HOSPITAL SERVICE DISTRICT NO 1 OF THE PARISH OF VERMILION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HOSPITAL SERVICE DISTRICT NO 1 OF THE PARISH OF VERMILION (EIN 72-6014624)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-03-28
IRS object ID
201240889349300514
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-28T08:04:04-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DARNALL SIKES GARDES & FREDERICK CPASBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11231 E Laurel AvenueAddressLine1
CityEuniceCity
StateLAState
ZIP Code70535ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN726014624EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ABROM KAPLAN MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlABRONameControl
Phone3376438300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11310 WEST 7TH STREETAddressLine1
CityKAPLANCity
StateLAState
ZIP Code70548ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLyman TrahanName
TitleAdministratorTitle
Date Signed2012-03-28DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSteven G Moosa CPAName
Phone3374574146Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts14800938GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Year Formation1957YearFormation
State Legal DomicileLAStateLegalDomicile
Activity Or Mission DescriptionThe Hospital provides a variety of healthcare services including: 1) in-patient services such as acute, psychiatric and skilled nursing; 2) out-patient services such as diagnostic and therapeutic ancillaries, emergency room, and physician specialty clinics; and 3) other services.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees159TotalNbrEmployees
Total Nbr Volunteers5TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11799625ProgramServiceRevenuePriorYear
Program Service Revenue CY12447055ProgramServiceRevenueCY
Investment Income Prior Year226973InvestmentIncomePriorYear
Investment Income Current Year151041InvestmentIncomeCurrentYear
Other Revenue Prior Year1693299OtherRevenuePriorYear
Other Revenue Current Year2202842OtherRevenueCurrentYear
Total Revenue Prior Year13719897TotalRevenuePriorYear
Total Revenue Current Year14800938TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3417297SalariesEtcPriorYear
Salaries Etc Current Year3652229SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8262360OtherExpensePriorYear
Other Expenses Current Year8428675OtherExpensesCurrentYear
Total Expenses Prior Year11679657TotalExpensesPriorYear
Total Expenses Current Year12080904TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2040240RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2720034RevenuesLessExpensesCY
Total Assets BOY21212166TotalAssetsBOY
Total Assets EOY23806436TotalAssetsEOY
Total Liabilities BOY647977TotalLiabilitiesBOY
Total Liabilities EOY522213TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20564189NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23284223NetAssetsOrFundBalancesEOY
Mission DescriptionThe Hospital provides a variety of healthcare services including: 1) in-patient services such as acute, psychiatric and skilled nursing; 2) out-patient services such as diagnostic and therapeutic ancillaries, emergency room, and physician specialty clinics; and 3) other services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense11051335Expense
Revenue12331670Revenue
DescriptionProfessional Services, in-patient and out-patient, provided by a hospital.Description
Total Program Service Expense11051335TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
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 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees159NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Annual Disclosure Covered PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonABROM KAPLAN MEMORIAL HOSPITALNamePerson
Telephone Number3376435284TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11310 WEST 7TH STREETAddressLine1
CityKAPLANCity
StateLAState
ZIP Code70548ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Winnie Broussard
Commissioner1.00X90000
Ronald Menard
V. Chairperson1.00X120000
Paul D Marceaux
Commissioner1.00X120000
Mona Hebert
Chairperson1.00X120000
Lyman Trahan
Administrator40.0010296008237X
John Francis
Commissioner1.00X120000
Ivan Bourque
Commissioner1.00X120000
Dr Scott Bergeaux
Physician40.0018089808140X
Del Dean David
Commissioner1.00X120000
FieldValueIRS element (for citing)
Total Reportable Comp From Org291958TotalReportableCompFromOrg
Total Other Compensation16377TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
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
Vermilion Emergency Group Inc
PO Box 82368LafayetteLA70508ER Physicians404103
Shared Imaging
Box 88544MilwaukeeWI53288CT Scan Lease119750
L-C Professional Resources
21431 W LA Hwy 33KaplanLA70548Pharmacist115010
Lafayette General
PO Box 53247LafayetteLA70505Affiliation Services120000
Compass Healthcare Inc
PO Box 428CrowleyLA70527BHU Mgmt Services1593000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicare/Medicaid payment72326857232685
Joint Venture Income115385115385
Hospital Care45129104512910
Fees & Contracts Gov Agencies586075586075
FieldValueIRS element (for citing)
Total Program Service Revenue12447055TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column151041TotalRevenueColumn
Related Or Exempt Function Income151041RelatedOrExemptFunctionIncome

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)
Real16599Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real16599Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column16599TotalRevenueColumn
Related Or Exempt Function Income16599RelatedOrExemptFunctionIncome

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Sales Tax Income16256101625610
Property Taxes525443525443
Miscellaneous3519035190
FieldValueIRS element (for citing)
Total Other Revenue2186243TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14800938TotalRevenueColumn
Related Or Exempt Function Income14800938RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total111060Total
Management And General111060ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3541169Total
Program Services3179238ProgramServices
Management And General361931ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total588657Total
Program Services588657ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionOther ExpensesDescription
Total7840018Total
Program Services7283440ProgramServices
Management And General556578ManagementAndGeneral

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12080904Total
Program Services11051335ProgramServices
Management And General1029569ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY447811BOY
EOY129696EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15547504BOY
EOY17770257EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2492922BOY
EOY3488713EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY275842BOY
EOY300977EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY42234BOY
EOY51261EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6703721LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4724080LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2202283BOY
EOY1979641EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY203570BOY
EOY85891EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21212166BOY
EOY23806436EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY613215BOY
EOY511785EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY34762BOY
EOY10428EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY647977BOY
EOY522213EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY20564189BOY
EOY23284223EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20564189BOY
EOY23284223EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21212166BOY
EOY23806436EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2720034ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis58893OtherCostOrOtherBasis
Book Value58893BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1868739OtherCostOrOtherBasis
Book Value1868739BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis104436OtherCostOrOtherBasis
Book Value104436BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2845440OtherCostOrOtherBasis
Book Value2845440BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1826213OtherCostOrOtherBasis
Depreciation4724080Depreciation
Book Value-2897867BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1979641TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Rounding$3
Obligation under capital lease$10,425
FieldValueIRS element (for citing)
Total Of Amounts10428TotalOfAmounts
Total Revenue14800938TotalRevenue
Total Expenses12080904TotalExpenses
Excess Or Deficit For Year2720034ExcessOrDeficitForYear
Excess Or Deficit Per FS2720034ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14800938TotRevenueEtcAuditedFinclStmt
Revenue Subtotal14800938RevenueSubtotal
Total Revenue Per Form99014800938TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12080904TotExpensesEtcAuditedFinclStmt
Expenses Subtotal12080904ExpensesSubtotal
Total Expenses Per Form99012080904TotalExpensesPerForm990

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicyfalseCharityCarePolicy
Written PolicyfalseWrittenPolicy
FPG Reference Free CarefalseFPGReferenceFreeCare
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1775515TotalCommunityBenefitExpense
Direct Offsetting Revenue1826105DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1775515TotalCommunityBenefitExpense
Direct Offsetting Revenue1826105DirectOffsettingRevenue

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense655349TotalCommunityBenefitExpense
Direct Offsetting Revenue1593337DirectOffsettingRevenue
Net Community Benefit Expense-937988NetCommunityBenefitExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense655349TotalCommunityBenefitExpense
Direct Offsetting Revenue1593337DirectOffsettingRevenue
Net Community Benefit Expense-937988NetCommunityBenefitExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2430864TotalCommunityBenefitExpense
Direct Offsetting Revenue3419442DirectOffsettingRevenue
Net Community Benefit Expense-937988NetCommunityBenefitExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$1,746,510BadDebtExpenseAmount
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Abrom Kaplan Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11310 West 7th StreetAddressLine1
CityKaplanCity
StateLAState
ZIP Code70548ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Abrom Kaplan Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedfalseEligibilityCriteriaExplained
Uses FPG FreefalseUsesFPGFree
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodfalseExplainsApplicationMethod
Includes Publicity MeasuresfalseIncludesPublicityMeasures
Actions On NonpaymentfalseActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonDr Scott BergeauxNamePerson
Base Compensation Filing Org180898BaseCompensationFilingOrg
Deferred Comp Filing Org8140DeferredCompFilingOrg
Total Compensation Filing Org189038TotalCompensationFilingOrg

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe organization makes records available at the administrative office located at the address listed in Part VI, Section C, Line 20.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Board of Directors approves the compensation of other officers or key employees based on industry analysis and comparable compensation paid by similiar organizations in the regional area.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessReturn is prepared by CPA and reviewed with the Hospital Administrator prior to filing.

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