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PONTOTOC HEALTH SERVICES INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
PONTOTOC HEALTH SERVICES INC (EIN 64-0751410)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-08-19
IRS object ID
202502319349301135
Schema version
2023v6.0
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

FieldValueIRS element (for citing)
Return2025-08-19T12:32:31+00:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Forvis Mazars LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 3667AddressLine1Txt
CityLittle RockCityNm
State AbbreviationARStateAbbreviationCd
ZIP722033667ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN640751410EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pontotoc Health Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPONTBusinessNameControlTxt
Phone6623773978PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 SOUTH GLOSTER STREETAddressLine1Txt
CityTUPELOCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHARON NOBLESPersonNm
Person TitleCFOPersonTitleTxt
Phone6623773978PhoneNum
Signature2025-08-19SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAmber SherrillPreparerPersonNm
PTINP00748683PTIN
Phone5013721040PhoneNum
Preparation2025-08-19PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1SHARON NOBLES CFOBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 SOUTH GLOSTER STREETAddressLine1Txt
CityTUPELOCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$33,224,371GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NMHS.NET/PONTOTOC/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateDELegalDomicileStateCd
Activity Or MissionPONTOTOC HEALTH SERVICES, INC. OPERATES A 25 BED HOSPITAL AND A 44 BED NURSING HOME LOCATED IN PONTOTOC, MISSISSIPPI.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee314TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$10,000PYContributionsGrantsAmt
CY Contributions Grants$760,000CYContributionsGrantsAmt
PY Program Service Revenue$28,587,152PYProgramServiceRevenueAmt
CY Program Service Revenue$32,181,292CYProgramServiceRevenueAmt
PY Investment Income$67,297PYInvestmentIncomeAmt
CY Investment Income$77,610CYInvestmentIncomeAmt
PY Other Revenue$287,398PYOtherRevenueAmt
CY Other Revenue$205,469CYOtherRevenueAmt
PY Total Revenue$28,951,847PYTotalRevenueAmt
CY Total Revenue$33,224,371CYTotalRevenueAmt
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$18,144,952PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,876,149CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,737,097PYOtherExpensesAmt
CY Other Expenses$8,899,503CYOtherExpensesAmt
PY Total Expenses$27,882,049PYTotalExpensesAmt
CY Total Expenses$27,775,652CYTotalExpensesAmt
PY Revenues Less Expenses$1,069,798PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,448,719CYRevenuesLessExpensesAmt
Total Assets BOY$28,124,979TotalAssetsBOYAmt
Total Assets EOY$37,372,681TotalAssetsEOYAmt
Total Liabilities BOY$14,264,777TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,042,846TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,860,202NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,329,835NetAssetsOrFundBalancesEOYAmt
MissionPONTOTOC HEALTH SERVICES, INC. OPERATES A 25 BED HOSPITAL AND A 44 BED NURSING HOME LOCATED IN PONTOTOC, MISSISSIPPI CALLED NORTH MISSISSIPPI MEDICAL CENTER-PONTOTOC(NMMC-PONTOTOC). NMMC-PONTOTOC IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ORGANIZATION. THE MISSION OF NMHS IS TO CONTINUOUSLY IMPROVE THE HEALTH OF THE PEOPLE OF OUR REGION. NMMC-PONTOTOC WORKS TO ACHIEVE THIS CORPORATE MISSION TO IMPROVE THE HEALTH OF THE PEOPLE OF THIS REGION BY PROVIDING CONVENIENTLY ACCESSIBLE, COST-EFFECTIVE HEALTH CARE OF THE HIGHEST QUALITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$27,368,286ExpenseAmt
Grant$0GrantAmt
Revenue$32,181,292RevenueAmt
DescNMMC-PONTOTOC SERVES PONTOTOC COUNTY AND THE SURROUNDING AREA. IN FISCAL YEAR 2024, THERE WERE 516 INPATIENT ADMISSIONS, 10,778 EMERGENCY DEPARTMENT VISITS, 53,697 OUTPATIENT VISITS, 30,037 RURAL HEALTH CLINIC VISITS, AND NO HOSPITAL BASED CLINIC VISITS. NMMC-PONTOTOC USES PRESS GANEY, THE LARGEST PATIENT SATISFACTION SURVEY COMPANY IN THE NATION, THAT WORKS WITH MORE THAN 7,000 HEALTHCARE FACILITIES. RANDOMLY SELECTED PATIENTS ARE ASKED ABOUT THEIR EXPERIENCE WITH INPATIENT, OUTPATIENT, ER, AND LONG-TERM CARE SERVICES. THE HOSPITAL OFFERS PARAMEDIC-LEVEL AMBULANCE SERVICE AND 24-HOUR PHYSICIAN COVERAGE IN ITS EMERGENCY DEPARTMENT. RADIOLOGY SERVICES INCLUDE X-RAY, COMPUTED TOMOGRAPHY (CT) AND ULTRASOUND. AREA RESIDENTS CAN STAY CLOSE TO HOME AND TAKE ADVANTAGE OF THE MOBILE MAMMOGRAPHY UNIT ON DESIGNATED DAYS EACH MONTH AT NMMC-PONTOTOC. THE 44-BED NURSING HOME OFFERS A VARIETY OF REHABILITATION SERVICES AND AMENITIES TO RESIDENTS. ONE OF THE PRIMARY WAYS NMMC-PONTOTOC SERVES THE COMMUNITY IS BY PROVIDING CARE TO VARIOUS POPULATIONS FOR WHICH IT RECEIVES NO COMPENSATION OR RECEIVES COMPENSATION AT RATES SIGNIFICANTLY LESS THAN ESTABLISHED RATES. THE BOARD OF DIRECTORS OF NMMC-PONTOTOC HAS ESTABLISHED A POLICY UNDER WHICH THE HOSPITAL PROVIDES CARE, WITHOUT CHARGE, TO NEEDY MEMBERS OF ITS COMMUNITY. THE FINANCIAL ASSISTANCE POLICY STATES THAT NMMC-PONTOTOC WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS FREE OF CHARGE WITH HOUSEHOLD INCOME LEVELS AT OR BELOW 150% OF THE FEDERAL POVERTY LEVEL. THE POLICY APPLIES TO INDIVIDUALS WHO RESIDE IN PONTOTOC COUNTY. PATIENTS FROM OUTSIDE THE COUNTY MAY ALSO BE GRANTED CHARITY CARE BASED ON THE JUDGMENT OF NMMC-PONTOTOC MANAGEMENT DEPENDING ON THEIR INDIVIDUAL CIRCUMSTANCES. THE POLICY ALSO REQUIRES THE PATIENT TO COOPERATE FULLY WITH NMMC-PONTOTOC'S REQUEST FOR INFORMATION WITH WHICH TO VERIFY THE PATIENT'S ELIGIBILITY. FOLLOWING THAT POLICY, THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. CHARGES FORGONE, BASED ON ESTABLISHED RATES, TOTALED APPROXIMATELY $1,440,555 IN FISCAL YEAR 2024. BASED ON THE GROSS CHARGES PROVIDED TO CHARITY PATIENTS COMPARED TO TOTAL HOSPITAL GROSS CHARGES, 6.01% OF ALL SERVICES IN FISCAL YEAR 2024 WERE PROVIDED ON A CHARITY BASIS. THE NET COST OF CHARITY CARE PROVIDED BY NMMC-PONTOTOC WAS APPROXIMATELY $1,525,287 IN FISCAL YEAR 2024. THE TOTAL COST ESTIMATE IS BASED ON THE RATIO OF COSTS TO CHARGES FOR NMMC-PONTOTOC. ALL THE FOREGONE CHARGES MENTIONED ABOVE ARE NETTED AGAINST PATIENT SERVICE REVENUE TO ARRIVE AT NET PATIENT SERVICE REVENUE AS REFLECTED AS PROGRAM SERVICE REVENUE ON PART VIII OF FORM 990 IN ORDER TO BE CONSISTENT WITH FINANCIAL STATEMENT REPORTING AND ARE NOT REPORTED AS FUNCTIONAL EXPENSES ON THE TAX RETURN.Desc
Total Program Service Expenses$27,368,286TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee314EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KRISTY DUKEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6623773977PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 SOUTH GLOSTER STREETAddressLine1Txt
CityTUPELOCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MITCH MONTGOMERY
CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
ERNIE WRIGHT
DIRECTOR1.00Yes (X)$0$0$0
JOHN BYERS
DIRECTOR1.00Yes (X)$0$0$0
LISA BRYANT
DIRECTOR1.00Yes (X)$0$0$0
PATRICIA HOBSON
DIRECTOR1.00Yes (X)$0$0$0
PATTY TURK
DIRECTOR1.00Yes (X)$0$0$0
SCOTT UITHOVEN
DIRECTOR1.00Yes (X)$0$0$0
BRUCE TOPPIN
SECRETARY1.039.0Yes (X)$0$667,572$14,992
MICHAEL S SPEES
PRESIDENT0.539.5Yes (X)$0$2,319,522$27,228
SHARON NOBLES
TREASURER1.039.0Yes (X)$0$1,007,522$29,248
JAMIE RODGERS
ADMINISTRATOR20.020.0$0$310,498$6,672Yes (X)
ANDREA P WARREN
PHYSICIAN40.00$355,237$0$31,422Yes (X)
BRAD J BOWLIN
PHYSICIAN40.00$398,100$0$34,368Yes (X)
CURTIS GLIDEWELL
PHYSICIAN40.00$454,324$0$18,920Yes (X)
JENNIFER D LOWERY
PHYSICIAN40.00$317,604$0$25,873Yes (X)
JUSTIN SMITH
PHYSICIAN40.00$455,224$0$17,167Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,980,489TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,305,114TotReportableCompRltdOrgAmt
Total Other Compensation$205,890TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RELIAS EMERGENCY MED
PO BOX 7058TUPELOMS38802ER PHYSICIAN$990,280
CROSS COUNTRY STAFFING
PO BOX 404674ATLANTAGA30384TRAVEL NURSE$805,102
RELIAS HOSPITALIST
PO BOX 7058TUPELOMS38802HOSPITALIST$563,545
TRILOGY HEALTHCARE SOLUTIONS
911 FLYNT DRIVEFLOWOODMS39232BILLING/COLLECTION SERVICES$364,000
CROTHALL HEALTHCARE
13028 COLLECTIONS CENTER DRIVECHICAGOIL60693HOUSEKEEPING SERVICES$111,185
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$750,000GovernmentGrantsAmt
All Other Contributions$10,000AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$760,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NET PATIENT SERVICE REVENUE622110$32,165,266$32,165,266$0$0
RELATED RENTAL REVENUE531120$16,026$16,026$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$32,181,292TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,688TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$9,688ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$67,922SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$67,922SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,922TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$67,922ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEMPLOYEE DRUGSDesc
Business446110BusinessCd
Total Revenue Column$205,469TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$205,469ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$205,469OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,224,371TotalRevenueColumnAmt
Related Or Exempt Func Income$32,181,292RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$283,079ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,996,804TotalAmt
Program Services$14,996,804ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$844,297TotalAmt
Program Services$844,297ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,024,096TotalAmt
Program Services$2,024,096ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,010,952TotalAmt
Program Services$950,759ProgramServicesAmt
Management And General$60,193ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$172,043TotalAmt
Program Services$0ProgramServicesAmt
Management And General$172,043ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,875TotalAmt
Program Services$0ProgramServicesAmt
Management And General$2,875ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$34,870TotalAmt
Program Services$0ProgramServicesAmt
Management And General$34,870ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,146,539TotalAmt
Program Services$3,146,539ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,381TotalAmt
Program Services$6,381ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$547,826TotalAmt
Program Services$547,826ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$440,425TotalAmt
Program Services$440,425ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$793,782TotalAmt
Program Services$793,782ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$49,172TotalAmt
Program Services$49,172ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$42,564TotalAmt
Program Services$42,564ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$419,325TotalAmt
Program Services$419,325ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$137,385TotalAmt
Program Services$0ProgramServicesAmt
Management And General$137,385ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$2,550,106$2,550,106$0$0
TAXES & LICENSES$343,202$343,202$0$0
REPAIRS & MAINTENANCE$119,031$119,031$0$0
DUES & SUBSCRIPTIONS$46,674$46,674$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$47,303TotalAmt
Program Services$47,303ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$27,775,652TotalAmt
Program Services$27,368,286ProgramServicesAmt
Management And General$407,366ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,790BOYAmt
EOY$2,790EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,218,020BOYAmt
EOY$272,410EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,320,573BOYAmt
EOY$1,391,610EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$308,607BOYAmt
EOY$400,207EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$17,626BOYAmt
EOY$28,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,938,089LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,804,057LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,258,299BOYAmt
EOY$2,134,032EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$21,999,064BOYAmt
EOY$33,143,632EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$28,124,979BOYAmt
EOY$37,372,681EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,924,265BOYAmt
EOY$11,047,007EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,340,512BOYAmt
EOY$6,995,839EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,264,777BOYAmt
EOY$18,042,846EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,739,053BOYAmt
EOY$19,204,171EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$121,149BOYAmt
EOY$125,664EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,860,202BOYAmt
EOY$19,329,835EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,124,979BOYAmt
EOY$37,372,681EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,448,719ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$20,914OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$60,613OtherCostOrOtherBasisAmt
Book Value$60,613BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$7,003,999OtherCostOrOtherBasisAmt
Depreciation$6,275,511DepreciationAmt
Book Value$728,488BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$11,616,527OtherCostOrOtherBasisAmt
Depreciation$10,371,217DepreciationAmt
Book Value$1,245,310BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$256,950OtherCostOrOtherBasisAmt
Depreciation$157,329DepreciationAmt
Book Value$99,621BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,134,032TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
DUE FROM THIRD PARTY PAYOR$534,017
DEFERRED COMPENSATION$1,275,566
INTEREST IN NA OF AFFILIATED FOUNDATION$125,664
OTHER RECEIVABLE$83,076
DUE FROM AFFILIATES$30,871,472
RIGHT OF USE LEASES$253,837
FieldValueIRS element (for citing)
Total Book Value Other Assets$33,143,632TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO RELATED PARTIES$1,537,502
DUE TO THIRD PARTY PAYORS$5,204,500
LEASE LIABILITY$253,837
FieldValueIRS element (for citing)
Total Liability$6,995,839TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$33,194,492TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$0NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants$0RecoveriesPriorYearGrantsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$33,194,492RevenueSubtotalAmt
Investment Expenses Not Incld$0InvestmentExpensesNotIncldAmt
Other Revenues Not Included$29,879OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$29,879RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$33,224,371TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$27,745,773TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$0DonatedServicesUseFcltsAmt
Prior Year Adjustments$0PriorYearAdjustmentsAmt
Losses Reported$0LossesReportedAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$27,745,773ExpensesSubtotalAmt
Investment Expenses Not Incld2$0InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$29,879OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$29,879ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$27,775,652TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2MANAGEMENT HAS EVALUATED ITS INCOME TAX POSITIONS UNDER GUIDANCE INCLUDED IN ASC 740. BASED ON ITS REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statementsPENSION COST - 29879
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statementsPENSION COST - 29879

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,525,287TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,525,287NetCommunityBenefitExpnsAmt
Total Expense0.0549TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$4,281,549TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,433,963DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$5,806,836TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,433,963DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,525,287NetCommunityBenefitExpnsAmt
Total Expense0.0549TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$5,806,836TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,433,963DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,525,287NetCommunityBenefitExpnsAmt
Total Expense0.0549TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$11,549,448ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,512,593CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$36,855MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PONTOTOC HEALTH SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1176 SOUTH MAIN STREETAddressLine1Txt
CityPONTOTOCCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38863ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.NMHS.NET/PONTOTOC/WebsiteAddressTxt
State License16-091StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PONTOTOC HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLwww.nmhs.net/About-Us/Community-Health-Needs-AsssessmentsOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.nmhs.net/About-Us/Community-Health-Needs-AsssessmentsStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-AssistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-AssistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-AssistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - PONTOTOC HEALTH SERVICES. INPUT FROM THE COMMUNITY WAS RECEIVED VIA INFORMANT INTERVIEWS, STANDARDIZED ELECTRONIC SURVEYS FROM KEY ORGANIZATIONS/STAKEHOLDERS, HEALTHCARE ADVOCATES/LEADERS, AND INTERESTED COMMUNITY PARTNERS RESIDING IN THE SERVICE AREAS SERVED BY NORTH MISSISSIPPI MEDICAL CENTER-PONTOTOC AND THE HEALTH SYSTEM. ADDITIONAL INPUT WAS SOLICITED FROM COMMUNITY RESIDENTS WHO REPRESENT BROADLY DIVERSE INTERESTS OF THE SERVICE AREA RANGING FROM NONPROFIT COMMUNITY VOLUNTEERS TO RETIRED EDUCATORS, BANKERS, AND PRIVATE BUSINESS LEADERS.
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - PONTOTOC HEALTH SERVICES. PONTOTOC HEALTH SERVICES IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES' DIVERSIFIED REGIONAL HEALTHCARE SYSTEM. NORTH MISSISSIPPI HEALTH SERVICES OPERATES SIX COMMUNITY HOSPITALS IN ADDITION TO PONTOTOC HEALTH SERVICES. THE CHNA INCLUDED PONTOTOC HEALTH SERVICES, CLAY COUNTY MEDICAL CORPORATION, NORTH MISSISSIPPI MEDICAL CENTER, WEBSTER HEALTH SERVICES, TISHOMINGO HEALTH SERVICES, MONROE HEALTH SERVICES, AND MARION REGIONAL MEDICAL CENTER.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - PONTOTOC HEALTH SERVICES. THE NEEDS OF THE COMMUNITY GO BEYOND THE RESOURCES OF THE ORGANIZATION WITH THE NON-EXPANSION OF MEDICAID IN THE STATE AND THE REDUCTION IN MEDICAID PAYMENTS AS WELL AS A SIGNIFICANT INCREASE IN UNINSURED. THE ORGANIZATION FOCUSES ON PROVIDING ACCESS TO BASIC HEALTHCARE NEEDS INCLUDING: A. INCREASE ACCESS TO PREVENTIVE SERVICE - EXPAND VIRTUAL/TELEHALTH OFFERINGS - COLLABORATE TO EXPLORE TRANSPORTATION NEEDS - INITIATE INNOVATIVE LISTEN-TO-LEARN COMMUNITY SESSIONS - UTILIZE PARTNERS TO ASSIST THOSE WITH LIMITED OR NO INSURANCE - INCREASE AFFORDABLE AFTER-HOURS CARE - IMPROVE ACCESS TO SPECIALTY CARE B. INCREASE PHYSICAL ACTIVITY AND PROMOTE EXERCISE AS MEDICINE - PARTNER WITH LOCAL WELLNESS CENTERS & GYMS - DEVELOP PARTNERSHIPS WITH LOCAL PARKS/RECREATION FACILITIES - UTILIZE EXERCISE "PRESCRIPTIONS" - ORGANIZE WALKING CLUBS - PROMOTE CORPORATE WELLNESS PROGRAMS - IDENTIFY COMMUNITY RESOURCES, E.G. TRAILS, WALKINGS TRACKS, ETC. C. DEVELOP A NUTRITIONALLY AWARE COMMUNITY CULTURE - SCREEN FOR AND CREATE ACCESS TO NUTRITIOUS FOODS - DEVELOP CULTURALLY APPROPRIATE EDUCATIONAL PROGRAMS - DEVELOP COMMUNITY COALITIONS TO PROVIDE FRESH FOOD/PROMOTE COMMUNITY GARDENS - TEACH FOOD PRESERVATION SKILLS - UTILIZE ESTABLISHED NETWORKS TO PROMOTE NUTRITION D. DEVELOP PARTNERSHIPS WITH PUBLIC ENTITIES - PUBLIC HEALTH -- STATE AND REGIONAL OFFICES - EDUCATIONAL INSTITUTIONS -- EARLY CHILDHOOD, PRIMARY, SECONDARY, AND POST-SECONDARY - GOVERNMENT -- STATE, REGIONAL, AND LOCAL
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - PONTOTOC HEALTH SERVICES. THE FAP DOES NOT COVER CHARGES FOR PATIENTS OR TREATMENTS WITH THE FOLLOWING CONDTIONS: I. THE PATIENT HAS ANY THIRD-PARTY INSURANCE COVERAGE. A DISCRETIONARY EXCEPTION MAY BE MADE FOR INSURED PATIENTS IS THE PROVISOIN FOR THE MEDICALLY UNDER-INSURED II. THE PATIENTS PRIMARY RESIDENCE IS OUTSIDE THE SERVICE AREA III. THE PATIENT IS CURRENTLY IN CUSTODY OF A CORRECTIONAL FACILITY IV. THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ANOTHER CITY, COUNTY, STATE, FEDERAL OR OTHER ASSISTANCE PROGRAM WHICH SUPERSEDES THE FAP. V. IF PATIENT'S CHARGES RESULTED FROM A WORK-RELATED ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE. VI. IF PATIENT CHARGES RESULTED FROM AN AUTO ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE. THE FINANCIAL ASSISTANCE POLICY IS NOT APPLICABLE TO PHYSICIANS OR THEIR IMMEDIATE FAMILY MEMBERS.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
PONTOTOC HEALTH SERVICES NURSING HOME
176 SOUTH MAIN STREETPONTOTOCMS38863LONG-TERM ACUTE CARE FACILITY
PONTOTOC OUTPATIENT COUNSELING
185 NORTH MAIN STREETPONTOTOCMS38863OUTPATIENT COUNSELING
PONTOTOC MEDICAL CLINIC
345 HWY 15 NORTHPONTOTOCMS38863RURAL HEALTH CLINIC
CHILDRENS CLINIC - ECRU
202 MAIN STREETECRUMS38841PEDIATRIC CLINIC
NEW ALBANY MEDICAL CLINIC
400 DOCTORS DRIVENEW ALBANYMS38652RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3cWEBSTER HEALTH SERVICES, INC. USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE CARE. IF THE PATIENT'S INCOME LEVEL IS 0-150% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 200% OF THE FPL, THE HOSPITAL MAY OFFER DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.
Schedule H, Part VI, Line 7STATE FILING OF COMMUNITY BENEFIT REPORT PONTOTOC HEALTH SERVICES DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF MISSISSIPPI AS THERE IS NO REQUIREMENT TO DO SO.
Schedule H, Part I, Line 6a Community benefit report prepared by related organizationPONTOTOC HEALTH SERVICES, INC. COMMUNITY BENEFIT INFORMATION IS INCLUDED IN THE COMMUNITY BENEFIT REPORT OF ITS PARENT COMPANY, NORTH MISSISSIPPI HEALTH SERVICES, INC. NORTH MISSISSIPPI HEALTH SERVICES (NMHS) IS A DIVERSIFIED REGIONAL HEALTH CARE ORGANIZATION, WHICH SERVES 24 COUNTIES IN NORTH MISSISSIPPI AND NORTHWEST ALABAMA FROM HEADQUARTERS IN TUPELO, MS. THE NMHS ORGANIZATION COVERS A BROAD RANGE OF ACUTE DIAGNOSTIC AND THERAPEUTIC SERVICES, OFFERED THROUGH NORTH MISSISSIPPI MEDICAL CENTER IN TUPELO; A COMMUNITY HOSPITAL SYSTEM WITH LOCATIONS IN EUPORA, IUKA, PONTOTOC, WEST POINT, AMORY, MS, AND HAMILTON AL; NORTH MISSISSIPPI MEDICAL CLINICS, A REGIONAL NETWORK OF 27 PRIMARY AND SPECIALTY CLINICS; AND NURSING HOMES. NMHS OFFERS A COMPREHENSIVE PORTFOLIO OF MANAGED CARE PLANS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceA COST TO CHARGE RATIO WAS USED FOR THE AMOUNTS REPORTED IN THE TABLE FOR LINE 7. THE COST TO CHARGE RATIO FOR LINE 7 WAS CALCULATED USING WORKSHEET 2.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountPONTOTOC HEALTH SERVICES' FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE SPECIFICALLY CONCERNING BAD DEBT. BAD DEBT IS SHOWN AS A SEPARATE LINE ITEM ON THE FACE OF THE INCOME STATEMENT. THE AMOUNT OF BAD DEBT BOOKED EACH YEAR IS BASED ON A REVIEW OF OUTSTANDING RECEIVABLES AND THEIR AGE FROM DATE OF SERVICE. THE OLDER THE ACCOUNT, THE HIGHER THE RESERVE PERCENTAGE USED TO ESTIMATE BAD DEBT. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATIONS AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyPONTOTOC HEALTH SERVICES (PHS) FOLLOWS THE CATHOLIC HEALTH ASSOCIATION GUIDELINES AND DOES NOT INCLUDE BAD DEBT IN ANY COMMUNITY BENEFIT AMOUNTS. PHS BELIEVES THAT SOME PORTION OF BAD DEBT RESULTS FROM PATIENTS WHO COULD QUALIFY FOR CHARITY CARE BUT HAS NO WAY OF MAKING AN ESTIMATE OF THE AMOUNT AND THEREFORE HAS ANSWERED "ZERO" FOR PART III LINE 3.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteTHE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2024.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs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
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistancePONTOTOC HEALTH SERVICES DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE HOSPITALS MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS.
Schedule H, Part V, Section B, Line 16a FAP website- PONTOTOC HEALTH SERVICES, INC.: Line 16a URL: www.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-Assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website- PONTOTOC HEALTH SERVICES, INC.: Line 16b URL: www.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-Assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- PONTOTOC HEALTH SERVICES, INC.: Line 16c URL: www.nmhs.net/Patients-and-Visitors/Billing-and-Insurance/Financial-Assistance;
Schedule H, Part VI, Line 2 Needs assessmentNEEDS ASSESSMENT PONTOTOC HEALTH SERVICES UTILIZES VARIED BUT COMPLIMENTARY METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. PONTOTOC HEALTH SERVICES AND PONTOTOC COUNTY ARE INCLUDED IN THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY HEALTH ASSESSMENT WHICH IS PERFORMED EVERY THREE YEARS AND PROVIDES INFORMATION ON HEALTH STATUS, UTILIZATION OF HEALTH SERVICES, HEALTHY BELIEFS AND SATISFACTION WITH HEALTH CARE SERVICES. THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY HEALTH ASSESSMENT COVERS THE 24 COUNTY SERVICE AREA INCLUDING PONTOTOC COUNTY AND PROVIDES INFORMATION BY COUNTY. IN ADDITION, THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY RELATIONS FACILITATOR CONDUCTS ROUTINE VISITS WITH OUR INTERNAL AND EXTERNAL STAKEHOLDERS ACROSS THE ENTIRE SERVICE AREA INCLUDING PONTOTOC COUNTY. THE INFORMATION GATHERED THROUGH SEVERAL QUALITATIVE SURVEY QUESTIONS IS USED TO DETERMINE OUR COMMUNITY'S NEEDS FOR THE ENTIRE SERVICE AREA AS WELL AS THE LOCAL SERVICE AREA FOR EACH HOSPITAL SUCH AS PONTOTOC HEALTH SERVICES.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistancePATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE EXPLANATIONS OF THE PONTOTOC HEALTH SERVICES CHARITY CARE POLICY ARE COMMUNICATED IN A VARIETY OF FORMS INCLUDING SIGNAGE AT ALL ADMISSION AND REGISTRATION AREAS, ON THE WEB SITE, ON BILLS AND STATEMENTS, AND IN ADMISSION PACKETS. FINANCIAL COUNSELORS ASSIST THE PATIENT AND RESPONSIBLE PARTIES WITH DETERMINING ELIGIBILITY FOR GOVERNMENT PROGRAMS, PRIMARILY MEDICAID, AND CHARITY CARE STATUS. THE PATIENT CAN APPLY FOR CHARITY CARE AT ANY TIME FROM THE DATE OF SERVICE THROUGH THE COLLECTION PROCESS AND ONCE QUALIFIED AND APPROVED ALL COLLECTION EFFORTS ARE STOPPED.
Schedule H, Part VI, Line 4 Community informationCOMMUNITY INFORMATION PONTOTOC HEALTH SERVICES SERVES MORE THAN 32,000 PEOPLE IN PONTOTOC COUNTY, MS, AND THE SURROUNDING AREA. THE POPULATION FOR THE SERVICE AREA IS PROJECTED TO REMAIN ESSENTIALLY FLAT OVER THE NEXT FIVE YEARS. ACCORDING TO THE U.S. CENSUS BUREAU, AGE DEMOGRAPHICS FOR THE SERVICE AREA SHOW THAT APPROXIMATELY 22% OF THE POPULATION IS UNDER 18 YEARS OF AGE, APPROXIMATELY 60% IS BETWEEN 18 AND 64 YEARS OF AGE AND THAT 18% IS 65 OR OLDER. CAUCASIANS MAKE UP 76% OF THE SERVICE AREA'S POPULATION WHILE AFRICAN AMERICANS MAKE UP 15% AND HISPANICS AND OTHERS MAKE UP 9%. MEDIAN HOUSEHOLD INCOME WAS $53,272 FOR THE SERVICE AREA, WHICH IS ABOVE THE OVERALL AVERAGE FOR MISSISSIPPI BUT SIGNIFICANTLY LESS THAN THE NATIONWIDE AVERAGE. THE PATIENT POPULATION FOR PONTOTOC HEALTH SERVICES THAT IS UNINSURED IS 15.5%.
Schedule H, Part VI, Line 5 Promotion of community healthPROMOTION OF COMMUNITY HEALTH PONTOTOC HEALTH SERVICES HAS A COMMITMENT TO A WIDE VARIETY OF COMMUNITY HEALTH OUTREACH ACTIVITIES, WHICH ARE COORDINATED BY THE COMMUNITY HEALTH COORDINATOR AND ARE STAFFED BY PONTOTOC HEALTH SERVICES EMPLOYEES WHO VOLUNTEER THEIR TIME TO HELP WITH THESE EVENTS AND ACTIVITIES. THE COMMUNITY HEALTH COORDINATOR ASSISTS IN EDUCATING THE COMMUNITY ON HEALTH-RELATED ISSUES BY ORGANIZING AND PRESENTING VARIOUS HEALTH FAIRS AND SEMINARS. THESE EVENTS ARE HELD AT LOCAL BUSINESSES, SCHOOLS AND COMMUNITY ORGANIZATIONS AND ADDRESS A VARIETY OF HEALTH-RELATED TOPICS. IN ADDITION, THE HOSPITAL SPONSORS CHOLESTEROL, BLOOD PRESSURE, VISION, MEMORY, AND HEART-RISK SCREENING EVENTS, THROUGH WHICH TESTS ARE MADE AVAILABLE TO THE PUBLIC FOR A NOMINAL FEE OR AT NO CHARGE WITH THE MAJORITY OF THE COSTS INCURRED ABSORBED BY THE HOSPITAL.
Schedule H, Part VI, Line 6 Affiliated health care systemAFFILIATED HEALTH CARE SYSTEM AS NOTED ABOVE, PONTOTOC HEALTH SERVICES (PHS) IS PART OF NORTH MISSISSIPPI HEALTH SERVICES (NMHS). NMHS OPERATES NORTH MISSISSIPPI MEDICAL CENTER, FIVE OTHER COMMUNITY HOSPITALS IN ADDITION TO PHS, AS WELL AS, NORTH MISSISSIPPI MEDICAL CLINICS, WHICH OPERATES MORE THAN 36 MEDICAL CLINICS. SOME OF THESE FACILITIES OPERATE AT AN ONGOING FINANCIAL LOSS AND NMHS PROVIDES OPERATING FUNDS IN THE FORM OF WORKING CAPITAL LOANS THAT HAVE NO SET REPAYMENT DATE. THESE WORKING CAPITAL LOANS HAVE HISTORICALLY BEEN CONVERTED TO CAPITAL TRANSFERS IN MANY CASES, AND THEREFORE, THE LOANS ARE FORGIVEN SUCH THAT THE FACILITY NEVER MAKES REPAYMENT. NMHS DOES THIS IN ORDER TO PROVIDE ACCESS TO A VARIETY OF SERVICES ACROSS THE SERVICE AREA AND IS AN INTENTIONAL PART OF ITS BUSINESS MODEL. THE COMMUNITY HEALTH DEPARTMENT THAT IS PART OF NMMC COORDINATES A VARIETY OF COMMUNITY HEALTH ACTIVITIES ACROSS THE SERVICE AREA AS WELL.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

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
MICHAEL S SPEES
PRESIDENT$0$1,110,231$0$1,032,676$0$176,615$0$19,800$0$7,428$0$2,346,750$0$0
SHARON NOBLES
TREASURER$0$568,363$0$359,729$0$79,430$0$19,800$0$9,448$0$1,036,770$0$0
BRUCE TOPPIN
SECRETARY$0$399,862$0$208,113$0$59,597$0$6,600$0$8,392$0$682,564$0$0
JAMIE RODGERS
ADMINISTRATOR$0$221,913$0$87,851$0$734$0$0$0$6,672$0$317,170$0$0
JUSTIN SMITH
PHYSICIAN$237,960$0$194,548$0$22,716$0$12,595$0$4,572$0$472,391$0$0$0
CURTIS GLIDEWELL
PHYSICIAN$247,864$0$183,744$0$22,716$0$14,252$0$4,668$0$473,244$0$0$0
BRAD J BOWLIN
PHYSICIAN$375,216$0$24$0$22,860$0$29,700$0$4,668$0$432,468$0$0$0
ANDREA P WARREN
PHYSICIAN$257,694$0$97,183$0$360$0$24,750$0$6,672$0$386,659$0$0$0
JENNIFER D LOWERY
PHYSICIAN$245,905$0$57,151$0$14,548$0$19,201$0$6,672$0$343,477$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationNORTH MISSISSIPPI HEALTH SERVICES (NMHS) ESTABLISHES THE PAY OF THE CEO AND COMPENSATES HIM. NMHS USES THE FOLLOWING METHODS FOR ESTABLISHING THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planFORM 990, SCHEDULE J, PART I, LINE 4B: THE FOLLOWING PEOPLE PARTICIPATED IN OR RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SHARON NOBLES - $ 54,519 MICHAEL SHANE SPEES - $111,507 BRUCE TOPPIN - $40,061
Schedule J, Part I, Line 7 Non-fixed paymentsPHYSICIAN BONUSES ARE ALL CONTINGENT INCOME DEPENDING UPON EITHER THE NUMBER OF SERVICES PROVIDED OR THE QUALITY OF PERFORMANCE PERFORMED. ALL ARE SPECIFIED IN THEIR CONTRACTS. ANY OTHER INCENTIVES ARE PAID OUT AS CONTINGENT INCOME ALSO BASED ON QUALITY AND FINANCIAL PERFORMANCE METRICS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15 A&BAN INDEPENDENT COMPENSATION CONSULTING FIRM, KORN FERRY, IS USED TO HELP ESTABLISH THE COMPENSATION OF THE SENIOR EXECUTIVES. THE FIRM PRESENTS THEIR INDEPENDENT ANALYSIS, WHICH CONTAINS COMPARABILITY DATA, TO THE COMPENSATION COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS). THE COMPENSATION OF THE INDIVIDUALS ARE THEN APPROVED BY THE COMPENSATION COMMITTEE. THE SALARIES OF NMHS' SENIOR EXECUTIVES ARE THEN REVIEWED BY THE NMHS BOARD OF DIRECTORS. THE INDIVIDUAL WHOSE COMPENSATION IS BEING DISCUSSED IS NOT PRESENT DURING THE DISCUSSION OR APPROVAL OF THEIR COMPENSATION. THE DISCUSSIONS AND DECISIONS REGARDING THE COMPENSATION ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS. COMPENSATION OF THESE INDIVIDUALS IS APPROVED ANNUALLY.
Form 990, Part VI, Line 6 Classes of members or stockholdersPONTOTOC HEALTH SERVICES, INC. IS A NOT-FOR-PROFIT, NONSTOCK, MEMBERSHIP CORPORATION OF WHICH NORTH MISSISSIPPI HEALTH SERVICES, INC. IS THE SOLE MEMBER AND HAS SOLE VOTING CONTROL.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE GOVERNANCE COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC., WHICH IS MADE UP OF PAST CHAIRMEN, NOMINATE CANDIDATES FOR THE BOARD. THESE CANDIDATES ARE THEN APPROVED BY THE BOARD OF NORTH MISSISSIPPI HEALTH SERVICES, INC.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE BOARD OF NORTH MISSISSIPPI HEALTH SERVICES, INC. APPROVES ALL TRANSACTIONS THAT EXCEED $1 MILLION.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE FORM 990 GOES THROUGH A REVIEW PROCESS IN THE ACCOUNTING DEPARTMENT. THE ACCOUNTANT FOR EACH FACILITY REVIEWS THE RETURNS FOR REASONABLENESS AND ACCURACY. ALL TOTALS ARE TIED TO THE AUDIT REPORTS, AND ALL AMOUNTS ARE CROSS REFERENCED TO SCHEDULES OR OTHER PARTS OF THE ACTUAL RETURN. ONCE THE ACCOUNTANT REVIEWS THE RETURN, THE ACCOUNTING SUPERVISOR AND THE DIRECTOR OF ACCOUNTING REVIEWS. THE SUPERVISOR DOES A DETAILED REVIEW BY CHECKING THE RETURN FOR THE SAME ITEMS THAT THE ACCOUNTANT CHECKED FOR. THE DIRECTOR THEN DOES A HIGHER-LEVEL REVIEW, READING THE RETURN FOR REASONABLENESS AND COMPARING PRIOR YEAR AMOUNTS TO CURRENT YEAR AMOUNTS. FINALLY, THE VICE PRESIDENT OF FINANCE REVIEWS THE RETURN FOR REASONABLENESS. THE RETURNS ARE THEN SENT TO THE EXECUTIVE VP/TREASURER TO BE REVIEWED. THE CHIEF FINANCIAL OFFICER SIGNS THE RETURN AND IT IS THEN SENT TO THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policyAN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE IS REQUIRED TO BE COMPLETED BY ALL OFFICERS AND DIRECTORS OF THE ORGANIZATION. THE QUESTIONNAIRE IS REVIEWED BY NORTH MISSISSIPPI HEALTH SERVICES, INC.'S COMPLIANCE OFFICER AND CONFLICT COMMITTEE. THE CONFLICT COMMITTEE REVIEWS CONFLICT TRANSACTIONS AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING CONFLICT TRANSACTIONS IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ALL MEMBERS OF THE CONFLICT COMMITTEE ARE PROHIBITED FROM ENGAGING IN TRANSACTIONS WITH THE ORGANIZATION OR ITS AFFILIATES DURING THEIR TENURE ON THE CONFLICT COMMITTEE AND ONE YEAR AFTER THEIR SERVICE CONCLUDES.
Form 990, Part VI, Line 19 Required documents available to the publicTHE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. A CONSOLIDATED STATEMENT OF OPERATIONS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.
Form 990, Part IX, Line 11g Other FeesOTHER PURCHASED SERVICES - Total Expense: 1378897, Program Service Expense: 1378897, Management and General Expenses: 0, Fundraising Expenses: 0; PHYSICIAN SERVICES - Total Expense: 1598800, Program Service Expense: 1598800, Management and General Expenses: 0, Fundraising Expenses: 0; CONTRACT SERVICES - Total Expense: 51709, Program Service Expense: 51709, Management and General Expenses: 0, Fundraising Expenses: 0; COLLECTION FEES - Total Expense: 117133, Program Service Expense: 117133, Management and General Expenses: 0, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesPENSION-RELATED CHANGES THAN NET PERIODIC PENSION COST - 16398; INCREASE IN INTEREST IN NA OF AFFILIATED FOUNDATION - 4516;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
NORTH MS MANAGEMENT SERVICES INC
830 SOUTH GLOSTER STREETTUPELOMS38801640762694MGMT & ADMINDE501(c)(3)Type INMHSYes (true)
NORTH MS HEALTH SERVICES INC
830 SOUTH GLOSTER STREETTUPELOMS38801640653269MGMT SERVICESDE501(c)(3)Type IINAfalse
CLAY COUNTY MEDICAL CORPORATION
830 SOUTH GLOSTER STREETTUPELOMS38801640668465HOSPITALDE501(c)(3)3NMHSYes (true)
TISHOMINGO HEALTH SERVICES
830 SOUTH GLOSTER STREETTUPELOMS38801640741047HOSPITALDE501(c)(3)3NMHSYes (true)
WEBSTER HEALTH SERVICES INC
830 SOUTH GLOSTER STREETTUPELOMS38801640819193HOSPITALDE501(c)(3)3NMHSYes (true)
NORTH MS MEDICAL CLINICS INC
830 SOUTH GLOSTER STREETTUPELOMS38801640787918MED CLINICSDE501(c)(3)3NMHSYes (true)
TUPELO SERVICE FINANCE INC
830 SOUTH GLOSTER STREETTUPELOMS38801640508308COLLECTIONSDE501(c)(3)3NMHSYes (true)
MONROE HEALTH SERVICES
830 SOUTH GLOSTER STREETTUPELOMS38801320583236HOSPITALDE501(c)(3)3NMHSYes (true)
MARION REGIONAL MEDICAL CENTER INC
830 SOUTH GLOSTER STREETTUPELOMS38801640926753HOSPITALDE501(c)(3)3NMHSYes (true)
NORTH MS MEDICAL CENTER INC
830 SOUTH GLOSTER STREETTUPELOMS38801640662976HOSPITALDE501(c)(3)3NMHSYes (true)
NORTH MS EMERGENCY SERVICES INC
830 SOUTH GLOSTER STREETTUPELOMS38801640780130ER PHYSICIANSDE501(c)(3)10NMHSYes (true)
HEALTH CARE FOUNDATION OF NORTH MS
830 SOUTH GLOSTER STREETTUPELOMS38801640914704FUNDRAISINGDE501(c)(3)7NMHSYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
MEDICAL IMAGING LLC
830 SOUTH GLOSTER STREETTUPELOMS38801770647210MEDICAL IMAGINGMSNAfalsefalse
CENTER FOR DIGESTIVE HEALTH LLC
589 GARFIELD STTUPELOMS38801201606438DIGESTIVE CAREMSNAfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
NORTH MS HEALTH LINK INC
830 S GLOSTER STREETTUPELOMS38801640715886MEDICAL SERVICESDENMHSC CorporationYes (true)
NORTH MS ENTERPRISES INC
830 S GLOSTER STREETTUPELOMS38801640658059MEDICAL SERVICESDENMHSC CorporationYes (true)
PROFESSIONAL PRACTICE MANAGEMENT INC
830 S GLOSTER STREETTUPELOMS38801721390014MED SERV MGMTDENMMCLC CorporationYes (true)
ACCLAIM INC
830 S GLOSTER STREETTUPELOMS38801721356116HEALTH CARE CLAIMSDEHEALTHLINKC CorporationYes (true)
NORTH MS SUPPORT SERVICES INC
830 S GLOSTER STREETTUPELOMS38801260718275SUPPORT SERVICESDENMHSC CorporationYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd