JEFFERSON HOSPITAL ASSN INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- JEFFERSON HOSPITAL ASSN INC (EIN 71-0329353)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-05-15
- IRS object ID
- 202031369349302323
- Schema version
- 2018v3.3
- 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 I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-15T11:15:12-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | 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 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710329353 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jefferson Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JEREMY JEFFERY | InCareOfNm |
| Business Name Control | JEFF | BusinessNameControlTxt |
| Phone | 8705417100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 West 40th Avenue | AddressLine1Txt |
| City | Pine Bluff | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71603 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY JEFFERY | PersonNm |
| Person Title | VP AND CFO | PersonTitleTxt |
| Phone | 8705417100 | PhoneNum |
| Signature | 2020-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeanette Verrelli | PreparerPersonNm |
| PTIN | P00742631 | PTIN |
| Phone | 9727028262 | 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 | 75465920201365000015 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-05-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BC2C8F7F1C2AD12471C74E6F8C925013EDB3E05D | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EB976710118F518B8933A72D91D1D85239D99EDA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN THOMAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 WEST 40TH AVENUE | AddressLine1Txt |
| City | PINE BLUFF | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $210,028,616 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.JRMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | AR | LegalDomicileStateCd |
| Activity Or Mission | JEFFERSON HOSPITAL ASSOCIATION, INC. PROVIDES A WIDE RANGE OF HEALTH CARE SERVICES TO PATIENTS FROM JEFFERSON COUNTY AND SURROUNDING AREAS IN SOUTHEAST ARKANSAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1983 | TotalEmployeeCnt |
| Total Volunteers | 44 | TotalVolunteersCnt |
| Total Gross UBI | $12,602 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $893,797 | PYContributionsGrantsAmt |
| CY Contributions Grants | $743,630 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $189,575,238 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $185,767,717 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,086,233 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,028,866 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,728,733 | PYOtherRevenueAmt |
| CY Other Revenue | $2,905,632 | CYOtherRevenueAmt |
| PY Total Revenue | $200,284,001 | PYTotalRevenueAmt |
| CY Total Revenue | $194,445,845 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $503,870 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $507,450 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $96,204,230 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $98,497,640 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $100,062,911 | PYOtherExpensesAmt |
| CY Other Expenses | $102,608,231 | CYOtherExpensesAmt |
| PY Total Expenses | $196,771,011 | PYTotalExpensesAmt |
| CY Total Expenses | $201,613,321 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,512,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,167,476 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $272,913,375 | TotalAssetsBOYAmt |
| Total Assets EOY | $270,623,412 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $64,968,181 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $67,419,473 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $207,945,194 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $203,203,939 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | JEFFERSON REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING MEASURABLE QUALITY HEALTH SERVICES IN A CARING ENVIRONMENT, WHICH FULFILL THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES AND COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $173,845,508 | ExpenseAmt |
| Grant | $507,450 | GrantAmt |
| Revenue | $187,572,223 | RevenueAmt |
| Desc | JEFFERSON HOSPITAL ASSOCIATION, INC. (JHA) OPERATES JEFFERSON REGIONAL MEDICAL CENTER (JRMC), A TERTIARY CARE FACILITY WITH 300 LICENSED BEDS AND 266 STAFFED BEDS LOCATED IN SOUTHEAST ARKANSAS THAT SERVES A POPULATION BASE OF 209,000 PEOPLE LIVING IN 11 COUNTIES. JRMC IS A NOT-FOR-PROFIT, SOLE COMMUNITY HOSPITAL, LICENSED BY THE ARKANSAS STATE HEALTH DEPARTMENT. SEE SCHEDULE O FOR MORE INFORMATION. | Desc |
| Total Program Service Expenses | $173,845,508 | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | 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 | 265 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1983 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY JEFFERY | PersonNm |
| Phone | 8705417100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 WEST 40TH AVENUE | AddressLine1Txt |
| City | PINE BLUFF | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| J ACOSTA - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| F ANTHONY - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| D ATKINSON - SEE SCH O | |||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| D BRIDGFORTH - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| D BROWN - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JA CAMPBELL - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| M CASTEEL - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| M ECKERT - SEE SCH O | |||||||||
| DIRECTOR | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| A KLINE - SEE SCH O | |||||||||
| VICE CHAIRMAN/Chairman | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JB MAYS - SEE SCH O | |||||||||
| DIRECTOR | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| S PITTILLO - SEE SCH O | |||||||||
| TREASURER/Vice Chairman | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| A SANDERS - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| H TROTTER III - SEE SCH O | |||||||||
| DIRECTOR/TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| C MORGAN - SEE SCH O | |||||||||
| CHAIRMAN/DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| G MAKRIS - SEE SCH O | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| P AUSTIN - SEE SCH O | |||||||||
| VP & COO | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| L HICKMAN - SEE SCH O | |||||||||
| VP & CNO | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| B JACKSON - SEE SCH O | |||||||||
| SVP & CFO | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| B THOMAS - SEE SCH O | |||||||||
| PRESIDENT & CEO | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| M ALI - SEE SCH O | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| G BIRK - SEE SCH O | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| R BURRELL - SEE SCH O | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| R FRAM - SEE SCH O | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| N WILLIS - SEE SCH O | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| T HARBUCK - SEE SCH O | |||||||||
| FORMER EXECUTIVE VP | 0.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| W JOHNSON - SEE SCH O | |||||||||
| FORMER DIR/PRES & CEO | 0.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 105 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|---|
| PREMIER ANESTHESIA LLC | |||||
| 2655 NORTHWINDS PKWY | ALPHARETTA | GA | 30009 | PROFESSIONAL SERVICE | $4,409,412 |
| TEG ARCHITECTS | |||||
| 903 SPRING ST | JEFFERSONVILLE | IN | 47130 | PROFESSIONAL SERVICE | $3,919,767 |
| REHAB CARE GROUP INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | THERAPY SERVICES | $3,544,543 |
| SODEXO INC AFFILIATES | |||||
| PO BOX 536922 | ATLANTA | GA | 30353 | NUTRITIONAL SERVICES | $2,820,546 |
| Southeast Arkansas Emergency Physic | |||||
| 4075 Copper Ridge Drive | TRAVERSE CITY | MI | 49684 | Professional Service | $2,338,470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 79 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $508,424 | GovernmentGrantsAmt |
| All Other Contributions | $235,206 | AllOtherContributionsAmt |
| Total Contributions | $743,630 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Revenue | 621110 | $180,514,964 | $180,514,964 | |
| EHR Incentive | 900099 | $41,842 | $41,842 | |
| Joint Venture Income | 621500 | $1,230,097 | $1,219,895 | $10,202 |
| Medical Office Rental | 531120 | $1,191,034 | $1,191,034 | |
| Pharmacy Revenue | 446110 | $2,789,780 | $2,789,780 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $185,767,717 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,049,821 | TotalRevenueColumnAmt |
| Exclusion | $5,049,821 | 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,520 | RealAmt |
| Personal | $2,400 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,520 | RealAmt |
| Personal | $2,400 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,920 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $2,400 | UnrelatedBusinessRevenueAmt |
| Exclusion | $32,520 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,542,426 | SecuritiesAmt |
| Other | $1,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,538,588 | SecuritiesAmt |
| Other | $26,293 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,838 | SecuritiesAmt |
| Other | -$24,793 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$20,955 | TotalRevenueColumnAmt |
| Exclusion | -$20,955 | 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 | $351,324 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $17,890 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $333,434 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $333,434 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Outside/Pathology Lab | 900099 | $17,528 | $17,528 | |
| Cafeteria | 722320 | $1,068,606 | $1,068,606 | |
| Wellness Center | 713490 | $565,201 | $565,201 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $885,943 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $885,943 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,537,278 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $194,445,845 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $187,559,621 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $12,602 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,129,992 | 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 | $144,821 | TotalAmt |
| Program Services | $144,821 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,629 | TotalAmt |
| Program Services | $362,629 | ProgramServicesAmt |
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 | $2,784,808 | TotalAmt |
| Program Services | $777,864 | ProgramServicesAmt |
| Management And General | $2,006,944 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,081,662 | TotalAmt |
| Program Services | $112,538 | ProgramServicesAmt |
| Management And General | $969,124 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,941,539 | TotalAmt |
| Program Services | $70,883,621 | ProgramServicesAmt |
| Management And General | $8,057,918 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,329,824 | TotalAmt |
| Program Services | $2,017,183 | ProgramServicesAmt |
| Management And General | $312,641 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,701,920 | TotalAmt |
| Program Services | $6,872,967 | ProgramServicesAmt |
| Management And General | $828,953 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,657,887 | TotalAmt |
| Program Services | $4,886,604 | ProgramServicesAmt |
| Management And General | $771,283 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,064,151 | TotalAmt |
| Program Services | $4,518,192 | ProgramServicesAmt |
| Management And General | $545,959 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,432 | TotalAmt |
| Program Services | $34,130 | ProgramServicesAmt |
| Management And General | $128,302 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,687 | TotalAmt |
| Management And General | $182,687 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,848 | TotalAmt |
| Management And General | $34,848 | ManagementAndGeneralAmt |
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 | $40,779,463 | TotalAmt |
| Program Services | $31,806,155 | ProgramServicesAmt |
| Management And General | $8,973,308 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,831 | TotalAmt |
| Program Services | $65,051 | ProgramServicesAmt |
| Management And General | $217,780 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,240,736 | TotalAmt |
| Program Services | $4,432,909 | ProgramServicesAmt |
| Management And General | $1,807,827 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,822,917 | TotalAmt |
| Program Services | $1,452,865 | ProgramServicesAmt |
| Management And General | $370,052 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,279,326 | TotalAmt |
| Program Services | $2,430,561 | ProgramServicesAmt |
| Management And General | $848,765 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,180 | TotalAmt |
| Program Services | $119,053 | ProgramServicesAmt |
| Management And General | $45,127 | 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 | $94,572 | TotalAmt |
| Program Services | $84,660 | ProgramServicesAmt |
| Management And General | $9,912 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,172,971 | TotalAmt |
| Program Services | $1,092,182 | ProgramServicesAmt |
| Management And General | $80,789 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,596,546 | TotalAmt |
| Program Services | $9,866,705 | ProgramServicesAmt |
| Management And General | $729,841 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,512,832 | TotalAmt |
| Program Services | $1,395,303 | ProgramServicesAmt |
| Management And General | $117,529 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $564,056 | $564,123 | -$67 |
| MEDICAL SUPPLIES | $27,282,026 | $27,298,734 | -$16,708 |
| DUES & FEES | $675,808 | $190,571 | $485,237 |
| LICENSE & TAXES | $2,636,070 | $2,417,260 | $218,810 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,779 | TotalAmt |
| Program Services | $18,827 | ProgramServicesAmt |
| Management And General | $40,952 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,613,321 | TotalAmt |
| Program Services | $173,845,508 | ProgramServicesAmt |
| Management And General | $27,767,813 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,600 | BOYAmt |
| EOY | $6,377 | 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 | $34,935,812 | BOYAmt |
| EOY | $34,044,860 | 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 | $921,348 | BOYAmt |
| EOY | $375,961 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,326,131 | BOYAmt |
| EOY | $3,779,030 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,763,498 | BOYAmt |
| EOY | $2,124,222 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $260,192,554 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $182,229,582 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,700,777 | BOYAmt |
| EOY | $77,962,972 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,159,838 | BOYAmt |
| EOY | $142,565,906 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,964,347 | BOYAmt |
| EOY | $2,797,057 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $7,133,024 | BOYAmt |
| EOY | $6,967,027 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,913,375 | BOYAmt |
| EOY | $270,623,412 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,573,465 | BOYAmt |
| EOY | $35,009,314 | 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 | $228,986 | BOYAmt |
| EOY | $70,486 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,677,626 | BOYAmt |
| EOY | $16,688,857 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $9,488,104 | BOYAmt |
| EOY | $15,650,816 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,968,181 | BOYAmt |
| EOY | $67,419,473 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,945,194 | BOYAmt |
| EOY | $203,203,939 | 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 | $207,945,194 | BOYAmt |
| EOY | $203,203,939 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,913,375 | BOYAmt |
| EOY | $270,623,412 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$7,167,476 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,426,221 | 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 | Yes (true) | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $34,848 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $34,848 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | LOBBYING ACTIVITIES: DURING THE FISCAL YEAR, MEMBERS OF JRMC'S STAFF HAD OCCASIONAL CONTACT WITH LEGISLATORS. ADDITIONALLY, JRMC CONTRIBUTED TO ORGANIZATIONS THAT UNDERTOOK LOBBYING ACTIVITIES DURING THE YEAR. JRMC ESTIMATES THE TOTAL AMOUNT OF DUES USED FOR LOBBYING ACTIVITIES AT $34,848. | 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 | $6,795,018 | OtherCostOrOtherBasisAmt |
| Book Value | $6,795,018 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $113,680,535 | OtherCostOrOtherBasisAmt |
| Depreciation | $82,855,948 | DepreciationAmt |
| Book Value | $30,824,587 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,841,991 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,449,039 | DepreciationAmt |
| Book Value | $392,952 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,164,459 | OtherCostOrOtherBasisAmt |
| Depreciation | $97,924,595 | DepreciationAmt |
| Book Value | $31,239,864 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,710,551 | OtherCostOrOtherBasisAmt |
| Book Value | $8,710,551 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $77,962,972 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| 457 Plan | $2,266,467 |
| Capital Lease Obligation | $576,667 |
| Line of Credit | $12,614,850 |
| Due to Affiliates | $192,832 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,650,816 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| 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) |
|---|---|---|
| Persons Served | 7579 | PersonsServedCnt |
| Total Community Benefit Expns | $3,616,633 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,616,633 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01790 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14781 | PersonsServedCnt |
| Total Community Benefit Expns | $12,314,709 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,314,709 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 22360 | PersonsServedCnt |
| Total Community Benefit Expns | $15,931,342 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,931,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07900 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 2892 | PersonsServedCnt |
| Total Community Benefit Expns | $61,528 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,600 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 26 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $5,157,200 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,249,095 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,908,105 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $6,114,121 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,563,948 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,550,173 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $507,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $361,379 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $146,071 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 39 | ActivitiesOrProgramsCnt |
| Persons Served | 2892 | PersonsServedCnt |
| Total Community Benefit Expns | $11,840,299 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,213,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,627,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02290 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 39 | ActivitiesOrProgramsCnt |
| Persons Served | 25252 | PersonsServedCnt |
| Total Community Benefit Expns | $27,771,641 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,213,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,558,619 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10190 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Persons Served | 1455 | PersonsServedCnt |
| Total Community Benefit Expns | $27,034 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,034 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Persons Served | 1455 | PersonsServedCnt |
| Total Community Benefit Expns | $27,034 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,034 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,472,753 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $59,993,758 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $52,512,577 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $7,481,181 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| 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 | JEFFERSON REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 W 40TH AVENUE | AddressLine1Txt |
| City | PINE BLUFF | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.JRMC.ORG | WebsiteAddressTxt |
| State License | AR4213 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | SEE PART V, SECTION C | 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 | SEE PART V, SECTION C | 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 | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | CONSULTING REPRESENTATIVES OF THE COMMUNITY: The Community Health Needs Assessment Toolkit developed by the National Center for Rural Health Works at Oklahoma State University, Center for Rural Health and Oklahoma Office of Rural Health was utilized as a guide for the CHNA facilitation process. The hospital created a Steering committee made up of officers of Jefferson Regional Medical Center and Officers of the Arkansas Rural Health Partnership. Due to the size of the service area, the steering committee chose to conduct their assessment through a focus group of community leaders and individuals in health-related fields. Approximately 60 Individuals from the community were selected for invitation to the focus group, or community advisory committee, by the Jefferson Regional Medical Center staff steering committee. Over 20 individuals who participated in the focus group were from various organizations such as: Jefferson Regional Medical Center, local physicians, Relyance Bank, Strong Manufacturing, Oudin Properties, Trotter Auto Group, Go Forward Pine Bluff, First Arkansas Insurance, Greater Mt. Calvary Baptist Church, Reed Architectural Firm, various other businesses and retirees. In addition to the focus group, 84 surveys were completed by members of the community. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | NEEDS ADDRESSED AND NOT ADDRESSED: THE ORGANIZATION IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE 2018 CHNA THROUGH THE EXECUTION OF ITS CHNA IMPLEMENTATION STRATEGY THAT WAS UPDATED IN October OF 2019. All needs identified within the assessment are being addressed in the implementation strategy. FOR ADDITIONAL INFORMATION, SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. |
| SCHEDULE H, PART V, SECTION B, LINES 7 & 10 | CHNA AND IMPLEMENTATION STRATEGY: THE CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: https://www.jrmc.org/about/community-health-needs-assessment/ |
| SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C | FINANCIAL ASSISTANCE POLICY: THE FAP, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: https://www.jrmc.org/patients-visitors/billing-insurance/financial-assista nce |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 18 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HEALTH CARE PLUS | ||||
| 209 N BLAKE | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| PINE BLUFF SPECIALTY CLINIC | ||||
| 1601 W 40TH AVE SUITE 301 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| CARDIOLOGY ASSOCIATES | ||||
| 1601 W 40TH AVE SUITE 301 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| ENDOCRINOLOGY OF SOUTH ARKANSAS | ||||
| 7500 DOLLARWAY RD | WHITE HALL | AR | 71603 | PHYSICIAN CLINIC |
| SOUTH ARKANSAS ORTHOPEADICS CENTER | ||||
| 1609 W 40TH AVE SUITE 501 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| NEUROSURGERY ASSOCIATES OF SOUTHEAST AR | ||||
| 1609 W 40TH AVE SUITE 501 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| OBGYN ASSOCIATES OF S AR | ||||
| 1801 W 40TH AVE SUITE 401 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| SURGICAL ASSOCIATES OF SOUTHEAST AR | ||||
| 1609 W 40TH AVE SUITE 403 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| FAMILY HEALTH ASSOC OF SOUTH ARKANSAS | ||||
| 4747 DUSTY LAKE DRIVE | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| GI ASSOC OF SOUTH ARKANSAS | ||||
| 1609 W 40TH AVE SUITE 312 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| PAIN SPECIALISTS OF SOUTH ARKANSAS | ||||
| 1609 W 40TH AVE SUITE 312 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| NEUROLOGY PRACTICE | ||||
| 1609 W 40TH AVE SUITE 207 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| CHILDREN'S CLINIC PA | ||||
| 1420 W 43RD AVE | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| I-530 IMAGING | ||||
| 4747 DUSTY LAKE DR | PINE BLUFF | AR | 71603 | OP IMAGING |
| JRMC OUTPATIENT PHYSICAL THERAPY | ||||
| 1600 W HOLLAND AVE | WHITE HALL | AR | 71602 | OP THERAPY |
| JRMC URGENT CARE CENTER | ||||
| 4201 S MULBERRY ST | PINE BLUFF | AR | 71603 | WALK-IN CLINIC |
| SURGICAL ASSOCIATES OF SOUTHEAST AR | ||||
| 1801 W 40TH AVE STE 7 | PINE BLUFF | AR | 76103 | PHYSICIAN CLINIC |
| OBGYN ASSOCIATES OF SOUTH AR | ||||
| 1609 W 40TH AVE STE 402 | PINE BLUFF | AR | 76103 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART III, SECTION A, LINE 2 | PROVISION FOR UNCOLLECTIBLE ACCOUNTS METHODOLOGY: 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. THEREFORE, BAD DEBT EXPENSE RELATED TO PATIENT ACCOUNTS WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS ACCOUNT ACTIVITY CONSISTENT WITH HISTORICAL PRACTICES AND THE AMOUNT THAT WOULD HAVE BEEN ATTRIBUTED TO BAD DEBT UNDER PREVIOUS ACCOUNTING POLICY HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: THE HOSPITAL HAS PROCESSES IN PLACE TO IDENTIFY THOSE PATIENTS THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE. THOSE ACCOUNTS ARE WRITTEN OFF TO CHARITY. THE HOSPITAL ALSO USES PRESUMPTIVE ELIGIBILITY TO IDENTIFY THOSE PATIENTS WHO HAVE NOT COMPLETED AN APPLICATION AND THOSE PATIENTS ARE CONSIDERED ASSISTANCE AS WELL. MANAGEMENT DOESN'T BELIEVE THAT ANY OF THE BAD DEBT WOULD BE ATTRIBUTABLE TO THOSE FAP-ELIGIBLE PATIENTS. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO THE ADOPTION OF ASU TOPIC 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COSTING METHODOLOGY: THE ORGANIZATION MAINTAINS A COST ACCOUNTING SYSTEM THAT COMPUTES COSTS AT THE PATIENT LEVEL. THE COSTING METHODOLOGIES ARE APPLIED TO THE ORGANIZATION'S MEDICARE PATIENTS TO DETERMINE THE COST OF PROVIDING CARE. AS A SAFETY NET HOSPITAL, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT; THEREFORE, COSTS TO PROVIDE CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED COMMUNITY BENEFIT TO THE EXTENT COSTS EXCEED MEDICARE REIMBURSEMENT. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTIONS POLICY: PATIENT ACCOUNTS QUALIFYING FOR free or discounted care WOULD NOT INTENTIONALLY BE PLACED WITH A DEBT COLLECTION SERVICE. FROM TIME TO TIME, INFORMATION THAT RESULTS IN THE DETERMINATION OF ASSISTANCE QUALIFICATION IS OBTAINED SUBSEQUENT TO A PATIENT'S ACCOUNT BEING PLACED WITH A DEBT COLLECTION AGENCY. THE ORGANIZATION'S COLLECTION AGENCY POLICY REQUIRES CONTRACTED COLLECTION AGENTS, IN ADDITION TO MANY OTHER PRUDENT PROCEDURES, TO INFORM THE DEBTOR OF THE APPROPRIATE HOSPITAL FINANCIAL ASSISTANCE PROFESSIONAL TO CONTACT IF THE COLLECTION AGENT IS MADE AWARE OF A PATIENT'S FINANCIAL HARDSHIP. THE COLLECTION AGENT IS ALSO REQUIRED TO NOTIFY THE ORGANIZATION OF THE PATIENT'S FINANCIAL HARDSHIP SO THE ORGANIZATION CAN ASSIST THE PATIENT IN ACCESSING THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS. |
| SCHEDULE H, PART VI, LINE 2 | Needs Assessment: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILTY FOR ASSISTANCE: A FINANCIAL COUNSELOR INITIATES A FINANCIAL SCREENING ON ALL INPATIENTS, OBSERVATION PATIENTS AND OUTPATIENTS OCCUPYING A BED HAVING NO INSURANCE INDICATED ON THEIR ACCOUNT. THIS PROCESS INCLUDES SCREENING FOR free or discounted care, MEDICAID COVERAGE AND OTHER THIRD PARTY COVERAGE. OUTPATIENTS RECEIVE A FINANCIAL ASSISTANCE GUIDE SHEET SUMMARIZING ASSISTANCE OFFERED BY JRMC AT THE TIME OF REGISTRATION. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: THIS IS NOT APPLICABLE FOR FISCAL YEAR 2019. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT: THIS IS NOT APPLICABLE FOR FISCAL YEAR 2019. |
| SCHEDULE H, PART I, LINE 3C | FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: -MEDICAL INDIGENCY -INSURANCE STATUS -UNDERINSURANCE STATUS |
| SCHEDULE H, PART II | COMMUNITY BUILDING ACTIVITIES: JRMC PERSONNEL SERVED ON THE BOARDS OF A NUMBER OF LOCAL VOLUNTEER AND BUSINESS ORGANIZATIONS THAT PROMOTED GENERAL COMMUNITY DEVELOPMENT AND HEALTH BY PROVIDING HEALTH EDUCATION AND VOLUNTEER SUPPORT. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| UNITED WAY OF SOUTH EAST ARKANSAS | |||||||
| PO BOX 8702 | PINE BLUFF | AR | 71611 | 710236869 | 501(C)(3) | $61,250 | 2017 CAMPAIGN PLEDGE |
| AR HOSPITAL EDUCATION & RESEARCH TRUST | |||||||
| 419 NATURAL RESOURCES DR | LITTLE ROCK | AR | 72205 | 710392458 | 501(C)(3) | $28,313 | 2018 AHERT DONATION |
| JEFFERSON CO TAX COLLECTOR | |||||||
| 101 W BARRAQUE ST | PINE BLUFF | AR | 71601 | 716009958 | GOVT | $10,000 | BOARD APPROVED DONATION TO JEFFERSON COUNTY SHERRIFF DEPT |
| PINE BLUFF COUNTRY CLUB | |||||||
| PO BOX 6809 | PINE BLUFF | AR | 71601 | 710141610 | 501(C)(7) | $12,000 | IRRIGATION SYSTEM & HALL OF FAME SPONSORSHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (6 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| FEDERAL PELL GRANTS | 65 | $270,974 |
| WIA ADULT PROGRAM GRANTS | 14 | $49,236 |
| STATE GO GRANTS | 2 | $750 |
| ACADEMIC CHALLENGE | 10 | $17,375 |
| STATE OF AR - REHABILITATION | 6 | $15,544 |
| JSN SCHOLARSHIPS | 10 | $7,500 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE I, PART I, LINE 2 | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: JEFFERSON HOSPITAL ASSOCIATION, INC. MAINTAINED RECORDS TO SUBSTANTIATE THE AMOUNT OF THE GRANTS OR ASSISTANCE, THE GRANTEES' ELIGIBILITY FOR THE GRANTS OR ASSISTANCE, AND THE SELECTION CRITERIA USED TO AWARD GRANTS OR ASSISTANCE. |
| FORM 990, PART IX, LINES 1 & 2 & SCHEDULE I, PARTS II & III | DIFFERENCE BETWEEN SCHEDULE I & STATEMENT OF FUNCTIONAL EXPENSES: THE ORGANIZATION IS REPORTING THE CONTRIBUTIONS PAID ON SCHEDULE I, WHICH IS NOT NECESSARILY ON THE ACCRUAL BASIS BECAUSE THE ORGANIZATION RECORDS LONG-TERM PLEDGES AT THEIR NPV AND RECORDS ACCRETION OF INTEREST OVER TIME. THE PLEDGES, WHEN PAID, ARE A REDUCTION OF THIS LIABILITY AND NOT CURRENT YEAR EXPENSE WHICH MAY CAUSE A DIFFERENCE BETWEEN AMOUNT REPORTED ON FORM 990, PART IX AND SCHEDULE I, PARTS II & III. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (27 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J ACOSTA - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| M ALI - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| F ANTHONY - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| D ATKINSON - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| P AUSTIN - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| G BIRK - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| D BRIDGFORTH - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| D BROWN - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| R BURRELL - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| JA CAMPBELL - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| M CASTEEL - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| M ECKERT - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| R FRAM - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| G Makris - See Sch O | |||||||||||||
| L HICKMAN - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| B JACKSON - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| A KLINE - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| JB MAYS - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| S PITTILLO - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| A SANDERS - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| B THOMAS - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| H TROTTER III - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| N WILLIS - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| T HARBUCK - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| W JOHNSON - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| C MORGAN - SEE SCH O | |||||||||||||
| $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| G Makris - See Sch O | |||||||||||||
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | DESCRIPTION OF BENEFITS: THE FOLLOWING BENEFITS ARE INCLUDED IN THE TAXABLE COMPENSATION OF THE RECIPIENTS. - TAX GROSS-UP PAYMENTS ARE INCLUDED IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IDENTIFIED BELOW. - COUNTRY CLUB MEMBERSHIPS ARE MAINTAINED BY THE ORGANIZATION FOR THE USE OF SPECIFIC EMPLOYEES AS DESIGNATED BY THE BOARD OF DIRECTORS. |
| SCHEDULE J, PART I, LINE 1B | WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT: THERE IS NO WRITTEN POLICY REGARDING PROVISION OF COUNTRY CLUB MEMBERSHIPS. THE BOARD OF DIRECTORS DESIGNATES WHICH EMPLOYEES MAY USE MEMBERSHIPS MAINTAINED BY THE ORGANIZATION. |
| SCHEDULE J, PART I, LINE 7 | NON-FIXED PAYMENTS: THE ORGANIZATION PROVIDES DEFINED MEMBERS OF MANAGEMENT A NON-FIXED PERFORMANCE BASED INCENTIVE PLAN. THE PLAN'S COMPONENTS ARE ESTABLISHED AND EVALUATED BY THE ORGANIZATION'S EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. |
| SCHEDULE J, PART I, LINE 4A | SEVERANCE PAYMENTS: Mr. Harbuck and Mr. Johnson received severance payments in accordance with the terms of employment agreements between them and the Association. THOMAS HARBUCK $408,637 WALTER JOHNSON $454,043 |
| SCHEDULE J, PART I, LINE 4B | PARTICIPANTS IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP PLAN REPORTED IN W-2 DEFERRED COMPENSATION --------------------------- ----------------- ---------------------- LOUISE HICKMAN $ 81,801 $NONE BRIAN THOMAS $ 108,080 $NONE BRYAN G. JACKSON $ 289,858 $NONE PETER AUSTIN $ NONE $28,356 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON COUNTY AR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 716009958 | BondIssuerEIN |
| CUSIP | 472705SP6 | CUSIPNum |
| Bond Issued | 2011-12-15 | BondIssuedDt |
| Issue Price | $26,013,416 | IssuePriceAmt |
| Purpose | REFUND 2001 BONDS | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,580,000 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $26,013,416 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $25,395,168 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $372,172 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $246,076 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $0 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | Yes (true) | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C | FormAndLineReferenceDesc |
| Explanation | ARBITRAGE REBATE COMPUTATION: THE COMPUTATION TO DETERMINE THERE IS NO REBATE CURRENTLY DUE WAS PERFORMED DECEMBER 1, 2016. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|
| mary virginia makris | ||
| SEE SUPPLEMENTAL INFO | SEE SUPPLEMENTAL INFO | false |
| Michael Acosta | ||
| SEE SUPPLEMENTAL INFO | SEE SUPPLEMENTAL INFO | false |
| ELIZABETH BRIDGFORTH Hartz | ||
| SEE SUPPLEMENTAL INFO | SEE SUPPLEMENTAL INFO | false |
| SIMMONS BANK | ||
| SEE SUPPLEMENTAL INFO | SEE SUPPLEMENTAL INFO | false |
| CHILDREN'S CLINIC PA | ||
| SEE SUPPLEMENTAL INFO | SEE SUPPLEMENTAL INFO | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE L, PART IV, COLUMNS B, C, & D | FormAndLineReferenceDesc |
| Explanation | A) NAME OF PERSON: MARY VIRGINIA MAKRIS (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF GEORGE MAKRIS (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: Michael Acosta (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF JANICE ACOSTA (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: ELIZABETH BRIDGFORTH HARTZ (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF DAVID BRIDGFORTH (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: SIMMONS BANK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CASTEEl AND TROTTER ARE OFFICERS AND/OR DIRECTORS. (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: BANKING SERVICES (A) NAME OF PERSON: CHILDREN'S CLINIC PA (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JOANN MAYS (JHA DIRECTOR) IS A MEMBER/OWNER OF CHILDREN'S CLINIC PA. (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: CONTRACTED PEDIATRIC SERVICES | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS: CONTINUED FROM PART III... IN EXISTENCE FOR OVER A CENTURY, JEFFERSON REGIONAL BEGAN AS DAVIS HOSPITAL IN 1908 TO MEET THE HEALTHCARE NEEDS OF SOUTHEAST ARKANSAS AND EXISTS TODAY WITH THE SAME PURPOSE. AS THE COUNTYS ONLY GENERAL ACUTE CARE HOSPITAL, JEFFERSON REGIONAL MEDICAL CENTER IS LICENSED FOR 471 ACUTE CARE BEDS AND CURRENTLY OPERATES AN AVAILABLE 258 BEDS AND PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. JEFFERSON REGIONALS GOVERNING BODY IS COMPRISED OF INDIVIDUALS WHO ARE REPRESENTATIVE OF THE COMMUNITY. APPROXIMATELY 65 PERCENT OF JEFFERSON REGIONALS PATIENTS ORIGINATE FROM ITS PRIMARY SERVICE AREA (JEFFERSON, CLEVELAND AND LINCOLN COUNTIES) WITH 35 PERCENT ORIGINATING FROM THE SECONDARY SERVICE AREA (ARKANSAS, ASHLEY, BRADLEY, CHICOT, DALLAS, DESHA, DREW AND GRANT COUNTIES.) WITH COMMUNITY SERVICE AND EDUCATION AS A SIGNIFICANT PART OF THE MISSION, JEFFERSON REGIONAL PROVIDES FINANCIAL SPONSORSHIPS WITHIN THE COMMUNITY AND OFFERS FREE HEALTH SCREENINGS AND EDUCATIONAL EVENTS EACH YEAR TO REALIZE THE MISSION, "TO PROVIDE MEASURABLE QUALITY HEALTH SERVICES IN A CARING ENVIRONMENT WHICH FULFILL THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES AND COMMUNITYVISION, "TO BE WIDELY RECOGNIZED AS THE HEALTH CARE LEADER AND REFERRAL CENTER OF CHOICE FOR SOUTH ARKANSAS BY PROVIDING QUALITY HEALTH CARE SERVICES IN A COST EFFECTIVE MANNER". WITH A VARIETY OF DIVERSE PROGRAMS AND MEDICAL SERVICES DESIGNED TO MEET THE SPECIFIC NEEDS OF SOUTH ARKANSANS, JEFFERSON REGIONALS MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, REPRESENTS MOST MAJOR SPECIALTIES, INCLUDING CARDIOLOGY, GENERAL SURGERY, CRITICAL CARE, GASTROENTEROLOGY, ORTHOPAEDICS, NEUROLOGY, NEUROSURGERY, ENDOCRINOLOGY, URGENT AND EMERGENT CARE, OBSTETRICS/GYNECOLOGY, RADIOLOGY, AND PSYCHIATRY, AND HAS AN ACTIVE TEACHING PROGRAMS FOR MEDICAL STUDENTS AND RESIDENTS AS WELL AS STUDENTS IN ALLIED HEALTH FIELDS. JEFFERSON REGIONAL SPECIALISTS ALSO CONDUCT SATELLITE SPECIALTY CLINICS IN SURROUNDING COMMUNITIES. THE EMERGENCY DEPARTMENT, OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, IS ALSO ACCOMPANIED BY AN URGENT CARE WALK-IN CLINIC AND THE HEALTHCARE PLUS CLINIC, WHICH PROVIDES OCCUPATIONAL HEALTH SERVICES TO AREA BUSINESSES, AND LABORATORY SERVICES, INPATIENT AND OUTPATIENT REHABILITATION (PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY). OUR COMMITMENT TO BRING INNOVATIVE PROGRAMS AND SERVICES TO SOUTHEAST ARKANSAS IS EVIDENT. DURING FISCAL YEAR 2019, JRMC INVESTED $7.9 MILLION IN CAPITAL ADDITIONS AND IMPROVEMENTS TO OUR PLANNING, BUDGETING AND SPENDING WITH THE GOAL OF CONTINUING TO PROVIDE STATE-OF-THE-ART TECHNOLOGIES IN A CARING ENVIRONMENT. JRMC CONTINUES TO BE A LEADER IN ELECTRONIC MEDICAL RECORD SYSTEM ADVANCEMENT, MEETING STAGE 2 MEANINGFUL USE REQUIREMENTS SET FORTH AS PART OF THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009. SINCE THE BEGINNING OF THE PROGRAM, JRMC HAS CONTINUED TO RECEIVE MONETARY INCENTIVES FROM THE ARKANSAS MEDICAID QUALITY PROGRAM BY ACHIEVING PERFORMANCE GOALS IN QUALITY, DOCUMENTATION AND VALIDATION EXCELLENCE. JRMC CONTINUES TO PARTICIPATE IN THE HCAHPS PATIENT PERSPECTIVES ON CARE. WE HAVE CHOSEN THE PHONE METHODOLOGY, WHICH ENSURES HIGHER RESPONSE RATE IN OUR SERVICE AREA. WE CONTINUALLY ANALYZE THE HCAHPS SURVEY RESULTS AND MAKE ADJUSTMENTS, WHEN NEEDED, TO IMPROVE THE OVERALL PATIENT EXPERIENCE AT JRMC. DURING THE PAST SEVERAL YEARS, THE BOARD OF DIRECTORS VIA ITS AUDIT COMMITTEE HAS FOCUSED ON MAINTAINING RECOMMENDATIONS MADE BY FITCH RATING WHICH URGED NOT-FOR-PROFIT HEALTHCARE PROVIDERS TO ADOPT NINE SPECIFIC PROVISIONS OF SARBANES-OXLEY COMPLIANCE. DURING THIS PERIOD WE HAVE CONTINUED TO MAINTAIN COMPLIANCE WITH ALL NINE OF THE FITCH/SOX PROVISIONS. THESE INCLUDE: PROHIBITION OF SPECIFIED NON-AUDIT SERVICES BY AUDITORS, FIVE YEAR AUDIT PARTNER ROTATION, AUDITOR COMMUNICATIONS, AUDIT COMMITTEE STANDARDS, MANAGEMENT CERTIFICATION OF FINANCIAL STATEMENTS, BONUS FORFEITURE, ADOPTION OF A CODE OF ETHICS, AUDIT COMMITTEE FINANCIAL EXPERT, AND INTERNAL CONTROL EVALUATION. IN ADDITION TO THE COMPLETE ADOPTION OF THE FITCH/SOX PROVISIONS, THE JHA BOARD OF DIRECTORS HAS UNDERTAKEN A COMPREHENSIVE SELF-ASSESSMENT REGARDING ITS NOT-FOR-PROFIT STATUS UTILIZING COMPLIANCE CHECK TOOL AND PROPOSED GUIDELINES PUBLISHED BY THE IRS. JHA HAS NO REASON TO BELIEVE ITS TAX EXEMPT STATUS HAS EVER BEEN IN JEOPARDY. |
| FORM 990, PART VI, SECTION A, LINE 1A | DELEGATION OF AUTHORITY: AN EXECUTIVE COMMITTEE MAY BE ELECTED BY THE BOARD OF DIRECTORS TO CONSIST OF NOT LESS THAN THREE DIRECTORS. THE COMMITTEE IS ABLE TO EXERCISE ALL AUTHORITY OF THE BOARD DURING INTERVALS BETWEEN MEETINGS OF THE BOARD WITH RESPECT TO THE AFFAIRS OF THE CORPORATION, BUT SHALL BE SUBJECT TO THE CONTROL AND DIRECTION OF THE FULL BOARD. THE COMMITTEE SHALL ALSO CONDUCT AN EVALUATION OF THE CHIEF EXECUTIVE OFFICER ANNUALLY FOR THE FULL BOARD OF DIRECTORS TO REVIEW. |
| FORM 990, PART VI, SECTION A, LINE 2 | RELATIONSHIPS OF OFFICERS, DIRECTORS, AND TRUSTEES: David Brown (JHA Director) and H. Ford Trotter III (JHA Director/Treasurer) have a business relationship. H. Ford Trotter III (JHA Director/Treasurer) and Marty Casteel (JHA Director) have a business relationship. Archie Sanders (JHA Director) and Annette Kline (JHA Vice-Chairman/Chairman) have a business relationship. Scott Pittillo (JHA Treasurer/Vice-Chairman) and Annette Kline (JHA Vice-Chairman/Chairman) have a business relationship. George Makris (JHA Director) and Marty Casteel (JHA Director) have a business relationship. H. Ford Trotter III (JHA Director/Treasurer) and George Makris (JHA Director) have business relationships. George Makris (JHA Director) and David Brown (JHA Director) have a business relationship. Chuck Morgan (JHA Chairman/Director) and Annette Kline (JHA Vice-Chairman/Chairman) have a business relationship. Marty Casteel (JHA Director) and Chuck Morgan (JHA Chairman/Director) have a business relationship. Chuck Morgan (JHA Chairman/Director) and George Makris (JHA Director) have a business relationship. Archie Sanders (JHA Director) and Chuck Morgan (JHA Chairman/Director) have a business relationship. Scott Pittillo (JHA Treasurer/Vice-Chairman) and Chuck Morgan (JHA Chairman/Director) have a business relationship. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: THE BYLAWS WERE AMENDED SEPTEMBER 2018. THE NEW BYLAWS CHANGED THE QUALIFICATIONS AND DEFINITIONS OF THE BOARD OFFICERS. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OR STOCKHOLDERS: THE ORGANIZATION HAS A MEMBERSHIP CONSISTING OF 30 JEFFERSON COUNTY ARKANSAS RESIDENTS. |
| FORM 990, PART VI, SECTION A, LINE 7A | POWER TO ELECT OR APPOINT MEMBERS OF GOVERNING BODY: THE MEMBERSHIP OF THE ORGANIZATION HAS THE RESPONSIBILITY OF ELECTING THE BOARD OF DIRECTORS AT THE ANNUAL MEMBERSHIP MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990: THE FORM 990 AND FORM 990-T ARE PREPARED AND REVIEWED UNDER THE DIRECTION OF THE CHIEF FINANCIAL OFFICER. FINAL DRAFTS OF THE RETURNS ARE PRESENTED TO THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS DESIGNATED BY THE BOARD OF DIRECTORS TO FULFILL THE FIDUCIARY RESPONSIBILITY OF THE GOVERNING BODY TO REVIEW THE RETURNS BEFORE THEY ARE FILED WITH THE IRS. AFTER ANY FINAL REVISIONS ARE MADE BASED UPON THE GOVERNANCE COMMITTEE'S REVIEW, A FINAL VERSION IS POSTED TO AN INTERNAL SECURE WEBSITE WITH A LINK E-MAILED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR AND ENFORCE COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION REQUIRES NOT ONLY AN ANNUAL CONFLICT OF INTEREST DISCLOSURE, BUT ALSO DISCLOSURE WHEN SITUATIONS SUBSEQUENT TO THE ANNUAL DISCLOSURE DEVELOP THAT WOULD POTENTIALLY PLACE THE INDIVIDUAL IN A CONFLICT OF INTEREST. IN THOSE SITUATIONS, IMMEDIATE DISCLOSURE IS REQUIRED. THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTS THE ANNUAL REVIEW OF CONFLICT OF INTEREST DISCLOSURES. IN THE EVENT THE GOVERNANCE COMMITTEE DETERMINES THAT A CONFLICT EXISTS, LEGAL COUNSEL IS CONSULTED. IF LEGAL COUNSEL DETERMINES THAT A CONFLICT EXISTS, THE PERSON IS INFORMED AND THE MATTER IS REPORTED TO THE BOARD FOR ACTION. ANY DIRECTOR OR OFFICER WHOSE TRANSACTIONS ARE BEING REVIEWED WOULD ABSENT HIMSELF/HERSELF FROM THE REVIEW. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION OF CEO AND OTHER OFFICERS: THE COMPENSATION COMMITTEE MOST RECENTLY ENGAGED A THIRD-PARTY GLOBAL HUMAN CAPITAL CONSULTING FIRM, KORN FERRY HAY GROUP IN OCTOBER 2019 TO PERFORM A TOTAL COMPENSATION REVIEW THAT WAS PREVIOUSLY CONDUCTED IN SEPTEMBER 2018. THE COMPENSATION COMMITTEE UTILIZES THIS REVIEW IN CONCERT WITH A DEFINED EXECUTIVE COMPENSATION POLICY TO DEVELOP AND MAINTAIN A TOTAL COMPENSATION PACKAGE THAT IS REASONABLE AS COMPARED TO SIMILAR POSITIONS AT NON-PROFIT HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY. THE DELIBERATIONS AND DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED AND A SUMMARY REPORT IS MADE TO THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF DOCUMENTS: THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST ONE OR MORE OF THE ITEMS. |
| FORM 990, PART VII, SECTION A & SCHEDULE J, PART II | COMPENSATION TABLE: COMPENSATION INFORMATION REQUIRED IN FORM 990, PART VII, SECTION A AND SCHEDULE J, PART II IS PROVIDED IN A TABLE IDENTIFIED AS ATTACHMENT 3 AND ATTACHED TO THE TAX RETURN DOCUMENT FOLLOWING SCHEDULE R. THE TABLES WITHIN THE RETURN ARE POPULATED WITH ZERO BECAUSE OF THE ELECTRONIC FILING REQUIREMENT, AND THE CORRECT AMOUNTS ARE INCLUDED IN THE ATTACHMENT. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:13129795 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:4195972 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:15419066 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:2499234 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES TOTAL FEES:5535396 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| JEFFERSON SURGERY CENTER PLLC | |||||||||
| 1600 W 40TH AVE | PINE BLUFF | AR | 71603 | 710810564 | AMB SURGERY | AR | $0 | $0 | JHA |
| JEFFERSON REGIONAL ANESTHESIA | |||||||||
| 1600 W 40th Ave | PINE BLUFF | AR | 71603 | 831984365 | ANESTHESIA | AR | $1,556,223 | $1,558,354 | JHA |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON REGIONAL MED CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 W 40TH AVE | AddressLine1Txt |
| City | PINE BLUFF | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 821820277 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | AR | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 12, TYPE I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JHA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFERSON MANAGEMENT SERVICES INC | ||||||||||||
| 1600 W 40TH AVE | PINE BLUFF | AR | 71603 | 710582753 | PHYS PRACTICE MGM | AR | JHA | C-CORPORATION | $0 | $631,226 | 1.00000 | Yes (true) |
| JHA HEALTH AFFILIATES INC | ||||||||||||
| 1600 W 40TH AVE | PINE BLUFF | AR | 71603 | 710766959 | REAL EST RENTAL | AR | JHA | C-CORPORATION | -$40,575 | $827,729 | 1.00000 | 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 | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | 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 | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| JEFFERSON MANAGEMENT SERVICES INC | ||
| L | $77,167 | G/L ACTIVITY |
| JEFFERSON MANAGEMENT SERVICES INC | ||
| S | $270,000 | G/L ACTIVITY |
| JEFFERSON REGIONAL MED CENTER FOUNDATION | ||
| L | $209,057 | G/L ACTIVITY |