2016-11-08T15:20:11-06:00 2015-12-31 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2015-01-01 271757642 KEMPER CAH INC KEMP 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 DARRELL WILDMAN TREASURER 6017039992 2016-11-02 1 AMIE T WHITTINGTON CPA P01082167 6013261000 2016-11-02 2015 2017-02-10 21:41:12Z DARRELL WILDMAN 1314 19TH AVENUE MERIDIAN MS 39301 21575334 0 X RUSHHEALTHSYSTEMS.ORG X 2008 MS HOSPITAL AND CLINIC PATIENT SERVICE 5 3 276 3 0 0 3586189 4818483 16157363 16747708 3495 1972 5792 7171 19752839 21575334 100 0 0 0 7749318 7938319 0 0 0 12231228 14451921 19980646 22390240 -227807 -814906 8599730 5801580 6296222 4312978 2303508 1488602 X ACUTE-CARE HOSPITAL PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES SERVICES TO THE KEMPER COUNTY AREA AND SURROUNDING COMMUNITIES. 0 0 19529080 16754831 JOHN C. STENNIS MEMORIAL HOSPITAL IS A 25-BED ACUTE-CARE, CRITICAL ACCESS HOSPITAL LOCATED IN DEKALB, MS. DEKALB, MS IS LOCATED IN KEMPER COUNTY, MS. DEKALB HAS A POPULATION OF 972 AND KEMPER COUNTY HAS A POPULATION OF 10,456. JOHN C. STENNIS MEMORIAL HOSPITAL'S SCOPE OF CARE INCLUDES A RANGE OF INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. A VARIETY OF OTHER SERVICES ARE AVAILABLE ON AN INPATIENT AND OUTPATIENT BASIS THROUGH THE HOSPITAL'S IMAGING, LABORATORY AND REHABILITATIVE SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. A 24-HOUR EMERGENCY DEPARTMENT IS STAFFED WITH QUALIFIED EMERGENCY ROOM HOSPITALISTS AND FAMILY NURSE PRACTITIONERS AND IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK. SKILLED NURSING AND REHABILITATIVE CARE ARE AVAILABLE AT JOHN C. STENNIS MEMORIAL HOSPITAL THROUGH THE SWING BED PROGRAM. THOSE RECOVERING FROM SURGERY, A STROKE, A FRACTURE OR AN EXTENDED MEDICAL ILLNESS AND HOSPITALIZATION CAN RECEIVE REHABILITATIVE CARE AT JOHN C. STENNIS MEMORIAL HOSPITAL, WHETHER OR NOT THEY WERE HOSPITALIZED IN ANOTHER LOCATION. JOHN C. STENNIS MEMORIAL HOSPITAL IS AFFILIATED WITH RUSH HEALTH SYSTEMS OF MERIDIAN, MS. ADDITIONALLY, THE INTENSIVE OUTPATIENT PROGRAM DESIGNED TO PROVIDE CARE FOR SENIOR ADULTS SUFFERING FROM CHRONIC ANXIETY, DEPRESSION AND GRIEF.AS PRESENTED IN THE ATTACHED SCHEDULE H, JOHN C. STENNIS MEMORIAL HOSPITAL PROVIDED FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS DURING 2015 AT A COST OF $2,780,035. ALTHOUGH EQUITABLE PAYMENT FOR SERVICES IS ESSENTIAL TO THE ORGANIZATION'S FINANCIAL VIABILITY, JOHN C. STENNIS MEMORIAL HOSPITAL RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE RESOURCES REQUIRED TO REIMBURSE THE HOSPITAL FOR ALL SERVICES PROVIDED. KEEPING ITS COMMITMENT TO THE COMMUNITY, JOHN C. STENNIS MEMORIAL HOSPITAL PROVIDES FREE CARE AND SUBSIDIZED CARE WITHIN EXISTING RESOURCES WHERE THE NEED FOR SUCH CARE EXISTS. ALONG WITH BEING THE ONE OF THE COUNTY'S LARGEST EMPLOYERS AND A MAJOR ECONOMIC STIMULUS BY VIRTUE OF ITS PAYROLL, JOHN C. STENNIS MEMORIAL HOSPITAL ALSO PROVIDES MANY BENEFITS TO THE BROADER COMMUNITY IN THE AREAS OF CIVIC INVOLVEMENT AND GIVING INCLUDING ACTIVELY SUPPORTING THE AMERICAN CANCER SOCIETY, SUPPORTING THE COMMUNITY WITH IT'S ANNUAL KEMPER DAY PROGRAM CONDUCTING AND ATTENDING COMMUNITY HEALTH FAIRS AND PROVIDING FREE MEDICAL SCREENING TESTS AND DISSEMINATION OF HEALTH INFORMATION AT CIVIC CLUB MEETINGS AND OTHER COMMUNITY FUNCTIONS. 19529080 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 27 0 1 276 1 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DARRELL WILDMAN 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 ART NESTER BOARD CHAIRMAN 1.00 X 11000 0 0 MARGARET WOMBLE BOARD MEMBER 1.00 X 0 0 0 CINDY CUMBERLAND BOARD MEMBER 1.00 X 0 0 0 JAMES GRANGER BOARD MEMBER 1.00 X 0 0 0 FRED ROGERS BOARD MEMBER 1.00 50.00 X 0 191774 32699 CHUCK REECE PRESIDENT 1.00 54.00 X 0 535976 116371 RICK BARRY SECRETARY 1.00 12.00 X 0 18000 0 DARRELL WILDMAN TREASURER 1.00 58.00 X 0 359114 44821 CATHY ROBINSON CORPORATE COMPLIANCE OFFIC 1.00 45.00 X 0 209334 21119 JAMES M NESTER ADMINISTRATOR 40.00 X 0 161665 20156 CHRIS RUSH CFO 1.00 50.00 X 0 263752 23920 SHARON HENSON NURSE PRACTIONER 40.00 X 223788 0 7979 WILLIAM M BRACKEN PHYSICIAN 40.00 X 0 244318 20156 TODD B VAUGHAN PHYSICIAN 40.00 X 0 193507 7979 MIYAKO MCCLOUD PHYSICIAN 40.00 X 0 300680 15779 ED ULMER PHYSICIAN 40.00 X 0 317887 14810 DALE ARMOUR FORMER CFO 0.00 56.00 X 0 281624 20386 234788 3077631 346175 7 1 1 0 EMCARE INC 7032 COLLECTIONS CENTER DR CHICAGO IL 60693 ER PHYSICIAN COVERAGE 723730 SERVICEMASTER PROFESSIONAL SERVICES PO BOX 745 MARION MS 39342 HOUSEKEEPING SERVICES 207476 DAVIDSON HAULING & CONSTRUCTION PO BOX 665 MARION MS 39342 CONSTRUCTION 101634 3 4809179 9304 4818483 PATIENT FEES 621990 16747708 16747708 16747708 1972 1972 MISCELLANEOUS 900099 7123 7123 CAFETERIA REVENUE 722210 48 48 7171 21575334 16754831 0 2020 11000 11000 6711735 6591860 119875 46966 46966 728894 724594 4300 439724 432262 7462 2002267 2002267 15000 15000 957272 956290 982 2678 1989 689 3352428 3352428 16996 14310 2686 90057 90057 224175 224175 127168 127168 PROVISION FOR BAD DEBT 3735564 3735564 PURCHASED SERVICES 2170173 1866165 304008 SUPPLIES 985532 921925 63607 UTILITIES 234748 51379 183369 537863 391948 145915 22390240 19529080 2861160 0 568339 29764 4471837 2591824 160987 145775 68276 127236 3803297 1731056 2281624 2072241 21885 21885 1026782 812855 8599730 5801580 1097102 1142437 883788 697727 4315332 2472814 6296222 4312978 X 2303508 1488602 2303508 1488602 8599730 5801580 -814906 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1472 1472 0 PART II-B, LINE 1: KEMPER CAH, INC. PAYS DUES TO MISSISSIPPI HOSPITAL ASSOCIATION TOTALING $5,696, OF WHICH 25.84% ($1,472) IS ATTRIBUTABLE TO LOBBYING. 2595454 735378 1860076 210435 170613 39822 997408 825065 172343 2072241 DUE FROM AFFILIATES 812855 812855 DUE TO AFFILIATES 2418287 OTHER LIABILITIES 54527 2472814 X PART X, LINE 2: RUSH HEALTH SYSTEMS, INC. AND THE AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON THEIR INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE SUBSIDIARIES, HOWEVER, ARE TAXABLE CORPORATIONS AND FILE CORPORATE INCOME TAX RETURNS. THE HEALTH SYSTEM FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HEALTH SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS GUIDANCE HAD NO MATERIAL EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE HEALTH SYSTEM'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN GENERAL AND ADMINISTRATIVE EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2012, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. DEFERRED TAXES ARE PROVIDED ON A LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASES. THE SUBSIDIARIES' TEMPORARY DIFFERENCES RELATE PRIMARILY TO PROPERTY AND EQUIPMENT AND NET OPERATING LOSS CARRYFORWARDS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE-LIKELY-THAN-NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN TAX LAWS AND RATES ON THE DATE OF ENACTMENT. 1 1 1 X 1 X 1 1 1 0 0 870312 870312 0.04670 1614476 738771 875705 0.04690 107494 80389 27105 0.00150 2592282 819160 1773122 0.09510 1776 1776 0.00010 19695 19695 0.00110 1665469 681119 984350 0.05280 1092 1092 0.00010 1688032 681119 1006913 0.05410 4280314 1500279 2780035 0.14920 3478 3478 0.00020 3478 3478 0.00020 1 3735564 0 6588504 5570487 1018017 X 1 1 1 1 KEMPER CAH INC 14365 HIGHWAY 16 WEST DEKALB MS 39328 X X JOHN C STENNIS HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X HTTP://WWW.JOHNCSTENNISMEMORIALHOSPITAL.COM X 1 13 0 1 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X 1 X SEE PART V, 16I X SEE PART V, 16I X X X X 1 X 0 X 1 X 0 0 JOHN C. STENNIS HOSPITAL PART V, SECTION B, LINE 5: THROUGH INTERNAL CONVERSATIONS AT THE HOSPITAL, ONE ON ONE INTERVIEWS WITH COMMUNITY LEADERS, DIALOGUE WITH COUNTY REPRESENTATIVES OF THE MISSISSIPPI STATE DEPARTMENT OF HEALTH, AND A HOSPITAL FOCUS GROUP, MUCH INFORMATION WAS GATHERED WHICH WAS INFLUENTIAL AS THE CHNA STEERING COMMITTEE DEVELOPED THE HOSPITAL'SIMPLEMENTATION PLAN. JOHN C. STENNIS HOSPITAL PART V, SECTION B, LINE 11: SEE ATTACHED IMPLEMENTATION STRATEGY JOHN C. STENNIS HOSPITAL PART V, SECTION B, LINE 16I: HTTP://WWW.RUSHHEALTHSYSTEMS.ORG/RUSHHEALTHSYSTEMS/ASSETS/FILE/POLICIES/PATIENT%20FINANCIAL%20ASSISTANCE.PDF 5 1 - IMMEDIATE CARE FAMILY CLINIC 1710 14TH STREET MERIDIAN MS 39301 MEDICAL CLINIC 2 - NORTH HILLS FAMILY MEDICAL CLINIC 4331 HWY 39 NORTH MERIDIAN MS 39305 MEDICAL CLINIC 3 - RUSH MEDICAL GROUP LIVINGSTON 1221 WASHINGTON STREET LIVINGSTON AL 35470 MEDICAL CLINIC 4 - MARION PRIMARY CARE CENTER 5334 DALE DRIVE MARION MS 39342 MEDICAL CLINIC 5 - RUSH MEDICAL CLINIC DEKALB 14365 HWY 16 WEST DEKALB MS 39328 MEDICAL CLINIC PART I, LINE 7: COSTING METHODOLOGY USED IN THE TABLE ON LINE 7 IS THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED FROM WORKSHEET 2. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,735,564. PART II, COMMUNITY BUILDING ACTIVITIES: ALL ACTIVITIES ENGAGED IN BY KEMPER CAH, INC. ARE GEARED TOWARD PROMOTION AND IMPROVEMENT OF THE WELLBEING OF THE CITIZENS OF OUR PRIMARY SERVICE AREA. KEMPER PROMOTES HEALTH EDUCATION THROUGH SUPPORT OF ITS COMMUNITY BASED NURSING AND ALLIED HEALTH PROGRAMS AS WELL AS COMMUNITY HEALTH EDUCATION AND TRAINING SESSIONS. KEMPER ALSO SUPPORTS THE COMMUNITY BY ENSURING THE PROVISION OF MUCH NEEDED EMERGENCY MEDICINE. PART III, LINE 4: BAD DEBT EXPENSE IS REFLECTED AS AMOUNT OF CHARGES ACTUALLY WRITTEN OFF. PER NOTE 1 OF THE FINANCIAL STATEMENTS, PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT ESTIMATED NET REALIZABLE VALUE AFTER DEDUCTION OF ALLOWANCES FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON HISTORICAL LOSSES AND AN ANALYSIS OF CURRENTLY OUTSTANDING AMOUNTS FOR ITS MAJOR PAYOR SOURCES. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFULACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTABLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIALDIFFICULTIES 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 HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BADDEBTS 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) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS, AS EVIDENCED ON LINE 7, SIGNIFICANTLY EXCEEDS REVENUE. THIS COST PROVIDES A NECESSARY HEALTH BENEFIT TO THE ELDERLY POPULATION IN THE HOSPITAL'S SERVICE AREA AND SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART III, LINE 9B: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAT ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. ADDITIONALLY, THE HOSPITAL MAY UTILIZE OUTSIDE AGENCIES AS APPROPRIATE TO ASSIST IN DETERMINING ACCOUNTS THAT QUALIFY AS CHARITY CARE. ANY ACCOUNTS DETERMINED TO BE CHARITY BASED ON AN AGENCY'S RECOMMENDATION ARE REPORTED AS CHARITY CARE AND REVENUE REDUCED BY THIS AMOUNT AS OPPOSED TO BEING REPORTED AS BAD DEBT EXPENSE. PART VI, LINE 2: OUTSIDE CONSULTANTS ARE HIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENT PERIODICALLY.THE CHNA CAN BE ACCESSED VIA THE HOSPITAL'S WEBSITE AT: HTTP://WWW.JOHNCSTENNISMEMORIALHOSPITAL.COM/JCSMH/INDEX.CFM/LINKSERVID/11B15D52-155D-0204-934FE91177AFC54F/SHOWMETA/0/ PART VI, LINE 3: PATIENTS ARE PROVIDED AN APPLICATION FOR CHARITY CARE AND A CRITERIA FOR CHARITY CARE CHECKLIST AS CLOSE TO POINT OF SERVICE AS POSSIBLE. ADDITIONALLY, THE HOSPITAL UTILIZES AN OUTSIDE ELIGIBILITY COMPANY THAT REVIEWS ALL NO INSURANCE PATIENTS FOR POTENTIAL QUALIFICATION FOR OTHER GOVERNMENTAL PROGRAMS SUCH AS MEDICAID. PART VI, LINE 4: KEMPER CAH, INC. IS A CRITICAL ACCESS ACUTE-CARE MEDICAL CENTER THAT SERVES INPATIENTS AND OUTPATIENTS, PRIMARILY IN THE MORTON, MISSISSIPPI AREA. AS A CRITICAL ACCESS HOSPITAL, KEMPER TRANSFERS THE EMERGENT AND MORE COMPLICATED CASES THAT REQUIRE SPECIALISTS PRIMARILY TO THE LARGER ACUTE CARE HOSPITALS IN THE MERIDIAN, MS AREA. OF THE COUNTIES SERVED, THE FOLLOWING ARE COUNTIES IDENTIFIED BY HEALTH RESOURCES AND SERVICES ADMINISTRATION OF THE US DEPT OF HEALTH AND HUMAN SERVICES AS HEALTH PROFESSIONAL SHORTAGE AREAS: CHOCTAW AND SUMTER COUNTIES IN ALABAMA; CLARKE, KEMPER, LAUDERDALE, NESHOBA, NEWTON AND SCOTT COUNTIES IN MISSISSIPPI.ADDITIONAL INFORMATION ON THE COMMUNITY SERVED CAN BE FOUND IN THE CHNA. THE CHNA CAN BE ACCESSED VIA THE HOSPITAL'S WEBSITE AT: HTTP://WWW.JOHNCSTENNISMEMORIALHOSPITAL.COM/JCSMH/INDEX.CFM/LINKSERVID/11B15D52-155D-0204-934FE91177AFC54F/SHOWMETA/0/ PART VI, LINE 5: ALL MEMBERS OF KEMPER CAH, INC.'S BOARD RESIDE IN KEMBER'S PRIMARY SERVICE AREA. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF EXTENDING PRIVILEGES TO ALL QUALIFIED PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS THAT APPLY FOR PRIVILEGES AND MEET ALL REQUIREMENTS OF CREDENTIALING AND THE MEDICAL STAFF RULES AND REGS AND BY-LAWS. THE FACILITY UTILIZES SURPLUS FUNDS FOR ADDITIONAL MEDICAL TECHNOLOGY, RECRUITMENT OF MEDICAL STAFF THAT IS OTHERWISE UNAVAILABLE (I.E. NEUROSURGERY, MIDWIFERY, ETC.), FUNDING OF LOCAL AREA HEALTHCARE WORKFORCE TRAINING AND ECONOMIC DEVELOPMENT. PART VI, LINE 6: KEMPER CAH, INC IS WHOLLY OWNED BY RUSH HEALTH SYSTEMS, A NON-PROFIT ORGAINIZATION. WITHIN RUSH HEALTH SYSTEMS ARE THE SPECIALTY HOSPITAL OF MERIDIAN (A LONG TERM ACUTE CARE FACILITY), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL, HC WATKINS HOSPITAL (A CRITICAL ACCESS HOSPITAL), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL), MEDICAL FOUNDATION INC. (A CLINIC ORGANIZATION), AND RUSH MEDICAL GROUP (A CLINIC ORGANIZATION). EACH OF THESE ENTITES COORDINATE TO IMPROVE THE HEALTHCARE OF EAST MISSISSIPPI AND WEST ALABAMA. CLINICAL INTEGRATION BETWEEN OUTLYING CRITICAL ACCESS HOSPITALS, SPECIALIST PHYSICIANS AND THE GENERAL ACUTE CARE HOSPITAL PROVIDE FOR IMPROVED ACCESS AND IMPROVED OUTCOMES FOR THE POPULATION WE SERVE. X X X X X X 0 1 0 0 0 0 0 0 0 FRED ROGERS BOARD MEMBER 0 136042 0 49152 0 6580 0 4428 0 28271 0 224473 0 0 CHUCK REECE PRESIDENT 0 312574 0 210900 0 12502 0 52000 0 64371 0 652347 0 0 DARRELL WILDMAN TREASURER 0 227414 0 120983 0 10717 0 7100 0 37721 0 403935 0 0 CATHY ROBINSON CORPORATE COMPLIANCE OFFIC 0 143942 0 57870 0 7522 0 4728 0 16391 0 230453 0 0 JAMES M NESTER ADMINISTRATOR 0 161665 0 0 0 0 0 0 0 20156 0 181821 0 0 CHRIS RUSH CFO 0 185898 0 72409 0 5445 0 2637 0 21283 0 287672 0 0 SHARON HENSON NURSE PRACTIONER 223788 0 0 0 0 0 0 0 7979 0 231767 0 0 0 WILLIAM M BRACKEN PHYSICIAN 0 244318 0 0 0 0 0 0 0 20156 0 264474 0 0 TODD B VAUGHAN PHYSICIAN 0 193507 0 0 0 0 0 0 0 7979 0 201486 0 0 MIYAKO MCCLOUD PHYSICIAN 0 300680 0 0 0 0 0 7800 0 7979 0 316459 0 0 ED ULMER PHYSICIAN 0 317887 0 0 0 0 0 1091 0 13719 0 332697 0 0 DALE ARMOUR FORMER CFO 0 200874 0 72409 0 8341 0 6316 0 14070 0 302010 0 0 PART I, LINE 4B RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). THERE WERE NO DISTRIBUTIONS OR CONTRIBUTIONS FOR 2015 FOR THOSE LISTED ON SCHEDULE J. SUE NESTER SUE NESTER IS THE WIFE OF BOARD CHAIRMAN ART NESTER 22213 SUE NESTER IS EMPLOYED BY KEMPER CAH, INC AND RECEIVES W-2 WAGES. 0 FORM 990, PART VI, SECTION A, LINE 6 RUSH HEALTH SYSTEMS, INC. IS THE PARENT ORGANIZATION AND SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPOINTS BOARD MEMBERS FOR THE ORGANIZATION ANNUALLY FOR A ONE YEAR TERM. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPROVES AND RATIFIES THE ACTIONS OF THE ORGANIZATION'S BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF THE ORGANIZATION) REVIEWED AND APPROVED THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE OFFICERS AND DIRECTORS OF THE ORGANIZATION REVIEW THE POLICY ANNUALLY AND SIGN A CONFLICT OF INTEREST STATEMENT STATING THEY HAVE READ AND UNDERSTAND THE POLICY AND ARE IN COMPLIANCE. EDUCATION IS GIVEN TO THE STAFF ON THE CONFLICT OF INTEREST POLICY WHICH INCLUDES DIRECTION TO VOICE ANY QUESTIONS OR CONCERNS THEY HAVE AND TO BRING FORTH ANY POTENTIAL CONFLICT OR CONCERN TO THE ATTENTION OF THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FOR THE AFFILIATED GROUP OF RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) IS REVIEWED ANNUALLY BY INDEPENDENT CONSULTANTS. CONSULTANTS COMPARE COMPENSATION ORDINARILY PROVIDED BY SIMILAR ORGANIZATIONS, UNDER LIKE CIRCUMSTANCES, AND ADJUSTED TO REFLECT CURRENT MARKET RATES. CONSULTANTS MEET WITH THE COMPENSATION COMMITTEE AND MAKE RECOMMENDATIONS WHICH ARE APPROVED AND RATIFIED BY THE BOARD. THE INDEPENDENT CONSULTANTS REGULARLY CONTRACTED TO PERFORM SUCH REVIEWS ARE HORNE LLP AND SULLIVAN, COTTER & ASSOCIATES, INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. PART XII, LINE 2C THE AUDIT/COMPENSATION COMMITTEE OF RUSH HEALTH SYSTEMS OVERSEES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. RUSH MEDICAL FOUNDATION DBA RUSH FOUNDATION HOSPITAL 1314 19TH AVENUE MERIDIAN MS 39301 640345119 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 MEDICAL FOUNDATION INC PO BOX 5183 MERIDIAN MS 39302 640834532 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH CARE INC DBA SPECIALTY HOSPITAL OF MERIDIAN 1314 19TH AVENUE MERIDIAN MS 39301 640833381 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 LAIRD HOSPITAL INC 25117 HWY 15 UNION MS 39365 201835779 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH MEDICAL GROUP OF NEWTON PA PO BOX 5187 MERIDIAN MS 39302 640783323 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 MERIDIAN SPEECH AND HEARING CENTER 1314 19TH STREET MERIDIAN MS 39301 640529831 PROVIDING AUDIOLOGY SERVICES AND TREATMENT MS 501(C)(3) 509(A)(2) RUSH HEALTH SYSTEMS INC 0 RUSH HEALTH SYSTEMS INC PO BOX 5187 MERIDIAN MS 39301 640664988 PROVIDING SUPPORT TO HEALTH CARE AFFILIATES MS 501(C)(3) 509(A)(3) N/A 0 RUSH HOME CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640670314 PROVIDING HOME HEALTH CARE MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 NEWCA CAH INC 1314 19TH AVENUE MERIDIAN MS 39301 201254928 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HOSPITAL - BUTLER INC 1314 19TH AVENUE MERIDIAN MS 39301 640655993 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 SCOTT REGIONAL MEDICAL CENTER INC 1314 19TH AVENUE MERIDIAN MS 39301 260792328 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 FOUNDATION FOR RUSH INC 1314 19TH AVENUE MERIDIAN MS 39301 473716882 FOUNDATION/FUNDRAISING MS 501(C)(3) 170(B)(1)(A)(VI) RUSH HEALTH SYSTEMS INC 0 MERIDIAN SURGERY CENTER LLC 2100 13TH STREET MERIDIAN MS 39301 300160065 AMBULATORY SURGERY CENTER MS N/A MANAGED HEALTH CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640862241 MANAGEMENT OF HEALTHCARE MS RUSH HEALTH SYSTEMS INC C 0 RUSH SERVICE COMPANY INC PO BOX 5188 MERIDIAN MS 39302 640670493 PROPERTY RENTAL MS RUSH HEALTH SYSTEMS INC C 0 PHYSICIAN MANAGEMENT SERVICES INC 1314 19TH AVENUE MERIDIAN MS 39301 710927411 HEALTHCARE MANAGEMENT MS RUSH HEALTH SYSTEMS INC C 0 RUSH MEDICAL GROUP INC 1314 19TH AVENUE MERIDIAN MS 39301 640524545 PHYSICIAN SERVICES MS RUSH HEALTH SYSTEMS INC C 0 CLINIC EQUIPMENT INC 1314 19TH AVENUE MERIDIAN MS 39301 640479520 EQUIPMENT LEASING MS RUSH HEALTH SYSTEMS INC C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0