WEST LOUISIANA HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: WEST LOUISIANA HEALTH SERVICES INC (EIN 72-0491106)
Tax period: 2011-11-01 to 2012-10-31
Filed: 2013-09-16
IRS object ID: 201332599349301163
Schema version: 2011v1.2
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 D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-09-16T16:31:15-05:00	Timestamp
Tax Period End Date	2012-10-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Steven M DeRouen CPA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	P O Box 4265	AddressLine1
City	Lake Charles	City
State	LA	State
ZIP Code	70606	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-11-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	720491106	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	West Louisiana Health Services Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	WEST	NameControl

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 730	AddressLine1
City	Deridder	City
State	LA	State
ZIP Code	70634	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Darrell Kingham	Name
Title	Director of Fin	Title
Phone	3374627106	Phone
Date Signed	2013-09-16	DateSigned
Authorize Third Party	false	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Steven M DeRouen CPA	Name
Phone	3375134915	Phone
Date Prepared	2013-09-16	DatePrepared
Self Employed	X	SelfEmployed

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	Ed ONeal	NameOfPrincipalOfficerPerson
Gross Receipts	35032869	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.beauregard.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1946	YearFormation
State Legal Domicile	LA	StateLegalDomicile
Activity Or Mission Description	To provide medical care and health programs by operating a 60 bed facility for Hospital Service District 2 of Beauregard Parish and six physician clinics recruit and employ physicians in HPSA	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	14	NbrIndependentVotingMembers
Total Nbr Employees	477	TotalNbrEmployees
Total Nbr Volunteers	99	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	34476756	ProgramServiceRevenuePriorYear
Program Service Revenue CY	34403123	ProgramServiceRevenueCY
Investment Income Prior Year	107175	InvestmentIncomePriorYear
Investment Income Current Year	335699	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1522	OtherRevenuePriorYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	34585453	TotalRevenuePriorYear
Total Revenue Current Year	34738822	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2291832	SalariesEtcPriorYear
Salaries Etc Current Year	2347614	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	33555117	OtherExpensePriorYear
Other Expenses Current Year	33502768	OtherExpensesCurrentYear
Total Expenses Prior Year	35846949	TotalExpensesPriorYear
Total Expenses Current Year	35850382	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1261496	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1111560	RevenuesLessExpensesCY
Total Assets BOY	10049179	TotalAssetsBOY
Total Assets EOY	10401357	TotalAssetsEOY
Total Liabilities BOY	7222975	TotalLiabilitiesBOY
Total Liabilities EOY	8422571	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2826204	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1978786	NetAssetsOrFundBalancesEOY
Mission Description	To provide medical care and health programs by operating a 60 bed facility for Hospital Service District 2 of Beauregard Parish and six physician clinics recruit and employ physicians in HPSA	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	32232453	Expense
Revenue	32169921	Revenue
Description	Operated a 60 bed facility for Hospital Service District 2 of Beauregard Parish providing general short term care to 2219 inpatients for 7406 days 363 newborns 1491 surgeries 16211 ER visits and 26452 outpatients 73 of hospital admission s are Medicaid and Medicare The hospital also conducts numerous community seminars and services to benefit the community	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	3617929	Expense
Revenue	2226271	Revenue
Description	Operated Beauregard Physician Group which consists of six physician clinics which provide medical services to Beauregard Parish	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	35850382	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	false	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	true	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	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
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	true	DisregardedEntity
Related Entity	false	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	43	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	477	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
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	14	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	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	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	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	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	Darrell L Kingham CPA VP of Finance	NamePerson
Telephone Number	3374627106	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	600 South Pine Street	AddressLine1
City	Deridder	City
State	LA	State
ZIP Code	70634	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Carl Slover
Board Member	2.00	X	0	0	0
Chris Granger MD
Board Member	2.00	X	0	0	0
Chuen Kwok MD
Board Member	2.00	X	0	0	0
Ed ONeal
President	2.00	X	0	0	0	X
Gerald Johnson
Board Member	2.00	X	0	0	0
Jared Morris
Secretary	2.00	X	0	0	0	X
Jim Morris
Board Member	2.00	X	0	0	0
Jodi Andrews
Board Member	2.00	X	0	0	0
Julie Orsoy
Board Member	2.00	X	0	0	0
Natha Gantt
Board Member	2.00	X	0	0	0
Terri Theaux
Past President	2.00	X	0	0	0	X
Thomas Shirley DDS
Board Member	2.00	X	0	0	0
Tom Dobbins MD
Board Member	2.00	X	0	0	0
Tom Rhodes
Vice-President	2.00	X	0	0	0	X
Darrell Kingham
Vice President of Finance	50.00		184753	0	9167	X
Theodore Badger Jr
CEO	40.00		231869	0	11000	X
Dr James Rudd Jr
Physician	40.00		289013	0	0		X
Dr Janet Lewis
Orthopedic Surgeon	40.00		606666	0	0		X
Dr Kanayochukwu Aluka
Physician	40.00		278807	0	0		X
Dr Stephen Farquhar
Physician	40.00		197032	0	0		X
Joseph Caraway
CRNA	40.00		197788	0	4827		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1985928	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	24994	TotalOtherCompensation
Number Individuals GT100 K	7	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
JFK Consulting Group Inc
PO Box 15105	Winston Salem	NC	27113	Consulting	237819
Cardiology Clinic of DeRidder LLC
102 West 6th Street	DeRidder	LA	70634	Physician	123200

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Reimbursement from Hosp	900099	32169921	32169921
Patient Service	621400	2226271	2226271
Bad Debt Recoveries	621400	6931	6931

Field	Value	IRS element (for citing)
Total Program Service Revenue	34403123	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	229766	TotalRevenueColumn
Related Or Exempt Function Income	229766	RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	399980	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	294047	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	105933	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	105933	TotalRevenueColumn
Related Or Exempt Function Income	105933	RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	34738822	TotalRevenueColumn
Related Or Exempt Function Income	34738822	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	436789	Total
Program Services	436789	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1908298	Total
Program Services	1908298	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2527	Total
Program Services	2527	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	9300	Total
Program Services	9300	ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	15	Total
Program Services	15	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	12442	Total
Program Services	12442	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	29504	Total
Program Services	29504	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	446	Total
Program Services	446	ProgramServices

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	11614	Total
Program Services	11614	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	8162	Total
Program Services	8162	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	433460	Total
Program Services	433460	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Other Professional Expenses	15554010	15554010
Fiscal & Admin Expenses	9087806	9087806
Nursing Expenses	4148455	4148455
General Service Expenses	3379650	3379650

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	827904	Total
Program Services	827904	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	35850382	Total
Program Services	35850382	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2408030	BOY
EOY	2787001	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	374736	BOY
EOY	378402	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	395792	BOY
EOY	276960	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	7234	BOY
EOY	21425	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	107282	BOY
EOY	90803	EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	325974	BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	5466007	BOY
EOY	5944182	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	670498	BOY
EOY	901618	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	293626	BOY
EOY	966	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	10049179	BOY
EOY	10401357	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1945677	BOY
EOY	1492157	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	5277298	BOY
EOY	6930414	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	7222975	BOY
EOY	8422571	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	2826204	BOY
EOY	1978786	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2826204	BOY
EOY	1978786	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	10049179	BOY
EOY	10401357	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-1111560	ReconcilationRevenueExpenses
Reconcilation Other Changes	264142	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	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	7513	BeginningOfYearBalance
Investment Earnings Or Losses	38	InvestmentEarningsOrLosses
End Of Year Balance	7551	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	7472	BeginningOfYearBalance
Investment Earnings Or Losses	41	InvestmentEarningsOrLosses
End Of Year Balance	7513	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
Description	Certificates of Deposit	Description
Book Value	901618	BookValue
Method Of Valuation	C	MethodOfValuation

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	901618	TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
Due to HSD 2	$5,305,429
Accrued Payroll	$811,249
Accrued Vacation Payable	$700,084
Accrued Disability Benefits	$113,652

Field	Value	IRS element (for citing)
Total Of Amounts	6930414	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	ExplanationExplanation
Endowment funds intended uses Part V line 4	These funds are board designated to provide educational scholarships to qualifying students
02 Footnote for uncertain tax position under FIN 48 Part X	West Louisiana Health Services Inc is a nonprofit corporation as described in Code Section 501c3 of the Internal Revenue Service and is exempt from Federal and State income taxes on related income pusuant to Section 501a of the code

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	false	AmountsBudgetedForCharityCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4521883	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3600877	DirectOffsettingRevenue
Net Community Benefit Expense	921006	NetCommunityBenefitExpense
Percent Of Total Expense	0.02660	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6835691	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6126905	DirectOffsettingRevenue
Net Community Benefit Expense	708786	NetCommunityBenefitExpense
Percent Of Total Expense	0.02050	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11357574	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9727782	DirectOffsettingRevenue
Net Community Benefit Expense	1629792	NetCommunityBenefitExpense
Percent Of Total Expense	0.0471	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	110543	TotalCommunityBenefitExpense
Net Community Benefit Expense	110543	NetCommunityBenefitExpense
Percent Of Total Expense	0.0032	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	175084	TotalCommunityBenefitExpense
Net Community Benefit Expense	175084	NetCommunityBenefitExpense
Percent Of Total Expense	0.0051	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4082394	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2289313	DirectOffsettingRevenue
Net Community Benefit Expense	1793081	NetCommunityBenefitExpense
Percent Of Total Expense	0.0518	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4368021	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2289313	DirectOffsettingRevenue
Net Community Benefit Expense	2078708	NetCommunityBenefitExpense
Percent Of Total Expense	0.0601	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15725595	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12017095	DirectOffsettingRevenue
Net Community Benefit Expense	3708500	NetCommunityBenefitExpense
Percent Of Total Expense	0.1072	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	133870	TotalCommunityBuildingExpense
Net Community Building Expense	133870	NetCommunityBuildingExpense
Percent Of Total Expense	0.0039	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	133870	TotalCommunityBuildingExpense
Net Community Building Expense	133870	NetCommunityBuildingExpense
Percent Of Total Expense	0.0039	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$1,231,364	BadDebtExpenseAmount
Amount Attributable To	492546	AmountAttributableTo
Amount Reimbursed By Medicare	8581553	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	10775621	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2194068	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	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	Hospital Service District 2	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	600 S Pine Street	AddressLine1
City	Deridder	City
State	LA	State
ZIP Code	70634	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
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	Hospital Service District 2	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	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
Needs Assessment Conducted	10	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	false	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	true	AllNeedsAddressed
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	2.000000	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.0000	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Collection Activities	true	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Beauregard Physician Group	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	600 S Pine Street	AddressLine1
City	Deridder	City
State	LA	State
ZIP Code	70634	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	Six Physician Clinics	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifier	ExplanationExplanation
01 Related organization annual community benefit report Part I line 6a	The Community Benefit report is made available to the public upon request and on its website
02 Bad debt description footnote Part III line 4	Part III Line 4 - The accounting policy of the Hospital regarding bad debts states that the allowance method in accounting for bad debts is used The allowance account consists of an estimate of uncollectable accounts and a general reserve Managements evaluation of the adequacy of the allowance is based on a continuing review of all accounts and includes a consideration of past patient history and adverse situations that might affect the patients ability to pay and current economic conditions
03 Allowable Medicare costing methodology Part III line 8	Part III Line 8 - The costing methodology for Medicare was derived form the Medicare Form CMS-2552 filed for the FYE 10-31-12 The Hospital continues to treat Medicare patients even as Medicare reimbursement is declining The Hospital views the 2194068 Medicare shortfall as a community benefit as all Hospital patients are accepted regardless of reimbursement
04 Subsidized health services costs Part I line 7g	Part I Line 7g - In accordance with identified community needs the Hospital had recruited physicians to serve in the community which is in a professional shortage area HPSA Subsidized health services include subsidies of 1721537 to nine clinics which provide orthopedic surgical pediatric internal medicine OB GYN and family practice services to the community
05 Debt expense included Part I line 7 col f	Part I Line 7f Part 3 Line 4 Bad Debt Expense - Bad debt cost was calculated by multiplying bad debt charges per accounting records by the worksheet 2 cost to charge ratio Line 3 is 40 of the bad debt costs based on historical information Self pay patients pay 15 of charges on average which charges totaled 145 million The community benefits from the Hospitals policy that all patients who are uninsured are accepted by the Hospital
06 Costing methodology explanation Part I line 7	Part I Line 7 - Costs on 7A and 7B were taken from the schedule of uncompensated care cost for small rural hospitals a reported used by the Louisiana Department of Health and Hospitals to determine uncompensated Medicaid and indigent costs and reimbursements A cost to charge ratio was also derived from worksheet 2 ratio of patient care cost to charges and used when needed Costs on line 7E 7F and 7G are actual costs per records
07 Collection practices Part III line 9b	Part III Line 9b - Regarding collection practices to be followed for patients who are known to qualify for financial assistance the Hospital tries to conduct a pre-admission interview with the patient or gurantor prior to admission when possible Potential charity care patients are offered the opportunity to apply for charity care at the time of admission Outpatients and ER patients are sent a notification about charity care through the mail Patients with no insurance receive a letter within 30 days of service stating that the Hospital has given them a 52 discount and that they are responsible for the balance of the bill The letter also states that the Hospital has a charity carefinancial assist prog and gives the contact persons name and phone number to obtain an applicationThe letter also gives the name and number to apply for Medicaid at the Hospital The letter states the account balances that is due and that payments can be spread over 12 to 18 months It also states that failure to pay the bill or set up financial arrangements will result in addtional collection efforts A second letter in the following month is sent that states their account is delinquent is due and failure to respond will result in further collection action If no response a third letter is sent stating their account is deliquent and is being reviewed to go to an outside collection agency A final notice is sent stating this is a final notice failure to pay will result in the account being placed with a collection agency and that they must have an authorized financial agreement with the Hospital to stop the account from being placed with an outside collection agency
08 Needs assessment Part VI question 2	The Hospital assesses the health care needs of the community through various studies discussions with community leaders and patient demand
09 Patient education Part VI question 3	See Collection Practices explanation Part III Line 9b
10 Community information Part VI question 4	The Hospital primarily services Beauregard Parish in Louisiana which consists of a rural population
11 Community building activities Part II	In accordance with identified community needs the Hospital trained and recruited physicians to serve in the community which is in a professional shortage area HPSA
12 Promoting community health Part VI question 5	The Organization operated a 60 bed facility for Hospital Service District 2 of Beauregard Parish providing general short term care to 2219 inpatients for 7406 days 363 newborns 1491 surgeries 16211 ER visits and 26452 outpatients 733 of hospital admissions are Medicaid and Medicare The hospital also conducts numerous community seminars and services to benefit the community
13 Affiliated health care system Part VI question 6	The Organization is not part of an affiliated health care system
14 State filings Part VI question 7	The Organization did file a community benefit report in 2012
15 Community representative input Part V question 3	The hospital took into account input from persons representing the community through a 3 phase plan The 1st phase sampled 400 residents of Beauregard and Vernon Parishes for telephone interviews and data collection The 2nd phase included sampling 38 employers of the local area and performing telephone interviews and data collection Finally the 3rd phase consisted of meetings with community leaders who reviewed community resident and employer survey perceptions and included roundtable group discussions The final meeting used a group discussion format to prioritize the community healthcare needs Community members that participated included individuals from various local banks non-profit organizations local government health professionals and community leaders

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	X	TravelForCompanions
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	false	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 (7 entries)

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
Theodore Badger Jr
231869	0	0	0	0	0	11000	0	0	0	242869	0	0	0
Dr Kanayochukwu Aluka
278807	0	0	0	0	0	0	0	0	0	278807	0	0	0
Darrell Kingham
184753	0	0	0	0	0	9167	0	0	0	193920	0	0	0
Joseph Caraway
197788	0	0	0	0	0	4827	0	0	0	202615	0	0	0
Dr Janet Lewis
606666	0	0	0	0	0	0	0	0	0	606666	0	0	0
Dr James Rudd Jr
289013	0	0	0	0	0	0	0	0	0	289013	0	0	0
Dr Stephen Farquhar
197032	0	0	0	0	0	0	0	0	0	197032	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	ExplanationExplanation
01 Benefit information Part I line 1a	Reasonable expenses submitted for a traveling spouce except for airfare accompanying a trustee on approved travel is reimbursed
02 Listed persons compensation information Part I line 4	Chief Executive Officer Theodore Badger received a serverance payment in the amount of 50667 from September 2012 and 2013

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	ExplanationExplanation
01. Form 990 governing body review (Part VI, line 11)	The Form 990 is reviewed by the board of directors prior to issuance
02. Conflict of interest policy compliance (Part VI, line 12c)	Every January a Conflict of Interest Questionaire is completed by each trustee These documents are reviewed and retained in the Board of Trustees files
03. CEO, executive director, top management comp (Part VI, line 15a)	The Board of Trustees Executive Committe conducts an annual performance evaluation following the end of each fiscal year Comparable compensation data for CEOs at other similiarly situated organizations is used Resources include the VHA Gulf States CEO Compensation Survey the Hay Group Hospital Compensation Report the Jackson Survey for quality goals Health Stream Emloyee Satisfaction Emergency Department Inpatient Same Day Surgery Lab and Radiology Satisfaction Surveys and other various reports The CEOs compensation is criteria based A bonus is dependent on achieving goals in community health quaility and financial areas A anaysis of salary history employee retention and self evaluation is also considered
04. Other officer or key employee compensation (Part VI, line 15b	Annual employee evaluations are conducted in November of each year These evaluations consider the employees achievement of goals salary and expense budgets compliance with quality controls and Joint Commission performance and competency and other criteria based objectives in determining remuneration In addition the CEO also considers the following salary surveys The Hay Group VHA Department Head Survey Louisiana Hospital Salary and Benefits Survey Greater New Orleans Society for Healthcare Human Resources Administration Executive Director and Management Survey
05. Governing documents, etc, available to public (Part VI, line 19)	Information is available upon request
06. Explanation of other changes in net assets or fund balances (Part XI, line 5)	Change in net assets is due to unrealized gains on investments of 264142

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	Beauregard Physician Group LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO Box 1540	AddressLine1
City	Deridder	City
State	LA	State
ZIP Code	70634	ZIPCode

Field	Value	IRS element (for citing)
EIN	270602265	EIN
Primary Activities	Physician Services	PrimaryActivities
Legal Domicile State	LA	LegalDomicileState
Total Income	2227863	TotalIncome
EOY Assets	822490	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1