DARDANELLE REGIONAL LLC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- DARDANELLE REGIONAL LLC (EIN 83-4538290)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-13
- IRS object ID
- 202323179349308672
- Schema version
- 2022v5.0
- 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 | 2023-11-13T14:38:33-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | PO BOX 3667 | AddressLine1Txt |
| City | LITTLE ROCK | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 722033667 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 834538290 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARDANELLE REGIONAL LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ALAN FINLEY | InCareOfNm |
| Business Name Control | DARD | BusinessNameControlTxt |
| Phone | 4792296131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH 3RD STREET | AddressLine1Txt |
| City | DARDANELLE | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72834 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALAN FINLEY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5013293831 | PhoneNum |
| Signature | 2023-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALAN | PersonFirstNm |
| Person Last | FINLEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER SHERRILL | PreparerPersonNm |
| PTIN | P00748683 | PTIN |
| Phone | 5013721040 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALAN FINLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH 3RD STREET | AddressLine1Txt |
| City | DARDANELLE | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72834 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,948,026 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DARDANELLEREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LLC | OtherOrganizationDsc |
| Formation | 2019 | FormationYr |
| Legal Domicile State | AR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MANAGEMENT SERVICES TO ENSURE HEALTHCARE SERVICES ARE AVAILABLE TO CITIZENS OF YELL COUNTY, ARKANSAS AND THE SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 173 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $327,390 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,424,818 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,627,012 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,478,908 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,709 | PYInvestmentIncomeAmt |
| CY Investment Income | $12,430 | CYInvestmentIncomeAmt |
| PY Other Revenue | $117,319 | PYOtherRevenueAmt |
| CY Other Revenue | $31,870 | CYOtherRevenueAmt |
| PY Total Revenue | $17,081,430 | PYTotalRevenueAmt |
| CY Total Revenue | $18,948,026 | 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 | $8,655,737 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,330,635 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,435,725 | PYOtherExpensesAmt |
| CY Other Expenses | $8,921,440 | CYOtherExpensesAmt |
| PY Total Expenses | $16,091,462 | PYTotalExpensesAmt |
| CY Total Expenses | $19,252,075 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $989,968 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$304,049 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,058,761 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,956,952 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,289,181 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,491,421 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$230,420 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$534,469 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DARDANELLE REGIONAL, LLC PROVIDES HIGH QUALITY COMPASSIONATE HEALTH CARE SERVICES TO THE RIVER VALLEY AREA CONSISTENT WITH THE OVERALL MISSION OF CONWAY REGIONAL MEDICAL CENTER. DARDANELLE REGIONAL, LLC WILL PROVIDE MANAGEMENT SERVICES TO ENSURE HEALTHCARE SERVICES ARE AVAILABLE TO CITIZENS OF YELL COUNTY, ARKANSAS AND THE SURROUNDING AREAS BY OPERATING THE HOSPITAL THAT IS OWNED BY THE YELL COUNTY BOARD OF GOVERNORS FOR DARDANELLE HOSPITAL OF YELL COUNTY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,985,893 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $17,478,908 | RevenueAmt |
| Desc | DARDANELLE REGIONAL, LLC PROVIDES MANAGEMENT SERVICES TO ENSURE HEALTHCARE SERVICES ARE AVAILABLE TO CITIZENS OF YELL COUNTY, ARKANSAS AND THE SURROUNDING AREAS BY OPERATING THE HOSPITAL THAT IS OWNED BY THE YELL COUNTY BOARD OF GOVERNORS FOR DARDANELLE HOSPITAL OF YELL COUNTY. | Desc |
| Total Program Service Expenses | $14,985,893 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 173 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form1098 C Filed | Yes (true) | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALAN FINLEY | PersonNm |
| Phone | 4792294677 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH 3RD STREET | AddressLine1Txt |
| City | DARDANELLE | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72834 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|---|
| BILL PACK | ||||||||
| CHIEF FINANCIAL OFFICER | 5.0 | 35.0 | Yes (X) | Yes (X) | $0 | $284,509 | $1,431 | |
| REBEKAH FINCHER | ||||||||
| CAO | 1.0 | 36.0 | Yes (X) | Yes (X) | $0 | $222,901 | $23,197 | |
| CHRISTOPHER KEY | ||||||||
| PHARMACIST | 40.0 | 0.0 | $176,769 | $0 | $19,523 | Yes (X) | ||
| JACQUELINE LOYD | ||||||||
| RN | 40.0 | 0.0 | $146,721 | $0 | $17,810 | Yes (X) | ||
| SARAH GAINES | ||||||||
| NURSE COORDINATOR(RN) | 40.0 | 0.0 | $126,526 | $0 | $17,278 | Yes (X) | ||
| ALAN FINLEY | ||||||||
| SECRETARY BOARD OF GOVERNORS | 40.0 | 2.0 | Yes (X) | Yes (X) | $0 | $119,864 | $14,109 | |
| JACQUELINE HOLT | ||||||||
| DIRECTOR OF NURSING | 40.0 | 0.0 | $110,905 | $0 | $11,072 | Yes (X) | ||
| MATTHEW TROUP | ||||||||
| CHAIRMAN/CEO | 2.0 | 40.0 | Yes (X) | Yes (X) | $0 | $765 | $0 | |
| TROY BROOKS | ||||||||
| TREASURER/CFO | 5.0 | 40.0 | Yes (X) | Yes (X) | $0 | $325 | $0 | |
| ANGIE LONGING | ||||||||
| CHIEF NURSING OFFICER | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JERRY DAWSON | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARK THRONE | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| APRIL KRANZ | ||||||||
| CHIEF NURSING OFFICER | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $560,921 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $628,364 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $104,420 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FLAGG EMERGENCY GROUP PLLC | |||||
| PO BOX 677979 | DALLAS | TX | 75267 | ER PHYSICIANS | $1,055,699 |
| SLEEP PARTNER HOLDINGS LLC | |||||
| 501 MILWOOD CIRCLE | MAUMELLE | AR | 72113 | MEDICAL/HEALTH CARE | $339,722 |
| FORVIS LLP | |||||
| PO BOX 3667 | LITTLE ROCK | AR | 72203 | ACCOUNTING/AUDIT | $172,415 |
| SIGNET HEALTH CORPORATION | |||||
| 235 W HICKORY ST SUITE 201 | DENTON | TX | 76201 | MEDICAL MANAGEMENT | $771,864 |
| QUALIVIS INC | |||||
| 5930 CORNERSTONE COURT WEST STE 30 | SAN DIEGO | CA | 92121 | AGENCY STAFFING | $1,088,830 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,337,416 | GovernmentGrantsAmt |
| All Other Contributions | $87,402 | AllOtherContributionsAmt |
| Noncash Contributions | $6,300 | NoncashContributionsAmt |
| Total Contributions | $1,424,818 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $17,423,394 | $17,423,394 |
| 340B REVENUE | 621999 | $32,783 | $32,783 |
| CAFETERIA REVENUE | 722310 | $22,731 | $22,731 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,478,908 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,430 | TotalRevenueColumnAmt |
| Exclusion | $12,430 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $10,365 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $10,365 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,365 | TotalRevenueColumnAmt |
| Exclusion | $10,365 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICAL RECORDS REVENUE | 900099 | $2,730 | $2,730 |
| PURCHASE DISCOUNTS | 900099 | $36 | $36 |
| SALE OF ID BADGES | 900099 | $5 | $5 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,734 | TotalRevenueColumnAmt |
| Exclusion | $18,734 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,505 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,948,026 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,478,908 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $44,300 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,571,904 | TotalAmt |
| Program Services | $6,672,405 | ProgramServicesAmt |
| Management And General | $1,899,499 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,166 | TotalAmt |
| Program Services | $146,469 | ProgramServicesAmt |
| Management And General | $41,697 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,006,755 | TotalAmt |
| Program Services | $783,662 | ProgramServicesAmt |
| Management And General | $223,093 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $563,810 | TotalAmt |
| Program Services | $438,872 | ProgramServicesAmt |
| Management And General | $124,938 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,934,050 | TotalAmt |
| Program Services | $1,505,472 | ProgramServicesAmt |
| Management And General | $428,578 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,046 | TotalAmt |
| Program Services | $18,718 | ProgramServicesAmt |
| Management And General | $5,328 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,211 | TotalAmt |
| Program Services | $137,942 | ProgramServicesAmt |
| Management And General | $39,269 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,529,851 | TotalAmt |
| Program Services | $2,747,650 | ProgramServicesAmt |
| Management And General | $782,201 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,335 | TotalAmt |
| Program Services | $41,516 | ProgramServicesAmt |
| Management And General | $11,819 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,142 | TotalAmt |
| Program Services | $85,735 | ProgramServicesAmt |
| Management And General | $24,407 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,336 | TotalAmt |
| Program Services | $155,942 | ProgramServicesAmt |
| Management And General | $44,394 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,931 | TotalAmt |
| Program Services | $156,406 | ProgramServicesAmt |
| Management And General | $44,525 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,043 | TotalAmt |
| Program Services | $49,073 | ProgramServicesAmt |
| Management And General | $13,970 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,692 | TotalAmt |
| Program Services | $279,986 | ProgramServicesAmt |
| Management And General | $79,706 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $687,599 | TotalAmt |
| Program Services | $535,230 | ProgramServicesAmt |
| Management And General | $152,369 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,203 | TotalAmt |
| Program Services | $49,197 | ProgramServicesAmt |
| Management And General | $14,006 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $746,994 | $581,463 | $165,531 |
| LAB BILLING | $512,880 | $399,228 | $113,652 |
| FOOD | $96,484 | $75,104 | $21,380 |
| REPAIRS & MAINTENANCE | $73,533 | $57,238 | $16,295 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,110 | TotalAmt |
| Program Services | $68,585 | ProgramServicesAmt |
| Management And General | $19,525 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,252,075 | TotalAmt |
| Program Services | $14,985,893 | ProgramServicesAmt |
| Management And General | $4,266,182 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,400,517 | BOYAmt |
| EOY | $459,449 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,263,395 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,543,632 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,394 | BOYAmt |
| EOY | $361,895 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,369,790 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $822,500 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,218 | BOYAmt |
| EOY | $4,547,290 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,311,987 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $12,936 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,058,761 | BOYAmt |
| EOY | $11,956,952 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,121,748 | BOYAmt |
| EOY | $1,824,086 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,879,583 | BOYAmt |
| EOY | $4,556,480 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,287,850 | BOYAmt |
| EOY | $6,110,855 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,289,181 | BOYAmt |
| EOY | $12,491,421 | 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 | -$230,420 | BOYAmt |
| EOY | -$534,469 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$230,420 | BOYAmt |
| EOY | -$534,469 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,058,761 | BOYAmt |
| EOY | $11,956,952 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$304,049 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $432,460 | OtherCostOrOtherBasisAmt |
| Book Value | $432,460 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,881,175 | OtherCostOrOtherBasisAmt |
| Depreciation | $334,800 | DepreciationAmt |
| Book Value | $2,546,375 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,060 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,324 | DepreciationAmt |
| Book Value | $9,736 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,976,736 | OtherCostOrOtherBasisAmt |
| Depreciation | $455,385 | DepreciationAmt |
| Book Value | $1,521,351 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,359 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,991 | DepreciationAmt |
| Book Value | $37,368 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,547,290 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATE | $6,097,919 |
| ROU LIABILITY | $12,936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,110,855 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $18,948,026 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $18,948,026 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $18,948,026 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,252,075 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $19,252,075 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $19,252,075 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 225. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,661 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,741,782 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,563,303 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $178,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,790,443 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,563,303 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $227,140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,006,938 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $769,205 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,237,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06430 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,006,938 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $769,205 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,237,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,797,381 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,332,508 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,464,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07610 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $4,181,306 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,371,595 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$190,289 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARDANELLE REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH 3RD STREET | AddressLine1Txt |
| City | DARDANELLE | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72834 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DARDANELLEREGIONAL.ORG | WebsiteAddressTxt |
| State License | AR5844 | StateLicenseNum |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARDANELLE REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 2 | EFFECTIVE JANUARY 1, 2022 DARDANELLE REGIONAL, LLC TOOK OVER THE HOSPITAL LICENSE. IN PRIOR YEARS DARDANELLE REGIONAL WAS MANAGING THE HOSPITAL BUT DID NOT OWN THE LICENSE. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 | THE COUNTY HEALTH RANKINGS MODEL (CHRM) WILL GUIDE THE CONWAY REGIONAL HEALTH SYSTEM 2022 CHNA. THE COUNTY HEALTH RANKINGS ARE BASED ON A POPULATION HEALTH MODEL THAT INCLUDES BOTH HEALTH OUTCOMES (LENGTH AND QUALITY OF LIFE) AND HEALTH FACTORS. THE CHRM HEALTH FACTORS ARE DIVIDED INTO FOUR CATEGORIES: PHYSICAL ENVIRONMENT, SOCIAL AND ECONOMIC FACTORS, CLINICAL CARE, AND HEALTH BEHAVIORS. THE CHRM INCLUDES 30 MEASURES ACROSS THE FOUR CATEGORIES THAT DEFINES THE OVERALL HEALTH OF THE COUNTY. THE RESEARCH TEAM WILL UTILIZE BOTH PRIMARY AND SECONDARY DATA SOURCES TO GATHER INFORMATION FOR THE CHNA. THE RESEARCH TEAM FURTHER REFINED THE POTENTIAL COMMUNITY HEALTH FOCUS AREAS THROUGH TWO SUBSEQUENT RESEARCH METHODOLOGIES: 1) COMMUNITY SURVEY RESEARCH (APPENDIX B) AND 2) COMMUNITY FOCUS GROUPS. THESE APPROACHES ALLOWED THE RESEARCHERS TO ENGAGE WITH AND RECEIVE FEEDBACK FROM A BROAD RANGE OF STAKEHOLDERS AS PER THE IRS REQUIREMENTS FOR NON-PROFIT HOSPITALS. THE SURVEY LINK WAS DISTRIBUTED BY EMAIL TO MORE THAN 150 COMMUNITY STAKEHOLDERS INCLUDING PHYSICIANS, HOSPITAL OFFICIALS, CHURCHES, SCHOOLS, COMMUNITY AGENCIES, PUBLIC SAFETY, AND PUBLIC HEALTH REPRESENTATIVES ACROSS FAULKNER COUNTY. INCOMPLETE OR ABANDONED SURVEYS WERE EXCLUDED FROM THE DATA SET. AT THE CONCLUSION OF THE SURVEY ENDING JULY 10, 2022, 37 STAKEHOLDERS COMPLETED THE SURVEY FOR A RESPONSE RATE OF 24.6%. FOCUS GROUPS WERE HELD IN JULY AND AUGUST 2022 AND WERE DESIGNED TO ALLOW FOR DIRECT ENGAGEMENT WITH COMMUNITY MEMBERS ACROSS A RANGE OF DEMOGRAPHICS. SESSIONS WERE HELD AT COMMUNITY CENTERS AND CONWAY REGIONAL MEDICAL CENTER WITH A TOTAL OF 40 PARTICIPANTS. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A | CONWAY REGIONAL REHABILITATION HOSPITAL, CONWAY REGIONAL MEDICAL CENTER |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7A & 10A | https://www.dardanelleregional.org/about/mission-vision/community-health |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7B | CONWAYREGIONAL.ORG/ABOUT/MISSION-VISION/COMMUNITY-HEALTH |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7D | THE CHNA REPORT WAS MADE WIDELY AVAILABLE TO THE PUBLIC BY RELEASING TO LOCAL MEDIA, PROVIDING ACCESS ON THE HOSPITAL'S WEBSITE, AND MAKING HARD COPIES AVAILABLE IN THE ADMINISTRATIVE OFFICES. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 | FOUR MAJOR AREAS EMERGED FROM THE QUALITATIVE AND QUANTITATIVE DATA AS THE PRIMARY HEALTH NEEDS FOR OUR COMMUNITY: - OBESITY - ACCESS TO CARE - SUBSTANCE ABUSE - CHRONIC DISEASE MANAGEMENT AND DIABETES 1. OBESITY A. INCREASE AWARENESS FOR OBESITY MANAGEMENT OPTIONS I. BARIATRIC SERVICES: INCREASE PATIENT ENGAGEMENT IN BARIATRIC SURGERY FOR OBESITY MANAGEMENT. II. OBESITY MANAGEMENT: PARTNER WITH PRIMARY CARE PROVIDERS TO REFER PATIENTS FOR MEDICAL NUTRITIONAL THERAPY WITH DX OF OBESITY. IN ADDITION, EDUCATE AND PRESCRIBE PATIENT PHARMACOLOGICAL APPROACHES. 2. ACCESS TO CARE A. ENHANCE ACCESS POINTS FOR PATIENT TO RECEIVE CARE I. TELEHEALTH: CONTINUE TO MAKE THIS A FOCUS AND EXPAND SERVICES THROUGHOUT THE ORGANIZATION. II. MOBILE HEALTH UNIT: PROVIDE CARE OUTSIDE OF OUR PRIMARY CARE AND SPECIALTY CARE CLINICS. III. REMOTE PATIENT MONITORING: UTILIZE TECHNOLOGY TO ENABLE MONITORING OF PATIENTS OUTSIDE OF CLINICAL SETTINGS. IV. CONTINUE TO PROMOTE AND ENHANCE PATIENT NAVIGATION CENTER; ONE CALL FOR HEALTHCARE NAVIGATION. V. SATELLITE CLINICS: PROVIDE VARIOUS SPECIALTY CARE SERVICES THROUGH SATELLITE CLINICS. B. CONTINUED FOCUS ON PROVIDER RECRUITMENT I. RECRUITMENT: RECRUIT PROVIDERS FOR AREAS IDENTIFIED AS COMMUNITY NEEDS. II. GRADUATE MEDICAL EDUCATION: SINCE 2020, CONWAY REGIONAL HAS WELCOMED TWELVE FAMILY MEDICINE RESIDENTS, FIVE INTERNAL MEDICINE RESIDENTS, AND TWO RURAL TRACK FAMILY MEDICINE RESIDENTS. WE WILL CONTINUE TO SUPPORT AND ENGAGE WITH OUR GME PROGRAMS WHICH WHEN FILLED THERE WILL BE A TOTAL OF 33 RESIDENTS. 3. SUBSTANCE ABUSE A. INCREASE ACCESS TO TOBACCO CESSATION PROGRAMS I. PROVIDE OPPORTUNITIES FOR TOBACCO TREATMENT WITH TOBACCO TREATMENT SPECIALISTS AT DARDANELLE REGIONAL. II. INCREASE PUBLIC HEALTH INFORMATION REGARDING RISKS ASSOCIATED WITH TOBACCO USAGE AND TOBACCO TREATMENT. B. INCREASE ACCESS TO MENTAL HEALTH CARE I. TELEHEALTH: PROVIDE MORE ACCESS TO TELEHEALTH MENTAL HEALTH SERVICES. II. MOBILE HEALTH UNIT: PROVIDE MENTAL HEALTH CARE TO RURAL AREAS. 4. MANAGEMENT OF CHRONIC DISEASES & DIABETES A. IMPROVE CHRONIC DISEASE MANAGEMENT AND DIABETES MANAGEMENT I. INCREASE AVAILABILITY FOR HEART AND HEALTH WELLNESS SCREENINGS II. CREATE AND IMPLEMENT COMMUNITY HEALTH EDUCATION LECTURES III. INCREASE AVAILABILITY OF MEDICAL NUTRITION THERAPY AND DIABETES CARE MANAGEMENT IN YELL COUNTY |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C | dardanelleregional.org/patients-visitors/billing-insurance/insurance-costs |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, SCHEDULE H, PART I, LINE 3C | SEE SCHEDULE H, PART V, LINES 13 THROUGH 16 FOR ADDITIONAL INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY. |
| FORM 990, SCHEDULE H, PART I, LINE 7 | THE COST TO CHARGE RATIO (CALCULATED USING WORKSHEET 2) WAS USED FOR LINE 7 AMOUNTS. |
| FORM 990, SCHEDULE H, PART III, SECTION A, LINE 2 | DARDANELLE REGIONAL MEDICAL CENTER USES A COMPLEX CALCULATION TO IDENTIFY REQUIRED BAD DEBT RESERVES BASED ON HISTORICAL KNOWLEDGE ASSOCIATED WITH THE AGE OF ACCOUNTS, THE PAYERS, AND THE PATIENT TYPES. |
| FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4 | PLEASE SEE ATTACHED AUDIT REPORT, NOTE 1, PATIENT ACCOUNTS RECEIVABLE. |
| FORM 990, SCHEDULE H, PART III, SECTION B, LINE 8 | THE MEDICARE COST REPORT WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS. THE ORGANIZATION DOES NOT COUNT MEDICARE SHORTFALL AS COMMUNITY BENEFIT. |
| FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B | ALL PATIENTS WILL BE OFFERED A FINANCIAL ASSISTANCE APPLICATION AT THE TIME OF REGISTRATION AND/OR DISCHARGE FROM THE FACILITY. IF THIS EVALUATION IS NOT CONDUCTED UNTIL AFTER THE PATIENT LEAVES THE FACILITY, OR IN CASE OF OUTPATIENTS OR EMERGENCY PATIENTS, A FINANCIAL COUNSELOR WILL MAIL A FINANCIAL ASSISTANCE APPLICATION TO THE PATIENT FOR COMPLETION. EACH PATIENT SIGNS A CONDITION OF ADMISSION FORM WHICH MAKES THEM AWARE OF CONWAY REGIONAL'S FINANCIAL ASSISTANCE POLICY. THERE IS ALSO A STATEMENT ON THE REVERSE SIDE OF THE PATIENT'S BILL WHICH EXPLAINS THAT FINANCIAL COUNSELORS ARE AVAILABLE. IF A PATIENT CALLS THE PATIENT ACCOUNTING OFFICE ABOUT THEIR BILL, THEY ARE MADE AWARE OF THE FINANCIAL ASSISTANCE POLICY. IN ADDITION, THE HOSPITAL WILL PROVIDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY TO THE PATIENT WITH ALL BILLING STATEMENTS AND COMMUNICATIONS WITHIN THE FIRST 120 DAYS FOLLOWING THE FIRST BILLING STATEMENT. THE POLICY WILL ALSO BE AVAILABLE ON THE HOSPITAL WEBSITE, AT ALL POINTS OF REGISTRATION WITHIN THE FACILITY, AND WILL BE PROVIDED BY MAIL TO ANYONE REQUESTING IT AT NO CHARGE. A PLAIN LANGUAGE SUMMARY OF THE POLICY WILL BE MADE AVAILABLE IN THESE LOCATIONS AS WELL. |
| FORM 990, SCHEDULE H, PART VI, LINE 2 | DARDANELLE REGIONAL ANNUALLY UPDATES THE COMMUNITY HEALTH NEEDS SCORECARD FROM VARIOUS SOURCES FROM THE STATE OF ARKANSAS, ESRI, CENSUS, COUNTY HEALTH RANKING, AND PROPRIETARY DATA SOURCES. BOTH PRIMARY AND SECONDARY RESEARCH METHODS ARE USED. |
| FORM 990, SCHEDULE H, PART VI, LINE 3 | ALL PATIENTS ARE OFFERED A FINANCIAL ASSISTANCE APPLICATION AT THE TIME OF REGISTRATION AND/OR DISCHARGE FROM THE FACILITY. IF THIS EVALUATION IS NOT CONDUCTED UNTIL AFTER THE PATIENT LEAVES THE FACILITY OR IN CASE OF OUTPATIENTS OR EMERGENCY PATIENTS, A FINANCIAL COUNSELOR WILL MAIL A FINANCIAL ASSISTANCE APPLICATION TO THE PATIENT FOR COMPLETION. EACH PATIENT SIGNS A CONDITION OF ADMISSION FORM WHICH MAKES THEM AWARE OF CONWAY REGIONAL'S FINANCIAL ASSISTANCE POLICY. THERE IS ALSO A STATEMENT ON THE REVERSE SIDE OF THE PATIENT'S BILL WHICH EXPLAINS THAT FINANCIAL COUNSELORS ARE AVAILABLE. IF A PATIENT CALLS THE PATIENT ACCOUNTING OFFICE ABOUT THEIR BILL, THEY ARE MADE AWARE OF THE ASSISTANCE POLICY. IN ADDITION, THE HOSPITAL WILL PROVIDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY TO THE PATIENT WITH ALL BILLING STATEMENTS AND COMMUNICATIONS WITHIN THE FIRST 120 DAYS FOLLOWING THE FIRST BILLING STATEMENT. THE POLICY WILL ALSO BE MADE AVAILABLE ONT HE HOSPITAL WEBSITE, AT ALL POINTS OF REGISTRATION WITHIN THE FACILITY, AND WILL BE PROVIDED BY MAIL TO ANYONE REQUESTING IT AT NO CHARGE. A PLAIN LANGUAGE SUMMARY OF THE POLICY WILL BE MADE AVAILABLE AT THESE LOCATIONS AS WELL. |
| FORM 990, SCHEDULE H, PART VI, LINE 4 | DARDANELLE REGIONAL MEDICAL CENTER'S PRIMARY SERVICE AREA IS YELL COUNTY, ARKANSAS. IN 2022: THE POPULATION OF YELL COUNTY IS 20,978 - A 1.7% DECREASE SINCE 2019. IN YELL COUNTY, 93% OF THE POPULATION IS CAUCASIAN, 2.5% IS AFRICAN AMERICAN, 1.3% IS AMERICAN INDIAN OR ALASKAN NATIVE, 1.6% IS ASIAN, 0.01% IS HAWAIIAN OR OTHER PACIFIC ISLANDER, 1.5% IS TWO OR MORE RACES, AND 0.09% IS OTHER. THE MEDIAN AGE OF YELL COUNTY IS 40, WHICH IS 1.9 YEARS OLDER THAN THE NATIONAL MEDIAN AGE OF 38.1. IN YELL COUNTY, 24.10% OF THE POPULATION IS UNDER 18 YEARS OLD, 57.80% OF THE POPULATION IS BETWEEN 19 AND 64 YEARS OLD, AND 18.10% IS OVER 65 YEARS OLD. THE MEDIAN HOUSEHOLD INCOME IN YELL COUNTY IS $47,981. THIS IS LOWER THAN THE ARKANSAS AVERAGE OF $49,475 AND THE U.S. AVERAGE OF $61,937. YELL COUNTY IS RANKED THE 25TH HEALTHIEST COUNTY IN ARKANSAS OUT OF 75 TOTAL COUNTIES. |
| FORM 990, SCHEDULE H, PART VI, LINE 5 | DARDANELLE REGIONAL PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE. WE WORK TO IMPROVE HEALTH BY FOCUSING ON THREE PRIMARY GOALS IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING OBESITY, NUTRITION AND EXERCISE, AND CHRONIC DISEASE MANAGEMENT. OUR FITNESS CENTER PROVIDES SUPPORT FOR MANY AREA SCHOOLS IN DEVELOPING RUNNING CLUBS AND ANNUALLY HOSTS THE KIDS RUN ARKANSAS EVENT TO ENCOURAGE FAMILIES TO EXERCISE TOGETHER. DARDANELLE REGIONAL PROVIDES HEALTHY EATING INFORMATION AND EDUCATION THROUGH OUR WOMEN'S COUNCIL AND OFFERS HUNDREDS OF FREE HEALTH SCREENINGS THROUGHOUT THE YEAR AT EVENTS SUCH AS THE SENIOR HEALTH FAIR AND THE WOMEN'S HEALTH FAIR. CONWAY REGIONAL PROVIDES EXPERT SPEAKERS FOR MANY CLUBS AND COMMUNITY MEETINGS TO HELP EDUCATE ON LIVING A HEALTHIER LIFE. DARDANELLE REGIONAL OFFERS SPECIALIZED SUPPORT FOR PARENTS INCLUDING BABY CARE CLASSES, BREASTFEEDING SUPPORT, AND SUPPORT DURING THE LOSS OF A PREGNANCY. |
| FORM 990, SCHEDULE H, PART VI, LINE 6 | DARDANELLE REGIONAL MEDICAL CENTER, INC. PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, PSYCHIATRIC AND EMERGENCY CARE SERVICES TO PATIENTS IN YELL COUNTY, ARKANSAS. DARDANELLE REGIONAL MEDICAL CENTER IS A SUBSIDIARY HOSPITAL OF CONWAY REGIONAL MEDICAL CENTER (THE MEDICAL CENTER). CONWAY REGIONAL MEDICAL CENTER, INC. (THE MEDICAL CENTER) PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, PSYCHIATRIC AND EMERGENCY CARE SERVICES TO PATIENTS IN CONWAY, ARKANSAS, AND SURROUNDING AREAS IN CENTRAL ARKANSAS. IT ALSO OPERATES A HOME HEALTH AGENCY AND PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. EFFECTIVE APRIL 1, 2022, THE MEDICAL CENTER'S BOARD OF DIRECTORS RENEWED THE AGREEMENT THROUGH APRIL 1, 2023, WITH CHI ST. VINCENT INFIRMARY MEDICAL CENTER, D/B/A CHI ST. VINCENT, AN ARKANSAS NONPROFIT CORPORATION AND A SUBSIDIARY OF CATHOLIC HEALTH INITIATIVES. THE GOAL OF THE AGREEMENT IS TO DEVELOP A LEVEL OF INTEGRATION AND COORDINATION THAT RESULTS IN MORE ACCESSIBLE, HIGH QUALITY, CLINICALLY INTEGRATED, COORDINATED AND LOWER-COST CARE FOR THE COMMUNITIES OF CENTRAL ARKANSAS THAT THEY SERVE WHILE ENHANCING THE OVERALL HEALTH OF THOSE COMMUNITIES. INSTITUTIONAL SERVICES CORPORATION (ISC) IS A WHOLLY OWNED TAXABLE SUBSIDIARY OF THE MEDICAL CENTER. ISC OWNS AND LEASES REAL ESTATE AND PERSONAL PROPERTY, PRIMARILY TO THE MEDICAL CENTER. THIRD TABLE, LLC WAS FORMED WITH THE MEDICAL CENTER AS THE SOLE MEMBER. EFFECTIVE DECEMBER 7, 2018, THIRD TABLE PROVIDES ACCOUNTABLE CARE MANAGEMENT (ACM) SERVICES THROUGH PARTICIPATING PHYSICIANS TO THE MEDICAL CENTER AND IS MANAGED BY AN ACM COMMITTEE WITH MEDICAL CENTER REPRESENTATION. CONWAY REGIONAL HEALTH FOUNDATION (THE FOUNDATION) IS A NOT-FOR-PROFIT ORGANIZATION WHOSE MISSION AND PRINCIPAL ACTIVITIES ARE TO SOLICIT AND RECEIVE CONTRIBUTIONS FOR THE BENEFIT OF THE MEDICAL CENTER. THE FOUNDATION'S REVENUES AND OTHER SUPPORT ARE DERIVED PRINCIPALLY FROM CONTRIBUTIONS IN FAULKNER COUNTY AND SURROUNDING AREAS. THE BOARD OF DIRECTORS OF THE FOUNDATION IS ELECTED ANNUALLY BY THE BOARD OF DIRECTORS OF THE MEDICAL CENTER. THE MEDICAL CENTER OWNS A MAJORITY MEMBER INTEREST OF 66.2% IN CONWAY REGIONAL REHABILITATION HOSPITAL, LLC (CRRH). CRRH PRIMARILY EARNS REVENUE BY PROVIDING INPATIENT REHABILITATIVE CARE TO PATIENTS IN CONWAY, ARKANSAS, AND SURROUNDING AREAS IN CENTRAL ARKANSAS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REBEKAH FINCHER | ||||||||||||||
| CAO | $0 | $222,901 | $0 | $0 | $0 | $0 | $0 | $8,856 | $0 | $14,341 | $0 | $246,098 | $0 | $0 |
| BILL PACK | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $89,762 | $0 | $153,575 | $0 | $41,172 | $0 | $923 | $0 | $508 | $0 | $285,940 | $0 | $0 |
| CHRISTOPHER KEY | ||||||||||||||
| PHARMACIST | $176,769 | $0 | $0 | $0 | $0 | $0 | $7,071 | $0 | $12,452 | $0 | $196,292 | $0 | $0 | $0 |
| JACQUELINE LOYD | ||||||||||||||
| RN | $146,721 | $0 | $0 | $0 | $0 | $0 | $3,717 | $0 | $14,093 | $0 | $164,531 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE REVIEW PROCESS OF FORM 990 INCLUDES A REVIEW BY THE PRESIDENT, CFO AND CONTROLLER OF THE ORGANIZATION. THE FORM 990 IS THEN PRESENTED TO ALL BOARD MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE DARDANELLE REGIONAL, LLC BOARD REVIEWS THE GOVERNING BOARD CONFLICT OF INTEREST POLICY ANNUALLY DURING THE JANUARY BOARD MEETING. A NEW CONFLICT OF INTEREST STATEMENT IS REQUIRED OF EACH BOARD MEMBER EVERY YEAR. THESE STATEMENTS ARE REVIEWED BY THE CHAIRMAN, PRESIDENT, AND CFO FOR MONITORING. BOARD MEMBERS WHO HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN MATTERS BROUGHT BEFORE THE BOARD ARE TO ALERT THE OTHER MEMBERS OF THE BOARD BEFOREHAND. THE CONFLICTED BOARD MEMBER IS TO WITHDRAW FROM THE MEETING DURING SAID DISCUSSION UNTIL THE MATTER HAS BEEN VOTED ON. IF THE MEMBER FAILS TO WITHDRAW VOLUNTARILY, THE CHAIRMAN IS EMPOWERED TO REQUIRE WITHDRAWAL FROM THE ROOM DURING DISCUSSION AND VOTE ON THE MATTER. IN THE EVENT THE CONFLICT OF INTEREST AFFECTS THE CHAIRMAN, THE VICE CHAIRMAN IS THEN EMPOWERED TO REQUIRE THE CHAIRMAN'S WITHDRAWAL. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | DARDANELLE REGIONAL, LLC DOES NOT COMPENSATE ANY TOP MANAGEMENT OFFICIALS, OFFICERS, OR KEY EMPLOYEES OF THE ORGANIZATION, THEREFORE THIS WILL NOT BE APPLICABLE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VIII, LINE 6 | PERSONAL PROPERTY RENTAL INCOME REPORTED ON LINE 6A OF PART VIII IS NOT UNRELATED BUSINESS INCOME. IT IS 100% RELATED TO EXEMPT PURPOSE AND IS RENTAL INCOME FROM A RELATED HOSPITAL ENTITY. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:AGENCY STAFF TOTAL FEES:475232 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTS TOTAL FEES:2430524 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EQUIPMENT SERVICE TOTAL FEES:138476 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:470219 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:15400 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CONWAY REGIONAL HEALTH FOUNDATION | ||||||||||
| 2302 COLLEGE AVE | CONWAY | AR | 72034 | 710797723 | SUPPORT | AR | 501(C)(3) | 12A | CRMC | Yes (true) |
| CONWAY REGIONAL MEDICAL CENTER | ||||||||||
| 2302 COLLEGE AVENUE | CONWAY | AR | 72034 | 710249735 | HOSPITAL | AR | 501(C)(3) | 3 | NA | false |
| CR HOSPITAL EMPLOYEES' MEDICAL TRUST | ||||||||||
| 2302 COLLEGE AVE | CONWAY | AR | 72034 | 521561768 | INSURANCE | AR | 501(C)(9) | CRMC | Yes (true) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONWAY REG REHAB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2210 ROBINSON AVE | AddressLine1Txt |
| City | CONWAY | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72034 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 412136339 | EIN |
| Primary Activities | IP REHAB SERV | PrimaryActivitiesTxt |
| Legal Domicile State | AR | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INSTITUTIONAL SERVICES CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2302 COLLEGE AVE | AddressLine1Txt |
| City | CONWAY | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 72034 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710575886 | EIN |
| Primary Activities | PROP OWNERSHIP | PrimaryActivitiesTxt |
| Legal Domicile State | AR | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORPORATION | EntityTypeTxt |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |