2019-11-15T16:07:34-06:00 2018-12-31 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2018-01-01 621808817 HEALTH SERVICES MANAGEMENT INC HEAL 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 WILLIAM NEELY EXECUTIVE VP 6158961191 2019-11-15 1 LUCY R CARTER P00026809 6152427351 2019-11-15 65.198.206.98 2019-11-15 15:59:03 CS P B68C22C976E44D36ACAA41583C666EA48034497C EE7BB5FE320B8FB13B25121C5E937124580CA208 2018 2020-04-17 16:48:07Z ERIC BELL 206 FORTRESS BLVD MURFREESBORO TN 37128 138150549 0 X N/A X 2000 TN TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 7 3 3462 0 0 0 0 152698 136722007 130781671 0 -146164 0 2473017 136722007 133261222 0 682001 0 0 62477605 67124845 0 0 0 76494955 63608998 138972560 131415844 -2250553 1845378 117764095 120298786 57373194 56598777 60390901 63700009 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 0 0 120693152 682001 131256280 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES IN INDIANA, TENNESSEE, TEXAS, AND FLORIDA. 120693152 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 1 615 0 1 3462 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 3 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X WILLIAM H NEELY 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 X MARSHALL P SWEENEY END 123118 CHAIRMAN OF THE BOARD 50.00 X X 12528 0 22088 JAMES E BELL CEO 50.00 X X 1236059 0 16159 ERIC P SWEENEY END 101518 PRESIDENT 50.00 X X 877901 0 12762 WILLIAM NEELY EXECUTIVE VP 50.00 X X 898683 0 12217 SCOTT FISHER VP OF FINANCE 50.00 X X 317151 0 27632 TIM PRIDDY DIRECTOR 1.00 X 84500 0 0 RANDY SHUCK DIRECTOR 1.00 X 84500 0 0 JIM SHATZ DIRECTOR 1.00 X 59500 0 0 BRIAN JACKSON DIRECTOR OF CORPORATE COMPLIANCE 50.00 X 175381 0 27682 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 50.00 X 223996 0 27235 JERELD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 50.00 X 141950 0 24126 JENNIFER DAVES CHIEF NURSING OFFICER 50.00 X 74270 0 7562 JOSHUA WHITE REGIONAL VP OF OPERATIONS 50.00 X 296448 0 5552 CHRISTOPHER GONZALEZ REGIONAL ADMINISTRATOR 50.00 X 228741 0 11945 WANDA MOAK ADMINISTRATOR 50.00 X 186078 0 27997 JOANNA BUCKLES ADMINISTRATOR 50.00 X 160288 0 21856 PATRICIA EDGELL REGIONAL DIRECTOR OF CLINICAL SERVICES 50.00 X 150972 0 14967 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVICES 50.00 X 125654 0 30723 5334600 0 290503 13 0 1 0 RELIANT REHABILITATION 5212 VILLAGE CREEK DRIVE PLANO TX 75093 THERAPY 14714858 QUALITY CARE REHAB 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 THERAPY 1133210 NIELSON FINANCIAL SERVICES INC 901 EAST WASHINGTON ST ORLANDO FL 32801 BILLING & AR SUPPORT 1132047 LTC TECHNOLOGY SYSTEMS INC 1906 SE 3RD AVE OCALA FL 34471 IT SERVICES 656166 MAUN-LEMKE 8031 W CENTER RD STE 222 OMAHA NE 68124 CONSULTING 520567 15 105439 47259 152698 PATIENT SERVICE REVENUE 623000 130437027 130437027 MANAGEMENT FEE REVENUE 623000 221555 221555 CAFETERIA & VENDING REVENUE 722514 47355 47355 CABLE & PHONE REVENUE 812900 41786 41786 33948 33948 130781671 418656 418656 3384214 1950626 1433588 1433588 1433588 2373881 2938701 -564820 -564820 -564820 PASSTHROUGH INCOME 446110 596243 596243 OTHER REVENUE 900099 443186 443186 1039429 133261222 131256280 0 1852244 X 682001 682001 4906569 3019819 1886750 54416628 52804397 1612231 151315 139946 11369 3265407 3091734 173673 4384926 4131641 253285 553629 553629 788671 788671 18659493 17705247 954246 991368 262020 729348 3813067 2300963 1512104 533059 79430 453629 12108995 11860435 248560 313620 74924 238696 411876 226124 185752 846775 810836 35939 333159 199770 133389 3521272 3303695 217577 2115045 2041528 73517 TAXES 4999504 4540217 459287 0 FOOD 4046346 4046346 0 0 PROGRAM SUPPLIES 3836365 3722039 114326 0 PHARMACEUTICAL DRUGS 3323385 3323385 0 0 2413369 2326655 86714 131415844 120693152 10722692 0 1 18547186 31059036 13061217 11396646 17843348 1638518 274505 295936 1124059 663840 107496032 40802360 70485210 66693672 439326 3207624 217014 1115743 117764095 120298786 7871443 9431209 129527 502026 48126546 42251580 1375205 4284435 57373194 56598777 X 60390901 63700009 60390901 63700009 117764095 120298786 1845378 1463728 0 X 0 1 X 0 0 X 152698 152698 138272877 138909137 138891066 136524035 130781671 683378786 3384214 3384214 138272877 138909137 138891066 136524035 134318583 686915698 0 0 0 686915698 103073 160992 152367 197972 418656 1033060 103073 160992 152367 197972 418656 1033060 1039429 1039429 138375950 139070129 139043433 136722007 135776668 688988187 0.99700 0.99900 0.00150 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 4790815 4790815 76920122 23532264 53387858 9232937 7212222 2020715 9324352 6765346 2559006 7227806 3292528 3935278 66693672 RESIDENT REFUNDS PAYABLE 4284435 4284435 X PART IV, LINE 2B: THE ORGANIZATION USES A THIRD PARTY ADMINISTRATOR TO MANAGE THE FUNDS HELD IN TRUST FOR RESIDENTS. PART X, LINE 2: MANAGEMENT PERFORMS AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE ORGANIZATION'S INCOME TAX RETURNS TO DETERMINE WHETHER THE INCOME TAX POSITIONS MEET A "MORE LIKELY THAN NOT" STANDARD OF BEING SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL INCOME TAX POSITIONS TAKEN ON ALL OPEN INCOME TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. ACCORDINGLY, THERE ARE NO PROVISIONS FOR INCOME TAXES, PENALTIES OR INTEREST RECEIVABLE OR PAYABLE RELATING TO UNCERTAIN INCOME TAX POSITIONS IN THE ACCOMPANYING FINANCIAL STATEMENTS. 0 ARROWHEAD RANCH INC 206 FORTRESS BLVD MURFREESBORO TN 37138 263456041 501(C)3 682001 TO PROVIDE ASSISTANCE TO ARROWHEAD OPERATIONS INC. 1 0 X X 0 1 X X X X 1 0 0 0 0 1 0 1 0 JAMES E BELL CEO 1191659 0 0 0 44400 0 0 0 16159 0 1252218 0 0 0 ERIC P SWEENEY END 101518 PRESIDENT 835301 0 0 0 42600 0 0 0 12762 0 890663 0 0 0 WILLIAM NEELY EXECUTIVE VP 854283 0 0 0 44400 0 0 0 12217 0 910900 0 0 0 SCOTT FISHER VP OF FINANCE 305151 0 0 0 12000 0 0 0 27632 0 344783 0 0 0 BRIAN JACKSON DIRECTOR OF CORPORATE COMPLIANCE 175381 0 0 0 0 0 0 0 27682 0 203063 0 0 0 ROBERT MCPHEE CORPORATE MEDICAL DIRECTOR 223996 0 0 0 0 0 0 0 27235 0 251231 0 0 0 JERELD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 141950 0 0 0 0 0 0 0 24126 0 166076 0 0 0 JOSHUA WHITE REGIONAL VP OF OPERATIONS 283448 0 0 0 13000 0 0 0 5552 0 302000 0 0 0 CHRISTOPHER GONZALEZ REGIONAL ADMINISTRATOR 224741 0 0 0 4000 0 0 0 11945 0 240686 0 0 0 WANDA MOAK ADMINISTRATOR 143455 0 40423 0 2200 0 0 0 27997 0 214075 0 0 0 JOANNA BUCKLES ADMINISTRATOR 132819 0 25269 0 2200 0 0 0 21856 0 182144 0 0 0 PATRICIA EDGELL REGIONAL DIRECTOR OF CLINICAL SERVIC 146972 0 4000 0 0 0 0 0 14967 0 165939 0 0 0 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVIC 121654 0 4000 0 0 0 0 0 30723 0 156377 0 0 0 PART I, LINE 1A DUE TO THE SUBSTANTIAL AMOUNT OF TIME OFFICERS SPEND TRAVELING, THE COMPANY PURCHASED AN AIRPLANE THAT OFFICERS USE TO TRAVEL TO AND BETWEEN FACILITIES AND OFFICES. IN ADDITION, IN 2018 MR. ERIC P. SWEENEY USED THE AIRPLANE FOR A LIMITED NUMBER OF HOURS FOR PERSONAL PURPOSES (LESS THAN 2). MR. ERIC P.` SWEENEY REIMBURSED THE ORGANIZATION FOR HIS PERSONAL USE. PART I, LINE 1B THE ORGANIZATION PROVIDED TRAVEL FOR THE SPOUSES OF ALL EMPLOYEES ATTENDING ITS ANNUAL MANAGEMENT CONFERENCE WHICH INCLUDED OFFICERS, DIRECTORS, AND FACILITY ADMINISTRATORS. ALL MARRIED PERSONS LISTED IN PART VII, SECTION A OF FORM 990 RECEIVED THIS BENEFIT UNLESS THEIR SPOUSE WAS UNABLE TO ATTEND. THE SPOUSES WERE ASKED TO ATTEND THIS CONFERENCE TO MAINTAIN THE FAMILY ATMOSPHERE THE ORGANIZATION TRIES TO FOSTER IN ITS STAFF AND OPERATIONS. THE MANAGEMENT OF THE ORGANIZATION BELIEVES THAT THE CONFERENCE WOULD NOT BE AS EFFECTIVE IF THE SPOUSES DID NOT ATTEND. THE EXPENSES PAID FOR THE SPOUSES WAS LIMITED TO MEALS AND AIRFARE AND RANGED FROM $800 T0 $1000 PER PERSON. THE DECISION TO INVITE THE SPOUSES TO ATTEND THE CONFERENCE WAS MADE BY THE CEO OF THE ORGANIZATION. PART I, LINE 4A ERIC P SWEENEY ENTERED INTO A SEPARATION AND RELEASE AGREEMENT EFFECTIVE OCTOBER 15, 2018. PART I, LINE 6 THE 2018 PLAN INCLUDES AN INCENTIVE PAYMENT TO ADMINISTRATORS, DON, SOCIAL SERVICES, ADMISSIONS DIRECTOR, AND DIETARY FOR CATEGORIES INCLUDING BUDGET COMPLIANCE, MEDICARE CENSUS, SUPER BONUS, CENTER OPERATIONAL PERFORMANCE SCORECARD, CUSTOMER CARE SATISFACTION SURVEY, TURNOVER, LABOR BUDGET,AND FOOD BUDGET. PART I, LINE 7 THE 2018 PLAN INCLUDES AN INCENTIVE PAYMENT TO THE CENTER ADMISSIONS DIRECTOR FOR OVERALL CENSUS PERFORMANCE (BASED ON PERCENTAGE OF AVAILABLE BEDS FROM THE CENTER'S BUDGET) AND FOR MEDICARE PLUS MANAGED CARE CENSUS LEVELS (BASED ON AVERAGE PER PATIENT DAY). HEALTH MANAGEMENT CONSULTANTS LLC OWNED 100% BY MARSHALL PRESTON SWEENEY, BOARD CHAIRMAN 500000 CONSULTING FEES PAID BY ORGANIZATION TO HEALTH MANAGEMENT CONSULTANTS, LLC FOR SERVICES PERFORMED FOR THE ORGANIZATION. 0 LORA SWEENEY MRS. SWEENEY IS THE WIFE OF THE BOARD CHAIRMAN, MARSHALL PRESTON SWEENEY 72000 PAYMENT OF THE W-2 REPORTED COMPENSATION FOR ADMINISTRATIVE AND MANAGERIAL DUTIES PERFORMED FOR THE ORGANIZATION'S CORPORATE OFFICE. 0 FORM 990, PART VI, SECTION A, LINE 2 OFFICERS MARSHALL PRESTON SWEENEY AND ERIC SWEENEY, FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S GENERAL COUNSEL REVIEWED THE FORM 990 AND PROVIDED COMMENTS AND QUESTIONS TO THE RETURN PREPARER. A COPY OF THE FORM 990 WAS EMAILED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C QUESTIONNAIRES ARE COMPLETED ANNUALLY BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USED THE SERVICES OF AN INDEPENDENT FIRM TO REVIEW THE COMPENSATION OF THE OFFICERS OF THE ORGANIZATION AND RELATED ENTITIES TO DETERMINE IF THEIR COMPENSATION WAS COMPARABLE TO OTHER EXECUTIVES AND ENTITIES IN THE SAME LINE OF BUSINESS. IN ADDITION, INDEPENDENT BOARD MEMBERS REVIEW THE COMPENSATION OF THE EXECUTIVE OFFICERS. THE INDEPENDENT BOARD MEMBERS AND THE FULL BOARD APPROVED THE COMPENSATION PAID IN 2018. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL DATA, ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN (D) PAYMENTS FROM DISREGARDED ENTITIES (WHOLLY OWNED LLCS) LISTED ON SCHEDULE R WERE MADE TO THE BOARD OF DIRECTORS AND CERTAIN EMPLOYEES FOR THEIR SERVICE RELATING TO GOVERNANCE. THESE PAYMENTS WERE DISBURSEMENTS FROM WHOLLY OWNED ENTITIES LISTED ON SCHEDULE R AS DISREGARDED ENTITIES. THAT AMOUNT IS NOT CONSIDERED RENUMERATION FOR PURPOSES OF IRC SECTION 4960 EXCESS COMPENSATION CALCULATION. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 16,136,815. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,136,815. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 300,248. MANAGEMENT AND GENERAL EXPENSES 526,593. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 826,841. STAFFING: PROGRAM SERVICE EXPENSES 723,530. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 723,530. HOSPITAL FACILITY SERVICES: PROGRAM SERVICE EXPENSES 102,226. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,226. PATIENT CARE: PROGRAM SERVICE EXPENSES 183,881. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 183,881. OTHER: PROGRAM SERVICE EXPENSES 258,547. MANAGEMENT AND GENERAL EXPENSES 427,653. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 686,200. 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