Cost reports filed for Ruston’s Northern Louisiana Medical Center with the federal Centers for Medicare and Medicaid Services show a pattern of financial distress, including up to $31 million in unpaid bills.
At the same time, the acute-care facility continues to pay out several million dollars annually in lease payments and management fees to companies tied to hospital owner Rock Bordelon.
The data appears to show that those payments — made from patient revenue — have been higher than what CMS allows.
All the while, the facility appears to be losing money annually. The numbers also indicate a patient occupancy rate around 24-26% for some of the years reviewed, which appears to corroborate patient exodus statistics cited by a local health care study released earlier this year.
Bordelon, from Avoyelles Parish, is president and CEO of Allegiance Health Management. The Bossier City-based company owns a variety of health care facilities, including 11 hospitals in Louisiana, more than half of which — including NLMC — are operating at a loss, according to CMS cost report data online.
CMS requires Medicare-certified providers to submit detailed annual cost reports that recap operating costs and patient statistics and other criteria.
An analysis of NLMC’s reports from fiscal years 2022-2025 appears to also substantiate oft-heard complaints that the hospital frequently doesn’t have routine supplies, because vendors who provide those supplies aren’t getting paid.
Former employees who agreed to talk on background said there have been times when neither fluids nor medicines were available, and housekeeping tasks were left unattended because there was no staff.
They’ve also complained about other sanitary and patient information privacy issues that they attribute to lapsed vendor contracts.
Though the local cost reports list the facility name as “North Louisiana Medical Center,” both the street address and other pertinent information are that of Northern Louisiana Medical Center.
Bordelon’s Allegiance Health Management bought NLMC from financially troubled Community Health Systems in 2020, just months before the COVID-19 pandemic hit hard.
Though Bordelon has not responded to requests from the Ruston Daily Leader over the last eight months for comment about NLMC, he has posted on social media that he’s “put in over 30 million into the Ruston community to keep the hospital open.”
He’s claimed NLMC would have closed “years ago” had it not been for him.
A call to Allegiance’s office Tuesday morning for comment went to voicemail and had not been returned as of press time.
Cost report data for fiscal year 2022 show NLMC had a negative of almost $437,000 cash on hand, with its fund balance in the red by $13 million.
It had $15 million in accounts payable that year. Total liabilities were listed at approximately $33 million and total assets at just under $20 million.
By the post-COVID fiscal year 2023, assets had shrunk by about $3 million, yet liabilities stayed close to the same. The same pattern happened the next fiscal year, and the negative fund balances grew.
At the end of FY 2024, the hole appeared to be deepening. NLMC’s fund balance was about $21 million in the red. Cash in the bank hit a negative $24.6 million, spiraling down from a positive $254,974 when FY 2023 ended.
That’s a change of almost $25 million in a single year. When matched up with patient revenue reported at $63 million, the cash crash appears to have been about 40% of NLMC’s income for the year.
But operating losses for FY 2024 are listed as only $4.95 million.
NLMC doesn’t own its facility. Both the building and the approximately 20 acres upon which it sits on East Vaughn Avenue belong to Ruston Real Estate Holdings, according to Lincoln Parish property tax records.
Bordelon is listed as “manager, member” of Ruston Real Estate Holdings. NLMC pays Ruston Real Estate an annual lease fee. In FY 2025, and every other year examined, that lease was $1.8 million.
But that’s evidently more than CMS allows, the reports show. The FY 2025 fee was some $519,000 beyond the CMS allowable limit, and NLMC’s overpay was even higher in some previous years.
On top of the lease, NLMC was paying as much as $2.4 million annually in management fees to Allegiance and group health insurance costs to yet another company that lists Bordelon as its vice president.
Sources familiar with health care management who also spoke on background said a business owner doing business with other companies they own is not illegal. Nor does CMS automatically consider overpayments fraudulent.
NLMC has been under public scrutiny for months, heightened by the discovery in September 2025 that it owed approximately $7 million to the IRS for failing to remit payroll taxes. The number ballooned to near $9.4 million before the liens began to be paid off fairly rapidly.
Bordelon has claimed the issues were caused by a bookkeeping lag on the part of the IRS. Failure to pay means the taxes were apparently deducted from employees’ checks, but not paid to the IRS, indicating the employer is using the money somehow else.
Meantime, a Lincoln Parish health care study, released in February of this year, found nearly half of local patients seeking inpatient care go outside the parish. The survey, commissioned by the non-profit Lincoln Health Foundation, in partnership with the city of Ruston and the Lincoln Parish Police Jury, reported an overall distrust of Allegiance and NLMC among respondents.
The document calls the existing health care landscape “a barrier to economic growth.”
Those findings, along with continuing community concern, led the police jury to request Louisiana’s Department of Health do a “timely review” of NLMC. That request was made May 12.
On May 22, reviewers from LDH’s Health Standards Section arrived in Ruston.
LDH is the licensing authority for Louisiana hospitals. Should a facility be cited for deficient practice, LDH can issue sanctions that include civil monetary penalties, directed plans of correction, or action against the hospital’s license.
Against all of that, NLMC’s CEO has retired, a departure that had apparently been in the works for several months. Other top positions including chief nursing officer, emergency room director, and controller are also in flux.