2011-11-14T09:45:56-06:00 2010-12-31 LAPORTE SEHRT ROMIG & HAND APAC 111 VETERANS MEMORIAL BLVD SUITE 60 METAIRIE LA 700054958 990 2010-01-01 720417281 AMERICAN LEGION HOSPITAL AMER 3377886406 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 CHARMAINE VIDRINE 3377886406 2011-11-11 1 5048355522 2010 2016-02-24 21:20:13Z TERRY OSBORNE 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 34706034 0 X N/A X 1951 LA PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, AND CHARITY HEALTHCARE SERVICES FOR RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. 7 5 572 50 0 0 4650 26442 37044530 34039503 487555 339091 179375 197585 37716110 34602621 3252 0 0 0 17881135 17806258 0 0 0 19013929 18345991 36898316 36152249 817794 -1549628 37099486 36764277 5652971 6867390 31446515 29896887 X THE MISSION OF AMERICAN LEGION HOSPITAL IS TO BE A COMMUNITY HEALTH CENTER PROVIDING A SPECTRUM OF HIGH QUALITY HEALTH SERVICES, PROMOTING EDUCATION WITHIN THE ORGANIZATION, EMPHASIZING SERVICE AND EXCELLENCE,AND CONTINUALLY IMPROVING THE QUALITY MANAGEMENT SYSTEM. 0 0 32145045 0 34028304 THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. TOTAL HOSPITAL (ACUTE & ICU) PATIENT DAYS TOTALLED 13,036; AVERAGE LENGTH OF STAY WAS 3.43 DAYS. TOTAL PSYCHIATRIC DAYS TOTALLED 8,287; AVERAGE LENGTH OF STAY WAS 11.49 DAYS. OUTPATIENT REGISTRATIONS TOTALLED 38,843 FOR THE YEAR. CARE PROVIDED TO MEDICARE AND MEDICAID BENEFICIARIES TOTALLED 43% AND 27%, RESPECTIVELY, OF TOTAL GROSS REVENUE. THE HOSPITAL PARTICIPATED IN FIVE DIFFERENT HEALTHCARE CAREER PROGRAMS WITH LOCAL SCHOOLS AND ORGANIZATIONS. THE HOSPITAL PARTICIPATED IN A LOCAL EVENT WHERBY VARIOUS HEALTH INFORMATION WAS DISTRIBUTED. THE HOSPITAL SPONSORED TWENTY-FOUR BIWEEKLY COMMUNITY BLOOD DRIVES AND ONE EMPLOYEE BLOOD DRIVE WITH A TOTAL OF 237 PARTICIPANTS. THE HOSPITAL ALSO PARTICIPATED WITH A LOCAL MOBILE OUTREACH PROGRAM FOR CANCER PATIENTS. DURING THE YEAR, THE MOBILE OUTREACH VISITED THE HOSPITAL ON TWENTY FOUR OCCASIONS AND 110 VISITS, WITH 61 CLIENTS PARTAKING OF THEIR BROAD SCOPE OF SERVICES, INCLUDING COUNSELING FOR PATIENTS AND THEIR FAMILES. THE HOSPITAL ALSO PARTICIPATED AS A CLINICAL OBSERVATION SITE WITH SEVERAL LOCAL COLLEGES AND UNIVERSITIES AS WELL AS A TEXAS-BASED UNIVERSITY FOR NURSE ANESTHETISTS. THE HOSPITAL ALSO PARTICIPATED IN A CHRISTMAS CARD RECYCLING PROJECT. 32145045 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 54 0 1 572 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X JACKIE VALDETERO 3377886404 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 J ANDRUS BAROUSSE 0.50 X 0 0 0 BC DELAHOUSSAYE MD 0.50 X 0 0 0 MICHAEL MCBRIDE 0.50 X 0 0 0 RALPH COWEN 0.50 X 0 0 0 LAWRENCE HABETZ 0.50 X 0 0 0 DONALD JONES 0.50 X 0 0 0 STEPHEN STEFANSKI 0.50 X 0 0 0 TERRY OSBORNE 40.00 X 237924 0 10022 CHARMAINE VIDRINE 40.00 X 163428 0 10496 SATINDER SAINI MD 40.00 X 182674 0 10648 CARLA GOSSEN 40.00 X 110647 0 10874 JAMES ROTEFF 40.00 X 131445 0 10236 HOPE ROSINSKI 40.00 X 105804 0 9660 GLENN DAILEY 40.00 X 104856 0 10496 1036778 0 72432 9 0 1 0 PROFESSIONAL ANESTHESIA SERVICES OF SWLA 1309 HILLCROFT DR LAKE CHARLES LA 70605 ANESTHESIA SERVICES 1210000 MCKESSON TECHNOLOGIES INC PO BOX 98347 CHICAGO IL 606938347 COMPUTER SERVICES 1182302 ARSHAVIR MICHAEL APMC PO BOX 2403 CROWLEY LA 70526 ANESTHESIA SERVICES 470000 ACADIA EMERGENCY GROUP LLC PO BOX 82368 LAFAYETTE LA 705982368 ER PHYSICIAN SERVICES 330000 ACCELECARE WOUND CENTERS INC PO BOX 671242 DALLAS TX 752671242 HBO/WOUNDCARE SERVICES 298481 16 26442 26442 PATIENT SERVICES 621990 34039503 34039503 34039503 350290 350290 124343 87531 36812 36812 36812 4683 15882 -11199 -11199 -11199 CAFETERIA REVENUE 722210 158909 158909 1864 1864 160773 34602621 34028304 0 547875 424443 424443 15554581 13761219 1793362 656400 565924 90476 1170834 1009450 161384 246503 246503 49490 49490 4335777 4022030 313747 30768 30768 6068755 5872819 195936 282487 243550 38937 689153 537860 151293 18010 10671 7339 9274 4878 4396 101755 100458 1297 1824727 1423287 401440 392614 369907 22707 BAD DEBTS 3059268 3059268 REPAIRS AND MAINTENANCE 950086 879900 70186 PHYSICIAN RECRUITMENT 205652 205652 COLLECTION EXPENSES 78172 78172 3500 3500 36152249 32145045 4007204 0 1625 1725 4141159 3907774 8002141 6302129 1048992 1183120 791945 1046108 33542932 20602967 11144799 12939965 995839 1006850 262279 262279 479266 305124 10231441 9809203 37099486 36764277 2358324 2275330 3294647 4592060 5652971 6867390 X 31174461 29624239 272054 272648 31446515 29896887 37099486 36764277 -1549628 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 82090 588836 670926 1512252 11360777 8974580 3898449 42737 19336073 11094200 8284610 40740 579427 534187 85980 12939965 RESTRICTED CASH AND INVESTMENTS 6799640 DEPOSITS FOR HEALTH INSURANCE ADMINISTRATOR 2433875 TRUST INVESTMENT 272648 COST REPORT SETTLEMENT RECEIVABLE 303040 9809203 34602621 36152249 -1549628 0 -1549628 35450375 883214 883214 34567161 35460 35460 34602621 37022208 782428 782428 36239780 -87531 -87531 36152249 PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY INCOME $ 883,214 -- AUDITED FINANCIAL STMTS WERE CONSOLIDATED PART XII, LINE 4B - OTHER ADJUSTMENTS: DIVIDEND FROM SUBSIDIARY $122,991 RENTAL EXPENSES REPORTED IN PART VIII, LINE 6B -- $87,531 PART XIII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSE $782,428 (AUDITED FINANCIAL STMTS WERE CONSOLIDATED) PART XIII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED IN PART VIII, LINE 6B -- $87,531 1 1 X 1 X 1 X 1 0 0 134783 134783 0.00410 8879461 6851714 2027747 0.06130 9014244 6851714 2162530 0.06540 2050 2050 0.00010 3500 3500 0.00010 5550 5550 0.00020 9019794 6851714 2168080 0.06560 0 1788563 804853 15660705 12240928 3419777 X 1 1 1 OPEN AIR MRI OF ACADIANA LLC PROVIDE OPEN AIR MRI 0.51000 2 SERVICES TO RESIDENTS 3 OF ACADIA PARISH & 4 SURROUNDING AREA 1 1 AMERICAN LEGION HOSPITAL

1305 CROWLEY-RAYNE HWY CROWLEY LA 70526

X X X INCLUDES OFFSITE PSYCHIATRIC CAMPUS AMERICAN LEGION HOSPITAL 1 PART I, LINE 7: PERCENT OF TOTAL COMMUNITY BENEFIT EXPENSE TO TOTAL EXPENSE IS 27.26% THE HOSPITAL USED TOTAL EXPENSES FROM PART IX ($36,152,249) FOR THIS CALCULATION LESS BAD DEBT EXPENSE ($3,059,268) (PART IX, LINE 24A) OR $33,092,981 PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3059268. PART III, LINE 4: FOOTNOTE IN FINANCIAL STATEMENTS FOR BAD DEBTS AND COSTING METHODOLOGIESPATIENT ACCOUNTS RECEIVABLES ARE CARRIED AT THE ORIGINAL BILLED AMOUNT LESS DEDUCTIONS FOR CONTRACTUALS AND OTHER DISCOUNTS AS WELL AS AN ESTIMATE FOR UNCOLLECTIBLE ACCOUNTS BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLES ARE WRITTEN-OFF WHEN DEEMED UNCOLLECTIBLE WHICH OCCURS AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLES PREVIOUSLY WRITTEN-OFF ARE RECORDED WHEN RECEIVED. THE HOSPITAL DOES NOT HAVE A POLICY OF CHARGING INTEREST ON PAST DUE BALANCES IN PATIENT ACCOUNTS RECEIVABLE.THE HOSPITAL USED THE SAME COSTING METHODOLOGY USED AND RECOMMENDED IN THE IRS WORKSHEET 2 FOR SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES FOR PART III, LINES 2 AND 3. FOR LINE 3, THE HOSPITAL ANALYZED ITS BAD DEBT POPULATION AND ITS CHARITY POPULATION; IT APPEARS THAT THE FINANCIAL CLASSES MIRRORED CLOSELY THE SAME PROPORTIONS BETWEEN CHARITY AND BAD DEBTS. APPROXIMATELY EIGHTY PERCENT OF OUR BAD DEBTS WERE UNINSURED. THUS, THE HOSPITAL ASSUMED THAT FIFTY PERCENT OF THOSE WOULD PROBABLY QUALIFY FOR CHARITY BUT FAILED TO PROVIDE THE APPROPRIATE DOCUMENTATION. THE OTHER TWENTY PERCENT OF OUR BAD DEBT POPULATION WAS ASSUMED THAT A FOURTH OF THOSE WOULD QUALIFY BUT DID NOT PRESENT THE APPROPRIATE DOCUMENTATION. THE HOSPITAL DID NOT INCLUDE ANY BAD DEBTS IN OUR COMMUNITY BENEFIT CALCULATIONS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR LINE 6 IS THE STANDARD MEDICARE COST REPORT COSTING SYSTEM. THE AMOUNTS WERE RECAPPED FROM THE HOSPITAL'S FILED 2010 COST REPORT; THE CORRESPONDING REVENUE AMOUNTS WERE INCLUDED ON LINE 5. THE AMOUNTS REPORTED INCLUDE THOSE RELATED TO MEDICARE PART A INPATIENT SERVICES (BOTH ACUTE AND PSYCHIATRIC) AND MEDICARE PART B HOSPITAL-RELATED OUTPATIENT SERVICES; IT EXCLUDES THE MEDICARE HOSPITAL OUTPATIENT LABORATORY CHARGES WHICH WERE REIMBURSED ON A FEE SCHEDULE AND, THUS, NOT REQUIRED TO BE REPORTED ON THE COST REPORT. ADDITIONALLY, THESE AMOUNTS EXCLUDE THE REIMBURSEMENT AND COSTS ASSOCIATED WITH OUR ANESTHESIA HOSPITAL BASED PRACTICE AS WELL AS OUR TWO PHYSICIAN OFFICES. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY ADDRESSES THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. OUR PRACTICE IS TO SEND A LETTER OFFERING A CHARITY CARE APPLICATION TO THOSE UNINSURED PATIENTS ALONG WITH A DETAILED BILL WITHIN SEVEN DAYS OF DISCHARGE. OUR HOSPITAL PRACTICE ALSO INCLUDES SENDING A WARNING LETTER TO PATIENTS WHO ARE NOT UNINSURED BEFORE THEY ARE WRITTEN OFF TO BAD DEBT; AT THIS TIME, THEY ARE INFORMED OF THE FINANCIAL ASSISTANCE PRACTICE AND ARE ENCOURAGED TO CONTACT THE HOSPITAL IF THEY FEEL THAT THEY WOULD QUALIFY. AT ANY TIME, ANY PATIENT MAY REQUEST A CHARITY CARE APPLICATION FORM. PART VI, LINE 2: NEEDS ASSESSMENTTHE HOSPITAL MAINTAINS AN EMERGENCY ROOM OPEN TO ALL PEOPLE REQUIRING EMERGENCY CARE, WITHOUT REGARD TO ABILITY TO PAY. THE HOSPITAL PROVIDES HOSPITAL CARE FOR ALL PERSONS IN THE COMMUNITY OTHERWISE ABLE TO PAY THE COST OF MEDICAL SERVICES EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT. THE HOSPITAL MAINTAINS A BOARD OF DIRECTORS DRAWN FROM THE COMMUNITY AND USES SURPLUS RECEIPTS OVER DISBURSEMENTS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. ADDITIONALLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE HOSPITAL COMPLIES WITH FEDERAL REQUIREMENTS OF NOTICES TO PATIENTS AS REQUIRED BY FEDERAL PROGRAMS, SUCH AS MEDICARE. ADDITIONALLY, THE HOSPITAL MAKES AVAILABLE SCREENING SERVICES ONSITE TO HELP INPATIENTS WHO QUALIFY FOR MEDICARE AND/ OR MEDICAID ASSISTANCE APPLY FOR BENEFITS. A PROMPT PAY DISCOUNT IS OFFERED TO ALL PATIENTS WITHOUT INSURANCE; ADDITIONALLY, UPON ORIGINAL BILL FOR SERVICES, ALL PATIENTS WITHOUT INSURANCE ARE OFFERED A CHARITY DISCOUNT WITH INFORMATION ON HOW TO APPLY. PART VI, LINE 4: COMMUNITY INFORMATIONTHE HOSPITAL SERVES THE RESIDENTS OF ACADIA PARISH AND THE SURROUNDING AREA. AS THE ONLY ACUTE HOSPITAL IN THE PARISH, THE HOSPITAL PROVIDES HEALTHCARE SERVICES TWENTY-FOUR HOURS A DAY. THE HOSPITAL STRIVES TO MAINTAIN A WELL CONDITIONED PLANT AND MODERN TECHNOLOGY TO BETTER SERVE THE CITIZENS OF OUR COMMUNITY; ADDITIONALLY, THE HOSPITAL STRIVES TO MAINTAIN A KNOWLEDGEABLE AND FRIENDLY STAFF TO PROVIDE PATIENT CARE TO THE RESIDENTS IN THE SURROUNDING AREA. ACADIA PARISH COVERS 655.12 SQUARE MILES IN SOUTHWEST LOUISIANA. THE ESTIMATED POPULATION FOR 2010 WAS AROUND 61,700 RESIDENTS. ACADIA PARISH'S POPULATION CONSISTS OF 12.8% OF PERSONS WHO ARE SIXTY-FIVE OR OLDER (SLIGHTLY HIGHER THAN THE STATE'S OVERALL PERCENTAGE OF 12.3%). ACCORDING TO THE 2008-2010 AMERICAN COMMUNITY SURVEY OF THE U.S. CENSUS BUREAU, THE MEDIAN HOUSEHOLD INCOME FOR ACADIA PARISH WAS $38,952. HOWEVER, FOR LOUISIANA IT WAS $43,362 AND FOR THE U.S.IT WAS $51,222. THIS SURVEY ALSO SHOWS THE PERCENT OF PEOPLE LIVING BELOW THE POVERTY LEVEL DURING 2008-2010 IN ACADIA PARISH TO BE 20.2%. HOWEVER, IN LOUISIANA IT WAS 17.8%, AND IN THE U.S. IT WAS 14.4%. THUS, ACADIA PARISH'S POPULATION IS POORER THAN THE REST OF LOUISIANA AND THE NATION. PART VI, LINE 6: PART VI, LINE 6: THE HOSPITAL IS THE SECOND LARGEST EMPLOYER IN THE PARISH, SECOND TO ONLY THE LOCAL SCHOOL BOARD. THE HOSPITAL IS A LARGE GENERATOR OF SALES TAX TO THE PARISH AS WELL. THE HOSPITAL CONTRIBUTED OVER $1,700,000 TO THE LOCAL ECONOMY IN ANNUAL EXPENDITURES. AS A RESULT, THE HOSPITAL'S PRESENCE SERVES AS A LARGE ECONOMIC FORCE IN OUR LOCAL COMMUNITY; TO ENSURE THAT WE CAN CONTINUE TO SERVE THE RESIDENTS OF OUR COMMUNITY, WE MUST CONTINUE TO MONITOR THE CURRENT CONDITIONS OF OUR WORKFORCE AND THE AVAILABILITY OF PHYSICIANS IN OUR AREA. THE HOSPITAL RECRUITS PHYSICIANS, INCLUDING SPECIALISTS, TO OUR AREA TO ENSURE THAT WE CAN CONTINUE TO BE THE HEALTHCARE PROVIDER OF THE FUTURE AS WELL. THE HOSPITAL ALSO JOINS FORCES WITH OTHER LOCAL ORGANIZATIONS AND COMPANIES TO PROVIDE HEALTHCARE SCREENINGS AT LOCAL EVENTS AS WELL AS PROVIDE INFORMATION TO PROMOTE A HEALTHIER, SAFER COMMUNITY.BY MAINTAINING AN OPEN MEDICAL STAFF, THE HOSPITAL CAN OFFER A VARIETY OF SPECIALISTS TO AN OTHERWISE RURAL PARISH, THEREBY INCREASING AVAILABLE RESOURCES FOR THE BEST PATIENT CARE. THE HOSPITAL ALSO MAINTAINS A BOARD OF DIRECTORS COMPRISED OF MEMBERS FROM THE COMMUNITY; BY INCORPORATING MEMBERS OF THE COMMUNITY, THE BOARD CAN ENSURE THE LONG-TERM VIABILITY OF THE HOSPITAL TO BE ABLE TO CONTINUE TO SERVE THE COMMUNITY FOR GENERATIONS TO COME. THE HOSPITAL DILIGENTLY STRIVES TO MAINTAIN A SURPLUS OF REVENUE OVER EXPENSES TO CONTINUE TO UPDATE THE HOSPITAL'S PLANT AND EQUIPMENT WITH THE RAPID CHANGING TECHNOLOGY IN TODAY'S MEDICAL WORLD TO BETTER MEET THE CHANGING NEEDS OF OUR COMMUNITY. IN THE CURRENT YEAR THERE WAS AN ADDITION OF A COMPUTERIZED HEALTH INFORMATION SYSTEM TOTALING OVER $4 MILLION WHICH INCLUDES ELECTRONIC MEDICAL RECORDS. PART VI, LINE 7: AFFILIATED HEALTH CARE SYSTEMTHE HOSPITAL IS NOT AFFILIATED WITH ANY OTHER HEALTH CARE SYSTEM.PART VI LINE 7 COMMUNITY BENEFIT REPORTCURRENTLY, LOUISIANA DOES NOT REQUIRE THE HOSPITAL TO ISSUE A COMMUNITY BENEFIT REPORT; HOWEVER, THE LOCAL NEWSPAPER DOES ON OCCASION RUN AN ARTICLE ON THE HOSPITAL WHERE THE HOSPITAL DOES MAKE THE PUBLIC AWARE OF THE HUGE ECONOMIC IMPACT IT HAS ON THE LOCAL ECONOMY, BOTH AS AN EMPLOYER AS WELL AS A PURCHASER OF SUPPLIES WHICH GENERATES SALES TAXES FOR THE LOCAL ECONOMY. X X X 0 0 0 0 0 1 0 1 0 TERRY OSBORNE 219465 0 0 0 18459 0 0 0 10022 0 247946 0 0 0 CHARMAINE VIDRINE 159990 0 3000 0 438 0 0 0 10496 0 173924 0 0 0 SATINDER SAINI MD 181898 0 0 0 776 0 0 0 10648 0 193322 0 0 0 PART I, LINE 6 THE HOSPITAL EMPLOYED TWO PHYSICIANS; THEIR CONTRACTS STATE THAT THEIR COMPENSATION SHALL CONSIST OF THE NET RECEIPTS OF EACH'S OFFICE PRACTICE LESS EXPENSES ASSOCIATED WITH RUNNING SUCH PRACTICE, INCLUDING PRACTICE-RELATED BAD DEBTS. THUS, THEIR BASE COMPENSATION EQUALS THEIR PRACTICE'S NET EARNINGS. THEIR COMPENSATION IS NOT BASED ON ANY EARNINGS OF THE HOSPITAL AS A WHOLE. PART I, LINE 7 IN 2010, THE HOSPITAL UNDERTOOK A HUGE ENDEAVOR TO LAUNCH THE HOSPITAL'S FIRST FULLY INTEGRATED HEALTH INFORMATION SYSTEM WHICH INCLUDES ELECTRONIC HEALTH RECORDS. AS A RESULT, BONUSES TOTALLING $33,800 WERE PAID TO 55 EMPLOYEES IN VARIED AMOUNTS DEPENDING ON THEIR LEVEL OF INVOLVEMENT IN THE PROJECT. THE HOSPITAL'S CHIEF FINANCIAL OFFICER WAS PAID A BONUS IN THE AMOUNT OF $3,000, WHICH WAS APPROVED IN ADVANCE BY THE CHIEF EXECUTIVE OFFICER AS ADDITIONAL COMPENSATION FOR THE PERFORMANCE OF ADDITIONAL SERVICES. OPEN AIR MRI OF ACADIANA LLC SEE PART V 15900 SEE PART V 0 TERRY OSBORNE SEE PART V 0 SEE PART V 0 CHARMAINE VIDRINE SEE PART V 0 SEE PART V 0 STEPHEN STEFANSKI SEE PART V 0 SEE PART V 0 MICHAEL MCBRIDE SEE PART V 0 SEE PART V 0 0 0 FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: OPEN AIR MRI OF ACADIANA, LLC (A) NAME OF PERSON: OPEN AIR MRI OF ACADIANA, LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OPEN AIR MRI OF ACADIANA, LLC, IS A SUBSIDIARY OF AMERICAN LEGION HOSPITAL.(C) AMOUNT OF TRANSACTION: $15,900(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE SERVICES OF OPEN AIR MRI OF ACADIANA, LLC, ITS SUBSIDIARY, TO PERFORM MRIS FOR THEIR INPATIENTS. OPEN AIR MRI OF ACADIANA, LLC LEASES SPACE FROM AMERICAN LEGION HOSPITAL. THIS ARRANGEMENT HAS BEEN REVIEWED IN ADVANCE AND APPROVED BY THE BOARD OF AMERICAN LEGION HOSPITAL. THE FEES FOR SERVICES PROVIDED BY OPEN AIR MRI OF ACADIANA, LLC ARE COMPARABLE TO OTHER THIRD PARTY REIMBURSEMENT. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: TERRY OSBORNE (A) NAME OF PERSON: TERRY OSBORNE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CEO OF AMERICAN LEGION HOSPITAL (ALH) AND BOARD MEMBER OF OPEN AIR MRI OF ACADIANA, LLC, A SUBSIDIARY OF ALH.(C) AMOUNT OF TRANSACTION: 0(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE SERVICES OF OPEN AIR MRI OF ACADIANA, LLC, ITS SUBSIDIARY, TO PERFORM MRIS FOR THEIR INPATIENTS. TERRY OSBORNE IS COMPENSATED BY AMERICAN LEGION HOSPITAL AS ITS CEO. HOWEVER, HE IS NOT COMPENSATED BY ALH FOR THESE TRANSACTIONS. THIS ARRANGEMENT HAS BEEN REVIEWED IN ADVANCE AND APPROVED BY THE BOARD OF AMERICAN LEGION HOSPITAL. MR. OSBORNE DOES NOT HAVE AN OWNERSHIP INTEREST IN OR RECEIVE COMPENSATION FROM OPEN AIR MRI OF ACADIANA, LLC. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: CHARMAINE VIDRINE (A) NAME OF PERSON: CHARMAINE VIDRINE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CFO OF AMERICAN LEGION HOSPITAL (ALH) AND SECRETARY-TREASURER OF OPEN AIR MRI OF ACADIANA, LLC, A SUBSIDIARY OF ALH.(C) AMOUNT OF TRANSACTION: 0(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE SERVICES OF OPEN AIR MRI OF ACADIANA, LLC, ITS SUBSIDIARY, TO PERFORM MRIS FOR THEIR INPATIENTS. MS. VIDRINE IS COMPENSATED BY AMERICAN LEGION HOSPITAL AS ITS CFO. HOWEVER, SHE IS NOT COMPENSATED BY ALH FOR THESE TRANSACTIONS. THIS ARRANGEMENT HAS BEEN REVIEWED IN ADVANCE AND APPROVED BY THE BOARD OF AMERICAN LEGION HOSPITAL. MS. VIDRINE DOES NOT HAVE AN OWNERSHIP INTEREST IN OR RECEIVE COMPENSATION FROM OPEN AIR MRI OF ACADIANA, LLC. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: STEPHEN STEFANSKI (A) NAME OF PERSON: STEPHEN STEFANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND FATHER OF INSURANCE AGENT, STEPHEN STEFANSKI, JR., OF LOCAL INSURANCE COMPANY.(C) AMOUNT OF TRANSACTION: 0(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL PAID THE $178,088 FOR WORKERS COMPENSATION INSURANCE AND $82,616 FOR PROPERTY INSURANCE. THE PREMIUM OF $27,338 WAS PAID DIRECTLY TO THE LOCAL INSURANCE COMPANY WHICH OUR BOARD MEMBER'S SON IS THE AGENT ON RECORD FOR THE PROPERTY INSURANCE POLICY. THE COST OF THE INSURANCE POLICIES WAS THE LOWEST PROPOSAL RECEIVED FROM THE VARIOUS INSURANCE COMPANIES; THE BOARD DECIDED ON THESE PARTICULAR POLICIES. THE BOARD MEMBER AT ISSUE (FATHER) WAS NOT PRESENT FOR THE BOARD MEETING WHEN THE DECISION WAS MADE FOR THE WORKERS COMPENSATION INSURANCE AND WAS NOT POLLED FOR THE PROPERTY INSURANCE VOTE DUE TO THE RELATIONSHIP. NEITHER FATHER NOR SON WAS COMPENSATED BY THE HOSPITAL. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: STEPHEN STEFANSKI (A) NAME OF PERSON: STEPHEN STEFANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND BOARD MEMBER OF OPEN AIR MRI OF ACADIANA, LLC, A SUBSIDIARY OF ALH.(C) AMOUNT OF TRANSACTION: 0(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE SERVICES OF OPEN AIR MRI OF ACADIANA, LLC, ITS SUBSIDIARY, TO PERFORM MRIS FOR THEIR INPATIENTS. MR. STEFANSKI DID NOT PARTICIPATE IN ANY DECISION MAKING PROCESS WITH THESE TRANSACTIONS. MR. STEFANSKI DOES NOT HAVE AN OWNERSHIP INTEREST IN OR RECEIVE COMPENSATION FROM OPEN AIR MRI OF ACADIANA, LLC, AND HE DOES NOT RECEIVE COMPENSATION FROM AMERICAN LEGION HOSPITAL. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: STEPHEN STEFANSKI (A) NAME OF PERSON: STEPHEN STEFANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND FATHER OF PARTIAL OWNER OF SECURITY COMPANY, BRETT STEFANSKI(C) AMOUNT OF TRANSACTION: 0(D) DESCRIPTION OF TRANSACTION: DURING 2010, THE HOSPITAL PAID $150,713 TO A LOCAL SECURITY COMPANY; DURING THE YEAR, THE BOARD MEMBER'S SON ACQUIRED INTEREST IN THE SECURITY COMPANY. THE HOSPITAL HAS USED THE PARTICULAR SECURITY COMPANY FOR YEARS PRIOR TO THIS ACQUISITION. THE BOARD MEMBER HAS NOT VOTED ON ANY RELATED MATTER FOR THE SECURITY COMPANY SINCE THE BOARD MEMBER'S SON'S ACQUISITION. FORM 990, SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS NAME OF PERSON: MICHAEL MCBRIDE (A) NAME OF PERSON: MICHAEL MCBRIDE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER OF AMERICAN LEGION HOSPITAL (ALH) AND REGIONAL PRESIDENT OF EVANGELINE BANK AND TRUST COMPANY(C) AMOUNT OF TRANSACTION : 0(D) DESCRIPTION OF TRANSACTION: AMERICAN LEGION HOSPITAL UTILIZES THE BANKING AND INVESTMENT MANAGEMENT SERVICES PROVIDED BY EVANGELINE BANK. MR. MCBRIDE IS NOT COMPENSATED BY AMERICAN LEGION HOSPITAL. THIS ARRANGEMENT WAS REVIEWED AND APPROVED BY THE BOARD OF AMERICAN LEGION HOSPITAL. THE SERVICES PROVIDED BY EVANGELINE BANK ARE COMPARABLE TO SERVICES AVAILABLE AT OTHER LOCAL FINANCIAL INSTITUTIONS. IN 2010, THE HOSPITAL HAD AN OUTSTANDING LOAN FROM THIS PARTICULAR FINANCIAL INSTITUTION. THE BOARD MEMBER REFRAINS FROM VOTING ON ANY RELATED BANKING ISSUES. FORM 990, PART VI, SECTION A, LINE 6 AMERICAN LEGION HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION. MEMBERS OF THE AMERICAN LEGION POST # 15 ARE AUTOMATICALLY MEMBERS OF THE AMERICAN LEGION HOSPITAL CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE AMERICAN LEGION HOSPITAL CORPORATION ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY IS PRESENTED TO THE AUDIT AND OVERSIGHT COMMITTEE (WHICH CONSISTS OF FOUR OF THE SEVEN MEMBERS OF THE BOARD OF DIRECTORS). THE FORM AND ITS CONTENTS ARE DISCUSSED AND FULLY REVIEWED BY THE AUDIT AND OVERSIGHT COMMITTEE ALONG WITH THE HOSPITAL'S CEO AND CFO BEFORE FILING WITH THE IRS. WHEN ONLY REVIEWED BY THE AUDIT AND OVERSIGHT COMMITTEE BEFORE FILING, A COMPLETE COPY IS REVIEWED BY THE FULL BOARD AFTER ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE TRANSACTIONS ARE ALL ENTERED INTO AT FAIR MARKET VALUE WITH THE CORRESPONDING BOARD MEMBERS ABSTAINING FROM VOTING ON ITEMS FOR WHICH A CONFLICT OF INTEREST EXISTS. THE HOSPITAL'S ADMINISTRATION REVIEWS ALL TRANSACTIONS TO EVALUATE WHETHER CONFLICTS OF INTEREST EXIST AND TAKES APPROPRIATE ACTION WHEN NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE HOSPITAL'S CEO IS BASED ON SURVEY DATA OF HOSPITALS SIMILAR TO AMERICAN LEGION HOSPITAL IN RESPECT TO REVENUES, BEDS, REGION AND FTES. ALL CONTRACTUAL CHANGES, INCLUDING INCREASES IN SALARY OF THE HOSPITAL'S CEO, ARE REVIEWED BY THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE. A RECOMMENDATION IS MADE FROM THE AUDIT & OVERSIGHT COMMITTEE TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY. THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE ALSO EVALUATES THE CEO'S PERFORMANCE ANNUALLY. LINE 15B: THE PROCESS FOR DETERMINING COMPENSATION OF THE HOSPITAL'S CFO IS BASED ON SURVEY DATA OF HOSPITALS SIMILAR TO AMERICAN LEGION HOSPITAL IN RESPECT TO REVENUES, BEDS, REGION AND FTES. ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY OF THE HOSPITAL'S CFO, ARE INITIATED BY THE CEO AND REVIEWED BY THE HOSPITAL'S AUDIT & OVERSIGHT COMMITTEE. A RECOMMENDATION IS MADE FROM THE AUDIT & OVERSIGHT COMMITTEE TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES ALL CONTRACT CHANGES, INCLUDING INCREASES IN SALARY. THE HOSPITAL'S CEO ALSO EVALUATES THE CFO'S PERFORMANCE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO ANYONE WHO REQUESTS SUCH WITHIN THE TERMS OF THE LAW. FORM 990, PART XI, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 4 THE HOSPITAL DID NOT DIRECTLY ATTEMPT TO INFLUENCE ANY LEGISLATION AT ANY LEVEL. NOR DID IT ATTEMPT TO INFLUENCE PUBLIC OPINION REGARDING A LEGISLATIVE MATTER. HOWEVER, THE HOSPITAL IS A MEMBER OF CERTAIN HEALTHCARE ORGANIZATIONS THAT DO USE DUES TO HELP COVER SUCH COSTS. THE HOSPITAL DOES NOT HAVE ANY CONTROL OR DIRECTION IN DETERMINING HOW OUR DUES WILL BE USED BY THESE ORGANIZATIONS. OPEN AIR MRI OF ACADIANA LLC PO BOX 2207 LAKE CHARLES LA 706022207 721510626 OPEN AIR MRI SERVICES LA AMERICAN LEGION HOSPITAL RELATED HEALTHCARE 120948 57919 0 0 0.51000 PROFESSIONAL ARTS MED CORP PO BOX 852 CROWLEY LA 705270852 720701822 RENTAL OF MEDICAL OFFICES LA N/A C 30944 110728 0.67000 CROWLEY PROFESSIONAL MED CORP 1305 CROWLEY-RAYNE HWY CROWLEY LA 70526 721142948 MAINTAIN MEDICAL OFFICE SPACE LA N/A C 2415 19535 0.48300 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 OPEN AIR MRI OF ACADIANA LLC A 32400 CASH OPEN AIR MRI OF ACADIANA LLC R 122991 CASH FORM 990, SCHEDULE R, PART V, LINE 1A: THE RENTING ACTIVITY OF OPEN AIR MRI OF ACADIANA, LLC IS SUBSTANTIALLY RELATED TO AMERICAN LEGION HOSPITAL'S EXEMPT PURPOSE OF PROVIDING MEDICAL CARE. IN ADDITION, THE RENTAL PAYMENTS, WHICH WERE ALSO QUALIFYING SPECIFIED PAYMENTS, RECEIVED FROM OPEN AIR MRI OF ACADIANA, LLC AND REPORTED ON SCHEDULE R, PART V, LINE 2, DID NOT EXCEED THE FAIR MARKET VALUE FOR THE PROPERTY BEING RENTED, AMERICAN LEGION HOSPITAL DOES NOT HAVE ANY UNRELATED TRADE OR BUSINESS INCOME TO REPORT ON FORM 990-T.