2012-11-15T13:24:46-06:00 2011-12-31 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2011-01-01 640324402 MAGEE BENEVOLENT ASSOCIATION MAGE 6018495070 300 THIRD AVENUE SE MAGEE MS 39111 ALTHEA H CRUMPTON 6018495070 2012-11-14 1 MARSHA H DIECKMAN CPA P00246741 6013261000 2012-11-14 2011 2016-02-24 21:20:13Z MAGEE GENERAL HOSPITAL ALTHEA H CRUMPTON 300 THIRD AVENUE SE MAGEE MS 39111 28047228 0 X WWW.MGHOSP.ORG X 1942 MS MAGEE GENERAL HOSPITAL SHALL CONTINUE TO PROVIDE QUALITY HEALTHCARE TO THOSE THAT PRESENT THEMSELVES FOR OUR SERVICES. WE ARE DEDICATED TO MEET THE CHALLENGES OF THE FUTURE TO ASSURE THAT PEOPLE OF THIS COMMUNITY RECEIVE QUALITY HEALTHCARE AT A REASONABLE COST. 8 4 424 28 0 0 67114 169647 27276968 27434782 54719 76479 329619 366320 27728420 28047228 0 0 0 0 11388684 11864914 0 0 0 15649944 16567650 27038628 28432564 689792 -385336 26489423 27715478 9247240 10874315 17242183 16841163 X MAGEE GENERAL HOSPITAL SHALL CONTINUE TO PROVIDE QUALITY HEALTHCARE TO THOSE THAT PRESENT THEMSELVES FOR OUR SERVICES. WE ARE DEDICATED TO MEET THE CHALLENGES OF THE FUTURE TO ASSURE THAT PEOPLE OF THIS COMMUNITY RECEIVE QUALITY HEALTHCARE AT A REASONABLE COST. WE ARE COMMITTED TO MAINTAIN PATIENT CONFIDENTIALITY AND TO COMFORT AND RESPECT PATIENTS, FAMILIES, AND FRIENDS. 0 0 24481467 27821102 MAGEE GENERAL HOSPITAL OFFERS A VARIETY OF MEDICAL SERVICES THAT ARE DESIGNED TO MEET HEALTHCARE NEEDS OF THE SURROUNDING COMMUNITY. THIS SERVICE IS ACCOMPLISHED THROUGH THE OPERATION OF A FULL SERVICE INPATIENT, OUTPATIENT, AND EMERGENCY CARE FACILITY. 24481467 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 105 0 1 424 1 0 0 0 0 0 0 0 0 0 0 X 8 4 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ALTHEA CRUMPTON 6018495070 300 3RD AVENUE SE MAGEE MS 39111 CHARLES PRUITT III MD 1.00 X 69000 0 0 JOE STEPHENS 1.00 X 250 0 0 ALTHEA H CRUMPTON 40.00 X X 105264 0 12799 LYN LAMPHERE 1.00 X 250 0 0 RS RUNNELS SR MD 1.00 X 16500 0 0 BETTY C WADE RN 1.00 X 250 0 0 PJ PASCO DO 1.00 X 250 0 0 KELLI SMITH MD 1.00 X 250 0 0 MELISSA D BRUNTLETT 40.00 X 95212 0 5224 SHARON SCRUGGS 40.00 X 137031 0 6664 MARTHA SMITH 40.00 X 200534 0 5822 DR GENE CATHEY 40.00 X 213067 0 5502 MOLLIE K SMITH SOWELL 40.00 X 128592 0 2668 JUANITA TURNER 40.00 X 112359 0 3948 1078809 0 42627 6 0 1 0 KEYSTONE HEALTHCARE MANAGEMENT 6075 POPLAR AVENUE STE 727 MEMPHIS TN 38119 ER COVERAGE 1391431 SOUTHERN ANESTHESIA SERVICES 135 PEARCE ROAD MT OLIVE MS 39119 ANESTHESIA SERVICES 648960 MID SOUTH REHAB 711 AVIGNON DRIVE RIDGELAND MS 39157 PHYSICAL THERAPY 621864 MAGEE RADIOLOGY 104 HICKORY HILLS DR CLINTON MS 39056 RADIOLOGY SERVICES 386173 HARRY DOWDY MD PA 3 EASTBROOK CIRCLE MADISON MS 391101764 RADIOLOGY SERVICES 298925 7 140028 24573 5046 16943 169647 PATIENT SERVICE REVENU 621990 27434782 27434782 27434782 56479 56479 20000 0 20000 20000 20000 OTHER HOSPITAL SERVICE 621990 366320 366320 366320 28047228 27821102 0 56479 287226 287226 10091058 8578003 1513055 102657 77383 25274 649557 536881 112676 734416 598305 136111 48229 48229 92929 92929 37478 37478 334974 16989 317985 66866 13549 53317 371409 371409 1546762 1546762 439379 424639 14740 FEES 5239439 5069432 170007 SUPPLIES 2803190 2693297 109893 BAD DEBTS 2784929 2784929 EQUIPMENT RENTAL & MAIN 1890052 1385275 504777 912014 347136 564878 28432564 24481467 3951097 0 2028 2575 1564570 2725983 4294707 4387918 597400 557473 328672 359123 209132 172277 28907677 13925042 14950047 14982635 3155465 3424621 1387402 1102873 26489423 27715478 1728724 1994772 6883534 6566347 634982 2313196 9247240 10874315 X 16898098 16791137 344085 50026 17242183 16841163 26489423 27715478 X -385336 -15684 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2121 2121 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION PAYS AN ANNUAL MEMBERSHIP FEE TO BE A MEMBER OF THE MISSISSIPPI HOSPITAL ASSOCIATION (MHA). THE ORGANIZATION WAS NOTIFIED BY MHA THAT 14.41% OF THE FYE 4/30/12 MEMBERSHIP FEE AND 19.67% OF THE FYE 4/30/11 MEMBERSHIP FEE WAS RELATED TO MHA'S LOBBYING ACTIVITIES. THIS AVERAGES TO 16.16% FOR CALENDAR YEAR 2011, IN WHICH $13,123 IN DUES WERE PAID BY THE HOSPITAL TO MHA. 1417341 1417341 10637574 3538811 7098763 228765 33936 194829 16623997 10352295 6271702 14982635 TRUSTMARK FINANCIAL SERVICES 2246942 F MHA INVESTMENT POOL 1177679 F 3424621 OBLIGATIONS UNDER CAPITAL LEASE 911415 LINE OF CREDIT 1401781 2313196 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FASB ASC TOPIC 740 ("ASC 740") CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN INCLUDING THE ENTITY'S STATUS AS A PASS-THROUGH ENTITY. ADDITIONALLY, ASC 740 PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE HOSPITAL HAD NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2011. TAX PERIODS FOR ALL FISCAL YEARS AFTER 2007 REMAIN OPEN TO EXAMINATION BY THE FEDERAL TAXING JURISDICTIONS TO WHICH THE HOSPITAL IS SUBJECT. 1 1 1 X 125.000000000000 0 0 1 1 0 0 873122 0 873122 0.03410 6383033 5057273 1325760 0.05180 194239 193963 276 0.00000 7450394 5251236 2199158 0.08590 255522 255522 0.01000 2683720 1478859 1204861 0.04710 2939242 1478859 1460383 0.05710 10389636 6730095 3659541 0.14300 1 2859882 1429941 6743830 7269894 -526064 X 1 1 1 1 MAGEE GENERAL HOSPITAL

300 THIRD AVENUE SE MAGEE MS 39111

X X X SKILLED NURSING; OUTPATIENT CLINIC MAGEE GENERAL HOSPITAL 1 1 1 125.000000000000 0 1 X X X 1 1 X X 1 X 1 X X X 1 X 0 0 6 PEDIATRIC CLINIC OF MAGEE

360 SIMPSON HWY 149 MAGEE MS 39111

PHYSICIAN CLINIC MGH CLINIC

360 SIMPSON HWY 149 MAGEE MS 39111

PHYSICIAN CLINIC GENE CATHEY MD CLINIC

360 SIMPSON HWY 149 MAGEE MS 39111

PHYSICIAN CLINIC MEDICAL PAVILION

234 MAGNOLIA DR RALEIGH MS 39153

PHYSICIAN CLINIC HARPER CLINIC

105 EATON ST TAYLORSVILLE MS 39168

PHYSICIAN CLINIC MIZE HEALTHCARE

208 HIGHWAY 28 MIZE MS 39116

PHYSICIAN CLINIC PART I, LINE 3C: IN ORDER FOR PATIENTS TO QUALIFY FOR CHARITY CARE, THEY MUST MEET THE FOLLOWING CRITERIA: PATIENT HAS NO INSURANCE; PATIENT SUBMITS DOCUMENTATION SHOWING THEY EARN LESS THAN 125% OF FEDERAL POVERTY LEVEL; PATIENT MAY QUALIFY IF THEY HAVE EXHAUSTED THEIR MEDICAID DAYS. PART I, LINE 7: COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 7G: COSTS ASSOCIATED WITH PHYSICIAN CLINICS INCLUDED IN THE SUBSIDIZED HEALTH COST ARE $595,692. 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 $ 2859882. PREPARATION OF ANNUAL COMMUNITY BENEFIT REPORT PART I, LINE 6A: THE HOSPITAL BEGAN ITS COMMUNITY NEEDS HEALTH ASSESSMENT IN 2011. PART III, LINE 4: BAD DEBT EXPENSE IS REFLECTED AS THE AMOUNT OF CHARGES ACTUALLY WRITTEN OFF. THE FOOTNOTE IN THE FINANCIAL STATEMENTS REFLECTS- THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON HISTORICAL LOSSES AND AN ANALYSIS OF CURRENTLY OUTSTANDING AMOUNTS. THIS ACCOUNT IS GENERALLY INCREASED BY CHARGES TO A PROVISION FOR DOUBTFUL ACCOUNTS, AND DECREASED BY WRITE-OFFS OF ACCOUNTS DETERMINED BY MANAGEMENT TO BE UNCOLLECTIBLE. THE AMOUNT INCLUDED ON LINE 3 IS AN ESTIMATED GUESS AT 50%. THIS IS LIKELY HIGHER BUT INSUFFICIENT INFORMATION EXISTS TO DETERMINE THAT AMOUNT. A MAJORITY OF PATIENTS DO NOT SEEK CHARITY CARE ASSISTANCE THROUGH THE PROPER CHANNELS, THUS THE HOSPITAL NOW HAS 3 FINANCIAL COUNSELORS ON STAFF TO BETTER SERVE PATIENTS IN THIS PROCESS. PART III, LINE 9B: MAGEE GENERAL HOSPITAL DOES NOT SEEK COLLECTIONS FROM PATIENTS WHO QUALIFY FOR CHARITY CARE. MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 10: NO DISCOUNTED CARE PROVIDED MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 11H: NO DISCOUNTED CARE PROVIDED MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 13G: FREE CARE IS DETERMINED BY THE CRITERIA OUTLINED IN THE FINANCIAL ASSISTANCE POLICY. DETERMINATIONS ARE THEN MADE BY A COMMITTEE. THE POLICY IS OFFERED TO PRIVATE PAY PATIENTS AND IS ALSO AVAILABLE ON REQUEST. MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 15E: UNDER THE CHARITY POLICY, THE PATIENT IS ASKED TO FILL OUT A FINANCIAL ASSISTANCE APPLICATION DURING REGISTRATION. IF AN APPLICATION IS NOT FILLED OUT, AND PATIENT DOESN'T PAY THEIR BILL, THEY CAN BE TURNED OVER TO A COLLECTION AGENCY. IF THE PATIENT IS LATER DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE COLLECTION AGENCY REQUESTS ARE REVERSED. MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 16E: PATIENTS THAT DID NOT FILL OUT A FINANCIAL ASSISTANCE APPLICATION, AND DID NOT PAY THEIR BILLS, WERE TURNED OVER TO A COLLECTION AGENCY. IF THE PATIENTS ARE LATER DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE COLLECTION AGENCY REQUESTS ARE REVERSED. MAGEE GENERAL HOSPITAL PART V, SECTION B, LINE 19D: HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR A 100% DISCOUNT TO ELIGIBLE INDIVIDUALS (125% OF FPG); THEREFORE, PATIENTS MEETING THIS REQUIREMENT ARE NOT CHARGED FOR THE SERVICES PROVIDED. PART VI, LINE 2: MAGEE GENERAL HOSPITAL ENGAGES AN OUTSIDE CONSULTING GROUP, STROUDWATER & ASSOCIATES, TO ANAYLZE COMMUNITY NEEDS. THIS ASSESSMENT INCLUDES DETERMINING HOW MANY AND WHAT TYPES OF SERVICES AND/OR PHYSICIANS ARE NEEDED TO SERVE THE POPULATION. PART VI, LINE 3: PATIENTS WHO MAY QUALIFY FOR CHARITY CARE ASSISTANCE ARE INFORMED BY AN ON-SITE FINANCIAL COUNSELOR OR ANOTHER STAFF MEMBER OF THE AVAILABILITY OF THE PROGRAM. PART VI, LINE 4: MAGEE GENERAL HOSPITAL SERVES THE MAGEE/SIMPSON COUNTY AND SURROUNDING AREAS. MGH IS THE LARGEST MEDICAL FACILITY ALONG HWY 49 BETWEEN JACKSON AND HATTIESBURG. MGH IS SETTLED IN A RURAL AREA, WITH ONLY ONE OTHER SMALLER HOSPITAL IN SIMPSON COUNTY. MAGEE HAS AN APPROXIMATE POPULATION OF 4,200 RESIDENTS. PART VI, LINE 5: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY AND DIRECTORS ARE CITIZENS OF SIMPSON OR SURROUNDING COUNTIES. MAGEE GENERAL HOSPITAL IS COMMITTED TO PROVIDE EXCELLENT HEALTHCARE FOR THE AREA BY ENSURING THE BEST QUALITY SERVICES AND CONTINUING TO EXPAND THE PROFESSIONAL SERVICES OF NUMEROUS GENERAL PRACTITIONERS AND SPECIALTY PHYSICIANS. MAGEE GENERAL HOSPITAL HAS RECENTLY EXPANDED TO INCLUDE AN UPDATED LAB, NEW LABOR AND DELIVERY SECTION, AND ADDITIONAL PHYSICIANS AND STAFF. THE NEW MEDICAL TOWERS OF TUSCAN COURT IS NEXT DOOR TO THE HOSPITAL AND INCLUDES MULTIPLE MEDICAL CLINICS AND PROVIDERS. NUMEROUS SERVICES HAVE BEEN ADDED TO SERVE THE COMMUNITY AND SURROUNDING AREAS. X 0 0 0 0 0 0 0 0 0 MARTHA SMITH 100093 0 100441 0 0 0 4046 0 1776 0 206356 0 0 0 DR GENE CATHEY 188067 0 25000 0 0 0 3569 0 1933 0 218569 0 0 0 CITY OF MAGEE HOSPITAL REVENUE BOND SERIES 2007A 646000664 2007-05-29 5500000 HOSPITAL CONSTRUCTION AND RENOVATION 0 1 0 CITY OF MAGEE HOSPITAL REVENUE BOND SERIES 2007B 646000664 2007-05-29 2000000 REFINANCING EXISTING HOSPITAL DEBT 0 1 0 5500000 169149 5330851 2009 0 0 1 1 2000000 61509 1938491 2007 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CHARLES PRUITT III MD CONSTRUCTION OF MEDICAL TOWERS AT TUSCAN COURT, LLC., DR. PRUITT OWNS 50%. X 989972 557473 0 1 1 557473 ALTHEA H CRUMPTON CEO OF HOSPITAL 3312 DISCOUNTED HOSPITAL SERVICES MELISSA D BRUNTLETT CFO OF HOSPITAL 2173 DISCOUNTED HOSPITAL SERVICES MED PROPERTIES OF MAGEE LLC MED PROPERTIES OF MAGEE, LLC IS WHOLLY OWNED BY 3 BOARD MEMBERS. 55740 RENTAL PAYMENTS PAID BY THE ORGANIZATION TO MED PROPERTIES OF MAGEE, LLC. MED PROPERTIES OF MAGEE, LLC IS WHOLLY OWNED BY 3 BOARD MEMBERS: CHARLES PRUITT, PATRICK PASCO, AND R.S. RUNNELS. 0 MEDICAL AND SURGICAL CLINIC PLLC MEDICAL SURGICAL, PLLC IS WHOLLY OWNED BY 2 BOARD MEMBERS. 50238 PAYMENTS RECEIVED FROM MEDICAL SURGICAL, PLLC FOR MANAGEMENT AND ASSISTANCE PROVIDED BY THE ORGANIZATION. MEDICAL SURGICAL, PLLC IS WHOLLY OWNED BY 2 BOARD MEMBERS: CHARLES PRUITT AND PATRICK PASCO. 0 0 MEDICAL AND SURGICAL CLINIC INC MEDICAL SURGICAL, INC. IS WHOLLY OWNED BY 3 BOARD MEMBERS. 28215 ENTAL PAYMENTS PAID BY THE ORGANIZATION TO MEDICAL SURGICAL, INC. MMEDICAL SURGICAL, INC IS WHOLLY OWNED BY 3 BOARD MEMBERS: CHARLES PRUITT, PATRICK PASCO, AND R.S. RUNNELS. 0 0 MEDICAL TOWERS AT TUSCAN COURT CHARLES PRUITT IS A 50% OWNER OF MEDICAL TOWERS AT TUSCAN COURT. 586743 RENTAL PAYMENTS PAID BY THE ORGANIZATION TO MEDICAL TOWERS AT TUSCAN COURT. CHARLES PRUITT, BOARD CHAIRMAN, IS A 50% OWNER OF MEDICAL TOWERS AT TUSCAN COURT. 0 FORM 990, PART VI, SECTION A, LINE 2 R.S. RUNNELS, SR, M.D. (VICE-PRESIDENT), DR. PATRICK PASCO (BOARD MEMBER), AND DR. CHARLES PRUITT (BOARD CHAIRMAN) ARE BUSINESS PARTNERS IN MAGEE AFTER HOURS CLINIC, PLLC, MED PROPERTIES OF MAGEE, LLC, MED CAMPUS, AND MEDICAL SURGICAL, INC. FORM 990, PART VI, SECTION A, LINE 2 DR. PATRICK PASCO (BOARD MEMBER), AND DR. CHARLES PRUITT (BOARD CHAIRMAN) ARE BUSINESS PARTNERS IN MEDICAL SURGICAL, PLLC. FORM 990, PART VI, SECTION A, LINE 2 DR. CHARLES PRUITT (BOARD CHAIRMAN) AND LYNN LAMPHERE (BOARD MEMBER) ARE SIBLINGS. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN WILL BE REVIEWED BY THE ORGANIZATION'S CHIEF EXECUTIVE AND CHIEF FINANCIAL OFFICERS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C PRIOR TO ANY GOVERNING BOARD ASSEMBLY DURING WHICH DECIDING VOTES WILL BE CAST REGARDING NEW FINANCIAL RELATIONSHIPS OR ARRANGEMENTS, THE CEO OF THE ORGANIZATION WILL REVIEW AND CONSIDER EACH MEMBER OF THE VOTING ASSEMBLY FOR ANY POTENTIAL CONFLICT OF INTEREST IN RELATION TO THE TRANSACTION OR ARRANGEMENT IN QUESTION. THE CEO WILL ASK ANY INDIVIDUAL WHOSE RELATIONSHIP MAY PRESENT A CONFLICT OF INTEREST TO ABSTAIN FROM CASTING A VOTE. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS OR THE COMPENSATION COMMITTEE APPROVES THE COMPENSATION OF THE ORGANIZATION'S CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS AT THE ADMINISTRATION OFFICES OF THE ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -15,684. AUDIT COMMITTEE FORM 990, PART XI, LINE 2C THE ORGANIZATION DOES HAVE AN AUDIT COMMITTEE AND THE PROCESS FOR SELECTING AND OVERSEEING THE INDEPENDENT AUDITORS HAS NOT CHANGED FROM PRIOR YEAR. SERVING ON THIS COMMITTEE ARE: ALTHEA CRUMPTON, MELISSA BRUNTLETT, AND DR. CHARLES PRUITT,III,MD. MAGEE BENEVOLENT FOUNDATION DBA HEALTHTRUST 300 THIRD AVENUE SE MAGEE MS 39111 270031018 SUPPORT MAGEE GENERAL HOSPITAL MS 501(C)(3) 509(A)(2) MAGEE BENEVOLENT ASSOCIATION DBA MAGEE GENERAL HOSPITAL 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 MAGEE BENEVOLENT FOUNDATION DBA HEALTHTRUST C 123085 CASH MAGEE BENEVOLENT FOUNDATION DBA HEALTHTRUST C 16943 FAIR MARKET VALUE MAGEE BENEVOLENT FOUNDATION DBA HEALTHTRUST P 77753 CASH