2014-07-22T19:34:38-05:00 2013-10-31 800488055 Steven M DeRouen & Associates P O Box 4265 Lake Charles LA 70606 990 2012-11-01 720491106 West Louisiana Health Services Inc WEST PO Box 730 Deridder LA 70634 Darrell Kingham 3374627106 2014-07-22 false Steven M DeRouen P01050140 3375134915 2014-07-22 X 2012 2015-11-30 17:44:51Z Beauregard Memorial Hospital Darrell Kingham 42608888 false X www.beauregard.org X 1946 LA To provide medical care and health programs by operating a 60 bed facility for Hospital Service District 2 of Beauregard Parish and six physician clinics; recruit and employ physicians in HPSA. 9 9 472 94 0 0 0 34403123 36881794 335699 1375415 2777 34738822 38259986 0 0 2347614 2691591 0 0 33502768 33948568 35850382 36640159 -1111560 1619827 10401357 11869117 8422571 4181863 1978786 7687254 To provide medical care and health programs by operating a 60 bed facility for Hospital Service District 2 of Beauregard Parish and six physician clinics; recruit and employ physicians in HPSA. false false 32960799 34174481 Operated a 60 bed facility for Hospital Service District 2 of Beauregard Parish, providing general short term care to 2,482 inpatients for 9,177 days; 349 newborns; 1,393 surgeries; 16,972 ER visits; and 46,620 outpatients. 67% of hospital admissions are Medicaid and Medicare. The hospital also conducts numerous community seminars and services to benefit the community. 3679360 2707313 Operated Beauregard Physician Group which consists of six physician clinics which provide medical services to Beauregard Parish. 36640159 true false false false false false false false true false false false true false 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 true false false false false false true 41 0 true 472 true false false false false false false false false false false false false false false X 9 9 false false false false false false false true true false false true true true true true true true true false X Darrell L Kingham CPA VP of Finance 3374627100 600 South Pine Street Deridder LA 70634 Carl Slover 2.00 X 0 0 0 Ed ONeal 2.00 X 0 0 0 Gerald Johnson 2.00 X 0 0 0 Jared Morris 2.00 X X 0 0 0 Jim Morris 2.00 X X 0 0 0 Natha Gantt 2.00 X 0 0 0 Terri Theaux 2.00 X 0 0 0 Thomas Shirley DDS 2.00 X 0 0 0 Tom Rhodes 2.00 X X 0 0 0 Darrell Kingham 53.00 X 188120 0 9424 Nathan Tudor 40.00 X 9894 0 0 Theodore Badger Jr 40.00 X 204521 0 9466 Joseph Caraway 40.00 X 204221 0 14044 Darren Caillouet 40.00 X 195668 0 9945 Dr James Rudd Jr 40.00 X 334980 0 16220 Dr Janet Lewis 40.00 X 361033 0 0 Dr Jennifer McCann 40.00 X 354982 0 0 Dr Stephen Farquhar 40.00 X 209462 0 10179 2062881 0 69278 8 false true false Southern Technologies 4840 Lake Street Ste B Lake Charles LA 70605 IT Consulting 114980 Cardiology Clinic of DeRidder LLC 109 West 4th Street DeRidder LA 70634 Physician EKG 177884 2 Reimbursement from Hosp 900099 34174481 34174481 Patient Service 621400 2707313 2707313 36881794 131358 131358 5592959 4348902 1244057 1244057 1244057 Other Revenues 900099 2777 2777 2777 38259986 38259986 0 0 639690 639690 1784743 1784743 150464 150464 116694 116694 15572 15572 119467 119467 28059 28059 48432 48432 33563 33563 321 321 233388 233388 Other Professional Expenses 16394588 16394588 Fiscal & Admin Expenses 8775007 8775007 Nursing Expenses 4332689 4332689 General Service Expenses 3404566 3404566 562916 562916 36640159 36640159 0 0 2787001 4239418 702384 378402 576869 276960 21425 13446 90803 67929 5944182 3822622 901618 59377 966 2387072 10401357 11869117 1492157 4181863 6930414 8422571 4181863 X 1978786 7687254 1978786 7687254 10401357 11869117 1619827 -464955 4553596 0 X false true X true false X 7551 38 7589 7513 38 7551 7472 41 7513 7416 56 7472 7342 74 7416 false false Notes Receivable 59377 C 59377 Due from Hospital Service Dist 2386096 Other Receivables 976 2387072 X D8 Endowment funds intended uses Part V line 4 These funds are board designated to provide educational scholarships to qualifying students. D13 Footnote for uncertain tax position under FIN 48 Part X West Louisiana Health Services, Inc. is a nonprofit corporation as described in Code Section 501(c)(3) of the Internal Revenue Service and is exempt from Federal and State income taxes on related income pusuant to Section 501(a) of the code. true true true X true X true false false 5865451 4848942 1016509 0.02780 5482295 4934356 547939 0.01500 11347746 9783298 1564448 0.0428 100339 100339 0.0027 66667 66667 0.0018 4145802 2846433 1299369 0.0355 380178 380178 0.0104 4692986 2846433 1846553 0.0504 16040732 12629731 3411001 0.0932 447135 447135 0.0122 447135 447135 0.0122 true 15562799 4565281 10282540 11840338 -1557798 X true true 1 1 Hospital Service District 2

600 South Pine Street Deridder LA 70634

www.beauregard.org X X X 1 Hospital Service District 2 1 true X X X X X X X X 12 true false true X X X X X X X X X X true false true true 2.0000 true 3.00000 true X X X X true true X X X true X true X X X true X false false 1 Beauregard Physician Group

600 S Pine Street Deridder LA 70634

Eight Physician Clinics H01 Related organization annual community benefit report Part I line 6a The Community Benefit report is made available to the public upon request and on it9s website. H02 Bad debt description footnote Part III line 4 Part III, Line 4 - The accounting policy of the Hospital regarding bad debts states that the allowance method in accounting for bad debts is used. The allowance account consists of an estimate of uncollectable accounts and a general reserve. Management9s evaluation of the adequacy of the allowance is based on a continuing review of all accounts and includes a consideration of past patient history, and adverse situations that might affect the patient9s ability to pay, and current economic conditions. H03 Allowable Medicare costing methodology Part III line 8 Part III, Line 8 - The costing methodology for Medicare was derived form the Medicare Form CMS-2552 filed for the FYE 10-31-13. The Hospital continues to treat Medicare patients, even as Medicare reimbursement is declining. The Hospital views the $1,557,798 Medicare shortfall as a community benefit as all Hospital patients are accepted regardless of reimbursement. H04 Subsidized health services costs Part I line 7g Part I, Line 7g - In accordance with identified community needs the Hospital had recruited physicians to serve in the community, which is in a professional shortage area (HPSA). Subsidized health services include subsidies of $1,299,369 to eight clinics which provide orthopedic, surgical, pediatric, internal medicine, OB GYN, and family practice services to the community. H05 Debt expense included Part I line 7 col f Bad debt expense of $15,562,799 is not included on Form 990, Part IX, line 25, but is a reduction from gross receipts per generally accecpted accounting principles. H06 Costing methodology explanation Part I line 7 Part I, Line 7 - Costs on 7A and 7B were taken from the schedule of uncompensated care cost for small rural hospitals, a reported used by the Louisiana Department of Health and Hospitals to determine uncompensated Medicaid and indigent costs and reimbursements. A cost to charge ratio was also derived from worksheet 2, ratio of patient care cost to charges and used when needed. Costs on line 7E, 7F, and 7G are actual costs per records. H07 Collection practices Part III line 9b Part III, Line 9b - Regarding collection practices to be followed for patients who are known to qualify for financial assistance, the Hospital tries to conduct a pre-admission interview with the patient or gurantor prior to admission when possible. Potential charity care patients are offered the opportunity to apply for charity care at the time of admission. Outpatients and ER patients are sent a notification about charity care through the mail. Patients with no insurance receive a letter within 30 days of service, stating that the Hospital has given them a 52% discount and that they are responsible for the balance of the bill. The letter also states that the Hospital has a charity care/financial assist prog and gives the contact person9s name and phone number to obtain an application.The letter also gives the name and number to apply for Medicaid at the Hospital. The letter states the account balances that is due and that payments can be spread over 12 to 18 months. It also states that failure to pay the bill or set up financial arrangements will result in addtional collection efforts. A second letter in the following month is sent that states their account is delinquent, is due and failure to respond will result in further collection action. If no response, a third letter is sent stating their account is deliquent and is being reviewed to go to an outside collection agency. A final notice is sent stating this is a final notice, failure to pay will result in the account being placed with a collection agency, and that they must have an authorized financial agreement with the Hospital to stop the account from being placed with an outside collection agency. H08 Needs assessment Part VI question 2 The Hospital assesses the health care needs of the community through various studies, discussions with community leaders, and patient demand. H09 Patient education Part VI question 3 See 4Collection Practices4 explanation (Part III, Line 9b). H10 Community information Part VI question 4 The Hospital primarily services Beauregard Parish in Louisiana which consists of a rural population. H11 Community building activities Part II In accordance with identified community needs the Hospital trained and recruited physicians to serve in the community, which is in a professional shortage area (HPSA). H12 Promoting community health Part VI question 5 The Organization operated a 60 bed facility for Hospital Service District 2 of Beauregard Parish, providing general short term care to 2,482 inpatients for 9,177 days; 349 newborns; 1,393 surgeries; 16,972 ER visits; and 46.620 outpatients. 67% of hospital admissions are Medicaid and Medicare. The hospital also conducts numerous community seminars and services to benefit the community. H13 Affiliated health care system Part VI question 6 The Organization is not part of an affiliated health care system. H14 State filings Part VI question 7 The Organization files community benefit reports in the state of Louisiana. H15 Community representative input Part V question 3 The hospital took into account input from persons representing the community through a 3 phase plan. The 1st phase sampled 400 residents of Beauregard and Vernon Parishes for telephone interviews and data collection. The 2nd phase included sampling 38 employers of the local area and performing telephone interviews and data collection. Finally, the 3rd phase consisted of meetings with community leaders who reviewed community resident and employer survey perceptions and included roundtable group discussions. The final meeting used a group discussion format to prioritize the community healthcare needs. Community members that participated included individuals from various local banks, non-profit organizations, local government, health professionals, and community leaders. H16 Additional Information for Schedule H Bad Debt Expense Methodology (Part III, Line 2) The Organization uses the allowance method in accounting for its uncollectible accounts. The allowance account consists of an estimate of uncollectable accounts and a general reserve. Management9s evaluation of the adequacy of the allowance is basied on a continuing review of all accounts and includes a consideration of past patient history, and adverse situations that might affect the patient9s ability to repay, and current economic conditions. Estimated and known uncollectible accounts are charged off to bad debt expense. Bad Debt Expense Attributable to Patient9s Eleigible Under Organizations Financial Assistance Policy Methodology (Part III, Line 3) The bad debt expense attributable to patient9s eligible under the Organization9s Financial Assistance Policy is determined through the following calculation: Total Self-Pay/Indigent Gross Revenue $17,578,072 Less Charity Care on General Ledger at 10/31/2013 (7,949,797) Subtotal $9,628,275 Less 52% Discount Given to All Non-Insured Patients (5,006,703) Subtotal 4,621,572 Less Patient Payments Percentage of 1.218% (56,291) Sch. H, Part II, Section A Line 3 Calculation Total 4,565,281 X true true X X X X true false false false false false false false false Theodore Badger Jr 204521 9466 213987 Dr Jennifer McCann 354982 354982 Darrell Kingham 188120 9424 197544 Joseph Caraway 204221 14044 218265 Dr Janet Lewis 361033 361033 Dr James Rudd Jr 334980 16220 351200 Dr Stephen Farquhar 209462 10179 219641 Darren Caillouet 195668 9945 205613 J1 Benefit information Part I line 1a Reasonable expenses submitted for a traveling spouce (except for airfare) accompanying a trustee on approved travel is reimbursed. J4 Listed persons compensation information Part I line 4 Chief Executive Officer Theodore Badger received serverance payments from September 2012 to 2013. O01 Form 990 governing body review Part VI line 11 The Form 990 is reviewed by the board of directors prior to issuance. O02 Conflict of interest policy compliance Part VI line 12c Every January, a Conflict of Interest Questionaire is completed by each trustee. These documents are reviewed and retained in the Board of Trustee9s files. O03 CEO executive director top management comp Part VI line 15a The Board of Trustees9 Executive Committe conducts an annual performance evaluation following the end of each fiscal year. Comparable compensation data for CEOs at other similiarly situated organizations is used. Resources include the VHA Gulf States CEO Compensation Survey, the Hay Group Hospital Compensation Report, the Jackson Survey for quality goals, Health Stream Emloyee Satisfaction, Emergency Department, Inpatient, Same Day Surgery, Lab and Radiology Satisfaction Surveys, and other various reports. The CEO9s compensation is criteria based. A bonus is dependent on achieving goals in community health, quaility and financial areas. A anaysis of salary history, employee retention and self evaluation is also considered. O04 Other officer or key employee compensation Part VI line 15b Annual employee evaluations are conducted in November of each year. These evaluations consider the employee9s achievement of goals, salary, and expense budgets, compliance with quality controls and Joint Commission, performance and competency, and other criteria based objectives in determining remuneration. In addition, the CEO also considers the following salary surveys: VHA Department Head Survey, Louisiana Hospital Salary and Benefits Survey, Greater New Orleans Society for Healthcare Human Resources Administration Executive Director and Management Survey. O05 Governing documents etc available to public Part VI line 19 Information is available upon request. Beauregard Physician Group LLC PO Box 1540 Deridder LA 70634 270602265 Physician Services LA 3977735 1253435 N/A