS TRAVEL COSTS AND INCREMENTAL LODGING COSTS (IF ANY) RESULTING FROM THE TRIP ARE PAID BY THE TAXPAYER. THE 2013 BOARD RETREAT WAS HELD IN TEXAS. SUPPLEMENTAL INFORMATION PART III THE OFFICERS, KEY EMPLOYEES AND 5 HIGHEST PAID EMPLOYEES LISTED IN PART II ARE EMPLOYED AND COMPENSATED BY GENERAL HEALTH SYSTEMS (GHS), A 501(C)(3) ORGANIZATION #72-0475545. GHS IS THE PARENT COMPANY OF BATON ROUGE GENERAL MEDICAL CENTER. PART I, LINE 4B: THE PRESIDENT/CEO WM. HOLMAN PARTICIPATES IN A NON-QUALIFIED RETIREMENT PLAN IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF HIS EMPLOYMENT CONTRACT WITH GHS. ALL EXECUTIVES PARTICIPATE IN A NON-QUALIFIED PLAN DESIGNED TO PROVIDE A RETIREMENT SUPPLEMENT. EXECUTIVES MAY DEFER A PRE-TAX PORTION OF THEIR WAGES AND THE ORGANIZATION PROVIDES A PERCENT OF WAGES SUPPLEMENT. THE AMOUNT PROVIDED IS DIRECTED BY THE BOARD AND THE BOARD'S COMPENSATION COMMITTEE BASED ON MARKET DATA PROVIDED BY AN INDEPENDENT BENEFIT CONSULTING FIRM THAT CONDUCTS A REVIEW OF RETIREMENT FUNDING FOR EXECUTIVES IN COMPARABLE HEALTHCARE ORGANIZATIONS. FUNDS DEPOSITED BY THE ORGANIZATION HAVE A RISK OF FORFEITURE TIED TO SOLVENCY, RETENTION, AND VESTING. PART I, LINE 7: IN ORDER TO MAKE HEALTHCARE COST EFFECTIVE AND OF THE HIGHEST QUALITY, VARIOUS EXECUTIVES LISTED IN PART VII, SECTION A HAD PART OF THEIR COMPENSATION PUT AT RISK AND PAID IN THE FORM OF A PERFORMANCE INCENTIVE BASED UPON A BALANCED SCORECARD THAT FACTORED IN QUALITY, PEOPLE, CUSTOMER SERVICE AND FINANCIAL PILLAR RESULTS. SAID INCENTIVE PAYMENTS WERE APPORVED BY THE BOARD'S COMPENSATION COMMITTEE. PART II - BOARD MEMBER (BANDA) IS COMPENSATED BY A RELATED, FOR-PROFIT ENTITY IN ACCORDANCE WITH AN EMPLOYMENT CONTRACT AS A PRACTICING PHYSICAN AND PROVIDER OF HOSPITALIST SERVICES. THE PRESIDENT/CEO AND OTHER QUALIFYING EXECUTIVES RECEIVED LUMP SUM PAYMENTS AS THE RESULT OF THE VESTING OF RETIREMENT BENEFITS DEPOSITED ON THEIR BEHALF IN PREVIOUS YEARS. OTHER REPORTABLE COMPENSATION PAID TO PHYSICIAN BOARD MEMBERS INCLUDES MEDICAL PRACTICE INCOME AND CONTRACTUAL PAYMENTS FOR PROFESSIONAL SERVICES. THE PRESIDENT/CEO (AGE 65) HAD THE FOLLOWING AMOUNT INCLUDED IN THE PART II, COLUMN E TOTALS-$212,677 IN RETIREMENT SUPPLEMENT AND RETIREMENT BENEFIT VESTING ACCUMULATED IN PRIOR YEARS. CHIEF MEDICAL OFFICER HAD A ONE-TIME TAXABLE EVENT WHEN HE BECAME VESTED IN RETIREMENT BENEFITS. SAID BENEFITS WERE DEPOSITED INTO A LIFE INSURANCE POLICY BY THE ORGANIZATION ON HIS BEHALF OVER THE COURSE OF HIS EMPLOYMENT AND ARE REPORTED IN PART II, COLUMN B (III). CERTAIN PHYSICIANS' "OTHER REPORTABLE COMPENSATION" CONSISTS OF VARIOUS AMOUNTS PAID BEYOND THEIR NORMAL CONTRACTUAL COMPENSATION FOR ON-CALL COVERAGES AND/OR DEPARTMENTAL MEDICAL DIRECTOR FEES. A SERIES 2004 BONDS LA PUBLIC FINANCE AUTHORITY 720895871 546398JW9 2004-12-08 205710000 TO RETIRE PREVIOUS BOND DEBT & FUND CAPITAL EXPANSION 1 0 0 B SERIES 2006 BONDS LA PUBLIC FINANCE AUTHORITY 720895871 2006-12-14 19570173 TO FUND PURCHASE OF CAPITAL EQUIPMENT 0 0 0 C SERIES 2008 BONDS LA PUBLIC FINANCE AUTHORITY 720895871 2008-01-31 10000000 TO FUND PURCHASE OF CAPITAL EQUIPMENT 0 0 0 A 180530000 2008 1 1 1 1 B 14393294 11991005 2402289 2007 0 0 1 1 C 10000000 7699446 2300554 2008 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 A 1 B 1 C 1 PART I LINE A IN DECEMBER 2012, A NEW ISSUANCE OF OTHER (TAXABLE) BONDS WAS ACCOMPLISHED. SAID NEW BOND PROCEEDS WERE USED FOR THE PURPOSE OF ADVANCE REFUNDING AND DEFEASEANCE OF THE N0NTAXABLE SERIES 2004 BONDS. M EVANS DAUGHTER OF PRES/CEO 10962 EMPLOYEE COMPENSATION 0 R MORRIS DAUGHTER OF BRD MEMBER 67011 EMPLOYEE COMPENSATION 0 M FRANKLIN SPOUSE OF BRD MEMBER 17689 EMPLOYEE COMPENSATION 0 A TENREIRO SON OF VP/COO 14461 EMPLOYEE COMPENSATION 0 J CAZES SPOUSE OF CNO 165214 EMPLOYEE COMPENSATION 0 KLEINPETER FARMS DAIRY BRD MEMBER 116730 DAIRY PURCHASES 0 VARIOUS FAMILY MEMBERS OF CERTAIN BOARD MEMBERS AND OFFICERS ARE EMPLOYED BY THE TAXPAYER:M. EVANS IS THE DAUGHTER OF PRES & CEO, WM HOLMANR. MORRIS IS THE DAUGHTER OF BOARD MEMBER, M. WOMACK HARTM. FRANKLIN IS THE SPOUSE OF BOARD MEMBER, P. FRANKLINA. TENREIRO IS THE SON OF VP & COO, E. TENREIROJ. CAZES IS THE SPOUSE OF CNO, A. CAZES VARIOUS BOARD MEMBERS ARE OWNERS/PRINCIPALS OF VENDORS PROVIDING GOODS OR SERVICES TO THE TAXPAYER. ALL GOODS AND SERVICES ARE PROVIDED AT FAIR MARKET VALUES. KLEINPETER FARMS DAIRY (PARTIALLY OWNED BY BOARD MEMBER, S.A. COX) SUPPLIES FOOD PRODUCTS TO THE TAXPAYER'S NUTRITIONAL CARE DEPT. SCHEDULE R, PAGE 3, LINE 2 GENERAL HEALTH SYSTEM (A 501C3 ORGANIZATION AND PARENT COMPANY OF THE TAXPAYER) PROVIDES CENTRALIZED MANAGEMENT, BANKING, ACCOUNTS PAYABLE AND ACCOUNTS RECEIVABLE/BILLING, PAYROLL, ACCOUNTING/TAX, INTERNAL AUDIT AND COMPLIANCE, HUMAN RESOURCE, RISK MANAGEMENT, INSURANCE, BENEFITS MANAGEMENT AND LEGAL SERVICES TO ALL MEMBERS OF THE GHS SYSTEM. ALL MONIES COLLECTED FROM OR SPENT FOR ALL GHS-RELATED ENTITIES ARE DEPOSITED INTO/SPENT FROM CENTRALIZED GHS BANK ACCOUNTS AND ACCOUNTED FOR AS RECEIVED OR DISBURSED. THE ANNUAL NET AMOUNTS OF THESE TRANSACTIONS ARE REFLECTED AS GHS RECEIVABLES/LIABILITIES ON AN ONGOING BASIS. DUE TO THE MASSIVE NUMBER OF TRANSACTIONS DESCRIBED ABOVE, A PROPER, SEGREGATED ACCOUNTING IN THE MANNER PROSCRIBED BY SCHEDULE R IS NOT POSSIBLE AT THIS TIME. FORM 990, PART VI, SECTION B, LINE 11 DURING PREPARATION OF THE 990, SENIOR FINANCE LEADERS ARE CONSULTED TO PROVIDE ANY ADDITIONAL INFORMATION ON CERTAIN, VARIOUS TRANSACTIONS ON AN AS-NEEDED BASIS. UPON COMPLETION OF THE 990 BUT PRIOR TO FILING, SAID LEADERS ARE PROVIDED WITH A DRAFT COPY OF ALL FORMS/SCHEDULES FOR THEIR REVIEW AND COMMENTS. UPON CLEARING ANY REVIEW COMMENTS, REVISED DRAFT COPIES ARE EMAILED TO ALL MEMBERS OF THE BOARD VIA SECURE BOARD NETWORK. THE EXECUTIVE COMMITTEE HAS BEEN TASKED BY THE BOARD TO FULLY REVIEW THE 990 AT THEIR NEXT MEETING AND FORWARD THEIR RECOMMENDATIONS TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C AS PART OF ITS ANNUAL WORK PLAN, THE GHS INTERNAL AUDIT & CORPORATE COMPLIANCE DEPARTMENT ADMINISTERS A MANDATORY ELECTRONIC CONFLICT OF INTEREST (COI) SURVEY THROUGH WHICH ALL LEADERSHIP EMPLOYEES (RANGING FROM SUPERVISORS TO EXECUTIVE MANAGEMENT), GHS FOUNDATION BOARD MEMBERS AND TRUSTEES OF THE ORGANIZATION ARE PROMPTED TO TIMELY DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. AFTER THE 2 WEEK COI SURVEY PERIOD IS OVER, MEMBERS OF THE INTERNAL AUDIT & CORPORATE COMPLIANCE DEPARTMENT SORT THROUGH & ORGANIZE ALL SURVEY RESPONSES RECEIVED AND CONDUCT AN INITIAL REVIEW OF ALL DISCLOSURES FOR POSSIBLE CONFLICTS. THE CORPORATE COMPLIANCE OFFICER THEN REVIEWS ALL OF THE DISCLOSURES FLAGGED AS POTENTIAL CONFLICTS AND OBTAINS ADDITIONAL INFORMATION/DOCUMENTATION AS NECESSARY FROM KEY STAKEHOLDERS TO CLARIFY OR RECTIFY (THROUGH APPROPRIATE MITIGATION) ANY CONFLICTS NOTED SO AS TO ENSURE GHS BUSINESS DECISIONS ARE DRIVEN BY THE BEST INTERESTS OF THE ORGANIZATION. UPON COMPLETION, THE CORPORATE COMPLIANCE OFFICER FORMALLY COMMUNICATES CONFLICT RESULTS TO THE CHIEF FINANCIAL OFFICER, CHIEF EXECUTIVE OFFICER AND THE CHAIRMAN OF THE AUDIT/FINANCE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE GHS BOARD OVERSEES ALL EXECUTIVE COMPENSATION. THE COMMITTEE ENGAGES AN INDEPENDENT THIRD PARTY CONSULTING FIRM TO CONDUCT AN ANNUAL INDEPENDENT MARKET-BASED COMPENSATION REVIEW OF EXECUTIVES IN COMPARABLE HEALTHCARE SYSTEMS AND USES THIS DATA IN DETERMINING REASONABLE AND APPROPRIATE EXECUTIVE COMPENSATION LEVELS. ALL COMMITTEE MEMBERS ARE INDEPENDENT WITH NO CONFLICT OF INTEREST WITH REGARD TO EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE CONSIDERS MANY FACTORS IN DETERMINING EXECUTIVE COMPENSATION LEVELS. SOME OF THESE FACTORS ARE, BUT ARE NOT LIMITED TO, THE KNOWLEDGE, EXPERIENCE AND COMPETENCIES OF THE EXECUTIVE, PERFORMANCE OF THE EXECUTIVE, AREAS OF RESPONSIBILITY, IMPORTANCE OF EXECUTIVE RETENTION AND PEER CALIBRATION AND TALENT MANAGEMENT RATING. THE COMMITTEE DOCUMENTS ITS DECISIONS AND THE PROCESS IT FOLLOWS IN DETAILED AND TIMELY MINUTES. IT DILIGENTLY FOLLOWS THE PRESCRIBED PROCESS FOR ESTABLISHING A PRESUMPTION OF REASONABLENESS. FORM 990, PART VI, SECTION C, LINE 19 THE TAXPAYER MAKES ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND TAX RETURNS AVAILABLE TO THE GENERAL PUBLIC ON AN AS-REQUESTED BASIS. FORM 990, PART VII, LINE 1A COLUMN E-COMPENSATION PAID TO THE PRESIDENT/CEO INCLUDES A LUMP SUM VESTING PAYMENT OF RETIREMENT BENEFITS EARNED IN PRIOR YEARS. COLUMN F-OTHER COMPENSATION TO THE PRESIDENT/CEO AND DESIGNATED EXECUTIVES INCLUDES 401K AND DEFERRED COMPENSATION BENEFITS SUBJECT TO FUTURE VESTING. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS IS TASKED WITH THE OVERSIGHT OF THE ANNUAL AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. GENERAL INFO THE BOARD OF TRUSTEES FOR PARENT COMPANY (GENERAL HEALTH STSTEM #72-0475545) ALSO SERVES AS THE BOARD OF TRUSTEES FOR THE ORGANIZATION. GENERAL HEALTH SYSTEM 8490 PICARDY AVE BATON ROUGE LA 70809 720475545 HOSP MANAGEMENT LA 501C3 3 N/A 0 GENERAL HEALTH SYSTEM FOUNDATION 8490 PICARDY AVE BATON ROUGE LA 70809 740801335 FOUNDATION LA 501C3 11 GHS 0 BEHAVIORAL HEALTH INC 8490 PICARDY AVE BATON ROUGE LA 70809 720893168 DORMANT CORP LA 501C3 3 GHS 0 GENERAL LIVING CENTERS INC 8490 PICARDY AVE BATON ROUGE LA 70809 581705626 DORMANT CORP LA 501C3 9 GHS 0 MID CITY HEALTH CENTER 8490 PICARDY AVE BATON ROUGE LA 70809 721260054 DORMANT CORP LA 501C3 3 GHS 0 THE GENERAL HEALTH FOUNDATION 8490 PICARDY AVE BATON ROUGE LA 70809 720907879 DORMANT CORP LA 501C3 11 GHS 0 GENERAL HEALTH MANAGEMENT INC 8490 PICARDY AVE BATON ROUGE LA 70809 720904131 MGT CO LA GHS C 1.00000 0 HEALTH MANAGEMENT SERVICES INC 8490 PICARDY AVE BATON ROUGE LA 70809 720929442 DORMANT CORP LA GEN HEALTH MGMT INC C 1.00000 0 HEALTH INITIATIVES INC 8490 PICARDY AVE BATON ROUGE LA 70809 720981798 DORMANT CORP LA GEN HEALTH MGMT INC C 1.00000 0 GENERAL HEALTH SYSTEM MGMT INC 8490 PICARDY AVE BATON ROUGE LA 70809 721335513 MGT CO LA GHS C 1.00000 0 VERITY HEALTHNET ACCT MGT SVCS INC 8490 PICARDY AVE BATON ROUGE LA 70809 721245224 PROVIDER NETWORK LA GHSM C 869250 38723 1.00000 0 VERITY HEALTHNET LLC 8490 PICARDY AVE BATON ROUGE LA 70809 450510673 MARKETER LA VHAMS C -50659 0.50000 0 VERITY HEALTHNET NATL LLC 8490 PICARDY AVE BATON ROUGE LA 70809 562353850 DORMANT CO LA VHAMS C 0.50000 0 BRGP AFTER HOURS CLINIC INC 8490 PICARDY AVE BATON ROUGE LA 70809 743109146 DORMANT CORP LA BRGPS C 1.00000 0 MEDICAL DIAGNOSTIC SERVICES INC 8490 PICARDY AVE BATON ROUGE LA 70809 720994499 DORMANT CORP LA GHSM C 88500 1.00000 0 BRGP SERVICES INC 8490 PICARDY AVE BATON ROUGE LA 70809 203756691 MGT CO LA GHSM C -1979825 355786 1.00000 0 BRG PHYSICIANS INC 8490 PICARDY AVE BATON ROUGE LA 70809 721245632 PHYS CLINICS LA BRGPS C -3133967 1725479 1.00000 0 HOSPITAL MEDICINE GROUP INC 8490 PICARDY AVE BATON ROUGE LA 70809 203720898 DORMANT CLINIC LA BRGPS C 100699 256970 1.00000 0 BRGP HOSP SPECIALISTS INC 8490 PICARDY AVE BATON ROUGE LA 70809 203756738 PHYS CLINIC LA GHSM C 194592 446382 1.00000 0 BRG PRIMARY CARE LLC 8490 PICARDY AVE BATON ROUGE LA 70809 452969168 DORMANT CORP LA GHSM C 141043 1.00000 0 BRGP MEDICAL GROUP LLC 8490 PICARDY AVE BATON ROUGE LA 70809 453063914 PHYS CLINIC LA GHSM C 30403 210500 1.00000 0 GHS STAFFING SERVICES LLC 8490 PICARDY AVE BATON ROUGE LA 70809 453058006 STAFFING SVCS LA GHSM C 13476 44043 1.00000 0 BR GENERAL LAB SERVICES LLC 8490 PICARDY AVE BATON ROUGE LA 70809 461735706 DORMANT CORP LA GHSM C 1.00000 0 GULF SOUTH HEALTH PLAN INC 8490 PICARDY AVE BATON ROUGE LA 70809 721068656 DORMANT CORP LA GHS C 415 13386 1.00000 0 0 1 1 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 SEE SCHEDULE O FOR ADD'L SCHEDULE R INFORMATION GENERAL HEALTH SYSTEM (PARENT COMPANY) 72-0475545 CASH VALUE GENERAL HEALTH SYSTEM FOUNDATION 74-0801335 CASH VALUE BATON ROUGE GENERAL PHYSICIANS INC #72-1245632 CASH VALUE HOSPITAL MEDICINE GROUP INC 20-3720898 CASH VALUE BATON ROUGE GENERAL PHYSICIANS HOSP SPECIALISTS INC 20-3756738 CASH VALUE SCHEDULE R, PAGE 3, PART V, LINE 2(A): THE TAXPAYER'S 501C3 PARENT COMPANY (GENERAL HEALTH SYSTEM 72-0475545) PROVIDES CENTRALIZED MANAGEMENT, BANKING, ACCOUNTS PAYABLE AND ACCOUNTS RECEIVABLE/BILLING, PAYROLL, ACCOUNTING/TAX, INTERNAL AUDIT AND COMPLIANCE, HUMAN RESOURCE, RISK MANAGEMENT, INSURANCE, BENEFITS MANAGEMENT AND LEGAL SERVICES TO ALL MEMBERS OF THE GHS SYSTEM. ALL MONIES COLLECTED FROM OR SPENT FOR ALL GHS-RELATED ENTITIES ARE DEPOSITED INTO/SPENT FROM CENTRALIZED GHS BANK ACCOUNTS AND ACCOUNTED FOR AS RECEIVED OR DISBURSED. THE ANNUAL NET AMOUNTS OF THESE TRANSACTIONS ARE REFLECTED AS GHS RECEIVABLES/LIABILITIES ON AN ONGOING BASIS. DUE TO THE MASSIVE NUMBER OF TRANSACTIONS DESCRIBED ABOVE, A PROPER, SEGREGATED ACCOUNTING IN THE MANNER PROSCRIBED BY SCHEDULE R IS NOT POSSIBLE AT THIS TIME.