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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 338,774 | 623,912 | 969,199 | 1,089,334 | 1,287,931 | 4,309,150 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 338,774 | 623,912 | 969,199 | 1,089,334 | 1,287,931 | 4,309,150 |
| 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) .. | 1,239,202 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 3,069,948 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 338,774 | 623,912 | 969,199 | 1,089,334 | 1,287,931 | 4,309,150 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 51,171 | 63,434 | 85,489 | 85,533 | 135,738 | 421,365 |
| 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.).. | 0 | 0 | 0 | 1,000 | 1,039 | 2,039 |
| 11 | Total support. Add lines 7 through 10 | 4,732,554 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, LINE 6 IN ACCORDANCE WITH THE ARTICLES OF INCORPORATION, ARTICLE IX MEMBERSHIP FOR CHRISTUS FOUNDATION SHREVEPORT-BOSSIER, CHRISTUS HEALTH NORTHERN LOUISIANA IS THE SOLE MEMBER OF THE CORPORATION. |
| DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS | FORM 990, PART VI, LINE 7A IN ACCORDANCE WITH THE AMENDED AND RESTATED BYLAWS OF THE CHRISTUS FOUNDATION SHREVEPORT-BOSSIER, SECTION 6.02, THE PERSONS EMPLOYED SHALL AUTOMATICALLY BE ELECTED WITHOUT TERM. ALSO, THE BOARD OF DIRECTORS OF THE CORPORATION SHALL INCLUDE AT LEAST ONE MEMBER OF THE CHRISTUS HEALTH NORTHERN LOUISIANA BOARD, ONE ACTIVE MEMBER OF CHRISTUS FOUNDATION SHREVEPORT-BOSSIER'S MEDICAL STAFF, AND A REPRESENTATIVE OF EITHER THE SISTERS OF CHARITY OF INCARNATE WORD OR THE CHRISTUS FOUNDATION SHREVEPORT-BOSSIER OFFICE OF MISSION EFFECTIVENESS. |
| DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS | FORM 990, PART VI, LINE 7B IN ACCORDANCE WITH THE AMENDED AND RESTATED BYLAWS OF THE CHRISTUS FOUNDATION SHREVEPORT-BOSSIER: THE GOVERNANCE OF THE AFFAIRS OF THE CORPORATION SHALL BE VESTED IN ITS GOVERNING BODY, KNOWN AS THE BOARD OF DIRECTORS, WHICH SHALL HAVE CHARGE, CONTROL AND MANAGEMENT OF THE PROPERTY, AFFAIRS AND FUNDS OF THE CORPORATION, AND SHALL HAVE THE POWER AND AUTHORITY TO DO AND PERFORM ALL ACTS AND FUNCTIONS ON BEHALF OF THE CORPORATION. HOWEVER, AMONG THESE ACTS AND FUNCTIONS, CERTAIN POWERS HAVE BEEN EXPRESSLY RESERVED TO THE SOLE MEMBER IN THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE CORPORATION. ACTION BY THE CORPORATION SHALL NOT BE TAKEN UNTIL, CHRISTUS HEALTH NORTHERN LOUISIANA, ACTING THROUGH ITS BOARD OF DIRECTORS, SHALL HAVE TAKEN ACTIONS BY CONSENT RESOLUTION OR RESOLUTIONS SIGNED ON BEHALF OF THE SOLE MEMBER BY ITS PRESIDENT OR CORPORATE SECRETARY AND RECORDED IN THE MINUTE BOOKS OF CHRISTUS HEALTH NORTHERN LOUISIANA. THE SOLE MEMBER MAY DELEGATE CERTAIN RESERVED POWERS TO THE CHRISTUS HEALTH NORTHERN LOUISIANA PRESIDENT. THE MATTERS SET FORTH BELOW ARE RESERVED EXCLUSIVELY TO THE SOLE MEMBER AND ARE NOT VALID UNTIL THEY HAVE BEEN SUBMITTED FOR AND RECEIVED APPROVAL BY THE MEMBER IN THE MANNER OUTLINED ABOVE: (A) ANY AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION. (B) THE ESTABLISHMENT OF ANY NEW CORPORATION OR THE MERGER, DISSOLUTION, OR CONSOLIDATION OF THE CORPORATION. (C) APPROVAL OF THE CAPITAL AND OPERATIONAL BUDGETS OF THE CORPORATION AND APPROVAL OF ANY AUDIT OR FINANCIAL REVIEW OF THE BOOKS AND RECORDS OF THE CORPORATION. THE SOLE MEMBER MAY REQUIRE AN AUDIT OR SOME LESSER FINANCIAL REVIEW OF THE BOOKS AND RECORDS OF THE CORPORATION BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT SELECTED BY THE SOLE MEMBER OF THE CORPORATION IF THE SOLE MEMBER DEEMS SUCH REVIEW OR AUDIT TO BE NECESSARY OR APPROPRIATE. (D) INCURRING OR RENEWING ANY INDEBTEDNESS BY THE CORPORATION. (E) ANY ACQUISITION, EXCHANGE, LEASE, SALE OR PURCHASE OF REAL PROPERTY BY THE CORPORATION. (F) THE APPROVAL OF ANY GIFT OF PROPERTY (OTHER THAN CASH, MARKETABLE SECURITIES, OR BONDS) TO THE CORPORATION AND THE APPROVAL OF ANY RESTRICTIONS IMPOSED AS A CONDITION OF ACCEPTING SAID GIFT. (G) APPROVAL OF SHORT-TERM AND LONG-RANGE STRATEGIC PLANS FOR THE CORPORATION. (H) APPROVAL OF THE STATED MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION WILL OPERATE ITS AFFAIRS. (I) ELECTION OR REMOVAL OF THE CHAIR, AND THE BOARD OF DIRECTORS OF THE CORPORATION. (J) THE SOLE MEMBER MAY FROM TIME TO TIME BY APPROPRIATE RESOLUTIONS ADOPTED AND APPROVED BY SAID SOLE MEMBER DELEGATE ADDITIONAL ACTIONS TO THE BOARD OF DIRECTORS OF THE CORPORATION. |
| DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED AND REVIEWED BY THE CHRISTUS HEALTH TAX DEPARTMENT. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH THE TAX DEPARTMENT IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATION'S CFO, OR OTHER DESIGNEE, REVIEWS THE FORM 990. THE FINAL FORM 990 THAT WILL BE FILED WITH THE IRS IS POSTED TO A SECURE INTERNET PORTAL FOR ALL MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW OF THE FINAL FORM 990 OCCURS PRIOR TO FILING WITH THE IRS IN THE SPRING 2025 VIA A WEB PORTAL POLLING TOOL BY THE RESPECTIVE CHRISTUS ORGANIZATION'S BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | FORM 990, PART VI, LINE 12C AT THE END OF EACH CALENDAR YEAR, THE CHRISTUS HEALTH CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL OF THE ORGANIZATION'S BOARD AND COMMITTEE MEMBERS FOR COMPLETION PRIOR TO THE 1ST OF JANUARY IN THE NEXT YEAR. THE CORPORATE SECRETARY THOROUGHLY REVIEWS ALL COMPLETED AND EXECUTED CONFLICT OF INTEREST QUESTIONNAIRE FORMS TO ENSURE ACCURACY AND THAT NO POTENTIAL OR IDENTIFIED CONFLICT IS DISCLOSED OR EXISTS. THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION. |
| COMPENSATION DETERMINATION PROCESS | FORM 990, PART VI, LINE 15A THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS PAID BY A RELATED ORGANIZATION; THEREFORE, THE FILING ORGANIZATION WAS NOT INVOLVED IN THE PROCESS OF DETERMINING COMPENSATION FOR THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION. THE RELATED ORGANIZATION DETERMINES THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE RELATED ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE RELATED ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE EXECUTIVE DIRECTOR'S COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE. THE EXECUTIVE DIRECTOR'S SALARY IS PAID BY THE RELATED ORGANIZATION. |
| PUBLIC DISCLOSURE OF 1023 AND FORMS 990 & 990-T | FORM 990, PART VI, LINE 18 THE FILING ORGANIZATION'S IRS DETERMINATION LETTER AND FORM 990 ARE AVAILABLE UPON REQUEST. |
| AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC | FORM 990, PART VI, LINE 19 THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTUS HEALTH ARE MADE AVAILABLE TO THE PUBLIC VIA THE CHRISTUS HEALTH WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 9 CHANGE IN RESTRICTED NET ASSETS (525,523) RESTRICTED CONTRIBUTIONS 1,599,767 RECLASS FOR GAAP FOR DONATIONS/GRANTS TO UNRNA (409,729) ROUNDING 1 ---------------- TOTAL $664,516 |
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| Software Version: |