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← OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC

Form 990 for tax year 2022

Filed by OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC.

Totals

Total revenue
$11,876,435
Total expenses
$8,894,232
Contributions and grants received
$0
Grants paid
$2,359
Program service revenue
$11,581,840
Investment income
$268,845
Other revenue
$25,750
Total assets, end of year
$25,380,919
Total liabilities, end of year
$2,950,558
Net assets or fund balances, end of year
$22,430,361
Program services expenses (Part IX)
$6,735,021
Management and general expenses
$2,159,211
Fundraising expenses
$0
Program service expenses (Part III)
$6,735,021

Program services were 75.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • STEPHANIE G MANSON

    LOURDES CEO

    Total calculated
    $605,781
    From this org
    $0
    From related orgs
    $552,790
    Other
    $52,991
    Hours/week
    2 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $423,753 related
    Bonus
    $0 + $127,327 related
    Other
    $0 + $1,710 related
    Deferred
    $0 + $27,450 related
    Nontaxable benefits
    $0 + $25,541 related
    Filer's total
    $0 + $605,781 related

  • LOWELL E STANTON

    REGIONAL CFO (UNTIL 8/2022)

    Total calculated
    $648,848
    From this org
    $0
    From related orgs
    $606,053
    Other
    $42,795
    Hours/week
    2 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $461,602 related
    Bonus
    $0 + $141,829 related
    Other
    $0 + $2,622 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $27,545 related
    Filer's total
    $0 + $648,848 related

  • BRIAN F TRIPODE

    SUPV PHARMACY/INTERIM ADMIN

    Total calculated
    $231,240
    From this org
    $205,437
    From related orgs
    $0
    Other
    $25,803
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $204,927
    Bonus
    $1,000
    Other
    -$490
    Deferred
    $10,560
    Nontaxable benefits
    $15,243
    Filer's total
    $231,240

  • WILLIAM E BALHOFF

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • CHARLES P BOLOTTE MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    10

  • HARRY J PHILIPS JR

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • GREG BOWSER

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • JENNIFER CLOWERS

    BOARD MEMBER/CFO (START 8/22)

    Total calculated
    $577,368
    From this org
    $0
    From related orgs
    $506,713
    Other
    $70,655
    Hours/week
    2 + 44.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,392 related
    Bonus
    $0 + $152,086 related
    Other
    $0 + $2,235 related
    Deferred
    $0 + $44,531 related
    Nontaxable benefits
    $0 + $26,124 related
    Filer's total
    $0 + $577,368 related

  • JOHN FRAICHE MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $594,796
    From this org
    $0
    From related orgs
    $557,919
    Other
    $36,877
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $448,486 related
    Bonus
    $0 + $98,309 related
    Other
    $0 + $11,124 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $21,627 related
    Filer's total
    $0 + $594,796 related

  • SCOTT N HENGSENS

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • CHARLES L SPICER

    BOARD MEMBER/PRESIDENT - OLOL

    Total calculated
    $266,643
    From this org
    $0
    From related orgs
    $237,105
    Other
    $29,538
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $123,121 related
    Bonus
    $0 + $113,782 related
    Other
    $0 + $202 related
    Deferred
    $0 + $27,451 related
    Nontaxable benefits
    $0 + $2,087 related
    Filer's total
    $0 + $266,643 related

  • KEVIN GUIDRY

    ADMINISTRATOR/CEO (UNTIL 7/22)

    Total calculated
    $155,739
    From this org
    $143,704
    From related orgs
    $0
    Other
    $12,035
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $138,785
    Bonus
    $0
    Other
    $4,919
    Deferred
    $0
    Nontaxable benefits
    $12,035
    Filer's total
    $155,739

  • DONNA M MULLINGS

    DIR. NURSING

    Total calculated
    $155,422
    From this org
    $123,035
    From related orgs
    $0
    Other
    $32,387
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $110,915
    Bonus
    $10,970
    Other
    $1,150
    Deferred
    $11,793
    Nontaxable benefits
    $20,594
    Filer's total
    $155,422

  • DAMIAN RICHARD

    MRI TECHNOLOGIST

    Total calculated
    $117,028
    From this org
    $108,359
    From related orgs
    $0
    Other
    $8,669
    Hours/week
    40

  • BRITTANY WYGER

    PHYSICIAN

    Total calculated
    $336,942
    From this org
    $320,076
    From related orgs
    $0
    Other
    $16,866
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $249,684
    Bonus
    $70,000
    Other
    $392
    Deferred
    $15,250
    Nontaxable benefits
    $1,616
    Filer's total
    $336,942

  • KENNETH WESTER

    FORMER PRESIDENT/OLOL CEO

    Total calculated
    $3,625,673
    From this org
    $0
    From related orgs
    $3,612,382
    Other
    $13,291
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $347,194 related
    Bonus
    $0 + $257,512 related
    Other
    $0 + $3,007,676 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $13,291 related
    Filer's total
    $0 + $3,625,673 related

  • JEFF LIMBOCKER

    FORMER VP FINANCE/FMOL CFO

    Total calculated
    $875,663
    From this org
    $0
    From related orgs
    $855,174
    Other
    $20,489
    Hours/week
    0 + 56.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $561,480 related
    Bonus
    $0 + $216,453 related
    Other
    $0 + $77,241 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $20,489 related
    Filer's total
    $0 + $875,663 related

  • WENDY GAUDET

    PAST INTERIM CEO/OLOL VP OPERATIONS

    Total calculated
    $298,436
    From this org
    $0
    From related orgs
    $267,996
    Other
    $30,440
    Hours/week
    2 + 40.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $214,092 related
    Bonus
    $0 + $52,239 related
    Other
    $0 + $1,665 related
    Deferred
    $0 + $13,504 related
    Nontaxable benefits
    $0 + $16,936 related
    Filer's total
    $0 + $298,436 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I QUESTION 4A
THE EXITING REGIONAL CFO, AND TWO BOARD MEMBERS ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE CFO AND ADMINISTRATOR/CEO ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. THE FORMER PRESIDENT AND THE FORMER CFO, WHO HAVE ROLES AT RELATED ENTITIES, ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON, AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. KENNETH SCOTT WESTER RECEIVED A SEVERANCE PAYMENT OF $351,655 IN THE CURRENT YEAR.
PART I QUESTION 4B
FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDE FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. KENNETH SCOTT WESTER RECEIVED A PAYMENT OF $2,653,381 AND JEFFREY LIMBOCKER RECEIVED A PAYMENT OF $75,123 FROM THE PLANS IN THE CURRENT YEAR.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202431369349307753

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