2018-05-15T11:35:44-05:00 2017-06-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2016-07-01 710329353 Jefferson Hospital Association Inc % BRYAN G JACKSON JEFF 8705417100 1600 West 40th Avenue Pine Bluff AR 71603 BRYAN G JACKSON SVP AND CFO 8705417100 2018-05-15 true Jeanette Verrelli P00742631 9727028262 2016 2022-09-23 18:48:47Z Jefferson Regional Medical Center BRIAN THOMAS 1600 WEST 40TH AVENUE PINE BLUFF AR 71603 196944074 false X WWW.JRMC.ORG X 1959 AR JEFFERSON HOSPITAL ASSOCIATION, INC. PROVIDES A WIDE RANGE OF HEALTH CARE SERVICES TO PATIENTS FROM JEFFERSON COUNTY AND SURROUNDING AREAS IN SOUTHEAST ARKANSAS. 13 6 2092 33 10446 649602 660031 168322763 180638693 3119177 3217709 5805137 2540237 177896679 187056670 415436 395039 0 0 83412916 90771950 0 0 0 83502464 95599431 167330816 186766420 10565863 290250 253030505 270326800 58539133 63681967 194491372 206644833 X 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. false false 164814686 395039 182186183 JEFFERSON HOSPITAL ASSOCIATION, INC. (JHA) OPERATES JEFFERSON REGIONAL MEDICAL CENTER (JRMC), A TERTIARY CARE FACILITY WITH 471 LICENSED BEDS AND 258 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. 164814686 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true true true true false false false false false true false false true true false false false false false true true true false false true 273 0 2092 true true true false false false false false false false false false X 13 6 true false false false true true false true true false false true true true true true true true true true true CA NC X BRYAN G JACKSON 8705417100 1600 WEST 40TH AVENUE PINE BLUFF AR 71603 X F ANTHONY - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 D ATKINSON - SEE SCH O SECRETARY 1.0 0.0 X X 0 0 0 D BROWN - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 JA CAMPBELL - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 M CASTEEL - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 M ECKERT - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 A KLINE - SEE SCH O VICE-CHAIRMAN 1.0 0.0 X X 0 0 0 G MAKRIS - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 JB MAYS - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 C MORGAN - SEE SCH O CHAIRMAN 1.0 0.0 X X 0 0 0 S PITTILLO - SEE SCH O TREASURER 1.0 0.0 X X 0 0 0 C ROAF - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 H TROTTER III - SEE SCH O DIRECTOR 1.0 0.0 X 0 0 0 B THOMAS - SEE SCH O PRESIDENT/CEO 1.0 0.0 X 0 0 0 L HICKMAN - SEE SCH O VP/CNO 40.0 0.0 X 0 0 0 B JACKSON - SEE SCH O VP/CFO 40.0 0.0 X 0 0 0 T HARBUCK - SEE SCH O FORMER EXECUTIVE VP 0.0 0.0 X 0 0 0 W JOHNSON - SEE SCH O FORMER DIRECTOR/PRES/CEO 0.0 0.0 X 0 0 0 R BURRELL - SEE SCH O PHYSICIAN 40.0 0.0 X 0 0 0 R GALLAHER - SEE SCH O PHYSICIAN 40.0 0.0 X 0 0 0 R PIERCE - SEE SCH O PHYSICIAN/VP/CMO 40.0 0.0 X 0 0 0 JA POLLARD - SEE SCH O PHYSICIAN 40.0 0.0 X 0 0 0 N WILLIS - SEE SCH O PHYSICIAN 40.0 0.0 X 0 0 0 0 0 0 84 true true false REHAB CARE GROUP INC PO BOX 502096 ST LOUIS MO 63150 REHAB SERVICE 3204461 SODEXO INC AFFILIATES PO BOX 536922 ATLANTA GA 30353 NUTRITIONAL SVCS 2522528 PREMIER ANESTHESIA LLC 2655 NORTHWINDS PKWY ATLANTA GA 30009 ANESTHESIA SVCS 2344072 SE AR HOSPITALISTS LLP PO BOX 677979 DALLAS TX 75267 HOSPITALIST SVCS 2326000 MEDTRONIC CARDIAC DIV PO BOX 848086 DALLAS TX 75284 CARDIAC SVCS 1752596 43 445102 214929 660031 PATIENT SERVICE REVENUE 621400 177729982 177729982 EHR INCENTIVE REVENUE 900099 57876 57876 JOINT VENTURE INCOME 621500 1099372 1091326 8046 MEDICAL OFFICE RENTAL 531120 1751463 1751463 180638693 3347760 3347760 0 0 15579 2400 15579 2400 17979 2400 15579 9354486 358034 9348290 494281 6196 -136247 -130051 -130051 0 0 0 0 0 0 380529 44833 335696 335696 Pathology/Outside Lab Billing 900099 36010 36010 CAFETERIA 722320 966722 966722 WELLNESS CENTER 713940 797101 797101 386729 386729 2186562 187056670 182186183 10446 4200010 X 94294 94294 300745 300745 0 0 2067700 611240 1456460 1299017 56340 1242677 74290758 67882108 6408650 2001229 1663510 337719 5813190 4766576 1046614 5300056 4381026 919030 3897840 3644189 253651 324196 217667 106529 251144 251144 44766 44766 0 0 37080895 31332708 5748187 353241 31740 321501 5703098 5019026 684072 1594646 1270614 324032 0 3646078 2744632 901446 280460 188620 91840 0 125108 103402 21706 852746 792769 59977 0 8929960 8301882 628078 1884202 1767407 116795 BAD DEBT EXPENSE 420374 420374 MEDICAL SUPPLIES 26123701 26123701 DUES & FEES 594242 182098 412144 LICENSE & TAXES 3347101 2912811 434290 145633 5207 140426 186766420 164814686 21951734 0 195491 -444527 10630884 4686478 0 0 22344148 27815850 0 0 22856 12856 1143791 648089 3607930 3701879 2610105 2477968 242723824 176933910 63664930 65789914 138521767 155548722 3704767 3756942 0 0 0 0 6583836 6332629 253030505 270326800 35614844 40481727 0 0 993276 635085 19553573 19232719 0 0 0 0 0 0 0 0 2377440 3332436 58539133 63681967 X 194491372 206644833 0 0 0 0 194491372 206644833 253030505 270326800 X 290250 11799641 308868 -245298 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true true 13226 true 31540 44766 false FORM 990, SCHEDULE C, PART II-B, LINE 1 LOBBYING ACTIVITIES: As part of the efforts to promote the Go Forward Pine Bluff campaign (city-wide campaign sponsored by various business and non-profit organizations to increase the local sales tax), members of JRMCs marketing staff had occasional contact with legislators. JRMC marketing employees also participated in rallies and other activities (periodic campaign leadership meetings and creation of promotional materials) whose purpose was to promote the passage of the sales tax increase. Additionally, JRMC contributed to organizations that undertook lobbying activities during the year. JRMC estimates the total amount of dues used for lobbying activities at $31,540. 6920676 6920676 111687891 80602949 31084942 1829310 1520905 308405 116102440 94810056 21292384 6183507 6183507 65789914 0 457 PLAN 1664205 Capital Lease Obligation 1668231 3332436 SCHEDULE D, PART X, LINE 2 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. true true X true X true X true true false true true 7827 2758785 2758785 0.01480 12386 10506526 10506526 0.05630 20213 13265311 13265311 0.07110 33 18149 127263 76704 50559 0.00030 25 5274069 2822861 2451208 0.01310 4 8460382 5184390 3275992 0.01750 395039 299995 95044 0.00050 62 18149 14256753 8383950 5872803 0.03140 62 38362 27522064 8383950 19138114 0.10250 71 95891 129980 129980 0.00070 71 95891 129980 129980 0.00070 true 6717688 60939223 56330579 4608644 X true true JEFFERSON SURGERY AMBULATORY SURGERY CENTER 0.715 0.07 0.215 CENTER PLLC 1 1 JEFFERSON REGIONAL MEDICAL CENTER 1600 W 40TH AVENUE PINE BLUFF AR 71603 WWW.JRMC.ORG AR4213 X X X X JEFFERSON REGIONAL MEDICAL CENTER false false true X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 16 true SEE PART V, SECTION C false true X 150. 300. X false true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 CONSULTING REPRESENTATIVES OF THE COMMUNITY: THE PREVIOUS JRMC CHNA (CONDUCTED IN 2013) INCLUDED EXTENSIVE INPUT FROM NUMEROUS REPRESENTATIVES OF THE COMMUNITY AS OUTLINED IN IRS NOTICE 2011-52. THAT INPUT REMAINED RELEVANT FOR THE CURRENT TAX REPORTING PERIOD; THEREFORE ADDITIONAL INPUT WAS NOT SOLICITED. INSTEAD, THE ORIGINAL NEEDS IDENTIFIED IN THE PREVIOUS ASSESSMENT WERE RE-EVALUATED BY JRMC SENIOR MANAGEMENT, REPRIORITIZED, AND UPDATED WITH ONE ADDITIONAL NEED. THE EARLIER CHNA CONSIDERED INPUT FROM ALL THREE GROUPS OUTLINED IN IRS NOTICE 2011-52. THE HOSPITAL CONSULTED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: THE CENTER FOR BUSINESS AND ECONOMIC RESEARCH, SAM M. WALTON COLLEGE OF BUSINESS, UNIVERSITY OF ARKANSAS; THE ARKANSAS DEPARTMENT OF HEALTH; AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL ALSO ENGAGED FIVE FOCUS GROUPS WITH BUSINESS AND COMMUNITY LEADERS, HEALTH CARE CONSUMERS, SOUTHEAST ARKANSAS COMMUNITY MEMBERS, AND PHYSICIANS FROM ITS PRIMARY AND SECONDARY SERVICE AREAS. THERE WERE OVER 160 INDIVIDUALS CONSULTED. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED: THE ORGANIZATION IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE 2013 CHNA THROUGH THE CONTINUED EXECUTION OF ITS CHNA IMPLEMENTATION STRATEGY THAT WAS UPDATED IN NOVEMBER OF 2016. ONE COMMUNITY HEALTH NEED IDENTIFIED IN THE CHNA WAS DETERMINED TO BE OUTSIDE THE SCOPE OF THE ORGANIZATION. OTHER ORGANIZATIONS, INCLUDING THE ARKANSAS DEPARTMENT OF HEALTH, SCHOOLS AND OTHER HEALTHCARE ORGANIZATIONS HAVE TAKEN ON THE RESPONSIBILITY OF EDUCATION AND PREVENTION OF SEXUALLY TRANSMITTED DISEASES IN THE YOUTH OF THE COMMUNITY. 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: http://www.jrmc.org/about-jrmc/community-health-needs-assessment-a 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: http://www.jrmc.org/patients/billinginsurance-services/jrmc-financial-assi stance SCHEDULE H, PART V, SECTION B, LINE 22D FINANCIAL ASSISTANCE POLICY ELIGIBILITY: AMOUNTS CHARGED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ARE DETERMINED BASED ON A SLIDING-SCALE THAT CONSIDERS INCOME AS COMPARED TO FEDERAL POVERTY GUIDELINES. SCHEDULE H, PART V, SECTION B COMPLIANCE WITH 501R: During a compliance review of the organizations Financial Assistance Policy in fiscal year 2017, management identified inadvertent omissions from the FAP, which resulted in non-compliance with 501r regulations. The following items were not included in the FAP: - DESCRIPTION OF THE METHOD TO CALCULATE THE AMOUNTS GENERALLY BILLED TO PATIENTS - A LIST OF PROVIDERS OR A DESCRIPTION OF THE DEPARTMENTS DELIVERING EMERGENCY OR MEDICALLY NECESSARY CARE COVERED OR NOT COVERED BY THE FAP - BASIS FOR CALCULATING THE AMOUNTS CHARGED TO PATIENTS In addition, a review of the Plain Language Summary of the FAP identified minor technical omissions that need to be corrected. Management is taking action to correct these oversights in order to be in full compliance with all 501r regulations. 10 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 HAL 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 PINE BLUFF AR 71603 PHYSICIAN CLINIC SURGICAL ASSOCIATES OF SOUTHEAST AR 1609 W 40TH AVE 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 STE 312 PINE BLUFF AR 71603 PHYSICIAN CLINIC SCHEDULE H, PART III, SECTION A, LINE 2 PROVISION FOR UNCOLLECTIBLE ACCOUNTS METHODOLOGY: THE AMOUNT REPORTED ON LINE 2 IS BASED ON THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. 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 charity as well. Management doesnt 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: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE ASSOCIATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ASSOCIATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR THE YEARS ENDED JUNE 30, 2017 AND 2016, THERE WERE NO SIGNIFICANT CHANGES IN THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE AND CHARITY ACCOUNTS OR IN THE POLICIES REGARDING UNCOLLECTIBLE ACCOUNTS FOR CHARITY CARE. 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 DETER 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 CHARITY CARE WOULD NOT INTENTIONALLY BE PLACED WITH A DEBT COLLECTION SERVICE. FROM TIME TO TIME, INFORMATION THAT RESULTS IN THE DETERMINATION OF CHARITY 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 CHARITY CARE ASSISTANCE, 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 TAX YEAR 2016 SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: THE REPORT HAS NOT BEEN FILED WITH THE STATE. SCHEDULE H, PART II, LINES 1 - 10 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 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 true CITY OF WHITE HALL PO BOX 20100 WHITE HALL AR 71612 710386836 GOVT 8000 CRENSHAW SPRINGS POOL USE ARTS & SCIENCES CENTER 701 MAIN ST PINE BLUFF AR 71601 710401966 501(C)(3) 6000 PLAYBILL & POTPOURRI & BENEFACTOR SPONSORSHIPS AND AR AFFILIATE OF SUSAN G KOMEN 904 AUTUMN ST LITTLE ROCK AR 72211 710724439 501(C)(3) 7000 SPONSORSHIP RACE FOR CURE PINE BLUFF COUNTRY CLUB PO BOX 6809 PINE BLUFF AR 71611 710141610 501(C)(7) 5300 HALL OF FAME SPONSORSHIP UNITED WAY OF SE ARKANSAS PO BOX 8702 PINE BLUFF AR 71611 710236869 501(C)(3) 35000 2016 CAMPAIGN PLEDGE 5 FEDERAL PELL GRANTS (US DEPT OF ED) 56 223595 WIA ADULT PROGRAM GRANTS (US DEPT OF LABOR) 18 55688 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, LINE 1 & SCHEDULE I, PART II, LINE 1 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, PAGE 10 AND SCHEDULE I, PART II. X X false true X X X X true true false false false false false true false F ANTHONY - SEE SCH O 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 D BROWN - SEE SCH O 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 J A CAMPBELL - SEE SCH O 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 M ECKERT - SEE SCH O 0 0 0 0 0 0 0 0 0 0 0 0 R GALLAHER - SEE SCH O 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 L HICKMAN - SEE SCH O 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 W JOHNSON - SEE SCH O 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 G MAKRIS - SEE SCH O 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 C MORGAN - SEE SCH O 0 0 0 0 0 0 0 0 0 0 0 0 R PIERCE - SEE SCH O 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 JA POLLARD - SEE SCH O 0 0 0 0 0 0 0 0 0 0 0 0 C ROAF - SEE SCH O 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 HF TROTTER - SEE SCH O 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 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 4A SEVERANCE PAYMENTS: THOMAS HARBUCK $300,215 WALTER JOHNSON $333,571 SCHEDULE J, PART I, LINE 4B PARTICIPANTS IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP PLAN REPORTED IN W-2 DEFERRED COMPENSATION --------------------------- ----------------- ---------------------- WALTER JOHNSON $ 142,400 $NONE THOMAS HARBUCK $ 120,166 $NONE LOUISE HICKMAN $ 69,595 $NONE BRIAN THOMAS $ 82,538 $NONE BRYAN G. JACKSON $ 98,112 $NONE 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. A JEFFERSON COUNTY AR 716009958 472705SP6 2011-12-15 26013416 REFUND 2001 BONDS false false false A 1450000 0 26013416 0 0 25395168 372172 246076 0 0 0 0 2012 true false false true A false false false false 0 false false false true A false false false true false false 0 false 0 false true A true SCHEDULE K, PART IV, LINE 2C ARBITRAGE REBATE COMPUTATION: THE COMPUTATION TO DETERMINE THERE IS NO REBATE CURRENTLY DUE WAS PERFORMED DECEMBER 1, 2016. CHILDREN'S CLINIC PA JHA DIRECTOR OWNER DHS ENROLLMENT X 32856 12856 false false true 12856 REBECCA PITTILLO SEE SUPPLEMENTAL INFO SEE SUPPLEMENTAL INFO false MARY VIRGINIA MAKRIS 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 FORM 990, SCHEDULE L, PART IV, COLUMNS B, C, & D (A) NAME OF PERSON: REBECCA PITTILLO (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF SCOTT PITTILLO (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (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: SIMMONS BANK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: MAKRIS, CASTEEL, ROAF, 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: PEDIATRIC SERVICES FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: CONTINUED FROM PART III... JRMC HAS A LONG TRADITION OF PROVIDING SIGNIFICANT BENEFITS TO OUR COMMUNITY WHICH IS ROOTED IN OUR 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." JRMC PROVIDES A VARIETY OF DIVERSE PROGRAMS AND MEDICAL SERVICES DESIGNED TO MEET THE SPECIFIC NEEDS OF INDIVIDUALS WHO LIVE IN SOUTH ARKANSAS. THESE INCLUDE CARDIOLOGY, GENERAL SURGERY, CRITICAL CARE, GASTROENTEROLOGY, ORTHOPAEDICS, NEUROLOGY, NEUROSURGERY, ENDOCRINOLOGY, URGENT AND EMERGENT CARE, OBSTETRICS/GYNECOLOGY, RADIOLOGY, PSYCHIATRY, LABORATORY SERVICES, INPATIENT AND OUTPATIENT REHABILITATION (PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY,) AND MANY MORE. OUR EMERGENCY DEPARTMENT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, AS WELL AS OUR URGENT CARE WALK-IN CLINIC AND OUR HEALTHCARE PLUS CLINIC, THE LATTER OF WHICH ALSO PROVIDES OCCUPATIONAL HEALTH SERVICES TO AREA BUSINESSES. JRMC HAS A ROBUST, OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; HAS A GOVERNING BODY COMPRISED OF INDIVIDUALS WHO ARE REPRESENTATIVE OF THE COMMUNITY; ENGAGES IN THE TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS; AND PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. JRMC SPECIALISTS ALSO CONDUCT SEVERAL SATELLITE SPECIALTY CLINICS IN SURROUNDING COMMUNITIES. COMMUNITY SERVICE AND EDUCATION CONTINUE TO BE A SIGNIFICANT PART OF OUR MISSION. JRMC PROVIDES FINANCIAL SPONSORSHIPS WITHIN THE COMMUNITY AND OFFERS FREE HEALTH SCREENINGS AND EDUCATIONAL EVENTS EACH YEAR. WE BELIEVE EVERYONE IN SOUTHEAST ARKANSAS IS IMPACTED, EITHER DIRECTLY OR INDIRECTLY, THROUGH THE COMMUNITY HEALTH EFFORTS AND COMMUNITY-BUILDING ACTIVITIES CHAMPIONED BY JRMC. OUR COMMITMENT TO BRING NEW AND INNOVATIVE PROGRAMS AND SERVICES TO SOUTHEAST ARKANSAS IS EVIDENT. DURING FISCAL YEAR 2017, JRMC INVESTED APPROXIMATELY $6.9 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 A 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: CHUCK MORGAN (JHA CHAIRMAN) AND ANNETTE KLINE (JHA VICE-CHAIRMAN) HAVE A BUSINESS RELATIONSHIP. MARTY CASTEEL (JHA DIRECTOR) AND DR. CLIFTON ROAF (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. GEORGE MAKRIS (JHA DIRECTOR) AND DR. CLIFTON ROAF (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. GEORGE MAKRIS (JHA DIRECTOR) AND MARTY CASTEEL (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. H. FORD TROTTER III (JHA DIRECTOR) AND DR. CLIFTON ROAF (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. H. FORD TROTTER III (JHA DIRECTOR) AND MARTY CASTEEL (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. H. FORD TROTTER III (JHA DIRECTOR) AND GEORGE MAKRIS (JHA DIRECTOR) HAVE BUSINESS RELATIONSHIPS. H. FORD TROTTER III (JHA DIRECTOR) AND DAVID BROWN (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. GEORGE MAKRIS (JHA DIRECTOR) AND DAVID BROWN (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. MARTY CASTEEL (JHA DIRECTOR) AND CHUCK MORGAN (JHA CHAIRMAN) HAVE A BUSINESS RELATIONSHIP. SCOTT PITTILLO (JHA TREASURER) AND ANNETTE KLINE (JHA VICE-CHAIRMAN) HAVE A BUSINESS RELATIONSHIP. SCOTT PITTILLO (JHA TREASURER) AND CHUCK MORGAN (JHA CHAIRMAN) HAVE A BUSINESS RELATIONSHIP. 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 August 2017 to perform a total compensation review that was previously conducted in 2014. 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 4 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 XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: PURCHASE OF NONCONTROLLING INTEREST IN JSC $(245,298) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:18463234 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:4995534 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:3676295 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:7956635 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:1989197 JEFFERSON SURGERY CENTER PLLC 1600 W 40TH AVE PINE BLUFF AR 71603 AMB SURGERY AR JHA RELATED -98401 1451739 false 0 false 0.71500 JEFFERSON MANAGEMENT SERVICES INC 1600 W 40TH AVE PINE BLUFF AR 71603 710582753 PHYS PRACTICE MGM AR JHA C-CORPORATION 0 791372 1.00000 true JHA HEALTH AFFILIATES INC 1600 W 40TH AVE PINE BLUFF AR 71603 710766959 REAL EST RENTAL AR JHA C-CORPORATION -11661 819149 1.00000 true true true false false false false false true false false true true true true true false false true true JEFFERSON SURGERY CENTER PLLC L 1600845 G/L ACTIVITY JEFFERSON SURGERY CENTER PLLC M 1518636 G/L ACTIVITY JEFFERSON SURGERY CENTER PLLC R 1493987 G/L ACTIVITY JEFFERSON SURGERY CENTER PLLC S 1579985 G/L ACTIVITY JEFFERSON SURGERY CENTER PLLC A 498896 G/L ACTIVITY JEFFERSON SURGERY CENTER PLLC H 245298 G/L ACTIVITY JHA HEALTH AFFILIATES INC B 200000 G/L Activity JEFFERSON MANAGEMENT SERVICES INC S 600000 G/L ACTIVITY JEFFERSON MANAGEMENT SERVICES INC L 271517 G/L ACTIVITY SCHEDULE R, PART III, LINE 1 RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP: ON JUNE 28, 2017, THE HOSPITAL PURCHASED THE REMAINING OWNERSHIP INTEREST IN JEFFERSON SURGERY CENTER, PLLC (JSC). DUE TO THIS TRANSACTION, WE ARE SHOWING ALL OF THE PARTNERSHIP'S ASSETS AT THE END OF THE YEAR AS BELONGING TO THE HOSPITAL IN COLUMN (G). HOWEVER, BECAUSE THE HOSPITAL DID NOT FULLY OWN JSC FOR A MAJORITY OF THE FISCAL YEAR, THE ACTIVITY IS NOT REFLECTED ON THE FORM 990, PARTS VIII, IX & X. GOING FORWARD JSC WILL BE REPORTED AS A DISREGARDED ENTITY.