2022-11-11T16:51:05-06:00 2021-12-31 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2021-01-01 621808817 HEALTH SERVICES MANAGEMENT INC HEAL 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 WILLIAM NEELY EXECUTIVE VP 6158961191 2022-11-11 1 WILLIAM NEELY 999009999 FRANCES E LEAHY P00713593 6152427351 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JAMES SHATZ 206 FORTRESS BLVD MURFREESBORO TN 37128 126872629 0 X N/A X 2000 TN TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 5 2 3414 0 0 0 10935145 1724219 130742072 122572362 435659 203880 5977127 54329 148090003 124554790 0 0 0 0 68633508 64358409 0 0 0 62961804 66720125 131595312 131078534 16494691 -6523744 140595095 127545587 58291797 51504748 82303298 76040839 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 0 0 119919432 123272980 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES IN INDIANA, TENNESSEE, TEXAS, AND FLORIDA. 119919432 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 666 0 1 3414 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 2 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X WILLIAM H NEELY 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 WILLIAM NEELY CHIEF LEGAL OFFICER 40.00 X X 821924 0 8564 SCOTT FISHER CFO 40.00 X X 607399 0 21784 JAMES SHATZ CEO (START 04/21) 40.00 X X 501564 0 7393 JAMES E BELL CEO, CHAIRMAN (END 04/21) 40.00 X X 394159 0 4166 TIMOTHY PRIDDY DIRECTOR 1.00 X 133000 0 0 RANDY SHUCK CHAIRMAN, DIRECTOR 1.00 X 131000 0 0 JOSHUA WHITE CHIEF OPERATING OFFICER 40.00 X 398849 0 13 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 40.00 X 267306 0 14830 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 40.00 X 241143 0 9245 JERELD ERLANDSON DIRECTOR OF PATIENT AFFAIR 40.00 X 199496 0 13092 JENNIFER DAVES CHIEF NURSING OFFICER (END 10/21) 40.00 X 185012 0 7155 RICHARD FLINCHUM LEAD REGIONAL NURSE 40.00 X 178387 0 13 MATTHEW FILE REGIONAL ADMINISTRATOR 40.00 X 165158 0 12156 MARK RICHARDSON REGIONAL DIRECTOR OF CLINICAL SERVICES 40.00 X 151871 0 4088 ANNA MARIE OWENS-WICKER ADMINISTRATOR (END 10/21) 40.00 X 186791 0 9871 JOANNA BUCKLES ADMINISTRATOR 40.00 X 154334 0 8180 MELISSA CROOKSHANKS ADMINISTRATOR 40.00 X 163884 0 7997 JACOB MITCHELL ADMINISTRATOR 40.00 X 162580 0 2045 KAREN BUCK ADMINISTRATOR 40.00 X 151737 0 1910 5195594 0 132502 48 0 1 0 RELIANT REHABILITATION 5800 GRANITE PKWY STE 1000 PLANO TX 75024 THERAPY 12108206 AMERISOURCE FUNDING INC PO BOX 4738 HOUSTON TX 77210 STAFFING AGENCY 1867049 PLEX CAPITAL PO BOX 219472 KANSAS CITY MO 64121 STAFFING AGENCY 1635205 CRESTMARK PHARMACY SERVICES LLC 132 HARRISION AVE PANAMA CITY FL 32401 PHARMACY 1613631 NETWORKS CONNECT HEALTHCARE STAFFING LL 7400 SHADELAND AVE STE 140 INDIANAPOLIS IN 46250 STAFFING AGENCY 1486795 34 1709125 15094 1724219 PATIENT SERVICE REVENUE 623000 121927828 121927828 CRESTMARK PHARMACY 446110 359477 359477 MANAGEMENT FEE REVENUE 623000 229679 229679 CABLE & PHONE REVENUE 812900 27673 27673 CAFETERIA & VENDING REVENUE 722514 6855 6855 20850 20850 122572362 221672 221672 1549854 2199999 -650145 -650145 -650145 98550 1498 112486 5354 -13936 -3856 -17792 -3856 -13936 OTHER REVENUE 900099 704474 704474 704474 124554790 123272980 0 -442409 X 4478767 895502 3583265 53002881 52981371 21510 139714 137018 2696 2452045 2451869 176 4285002 4057684 227318 979027 979027 710502 710502 21560506 21143675 416831 1929755 783186 1146569 4032183 2219310 1812873 718491 136025 582466 12563560 12300097 263463 209179 107041 102138 330041 219116 110925 620209 589865 30344 509037 344956 164081 3397547 3180500 217047 2511737 2424432 87305 TAXES 4310920 3782028 528892 PROGRAM SUPPLIES 4072093 3987405 84688 FOOD 3659575 3659575 0 PHARMACEUTICAL DRUGS 2798689 2798689 0 1807074 1720088 86986 131078534 119919432 11159102 0 38911761 32284925 13699660 8305494 18041767 19879897 1638435 1748909 357592 378730 1046084 719082 113979751 50986265 65085253 62993486 504200 359677 71058 34813 1239285 840574 140595095 127545587 10202629 7242650 726664 0 1118198 719487 39153053 37393582 7091253 6149029 58291797 51504748 X 82303298 76040839 82303298 76040839 140595095 127545587 -6523744 261285 0 X X 0 1 X 1 0 X 152698 74852 10935145 1724219 12886914 136524035 130781671 133495798 130742072 122572362 654115938 3384214 3419006 6695020 1549854 15048094 136524035 134318583 136989656 148372237 125846435 682050946 0 0 0 682050946 197972 418656 530959 296326 221672 1665585 197972 418656 530959 296326 221672 1665585 1039429 690418 1368633 704474 3802954 136722007 135776668 138211033 150037196 126772581 687519485 0.99200 0.99330 0.00240 0.00230 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 6207239 6207239 79574826 32156483 47418343 15018731 8348000 6670731 9496847 7873130 1623717 3682108 2608652 1073456 62993486 RESIDENT REFUNDS PAYABLE 3677431 DUE TO RELATED PARTIES 2434424 CONTRACT LIABILITIES 37174 6149029 X PART IV, LINE 2B: THE ORGANIZATION USES A THIRD PARTY ADMINISTRATOR TO MANAGE THE FUNDS HELD IN TRUST FOR RESIDENTS. PART X, LINE 2: MANAGEMENT PERFORMS AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE ORGANIZATION'S INCOME TAX RETURNS TO DETERMINE WHETHER THE INCOME TAX POSITIONS MEET A "MORE LIKELY THAN NOT" STANDARD OF BEING SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL INCOME TAX POSITIONS TAKEN ON ALL OPEN INCOME TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. ACCORDINGLY, THERE ARE NO PROVISIONS FOR INCOME TAXES, PENALTIES OR INTEREST RECEIVABLE OR PAYABLE RELATING TO UNCERTAIN INCOME TAX POSITIONS IN THE ACCOMPANYING FINANCIAL STATEMENTS. X X X X 0 0 0 0 0 1 0 1 0 WILLIAM NEELY CHIEF LEGAL OFFICER 801924 0 0 0 20000 0 0 0 8564 0 830488 0 0 0 SCOTT FISHER CFO 587399 0 0 0 20000 0 3625 0 18159 0 629183 0 0 0 JAMES SHATZ CEO (START 04/21) 438564 0 0 0 63000 0 0 0 7393 0 508957 0 0 0 JOSHUA WHITE CHIEF OPERATING OFFICER 398849 0 0 0 0 0 0 0 13 0 398862 0 0 0 JAMES E BELL CEO, CHAIRMAN (END 04/21) 386159 0 0 0 8000 0 200 0 3966 0 398325 0 0 0 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 267306 0 0 0 0 0 3444 0 11386 0 282136 0 0 0 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 241143 0 0 0 0 0 2865 0 6380 0 250388 0 0 0 JERELD ERLANDSON DIRECTOR OF PATIENT AFFAIR 199496 0 0 0 0 0 1300 0 11792 0 212588 0 0 0 ANNA MARIE OWENS-WICKER ADMINISTRATOR (END 10/21) 174461 0 12330 0 0 0 2525 0 7346 0 196662 0 0 0 JENNIFER DAVES CHIEF NURSING OFFICER (END 10/21) 185012 0 0 0 0 0 2357 0 4798 0 192167 0 0 0 RICHARD FLINCHUM LEAD REGIONAL NURSE 177387 0 1000 0 0 0 0 0 13 0 178400 0 0 0 MATTHEW FILE REGIONAL ADMINISTRATOR 165158 0 0 0 0 0 0 0 12156 0 177314 0 0 0 MELISSA CROOKSHANKS ADMINISTRATOR 136554 0 27330 0 0 0 2092 0 5905 0 171881 0 0 0 JACOB MITCHELL ADMINISTRATOR 135250 0 27330 0 0 0 2032 0 13 0 164625 0 0 0 JOANNA BUCKLES ADMINISTRATOR 142004 0 12330 0 0 0 2065 0 6115 0 162514 0 0 0 MARK RICHARDSON REGIONAL DIRECTOR OF CLINICAL SERVIC 151871 0 0 0 0 0 1726 0 2362 0 155959 0 0 0 KAREN BUCK ADMINISTRATOR 132407 0 19330 0 0 0 1897 0 13 0 153647 0 0 0 PART I, LINE 6 THE 2021 PLAN INCLUDES AN INCENTIVE PAYMENT TO ADMINISTRATORS, DON, SOCIAL SERVICES, ADMISSIONS DIRECTOR, AND DIETARY FOR CATEGORIES INCLUDING MEDICARE CENSUS, SUPER BONUS, CUSTOMER CARE SATISFACTION SURVEY, TURNOVER, LABOR BUDGET, FOOD BUDGET AND INFECTION CONTROL METRICS. PART I, LINE 7 THE 2021 PLAN INCLUDES AN INCENTIVE PAYMENT TO THE CENTER ADMISSIONS DIRECTOR FOR OVERALL CENSUS PERFORMANCE (BASED ON PERCENTAGE OF AVAILABLE BEDS FROM THE CENTER'S BUDGET) AND FOR MEDICARE PLUS MANAGED CARE CENSUS LEVELS (BASED ON AVERAGE PER PATIENT DAY). FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S GENERAL COUNSEL REVIEWED THE FORM 990 AND PROVIDED COMMENTS AND QUESTIONS TO THE RETURN PREPARER. A COPY OF THE FORM 990 WAS EMAILED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C QUESTIONNAIRES ARE COMPLETED ANNUALLY BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USED THE SERVICES OF AN INDEPENDENT FIRM TO REVIEW THE COMPENSATION OF THE OFFICERS OF THE ORGANIZATION AND RELATED ENTITIES TO DETERMINE IF THEIR COMPENSATION WAS COMPARABLE TO OTHER EXECUTIVES AND ENTITIES IN THE SAME LINE OF BUSINESS. IN ADDITION, INDEPENDENT BOARD MEMBERS REVIEW THE COMPENSATION OF THE INSIDE BOARD MEMBERS, AND THE FULL BOARD THEN APPROVES COMPENSATION PAYABLE TO BOTH THE INSIDE AND INDEPENDENT BOARD MEMBERS. MANAGEMENT DETERMINES THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL DATA, ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 20,082,914. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,082,914. CASE MANAGEMENT: PROGRAM SERVICE EXPENSES 230,293. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,293. UTILIZATION REVIEW: PROGRAM SERVICE EXPENSES 37,908. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,908. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 792,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 792,560. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 416,831. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 416,831. FORM 990, PART IX, LINE 24E REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 1,678,445. MANAGEMENT AND GENERAL EXPENSES 18,008. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,696,453. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 41,643. MANAGEMENT AND GENERAL EXPENSES 68,978. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 110,621. FORM 990, PART XII, LINE 2C THE PROCESS IS THE SAME AS IN THE PRIOR YEAR. 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