2014-12-15T13:40:52-06:00 2014-09-30 710355269 BEALL BARCLAY & COMPANY PLC P O BOX 10148 FORT SMITH AR 729170148 990 2013-10-01 237237381 ARKANSAS FOUNDATION FOR MEDICAL CARE INC ARKA 4795737616 PO BOX 180001 FORT SMITH AR 729180001 MARY COUNTS CHIEF FINANCIAL OFFICER 4795737616 2014-12-11 1 BARBARA HAMBRICK P00387600 4794845740 2014-12-11 2013 2015-11-30 17:44:51Z MARY COUNTS PO BOX 180001 FORT SMITH AR 729180001 21279442 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. 20 20 219 0 0 0 0 0 20236424 20934548 158223 107232 29078 20983 20423725 21062763 8600 9120 0 0 15317515 15945951 0 0 0 4488779 4962419 19814894 20917490 608831 145273 23187298 24261747 1701598 1751907 21485700 22509840 X TO PROMOTE EXCELLENCE IN HEALTH CARE THROUGH EVALUATION AND EDUCATION 0 0 3454300 3601347 QIO (QUALITY IMPROVEMENT ORGANIZATION) --- "FEDERAL" CONTRACT FOR MEDICAL PEER REVIEW AND QUALITY IMPROVEMENT. 5195708 5710666 MEDICAID REVIEW --- RETROSPECTIVE MEDICAL REVIEWS ON A PERCENTAGE OF PATIENTS DISCHARGED FROM THE HOSPITALS. 1916584 1823969 HITREC (HEALTH INFOROMATION TECHNOLOGY REGIONAL EXTENSION CENTER) --- ASSIST PROVIDERS SELECT, IMPLEMENT AND USE CERTIFIED EHR TECHNOLOGY. 10350900 9798566 OTHER PROGRAMS CONSIST OF CONTRACTS THAT THE ORGANIZATION HAS WITH VARIOUS FEDERAL, STATE, AND PRIVATE AGENCIES. 10350900 9798566 20917492 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 77 0 219 1 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AR X MARY COUNTS 4795737616 PO BOX 180001 FORT SMITH AR 72918 DWIGHT WILLIAMS MD CHAIRMAN OF BOARD 1.00 X X 5456 0 0 ROBERT SANDERS DO VICE-CHAIRMAN 1.00 X X 1400 0 0 RANDY FORTNER FACHE TREASURER 1.00 X X 5456 0 0 CARL COVEY MD SECRETARY 1.00 X X 4100 0 0 JAMES R TEETER MEMBER-AT-LARGE 1.00 X 4800 0 0 SHARON ALLEN BOD, MEDICARE BENEFICIARY 1.00 X 2100 0 0 E SCOTT FERGUSON MD BOD 1.00 X 4225 0 0 SUSAN GREENWOOD BOD 1.00 X 4800 0 0 RAY MONTGOMERY II FACHE BOD 1.00 X 4917 0 0 SHARON MOONE-JOCHUMS BOD 1.00 X 2569 0 0 CHADWICK T RODGERS MD BOD 1.00 X 3400 0 0 MARY PORTIA SHORT BOD, MEDICARE BENEFICIARY 1.00 X 5384 0 0 ALVIN SIMMONS BOD 1.00 X 5331 0 0 RONALD WAUTERS MD BOD 1.00 X 4800 0 0 STACY C ZIMMERMAN MD BOD 1.00 X 1400 0 0 AMY JOHNSON BOD 1.00 X 0 0 0 STEVE JONES BOD 1.00 X 0 0 0 MELISSA PIERCE BOD 1.00 X 0 0 0 TOMMY BUTLER BOD 1.00 X 0 0 0 KAREN PETITT BOD 1.00 X 0 0 0 JOHN HENDERSON BOD 1.00 X 3298 0 0 EUGENE SHELBY BOD 1.00 X 3806 0 0 CHRISTI SMITH MANAGER QUALITY PROGRAMS 43.00 X 101816 0 10914 WALLACE R HANLEY CEO/PRESIDENT 45.00 X 309617 0 31471 DEBBIE HOPKINS CHIEF OPERATING OFFICER 28.00 X 94597 0 7414 MICHAEL N MOODY MD VP CORPORATE MED DIRECTOR 17.00 X 151939 0 5441 MARY S MOORE CHIEF COMPLIANCE OFFICER 41.00 X 117515 0 24493 MARY N COUNTS CHIEF FINANCIAL OFFICER 45.00 X 151047 0 19534 JULIA KETTLEWELL AVP QUALITY PROGRAMS 39.00 X 128276 0 18559 PEGGY J STARLING AVP MMCS 45.00 X 159952 0 12310 JUDITH E MCGHEE ASSOC MED DIR MEDICAID 28.00 X 160828 0 13607 THOMAS D TINSMAN ASSOC MED DIRECTOR 38.00 X 197235 0 19209 PATRICIA J WILLIAMS SENIOR EXECUTIVE ASSISTANT 38.00 X 62351 0 10801 BRIAN C HERZIG DIRECTOR INFORMATION SERVI 40.00 X 107077 0 22071 JOHN H CLAYBORN DIRECTOR HUMAN RESOURCES 39.00 X 102999 0 9442 JASON E SCHEEL DIRECTOR M'CAID ANALYTICAL 40.00 X 106043 0 22353 BETTY BENNETT DIRECTOR AIPP 40.00 X 105602 0 15077 AMY ROSSI VP INNOVATIONS & STRATEGIC DEVELOPMENT 46.00 X 152913 0 20366 JONATHAN FUCHS CHIEF OPERATING OFFICER 36.00 X 236925 0 30921 LINDA MILLIGAN VP CORPORATE MED DIRECTOR 26.00 X 117296 0 8231 JARROD MCCLAIN SR DIRECTOR CLINICAL REVIEW 44.00 X 113261 0 16117 JENNA CLEMONS DIRECTOR FINANCE 44.00 X 106361 0 20786 2850892 0 339117 17 0 1 0 GGNSC ADMINISTRATIVE SERVICES LLC 1000 FIANNA WAY FORT SMITH AR 72919 RENTAL 243550 MICROSOFT LICENSING GP PO BOX 73843 CLEVELAND OH 44193 SOFTWARE 161969 NACR 3344 HIGHWAY 149 EAGAN MN 55121 COMMUNICATIONS 150121 SOFTCHOICE CORPORATION 16609 COLLECTIONS CENTER DR CHICAGO IL 60693 IT SUPPORT 134317 DELTEK SYSTEMS INC PO BOX 79581 BALTIMORE MD 212790581 SOFTWARE 106412 6 STATE REVENUE FROM OPERATIONS 900099 14215391 14215391 REVENUE FROM OPERATIONS 900099 5512361 5512361 PRIVATE REVENUE FROM OPERATIONS 900099 1206796 1206796 20934548 104870 104870 231024 210041 20983 20983 20983 9000 6638 2362 2362 2362 21062763 20934548 0 128215 9120 2917928 8109249 356539 3576082 986153 49809 51110 457434 60873 1102843 1268029 525574 604745 191741 452447 174001 PASS THROUGH COSTS 23293 PARKING 1859 MISCELLANEOUS -1339 20917490 1100 1100 1344055 1779467 2314466 2198633 306432 504707 11511275 3787142 8066080 7724133 10678074 11576616 477091 477091 23187298 24261747 1676339 1726648 25259 25259 1701598 1751907 X 21485700 22509840 21485700 22509840 23187298 24261747 145273 878867 0 X X 0 0 0 1 0 0 1060000 1060000 4655121 4655121 55530 55530 5740624 3787142 1953482 7724133 DUE TO RELATED PARTIES 25259 25259 990 PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE - 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. 1 COMPREHENSIVE JUVENILE SVC 1000 CHARITABLE CONTRIBUTION STUFF THE SLEIGH 1000 CHARITABLE CONTRIBUTION ARKANSAS FOODBANK NETWORK 500 CHARITABLE CONTRIBUTION AMERICAN HEART ASSOCIATION 5000 CHARITABLE CONTRIBUTION CARELINK 1000 CHARITABLE CONTRIBUTION COMMUNITY BAKERY 70 CHARITABLE CONTRIBUTION GRAVEL HILL CEMETERY FUND 50 CHARITABLE CONTRIBUTION HEIFER INTERNATIONAL 500 CHARITABLE CONTRIBUTION X 0 0 0 WALLACE R HANLEY CEO/PRESIDENT 309617 0 0 0 0 0 0 0 0 31471 309617 31471 0 0 MICHAEL N MOODY MD VP CORPORATE MED DIRECTOR 151939 0 0 0 0 0 0 0 0 5441 151939 5441 0 0 MARY N COUNTS CHIEF FINANCIAL OFFICER 151047 0 0 0 0 0 0 0 0 19534 151047 19534 0 0 PEGGY J STARLING AVP MMCS 159952 0 0 0 0 0 0 0 0 12310 159952 12310 0 0 JUDITH E MCGHEE ASSOC MED DIR MEDICAID 160828 0 0 0 0 0 0 0 0 13607 160828 13607 0 0 THOMAS D TINSMAN ASSOC MED DIRECTOR 197235 0 0 0 0 0 0 0 0 19209 197235 19209 0 0 AMY ROSSI VP INNOVATIONS & STRATEGIC DEVELOPME 152913 0 0 0 0 0 0 0 0 20366 152913 20366 0 0 JONATHAN FUCHS CHIEF OPERATING OFFICER 236925 0 0 0 0 0 0 0 0 30921 236925 30921 0 0 FORM 990, PART VI, SECTION B, LINE 11 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. FORM 990, PART XII, LINE 2C THE PROCESS OF REVIEWING 990 HAS NOT BEEN CHANGED FROM PRIOR YEAR. ARKANSAS QUALITY FOUNDATION INC PO BOX 1800001 FORT SMITH AR 72918 264518098 TO PROMOTE HEALTH THROUGH RESEARCH AND DEVELOPMENT IN ARKANSAS AR 501(C)(3) LINE 9 N/A 0 QUALITY EXCELLENCE INC PO BOX 180001 FORT SMITH AR 72918 263908892 TO PROVIDE CONSULTING AND ADVISORY SERVICES FOR HEALTHCARE INDUSTRY AR N/A C 7256 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 ARKANSAS QUALITY FOUNDATION INC N QUALITY EXCELLENCE INC N