ST MARTIN HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ST MARTIN HOSPITAL INC (EIN 26-4626264)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-14
- IRS object ID
- 201412269349302491
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-14T15:57:20-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201941244 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HORNE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1020 HIGHLAND COLONY PKWY STE 400 | AddressLine1 |
| City | RIDGELAND | City |
| State | MS | State |
| ZIP Code | 39157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264626264 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STMA | NameControl |
| Phone | 3375071201 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHERINE HEBERT | Name |
| Title | CEO | Title |
| Phone | 3375071201 | Phone |
| Date Signed | 2014-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARSHA H DIECKMAN CPA | Name |
| PTIN | P00246741 | PTIN |
| Phone | 6013261000 | Phone |
| Date Prepared | 2014-08-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KATHERINE HEBERT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16582982 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARTINHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2009 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | THE ORGANIZATION PROVIDES MEDICAL CARE TO IMPROVE, MAINTAIN, AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 167 | TotalNbrEmployees |
| Total Nbr Volunteers | 52 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 40 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17345024 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16428076 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 63889 | OtherRevenuePriorYear |
| Other Revenue Current Year | 154866 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17408919 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16582982 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2482 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3596 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5621378 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6583701 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10782242 | OtherExpensePriorYear |
| Other Expenses Current Year | 11297441 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 16406102 | TotalExpensesPriorYear |
| Total Expenses Current Year | 17884738 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1002817 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1301756 | RevenuesLessExpensesCY |
| Total Assets BOY | 7288911 | TotalAssetsBOY |
| Total Assets EOY | 7335156 | TotalAssetsEOY |
| Total Liabilities BOY | 4468821 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5816822 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2820090 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1518334 | NetAssetsOrFundBalancesEOY |
| Mission Description | ST. MARTIN HOSPITAL'S MISSION IS TO IMPROVE, MAINTAIN AND RESTORE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14625470 | Expense |
| Grants | 3596 | Grants |
| Revenue | 16559932 | Revenue |
| Description | COMMUNITY MEDICAL CARE PROVIDER. THE ORGANIZATION PROVIDES NEEDED MEDICAL CARE TO THE PARISH REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SERVICES INCLUDE INPATIENT AND OUTPATIENT CARE IN FURTHERANCE OF THE ORGANIZATION'S HEALTHCARE MISSION.PROGRAM SERVICE STATISTICS RELATED TO PROVIDING MEDICAL CARE FOR THE HOSPITAL: TOTAL PATIENT DAYS WERE 3,369, TOTAL EMERGENCY ROOM VISITS WERE 15,359, AND TOTAL REHAB VISITS WERE 8,926. | Description |
| Total Program Service Expense | 14625470 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 40 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 167 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATHERINE D HEBERT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3375071201 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DAVID CALLECOD | ||||||||
| CHAIRMAN/CEO - LGHS | 1.00 | 42.00 | X | X | 0 | 765892 | 145251 | |
| KATHERINE D HEBERT | ||||||||
| CEO/SECRETARY | 40.00 | 1.00 | X | X | 0 | 219825 | 41760 | |
| ED KRAMPE | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | ||
| DR WARREN DEGATUR | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| BURTON DUPUIS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DOLLIE HAMNER | ||||||||
| PHARMACIST | 40.00 | 123041 | 0 | 4207 | X | |||
| DEBORAH K HIGGINBOTHAM | ||||||||
| RN | 53.00 | 109254 | 0 | 2330 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 232295 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 985717 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 193548 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CORRECT CARE INC | |||||
| PO BOX 9146 | MANDEVILLE | LA | 70470 | ER PHYSICIAN SERVICES | 1562556 |
| SOUTHWEST CONTRACTORS LLC | |||||
| 100 CENTRAL STREET STE 100 | LAFAYETTE | LA | 70501 | CONSTRUCTION CONTRACTORS | 759365 |
| REHABCARE GROUP INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 631502096 | CONTRACTED REHAB DEPT | 658741 |
| CARDIOVASCULAR INSTITUTE OF THE SOUTH | |||||
| 225 DUNN STREET | HOUMA | LA | 70360 | CARDIOLOGY DIAGNOSTIC SERVICES | 305273 |
| POCHE PROUET ASSOCIATES | |||||
| 100 CENTRAL STREET STE 200 | LAFAYETTE | LA | 70501 | ARCHITECTURAL FEES | 161794 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 40 | AllOtherContributions |
| Total Contributions | 40 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 16428076 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16428076 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16428076 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23010 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23010 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23010 | TotalRevenueColumn |
| Exclusion | $23,010 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OTHER REVENUE | 900099 | 105961 | 105961 |
| DIETARY REVENUE | 722210 | 25895 | 25895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 131856 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16582982 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16559932 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $23,010 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3596 | Total |
| Program Services | 3596 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5675183 | Total |
| Program Services | 5034168 | ProgramServices |
| Management And General | 641015 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44035 | Total |
| Program Services | 37674 | ProgramServices |
| Management And General | 6361 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442212 | Total |
| Program Services | 388929 | ProgramServices |
| Management And General | 53283 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 422271 | Total |
| Program Services | 370982 | ProgramServices |
| Management And General | 51289 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 272056 | Total |
| Management And General | 272056 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31000 | Total |
| Program Services | 151 | ProgramServices |
| Management And General | 30849 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 183290 | Total |
| Program Services | 89323 | ProgramServices |
| Management And General | 93967 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276655 | Total |
| Program Services | 163675 | ProgramServices |
| Management And General | 112980 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7958 | Total |
| Program Services | 3551 | ProgramServices |
| Management And General | 4407 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4470 | Total |
| Program Services | 3264 | ProgramServices |
| Management And General | 1206 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 284501 | Total |
| Program Services | 18181 | ProgramServices |
| Management And General | 266320 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242813 | Total |
| Program Services | 242813 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62157 | Total |
| Management And General | 62157 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 4291701 | 4291701 | |
| CONTRACT LABOR | 3545143 | 2146173 | 1398970 |
| MEDICAL SUPPLIES | 964896 | 963670 | 1226 |
| EQUIP. RENTAL & REPAIR | 784301 | 602863 | 181438 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 346500 | Total |
| Program Services | 264756 | ProgramServices |
| Management And General | 81744 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17884738 | Total |
| Program Services | 14625470 | ProgramServices |
| Management And General | 3259268 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 377555 | BOY |
| EOY | 462248 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3701464 | BOY |
| EOY | 1901143 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 279378 | BOY |
| EOY | 405245 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74449 | BOY |
| EOY | 14487 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4515328 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 589115 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2349662 | BOY |
| EOY | 3926213 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 506403 | BOY |
| EOY | 625820 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7288911 | BOY |
| EOY | 7335156 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 780759 | BOY |
| EOY | 854635 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3688062 | BOY |
| EOY | 4962187 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4468821 | BOY |
| EOY | 5816822 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2820090 | BOY |
| EOY | 1518334 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2820090 | BOY |
| EOY | 1518334 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7288911 | BOY |
| EOY | 7335156 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1301756 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
Total Grassroots Lobbying TotalGrassrootsLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 3249 | FilingOrganizationsTotals |
| Affiliated Group Totals | 27838 | AffiliatedGroupTotals |
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 3249 | FilingOrganizationsTotals |
| Affiliated Group Totals | 27838 | AffiliatedGroupTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 14622221 | FilingOrganizationsTotals |
| Affiliated Group Totals | 317991369 | AffiliatedGroupTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 14625470 | FilingOrganizationsTotals |
| Affiliated Group Totals | 318019207 | AffiliatedGroupTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 881274 | FilingOrganizationsTotals |
| Affiliated Group Totals | 1000000 | AffiliatedGroupTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 220319 | FilingOrganizationsTotals |
| Affiliated Group Totals | 250000 | AffiliatedGroupTotals |
Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 826841 | CurrentYearMinus1 |
| Current Year | 881274 | CurrentYear |
| Total | 1708115 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $2,562,173 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 1821 | CurrentYearMinus1 |
| Current Year | 3249 | CurrentYear |
| Total | 5070 | Total |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 206710 | CurrentYearMinus1 |
| Current Year | 220319 | CurrentYear |
| Total | 427029 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $640,544 | GrassrootsCeilingAmount |
Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 1821 | CurrentYearMinus1 |
| Current Year | 3249 | CurrentYear |
| Total | 5070 | Total |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART IV, SUPPLEMENTAL INFORMATION: | Identifier |
| Explanation | ALL LOBBYING ACTIVITIES OCCUR INDIRECTLY THROUGH LOUISIANA HOSPITAL ASSOCIATION AND THE RURAL HOSPITAL COALITION. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW SUCH DUES PAID TO THESE TWO ORGANIZATIONS ARE USED. | Explanation |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2576065 | OtherCostOrOtherBasis |
| Depreciation | 282007 | Depreciation |
| Book Value | 2294058 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 605136 | OtherCostOrOtherBasis |
| Depreciation | 51701 | Depreciation |
| Book Value | 553435 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 787161 | OtherCostOrOtherBasis |
| Depreciation | 255407 | Depreciation |
| Book Value | 531754 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 546966 | OtherCostOrOtherBasis |
| Book Value | 546966 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3926213 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER ASSETS | 26766 |
| OTHER ACCOUNTS RECEIVABLE | 292445 |
| RELATED PARTY RECEIVABLES | 306609 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 625820 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| OTHER ACCOUNTS PAYABLE | $1,393,910 |
| RELATED PARTY PAYABLES | $81 |
| CAPITAL LEASE OBLIGATION | $3,568,196 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4962187 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACS 740. FASB ACS 740 PRESCRIBES A RECOGNITION 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 ORGANIZATION'S VARIOUS FEDERAL INCOME TAX AND EXEMPT ORGANIZATION INCOME TAX RETURNS (IRS FORMS 1065, 1120, AND 990), WHETHER FILED ON A CALENDAR OR FISCAL YEAR BASIS, ARE SUBJECT TO EXAMINATION BY THE IRS. THE INCOME TAX RETURNS FOR YEARS 2010 THROUGH 2012 ARE SUBJECT TO EXAMINATION BY THE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6949 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2433858 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2426909 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1979249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1273680 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 705569 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05190 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1986198 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3707538 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1721340 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05190 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1141629 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 429299 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 712330 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05240 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3596 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3596 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1145225 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 429299 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 715926 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05270 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3131423 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4136837 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1005414 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10460 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $4,291,701 | BadDebtExpenseAmount |
| Amount Attributable To | 3433360 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7262838 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6827096 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 435742 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 CHAMPAGNE BLVD | AddressLine1 |
| City | BREAUX BRIDGE | City |
| State | LA | State |
| ZIP Code | 70517 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARTIN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7: THE HOSPITAL USED TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, EXCLUDING BAD DEBT EXPENSE. A COST-TO-CHARGE RATIO WAS USED TO ESTIMATE COSTS INCLUDED IN LINE 7. THE COST-TO-CHARGE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, AS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H. | |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4291701. | |
| PART II: WE PROVIDE HEALTH SCREENINGS, WHICH INCLUDE BLOOD PRESSURE CHECKS, GLUCOSE SCREENING AND EKGS. WE ALSO PROVIDE EDUCATIONAL PROGRAMS WITHIN OUR COMMUNITY. | |
| PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS READS: THE ORGANIZATION REPORTS ACCOUNTS RECEIVABLE NET OF ESTIMATED ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS AND ADJUSTMENTS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE ORGANIZATION ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING AMOUNT OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE AMOUNT CHARGED TO THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON THE ORGANIZATION'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, AND TRENDS IN GOVERNMENT REIMBURSEMENT. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN OFF WHEN THE ORGANIZATION HAS DETERMINED THE ACCOUNT WILL NOT BE COLLECTED.BAD DEBT EXPENSE REFLECTED IN PART III EQUALS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL ANALYZED THE POPULATION THAT WAS WRITTEN OFF TO BOTH CHARITY AND BAD DEBT DURING THE YEAR. IT WAS ESTIMATED THAT AT LEAST 80% OF THE PATIENTS THAT WERE ADJUSTED TO BAD DEBT ARE LIKELY PATIENTS THAT COULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE POLICY BUT DID NOT OR ARE UNWILLING TO INITIATE OR COMPLETE THE NECESSARY DOCUMENTATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. HOWEVER, HOSPITAL BELIEVES THAT THE COST OF THIS BAD DEBT IS A COMMUNITY BENEFIT BECAUSE BY CONTINUING TO TREAT PATIENTS THAT ARE UNABLE TO AFFORD CARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL CARE. | |
| PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 WAS THE STANDARD MEDICARE COST REPORT COST SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITALS FILED 2013 COST REPORT. THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE HOSPITAL DID NOT INCLUDE THE MEDICARE SHORTFALL IN OUR COMMUNITY BENEFIT CALCULATIONS REPORTED ON PART I, LINE 7. | |
| PART III, LINE 9B: WE SEEK TO SCREEN PATIENTS TO DETERMINE IF THEY HAVE THIRD PARTY COVERAGE OR ASSIST THEM IN APPLYING FOR FEDERAL ASSISTANCE. IF THEY DO NOT HAVE THIRD PARTY COVERAGE OR CANNOT QUALIFY FOR FEDERAL ASSISTANCE, WE THEN SCREEN TO SEE IF THEY MEET QUALIFICATIONS FOR OUR CHARITY CARE PROGRAM. THOSE NOT QUALIFYING FOR CHARITY CARE ,WE TRY TO COLLECT OR MAKE MONTHLY PAYMENT ARRANGEMENTS, IF THEY DO NOT COMPLY WE WILL REFER TO OUR COLLECTION AGENCY. | |
| PART V, SECTION B, LINE 1J: CHNA ALSO DESCRIBES THE INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND THE FOCUS GROUPS USED IN ORDER TO OBTAIN DATA. | ST. MARTIN HOSPITAL |
| PART V, SECTION B, LINE 3: INTERVIEW METHODOLOGYEIGHT INTERVIEWS WERE CONDUCTED IN-PERSON FROM NOVEMBER 13-14, 2012. INTERVIEWS REQUIRED APPROXIMATELY 30 MINUTES TO COMPLETE. INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY. ADDITIONALLY, THE FOLLOWING COMMUNITY-FOCUSED QUESTIONS WERE USED AS THE BASIS FOR DISCUSSION:-INTERVIEWEE'S NAME-INTERVIEWEE'S TITLE-INTERVIEWEE'S ORGANIZATION-OVERVIEW INFORMATION ABOUT THE INTERVIEWEE'S ORGANIZATION-WHAT ARE THE TOP THREE STRENGTHS OF THE COMMUNITY?-WHAT ARE THE TOP THREE HEALTH CONCERNS OF THE COMMUNITY?-WHAT ARE THE HEALTH ASSETS AND RESOURCES AVAILABLE IN THE COMMUNITY?-WHAT ARE THE HEALTH ASSETS OR RESOURCES THAT THE COMMUNITY LACKS?-WHAT ASSETS OR RESOURCES IN THE COMMUNITY ARE NOT BEING USED TO THEIR FULL CAPACITY?-WHAT ARE THE BARRIERS TO OBTAINING HEALTH SERVICES IN THE COMMUNITY?-WHAT IS THE SINGLE MOST IMPORTANT THING THAT COULD BE DONE TO IMPROVE THE HEALTH IN THE COMMUNITY?-WHAT CHANGES OR TRENDS IN THE COMMUNITY DO YOU EXPECT OVER THE NEXT FIVE YEARS?-WHAT OTHER INFORMATION CAN BE PROVIDED ABOUT THE COMMUNITY THAT HAS NOT ALREADY BEEN DISCUSSED?THESE INTERVIEWS WERE CONDCUTED WITH THE FOLLOWING COMMUNITY LEADERS:JODY WEST,COORDINATOR, ST. MARTIN PARISH SCHOOL-BASED HEALTH CENTER, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONJACK DALE DELHOMME, MAYOR-CITY OF BREAUX BRIDGE, AREA REPRESENTED: ELECTED OFFICIALDR. GUS INGRALDI, CARDIOLOGIST-CARDIOVASCULAR INSTITUTE OF THE SOUTH, AREA REPRESENTED: PHYSICIANSTACEY SAVOY, COMMUNITY HEALTH SERVICES COORDINATOR-ST. MARTIN HEALTH UNIT, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONFRANCINE GUILLORY, PSYCHOTHERAPIST/WELLNESS COUNSELOR, AREA REPRESENTED: MENTAL HEALTHAIMEE GUIDRY, NURSE PRACTITIONER-PARTNERS IN HEALTH CARE, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONDIANE SANT, ACADIANA HOME HEALTH, AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONTEDDY THOMAS, CLERK/NUTRITION EDUCATOR-ST. MARTIN HEALTH UNIT AREA REPRESENTED: COMMUNITY HEALTH ORGANIZATIONIN ADDITION TO INTERVIEWS WITH COMMUNITY LEADERS, FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED TO ALLOW PARTICIPANTS TO PROVIDE INFORMATION ABOUT THEIR EXPERIENCES IN THE COMMUNITY AND WAYS IN WHICH THEY THINK THE SERVICES AND RESOURCES PROVIDED TO THE COMMUNITY CAN BE IMPROVED. PARTICIPANTS COMPLETED A DEMOGRAPHIC QUESTIONNAIRE AND A CONSENT FORM AGREEING TO PARTICIPATE IN THE FOCUS GROUP. THE REQUESTED INFORMATION INCLUDED: -GENDER-AGE -ZIP CODE -ETHNICITY -RACE -EDUCATION LEVEL -EMPLOYMENT STATUS -HOUSEHOLD INCOME -HEALTH INSURANCE STATUS | ST. MARTIN HOSPITAL |
| PART V, SECTION B, LINE 7: UNADDRESSED PRIORITIES INCLUDED:COMMUNICABLE DISEASE: INTERVIEWEES EXPRESSED CONCERN MOSTLY RELATING TO PEDIATRIC IMMUNIZATION RATES. ST. MARTIN HOSPITAL DOES NOT OFFER WOMEN'S OR PEDIATRIC HEALTH SERVICES, AND DOES NOT ADVERTISE LABOR AND DELIVERY SERVICES TO THE COMMUNITY. NOT ONLY ARE RESOURCES LIMITED TO ACCOMODATE THE NEED, ST. MARTIN HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS PEDIATRIC HEALTHCONCERNS AMONG ITS PHYSICIANS AS THEIR COMPETENCIES ARE FOCUSED ON OTHER AREAS OF MEDICINE.MENTAL HEALTH: ST. MARTIN HOSPITAL DOES NOT HAVE A BEHAVIORAL HEALTH UNIT. THEY DO NOT HAVE THE RESOURCES OR EXPERTISE TO CONTINUOUSLY REMAIN ACTIVE IN THE SEARCH FOR ENHANCEMENT IN MENTALHEALTH SERVICES. THE HOSPITAL'S FOCUS IS TO ENHANCE MEDICAL SERVICES IN THE COMMUNITY TO MEET OTHER HEALTH NEEDS MORE WITHIN THEIR SCOPE OF CARE AND COMPETENCY.SUBSTANCE ABUSE: ST. MARTIN HOSPITAL DOES NOT HAVE A BEHAVIORAL HEALTH OR ACUTE SUBSTANCE ABUSE TREATMENT UNIT. THE HOSPITAL DOES NOT HAVE THE RESOURCES OR EXPERTISE TO CONTINUOUSLY REMAINACTIVE IN THE SEARCH FOR ENHANCEMENT IN SUBSTANCE ABUSE SERVICES. THE HOSPITAL'S FOCUS IS TO ENHANCE MEDICAL SERVICES IN THE COMMUNITY TO MEET OTHER HEALTH NEEDS MORE WITHIN THEIR SCOPE OF CARE AND COMPETENCY. | ST. MARTIN HOSPITAL |
| PART V, SECTION B, LINE 20D: THE AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS ARE BASED ON A SLIDING SCALE MODEL INCORPORATING THE POVERTY INCOME GUIDELINES. THE INDIVIDUAL'S INCOME LIMITS AND QUALIFYING FAMILY SIZE ARE COMPARED TO THE SLIDING SCALE AND THE MAXIMUM AMOUNT THAT CAN BE CHARGED IS DETERMINED. | ST. MARTIN HOSPITAL |
| PART VI, LINE 2: THE HOSPITAL DOES HAVE A BOARD OF TRUSTEES AND MEMBERS OF THE CORPORATION COMPRISED OF INDIVIDUALS FROM THE LOCAL COMMUNITY, WHICH ARE INDEPENDENTLY AWARE OF THE MEDICAL NEEDS OF THE COMMUNITY. SURPLUS RECEIPTS OVER DISBURSEMENTS ARE INVESTED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES AND EQUIPMENT, ADVANCE MEDICAL TRAINING AND EDUCATI0N. THE H0SPITAL ALSO MAINTAINS AN OPEN MEDICAL STAFF.A FORMAL NEEDS ASSESSMENT WAS UNDERTAKEN FOR YEAR ENDING 9/30/13. WE ENGAGED THE CARNAHAN GROUP TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS COMPLETED IN JUNE OF 2013. THIS ASSESSMENT INCLUDES USING NATIONAL DATA, INTERVIEWS WITH HEALTHCARE PROVIDERS IN THE COMMUNITY AND FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY CITIZENS.THE CHNA CAN BE ACCESSED AT: HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/ST-MARTIN-COMMUNITY-NEEDS-ASSESSMENT.PDF | |
| PART VI, LINE 3: WE POST A NOTICE THAT WE HAVE A CHARITY POLICY THAT PROVIDES FOR FINANCIAL ASSISTANCE TO THOSE THAT MEET SPECIFIC CRITERIA IN THE RECEPTION AREA OF THE HOSPITAL. | |
| PART VI, LINE 4: WE ARE LOCATED IN A RURAL PARISH IN LOUISIANA. ST. MARTIN PARISH IS AN AGRICULTURAL COMMUNITY WITH COMMERCIAL FISHING. WE ARE THE ONLY HOSPITAL IN OUR PARISH (ST. MARTIN). WE ALSO HAVE BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA.THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING GEOGRAPHIC AND DEMOGRAPHIC AREAS, IS ADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED DURING 2013. THE CHNA CAN BE ACCESSED AT:HTTP://WWW.LAFAYETTEGENERAL.COM/SITES/WWW/UPLOADS/FILES/COMMUNITY%20REPORTS/ST-MARTIN-COMMUNITY-NEEDS-ASSESSMENT.PDF | |
| PART VI, LINE 5: OUR BOARD OF TRUSTEES IS COMPRISED OF MEMBERS FROM OUR COMMUNITY, WHICH MAKE UP OUR PRIMARY SERVICE AREA. ST. MARTIN HOSPITAL EXTENDS PRIVILEGES TO PRIMARY CARE PHYSICIANS IN OUR COMMUNITY. SURPLUS FUNDS ARE USED TO PROVIDE CAPITAL IMPROVEMENTS TO OUR HOSPITAL TO ENRICH THE QUALITY CARE THAT WE PROVIDE. WE ALSO RECRUIT PHYSICIANS INTO OUR COMMUNITY, ORGANIZE FUND-RAISERS FOR CANCER RESEARCH THROUGH OUR PARTICIPATION IN THE RELAY FOR LIFE. WE ALSO PROVIDE SUPPORT TO THE UNITED WAY OF ACADIANA BY HAVING A FUND-RAISING CAMPAIGN AND HAVING MEMBERS OF OUR STAFF ON THEIR BOARD AND COMMITTEES. | |
| PART VI, LINE 6: THE HOSPITAL IS OWNED BY LAFAYETTE GENERAL MEDICAL CENTER. THIS ALLIANCE HAS ALLOWED THE HOSPITAL TO EXTEND ITS OUTREACH TO ALL THE CITIZENS OF ST. MARTIN PARISH. THE HOSPITAL WAS ABLE TO EXPAND ITS OUTPATIENT AND EMERGENCY SERVICES. THE HOSPITAL WAS ALSO ABLE TO ENRICH ITS INPATIENT SERVICES BY IMPLEMENTING A HOSPITALIST PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID CALLECOD | ||||||||||||||
| CHAIRMAN/CEO - LGHS | 0 | 572400 | 0 | 175154 | 0 | 18338 | 0 | 135225 | 0 | 10026 | 0 | 911143 | 0 | 0 |
| KATHERINE D HEBERT | ||||||||||||||
| CEO/SECRETARY | 0 | 187387 | 0 | 28670 | 0 | 3768 | 0 | 32351 | 0 | 9409 | 0 | 261585 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 4B | A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (SERP) WAS ADOPTED BY LAFAYETTE GENERAL MEDICAL CENTER, THE SOLE MEMBER OF ST. MARTIN HOSPITAL, EFFECTIVE JANUARY 01, 2008. THE SERP IS CLASSIFIED AS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, THE PURPOSE OF WHICH IS TO PROVIDE PARTICIPANTS WITH SUPPLEMENTAL RETIREMENT BENEFITS. CONTRIBUTION FOR THE YEAR WAS $400,100, WHICH INCLUDES BOTH LAFAYETTE GENERAL MEDICAL CENTER AND ST. MARTIN HOSPITAL EMPLOYEES. THE BOARD DETERMINES WHICH EMPLOYEES ARE ELIGIBLE FOR PLAN CONTRIBUTIONS. PARTICIPANTS WERE DAVID CALLECOD, CEO OF LAFAYETTE GENERAL HEALTH SYSTEMS AND KATHERINE D. HEBERT, CEO OF ST. MARTIN HOSPITAL. |
| PART I, LINE 6 | THE ORGANIZATION DOES HAVE A PROFIT SHARING PLAN (SUCCESS SHARING) FOR ALL EMPLOYEES IN GOOD STANDING, DETERMINED IN PART ON NET EARNINGS. THE CRITERIA USED TO DETERMINE IF PROFIT SHARING WILL BE MADE IS BASED ON METRICS DEVELOPED WITHIN FIVE AREAS; 20% EMPLOYEES, 15% SERVICE, 20% QUALITY, 35% FUNDING OUR FUTURE, AND 10% GROWTH. EARNINGS IN EXCESS OF BUDGETED EARNINGS MUST BE AVAILABLE FOR PROFIT SHARING TO BE PAID. THE OFFICERS, AS LISTED ON PART VII OF FORM 990, CALCULATION OF PROFIT SHARING IS IN PART BASED ON THE CONSOLIDATED NET EARNINGS. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN J DEGATOR JR MD INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | WARREN DEGATUR, BOARD MEMBER, IS SOLE OWNER OF WARREN J DEGATOR JR MD INC. | Relationship |
| Amount Of Transaction | 61689 | AmountOfTransaction |
| Description Of Transaction | DR. DEGATUR'S PRACTICE WAS ISSUED A FORM 1099 IN THE AMOUNT OF $61,688.69. OF THIS AMOUNT, 41,919.86 WAS FOR INCOME GUARANTEE PAYMENTS, UNDER AGREEMENT, BETWEEN THE PRACTICE AND THE HOSPITAL. $6,000 WAS FOR ON CALL PAY, $6,000 WAS FOR MEDICAL DIRECTOR PAY, AND THE REMAINDER WAS FOR START UP EXPENES RELATED TO THE INCOME GUARANTEE. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS A NON-STOCK NOT-FOR-PROFIT CORPORATION WITH ONE CLASS OF MEMBERSHIP |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS RATIFY THE SELECTION OF THE INDIVIDUALS THAT SERVE ON THE BOARD OF TRUSTEES (GOVERNING BODY) AFTER THOSE INDIVIDUALS HAVE BEEN SELECTED AS A TRUSTEE BY THE BOARD OF TRUSTEES |
| FORM 990, PART VI, SECTION A, LINE 7B | YES, THE INDIVIDUALS OF THE TRUSTEES (GOVERNING BODY) AND THE MEMBERS MUST BE APPROVED BY THE MEMBERSHIP BODY |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S ACCOUNTING STAFF THE COMPLETED FORMS ARE REVIEWED BY THE OFFICERS AND THEN PRESENTED TO THE BOARD FOR REVIEW, COMMENT AND CORRECTIONS IF NEEDED BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL SURVEY IS SENT TO THE BOARD MEMBERS AND OFFICERS REQUIRING THEM TO DISCLOSE CONFLICTS OF INTEREST. AFTER RECEIPT OF THESE SURVEYS, THE GOVERNANCE COMMITTEE AND ITS CHAIRPERSON REVIEW ALL CONFLICTS AND REPORT ON SAME TO THE GOVERNANCE COMMITTEE; THEREAFTER, THE CHAIRPERSON OF THE GOVERNANCE COMMITTEE AND THE ORGANIZATION'S GENERAL COUNCIL (WHO ATTENDS ALL BOARD MEETINGS) INSURES THAT ALL CONFLICTS ARE TIMELY DISCLOSED AND APPROPRIATE RECUSALS ARE MADE ON BUSINESS MATTERS THAT MAY BE RELATED TO THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15A | AN INDEPENDENT EXTERNAL CONSULTANT FIRM, SULLIVAN COTTER AND ASSOCIATES, IS ENGAGED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, WHICH IS COMPRISED OF DISINTERESTED DIRECTORS, TO PREPARE COMPENSATION SURVEY AND FAIR MARKET VALUE REPORT. THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE MARKET COMPARABLES AND MAKES ADJUSTMENT THE PRESIDENT/CEO'S COMPENSATION THEREAFTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | OTHER DOCUMENTS AND FINANCIAL INFORMATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHIN THE PARAMETERS OF REGULATORY/LEGAL AUTHORITIES. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM PREVIOUS YEAR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAFAYETTE GENERAL MEDICAL CENTER INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 720535375 | HOSPITAL | LA | 501(C)(3) | 170(B)(1)(A) (III) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| LAFAYETTE HEALTH VENTURES INC | |||||||||||
| PO BOX 53092 | LAFAYETTE | LA | 70503 | 721006966 | PHYSICIAN PRACTICES | LA | 501(C)(3) | 509 (A)(3) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
| LAFAYETTE GENERAL HEALTH SYSTEMS INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 383646817 | HEALTHCARE SUPPORT | LA | 501(C)(3) | 509 (A)(3) | 0 | N/A | |
| UNIVERSITY HOSPITAL & CLINICS INC | |||||||||||
| 1214 COOLIDGE BLVD | LAFAYETTE | LA | 70503 | 462605366 | HOSPITAL | LA | PENDING 501(C)(3) | 170(B)(1)(A) (III) | LAFAYETTE GENERAL HEALTH SYSTEMS | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| LAFAYETTE INVESTMENT GROUP LLC | |||||||
| 1000 W PINHOOK SUITE 206 | LAFAYETTE | LA | 70503 | 421594593 | MANAGEMENT | LA | N/A |
| LAFAYETTE GENERAL SURGICAL HOSPITAL LLC | |||||||
| 1000 W PINHOOK | LAFAYETTE | LA | 70503 | 481300080 | SURGICAL HOSPITAL | LA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER LAFAYETTE PHYSICIANS HOSPITAL ORG | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 AUDUBON BLVD | AddressLine1 |
| City | LAFAYETTE | City |
| State | LA | State |
| ZIP Code | 70503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721286969 | EIN |
| Primary Activity | SUPPORT SERVICES | PrimaryActivity |
| Legal Domicile State | LA | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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