2024-12-16T11:40:48+00:00 2024-01-31 440160260 Forvis Mazars LLP PO Box 3667 Little Rock AR 722033667 990 2023-02-01 710623643 MAINLINE HEALTH SYSTEMS INC MAIN 8705385414 PO BOX 509 DERMOTT AR 71638 GARY ALLAN NICHOLS CEO 8705385414 2024-12-16 true true Amber Sherrill P00748683 5013721040 2023-12-06 2023 2024-10-15 13:58:12Z GARY ALLAN NICHOLS PO BOX 509 DERMOTT AR 71638 42645863 false X https://www.mainlinehealth.net X 1986 AR TO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE. 13 13 328 13 0 0 8308017 7543343 26998192 34930897 490 -5856 1343 111779 35308042 42580163 15372 15000 0 20176402 24937205 0 0 12816990 17831705 33008764 42783910 2299278 -203747 33839417 33841173 10120990 9876324 23718427 23964849 TO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE. SERVICES INCLUDE MEDICAL, DENTAL, MENTAL HEALTH AND PREVENTIVE HEALTH SERVICES FOR THE ENTIRE FAMILY. false false 33392811 15000 34930897 PROVIDED MEDICAL SERVICES TO 23,917 PATIENTS, DENTAL SERVICES TO 4,599 PATIENTS, AND BEHAVIORAL HEALTH SERVICES TO 1,352 PATIENTS IN SOUTHEAST ARKANSAS; SERVED RESIDENTS OF CHICOT, BRADLEY, ASHLEY, DREW, LINCOLN, GRANT, CLEVELAND & PULASKI COUNTIES. 33392811 true true false false false false false false false true false false true true false true false false false false false false false false false false true false true false false false false false false false false true false false false false false false false false true 58 0 true 328 true false false false false false false false false false false false false X 13 13 false false false false false false false true true false false true true true true true true true true false X MAINLINE HEALTH SYSTEMS INC 8705385414 108 E SPEEDWAY DERMOTT AR 71638 ALICIA WHITAKER BOARD CHAIR 1.0 0.0 X X 0 0 0 BECKY PHILLIPS TREASURER 1.0 0.0 X X 0 0 0 FRANK HENTRY JR SECRETARY 1.0 0.0 X X 0 0 0 RON MILLER BOARD VICE CHAIR 1.0 0.0 X X 0 0 0 BRANDI POOLE BOARD MEMBER 1.0 0.0 X 0 0 0 EUGENE BUTLER BOARD MEMBER 1.0 0.0 X 0 0 0 IRMA BERNAL BOARD MEMBER 1.0 0.0 X 0 0 0 KEITH SHEPHERD BOARD MEMBER 1.0 0.0 X 0 0 0 LESLIE ADAMS BOARD MEMBER 1.0 0.0 X 0 0 0 MARY HOLLINS-SCOTT RN BOARD MEMBER 1.0 0.0 X 0 0 0 MICHELLE DUNBAR BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT THOMAS BOARD MEMER 1.0 0.0 X 0 0 0 SHANNA KNOWLES BOARD MEMBER 1.0 0.0 X 0 0 0 AMANDA GILBERT CPO 40.0 0.0 X 127348 0 12889 ASHLEY ANTHONY COO 40.0 0.0 X 144042 0 7708 BYRON MONTGOMERY CIO 40.0 0.0 X 147523 0 13890 GARY ALLAN NICHOLS CEO 40.0 0.0 X 307840 0 20565 JENI BARHAM CQO & CCO 40.0 0.0 X 121894 0 11555 TAFTA MCCAIN CFO - THROUGH 1/21/24 40.0 0.0 X 154169 0 14116 BLAYNE BEENE DO MEDICAL DOCTOR 40.0 0.0 X 253291 0 16617 CONSTANCE CHAPMAN MD MEDICAL DOCTOR 40.0 0.0 X 341430 0 7708 KELLY SHRUM MD MEDICAL DOCTOR 40.0 0.0 X 321935 0 20742 KERRY PENNINGTON MD MEDICAL DOCTOR 40.0 0.0 X 391926 0 16054 PAUL WHIPPLE MD MEDICAL DOCTOR 40.0 0.0 X 295566 0 18200 2606964 0 160044 39 false true false CPI 340B LLC PO BOX 7 MAMMOTH SPRING AR 72554 340B Pharmacy Consultant 240428 FORVIS MAZARS LLP 111 Center St 1600 Little Rock AR 72201 ACCOUNTING 206699 REAL RADIOLOGY 17310 Wright St Omaha NE 68130 RADIOLOGY SERVICES 190316 PHILLIPS MANAGEMENT 148 QUAIL RUN MONTICELLO AR 71655 JANITORIAL SERVICES 153514 CHARLES ALAN MELDERS ELECTRIC LLC 139 WILSON LANE MONTICELLO AR 71655 ELECTRICAL SERVICES CONTRACTOR 141772 7 6752864 790479 351928 7543343 PATIENT REVENUE 621110 19246253 19246253 340B REVENUE 621110 14675396 14675396 SHARED SAVINGS REVENUE 621110 1009248 1009248 0 0 0 0 34930897 270 270 0 0 59574 65700 0 -6126 -6126 -6126 INSURANCE PROCEEDS 900999 84513 84513 27266 0 0 27266 111779 42580163 34930897 0 105923 15000 15000 1090180 1090180 19038577 13905788 5132789 368383 269067 99316 2987064 2181753 805311 1453001 1061273 391728 16177 11816 4361 191353 139764 51589 2615385 1910279 705106 0 74463 54388 20075 628800 459276 169524 795861 581297 214564 278089 203116 74973 330797 241614 89183 653182 477085 176097 192055 140277 51778 340B EXPENSES 7724126 7724126 MEDICAL SUPPLIES 3164779 3164779 REPAIRS & MAINTENANCE 288006 210360 77646 EQUIPMENT EXPENSE 142151 103827 38324 736481 537926 198555 0 42783910 33392811 9391099 0 3982571 2157857 4894438 0 7354833 7528076 0 0 0 0 700595 559272 313390 434401 18504450 5865270 12388032 12639180 1005993 5291805 0 0 1004219 570109 506764 2629456 3719599 33839417 33841173 2477434 2129789 0 0 7417474 7641010 226082 105525 10120990 9876324 X 23718427 23964849 23718427 23964849 33839417 33841173 -203747 395593 54576 0 X false true X true true true X 5276625 10053958 6629500 8308017 7543343 37811443 0 0 5276625 10053958 6629500 8308017 7543343 37811443 1068498 36742945 1222 1080 534 259 270 3365 0 2750712 210504 0 1343 111779 3074338 40889146 108315246 0.8986 0.8576 X Schedule A, Part II, Line 10 Other Income DESCRIPTION - OTHER INCOME, COLUMN A - 12619.0, COLUMN B - 210504.0, COLUMN C - 0.0, COLUMN D - 1343.0, COLUMN E - 27266.0, COLUMN F - 251732.0; DESCRIPTION - 340B REVENUE, COLUMN A - 2738093.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 2738093.0; DESCRIPTION - INSURANCE PROCEEDS, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 84513.0, COLUMN F - 84513.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 914746 914746 13649811 3284090 10365721 3491889 2581180 910709 448004 448004 12639180 FQHC COST REPORT RECEIVABLE 3610090 ROU ASSET 109509 3719599 LEASE LIABILITY 105525 105525 43036458 395593 54576 6126 456295 42580163 0 0 42580163 42790036 6126 6126 42783910 0 0 42783910 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. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 LOSS ON DISPOSAL - 6126 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 LOSS ON DISPOSAL - 6126 true CHICOT MEMORIAL MEDICAL CENTER 2729 HWY 65 82 SOUTH LAKE VILLAGE AR 71653 383807713 501 (C) (3) 15000 0 N/A N/A Wellness Center 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. WE MAKE CONTRIBUTIONS TO LOCAL SCHOOLS AND OTHER LOCAL ORGANIZATIONS. THESE ARE APPROVED BY THE MARKETING MANAGER BASED ON HER BUDGET. X X X false false false false false false false true false TAFTA MCCAIN CFO - THROUGH 1/21/24 135716 0 13001 0 5452 0 6408 0 7708 0 168285 0 0 0 BYRON MONTGOMERY CIO 131756 0 15767 0 0 0 6182 0 7708 0 161413 0 0 0 ASHLEY ANTHONY COO 124497 0 14160 0 5385 0 0 0 7708 0 151750 0 0 0 GARY ALLAN NICHOLS CEO 206916 0 97320 0 3604 0 12857 0 7708 0 328405 0 0 0 KERRY PENNINGTON MD MEDICAL DOCTOR 298319 0 82089 0 11518 0 8346 0 7708 0 407980 0 0 0 PAUL WHIPPLE MD MEDICAL DOCTOR 256778 0 31433 0 7355 0 10492 0 7708 0 313766 0 0 0 BLAYNE BEENE DO MEDICAL DOCTOR 248741 0 4550 0 0 0 8909 0 7708 0 269908 0 0 0 KELLY SHRUM MD MEDICAL DOCTOR 250006 0 71929 0 0 0 13034 0 7708 0 342677 0 0 0 CONSTANCE CHAPMAN MD MEDICAL DOCTOR 336630 0 4800 0 0 0 0 0 7708 0 349138 0 0 0 Schedule J, Part I, Line 7 Non-fixed payments INCENTIVE PAY IS OFFERED FOR PROVIDERS AND CLINICAL STAFF WHO MEET VARIOUS PRODUCTIVITY GOALS AND FINANCIAL AND QUALITY MEASURES ON A QUARTERLY BASIS. CLINICAL STAFF: LEVEL 1 = $200 LEVEL 2 = $400 LEVEL 3 = $600 LEVEL 4 = $800 INCENTIVE PAY WAS OFFERED TO THE CEO BASED ON LEVEL OF PCMH REACHED, PATIENT GROWTH, AND BOARD EVALUATION. INCENTIVE PAY WAS OFFERED TO THE MEDICAL DIRECTOR BASED ON LEVEL OF PCMH REACHED, PATIENT GROWTH, PATIENT SATISFACTION, AND QUALITY PERFORMANCE. INCENTIVE PAY WAS OFFERED TO THE CFO BASED ON LEVEL OF PCMH REACHED, LEVEL OF PROFIT, AUDIT PERFORMANCE, AND EVALUATION BY THE CEO. PROVIDER BONUSES ARE BASED ON THE NUMBER OF ENCOUNTERS OVER THE MINIMUM REQUIREMENT AND AVERAGE QUALITY METRICS FOR THE QUARTER. X 1 351928 Market value 0 false false false Schedule M, Part I Explanations of reporting method for number of contributions Drugs and medical supplies - COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS MADE. Form 990, Part VI, Line 11b Review of form 990 by governing body CFO REVIEWS FORM 990 AND PRESENTS IT TO THE BOARD FOR REVIEW PRIOR TO FILING. Form 990, Part VI, Line 12c Conflict of interest policy MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES THE APPROPRIATE ACTION AS NEEDED/NECESSARY. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue ACH SETTLEMENT - Total Revenue: 12, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 12; MID DELTA - Total Revenue: 12900, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 12900; WINTHROP - Total Revenue: 5300, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 5300; CHASE CASHBACK - Total Revenue: 6159, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 6159; ALEDADE PAYMENT CORRECTION - Total Revenue: 2895, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 2895; FORM 990, PART VI, LINE 15A & 15B COMPENSATION COMMITTEE BASES CEO'S COMPENSATION ON THE NUMBER OF SITES SERVED. THE COMMITTEE COMPARES TO OTHER SYSTEMS IN THE STATE WITH REGARD TO THE NUMBER OF SITES SERVED TO DETERMINE COMPENSATION. COMPENSATION COMMITTEE PRESENTS PROPOSED COMPENSATION TO THE BOARD FOR APPROVAL. THERE IS A WRITTEN EMPLOYMENT CONTRACT WHICH PROVIDES FOR AN INCREASE IN PAY AFTER 90 DAYS OF EMPLOYMENT. THE CEO DETERMINES THE C-SUITE'S SALARY. A COMPENSATION REVIEW IS COMPLETED EVERY AUGUST/SEPTEMBER.