FURP.ORG / PUBLIC DATA EXPLORER

OUR LADY OF THE LAKE ASCENSION COMMUNITY: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
OUR LADY OF THE LAKE ASCENSION COMMUNITY (EIN 72-1470744)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201341359349309119
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T18:17:25-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1450 Laurel Street Suite 1700AddressLine1
CityBaton RougeCity
StateLAState
ZIP Code70801ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN721470744EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OUR LADY OF THE LAKE ASCENSIONBusinessNameLine1
Business Name Line2COMMUNITY HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% SCOTT RICHARDInCareOfName
Name ControlOURLNameControl
Phone2256475000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11125 HIGHWAY 30AddressLine1
CityGONZALESCity
StateLAState
ZIP Code70737ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSCOTT RICHARDName
TitleVP OF FINANCETitle
Phone2256475000Phone
Date Signed2013-05-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2253444000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDOLORES LEJEUNENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11125 HIGHWAY 30AddressLine1
CityGONZALESCity
StateLAState
ZIP Code70737ZIPCode
FieldValueIRS element (for citing)
Gross Receipts91760243GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.steh.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileLAStateLegalDomicile
Activity Or Mission DescriptionThe purpose of the hospital is to provide for the care of the ill, injured, or disabled persons and to enhance the health of those in the community through research and education.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees905TotalNbrEmployees
Total Nbr Volunteers44TotalNbrVolunteers
Total Gross UBI-257TotalGrossUBI
Net Unrelated Business Txbl Income-1837NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year85561ContributionsGrantsPriorYear
Contributions Grants Current Year469500ContributionsGrantsCurrentYear
Program Service Revenue Prior Year83522419ProgramServiceRevenuePriorYear
Program Service Revenue CY90425776ProgramServiceRevenueCY
Investment Income Prior Year101424InvestmentIncomePriorYear
Investment Income Current Year83981InvestmentIncomeCurrentYear
Other Revenue Prior Year391043OtherRevenuePriorYear
Other Revenue Current Year357750OtherRevenueCurrentYear
Total Revenue Prior Year84100447TotalRevenuePriorYear
Total Revenue Current Year91337007TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year93998GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY56187GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year46594643SalariesEtcPriorYear
Salaries Etc Current Year48617568SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year32754961OtherExpensePriorYear
Other Expenses Current Year35423451OtherExpensesCurrentYear
Total Expenses Prior Year79443602TotalExpensesPriorYear
Total Expenses Current Year84097206TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4656845RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7239801RevenuesLessExpensesCY
Total Assets BOY88530644TotalAssetsBOY
Total Assets EOY95702620TotalAssetsEOY
Total Liabilities BOY28983663TotalLiabilitiesBOY
Total Liabilities EOY32744634TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY59546981NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY62957986NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionINSPIRED 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 THOSE WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING-WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32347617Expense
Grants56187Grants
Revenue52606764Revenue
DescriptionST. ELIZABETH HOSPITAL PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION OF MEETING THE HEALTHCARE NEEDS OF THE PEOPLE OF GOD, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO THE NEEDY MEMBERS OF ITS COMMUNITIES. FOLLOWING THAT POLICY, HEALTH CARE SERVICES WERE PROVIDED WITHOUT CHARGE OR AT RATES WHICH ARE LESS THAN THE COST OF PROVIDING SUCH SERVICES. THE HOSPITAL PROVIDED INPATIENT AND OUTPATIENT MEDICAL SERVICES FOR 10,551 PATIENT DAYS AND 183,390 PHYSICIAN OFFICE VISITS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8148714Expense
Revenue12830009Revenue
DescriptionTHE HOSPITAL PROVIDES PATIENTS WITH SURGICAL CARE. 47,400 SURGICAL MINUTES WERE USED DURING THE YEAR.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense5863463Expense
Revenue24989003Revenue
DescriptionTHE HOSPITAL PROVIDES RADIOLOGY SERVICES TO ITS INPATIENTS AND OUTPATIENTS. DURING THE CURRENT YEAR, THE HOSPITAL PERFORMED 41,230 RADIOLOGY PROCEDURES.Description
FieldValueIRS element (for citing)
Total Program Service Expense46359794TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109664NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees905NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSCOTT RICHARDNamePerson
Telephone Number2256475071TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11125 W HIGHWAY 30AddressLine1
CityGONZALESCity
StateLAState
ZIP Code70737ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
BILL MARTIN
BOARD MEMBER - CHAIR2.0XX000
ROBERT BURGESS
BOARD MEMBER - VICE CHAIR2.0XX000
CHRIS TREVINO MD
BOARD MEMBER- SECRETARY2.0XX000
CARY PAUL AGUILLARD JR MD
BOARD MEMBER40.0X301058038082
THE HONORABLE JOHN A BERTHELOT
BOARD MEMBER2.0X000
GREGORY BRANDAO EDD
BOARD MEMBER2.0X000
SR HELEN CAHILL OSF
BOARD MEMBER1.0X000
THE HONORABLE TERI CASSO
BOARD MEMBER2.0X000
DEBORAH CAVALIER MD
BOARD MEMBER2.0X000
JAMES D'ANTONI MD
CHIEF OF STAFF/BOARD MEMBER40.0X225961030835
JOHN F FRAICHE MD
BOARD MEMBER40.0X656879011765
ROGER KEESE
CHIEF OF STAFF/BOARD MEMBER2.0X000
DOLORES N LEJEUNE RN C N A
PRESIDENT AND CEO2.0X041216168873
ANTHONY NOBILE
BOARD MEMBER2.0X000
SCOTT PETRIE MD
BOARD MEMBER2.0X000
DONALD SONGY
BOARD MEMBER2.0X000
HONORABLE ALVIN TURNER JR
BOARD MEMBER2.0X000
DAWN ZITMAN MD
BOARD MEMBER2.0X183892015140
CRAIG A VITRANO MD
CHIEF MEDICAL OFFICER40.0XX428496059969
LESLIE NORMAN RN C N A
CHIEF NURSING OFFICER40.0XX178948028032
SUE KNIGHT
CHIEF OPERATING OFFICER40.0X216640075111
SCOTT RICHARD CPA
VP FINANCE40.0X170777011450
THOMAS EWING MD
STAFF PHYSICIAN40.0553905031782X
DAWN SHARP MD
STAFF PHYSICIAN40.0369420035697X
JOHN KNAPP MD
STAFF PHYSICIAN40.0369526032398X
THOMAS PERKINS MD
STAFF PHYSICIAN40.0311770034787X
HAYTHAM KAWJI MD
STAFF PHYSICIAN40.0310279032807X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4277551TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs412161TotalReportableCompFrmRltdOrgs
Total Other Compensation506728TotalOtherCompensation
Number Individuals GT100 K57NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
FMOL HEALTH SYSTEM
4200 ESSEN LANEBATON ROUGELA70809MANAGEMENT SERVICES6410601
PONTCHARTRAIN LITHOTRIPSY
6339 E Speedway STE 201TUCSONAZ85710MANAGEMENT SERVICES361034
LOTT SHEFFIELD ANESTHESIA
5253 Dijon AvenueBATON ROUGELA70809Anesthesia services360560
XAM
7676 Hillmont Suite 250HOUSTONTX77040MANAGEMENT SERVICES356719
THEREX
Dept at 952740ATLANTAGA311922740PT SERVICES324630
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
Fundraising Events34935FundraisingEvents
Related Organizations324759RelatedOrganizations
Government Grants97950GovernmentGrants
All Other Contributions11856AllOtherContributions
Noncash Contributions4205NoncashContributions
Total Contributions469500TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENUE9000998965091089650910
CAFETERIA900099320425320425
PURCHASE DISCOUNTS900099218581218581
OUTREACH LAB900099104296104296
HEARING AND BALANCE9000996940169401

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column62163TotalRevenueColumn
Related Or Exempt Function Income62163RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue90425776TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column438TotalRevenueColumn
Unrelated Business Revenue-503UnrelatedBusinessRevenue
Exclusion$941ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real605515Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real229860Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real375655Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column375655TotalRevenueColumn
Related Or Exempt Function Income375655RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities233300Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities37491Securities
Other112266Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities195809Securities
Other-112266Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column83543TotalRevenueColumn
Unrelated Business Revenue246UnrelatedBusinessRevenue
Exclusion$83,297ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events9861GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events34935CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses19578FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-9717TotalRevenueColumn
Exclusion-$9,717ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory15853GrossSalesOfInventory
Cost Of Goods Sold24041CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-8188TotalRevenueColumn
Exclusion-$8,188ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column91337007TotalRevenueColumn
Related Or Exempt Function Income90801431RelatedOrExemptFunctionIncome
Unrelated Business Revenue-257UnrelatedBusinessRevenue
Exclusion$66,333ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total56187Total
Program Services56187ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1006083Total
Program Services822882ProgramServices
Management And General183201ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total39334882Total
Program Services20725082ProgramServices
Management And General18609800ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2477821Total
Program Services1323518ProgramServices
Management And General1154303ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3292967Total
Program Services1758925ProgramServices
Management And General1534042ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2505815Total
Program Services1516672ProgramServices
Management And General989143ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total281645Total
Program Services281645ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total57605Total
Program Services0ProgramServices
Management And General57605ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total822376Total
Management And General822376ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total8258Total
Program Services0ProgramServices
Management And General8258ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11037789Total
Program Services2724978ProgramServices
Management And General8312811ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total595751Total
Program Services10895ProgramServices
Management And General584856ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3094663Total
Program Services1620347ProgramServices
Management And General1474316ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1099015Total
Program Services706993ProgramServices
Management And General392022ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total23063Total
Program Services7790ProgramServices
Management And General15273ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total125571Total
Program Services35904ProgramServices
Management And General89667ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total723899Total
Program Services465682ProgramServices
Management And General258217ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4742258Total
Program Services3050680ProgramServices
Management And General1691578ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1155285Total
Program Services632018ProgramServices
Management And General523267ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES91439638874863269100
EQUIPMENT RENTAL & MAINTENANCE23922211714660677561
RECRUITMENT632422970933533
SPECIAL EVENTS56264056264

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total583Total
Program Services364ProgramServices
Management And General219ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total84097206Total
Program Services46359794ProgramServices
Management And General37737412ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14067585BOY
EOY16417706EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9640206BOY
EOY11304258EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1128289BOY
EOY1229332EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY821988BOY
EOY738750EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis84024620LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec30094821LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY55003077BOY
EOY53929799EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY711059BOY
EOY1597626EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2711952BOY
EOY2951757EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY3321208BOY
EOY2985723EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1125279BOY
EOY4547669EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY88530644BOY
EOY95702620EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10781527BOY
EOY12302036EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY11566000BOY
EOY11566000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6193293BOY
EOY5155766EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY442843BOY
EOY3720832EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY28983663BOY
EOY32744634EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY59297118BOY
EOY62591533EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY249863BOY
EOY366453EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59546981BOY
EOY62957986EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY88530644BOY
EOY95702620EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7239801ReconcilationRevenueExpenses
Reconcilation Other Changes-3828796ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3382276OtherCostOrOtherBasis
Book Value3382276BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis56254808OtherCostOrOtherBasis
Depreciation13314644Depreciation
Book Value42940164BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis505575OtherCostOrOtherBasis
Depreciation321759Depreciation
Book Value183816BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis20815294OtherCostOrOtherBasis
Depreciation14104618Depreciation
Book Value6710676BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3664156OtherCostOrOtherBasis
Depreciation2951289Depreciation
Book Value712867BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings53929799TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
SELF-INSURANCE LIABILITY$2,642,484
DUE TO AFFILIATES$1,078,348
FieldValueIRS element (for citing)
Total Of Amounts3720832TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) FOOTNOTEIdentifier
ExplanationThe 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 judgment occurs. No reserves for uncertain tax position have been recorded.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted
Total Expenditures544117TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent544117SubtotalAmountSpent
Total Amount Spent544117TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CotruePassiveForeignInvestCo
Foreign PartnershiptrueForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event144796GrossReceiptsEvent1
Charitable Contributions Event134935CharitableContributionsEvent1
Gross Revenue Event19861GrossRevenueEvent1
Non Cash Prizes Event1986NonCashPrizesEvent1
Rent Facility Costs Event17870RentFacilityCostsEvent1
Other Direct Expenses Event110722OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total44796GrossReceiptsTotal
Charitable Contributions Total34935CharitableContributionsTotal
Gross Revenue Total Events9861GrossRevenueTotalEvents
Non Cash Prizes Total Events986NonCashPrizesTotalEvents
Rent Facility Costs Total Events7870RentFacilityCostsTotalEvents
Other Direct Expenses Total Events10722OtherDirectExpensesTotalEvents
Direct Expense Summary Events19578DirectExpenseSummaryEvents
Net Income Summary-9717NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense911225TotalCommunityBenefitExpense
Net Community Benefit Expense911225NetCommunityBenefitExpense
Percent Of Total Expense0.01080PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11356936TotalCommunityBenefitExpense
Direct Offsetting Revenue4518786DirectOffsettingRevenue
Net Community Benefit Expense6838150NetCommunityBenefitExpense
Percent Of Total Expense0.08130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense12268161TotalCommunityBenefitExpense
Direct Offsetting Revenue4518786DirectOffsettingRevenue
Net Community Benefit Expense7749375NetCommunityBenefitExpense
Percent Of Total Expense0.09210PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense106889TotalCommunityBenefitExpense
Net Community Benefit Expense106889NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense198751TotalCommunityBenefitExpense
Net Community Benefit Expense198751NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense483409TotalCommunityBenefitExpense
Direct Offsetting Revenue28256DirectOffsettingRevenue
Net Community Benefit Expense455153NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense70029TotalCommunityBenefitExpense
Net Community Benefit Expense70029NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense859078TotalCommunityBenefitExpense
Direct Offsetting Revenue28256DirectOffsettingRevenue
Net Community Benefit Expense830822NetCommunityBenefitExpense
Percent Of Total Expense0.00990PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense13127239TotalCommunityBenefitExpense
Direct Offsetting Revenue4547042DirectOffsettingRevenue
Net Community Benefit Expense8580197NetCommunityBenefitExpense
Percent Of Total Expense0.10200PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense3115TotalCommunityBuildingExpense
Net Community Building Expense3115NetCommunityBuildingExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense10561TotalCommunityBuildingExpense
Net Community Building Expense10561NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense9454TotalCommunityBuildingExpense
Net Community Building Expense9454NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense23130TotalCommunityBuildingExpense
Net Community Building Expense23130NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,278,632BadDebtExpenseAmount
Amount Reimbursed By Medicare7111333AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9339961CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2228628MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH IMAGINBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityIMAGING SERVICESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.51000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.12250OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.36750PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11125 HIGHWAY 30AddressLine1
CityGONZALESCity
StateLAState
ZIP Code70737ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledtrueAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
ST ELIZABETH AFTER HOURS
1702 N BURNSIDE AVENUEGONZALESLA70737URGENT CARE CENTER
ST ELIZ-MARY BIRD PERKINS CANCER CENTER
4950 ESSEN LANEBATON ROUGELA70809CANCER TREATMENT CENTER
ST ELIZABETH IMAGING CENTER
1125 HIGHWAY 30GONZALESLA70737IMAGING SERVICES
COMMUNITY HEALTH CLINIC
1125 HIGHWAY 30GONZALESLA70737LOW INCOME CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 7THE COST TO CHARGE RATIO, AS CALCULATED USING IRS WORKSHEET 2, IS UTILIZED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNTS REPORTED IN PART 1, LINES 7A-F. THE COST ACCOUNTING SYSTEM OF THE ORGANIZATION WAS USED TO CALCULATE THE COST TO CHARGE RATIO OF THE SUBSIDIZED HEALTH SERVICES INCLUDED ON PART I, LINE 7G.
PART III, LINE 4THE COST TO CHARGE RATIO WAS UTILIZED IN DETERMINING THE COST OF BAD DEBT EXPENSE AS REPORTED IN PART III, LINE 2. DISCOUNTS PROVIDED ARE NOT INCLUDED IN BAD DEBT EXPENSE. NO ESTIMATE HAS BEEN MADE FOR ANY AMOUNTS INCLUDED IN BAD DEBT EXPENSE THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE. THE ORGANIZATION ACCOUNTS FOR BAD DEBTS BASED ON THE AGING OF ACCOUNTS AND HISTORICAL COLLECTION HISTORY ASSOCIATED WITH THE VARIOUS AGING CATEGORIES. ON A PERIODIC BASIS, THE ORGANIZATION CONDUCTS A RETROSPECTIVE REVIEW OF THE COLLECTIONS TO DETERMINE THE APPROPRIATE COLLECTION PERCENTAGE TO USE IN ESTIMATING BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS FOR THE CURRENT YEAR DID NOT INCLUDE A BAD DEBT FOOTNOTE.
PART III, LINE 8CMS REGULATIONS/GUIDELINES ARE USED IN COMPLETING THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS THE TOOL USED IN DETERMINING MEDICARE ALLOWABLE COSTS.
PART III, LINE 9BINDIVIDUALS WITH NO MEANS OF PAYMENTS ARE PROVIDED THE FINANCIAL ASSISTANCE INFORMATION AND APPLICATION. THE DETERMINATION OF FINANCIAL ASSISTANCE IS BASED ON THE PATIENT'S INCOME LEVEL AND OTHER CRITERIA AS SET FORTH IN THE FINANCIAL ASSISTANCE POLICY. IF IT IS DETERMINED THAT A PATIENT QUALIFIES FOR CHARITY CARE AFTER THE INDIVIDUAL'S ACCOUNT HAS BEEN SENT TO COLLECTIONS, ACCOUNT IS IMMEDIATELY REMOVED FROM THE COLLECTION PROCESS.
PART VI, LINE 2RESPONDING TO THE HEALTH NEEDS OF OUR COMMUNITY, ESPECIALLY TO THOSE MOST IN NEED IS PRIMARY TO THE MISSION OF ST. ELIZABETH HOSPITAL. ST. ELIZABETH HOSPITAL IDENTIFIES THE COMMUNITY'S HEALTH NEEDS BY UTILIZING THE FOLLOWING INFORMATION GATHERING TECHNIQUES: COMMUNITY SURVEY: ON AN ANNUAL BASIS, ST. ELIZABETH HOSPITAL, ALONG WITH THE HELP OF STRATEGIC MARKETING AND RESEARCH, LLC, PERFORM A COMMUNITY SURVEY AIMED AT IDENTIFYING THE HEALTH CARE NEEDS AND PREFERENCES OF LOCAL RESIDENTS. THE SURVEY IS CONDUCTED VIA PHONE WHILE USING A RANDOM SAMPLE OF 500 RESPONDENTS. THE FINDINGS FROM THIS RESEARCH SERVE AS A FOUNDATION FOR THE DEVELOPMENT OF FUTURE PROGRAMS FOR OFFERING HEALTHCARE IN ASCENSION PARISH. THE SURVEY ALSO IDENTIFIES THOSE SERVICES THAT ARE SOUGHT OUTSIDE OF ASCENSION PARISH, DUE TO SERVICES NOT BEING OFFERED OR NOT KNOWN TO BE OFFERED (PUBLIC AWARENESS). SUCH DATA HELPS ST. ELIZABETH HOSPITAL ASSESS WHETHER SPECIFIC MEDICAL NEEDS ARE UNDERSERVED. COMMUNITY EDUCATION SURVEY: EVERY TWO YEARS, THE COMMUNITY EDUCATION DEPARTMENT PREPARES A COMMUNITY EDUCATION SURVEY THAT IS GIVEN TO ASCENSION PARISH RESIDENTS WHO ATTEND LOCAL HEALTH SCREENINGS OR OTHER EDUCATIONAL EVENTS. THIS SURVEY IS DESIGNED TO IDENTIFY THE HEALTH EDUCATION NEEDS OF THE AREA RESIDENTS. COMMUNITY NEEDS ASSESSMENT: ST. ELIZABETH HOSPITAL PREPARES A COMMUNITY NEEDS ASSESSMENT ON AN AS-NEEDED BASIS. ST. ELIZABETH HOSPITAL IS ADOPTING A SYSTEMATIC PROCESS FOR IDENTIFYING AND EVALUATING THE NEEDS OF THE COMMUNITY BASED ON THE NEWLY PUBLISHED IRS REGULATIONS AND CATHOLIC HEALTH ASSOCIATION GUIDELINES. ST. ELIZABETH HOSPITAL CONDUCTED THE NEWLY DESIGNED COMMUNITY NEEDS ASSESSMENT IN FY2013 AND WILL CONTINUE EVERY THREE YEARS THEREAFTER.NEEDS ASSESSMENT
PART VI, LINE 3INDIVIDUALS ARE EDUCATED ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S CHARITY CARE POLICY AT VARIOUS STAGES OF THE ENCOUNTER WITH ST. ELIZABETH HOSPITAL: 1. SCHEDULING (OUTPATIENT/SURGERY): DURING THE SCHEDULING OF PROCEDURES, A SCHEDULER INFORMS INDIVIDUALS OF THE VARIOUS TYPES OF FINANCIAL ASSISTANCE VIA PHONE. IF THE INDIVIDUAL IS INTERESTED, A FORM IS PROVIDED EITHER BY MAIL OR PICKUP TO COMPLETE AND RETURN TO THE HOSPITAL VIA PRE-PAID POSTAGE ENVELOPE. 2. THE POLICY IS PROVIDED, IN WRITING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY. 3. FINANCIAL COUNSELING: DURING FINANCIAL COUNSELING, THE INDIVIDUAL IS INFORMED OF THE VARIOUS TYPES OF FINANCIAL ASSISTANCE VIA PERSON TO PERSON CONVERSATION. IF THE INDIVIDUAL IS INTERESTED, A FORM IS PROVIDED AT THAT TIME FOR THE INDIVIDUAL TO COMPLETE AND RETURN TO THE HOSPITAL. ADDITIONALLY, CASHIERS HAVE POSTED NOTIFICATIONS OF THE FINANCIAL ASSISTANCE OPPORTUNITIES IN THE CASHIER'S OFFICE AND THE EMERGENCY ROOM COLLECTION DESK. 4. WEBSITE NOTIFICATION: ST. ELIZABETH HOSPITAL'S WEBSITE, LOCATED AT WWW.STEH.COM INCLUDES A PAGE CALLED "HELP FOR THE UNINSURED" WHICH PROVIDES INFORMATION CONCERNING ST. ELIZABETH HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A TELEPHONE NUMBER IS ALSO PROVIDED TO THOSE WHO ARE INTERESTED IN CONTACTING OUR FINANCIAL COUNSELORS FOR ADDITIONAL INFORMATION. 5. THE POLICY IS AVAILABLE UPON REQUESTPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
PART VI, LINE 4ST. ELIZABETH HOSPITAL SERVES ASCENSION PARISH AND PORTIONS OF THE SURROUNDING PARISHES OF ASSUMPTION, IBERVILLE, EAST BATON ROUGE, AND ST. JAMES. THIS AREA HAS SEEN SIGNIFICANT GROWTH IN THE LAST DECADE. SOME OF THIS GROWTH CAN BE ATTRIBUTED TO THE HURRICANES THAT HAVE DEVASTATED THE LOUISIANA COASTLINE IN RECENT YEARS. SPECIFICALLY, THE HISPANIC/LATINO POPULATION HAS MORE THAN DOUBLED IN SOME PORTIONS OF THE SERVICE AREA. THE NORTHERN PARTS OF THE SERVICE AREA TEND TO HAVE A MORE AFFLUENT POPULATION; WHEREAS, THE SOUTHERN TRACTS HAVE CONTINUED BARRIERS TO HEALTHCARE. THE AVERAGE PER CAPITA INCOME FOR THE SERVICE AREA IS $22,535 WITH 17.6% OF FAMILIES LIVING BELOW THE POVERTY LEVEL. HEALTH STATISTICS THAT ARE ROUTINELY COLLECTED INDICATE THAT RESIDENTS OF THE SERVICE AREA EXPERIENCE MANY HEALTH PROBLEMS. SPECIFICALLY, THE POPULATION SUFFERS HIGHER RATES OF STROKE, OBESITY, CANCER, DIABETES AND HYPERTENSION THAN THE NATION AS A WHOLE.COMMUNITY INFORMATION
PART IIST. ELIZABETH PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES BECAUSE IT UNDERSTANDS THAT IMPROVEMENTS TO A COMMUNITY HAVE A DIRECT LINK TO THE IMPROVED HEALTH OF COMMUNITY RESIDENTS. COMMUNITY BUILDING ACTIVITIES INCLUDE DEVOTING TIME TO NEIGHBORHOOD IMPROVEMENT AND REVITALIZATION PROJECTS, PARTICIPATING IN ECONOMIC DEVELOPMENT COUNCILS/CHAMBERS OF COMMERCE AND PARTICIPATING IN SCHOOL MENTORING PROGRAMS. ALL OF THESE PROGRAMS HELP DEVELOP THE GENERAL WELL-BEING OF THE COMMUNITY WHICH, IN TURN, PROMOTES THE HEALTH OF THE COMMUNITY ST. ELIZABETH SERVES. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE TIME DEVOTED TO FORMING COLLABORATIVE PARTNERSHIPS WITH VARIOUS ORGANIZATIONS SUCH AS THE DEPARTMENT OF HEALTH & HUMAN SERVICES, LOCAL SCHOOL BOARDS, AND OTHER LOCAL HOSPITALS TO IMPROVE THE GENERAL COMMUNITY HEALTH. ADDITIONALLY, ST. ELIZABETH PARTNERS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORKFORCE SHORTAGES. IT ALSO PARTICIPATES IN SCHOOL-BASED PROGRAMS RELATED TO HEALTH CARE CAREERS.
OTHER INFORMATIONSEE THE QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT REPORT ON SCHEDULE O.
AFFILIATED HEALTH CARE SYSTEMST. ELIZABETH IS PART OF THE FMOLHS HEALTH CARE SYSTEM WHICH INCLUDES SEVERAL HOSPITALS AND TAX-EXEMPT AFFILIATES THROUGHOUT THE STATE. ST. ELIZABETH HOSPITAL SERVES THE COMMUNITY IN GONZALES, LA AND SURROUNDING PARISHES. ST. ELIZABETH HOSPITAL WORKS CLOSELY WITH OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER (A TAX-EXEMPT HOSPITAL AFFILIATE) TO PROVIDE COMPREHENSIVE MEDICAL SERVICES AS PART OF THE OVERALL HEALTHCARE PROVIDED TO THE COMMUNITY.
PART V LINE 13REGISTRATION PERSONNEL REFER PATIENTS THAT MAY HAVE DIFFICULTY PAYING FOR THEIR MEDICAL CARE TO FINANCIAL COUNSELORS TO DISCUSS QUALIFICATION FOR FREE OR DISCOUNTED CARE.
PART V, LINE 20THE HOSPITAL FACILITY HAS CALCULATED THE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE AT APPROXIMATELY A 30% DISCOUNT FROM CHARGE MASTER RATES. UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), MULTIPLE LEVELS OF DISCOUNTS ARE PROVIDED FOR. THE MAJORITY OF FAP ELIGIBLE PATIENTS FALL IN THE 50%, 75%, AND 100% DISCOUNT LEVELS. THERE IS HOWEVER A 25% DISCOUNT LEVEL. THE HOSPITAL ALSO OFFERS A 25% SELF-PAY DISCOUNT. SO FOR UNINSURED FAP PATIENTS, MULTIPLE DISCOUNTS MAY APPLY. IT IS POSSIBLE, HOWEVER, THAT AN UNDERINSURED PATIENT WITHIN CERTAIN INCOME LEVELS WOULD BE OFFERED ONLY THE 25% CHARITY DISCOUNT. THE NUMBER OF PATIENTS IN THIS SCENARIO WOULD BE EXTREMELY SMALL, IF ANY, BUT IT IS POSSIBLE THAT THIS CATEGORY OF PATIENT MAY HAVE BEEN CHARGED MORE THAN AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE COVERING SUCH CARE. IN ADDITION, THERE IS LOW PROBABILITY THAT ANY PATIENT IN THIS 25% CHARITY DISCOUNT CATEGORY ACTUALLY PAID MORE THAN AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE COVERING SUCH CARE. THE HOSPITAL FACILITY IS CURRENTLY WORKING TO CORRECT THIS SITUATION FOR THIS SMALL NUMBER OF PATIENTS.
PART V, LINE 19DTHE HOSPITAL OFFERS VARIOUS LEVELS OF DISCOUNTS WHICH ARE BASED ON A SLIDING SCALE USING THE FEDERAL POVERTY GUIDELINE FAMILY INCOME LEVELS AND OTHER FACTORS. SUCH OTHER FACTORS INCLUDE ASSET LEVELS, MEDICAL INDIGENCY, AND A PATIENT'S QUALIFICATION FOR MEDICARE OR MEDICAID. TOGETHER THESE CRITERIA ARE USED TO SET THE MAXIMUM AMOUNT CHARGED. ALSO, A 25% SELF-PAY DISCOUNT IS GIVEN IN ADDITION TO THE CHARITY DISCOUNTS DESCRIBED ABOVE.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Volunteer Ascension
PO Box 1564GonzalesLA70707721376404501(C)(3)8180GENERAL SUPPORT
OUR LADY OF THE LAKE FOUNDATION
5000 HENNESSY BLVDBATON ROUGELA70808721014324501(C)(3)8594
PROJECT KIDZ KOVE
PO BOX 179BRITTANYLA70718273095254501(C)(3)15025
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPART I, QUESTION 2Identifier
ExplanationAll charitable donations are made to well-known charitable organizations or through referral from either a board or team member associated with the local/national charity. St. Elizabeth Hospital utilizes several resources to verify the integrity and authenticity of the charitable organization including, but not limited to, 1) Office of Inspector General Sanction List 2) General Services Administration Sanctions List 3) U.S Treasury Sanctions List 4) Internal Revenue Service's list of tax deductible charitable organizations or 5) Better Business Bureau Resource Library. Charitable recipients are asked to provide a donation letter explaining the intent for which the donation will be used.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CARY PAUL AGUILLARD JR MD
24002006103800098000282820339140000
JAMES D'ANTONI MD
17846604749500089570218780256796000
JOHN F FRAICHE MD
52862301282560009800019650668644000
DOLORES N LEJEUNE RN C N A
02769080103901031352048531020342048103400
DAWN ZITMAN MD
1582920256000007424077160199032000
CRAIG A VITRANO MD
347492074001070030400250199440488465000
SUE KNIGHT
17699003946501850370650380460291751000
SCOTT RICHARD CPA
140444030196013708941025090182227000
LESLIE NORMAN RN C N A
1462850325170146021052069800206980000
THOMAS EWING MD
453520010038500098000219820585687000
DAWN SHARP MD
3694200000098000258970405117000
JOHN KNAPP MD
30549806402800098000225980401924000
THOMAS PERKINS MD
26153405023600098000249870346557000
HAYTHAM KAWJI MD
3102790000098000230070343086000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanation
Part I, Question 7THE ORGANIZATION HAS PROVIDED LISTED PERSONS WITH INCENTIVE COMPENSATION WHICH IS BASED ON A FORMULA DERIVED FROM QUALITY, EFFICIENCY, AND OTHER PERFORMANCE MEASURES. SUCH BONUSES WERE APPROVED BY THE CEO OR THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS.
Part I question 4aThe CEO 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. If triggered, the executive would be paid 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 months depending on the executive and the length of service. No payments were made under the plan in the current year. Other persons listed on part VII, Section A are entitled to a severance benefit. The payout of such benefit is remote as it is effective only for a termination of employment due to reorganization of hospital departments, hospital functions or downsizing activity. If triggered, the employee would be paid his or her base salary for an entitlement period. The entitlement period ranges from 4 weeks to 4 months depending on the length of service and the level of such employee. No payments were made to persons listed on Part VII, Section A under the plan in the current year.
PART I, QUESTION 3THE CEO 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'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 MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJOHN F FRAICHE MDNamePerson
FieldValueIRS element (for citing)
RelationshipSON RECEIVES COMPENSATIONRelationship
Amount Of Transaction112445AmountOfTransaction
Description Of TransactionCOMPENSATION AS PHYSICIANDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART VI, SECTION A, QUESTION 6Question 8FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL
PART VI, SECTION A, QUESTION 7AFMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF ST. ELIZABETH HOSPITAL, RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. ELIZABETH HOSPITAL
Page 6, Part VI, Section BQuestion 12cSt. Elizabeth Hospital 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 a 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 St. Elizabeth Hospital 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, St. Elizabeth Hospital 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 of possible conflicts of interest are reviewed and investigated by the Corporate Compliance Department and appropriate action is taken.
Page 6, Part VI, Section BQuestion 15THE BOARD OF DIRECTORS DESIGNATES THE EXECUTIVE COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR EXECUTIVES AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION FROM AN OUTSIDE CONSULTING FIRM. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE EXECUTIVE COMMITTEE. THE PRESIDENT AND CEO OF ST. ELIZABETH HOSPITAL IS AN EMPLOYEE OF FMOL HEALTH SYSTEM, AND HER SALARY IS DETERMINED BY THE PAY PRACTICES OF THAT ORGANIZATION WHICH RESEMBLE THE ABOVE.
Page 6, Part VI, Section CQuestion 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
PART VI, SECTION A, QUESTION 7BTHE RESERVED POWERS TO FMOL HEALTH SYSTEM, INC. ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION 3. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION 6. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION 7. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION 8. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION 10. 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 11. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION 12. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION
PART VI, SECTION A, QUESTION 11AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG, LLP, THE RETURN IS REVIEWED BY ONE OR MORE MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS.
Part VI, Section A Question 2DR. CRAIG A. VITRANO AND DR. JOHN FRAICHE - BUSINESS RELATIONSHIP
PROGRAM SERVICE ACCOMPLISHMENTSSECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. ORGANIZATIONAL COMMITMENT TO PROVIDE COMMUNITY BENEFIT ST. ELIZABETH HOSPITAL OPERATES AS A MISSION OF THE FRANCISCAN MISSIONARIES OF OUR LADY, A CATHOLIC HEALTHCARE ORGANIZATION. ST. ELIZABETH HOSPITAL IS PART OF CHA (CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES). ST. ELIZABETH HOSPITAL IS LOCATED IN GONZALES, LOUISIANA IN THE PARISH OF ASCENSION. THE HOSPITAL SERVES THE ENTIRE ASCENSION PARISH COMMUNITY ALONG WITH PARTS OF IBERVILLE AND LIVINGSTON PARISHES. THE HOSPITAL IS LOCATED OFF OF INTERSTATE 10 AT 1125 WEST HIGHWAY 30, GONZALES, LOUISIANA. ST. ELIZABETH ACQUIRED ST. ELIZABETH PHYSICIANS, A WHOLLY OWNED SUBSIDIARY, ON JULY 1, 2007 AS PART OF ITS STRATEGIC PLAN. IN FISCAL YEAR 2010, THE PRACTICE CONTINUED TO RECRUIT SPECIALISTS TO THE UNDERSERVED AREA OF ASCENSION PARISH. ST. ELIZABETH PHYSICIANS MAINTAIN OFFICES IN PRAIRIEVILLE, GONZALES, DUTCHTOWN, AND DONALDSONVILLE, LOUISIANA. ST. ELIZABETH PHYSICIANS ALSO OPERATES TWO AFTER HOURS CLINICS IN GONZALES AND PRAIRIEVILLE. THE HOSPITAL SERVES AS THE ONLY ACUTE CARE ACCESS HOSPITAL IN ASCENSION PARISH WITH EMERGENCY ROOM SERVICES. THE HOSPITAL IS ABLE TO SUPPORT THE NEEDS OF ASCENSION PARISH AS WELL AS OUTLYING PARISHES. THE HOSPITAL'S PHILOSOPHY IS TO SERVE ITS COMMUNITY AND IN PARTICULAR THOSE MOST IN NEED. THE HOSPITAL SERVES THE NEEDS OF THE UNDERSERVED IN ITS COMMUNITY THROUGH ACCESS TO PRIMARY HEALTHCARE VIA ITS EMERGENCY DEPARTMENT AND THROUGH ITS RELATIONSHIP WITH COMMUNITY PHYSICIANS. THE HOSPITAL'S EFFORTS TO EXPAND SERVICES TO THE COMMUNITY THROUGH OUTREACH INCLUDE THE FOLLOWING: - THE HOSPITAL PROVIDED FLU VACCINES TO THE EMPLOYEES OF THE FOLLOWING COMMUNITY ORGANIZATIONS IN ORDER TO PROMOTE WELLNESS AND HAVE AN ACTIVE ROLE IN INCREASING THE HEALTH OF THE COMMUNITY: 1. ASCENSION PARISH SCHOOL BOARD 2. ASCENSION PARISH SHERIFF'S OFFICE 3. EAST ASCENSION HIGH SCHOOL 4. ST. AMANT HIGH SCHOOL 5. DONALDSONVILLE HIGH SCHOOL 6. DUTCHTOWN HIGH SCHOOL 7. HOUSE HOLD OF FAITH 8. United Community Bank 9. America Styrenics 10. Clerk of Court 11. Baker Donelson Bearman Attorneys 12. Rubicon 13. St. John's Church - THE HOSPITAL AND PHYSICIAN PRACTICE PARTICIPATES IN HEALTHCARE EDUCATION FOR THE PARISH THROUGH THE ST. ELIZABETH HOSPITAL ANNUAL HEALTH FAIR AND IN A COLLABORATIVE EFFORT: EDUCATIONAL OFFERINGS INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: 1. LOSS AND GRIEF EDUCATION AND SUPPORT 2. THRIVING WITH DIABETES 3. GROWING UP-PRETEEN CLASSES 4. ALZHEIMER'S LNL 5. BODYWORKS 6. ARC BABYSITTER COURSE 7. LOOK GOOD, FEEL BETTER (CANCER) 8. COPING WITH DIABETES 9. COPD 10. WELLNESS DAY FOR WOMEN - THE HOSPITAL PROVIDES THE FOLLOWING SCREENINGS FOR THE COMMUNITY: - SKIN CANCER - SCOLIOSIS - VISION - PROSTATE CANCER - DIABETES - COLORECTAL CANCER - BLOOD PRESSURE - THE HOSPITAL HAS PARTNERED WITH MARY BIRD PERKINS CANCER CENTER TO PROVIDE CANCER TREATMENT SERVICES TO THE CITIZENS OF ASCENSION PARISH AND SURROUNDING AREAS. MARY BIRD PERKINS CANCER CENTER IS LOCATED ACROSS FROM ST. ELIZABETH HOSPITAL AND BEGAN SERVING PATIENTS IN FEBRUARY 2010. - THE HOSPITAL PARTICIPATES IN LEADERSHIP ASCENSION WHERE LEADERS FROM ST. ELIZABETH HOSPITAL AND ST. ELIZABETH PHYSICIANS LEARN ABOUT ASCENSION PARISH AND HOW TO MAKE A DIFFERENCE IN THE COMMUNITY THROUGH VOLUNTEERISM. - ST. ELIZABETH HOSPITAL SECURED OTHER FUNDING THROUGH FMOL FOR A COMMUNITY CLINIC. THE MISSION OF THIS CLINIC IS TO PROVIDE ACCESS TO CARE FOR THE UNINSURED AND UNDERINSURED RESIDENTS OF ASCENSION PARISH. SERVING THIS POPULATION OF ASCENSION PARISH RESIDENTS WILL ALLOW ST. ELIZABETH HOSPITAL TO POSITIVELY AFFECT THE FACE OF HEALTH CARE BY EDUCATING, TREATING AND MAINTAINING THE HEALTH STATUS OF ITS RESIDENTS. FROM JULY 2009 TO JUNE 2011, THE COMMUNITY CLINIC HAS HAD MORE THAN 9,000 VISITS. - St. Elizabeth Hospital secured grant funding through HRSA for a feasibility study to be conducted in evaluating the need for a Federally Qualified Health Center in Ascension Parish. The feasibility study is underway. - St. Elizabeth Physicians secured grant funding through FMOL to begin providing diabetic education to individuals with diabetes in Ascension Parish. The Diabetic Clinic began seeing patients in September, 2011. - THE HOSPITAL AND PHYSICIAN PRACTICE PROVIDES FINANCIAL ASSISTANCE TO LOW INCOME PERSONS THROUGH ITS CHARITY CARE PROGRAM. IN ADDITION, THE HOSPITAL PROVIDES PROMPT PAY DISCOUNTS TO UNINSURED PATIENTS. THESE POLICIES ARE COMMUNICATED THROUGH FINANCIAL COUNSELORS EMPLOYED BY THE HOSPITAL. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAX THROUGH ITS 501(C)(3) DESIGNATION. TO FULFILL ITS MISSION, THE HOSPITAL: A. OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; B. GRANTS MEDICAL STAFF PRIVILEGES TO THOSE PHYSICIANS QUALIFIED TO PARTICIPATE IN THEIR PARTICULAR SPECIALTY. C. HAS A GOVERNING BODY THAT IS COMPRISED OF MEMBERS OF THE MEDICAL STAFF, COMMUNITY MEMBERS, MEMBERS OF THE HOSPITAL'S SPONSORING ORDER (FMOL), AND HOSPITAL EMPLOYEES. THE MAJORITY OF THE BOARD IS COMPOSED OF INDEPENDENT PEOPLE REPRESENTATIVE OF THE COMMUNITY. D. THE HOSPITAL IS AN EDUCATIONAL SITE FOR SEVERAL DIFFERENT PROFESSIONAL HEALTH CARE STUDENTS. ST. ELIZABETH HOSPITAL CLINICAL AND PROFESSIONAL STAFF PROVIDES OVER 7,667 HOURS OF HEALTH PROFESSIONS EDUCATION TO STUDENT IN SPECIALTIES SUCH AS: " NURSING " PHARMACY " LABORATORY " RADIOLOGY " CARDIOPULMONARY " FOOD AND NUTRITIONAL THERAPY E. ST. ELIZABETH HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS AS APPROPRIATE. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS A. ST. ELIZABETH HOSPITAL SPONSORS AN ANNUAL HEALTH FAIR FOR THE CITIZENS OF ASCENSION PARISH AS WELL AS OTHER PARISHES. THE ANNUAL HEALTH FAIR IS COMPRISED OF NUMEROUS BOOTHS PROVIDING HEALTH EDUCATION, SCREENING AND DIAGNOSTIC TESTING. THE FAIR IS STAFFED BY THE TEAM MEMBERS OF ST. ELIZABETH HOSPITAL ALONG WITH OTHER HEALTH CARE PROFESSIONALS AND BUSINESSES FROM ASCENSION PARISH. IN 2012, ST. ELIZABETH PARTNERED WITH ASCENSION PARISH TO PROVIDE THE HEALTH FAIR IN A LARGER ENCLOSED LOCATION. THE OVERALL GOAL OF THE ANNUAL HEALTH FAIR IS TO RAISE AWARENESS AND OFFER HEALTH EDUCATION AND SCREENINGS TO THE CITIZENS OF ASCENSION PARISH. PUBLIC AWARENESS REGARDING THE EVENT IS DELIVERED VIA RADIO, TELEVISION AND NEWSPAPER. THE ST. ELIZABETH HOSPITAL ANNUAL HEALTH FAIR HAS BEEN WELL RECEIVED BY THE COMMUNITY. B. ST. ELIZABETH HOSPITAL TEAM MEMBERS DONATED OVER 8,180 HOURS OF TIME FOR VARIOUS COMMUNITY BENEFIT ACTIVITIES. THESE ACTIVITIES INCLUDE CHARITY INVOLVEMENT IN SUCH NOT FOR PROFIT ORGANIZATIONS AS BETTER BUSINESS BUREAU, ASCENSION CHAMBER OF COMMERCE, ARC OF EAST ASCENSION, ETC. AS AN EXPRESSION OF OUR MISSION AND CORE VALUES, THE TEAM MEMBERS OF ST. ELIZABETH HOSPITAL DONATE TIME TO COMMUNITY ACTIVITIES AS A WAY OF GIVING BACK TO THE COMMUNITY THAT WE SERVE. OUR GOAL IS TO REACH OUT TO THOSE WHO MAY NOT HAVE ACCESS TO THE SERVICES WE PROVIDE. DONATED HOURS ARE A WAY OF PROVIDING THAT ACCESS. SECTION 2 - QUANTIFIABLE COMMUNITY BENEFIT 1)CHARITY CARE - AT COST $ 904,197 2)MEDICAID SPONSORED HEALTHCARE - NET EXPENSE $ 3,118,506 3) COMMUNITY HEALTH SERVICES: COMMUNITY HEALTH EDUCATION $ 76,855 COMMUNITY BASED CLINICAL SERVICES $ 13,376 4) HEALTH PROFESSIONS EDUCATION TRAINING STAFF $ 226,964 5) FINANCIAL AND IN-KIND CONTRIBUTIONS: CASH DONATIONS $ 50,265 IN KIND DONATIONS $ 61,979 6) SUBSIDIZED HEALTH SERVICES SENIOR CARE LOSS $275,899 COMMUNITY CLINIC LOSS $276,882 7) COMMUNITY BENEFIT OPERATIONS: DEDICATED STAFF $ 20,875 8) COMMUNITY BUILDING ACTIVITIES: IN KIND DONATIONS $ 19,562 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $ 5,045,360
Part XI, Question 5Capital Transfer - $ (3,602,002) Unrealized Gain - $ (226,794) Total $ (3,828,796)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DOLORES N LEJEUNE RN C N A TITLE:PRESIDENT AND CEO HOURS:41
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:SUE KNIGHT TITLE:CHIEF OPERATING OFFICER HOURS:7

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH PHYSICIANSBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12647 S ST ELIZABETH BLVDAddressLine1
CityGONZALESCity
StateLAState
ZIP Code70737ZIPCode
FieldValueIRS element (for citing)
EIN721439296EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateLALegalDomicileState
Total Income28410684TotalIncome
EOY Assets5027177EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1STEHBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ST BERNARD HEALTH FUND
4200 ESSEN LANEBATON ROUGELA70809204685614HEALTHCARELA501(C)(3)11 TYPE 1FMOLHSfalse
HEALTH PARTNERS NETWORK OF SOUTH LA
4801 AMBASSADOR CAFFERY PARKWAYLAFAYETTELA70508HEALTHCARELA501(C)(3)3LOURDES RMCtrue
HEALTH CARE CENTERS IN SCHOOLS
5000 HENNESSY BLVDBATON ROUGELA70808721443935HEALTHCARELA501(C)(3)7OLOLtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsCode VCodeVAmountPercentage OwnershipPercentageOwnership
LOURDES IMAGING CENTER LLC
4801 AMBASSADOR CAFFERY PARKWAYLAFAYETTELA70508208326214HEALTHCARELALOURDESN/Afalsetrue
HEART HOSPITAL OF ACADIANA
1105 KALISTE SALOOM ROADLAFAYETTELA70508300442368HEALTHCARELALOURDESN/Afalsetrue
PERKINS PLAZA MEDICAL ARTS DEVELOPMENT
5000 HENNESSY BOULEVARDBATON ROUGELA70808450516574REAL ESTATELAOLOLN/Afalsetrue
PERKINS PLAZA IMAGING CENTER
5000 HENNESSY BOULEVARDBATON ROUGELA70808203697665HEALTHCARELAOLOLN/Afalsetrue
PERKINS PLAZA IMAGING DEVELOPMENT
5000 HENNESSY BOULEVARDBATON ROUGELA70808203894521REAL ESTATELAOLOLN/Afalsetrue
NUCLEAR IMAGING LLC
5000 HENNESSY BOULEVARDBATON ROUGELA70808721470061HEALTHCARELAOLOLN/Afalsetrue
P&S SURGERY CENTER LLC
312 GRAMMONT STREETMONROELA71201721387312HEALTHCARELAST FRANCISN/Afalsetrue
ST FRANCIS PEDIATRIC AFTER HOURS LLC
POST OFFICE 207MONROELA71210061782572HEALTHCARELAST FRANCISN/Afalsetrue
LOURDES IMAGING DEVELOPMENT LLC
4801 AMBASSADOR CAFFERY PARKWAYLAFAYETTELA70508208326287REAL ESTATELALOURDESN/Afalsetrue
PARK PLACE SURGICAL HOSPITAL
7901 WILSON STREETLAFAYETTELA70503721404092HEALTHCARELALOURDESN/Afalsetrue
BRPT LAKE REHABILITATION CENTERS LLC
530 SHADOWS LANEBATON ROUGELA70806721506100HEALTHCARELAOLOLN/Afalsetrue
CONVENIENT CARE LLC
7777 HENNESSY BOULEVARD SUITE 1004BATON ROUGELA70808721439481HEALTHCARELAOLOLN/Afalsetrue
PERKINS PLAZA AMBULATORY SURGERY CENTER
54 THE LEGENDS PARKWAY SUITE 159EUREKAMO63025481264699HEALTHCARELAOLOLN/Afalsetrue
SURGICAL SPECIALTY CENTER OF BATON ROUGE
8080 BLUEBONNET BOULEVARDBATON ROUGELA70810263160962HEALTHCARELAOLOLN/Afalsetrue
ST ELIZABETH-MARY BIRD PERKINS
4950 ESSEN LANEBATON ROUGELA70809260628752HEALTHCARELASTEHRELATEDfalsetrue596772943907$00.35000
REGIONAL EYE SURGERY CENTER LLC
7777 HENNESSY BLVD SUITE 400BATON ROUGELA70808721484653HEALTHCARELAOLOLN/Afalsetrue
ST MARY'S IMAGING CENTER II LLC
4801 AMBASSADOR CAFFERY PARKWAYLAFAYETTELA70508HEALTHCARELALOURDES IMAGINGN/Afalsetrue
NORTHEAST LA CANCER INSTITUTE
141 DESIARD STREET SUITE 704MONROELA71201721329499HEALTHCARELAST FRANCISN/Afalsetrue
LHCG-XIII LLC
420 WEST PINHOOK ROAD SUITE ALAFAYETTELA70503208068308HEALTHCARELALOURDESN/Afalsetrue
LOURDES AFTER HOURS LLC
7777 HENNESSY BLVD SUITE 1004-202BATON ROUGELA70808201367299HEALTHCARELALOUDRESN/Afalsetrue
ST ELIZABETH IMAGING CENTER
1125 HIGHWAY 30GONZALESLA70737364701565HEALTHCARELASTEHRELATEDfalsetrue-6184482$00.51000
CAPITAL AREA SHARED SERVICES ORG LLC
5000 HENNESSY BLVDBATON ROUGELA70808275173212HEALTHCARELAOLOL PGN/Afalsetrue
CAPITAL AREA SHARED SERVICES ORG LLC
5000 HENNESSY BLVDBATON ROUGELA70808275173212HEALTHCARELASTEPRELATEDfalsetrue-19847149896$00.17000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
ST FRANCIS INSURANCE AGENCY
309 JACKSON STREETMONROELA71201721435136INSURANCELAST FRANCISC CORP
HOSPITAL ASSISTANCE SERVICES
POBOX 4027-CLAFAYETTELA70502721073486HEALTHCARELALOURDESC CORP
LOUISE INSURANCE COMPANY
INSURANCEFMOLC CORPPO BOX 1051CJKY1-1102CJ
MONROE HEALTH SERVICES
POBOX 3187MONROELA71210721057820HEALTHCARELAAMBULATORYC CORP
Charitable Remainder Trust
INVESTMENTLAOLOL FOUNDATIONTRUST
FRANCISCAN HEALTH & WELLNESS SERVICES I
4200 ESSEN LANEBATON ROUGELA70809455492379HEALTHCARELAFMOLC CORP
FMOL HEALTH SYSTEM HOLDINGS INC
4200 ESSEN LANEBATON ROUGELA70809454405024INVESTMENTLAFMOLC CORP
NORTHEAST LA HEALTH NETWORK
309 JACKSON STREETMONROELA71201721294587HEALTHCARELAAMBULATORYC CORP
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg