2019-02-08T19:05:59-06:00 2018-09-30 710355269 LANDMARK PLC CPAS P O BOX 10148 FORT SMITH AR 729170148 990 2017-10-01 237237381 ARKANSAS FOUNDATION FOR MEDICAL CARE INC ARKA 4795737616 PO BOX 180001 FORT SMITH AR 729180001 JENNA CLEMONS CONTROLLER 4795737616 2019-02-04 1 BARBARA HAMBRICK P00387600 4794845740 2019-02-04 24.248.194.80 2019-02-04 09:41:01 CS P F938EC411E1B5E51ED8716FDCEC73E351A02AD7F 53789A3AF3D137E9D071622BE5F20C09E0391B02 2017 2019-02-21 02:37:17Z JENNA CLEMONS PO BOX 180001 FORT SMITH AR 729180001 29904479 0 X WWW.AFMC.ORG X 1972 AR ARKANSAS FOUNDATION FOR MEDICAL CARE, INC. DEVELOPS AND PROMOTES COOPERATIVE QUALITY IMPROVEMENT PROJECTS INVOLVING HOSPITALS, NURSING HOMES, HOME HEALTH AGENCIES, PHYSICIANS, AND OTHER STAKEHOLDERS IN ORDER TO IMPROVE THE DELIVERY, QUALITY, AND COST-EFFECTIVENESS OF HEALTH CARE PROVIDED FOR MEDICARE AND MEDICAID BENEFICIARIES. 16 16 320 0 0 0 25029850 23399932 3919768 5815958 179137 232605 7085 60890 29135840 29509385 2500 3000 0 0 22178498 21595111 0 0 0 6397709 7149616 28578707 28747727 557133 761658 28650035 30461299 2837416 3195324 25812619 27265975 X TO PROMOTE EXCELLENCE IN HEALTH CARE THROUGH EVALUATION AND EDUCATION 0 0 1706830 CMS QIN/QIO 11TH SOW WHICH WE PARTICIPATE IN AS A SUB TO TMF (TEXAS MEDICAL FOUNDATION) - PROVIDED QUALITY CONTROL PEER REVIEW SERVICES IN ACORDANCE WITH SECTION 1154 OF THE SOCIAL SECURITY ACT IN ACCORDANCE WITH THE REQUIREMENTS AND DELIVERABLES OF THE 11TH SCOPE OF WORK. 6249945 ARKANSAS MEDICAID REVIEW - PROVIDED REVIEW SERVICES AS REQUIRED BY CONTRACT:PRIOR AUTHORIZATION OF MED/SURG PROCEDURES - 7,006PRIOR AUTHORIZATION OF MUMPS - 23,232PRIOR AUTHORIZATION OF DME - 28,247PRIOR AUTHORIZATION OF REHAB THERAPY - 610TARGETED CASE MANAGEMENT REVIEW - 145RETRO EMERGENCY ROOM REVIEW - 37,390RETRO INPATIENT REVIEW - 30,902EXTENSION OF BENEFIT/MOLECULAR PATHOLOGY REVIEW - 27,877MOLECULAR PATHOLOGY - 1,614ORGAN TRANSPLANT REVIEW - 72PVT OPTION REVIEWS - 81NICU - 1,474THERAPY PERSONAL CARE - 1,049CHMS - 8,478CHMS PA EXT - 573CHMS PARE EXT - 318CHMS RETRO - 867THERAPY RETRO 90 MIN OR LESS - 7,879THERAPY PA OVER 90 MIN - 29,394 10652009 MEDICAID BENEFICIARY RELATIONS - A CONTRACT TO MAINTAIN ACTIVE FEEDBACK AND PROFESSIONAL RELATIONS WITH MEDICAID BENEFICIARIES. IT ALSO INCLUDES MAINTAINING A CALL SERVICE CENTER TO ASSIST INDIVIDUALS WITH MEDICAID AND PRIVATE OPTION COVERAGE. SURVEYS AND MONITORING OF THE NON-EMERGENCY TRANSPORTATION (NET) SERVICES ARE ADDITIONAL DELIVERABLES UNDER THIS CONTRACT. PROVIDER RELATIONS AND CONNECTCARE ACTIVITIES WERE ALSO ADDED TO THIS CONTRACT THIS YEAR. 8685861 3000 5815958 OTHER PROGRAMS CONSIST OF CONTRACTS THAT THE ORGANIZATION HAS WITH VARIOUS FEDERAL, STATE, AND PRIVATE AGENCIES. 8685861 3000 5815958 27294645 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 64 0 1 320 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AR X JENNA CLEMONS 4795737616 PO BOX 180001 FORT SMITH AR 72918 E SCOTT FERGUSON MD BOD 1.00 X 5625 0 0 JENNIFER STYRON TREASURER 1.00 X X 5500 0 0 JANE SNEED MD BOD 1.00 X 0 0 0 TOM BUTLER BOD 1.00 X 5625 0 0 AMY JOHNSON BOD 1.00 X 2800 0 0 GARY PAXSON BOD 1.00 X 0 0 0 MARCUS OSBORNE BOD 1.00 X 4675 0 0 KAREN PETTIT RNP CPHQ BOD 1.00 X 5100 0 0 MELISSA PIERCE RNP BOD 1.00 X 5625 0 0 MICHAEL MOODY MD BOD 1.00 X 5100 0 0 STACY C ZIMMERMAN MD CHAIRMAN OF BOARD 1.00 X X 4400 0 0 CAROLYN HOOD RN BSN BOD 1.00 X 5100 0 0 ALAN WILSON MD SECRETARY 1.00 X X 5100 0 0 HARVEY POTTS MD MPH VICE CHAIRMAN 1.00 X X 2400 0 0 LADELL DOUGLAS MD MEMBER-AT-LARGE 1.00 X X 2400 0 0 DAN WILKERSON MD BOD 1.00 X 0 0 0 WALLACE R HANLEY CEO/PRESIDENT 39.00 X 363003 0 38794 MARILYN LITTLE CHIEF OPERATING OFFICER 39.00 X 204636 0 11571 MARY S MOORE CHIEF COMPLIANCE OFFICER 43.00 X 160824 0 29593 MARY N COUNTS CHIEF FINANCIAL OFFICER 46.00 X 168937 0 26903 DANIEL J RILEY CHIEF FINANCIAL OFFICER 43.00 X 0 0 0 PEGGY J STARLING CHIEF OUTREACH SERVICES OF 44.00 X 194307 0 25499 NATHAN RAY CHIEF TECHNOLOGY OFFICER 44.00 X 160976 0 23996 MELISSA MASINGILL CHIEF PUBLIC AFFAIRS OFFIC 38.00 X 123239 0 23410 CATHY BAIN CHIEF ADMINISTRATIVE OFFIC 49.00 X 145295 0 20644 CHAD T RODGERS MD CHIEF MEDICAL OFFICER 17.00 X 116676 0 6754 JULIA KETTLEWELL DIRECTOR QUALITY 40.00 X 140821 0 24341 JENNA CLEMONS CONTROLLER 43.00 X 135946 0 30618 JARROD MCCLAIN DIRECTOR CLINICAL REVIEW 39.00 X 129264 0 19422 STEVEN CHASTEEN DIRECTOR PRAC TRANSFORMATI 47.00 X 123303 0 31095 THOMAS D TINSMAN ASSOC MED DIRECTOR 42.00 X 224189 0 21987 2450866 0 334627 23 0 1 0 COLLIERS INTERNATIONAL PO BOX 3546 LITTLE ROCK AR 72203 REAL ESTATE MANAGEMENT 756266 OFFICE TEAM 12400 COLLECTIONS CENTER DR CHICAGO IL 60693 TEMPORARY STAFFING 442914 SALESFORCECOM INC PO BOX 3370 TUPELO MS 38803 CUSTOMER RELATIONSHIP MGMT 413296 DELL MARKETING PO BOX 3370 TUPELO MS 38803 COMPUTER TECHNOLOGY 289575 DATAPATH ADMIN SVCS INC 1601 WESTPARK DRIVE STE 9 LITTLE ROCK AR 72204 THIRD PARTY BENEFITS ADMIN 260959 12 23399932 23399932 PRIVATE REVENUE FROM OPERATIONS 900099 5815958 5815958 5815958 244024 244024 244223 183333 60890 60890 60890 200342 211761 -11419 -11419 -11419 29509385 5815958 0 293495 3000 3000 1776976 1776976 13105412 12588108 517304 492093 492093 4993309 4758883 234426 1227321 1227321 35221 35221 57009 57009 1894047 1765188 128859 109402 50775 58627 1238218 967517 270701 1581504 1581355 149 421787 421668 119 577511 546396 31115 177910 88598 89312 755722 722597 33125 153504 153504 PASS THROUGH COSTS 127426 127426 PARKING 1233 1233 19122 -70223 89345 28747727 27294645 1453082 0 1100 1100 1781522 2895299 4841226 4149752 1392694 1348140 12914894 4802024 7796782 8112870 12836711 13954138 28650035 30461299 2837416 2656514 538810 2837416 3195324 X 25812619 27265975 25812619 27265975 28650035 30461299 761658 691698 0 X X 0 1 X 1 1 1 X 19727752 20147853 28627730 25029850 23399932 116933117 1206796 1673087 671258 3919768 5815958 13286867 20934548 21820940 29298988 28949618 29215890 130219984 0 0 0 130219984 335894 329862 435506 449393 488247 2038902 335894 329862 435506 449393 488247 2038902 2362 2362 21272804 22150802 29734494 29399011 29704137 132261248 0.98460 0.98450 0.01540 0.01550 X 0 0 X 106742 106742 28640985 28747727 1000000 250000 0 0 PART I-A, LINE 1: THE CEO WAS INVOLVED IN EDUCATING LEGISLATORS ON PRIVATE OPTION IMPACT DURING THIS YEAR'S SESSION. 1060000 1060000 6598328 1383238 5215090 424668 149405 275263 937672 502010 435662 3894226 2767371 1126855 8112870 X 30201083 691698 691698 29509385 0 29509385 28747727 0 28747727 0 28747727 PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) CODIFICATION TOPIC INCOME TAXES. FASB CODIFICATION TOPIC INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES AND REQUIRES THE ORGANIZATION TO RECOGNIZE IN THEIR FINANCIAL STATEMENTS THE IMPACT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED UNDER AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS ASSESSED THE TAX POSITIONS OF THE ORGANIZATION AND DETERMINED THAT NO POSITIONS EXIST THAT REQUIRE ADJUSTMENT OR DISCLOSURE UNDER THE PROVISIONS OF FASB CODIFICATION TOPIC INCOME TAXES. ARKANSAS FOUNDATION FOR MEDICAL CARE, INC. (AFMC) FILES INFORMATIONAL "RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX" (FORM 990) IN THE U.S. FEDERAL JURISDICTION AND ARKANSAS. 1 X 0 0 0 0 0 0 0 0 0 WALLACE R HANLEY CEO/PRESIDENT 363003 0 0 0 0 0 10800 0 27994 0 401797 0 0 0 MARILYN LITTLE CHIEF OPERATING OFFICER 204636 0 0 0 0 0 8291 0 3280 0 216207 0 0 0 MARY S MOORE CHIEF COMPLIANCE OFFICER 160824 0 0 0 0 0 6638 0 22955 0 190417 0 0 0 MARY N COUNTS CHIEF FINANCIAL OFFICER 168937 0 0 0 0 0 6907 0 19996 0 195840 0 0 0 PEGGY J STARLING CHIEF OUTREACH SERVICES OF 194307 0 0 0 0 0 7890 0 17609 0 219806 0 0 0 NATHAN RAY CHIEF TECHNOLOGY OFFICER 160976 0 0 0 0 0 6486 0 17510 0 184972 0 0 0 CATHY BAIN CHIEF ADMINISTRATIVE OFFIC 145295 0 0 0 0 0 5930 0 14714 0 165939 0 0 0 JULIA KETTLEWELL DIRECTOR QUALITY 140821 0 0 0 0 0 5826 0 18515 0 165162 0 0 0 JENNA CLEMONS CONTROLLER 135946 0 0 0 0 0 5541 0 25077 0 166564 0 0 0 STEVEN CHASTEEN DIRECTOR PRAC TRANSFORMATI 123303 0 0 0 0 0 5041 0 26054 0 154398 0 0 0 THOMAS D TINSMAN ASSOC MED DIRECTOR 224189 0 0 0 0 0 9025 0 12962 0 246176 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS A PRELIMINARY 990 AT THEIR BOARD MEETING. ANY QUESTIONS ARE ANSWERED. THE RETURN IS THEN APPROVED BY THE BOARD FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICER OF THE ORGANIZATION CONTINOUSLY MONITORS THESE POLICIES. THEY ALSO PROVIDE TRAINING AND EDUCATION RELATED TO CONFLICTS OF INTEREST AND REQUIRE THAT ALL EMPLOYEES AND BOARD MEMBERS SIGN A CONFLICTS OF INTEREST FORM ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE HIRING COMMITTEE OF THE BOARD OF DIRECTORS SET THE MAXIMUM DOLLAR AMOUNT OF SALARY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR