2016-02-11T16:35:55-06:00 2015-03-31 BKD LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2014-04-01 710787860 NORTH ARKANSAS REGIONAL MEDICAL CENTER % DEBRA HENRY NORT 8704145157 620 NORTH MAIN HARRISON AR 72601 DEBRA HENRY CFO 8704144274 2016-02-11 true AMBER SHERRILL P00748683 5013721040 2014 2016-08-17 19:52:53Z VINCE LEIST 620 NORTH MAIN HARRISON AR 72601 114862540 false X WWW.NARMC.COM X 1996 AR OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING SAFE, QUALITY HEALTHCARE AND RESOURCES WITH COMPASSION AND INTEGRITY. 9 7 1008 243 0 495660 372087 91232015 86833272 2037862 890485 1996681 1824617 95762218 89920461 0 0 0 0 40173692 41872189 0 0 0 54295944 46566564 94469636 88438753 1292582 1481708 92981505 93319342 36966223 35647204 56015282 57672138 WE ARE DEDICATED TO PROVIDING QUALITY SERVICES THAT ARE COMPREHENSIVE AND AFFORDABLE. WE EXPECT SERVICES TO BE DELIVERED COMPASSIONATELY, APPROPRIATELY, RESPONSIBLY, SAFELY AND EFFICIENTLY. false false 66513513 86195932 NARMC PROVIDED OVER 13,415 DAYS OF PATIENT CARE WITH 51.00% BEING PROVIDED TO MEDICARE AND MEDICAID PATIENTS. IN CONNECTION WITH THE PROVIDING OF CARE, NARMC WROTE OFF $141,912,808 OF CHARGES IN THE FORM OF CONTRACTUALS AND CHARITY EQUALING 62.04% OF TOTAL GROSS INCOME. 533948 395851 NARMC IS A CO-SPONSOR OF NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, INC. (A NOT-FOR-PROFIT CORPORATION). 506710 241489 HOSPICE OF THE HILLS MISSION IS TO PROVIDE A SPECIAL KIND OF CARE DESIGNED TO PROVIDE SENSITIVITY AND SUPPORT FOR PEOPLE IN THE FINAL PHASE OF A TERMINAL ILLNESS. WE SEEK TO ENABLE PATIENTS TO CARRY ON AN ALERT, PAIN-FREE LIFE AND TO MANAGE OTHER SYMPTOMS SO THAT THEIR LAST DAYS MAY BE SPENT WITH DIGNITY AND QUALITY. WE VIEW THE FAMILY, NOT JUST THE PATIENT AS THE UNIT OF CARE. 67554171 true true false true false false false false false false true true false false false false false true false false false false false false false false true true false false true true false false false false false false false false false true false false false false false true true true false false true 115 0 true 1008 true false false false false false false false false false false X 9 7 false false false false false false false true true false false true true true true true true true true false AR X DEBRA HENRY 8704145158 620 NORTH MAIN STREET HARRISON AR 72601 X X WESLEY HUDSON VICE CHAIRMAN 1.0 3.0 X X 0 0 0 DAN BOWERS TREASURER 1.0 3.0 X X 0 0 0 MIKE MCNUTT BOARD MEMBER 1.0 3.0 X 0 0 0 ANN MAIN BOARD MEMBER 1.0 3.0 X 0 0 0 FREDERICK S STROOPE BOARD MEMBER 1.0 1.0 X 0 0 0 DR CHARLES ADAIR CHAIRMAN 1.0 3.0 X X 0 0 0 DR STEVE SHRUM BOARD MEMBER 1.0 1.0 X 0 0 0 MIKE NORTON SECRETARY 1.0 3.0 X X 0 0 0 DR JOHN LESLIE BOARD MEMBER 40.0 1.0 X 305493 0 38161 DR TOM LANGSTON BOARD MEMBER 40.0 1.0 X 198074 0 27760 VINCENT LEIST CHIEF EXECUTIVE OFFICER 40.0 1.0 X 358756 0 45886 RICHARD MCBRYDE CHIEF OPERATING OFFICER 40.0 1.0 X 202610 0 38543 DEBRA HENRY CHIEF FINANCIAL OFFICER 40.0 1.0 X 185106 0 39793 DIANE ROBERTS DIRECTOR OF QUALITY IMPROVE. 40.0 1.0 X 125084 0 14435 SAMMIE CRIBBS CHIEF NURSING OFFICER 40.0 1.0 X 103489 0 22170 RICHARD BLAKE CHITSEY PHYSICIAN 40.0 0.0 X 882574 0 35614 SARA LYNNE ROGERS ANESTHESIOLOGIST 40.0 0.0 X 402292 0 45077 JAMES D WATERS ANESTHESIOLOGIST 40.0 0.0 X 373119 0 47308 ANDREW L COBLE PHYSICIAN 40.0 0.0 X 335431 0 40386 KENNETH FATTMANN PSYCHIATRIST 40.0 0.0 X 319367 0 28138 3791395 0 423271 37 false true false 360 DEGREE MEDICINE LLC 108 SUNNY LANE BRANSON WEST MO 65737 ER PHYSICIANS 3546362 AUX ARCS HOSPITALIST LLC 108 SUNNY LANE BRANSON WEST MO 65737 HOSPITALISTS 1236837 LOCKARD WILLIAMS INSURANCE P O BOX 1688 PASCAGOULA MS 39568 INSURANCE 389563 BILLING SPECIALIST INC P O BOX 1354 MOUNTAIN HOME AR 72654 INSURANCE BILLING 380457 THE RIGHT SOLUTIONS P O BOX 595 TONTITOWN AR 72770 CONTRACT LABOR 380457 19 116327 255760 372087 PATIENT SERVICES 621110 86809145 86809145 MEDICAL OFFICE BUILDING & RADIATION BUILDING 621110 24127 24127 86833272 836561 0 0 836561 0 0 0 0 0 24911003 85000 24845815 96264 65188 -11264 53924 0 0 53924 0 0 0 MEANINGFUL USE REVENUE 900099 949330 949330 CAFETERIA REVENUE 722320 439663 439663 MEDICAL RECORDS 900099 28074 28074 407550 407550 1824617 89920461 86833272 0 2715102 X 0 0 0 0 1765137 0 1765137 0 0 31376134 22387507 8988627 829381 591780 237601 5665479 4042434 1623045 2236058 1595473 640585 0 118094 84262 33832 356299 254227 102072 0 0 0 12237830 8731939 3505891 252741 180336 72405 2107659 1503857 603802 0 0 1528414 1090554 437860 363879 259635 104244 0 0 917029 654319 262710 0 3830842 2733383 1097459 704997 503030 201967 BAD DEBTS 8965990 8965990 MEDICAL SUPPLIES 7854894 7854894 DRUGS 3113478 3113478 FOOD EXPENSE 759599 541989 217610 3454819 2465084 989735 88438753 67554171 20884582 0 499849 1949812 0 0 0 0 13810391 10656253 0 0 0 0 1568635 1241537 1527823 1838107 380640 435523 100589916 59524085 43261490 41065831 0 0 30043990 34952104 0 0 0 0 1888687 1180175 92981505 93319342 8471614 9111985 0 0 0 0 27459467 26208607 0 0 0 0 1035142 326612 0 0 0 0 36966223 35647204 X 56015282 57672138 0 0 0 0 56015282 57672138 92981505 93319342 1481708 175148 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9734 9734 false false FORM 990, SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES 20% OF AHA MEMBERSHIP DUES ALLOCABLE TO LOBBYING: $9,734. 393817 393814 51517215 21017133 30500082 47477819 37796830 9680989 1201068 710122 490946 41065831 0 81140883 175148 175148 80965735 8954726 8954726 89920461 79484027 79484027 8954726 8954726 88438753 FORM 990, SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. 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X X X X X X true true X X X X true X WWW.NARMC.COM X WWW.NARMC.COM X WWW.NARMC.COM X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 DIALOGUES WITH 20 KEY INTERVIEWEES WERE CONDUCTED IN SEPTEMBER 2012. INTERVIEWEES WERE DETERMINED BASED ON THEIR A) SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, B) THEIR AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY OR C) THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. INTERVIEWS WERE CONDUCTED BOTH AT THE MEDICAL CENTER AND IN LOCATIONS MORE CONVENIENT FOR THE INTERVIEWEE. COMMUNITY LEADERS PROVIDED COMMENTS ON THE FOLLOWING ISSUES 1) HEALTH AND QUALITY OF LIFE FOR RESIDENTS IN THE PRIMARY COMMUNITY, 2) BARRIERS TO IMPROVING HEALTH AND QUALITY OF LIFE FOR RESIDENTS OF THE PRIMARY COMMUNITY, 3) OPINIONS REGARDING THE IMPORTANT HEALTH ISSUES THAT AFFECT COMMUNITY RESIDENTS AND THE TYPES OF SERVICES THAT ARE IMPORTANT FOR ADDRESSING THESE ISSUES, AND 4) DELINEATION OF THE MOST IMPORTANT HEALTH CARE ISSUES OR SERVICES DISCUSSED AND ACTIONS NECESSARY FOR ADDRESSING THOSE ISSUES. THESE 20 INTERVIEWEES INCLUDED THE PRESIDENT OF NORTH ARKANSAS COLLEGE, JASPER SCHOOL DISTRICT HEALTH COORDINATOR, JASPER SCHOOL DISTRICT SCHOOL NURSE, CLAUDE PARRISH RURAL HEALTH CLINIC PHYSICIAN ASSISTANT, BOONE COUNTY HEALTH DEPARTMENT ADMINISTRATOR, NEWTON COUNTY FAMILY CLINIC PHYSICIAN, NARMC FAMILY PRACTICE PHYSICIAN, NARMC BOARD MEMBER, NARMC PRESIDENT AND CEO, HARRISON SCHOOL DISTRICT SUPERINTENDENT, BOARD OF GOVERNORS MEMBER, BOONE COUNTY JUDGE, CARROLL COUNTY DEPARTMENT OF HEALTH LOCAL HEALTH UNIT ADMINISTRATOR, FEDEX VICE PRESIDENT AND GENERAL COUNSEL, CARROLL COUNTY DEPARTMENT OF HEALTH HISPANIC ADVOCATE, SEARCY COUNTY DEPARTMENT OF HEALTH ADMINISTRATOR, MARION COUNTY DEPARTMENT OF HEALTH ADMINISTRATOR, BOONE COUNTY SPECIAL SERVICES, AND NEWTOWN COUNTY DEPARTMENT OF HEALTH ADMINISTRATOR. SCHEDULE H, PART V, SECTION B, LINE 11 NARMC OWNS THREE RURAL HEALTH CLINICS. 1. NEWTON COUNTY FAMILY PRACTICE IN JASPER, AR, 2. CLAUDE PARRISH COMMUNITY HEALTH CLINIC IN LEAD HILL, AR, 3. MARSHALL FAMILY PRACTICE IN MARSHALL, AR. NARMC ALSO HAS THREE MANNED AMBULANCE SUBSTATIONS. THEY ARE LOCATED IN JASPER, DIAMOND CITY AND MARSHALL. THROUGH THESE RURAL HEALTH CLINICS AND AMBULANCE SUBSTATIONS WE CONTINUALLY MEET THE NEEDS OF THE COMMUNITIES WE SERVE IN THE RURAL AREAS. NARMC SUPPORTS AND STAFFS THE LOCAL HOSPICE HOUSE WHICH PROVIDES TERMINALLY ILL PATIENTS AND THEIR FAMILIES WITH AN ALTERNATIVE TO HOSPICE SERVICES IN THEIR HOMES. COST OF SERVICES IS INCLUDED IN THE CHARITY SUBSIDY INFORMATION. NARMC PARTNERS WITH NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION WHICH PROVIDES QUALITY CERTIFIED HEALTH CARE TRAINING FOR COMMUNITY NEEDS. TRAINING AND EDUCATION INCLUDES CLASSES FOR NURSE ASSISTANTS, HOME HEALTH AIDES, FIRST AIDE, CPR TRAINING AND CONTINUING HEALTH EDUCATION FOR HEALTHCARE PROFESSIONALS, AS WELL AS, COMMUNITY EDUCATION FOR HEALTHY LIVES, WEIGHT LOSS AND SMOKING CESSATION. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY SUPPORT GROUP EDUCATION. SCHEDULE H, PART V, SECTION B, LINE 22D NORTH ARKANSAS REGIONAL MEDICAL CENTER USED AN AVERAGE OF MAJOR COMMERCIAL INSURANCE DISCOUNTS TO DETERMINE THE AMOUNT OF DISCOUNTS PROVIDED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. 17 NEWTON COUNTY FAMILY PRACTICE CLINIC 502 WEST COURT PO BOX 445 JASPER AR 72641 RURAL HEALTH CLINIC CLAUDE PARRISH COMMUNITY HEALTH CLINIC 131 EAST HIGHWAY 14 PO BOX 366 LEAD HILL AR 72644 RURAL HEALTH CLINIC MARSHALL FAMILY PRACTICE CLINIC 211 AIRPORT ROAD PO BOX 1266 MARSHALL AR 72650 RURAL HEALTH CLINIC NARMC EMS NEWTON COUNTY SUBSTATION HWY 7 SOUTH JASPER AR 72641 EMS RURAL SUB-STATION NARMC EMS SEARCY COUNTY SUBSTATION 834 AIRPORT ROAD MARSHALL AR 72650 EMS RURAL SUB-STATION NARMC EMS DIAMOND CITY SUBSTATION 311 GREENWOOD ST DIAMOND CITY AR 72630 EMS RURAL SUB-STATION NARMC MEDICINE GROUP 114 E CRANDELL AVENUE HARRISON AR 72601 SINGLE PHYSICIAN FAMILY PRACTI NARMC FAMILY MEDICINE CLINIC 724 N SPRING STREET HARRISON AR 72601 FAMILY MEDICINE NARMC MEDIQUICK 724 N SPRING STREET HARRISON AR 72601 FAMILY MEDICINE NARMC GENERAL & SPECIALTY SURGERY 520 N SPRING STREET HARRISON AR 72601 GENERAL & SPECIALTY SURGERY NARMC FAMILY DOCTOR'S CLINIC 520 N SPRING STREET HARRISON AR 72601 FAMILY MEDICINE NARMC INTERNAL MEDICINE 724 N SPRING STREET HARRISON AR 72601 FAMILY MEDICINE NARMC HOME HEALTH AND HOSPICE 825 N MAIN ST SUITE E HARRISON AR 72601 HOME HEALTH & HOSPICE NARMC JASPER SCHOOL BASED CLINIC 609 W CLARK JASPER AR 72641 FAMILY MEDICINE NARMC EMS HARRISON SUBSTATION 303 HWY 65 BYPASS HARRISON AR 72601 EMS RURAL SUB-STATION HOSPICE OF THE HILLS 501 E SHERMAN HARRISON AR 72601 HOSPICE WOMEN'S HEALTH AND SURGERY CENTER NARMC 520 N PINE HARRISON AR 72601 FAMILY PRACTICE/OBSTETRICS & GYNECOLOGY FORM 990, SCHEDULE H, PART I, LINE 7 THE COST TO CHARGE RATIO, CALCULATED USING WORKSHEET 2, WAS USED IN COMPLETING LINE 7A AND 7B. LINE 7E, 7F, 7G, AND 7I WERE CALCULATED USING ACTUAL COSTS. FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F BAD DEBT EXPENSE IN THE AMOUNT OF $8,965,990 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4 THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE CAN BE FOUND IN THE ATTACHED AUDIT REPORT IN SUPPLEMENTARY NOTE 1, UNDER PATIENT ACCOUNTS RECEIVABLE. FORM 990, SCHEDULE H, PART III, LINE 8 THE AMOUNT REPORTED ON LINE 6 WAS CALCULATED USING THE MEDICARE COST REPORT. FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B ONCE A PATIENT IS KNOWN TO QUALIFY FOR CHARITY CARE, ALL COLLECTION EFFORTS CEASE. FORM 990, SCHEDULE H, PART VI, LINE 2 NARMC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY WORKING VERY CLOSELY WITH OTHER HEALTHCARE PROVIDERS AND EDUCATORS IN THE AREA AND PARTICIPATING IN THE SURVEY COMPLETED BY THE HOMETOWN HEALTH COALITION THROUGH THE BOONE COUNTY HEALTH UNIT. THIS DOCUMENT COMPILES DATA FROM SCHOOLS, PHYSICIANS, GOVERNMENT AGENCIES AND THE HOSPITAL TO DETERMINE WHERE OUR COMMUNITY CAN HELP FILL THE VOID IN MEDICAL CARE NEEDS FOR OUR CITIZENS. FORM 990, SCHEDULE H, PART VI, LINE 3 OUR COMMITMENT IS TO IDENTIFY WAYS OF HELPING PATIENTS PAY FOR MEDICALLY NECESSARY SERVICES. NARMC'S PUBLIC BENEFITS DEPARTMENT IS RESPONSIBLE FOR THE HANDLING OF THE NARMC FINANCIAL ASSISTANCE PROGRAM IN CONJUNCTION WITH THE NARMC BUSINESS OFFICE. APPLICATIONS FOR NARMC'S FINANCIAL ASSISTANCE PROGRAM ARE TAKEN BY MAIL, IN PERSON, OVER THE PHONE OR BY APPOINTMENT THROUGH THE PUBLIC BENEFITS DEPARTMENT. A PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE WHEN THE PATIENT REGISTERS AS A SELF-PAY PATIENT OR HAS A SELF-PAY BALANCE AFTER INSURANCE ON THEIR ACCOUNT. SELF-PAY ACCOUNTS ARE REVIEWED BY THE PUBLIC BENEFITS DEPARTMENT. ALL QUALIFYING SELF-PAY ACCOUNTS RECEIVE A DISCOUNT BASED ON THE REIMBURSEMENT PERCENTAGES RECEIVED FROM MEDICARE AND ALL PRIVATE HEALTH INSURANCES PAYING CLAIMS TO THE HOSPITAL BASED UPON A LOOK BACK PERIOD. CURRENTLY THE SELF PAY DISCOUNT IS 45% OF GROSS CHARGES. ONCE THE PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE, THE PATIENT IS SEEN OR CONTACTED BY NARMC'S PUBLIC BENEFITS DEPARTMENT TO DETERMINE ELIGIBILITY AND APPLY FOR THE NARMC FINANCIAL ASSISTANCE PROGRAM INCLUDING THOSE WITH MEDICAL CONDITIONS/NEEDS THAT HAVE EXHAUSTED THEIR FINANCIAL RESOURCES, HELP IN APPLYING FOR GOVERNMENTAL ASSISTANCE, HELP IN DETERMINING ELIGIBILITY, APPLYING FOR PHARMACEUTICAL ASSISTANCE PROGRAMS OR ANY OTHER PUBLIC ASSISTANCE. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 0% TO 138% OF THE FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 100%. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 138% TO 200% OF FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 50%. NARMC TAKES THE FOLLOWING MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE PROGRAM TO THE COMMUNITY AND PATIENTS IN THE FOLLOWING WAYS: 1. POST THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND A SUMMARY OF THE POLICY ON THE NARMC WEBSITE AT WWW.NARMC.COM. 2. PROVIDE PAPER COPIES OF THE POLICY, APPLICATION AND SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM UPON REQUEST IN ADMISSIONS AND BUSINESS OFFICE. 3. POST NOTICES ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN THE EMERGENCY DEPARTMENT, ADMITTING AREAS AND BUSINESS OFFICE. 4. DISTRIBUTE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM AND OFFER A FINANCIAL ASSISTANCE APPLICATION TO PATIENTS AT REGISTRATION OR BEFORE DISCHARGE FROM THE HOSPITAL. 5. INFORM PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN PERSON OR DURING BILLING AND CUSTOMER SERVICE PHONE CONTACTS. 6. PROVIDE A SUMMARY OF THIS FINANCIAL ASSISTANCE PROGRAM IN THE PATIENTS' MONTHLY BILLING STATEMENTS. PATIENTS WILL RECEIVE THEIR FIRST STATEMENT WITHIN 15 DAYS FROM COMPUTATION OF THE FINAL BILL. NARMC WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH ALL BILLING STATEMENTS (MINIMUM OF 3 STATEMENTS) AND WITH ANY OTHER WRITTEN COMMUNICATIONS REGARDING THE BILL THAT IS PROVIDED TO THE PATIENTS. NARMC SHALL INFORM THE PATIENT ABOUT THE FINANCIAL ASSISTANCE POLICY IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE. NARMC WILL PROVIDE THE PATIENT WITH AT LEAST ONE WRITTEN NOTICE THAT INFORMS THAT PATIENT ABOUT EXTRAORDINARY COLLECTIONS ACTIONS THAT MAY BE TAKEN IF THE FINANCIAL ASSISTANCE APPLICATION IS NOT SUBMITTED OR THE AMOUNT IS NOT PAID IN FULL BY THE DUE DATE SPECIFIED IN THE NOTICE. NARMC SHALL NOT UNDERTAKE EXTRAORDINARY COLLECTION ACTIONS IN LESS THAN 120 DAYS FROM THE DATE OF THE FIRST STATEMENT. PATIENTS MAY REQUEST FINANCIAL ASSISTANCE UP TO 240 DAYS FROM THE DATE OF THE PATIENT'S FIRST STATEMENT. IF THE PATIENT SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION AFTER 120 DAYS FROM THE FIRST STATEMENT DATE, NARMC SHALL SUSPEND ALL EXTRAORDINARY COLLECTION ACTIONS AND PROVIDE THE PATIENT WITH A WRITTEN NOTICE DESCRIBING THE ADDITIONAL INFORMATION/DOCUMENTATION THAT IS REQUIRED TO COMPLETE THE APPLICATION. IF THE PATIENT FAILS TO PROVIDE THE ADDITIONAL INFORMATION REQUESTED BY THE DATE SPECIFIED IN THE WRITTEN NOTICE, NARMC MAY PROCEED WITH EXTRAORDINARY COLLECTIONS ACTIONS. COMPLETED FINANCIAL ASSISTANCE APPLICATIONS SUBMITTED WITHIN THE 240 DAY PERIOD SHALL BE REVIEWED BY NARMC. A DETERMINATION SHALL BE MADE AND DOCUMENTED AS TO WHETHER THE PATIENT IS ELIGIBLE AND WRITTEN NOTIFICATION SHALL BE SENT TO THE PATIENT DESCRIBING THE ELIGIBILITY AND BASIS FOR THE DETERMINATION. IF NARMC DETERMINES THE PATIENT TO BE ELIGIBLE THEY WILL PROVIDE THE PATIENT WITH A BILLING STATAEMENT SHOWING THE AMOUNT OWED AND HOW NARMC DETERMINED THE AMOUNT OWED AS A FINANCIAL ASSISTANCE PROGRAM ELIGIBLE PATIENTS, REFUND ANY AMOUNTS PAID IN EXCESS OF THE AMOUNT THE PATIENT TIS DETERMINED TO OWE AS A FINANCIAL ASSISTANCE PROGRAM PATIENT, AND TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN AGAINST THE INDIVIDUAL INCLUDING VACATE JUDGMENTS, LIFT ANY LIENS OR LEVY AND REMOVE FROM THAT PATIENT'S CREDIT REPORT ANY INFORMATION THAT WAS REPORTED TO A CONSUMER REPORTING AGENCY OR CREDIT BUREAU. NARMC SHALL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS UNTIL IT HAS MADE REASONABLE EFFORTS TO DETERMINE FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY, SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS IF THE PATIENT SUBMITS A FINANCIAL ASSISTANCE PROGRAM APPLICATION UNTIL NARMC DETERMINES FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY. IF THE PATIENT IS ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM, NARMC WILL ENSURE THE PATIENT DOES NOT PAY MORE THAN THE PATIENT IS REQUIRED TO PAY UNDER THE FINANCIAL ASSISTANCE PROGRAM. FORM 990, SCHEDULE H, PART VI, LINE 4 THE MEDICAL CENTER IS LOCATED IN HARRISON ARKANSAS; IN BOONE COUNTY. HARRISON IS APPROXIMATELY AN HOUR AND A HALF EAST OF FAYETTEVILLE, ARKANSAS AND AN HOUR SOUTH OF SPRINGFIELD, MISSOURI, THE CLOSEST METROPOLITAN AREAS. ONE DIVIDED HIGHWAY SERVES THE AREA FROM THE NORTH. BASED ON THE PATIENT ORIGIN OF ACUTE CARE INPATIENT DISCHARGES AND OUTPATIENT VISITS FROM APRIL 1, 2011 THROUGH MARCH 31, 2012; MANAGEMENT HAS IDENTIFIED THE COMMUNITY TO INCLUDE ALL OF BOONE AND NEWTON COUNTIES, SIGNIFICANT PORTIONS OF CARROLL,, MARION, AND SEARCY COUNTIES AND A SMALL PORTION OF POPE COUNTY. THE OVERALL POPULATION IS PROJECTED TO INCREASE OVER THE FIVE-YEARS OF 2012 TO 2017, FROM 80,599 TO 87,713 OR 3.9%. HOWEVER, THE AGE CATEGORY THAT UTILIZES HEALTH CARE SERVICES THE MOST, 65 YEARS AND OVER, IS PROJECTED TO INCREASE FROM 14,540 TO 16,627 OR 14.4%. THE RATIO OF MALES TO FEMALES IN THE TOTAL COMMUNITY IS PROJECTED TO REMAIN APPROXIMATELY THE SAME OVER THE FIVE-YEAR PERIOD. IN TOTAL, THE POPULATION BREAKDOWN FOR THE COMMUNITY IS SIMILAR TO THE STATE OF ARKANSAS WITH HISPANIC RESIDENTS COMPRISING LESS THAN 10% OF THE TOTAL. HOWEVER, A REVIEW OF THE SPECIFIC ZIP CODE AREAS DOES SHOW A RELATIVELY LARGE PERCENTAGE OF HISPANIC RESIDENTS IN THE BERRYVILLE AND GREEN FOREST ZIP CODES. ADDITIONALLY, THE HISPANIC POPULATIONS IS PROJECTED TO GROW NEARLY 18%, FROM 2012 TO 2017, AS COMPARED TO THE 3.7% GROWTH IN NON-HISPANIC POPULATION. IN 2010, A FAMILY OF TWO ADULTS AND TWO CHILDREN WAS CONSIDERED POOR IF THEIR ANNUAL HOUSEHOLD INCOME FELL BELOW $22,050 AND ARKANSAS IS CONSISTENTLY RANKED ON AS ONE OF THE POOREST STATES IN THE COUNTRY. POVERTY RATES FOR NEWTON AND SEARCY COUNTIES RANK UNFAVORABLY WHEN COMPARED TO THE STATE AVERAGES. ALL COUNTIES COMPARE UNFAVORABLY TO NATIONAL POVERTY RATES AND MEDIAN INCOME. FORM 990, SCHEDULE H, PART VI, LINE 5 NARMC'S BOARD OF DIRECTORS CONSISTS OF COMMUNITY LEADERS WITH GOALS OF PROMOTING COMMUNITY HEALTH. THE HOSPITAL PROVIDES FOUR FREE HEALTH SCREENINGS PER YEAR AND PROVIDES HEALTH CHECKS AT SEVERAL COMMUNITY EVENTS, SUCH AS COMMUNITY HEALTH FAIRS, COUNTY FAIRS, RODEOS, LOCAL BUSINESSES, ETC. NARMC PARTNERS WITH AND FINANCIALLY SUPPORTS NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, WHICH PROVIDES HEALTH EDUCATION TO THE GENERAL POPULATION OF THE COMMUNITY. EMERGENCY SERVICES ARE PROVIDED AT NUMEROUS COMMUNITY EVENTS WITH EITHER PHYSICIANS, PARAMEDICS, EMTS, NURSES, ETC. ADDITIONALLY, NARMC IS VERY INVOLVED IN THE COMMUNITIES IT SERVES BY PROVIDING COMMUNITY HEALTH SUPPORT AND EDUCATION. THE HOSPITAL'S STAFF PARTICIPATES IN A VARIETY OF COMMUNITY SUPPORT ACTIVITIES INCLUDING, BUT NOT LIMITED TO, BUSINESS AFTER HOURS, WORLD'S LARGEST BABY FAIR, THE BUSINESS EXPO AND OZARK EXPO, KHOZ/NARMC HEALTH FAIR, THE KHOZ RADIO STATION MCDONALD'S BREAKFAST CLUB, TKO TELEVISION PROGRAM COMMUNITY CONNECTIONS, KHOZ RADIO STATION COMMUNITY CONTACT AND K26 TV'S 726 COMMUNITY INFORMATION PROGRAMS. THE RURAL HEALTH CLINICS AND RURAL AMBULANCE STATIONS HAVE REPRESENTATIVES ON THE LOCAL CHAMBER OF COMMERCE BOARD OF DIRECTORS, MEMBERS OF KIWANIS, ROTARY, LIONS, EVENING LIONS, FIRST RESPONDERS, VOLUNTEER FIRE DEPARTMENT, ETC. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY SUPPORT GROUP EDUCATION. FORM 990, SCHEDULE H, PART VI, LINE 6 NORTH ARKANSAS MEDICAL SYSTEM IS A PUBLIC BENEFIT CORPORATION TO NORTH ARKANSAS REGIONAL MEDICAL CENTER. IT IS ORGANIZED TO OPERATE FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND/OR TO CARRY OUT THE PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL SERVICES IS A PUBLIC BENEFIT CORPORATION TO NORTH PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL FOUNDATION'S MISSION IS TO ENCOURAGE PUBLIC SUPPORT FOR THE ACTIVITIES AND PURPOSE OF NORTH ARKANSAS REGIONAL MEDICAL CENTER. FORM 990, SCHEDULE H, PART VI, LINE 7 THE STATE OF ARKANSAS DOES NOT REQUIRE NONPROFIT HOSPITALS TO PROVIDE COMMUNITY BENEFIT REPORTS. X true true X X X X X false false false false false false false false false DR JOHN LESLIE BOARD MEMBER 282789 0 5100 0 17604 0 24375 0 13786 0 343654 0 0 0 VINCENT LEIST CHIEF EXECUTIVE OFFICER 338446 0 1000 0 19310 0 32100 0 13786 0 404642 0 0 0 RICHARD MCBRYDE CHIEF OPERATING OFFICER 200331 0 500 0 1779 0 23392 0 15151 0 241153 0 0 0 DEBRA HENRY CHIEF FINANCIAL OFFICER 178760 0 500 0 5846 0 23507 0 16286 0 224899 0 0 0 RICHARD BLAKE CHITSEY PHYSICIAN 844953 0 20000 0 17621 0 26600 0 9014 0 918188 0 0 0 SARA LYNNE ROGERS ANESTHESIOLOGIST 401927 0 100 0 265 0 31362 0 13715 0 447369 0 0 0 JAMES D WATERS ANESTHESIOLOGIST 372754 0 100 0 265 0 31272 0 16036 0 420427 0 0 0 ANDREW L COBLE PHYSICIAN 335216 0 100 0 115 0 26600 0 13786 0 375817 0 0 0 KENNETH FATTMANN PSYCHIATRIST 318771 0 100 0 496 0 21502 0 6636 0 347505 0 0 0 DR TOM LANGSTON BOARD MEMBER 192309 0 5500 0 265 0 21608 0 6152 0 225834 0 0 0 SCHEDULE J, PART I, LINE 1A NARMC PAYS A COUNTRY CLUB MEMBERSHIP FOR VINCENT LEIST, WHICH IS ONLY USED FOR BUSINESS PURPOSES. ANY PERSONAL EXPENSES ARE PAID BY VINCENT LEIST DIRECTLY. NARMC ALSO PAYS ROTARY DUES FOR VINCENT LEIST, DEBBIE HENRY, AND RICHARD MCBRYDE, AND KIWANIS DUES FOR DIANE ROBERTS. THE AMOUNTS ARE NOT INCLUDED IN THEIR WAGES, AS THEY ARE FOR BUSINESS PURPOSES. A BOONE COUNTY AR 710386082 098646AS1 2006-03-16 25000000 HOSPITAL REVENUE CONSTRUCTION false false false B BOONE COUNTY AR 710386082 098646BB7 2010-11-16 5314921 HOSPITAL REVENUE REFUNDING BONDS false false false C BOONE COUNTY AR 710386082 098646BR2 2011-12-20 9959500 HOSPITAL REVENUE REFUNDING BONDS false false false D BOONE COUNTY AR 710386082 098646CC4 2013-03-01 9854770 HOSPITAL REVENUE REFUNDING BONDS false false false A 20300000 0 26424625 0 0 0 272406 377517 0 24350077 0 0 2008 false false true true B 2030000 0 5335000 533500 0 5736028 107135 0 0 0 0 0 2010 true false true true C 1625000 0 9965000 934391 0 9175000 169598 0 0 0 0 0 2011 true false true true D 0 0 9854872 994000 0 9790000 184280 0 0 0 0 0 2013 true false true true A false false false false 0.00000 0.00000 0.00000 false false false true B false false false false 0.00000 0.00000 0.00000 false false false false C false false false false 0.00000 0.00000 0.00000 false false false false D false false false false 0.00000 0.00000 0.00000 false false false false A false false false true true false 0 false 0 false true B false true false false false false 0 false 0 false true C false true false false false false 0 false 0 false true D false true false false false false 0 false 0 false true A true B true C true D true FORM 990, SCHEDULE K, PART I, A - D A - COMPLETED ON BOND YEAR OF 2/28/2015 B - COMPLETED ON BOND YEAR OF 5/1/2014 C - COMPLETED ON BOND YEAR OF 5/1/2014 D - COMPLETED ON BOND YEAR OF 5/1/2014 FORM 990, SCHEDULE K, PART II, LINE 3 TOTAL PROCEEDS OF ISSUE DO NOT EQUAL ISSUE PRICE DUE TO INCLUDED INVESTMENT EARNINGS. FORM 990, SCHEDULE K, PART IV, LINE 2C FOR BOND SERIES 2006, THE LAST REBATE COMPUTATION DATE WAS 02/28/2011. MCNUTT FAMILY LLP LLC BOD MIKE MCNUTT-OWNER 33600 RENTAL OF PROPERTY false HARRISON PROFESSIONAL BUILDING CORP BOD TOM LANGSTON-OWNER 77803 RENTAL OF PROPERTY false FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO EACH BOARD DIRECTOR DURING THE BOARD COMMITTEE MEETINGS. MANAGEMENT REVIEWED EACH SECTION AND ALL SIGNIFICANT DISCLOSURES WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS COMPLETE A QUESTIONNAIRE EACH YEAR AND DISCLOSURES (IF ANY) ARE REVIEWED BY THE BOARD AND OFFICERS. KEY EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST TO THEIR SUPERVISORS AND TO HUMAN RESOURCES. FORM 990, PART VI, SECTION B, LINE 15A AND 15B THE LAST REVIEW COMPLETED IN JANUARY 2015 BY THE VICE PRESIDENT OF HUMAN RESOURCES AT NARMC. OTHER OFFICERS OR KEY EMPLOYEES ARE COMPARED TO AHA SALARY DATABASE BY HUMAN RESOURCES AND ARE REVIEWED AND APPROVED BY THE CEO. SALARIES OF OFFICERS AND KEY EMPLOYEES ARE ALSO REVIEWED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 PROVIDED UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:6191849 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE AGREEMENTS TOTAL FEES:3380893 FORM 990 PART IX LINE 11G DESCRIPTION:DIRECTORS FEE TOTAL FEES:1406801 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:1258287 NORTH ARKANSAS MEDICAL FOUNDATION 620 NORTH MAIN STREET HARRISON AR 72601 710787861 SUPPORT AR 501 (C) (3) 11A NAMS true NORTH ARKANSAS MEDICAL SYSTEM 620 NORTH MAIN STREET HARRISON AR 72601 710787859 SUPPORT AR 501 (C) (3) 11A NA false NORTH ARKANSAS MEDICAL SERVICES 620 NORTH MAIN STREET HARRISON AR 72601 710787858 SUPPORT AR 501 (C) (3) 11A NAMS true false false true false false false false false false false true false false false false false true false false NORTH ARKANSAS MEDICAL FOUNDATION C 116327 FMV