NORTH ARKANSAS REGIONAL MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: NORTH ARKANSAS REGIONAL MEDICAL CENTER (EIN 71-0787860)
Tax period: 2018-04-01 to 2019-03-31
Filed: 2020-02-17
IRS object ID: 202010489349300411
Schema version: 2018v3.1
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-02-17T08:43:05-06:00	ReturnTs
Tax Period End	2019-03-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 3667	AddressLine1Txt
City	LITTLE ROCK	CityNm
State Abbreviation	AR	StateAbbreviationCd
ZIP	722033667	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-04-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	710787860	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH ARKANSAS REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% KEN PANNELL	InCareOfNm
Business Name Control	NORT	BusinessNameControlTxt
Phone	8704145157	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 NORTH MAIN	AddressLine1Txt
City	HARRISON	CityNm
State Abbreviation	AR	StateAbbreviationCd
ZIP	72601	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KEN PANNELL	PersonNm
Person Title	VP FINANCE/CFO	PersonTitleTxt
Phone	8704144549	PhoneNum
Signature	2020-01-28	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	AMBER SHERRILL	PreparerPersonNm
PTIN	P00748683	PTIN
Phone	5013721040	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	71015520200485000002	FederalOriginalSubmissionId
Federal Original Submission Id	2020-02-17	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	8B484ADD3177755575C2D061B48861D965F12CF4	AtSubmissionCreationDeviceId
At Submission Filing Device Id	CC61051F674196C1A7C00C4FC8A1F1691B9B2D69	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-11-06 18:47:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	VINCE LEIST	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 NORTH MAIN	AddressLine1Txt
City	HARRISON	CityNm
State Abbreviation	AR	StateAbbreviationCd
ZIP	72601	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$118,576,626	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.NARMC.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1996	FormationYr
Legal Domicile State	AR	LegalDomicileStateCd
Activity Or Mission	OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING SAFE, QUALITY HEALTHCARE AND RESOURCES WITH COMPASSION AND INTEGRITY.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	1109	TotalEmployeeCnt
Total Volunteers	212	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$135,833	PYContributionsGrantsAmt
CY Contributions Grants	$246,373	CYContributionsGrantsAmt
PY Program Service Revenue	$102,278,503	PYProgramServiceRevenueAmt
CY Program Service Revenue	$96,736,592	CYProgramServiceRevenueAmt
PY Investment Income	$1,394,286	PYInvestmentIncomeAmt
CY Investment Income	$1,297,120	CYInvestmentIncomeAmt
PY Other Revenue	$2,650,677	PYOtherRevenueAmt
CY Other Revenue	$2,300,095	CYOtherRevenueAmt
PY Total Revenue	$106,459,299	PYTotalRevenueAmt
CY Total Revenue	$100,580,180	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$51,875,718	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$54,677,867	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$52,237,255	PYOtherExpensesAmt
CY Other Expenses	$57,445,311	CYOtherExpensesAmt
PY Total Expenses	$104,112,973	PYTotalExpensesAmt
CY Total Expenses	$112,123,178	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,346,326	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$11,542,998	CYRevenuesLessExpensesAmt
Total Assets BOY	$98,787,879	TotalAssetsBOYAmt
Total Assets EOY	$87,482,353	TotalAssetsEOYAmt
Total Liabilities BOY	$31,213,582	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$30,900,812	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$67,574,297	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$56,581,541	NetAssetsOrFundBalancesEOYAmt
Mission	WE ARE DEDICATED TO PROVIDING QUALITY SERVICES THAT ARE COMPREHENSIVE AND AFFORDABLE. WE EXPECT SERVICES TO BE DELIVERED COMPASSIONATELY, APPROPRIATELY, RESPONSIBLY, SAFELY AND EFFICIENTLY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$82,405,539	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$96,528,310	RevenueAmt
Desc	NARMC PROVIDED OVER 11,066 DAYS OF PATIENT CARE WITH 61.17% BEING PROVIDED TO MEDICARE AND MEDICAID PATIENTS. IN CONNECTION WITH THE PROVIDING OF CARE, NARMC WROTE OFF $180,226,795 OF CHARGES IN THE FORM OF CONTRACTUALS AND CHARITY EQUALING 66.7% OF TOTAL GROSS INCOME.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$715,858	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$64,501	RevenueAmt
Desc	HOSPICE OF THE HILLS MISSION IS TO PROVIDE A SPECIAL KIND OF CARE DESIGNED TO PROVIDE SENSITIVITY AND SUPPORT FOR PEOPLE IN THE FINAL PHASE OF A TERMINAL ILLNESS. WE SEEK TO ENABLE PATIENTS TO CARRY ON AN ALERT, PAIN-FREE LIFE AND TO MANAGE OTHER SYMPTOMS SO THAT THEIR LAST DAYS MAY BE SPENT WITH DIGNITY AND QUALITY. WE VIEW THE FAMILY, NOT JUST THE PATIENT AS THE UNIT OF CARE.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$424,347	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$143,781	RevenueAmt
Desc	NARMC IS A CO-SPONSOR OF NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, INC. (A NOT-FOR-PROFIT CORPORATION).	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$83,545,744	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	92	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1109	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	AR	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KEN PANNELL	PersonNm
Phone	8704145157	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 NORTH MAIN STREET	AddressLine1Txt
City	HARRISON	CityNm
State Abbreviation	AR	StateAbbreviationCd
ZIP	72601	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
DAN BOWERS
CHAIRMAN	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
DR TOM LANGSTON
BOARD MEMBER	40.0	1.0	Yes (X)		$190,492	$0	$23,278
DR JOANNE HOLLIMAN
BOARD MEMBER	40.0	1.0	Yes (X)		$230,056	$0	$24,548
MIKE MCNUTT
VICE CHAIRMAN	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
MIKE NORTON
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
ANN MAIN
TREASURER	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
BRAD CRAWFORD
SECRETARY	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
MATT MILLER
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
SHERRI BILLINGS
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
VINCE LEIST
PRESIDENT/CEO	40.0	1.0		Yes (X)	$481,365	$0	$27,814
SAMMIE CRIBBS
COO/CNO	40.0	1.0		Yes (X)	$247,994	$0	$16,305
DEANA THOMAS
VP FINANCE/CFO	40.0	1.0		Yes (X)	$222,886	$0	$25,497
RICHARD BLAKE CHITSEY
PHYSICIAN	40.0	0.0			$743,733	$0	$22,109	Yes (X)
ALI F ABDELAAL
PHYSICIAN	40.0	0.0			$555,184	$0	$27,814	Yes (X)
THOMAS B ROSSON JR
PHYSICIAN	40.0	0.0			$501,009	$0	$26,662	Yes (X)
FRANK A DESANDRE
ANESTHESIOLOGIST	40.0	0.0			$425,838	$0	$18,539	Yes (X)
JAMES D LANGSTON
PHYSICIAN	40.0	0.0			$405,580	$0	$25,674	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,004,137	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$238,240	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	49	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
360 DEGREE MEDICINE LLC
108 SUNNY LANE	BRANSON WEST	MO	65737	PHYSICIAN ER SERVICE	$4,008,262
AUX ARCS HOSPITALISTS LLC
207 HOGAN DRIVE	HARRISON	AR	72601	PHYSICIAN SERVICE	$1,176,026
BKD LLP
400 WEST CAPITAL SUITE 2500	LITTLE ROCK	AR	722033667	ACCOUNTING/AUDIT	$823,821
AYA HEALTHCARE
PO BOX 123519	DALLAS	TX	753123519	CONTRACT LABOR	$501,875
AEGIS THERAPIES
PO BOX 8103	FORT SMITH	AR	72902	CONTRACT LABOR	$495,931

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	30	CntrctRcvdGreaterThan100KCnt
Government Grants	$246,252	GovernmentGrantsAmt
All Other Contributions	$121	AllOtherContributionsAmt
Total Contributions	$246,373	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES	621110	$96,691,644	$96,691,644
MEDICAL OFFICE BUILDING & RADIATION BUILDING	621110	$44,948	$44,948

Field	Value	IRS element (for citing)
Total Program Service Revenue	$96,736,592	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$787,387	TotalRevenueColumnAmt
Exclusion	$787,387	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$18,506,179	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$17,996,446	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$509,733	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$509,733	TotalRevenueColumnAmt
Exclusion	$509,733	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
PHARMACY REVENUE	900099	$1,391,360	$1,391,360
FOODS & NUTRITION SERVICES	900099	$474,442	$474,442
EDUCATION REVENUE	900099	$18,381	$18,381

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$415,912	TotalRevenueColumnAmt
Exclusion	$415,912	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$2,300,095	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$100,580,180	TotalRevenueColumnAmt
Related Or Exempt Func Income	$96,736,592	RelatedOrExemptFuncIncomeAmt
Exclusion	$3,597,215	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,406,339	TotalAmt
Management And General	$1,406,339	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$39,956,763	TotalAmt
Program Services	$27,422,400	ProgramServicesAmt
Management And General	$12,534,363	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,034,680	TotalAmt
Program Services	$710,103	ProgramServicesAmt
Management And General	$324,577	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,553,539	TotalAmt
Program Services	$6,556,611	ProgramServicesAmt
Management And General	$2,996,928	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,726,546	TotalAmt
Program Services	$1,871,234	ProgramServicesAmt
Management And General	$855,312	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$130,520	TotalAmt
Program Services	$89,576	ProgramServicesAmt
Management And General	$40,944	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$273,080	TotalAmt
Program Services	$187,415	ProgramServicesAmt
Management And General	$85,665	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$19,079,114	TotalAmt
Program Services	$13,094,031	ProgramServicesAmt
Management And General	$5,985,083	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$91,219	TotalAmt
Program Services	$62,604	ProgramServicesAmt
Management And General	$28,615	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,694,635	TotalAmt
Program Services	$1,849,333	ProgramServicesAmt
Management And General	$845,302	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,727,105	TotalAmt
Program Services	$1,185,315	ProgramServicesAmt
Management And General	$541,790	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$373,862	TotalAmt
Program Services	$256,582	ProgramServicesAmt
Management And General	$117,280	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$958,287	TotalAmt
Program Services	$657,674	ProgramServicesAmt
Management And General	$300,613	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,092,817	TotalAmt
Program Services	$2,122,606	ProgramServicesAmt
Management And General	$970,211	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,019,621	TotalAmt
Program Services	$699,768	ProgramServicesAmt
Management And General	$319,853	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
BAD DEBT EXPENSE	$9,016,721	$9,016,721
DRUGS	$7,716,299	$7,716,299
MEDICAL SUPPLIES	$6,288,119	$6,288,119
PROVIDER ASSESSMENT TAX	$1,080,292	$1,080,292

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,903,620	TotalAmt
Program Services	$2,679,061	ProgramServicesAmt
Management And General	$1,224,559	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$112,123,178	TotalAmt
Program Services	$83,545,744	ProgramServicesAmt
Management And General	$28,577,434	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$160,678	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$15,203,976	BOYAmt
EOY	$11,470,142	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$399,041	BOYAmt
EOY	$517,829	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,624,221	BOYAmt
EOY	$1,516,516	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$842,425	BOYAmt
EOY	$695,460	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$106,438,122	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$72,480,867	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$36,255,070	BOYAmt
EOY	$33,957,255	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$43,980,975	BOYAmt
EOY	$38,759,973	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$121,250	BOYAmt
EOY	$160,000	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$360,921	BOYAmt
EOY	$244,500	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$98,787,879	BOYAmt
EOY	$87,482,353	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$9,091,679	BOYAmt
EOY	$10,218,963	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$21,988,390	BOYAmt
EOY	$20,647,505	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$133,513	BOYAmt
EOY	$34,344	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,213,582	BOYAmt
EOY	$30,900,812	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$67,574,297	BOYAmt
EOY	$56,581,541	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$67,574,297	BOYAmt
EOY	$56,581,541	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$98,787,879	BOYAmt
EOY	$87,482,353	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$11,542,998	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$550,242	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$18,057	OtherActivitiesAmt
Total Lobbying Expenditures	$18,057	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	32% OF AHA MEMBERSHIP DUES ALLOCABLE TO LOBBYING: $18,057.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$393,814	OtherCostOrOtherBasisAmt
Book Value	$393,814	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$52,710,798	OtherCostOrOtherBasisAmt
Depreciation	$26,310,844	DepreciationAmt
Book Value	$26,399,954	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$52,031,388	OtherCostOrOtherBasisAmt
Depreciation	$45,389,973	DepreciationAmt
Book Value	$6,641,415	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,302,122	OtherCostOrOtherBasisAmt
Depreciation	$780,050	DepreciationAmt
Book Value	$522,072	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$33,957,255	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (3 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
INTERNALLY DESIGNATED	$34,477,275	F
HELD BY TRUSTEE	$4,078,698	F
WORKERS COMPENSATION	$204,000	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$38,759,973	TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt	$92,113,701	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$550,242	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$550,242	RevenueNotReportedAmt
Revenue Subtotal	$91,563,459	RevenueSubtotalAmt
Other Revenues Not Included	$9,016,721	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$9,016,721	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$100,580,180	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$103,106,457	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$103,106,457	ExpensesSubtotalAmt
Other Expenses Not Included	$9,016,721	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$9,016,721	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$112,123,178	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
FORM 990, SCHEDULE D, PART XI, LINE 4B	BAD DEBT EXPENSE $9,016,721
FORM 990, SCHEDULE D, PART XII, LINE 4B	BAD DEBT EXPENSE $9,016,721

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	138.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$666,344	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$666,344	NetCommunityBenefitExpnsAmt
Total Expense	0.00650	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,294,639	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,488,555	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,806,084	NetCommunityBenefitExpnsAmt
Total Expense	0.02720	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,960,983	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,488,555	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,472,428	NetCommunityBenefitExpnsAmt
Total Expense	0.03370	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,902	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$30,902	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$570,837	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$570,837	NetCommunityBenefitExpnsAmt
Total Expense	0.00550	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,029,504	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,819,117	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,210,387	NetCommunityBenefitExpnsAmt
Total Expense	0.05050	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,750	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$18,750	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,649,993	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,819,117	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,830,876	NetCommunityBenefitExpnsAmt
Total Expense	0.05650	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,610,976	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,307,672	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,303,304	NetCommunityBenefitExpnsAmt
Total Expense	0.09020	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,648	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,648	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,648	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,648	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$9,016,721	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,354,019	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$21,780,419	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$25,711,957	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,931,538	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
NORTH AR REGIONAL PH
MANAGEMENT	0.5	0.5
NORTH AR PARTNER HEA
HEALTHCARE TRAINING & EDUCATI	0.5	0.5

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH ARKANSAS MEDICAL SYSTEM	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 NORTH MAIN STREET	AddressLine1Txt
City	HARRISON	CityNm
State Abbreviation	AR	StateAbbreviationCd
ZIP	72601	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.NARMC.COM	WebsiteAddressTxt
State License	AR3203	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	3 RURAL HEALTH CLINI 4 EMS SUBSTATIONS 12 CLINICS	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH ARKANSAS MEDICAL SYSTEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.NARMC.COM	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.NARMC.COM	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	138.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.NARMC.COM	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.NARMC.COM	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.NARMC.COM	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE H, PART V, SECTION B, LINE 5

DIALOGUES WITH 7 KEY INTERVIEWEES WERE CONDUCTED IN FEBRUARY AND MARCH 2019. INTERVIEWEES WERE DETERMINED BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, OR THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. INTERVIEWS WERE CONDUCTED VIA TELEPHONE, OR THE INTERVIEWEE ANSWERED THE INTERVIEW QUESTIONS VIA EMAIL; WHICHEVER WAS MORE CONVENIENT FOR THE INTERVIEWEE. COMMUNITY LEADERS PROVIDED COMMENTS ON THE FOLLOWING ISSUES 1) HEALTH AND QUALITY OF LIFE FOR RESIDENTS IN THE PRIMARY COMMUNITY, 2) BARRIERS TO IMPROVING HEALTH AND QUALITY OF LIFE FOR RESIDENTS OF THE PRIMARY COMMUNITY, 3) OPINIONS REGARDING THE IMPORTANT HEALTH ISSUES THAT AFFECT COMMUNITY RESIDENTS AND THE TYPES OF SERVICES THAT ARE IMPORTANT FOR ADDRESSING THESE ISSUES, AND 4) DELINEATION OF THE MOST IMPORTANT HEALTH CARE ISSUES OR SERVICES DISCUSSED AND ACTIONS NECESSARY FOR ADDRESSING THOSE ISSUES. THE OPINIONS OF THE INTERVIEWEES REVEALS COMMUNITY INPUT FOR SOME FACTORS AFFECTING THE VIEWS AND SENTIMENTS ABOUT OVERALL HEALTH AND QUALITY OF LIFE WITHIN THE COMMUNITY.

SCHEDULE H, PART V, SECTION B, LINE 11

NARMC OWNS THREE RURAL HEALTH CLINICS: NEWTON COUNTY FAMILY PRACTICE (JASPER, AR), CLAUDE PARRISH COMMUNITY HEALTH CLINIC (LEAD HILL, AR) AND MARSHALL FAMILY PRACTICE (MARSHALL, AR). NARMC ALSO HAS FOUR MANNED AMBULANCE SUBSTATIONS LOCATED IN HARRISON, JASPER, DIAMOND CITY AND MARSHALL. THROUGH THESE RURAL HEALTH CLINICS AND AMBULANCE SUBSTATIONS, WE CONTINUALLY MEET THE NEEDS OF THE COMMUNITIES WE SERVE IN THE RURAL AREAS. NARMC SUPPORTS AND STAFFS THE LOCAL HOSPICE HOUSE, WHICH PROVIDES TERMINALLY ILL PATIENTS AND THEIR FAMILIES WITH AN ALTERNATIVE TO HOSPICE SERVICES IN THEIR HOMES. COST OF SERVICES IS INCLUDED IN THE CHARITY SUBSIDY INFORMATION. NARMC PARTNERS WITH NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, WHICH PROVIDES QUALITY, CERTIFIED HEALTH CARE TRAINING FOR COMMUNITY NEEDS. TRAINING AND EDUCATION INCLUDES CLASSES FOR NURSE ASSISTANTS, HOME HEALTH AIDES, FIRST AID, CPR TRAINING AND CONTINUING HEALTH EDUCATION FOR HEALTHCARE PROFESSIONALS, AS WELL AS, COMMUNITY EDUCATION FOR HEALTH LIVES, WEIGHT LOSS AND SMOKING CESSATION. THESE NEEDS WERE PRIORITIZED AND EVALUATED TO DETERMINE WHICH WERE SIGNIFICANT TO THE COMMUNITY. THE CRITERIA INCLUDED THE NUMBERS OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED PARTICULARLY AFFECTED PERSONS LIVING IN POVERTY OR MEMBERS OF AN UNDERSERVED POPULATION AND AVAILABILITY OF COMMUNITY RESOURCES TO ADDRESS THE NEED. -UNINSURED ADULTS: RESULTS OF THE INTERVIEWS SHOW THAT CIVILIANS ARE STILL STRUGGLING WITH UNINSURED PATIENTS. NARMC HAS BEEN DESIGNATED A CERTIFIED APPLICATION COUNSELOR ORGANIZATION IN ORDER TO ASSIST THE UNINSURED AND UNDERINSURED IN THE APPLICATION FOR COVERAGE UNDER THE AFFORDABLE CARE ACT. -RECRUITMENT OF ADDITIONAL PHYSICIANS AND PRACTITIONERS: THERE ARE HIGH PRIORITY NEEDS FOR SEVERAL AREAS IN THE HOSPITAL. THE MEDICAL CENTER HAS EMPLOYED A PHYSICIAN RECRUITER TO HELP BRING MORE DOCTORS TO THE COMMUNITY. -MENTAL HEALTH: THE HOSPITAL HAS OPENED AN INPATIENT GERIATRIC BEHAVIORAL HEALTH SERVICE THAT EMPLOYS A FULL TIME PSYCHIATRIST. THE OUTPATIENT SERVICES BEGAN DURING 2016 -RURAL OUTREACH: THE HOSPITAL WILL CONTINUE TO OFFER APPOINTMENTS FOR SPECIALTY PHYSICIANS AT RURAL HEALTH CLINICS. -ELDER CARE: THE HOSPITAL WILL ESTABLISH AND CONTINUE TO SEARCH NEW SERVICES TO MEET THE NEEDS OF SENIORS SUCH AS PALLIATIVE CARE, COMMUNITY PARAMEDIC AND AVAILABILITY OF DURABLE MEDICAL EQUIPMENT. -HEALTH CARE ACCOMODATIONS FOR NON-ENGLISH SPEAKERS: THE HOSPITAL WILL CONTINUE TO IMPROVE AND USE THE LIFELINKS INTERPRETING SERVICE. -HEALTH EDUCATION: THE HOSPITAL WILL CONTINUE TO HOST COMMUNITY HEALTH SCREENINGS AND SUPPORT GROUPS. HEALTH EDUCATION IS VERY IMPORTANT AND THE HOSPITAL'S INVOLVEMENT IN COMMUNITY EVENTS WILL HELP REACH THE COMMUNITY. HEALTH SCREENINGS AND EDUCATIONAL EVENTS SUCH AS BUSINESS EXPO AND HEALTH FAIR, LOOK GOOD, FEEL BETTER CANCER SUPPORT, GRIEF SUPPORT GROUPS AMONG OTHERS WILL HELP PROMOTE HEALTH EDUCATION. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY GROUP EDUCATION. NARMC HAS FOUNDED THE COMMUNITY PARAMEDIC PROGRAM IN AN EFFORT TO REDUCE RE-ADMISSION RATES OF THE HOSPITAL AND TO PROMOTE/FACILITATE APPROPRIATE UTILIZATION OF PRIMARY CARE PROVIDERS, THE EMERGENCY DEPARTMENT AND EMS. THE MISSION OF THE PROGRAM IS TO IDENTIFY AT-RISK PATIENTS THROUGH PERSONAL INTERACTION AND EDUCATE THEM ON NAVIGATING THE HEALTHCARE SYSTEM IN ORDER TO BETTER UTILIZE RESOURCES TO THE MUTUAL BENEFIT OF THE PATIENT AND THE HEALTHCARE PROVIDER.

Field	Value	IRS element (for citing)
Facility	19	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
NEWTON COUNTY FAMILY PRACTICE CLINIC
502 WEST COURT PO BOX 445	JASPER	AR	72641	RURAL HEALTH CLINIC
CLAUDE PARRISH COMMUNITY HEALTH CLINIC
131 EAST HIGHWAY 14 PO BOX 366	LEAD HILL	AR	72644	RURAL HEALTH CLINIC
MARSHALL FAMILY PRACTICE CLINIC
211 AIRPORT ROAD PO BOX 1266	MARSHALL	AR	72650	RURAL HEALTH CLINIC
NARMC EMS NEWTON COUNTY SUBSTATION
HWY 7 SOUTH	JASPER	AR	72641	EMS RURAL SUB-STATION
NARMC EMS SEARCY COUNTY SUBSTATION
834 AIRPORT ROAD	MARSHALL	AR	72650	EMS RURAL SUB-STATION
NARMC EMS DIAMOND CITY SUBSTATION
311 GREENWOOD ST	DIAMOND CITY	AR	72630	EMS RURAL SUB-STATION
NARMC MEDICINE GROUP
715 W SHERMAN STE J	HARRISON	AR	72601	SINGLE PHYSICIAN FAMILY PRACTICE
NARMC FAMILY MEDICINE CLINIC
724 N SPRING STREET	HARRISON	AR	72601	FAMILY MEDICINE
NARMC MEDIQUICK
724 N SPRING STREET	HARRISON	AR	72601	FAMILY MEDICINE
NARMC GENERAL AND SPECIALTY SURGERY
604 N SPRING ST	HARRISON	AR	72601	GENERAL AND SPECIALTY SURGERY
NARMC FAMILY DOCTOR'S CLINIC
520 N SPRING STREET	HARRISON	AR	72601	FAMILY MEDICINE
NARMC INTERNAL MEDICINE
724 N SPRING STREET	HARRISON	AR	72601	FAMILY MEDICINE
NARMC HOME HEALTH AND HOSPICE
501 E SHERMAN	HARRISON	AR	72601	HOME HEALTH AND HOSPICE
NARMC EMS HARRISON SUBSTATION
303 HWY 65 BYPASS	HARRISON	AR	72601	EMS RURAL SUB-STATION
HOSPICE OF THE HILLS
501 E SHERMAN	HARRISON	AR	72601	HOME HEALTH AND HOSPICE
WOMEN'S HEALTH AND SURGERY CENTER NARMC
520 N PINE	HARRISON	AR	72601	FAMILY PRACTICE/OBSTETRICS AND WOMEN'S HEALTH
CLAUDE PARRISH CANCER CENTER
620 N MAIN STREET	HARRISON	AR	72601	ONCOLOGY
INTERVENTIONAL PAIN MANAGEMENT CENTER
620 N MAIN STREET	HARRISON	AR	72601	PAIN MANAGEMENT
THE PHYSICIANS CLINIC OF BERRYVILLE
408 E ORCHARD	BERRYVILLE	AR	72616	FAMILY MEDICINE

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SCHEDULE H, PART I, LINE 7	THE COST TO CHARGE RATIO, CALCULATED USING WORKSHEET 2, WAS USED IN COMPLETING LINE 7A AND 7B. LINE 7E, 7F, 7G AND 7I WERE CALCULATED USING ACTUAL COSTS.
FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE IN THE AMOUNT OF $9,016,721 IS INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN A ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN.
FORM 990, SCHEDULE H, PART III, SECTION A, LINES 2, 3 & 4	THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE CAN BE FOUND IN THE ATTACHED AUDIT REPORT IN SUPPLEMENTARY NOTE 1, UNDER PATIENT ACCOUNTS RECEIVABLE.
FORM 990, SCHEDULE H, PART III, LINE 8	THE AMOUNT REPORTED ON LINE 6 WAS CALCULATED USING THE MEDICARE COST REPORT.
FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B	IN THE CASE OF EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, A PATIENT WHO IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM WILL NOT BE CHARGED MORE THAN AMOUNTS GENERALLY BILLED FOR INDIVIDUALS WHO HAVE INSURANCE COVERAGE. IF NARMC DETERMINES A PATIENT TO BE FAP ELIGIBLE, THEY WILL PROVIDE THE PATIENT WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED AND HOW NARMC DETERMINED THE AMOUNT OWED AS A FAP ELIGIBLE PATIENT, REFUND ANY AMOUNTS PAID IN EXCESS OF THE AMOUNT THE PATIENT IS DETERMINED TO OWE AS A FAP ELIGIBLE PATIENT AND WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS (ECAS).
FORM 990, SCHEDULE H, PART V, SECTION A, LINE 1, OTHER	2 HOME HEALTH/HOSPICE 2 SPECIALTY CENTERS
FORM 990, SCHEDULE H, PART VI, LINE 2	NARMC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY WORKING VERY CLOSELY WITH OTHER HEALTHCARE PROVIDERS AND EDUCATORS IN THE AREA AND PARTICIPATING IN THE SURVEY COMPLETED BY THE HOMETOWN HEALTH COALITION THROUGH THE BOONE COUNTY HEALTH UNIT. THIS DOCUMENT COMPILES DATA FROM SCHOOLS, PHYSICIANS, GOVERNMENT AGENCIES AND THE HOSPITAL TO DETERMINE WHERE OUR COMMUNITY CAN HELP FILL THE VOID IN MEDICAL CARE NEEDS FOR OUR CITIZENS.
FORM 990, SCHEDULE H, PART VI, LINE 3	A PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE WHEN THE PATIENT REGISTERS AS A SELF-PAY PATIENT OR HAS A SELF-PAY BALANCE AFTER INSURANCE ON THEIR ACCOUNT. SELF-PAY ACCOUNTS ARE REVIEWED BY THE PATIENT FINANCIALS SERVICES DEPARTMENT. ALL QUALIFYING SELF-PAY ACCOUNTS RECEIVE A DISCOUNT BASED ON THE REIMBURSEMENT PERCENTAGES RECEIVED FROM MEDICARE AND ALL PRIVATE HEALTH INSURANCES PAYING CLAIMS TO THE HOSPITAL BASED UPON THE LOOK BACK PERIOD. CURRENTLY THE SELF PAY DISCOUNT IS 45% OF GROSS CHARGES. ONCE THE PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE, THE PATIENT IS SEEN OR CONTACTED BY NARMC'S PATIENT FINANCIAL SERVICES DEPARTMENT TO DETERMINE ELIGIBILITY AND APPLY FOR NARMC'S FINANCIAL ASSISTANCE PROGRAM INCLUDING THOSE WITH MEDICAL CONDITIONS/NEEDS THAT HAVE EXHAUSTED THEIR FINANCIAL RESOURCES, HELP IN APPLYING FOR GOVERNMENTAL ASSISTANCE, HELP IN DETERMINING ELIGIBILITY, APPLY FOR PHARMACEUTICAL ASSISTANCE PROGRAMS OR ANY OTHER PUBLIC ASSISTANCE. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 0% TO 138% OF THE FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 100%. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 138% TO 200% OF FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 50%. NARMC TAKES THE FOLLOWING MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE PROGRAM TO THE COMMUNITY AND PATIENTS IN THE FOLLOWING WAYS: 1) POST THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND A SUMMARY OF THE POLICY ON THE NARMC WEBSITE AT WWW.NARMC.COM. 2) PROVIDE PAPER COPIES OF THE POLICY, APPLICATION AND SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM UPON REQUEST IN THE PATIENT ACCESS AND PATIENT FINANCIAL SERVICES OFFICES. 3)POST NOTICES ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND PATIENT FINANCIALS SERVICES OFFICES. 4) DISTRIBUTE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM AND OFFER A FINANCIAL ASSISTANCE APPLICATION TO PATIENTS AT THE TIME OF REGISTRATION OR BEFORE DISCHARGE FROM THE HOSPITAL. 5) INFORM PATIENT ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN PERSON OR DURING CUSTOMER SERVICE INTERACTIONS. 6) PROVIDE A SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM IN THE PATIENT'S MONTHLY BILLING STATEMENT. PATIENTS WILL RECEIVE THEIR FIRST STATEMENT WITHIN 15 DAYS FROM COMPUTATION OF THE FINAL BILL. NARMC WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH ALL BILLING STATEMENTS (MINIUMUM OF THREE STATEMENTS) AND WITH ANY OTHER WRITTEN COMMUNICATIONS REGARDING THE BILL THAT IS PROVIDED TO THE PATIENTS. NARMC SHALL INFORM THE PATIENT ABOUT THE FINANCIAL ASSISTANCE POLICY IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE. NARMC WILL PROVIDE THE PATIENT WITH AT LEAST ONE WRITTEN NOTICE THAT INFORMS THAT PATIENT ABOUT EXTRAORDINARY COLLECTIONS ACTIONS THAT MAY BE TAKEN IF THE FINANCIAL ASSISTANCE APPLICATION IS NOT SUBMITTED OR THE AMOUNT IS NOT PAID IN FULL BY THE DATE SPECIFIED IN THE NOTICE. NARMC SHALL NOT UNDERTAKE EXTRAORDINARY COLLECTION ACTIONS IN LESS THAN 120 DAYS FROM THE DATE OF THE FIRST STATEMENTS. PATIENTS MAY REQUEST FINANCIAL ASSISTANCE UP TO 240 DAYS FROM THE DATE OF THE PATIENT'S FIRST STATEMENT. IF THE PATIENT SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION AFTER 120 DAYS FROM THE FIRST STATEMENT DATE, NARMC SHALL SUSPEND ALL EXTRAORDINARY COLLECTION ACTIONS AND PROVIDE THE PATIENT WITH A WRITTEN NOTICE DESCRIBING THE ADDITIONAL INFORMATION/DOCUMENTATION THAT IS REQUIRED TO COMPLETE THE APPLICATIONS. IF THE PATIENT FAILS TO PROVIDE THE ADDITIONAL INFORMATION REQUESTED BY DATE SPECIFIED IN THE WRITTEN NOTICE, NARMC MAY PROCEED WITH EXTRAORDINARY COLLECTION ACTIONS. COMPLETED FINANCIAL ASSISTANCE APPLICATIONS SUBMITTED WITHIN THE 240 DAY PERIOD SHALL BE REVIEWED BY NARMC. A DETERMINATION SHALL BE MADE AND DOCUMENTED AS TO WHETHER THE PATIENT IS ELIGIBLE AND WRITTEN NOTIFICATION SHALL BE SENT TO THE PATIENT DESCRIBING THE ELIGIBILITY AND BASIS FOR THE DETERMINATION. IF NARMC DETERMINES THE PATIENT TO BE ELIGIBLE, THEY WILL PROVIDE THE PATIENT WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED AND HOW NARMC DETERMINED THE AMOUNT OWED AS A FINANCIAL ASSISTANCE PROGRAM ELIGIBLE PATIENT, REFUND ANY AMOUNTS PAID IN EXCESS OF THE AMOUNT THE PATIENT IS DETERMINED TO OWE AS A FINANCIAL ASSISTANCE PROGRAM PATIENT, AND TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN AGAINST THE INDIVIDUAL INCLUDING VACATE JUDGEMENTS, LIFT ANY LIENS OR LEVY AND REMOVE FROM THAT PATIENT'S CREDIT REPORT ANY INFORMATION THAT WAS REPORTED TO A CONSUMER REPORTING AGENCY OR CREDIT BUREAU. NARMC SHALL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS UNTIL IT HAS MADE REASONABLE EFFORTS TO DETERMINE FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY, SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS IF THE PATIENT SUBMITS A FINANCIAL ASSISTANCE PROGRAM APPLICATION UNTIL NARMC DETERMINES FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY. IF THE PATIENT IS ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM, NARMC WILL ENSURE THE PATIENT DOES NOT PAY MORE THAN THE PATIENT IS REQUIRED TO PAY UNDER THE FINANCIAL ASSISTANCE PROGRAM.
FORM 990, SCHEDULE H, PART VI, LINE 4	THE MEDICAL CENTER IS LOCATED IN HARRISON, ARKANSAS (BOONE COUNTY). HARRISON IS APPROXIMATELY AN HOUR AND A HALF EAST OF FAYETTEVILLE, ARKANSAS AND AN HOUR SOUTH OF SPRINGFIELD, MISSOURI (THE CLOSEST METROPOLITAN AREAS). ONE DIVIDED HIGHWAY SERVES THE AREA FROM THE NORTH. MANAGEMENT HAS IDENTIFIED THE COMMUNITY TO INCLUDE ALL OF BOONE AND NEWTON COUNTIES AS WELL AS SIGNIFICANT PORTIONS OF CARROLL, MARION AND SEARCY COUNTIES AND A SMALL PORTION OF POPE COUNTY. BASED ON THE 2015 US CENSUS BUREAU ESTIMATES, ABOUT 101,000 PEOPLE LIVE IN THE FIVE COUNTIES INCLUDED IN THE COMMUNITY . THE MEDICAL CENTER IS LOCATED IN HARRISON, ARKANSAS, WHICH IS THE LARGEST TOWN IN THE COMMUNITY WITH A POPULATION OF APPROXIMATELY 13,000 PEOPLE. THE POPULATION OF THE COMMUNITY IS ABOUT 95% WHITE, MAKING IT MUCH MORE RACIALLY HOMOGENOUS THAT EITHER THE STATE OF ARKANSAS OR THE UNITED STATES AS A WHOLE. MOST OF THE REMAINING POPULATION IS HISPANIC OR LATINO WITH APPROXIMATELY ONE-THIRD OF THIS GROUP HAVING LIMITED ENGLISH PROFICIENCY. ACCORDING TO THE US CENSUS BUREAU, ABOUT 22% OF THE COMMUNITY'S POPULATION IS OVER AGE 65, WHICH IS MUCH HIGHER THAN THE STATE OF ARKANSAS (16%) OR THE UNITED STATES (15%) AS A WHOLE. ADDITIONALLY, THE PERCENTAGE OF THE COMMUNITY POPULATION OVER AGE 65 IS EXPECTED TO CONTINUE INCREASING OVER THE NEXT TWO YEARS. THIS AGE GROUP USES MORE HEALTH SERVICES THAN ANY OTHER SO THE MEDICAL CENTER SHOULD PREPARE FOR INCREASED PATIENT VOLUME IN THE NEAR FUTURE. THE AVERAGE HOUSEHOLD INCOME IN THE MEDICAL CENTER'S COMMUNITY IS $50,912 COMPARED TO $61,330 FOR THE STATE OF ARKANSAS AND $81,283 FOR THE UNITED STATES. LOWER THAN AVERAGE HOUSEHOLD INCOME SUGGESTS THAT MANY MEMBERS OF THE COMMUNITY MAY HAVE DIFFICULTY OBTAINING HEALTH CARE, ESPECIALLY PREVENTATIVE CARE.
FORM 990, SCHEDULE H, PART VI, LINE 5	NARMCS BOARD OF DIRECTORS CONSISTS OF COMMUNITY LEADERS WITH GOALS OF PROMOTING COMMUNITY HEALTH. THE HOSPITAL PROVIDES FOUR FREE HEALTH SCREENINGS PER YEAR AND PROVIDES HEALTH CHECKS AT SEVERAL COMMUNITY EVENTS SUCH AS COMMUNITY HEALTH FAIRS, COUNTY FAIRS, RODEOS, LOCAL BUSINESSES, ETC. NARMC PARTNERS WITH AND FINANCIALLY SUPPORTS NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, WHICH PROVIDES HEALTH EDUCATION TO THE GENERAL POPULATION OF THE COMMUNITY. EMERGENCY SERVICES ARE PROVIDED AT NUMEROUS COMMUNITY EVENTS WITH EITHER PHYSICIANS, PARAMEDICS, EMTS, NURSES, ETC. ADDITIONALLY, NARMC IS VERY INVOLVED IN THE COMMUNITIES IT SERVES BY PROVIDING COMMUNITY HEALTH SUPPORT AND EDUCATION. THE HOSPITALS STAFF PARTICIPATES IN A VARIETY OF COMMUNITY SUPPORT ACTIVITIES INCLUDING, BUT NOT LIMITED TO, BUSINESS AFTER HOURS, WORLDS LARGEST BABY FAIR, THE BUSINESS EXPO AND OZARK EXPO, KHOZ/NARMC HEALTH FAIR, THE KHOZ RADIO STATION MCDONALDS BREAKFAST CLUB, TKO TELEVISION PROGRAM COMMUNITY CONNECTIONS, KHOZ RADIO STATION COMMUNITY CONTACT AND K26 TVS 726 COMMUNITY INFORMATION PROGRAMS. THE RURAL HEALTH CLINICS AND RURAL AMBULANCE STATIONS HAVE REPRESENTATIVES ON THE LOCAL CHAMBER OF COMMERCE BOARD OF DIRECTORS, MEMBERS OF KIWANIS, ROTARY, LIONS, EVENING LIONS, FIRST RESPONDERS, VOLUNTEER FIRE DEPARTMENT, ETC. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY SUPPORT GROUP EDUCATION.
FORM 990, SCHEDULE H, PART VI, LINE 6	NORTH ARKANSAS MEDICAL SYSTEM IS A PUBLIC BENEFIT CORPORATION TO NORTH ARKANSAS REGIONAL MEDICAL CENTER. IT IS ORGANIZED TO OPERATE FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND/OR TO CARRY OUT THE PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL SERVICES IS A PUBLIC BENEFIT CORPORATION TO PROMOTE PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL FOUNDATION'S MISSION IS TO ENCOURAGE PUBLIC SUPPORT FOR THE ACTIVITIES AND PURPOSE OF NORTH ARKANSAS REGIONAL MEDICAL CENTER.
FORM 990, SCHEDULE H, PART VI, LINE 7	THE STATE OF ARKANSAS DOES NOT REQUIRE NONPROFIT HOSPITALS TO PROVIDE COMMUNITY BENEFIT REPORTS.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR TOM LANGSTON
BOARD MEMBER	$162,096	$0	$27,155	$0	$1,241	$0	$6,166	$0	$17,112	$0	$213,770	$0	$0	$0
DR JOANNE HOLLIMAN
BOARD MEMBER	$165,606	$0	$64,086	$0	$364	$0	$6,009	$0	$18,539	$0	$254,604	$0	$0	$0
VINCE LEIST
PRESIDENT/CEO	$390,522	$0	$70,363	$0	$20,480	$0	$9,275	$0	$18,539	$0	$509,179	$0	$0	$0
SAMMIE CRIBBS
COO/CNO	$231,561	$0	$16,163	$0	$270	$0	$6,730	$0	$9,575	$0	$264,299	$0	$0	$0
DEANA THOMAS
VP FINANCE/CFO	$206,273	$0	$16,163	$0	$450	$0	$6,958	$0	$18,539	$0	$248,383	$0	$0	$0
RICHARD BLAKE CHITSEY
PHYSICIAN	$723,105	$0	$20,150	$0	$478	$0	$9,275	$0	$12,834	$0	$765,842	$0	$0	$0
ALI F ABDELAAL
PHYSICIAN	$332,388	$0	$220,816	$0	$1,980	$0	$9,275	$0	$18,539	$0	$582,998	$0	$0	$0
THOMAS B ROSSON JR
PHYSICIAN	$264,782	$0	$236,227	$0	$0	$0	$8,123	$0	$18,539	$0	$527,671	$0	$0	$0
FRANK A DESANDRE
ANESTHESIOLOGIST	$424,998	$0	$150	$0	$690	$0	$0	$0	$18,539	$0	$444,377	$0	$0	$0
JAMES D LANGSTON
PHYSICIAN	$301,351	$0	$102,727	$0	$1,502	$0	$9,275	$0	$16,399	$0	$431,254	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE J, PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	NARMC PAYS A COUNTRY CLUB MEMBERSHIP FOR VINCENT LEIST, WHICH IS ONLY USED FOR BUSINESS PURPOSES. ANY PERSONAL EXPENSES ARE PAID BY VINCENT LEIST DIRECTLY. NARMC ALSO PAYS ROTARY DUES FOR VINCENT LEIST. THE AMOUNTS ARE NOT INCLUDED IN HIS WAGES, AS THEY ARE FOR BUSINESS PURPOSES.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
BOONE COUNTY AR
A	710386082	098646BB7	2010-11-16	$5,317,921	HOSPITAL REVENUE REFUNDING BONDS	false	false	false
BOONE COUNTY AR
B	710386082	098646BR2	2011-12-20	$9,959,500	HOSPITAL REVENUE REFUNDING BONDS	false	false	false
BOONE COUNTY AR
C	710386082	098646CC4	2013-03-01	$9,854,770	HOSPITAL REVENUE REFUNDING BONDS	false	false	false
BOONE COUNTY AR
D	710386082	098646AS1	2006-03-16	$25,000,000	HOSPITAL REVENUE CONSTRUCTION	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$4,630,000	$0	$5,319,797	$533,500	$0	$0	$107,135	$0	$0	$0	$5,736,028	$0	2010	Yes (true)	false	Yes (true)	Yes (true)
B	$4,355,000	$0	$9,968,186	$934,391	$0	$0	$169,598	$0	$0	$0	$9,175,000	$0	2011	Yes (true)	false	Yes (true)	Yes (true)
C	$0	$0	$9,879,977	$994,000	$0	$0	$184,280	$0	$0	$0	$9,790,000	$0	2013	Yes (true)	false	Yes (true)	Yes (true)
D	$20,300,000	$0	$26,427,218	$0	$0	$0	$272,406	$377,517	$0	$0	$25,777,295	$0	2008	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	false	false	false	Yes (true)
B	false	false	false	false	false	false	false	Yes (true)
C	false	false	false	false	false	false	false	Yes (true)
D	false	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
C	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
D	false	false	false	Yes (true)	Yes (true)	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SCHEDULE K, PART II, LINE 3	TOTAL PROCEEDS OF ISSUE DO NOT EQUAL ISSUE PRICE DUE TO INCLUDED INVESTMENT EARNINGS.
FORM 990, SCHEDULE K, PART IV, LINE 2C	FOR BOND SERIES 2006, THE LAST REBATE COMPUTATION DATE WAS 02/28/2016. FOR BOND SERIES 2010, THE LAST REBATE COMPUTATION DATE WAS 05/01/2015. FOR BOND SERIES 2011, THE LAST REBATE COMPUTATION DATE WAS 05/01/2016. FOR BOND SERIES 2013, THE LAST REBATE COMPUTATION DATE WAS 05/01/2018.
FORM 990, SCHEDULE K, PART IV, LINE 2C	A - COMPLETED ON BOND YEAR OF 5/1/2018 B - COMPLETED ON BOND YEAR OF 5/1/2018 C - COMPLETED ON BOND YEAR OF 5/1/2018 D - COMPLETED ON BOND YEAR OF 2/28/2019

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	HARRISON PROFESSIONAL BUILDING CORP	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	BOD TOM LANGSTON - OWNER	RelationshipDescriptionTxt
Transaction	$77,803	TransactionAmt
Transaction	RENTAL OF PROPERTY	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	DR TOM LANGSTON AND DR JAMES LANGSTON HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS PROVIDED TO EACH BOARD DIRECTOR DURING THE BOARD COMMITTEE MEETINGS. MANAGEMENT REVIEWED EACH SECTION AND ALL SIGNIFICANT DISCLOSURES WITH THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF DIRECTORS COMPLETE A QUESTIONNAIRE EACH YEAR AND DISCLOSURES (IF ANY) ARE REVIEWED BY THE BOARD AND OFFICERS. KEY EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST TO THEIR SUPERVISORS AND TO HUMAN RESOURCES.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	THE LAST REVIEW COMPLETED IN NOVEMBER 2019 BY THE VICE PRESIDENT OF HUMAN RESOURCES AT NARMC. OTHER OFFICERS OR KEY EMPLOYEES ARE COMPARED TO AHA SALARY DATABASE BY HUMAN RESOURCES AND ARE REVIEWED AND APPROVED BY THE CEO. SALARIES OF OFFICERS AND KEY EMPLOYEES ARE ALSO REVIEWED BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	PROVIDED UPON REQUEST.
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:6858507
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:5633090
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT LABOR TOTAL FEES:4331490
FORM 990 PART IX LINE 11G	DESCRIPTION:SERVICE AGREEMENTS TOTAL FEES:2256027

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
NORTH ARKANSAS MEDICAL FOUNDATION
620 NORTH MAIN STREET	HARRISON	AR	72601	710787861	SUPPORT	AR	501(C)(3)	12A	NAMS	Yes (true)
NORTH ARKANSAS MEDICAL SYSTEM
620 NORTH MAIN STREET	HARRISON	AR	72601	710787859	SUPPORT	AR	501(C)(3)	12A	NA	false
NORTH ARKANSAS MEDICAL SERVICES
620 NORTH MAIN STREET	HARRISON	AR	72601	710787858	SUPPORT	AR	501(C)(3)	12A	NAMS	Yes (true)
NARMC AMBULANCE DIVISION ONE INC
620 NORTH MAIN STREET	HARRISON	AR	72601	822720963	SUPPORT	AR	501(C)(3)	12A	NAMS	Yes (true)
NARMC AMBULANCE DIVISION TWO INC
620 NORTH MAIN STREET	HARRISON	AR	72601	822727645	SUPPORT	AR	501(C)(3)	12A	NAMS	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
NORTH ARKANSAS MEDICAL SERVICES
K	$273,502	FMV
NORTH ARKANSAS MEDICAL FOUNDATION
M	$114,485	FMV