2013-11-14T13:45:07-07:00 2012-12-31 990 2012-01-01 943480131 LOUISIANA CHILDRENS MEDICAL CENTER LOUI 5048969581 200 Henry Clay Avenue New Orleans LA 701185720 Greg Feirn 5048969461 2013-11-14 2012 2016-02-25 16:41:14Z Steve Worley 200 Henry Clay Avenue New Orleans LA 701185720 18303932 0 X X 2009 LA The primary purpose of LCMC will be to create, maintain, and grow health care services in New Orleans consistent with the charitable mission of the LCMC affiliates. LCMC will provide the above functions to the System Entities so that the entities in turn can focus their efforts on carrying out their exempt purposes. To that end, the executive management of the System and their support staff and systems will be centralized at LCMC. LCMC's activities will be exclusively limited to providing support services to the System. The revenue of LCMC will be derived from management fees received from the System Entities. While Children's and Touro are both tax exempt organizations, some of the affiliates and/or subsidiaries of Children's and Touro are for-profit entities. Any services provided to such entities will be at the express direction and for the benefit of Children's and Touro. 31 28 6 0 0 0 0 0 1360309 18303932 0 0 0 0 1360309 18303932 0 0 0 0 1209651 1059024 0 0 0 150658 17244908 1360309 18303932 0 0 2355291 5726863 2355291 5726863 0 0 The primary purpose of LCMC will be to create, maintain, and grow health care services in New Orleans consistent with the charitable mission of the LCMC affiliates. LCMC will provide the above functions to the System Entities so that the entities in turn can focus their efforts on carrying out their exempt purposes. To that end, the executive management of the System and their support staff and systems will be centralized at LCMC. LCMC's activities will be exclusively limited to providing support services to the System. The revenue of LCMC will be derived from management fees received from the System Entities. While Children's and Touro are both tax exempt organizations, some of the affiliates and/or subsidiaries of Children's and Touro are for-profit entities. Any services provided to such entities will be at the express direction and for the benefit of Children's and Touro. 0 0 0 0 0 Louisiana Children's Medical Center ("LCMC") was organized in the State of Louisiana on February 4, 2009, as a non-stock, non-profit corporation, in connection with a proposed affiliation (the "Transaction") between Children's Hospital ("Children's") and Touro Infirmary ("Touro"), both Louisiana non-profit, tax-exempt, publicly supported corporations, and their respective subsidiaries and affiliates (together with Children's and Touro, the "System Entities", and together with LCMC, the "System". LCMC is a support organization which will spend 100% of its time performing specific functions of, and carrying out the purposes of the System Entities, including increasing the management and operational efficiency of the System Entities. All of these organizations are located in the greater New Orleans area and provide health care related services, primarily hospital based, to a regional population. 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 6 1 0 0 0 0 0 0 X 31 28 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Jessica Cahill CH Controller 5048969388 200 Henry Clay Avenue New Orleans LA 70118 X A Whitfield Huguley IV 1 0 X 0 0 0 Mrs Julie Livaudais George 1 0 X 0 0 0 William L Mimeles 1 0 X 0 0 0 Katie Andry Crosby 1 0 X 0 0 0 Mrs George Villere 1 0 X 0 0 0 Michael Adinolfi MD 1 0 X 0 0 0 Brian Barkemeyer MD 1 0 X 0 0 0 Paul Barron 1 0 X 0 0 0 Kenneth H Beer 1 0 X 0 0 0 Allan Bissinger 1 0 X 0 0 0 Ralph O Brennan 1 0 X 0 0 0 Elwood F Cahill Jr 1 0 X 0 0 0 Philip deV Claverie 1 0 X 0 0 0 Stephen Hales MD 1 0 X 0 0 0 Mrs E Douglas Johnson Jr 1 0 X 0 0 0 Ruth Kullman 1 0 X 0 0 0 Stephen Kupperman 1 0 X 0 0 0 Mrs Francis Lauricella 1 0 X 0 0 0 Theodore Le Clercq 1 0 X 0 0 0 Hugh W Long PhD 1 0 X 0 0 0 John Y Pearce 1 0 X 0 0 0 Anthony Recasner PhD 1 0 X 0 0 0 Leon J Reymond III 1 0 X 0 0 0 Eduardo Rodriguez MD 1 0 X 0 0 0 Stephen L Sontheimer 1 0 X 0 0 0 Mrs Betty Sullivan 1 0 X 0 0 0 Everett J Williams PhD 1 0 X 0 0 0 Knight Worley MD 1 0 X 0 0 0 Alan Robson Sr MD 1 0 X 0 693323 29064 Joseph Nadell MD 1 0 X 0 229476 30672 Steve Worley 20 35 X X 418917 628376 380035 Gregory Feirn 22 33 X 261716 392574 31653 Ricardo Guevara 22 33 X 145927 218891 64314 826560 2162640 535738 3 0 1 0 Merrill Lynch Pierce Fenner & Smith Inc One Bryant Park 12th Floor New York NY 10036 Financial Services 250000 1 0 Management Services 561000 18303932 18303932 0 0 0 0 0 0 18303932 0 0 0 0 0 18303932 18303932 0 0 0 0 0 0 0 0 0 0 686826 0 686826 0 0 0 0 0 0 0 0 0 350975 0 350975 0 0 0 0 0 21223 0 21223 0 0 0 0 0 122918 0 122918 0 2500 0 2500 0 0 0 0 0 0 0 0 0 0 0 358777 0 358777 0 0 0 0 0 1523 0 1523 0 0 0 0 0 0 0 0 0 0 0 0 0 1600 0 1600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Management Fee Expense 16740551 0 16740551 0 Certificates and Licenses 5550 0 5550 0 Books and Periodicals 3146 0 3146 0 Meals 503 0 503 0 7840 0 7840 0 18303932 0 18303932 0 2355291 5726863 2355291 5726863 3306166 2355291 2420697 2355291 5726863 X 0 0 0 0 0 0 0 0 2355291 5726863 0 0 0 0 0 0 X 1 X 1 X 1 0 X X X 0 0 0 Children's Hospital 720467503 501(c)(3) 1 1 1 9136657 Touro Infirmary 720423659 501(c)(3) 1 1 1 9167275 2 18303932 7911389 -80096 0 0 0 0 7831293 7911389 0 0 0 0 0 7911389 7868129 43260 0 0 0 0 7911389 7868129 0 0 0 0 0 7868129 7863627 4502 0 0 0 0 7868129 0 1 0 0 1 1 0 Due to Childrens Hospital 2420697 2420697 SchD_P05_S00_L04 Schedule D, Part V, Line 4 1) In 1981 "The Beatrice and Harold Forgotston Philanthropic Fund of Children's Hospital" was established and donated to Children's Hospital. The gift resolution states that the funds are to always be fully invested and only the income is available for use as requested by the donor. 2) As stated in the will of Leon S. Mann, a sum of $5,000 was donated to Children's Hospital in memory of his sister and parents. The sum to be deposited in a separate, interest bearing account, and the interest to be used on the twenty-first day of July of each year to purchase presents for the children in the hospital. Investment earnings or losses are comingled with all other investments for Children's Hospital EIN XXX-XX-XXXX. 3) The remainder of funds is intended to be used for the exempt purposes of related filing organization of Touro Infirmary EIN 72-0423659. 0 0 0 0 0 0 0 0 0 Steve Worley 300986 451479 92300 138450 25631 38446 126975 190462 27022 40533 572914 859370 0 0 Gregory Feirn 158087 237130 85656 128485 17973 26959 8400 12600 4873 7310 274989 412484 0 0 Ricardo Guevara 98303 147455 28567 42851 19057 28585 20389 30584 5848 8773 172164 258248 0 0 Alan Robson Sr MD 0 491326 0 162497 0 39500 0 21250 0 9344 0 723917 0 0 Joseph Nadell MD 0 206976 0 0 0 22500 0 19331 0 12341 0 261148 0 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 Base compensation, incentive compensation and all other reportable and non-reportable compensation is reviewed annually by the Executive Committee of the Board of Trustees. The Executive Committee is a subset of the Board of Trustees. Decisions made by the Executive Committee are documented and reported in summary to the full board of Trustees. In addition to board review, third-party consultants periodically review compensation and incentive amounts to ensure market reasonableness and competitiveness. Third-party prepared compensation and incentive review is presented to the Executive Committee. Incentive bonuses are based on 25% Revenue Growth, 30% Operating Income, and 45% Board discretionary based on overall performance, quality initiatives, and accreditation, etc. F990_P05_S00_L02a Form 990, Part V, Line 2a The employees reported in Part V, Line 2a are reported on Form W-3 for the related filing organization of Children's Hospital EIN 72-0467503 along with all required federal employment tax returns. These six employees are also included in the number of employees reported in Part V, Line 2a on the 990 for Children's Hospital as they devote time to both filing organizations. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The form 990s are prepared and reviewed in detail by the organization's Controller and the respective accounting staff. The CFO/Senior Vice President reviews the 990 in final draft format, including supporting work papers and reconciliations. The CFO then reviews the completed 990 with the organization's CEO, Chairperson of the Board of Trustees and Chairperson of the Finance/Audit committee of the Board of Trustees. The 990s are then distributed to the full board for review and comment. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c An annual survey is sent to the Board Members, and it requires them to disclose conflicts of interest. If conflicts exist, they are resolved by the governing body, and the resolution could include removal of the board member. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 Base compensation, incentive compensation and all other reportable and non-reportable compensation is reviewed annually by the Executive Committee of the Board of Trustees. The Executive Committee is a subset of the Board of Trustees. Decisions made by the Executive Committee are documented and reported in summary to the full board of Trustees. In addition to board review, third-party consultants periodically review compensation and incentive amounts to ensure market reasonableness and competitiveness. Third-party prepared compensation and incentive review is presented to the Executive Committee. Incentive bonuses are based on 25% Revenue Growth, 30% Operating Income, and 45% Board discretionary based on overall performance, quality initiatives, and accreditation, etc. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Documents are made available upon request. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a Column (B) Average hours per week for related organizations: Steve Worley, President and CEO of Children's Hospital (EIN 72-0467503) and of LCMC (EIN 94-3480131) also works 32 hours for the related filing organization of Children's Hospital (EIN 72-0467503), 1 hour for services as Board Member of related filing organization, Touro Infirmary (EIN 72-0423659), and 1 hour of services as Board Member of the related filing organization Touro Infirmary Foundation (EIN 72-1169939); and both Gregory Feirn and Ricardo Guevara also work 33 hours for related filing organization of Children's Hospital (EIN 72-0467503). Children's Hospital 200 Henry Clay Avenue New Orleans LA 701185720 720467503 Pediatric Hospital LA 501(c)(3) Line 3 LCMC EIN 94-3480131 0 Touro Infirmary 1401 Foucher Street New Orleans LA 70115 720423659 Hospital LA 504(c)(3) Line 3 LCMC EIN 94-3480131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Children's Hospital n 0 Children's Hospital o 0 SchR_P05_S00_L01n Schedule R, Part V, Line 1n "Louisiana Children's Medical Center (""LCMC"") was organized in the State of Louisiana on February 4, 2009, as a non-stock, non-profit corporation, in connection with a proposed affiliation (the ""Transaction"") between Children's Hospital (""Children's"") and Touro Infirmary (""Touro""), both Louisiana non-profit, tax-exempt, publicly supported corporations, and their respective subsidiaries and affiliates (together with Children's and Touro, the ""System Entities"", and together with LCMC, the ""System"". LCMC is a support organization which will spend 100% of its time performing specific functions of, and carrying out the purposes of the System Entities, including increasing the management and operational efficiency of the System Entities. LCMC and Children's Hospital have the same President of the Board. Audited financial statements are consolidated and all fund activities between the System Entities are eliminated. The activities of LCMC are carried on in the facilities of Children's Hospital, and Children's Hospital processes the payables and the payroll for LCMC using its own funds. LCMC charges Touro and Children's Hospital for the management services provided to the facilities. SchR_P05_S00_L01o Schedule R, Part V, Line 1o Same explanation as 1n Request for automatic 3 month extension was approved and granted by the IRS. Additional 3 month extension until November 15, 2013 was also granted by the IRS.