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ANDERSON PHYSICIAN ALLIANCE INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
ANDERSON PHYSICIAN ALLIANCE INC (EIN 27-3274203)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-09
IRS object ID
202212219349301611
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-08-09T13:10:38-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN273274203EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON PHYSICIAN ALLIANCE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANDEBusinessNameControlTxt
Phone6015536000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1Txt
CityMERIDIANCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVEN BROWNPersonNm
Person TitleVP OF FINANCEPersonTitleTxt
Phone6015536000PhoneNum
Signature2022-08-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSTEVENPersonFirstNm
Person LastBROWNPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
Preparation2022-08-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVEN BROWNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1Txt
CityMERIDIANCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39301ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,053,669GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ANDERSONREGIONAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee63TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$4,053,900PYProgramServiceRevenueAmt
CY Program Service Revenue$5,053,666CYProgramServiceRevenueAmt
PY Investment Income$12PYInvestmentIncomeAmt
CY Investment Income$3CYInvestmentIncomeAmt
PY Other Revenue$112PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,054,024PYTotalRevenueAmt
CY Total Revenue$5,053,669CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,899,489PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,489,614CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,851,290PYOtherExpensesAmt
CY Other Expenses$1,821,636CYOtherExpensesAmt
PY Total Expenses$5,750,779PYTotalExpensesAmt
CY Total Expenses$7,311,250CYTotalExpensesAmt
PY Revenues Less Expenses-$1,696,755PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,257,581CYRevenuesLessExpensesAmt
Total Assets BOY$1,089,622TotalAssetsBOYAmt
Total Assets EOY$2,357,545TotalAssetsEOYAmt
Total Liabilities BOY$31,645,895TotalLiabilitiesBOYAmt
Total Liabilities EOY$35,163,272TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$30,556,273NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$32,805,727NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. THE SPECIFIC PURPOSES AND OBJECTIVES OF THE CORPORATION SHALL INCLUDE BUT NOT BE LIMITED TO EMPLOYING PHYSICIANS AND OTHER MEDICAL PERSONNEL TO CARRY OUT THE PURPOSES AND OBJECTIVES OF ANDERSON REGIONAL MEDICAL CENTER, AS FOLLOWS:1.) TO ESTABLISH AND MAINTAIN AN INSTITUTION OR INSTITUTIONS, WITHIN OR WITHOUT THE STATE WHERE INCORPORATED, WITH PERMANENT FACILITIES TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS2.) TO CARRY ON ANY EDUCATION ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH3.) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED4.) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITYMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,035,465ExpenseAmt
Revenue$5,052,690RevenueAmt
DescSEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. THE PHYSICIANS, NURSE PRACTITIONERS AND STAFF FOCUS ON PRIMARY HEALTHCARE NEEDS OF THE COMMUNITY.ANDERSON EAR, NOSE & THROAT CENTER DIAGNOSES, TREATS AND MANAGES PATIENTS WITH DISORDERS AND CONDITIONS OF THE EAR, NOSE AND THROAT REGION, AND RELATED AREAS OF THE HEAD AND NECK.AT ANDERSON NEUROLOGY CENTERTREATS DISORDERS THAT AFFECT THE BRAIN, SPINAL CORD AND NERVES. DIAGNOSES COMPLEX CONDITIONS THROUGH DETAILED HISTORY AND PHYSICAL EXAMINATION, INCLUDING TESTING OF MENTAL STATUS, VISION, SPEECH, STRENGTH, SENSATION, COORDINATION, REFLEXES, AND GAIT. ANDERSON UROLOGY CLINIC OF MERIDIANTREATS A WIDE VARIETY OF CONDITIONS THAT AFFECT THE URINARY SYSTEM AND THE MALE REPRODUCTIVE SYSTEM.ANDERSON CARDIAC SURGICAL ASSOCIATESOFFERS A WEALTH OF KNOWLEDGE AND EXPERIENCE, MODERN SURGICAL EQUIPMENT, ADVANCED TECHNIQUES, AND HIGH-QUALITY CARE FOR COMPLEX OPEN HEART AND VASCULAR SURGERIES. PEDIATRIC HOSPITALISTSTHE PEDIATRIC HOSPITALIST PARTNERS WITH PRIMARY CARE PEDIATRICIANS AND OTHER SUB-SPECIALISTS AND NURSE PRACTITIONERS TO PROVIDE COMPREHENSIVE, FAMILY CENTERED CARE DURING AN ACUTE HOSPITALIZATION.THE PURVIS CLINICFROM PUBERTY THROUGH CHILD-BEARING YEARS, MENOPAUSE AND BEYOND, THE PRACTICE PROVIDES PERSONAL AND HIGH QUALITY CARE FOR WOMEN. WOMEN'S MEDICAL CENTER OF MERIDIANTHE WOMEN'S MEDICAL CENTER OF MERIDIAN SERVE PATIENTS RANGING IN AGE FROM ADOLESCENCE TO ELDERLY, BELIEVING ALL ARE ENTITLED TO THE VERY BEST IN HEALTHCARE, UTILIZING STATE-OF-THE-ART MEDICAL TREATMENT AND SURGICAL PROCEDURES.Desc
Total Program Service Expenses$7,035,465TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee63EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVEN BROWNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6015536647PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1Txt
CityMERIDIANCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39301ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
GEORGE D FARR JR
DIRECTOR (CHAIRMAN)1.0050.00Yes (X)Yes (X)$0$190,142$47,287
WANDA B COOPER
DIRECTOR (SECRETARY)1.0050.00Yes (X)Yes (X)$0$221,493$9,517
SHAWN C ANDERSON
DIRECTOR1.005.00Yes (X)Yes (X)$0$22,000$0
STEVEN W BROWN
DIRECTOR1.0050.00Yes (X)Yes (X)$0$238,797$59,015
THURMAN K EVERETT
DIRECTOR1.00Yes (X)Yes (X)$0$357,437$49,768
CODY B AULL
PHYSICIAN40.00$603,395$0$38,037Yes (X)
ZAINEB DAUD
PHYSICIAN40.00$263,371$0$0Yes (X)
DAVID A GEER
PHYSICIAN40.00$451,957$0$18,723Yes (X)
DANIEL J MCKIEVER JR
PHYSICIAN40.00$257,205$0$12,955Yes (X)
RONNY PURVIS
PHYSICIAN40.00$483,430$0$12,298Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,059,358TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,029,869TotReportableCompRltdOrgAmt
Total Other Compensation$247,600TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
LARAIB TABBA
127C AIRPARK DRIVEPHILADELPHIAMS39350CONTRACT PHYSICIAN SERVICES$230,171
NTT DATA SERVICES LLC
POB 534118ATLANTAGA303534118EMR - BILLING SOFTWARE$111,168
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT621990$5,043,550$5,043,550
PROVIDER RELIEF FUNDS900099$10,116$10,116
FieldValueIRS element (for citing)
Total Program Service Revenue$5,053,666TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3TotalRevenueColumnAmt
Exclusion$3ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,053,669TotalRevenueColumnAmt
Related Or Exempt Func Income$5,053,666RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,037,649TotalAmt
Program Services$4,840,134ProgramServicesAmt
Management And General$197,515ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$33,053TotalAmt
Program Services$30,896ProgramServicesAmt
Management And General$2,157ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$202,849TotalAmt
Program Services$196,337ProgramServicesAmt
Management And General$6,512ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$216,063TotalAmt
Program Services$213,286ProgramServicesAmt
Management And General$2,777ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$602,600TotalAmt
Program Services$596,457ProgramServicesAmt
Management And General$6,143ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,123TotalAmt
Program Services$1,123ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$150,668TotalAmt
Program Services$118,961ProgramServicesAmt
Management And General$31,707ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$469,311TotalAmt
Program Services$469,239ProgramServicesAmt
Management And General$72ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,728TotalAmt
Program Services$25,762ProgramServicesAmt
Management And General$966ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,120TotalAmt
Program Services$1,120ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$103,781TotalAmt
Program Services$83,437ProgramServicesAmt
Management And General$20,344ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$159,134TotalAmt
Program Services$159,134ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$196,492$195,619$873
BAD DEBT EXPENSE$110,679$103,960$6,719

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,311,250TotalAmt
Program Services$7,035,465ProgramServicesAmt
Management And General$275,785ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,213BOYAmt
EOY$12,787EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$394,514BOYAmt
EOY$458,894EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$26,667BOYAmt
EOY$26,667EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,113,874LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,254,677LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$658,228BOYAmt
EOY$1,859,197EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,089,622BOYAmt
EOY$2,357,545EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$211,882BOYAmt
EOY$333,104EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,434,013BOYAmt
EOY$34,830,168EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,645,895BOYAmt
EOY$35,163,272EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$30,556,273BOYAmt
EOY-$32,805,727EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$30,556,273BOYAmt
EOY-$32,805,727EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,089,622BOYAmt
EOY$2,357,545EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,257,581ReconcilationRevenueExpnssAmt
Prior Period Adjustments$8,127PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$160,000OtherCostOrOtherBasisAmt
Book Value$160,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,953,238OtherCostOrOtherBasisAmt
Depreciation$358,752DepreciationAmt
Book Value$1,594,486BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,777OtherCostOrOtherBasisAmt
Depreciation$28,458DepreciationAmt
Book Value$1,319BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$970,859OtherCostOrOtherBasisAmt
Depreciation$867,467DepreciationAmt
Book Value$103,392BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,859,197TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILIATES$34,671,416
MEDICARE ACCELERATED PAYMENT$158,752
FieldValueIRS element (for citing)
Total Liability$34,830,168TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationANDERSON PHYSICIAN ALLIANCE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. ANDERSON PHYSICIAN ALLIANCE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2021 AND 2020.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CODY B AULL
PHYSICIAN$594,813$0$7,686$0$896$0$5,600$0$32,437$0$641,432$0$0$0
RONNY PURVIS
PHYSICIAN$465,222$0$15,277$0$2,931$0$0$0$12,298$0$495,728$0$0$0
DAVID A GEER
PHYSICIAN$442,045$0$0$0$9,912$0$5,600$0$13,123$0$470,680$0$0$0
THURMAN K EVERETT
DIRECTOR$0$342,934$0$0$0$14,503$0$49,768$0$0$0$407,205$0$0
STEVEN W BROWN
DIRECTOR$0$236,699$0$0$0$2,098$0$41,228$0$17,787$0$297,812$0$0
DANIEL J MCKIEVER JR
PHYSICIAN$200,994$0$56,211$0$0$0$0$0$12,955$0$270,160$0$0$0
ZAINEB DAUD
PHYSICIAN$263,371$0$0$0$0$0$0$0$0$0$263,371$0$0$0
GEORGE D FARR JR
DIRECTOR (CHAIRMAN)$0$188,295$0$0$0$1,847$0$32,967$0$14,320$0$237,429$0$0
WANDA B COOPER
DIRECTOR (SECRETARY)$0$212,785$0$0$0$8,708$0$2,600$0$6,917$0$231,010$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AEXECUTIVE TEAM MEMBERS ARE OFFERED FREE MEMBERSHIPS TO ANDERSON HEALTH AND FITNESSS CENTER. WANDA COOPER, GEORGE DENTON FARR, AND JOHN ANDERSON RECEIVED FREE MEMBERSHIPS.
PART I, LINE 3THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE ARE COMPENSATED BY ARMC. AS SUCH APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE PERSON COMMITTEE AND HAS AN OUTSIDE CONTRACTED ORGANIZATION TO STUDY AND RECOMMEND COMPENSATION FOR EXECUTIVES.
PART I, LINE 4BARMC PROVIDES TO CERTAIN EXECUTIVES AN IRS SEC. 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE PURPOSE OF THIS PLAN IS TO OFFER PARTICIPATING EXECUTIVES TAXABLE DEFERRED COMPENSATION BENEFITS TO SUPPLEMENT SUCH EXECUTIVE'S RETIREMENT UNDER ARMC'S TAX-QUALIFIED RETIREMENT PLAN. THE PLAN SHALL BE UNFUNDED FOR TAX PURPOSES AND FOR PURPOSE OF TITLE I OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1975 ("ERISA"). SEE COMPENSATION SECTION FOR DETAIL INFORMATION ON PERSONS AND AMOUNTS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1UNLESS PROHIBITED OR LIMITED BY THE ARTICLES OF INCORPORATION OR THESE BYLAWS, THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE AND ONE OR MORE THAN OTHER COMMITTEES OF THE BOARD AND APPOINT MEMBERS OF THE BOARD OF DIRECTORS TO SERVE ON THEM.
FORM 990, PART VI, SECTION A, LINE 2GEORGE DENTON FARR AND SHAWN ANDERSON ARE FIRST COUSINS. JOHN ANDERSON AND SHAWN ANDERSON ARE UNCLE AND NEPHEW.
FORM 990, PART VI, SECTION A, LINE 6ANDERSON REGIONAL MEDICAL CENTER (ARMC) IS THE SOLE MEMBER OF ANDERSON PHYSICIAN ALLIANCE, INC.
FORM 990, PART VI, SECTION A, LINE 7AANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCISE ALL VOTING RIGHTS OF THE MEMBERS
FORM 990, PART VI, SECTION A, LINE 7BANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APRROVE APA'S PHYSICIAN COMPENSATION MODELS, PHYSICIAN COMPENSATION AND PHYSICIAN COMPENSATION POLICIES, (2) TO APPROVE PHYSICIAN EMPLOYMENT AGREEMENTS, AND (3) TO INITIATE AND/OR APPROVE VARIOUS OTHER ACTIONS AND POLICIES AS ENUMERATED IN APA'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND AS REQUIRED BY STATE LAW.
FORM 990, PART VI, SECTION B, LINE 11BEACH BOARD MEMBER WAS PROVIDED A COPY OF THE FORM 990. THE BOARD MEMBERS WERE ASKED TO REVIEW THE FORM AND SUBMIT QUESTIONS AND COMMENTS PROIR TO THE FORM 990 BEING FINALIZED. AFTER REVIEW, THE FINALIZED FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REQUESTS ALL BOARD MEMBERS TO ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE ARE COMPENSATED BY ARMC. AS SUCH APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE PERSON COMMITTEE AND HAS AN OUTSIDE CONTRACTED ORGANIZATION TO STUDY AND RECOMMEND COMPENSATION FOR EXECUTIVES.
FORM 990, PART VI, SECTION C, LINE 18IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART VI, LINE 1: INDEPENDENCE OF VOTING BOARD MEMBERS:THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE SOLE MEMBER ORGANIZATION HAS A FIFTY PERCENT INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER AND ITS AUTHORITY.
FORM 990; PART XII; LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ANDERSON REGIONAL MEDICAL CENTER
2124 14TH STREETMERIDIANMS39301640362400HEALTHCAREMS501(C)(3)LINE 3N/A0
MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION
122 WOODMONT WAYRIDGELANDMS39157640722433SUPPORTING ORGANIZATIONMS501(C)(3)LINE 12C, III-FI0ANDERSON REGIONAL MEDICAL CENTER
ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION
7651 POPLAR SPRINGS DRMERIDIANMS39305640730109SUPPORTING ORGANIZATIONMS501(C)(3)LINE 12D, III-O0ANDERSON REGIONAL MEDICAL CENTER
MIRACLES OF GRACE FOUNDATION
1827 SUNRISE LANETOOMSUBAMS39364640730366SUPPORTING ORGANIZATIONMS501(C)(3)LINE 12C, III-FI0ANDERSON REGIONAL MEDICAL CENTER
CARE CONSISTENCY FOUNDATION INC
7761 MEADOW CIRCLEMERIDIANMS39305640730846SUPPORTING ORGANIZATIONMS501(C)(3)LINE 12D, III-O0ANDERSON REGIONAL MEDICAL CENTER

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EAST MISSISSIPPI ENDOSCOPY CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11926 23RD AVENUEAddressLine1Txt
CityMERIDIANCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39301ZIPCd
FieldValueIRS element (for citing)
EIN440884792EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateMSLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ARMC HOSPITAL PROF & GEN LLFTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1512 22ND AVENUEAddressLine1Txt
CityMERIDIANCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39301ZIPCd
FieldValueIRS element (for citing)
EIN206131090EIN
Primary ActivitiesTRUSTPrimaryActivitiesTxt
Legal Domicile StateMSLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeTEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd