2024-08-02T11:24:33-05:00 2023-09-30 720506596 COLE EVANS & PETERSON POST OFFICE DRAWER 1768 SHREVEPORT LA 711661768 990 2022-10-01 720400933 WILLIS-KNIGHTON MEDICAL CENTER WILL 3182124000 CO COLEEVANS PETERSONPODRAWE SHREVEPORT LA 711661768 JERRY A FIELDER II PRESIDENT 3182124000 2024-07-31 1 0 TIM W BORST P00024750 3182228367 2022 2024-08-08 14:25:15Z JERRY A FIELDER II POST OFFICE BOX 32600 SHREVEPORT LA 711302600 1398937370 0 X WWW.WKHS.COM X 1949 LA THE MEDICAL CENTER PROVIDES A FULL-RANGE OF HEALTH CARE SERVICES TO THE GENERAL PUBLIC. 11 6 8183 156 4353940 0 10092175 2197 1251877803 1352702835 6101236 22681455 39636632 20765000 1307707846 1396151487 2064083 5353840 0 0 501993540 544532034 0 0 0 797116171 832251390 1301173794 1382137264 6534052 14014223 2146013923 2473931125 919926931 916247854 1226086992 1557683271 X TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. 0 0 1122491069 5353840 1362621655 WILLIS-KNIGHTON MEDICAL CENTER STRIVES TO PROVIDE HIGH QUALITY, COST-EFFECTIVE MEDICAL CARE TO THE COMMUNITIES OF NORTHWEST LOUISIANA, NORTHEAST TEXAS, AND SOUTHWEST ARKANSAS. THE MEDICAL CENTER OFFERS SOPHISTICATED TECHNOLOGY AND PROCEDURES THAT MAKE IT A TERTIARY CARE REFERRAL CENTER. GENERAL THE MEDICAL CENTER PROVIDES 24-HOUR EMERGENCY CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, AT ITS FOUR HOSPITALS. THE MEDICAL CENTER PROVIDES AN ORGAN TRANSPLANT PROGRAM, OBSTETRICS, COMPREHENSIVE HEART AND CANCER PROGRAMS, EXTENSIVE SURGICAL OPTIONS, LEADING-EDGE DIAGNOSTICS AS WELL AS A BROAD NETWORK OF PHYSICIANS ENCOMPASSING MOST SPECIALTIES AND SUBSPECIALTIES. THE MEDICAL CENTER PROVIDES THESE SERVICES REGARDLESS OF RACE, COLOR, RELIGION, SEX, ETHNIC ORIGIN, VETERAN STATUS, DISABILITY OR AGE. THE MEDICAL CENTER HAD 47,964 ADMITTANCES DURING THE YEAR ENDED SEPTEMBER 30, 2023 WITH A TOTAL OF 206,365 PATIENT DAYS AND 2,392 BIRTHS. THE MEDICAL CENTER PARTICIPATES IN THE MEDICAID PROGRAM AND ADMINISTERS A CHARITY CARE POLICY WHEREBY FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO QUALIFIED INDIVIDUALS WITH LIMITED FINANCIAL MEANS. DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER PROVIDED AN ESTIMATED $19,500,000 IN UNREIMBURSED COSTS ATTRIBUTABLE TO CHARITY CARE (EXCLUDING PROJECT NEIGHBORHEALTH). THIS ESTIMATE IS BASED ON THE MEDICAL CENTER'S OVERALL COST-TO-CHARGE RATIO. IN ADDITION TO THESE SERVICES, WILLIS-KNIGHTON PROJECT NEIGHBORHEALTH OPERATES TWO CLINICS IN COMMUNITIES THAT ARE ECONOMICALLY DISTRESSED AND/OR DESIGNATED AS MEDICALLY UNDER-SERVED AREAS WITH HEALTH PROFESSIONAL SHORTAGES. REGIONAL TRANSPLANT CENTER THE MEDICAL CENTER OPERATES THE JOHN C. MCDONALD REGIONAL TRANSPLANT CENTER AT WILLIS-KNIGHTON MEDICAL CENTER. ALL TRANSPLANT PATIENTS RECEIVE TRANSPLANTS WITHOUT REGARD TO THEIR ECONOMIC STATUS. THE REGIONAL TRANSPLANT CENTER PROVIDES KIDNEY, PANCREAS, AND LIVER TRANSPLANTS. SUBSTANTIALLY ALL THE COSTS OF OPERATING THE REGIONAL TRANSPLANT CENTER ARE BORNE BY WILLIS-KNIGHTON MEDICAL CENTER. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, 70 PATIENTS RECEIVED ORGAN TRANSPLANTS, CONSISTING OF 63 KIDNEYS (14 OF THOSE PATIENTS ALSO HAD A PANCREAS TRANSPLANT AND 1 OF THOSE PATIENTS ALSO HAD A LIVER TRANSPLANT), AND 7 LIVERS. OF THE 70 TRANSPLANT SURGERIES PERFORMED AT THE MEDICAL CENTER DURING THE YEAR ENDED SEPTEMBER 30, 2023, 27 PATIENTS WERE BENEFICIARIES OF THE MEDICARE PROGRAM. AS SUCH, THESE TRANSPLANTS WERE PERFORMED AT VERY LITTLE, IF ANY, COST TO THE PATIENTS.EMERGENCY CARE THE MEDICAL CENTER PROVIDES EMERGENCY SERVICES AT FOUR LOCATIONS ON A 24-HOUR BASIS STAFFED BY FULL-TIME EMERGENCY ROOM PHYSICIANS. EMERGENCY PATIENTS ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY. DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER'S EMERGENCY ROOMS WERE VISITED BY 152,911 PATIENTS, OF WHOM 22,182 WERE ADMITTED TO THE HOSPITAL FOR FURTHER TREATMENT.WOMEN AND CHILDREN'S HEALTH THE MEDICAL CENTER PROVIDES A VARIETY OF MEDICAL SERVICES FOR WOMEN AND CHILDREN, INCLUDING OBSTETRICS, GYNECOLOGY, NEONATOLOGY, MATERNAL/FETAL HEALTH SERVICES FOR HIGH RISK PREGNANCY, PEDIATRIC INTENSIVE CARE AND PEDIATRIC SUPPORT SERVICES SUCH AS PEDIATRIC GASTROENTEROLOGY, SURGERY, AND PULMONOLOGY. THESE SERVICES INCLUDE BOTH HIGH-RISK AND LOW-RISK OBSTETRICS. MATERNAL TRANSPORTS ARE ACCEPTED. THE LABOR AND DELIVERY (L&D) UNITS ARE DIRECTED BY BOARD CERTIFIED OB-GYN PHYSICIANS AND MANY OF THE NURSES ARE CERTIFIED BY THE ASSOCIATION OF WOMEN'S HEALTH, OBSTETRIC & NEONATAL NURSES (AWHON). THERE WERE 2,392 BIRTHS; 2,502 OBSTETRICAL VISITS TO THE L&D UNITS; DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023.HEALTH AND WELLNESS CENTERS THE MEDICAL CENTER HAS FIVE MEDICALLY-SUPERVISED HEALTH AND WELLNESS CENTERS DEDICATED TO THE PREVENTION OF HEALTH PROBLEMS, FOUR IN SHREVEPORT AND ONE IN BOSSIER CITY WITH A TOTAL MEMBER ENROLLMENT AT SEPTEMBER 30, 2023 OF 4,104. THE CENTERS ARE LOCATED ON EACH OF THE FOUR HOSPITAL CAMPUSES AND IN THE WK COMMUNITY HEALTH & WELLNESS CENTER - ALLENDALE. A MEDICAL EVALUATION, INCLUDING A BLOOD CHEMISTRY WORK-UP, IS REQUIRED FOR MEMBERSHIP. THE CENTERS SERVE PULMONARY AND CARDIAC REHABILITATION PATIENTS AND PROVIDE HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE LOCATED. NEONATAL INTENSIVE CARE UNIT WILLIS-KNIGHTON'S CENTER FOR WOMEN'S HEALTH HOUSES A 42-BED LEVEL III REGIONAL OBSTETRICAL AND NEONATAL UNIT. THIS UNIT ACCEPTS REFERRALS FROM THE ARK-LA-TEX AREA AND IS SERVICED BY BOTH AIR AND GROUND EMERGENCY TRANSPORT ON A 24-HOUR BASIS. THIS UNIT IS DIRECTED BY A BOARD CERTIFIED NEONATOLOGIST. THE MAJORITY OF THE NURSING STAFF IS CERTIFIED BY AWHON. THE AVERAGE LENGTH OF STAY PER ADMIT IS 28.4 DAYS.HOSPICE HOSPICE OF LOUISIANA IS A DEPARTMENT OF WILLIS-KNIGHTON MEDICAL CENTER THAT PROVIDES COMPREHENSIVE END-OF-LIFE CARE INCLUDING SKILLED AND SUPPORTIVE SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. THE HOSPICE TEAM, UNDER THE GUIDANCE OF THE ATTENDING PHYSICIAN, FOCUSES ON THE ALLEVIATION OF THE PAIN AND DISCOMFORT CONNECTED WITH LIFE-ENDING ILLNESS. QUALITY OF LIFE, EMOTIONAL AND SPIRITUAL BALANCE, SYMPTOM MANAGEMENT, AND PAIN CONTROL ARE THE GOALS THAT TEAM MEMBERS STRIVE FOR AS THEY ASSIST DYING PATIENTS AND THEIR FAMILIES. BEREAVEMENT SUPPORT FOR THE IMMEDIATE FAMILY AND COMPANIONS IS PROVIDED FOR AT LEAST ONE YEAR FOLLOWING THE PATIENT'S DEATH. FOR THE YEAR ENDED SEPTEMBER 30, 2023, HOSPICE OF LOUISIANA SERVED 159 PATIENTS AND THEIR FAMILIES AS DIRECT ADMITS, NOT INCLUDING VISITATION AND COUNSELING PROVIDED THROUGH PRE-ADMIT AND/OR BEREAVEMENT SERVICES. THE TEAM INCLUDES: REGISTERED NURSES, CERTIFIED NURSING ASSISTANTS, SOCIAL WORKERS, CHAPLAINS, VOLUNTEERS, ATTENDING PHYSICIANS, AND MEDICAL DIRECTOR. 11621419 6284834 THE MEDICAL CENTER PROVIDES HOUSING, HEALTHCARE, AND RELATED SERVICES TO THE ELDERLY THROUGH THE OAKS OF LOUISIANA. THE OAKS OF LOUISIANA IS A COMMUNITY DESIGNED SPECIFICALLY FOR ADULTS AGED 55 AND OVER. THIS COMMUNITY PROVIDES SECURE, MAINTENANCE-FREE LIVING AND PROMOTES AN ACTIVE, HEALTHY LIFESTYLE. THE CAMPUS OF THE OAKS OF LOUISIANA INCLUDES THE TOWER AT THE OAKS, A RESIDENTIAL COMMUNITY, AND SAVANNAH AT THE OAKS, AN ASSISTED LIVING FACILITY. 1134112488 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 489 0 1 8183 1 1 1 0 0 0 0 0 0 0 1 0 X 11 6 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MR JAF FIELDER 3182124000 2600 GREENWOOD ROAD SHREVEPORT LA 711033908 JAMES K ELROD FORMER CEO/TRUSTEE 40.00 X 1124655 4500 4762 JERRY A FIELDER II PRESIDENT/CEO/TRUSTEE 53.00 X X 2571730 0 26814 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 40.00 X 233843 0 7810 FRANK B HUGHES MD TRUSTEE/CHAIRMAN 4.00 X 0 0 0 WILLIAM J COLE CPA TRUSTEE/TREASURER 8.00 X X 0 0 0 RICHARD H SALE TRUSTEE/ SECRETARY 4.00 X X 0 0 0 EUGENE W BRYSON JR TRUSTEE 4.00 X 0 0 0 ELAINE SIMPKINS PHD TRUSTEE 4.00 X 0 0 0 RAYMOND J LASSEIGNE TRUSTEE 4.00 X 0 0 0 LAMAR P PUGH TRUSTEE 4.00 X 0 0 0 DEBORAH D OLDS TRUSTEE 4.00 X 0 0 0 MARY JANE WARD SR VICE PRESIDENT/CFO 40.00 X 512859 0 21292 JILL K ELROD VP OF LEGAL AFFAIRS 40.00 X 289167 0 11087 IRA L MOSS VP/ADMIN WK PIERREMONT 40.00 X 260773 0 22429 BRIAN A CRAWFORD SENIOR VICE PRESIDENT 40.00 X 383093 0 9953 GREGORY J GAVIN VP/PHYSICIAN NETWORK 40.00 X 252732 0 9984 PEGGY J GAVIN SR VP OF PHYSICIAN SERVICE 40.00 X 242903 0 10015 MARGARET G ELROD SR VP/IND WELLNESS/COMMUN 40.00 X 238164 0 13577 JANET K ELROD VP/ADMIN WK SOUTH 40.00 X 229612 0 11171 TODD J BLANCHARD VP/ADMIN WK BOSSIER 40.00 X 248211 0 22499 DIANE R MCCULLER SR VP NURSING - PATIENT SE 40.00 X 283610 0 12628 MARGARET C REBOUCHE SR VP QUALITY & CLINICAL P 40.00 X 252626 0 13449 JOHN L FORTENBERRY JR VP/MARKETING & STRATEGY 40.00 X 197602 0 2450 ALJAY J FOREMAN JR VP/ADMINISTRATOR REHAB INS 40.00 X 148428 0 29832 VINCENT R SEDMINIK VP/ADMINISTRATOR WKMC 40.00 X 235208 0 2902 MILAN G MODY MD PHYSICIAN 40.00 X 1981853 0 26826 SARAH GLORIOSO MD PHYSICIAN 40.00 X 2213672 0 26474 WYCHE T COLEMAN III MD PHYSICIAN 40.00 X 1727809 0 27451 ANIL VELUVOLU MD PHYSICIAN 40.00 X 1613605 0 29799 CHRISTOPHER SHELBY PHYSICIAN 40.00 X 1766705 0 28845 17008860 4500 372049 1260 0 1 0 TRAVEL NURSE ACROSS AMERICA PO BOX 631820 CINCINNATI OH 45263 MEDICAL STAFFING 14566287 SHREVEPORT ANESTHESIA SERVICES 2600 GREENWOOD ROAD SHREVEPORT LA 71103 PHYSICIAN SERVICES 5683337 RED RIVER CARDIOVASCULAR 2751 ALBERT BICKNELL DR SUITE 5C SHREVEPORT LA 71103 PHYSICIAN SERVICES 5673095 MAYO MEDICAL LABORATORIES PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY TESTING 4687850 RADIATION ONCOLOGY SERVICES 2600 KINGS HIGHWAY SHREVEPORT LA 71103 PHYSICIAN SERVICES 4459691 134 2197 2197 HOSPITAL SERVICES 900099 1348513719 1348513719 RESIDENTIAL COMMUNITY 900099 4189116 4189116 1352702835 22888861 22888861 3141601 2470718 670883 670883 670883 107759 315165 -207406 -207406 -207406 NONOPERATING COMPONENTS OF NET PE 900099 19107510 19107510 LABORATORY REVENUE 621500 4105735 4105735 (LOSS) FROM SUBSIDIARY - MULTI-FA 623000 -1494734 -1494734 -1624394 -1872599 248205 20094117 1396151487 1368906489 4353940 22888861 5353840 5353840 8960459 8960459 416027526 373108459 42919067 81141762 71236549 9905213 38402287 25436704 12965583 996915 996915 3015237 3015237 3206403 951430 2254973 44653097 44653097 27751066 27751066 70229883 27080150 43149733 10882380 10882380 DIRECT DEPARTMENTAL EXP 629496468 629496468 TAXES & LICENSES 13670616 13670616 BUSINESS OFFICE 10234184 10234184 18115141 1448888 16666253 1382137264 1134112488 248024776 0 7491534 2160143 39010868 37067777 279662122 282494133 2836284 2800135 29614601 32156338 14589891 16749428 1499476102 988216875 519170752 511259227 1062845730 1279754599 9813726 7410954 11438 10313 180966977 302068078 2146013923 2473931125 145303200 147769739 30955 25704 47483991 32186276 702550000 700850000 24558785 35416135 919926931 916247854 X 1226086992 1557683271 1226086992 1557683271 2146013923 2473931125 X 14014223 192003264 125578792 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 1092038 1092038 0 PART II-B, LINE 1: DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER PAID DUES TOTALING $37,700 TO THE LOUISIANA STATE MEDICAL SOCIETY ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $18,850 WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER PAID DUES TOTALING $8,235 TO THE AMERICAN MEDICAL ASSOCIATION ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $5,353 WAS RELATED TO LOBBYING ACTIVITIES. DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER PAID DUES TOTALING $269,746 TO THE LOUISIANA HOSPITAL ASSOCIATION FOR THE MEDICAL CENTER'S MEMBERSHIP IN THE ASSOCIATION AND ON BEHALF OF DOCTORS IN THE MEDICAL CENTER'S PHYSICIAN NETWORK, WHICH CONSISTS OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEDICAL CENTER. A PORTION OF THE DUES, $175,335 WAS RELATED TO LOBBYING ACTIVITIES. IN ADDITION TO THE PORTION OF THE DUES ABOVE RELATED TO LOBBYING EXPENSES, THE MEDICAL CENTER HAS CONTRACTED WITH PRADOS & ASSOCIATES TO PROVIDE LOBBYING SERVICES ON BEHALF OF THE MEDICAL CENTER. SERVICES SHALL INCLUDE STRATEGIC PLANNING, BUSINESS DEVELOPMENT AND LOBBYING. THE CONTRACT CALLS FOR A $135,000 MONTHLY RETAINER FEE THROUGH DECEMBER 31, 2022. THE CONTRACT WAS REVISED EFFECTIVE JANUARY 1, 2023, CALLING FOR A $54,167 MONTHLY RETAINER FEE. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, TOTAL LOBBYING EXPENSES UNDER THIS CONTRACT TOTALED $892,500. HEALTHCARE POLICY IS CRITICAL TO THE MISSION OF THE MEDICAL CENTER, AND ITS MANAGEMENT BELIEVES THAT HEALTHCARE PROVIDERS SHOULD PARTICIPATE IN FORMING HEALTHCARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFFS, WHEN POSSIBLE, TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTHCARE ISSUES. THE MEDICAL CENTER'S MANAGEMENT IS AVAILABLE TO LAWMAKERS, GOVERNMENT OFFICIALS, AND THEIR STAFF MEMBERS, FOR INFORMATION AND OCCASIONALLY RESPONDS TO QUESTIONS AND INITIATES COMMUNICATIONS ABOUT HOW PROPOSED LAWS, POLICIES, REGULATIONS, ETC. MIGHT AFFECT THE MEDICAL CENTER'S ABILITY TO DELIVER COST-EFFECTIVE, QUALITY HEALTHCARE. THE AMOUNT OF TIME AND MONEY RESOURCES INVOLVED IN THESE ACTIVITIES IS INSUBSTANTIAL. THE MEDICAL CENTER HAS NOT AND DOES NOT INTERVENE IN ANY POLITICAL CAMPAIGN. 306790 58869890 59176680 6285099 839679412 569545180 276419331 2163854 1890956 272898 519008098 395212817 123795281 73162959 21567922 51595037 511259227 MUSEUM ASSETS 287471 DEPOSIT 12424 OPERATING LEASE RIGHT-OF-USE ASSETS 6494728 NET EXCESS FUNDED PENSION BENEFITS 295273455 302068078 INVESTMENT IN SUB. - VIRGINIA HALL NURSING HOME 9996263 OPERATING LEASE LIABILITY 6593878 FINANCE LEASE LIABILITY 220978 ARBITRAGE REBATE LIABILITY 56760 PAYABLE-340B RECOVERY 18548256 35416135 1607619449 192003264 192003264 1415616185 -19464698 -19464698 1396151487 1276023170 -106114094 -106114094 1382137264 0 1382137264 PART XI, LINE 4B - OTHER ADJUSTMENTS: UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSING, LAUNDRY SUBSIDIARIES EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARIES INCOME/EXPENSE UNRELATED BUSINESS INCOME-EXTERNAL HOUSEKEEPING, DATA PROCESSNG, LAUNDRY FASB ASC 715-30 PENSION FORM 990, SCHEDULE D, PART XI, LINE 4D AND PART XII, LINE 2D PART XI, LINE 4B DATA PROCESSING 224,090 SUBSIDIARIES EXPENSES (19,688,788) TOTAL (19,464,698) PART XII, LINE 2D DATA PROCESSING (224,090) SUBSIDIARIES EXPENSES 19,688,788 PENSION RELATED CHANGES (125,578,792) TOTAL (106,114,094) 1 1 X 1 X 1 X 1 1 1 0 1 1 19511444 19511444 0.01410 233173277 276833052 0 0.00000 252684721 276833052 19511444 0.01410 3629135 3629135 0.00260 1783923 1783923 0.00130 1933179 556788 1376391 0.00100 5353840 5353840 0.00390 12700077 556788 12143289 0.00880 265384798 277389840 31654733 0.02290 1 17967967 0 227942336 247090135 -19147799 X 1 1 4 1 WILLIS-KNIGHTON MEDICAL CENTER 2600 GREENWOOD ROAD SHREVEPORT LA 71103 232 X X X X REHAB CTR, SNF, PHYSICIAN CLINICS A 2 WK PIERREMONT HEALTH CENTER 8001 YOUREE DRIVE SHREVEPORT LA 71115 232-C X X X X PHYSICIAN CLINICS A 3 WK BOSSIER HEALTH CENTER 2400 HOSPITAL DRIVE BOSSIER CITY LA 71111 387 X X X PHYSICIAN CLINICS A 4 WILLIS-KNIGHTON SOUTH 2510 BERT KOUNS INDUSTRIAL LOOP SHREVEPORT LA 71118 232-A X X X X PHYSICIAN CLINICS A WILLIS-KNIGHTON HEALTH SYSTEM 0 0 1 X X X X X X X X X 21 1 1 0 1 X WWW.WKHS.COM 1 21 1 WWW.WKHS.COM 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X WWW.WKHS.COM X WWW.WKHS.COM X WWW.WKHS.COM X X X X X X 1 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: WILLIS-KNIGHTON MEDICAL CENTER, - FACILITY 4: WILLIS-KNIGHTON SOUTH, - FACILITY 3: WK BOSSIER HEALTH CENTER, - FACILITY 2: WK PIERREMONT HEALTH CENTER GROUP A-FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 3J: THE COMMUNITY NEEDS ASSESSMENT TEAM ENTERED INTO DIALOGUE WITH KEY HOSPITAL ADMINISTRATORS, PHYSICIANS, KEY COMMUNITY MEMBERS, THOSE WITH KNOWLEDGE/EXPERTISE IN PUBLIC HEALTH, AND THOSE SERVING UNDERSERVED AND CHRONIC DISEASE POPULATIONS. DURING THIS PHASE, THE TEAM CONDUCTED FOCUS GROUPS AND SURVEYS TO GAIN THIS KNOWLEDGE.THERE WERE 23 INTERVIEW AND SURVEY RESPONDENTS WHICH CONSISTED OF THE FOLLOWING. -HEALTH ORGANIZATIONS -PHYSICIANS -PROVIDERS -COMMUNITY LEADERS -COMMUNITY ORGANIZATIONS -LOCAL GOVERNMENTEACH PERSON PARTICIPATING RANKED THE CURRENT HEALTH OF THE COMMUNITY ON A SCALE OF 1 TO 10, 10 BEING THE BEST. THE SCORE AFTER AVERAGING THE 23 RESPONDENTS' FEEDBACK WAS 4.46.RESPONDENTS WERE ASKED WHAT THEY VIEWED AS THE TOP HEALTH ISSUES FACING THE SERVICE AREA PARISHES AND ITS RESIDENTS. THEY WERE THEN ASKED TO ELABORATE ON CERTAIN BARRIERS, GAPS, AND ACCESS TO CARE ISSUES.BASED ON THE FEEDBACK PROVIDED IN THE COMMUNITY INPUT PHASE OF THE CHNA, THE FOLLOWING BARRIERS AND OPPORTUNITIES WERE IDENTIFIED WHEN EVALUATING THE HEALTH OF CADDO AND BOSSIER PARISHES.BARRIERS - ACCESS TO AFFORDABLE HEALTHCARE - ACCESS TO A PRIMARY CARE PROVIDER - EDUCATION ON HEALTHY HABITS - HEALTHCARE LITERACY - RIGHT SITE OF CARE UTILIZATION - CHRONIC CONDITION MANAGEMENT - PATIENTS' NON-COMPLIANCEOPPORTUNITY - WEIGHT MANAGEMENT/OBESITY - COMMUNITY SAFETY - DRUG/SUBSTANCE ABUSE - MENTAL HEALTH SERVICES - PROVIDER ALIGNMENT ONCE THE ISSUES/COMMUNITY NEEDS WERE IDENTIFIED AND ORGANIZED, A PRIORITIZATION SESSION WAS HELD WITH MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE. THIS SESSION RESULTED IN THE DEVELOPMENT OF A PRIORITIZATION TABLE. THE PRIORITIES WERE RANKED BASED ON SIGNIFICANCE OF THE COMMUNITY NEED AND WKHS'S ABILITY TO IMPACT THE NEED. THIS PROCESS IDENTIFIED PRIORITY HEALTH ISSUES FOR BOTH BOSSIER AND CADDO PARISHES THAT WKHS FEELS IT HAS AN ABILITY TO IMPACT AT CERTAIN LEVELS. PRIORITIZED 2022 COMMUNITY HEALTH NEEDS ARE PREVENTATIVE CARE, HEALTH COMMUNICATION, HEALTH CARE ACCESS, HEALTH ISSUES OF ADULTS AND 65+, AND MENTAL HEALTH AND MENTAL DISORDERS. GROUP A-FACILITY 1 -- WILLIS-KNIGHTON MEDICAL CENTER PART V, SECTION B, LINE 6A: WK PIERREMONT HEALTH CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 3J: THE COMMUNITY NEEDS ASSESSMENT TEAM ENTERED INTO DIALOGUE WITH KEY HOSPITAL ADMINISTRATORS, PHYSICIANS, KEY COMMUNITY MEMBERS, THOSE WITH KNOWLEDGE/EXPERTISE IN PUBLIC HEALTH, AND THOSE SERVING UNDERSERVED AND CHRONIC DISEASE POPULATIONS. DURING THIS PHASE, THE TEAM CONDUCTED FOCUS GROUPS AND SURVEYS TO GAIN THIS KNOWLEDGE.THERE WERE 23 INTERVIEW AND SURVEY RESPONDENTS WHICH CONSISTED OF THE FOLLOWING. -HEALTH ORGANIZATIONS -PHYSICIANS -PROVIDERS -COMMUNITY LEADERS -COMMUNITY ORGANIZATIONS -LOCAL GOVERNMENTEACH PERSON PARTICIPATING RANKED THE CURRENT HEALTH OF THE COMMUNITY ON A SCALE OF 1 TO 10, 10 BEING THE BEST. THE SCORE AFTER AVERAGING THE 23 RESPONDENTS' FEEDBACK WAS 4.46.RESPONDENTS WERE ASKED WHAT THEY VIEWED AS THE TOP HEALTH ISSUES FACING THE SERVICE AREA PARISHES AND ITS RESIDENTS. THEY WERE THEN ASKED TO ELABORATE ON CERTAIN BARRIERS, GAPS, AND ACCESS TO CARE ISSUES.BASED ON THE FEEDBACK PROVIDED IN THE COMMUNITY INPUT PHASE OF THE CHNA, THE FOLLOWING BARRIERS AND OPPORTUNITIES WERE IDENTIFIED WHEN EVALUATING THE HEALTH OF CADDO AND BOSSIER PARISHES.BARRIERS - ACCESS TO AFFORDABLE HEALTHCARE - ACCESS TO A PRIMARY CARE PROVIDER - EDUCATION ON HEALTHY HABITS - HEALTHCARE LITERACY - RIGHT SITE OF CARE UTILIZATION - CHRONIC CONDITION MANAGEMENT - PATIENTS' NON-COMPLIANCEOPPORTUNITY - WEIGHT MANAGEMENT/OBESITY - COMMUNITY SAFETY - DRUG/SUBSTANCE ABUSE - MENTAL HEALTH SERVICES - PROVIDER ALIGNMENT ONCE THE ISSUES/COMMUNITY NEEDS WERE IDENTIFIED AND ORGANIZED, A PRIORITIZATION SESSION WAS HELD WITH MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE. THIS SESSION RESULTED IN THE DEVELOPMENT OF A PRIORITIZATION TABLE. THE PRIORITIES WERE RANKED BASED ON SIGNIFICANCE OF THE COMMUNITY NEED AND WKHS'S ABILITY TO IMPACT THE NEED. THIS PROCESS IDENTIFIED PRIORITY HEALTH ISSUES FOR BOTH BOSSIER AND CADDO PARISHES THAT WKHS FEELS IT HAS AN ABILITY TO IMPACT AT CERTAIN LEVELS. PRIORITIZED 2022 COMMUNITY HEALTH NEEDS ARE PREVENTATIVE CARE, HEALTH COMMUNICATION, HEALTH CARE ACCESS, HEALTH ISSUES OF ADULTS AND 65+, AND MENTAL HEALTH AND MENTAL DISORDERS. GROUP A-FACILITY 2 -- WK PIERREMONT HEALTH CENTER PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 3J: THE COMMUNITY NEEDS ASSESSMENT TEAM ENTERED INTO DIALOGUE WITH KEY HOSPITAL ADMINISTRATORS, PHYSICIANS, KEY COMMUNITY MEMBERS, THOSE WITH KNOWLEDGE/EXPERTISE IN PUBLIC HEALTH, AND THOSE SERVING UNDERSERVED AND CHRONIC DISEASE POPULATIONS. DURING THIS PHASE, THE TEAM CONDUCTED FOCUS GROUPS AND SURVEYS TO GAIN THIS KNOWLEDGE.THERE WERE 23 INTERVIEW AND SURVEY RESPONDENTS WHICH CONSISTED OF THE FOLLOWING. -HEALTH ORGANIZATIONS -PHYSICIANS -PROVIDERS -COMMUNITY LEADERS -COMMUNITY ORGANIZATIONS -LOCAL GOVERNMENTEACH PERSON PARTICIPATING RANKED THE CURRENT HEALTH OF THE COMMUNITY ON A SCALE OF 1 TO 10, 10 BEING THE BEST. THE SCORE AFTER AVERAGING THE 23 RESPONDENTS' FEEDBACK WAS 4.46.RESPONDENTS WERE ASKED WHAT THEY VIEWED AS THE TOP HEALTH ISSUES FACING THE SERVICE AREA PARISHES AND ITS RESIDENTS. THEY WERE THEN ASKED TO ELABORATE ON CERTAIN BARRIERS, GAPS, AND ACCESS TO CARE ISSUES.BASED ON THE FEEDBACK PROVIDED IN THE COMMUNITY INPUT PHASE OF THE CHNA, THE FOLLOWING BARRIERS AND OPPORTUNITIES WERE IDENTIFIED WHEN EVALUATING THE HEALTH OF CADDO AND BOSSIER PARISHES.BARRIERS - ACCESS TO AFFORDABLE HEALTHCARE - ACCESS TO A PRIMARY CARE PROVIDER - EDUCATION ON HEALTHY HABITS - HEALTHCARE LITERACY - RIGHT SITE OF CARE UTILIZATION - CHRONIC CONDITION MANAGEMENT - PATIENTS' NON-COMPLIANCEOPPORTUNITY - WEIGHT MANAGEMENT/OBESITY - COMMUNITY SAFETY - DRUG/SUBSTANCE ABUSE - MENTAL HEALTH SERVICES - PROVIDER ALIGNMENT ONCE THE ISSUES/COMMUNITY NEEDS WERE IDENTIFIED AND ORGANIZED, A PRIORITIZATION SESSION WAS HELD WITH MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE. THIS SESSION RESULTED IN THE DEVELOPMENT OF A PRIORITIZATION TABLE. THE PRIORITIES WERE RANKED BASED ON SIGNIFICANCE OF THE COMMUNITY NEED AND WKHS'S ABILITY TO IMPACT THE NEED. THIS PROCESS IDENTIFIED PRIORITY HEALTH ISSUES FOR BOTH BOSSIER AND CADDO PARISHES THAT WKHS FEELS IT HAS AN ABILITY TO IMPACT AT CERTAIN LEVELS. PRIORITIZED 2022 COMMUNITY HEALTH NEEDS ARE PREVENTATIVE CARE, HEALTH COMMUNICATION, HEALTH CARE ACCESS, HEALTH ISSUES OF ADULTS AND 65+, AND MENTAL HEALTH AND MENTAL DISORDERS. GROUP A-FACILITY 3 -- WK BOSSIER HEALTH CENTER PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK PIERREMONT HEALTH CENTERWILLIS-KNIGHTON SOUTH GROUP A-FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 3J: THE COMMUNITY NEEDS ASSESSMENT TEAM ENTERED INTO DIALOGUE WITH KEY HOSPITAL ADMINISTRATORS, PHYSICIANS, KEY COMMUNITY MEMBERS, THOSE WITH KNOWLEDGE/EXPERTISE IN PUBLIC HEALTH, AND THOSE SERVING UNDERSERVED AND CHRONIC DISEASE POPULATIONS. DURING THIS PHASE, THE TEAM CONDUCTED FOCUS GROUPS AND SURVEYS TO GAIN THIS KNOWLEDGE.THERE WERE 23 INTERVIEW AND SURVEY RESPONDENTS WHICH CONSISTED OF THE FOLLOWING. -HEALTH ORGANIZATIONS -PHYSICIANS -PROVIDERS -COMMUNITY LEADERS -COMMUNITY ORGANIZATIONS -LOCAL GOVERNMENTEACH PERSON PARTICIPATING RANKED THE CURRENT HEALTH OF THE COMMUNITY ON A SCALE OF 1 TO 10, 10 BEING THE BEST. THE SCORE AFTER AVERAGING THE 23 RESPONDENTS' FEEDBACK WAS 4.46.RESPONDENTS WERE ASKED WHAT THEY VIEWED AS THE TOP HEALTH ISSUES FACING THE SERVICE AREA PARISHES AND ITS RESIDENTS. THEY WERE THEN ASKED TO ELABORATE ON CERTAIN BARRIERS, GAPS, AND ACCESS TO CARE ISSUES.BASED ON THE FEEDBACK PROVIDED IN THE COMMUNITY INPUT PHASE OF THE CHNA, THE FOLLOWING BARRIERS AND OPPORTUNITIES WERE IDENTIFIED WHEN EVALUATING THE HEALTH OF CADDO AND BOSSIER PARISHES.BARRIERS - ACCESS TO AFFORDABLE HEALTHCARE - ACCESS TO A PRIMARY CARE PROVIDER - EDUCATION ON HEALTHY HABITS - HEALTHCARE LITERACY - RIGHT SITE OF CARE UTILIZATION - CHRONIC CONDITION MANAGEMENT - PATIENTS' NON-COMPLIANCEOPPORTUNITY - WEIGHT MANAGEMENT/OBESITY - COMMUNITY SAFETY - DRUG/SUBSTANCE ABUSE - MENTAL HEALTH SERVICES - PROVIDER ALIGNMENT ONCE THE ISSUES/COMMUNITY NEEDS WERE IDENTIFIED AND ORGANIZED, A PRIORITIZATION SESSION WAS HELD WITH MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE. THIS SESSION RESULTED IN THE DEVELOPMENT OF A PRIORITIZATION TABLE. THE PRIORITIES WERE RANKED BASED ON SIGNIFICANCE OF THE COMMUNITY NEED AND WKHS'S ABILITY TO IMPACT THE NEED. THIS PROCESS IDENTIFIED PRIORITY HEALTH ISSUES FOR BOTH BOSSIER AND CADDO PARISHES THAT WKHS FEELS IT HAS AN ABILITY TO IMPACT AT CERTAIN LEVELS. PRIORITIZED 2022 COMMUNITY HEALTH NEEDS ARE PREVENTATIVE CARE, HEALTH COMMUNICATION, HEALTH CARE ACCESS, HEALTH ISSUES OF ADULTS AND 65+, AND MENTAL HEALTH AND MENTAL DISORDERS. GROUP A-FACILITY 4 -- WILLIS-KNIGHTON SOUTH PART V, SECTION B, LINE 6A: WILLIS-KNIGHTON MEDICAL CENTERWK BOSSIER HEALTH CENTERWK PIERREMONT HEALTH CENTER 5 1 - OUTPATIENT CLINICS VARIOUS LOCATIONS SHREVEPORT LA 71130 OUTPATIENT CLINICS 2 - THE OAKS OF LOUISIANA 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 RESIDENTIAL COMMUNITY FOR ADULTS AGE 55 AND OVER 3 - SAVANNAH AT THE OAKS 600 EAST FLOURNOY LUCUS ROAD SHREVEPORT LA 71115 ASSISTED LIVING FACILITY 4 - EXTENDED CARE CENTER 2550 KINGS HIGHWAY SHREVEPORT LA 71103 SUBACUTE REHABILITATION 5 - WK REHABILITATION SERVICES 1111 LINE AVENUE SHREVEPORT LA 71101 REHABILITATION/DIALYSIS PART I, LINE 7: ALL ITEMS IN THE TABLE, EXCEPT FOR LINE 7G, USE THE COST-TO-CHARGE RATIO COSTING METHOD. PROJECT NEIGHBORHEALTH, WHICH IS INCLUDED ON LINE 7G, USES THE ACTUAL COST METHOD. PART III, LINE 4: THE MEDICAL CENTER HAS DETERMINED THAT SUBSTANTIALLY ALL OF ITS UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE REPRESENT IMPLICIT PRICE CONCESSIONS. AS SUCH, AMOUNTS DETERMINED TO BE IMPLICIT PRICE CONCESSIONS ARE NOT INCLUDED IN THE TRANSACTION PRICE AND NOT INCLUDED IN PATIENT ACCOUNTS RECEIVABLE. ACCORDINGLY, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR PATIENTS' ACCOUNTS IS NOT RELEVANT AND NOT MAINTAINED. IN REGARDS TO RECEIVABLES FROM THIRD-PARTY PAYORS, BAD DEBT LOSSES HAVE NOT BEEN MATERIAL IN THE MEDICAL CENTER'S EXPERIENCE; ACCORDINGLY, AN ALLOWANCE FOR BAD DEBTS ON ACCOUNTS FROM THIRD-PARTY PAYORS IS ALSO NOT MAINTAINED. SEE NOTE 3(PAGE 10), IN THE SEPTEMBER 30, 2023, AUDITED FINANCIAL STATEMENTS ATTACHED. PART III, LINE 8: THE MEDICAL CENTER HAS NOT TO DATE INCLUDED MEDICARE SHORTFALLS IN ANY PUBLIC REPRESENTATION OF ITS COMMUNITY BENEFITS. THE MEDICAL CENTER IS AWARE OF THE VARIOUS ARGUMENTS CIRCULATING WITH REGARDS TO WHETHER THE SO CALLED MEDICARE SHORTFALL SHOULD BE IN WHOLE OR PART TREATED AS A COMMUNITY BENEFIT. THE MOST COMPELLING OF THE PROPONENTS' ARGUMENTS IS THAT BECAUSE TAX EXEMPT HOSPITALS MUST SERVE MEDICARE BENEFICIARIES AT NONNEGOTIABLE RATES SET BY THE GOVERNMENT, SHORTFALLS RESULT FROM UNDERPAYMENTS AND AS SUCH ARE UNAVOIDABLE COMMUNITY BENEFITS. OPPONENTS ARGUE SHORTFALLS ARE RELATED TO EFFICIENCY. THE MEDICAL CENTER IS CONFIDENT THAT ITS MEDICARE SHORTFALL IS NOT ATTRIBUTABLE TO INEFFICIENCIES BUT INSTEAD TO UNDERPAYMENTS FOR COSTS OF PROVIDING HIGH QUALITY MEDICAL CARE AND PATIENT SERVICES BY AN APPROPRIATE NUMBER OF COMPETENT STAFF IN HIGH QUALITY WELL EQUIPPED FACILITIES.THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTS AND GUIDELINES. PART III, LINE 9B: 1. MONTHLY STATEMENTS ARE GENERATED AND MAILED BY THE MEDICAL CENTER TO PATIENTS/GUARANTORS TO MAKE THEM AWARE OF OUTSTANDING BALANCES.2. THE ACCOUNTS RECEIVABLE FILE IS REVIEWED MONTHLY FOR ACCOUNTS THAT HAVE AN OUTSTANDING BALANCE SHOWN TO BE THE PATIENT/GUARANTOR'S RESPONSIBILITY. AN ACCOUNT IS CONSIDERED TO BE IN THE EARLY STAGES OF DELINQUENCY AT A MINIMUM OF 136 DAYS FROM THE FIRST STATEMENT DATE, AT LEAST 3 STATEMENTS HAVE BEEN GENERATED FROM THE MEDICAL CENTER AND IT HAS BEEN GREATER THAN 45 DAYS SINCE THE LAST PAYMENT WAS RECEIVED FROM INSURANCE OR THE PATIENT/GUARANTOR.3. ACCOUNTS MEETING THE ABOVE CRITERIA ARE REFERRED TO AN EARLY OUT AGENCY FOR COLLECTION. THE EARLY OUT AGENCY WILL ATTEMPT TO COLLECT THE OUTSTANDING BALANCE FOR A PERIOD OF 90 DAYS. THE EARLY OUT COLLECTION EFFORTS WILL INCLUDE BOTH PHONE AND WRITTEN COMMUNICATIONS. PAYMENTS AND PATIENT CORRESPONDENCE WILL BE DIRECTED TO THE MEDICAL CENTER, NOT THE EARLY OUT AGENCY.4. THE EARLY OUT AGENCY WILL RETURN FILES TO THE MEDICAL CENTER AT THE END OF THE 90 DAY PERIOD WITH STATUS INFORMATION AS FOLLOWS:A. RETURNED WITH A PAYMENT ARRANGEMENT - ACCOUNTS ARE MAINTAINED IN-HOUSE AND MONITORED BY THE BUSINESSS OFFICE. THE BAD DEBT AGENCY IS CHANGED TO WK-REG. STATEMENTS ARE GENERATED AND MAILED TO THE PATIENT/GUARANTOR MONTHLY. ACCOUNTS ARE MONITORED MONTHLY. IF THE PATIENT DEFAULTS ON THE PAYMENT ARRANGEMENT, THE MEDICAL CENTER WILL MAIL NOTIFICATION CONCERNING THE WILLIS-KNIGHTON HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY AND A FINANCIAL ASSISTANCE APPLICATION AND ALLOW A MINIMUM OF 30 DAYS FOR RESPONSE. APPLICATIONS RECEIVED WILL BE PROCESSED AND NOTIFICATION WILL BE SENT TO THE PATIENT. ACCOUNTS WILL NOT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY UNLESS THE PATIENT FAILS TO RESPOND OR DOES NOT MEET THE FINANCIAL REQUIREMENTS FOR FINANCIAL ASSISTANCE.B. RETURNED WITH NO PAYMENT ARRANGEMENT - THE MEDICAL CENTER WILL MAIL NOTIFICATION CONCERNING THE WILLIS-KNIGHTON HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY AND A FINANCIAL ASSISTANCE APPLICATION AND ALLOW A MINIMUM OF 30 DAYS FOR RESPONSE. APPLICATIONS RECEIVED WILL BE PROCESSED AND NOTIFICATION WILL BE SENT TO THE PATIENT. ACCOUNTS WILL NOT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY UNLESS THE PATIENT FAILS TO RESPOND OR DOES NOT MEET THE FINANCIAL REQUIREMENTS FOR FINANCIAL ASSISTANCE. THE BUSINESS OFFICE DIRECTOR WILL HAVE THE FINAL AUTHORITY FOR DETERMINING THAT THE MEDICAL CENTER HAS MADE REASONABLE EFFORTS TO DETERMINE THAT A PATIENT IS NOT FINANCIAL ASSISTANCE ELIGIBLE AND MAY THEREFORE ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS AGAINST THE PATIENT. COLLECTION EFFORTS MAY INCLUDE REPORTING TO CREDIT AGENCIES, LAWSUITS OR WAGE GARNISHMENTS.5. THE BUSINESS OFFICE DIRECTOR WILL HAVE THE FINAL AUTHORITY FOR DETERMINING THAT THE MEDICAL CENTER HAS MADE REASONABLE EFFORTS TO DETERMINE THAT A PATIENT IS NOT FINANCIAL ASSISTANCE ELIGIBLE AND MAY THEREFORE ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS AGAINST THE PATIENT. COLLECTION EFFORTS MAY INCLUDE REPORTING TO CREDIT AGENCIES, LAWSUITS OR WAGE GARNISHMENT. PART VI, LINE 2: WILLIS-KNIGHTON MEDICAL CENTER OPERATES THROUGHOUT SHREVEPORT, BOSSIER CITY AND NEARBY PARISHES AND PROVIDES FOUR HOSPITALS, URGENT CARE CENTERS, NUMEROUS SATELLITE CLINICS, A SKILLED NURSING FACILITY, A RETIREMENT COMMUNITY, AN ASSISTED LIVING FACILITY, AND A REHABILITATION INSTITUTE. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES THAT IT SERVES BY STAYING INFORMED ABOUT THE RELEVANT TRENDS OCCURRING IN THE AREAS IN WHICH IT OPERATES. PART VI, LINE 3: WILLIS-KNIGHTON HEALTH SYSTEM IS COMMITTED TO PROVIDING CHARITY CARE TO PERSONS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE. CONSISTENT WITH ITS MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTHCARE SERVICES AND TO BE AN ADVOCATE FOR THOSE WHO ARE MOST IN NEED, WILLIS-KNIGHTON HEALTH SYSTEM STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE. PATIENTS ARE EXPECTED TO COOPERATE WITH WILLIS-KNIGHTON HEALTH SYSTEM'S PROCEDURES FOR OBTAINING CHARITY OR OTHER FORMS OF PAYMENT OR FINANCIAL ASSISTANCE, AND TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR INDIVIDUAL ABILITY TO PAY. PART VI, LINE 4: WILLIS-KNIGHTON'S PRIMARY SERVICE AREA (PSA) COVERS AN APPROXIMATE 35 MILE RADIUS OF SHREVEPORT, COVERING THE LOUISIANA PARISHES OF CADDO, BOSSIER, WEBSTER, CLAIBORNE, RED RIVER, DESOTO AND BIENVILLE, AND WHICH HAS AN ESTIMATED POPULATION OF APPROXIMATELY 470,000 PERSONS. THE AVERAGE HOUSEHOLD INCOME FOR THE PSA IS $59,460. PART VI, LINE 5: WILLIS-KNIGHTON PROVIDES A MOBILE UNIT THAT OFFERS "SHOTS FOR TOTS". USING ITS MOBILE VAN AND STAFF, VACCINES ARE TAKEN TO VARIOUS NEIGHBORHOODS TO MAKE THEM CONVENIENT FOR PARENTS. UNDER THIS PROGRAM, ANY CHILD MAY RECEIVE IMMUNIZATION SHOTS, FREE OF CHARGE, FOR MEASLES, MUMPS, RUBELLA, DIPHTHERIA, PERTUSSIS, TETANUS, HEPATITIS B, POLIO, MENINGITIS, FLU, AND CHICKEN POX. THE MEDICAL CENTER SUBSIDIZES ALL EXPENSES OF THE PROGRAM EXCEPT THE VACCINE, WHICH IS PROVIDED BY THE LOUISIANA DEPARTMENT OF PUBLIC HEALTH. DURING THE YEAR ENDED SEPTEMBER 30, 2023, THE MEDICAL CENTER IMMUNIZED 1,128 PATIENTS UNDER THIS PROGRAM.HEALTH PROFESSIONS EDUCATIONTHE MEDICAL CENTER PROVIDES VARIOUS EDUCATION PROGRAMS THAT RESULT IN HEALTHCARE PROFESSIONALS RECEIVING DEGREES, CERTIFICATES OR TRAINING THAT IS NECESSARY TO BE LICENSED TO PRACTICE AS HEALTH CARE PROFESSIONALS. WHILE THE MEDICAL CENTER ALSO PROVIDES A VARIETY OF EDUCATION, TRAINING AND STIPEND PROGRAMS THAT ARE EXCLUSIVE TO THE MEDICAL CENTER'S EMPLOYEES AND MEDICAL STAFF, THOSE COSTS ARE NOT INCLUDED IN THIS CATEGORY. THE MEDICAL CENTER MAINTAINS AN ASSOCIATION WITH LSU HEALTH SCIENCES CENTER (A PUBLIC TEACHING, RESEARCH, AND INDIGENT CARE FACILITY) BY PROVIDING GRANTS, ASSISTANCE WITH RESIDENTS AND FELLOWS, ALONG WITH UNDERWRITING THE COST OF CLINICAL SETTINGS FOR TRAINING AND INTERNSHIPS FOR A VARIETY OF OTHER HEALTH PROFESSIONALS.SPORTS MEDICINESPORTS MEDICINE EXPERTS AT WILLIS-KNIGHTON SPORTS MEDICINE WORK WITH ATHLETES ON THE PREVENTION AND TREATMENT OF SPORTS-RELATED INJURIES, HELPING THEM TO MAINTAIN A HEALTHY LIFESTYLE. THIS SERVICE IS OFFERED TO VARIOUS SCHOOLS AND PROGRAMS THROUGHOUT THE LOCAL AREA. THE MEDICAL CENTER SPONSORS FREE ATHLETIC PHYSICALS FOR YOUNG ATHLETES, STAFFED BY SPORTS MEDICINE PHYSICIANS AND STAFF.WK INTEGRIN HEALTHIN JUNE 2019, WILLIS-KNIGHTON HEALTH SYSTEM FORMED WK INTEGRIN HEALTH, L3C, DBA HEALTH PLUS NETWORK, A CLINICALLY INTEGRATED NETWORK (CIN) DESIGNED TO IMPROVE THE QUALITY OF PATIENT CARE DELIVERED TO RESIDENTS OF NORTHWEST LOUISIANA. HEALTH PLUS NETWORK CIN IS A PHYSICIAN-LED ENTITY THAT INCENTIVIZES HIGH-QUALITY PATIENT CARE THROUGH COORDINATED EFFORTS BETWEEN CARE PROVIDERS. THE CIN'S PRIMARY OBJECTIVE IS TO FOSTER A HEALTHCARE INFRASTRUCTURE CENTERED AROUND PREVENTATIVE CARE, PROACTIVE CHRONIC DISEASE MANAGEMENT AND APPROPRIATE UTILIZATION OF HEALTHCARE RESOURCES. THROUGH ITS FIRST THREE YEARS IN OPERATION, HEALTH PLUS NETWORK CIN HAS SERVED AS A CATALYST IN IMPROVING THE QUALITY OF CARE DELIVERED TO PATIENTS THROUGHOUT NORTHWEST LOUISIANA. CIN-LED EFFORTS HAVE GENERATED SHARED SAVINGS/VALUE BASED PURCHASING REVENUE IN EXCESS OF $5 MILLION, OF WHICH 60% HAS BEEN SHARED WITH PARTICIPATING PROVIDERS AND 40% HAS BEEN RETAINED WITHIN HEALTH PLUS NETWORK CIN. WK INTEGRIN HEALTH, L3C, DBA HEALTH PLUS NETWORK IS COMPRISED OF 450 PHYSICIANS AND MID-LEVEL PROVIDERS, AND IS GOVERNED BY A 13-MEMBER BOARD OF DIRECTORS, COMPRISED OF 11 WKHS EMPLOYED PHYSICIANS AND 2 WKHS ADMINISTRATORS-JERRY A. FIELDER, II, CEO, AND MARGARET C. REBOUCHE, SR. VP QUALITY & CLINICAL PERFORMANCE. 1 AMERICAN CANCER SOCIETY 920 PIERREMONT SUITE 300 SHREVEPORT LA 71106 237040934 501(C)(3) 15000 0 SPONSORSHIP BOSSIER CHAMBER OF COMMERCE 710 BENTON ROAD BOSSIER CITY LA 71111 720382231 501(C)(6) 25200 0 SPONSORSHIP CHILDREN AND ARTHRITIS 2751 ALBERT BICKNELL DRIVE SUITE 2 SHREVEPORT LA 71103 721170530 501(C)(3) 15000 0 SPONSORSHIP SHREVEPORT CHAMBER OF COMMERCE 400 EDWARDS STREET SHREVEPORT LA 71101 720315700 501(C)(6) 25000 0 SPONSORSHIP HOLY ANGELS RESIDENTIAL FACILITY INC 10450 ELLERBE ROAD SHREVEPORT LA 71106 720628035 501(C)(3) 60000 0 DONATION FOR OPERATIONS INDEPENDENCE BOWL FOUNDATION PO BOX 1723 SHREVEPORT LA 71166 720297228 501(C)(3) 53750 0 SPONSORSHIP LA TROOPER FOUNDATION PO BOX 65076 BATON ROUGE LA 70896 742918404 501(C)(3) 25000 0 DONATION FOR OPERATIONS MARTIN LUTHER KING HEALTH CENTER POST OFFICE BOX 393 SHREVEPORT LA 71162 721079721 501(C)(3) 20000 0 DONATION FOR OPERATIONS NORTHWEST LOUISIANA FOOD BANK 2307 TEXAS AVENUE SHREVEPORT LA 71103 721328890 501(C)(3) 25000 0 DONATION FOR OPERATIONS NORTHWESTERN FOUNDATION UNIVERSITY PARKWAY NATCHITOCHES LA 71497 726021495 501(C)(3) 1429700 0 DONATION FOR OPERATIONS SHREVEPORT-BOSSIER RESCUE MISSION 2033 TEXAS AVENUE SHREVEPORT LA 71103 237050551 501(C)(3) 40916 0 HEALTH INSURANCE FOR RESCUE MISSION EMPLOYEES AND DONATION FOR OPERATIONS SHREVEPORT LITTLE THEATRE 812 MARGARET PLACE SHREVEPORT LA 71101 720363143 501(C)(3) 10000 0 SPONSORSHIP SHREVEPORT OPERA 212 TEXAS STREET NO 1 SHREVEPORT LA 71101 726021455 501(C)(3) 12500 0 DONATION FOR OPERATIONS SHREVEPORT SYMPHONY 619 LOUISIANA AVENUE SHREVEPORT LA 71101 726001334 501(C)(3) 124000 0 SPONSORSHIP ST JUDE'S CHILDREN'S RESEARCH HOSPITAL PO BOX 810 MEMPHIS TN 38101 620646012 501(C)(3) 10000 0 DONATION FOR OPERATIONS VOLUNTEERS FOR YOUTH JUSTICE 900 JORDAN STREET SHREVEPORT LA 71101 721057695 501(C)(3) 55000 0 DONATION FOR OPERATIONS PROVIDENCE HOUSE 814 COTTON STREET SHREVEPORT LA 71101 721205164 501(C)(3) 25000 0 DONATION FOR OPERATIONS LSUHSC PO BOX 31650 SHREVEPORT LA 71115 721402222 GOVERNMENT 20475 0 DONATION FOR OPERATIONS SHREVEPORT LITTLE LEAGUE 1651 EAST 70TH STREET NO 183 SHREVEPORT LA 71105 721422019 501(C)(3) 15000 0 SPONSORSHIP INSTITUTE FOR GLOBAL OUTREACH 1024 PIERRE AVENUE ROOM B SHREVEPORT LA 71103 331180777 501(C)(3) 25000 0 SPONSORSHIP AMERICAN HEART ASSOCIATION PO BOX 37388 SHREVEPORT LA 71133 135613797 501(C)(3) 20000 0 SPONSORSHIP CADDO PARISH SCHOOL BOARD 1961 MIDWAY AVENUE SHREVEPORT LA 71130 726000224 GOVERNMENT 3000000 0 SPONSORSHIP COUNCIL ON ALCOHOLISM & DRUG ABUSE 2000 FAIRFIELD AVENUE SHREVEPORT LA 71104 720544581 501(C)(3) 10000 0 SPONSORSHIP FOUNDATION FOR EXCELLENCE IN BROADCASTING 7733 PERKINS ROAD BATON ROUGE LA 70810 721233347 501(C)(3) 33500 0 SPONSORSHIP OAKWOOD HOME FOR WOMEN INC 1700 HIGHLAND AVENUE SHREVEPORT LA 71101 237368054 501(C)(3) 7500 0 DONATION FOR OPERATIONS JUNIOR ACHIEVEMENT 3003 KNIGHT STREET SHREVEPORT LA 71105 720595081 501(C)(3) 10000 0 SPONSORSHIP LOUISIANA KEY ACADEMY 3172 GOVERNMENT STREET BATON ROUGE LA 70806 455616292 501(C)(3) 25000 0 SPONSORSHIP NORTHWEST LOUISIANA MEDICAL SOCIETY PO BOX 3188 SHREVEPORT LA 71133 720518510 501(C)(6) 6700 0 SPONSORSHIP RONALD MCDONALD HOUSE CHARITIES INC 110 N CARPENTER STREET CHICAGO IL 60607 362934689 501(C)(3) 42961 0 SPONSORSHIP SHREVEPORT FIRE DEPARTMENT 263 NORTH COMMON STREET SHREVEPORT LA 71101 726001326 GOVERNMENT 31200 0 DONATION FOR OPERATIONS STRAND THEATRE 619 LOUISIANA AVENUE SHREVEPORT LA 71101 720800065 501(C)(3) 25000 0 SPONSORSHIP 28 3 PART I, LINE 2: THE MEDICAL CENTER HAS A CONTRIBUTION COMMITTEE THAT APPROVES SUBSTANTIALLY ALL CONTRIBUTIONS. THE CONTRIBUTION COMMITTEE REQUESTS THAT THE ORGANIZATION REQUESTING THE DONATION COMPLETE A CONTRIBUTION REQUEST FORM THAT IS AVAILABLE ON THE MEDICAL CENTER'S WEBSITE. BEFORE THE MEDICAL CENTER'S CONTRIBUTION COMMITTEE WILL APPROVE THE CONTRIBUTIONS THE PURPOSE OF THE CONTRIBUTION MUST BE STATED ON THE CONTRIBUTION REQUEST FORM. THE MEDICAL CENTER CONTRIBUTIONS ARE USUALLY PROVIDED TO ORGANIZATIONS FOR GENERAL OPERATIONS AND ARE NOT MONITORED. X 1 1 X X X X X 1 1 0 1 0 0 0 0 0 JERRY A FIELDER II PRESIDENT/CEO/TRUSTEE 1113733 0 0 0 1457997 0 1345 0 25469 0 2598544 0 0 0 SARAH GLORIOSO MD PHYSICIAN 719986 0 1500023 0 -6337 0 1164 0 25310 0 2240146 0 0 0 MILAN G MODY MD PHYSICIAN 1199977 0 787586 0 -5710 0 1957 0 24869 0 2008679 0 0 0 CHRISTOPHER SHELBY PHYSICIAN 799985 0 975161 0 -8441 0 1226 0 27619 0 1795550 0 0 0 WYCHE T COLEMAN III MD PHYSICIAN 803186 0 931036 0 -6413 0 2064 0 25387 0 1755260 0 0 0 ANIL VELUVOLU MD PHYSICIAN 799985 0 820617 0 -6997 0 1291 0 28508 0 1643404 0 0 0 JAMES K ELROD FORMER CEO/TRUSTEE 1099333 4500 0 0 25322 0 0 0 4762 0 1129417 4500 0 0 MARY JANE WARD SR VICE PRESIDENT/CFO 478397 0 0 0 34462 0 2360 0 18932 0 534151 0 0 0 BRIAN A CRAWFORD SENIOR VICE PRESIDENT 354369 0 0 0 28724 0 2201 0 7752 0 393046 0 0 0 JILL K ELROD VP OF LEGAL AFFAIRS 257212 0 0 0 31955 0 1912 0 9175 0 300254 0 0 0 DIANE R MCCULLER SR VP NURSING - PATIENT SE 257683 0 0 0 25927 0 2821 0 9807 0 296238 0 0 0 IRA L MOSS VP/ADMIN WK PIERREMONT 233755 0 0 0 27018 0 1729 0 20700 0 283202 0 0 0 TODD J BLANCHARD VP/ADMIN WK BOSSIER 253189 0 0 0 -4978 0 4055 0 18444 0 270710 0 0 0 MARGARET C REBOUCHE SR VP QUALITY & CLINICAL P 225496 0 0 0 27130 0 5224 0 8225 0 266075 0 0 0 GREGORY J GAVIN VP/PHYSICIAN NETWORK 227870 0 0 0 24862 0 2136 0 7848 0 262716 0 0 0 PEGGY J GAVIN SR VP OF PHYSICIAN SERVICE 208432 0 0 0 34471 0 2167 0 7848 0 252918 0 0 0 MARGARET G ELROD SR VP/IND WELLNESS/COMMUN 209286 0 0 0 28878 0 2435 0 11142 0 251741 0 0 0 PIERRE V BLANCHARDIV MD TRUSTEE/PHYSICIAN 199996 0 2308 0 31539 0 1462 0 6348 0 241653 0 0 0 JANET K ELROD VP/ADMIN WK SOUTH 204948 0 0 0 24664 0 2123 0 9048 0 240783 0 0 0 VINCENT R SEDMINIK VP/ADMINISTRATOR WKMC 228370 0 0 0 6838 0 1546 0 1356 0 238110 0 0 0 JOHN L FORTENBERRY JR VP/MARKETING & STRATEGY 196795 0 0 0 807 0 1679 0 771 0 200052 0 0 0 ALJAY J FOREMAN JR VP/ADMINISTRATOR REHAB INS 151364 0 0 0 -2936 0 2324 0 27508 0 178260 0 0 0 FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) EXPLANATION OF PART II, COLUMN (B)(III) OTHER COMPENSATION JAMES K. ELROD VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$1,121 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$4,820 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,319) TOTAL--$25,322 MARY JANE WARD UNUSED SICK PAY-$11,449 VALUE ADDED FOR CELL PHONE USAGE-$960 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$7,011 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(5,458) TOTAL--$34,462 MARGARET G. ELROD UNUSED SICK PAY-$5,009 VALUE ADDED FOR CELL PHONE USAGE-$1,602 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,451 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,684) TOTAL--$28,878 JERRY A. FIELDER,II UNUSED SICK PAY-$21,808 VALUE ADDED FOR COMPUTER USAGE-$200 VALUE ADDED FOR CELL PHONE USAGE-$1,042 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,359 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,570) VALUE ADDED FOR CABLE/INTERNET- 2,158 SEVERANCE PAY-$1,417,500** TOTAL--$1,457,997 **THE INCREASE IN GROSS SEVERANCE BENEFIT, TO BE PAID TO MR. FIELDER ON TERMINATION OF EMPLOYMENT (AS ADDITIONAL COMPENSATION FOR EACH OF HIS YEARS OF SERVICE TO WILLIS-KNIGHTON MEDICAL CENTER), WAS TAXABLE DURING 2022, AND ACCORDINGLY, WAS INCLUDED IN HIS 2022 FORM W-2. WILLIS-KNIGHTON DISBURSED TO THE INTERNAL REVENUE SERVICE AND TO THE LOUISIANA DEPARTMENT OF REVENUE THE REQUIRED TAX WITHHOLDING. WILLIS-KNIGHTON DID NOT PAY MR. FIELDER THE NET-OF-TAX AMOUNT OF THIS COMPENSATION, BUT, UNDER THE TERMS OF THE AGREEMENT, THE MEDICAL CENTER IS RETAINING THE NET-OF-TAX AMOUNT UNTIL HIS EMPLOYMENT TERMINATES. ACCORDINGLY, THERE WAS NO CURRENT DISBURSEMENT TO MR. FIELDER FOR SEVERANCE PAY. JANET K. ELROD UNUSED SICK PAY-$4,905 VALUE ADDED FOR CELL PHONE USAGE-$1,397 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,322 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,460) TOTAL--$24,664 IRA L. MOSS UNUSED SICK PAY-$5,594 VALUE ADDED FOR CELL PHONE USAGE-$502 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$7,490 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,226) PERSONAL USE OF EMPLOYER VEHICLES-$158 TOTAL--$27,018 JILL K. ELROD UNUSED SICK PAY-$6,156 VALUE ADDED FOR CELL PHONE USAGE-$982 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,564 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(4,587) VALUE ADDED FOR CABLE/INTERNET- $1,441 PERSONAL USE OF EMPLOYER VEHICLES-$3,899 TOTAL--$31,955 PEGGY J. GAVIN UNUSED SICK PAY-$4,988 VALUE ADDED FOR CELL PHONE USAGE-$1,121 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$6,403 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,260) PERSONAL USE OF EMPLOYER VEHICLES-$4,719 TOTAL--$34,471 PIERRE V. BLANCHARD,IV, M.D. VALUE ADDED FOR HEALTH & FITNESS USAGE-$384 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,214 SHARED SAVINGS QUALITY PROGRAM-$9,201 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(1,760) TOTAL--$31,539 TODD J. BLANCHARD VALUE ADDED FOR CELL PHONE USAGE-$655 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$846 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,479) TOTAL--($4,978) GREGORY J. GAVIN VALUE ADDED FOR CELL PHONE USAGE-$502 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$7,119 SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,259) TOTAL--$24,862 MILAN G. MODY, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,260 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,970) TOTAL--($5,710) CHRISTOPHER L. SHELBY, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,279 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(9,720) TOTAL--($8,441) SARAH GLORIOSO, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$573 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,910) TOTAL--($6,337) BRIAN A. CRAWFORD COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,346 VALUE ADDED FOR CELL PHONE USAGE-$562 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,165) SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 UNUSED SICK PAY-$8,481 TOTAL--$28,724 JOHN L. FORTENBERRY, JR. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$1,203 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(396) TOTAL--$807 MARGARET C. REBOUCHE UNUSED SICK PAY-$5,585 VALUE ADDED FOR CELL PHONE USAGE-$1,033 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,649 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(3,637) SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 TOTAL--$27,130 DIANE R. MCCULLER UNUSED SICK PAY-$6,283 VALUE ADDED FOR CELL PHONE USAGE-$641 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$3,722 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-($5,219) SECTION 457(B) DEFERRED COMPENSATION PLAN-$20,500 TOTAL--$25,927 ALJAY J. FOREMAN, JR. UNUSED SICK PAY-$4,615 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$503 VALUE ADDED FOR CELL PHONE USAGE-$982 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(9,037) TOTAL--($2,936) ANIL VELUVOLU, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$840 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(7,837) TOTAL--($6,997) WYCHE T. COLEMAN, III, M.D. COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$557 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(6,970) TOTAL--($6,413) VINCENT R. SEDMINIK UNUSED SICK PAY-$5,464 COST OF GROUP TERM LIFE INSURANCE IN EXCESS OF $50,000-$2,356 EMPLOYEE CAFETERIA PLAN CONTRIBUTIONS-$(982) TOTAL--$6,838 EXPLANATION OF PART II, COLUMN (C) DEFERRED COMPENSATION THIS EMPLOYEE PARTICIPATES IN A DEFINED BENEFIT PENSION PLAN, THE CONTRIBUTIONS TO WHICH ARE ACTUARIALLY DETERMINED. THE AMOUNT SHOWN IS THE INCREASE IN THE ANNUAL VESTED BENEFIT AT NORMAL RETIREMENT FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 (NOT DISCOUNTED TO PRESENT VALUE) (NORMAL RETIREMENT IS AGE 65 WITH 5 YEARS OF PARTICIPATION). MR. ELROD HAS REACHED THE MAXIMUM BENEFIT UNDER THE PLAN. EXPLANATION OF PART II, COLUMN (D) NONTAXABLE BENEFITS INCLUDED IN THIS COLUMN IS THE COST OF THE FOLLOWING NONTAXABLE BENEFITS: LONG-TERM DISABILITY INCOME INSURANCE PLAN, GROUP TERM-LIFE INSURANCE, AND THE ESTIMATED COST OF SELF-FUNDED HEALTH INSURANCE PLAN. FRANK B HUGHES MD TRUSTEE 124616 RENT-BUILDING 0 JENIFER LASSEIGNE FAMILY MEMBER OF RAYMOND LASSEIGNE, TRUSTEE 51415 EMPLOYMENT 0 CHARLES L HANKINS FAMILY MEMBER OF RENEE MCCULLER, OFFICER 87322 EMPLOYMENT 0 CHARLES E MULLINS FAMILY MEMBER OF PEGGY GAVIN, OFFICER 133046 EMPLOYMENT 0 ROGER S DEVILBISS FAMILY MEMBER OF JILL K. ELROD, OFFICER 143037 EMPLOYMENT 0 CHRIS ELBERSON FAMILY MEMBER OF RICHARD SALE, TRUSTEE 342909 ARCHITECTURAL SERVICES PAID TO SOMDAL ASSOCATIES, LLC FOR WHICH CHRIS ELBERSON IS THE MANAGING MEMBER. 0 WILLIAM J COLE CPA TRUSTEE 3348335 ACCOUNTING, PAYROLL AND CONSULTING SERVICES PAID TO COLE, EVANS & PETERSON FOR WHICH WILLIAM J. COLE IS THE MANAGING PARTNER. 0 ARIEN WARD PYSD FAMILY MEMBER OF MARY JANE WARD, OFFICER 92405 EMPLOYMENT 0 GREGORY BLANCHARD FAMILY MEMBER OF PIERRE V. BLANCHARD, M.D., TRUSTEE 148695 EMPLOYMENT 0 CECILIA BLANCHARD FAMILY MEMBER OF PIERRE V. BLANCHARD, M.D., TRUSTEE 43078 EMPLOYMENT 0 JAMES D REBOUCHE FAMILY MEMBER OF MARGARET C. REBOUCHE, OFFICER 90273 EMPLOYMENT 0 JENNA A FIELDER FAMILY MEMBER OF JERRY A. FIELDER, II, OFFICER 77088 EMPLOYMENT 0 LAMAR P PUGH TRUSTEE 1082058 EXECUTIVE AND DEPARTMENT LEVEL ASSISTANCE AND REPRESENTATION RELATED TO LEGAL ISSUES AND REGULATORY COMPLIANCE PAID TO THE LAW FIRM OF PUGH, PUGH & PUGH, L.L.P. FOR WHICH LAMAR P. PUGH, TRUSTEE, IS A PARTNER. 0 JORDAN E FIELDER FAMILY MEMBER OF JERRY A. FIELDER, II, OFFICER 36316 EMPLOYMENT 0 GENTRY A WARD FAMILY MEMBER OF MARY JANE WARD, OFFICER 42320 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 1. FAMILY RELATIONSHIPS WITH JAMES K. ELROD - FORMER CEO AND TRUSTEE MARGARET ELROD, SPOUSE - VP-MARKETING, LIVE OAK RETIREMENT COMMUNITY, QUICK CARE, OCCUPATIONAL MEDICINE, AND WELLNESS CENTERS JILL K. ELROD, DAUGHTER - VP OF LEGAL AFFAIRS JANET K. ELROD, DAUGHTER - VP AND ADMINISTRATOR OF WK SOUTH HOSPITAL FORM 990, PART VI, SECTION B, LINE 11B THE MEDICAL CENTER'S CPA FIRM PREPARES THE FORM 990 WITH THE ASSISTANCE OF SEVERAL OF THE MEDICAL CENTER'S EMPLOYEES. THE FORM 990 IS THEN REVIEWED BY THE MEDICAL CENTER'S PRESIDENT, GENERAL COUNSEL AND CPA FIRM. A COMPLETE COPY OF THIS REVIEWED FORM 990 IS PROVIDED TO EACH BOARD MEMBER OF THE BOARD OF TRUSTEES, AND THE PRESIDENT AND GENERAL COUNSEL TO REVIEW AND DISCUSS THE FORM 990 WITH THE TRUSTEES BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICTS OF INTEREST POLICY COVERS ALL "INTERESTED PERSONS." AN "INTERESTED PERSON" IS DEFINED AS ANY TRUSTEE, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DESIGNATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN AN ENTITY WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A COMPENSATION ARRANGEMENT WITH THE MEDICAL CENTER OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER HAS A TRANSACTION OR ARRANGEMENT; OR A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE MEDICAL CENTER IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. INTERESTED PERSONS HAVE A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST AND ALL MATERIAL FACTS RELATED TO THE PROPOSED TRANSACTION OR ARRANGEMENT TO THE TRUSTEES AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. THE INTERESTED PERSON IS ALLOWED TO MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION THE INTERESTED PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. IF THE BOARD OR COMMITTEE BELIEVES A MEMBER HAS VIOLATED THE CONFLICTS OF INTEREST POLICY, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE. IF THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. PERIODIC REVIEWS ARE CONDUCTED WHICH, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING. 2. WHETHER ACQUISITIONS OF GOODS OR SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 3. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. 4. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION OF THE CEO OF THE MEDICAL CENTER. A SECOND COMPENSATION COMMITTEE, WHICH INCLUDES THE CEO, DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEES STUDY DATA FROM INDEPENDENT SALARY SURVEYS (SUCH AS "MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS," WHICH IS AN ANNUAL SURVEY PREPARED BY SULLIVAN COTTER) TO UNDERSTAND COMPENSATION PAID TO SIMILARLY QUALIFIED INDIVIDUALS IN COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE COMPENSATION COMMITTEES ALSO COMPILE DATA FROM OTHER TAX-EXEMPT HEALTH SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AND USE THAT INFORMATION AS COMPARATIVE COMPENSATION. THE COMMITTEES USE THE INFORMATION FROM THESE SOURCES AS BENCHMARKS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION. THE COMMITTEES ALSO CONSIDER OTHER FACTORS IN DETERMINING OFFICER AND KEY EMPLOYEE COMPENSATION, SUCH AS LENGTH OF EMPLOYMENT AND THEIR RESPONSIBILITIES. THE EXECUTIVE COMPENSATION COMMITTEE PERIODICALLY HIRES INDEPENDENT CONSULTANTS FOR ANALYSIS OF THE COMPENSATION OF THE MEDICAL CENTER'S CEO. THE COMMITTEES MAINTAIN CONTEMPORANEOUS DOCUMENTATION OF THE BASIS FOR THEIR DECISIONS REGARDING COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 WILLIS-KNIGHTON MEDICAL CENTER'S GOVERNING DOCUMENTS AND ITS CONFLICT OF INTEREST POLICY ARE AVAILABLE ON ITS WEBSITE: WWW.WKHS.COM. THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.EMMA.MSRB.ORG. FORM 990, PART XI, LINE 9: FASB ASC 715-30 PENSION 125,578,792. 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