ANDERSON PHYSICIAN ALLIANCE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ANDERSON PHYSICIAN ALLIANCE INC (EIN 27-3274203)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-06-12
- IRS object ID
- 202341639349301214
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-06-12T11:52:32-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273274203 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON PHYSICIAN ALLIANCE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANDE | BusinessNameControlTxt |
| Phone | 6015536000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN BROWN | PersonNm |
| Person Title | VP OF FINANCE | PersonTitleTxt |
| Phone | 6015536000 | PhoneNum |
| Signature | 2023-06-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEVEN | PersonFirstNm |
| Person Last | BROWN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2023-06-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,312,069 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ANDERSONREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 61 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,053,666 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,312,067 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3 | PYInvestmentIncomeAmt |
| CY Investment Income | -$459,707 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,053,669 | PYTotalRevenueAmt |
| CY Total Revenue | $4,852,360 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,489,614 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,538,631 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,821,636 | PYOtherExpensesAmt |
| CY Other Expenses | $1,453,594 | CYOtherExpensesAmt |
| PY Total Expenses | $7,311,250 | PYTotalExpensesAmt |
| CY Total Expenses | $6,992,225 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,257,581 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,139,865 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,357,545 | TotalAssetsBOYAmt |
| Total Assets EOY | $723,173 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $35,163,272 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,668,765 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$32,805,727 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$34,945,592 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. THE SPECIFIC PURPOSES AND OBJECTIVES OF THE CORPORATION SHALL INCLUDE BUT NOT BE LIMITED TO EMPLOYING PHYSICIANS AND OTHER MEDICAL PERSONNEL TO CARRY OUT THE PURPOSES AND OBJECTIVES OF ANDERSON REGIONAL MEDICAL CENTER, AS FOLLOWS:1.) TO ESTABLISH AND MAINTAIN AN INSTITUTION OR INSTITUTIONS, WITHIN OR WITHOUT THE STATE WHERE INCORPORATED, WITH PERMANENT FACILITIES TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS2.) TO CARRY ON ANY EDUCATION ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH3.) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED4.) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,745,362 | ExpenseAmt |
| Revenue | $5,312,067 | RevenueAmt |
| Desc | SEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. THE PHYSICIANS, NURSE PRACTITIONERS AND STAFF FOCUS ON PRIMARY HEALTHCARE NEEDS OF THE COMMUNITY.ANDERSON EAR, NOSE & THROAT CENTER - CLOSED 6/30/2022DIAGNOSES, TREATS AND MANAGES PATIENTS WITH DISORDERS AND CONDITIONS OF THE EAR, NOSE AND THROAT REGION, AND RELATED AREAS OF THE HEAD AND NECK.ANDERSON NEUROLOGY CENTER - CLOSED 7/31/2022TREATS DISORDERS THAT AFFECT THE BRAIN, SPINAL CORD AND NERVES. DIAGNOSES COMPLEX CONDITIONS THROUGH DETAILED HISTORY AND PHYSICAL EXAMINATION, INCLUDING TESTING OF MENTAL STATUS, VISION, SPEECH, STRENGTH, SENSATION, COORDINATION, REFLEXES, AND GAIT. ANDERSON UROLOGY CLINIC OF MERIDIANTREATS A WIDE VARIETY OF CONDITIONS THAT AFFECT THE URINARY SYSTEM AND THE MALE REPRODUCTIVE SYSTEM.ANDERSON CARDIAC SURGICAL ASSOCIATESOFFERS A WEALTH OF KNOWLEDGE AND EXPERIENCE, MODERN SURGICAL EQUIPMENT, ADVANCED TECHNIQUES, AND HIGH-QUALITY CARE FOR COMPLEX OPEN HEART AND VASCULAR SURGERIES. PEDIATRIC HOSPITALISTSTHE PEDIATRIC HOSPITALIST PARTNERS WITH PRIMARY CARE PEDIATRICIANS AND OTHER SUB-SPECIALISTS AND NURSE PRACTITIONERS TO PROVIDE COMPREHENSIVE, FAMILY CENTERED CARE DURING AN ACUTE HOSPITALIZATION.THE PURVIS CLINICFROM PUBERTY THROUGH CHILD-BEARING YEARS, MENOPAUSE AND BEYOND, THE PRACTICE PROVIDES PERSONAL AND HIGH QUALITY CARE FOR WOMEN. WOMEN'S MEDICAL CLINIC OF MERIDIANTHE WOMEN'S MEDICAL CENTER OF MERIDIAN SERVE PATIENTS RANGING IN AGE FROM ADOLESCENCE TO ELDERLY, BELIEVING ALL ARE ENTITLED TO THE VERY BEST IN HEALTHCARE, UTILIZING STATE-OF-THE-ART MEDICAL TREATMENT AND SURGICAL PROCEDURES.ANDERSON PREMIER WOMEN'S CENTEROBSTETRIC AND GYNECOLOGIC SERVICES FOR WOMEN OF ALL AGES- FROM ADOLESCENCE THROUGH CHILDBEARING YEARS AND BEYOND. THE PROVIDER IS BOARD CERTIFIED BY THE AMERICAN BOARD OF OBSTETRICS AND GYNECOLOGY AND PROVIDES KNOWLEDGEABLE, COMPASSIONATE CARE THAT IS PERSONALIZED TO EACH PATIENT'S NEEDS. | Desc |
| Total Program Service Expenses | $6,745,362 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 61 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN BROWN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6015536647 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GEORGE D FARR JR | ||||||||
| DIRECTOR (CHAIRMAN) | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $193,124 | $51,541 | |
| WANDA B COOPER | ||||||||
| DIRECTOR (SECRETARY) | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $225,687 | $9,597 | |
| SHAWN C ANDERSON | ||||||||
| DIRECTOR | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $22,000 | $0 | |
| STEVEN W BROWN | ||||||||
| DIRECTOR | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $262,820 | $79,584 | |
| THURMAN K EVERETT | ||||||||
| DIRECTOR | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $364,505 | $51,752 | |
| JAMES H WALLACE | ||||||||
| PHYSICIAN | 40.00 | $901,584 | $0 | $71,584 | Yes (X) | |||
| DANIEL J MCKIEVER JR | ||||||||
| PHYSICIAN | 40.00 | $1,019,436 | $0 | $26,039 | Yes (X) | |||
| RONNY E PURVIS | ||||||||
| PHYSICIAN | 40.00 | $543,443 | $0 | $12,797 | Yes (X) | |||
| DAVID A GEER | ||||||||
| PHYSICIAN | 40.00 | $451,448 | $0 | $19,358 | Yes (X) | |||
| CODY B AULL | ||||||||
| PHYSICIAN | 40.00 | $576,912 | $0 | $26,181 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,492,823 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,068,136 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $348,433 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NTT DATA SERVICES LLC | |||||
| POB 534118 | ATLANTA | GA | 303534118 | EMR - BILLING SOFTWARE | $175,615 |
| LOCUMTENENSCOM | |||||
| 2655 NORTHWINDS PARKWAY | ATLANTA | GA | 30384 | CONTRACT PHYSICIAN SERVICES | $145,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT | 621990 | $5,004,358 | $5,004,358 |
| PROVIDER RELIEF FUNDS | 900099 | $307,709 | $307,709 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,312,067 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2 | TotalRevenueColumnAmt |
| Exclusion | $2 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $459,709 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$459,709 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$459,709 | TotalRevenueColumnAmt |
| Exclusion | -$459,709 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,852,360 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,312,067 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$459,707 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,100,737 | TotalAmt |
| Program Services | $4,915,871 | ProgramServicesAmt |
| Management And General | $184,866 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,433 | TotalAmt |
| Program Services | $50,426 | ProgramServicesAmt |
| Management And General | $2,007 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,518 | TotalAmt |
| Program Services | $179,310 | ProgramServicesAmt |
| Management And General | $4,208 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,943 | TotalAmt |
| Program Services | $199,322 | ProgramServicesAmt |
| Management And General | $2,621 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,353 | TotalAmt |
| Program Services | $427,699 | ProgramServicesAmt |
| Management And General | $14,654 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,686 | TotalAmt |
| Program Services | $154,872 | ProgramServicesAmt |
| Management And General | $23,814 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,785 | TotalAmt |
| Program Services | $323,695 | ProgramServicesAmt |
| Management And General | $90 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,732 | TotalAmt |
| Program Services | $16,098 | ProgramServicesAmt |
| Management And General | $634 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,630 | TotalAmt |
| Program Services | $4,630 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,524 | TotalAmt |
| Program Services | $70,375 | ProgramServicesAmt |
| Management And General | $13,149 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,394 | TotalAmt |
| Program Services | $139,394 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $151,088 | $150,268 | $820 |
| BAD DEBT EXPENSE | $113,402 | $113,402 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,992,225 | TotalAmt |
| Program Services | $6,745,362 | ProgramServicesAmt |
| Management And General | $246,863 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | -$7 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,787 | BOYAmt |
| EOY | $8,540 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,894 | BOYAmt |
| EOY | $2,809 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,667 | BOYAmt |
| EOY | $26,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,943,439 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,258,275 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,859,197 | BOYAmt |
| EOY | $685,164 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,357,545 | BOYAmt |
| EOY | $723,173 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,104 | BOYAmt |
| EOY | $254,579 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,830,168 | BOYAmt |
| EOY | $35,414,186 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,163,272 | BOYAmt |
| EOY | $35,668,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$32,805,727 | BOYAmt |
| EOY | -$34,945,592 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$32,805,727 | BOYAmt |
| EOY | -$34,945,592 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,357,545 | BOYAmt |
| EOY | $723,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,139,865 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $838,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $367,503 | DepreciationAmt |
| Book Value | $471,212 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,777 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,004 | DepreciationAmt |
| Book Value | $773 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,074,947 | OtherCostOrOtherBasisAmt |
| Depreciation | $861,768 | DepreciationAmt |
| Book Value | $213,179 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $685,164 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $35,414,186 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $35,414,186 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ANDERSON PHYSICIAN ALLIANCE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. ANDERSON PHYSICIAN ALLIANCE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2022 AND 2021. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL J MCKIEVER JR | ||||||||||||||
| PHYSICIAN | $599,768 | $0 | $416,611 | $0 | $3,057 | $0 | $0 | $0 | $26,039 | $0 | $1,045,475 | $0 | $0 | $0 |
| JAMES H WALLACE | ||||||||||||||
| PHYSICIAN | $621,709 | $0 | $259,193 | $0 | $20,682 | $0 | $57,953 | $0 | $13,631 | $0 | $973,168 | $0 | $0 | $0 |
| CODY B AULL | ||||||||||||||
| PHYSICIAN | $362,625 | $0 | $214,057 | $0 | $230 | $0 | $13,154 | $0 | $13,027 | $0 | $603,093 | $0 | $145,404 | $0 |
| RONNY E PURVIS | ||||||||||||||
| PHYSICIAN | $481,314 | $0 | $55,591 | $0 | $6,538 | $0 | $0 | $0 | $12,797 | $0 | $556,240 | $0 | $0 | $0 |
| DAVID A GEER | ||||||||||||||
| PHYSICIAN | $441,510 | $0 | $0 | $0 | $9,938 | $0 | $5,700 | $0 | $13,658 | $0 | $470,806 | $0 | $0 | $0 |
| THURMAN K EVERETT | ||||||||||||||
| DIRECTOR | $0 | $350,002 | $0 | $0 | $0 | $14,503 | $0 | $51,752 | $0 | $0 | $0 | $416,257 | $0 | $0 |
| STEVEN W BROWN | ||||||||||||||
| DIRECTOR | $0 | $260,722 | $0 | $0 | $0 | $2,098 | $0 | $61,464 | $0 | $18,120 | $0 | $342,404 | $0 | $0 |
| GEORGE D FARR JR | ||||||||||||||
| DIRECTOR (CHAIRMAN) | $0 | $191,214 | $0 | $0 | $0 | $1,910 | $0 | $36,135 | $0 | $15,406 | $0 | $244,665 | $0 | $0 |
| WANDA B COOPER | ||||||||||||||
| DIRECTOR (SECRETARY) | $0 | $217,050 | $0 | $0 | $0 | $8,637 | $0 | $2,700 | $0 | $6,897 | $0 | $235,284 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CEO, VICE PRESIDENTS AND BOARD MEMBERS ARE OFFERED FREE MEMBERSHIPS TO ANDERSON HEALTH AND FITNESSS CENTER. WANDA B. COOPER AND GEORGE D. FARR, JR. RECEIVED FREE MEMBERSHIPS. |
| PART I, LINE 3 | THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE INC (APA) ARE COMPENSATED BY ARMC. AS SUCH, APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE (3) PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS AND HAS CONTRACTED FOR AND USED THE PROFESSIONAL SERVICES OF LOCKTON FOR THE CEO AND VICE PRESIDENTS. |
| PART I, LINE 4B | ARMC PROVIDES TO CERTAIN EXECUTIVES AN IRS SEC. 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE PURPOSE OF THIS PLAN IS TO OFFER PARTICIPATING EXECUTIVES TAXABLE DEFERRED COMPENSATION BENEFITS TO SUPPLEMENT SUCH EXECUTIVE'S RETIREMENT UNDER ARMC'S TAX-QUALIFIED RETIREMENT PLAN. THE PLAN SHALL BE UNFUNDED FOR TAX PURPOSES AND FOR PURPOSE OF TITLE I OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1975 ("ERISA"). SEE COMPENSATION SECTION FOR DETAIL INFORMATION ON PERSONS AND AMOUNTS. DURING THE 2021 CALENDAR YEAR DR. CODY AULL RECEIVED A PAYOUT OF HIS SUPPLEMENT RETIREMENT PLAN IN THE AMOUNT OF 145,404. THIS AMOUNT WAS INCLUDED IN HIS FORM W-2. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | UNLESS PROHIBITED OR LIMITED BY THE ARTICLES OF INCORPORATION OR THESE BYLAWS, THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE AND ONE OR MORE THAN OTHER COMMITTEES OF THE BOARD AND APPOINT MEMBERS OF THE BOARD OF DIRECTORS TO SERVE ON THEM. |
| FORM 990, PART VI, SECTION A, LINE 6 | ANDERSON REGIONAL MEDICAL CENTER (ARMC) IS THE SOLE MEMBER OF ANDERSON PHYSICIAN ALLIANCE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCISE ALL VOTING RIGHTS OF THE MEMBERS |
| FORM 990, PART VI, SECTION A, LINE 7B | ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APRROVE APA'S PHYSICIAN COMPENSATION MODELS, PHYSICIAN COMPENSATION AND PHYSICIAN COMPENSATION POLICIES, (2) TO APPROVE PHYSICIAN EMPLOYMENT AGREEMENTS, AND (3) TO INITIATE AND/OR APPROVE VARIOUS OTHER ACTIONS AND POLICIES AS ENUMERATED IN APA'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND AS REQUIRED BY STATE LAW. |
| FORM 990, PART VI, SECTION B, LINE 11B | EACH BOARD MEMBER WAS PROVIDED A COPY OF THE FORM 990. THE BOARD MEMBERS WERE ASKED TO REVIEW THE FORM AND SUBMIT QUESTIONS AND COMMENTS PROIR TO THE FORM 990 BEING FINALIZED. AFTER REVIEW, THE FINALIZED FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REQUESTS ALL BOARD MEMBERS TO ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE (APA) ARE COMPENSATED BY ARMC. AS SUCH APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS AND HAS CONTRACTED FOR AND USED THE PROFESSIONAL SERVICES OF LOCKTON FOR THE CEO AND VICE PRESIDENTS. |
| FORM 990, PART VI, SECTION C, LINE 18 | IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ARTICLES OF INCORPORATION ARE ON FILE AND ARE AVAILABLE TO THE PUBLIC AT THE MISSISSIPPI SECRETARY OF STATE'S OFFICE. THE BYLAWS AND THE CONFLICT OF INTEREST POLICY ARE NOT PUBLICLY AVAILABLE. THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AS A PART OF THE 990 FORM AS CONSOLIDATED FINANCIALS OF ARMC. |
| FORM 990, PART VI, LINE 1: INDEPENDENCE OF VOTING BOARD MEMBERS: | THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE SOLE MEMBER ORGANIZATION HAS A FIFTY PERCENT INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER AND ITS AUTHORITY. |
| FORM 990; PART XII; LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDERSON REGIONAL MEDICAL CENTER | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 640362400 | HEALTHCARE | MS | 501(C)(3) | LINE 3 | N/A | 0 | |
| MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION | |||||||||||
| 122 WOODMONT WAY | RIDGELAND | MS | 39157 | 640722433 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | LINE 12C, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION | |||||||||||
| 7651 POPLAR SPRINGS DR | MERIDIAN | MS | 39305 | 640730109 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | LINE 12D, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| MIRACLES OF GRACE FOUNDATION | |||||||||||
| 1827 SUNRISE LANE | TOOMSUBA | MS | 39364 | 640730366 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | LINE 12C, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| CARE CONSISTENCY FOUNDATION INC | |||||||||||
| 7761 MEADOW CIRCLE | MERIDIAN | MS | 39305 | 640730846 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | LINE 12D, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST MISSISSIPPI ENDOSCOPY CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1926 23RD AVENUE | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440884792 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMC HOSPITAL PROF & GEN LLFT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 512 22ND AVENUE | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 206131090 | EIN |
| Primary Activities | TRUST | PrimaryActivitiesTxt |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |