2020-11-16T16:17:40-06:00 2019-12-31 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2019-01-01 621808817 HEALTH SERVICES MANAGEMENT INC HEAL 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 WILLIAM NEELY EXECUTIVE VP 6158961191 2020-11-16 1 LUCY R CARTER P00026809 6152427351 2020-11-16 65.198.206.98 2020-11-16 16:05:35 CS P 1859125A1FFEB578F7BB16A7BCB2D4782BFF1E26 EE7BB5FE320B8FB13B25121C5E937124580CA208 2019 2021-01-29 14:40:06Z ERIC BELL 206 FORTRESS BLVD MURFREESBORO TN 37128 138456229 0 X N/A X 2000 TN TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 6 3 3421 0 0 0 152698 74852 130781671 133495798 -146164 286265 2473017 2043170 133261222 135900085 682001 556668 0 0 67124845 68831994 0 0 0 63608998 64402825 131415844 133791487 1845378 2108598 120298786 119911864 56598777 54103257 63700009 65808607 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 0 0 121346060 556668 133941522 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES IN INDIANA, TENNESSEE, TEXAS, AND FLORIDA. 121346060 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 503 0 1 3421 1 0 0 0 0 0 0 0 0 0 0 1 0 X 6 3 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 JAMES E BELL CEO, CHAIRMAN 50.00 X X 1235790 0 11834 WILLIAM NEELY EXECUTIVE VP 50.00 X X 898881 0 8074 SCOTT FISHER CFO 50.00 X X 597961 0 20990 JOSHUA WHITE REGIONAL VP OF OPERATIONS 50.00 X 335374 0 13 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 50.00 X 232292 0 10647 ANNA-MARIE OWENS-WICKER ADMINISTRATOR 50.00 X 219221 0 7823 CHRISTOPHER GONZALEZ REGIONAL ADMINISTRATOR 50.00 X 212659 0 3794 WANDA MOAK ADMINISTRATOR 50.00 X 192254 0 6202 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 50.00 X 180570 0 7384 JENNIFER DAVES CHIEF NURSING OFFICER 50.00 X 180179 0 7441 JOANNA BUCKLES ADMINISTRATOR 50.00 X 171837 0 5912 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVICES 50.00 X 158105 0 969 PATRICIA EDGELL END 10819 REGIONAL NURSE 40.00 X 153387 0 2592 JERALD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 50.00 X 148229 0 16685 JENNIFER BARBER CORPORATE CONTROLLER 50.00 X 114869 0 15616 TIMOTHY PRIDDY DIRECTOR 1.00 X 84500 0 0 RANDY SHUCK DIRECTOR 1.00 X 83000 0 0 JIM SHATZ DIRECTOR 1.00 X 59500 0 0 5258608 0 125976 46 0 1 0 RELIANT REHABILITATION 5212 VILLAGE CREEK DRIVE PLANO TX 75093 PHYSICAL, OCCUPATIONAL & SPEECH THERAPY 13421348 QUALITY CARE REHAB 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 PHYSICAL, OCCUPATIONAL & SPEECH THERAPY 1615589 NIELSON FINANCIAL SERVICES INC 901 EAST WASHINGTON ST ORLANDO FL 32801 BILLING & AR SUPPORT 787990 LTC TECHNOLOGY SYSTEMS INC 1906 SE 3RD AVE OCALA FL 34471 IT SERVICES 492103 LBMC EMPLOYMENT PARTNERS PO BOX 1869 BRENTWOOD TN 37027 PAYROLL & HR SERVICES 436855 22 74852 74852 PATIENT SERVICE REVENUE 623000 133149754 133149754 MANAGEMENT FEE REVENUE 623000 172468 172468 CAFETERIA & VENDING REVENUE 722514 41987 41987 CABLE & PHONE REVENUE 812900 29609 29609 101980 101980 133495798 530959 530959 3419006 2066254 1352752 1352752 1352752 245196 489890 -244694 -244694 -244694 PASSTHROUGH INCOME 446110 584523 584523 OTHER REVENUE 900099 105895 105895 690418 135900085 133941522 0 1883711 X 556668 556668 3783956 213895 3570061 58566660 56968646 1598014 64792 59543 5249 1925528 1621540 303988 4491058 4147941 343117 14494 14494 554106 554106 670537 670537 18615397 17913995 701402 1211634 429297 782337 3506431 1999339 1507092 550410 105413 444997 12200088 11946698 253390 211250 112833 98417 544848 269720 275128 703534 670417 33117 359647 241875 117772 3275324 3066388 208936 2972560 2869237 103323 TAXES 5002964 4503224 499740 FOOD 4060101 4060101 PROGRAM SUPPLIES 3864206 3738589 125617 PHARMACEUTICAL DRUGS 3081881 3081881 3003413 2768820 234593 133791487 121346060 12445427 0 18547186 18479587 13061217 13474429 17843348 18163647 1638518 1638518 295936 297611 663840 1265675 109913555 44318170 66693672 65595385 439326 423849 1115743 573163 120298786 119911864 9431209 8655577 129527 96757 502026 449793 42251580 40720635 4284435 4180495 56598777 54103257 X 63700009 65808607 63700009 65808607 120298786 119911864 2108598 0 X X 0 1 X 1 0 X 152698 74852 227550 138909137 138891066 136524035 130781671 133495798 678601707 3384214 3419006 6803220 138909137 138891066 136524035 134318583 136989656 685632477 0 0 0 685632477 160992 152367 197972 418656 530959 1460946 160992 152367 197972 418656 530959 1460946 1039429 690418 1729847 139070129 139043433 136722007 135776668 138211033 688823270 0.99540 0.99700 0.00210 0.00150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 4790815 4790815 77874404 26195514 51678890 9627321 7305351 2321970 9504162 7313543 2190619 8116853 3503762 4613091 65595385 RESIDENT REFUNDS PAYABLE 2670859 DUE TO RELATED PARTIES 1509636 4180495 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. 0 ARROWHEAD RANCH INC 206 FORTRESS BLVD MURFREESBORO TN 37138 263456041 501(C)3 556668 TO PROVIDE ASSISTANCE TO ARROWHEAD OPERATIONS INC. 1 X X 0 0 X X X X 0 0 0 0 0 1 0 1 0 JAMES E BELL CEO, CHAIRMAN 1191390 0 0 0 44400 0 325 0 11509 0 1247624 0 0 0 WILLIAM NEELY EXECUTIVE VP 854481 0 0 0 44400 0 0 0 8074 0 906955 0 0 0 SCOTT FISHER CFO 576261 0 0 0 21700 0 3268 0 17722 0 618951 0 0 0 JOSHUA WHITE REGIONAL VP OF OPERATIONS 322374 0 0 0 13000 0 0 0 13 0 335387 0 0 0 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 232292 0 0 0 0 0 1489 0 9158 0 242939 0 0 0 ANNA-MARIE OWENS-WICKER ADMINISTRATOR 192021 0 20000 0 7200 0 1498 0 6325 0 227044 0 0 0 CHRISTOPHER GONZALEZ REGIONAL ADMINISTRATOR 180690 0 28269 0 3700 0 1434 0 2360 0 216453 0 0 0 WANDA MOAK ADMINISTRATOR 135054 0 50000 0 7200 0 1466 0 4736 0 198456 0 0 0 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 180570 0 0 0 0 0 1157 0 6227 0 187954 0 0 0 JENNIFER DAVES CHIEF NURSING OFFICER 180179 0 0 0 0 0 1214 0 6227 0 187620 0 0 0 JOANNA BUCKLES ADMINISTRATOR 137637 0 27000 0 7200 0 1176 0 4736 0 177749 0 0 0 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVIC 158105 0 0 0 0 0 0 0 969 0 159074 0 0 0 PATRICIA EDGELL END 10819 REGIONAL NURSE 140387 0 0 0 13000 0 555 0 2037 0 155979 0 0 0 JERALD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 148229 0 0 0 0 0 650 0 16035 0 164914 0 0 0 PART I, LINE 1B THE ORGANIZATION PROVIDED TRAVEL FOR THE SPOUSES OF ALL EMPLOYEES ATTENDING ITS ANNUAL MANAGEMENT CONFERENCE WHICH INCLUDED OFFICERS, DIRECTORS, AND FACILITY ADMINISTRATORS. ALL MARRIED PERSONS LISTED IN PART VII, SECTION A OF FORM 990 RECEIVED THIS BENEFIT UNLESS THEIR SPOUSE WAS UNABLE TO ATTEND. THE SPOUSES WERE ASKED TO ATTEND THIS CONFERENCE TO MAINTAIN THE FAMILY ATMOSPHERE THE ORGANIZATION TRIES TO FOSTER IN ITS STAFF AND OPERATIONS. THE MANAGEMENT OF THE ORGANIZATION BELIEVES THAT THE CONFERENCE WOULD NOT BE AS EFFECTIVE IF THE SPOUSES DID NOT ATTEND. THE EXPENSES PAID FOR THE SPOUSES WAS LIMITED TO MEALS AND AIRFARE AND RANGED FROM $800 T0 $1000 PER PERSON. THE DECISION TO INVITE THE SPOUSES TO ATTEND THE CONFERENCE WAS MADE BY THE CEO OF THE ORGANIZATION. PART I, LINE 6 THE 2019 PLAN INCLUDES AN INCENTIVE PAYMENT TO ADMINISTRATORS, DON, SOCIAL SERVICES, ADMISSIONS DIRECTOR, AND DIETARY FOR CATEGORIES INCLUDING BUDGET COMPLIANCE, MEDICARE CENSUS, SUPER BONUS, CENTER OPERATIONAL PERFORMANCE SCORECARD, CUSTOMER CARE SATISFACTION SURVEY, TURNOVER, LABOR BUDGET,AND FOOD BUDGET. PART I, LINE 7 THE 2019 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 EXECUTIVE OFFICERS. THE INDEPENDENT BOARD MEMBERS AND THE FULL BOARD APPROVED THE COMPENSATION PAID IN 2019. 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 17,127,525. MANAGEMENT AND GENERAL EXPENSES 79,018. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,206,543. CASE MANAGEMENT: PROGRAM SERVICE EXPENSES 165,112. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 165,112. UTILIZATION REVIEW: PROGRAM SERVICE EXPENSES 53,400. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,400. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 622,384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 622,384. OTHER: PROGRAM SERVICE EXPENSES 567,958. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 567,958. FORM 990, PART XII, LINE 2C THE PROCESS IS THE SAME AS IN THE PRIOR YEAR. 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