2023-08-15T09:49:08-05:00 2022-09-30 FORVIS LLP 1400 Meadowbrook Road Suite 300 Jackson MS 392116349 990 2021-10-01 640668465 Clay County Medical Corporation % KRISTY DUKE CLAY 6623773978 830 South Gloster Street Tupelo MS 38801 SHARON NOBLES CFO 6623773978 2023-06-30 true SHARON NOBLES 999009999 Amber Sherrill CPA P00748683 6019486700 2 2021 2023-04-26 12:10:37Z SHARON NOBLES 830 South Gloster Street Tupelo MS 38801 48997832 false X www.nmhs.net/westpoint/ X 1982 DE Clay County Medical Corporation operates a 60 bed acute-care hospital and related outpatient care facilities in West Point, Mississippi. 12 11 373 19 0 0 987297 2298901 42369407 46415636 82263 -106960 698501 262044 44137468 48869621 0 0 0 0 23706967 23953002 0 0 0 18928133 20639426 42635100 44592428 1502368 4277193 32451173 39018764 20196917 21845654 12254256 17173110 X CLAY COUNTY MEDICAL CORPORATION OWNS AND OPERATES A 60 BED ACUTE-CARE HOSPITAL AND RELATED OUTPATIENT CARE FACILITIES IN WEST POINT, MISSISSIPPI CALLED NORTH MISSISSIPPI MEDICAL CENTER-WEST POINT (NMMC-WEST POINT). NMMC-WEST POINT IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ORGANIZATION. THE MISSION OF NMHS IS TO CONTINUOUSLY IMPROVE THE HEALTH OF THE PEOPLE OF OUR REGION. NMMC-WEST POINT WORKS TO ACHIEVE THIS CORPORATE MISSION TO IMPROVE THE HEALTH OF THE PEOPLE OF THIS REGION BY PROVIDING CONVENIENTLY ACCESSIBLE, COST-EFFECTIVE HEALTH CARE OF THE HIGHEST QUALITY. false false 42726074 0 46415636 NMMC-West Point serves Clay County and the surrounding area. In fiscal year 2022, there were 1,133 inpatient admissions, 15,938 emergency department visits, 86,555 outpatient visits, 30,762 rural health clinic visits, and 17,771 visits to other hospital clinics. NMMC-West Point uses Press Ganey, the largest patient satisfaction survey company in the nation, that works with more than 7,000 healthcare facilities. Randomly selected patients are asked about their experience with inpatient, outpatient, ER, and long term care services. NMMC-West Point's remarkable design was inspired by the history and culture of this charming Southern community. Medical-surgical patient rooms are entered from a foyer area and open onto a private terrace. Rooms are "nested," which means four to six rooms are clustered around each nursing unit. This design reduces walking distance, allows nurses to view several patients from a central point, and provides closer access to medical equipment. Surgeons utilize four operating suites for a wide array of cases, including general, orthopedic and obstetrics-gynecology. The Same Day Surgery Unit features six rooms for outpatient surgery patients to rest before and after their procedure, as well as two endoscopy suites. The six-bed Intensive Care Unit offers invasive and non-invasive monitoring for medical and surgical patients. The hospital also has 10 licensed swing beds for patients who need extended care. The Women's Pavilion provides family-centered maternity services in a homelike environment. Mothers labor, deliver and recover in the same comfortable room. The nursery is equipped to care for healthy newborns as well as provide immediate stabilization of infants requiring intensive care. NMMC-West Point offers 24-hour emergency services at the Level III Trauma Center, as well as a paramedic-level ambulance service. Outpatient services include cardiac and pulmonary rehabilitation programs, as well as physical, occupational and speech-language therapy. Cardiac stress tests and holter monitoring are also offered. One of the primary ways NMMC-West Point serves the community is by providing care to various populations for which it receives no compensation or receives compensation at rates significantly less than established rates. The board of directors of NMMC-West Point has established a policy under which the hospital provides care, without charge, to needy members of its community. THE FINANCIAL ASSISTANCE POLICY STATES THAT NMMC-WEST POINT WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS FREE OF CHARGE WITH HOUSEHOLD INCOME LEVELS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. THE POLICY FURTHER PROVIDES, PATIENTS WITH HOUSEHOLD INCOME LEVELS BETWEEN 101% AND 150% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE TO RECEIVE SERVICES AT A DISCOUNTED RATE. THE DISCOUNT WILL BE PRO-RATED BASED ON THE PATIENT'S GROSS FAMILY INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY LEVEL. The policy applies to individuals who reside in Clay County. Patients from outside the county may also be granted charity care based on the judgment of NMMC-West Point management depending on their individual circumstances. The policy also requires the patient to cooperate fully with NMMC-West Point's request for information with which to verify the patient's eligibility. Following that policy, the hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. Charges forgone, based on established rates, totaled approximately $4,576,323 in fiscal year 2022. Based on the gross charges provided to charity patients compared to total hospital gross charges, 3.96% of all services in fiscal year 2022 were provided on a charity basis. The net cost of charity care provided by NMMC-West Point was approximately $1,743,488 in fiscal year 2022. The total cost estimate is based on the ratio of costs to charges for NMMC-West Point. All of the foregone charges mentioned above are netted against patient service revenue to arrive at net patient service revenue as reflected as program service revenue on Part VIII of Form 990 in order to be consistent with financial statement reporting and are not reported as functional expenses on the tax return. 42726074 true true false false false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 40 0 true 373 true false false false false false false false false false false false false X 12 11 false false false false true true true true true false false false true true true true true true true false X KRISTY DUKE 6623773977 830 GLOSTER STREET Tupelo MS 38801 X Michael S Spees President & CEO 0.5 39.5 X 0 2719746 24518 Sharon Nobles Treasurer & CFO 1.0 39.0 X 0 1217017 15756 Bruce Toppin Secretary 1.0 39.0 X 0 913073 14472 Edmund M Miller Director 1.0 0.0 X 0 534543 30768 KENNETH R THOMAS PHYSICIAN 40.0 0.0 X 514802 0 8352 WOODROW W BRAND PHYSICIAN 40.0 0.0 X 436546 0 7152 Barry Keel Administrator 40.0 0.0 X 369115 0 11599 Andrzej J Wartak Physician 40.0 0.0 X 333859 0 25518 Edmund A Miller Physician 40.0 0.0 X 342608 0 11800 Elisabeth F Hale CRNA 40.0 0.0 X 295238 0 13406 DWIGHT DYESS DIRECTOR 1.0 0.0 X 0 0 0 Mary Ann Briggs Chairman 1.0 0.0 X X 0 0 0 Karen Mooney Director 1.0 0.0 X 0 0 0 Tim O'Brien Director 1.0 0.0 X 0 0 0 Joe Stevens Director 1.0 0.0 X 0 0 0 Ronald E Powell DO Director 1.0 0.0 X 0 0 0 Billy Milican Director 1.0 0.0 X 0 0 0 William Sugg Jr Vice Chairman 1.0 0.0 X X 0 0 0 Alice Pitts Director 1.0 0.0 X 0 0 0 Fred Zepponi III Director 1.0 0.0 X 0 0 0 LISA KLUTTS DIRECTOR 1.0 0.0 X 0 0 0 2292168 5384379 163341 34 false true false RELIAS EMERGENCY MED SPECIALIST OF PO BOX 30695 CHARLOTTE NC 38802 ER PHYSICIAN 1429329 MID SOUTH REHAB SERVICES 599C STEED ROAD RIDGELAND MS 39157 Physical Therapy 705832 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 303682289 Food & Nutr MGMT 332303 PONTCHARTRAIN LITHOTRIPSY LLC PO BOX 96024 LAS VEGAS NV 891936024 LITHOTRIPTOR RENTAL 395220 CROSS COUNTY STAFFING INC PO BOX 404674 ATLANTA GA 303844674 NURSING COVERAGE 127290 7 10417 2288484 2298901 Net Patient Service Revenue 622110 45369802 45369802 MOB RENTAL INCOME 531120 444252 444252 340B REVENUE 622110 375190 375190 WELLNESS CENTER REVENUE 621111 226077 226077 CAFETERIA INCOME 722310 315 315 46415636 21251 21251 0 0 0 0 0 128211 -128211 -128211 -128211 0 0 0 0 0 0 0 0 0 Employee Drug Sales 446110 142323 142323 VENDOR REBATES 900099 75257 75257 MSU IMAGING FEES 900099 31330 31330 13134 0 13134 262044 48869621 46415636 0 155084 X 0 0 0 0 376479 376479 0 19884331 19265687 618644 447481 447481 1877368 1877368 1367343 1234381 132962 416028 416028 8066 8066 43620 43620 0 0 0 5557287 5551962 5325 0 75264 75264 777845 777845 646031 646031 0 1348179 1348179 80832 80832 0 48626 48626 54117 54117 0 1568714 1568714 265230 265230 MEDICAL SUPPLIES 9383255 9383255 Repairs and Maintenance 141930 141930 Collection Fees 130775 130775 Dues and Subscriptions 110496 110496 -16869 -16869 44592428 42726074 1866354 0 2535 2740 1257293 959163 0 0 3057110 4243116 0 0 0 0 0 0 1076403 1131666 119739 256413 44531032 35051242 10100011 9479790 0 0 0 0 0 0 0 0 16838082 22945876 32451173 39018764 7937372 5848745 0 0 0 0 0 0 0 0 0 0 2579006 2336045 0 0 9680539 13660864 20196917 21845654 X 12219353 17136174 34903 36936 12254256 17173110 32451173 39018764 X 4277193 641661 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 471036 471036 17689487 12268019 5421468 0 0 0 23467745 20395938 3071807 2902764 2387285 515479 9479790 Deferred Compensation 969656 Other Receivables 19980 Int. in Net Assets of Aff.Fdn 36936 Due from Third Party Payors 333359 Other Asset 21115859 RIGHT OF USE LEASES 470086 22945876 0 Due to Third Party Payors 3608866 Due to Affiliates 9581912 LEASE LIABILITY 470086 13660864 49433103 563482 563482 48869621 48869621 45155910 563482 563482 44592428 44592428 FORM 990, SCHEDULE D, Part X, Line 2: MANAGEMENT HAS EVALUATED ITS INCOME TAX POSITIONS UNDER GUIDANCE INCLUDED IN ASC 740. BASED ON ITS REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, SCHEDULE D, PART XI, LINE 2D PENSION COST INCLUDED IN REVENUE PER AUDIT $563,482 FORM 990, SCHEDULE D, PART XII, LINE 2D PENSION COST INCLUDED IN REVENUE PER AUDIT $563,482 true true X true X true X true true true false true true 1743488 1743488 0.03910 8026037 9526143 9769525 9526143 1743488 0.03910 9769525 9526143 1743488 0.03910 false 11446505 11012813 433692 X true true 1 1 Clay County Medical Corporation 835 Medical Center Drive West Point MS 39773 http://www.nmhs.net/westpoint/ 13-312 X X X Clay County Medical Corporation 1 false false true X X X X X X X X X 21 true true false true X SEE PART V, SECTION C X true 21 true SEE PART V, SECTION C false true X 150. 200. X X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM THE COMMUNITY WAS RECEIVED VIA INFORMANT INTERVIEWS, STANDARDIZED ELECTRONIC SURVEYS FROM KEY ORGANIZATIONS/STAKEHOLDERS, HEALTHCARE ADVOCATES/LEADERS, AND INTERESTED COMMUNITY PARTNERS RESIDING IN THE SERVICE AREAS SERVED BY NORTH MISSISSIPPI MEDICAL CENTER-WEST POINT AND THE HEALTH SYSTEM IN ADDITION TO COLLECTING SOCIAL AND DEMOGRAPHIC DATA FROM SECONDARY SOURCES, ADDITIONAL INPUT WAS SOLICITED FROM COMMUNITY RESIDENTS WHO REPRESENT BROADLY DIVERSE INTERESTS OF THE SERVICE AREA RANGING FROM NONPROFIT COMMUNITY VOLUNTEERS TO RETIRED EDUCATORS, BANKERS AND PRIVATE BUSINESS LEADERS FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A Clay County Medical Corporation is part of the North Mississippi Health Services' diversified regional healthcare system. North Mississippi Health Services operates six community hospitals in addition to Clay County Medical Corporation. The CHNA included Clay County Medical Corporation, North Mississippi Medical Center, Pontotoc Health Services, Webster Health Services, Tishomingo Health Services, Marion Regional Medical Center, and Monroe Health Services. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7B & 10A https://www.nmhs.net/about-us/community-benefit/ FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11: THE NEEDS OF THE COMMUNITY GO BEYOND THE RESOURCES OF THE ORGANIZATION WITH THE NON-EXPANSION OF MEDICAID IN THE STATE AND THE REDUCTION IN MEDICAID PAYMENTS AS WELL AS A SIGNIFICANT INCREASE IN UNINSURED. THE ORGANIZATION FOCUSES ON PROVIDING ACCESS TO BASIC HEALTHCARE NEEDS INCLUDING: A. INCREASE ACCESS TO PREVENTIVE SERVICE - EXPAND VIRTUAL/TELEHALTH OFFERINGS - COLLABORATE TO EXPLORE TRANSPORTATION NEEDS - INITIATE INNOVATIVE LISTEN-TO-LEARN COMMUNITY SESSIONS - UTILIZE PARTNERS TO ASSIST THOSE WITH LIMITED OR NO INSURANCE - INCREASE AFFORDABLE AFTER-HOURS CARE - IMPROVE ACCESS TO SPECIALTY CARE B. INCREASE PHYSICAL ACTIVITY AND PROMOTE EXERCISE AS MEDICINE - PARTNER WITH LOCAL WELLNESS CENTERS & GYMS - DEVELOP PARTNERSHIPS WITH LOCAL PARKS/RECREATION FACILITIES - UTILIZE EXERCISE "PRESCRIPTIONS" - ORGANIZE WALKING CLUBS - PROMOTE CORPORATE WELLNESS PROGRAMS - IDENTIFY COMMUNITY RESOURCES, E.G. TRAILS, WALKINGS TRACKS, ETC. C. DEVELOP A NUTRITIONALLY AWARE COMMUNITY CULTURE - SCREEN FOR AND CREATE ACCESS TO NUTRITIOUS FOODS - DEVELOP CULTURALLY-APPROPRIATE EDUCATIONAL PROGRAMS - DEVELOP COMMUNITY COALITIONS TO PROVIDE FRESH FOOD/PROMOTE COMMUNITY GARDENS - TEACH FOOD PRESERVATION SKILLS - UTILIZE ESTABLISHED NETWORKS TO PROMOTE NUTRITION D. DEVELOP PARTNERSHIPS WITH PUBLIC ENTITIES - PUBLIC HEALTH -- STATE AND REGIONAL OFFICES - EDUCATIONAL INSTITUTIONS -- EARLY CHILDHOOD, PRIMARY, SECONDARY, AND POST-SECONDARY - GOVERNMENT -- STATE, REGIONAL, AND LOCAL FORM 990, SCHEDULE H, PART V, SECTION B, LINE 13H: THE FAP DOES NOT COVER CHARGES FOR PATIENTS OR TREATMENTS WITH THE FOLLOWING CONDTIONS: I. THE PATIENT HAS ANY THIRD-PARTY INSURANCE COVERAGE. A DISCRETIONARY EXCEPTION MAY BE MADE FOR INSURED PATIENTS IS THE PROVISOIN FOR THE MEDICALLY UNDER-INSURED II. THE PATIENTS PRIMARY RESIDENCE IS OUTSIDE THE SERVICE AREA III. THE PATIENT IS CURRENTLY IN CUSTODY OF A CORRECTIONAL FACILITY IV. THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ANOTHER CITY, COUNTY, STATE, FEDERAL OR OTHER ASSISTANCE PROGRAM WHICH SUPERSEDES THE FAP. V. IF PATIENTS CHARGES RESULTED FROM A WORK-RELATED ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE. VI. IF PATIENT CHARGES RESULTED FROM AN AUTO ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE THE FINANCIAL ASSISTANCE POLICY IS NOT APPLICABLE TO PHYSICIANS OR THEIR IMMEDIATE FAMILY MEMBERS. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C https://www.nmhs.net/patient-family-information/financial-assistance/ 8 Clay County Medical Corp Wellness Center 185 Medical Center Drive West Point MS 39773 Wellness Center WEST POINT PRIMARY CARE 977 EMERGENCY DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC WEST POINT CHILDREN'S RHC 63 MEDICAL CENTER DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC NORTH MS SURGERY CLINIC 187 MEDICAL CENTER DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC NMMC RADIATION ONCOLOGY - STARKVILLE 1205 HIGHWAY 182 WEST STARKVILLE MS 39759 RURAL HEALTH CLINIC NORTH MS CANCER CARE - STARKVILLE 1205 HIGHWAY 182 WEST STARKVILLE MS 39759 RURAL HEALTH CLINIC NORTH MS UROLOGY 100 WILBURN WAY SUITE A STARKVILLE MS 39759 UROLOGY CLINIC STARKVILLE MEDICAL CLINIC 100 WILBURN WAY SUITE B STARKVILLE MS 39759 RURAL HEALTH CLINIC FORM 990, SCHEDULE H, Part I, Line 3c CLAY COUNTY MEDICAL CORPORATION USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. IF THE PATIENT'S INCOME LEVEL IS 0-150% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 200% OF THE FPL, THE HOSPITAL MAY OFFER DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE. FORM 990, SCHEDULE H, Part I, Line 6a Clay County Medical Corporation's community benefit information is included in the community benefit report of its parent company, North Mississippi Health Services, Inc. North Mississippi Health Services (NMHS) is a diversified regional health care organization, which serves 24 counties in north Mississippi and northwest Alabama from headquarters in Tupelo, MS. The NMHS organization covers a broad range of acute diagnostic and therapeutic services, offered through North Mississippi Medical Center in Tupelo; a community hospital system with locations in Eupora, Iuka, Pontotoc, West Point, Amory, MS, and Hamilton AL; North Mississippi Medical Clinics, a regional network of 27 primary and specialty clinics; and nursing homes. NMHS offers a comprehensive portfolio of managed care plans. FORM 990, SCHEDULE H, Part I, Line 7 A cost to charge ratio was used for the amounts reported in the table for Line 7. The cost to charge ratio for Line 7 was calculated using Worksheet 2. FORM 990, SCHDULE H, Part III, Line 2-4 Clay County Medical Corporation's financial statements do not include a footnote specifically concerning bad debt. Bad debt is shown as a separate line item on the face of the income statement. The amount of bad debt booked each year is based on a review of outstanding receivables and their age from date of service. The older the account, the higher the reserve percentage used to estimate bad debt. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluations and specific circumstances of the account. Clay County Medical Corporation (CCMC) follows the Catholic Health Association guidelines and does not include bad debt in any community benefit amounts. CCMC believes that some portion of bad debt results from patients who could qualify for charity care but has no way of making an estimate of the amount and therefore has answered "zero" for Part III Line 3. THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2022. FORM 990, SCHEDULE H, Part III, Line 8 The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. Lines 5, 6, & 7 do not include certain Medicare programs and costs and thus do not reflect all of the organization's revenues and costs associated with its participation in Medicare programs. Additional revenues and costs not reported on Lines 5, 6, & 7 include those associated with the organization's Medicare outpatient lab, ambulance and therapy services. Total revenues from these activities were $433,964 and total costs were $629,332 for a net shortfall of $195,368. When combined with the surplus reported on Line 7, the net surplus from all Medicare programs is $238,324. FORM 990, SCHEDULE H, Part III, Line 9b Clay County Medical Corporation does not pursue collection of amounts determined to qualify as charity care. For patients who qualify for charity care or financial assistance and who are cooperating in good faith to resolve their discounted hospital bills, the hospitals may offer extended payment plans, will not send unpaid bills to outside collection agencies, and will cease all collection efforts. FORM 990, SCHEDULE H, Part VI, Line 2 Needs Assessment Clay County Medical Corporation utilizes varied but complimentary methods to assess the health care needs of the community it serves. Clay County Medical Corporation and Clay County are included in the North Mississippi Health Services Community Health Assessment which is performed every three years and provides information on health status, utilization of health services, healthy beliefs and satisfaction with health care services. The North Mississippi Health Services Community Health Assessment covers the 24 county service area including Clay County and provides information by county. In addition, the North Mississippi Health Services Community Relations Facilitator conducts routine visits with our internal and external stakeholders across the entire service area including Clay County. The information gathered through several qualitative survey questions is used to determine our community's needs for the entire service area as well as the local service area for each hospital such as Clay County Medical Corporation. FORM 990, SCHEDULE H, Part VI, Line 3 Patient Education of Eligibility for Assistance Explanations of the Clay County Medical Corporation charity care policy are communicated in a variety of forms including signage at all admission and registration areas, on the web site, on bills and statements, and in admission packets. Financial counselors assist the patient and responsible parties with determining eligibility for government programs, primarily Medicaid, and charity care status. The patient can apply for charity care at any time from the date of service through the collection process and once qualified and approved all collection efforts are stopped. FORM 990, SCHEDULE H, Part VI, Line 4 Community Information Clay County Medical Corporation serves more than 19,000 people in Clay County, MS and the surrounding area. The population for the service area is projected to remain essentially flat over the next five years. According to the U.S. CENSUS BUREAU, age demographics for the service area show that approximately 22% of the population is under 18 years of age, approximately 60% is between 18 and 64 years of age and that 18% is 65 or older. Caucasians make up 38% of the service area's population while African Americans make up 59% and Hispanics and other make up 3%. Median household income was $36,536 for the service area, which is below the overall average for Mississippi and significantly less than the nationwide average. THE PERCENTAGE OF CLAY COUNTY MEDICAL CORPORATION'S PATIENT POPULATION UNDER 65 WITHOUT HEALTH INSURANCE IS 14.8% WHICH IS HIGHER THAN THE STATE OF MISSISSIPPI AND THE U.S. FORM 990, SCHEDULE H, Part VI, Line 5 Promotion of Community Health Clay County Medical Corporation has a commitment to a wide variety of community health outreach activities, which are coordinated by the community health coordinator and are staffed by Clay County Medical Corporation employees who volunteer their time to help with these events and activities. The community health coordinator assists in educating the community on health-related issues by organizing and presenting various health fairs and seminars. These events are held at local businesses, schools and community organizations and address a variety of health-related topics. In addition, the hospital sponsors cholesterol, blood pressure, vision, memory, and heart-risk screening events, through which tests are made available to the public for a nominal fee or at no charge with the majority of the costs incurred absorbed by the hospital. FORM 990, SCHEDULE H, Part VI, Line 6 Affiliated Health Care System As noted above, Clay County Medical Corporation (CCMC) is part of North Mississippi Health Services (NMHS). NMHS operates North Mississippi Medical Center, five other community hospitals in addition to CCMC, as well as, North Mississippi Medical Clinics, which operates more than 36 medical clinics. Some of these facilities operate at an ongoing financial loss and NMHS provides operating funds in the form of working capital loans that have no set repayment date. These working capital loans have historically been converted to capital transfers in many cases, and therefore, the loans are forgiven such that the facility never makes repayment. NMHS does this in order to provide access to a variety of services across the service area and is an intentional part of its business model. The Community Health department that is part of NMMC coordinates a variety of community health activities across the service area as well. FORM 990, SCHEDULE H, Part VI, Line 7 State Filing of Community Benefit Report Clay County Medical Corporation does not file a community benefit report with the state of Mississippi as there is no requirement to do so. false true false false false false false true false Bruce Toppin Secretary 0 335156 0 348018 0 229899 0 5800 0 8672 0 927545 0 0 Michael S Spees President & CEO 0 1006122 0 1522351 0 191273 0 17400 0 7118 0 2744264 0 0 Sharon Nobles Treasurer & CFO 0 541246 0 653770 0 22001 0 8700 0 7056 0 1232773 0 0 Barry Keel Administrator 240116 0 102842 0 26157 0 9925 0 1674 0 380714 0 0 0 Edmund A Miller Physician 219720 0 100340 0 22548 0 6694 0 5106 0 354408 0 0 0 Andrzej J Wartak Physician 237192 0 93619 0 3048 0 21750 0 3768 0 359377 0 0 0 Edmund M Miller Director 0 223968 0 290835 0 19740 0 26100 0 4668 0 565311 0 0 Elisabeth F Hale CRNA 294704 0 534 0 0 0 11732 0 1674 0 308644 0 0 0 KENNETH R THOMAS PHYSICIAN 479011 0 35551 0 240 0 0 0 8352 0 523154 0 0 0 WOODROW W BRAND PHYSICIAN 395971 0 39543 0 1032 0 0 0 7152 0 443698 0 0 0 FORM 990, SCHEDULE J, Part I, Line 3: NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ESTABLISHES THE PAY OF THE CEO AND COMPENSATES HIM. NMHS USES THE FOLLOWING METHODS FOR ESTABLISHING THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, SCHEDULE J, Part I, Line 4b: The following people participated in or received payment from a supplemental nonqualified retirement plan: Michael Shane Spees - $131,709 Bruce Toppin - $197,951 FORM 990, SCHEDULE J, Part I, Line 7 PHYSICIAN BONUSES ARE ALL CONTINGENT INCOME DEPENDING UPON EITHER THE NUMBER OF SERVICES PROVIDED OR THE QUALITY OF PERFORMANCE PERFORMED. ALL ARE SPECIFIED IN THEIR CONTRACTS. ANY OTHER INCENTIVES ARE PAID OUT AS CONTINGENT INCOME ALSO BASED ON QUALITY AND FINANCIAL PERFORMANCE METRICS. Form 990, Part VI, Section A, Line 6 Clay County Medical Corporation is a not-for-profit, nonstock, membership corporation of which North Mississippi Health Services, Inc. is the sole member and has sole voting control. Form 990, Part VI, Section A, Line 7a The Governance Committee of North Mississippi Health Services, Inc. (NMHS), which is made up of past Chairmen, nominate candidates for the Board. These candidates are then approved by the Board of NMHS. Form 990, Part VI, Section A, Line 7b The Board of North Mississippi Health Services, Inc. approves all transactions that exceed $1 million. Form 990, Part VI, Section B, Line 11b The Form 990 goes through a review process in the Accounting Department. The accountant for each facility reviews the return for reasonableness and accuracy. All totals are tied to the audit reports, and all amounts are cross-referenced to schedules or other parts of the actual return. Once the accountant reviews, the Accounting Supervisor and the Director of Accounting reviews. The Supervisor does a detailed review by checking the return for the same items that the accountant checked for. Then the Director does a more high level review, reading the return for reasonableness and comparing prior year amounts to current year amounts. Finally, the VP of Finance reviews the return for reasonableness. The returns are then sent to the Executive VP/Treasurer to be reviewed. The Chief Financial Officer signs the return and it is then sent to the IRS. Form 990, Part VI, Section B, Line 12c An annual conflict of interest questionnaire is required to be completed by all officers and directors of the organization. The questionnaire is reviewed by North Mississippi Health Services, Inc.'s compliance officer and Conflict Committee. The Conflict Committee reviews conflict transactions and makes recommendations to the board of directors regarding conflict transactions in accordance with the organization's conflict of interest policy. All members of the Conflict Committee are prohibited from engaging in transactions with the organization or its affiliates during their tenure on the Conflict Committee and one year after their service concludes. Form 990, Part VI, Section B, Line 15A & 15B AN INDEPENDENT COMPENSATION CONSULTING FIRM, KORN FERRY, IS USED TO HELP ESTABLISH THE COMPENSATION OF THE SENIOR EXECUTIVES. THE FIRM PRESENTS THEIR INDEPENDENT ANALYSIS, WHICH CONTAINS COMPARABILITY DATA, TO THE COMPENSATION COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS). THE COMPENSATION OF THE INDIVIDUALS ARE THEN APPROVED BY THE COMPENSATION COMMITTEE. THE SALARIES OF NMHS' SENIOR EXECUTIVES ARE THEN REVIEWED BY THE NMHS BOARD OF DIRECTORS. THE INDIVIDUAL WHOSE COMPENSATION IS BEING DISCUSSED IS NOT PRESENT DURING THE DISCUSSION OR APPROVAL OF THEIR COMPENSATION. THE DISCUSSIONS AND DECISIONS REGARDING THE COMPENSATION ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS. COMPENSATION OF THESE INDIVIDUALS IS APPROVED ANNUALLY. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. A consolidated statement of operations is available on the organization's website. Form 990, Part XI, Line 9 PENSION RELATED CHANGES $351,898 INTEREST IN NET ASSTS OF AFFILIATED FOUNDATION $2,032 CONTRIBUTED CAPITAL $287,731 ------------------------------------------------------------- TOTAL OTHER CHANGES IN NET ASSETS $641,661 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:3239974 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT EMPLOYEES TOTAL FEES:818630 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:1498683 North MS Management Services Inc 830 S Gloster Street Tupelo MS 38801 640762694 Mgmt & Admin DE 501(c)(3) 12-I NMHS true North MS Health Services Inc 830 S Gloster Street Tupelo MS 38801 640653269 Mgmt Services DE 501(c)(3) 12-II NA false North MS Medical Center Inc 830 S Gloster Street Tupelo MS 38801 640662976 Hospital DE 501(c)(3) 3 NMHS true Tishomingo Health Services Inc 830 S Gloster Street Tupelo MS 38801 640741047 Hospital DE 501(c)(3) 3 NMHS true Pontotoc Health Services Inc 830 S Gloster Street Tupelo MS 38801 640751410 Hospital DE 501(c)(3) 3 NMHS true North MS Medical Clinics Inc 830 S Gloster Street Tupelo MS 38801 640787918 Med Clinics DE 501(c)(3) 3 NMHS true Tupelo Service Finance Inc 830 S Gloster Street Tupelo MS 38801 640508308 Collections DE 501(c)(3) 3 NMHS true Webster Health Services Inc 830 S Gloster Street Tupelo MS 38801 640819193 Hospital DE 501(c)(3) 3 NMHS true Marion Regional Medical Center Inc 830 S Gloster Street Tupelo MS 38801 640926753 Hospital DE 501(c)(3) 3 NMHS true North MS Emergency Services Inc 830 S Gloster Street Tupelo MS 38801 640780130 ER Physicians DE 501(c)(3) 10 NMHS true Monroe Health Services 830 South Gloster Street Tupelo MS 38801 320583236 Hospital DE 501(c)(3) 3 NMHS true Health Care Foundation of North MS 830 S Gloster Street Tupelo MS 38801 640914704 FUNDRAISING DE 501(C)(3) 7 NMHS true North MS Ambulatory Surgery Center LLC Tupelo MS 38801 200145190 Ambulatory Surg MS NA false false Medical Imaging LLC Tupelo MS 38801 770647210 Medical Imaging MS NA false false Cntr for Digestive Health LLC Tupelo MS 38801 201606438 Digestive Care MS NA false false North MS Health Link Inc 830 S Gloster Street Tupelo MS 38801 640715886 Medical Servi DE NA C Corp true North MS Enterprises Inc 830 S Gloster Street Tupelo MS 38801 640658059 Medical Servi DE NA C Corp true Professional Practice Management Inc 830 S Gloster Street Tupelo MS 38801 721390014 Med Ser Mgmt DE NA C Corp true Acclaim Inc 830 S Gloster Street Tupelo MS 38801 721356116 Hlth Care Cla DE NA C Corp true North MS Support Services Inc 830 S Gloster Street Tupelo MS 38801 260718275 Support Servi DE NA C Corp true false false true false false false false false false true true false true false true true true true true