2013-09-16T16:31:15-05:00 2012-10-31 Steven M DeRouen CPA P O Box 4265 Lake Charles LA 70606 990 2011-11-01 720491106 West Louisiana Health Services Inc WEST PO Box 730 Deridder LA 70634 Darrell Kingham 3374627106 2013-09-16 false Steven M DeRouen CPA 3375134915 2013-09-16 X 2011 2016-02-24 21:20:13Z Ed ONeal 35032869 false X www.beauregard.org X 1946 LA 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 14 14 477 99 0 0 0 34476756 34403123 107175 335699 1522 0 34585453 34738822 0 0 2291832 2347614 0 0 33555117 33502768 35846949 35850382 -1261496 -1111560 10049179 10401357 7222975 8422571 2826204 1978786 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 false false 32232453 32169921 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 3617929 2226271 Operated Beauregard Physician Group which consists of six physician clinics which provide medical services to Beauregard Parish 35850382 true false false false false false false false true false false true false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true false false false false false true 43 0 true 477 true false false false false false false false false false false false false false false X 14 14 false false false false false false false true true false false true true true true true true true true false X Darrell L Kingham CPA VP of Finance 3374627106 600 South Pine Street Deridder LA 70634 Carl Slover 2.00 X 0 0 0 Chris Granger MD 2.00 X 0 0 0 Chuen Kwok MD 2.00 X 0 0 0 Ed ONeal 2.00 X X 0 0 0 Gerald Johnson 2.00 X 0 0 0 Jared Morris 2.00 X X 0 0 0 Jim Morris 2.00 X 0 0 0 Jodi Andrews 2.00 X 0 0 0 Julie Orsoy 2.00 X 0 0 0 Natha Gantt 2.00 X 0 0 0 Terri Theaux 2.00 X X 0 0 0 Thomas Shirley DDS 2.00 X 0 0 0 Tom Dobbins MD 2.00 X 0 0 0 Tom Rhodes 2.00 X X 0 0 0 Darrell Kingham 50.00 X 184753 0 9167 Theodore Badger Jr 40.00 X 231869 0 11000 Dr James Rudd Jr 40.00 X 289013 0 0 Dr Janet Lewis 40.00 X 606666 0 0 Dr Kanayochukwu Aluka 40.00 X 278807 0 0 Dr Stephen Farquhar 40.00 X 197032 0 0 Joseph Caraway 40.00 X 197788 0 4827 1985928 0 24994 7 false true false 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 2 Reimbursement from Hosp 900099 32169921 32169921 Patient Service 621400 2226271 2226271 Bad Debt Recoveries 621400 6931 6931 34403123 229766 229766 399980 294047 105933 105933 105933 34738822 34738822 0 0 436789 436789 1908298 1908298 2527 2527 9300 9300 15 15 12442 12442 29504 29504 446 446 11614 11614 8162 8162 433460 433460 Other Professional Expenses 15554010 15554010 Fiscal & Admin Expenses 9087806 9087806 Nursing Expenses 4148455 4148455 General Service Expenses 3379650 3379650 827904 827904 35850382 35850382 0 0 2408030 2787001 374736 378402 395792 276960 7234 21425 107282 90803 325974 5466007 5944182 670498 901618 293626 966 10049179 10401357 1945677 1492157 5277298 6930414 7222975 8422571 X 2826204 1978786 2826204 1978786 10049179 10401357 X -1111560 264142 X false true true X false X 7513 38 7551 7472 41 7513 1.00000 false false Certificates of Deposit 901618 C 901618 Due to HSD 2 5305429 Accrued Payroll 811249 Accrued Vacation Payable 700084 Accrued Disability Benefits 113652 6930414 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 true true true X true X true false true true 4521883 3600877 921006 0.02660 6835691 6126905 708786 0.02050 11357574 9727782 1629792 0.0471 110543 110543 0.0032 175084 175084 0.0051 4082394 2289313 1793081 0.0518 4368021 2289313 2078708 0.0601 15725595 12017095 3708500 0.1072 133870 133870 0.0039 133870 133870 0.0039 true 1231364 492546 8581553 10775621 -2194068 X true true 1 1 Hospital Service District 2

600 S Pine Street Deridder LA 70634

X X X Hospital Service District 2 1 true X X X X X X X X 10 true false true X X X X X X X X X X true true true 2.000000 true 300.0000 true X X X X true true X X X true X true X X X true X false false 1 Beauregard Physician Group

600 S Pine Street Deridder LA 70634

Six Physician Clinics 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 X true true X X X X true false false false false false false false false 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 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 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 Beauregard Physician Group LLC PO Box 1540 Deridder LA 70634 270602265 Physician Services LA 2227863 822490 NA