2011-08-11T10:34:04-05:00 2010-09-30 BKD LLP 190 E Capitol Street Suite 500 Jackson MS 392012190 990 2009-10-01 640668465 Clay County Medical Corporation CLAY 6623773977 830 South Gloster Street Tupelo MS 38801 Joe Reppert 2011-08-15 Penny Wood CPA 6019486700 2009 2016-02-24 21:20:13Z Joe Reppert 830 Gloster Street Tupelo MS 38801 34535312 false X www.nmhs.net/westpoint/ X 1982 DE Clay County Medical Corporation operates a 60 bed acute-care hospital and related outpatient care facilities in West Point, Mississippi. 12 11 340 30 0 0 281311 304761 29246222 27506336 312989 231194 531188 507772 30371710 28550063 0 0 0 0 17319861 16521736 0 0 0 12449114 13432670 29768975 29954406 602735 -1404343 24451529 23461059 12041519 13127936 12410010 10333123 CLAY COUNTY MEDICAL CORPORATION OWNS AND OPERATES A 60 BED ACUTE-CARE HOSPITAL AND RELATED OUTPATIENT CARE FACILITIES IN WEST POINT, MISSISSIPPI CALLED NORTH MISSISSIPPI MEDICAL CENTER-WEST POINT (NMMC-WEST POINT). NMMC-WEST POINT IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ORGANIZATION. THE MISSION OF NMHS IS TO CONTINUOUSLY IMPROVE THE HEALTH OF THE PEOPLE OF OUR REGION. NMMC-WEST POINT WORKS TO ACHIEVE THIS CORPORATE MISSION TO IMPROVE THE HEALTH OF THE PEOPLE OF THIS REGION BY PROVIDING CONVENIENTLY ACCESSIBLE, COST-EFFECTIVE HEALTH CARE OF THE HIGHEST QUALITY. false false 27613177 27616670 NMMC-West Point serves Clay County and the surrounding area. In fiscal year 2010, there were over 2,500 inpatient admissions, over 16,100 emergency department visits, and over 28,400 outpatient visits. NMMC-West Point uses Press Ganey, the largest patient satisfaction survey company in the nation, that works with more than 7,000 healthcare facilities. Randomly selected patients are asked about their experience with inpatient, outpatient, ER, and long term care services. NMMC-West Point's remarkable design was inspired by the history and culture of this charming Southern community. Medical-surgical patient rooms are entered from a foyer area and open onto a private terrace. Rooms are "nested," which means four to six rooms are clustered around each nursing unit. This design reduces walking distance, allows nurses to view several patients from a central point, and provides closer access to medical equipment. Surgeons utilize four operating suites for a wide array of cases, including general, orthopedic and obstetrics-gynecology. The Same Day Surgery Unit features six rooms for outpatient surgery patients to rest before and after their procedure, as well as two endoscopy suites. The six-bed Intensive Care Unit offers invasive and non-invasive monitoring for medical and surgical patients. The hospital also has 10 licensed swing beds for patients who need extended care. The Women's Pavilion provides family-centered maternity services in a homelike environment. Mothers labor, deliver and recover in the same comfortable room. The nursery is equipped to care for healthy newborns as well as provide immediate stabilization of infants requiring intensive care. NMMC-West Point offers 24-hour emergency services at the Level III Trauma Center, as well as a paramedic-level ambulance service. Outpatient services include cardiac and pulmonary rehabilitation programs, as well as physical, occupational and speech-language therapy. Cardiac stress tests and holter monitoring are also offered. One of the primary ways NMMC-West Point serves the community is by providing care to various populations for which it receives no compensation or receives compensation at rates significantly less than established rates. The board of directors of NMMC-West Point has established a policy under which the hospital provides care, without charge, to needy members of its community. The charity care policy states that NMMC-West Point will provide necessary hospital services to patients free of charge with household income levels based on the median income for Mississippi compared to the median income nationally. The Mississippi Adjusted Poverty Guidelines is approximately 75% of the federal poverty rate. The policy further provides patients with household income levels above the Mississippi Adjusted Poverty Guidelines will be liable for no more than the amount that their household income exceeds the applicable federal poverty guidelines. The policy applies to individuals who reside in Clay County. Patients from outside the county may also be granted charity care based on the judgment of NMMC-West Point management depending on their individual circumstances. The policy also requires the patient to cooperate fully with NMMC-West Point's request for information with which to verify the patient's eligibility. Following that policy, the hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. Charges forgone, based on established rates, totaled approximately $2,689,000 in fiscal year 2010. Based on the gross charges provided to charity patients compared to total hospital gross charges, 4% of all services in fiscal year 2010 were provided on a charity basis. The net cost of charity care provided by NMMC-West Point was approximately $1,165,000 in fiscal year 2010. The total cost estimate is based on the ratio of costs to charges for NMMC-West Point. All of the foregone charges mentioned above are netted against patient service revenue to arrive at net patient service revenue as reflected as program service revenue on Part VIII of Form 990 in order to be consistent with financial statement reporting and are not reported as functional expenses on the tax return. 27613177 true true false false false false false false false true true false false false false false false false false false true false false true true true false false false false false false false false false false false false false false true false false false true 9 0 true 340 true false false false false false false false false false 12 11 false false false false true true true true true false false false true true true true true true true false X JOE REPPERT 6623773977 830 GLOSTER STREET Tupelo MS 38801 Charlotte Magnussen MD 1.0 X 0 381011 0 Sheila Carter 1.0 X 0 0 0 Gene Childress 1.0 X 0 0 0 Glenda Colbert 1.0 X 0 0 0 Edgar Harris 1.0 X 0 0 0 LaDonna Helveston 1.0 X 0 0 0 Phyllis Mason MD 1.0 X 0 0 0 George Purnell 1.0 X 0 0 0 Rod Bobo 1.0 X 0 0 0 Eluster Wicks 1.0 X 0 0 0 Doug Wood 1.0 X 0 0 0 C Carey Upton 1.0 X 0 0 0 Gerald Wages 1.0 X 0 848369 8020 Bruce Toppin 1.0 X 0 298009 8020 Joe Reppert 1.0 X 0 452988 2860 Edward Riley 40.0 X 322804 0 8370 Christopher L Behr 40.0 X 294265 0 8020 Stanko Vuk 40.0 X 263021 0 9072 Carlie B Godwin 40.0 X 233769 0 6351 Amanda Coan 40.0 X 204354 0 4038 Robert Jones 1.0 X 0 223281 6430 1318213 2203658 61181 13 true true false Medicomp PO Box 426 MAGEE MS 39111 Phys. Therapy Serv. 597726 Keystone 3150 Lenox Park Blvd Ste 109 MEMPHIS TN 38115 ER Physician Fees 325729 Thomas Vinson MD 121 Montley Road COLUMBUS MS 39701 Physician Fees 278812 Alliance Healthcare PO Box 96485 CHICAGO IL 60693 Contract MRI Serv. 262798 Cardinal Health PO Box 905488 CHARLOTTE NC 282905488 Radiology Services 136600 5 34306 260000 10455 304761 Net Patient Service Revenue 900099 27225538 27225538 Net Related Rental Income 900099 280798 280798 27506336 161958 161958 0 0 6034485 20000 5985249 0 49236 20000 69236 69236 0 0 0 Employee Drug Sales 900099 360827 360827 Cafeteria Revenue 900099 110334 110334 Miscellaneous Revenue 900099 11230 11230 25381 25381 507772 28550063 27616670 0 628632 0 0 0 0 0 0 12051335 10956505 1094830 605313 605313 3019548 3019548 845540 727723 117817 626041 626041 18471 18471 41605 41605 0 0 11801 11801 2460916 2451630 9286 28121 28121 2936676 2936676 295592 295592 0 653052 653052 57131 57131 0 30324 30324 114517 114517 0 1269295 1269295 433179 433179 Bad Debt Expense 3944713 3944713 Repairs and Maintenance 140322 140322 Collection Fees 134978 134978 Dues and Subscriptions 89342 89342 Recruitment Expense 83971 83971 62623 62623 29954406 27613177 2341229 0 1665 1852 458081 193656 5927858 6003309 518863 481460 29260 0 30867823 21800222 9447622 9067601 7474141 7014080 594039 699101 24451529 23461059 3941727 4894713 7684787 7132493 415005 1100730 12041519 13127936 X 12333690 10256049 76320 77074 12410010 10333123 24451529 23461059 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 398036 398036 11441016 6646864 4794152 16811041 13448337 3362704 2217730 1705021 512708 9067600 0 DUE TO AFFILIATES 895077 FAIR VALUE OF INT RATE SWAP 205653 1100730 28550063 29954406 -1404343 124165 -796709 -672544 -2076887 28725348 124165 124165 28601183 -51120 -51120 28550063 30005526 51120 51120 29954406 29954406 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 XI, Line 8: Pension-related changes other than net periodic pension cost <$797,463> Increase in interest in net assets of affiliated foundation $754 Schedule D, Part XII, Line 2d: Rental expense is netted with rental income on the return but included in expense on the financial statements. Schedule D, Part XIII, Line 4b: Rental expense is netted with rental income on the return but included in expense on the financial statements. true true X true X 75. false false true true false true true 1111879 1111879 0.04270 6703877 6295016 408862 0.01570 7815756 6295016 1520741 0.05840 7815756 6295016 1520741 0.05840 false 1631325 0 7036148 7480947 -444799 X true true Clay County Medical Corporation

835 Medical Center Drive West Point MS 39773

X West Point Wellness Center

851 Medical Center Drive West Point MS 39773

Wellness Center Clay County Medical Corporation does not use the Federal Poverty Guidelines to determine eligibility for discounted care. The Federal Poverty Guidelines are used only for free care. Discounted care is given to anyone regardless of income level if they do not have insurance. Clay County Medical Corporation will provide its prevalent managed care discount to any patient that meets Clay County Medical Corporation's definition of uninsured (an individual having no third party coverage by commercial third party insurer, an ERISA plan, Medicare, Medicaid, SCHIP, Champus or other coverage for all or part of their bill). Clay County Medical Corporation's community benefit information is included in the community benefit report of its parent company, North Mississippi Health Services, Inc. North Mississippi Health Services (NMHS) is a diversified regional health care organization, which serves 24 counties in north Mississippi and northwest Alabama from headquarters in Tupelo, MS. The NMHS organization covers a broad range of acute diagnostic and therapeutic services, offered through North Mississippi Medical Center in Tupelo; a community hospital system with locations in Eupora, Iuka, Pontotoc, West Point, MS, and Hamilton AL; North Mississippi Medical Clinics, a regional network of more than 30 primary and specialty clinics; and nursing homes. NMHS offers a comprehensive portfolio of managed care plans. A cost to charge ratio was used for the amounts reported in the table for Line 7. The cost to charge ratio for Line 7 was calculated using Worksheet 2. Not Applicable Bad Debt Expense of $3,944,713 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). Clay County Medical Corporation's financial statements do not include a footnote specifically concerning bad debt. Bad debt is shown as a separate line item on the face of the income statement. The amount of bad debt booked each year is based on a review of outstanding receivables and their age from date of service. The older the account, the higher the reserve percentage used to estimate bad debt. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluations and specific circumstances of the account. The bad debt expense at cost in Part III Line 2 was calculated using the cost to charge ratio from Worksheet 2. Clay County Medical Corporation (CCMC) follows the Catholic Health Association guidelines and does not include bad debt in any community benefit amounts. CCMC, however, believes that some portion of bad debt results from patients who could qualify for charity care but has no way of making an estimate of the amount and therefore has answered "zero" for Part III Line 3. The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. Lines 5, 6, & 7 do not include certain Medicare programs and costs and thus do not reflect all of the organization's revenues and costs associated with its participation in Medicare programs. Additional revenues and costs not reported on Lines 5, 6, & 7 include those associated with the organization's Medicare outpatient lab, ambulance and therapy services. Total revenues from these activities were $863,858 and total costs were $1,355,377 for a net shortfall of $491,519. When combined with the shortfall reported on Line 7, the net shortfall from all Medicare programs is $936,318. Clay County Medical Corporation does not pursue collection of amounts determined to qualify as charity care. Clay County Medical Corporation utilizes varied but complimentary methods to assess the health care needs of the community it serves. Clay County Medical Corporation and Clay County are included in the North Mississippi Health Services Community Health Assessment which is performed every three years and provides information on health status, utilization of health services, healthy beliefs and satisfaction with health care services. The North Mississippi Health Services Community Health Assessment covers the 24 county service area including Clay County and provides information by county. In addition, the North Mississippi Health Services Community Relations Facilitator conducts routine visits with our internal and external stakeholders across the entire service area including Clay County. The information gathered through several qualitative survey questions is used to determine our community's needs for the entire service area as well as the local service area for each hospital such as Clay County Medical Corporation. Explanations of the Clay County Medical Corporation charity care policy are communicated in a variety of forms including signage at all admission and registration areas, on the web site, on bills and statements, and in admission packets. Financial counselors assist the patient and responsible parties with determining eligibility for government programs, primarily Medicaid, and charity care status. The patient can apply for charity care at any time from the date of service through the collection process and once qualified and approved all collection efforts are stopped. Clay County Medical Corporation serves more than 20,000 people in Clay County, MS and the surrounding area. The population for the service area is projected to remain essentially flat over the next five years. Age demographics for the service area show that approximately 26% of the population is under 18 years of age, approximately 60% is between 18 and 64 years of age and that 14% is 65 or older. Caucasians make up 41% of the service area's population while African Americans make up 57% and Hispanics and other make up 2%. Median household income of $33,205 for the service area is below the overall average for Mississippi and significantly less than the nationwide average. The patient population for Clay County Medical Corporation is covered by insurance or is uninsured as follows: 34.85% Medicare, 26.74% Medicaid, and 27.69% private insurance with 10.72% being uninsured. Not Applicable How the organization's hospitals further its exempt purpose by promoting the health of the community: Clay County Medical Corporation has a commitment to a wide variety of community health outreach activities, which are coordinated by the community health coordinator and are staffed by Clay County Medical Corporation employees who volunteer their time to help with these events and activities. The community health coordinator assists in educating the community on health-related issues by organizing and presenting various health fairs and seminars. These events are held at local businesses, schools and community organizations and address a variety of health-related topics. In addition, the hospital sponsors cholesterol, blood pressure, vision, memory, and heart-risk screening events, through which tests are made available to the public for a nominal fee or at no charge with the majority of the costs incurred absorbed by the hospital. As noted above, Clay County Medical Corporation (CCMC) is part of North Mississippi Health Services (NMHS). NMHS operates North Mississippi Medical Center, four other community hospitals in addition to CCMC, as well as, North Mississippi Medical Clinics, which operates more than 30 medical clinics. Some of these facilities operate at an ongoing financial loss and NMHS provides operating funds in the form of working capital loans that have no set repayment date. These working capital loans have historically been converted to capital transfers in many cases, and therefore, the loans are forgiven such that the facility never makes repayment. NMHS does this in order to provide access to a variety of services across the service area and is an intentional part of its business model. The Community Health department that is part of NMMC coordinates a variety of community health activities across the service area as well. States Community Benefit Report Filed: Clay County Medical Corporation does not file a community benefit report with the state of Mississippi as there is no requirement to do so. The community benefit report is available online at nmhs.net. X X X X X false true false false false false false false false Charlotte Magnussen MD 0 317570 0 62409 0 1032 0 0 0 0 0 381011 Gerald Wages 0 444917 0 177119 0 226333 0 4900 0 3120 0 856389 Bruce Toppin 0 224620 0 66958 0 6431 0 4900 0 3120 0 306029 Joe Reppert 0 336586 0 96866 0 19536 0 0 0 2860 0 455848 Robert Jones 0 173881 0 47898 0 1502 0 3310 0 3120 0 229711 Edward Riley 309138 0 12082 0 1584 0 4900 0 3470 0 331174 0 Christopher L Behr 282988 0 10725 0 552 0 4900 0 3120 0 302285 0 Stanko Vuk 251893 0 11128 0 0 0 4900 0 4172 0 272093 0 Carlie B Godwin 221670 0 8262 0 3837 0 3231 0 3120 0 240120 0 Amanda Coan 192906 0 7779 0 3669 0 4038 0 0 0 208392 0 Part I, Line 4b: Participants: Gerald Wages $208,380 Joseph A. Reppert $8,461 Terms & Conditions: North Mississippi Health Services, Inc. (NMHS) Adopted the management deferred annuity plan (the Plan) on October 1, 1998. Participants in the plan are designated by the compensation committee of the board of directors of NMHS. At the beginning of each plan year, NMHS shall pay a contribution, less witholding for taxes, to the participant's annuity contract, which is a deferred annuity contract selected, owned, and controlled by the participant. The contribution is determined by multiplying the participant's compensation in the preceding plan year by a percentage set forth in appendix b of the plan. A participant is terminated from the plan on the earliest of: (1) the date the board determines the employee is no longer a participant; (2) the date the participant retires; (3) the date that the participant dies; or (4) the date the participant no longer is employed by NMHS for reasons other than retirement or death. Mississippi Hospital Equip & Facilities Authority 640732320 605360MV5 2003-07-02 6835969 to refund a prior issue false false 6835969 67510 2009 true false true true false false false false true 0.00000 0.00000 0.00000 true false true true Goldman Sachs 12.7 false true false Form 990, Page 6, Part VI, Section A, Line 6: Clay County Medical Corporation is a not-for-profit, nonstock, membership corporation of which North Mississippi Health Services, Inc. is the sole member and has sole voting control. Form 990, Page 6, Part VI, Section A, Line 7a: The Governance Committee of North Mississippi Health Services, Inc. (NMHS), which is made up of past Chairmen, nominate candidates for the Board. These candidates are then approved by the Board of NMHS. Form 990, Page 6, Part VI, Section A, Line 7b: The Board of North Mississippi Health Services, Inc. approves all transactions that exceed $1 million. Form 990, Page 6, Part VI, Section B, Line 11A: The Form 990 goes through a review process in the Accounting Department. The accountant for each facility reviews the returns for reasonableness and accuracy. All totals are tied to the audit reports, and all amounts are cross-referenced to schedules or other parts of the actual return. Once the accountant reviews, the Accounting Supervisor and the Director of Accounting reviews. The Supervisor does a detailed review by checking the return for the same items that the accountant checked for. Then the Director does a more high level review, reading the return for reasonableness and comparing prior year amounts to current year amounts. Finally, the VP of Finance reviews the return for reasonableness. The returns are then sent to the Executive VP/Treasurer to be reviewed. The Treasurer signs the return and it is then sent to the IRS. Form 990, Page 6, Part VI, Section B, Line 12c: An annual conflict of interest questionnaire is required to be completed by all officers and directors of the organization. The questionnaire is reviewed by North Mississippi Health Services, Inc.'s compliance officer and Conflict Committee. The Conflict Committee reviews conflict transactions and makes recommendations to the board of directors regarding conflict transactions in accordance with the organization's conflict of interest policy. All members of the Conflict Committee are prohibited from engaging in transactions with the organization or its affiliates during their tenure on the Conflict Committee and one year after their service concludes. Form 990, Page 6, Part VI, Section B, Line 15 a&b: An independent compensation consulting firm, The Hay Group, is used to help establish the compensation of the CEO, Executive Director, other officers, and key employees. The firm presents their independent analysis, which contains comparability data, to the Compensation Committee of North Mississippi Health Services, Inc. (NMHS). In addition to this, the VP of Human Resources obtains another independent analysis from another compensation consulting firm in order to verify the information provided by The Hay Group. The compensation of the individuals are then approved by the Compensation Committee. The salaries of NMHS' CEO and senior leadership are then reviewed by the NMHS Board of Directors. The individual whose compensation is being discussed is not present during the discussion or approval of their compensation. The discussions and decisions regarding the compensation are documented in the minutes of the meetings. Compensation of these individuals is approved annually. Form 990, Page 6, Part VI, Section C, Line 19: The governing documents, conflict of interest policy, and financial statements are available to the public upon request. A consolidated statement of operations is available on the organization's website. Form 990, Page 7, Part VII, Column (E): Estimate of average hours worked per week devoted to related organization: Gerald Wages 1 hr Tishomingo Health Services, Inc. 1 hr Webster Health Services, Inc. 1 hr Marion Regional Medical Center 1 hr Pontotoc Health Services, Inc. 35 hrs North Mississippi Health Services, Inc. Bruce Toppin 1 hr North Mississippi Medical Clinics, Inc. 1 hr Tupelo Service Finance 1 hr Tishomingo Health Services, Inc. 1 hr Webster Health Services, Inc. 1 hr Marion Regional Medical Center 1 hr Pontotoc Health Services, Inc. 1 hr North Mississippi Medical Center, Inc. 1 hr North Mississippi Emergency Services, Inc. 1 hr North Mississippi Management Services, Inc. 30 hrs North Mississippi Health Services, Inc. Robert Jones 39 hrs Webster Health Services, Inc. Joe Reppert 1 hr North Mississippi Medical Clinics, Inc. 1 hr Tupelo Service Finance 1 hr Tishomingo Health Services, Inc. 1 hr Webster Health Services, Inc. 1 hr Marion Regional Medical Center 1 hr Pontotoc Health Services, Inc. 1 hr North Mississippi Medical Center, Inc. 1 hr North Mississippi Emergency Services, Inc. 1 hr North Mississippi Management Services, Inc. 30 hrs North Mississippi Health Services, Inc. Schedule K, Part I: Clay County Medical Corporation, along with certain North Mississippi Health Service affiliates (collectively known as the obligated group), periodically issue tax exempt revenue bonds under the terms of a related master indenture. Only Clay County Medical Corporation's share is reported in this schedule. Schedule K, Part IV, Line 5: Although funds were invested beyond a temporary period, the yield did not exceed the allowable amount. 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