2013-05-15T13:35:55-05:00 2012-06-30 KPMG LLP 450 Laurel Street Suite 1700 Baton Rouge LA 70801 990 2011-07-01 721028323 FMOL HEALTH SYSTEM INC % ROBERT D RAMSEY FMOL 2259232701 4200 ESSEN LANE BATON ROUGE LA 708092158 Robert Ramsey 2259232701 2013-05-09 true KPMG LLP 2253444000 2011 2016-02-24 21:20:13Z JOHN FINAN 4200 ESSEN LANE BATON ROUGE LA 70809 87422882 false 0928 X N/A X 1984 LA FMOL Health System manages an integrated health system to make a difference in our communities through Catholic Health Services by calling forth all who serve in the healthcare ministry. 15 12 587 9 1184378 0 0 0 71499367 86359969 4781122 21631 0 954836 76280489 87336436 165075 741200 0 0 35080332 45119210 0 0 0 48692432 72370733 83937839 118231143 -7657350 -30894707 59169404 72379045 34853979 52620498 24315425 19758547 X INSPIRED BY THE VISION OF ST. FRANCIS 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 4856977 477110 FMOL HEALTH SYSTEM INCLUDES CALAIS HEALTH, LLC, AND FRANCISCAN HEALTH AND WELLNESS WHICH PROVIDE OCCUPATIONAL MEDICINE, BEHAVORIAL HEALTH AND HEALTH AND WELLNESS SERVICES TO LOUISIANA RESIDENTS. 741200 741200 0 GRANTS ARE MADE TO CHARITABLE ORGANIZATIONS IN ORDER TO SUPPORT THE CHARITABLE MISSION OF FMOL HEALTH SYSTEMS, INC. 5598177 true false false true false false false false false true false false false true true false true false false true false false false false false false true false true true false false false false false false false false false false false false false false true true true true false false true 46 0 true 587 true true true true CJ false false false false false false false false false X 15 12 false false false false true true true true true false false true true true true false false true true false X ROBERT D RAMSEY 2259232701 4200 ESSEN LANE BATON ROUGE LA 70809 X JOHN J FINAN 50.0 X X 1588349 0 75222 C STEVEN CLARK 1.0 X 0 0 0 JOHN S LORE 1.0 X 0 0 0 ARCHBISHOP GREGORY AYMOND 1.0 X 0 0 0 MR CLAUDE HARBARGER 1.0 X 0 0 0 JAMES W MOORE JR 1.0 X 0 0 0 CW LOVELL II MD 1.0 X X 0 1400 0 RICHARD M DEARMAN MD 1.0 X 0 0 0 SR BRENDAN MARY RONAYNEOSF 1.0 X 0 0 0 SR LILIAN LYNCH OSF 1.0 X 0 0 0 DR WILLIAM JENKINS 1.0 X 0 0 0 JIM PRINCE 1.0 X 0 0 0 KEVIN SCHEXNAYDER 1.0 X 0 0 0 SR BARBARA ARCENEAUX OSF 1.0 X 0 0 0 SR KATHLEEN CAIN OSF 1.0 X 0 0 0 SR MARGARIDA VASQUESOSF 1.0 X 0 0 0 SR MARTHA ANN ABSHIRE OSF 1.0 X 0 0 0 HOWARD L HARVILL 1.0 X 92877 0 0 JOLEE H BOLLINGER ESQ 50.0 X 388062 0 65663 ROBERT D RAMSEY JR 50.0 X 525841 0 132027 KENNETH SCOTT WESTER 50.0 X 604515 0 92564 WILLIAM BARROW 50.0 X 502799 0 60881 DOLORES LEJEUNE 50.0 X 412161 0 68873 PAMELA B SHOWS 50.0 X 347132 0 63614 LAURA T MARTIN 50.0 X 245669 0 64035 PETER F GUARISCO JR 50.0 X 221552 0 41938 WILSON J GORDON III 50.0 X 431435 0 123660 STEPHANIE A MILLS MD 50.0 X 491881 0 79010 REDFIELD E BRYAN MD 20.0 X 179966 0 4925 LOUIS BREMER 50.0 X 536833 0 33847 KAREN B ALLEN 25.0 X 246513 0 41391 SUE E MCMAHON 50.0 X 343171 0 57090 KAREN PARKER 50.0 X 192814 0 49824 DAVID E WENDT 50.0 X 219058 0 48484 VINDELL WASHINGTON 50.0 X 397101 0 33282 WILLIAM P MOSSER 50.0 X 221804 0 25488 8189533 1400 1161818 61 false true false CERNER CORPORATION 2800 ROCKCREEK PKWY KANSAS CITY MO 64117 CONSULTING & SERVICE 13869352 CDW Government LLC 230 N Milwaukee Ave VERNON HILLS IL 600611577 CONSULTING & SERVICE 4379108 Mainline Information Systems 1700 Summit Lake Dr TALLAHASSEE FL 32317 CONSULTING & SERVICE 3716455 SHI International Corporation 33 Nightsbridge Road PISCATAWAY NJ 08854 Consulting & service 2767097 Venture Technologies 860 Center Street RIDGELAND MS 39157 CONSULTING & SERVICE 1499699 63 0 MANAGEMENT FEES 900099 84636784 84636784 CONTRACT INCOME 900099 740740 740740 PURCHASED DISCOUNT 900099 209706 209706 MEDICAL RECORDS REVENUE 900099 66087 66087 HEALTHY LIVES REVENUE 900099 706652 477110 229542 86359969 108077 0 108077 0 0 86446 -86446 -86446 -86446 0 0 0 CONSULTING REVENUE 900099 954836 954836 954836 87336436 86130427 1184378 21631 741200 741200 0 0 0 6520476 26580 6493896 0 30140666 3293238 26847428 3264292 150277 3114015 2917077 246638 2670439 2276699 184182 2092517 0 354549 52263 302286 127446 127446 73687 73687 0 0 35240911 390518 34850393 911669 96162 815507 824926 72234 752692 119912 119912 0 1852432 116038 1736394 1161496 85665 1075831 0 0 739522 739522 0 14809576 13302 14796274 777946 48249 729697 CHG IN VALUE OF INT RATE SWAP 14117895 14117895 0 DUES/SUBSCRIPTIONS 675232 2291 672941 MINOR UNCAP EQUIPMENT 168072 2174 165898 DEPARTMENT FOOD 133121 18298 114823 282341 58868 223473 118231143 5598177 112632966 0 6005114 11487964 2055917 2149908 0 0 47743 1334018 0 0 0 0 0 0 0 0 7438466 7208381 105444148 58553400 42980127 46890748 0 0 0 -720 0 0 0 0 642037 3308746 59169404 72379045 14760478 20505880 0 0 0 0 170000 170000 0 0 0 0 0 0 0 0 19923501 31944618 34853979 52620498 X 24315425 19758547 0 0 0 0 24315425 19758547 59169404 72379045 X -30894707 26337829 X false true true X false X X X false false false OUR LADY OF THE LAKE HOSPITAL INC 720423651 03 true true true 62897541 OUR LADY OF LOURDES REGIONAL MEDICAL CENTER 720423635 03 true true true 20338921 ST FRANCIS MEDICAL CENTER 720408970 03 true true true 26459967 ST ELIZABETH HOSPITAL 721470744 03 true true true 8375799 FRANCISCAN PACE INC 260297860 09 true true true 158914 5 118231142 false false false false false true 73687 false false false 73687 false 1008267 118447 889820 100680541 58434953 42245588 3755340 3755340 46890748 0 ACCRUED KEYSOP LIABILITY 973728 OTHER LIABILITIES 373500 CAPITAL LEASE - CERNER 9295112 SELF INSURANCE LIAB-L.T. 1175442 INTEREST RATE SWAP 20126836 31944618 FIN 48 (ASC 740) FOOTNOTE "FMOLHS 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." Central America and the Caribbean Investments 130000 130000 130000 true false true true true false true OUR LADY OF THE LAKE HOSPITAL INC 5000 HENNESSY BLVD BATON ROUGE LA 70808 720423651 501(C)(3) 24100 GENERAL SUPPORT LOUISIANA HEALTH CARE QUALITY FORUM 8550 UNITED PLAZA SUITE 500 BATON ROUGE LA 70809 260497115 501(C)(3) 75000 LAPOST GRANT COALITION TO PROTECT AMERICA'S HEALTHCARE PO BOX 30211 BETHESDA MD 20824 522253225 501(c)(4) 77000 GENERAL SUPPORT LOUISIANA HOSPITAL ASSOCIATION 9521 BROOKLINE AVENUE BATON ROUGE LA 70809 720489377 501(c)(6) 10000 SPONSORSHIP ST BERNARD HEALTH FUND INC 4200 ESSEN LANE BATON ROUGE LA 70809 204685614 501(c)(3) 500000 GENERAL SUPPORT BATON ROUGE EYE BANK AUXILLARY 7777 HENNESSEY BLVD PMB 163 BATON ROUGE LA 70809 720829881 501(C)(3) 7500 GALA & DAY AT RACES COUNCIL FOR A BETTER LOUISIANA PO BOX 4308 BATON ROUGE LA 70821 720570930 501(c)(6) 5500 SEE PART IV COMMUNITY FUND FOR THE ARTS 427 LAUREL STREET BATON ROUGE LA 70801 720735814 501(C)(3) 10000 GENERAL SUPPORT 5 3 SCHEDULE I, PART 1, LINE 2 ACCORDING TO THE LEVELS OF AUTHORIZATION'S POLICIES AND PROCEDURES, ALL CHARITABLE CONTRIBUTIONS ARE APPROVED BY THE CEO OF THE FMOL HEALTH SYSTEM. SCHEDULE I, PART II, LINE 7 ANNIVERSARY FUND DONATION X X X false true X X X true true false false false false false true false JOHN J FINAN 779604 0 680031 0 128714 0 43095 0 32127 0 1663571 0 0 0 KENNETH SCOTT WESTER 424810 0 142134 0 37571 0 62240 0 30324 0 697079 0 0 0 WILLIAM BARROW 367005 0 82987 0 52807 0 40025 0 20856 0 563680 0 0 0 DOLORES LEJEUNE 276908 0 103901 0 31352 0 48531 0 20342 0 481034 0 0 0 PAMELA B SHOWS 231675 0 74321 0 41136 0 38366 0 25248 0 410746 0 0 0 LAURA T MARTIN 174440 0 55535 0 15694 0 44122 0 19913 0 309704 0 0 0 SUE E MCMAHON 169261 0 0 0 173910 0 44009 0 13081 0 400261 0 0 0 KAREN PARKER 161059 0 25300 0 6455 0 24652 0 25172 0 242638 0 0 0 DAVID E WENDT 176712 0 27388 0 14958 0 30771 0 17713 0 267542 0 0 0 VINDELL WASHINGTON 310438 0 78343 0 8320 0 9800 0 23482 0 430383 0 0 0 WILLIAM P MOSSER 201679 0 20125 0 0 0 9113 0 16375 0 247292 0 0 0 PETER F GUARISCO JR 147030 0 42900 0 31622 0 15602 0 26336 0 263490 0 0 0 JOLEE H BOLLINGER ESQ 287147 0 84183 0 16732 0 35103 0 30560 0 453725 0 0 0 WILSON J GORDON III 307420 0 103757 0 20258 0 89449 0 34211 0 555095 0 0 0 STEPHANIE A MILLS MD 338190 0 114740 0 38951 0 44451 0 34559 0 570891 0 0 0 REDFIELD E BRYAN MD 130000 0 45000 0 4966 0 0 0 4925 0 184891 0 0 0 LOUIS BREMER 311473 0 95607 0 129753 0 9800 0 24047 0 570680 0 0 0 ROBERT D RAMSEY JR 367591 0 116407 0 41843 0 92624 0 39403 0 657868 0 0 0 KAREN B ALLEN 165319 0 50275 0 30919 0 14635 0 26756 0 287904 0 0 0 SCHEDULE J, PART I, LINE 1A LOUIS BREMER RECEIVED A HOUSING ALLOWANCE. THESE EXPENSES WERE TREATED AS TAXABLE COMPENSATION TO THE LISTED PERSON. WILLIAM BARROW RECEIVED REIMBURSEMENT FOR SOCIAL CLUB DUES. THESE EXPENSES WERE TREATED AS TAXABLE COMPENSATION TO THE LISTED PERSON. DOLORES LEJEUNE RECEIVED PAYMENT FOR A TRAVEL COMPANION. THESE EXPENSES WERE TREATED AS TAXABLE COMPENSATION TO THE LISTED PERSON. FMOL HEALTH SYSTEM PAID FOR TRAVEL FOR A COMPANION OF VINDELL WASHINGTON. THIS BENEFIT IS EXCLUDED FROM THE EMPLOYEE'S TAXABLE INCOME AS A WORKING CONDITION FRINGE BENEFIT. SCHEDULE J, PART I, LINE 1B HUMAN RESOURCES IS INVOLVED IN THE DECISION-MAKING PROCESS IN DETERMINING THAT THE ORGANIZATION WOULD PROVIDE HOUSING ALLOWANCES, SOCIAL CLUB DUES, AND TRAVEL COMPANION PAYMENTS. SCHEDULE J, PART I, LINE 4A THE CFO, SECRETARY/GENERAL COUNSEL, AND TWO KEY EMPLOYEES ARE 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 A 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. THE CEO IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID 75% OF HIS BASE SALARY AND 75% OF HIS INCENTIVE PAYMENT DETERMINED 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. TWO KEY EMPLOYEES ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE. 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 RANGES FROM 18 TO 36 MONTHS DEPENDING ON THE EXECUTIVE AND THE LENGTH OF SERVICE. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. SUE E. MCMAHON RECEIVED A SEVERANCE PAYMENT OF $150,000 IN THE CURRENT YEAR. SCHEDULE J, PART I, LINE 4B FMOLHS 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 J, PART I, LINE 7 DISCRETIONARY BONUSES WERE PAID WITH REGARD TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE DEPENDING ON THE INDIVIDUAL'S JOB LEVEL. LOUISIANA PUBLIC FACILITIES AUTHORITY 05A 05D 720895871 546395B78 2005-10-25 170286095 CAPITAL, REFUND PRIOR ISSUES 7/23/ false false false 0 0 86933548 0 0 0 1683949 1675000 0 83574599 0 0 2009 false true true true false true true true false 0.04410 0.00150 0.04560 true true false true MERRILL LYNCH 23.5 true false true HYPO RE BANK 3.5 true true false PART II, LINE 3 0 THE INTEREST EARNINGS WERE SPENT ON CAPITAL EXPENDITURES. PART IV, LINE 3C 0 THE TERM ON THE HEDGE LISTED IS THE ENTIRE TERM. REMAINING TIME LEFT ON THE HEDGE DIFFERS BY BOND ISSUE. PART IV, LINE 4C 0 THE GROSS PROCEEDS WERE INVESTED IN A GIC IN 2005 FOR 3 YEARS. NO PROCEEDS ARE CURRENTLY INVESTED IN A GIC. PART IV 0 THE FIVE YEAR REBATE CALCULATION IS NOT YET DUE. LA PUBLIC FACILITIES AUTHORITY O5B 05C 720895871 546395D92 2008-05-28 100000000 CAPITAL, REFUND PRIOR ISSUE 10/04/ false false false 0 0 104257715 0 0 0 1141630 0 0 103116085 0 0 2009 true false true true false true true true false 0.00020 0.00110 0.00130 true true true false 0 false false true HYPO RE BANK 3. true false false PART IV, LINE 4C 0 THE GROSS PROCEEDS WERE INVESTED IN A GIC IN 2005 FOR 3 YEARS. NO PROCEEDS ARE CURRENTLY INVESTED IN A GIC. LA PUBLIC FACILITIES AUTHORITY 2005D 720895871 546395C28 2008-07-21 88325000 REFUND 10/25/05, REFUND 7/23/98 false false false 5800000 0 0 0 0 0 0 0 0 0 0 0 true false true true false false false false 0.00000 0.00000 0.00000 true false false true MERRILL LYNCH 20.5 true false false 0 false false PART IV, LINE 3C 0 THE TERM ON THE HEDGE LISTED IS THE ENTIRE TERM. REMINAING TIME LEFT ON THE HEDGE DIFFERS BY BOND ISSUE. LA PUBLIC FACILITIES AUTHORITY 98B 08A 720895871 546395E83 2008-08-07 82485000 REFUND PRIOR ISSUES '98 '05 false false false 535000 0 535600 0 0 0 467933 67667 0 0 0 0 2009 true false true true false false false false 0.00000 0.00000 0.00000 true false false true MERRILLGOLDMAN 17. true false false 0 false false PART IV, LINE 3C 0 THE TERM ON THE HEDGE LISTED IS THE ENTIRE TERM. REMAINING TIME LEFT ON THE HEDGE DIFFERS BY BOND ISSUE. LA PUBLIC FACILITIES AUTHORITY 2009A 720895871 546395H72 2009-07-23 202528691 CAPITAL, REFUND PRIOR ISSUES '98 false false false 0 0 121483978 0 4518157 0 2163735 0 0 114802086 0 0 2009 true false true true false true true true false 0.00040 0.00190 0.00230 true false false false 0 false 0 false false PART VI, SECTION A, QUESTION 6 THE ENTITY IS ORGANIZED AS A NON-PROFIT CORPORATION WITH MEMBERS. THE MEMBERS ARE THE PROVINCIAL OF THE FMOL NORTH AMERICAN PROVINCE AND THOSE PERSONS ARE MEMBERS OF THE PROVINCIAL COUNCIL OF FMOL NORTH AMERICAN PROVINCE. PART VI, SECTION A, QUESTION 7A THE MEMBERS RETAIN THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF FMOL HEALTH SYSTEM. PART VI, SECTION A, QUESTION 7B THE RESERVED POWERS TO THE MEMBERS ARE AS FOLLOWS: 1. CHANGE PHILOSOPHY, OBJECTIVES, PURPOSES OF CORPORATION AND ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS 2. APPOINT AND REMOVE BOARD OF TRUSTEES AND OFFICERS OF FMOL HEALTH SYSTEM 3. ALTER ARTICLES OF INCORPORATION AND BYLAWS OF FMOL HEALTH SYSTEM AND ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS 4. AUTHORIZE MERGER, CONSOLIDATION OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. DISSOLVE AND DISTRIBUTE ASSETS OF FMOL HEALTH SYSTEM OR ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS 6. APPOINT AND TERMINATE CEO OF FMOL HEALTH SYSTEM OR ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS 7. ACQUIRE, LEASE, ENCUMBER REAL ESTATE ON BEHALF OF FMOL HEALTH SYSTEM OR ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS 8. ADD TO OR INCUR LONG TERM DEBT IN EXCESS OF $5 MILLION BY FMOL HEALTH SYSTEM OR ANY CORPORATION IN WHICH FMOL HEALTH SYSTEM RETAINS VOTING RIGHTS PART VI, SECTION A, QUESTION 11 AFTER PREPARATION AND REVIEW BY KPMG, LLP, MANAGEMENT WILL REVIEW THE FORM 990. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. PART VI, SECTION B, QUESTION 12C FMOL HEALTH SYSTEM 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 RESULTS IN CREATING 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 SHE OR HE (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 FMOL HEALTH SYSTEM 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, FMOL HEALTH SYSTEM 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. PART VI, SECTION B, QUESTION 15A & 15B OUR BOARD OF DIRECTORS DESIGNATES THE HUMAN RESOURCES AND COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR EXECUTIVES AND KEY EMPLOYEES. THE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION FROM AN OUTSIDE CONSULTING FIRM. THE COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE COMMITTEE. PART VI, SECTION C, QUESTION 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PROGRAM SERVICE THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM ("FMOLHS") WAS FORMED IN 1984 BY THE FRANCISCAN MISSIONARIES OF OUR LADY - NORTH AMERICAN PROVINCE, A RELIGIOUS COMMUNITY OF THE ROMAN CATHOLIC CHURCH, TO ENSURE THE PERPETUATION OF THEIR MISSION. THE HEALTH SYSTEM DELIVERS MEDICAL CARE AND COMMUNITY SERVICES THROUGH ITS SPONSORED HOSPITALS, SUBSIDIARIES AND AFFILIATES: OUR LADY OF THE LAKE HOSPITAL, INC. IN BATON ROUGE, LOUISIANA; ST. ELIZABETH HOSPITAL, IN GONZALES, LOUISIANA; OUR LADY OF LOURDES REGIONAL MEDICAL CENTER IN LAFAYETTE, LOUISIANA; AND ST. FRANCIS MEDICAL CENTER IN MONROE, LOUISIANA. CALAIS HEALTH, LLC, A WHOLLY OWNED CORPORATE HEALTH SERVICES SUBSIDIARY, AND FRANCISCAN PACE, INC., A WHOLLY OWNED CORPORATION FORMED FOR THE PURPOSE OF PERFORMING RELIGIOUS, BENEVOLENT, CHARITABLE, HEALTHCARE AND EDUCATIONAL ACTIVITIES, ARE BOTH HEADQUARTERED IN BATON ROUGE AND OPERATE THROUGHOUT LOUISIANA. LOUISE INSURANCE COMPANY SEEKS TO ASSURE BEST-COST LIABILITY COVERAGE FOR HEALTH SYSTEM-SPONSORED ORGANIZATIONS. THESE SPONSORED HOSPITALS, SUBSIDIARIES AND AFFILIATES ARE REFERRED TO HEREIN AS "FMOLHS AFFILIATES". FMOLHS SUPPORTS THE PURPOSE AND ACTIVITIES OF FMOLHS AFFILIATES AND ITS POWER MUST BE EXERCISED IN ACCORDANCE WITH THE TEACHINGS, TRADITIONS AND CANON LAW OF THE ROMAN CATHOLIC CHURCH AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH FACILITIES PROMULGATED BY THE NATIONAL CONFERENCE OF CATHOLIC BISHOPS OF THE UNITED STATES CATHOLIC CONFERENCE. FMOLHS SUPPORTS THE ACTIVITIES OF THE ENTIRE SYSTEM BY PROVIDING EXECUTIVE LEADERSHIP AND CENTRALIZED SUPPORT AND MANAGERIAL FUNCTIONS. SYSTEM-LEVEL ACTIVITIES INCLUDE STRATEGIC PLANNING, CAPITAL AND OPERATIONAL BUDGETING, HUMAN RESOURCES ADMINISTRATION, CENTRALIZED CASH MANAGEMENT AND TREASURY FUNCTIONS, INFORMATION TECHNOLOGY DEVELOPMENT AND SUPPORT, BUSINESS OFFICE, DECISION SUPPORT, AND OTHER SUPPORT AND MANAGEMENT FUNCTIONS. FMOLHS AND THE FMOLHS AFFILIATES ARE ACTIVE, CARING MEMBERS OF THE COMMUNITIES THEY SERVE. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTH NEEDS OF THE PEOPLE OF GOD, THE BOARD OF DIRECTORS HAS ESTABLISHED A POLICY UNDER WHICH FMOLHS AFFILIATES PROVIDE CARE TO NEEDY MEMBERS OF THEIR COMMUNITIES. FOLLOWING THAT POLICY, HEALTH CARE SERVICES COSTING $11,216,000 WERE PROVIDED WITHOUT CHARGE DURING THE YEAR ENDED JUNE 30, 2012. CHARGES FOREGONE, BASED ON ESTABLISHED RATES, TOTALED $30,305,000 FOR THE YEAR ENDED JUNE 30, 2012. THE FMOLHS AFFILIATES ALSO PARTICIPATE IN GOVERNMENT PROGRAMS INCLUDING MEDICARE, MEDICAID, AND THE TRICARE PROGRAM. UNDER THESE PROGRAMS, THE FMOLHS AFFILIATES PROVIDE CARE TO PATIENTS AT PAYMENT RATES THAT ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF ACTUAL COST. IN SOME CASES, THESE PROGRAMS PAY THE FMOLHS AFFILIATES AT AMOUNTS WHICH ARE LESS THAN THEIR COST OF PROVIDING SERVICES. THE FOLLOWING TABLE SUMMARIZES THE AMOUNT OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND THE ESTIMATED LOSSES INCURRED BY THE FMOLHS AFFILIATES DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR CHARITY FOR THE YEAR ENDED JUNE 30, 2012: CHARGES FOREGONE ESTIMATED UNREIMBURSED COSTS MEDICARE $804,845,000 $82,204,000 MEDICAID $316,398,000 $59,084,000 OTHER $ 6,713,000 $ 1,544,000 CHARITY $ 30,305,000 $11,216,000 TOTALS 1,158,261,000 $154,048,000 IN ADDITION TO COMMUNITY SERVICES DIRECTLY ASSOCIATED WITH PROVIDING HOSPITAL BASED CARE, FMOLHS AFFILIATES SERVE THEIR COMMUNITIES IN NUMEROUS OTHER WAYS. ALTHOUGH THE FMOLHS AFFILIATES HAVE ESTIMATED THE COST OF EACH OF THESE EFFORTS TO SERVE THEIR COMMUNITIES, MANAGEMENT AND THE BOARDS OF DIRECTORS BELIEVE THAT SUCH COSTS REPRESENT ONLY SOME OF THE MANY WAYS FMOLHS AFFILIATES SERVE THEIR COMMUNITIES. THE ESTIMATED COSTS FOR THE YEAR ENDED JUNE 30, 2012 ARE AS FOLLOWS: NET COMMUNITY BENEFIT EXPENSE SUBSIDIZED HEALTH SERVICES 27,985,000 COMMUNITY HEALTH IMPROVEMENT SERVICES 3,504,000 HEALTH PROFESSIONS EDUCATION 7,474,000 COMMUNITY BUILDING ACTIVITIES 1,212,000 DONATIONS AND IN-KIND CONTRIBUTIONS 1,419,000 TOTAL 41,594,000 SUBSIDIZED HEALTH SERVICES-INCLUDES THE DISCOUNT PROVIDED, AT COST, TO ALL PATIENTS THAT HAVE NO FORM OF INSURANCE COVERAGE. PROGRAMS SUCH AS ST. ELIZABETH COMMUNITY CLINIC, SCOTT FAMILY CLINIC, ST. BERNADETTE'S CLINIC, SCOTLANDVILLE CLINIC, KID-MED CLINIC WHICH SERVES THE UNDERINSURED AND UNINSURED. MENTAL HEALTH SERVICES AND PALLIATIVE CARE ARE ALSO PROVIDED TO THE COMMUNITY. COMMUNITY HEALTH IMPROVEMENT SERVICES - INCLUDES ACTIVITIES CARRIED OUT TO IMPROVE COMMUNITY HEALTH AND COSTS WHICH ARE UNDERWRITTEN BY FMOLHS AFFILIATES. THESE SERVICES INCLUDE CAMP BLUEBIRD, LAFAYETTE COMMUNITY HEALTHCARE CLINIC, A MEDICATION PROGRAM, CONGREGATIONAL HEALTH SERVICES, NORTHSIDE HIGH SCHOOL HEALTH CENTER, COMMUNITY SEMINARS, IMMUNOLOGICAL SUPPPORT, PARISH NURSE PROGRAM, LAKELINE DIRECT, ST. MARTHA ACTIVITY CENTER, ELDERLY SERVICES, AND ELDERLY HOUSING. HEALTH PROFESSIONS EDUCATION - INCLUDES ASSISTANCE TO FUTURE HEALTH CARE PROFESSIONALS, NURSING STUDENTS AND PHARMACY STUDENTS. CLINICAL SETTING FOR UNDERGRADUATE, VOCATIONAL TRAINING, INTERNSHIPS, CLERKSHIPS, AND RESIDENCIES. COLLABORATION WITH LOCAL COLLEGES FOR SUPERVISION AND CLINICAL TRAINING IN PHARMACY, RESPIRATORY THERAPY, HEALTH INFORMATION MANAGEMENT, AND MEDICAL TECHNOLOGY. REGISTERED NURSE RECRUITMENT ACTIVITIES, OLOL COLLEGE, AND PARTICIPATION IN MEDICARE'S GRADUATE MEDICAL EDUCATION THROUGH AFFILIATION WITH LOUISIANA MEDICAL SCHOOL AND MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS; WILL CONTINUE TO SUPPORT AVAILABILITY OF FUTURE HEALTH CARE PROFESSIONALS. COMMUNITY BUILDING ACTIVITIES- INCLUDES LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS SUCH AS EMERGENCY PREPAREDNESS PROGRAMS; COMMUNITY HEALTH EDUCATION SUCH AS CLASSES ON BREAST FEEDING, CHILDBIRTH BASICS, SIBLING CLASS, AND ABC'S OF CHILDCARE; COMMUNITY SUPPORT WITH MEALS ON WHEELS; COMMUNITY-BASED CLINICAL SERVICES, INCLUDING HEALTH SCREENINGS, DISCOUNTED SERVICES PROVIDED TO LOUISIANA BAPTIST CHILDREN'S HOME, VETERAN'S ADMINISTRATION, RURAL HOSPITALS, ULM ATHLETIC DEPARTMENT, MDA, WELLSPRING, AND HANDICAP CHILDREN; WORKFORCE DEVELOPMENT; AND PROVIDES COMMUNITY CLINICS, ST. VINCENT DEPAUL CHARITABLE PHARMACY AND MARY BIRD PERKINS USE OF LAND AND BUILDINGS. DONATIONS AND IN-KIND CONTRIBUTIONS - INCLUDES DONATIONS TO VARIOUS AREA COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY, FAMILIES HELPING FAMILIES, CHILDREN'S COALITION, WELLSPRING, YMCA, HAITI PROJECT, PREVENT CHILD ABUSE, KOMEN FOUNDATION, ALZHEIMER'S FOUNDATION, MARCH OF DIMES, JUNIOR ACHIEVEMENT, CYSTIC FIBROSIS, COMMUNITY FUND FOR THE ARTS AND AMERICAN HEART ASSOCIATION. PROVIDES OFFICE SPACE FOR THE FAMILY TREE PARENTING CENTER, AS WELL AS EMPLOYEE COSTS ASSOCIATED WITH BOARD AND COMMUNITY INVOLVEMENT IN VARIOUS COMMUNITY ORGANIZATIONS. PART XI, LINE 5 CAPITAL TRANSFERS $26,338,548 GAIN/LOSS ON EQUITY INVESTEES (720) TOTAL $26,337,828 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. BRENDAN MARY RONAYNE,O.S.F. TITLE:BOARD MEMBER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. LILIAN LYNCH, O.S.F. TITLE:BOARD MEMBER HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JIM PRINCE TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. BARBARA ARCENEAUX, O.S.F. TITLE:BOARD MEMBER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. MARGARIDA VASQUES,O.S.F. TITLE:BOARD MEMBER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOLEE H. BOLLINGER, ESQ. TITLE:SECRETARY/GENERAL COUNSEL HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT D. RAMSEY, JR. TITLE:SR. VICE PRESIDENT/CFO HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:REDFIELD E. BRYAN, M.D. TITLE:SPECIAL PROJECTS CONSULTANT HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KAREN B. ALLEN TITLE:PRESIDENT/CEO SR. 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