2020-08-14T16:48:23-05:00 2019-09-30 BKD LLP 190 E Capitol Street Ste 500 Jackson MS 392012190 990 2018-10-01 640668465 Clay County Medical Corporation % KRISTY DUKE CLAY 6623773978 830 South Gloster Street Tupelo MS 38801 SHARON NOBLES Chief Financial Off. 6623773978 2020-08-15 true Mary F Overstreet CPA P01270094 6019486700 167.68.126.162 64248120202275000011 2020-08-14 P 6A1D99355E63E1E2B951C629597D7F40CF219E97 5A0E8D6C4B5950E52DE464BEBEDA7C30598AEA7B 2018 2020-09-23 17:36:50Z SHARON NOBLES 830 South Gloster Street Tupelo MS 38801 48486494 false X www.nmhs.net/westpoint/ X 1982 DE Clay County Medical Corporation operates a 60 bed acute-care hospital and related outpatient care facilities in West Point, Mississippi. 12 10 362 32 0 34658 13333 46113311 47973492 7292 37349 464181 462320 46619442 48486494 925 0 0 0 19027279 20625948 0 0 0 23329273 24633754 42357477 45259702 4261965 3226792 19496478 21667501 11315496 14946424 8180982 6721077 CLAY COUNTY MEDICAL CORPORATION OWNS AND OPERATES A 60 BED ACUTE-CARE HOSPITAL AND RELATED OUTPATIENT CARE FACILITIES IN WEST POINT, MISSISSIPPI CALLED NORTH MISSISSIPPI MEDICAL CENTER-WEST POINT (NMMC-WEST POINT). NMMC-WEST POINT 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-WEST POINT 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. false false 42885701 48199968 NMMC-West Point serves Clay County and the surrounding area. In fiscal year 2019, there were 1,810 inpatient admissions, 14,670 emergency department visits, 66,628 outpatient visits, 31,713 rural health clinic visits, and 5,988 visits to other hopsital clinics. NMMC-West Point 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. NMMC-West Point's remarkable design was inspired by the history and culture of this charming Southern community. Medical-surgical patient rooms are entered from a foyer area and open onto a private terrace. Rooms are "nested," which means four to six rooms are clustered around each nursing unit. This design reduces walking distance, allows nurses to view several patients from a central point, and provides closer access to medical equipment. Surgeons utilize four operating suites for a wide array of cases, including general, orthopedic and obstetrics-gynecology. The Same Day Surgery Unit features six rooms for outpatient surgery patients to rest before and after their procedure, as well as two endoscopy suites. The six-bed Intensive Care Unit offers invasive and non-invasive monitoring for medical and surgical patients. The hospital also has 10 licensed swing beds for patients who need extended care. The Women's Pavilion provides family-centered maternity services in a homelike environment. Mothers labor, deliver and recover in the same comfortable room. The nursery is equipped to care for healthy newborns as well as provide immediate stabilization of infants requiring intensive care. NMMC-West Point offers 24-hour emergency services at the Level III Trauma Center, as well as a paramedic-level ambulance service. Outpatient services include cardiac and pulmonary rehabilitation programs, as well as physical, occupational and speech-language therapy. Cardiac stress tests and holter monitoring are also offered. One of the primary ways NMMC-West Point 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-West Point 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-WEST POINT WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS FREE OF CHARGE WITH HOUSEHOLD INCOME LEVELS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. THE POLICY FURTHER PROVIDES, PATIENTS WITH HOUSEHOLD INCOME LEVELS BETWEEN 101% AND 150% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE TO RECEIVE SERVICES AT A DISCOUNTED RATE. THE DISCOUNT WILL BE PRO-RATED BASED ON THE PATIENT'S GROSS FAMILY INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY LEVEL. The policy applies to individuals who reside in Clay County. Patients from outside the county may also be granted charity care based on the judgment of NMMC-West Point management depending on their individual circumstances. The policy also requires the patient to cooperate fully with NMMC-West Point'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 $8,800,971 in fiscal year 2019. Based on the gross charges provided to charity patients compared to total hospital gross charges, 4.72% of all services in fiscal year 2019 were provided on a charity basis. The net cost of charity care provided by NMMC-West Point was approximately $1,843,366 in fiscal year 2019. The total cost estimate is based on the ratio of costs to charges for NMMC-West Point. All of 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. 42885701 true false false false false false false false false false true false false true true true false true false false false false false false false false true true false false true true true false false false false false false false false false false false false false false true false false false true 15 0 362 true false false false false false false false false false false false false X 12 10 false false false false true true true true true false false false true true true true true true true false X KRISTY DUKE 6623773977 830 GLOSTER STREET Tupelo MS 38801 Deloris Doss Director 1.0 0.0 X 0 0 0 DWIGHT DYESS DIRECTOR 1.0 0.0 X 0 0 0 Key Blair Director 1.0 0.0 X 0 0 0 George Purnell Chairman 1.0 0.0 X 0 0 0 Mary Ann Briggs Vice Chairman 1.0 0.0 X 0 0 0 Karen Mooney Director 1.0 0.0 X 0 0 0 Tim O'Brien Director 1.0 0.0 X 0 0 0 Joe Stevens Director 1.0 0.0 X 0 0 0 Ronald E Powell DO Director 0.0 40.0 X 0 278672 25001 Edmund M Miller Director 0.0 40.0 X 0 344106 28279 Billy Milican Director 1.0 0.0 X 0 0 0 William Sugg Jr Director 1.0 0.0 X 0 0 0 Bruce Toppin Secretary 1.0 39.0 X 0 497334 14160 Michael S Spees President 0.5 39.5 X 0 1791663 14954 Sharon Nobles Treasurer 1.0 39.0 X 0 631824 14416 Barry Keel Administrator 40.0 0.0 X 238728 0 11324 Hiroji Noguchi Physician 40.0 0.0 X 338027 0 8331 Byron K Watson MD Director 40.0 0.0 X 374849 8666 27754 Edmund A Miller Physician 40.0 0.0 X 370812 0 6203 Andrzej J Wartak Physician 40.0 0.0 X 319411 9044 24273 Mark J Wilson Physician 40.0 0.0 X 251667 8646 7576 Stacey S George CRNA 40.0 0.0 X 225461 0 18860 Robert S Chamblee CRNA 40.0 0.0 X 218643 0 20246 2337598 3569955 221377 17 true true false Keystone 3150 Lenox Park Blvd Ste 109 MEMPHIS TN 38115 ER Coverage 1769277 Midsouth Rehab Therapy 711 Avignon Drive RIDGELAND MS 39157 Physical Therapy 518359 Morrison Management PO Box 102289 ATLANTA GA 303682289 Food & Nutr MGMT 338489 Alliance Healthcare 18201 Von Karman Avenue Suite 600 IRVINE CA 92612 Contract MRI Service 172303 SGK Landscapes Inc 1406 Fire Station Road STARKVILLE MS 39759 Landscaping Services 101664 5 13333 13333 Net Patient Service Revenue 900099 47536339 47536339 Net Related Rental Income 900099 437153 437153 47973492 5678 5678 0 0 0 0 0 21671 10000 21671 10000 31671 31671 0 0 0 0 0 0 0 0 0 Employee Drug Sales 900099 124168 124168 WELLNESS CENTER REVENUE 900099 226287 226287 Vendor Rebates 900099 60784 60784 51081 189 50892 462320 48486494 48199968 273193 0 0 0 0 257015 257015 0 16194392 14815471 1378921 720872 720872 2358784 2358784 1094885 983078 111807 373999 373999 217567 217567 39150 39150 0 0 0 4207050 4203450 3600 28858 28858 603397 603397 772937 772937 0 1185834 1185834 80923 80923 0 34301 34301 41215 41215 0 1409742 1409742 -8058 -8058 MEDICAL SUPPLIES 9027629 9027629 BAD DEBT EXPENSE 5747930 5747930 RECRUITMENT EXPENSE 288210 288210 COLLECTION FEES 257726 257726 325344 325344 45259702 42885701 2374001 0 2285 2285 818229 1966766 0 0 6453384 3975589 0 0 0 0 0 0 853569 850103 86627 64323 44214389 33835583 10104717 10378806 0 0 0 0 0 0 0 0 1177667 4429629 19496478 21667501 8001277 10775248 0 0 0 0 2993815 2771955 0 0 0 0 0 0 0 0 320404 1399221 11315496 14946424 X 8115588 6671202 65394 49875 0 0 8180982 6721077 19496478 21667501 X 3226792 -4686697 X false true X true false X 471036 471036 17052669 10768903 6283766 23767484 20894295 2873189 2923201 2172386 750815 10378806 Deferred Compensation 1015817 Other Receivables 22470 Int. in Net Assets of Aff.Fdn 49875 Assets Held By Trustee 3016 Due from Third Party Payors 107000 DUE FROM AFFILIATES 3231451 4429629 0 Due to Third Party Payors 1277000 Due to Affiliates 122221 1399221 42744070 -5747930 -5747930 48492000 -5506 -5506 48486494 39517278 5506 5506 39511772 5747930 5747930 45259702 Part X, Line 2: The System applies FASB ASC Topic 740 for Income Taxes (Topic 740), which clarifies the accounting for uncertainty in income tax positions and provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There has been no impact on the system's financial statements as a result of Topic 740. Part XI, Line 2d: Bad Debt expense is netted with patient revenue on the financial statements but included in expense on the return. Part XI, Line 4b: RENTAL EXPENSE IS NETTED WITH RENTAL INCOME ON THE RETURN BUT INCLUDED IN EXPENSE ON THE FINANCIAL STATEMENTS. Part XII, Line 2d: RENTAL EXPENSE IS NETTED WITH RENTAL INCOME ON THE RETURN BUT INCLUDED IN EXPENSE ON THE FINANCIAL STATEMENTS. Part XII, Line 4b: Bad Debt expense is netted with patient revenue on the financial statements but included in expense on the return. true true X true X true X 150. true true true false true true 1843366 1843366 0.04640 8411237 9374284 -963047 10254603 9374284 880319 0.04640 10254603 9374284 880319 0.04640 false 5747930 14048040 13142789 905251 X true true 1 1 Clay County Medical Corporation 835 Medical Center Drive West Point MS 39773 http://www.nmhs.net/westpoint/ 13-312 X Clay County Medical Corporation 1 false false true X X X X X X X 18 true true false true X SEE SECTION C X true 18 true SEE SECTION C false true X 100 150. X X X X X X true true X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X true X false X X X true X false false PART V, SECTION B, LINE 5: Information for the CHNA report was gathered by conducting interviews and surveys with key organizations/stakeholders, healthcare advocates/leaders, and interested community partners. CONSULTATION OR INPUT WAS ALSO REQUESTED FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED, WHICH INCLUDED THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; HEALTHCARE COMMUNITY ADVOCATES; FAMILY COMMUNITY ADVOCATES; COMMUNITY-BASED ORGANIZATIONS, INCLUDING ORGANIZATIONS FOCUSED ON ONE OR MORE HEALTH ISSUES; PRIVATE BUSINESS LEADERS WITH AN UNDERSTANDING OF THE GENERAL AND DIVERSE COMMUNITIES NEEDS, WHO ALSO PROVIDE A FINANCIAL AND ECONOMIC PERSPECTIVE; RETIRED HEALTHCARE WORKERS WITH KNOWLEDGE OF PATIENT AND FAMILY NEEDS; OTHER VARIOUS COMMUNITY LEADERS AND VOLUNTEERS WITH AN UNDERSTANDING OF THE DIVERSE POPULATION AND NEEDS OF THE COMMUNITY. PART V, SECTION B, LINE 6A: Clay County Medical Corporation is part of the North Mississippi Health Services' diversified regional healthcare system. North Mississippi Health Services operates six community hospitals in addition to Clay County Medical Corporation. The CHNA included Clay County Medical Corporation, North Mississippi Medical Center, Pontotoc Health Services, Webster Health Services, Tishomingo Health Services, Marion Regional Medical Center, and Monroe Health Services. PART V, SECTION B, LINE 7B: https://www.nmhs.net/app/files/public/1399/west-point.pdf PART V, SECTION B, LINE 10A: https://www.nmhs.net/app/files/public/1399/west-point.pdf PART V, SECTION B, LINE 11: 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: - BLOOD PRESSURE SCREENING AND TREATMENT, - OBESITY TREATMENT, - DIABETES SCREENING AND TREATMENT, - IMMUNIZATIONS, AND - CHILDREN'S HEALTH BY PLACEMENT OF NURSES IN LOCAL SCHOOLS. PART V, SECTION B, LINE 13H: The Hospital's eligibility criteria also included the following: - Service type provided to patient, - Patient's relationship to physicians, - Patient's eligibility for financial assistance under another city, county, state, federal or other assistance program that supercedes the FAP, - Whether or not the patient's charges resulted from a work-related incident, - Whether or not the patient's charges resulted from an auto accident, and - Whether the patient is in the custody of a correctional facility PART V, SECTION B, LINE 16A-C: HTTP://NMHS.NET/FINANCIAL_ASSISTANCE.PHP 5 Clay County Medical Corp Wellness Center 851 Medical Center Drive West Point MS 39773 Wellness Center WEST POINT IMA 977 EMERGENCY DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC WEST POINT CHILDREN'S RHC 83 MEDICAL CENTER DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC NORTH MS SURGERY CLINIC 187 MEDICAL CENTER DRIVE WEST POINT MS 39773 RURAL HEALTH CLINIC NORTH MS HEMATOLOGY ONCOLOGY-STARKVILLE 1205 HIGHWAY 182 WEST STARKVILLE MS 39759 RURAL HEALTH CLINIC Part I, Line 3c: CLAY COUNTY MEDICAL CORPORATION USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. IF THE PATIENT'S INCOME LEVEL IS 0-100% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. IF THE PATIENT'S INCOME LEVEL IS 101-150% OF THE FPL, A DISCOUNT OF THE HOSPITAL'S STATED CHARGES WILL BE PRO-RATED BASED ON THE PATIENT'S GROSS FAMILY INCOME AS A PERCENTAGE OF THE FPL. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 150% 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. Part I, Line 6a: Clay County Medical Corporation's 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. Part I, Line 7, column (f): Bad Debt Expense of $5,747,930 was included in total expense on Form 990, Part IX, Line 25, Column (A), but was subtracted from total expense for purposes of calculating the percentage of total expense in column (F). Part I, Line 7: A 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. Part III, Line 2-4: Clay County Medical Corporation's 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. Bad debt expense reported in part III line 2 matches the amount of bad debt expense reported on Clay County Medical Corporation's audited financial statements. Clay County Medical Corporation (CCMC) follows the Catholic Health Association guidelines and does not include bad debt in any community benefit amounts. CCMC, however, 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. THE 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, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. Part III, Line 8: The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. Lines 5, 6, & 7 do not include certain Medicare programs and costs and thus do not reflect all of the organization's revenues and costs associated with its participation in Medicare programs. Additional revenues and costs not reported on Lines 5, 6, & 7 include those associated with the organization's Medicare outpatient lab, ambulance and therapy services. Total revenues from these activities were $435,260 and total costs were $665,833 for a net shortfall of $230,573. When combined with the surplus reported on Line 7, the net surplus from all Medicare programs is $674,678. Part III, Line 9b: Clay County Medical Corporation 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. Part VI, Line 2: Needs Assessment Clay County Medical Corporation utilizes varied but complimentary methods to assess the health care needs of the community it serves. Clay County Medical Corporation and Clay 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 Clay 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 Clay 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 Clay County Medical Corporation. Part VI, Line 3: Patient Education of Eligibility for Assistance Explanations of the Clay County Medical Corporation 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. Part VI, Line 4: Community Information Clay County Medical Corporation serves more than 20,000 people in Clay 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 2019 census, age demographics for the service area show that approximately 23% of the population is under 18 years of age, approximately 58% is between 18 and 64 years of age and that 19% is 65 or older. Caucasians make up 40% of the service area's population while African Americans make up 59% and Hispanics and other make up 1%. Median household income for 2014-2018 was $35,121 for the service area, which is below the overall average for Mississippi and significantly less than the nationwide average. The patient population for Clay County Medical Corporation is covered by insurance or is uninsured as follows: 41.04% Medicare, 2.17% Medicare Advantage, 6.38% Medicaid, 15.16% MS CAN, and 30.53% private insurance with 4.72% being uninsured. Part VI, Line 5: Promotion of Community Health Clay County Medical Corporation has a commitment to a wide variety of community health outreach activities, which are coordinated by the community health coordinator and are staffed by Clay County Medical Corporation 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. Part VI, Line 6: Affiliated Health Care System As noted above, Clay County Medical Corporation (CCMC) is part of North Mississippi Health Services (NMHS). NMHS operates North Mississippi Medical Center, five other community hospitals in addition to CCMC, 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. Part VI, Line 7: State Filing of Community Benefit Report Clay County Medical Corporation does not file a community benefit report with the state of Mississippi as there is no requirement to do so. X X X X X false false false false false false false false false Bruce Toppin Secretary 301281 186494 9559 5500 8660 511494 Michael S Spees President 930931 826691 34041 8250 6704 1806617 Stacey S George CRNA 209730 33 15698 12692 6168 244321 Sharon Nobles Treasurer 461315 169219 1290 8250 6166 646240 Robert S Chamblee CRNA 214860 36 3747 13480 6766 238889 Barry Keel Administrator 184280 35067 19381 6236 5088 250052 Hiroji Noguchi Physician 293710 42794 1523 2043 6288 346358 Byron K Watson MD Director 203716 8666 170787 0 346 0 21946 0 5566 242 402361 8908 Edmund A Miller Physician 211758 156123 2931 1883 4320 377015 Ronald E Powell DO Director 209229 66757 2686 20081 4920 303673 Andrzej J Wartak Physician 221576 9044 96312 0 1523 0 20625 0 3496 152 343532 9196 Mark J Wilson Physician 185135 7933 48398 0 18134 713 955 0 6359 262 258981 8908 Edmund M Miller Director 209841 134057 208 23971 4308 372385 A MS Hospital Equipment and Facilities Authority 640732320 605360MV5 2003-07-02 6835969 To refund a prior issue false false false A 0 0 6835969 0 0 0 67510 0 0 0 6768459 0 2009 true false true true A false false false false 0 false false false true A false false false true true true GSMMDP 12.7 false false false 0 true true A true . Schedule K, Part I: Clay County Medical Corporation, along with certain North Mississippi Health Services Affiliates (collectively known as the obligated group), periodically issue tax exempt revenue bonds under the terms of a related master indenture. Only Clay County Medical Corporation's share is reported in this schedule. Schedule K, Part IV, line 2c: Rebate Computation Date: 9/9/2010 Schedule K, Part IV, Line 6: Although funds were invested beyond a temporary period, the yield did not exceed the allowable amount. Form 990, Page 6, Part VI, Section A, Line 6: Clay County Medical Corporation 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, Page 6, Part VI, Section A, Line 7a: The Governance Committee of North Mississippi Health Services, Inc. (NMHS), which is made up of past Chairmen, nominate candidates for the Board. These candidates are then approved by the Board of NMHS. Form 990, Page 6, Part VI, Section A, Line 7b: The Board of North Mississippi Health Services, Inc. approves all transactions that exceed $1 million. Form 990, Page 6, Part VI, Section B, Line 11b: The Form 990 goes through a review process in the Accounting Department. The accountant for each facility reviews the return 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 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. Then the Director does a more high level review, reading the return for reasonableness and comparing prior year amounts to current year amounts. Finally, the VP 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, Page 6, Part VI, Section B, Line 12c: An 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, Page 6, Part VI, Section B, Line 15 a&b: AN 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, Page 6, Part VI, Section C, Line 19: The 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, Page 12, Part XI, Line 9: Pension-related changes other than net periodic pension costs: (2,726,245) Decrease in interest in net assets of affiliated foundation: (15,519) Contributed Capital: 80,000 ASU 606 Transition Adjustment: (2,024,931) Total other changes in net assets or fund balance = (4,686,695) North MS Management Services Inc 830 S Gloster Street Tupelo MS 38801 640762694 Mgmt & Admin DE 501(c)(3) 12-I NMHS false North MS Health Services Inc 830 S Gloster Street Tupelo MS 38801 640653269 Mgmt Services DE 501(c)(3) 12-II NMHS false North MS Medical Center Inc 830 S Gloster Street Tupelo MS 38801 640662976 Hospital DE 501(c)(3) 3 NMHS false Tishomingo Health Services Inc 830 S Gloster Street Tupelo MS 38801 640741047 Hospital DE 501(c)(3) 3 NMHS false Pontotoc Health Services Inc 830 S Gloster Street Tupelo MS 38801 640751410 Hospital DE 501(c)(3) 3 NMHS false North MS Medical Clinics Inc 830 S Gloster Street Tupelo MS 38801 640787918 Med Clinics DE 501(c)(3) 3 NMHS false Tupelo Service Finance Inc 830 S Gloster Street Tupelo MS 38801 640508308 Collections DE 501(c)(3) 3 NMHS false Webster Health Services Inc 830 S Gloster Street Tupelo MS 38801 640819193 Hospital DE 501(c)(3) 3 NMHS false Marion Regional Medical Center Inc 830 S Gloster Street Tupelo MS 38801 640926753 Hospital DE 501(c)(3) 3 NMHS false North MS Emergency Services Inc 830 S Gloster Street Tupelo MS 38801 640780130 ER Physicians DE 501(c)(3) 10 NMHS false Monroe Health Services 830 South Gloster Street Tupelo MS 38801 320583236 Hospital DE 501(c)(3) 3 NMHS false North MS Health Link Inc 830 S Gloster Street Tupelo MS 38801 640715886 Medical Servi DE NMHS C Corp false North MS Enterprises Inc 830 S Gloster Street Tupelo MS 38801 640658059 Medical Servi DE NMHS C Corp false Professional Practice Management Inc 830 S Gloster Street Tupelo MS 38801 721390014 Med Ser Mgmt DE NMMCI C Corp false Acclaim Inc 830 S Gloster Street Tupelo MS 38801 721356116 Hlth Care Cla DE Healthlink C Corp false North MS Support Services Inc 830 S Gloster Street Tupelo MS 38801 260718275 Support Servi DE NMHS C Corp false false false false false false false false false false true true false true false true true true true true