2014-05-15T15:20:02-05:00 2013-06-30 KPMG LLP 301 Main Street Suite 2150 Baton Rouge LA 70801 990 2012-07-01 721495500 OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL % JEFF LIMBOCKER OURL 2257657709 5000 HENNESSY BOULEVARD Suite BATON ROUGE LA 70808 JEFF LIMBOCKER 2257657709 2014-05-14 true RYAN HOOKS 2253444000 2012 2015-11-30 17:44:51Z WAYNE M ARBONEAUX 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 7561723 false 0928 X N/A X 2001 LA THE PURPOSE OF THE HOSPITAL IS TO PROVIDE FOR THE CARE OF ILL, INJURED AND DISABLED PERSONS AND TO ENHANCE THE HEALTH OF THOSE IN THE COMMUNITY THROUGH RESEARCH AND EDUCATION. 7 4 75 7 0 0 31913 87601 6917562 7407402 44360 40303 21545 22272 7015380 7557578 0 0 0 0 3054978 3181760 0 0 0 2891465 3034541 5946443 6216301 1068937 1341277 9817644 10953660 5148908 4952556 4668736 6001104 X INSPIRED BY THE VISION OF ST. FRANCIS AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING- WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. false false 2164765 0 3515930 OUR LADY OF THE LAKE ASSUMPTION PROVIDES TWENTY-FOUR HOUR HEALTHCARE SERVICES FOR PATIENTS IN THE SURROUNDING RURAL COMMUNITIES. THE HOSPITAL HAD 6,881 EMERGENCY ROOM VISITS THIS YEAR. THE HOSPITAL'S EMERGENCY ROOM IS OPEN TO EVERYONE, REGARDLESS OF ABILITY TO PAY. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. 865009 0 2190251 LABORATORY - PROVIDES PATIENTS WITH LABORATORY RESULTS. THE HOSPITAL PERFORMED 24,664 LAB TESTS DURING THE YEAR. 836451 0 693244 PATIENT CARE - THE HOSPITAL PROVIDED GENERAL MEDICAL AND SURGICAL SERVICES TO ITS PATIENTS FOR 240 INPATIENT DAYS. 761533 1007977 4627758 true true false false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 13 0 true 75 true false false false false false false false false false false X 7 4 false false false false true true true true true false false true true true true false true true false false X JEFF LIMBOCKER 2257656565 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 X DONALD DAIGLE 2.0 2.0 X X 0 0 0 DANIEL MONTELARO 2.0 2.0 X X 0 0 0 KENNETH WESTER 2.0 58.0 X 0 647415 92415 JEFFERY LIMBOCKER 2.0 48.0 X X 0 370271 57112 CHARLES P BOLOTTE MD 2.0 0.0 X 0 0 0 WAYNE M ARBONEAUX 50.0 0.0 X X 178792 0 60372 RENEE FURR 2.0 0.0 X X 0 0 0 BRIAN F TRIPODE 40.0 0.0 X 138852 0 6189 317644 1017686 216088 2 false true false CORRECT CARE INC 17438 HARD HAT DRIVE COVINGTON LA 70435 ER Physicians 1076768 OUR LADY OF THE LAKE HOSPITAL INC 5000 HENNESSY BLVD BATON ROUGE LA 70808 Management 138803 TRIAGE STAFFING INC 13934 Gold Circle OMAHA NE 68144 Labor Services 127409 3 23203 8760 55638 87601 PATIENT SERVICE REVENUE 900099 7392751 7392751 MISCELLANEOUS REVENUE 900099 7849 7849 MEDICAL RECORDS REVENUE 900099 6223 6223 VENDING REVENUE 900099 579 579 7407402 40053 40053 0 0 26417 4145 22272 0 22272 22272 250 250 250 250 0 0 0 0 0 7557578 7429674 0 40303 0 0 0 0 189283 146633 42650 0 2073910 1638267 435643 408223 322472 85751 354352 251390 102962 155992 125598 30394 1304569 1107566 197003 3422 3422 0 0 0 0 565923 519381 46542 51532 51532 333459 135011 198448 8475 8475 0 227247 39522 187725 11881 5009 6872 0 0 264 264 0 223237 73162 150075 35269 35269 MEDICAL SUPPLIES EXPENSE 269263 263747 5516 0 6216301 4627758 1588543 0 X 1975133 2714235 46347 16891 26952 23688 1198550 1571110 0 0 0 0 0 0 0 0 54504 26932 3446857 1792404 1822898 1654453 4693260 4946351 0 0 0 0 0 0 0 0 9817644 10953660 4002499 3311992 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146409 1640564 5148908 4952556 X 4641784 5977416 26952 23688 0 0 4668736 6001104 9817644 10953660 1341277 -8909 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 55461 55461 843721 512529 331192 50036 27954 22082 2497639 1251921 1245718 0 0 0 1654453 0 DUE TO AFFILIATES 612864 ACCRUED PENSION COSTS 1027207 CAPITAL LEASES 493 1640564 X FIN 48 (ASC 740) FOOTNOTE FMOLHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. true true true X true X true true true false true true 5746 5746 0.00090 5746 5746 0.00090 5746 5746 0.00090 false 1179248 1484036 1642660 -158624 X true true 1 1 Assumption Community Hospital

135 HIGHWAY 402 NAPOLEONVILLE LA 70390

X X X X Rural Health Clinic Assumption Community Hospital 1 true X X X X X X X X X 12 true false true X X X false false true true 200. true 400. true X X X X X X true true X X X true false X X X X true X false false PART I, LINE 3C Eligibility for charity is based on an individualized determination of financial need, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation. Discounted care is based upon current Federal Poverty Levels (FPL) with those at 200% or below eligible for free care, and those above 200% receive discounted care on a sliding scale, up to but not more than 400% of FPL. PART I, LINE 6A THE OPERATION OF OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS A COMMUNITY BENEFIT IN ITSELF. OUR LADY OF THE LAKE ASSUMPTION IS LOCATED IN AN UNDER-INSURED/LOW INCOME AREA. THE HOSPITAL IS THE ONLY SOURCE OF EMERGENCY HEALTH SERVICES AVAILABLE IN THE IMMEDIATE AREA. THE HOSPITAL DOES NOT HAVE A FORMAL COMMUNITY BENEFIT REPORT BUT IS CONSOLIDATED WITH THE SOLE MEMBER, OUR LADY OF THE LAKE HOSPITAL, INC. PART I, LINE 7, COLUMN F FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN F, FUNCTIONAL EXPENSES WERE USED WHICH DID NOT INCLUDE BAD DEBT EXPENSE. PART I, LINE 7 THE COST-TO-CHARGE RATIO IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART I 7A-D AND IS BASED ON IRS WORKSHEET 2. PART III, LINE 4 Patient Receivables are reduced by an allowance for uncollectible accounts. The allowance for uncollectible accounts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, major payor sources, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of this review are then used to make modifications to the provision for uncollectible accounts to establish an appropriate allowance for uncollectible receivables. After satisfaction of amounts due from insurance, FMOLHS Affiliates follow 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 FMOLHS Affiliates. PART III, LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. IT REFLECTS ALL COSTS INCURRED BY THE HOSPITAL IN PROVIDING PATIENT CARE SERVICES TO THE PATIENT POPULATION. THE AMOUNT ON PART III, LINE 6 REPRESENTS MEDICARE ALLOWABLE COSTS FROM THE COST REPORT. PART III, LINE 9B PATIENTS WITH NO MEANS OF PAYMENT MAY APPLY FOR FINANCIAL ASSISTANCE. APPROVAL WILL BE BASED ON CRITERIA SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. ACCOUNTS MAY ALSO BE WRITTEN OFF TO CHARITY BASED ON THE INFORMATION PROVIDED BY CREDIT BUREAUS, THROUGH THE SYSTEMS AND TOOLS UTILIZED AS WELL AS THE PATIENT'S MEDICAL EXPENSE. IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, THE ACCOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTION PROCESS. TO THE EXTENT APPROPRIATE AND PERMITTED BY LAW, FINANCIAL COUNSELING AND SCREENINGS ARE CONDUCTED AT THE TIME OF ENCOUNTER TO ASSIST IN IDENTIFYING PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. PART VI, LINE 2 NEEDS ASSESSMENT RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED, IS PRIMARY TO THE HOSPITAL'S MISSION. OUR LADY OF THE LAKE ASSUMPTION HOSPITAL WORKS TO CONDUCT HEALTH CARE NEEDS ASSESSMENTS. THEY WORK CLOSELY WITH MANY OTHER NOT-FOR-PROFIT ORGANIZATIONS WHOSE MISSION IS FOCUSED ON COMMUNITY SERVICE AND HEALTH. THEY WORK TO DEFINE COMMUNITY NEEDS AND TO CONSOLIDATE EFFORTS TO MEET THOSE COMMUNITY NEEDS. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE HOSPITAL'S CHARITY CARE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH OUR LADY OF THE LAKE ASSUMPTION. SYSTEMS AND TOOLS ARE UTILIZED TO CONDUCT HIGH LEVEL FINANCIAL SCREENING TO ASSIST IN IDENTIFYING PATIENTS ELIGIBLE FOR CHARITY CARE, FINANCIAL ASSISTANCE AND SELF PAY DISCOUNTS. FINANCIAL COUNSELORS WORK WITH PATIENTS TO ASSIST WITH ENROLLMENT FOR MEDICAID FOR THOSE WHO ARE ELIGIBLE AS WELL AS TO ASSIST THOSE WHO QUALIFY FOR CHARITY CARE. PART VI, LINE 4 COMMUNITY INFORMATION OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS A COMMUNITY-BASED, NOT-FOR-PROFIT 11 BED CRITICAL ACCESS HOSPITAL LOCATED IN NAPOLEONVILLE, LOUISIANA THAT SERVES EAST ASSUMPTION PARISH AND PORTIONS OF THE SURROUNDING PARISHES. BASED ON THE 2010 CENSUS INFORMATION, NAPOLEONVILLE HAS A TOTAL POPULATION OF AROUND 660 RESIDENTS. THE MAJORITY ARE CHILDREN UNDER THE AGE OF 18 AND SENIORS WHO ARE 65 AND OLDER. THE MEDIAN AGE WAS 37.6. THE MEDIAN FAMILY INCOME WAS $49,167 WHILE THE MEDIAN HOUSE HOLD INCOME WAS $30,735. ROUGHLY 28.9% OF THE FAMILIES FALL INTO THE POVERTY LEVEL. PART VI, LINE 5 OTHER INFORMATION THE MAJORITY OF THE GOVERNING BODY OF OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS COMPRISED OF INDIVIDUALS WITH A BROAD CROSS-SECTION OF HEALTH CARE AND BUSINESS EXPERIENCE. OUR LADY OF THE LAKE ASSUMPTION HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF THE HOSPITAL DEPARTMENTS AS NEEDED. SURPLUS FUNDS ARE APPLIED TO IMPROVEMENT IN PATIENT CARE AREAS THROUGH THE INVESTMENT IN CLINICAL TECHNOLOGY, MEDICAL INFORMATION TECHNOLOGY, AND CONTINUED TRAINING OF CLINICAL STAFF. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS A NOT-FOR-PROFIT, NON-STOCK, MEMBER CORPORATION OF WHICH OUR LADY OF THE LAKE HOSPITAL, INC. IS THE SOLE MEMBER. OUR LADY OF THE LAKE ASSUMPTION HOSPITAL IS PART OF THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE. OUR LADY OF THE LAKE ASSUMPTION SERVES THE COMMUNITY IN LOUISIANA'S ASSUMPTION PARISH AND SURROUNDING PARISHES. OTHER RELATED HOSPITALS IN LOUISIANA INCLUDE: OUR LADY OF THE LAKE HOSPITAL OUR LADY OF LOURDES REGIONAL MEDICAL CENTER ST. FRANCIS MEDICAL CENTER ST. ELIZABETH HOSPITAL PART V, LINE 12H OTHER FACTORS USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS CREDIT SCORING PART V, LINE 18E OTHER EFFORTS THE HOSPITAL FACILITY MADE THE SELF-PAY COMPASS SYSTEM IS USED TO HELP IDENTIFY PATIENTS THAT ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON ADDRESS/ZIP CODE AND OTHER IDENTIFYING INFORMATION. PART V, LINE 14G REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE. PART V, LINE 3 The hospital met separately with four different groups in order to gather information during its CHNA process. It met with representatives from Pierre Part Community Development Board, Assumption Rural Health Clinic Community Advisory Board, Assumption Parish Council on Aging and the Louisiana Office and Public Health and DHH Bureau of Primary Care and Rural Health. PART V, LINE 5 The hospital does not have its own website but it has posted its CHNA on its parent's website - www.fmolhs.org/ololrmc/Pages/Quality/Community-Health-Assessment.aspx. PART V, LINE 7 The hospital decided to only address four out of the five health risks identified through the CHNA process. Public transportation was identified as a priority but due to the tremendous amount of resources that would be needed to address this issue in a rural area, the facility decided not to address this issue in the near term. X X X false true false false false false false true false KENNETH WESTER 0 481556 0 147200 0 18659 0 78953 0 13462 0 739830 0 0 JEFFERY LIMBOCKER 0 298157 0 60125 0 11989 0 28981 0 28131 0 427383 0 0 WAYNE M ARBONEAUX 163151 0 15125 0 516 0 35429 0 24943 0 239164 0 0 0 PART I QUESTION 4A A BOARD MEMBER LISTED IN PART VII, WHO IS ALSO THE CEO OF A RELATED ORGANIZATION, IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. PART I QUESTION 4B FMOL HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION, MAINTAINS AN UNFUNDED DEFERRED COMPENSATION PLAN WHICH MEETS THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLAN IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. NO ONE LISTED ON PART VII, SECTION A RECEIVED A PAYMENT FROM THE PLAN IN THE CURRENT YEAR. PART I QUESTION 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO/PRESIDENT OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART III, QUESTION 4D THE HOSPITAL PROVIDES VARIOUS OTHER PROGRAMS SUCH AS DIETARY, RESPIRATORY, PHARMACY AND SPECIAL PROCEDURES. PART VI, SECTION A, QUESTION 6 OUR LADY OF THE LAKE HOSPITAL (AN IRC SECTION 501 (C) (3) ORGANIZATION) IS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL. PART VI, SECTION A, QUESTION 7A OUR LADY OF THE LAKE HOSPITAL, AS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS AND THE OFFICERS OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL. PART VI, SECTION A, QUESTION 7B OUR LADY OF THE LAKE HOSPITAL, INC. AS THE SOLE MEMBER OF OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL CAN MAKE THE DECISIONS AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES, PURPOSES OF CORPORATION 2. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF CORPORATION 3. TO AUTHORIZE MERGER, CONSOLIDATION OR AFFILIATION, OR PARTICIPATION IN JOINT VENTURES 4. TO DISSOLVE AND DISTRIBUTE ASSETS OF THE CORPORATION 5. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 6. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER IMMOVABLE PROPERTY ON BEHALF OF CORPORATION 7. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY CORPORATION 8. TO APPOINT FISCAL AUDITOR OF CORPORATION 9. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION 10. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF CORPORATION 11. TO APPROVE STRATEGIC BUSINESS PLANS OF CORPORATION 12. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF THE CORPORATION. PART VI, SECTION A, QUESTION 11 AFTER PREPARATION OF THE FORM 990 BY KPMG LLP, MANAGEMENT REVIEWED THE FORM 990. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. PART VI, SECTION B, QUESTION 12C OLOL ASSUMPTION COMMUNITY HOSPITAL HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT REQUIRES EACH OFFICER, TRUSTEE, BOARD COMMITTEE MEMBER AND EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLETED DISCLOSURE FORMS ARE REVIEWED AND MAINTAINED BY THE CHIEF COMPLIANCE OFFICER. IF ANY TRUSTEE, BOARD COMMITTEE MEMBER OR SENIOR MANAGER HAS A POTENTIAL CONFLICT, THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES WHETHER ACTION NEEDS TO BE TAKEN AND COMMUNICATES ANY SUCH ACTION TO THE INDIVIDUAL. A POTENTIAL CONFLICT OF ANY OTHER EMPLOYEE IS REVIEWED BY THE CEO OR HIS DESIGNEE. THE EXECUTIVE COMMITTEE, CEO OR DESIGNEE, AS APPLICABLE, DETERMINES IF A CONFLICT OF INTEREST EXISTS OR CREATES THE APPEARANCE OF IMPROPRIETY. IF SUCH A DETERMINATION IS MADE, THE INDIVIDUAL WILL BE EXCUSED FROM PARTICIPATING IN THE BUSINESS DECISION. DURING THE YEAR, ANY CHANGE TO THE INFORMATION IN THE DISCLOSURE STATEMENT MUST BE DISCLOSED PROMPTLY TO THE CHIEF COMPLIANCE OFFICER, WHO TAKES APPROPRIATE ACTION. THE PROCESS ALSO REQUIRES AFFIRMATION FROM EACH INDIVIDUAL THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT OLOL ASSUMPTION COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION TO THE ABOVE, OLOL ASSUMPTION COMMUNITY HOSPITAL PROVIDES MECHANISMS FOR CONFIDENTIAL REPORTING OF COMPLIANCE ISSUES. THESE MECHANISMS INCLUDE AN ANONYMOUS HOTLINE AND WEB SITE WHERE INDIVIDUALS MAY RAISE ISSUES, SEEK CLARIFICATION, AND REPORT POSSIBLE CONFLICTS OF INTEREST OR OTHER CONCERNS. THESE REPORTS, INCLUDING REPORTS OF POSSIBLE CONFLICTS OF INTEREST, ARE REVIEWED AND INVESTIGATED BY THE CORPORATE COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN. PART VI, SECTION B QUESTION 13 Throughout the tax year, the organization had a whistleblower policy in place although it was not approved by the organization's board of directors before June 30, 2013. The whistleblower policy has, however, been approved by the board of directors of Our Lady of the Lake Hospital, Inc. (the organization's sole-member). The organization intends to have the policy approved by filing organization's board of directors or committee thereof. PART VI, SECTION B, QUESTION 15A & 15B THE CEO'S COMPENSATION IS SET BY THE COMPENSATION COMMITTEE OF THE OUR LADY OF THE LAKE ASSUMPTION BOARD OF DIRECTORS. OTHER RELATED ORGANIZATIONS SET THE COMPENSATION AND PAY FOR OTHER PAID OFFICERS. EACH BOARD OF DIRECTORS DESIGNATES THE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY OUTSIDE SOURCES. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMPENSATION COMMITTEE. PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. STBERNARD HEALTH FUND 4200 ESSEN LANE BATON ROUGE LA 70809 204685614 HEALTHCARE LA 501(C)(3) 11 TYPE 1 FMOLHS false HEALTH PARTNERS NETWORK OF SOUTH LA 4801 AMBASSADOR CAFFERY LAFAYETTE LA 70506 HEALTHCARE LA 501(C)(3) 3 LOURDES RMC true HEALTH CARE CENTERS IN SCHOOLS 5000 HENNESSY BLVD BATON ROUGE LA 70808 721443935 HEALTHCARE LA 501(C)(3) 7 OLOL true HEART HOSPITAL OF ACADIANA 1105 KALISTE SALOOM ROAD LAFAYETTE LA 70508 300442368 HEALTHCARE LA LOURDES N/A false true PERKINS PLAZA MEDICAL ARTS DEVELOPMENT 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 450516574 REAL ESTATE LA OLOL N/A false true PERKINS PLAXA IMAGING DEVELOPMENT 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 203894521 REAL ESTATE LA OLOL N/A false true CAPITAL AREA SHARED SERVICES ORG LLC 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 275173212 HEALTHCARE LA OLOL PG N/A false true NUCLEAR IMAGING LLC 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 721470061 HEALTHCARE LA OLOL N/A false true P&S SURGERY CENTER LLC 312 GRAMMONT STREET MONROE LA 71201 721387870 HEALTHCARE LA ST FRANCIS N/A false true ST ELIZABETH-MARY BIRD PERKINS CANCER 4950 ESSEN LANE BATON ROUGE LA 70809 260628752 HEALTHCARE LA STEH N/A false true LOURDES IMAGING DEVELOPMENT LLC 4801 AMBASSADOR CAFFERY LAFAYETTE LA 70508 208326287 REAL ESTATE LA LOURDES N/A false true PARK PLACE SURGICAL HOSPITAL 901 WILSON STREET LAFAYETTE LA 70503 721404092 HEALTHCARE LA LOURDES N/A false true BRPT LAKE REHABILITATION CENTER 530 SHADOWS LANE BATON ROUGE LA 70806 721506100 HEALTHCARE LA OLOL N/A false true CONVENIENT CARE LLC 7777 HENNESSY BOULEVARD SUITE 1004 BATON ROUGE LA 70808 721439481 HEALTHCARE LA OLOL N/A false true PERKINS PLAZA AMBULATORY SURGERY CENTER 54 THE LEGENDS PARKWAY SUITE 159 EUREKA MO 63025 481264699 HEALTHCARE LA OLOL N/A false true SURGICAL SPECIALTY CENTER OF BATON ROUGE 8080 BLUEBONNET BOULEVARD BATON ROUGE LA 70810 233160962 HEALTHCARE LA OLOL N/A false true STELIZABETH IMAGING CENTER 1125 HIGHWAY 30 GONZALES LA 70737 364701565 HEALTHCARE LA STEH N/A false true REGIONAL EYE SURGERY CENTER LLC 7777 HENNESSY BLVD SUITE 400 BATON ROUGE LA 70808 721484653 HEALTHCARE LA OLOL N/A false true ST MARY'S IMAGING CENTER II LLC 4801 AMBASSADOR CAFFERY LAFAYETTE LA 70508 HEALTHCARE LA LOURDES IMAGING N/A false true NORTHEAST LA CANCER INSTITUTE 141 DESIARD STREET SUITE 704 MONROE LA 71201 721329499 HEALTHCARE LA SFMC N/A false true LHCG-XIII LLC 48420 WEST PINHOOK ROAD SUITE A LAFAYETTE LA 70506 208068308 HEALTHCARE LA LOURDES N/A false true LOURDES AFTER HOURS LLC 7777 HENNESSY BLVD SUITE 100 BATON ROUGE LA 70808 201367299 HEALTHCARE LA LOURDES N/A false true CAPITAL AREA SHARED SERVICES ORG LLC 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 275173212 HEALTHCARE LA STEP N/A false true LAKE URGENT CARE ASCENSION 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 352463092 HEALTHCARE LA OLOL N/A false true OLOL PONTCHARTRAIN SURGERY CENTER 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 461379031 HEALTHCARE TX OLOLUSP N/A false true OLOLUSP SURGERY CENTER LLC 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 352457810 HEALTHCARE LA OLOL N/A false true LAKE URGENT CARE ASCENTION LLC 10319 JEFFERSON HIGHWAY BATON ROUGE LA 70809 352463092 HEALTHCARE LA STEH N/A false true ST FRANCIS INSURANCE AGENCY 309 JACKSON STREET MONROE LA 71201 721435136 INSURANCE LA SFMC C CORP HOSPITAL ASSISTANCE SERVICES PO BOX 4027-C LAFAYETTE LA 70502 721073486 HEALTHCARE LA LOURDES C CORP LOUISE INSURANCE COMPANY PO BOX 1051 CJ KY1-1102 INSURANCE CJ FMOL C CORP NORTHEAST LA HEALTH NETWORK 309 JACKSON STREET MONROE LA 71201 721294587 HEALTHCARE LA AMBULATORY C CORP CHARITABLE REMAINDER TRUST INVESTMENT LA OLOL FOUNDATION TRUST MONROE HEALTH SERVICES PO BOX 3187 MONROE LA 72101 721057820 HEALTHCARE LA AMBULATORY C CORP FRANCISCAN HEALTH & WELLNESS SERVICES 4200 ESSEN LANE BATON ROUGE BATON ROUGE LA 70809 455492379 HEALTHCARE LA FMOL C CORP FMOL HEALTH SYSTEM HOLDINGS INC 4200 ESSEN LANE BATON ROUGE LA 70809 454405024 INVESTMENT LA FMOL C CORP false false true false false false false false false false false false true false false true true false false