2011-03-09T19:05:18-05:00 2010-07-31 BKD LLP 190 E Capitol Street Suite 500 Jackson MS 392012190 990 2009-08-01 721379812 Prentiss Regional Hospital and Extended Care Facility Inc PREN 6017924276 Post Office Box 1288 Prentiss MS 394741288 Lee McCall 2011-03-15 Penny Wood CPA 6019486700 2009 2016-02-24 21:20:13Z Jefferson Davis Community Hospital Lee McCall 1102 Rose Street Prentiss MS 39474 13199680 false X www.jdchnet.org X 1997 MS Prentiss Regional Hospital & Extended Care Facility, Inc. D/B/A Jefferson Davis Community Hospital, (The Hospital) is an acute care hospital located in Prentiss, MS. 7 6 277 0 0 0 25000 21630 14738568 12762497 462 -57596 452814 289461 15216844 13015992 0 0 0 0 6681257 5889506 0 0 0 8476718 7846610 15157975 13736116 58869 -720124 6100495 5160132 3822915 3602676 2277580 1557456 Prentiss Regional Hospital & Extended Care Facility, Inc. D/B/A Jefferson Davis Community Hospital, (the Hospital) located in Prentiss, MS is a not-for-profit acute care hospital that provides inpatient, outpatient, and emergency care services primarily for local residents and residents of the surrounding area. The Hospital is licensed for 25 acute care beds, 10 geriatric psychiatric unit beds, and 60 nursing home beds. The Hospital provides medical care without charge or at a reduced charge to patients who meet certain criteria under its charity care policy. false false 9422692 12815935 Inpatient, outpatient, and emergency care services The hospital provides medical care without charge or at a reduced charge to patients who meet certain criteria under its charity care policy. The amount of charges foregone for services and supplies furnished under the Hospital's charity care policy aggregated $82,634 during fiscal year 2010. Charges foregone are netted against patient service revenue to arrive at net patient service revenue and are not reported as functional expenses on the tax return. 2311270 The Hospital grants credit without collateral to its patients. Charges deemed uncollectible during fiscal year 2010 were approximately $2,311,270. 11733962 true true false false false false false false false true true false false false false false false false false false true false false true false false false false false false false false false false false false false false false false false true 12 0 true 277 true false false false false false false false false false 7 6 false false false false false false false true true false false false true true true true true true true false X PAUL BLACK 6017921136 1102 ROSE STREET Prentiss MS 39474 Jack Berry 1.0 X 11189 0 0 Keith Bridges 1.0 X 1200 0 0 Kathy Cloyd 1.0 X 1200 0 0 Willis Graves 1.0 X 1315 0 0 Lola Bass 1.0 X 1315 0 0 Ralph Fortenberry 1.0 X 1284 0 0 Reggie Magee 1.0 X 1277 0 0 Lee McCall 40.0 X 87716 0 12113 Paul Black 40.0 X 34200 0 0 Mary Curtis 40.0 X 69800 0 0 Earl Mahaffey MD 40.0 X 165392 0 6962 Joe Taylor 48.0 X 160012 0 6338 Roy Evans MD 40.0 X 145208 0 5462 681108 0 30875 3 false true true Correct Care 17438 Hard Hat Drive COVINGTON LA 70435 ER Physician 435188 Healthcare Services Group Inc 3220 Tillman Drive BENSALEM PA 19020 Housekeeping 279553 Physical Rehab Management Inc 1106 Pointe Cove BRANDON MS 39042 Physical Therapy 223636 The Summit Health Rehab Services I PO Box 2377 MCCOMB MS 39649 Physical Therapy 166097 GAR Management 1590 Cooper Road PEARL MS 39208 GPU Management 120000 5 21630 21630 Patient Service Revenue 900099 12706970 12706970 RELATED RENTAL INCOME 900099 55527 55527 12762497 5 5 0 0 126087 183688 -57601 -57601 -57601 0 0 0 Miscellaneous Revenue 900099 60535 60535 Cafeteria Revenue 722210 53438 53438 Wellness Center Revenue 713940 65599 65599 109889 109889 289461 13015992 12815935 0 178427 0 0 0 0 99828 99828 0 4919261 4373623 545638 50444 44063 6381 436833 392157 44676 383140 334675 48465 0 16999 16999 80685 80685 0 0 0 2352729 2125834 226895 7855 7855 1564801 1296248 268553 39905 3175 36730 0 209738 209738 24908 11153 13755 0 3873 3223 650 195992 195992 0 357508 357508 262374 262374 Bad Debt Expense 2311270 2311270 Taxes and Licenses 404015 74146 329869 Repairs and Maintenance 651 651 Dues and Subscriptions 13307 506 12801 13736116 11733962 2002154 0 107527 138192 17160 46000 2012053 1417834 118349 108896 78081 30119 7446450 4717682 3186891 2728768 580434 690323 6100495 5160132 1633821 1533429 1303234 1144979 885860 924268 3822915 3602676 X 2277580 1557456 2277580 1557456 6100495 5160132 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 97900 97900 3454482 1411800 2042682 38629 34019 4610 3707635 3130580 577055 147804 141283 6521 2728768 INVESTMENT IN HPIC 690323 C 690323 0 Third-Party Payor Settlements 924268 924268 13015992 13736116 -720124 -720124 13073593 13073593 -57601 -57601 13015992 13793717 57601 57601 13736116 13736116 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 uncertain tax positions to be recorded or disclosed in the financial statements. Schedule D, Part XII, Line 4b: Loss on sale of assets reported as expense on the financial statements but included as revenue on the Form 990 Schedule D, Part XIII, Line 2d: Losses on sale of assets reported as expenses on the financial statements but included as revenue on the Form 990 true true X false true X true false false 47170 47170 0.00410 3326266 807464 2518802 0.21940 3373436 807464 2565972 0.22350 3373436 807464 2565972 0.22350 false 1331523 0 4813646 4813646 X true false Rural Health Management Services 0.50000 Curtis Management Management Services 0.50000 GAR Management Management Services 1.00000 Prentiss Regional Hospital & ECF

1102 Rose Street Prentiss MS 39474

X X X The costing methodology used to calculate the amounts in Part I, Line 7 is a ratio of patient care cost to charges and includes all patient segments. Worksheets 1, 2, and 3 were used to determine the amounts reported in Part I, Line 7a and b. Bad debt expense of $2,311,270 was included in total expense on Form 990, Part IX, Line 25, Column (a), but was subtracted from total expense for purposes of calculating the percentage of total expense in Column (f). The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific cirmcumstances of the account. The Hospital offers a charity assistance application to patients upon admission. Accounts of patients who choose not to apply for charity care but who are unable to pay their medical bills are ultimately written off as bad debt based on the Hospital's bad debt policy. This policy does not include provisions for those patients who are known to qualify for charity care but do not apply for the assistance. The Hospital is unable to quantify the amount of bad debt that is related to patients who would qualify for charity care if applied for, but consider a majority of bad debt to consist of these accounts. The costing methodology used to report the organization's bad debt expense at cost is a ratio of patient care cost to charges using Worksheet 2 of the instructions. The Hospital uses its medicare cost report to determine the amount reported on Schedule H, Part III, Line 6. All health care facilities operated by the hospital are reported in Schedule H, Part V. The organization does not operate facilities that are not required to be licensed, registered or similarly recognized as a health care facility under state law. The Hospital assesses the needs of the community it serves by engaging in community programs, conducting and participating in community meetings, through dialogue with constituents, and by receiving feedback through evaluations of its services. Patients are informed about their eligibility for government and charity care assistance during the registration process. The Hospital serves Jefferson Davis County, a rural area located in south central Mississippi with a population of approximately 12,000 and median household income of approximatley $27,000. The Hospital educates and informs community members of various programs and services which increases community accessibility and involvement in healthcare programs offered by the Hospital. A majority of the organization's governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization, nor family members thereof. X X X false false false false false false false false false Paul Black 34200 0 0 0 0 0 0 0 0 0 34200 0 Mary Curtis 69800 0 0 0 0 0 0 0 0 0 69800 0 Earl Mahaffey MD 165392 0 0 0 0 0 3120 0 3842 0 172354 0 Joe Taylor 160012 0 0 0 0 0 2496 0 3842 0 166350 0 Roy Evans MD 145208 0 0 0 0 0 1620 0 3842 0 150670 0 Schedule J, Part II: Paul Black, CFO, was paid approximately $34,200 by Rural Health Management, Inc., an unrelated organization, for services to the Hospital. Mary Curtis, Compliance Officer, was paid $69,800 by Curtis Management, Inc., an unrelated organization, for services rendered to the Hospital. Form 990, Page 6, Part VI, Section B, Line 11A: The Form 990 is reviewed by the organization's CEO and CFO prior to filing with the IRS. Form 990, Page 6, Part VI, Section B, Line 12: Annual disclosure forms are required to be completed by all board members, officers, and highest compensated employees. The questionnaires are reviewed by the organization's CEO and any persons with conflicts of interest are prohibited from participating in the board's deliberations and decisions in the transaction in which the conflict exists. Form 990, Page 6, Part VI, Section B, Line 15: Compensation of top management officials and other officers of the organization is determined by the board of directors based on comparability data received from salary surveys conducted by the Mississippi Hospital Association. Form 990, Page 6, Part VI, Section C, Line 19: The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.