2013-05-15T16:22:42-05:00 2012-06-30 721202445 POSTLETHWAITE & NETTERVILLE ONE GALLERIA BLVD STE 2100 METAIRIE LA 70001 990 2011-07-01 721332678 DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS DAUG 5044822080 PO BOX 4148 NEW ORLEANS LA 701784148 MICHAEL GRIFFIN 5044822080 2013-05-15 1 SHARON CASSIERE P00543368 5048375990 2011 2016-02-24 21:20:13Z X MICHAEL GRIFFIN PO BOX 4148 NEW ORLEANS LA 701784148 19220424 0 0928 X WWW.DCSNO.ORG X 1997 LA TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. 6 6 178 6 0 0 3466330 7189262 4262602 11326280 30898 13072 37277 593608 7797107 19122222 1411977 0 0 0 5559924 6114130 0 0 0 4228410 4618795 11200311 10732925 -3403204 8389297 21414110 30198776 14339879 15093529 7074231 15105247 X DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS' (DCSNO) MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY AND TO BE A PRESENCE OF THE LOVE OF JESUS IN THE LIVES OF ALL WE SERVE AND WITH WHOM WE PARTNER. 0 1 7982325 11326280 DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS PROVIDES HEALTH CARE SERVICES, EDUCATION AND COUNSELING SERVICES TO THE POOR AND WORKING POOR OF THE NEW ORLEANS AREA. TOTAL SERVICES INCLUDED 113,623 ENCOUNTERS. DURING THE YEAR, DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS PROVIDED MEDICAL CARE, DENTAL SERVICES, BEHAVIORAL HEALTH COUNSELING, PHARMACY, AND OPTOMETRY SERVICES. 134986 TO SUPPORT DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS FOUNDATION, A RELATED ENTITY, WHICH WAS ESTABLISHED TO PARTICIPATE IN THE ACQUISITION AND CONSTRUCTION BY DCSNO OF TWO NONPROFIT MEDICAL CENTERS LOCATED AT 3201 SOUTH CAROLLTON AVENUE AND 4201 NORTH RAMPART STREET, NEW ORLEANS, LOUISIANA, AS PART OF THE NEW MARKETS TAX CREDIT TRANSACTION, BY ACTING AS A LEVERAGE LENDER TO THE INVESTMENT FUND PROVIDING EQUITY TO THE PROJECT. 8117311 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 1 18 0 1 178 1 0 0 0 0 0 1 1 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X TOM MASSEY CFO 5042129505 3201 S CARROLLTON AVENUE NEW ORLEANS LA 70118 SR PATRICIA BACHMAN DC 1.00 X 0 0 0 MR JUAN BARETTO 1.00 X 0 0 0 DR JOHN J ESTRADA 1.00 X 0 0 0 MR SAM LEBLANC 1.00 X 0 0 0 MRS STEPHANIE RHODES NAVARRE 1.00 X 0 0 0 MR RODERIC F TEAMER 1.00 X 0 0 0 MR ROBERT ANGELICO 1.00 X X 0 0 0 MRS THERESE M BADON 1.00 X X 0 0 0 SR MARIE THERESE SEDGWICK DC 1.00 X X 0 0 0 MR MICHAEL S TODD 1.00 X X 0 0 0 MR MICHAEL G GRIFFIN 40.00 X 123010 0 11197 MR TOM MASSEY 40.00 X 126923 0 5316 LOUIS BEVROTTE 40.00 X 211564 0 3063 WILLARD DUMAS 40.00 X 144846 0 0 JAY DUMAS 40.00 X 143909 0 2856 CAROLINA URBIZO 40.00 X 143806 0 2831 CASEY WILLIAMS 40.00 X 143198 0 4313 1037256 0 29576 16 0 1 0 DONAHUE FAVRET CONTRACTORS 3030 EAST CAUSEWAY APPROACH MANDEVILLE LA 70448 CONTRACTOR 712547 SUCCESS EHS ONE METROPLEX DR SUITE 500 BIRMINGHAM AL 35209 INFORMATION SYSTEMS 221418 THE FISHER CONSULTATING GROUP LTD PO BOX 987 PRAIRIEVILLE LA 70769 CONSULTING 215810 BARBARA ENTERPRISES INC 22278 10TH ST ABITA SPRINGS LA 70420 CONTRACTOR 149937 LISKOW & LEWIS APLC 701 POYDRAS ST SUITE 5000 NEW ORLEANS LA 70139 LEGAL 140688 8 101912 189926 513680 6383744 3625 7189262 MEDICARE/MEDICAID PAYM 621110 8296558 8296558 CLINICAL SERVICE FEES 621110 2987144 2987144 MEDICAL RECORD FEES 621110 42578 42578 11326280 13072 13072 282656 0 282656 282656 282656 10619 101912 98202 -87583 -87583 PENSION RELATED CHANGE 900099 202208 202208 LA ENTERPRISE ZONE TAX 900099 196327 196327 398535 19122222 11326280 0 606680 222380 222380 4800007 3653829 1146178 59101 15864 43237 588102 534400 53702 444540 334621 109919 59877 31007 28870 34050 17633 16417 1054806 646611 408195 143377 63455 79922 601315 468291 133024 5839 3872 1967 72529 12784 59745 158670 154455 4215 855673 828186 27487 141537 108145 33392 SUPPLIES 804554 763975 40579 BAD DEBTS 460279 460279 CONSUMER AWARENESS 178429 11684 166745 TEMPORARY EMPLOYEES / I 27995 3360 24635 19865 4860 15005 10732925 8117311 2615614 0 57364 4281550 635577 1558382 2763804 3343535 95793 158799 169642 243921 18103613 1961294 15823956 16142319 1867974 4470270 21414110 30198776 148952 631679 13692217 13644163 498710 817687 14339879 15093529 X 4739228 12911761 2335003 2193486 7074231 15105247 21414110 30198776 X 8389297 -358281 X X 0 1 1 X 1 1 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PART I, LINE 3 SCHEDULE H IS NOT REQUIRED TO BE COMPLETED PER THE INSTRUCTIONS FOR SCHEDULE A, LINE 3. PER THE INSTRUCTIONS AND DEFINITIONS FOR BOTH SCHEDULE A, LINE 3 AND FORM 990, PART IV, LINE 20, SCHEDULE H IS NOT REQUIRED TO BE ATTACHED. DSCNO IS A MEDICAL GROUP THAT IS NOT REGULATED OR REGISTERED WITH THE STATE OF LOUISIANA AS A HOSPITAL. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1622516 1622516 12212093 672821 11539272 199222 68739 130483 3043597 958283 2085314 1026185 261451 764734 16142319 HEALTH SYSTEM DEPOSITORY ACCOUNT 1649423 OTHER ASSETS 85159 NEW MARKET TAX CREDIT FINANCING FEES, NET OF AMORTIZATION 466501 DUE FROM MARILLAC COMMUNITY HEALTH CENTERS (MCHC) 2269187 4470270 PAYROLL TAXES PAYABLE 104146 ACCRUED PENSION, SALARIES AND VACATION PAY 531453 SELF INSURANCE LIABILITY 95838 NEW MARKET TAX CREDIT FEES PAYABLE 86250 817687 19122222 10732925 8389297 52 -358333 -358281 8031016 21805326 52 23106 2670506 2693664 19111662 10560 10560 19122222 13774310 23106 3028839 3051945 10722365 10560 10560 10732925 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: DCSNO IS A NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF LOUISIANA IN 1996. IT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND QUALIFIES AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION AS DEFINED IN SECTION 509(A) OF THE CODE. IT IS ALSO EXEMPT FROM LOUISIANA INCOME TAX UNDER THE AUTHORITY OF R.S.47:121(5). DCSNOF WAS INCORPORATED IN THE STATE OF LOUISIANA ON NOVEMBER 23, 2009. THE SOLE MISSION OF THE FOUNDATION IS TO PROVIDE FINANCIAL RESOURCES FOR THE EXECUTION OF THE MISSION OF DCSNO. DCSNOE WAS INCORPORATED IN THE STATE OF LOUISIANA ON JANUARY 24, 2012. IT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND QUALIFIES AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION AS DEFINED IN SECTION 509(A) OF THE CODE. IT IS ALSO EXEMPT FROM LOUISIANA INCOME TAX UNDER THE AUTHORITY OF R.S.47:121(5). THE PRIMARY PURPOSE OF THE CORPORATION IS TO FURTHER THE TRADITION OF HEALING AND SERVICE TO THE SICK AND POOR ESTABLISHED BY ST. VINCENT DEPAUL, ST. LOUISE DE MARILLAC, AND ST. ELIZABETH ANN SETON AND EXEMPLIFIED BY THE PHILOSOPHY AND MISSION OF DCSNO. THE ORGANIZATION APPLIES A "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD FOR ALL TAX UNCERTAINTIES. THIS APPROACH ONLY ALLOWS THE RECOGNITION OF THOSE TAX BENEFITS THAT HAVE A GREATER THAN 50% LIKELIHOOD OF BEING SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES. AS A RESULT OF IMPLEMENTING THIS APPROACH, THE ORGANIZATION HAS REVIEWED ITS TAX POSITIONS AND DETERMINED THERE WERE NO OUTSTANDING, OR RETROACTIVE TAX POSITIONS WITH LESS THAN A 50% LIKELIHOOD OF BEING SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES. THEREFORE, THE IMPLEMENTATION OF THIS STANDARD HAS NOT HAD A MATERIAL EFFECT ON THE ORGANIZATION. THE ORGANIZATION'S TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2011, 2010 AND 2009 REMAIN OPEN AND SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. THE ORGANIZATION'S TAX RETURN FOR THE YEAR ENDED JUNE 30, 2012 HAS NOT YET BEEN FILED. PART XI, LINE 8 - OTHER ADJUSTMENTS: GRANT TO AFFILIATE FOR DONATED SERVICES & USE OF FACILITIES -358,333. PART XII, LINE 2D - OTHER ADJUSTMENTS: REIMBURSEMENTS FROM AFFILIATE SEPARATELY STATED IN AUDIT 2,670,506. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE REPORTED NET IN AUDIT 10,560. PART XIII, LINE 2D - OTHER ADJUSTMENTS: GRANT TO AFFILIATE FOR DONATED SERVICES & USE OF FACILITIES 358,333. REIMBURSEMENTS FROM AFFILIATE SEPARATELY STATED IN AUDIT 2,670,506. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE REPORTED NET IN AUDIT 10,560. INAUGURAL GALA 112531 101912 10619 98202 112531 101912 10619 98202 98202 -87583 X X X 0 0 0 0 0 0 0 0 0 LOUIS BEVROTTE 211564 0 0 0 0 0 0 0 3063 0 214627 0 0 0 X 20 3625 VALUE GIVEN BY DONOR 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE ORGANIZATION ENTERED INTO AN AFFILIATION AGREEMENT WITH MARILLAC COMMUNITY HEALTH CENTERS (MCHC) EFFECTIVE MARCH 1, 2012. UNDER THE TERMS, THE ORGANIZATION PROVIDES LEASED EMPLOYEES, BUILDING SPACE, EQUIPMENT, SUPPLIES, AND OTHER SERVICES TO MCHC IN ORDER FOR MCHC TO PROVIDE PRIMARY CARE AND PREVENTATIVE MEDICAL AND DENTAL SERVICES. THE ORGANIZATION CONTINUES TO PROVIDE NEIGHBORHOOD OUTREACH, PHARMACY, AND OPTOMETRY SERVICES TO THE COMMUNITY. FORM 990, PART VI, SECTION A, LINE 6 DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH. FORM 990, PART VI, SECTION A, LINE 7A DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BOARD OF DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS. FORM 990, PART VI, SECTION A, LINE 7B ASCENSION HEALTH HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY TO THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE NEW ORGANIZATIONS & MAJOR TRANSACTIONS, GOVERNING DOCUMENTS, APPOINTMENTS/REMOVALS, EVALUATION, DEBT LIMITS, STRATEGIC & FINANCIAL PLANS, ASSETS, SYSTEM POLICIES & PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION PER THE SYSTEM AUTHORITY MATRIX. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS REVIEWED BY THE CFO PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MAINTAINS A FORMAL CORPORATE COMPLIANCE PROGRAM WHICH INCLUDES A CORPORATE COMPLIANCE OFFICE AND CORPORATE COMPLIANCE COMMITTEE. ALL BOARD MEMBERS ARE SUBJECT TO THE POLICY WHICH IS UPDATED AND SIGNED BY MEMBERS EACH YEAR. ANY CONFLICTS OF INTEREST ARE SELF-REPORTED BY MEMBERS. MEMBERS THAT ARE FOUND TO HAVE A CONFLICT EITHER ABSTAIN FROM VOTING ON ISSUES THAT CREATE THE CONFLICT OR ARE EXCUSED FROM THE BOARD DEPENDING ON THE SEVERITY OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING COMPENSATION FOR THE CEO, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION WITH THE FACILITATION BY THE SCP OF HR AND THE DIRECTOR OF COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER SIMILAR ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER SIMILAR ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO THE PUBLIC INSPECTION UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 52. GRANT TO AFFILIATE FOR DONATED SERVICES & USE OF FACILITIES -358,333. TOTAL TO FORM 990, PART XI, LINE 5: -358,281. COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT FORM 990, PART XII, LINE 2C NO CHANGE FROM THE PRIOR YEAR. ASCENSION HEALTH 4600 EDMUNDSON ROAD ST LOUIS MO 63134 311662309 NATIONAL HEALTH SYSTEM MO 501(C)(3) LINE 11A, I N/A 0 DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS FOUNDATION PO BOX 4148 NEW ORLEANS LA 70178 721658000 PROVIDE SUPPPORT TO DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS LA 501(C)(3) LINE 11B, II DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 ASCENSION HEALTH C 50000 ACTUAL AMOUNT TRANSFERRED DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS FOUNDATION Q 134986 ACTUAL AMOUNT TRANSFERRED DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS FOUNDATION C 139926 ACTUAL AMOUNT TRANSFERRED DAUGHTERS OF CHARITY SERVICES OF NEW ORLEANS FOUNDATION E 67493 ACTUAL AMOUNT TRANSFERRED