Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TWO OF THE BOARD MEMBERS/TRUSTEES, MRS. FRANCIS LAURICELLA (BETTY)AND LOUIS LAURICELLA ARE MOTHER AND SON RELATED. |
| FORM 990, PART VI, SECTION A, LINE 6 | LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC) ACTS AS A SYSTEM PARENT AND IT IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC) HAS THE SOLE AUTHORITY TO APPOINT THE BOARD OF CHILDREN'S HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | ON JULY 13, 2009, AS PART OF THE ACQUISITION OF TOURO INFIRMARY, LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC), A 501(C)3 CORPORATION, BECAME THE SOLE MEMBER OF CHILDREN'S HOSPITAL, INC. AND TOURO INFIRMARY, INC. LCMC, THROUGH VARIOUS RESERVE POWERS, HAS THE ABILITY TO APPROVE, DISAPPROVE AND RATIFY DECISIONS MADE BY THE BOARD OF TRUSTEE'S OF CHILDREN'S HOSPITAL. THE BOARD OF TRUSTEE'S OF LCMC, THROUGH A MAJORITY VOTE APPROVES THE ANNUAL OPERATING BUDGETS AND CAPITAL EXPENDITURES OF CHILDREN'S HOSPITAL. LCMC ALSO APPROVES THE APPOINTMENT OF NEW MEMBERS OF THE BOARD OF TRUSTEES OF CHILDREN'S HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S FORM 990 WAS PRESENTED TO ALL MEMBERS OF THE ORGANIZATION'S BOARD FOR REVIEW VIA EMAIL LINK TO A SECURE DROP BOX. THE FORM 990 WAS PREPARED BY CHILDREN'S ACCOUNTING DEPARTMENT AND REVIEWED BY CHILDREN'S CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT THE TIME OF HIRE, EACH EMPLOYEE REVIEWS THE CONFLICT OF INTEREST FORM, HAS AN OPPORTUNITY TO ASK QUESTIONS ABOUT THE POLICY, AND SIGNS A DOCUMENT STATING THAT THEY HAVE REVIEWED AND UNDERSTAND THE POLICY. THIS IS A PART OF THE EMPLOYEE'S PERMANENT RECORD AND APPLIES TO ALL EMPLOYEES. SENIOR MANAGEMENT (DIRECTORS, VICE PRESIDENTS, CEO) AND MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CORPORATION RELIES ON COMPARABLE DATA FROM UNRELATED ENTITIES TO DETERMINE THE AMOUNT OF COMPENSATION FOR ITS EXECUTIVES, AND DOCUMENTATION IS MAINTAINED REGARDING THE DETERMINATION OF THESE AMOUNTS. THE FINAL DECISION REGARDING THE AMOUNT OF COMPENSATION IS SUBJECT TO APPROVAL OF THE LCMC EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | GENERAL MEDICAL PROF FEES: PROGRAM SERVICE EXPENSES 62,164,028. MANAGEMENT AND GENERAL EXPENSES 19,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,183,348. THE LEMOINE COMPANY: PROGRAM SERVICE EXPENSES 2,837,749. MANAGEMENT AND GENERAL EXPENSES 644,232. FUNDRAISING EXPENSES 141,984. TOTAL EXPENSES 3,623,965. PREMIUM PARKING SERVICE: PROGRAM SERVICE EXPENSES 753,723. MANAGEMENT AND GENERAL EXPENSES 171,112. FUNDRAISING EXPENSES 37,712. TOTAL EXPENSES 962,547. CONVERGINT TECHNOLOGY: PROGRAM SERVICE EXPENSES 574,374. MANAGEMENT AND GENERAL EXPENSES 130,396. FUNDRAISING EXPENSES 28,738. TOTAL EXPENSES 733,508. WESTPORT LINEN SERVICE: PROGRAM SERVICE EXPENSES 552,979. MANAGEMENT AND GENERAL EXPENSES 125,539. FUNDRAISING EXPENSES 27,668. TOTAL EXPENSES 706,186. ORDES SERVICES LLC: PROGRAM SERVICE EXPENSES 500,464. MANAGEMENT AND GENERAL EXPENSES 113,616. FUNDRAISING EXPENSES 25,040. TOTAL EXPENSES 639,120. TK ELEVATOR CORP: PROGRAM SERVICE EXPENSES 483,059. MANAGEMENT AND GENERAL EXPENSES 109,665. FUNDRAISING EXPENSES 24,169. TOTAL EXPENSES 616,893. THE MCDONNEL GROUP LLC: PROGRAM SERVICE EXPENSES 438,530. MANAGEMENT AND GENERAL EXPENSES 99,556. FUNDRAISING EXPENSES 21,941. TOTAL EXPENSES 560,027. WESTERN ASSET MGMNT FEES: PROGRAM SERVICE EXPENSES 432,167. MANAGEMENT AND GENERAL EXPENSES 98,112. FUNDRAISING EXPENSES 21,623. TOTAL EXPENSES 551,902. AUGIE LEOPOLD ADVERTISING: PROGRAM SERVICE EXPENSES 414,114. MANAGEMENT AND GENERAL EXPENSES 94,013. FUNDRAISING EXPENSES 20,720. TOTAL EXPENSES 528,847. MERCER MGMNT FEES: PROGRAM SERVICE EXPENSES 392,629. MANAGEMENT AND GENERAL EXPENSES 89,135. FUNDRAISING EXPENSES 19,645. TOTAL EXPENSES 501,409. OTHER FEES: PROGRAM SERVICE EXPENSES 10,970,185. MANAGEMENT AND GENERAL EXPENSES 2,490,476. FUNDRAISING EXPENSES 548,881. TOTAL EXPENSES 14,009,542. |
| PART XII, LINE 2C | THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. |
| FORM 990, PART VIII, LINE 1E | IN RESPONSE TO THE ECONOMIC IMPACT OF COVID-19, THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT) WAS ENACTED BY CONGRESS AND WAS SUBSEQUENTLY SIGNED INTO LAW ON MARCH 27, 2020. THE CARES ACT INCLUDED A VARIETY OF ECONOMIC ASSISTANCE PROVISIONS FOR BUSINESSES AND INDIVIDUALS. CHILDREN'S HOSPITAL SUSPENDED NONEMERGENT OR NON-CRITICAL SURGERIES, PROCEDURES AND APPOINTMENTS BEGINNING IN MID-MARCH THROUGH EARLY MAY IN 2020 DUE TO COVID-19. UNDER CERTAIN PROVISIONS IN THE CARES ACT, THE ORGANIZATION RECEIVED BENEFITS RELATED TO PROVIDER RELIEF FUNDING TOTALING $1,309,666 FOR THE YEAR ENDED DECEMBER 31, 2022. THE HOSPITAL ALSO RECEIVED $3,235,812 OF FUNDING FROM FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) AND $7,138,947 FROM THE DHH HRSA CH GRADUATE MEDICAL EDUCATION PROGRAM. THE HOSPITAL IS REPORTING $11,684,425 AS GOVERNMENT GRANTS ON PART VII OF THE FORM 990 OPERATIONS. |
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| Software Version: |