2013-05-20T14:54:13-05:00 2012-06-30 KPMG LLP 450 Laurel Street Suite 1700 Baton Rouge LA 70801 990 2011-07-01 720780429 OLLIE STEELE BURDEN MANOR INC % JEFF LIMBOCKER OLLI 2257657709 4250 ESSEN LANE BATON ROUGE LA 70809 Jeff Limbocker 2257657709 2013-05-13 true 2253444000 2011 2016-02-24 21:20:13Z KAREN ALLEN 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 17325336 false 0928 X N/A X 1963 LA 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 9 8 528 9 0 0 2597 2402 17624754 17317666 3388 5268 27753 0 17658492 17325336 1389 1204 0 0 13524992 12906297 0 0 0 5204559 5675510 18730940 18583011 -1072448 -1257675 22134106 22110926 11550227 12787221 10583879 9323705 X 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. false false 13389976 1204 17317666 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. 13389976 true false false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 16 0 true 528 true false false false false false false false false false false X 9 8 false false false false true true true true true false false true false false false false false false X JEFF LIMBOCKER 2257656565 5000 HENNESSY BLVD BATON ROUGE LA 70808 X ALDEN L ANDRE 2.0 X X 0 0 0 DAVID THOMPSON 2.0 X 0 0 0 SCOTT WESTER 2.0 X X 604515 92564 DR JAMES W FIRNBERG 2.0 X 0 0 0 LAWRENCE BRAUD MD 2.0 X 0 0 0 MARY TAUZIN 2.0 X 0 0 0 SR MARTHA ANN ABSHIRE 2.0 X 0 0 0 KEVIN CURRY 2.0 X 0 0 0 SR LILLIAN LYNCH 2.0 X 0 0 0 SR HELEN CAHILL 2.0 X 0 0 0 KAREN ALLEN 12.5 X 246513 41157 JEFF LIMBOCKER 2.0 X 0 366920 50142 0 1217948 183863 0 false true false TRITON HEALTHCARE INC 8128 FLORIDA BLVD DENHAM SPRINGS LA 70726 PHYSICAL THERAPY 431693 1 2402 2402 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 17317666 5268 5268 0 0 0 0 0 0 0 17325336 17317666 5268 1204 1204 0 0 0 0 0 0 10024141 7844703 2179438 515598 403497 112101 0 1649058 1114453 534605 717500 564140 153360 5127 5127 791 791 27649 27649 0 0 0 0 749055 670183 78872 3455 3455 1784227 1201939 582288 44240 1526 42714 0 714688 548913 165775 3070 568 2502 0 7060 450 6610 0 0 0 1087113 861657 225456 159237 159237 PROVIDER FEES 836896 836896 MISCELLANEOUS 24458 4021 20437 RECRUITMENT 5012 5012 MEDICAL SUPPLIES 223432 172722 50710 18583011 13389976 5193035 0 0 0 1085842 1415380 0 0 1515250 1611317 0 0 0 0 0 0 66946 57749 142701 121680 29321134 10808786 18906643 18512348 0 0 130724 130452 0 0 286000 262000 0 0 22134106 22110926 1837023 1557238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9713204 11229983 11550227 12787221 X 10581357 9320614 2522 3091 0 0 10583879 9323705 22134106 22110926 X -1257675 -2499 X false true true X true true X 905168 905168 22990053 7505118 15484935 450852 374717 76135 4975060 2928951 2046109 0 0 0 18512347 0 DEPOSITS 71301 DUE TO AFFILIATES 8450419 ACCRUED PENSION COSTS 2708263 11229983 FIN 48 (ASC 740) FOOTNOTE SCHEDULE D 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. false true false false false false false false false SCOTT WESTER 424810 142134 37571 62240 30324 697079 0 KAREN ALLEN 165319 50275 30919 14635 26522 287670 0 JEFF LIMBOCKER 0 285899 0 70000 0 11021 0 20052 0 30090 0 417062 0 0 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. 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 ADJUSTMENT TO FUND BALANCE UNREALIZED LOSS $(2,499) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ALDEN L. ANDRE TITLE:CHAIRMAN HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SCOTT WESTER TITLE:BOARD MEMBER HOURS:58 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. LILLIAN LYNCH TITLE:BOARD MEMBER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. HELEN CAHILL TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KAREN ALLEN TITLE:PRESIDENT OF SSD HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFF LIMBOCKER TITLE:CFO HOURS:58 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 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 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 PO BOX 1051 CJ KY1-1102 Insurance CJ FMOL C Corp 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 false false false false false false false false false false true true false false true false false false