WEST LOUISIANA HEALTH SERVICES INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- WEST LOUISIANA HEALTH SERVICES INC (EIN 72-0491106)
- Tax period
- 2009-11-01 to 2010-10-31
- Filed
- 2011-09-14
- IRS object ID
- 201112579349300146
- Schema version
- 2009v1.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-09-14T18:21:23-05:00 | Timestamp |
| Tax Period End Date | 2010-10-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN M DEROUEN CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 4265 | AddressLine1 |
| City | LAKE CHARLES | City |
| State | LA | State |
| ZIP Code | 70606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-11-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720491106 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST LOUISIANA HEALTH SERVICES INC | BusinessNameLine1 |
| Business Name Line2 | BEAUREGARD MEMORIAL HOSPITAL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WEST | NameControl |
| Phone | 3374627106 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 730 | AddressLine1 |
| City | DERIDDER | City |
| State | LA | State |
| ZIP Code | 70634 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THEODORE BADGER JR | Name |
| Title | CEO | Title |
| Phone | 3374627106 | Phone |
| Date Signed | 2011-09-14 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Steven M DeRouen | Name |
| Phone | 3375134915 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | THEODORE BADGER JR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 206 KERRY STREET | AddressLine1 |
| City | DERIDDER | City |
| State | LA | State |
| ZIP Code | 70634 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32597483 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.BEAUREGARD.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | LA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE MEDICAL CARE AND HEALTH PROGRAMS BY OPERATING A 60 BED FACILITY FOR HOSPITAL SERVICE DISTRICT #2 OF BEAUREGARD PARISH AND FIVE PHYSICIAN CLINICS; RECRUIT AND EMPLOY PHYSICIANS IN HPSA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 423 | TotalNbrEmployees |
| Total Nbr Volunteers | 90 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 28259875 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 31386563 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -581542 | InvestmentIncomePriorYear |
| Investment Income Current Year | -10568 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 23923 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 27678333 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31399918 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 1058249 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28689811 | OtherExpensePriorYear |
| Other Expenses Current Year | 31346829 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 28689811 | TotalExpensesPriorYear |
| Total Expenses Current Year | 32405078 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1011478 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1005160 | RevenuesLessExpensesCY |
| Total Assets BOY | 7752380 | TotalAssetsBOY |
| Total Assets EOY | 8104055 | TotalAssetsEOY |
| Total Liabilities BOY | 3296800 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4353335 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4455580 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3750720 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE MEDICAL CARE AND HEALTH PROGRAMS BY OPERATING A 60 BED FACILITY FOR HOSPITAL SERVICE DISTRICT #2 OF BEAUREGARD PARISH AND FIVE PHYSICIAN'S CLINICS; RECRUIT AND EMPLOY PHYSICIANS IN HPSA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 30856226 | Expense |
| Revenue | 30834989 | Revenue |
| Description | OPERATED A 60 BED FACILITY FOR HOSPITAL SERVICE DISTRICT #2 OF BEAUREGARD PARISH, PROVIDING GENERAL SHORT TERM CARE TO 2,862 INPATIENTS FOR 10,493 DAYS; 404 NEWBORNS; 1,628 SURGERIES; 16,740 E/R VISITS; AND 23,854 OUTPATIENTS; OPERATED PHYSICIAN'S CLINIC. 74.3% OF HOPITAL ADMISSIONS ARE MEDICARE AND MEDICAID. THE HOSPITAL ALSO CONDUCTS NUMEROUS COMMUNITY SEMINARS AND SERVICES TO BENEFIT THE COMMUNITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1548852 | Expense |
| Revenue | 564929 | Revenue |
| Description | OPERATED BEAUREGARD PHYSICIANS GROUP WHICH CONSISTS OF FIVE PHYSICIAN'S CLINICS WHICH PROVIDE MEDICAL SERVICES TO BEAUREGARD PARISH. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 32405078 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 423 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARRELL L KINGHAM CPA VP OF FINA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3374627106 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 SOUTH PINE STREET | AddressLine1 |
| City | DERIDDER | City |
| State | LA | State |
| ZIP Code | 70634 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Average Hours Per WeekAverageHoursPerWeek | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JULIE OZSOY CPA | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| CARL SLOVER | ||||||||
| PRESIDENT | X | 0 | 0 | 0 | X | |||
| TERRI THEAUX | ||||||||
| VICE PRESIDENT | X | 0 | 0 | 0 | X | |||
| JARED MORRIS | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| NATHA GANTT | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| DAVID BROWN MD | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| TOM DOBBINS MD | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| CHRISTOPHER GRANGER MD | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| TOM RHODES | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| GERALD JOHNSON | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| MARARETTA MAYES | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| ED O'NEAL | ||||||||
| SECRETARY | X | 0 | 0 | 0 | X | |||
| THOMAS SHIRLEY DDS | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| JAY STINE | ||||||||
| TRUSTEE | X | 0 | 0 | 0 | ||||
| THEODORE BADGER JR | ||||||||
| CEO | 213488 | 0 | 13346 | 45.00 | X | |||
| DARRELL L KINGHAM | ||||||||
| VICE PRESIDENT OF FINANC | 166961 | 0 | 11338 | 52.00 | X | |||
| DARREN CAILLOUET | ||||||||
| CRNA | 201688 | 0 | 10757 | 40.00 | X | |||
| ROBERT RUSHFORD | ||||||||
| CRNA | 165345 | 0 | 8249 | 40.00 | X | |||
| THOMAS FRANKS | ||||||||
| CRNA | 182464 | 0 | 9285 | 40.00 | X | |||
| ALEX MANITZAS RPH | ||||||||
| DIRECTOR OF PHARMACY | 129188 | 0 | 6807 | 40.00 | X | |||
| JANET LEWIS | ||||||||
| ORTHOPEDIC SURGEON | 224950 | 0 | 0 | 40.00 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1284084 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 59782 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CARDIOLOGY CLINIC OF DERIDDER LLC | |||||
| 109 W 4TH STREET | DERIDDER | LA | 70634 | PHYSICIAN SERVICES | 188204 |
| DAVENPORT FAMILY MEDICAL CLINIC | |||||
| 101 W 6TH STREET | DERIDDER | LA | 70634 | PHYSICIAN SERVICES | 174423 |
| BEAUREGARD PHYSICAL THERAPY | |||||
| 309 S WASHINGTON | DERIDDER | LA | 70634 | PHYSICAL THERAPY SERVICES | 166442 |
| JENNIFER MCCANN MD | |||||
| 206 W 5TH STREET | DERIDDER | LA | 70634 | PHYSICIAN SERVICES | 160736 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| REIMBURSEMENTS FROM HO | 900099 | 30821634 | 30821634 |
| PATIENT SERVICES | 621400 | 564929 | 564929 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 31386563 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 141378 | TotalRevenueColumn |
| Related Or Exempt Function Income | 141378 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1045619 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1197565 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -151946 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -151946 | TotalRevenueColumn |
| Related Or Exempt Function Income | -151946 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 23923 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23923 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 23923 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31399918 | TotalRevenueColumn |
| Related Or Exempt Function Income | 31399918 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224950 | Total |
| Program Services | 224950 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 833299 | Total |
| Program Services | 833299 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15941 | Total |
| Program Services | 15941 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1927 | Total |
| Program Services | 1927 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7757 | Total |
| Program Services | 7757 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13088 | Total |
| Program Services | 13088 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13116 | Total |
| Program Services | 13116 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10605 | Total |
| Program Services | 10605 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34194 | Total |
| Program Services | 34194 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| OTHER PROFESSIONAL EXPE | 15423227 | 15423227 |
| FISCAL & ADMINISTRATIVE | 7524132 | 7524132 |
| NURSING EXPENSES | 4628420 | 4628420 |
| GENERAL SERVICE EXPENSE | 3245855 | 3245855 |
| MINOR EQUIPMENT | 150478 | 150478 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278089 | Total |
| Program Services | 278089 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32405078 | Total |
| Program Services | 32405078 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1228768 | BOY |
| EOY | 857339 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26449 | BOY |
| EOY | 170456 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 434765 | BOY |
| EOY | 568813 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1872 | BOY |
| EOY | 13462 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5084 | BOY |
| EOY | 94430 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 56911 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14377 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41488 | BOY |
| EOY | 42534 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5749694 | BOY |
| EOY | 5285067 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 873805 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264260 | BOY |
| EOY | 198149 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7752380 | BOY |
| EOY | 8104055 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3032540 | BOY |
| EOY | 1259450 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264260 | BOY |
| EOY | 3093885 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3296800 | BOY |
| EOY | 4353335 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4455580 | BOY |
| EOY | 3750720 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4455580 | BOY |
| EOY | 3750720 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7752380 | BOY |
| EOY | 8104055 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7416 | BeginningOfYearBalance |
| Contributions | 56 | Contributions |
| End Of Year Balance | 7472 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7342 | BeginningOfYearBalance |
| Contributions | 74 | Contributions |
| End Of Year Balance | 7416 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 56911 | OtherCostOrOtherBasis |
| Depreciation | 14377 | Depreciation |
| Book Value | 42534 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 42534 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CERTIFICATES OF DEPOSIT | Description |
| Book Value | 873805 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 873805 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO HSD #2 | $1,923,758 |
| ACCRUED PAYROLL | $398,106 |
| ACCRUED VACATION PAYABLE | $596,057 |
| ACCRUED DISABILITY BENEFITS | $175,964 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3093885 | TotalOfAmounts |
| Total Revenue | 31399918 | TotalRevenue |
| Total Expenses | 32405078 | TotalExpenses |
| Excess Or Deficit For Year | -1005160 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 300300 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 300300 | TotalAdjustments |
| Excess Or Deficit Per FS | -704860 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31700218 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 300300 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 300300 | RevenueNotRptdF990 |
| Revenue Subtotal | 31399918 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31399918 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 32405078 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 32405078 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 32405078 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4506841 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3507634 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 999207 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03080 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6289354 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5620333 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 669021 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02060 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10796195 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9127967 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1668228 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05140 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 66962 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 66962 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 263000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 263000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00810 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2172638 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 618189 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1554449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04800 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2502600 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 618189 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1884411 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05820 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13298795 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9746156 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3552639 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10960 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 315549 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 315549 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 315549 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 315549 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,254,715 | BadDebtExpenseAmount |
| Amount Attributable To | 901886 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10749625 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11188323 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -438698 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| HOSPITAL SERVICE DISTRICT #2 | |||||||
| 600 S PINE STREET | DERIDDER | LA | 70634 | X | X | X | |
| BEAUREGARD PHYSICIAN GROUP LLC | |||||||
| 600 S PINE STREET | DERIDDER | LA | 70634 | A disregarded entity; physician recruitment to a HPSA | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: PART I, LINE 7 - COSTS ON 7A AND 7B WERE TAKEN FROM THE SCHEDULE OF UNCOMPENSATED CARE COST FOR SMALL RURAL HOSPITALS, A REPORT USED BY THE LA. DEPT. OF HEALTH AND HOSPITALS TO DETERMINE UNCOMPENSATED MEDICAID AND INDIGENT COSTS AND REIMBURSEMENTS. A COST TO CHARGH RATIO WAS ALSO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES AND USED WHEN NEEDED. COSTS ON LINE 7E, 7F AND 7G ARE ACTUAL COSTS PER RECORDS. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: PART I, LINE 7 G - IN ACCORDANCE WITH IDENTIFIED COMMUNITY NEEDS THE HOSPITAL HAD RECRUITED PHYSICIANS TO SERVE IN THE COMMUNITY, WHICH IS IN A PROFESSIONAL SHORTAGE AREA (HPSA). SUBSIDIZED HEALTH SERVICES INCLUDE SUBSIDIES OF $1,435,584 TO NINE CLINICS WHICH PROVIDE ORTHOPEDIC, SURGICAL, PEDIATRIC, INTERNAL MEDICINE, OB/GYN, CARDIOLOGY AND FAMILY PRACTICE SERVICES TO THE COMMUNITY. THE HOSPITAL SUBSIDIZED AN OB/GYN CLINIC $41,112 FOR MALPRACTICE INSURANCE AS THE MAJORITY OF PATIENTS SERVED WERE MEDICAID. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: PART 3 LINE 4 BAD DEBT EXPENSE - LINE 2, BAD DEBT COST WAS CALCULATED BY MULTIPLYING BAD DEBT CHARGES PER ACCOUNTING RECORDS BY THE WORKSHEET 2 COST TO CHARGE RATIO. LINE 3 IS 40% OF THE BAD DEBT COSTS, BASED ON HISTORICAL INFORMATION. SELF PAY PATIENTS PAY 5% OF CHARGES ON AVERAGE, WHICH CHARGES TOTALED $12.3 MILLION. THE COMMUNITY BENEFITS FROM THE HOSPITAL'S POLICY THAT ALL PATIENTS WHO ARE UNINSURED ARE ACCEPTED BY THE HOSPITAL. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: THE ACCOUNTING POLICY OF THE HOSPITAL REGARDING BAD DEBTS STATES THAT THE ALLOWANCE METHOD IN ACCOUNTING FOR BAD DEBTS IS USED. THE ALLOWANCE ACCOUNT CONSISTS OF AN ESTIMATE OF UNCOLLECTABLE ACCOUNTS AND A GENERAL RESERVE. MANAGEMENT'S EVALUATION OF THE ADEQUACY OF THE ALLOWNACE IS BASED ON A CONTINUING REVIEW OF ALL ACCOUNTS AND INCLUDES A CONSIDERATION OF PAST PATIENT HISTORY, AND ADVERSE SITUATIONS THAT MIGHT AFFECT THE PATIENT'S ABILITY TO PAY, AND CURRENT ECONOMIC CONDITIONS. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: PART III, LINE 8 - THE COSTING METHODOLOGY FOR MEDICARE WAS DERIVED FROM THE MEDICARE FORM CMS-2552 FILED FOR FYE 10/31/10. THE HOSPITAL CONTINUES TO TREAT MEDICARE PATIENTS, EVEN AS MEDICARE REIMBURSEMENT IS DECLINING. THE HOSPITAL VIEWS THE $438,698 MEDICARE SHORTFALL AS A COMMUNITY BENEFIT, AS ALL HOSPITLA PATIENTS ARE ACCEPTED REGARDLESS OF REIMBURSENT. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: PART III, LINE 9B - REGARDING COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL TRIES TO CONDUCT A PRE ADMISSION INTERVIEW WITH THE PATIENT OR GUARANTOR PRIOR TO ADMISSION WHEN POSSIBLE. POTENTIAL CHARITY CARE PATIENTS ARE OFFERED THE OPPORTUNITY TO APPLY FOR CHARITY CARE AT THE TIME OF ADMISSION. OUTPATIENTS AND ER PATIENTS ARE SENT A NOTIFICATION ABOUT CHARITY CARE THROUGH THE MAIL. PATIENT WITH NO INSURANCE RECEIVE A LETTER WITHIN 30 DAYS OF SERVICE, STATING THAT THE HOSPITAL HAS GIVEN THEM A 52% DISCOUNT AND THAT THEY ARE RESPONSIBLE FOR THE BALANCE OF THE BILL. THE LETTER ALSO STATES THAT THE HOSPITAL HAS A CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM AND GIVES THE CONTACT PERSON'S NAME AND PHONE NUMBER TO OBTAIN AN APPLICATION. THE LETTER ALSO GIVES THE NAME AND NUMBER TO APPLY FOR MEDICAID AT THE HOSPITAL. THE LETTER STATES THE ACCOUNT BALANCE THAT IS DUE AND THAT PAYMENTS CAN BE SPREAD OVER 12 TO 18 MONTHS. IT ALSO STATES THAT FAILURE TO PAY THE BILL OR SET UP FINANCIAL ARRANGEMENTS WILL RESULT IN ADDITIONAL COLLECTION EFFORTS. A SECOND LETTER IN THE FOLLOWING MONTH IS SENT THAT STATES THEIR ACCOUNT IS DELINQUENT, IS DUE AND FAILURE TO RESPOND WILL RESULT IN FURTHER COLLECTION ACTION. IF NO RESPONSE, A THIRD LETTER IS SENT STATING THEIR ACCOUNT IS DELIQUENT AND IS BEING REVIEWED TO GO TO AN OUTSIDE COLLECTION AGENCY. A FINAL NOTICE IS SENT STATING THIS A FINAL NOTICE, FAILURE TO PAY WILL RESULT IN THE ACCOUNT BEING PLACED WITH A COLLECTION AGENCY, AND THAT THEY MUST HAVE AN AUTHORIZED FINANCIAL AGREEMENT WITH THE HOSPITAL TO STOP THE ACCOUNT FROM BEING PLACED WITH AN OUTSIDE COLLECTION AGENCY. | DebtCollectionPolicy |
| General Explanation | PART I, LINE 6A THE HOSPITAL'S COMMUNITY BENEFIT REPORT WAS PREPARED BY THE HOSPITAL AND WAS NOT PREPARED BY A RELATED ORGANIZATION. | GeneralExplanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THEODORE BADGER JR | |||||||||||||
| 205366 | 0 | 0 | 0 | 8122 | 0 | 11000 | 0 | 2346 | 0 | 226834 | 0 | 0 | 0 |
| DARRELL L KINGHAM | |||||||||||||
| 166961 | 0 | 0 | 0 | 0 | 0 | 8992 | 0 | 2346 | 0 | 178299 | 0 | 0 | 0 |
| DARREN CAILLOUET | |||||||||||||
| 201688 | 0 | 0 | 0 | 0 | 0 | 10757 | 0 | 0 | 0 | 212445 | 0 | 0 | 0 |
| ROBERT RUSHFORD | |||||||||||||
| 165345 | 0 | 0 | 0 | 0 | 0 | 8249 | 0 | 0 | 0 | 173594 | 0 | 0 | 0 |
| THOMAS FRANKS | |||||||||||||
| 182464 | 0 | 0 | 0 | 0 | 0 | 9285 | 0 | 0 | 0 | 191749 | 0 | 0 | 0 |
| JANET LEWIS | |||||||||||||
| 224950 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 224950 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1b | SCHEDULE J, PART 1, LINE 1a - Reasonable expenses submitted for a traveling spouse (except for airfare) accompanying a trustee on approved travel is reimbursed. |
| Part I, Line 7 | SCHEDULE J, PART 1, LINE 7 - The CEO bonus criteria is weighted 40% quality, 40% financial, and 20% community. 62% of the 18 goals were met, resulting in the additional non-fixed payment of $6,200 of a possible $10,000 maximum amount available. Other officers, key employees and the highly compensated employees are not eligible for bonuses. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JAY STINE | |||
| WEST LA HEALTH SERVICES BOARD MEMBER | 7197 | WLHS PURCHASED MATERIALS FOR HOSPITAL REPAIRS AND MAINTENANCE FROM LUMBER COMPANY PARTIALLY OWNED BY BOARD MEMBER. | 0 |
| DR DAVID BROWN | |||
| WEST LA HEALTH SERVICES BOARD MEMBER | 48000 | BOARD MEMBER PROVIDED CONTRACT PHYSICIAN SERVICES TO WLHS MANAGED HOSPITAL. | 0 |
| DR TOM DOBBINS | |||
| WEST LA HEALTH SERVICES BOARD MEMBER | 600 | BOARD MEMBER PROVIDED CONTRACT PHYSICIAN SERVICES TO WLHS MANAGED HOSPITAL. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | PART VI SECTION A, LINE 10: AVAILABILITY OF FORM 990 - The Form 990 is available to the Board of Trustees by its posting on the hospital's intranet portal for subsequent board meeting discussion. | |
| Form 990, Part VI, Section B, line 12c | PART VI SECTION B, LINE 12C: CONFLICT OF INTEREST POLICY - Every January, a Conflict of Interest Questionaire is completed by each trustee. These documents are reviewed and retained in the Board of Trustee's files. | |
| Form 990, Part VI, Section B, line 15 | PART VI SECTION B, LINE 15A: CEO COMPENSATION PROCESS - The Board of Trustees' Executive Committee conducts an annual performance evaluation following the end of each fiscal year. Comparable compensation data for CEOs at other similiarly situated organizations is used. Resources include the VHA Gulf States CEO Compensation Survey, the Hay Group Hospital Compensation Report, the Jackson Survey for quality goals, Health Stream Employee Satisfaction, Emergency Department, Inpatient, Same Day Surgery, Lab and Radiology Satifaction Surveys, and other various reports. The CEO's compensation is criteria based. A bonus is dependent on achieving goals in community health, quality and financial areas. A analysis of salary history, employee retention and self evaluation is also considered. PART VI SECTION B, LINE 15B: OTHER KEY EMPLOYEE COMPENSATION PROCESS - Annual employee evaluations are conducted in November of each year. These evaluations consider the employee's achievement of goals, salary and expense budgets, compliance with quality controls and Joint Commission, performance and competency, and other criteria based objectives in determining remuneration. In addition, the CEO also considers the following salary surveys: The Hay Group, VHA Department Head Survey, Louisiana Hospital Salary and Benefits Survey, Greater New Orleans Society for Healthcare Human Resources Administration Executive Director and Management Survey. | |
| Form 990, Part VI, Section C, line 19 | PART VI SECTION C, LINE 19: AVAILABILITY OF THE ORGANIZATION'S DOCUMENTS AND POLICIES - Information is available upon request. | |
| PART XI, LINE 2C | THERE HAS BEEN NO CHANGE IN INDEPENDENT ACCOUNTANT OVERSIGHT AND SELECTION PROCESS FROM THE PRIOR YEAR. | NO CHANGE IN PROCESSES FROM PRIOR YEAR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAUREGARD PHYSICIAN GROUP LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1540 | AddressLine1 |
| City | DERIDDER | City |
| State | LA | State |
| ZIP Code | 70634 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270602265 | EIN |
| Primary Activities | PHYSICIAN SERVICES | PrimaryActivities |
| Legal Domicile State | LA | LegalDomicileState |
| Total Income | 566477 | TotalIncome |
| EOY Assets | 899125 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |