OLLIE STEELE BURDEN MANOR INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- OLLIE STEELE BURDEN MANOR INC (EIN 72-0780429)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-20
- IRS object ID
- 201331409349300433
- Schema version
- 2011v1.5
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-20T14:54:13-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 Laurel Street Suite 1700 | AddressLine1 |
| City | Baton Rouge | City |
| State | LA | State |
| ZIP Code | 70801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720780429 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLLIE STEELE BURDEN MANOR INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % JEFF LIMBOCKER | InCareOfName |
| Name Control | OLLI | NameControl |
| Phone | 2257657709 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4250 ESSEN LANE | AddressLine1 |
| City | BATON ROUGE | City |
| State | LA | State |
| ZIP Code | 70809 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeff Limbocker | Name |
| Title | CFO | Title |
| Phone | 2257657709 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2253444000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KAREN ALLEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 HENNESSY BOULEVARD | AddressLine1 |
| City | BATON ROUGE | City |
| State | LA | State |
| ZIP Code | 70808 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17325336 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1963 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | THE PURPOSE OF THE HOSPITAL IS TO PROVIDE FOR THE CARE OF THE ill INJURED OR DISABLED PERSONS, especially the elderly, and FOR THE ENHANCEMENT OF HEALTH OF the elderly in the COMMUNITY | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 528 | TotalNbrEmployees |
| Total Nbr Volunteers | 9 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2597 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2402 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17624754 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17317666 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3388 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5268 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 27753 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17658492 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17325336 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1389 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1204 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13524992 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12906297 | 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 | 5204559 | OtherExpensePriorYear |
| Other Expenses Current Year | 5675510 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18730940 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18583011 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1072448 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1257675 | RevenuesLessExpensesCY |
| Total Assets BOY | 22134106 | TotalAssetsBOY |
| Total Assets EOY | 22110926 | TotalAssetsEOY |
| Total Liabilities BOY | 11550227 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 12787221 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10583879 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9323705 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 13389976 | Expense |
| Grants | 1204 | Grants |
| Revenue | 17317666 | Revenue |
| Description | Ollie Steele Burden Manor operates two nursing home facilities specially designed to provide the highest level of care for those suffering with complex physical health issues including Alzheimer's disease and dementia. The nursing homes provide 24 hour nursing care in a rehabilitative setting that ministers to the needs of the whole person. The nursing home provided care and housing for 104,415 resident days. | Description |
| Total Program Service Expense | 13389976 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 16 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 528 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JEFF LIMBOCKER | NamePerson |
| Telephone Number | 2257656565 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 HENNESSY BLVD | AddressLine1 |
| City | BATON ROUGE | City |
| State | LA | State |
| ZIP Code | 70808 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| ALDEN L ANDRE | ||||||
| CHAIRMAN | 2.0 | X | X | 0 | 0 | 0 |
| DAVID THOMPSON | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| SCOTT WESTER | ||||||
| BOARD MEMBER | 2.0 | X | X | 604515 | 92564 | |
| DR JAMES W FIRNBERG | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| LAWRENCE BRAUD MD | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| MARY TAUZIN | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| SR MARTHA ANN ABSHIRE | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| KEVIN CURRY | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| SR LILLIAN LYNCH | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| SR HELEN CAHILL | ||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |
| KAREN ALLEN | ||||||
| PRESIDENT OF SSD | 12.5 | X | 246513 | 41157 | ||
| JEFF LIMBOCKER | ||||||
| CFO | 2.0 | X | 0 | 366920 | 50142 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1217948 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 183863 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TRITON HEALTHCARE INC | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8128 FLORIDA BLVD | AddressLine1 |
| City | DENHAM SPRINGS | City |
| State | LA | State |
| ZIP Code | 70726 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | PHYSICAL THERAPY | DescriptionOfServices |
| Compensation | 431693 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 2402 | AllOtherContributions |
| Total Contributions | 2402 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 900099 | 17211507 | 17211507 |
| BEAUTY/BARBER SERVICES | 900099 | 60715 | 60715 |
| OTHER REVENUE | 900099 | 29296 | 29296 |
| FRANCISCAN SISTER SERVICES | 900099 | 9600 | 9600 |
| VENDING REVENUE | 900099 | 6548 | 6548 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17317666 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5268 | TotalRevenueColumn |
| Exclusion | $5,268 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17325336 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17317666 | RelatedOrExemptFunctionIncome |
| Exclusion | $5,268 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1204 | Total |
| Program Services | 1204 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10024141 | Total |
| Program Services | 7844703 | ProgramServices |
| Management And General | 2179438 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 515598 | Total |
| Program Services | 403497 | ProgramServices |
| Management And General | 112101 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1649058 | Total |
| Program Services | 1114453 | ProgramServices |
| Management And General | 534605 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 717500 | Total |
| Program Services | 564140 | ProgramServices |
| Management And General | 153360 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5127 | Total |
| Management And General | 5127 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 791 | Total |
| Management And General | 791 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27649 | Total |
| Management And General | 27649 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 749055 | Total |
| Program Services | 670183 | ProgramServices |
| Management And General | 78872 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3455 | Total |
| Management And General | 3455 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1784227 | Total |
| Program Services | 1201939 | ProgramServices |
| Management And General | 582288 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44240 | Total |
| Program Services | 1526 | ProgramServices |
| Management And General | 42714 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 714688 | Total |
| Program Services | 548913 | ProgramServices |
| Management And General | 165775 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3070 | Total |
| Program Services | 568 | ProgramServices |
| Management And General | 2502 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7060 | Total |
| Program Services | 450 | ProgramServices |
| Management And General | 6610 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1087113 | Total |
| Program Services | 861657 | ProgramServices |
| Management And General | 225456 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159237 | Total |
| Management And General | 159237 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| PROVIDER FEES | 836896 | 836896 | |
| MISCELLANEOUS | 24458 | 20437 | 4021 |
| RECRUITMENT | 5012 | 5012 | |
| MEDICAL SUPPLIES | 223432 | 50710 | 172722 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18583011 | Total |
| Program Services | 13389976 | ProgramServices |
| Management And General | 5193035 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1085842 | BOY |
| EOY | 1415380 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1515250 | BOY |
| EOY | 1611317 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66946 | BOY |
| EOY | 57749 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 142701 | BOY |
| EOY | 121680 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 29321134 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10808786 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18906643 | BOY |
| EOY | 18512348 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130724 | BOY |
| EOY | 130452 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286000 | BOY |
| EOY | 262000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22134106 | BOY |
| EOY | 22110926 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1837023 | BOY |
| EOY | 1557238 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9713204 | BOY |
| EOY | 11229983 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11550227 | BOY |
| EOY | 12787221 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10581357 | BOY |
| EOY | 9320614 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2522 | BOY |
| EOY | 3091 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10583879 | BOY |
| EOY | 9323705 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22134106 | BOY |
| EOY | 22110926 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1257675 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2499 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 905168 | OtherCostOrOtherBasis |
| Book Value | 905168 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22990053 | OtherCostOrOtherBasis |
| Depreciation | 7505118 | Depreciation |
| Book Value | 15484935 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 450852 | OtherCostOrOtherBasis |
| Depreciation | 374717 | Depreciation |
| Book Value | 76135 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4975060 | OtherCostOrOtherBasis |
| Depreciation | 2928951 | Depreciation |
| Book Value | 2046109 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18512347 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEPOSITS | $71,301 |
| DUE TO AFFILIATES | $8,450,419 |
| ACCRUED PENSION COSTS | $2,708,263 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11229983 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D | ReturnReference |
| Explanation | The Medical Center 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 judgement occurs. No reserves for uncertain tax positions have been recorded. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT WESTER | |||||||||||||
| 424810 | 142134 | 37571 | 62240 | 30324 | 697079 | 0 | |||||||
| KAREN ALLEN | |||||||||||||
| 165319 | 50275 | 30919 | 14635 | 26522 | 287670 | 0 | |||||||
| JEFF LIMBOCKER | |||||||||||||
| 285899 | 70000 | 11021 | 20052 | 30090 | 417062 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART I QUESTION 3 | THE PRESIDENT IS PAID BY FMOL HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO/EXECUTIVE DIRECTOR'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. 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 I QUESTION 4A | A BOARD MEMBER 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. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, QUESTION 6 | OUR LADY OF THE LAKE HOSPITAL, INC.( AN IRC SECTION 501 (C)(3) ORGANIZATION) IS THE SOLE MEMBER OF OLLIE STEELE BURDEN MANOR, INC. | |
| FORM 990, PART VI, QUESTION 7A | OUR LADY OF THE LAKE HOSPITAL INC., AS THE SOLE MEMBER OF OLLIE STEEL BURDEN MANOR, INC., RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF OLLIE STEELE BURDEN MANOR, INC. | |
| FORM 990, PART VI, QUESTION 7B | OUR LADY OF THE LAKE HOSPITAL, AS THE SOLE MEMBER OF OLLIE STEELE BURDEN MANOR, INC. RESERVES THE FOLLOWING POWERS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES, PURPOSES OF CORPORATION 2. TO AMEND, ALTER, MODIFY OR REPEAL ARTICLES OF INCORPORATION AND BYLAWS OF CORPORATION 3. TO AUTHORIZE MERGER, CONSOLIDATION OR AFFILIATION, OR PARTICIPATE 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 THE 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 THE CORPORATION 11. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION 12. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION | |
| FORM 990, PART VI, QUESTION 12C | OLLIE STEELE BURDEN MANOR 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 OLLIE STEELE BURDEN MANOR 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, OLLIE STEELE BURDEN MANOR 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. | |
| FORM 990, PART VI, SECTION C, QUESTION 19 | OLLIE STEELE BURDEN MANOR, INC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. | |
| FORM 990 PART VI, SECTION B QUESTION 15A & 15B | OTHER RELATED TAX EXEMPT ORGANIZATIONS SET THE COMPENSATION AND PAY THE EXECUTIVES. THAT BOARD OF DIRECTORS DESIGNATES THE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE COMPENSATION ANNUALLY OF EXECUTIVES. 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. | |
| FORM 990, 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. | |
| FORM 990, PART VI, QUESTIONS 12-14 | THROUGHOUT THE TAX YEAR, THE ORGANIZATION HAD A CONFLICT OF INTEREST POLICY, DOCUMENT RETENTION POLICY, AND A WHISTLEBLOWER POLICY IN PLACE ALTHOUGH THEY WERE NOT APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE JUNE 30, 2012. THE CONFLICT OF INTEREST POLICY AND THE DOCUMENT RETENTION POLICY HAVE, 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 POLICIES APPROVED BY THE FILING ORGANIZATION'S BOARD OF DIRECTORS OR COMMITTEE THEREOF. | |
| FORM 990, PART XI, LINE 5 | UNREALIZED LOSS $(2,499) | ADJUSTMENT TO FUND BALANCE |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ALDEN L. ANDRE TITLE:CHAIRMAN HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:SCOTT WESTER TITLE:BOARD MEMBER HOURS:58 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:SR. LILLIAN LYNCH TITLE:BOARD MEMBER HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:SR. HELEN CAHILL TITLE:BOARD MEMBER HOURS:4 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:KAREN ALLEN TITLE:PRESIDENT OF SSD HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:JEFF LIMBOCKER TITLE:CFO HOURS:58 | FORM 990 PART VII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| St Bernard Health Fund | ||||||||||
| 4200 Essen Lane | Baton Rouge | LA | 70809 | 204685614 | Healthcare | LA | 501(c)(3) | 11 TYPE 1 | FMOL | false |
| Health Partners Network of South LA | ||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | Lafayette | LA | 70508 | 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 |
Form990 Schedule R Part III Form990ScheduleRPartIII (23 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| Lourdes Imaging Center LLC | ||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | Lafayette | LA | 70506 | 208326214 | Healthcare | LA | LOURDES | N/A | false | 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 Plaza Imaging Center | ||||||||||
| 5000 Hennessy Boulevard | Baton Rouge | LA | 70808 | 203697665 | Healthcare | LA | OLOL | N/A | false | true |
| Perkins Plaza Imaging Development | ||||||||||
| 5000 Hennessy Boulevard | Baton Rouge | LA | 70808 | 203894521 | Real Estate | LA | OLOL | 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 FRANCIS PEDIATRIC AFTER HOURS | ||||||||||
| Post office 207 | MONROE | LA | 71210 | 061782572 | Healthcare | LA | ST FRANCIS | N/A | false | true |
| LOURDES IMAGING DEVELOPMENT LLC | ||||||||||
| 611 ST LANDRY STREET | LAFAYETTE | LA | 70506 | 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 |
| ST ELIZABETH-MARY BIRD PERKINS CANCER | ||||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 260628752 | 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 IILLC | ||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | 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 | ST FRANCIS | N/A | false | true |
| LHCG-XIII LLC | ||||||||||
| 420 WEST PINHOOK ROAD SUITE A | LAFAYETTE | LA | 70503 | 208068308 | HEALTHCARE | LA | LOURDES | N/A | false | true |
| LOURDES AFTER HOURS LLC | ||||||||||
| 2130 KALISTE SALOOM RD | LAFAYETTE | LA | 70508 | 201367299 | HEALTHCARE | LA | LOURDES | N/A | false | true |
| CAPITAL AREA SHARED SERVICES ORG LLC | ||||||||||
| 5000 HENNESSY BOULEVARD | BATON ROUE | LA | 70808 | 275173212 | HEALTHCARE | LA | OLOL PG | N/A | false | true |
| CAPITAL AREA SHARED SERVICES ORGANIZATIO | ||||||||||
| 5000 HENNESSY BOULEVARD | BATON ROUGE | LA | 70808 | 275173212 | HEALTHCARE | LA | STEP | N/A | false | true |
| ST ELIZABETH IMAGING CENTER | ||||||||||
| 1125 HIGHWAY 30 | GONZALES | LA | 70737 | 364701565 | HEALTHCARE | LA | STEH | N/A | false | true |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| St Francis Insurance Agency | ||||||||||||
| 309 Jackson Street | Monroe | LA | 71201 | 721435136 | Insurance | LA | ST FRANCIS | C Corp | ||||
| Hospital Assistance Services | ||||||||||||
| PO Box 4027-C | Lafayette | LA | 70502 | 721073486 | Healthcare | LA | LOURDES | C Corp | ||||
| Louise Insurance Company | ||||||||||||
| Insurance | FMOL | C Corp | PO BOX 1051 | CJ | KY1-1102 | CJ | ||||||
| Monroe Health Services | ||||||||||||
| PO Box 3187 | Monroe | LA | 71210 | 721057820 | Healthcare | LA | AMBULATORY | 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 | |||||||||
| Franciscan Health & Wellness ServicesIn | ||||||||||||
| 4200 ESSEN LANE | 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 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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