DELTA MEMORIAL HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DELTA MEMORIAL HOSPITAL (EIN 71-0276839)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202331359349315113
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-15T15:30:11-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3667 | AddressLine1Txt |
| City | LITTLE ROCK | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 722033667 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710276839 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % VICKI ALLEN | InCareOfNm |
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 8703824303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 811 HWY 65 SOUTH | AddressLine1Txt |
| City | DUMAS | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71639 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY JONES | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 8703824303 | PhoneNum |
| Signature | 2023-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIMOTHY | PersonFirstNm |
| Person Last | JONES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 000000000 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER SHERRILL | PreparerPersonNm |
| PTIN | P00748683 | PTIN |
| Phone | 5013721040 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY JONES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 811 HWY 65 SOUTH | AddressLine1Txt |
| City | DUMAS | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,614,739 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DELTAMEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | AR | LegalDomicileStateCd |
| Activity Or Mission | DELTA MEMORIAL HOSPITAL IS COMMITTED TO AID HEALING AND PROMOTE WELLNESS FOR SOUTHEAST ARKANSAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 257 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,869,271 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,567,861 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,434,463 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,897,831 | CYProgramServiceRevenueAmt |
| PY Investment Income | $592,060 | PYInvestmentIncomeAmt |
| CY Investment Income | $26,291 | CYInvestmentIncomeAmt |
| PY Other Revenue | $152,878 | PYOtherRevenueAmt |
| CY Other Revenue | $122,756 | CYOtherRevenueAmt |
| PY Total Revenue | $24,048,672 | PYTotalRevenueAmt |
| CY Total Revenue | $18,614,739 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,578,779 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,966,833 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,014,910 | PYOtherExpensesAmt |
| CY Other Expenses | $8,901,255 | CYOtherExpensesAmt |
| PY Total Expenses | $19,593,689 | PYTotalExpensesAmt |
| CY Total Expenses | $19,868,088 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,454,983 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,253,349 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,360,595 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,185,895 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,489,514 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,479,980 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,871,081 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,705,915 | NetAssetsOrFundBalancesEOYAmt |
| Mission | AT DELTA MEMORIAL HOSPITAL, WE ARE COMMITTED TO PROMOTING HEALING AND WELLNESS FOR THE RESIDENTS OF THE SOUTHEAST REGION IN A COURTEOUS AND COMPASSIONATE MANNER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $15,729,238 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $15,897,831 | RevenueAmt |
| Desc | DELTA MEMORIAL HOSPITAL PROVIDES MEDICAL HEALTH CARE SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $15,729,238 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 257 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICKI ALLEN | PersonNm |
| Phone | 8703824303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 811 HWY 65 SOUTH | AddressLine1Txt |
| City | DUMAS | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| FRANKLIN CHAMBERS | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $986,833 | $0 | $5,321 | ||
| RALPH MAXWELL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $672,012 | $0 | $15,111 | ||
| SARAH FRANKLIN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $519,201 | $0 | $8,408 | ||
| DEREK WHITE | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | Yes (X) | $222,579 | $0 | $7,876 | ||
| TRISHA BLAIR | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | Yes (X) | $153,924 | $0 | $0 | ||
| VICKI ALLEN | ||||||||
| CFO | 40.0 | 0.0 | $110,427 | $0 | $4,452 | Yes (X) | ||
| LEAH OSBAHR | ||||||||
| CEO | 40.0 | 0.0 | $101,172 | $0 | $0 | Yes (X) | ||
| TIMOTHY JONES | ||||||||
| CHAIRMAN | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| SHIRLEY TEETER | ||||||||
| SECRETARY | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JOHN FREEMAN | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| PRICE BONEY JR | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| HEATHER HARRIS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| JOHN WALTERS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| WARREN PARKER | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,766,148 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $41,168 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUALIVIS | |||||
| DEPT 3847 PO BOX 123847 | DALLAS | TX | 75312 | NURSE CONTRACT AGENC | $1,005,004 |
| ZION REVENUE SOLUTIONS | |||||
| 2019A RICHMOND ROAD 363 | TEXARKANA | TX | 75503 | BILLING AGENCY | $425,685 |
| KINDRED HOSPITAL REHAB SVCS | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | THERAPY CONTRACT AGE | $454,873 |
| GRAYCORP LLC | |||||
| 3 ROBINWOOD DR | DUMAS | AR | 71639 | ER PHYSICIAN COVERAG | $390,893 |
| LEWIS NELSON BALLARD III | |||||
| 100 RAVENWOOD PLACE | HOT SPRINGS | AR | 71901 | CRNA | $250,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,764,542 | GovernmentGrantsAmt |
| All Other Contributions | $803,319 | AllOtherContributionsAmt |
| Total Contributions | $2,567,861 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $15,438,881 | $15,438,881 |
| 340B REVENUE | 622110 | $456,550 | $456,550 |
| MEDICAL OFFICE BUILDING RENT | 531120 | $2,400 | $2,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,897,831 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,291 | TotalRevenueColumnAmt |
| Exclusion | $26,291 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEAL REVENUE | 624210 | $48,033 | $48,033 |
| ACO SHARED SAVINGS | 900099 | $22,579 | $22,579 |
| REFUNDS & REIMBURSEMENTS | 900099 | $18,648 | $18,648 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,496 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $33,496 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $122,756 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,614,739 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,897,831 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $149,047 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,906 | TotalAmt |
| Management And General | $268,906 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,646,881 | TotalAmt |
| Program Services | $7,568,003 | ProgramServicesAmt |
| Management And General | $2,078,878 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,422 | TotalAmt |
| Program Services | $16,021 | ProgramServicesAmt |
| Management And General | $4,401 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,577 | TotalAmt |
| Program Services | $311,900 | ProgramServicesAmt |
| Management And General | $85,677 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $633,047 | TotalAmt |
| Program Services | $496,627 | ProgramServicesAmt |
| Management And General | $136,420 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,808 | TotalAmt |
| Program Services | $11,617 | ProgramServicesAmt |
| Management And General | $3,191 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,675 | TotalAmt |
| Program Services | $84,471 | ProgramServicesAmt |
| Management And General | $23,204 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,486,504 | TotalAmt |
| Program Services | $3,519,674 | ProgramServicesAmt |
| Management And General | $966,830 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,693 | TotalAmt |
| Program Services | $2,897 | ProgramServicesAmt |
| Management And General | $796 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,697 | TotalAmt |
| Program Services | $108,024 | ProgramServicesAmt |
| Management And General | $29,673 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,624 | TotalAmt |
| Program Services | $241,332 | ProgramServicesAmt |
| Management And General | $66,292 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,087 | TotalAmt |
| Program Services | $44,785 | ProgramServicesAmt |
| Management And General | $12,302 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,233 | TotalAmt |
| Program Services | $98,246 | ProgramServicesAmt |
| Management And General | $26,987 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,162,355 | TotalAmt |
| Program Services | $911,871 | ProgramServicesAmt |
| Management And General | $250,484 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,862 | TotalAmt |
| Program Services | $469,024 | ProgramServicesAmt |
| Management And General | $128,838 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies Expense | $1,504,565 | $1,504,565 | |
| PROVIDER ASSESSMENT FEES | $136,424 | $136,424 | |
| MINOR EQUIPMENT | $87,422 | $68,583 | $18,839 |
| DUES & SUBSCRIPTIONS | $74,212 | $58,220 | $15,992 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,094 | TotalAmt |
| Program Services | $76,954 | ProgramServicesAmt |
| Management And General | $21,140 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,868,088 | TotalAmt |
| Program Services | $15,729,238 | ProgramServicesAmt |
| Management And General | $4,138,850 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,035,097 | BOYAmt |
| EOY | $2,461,706 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,356 | BOYAmt |
| EOY | $14,356 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,575,470 | BOYAmt |
| EOY | $2,525,228 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $414,164 | BOYAmt |
| EOY | $469,653 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $605,221 | BOYAmt |
| EOY | $580,896 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,298,308 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,165,351 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,106,097 | BOYAmt |
| EOY | $7,132,957 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,610,190 | BOYAmt |
| EOY | $2,001,099 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,360,595 | BOYAmt |
| EOY | $15,185,895 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,106,753 | BOYAmt |
| EOY | $3,047,851 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,406,627 | BOYAmt |
| EOY | $1,047,726 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $418,369 | BOYAmt |
| EOY | $224,219 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,974,916 | BOYAmt |
| EOY | $959,120 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,582,849 | BOYAmt |
| EOY | $201,064 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,489,514 | BOYAmt |
| EOY | $5,479,980 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,371,213 | BOYAmt |
| EOY | $2,698,883 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,499,868 | BOYAmt |
| EOY | $7,007,032 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,871,081 | BOYAmt |
| EOY | $9,705,915 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,360,595 | BOYAmt |
| EOY | $15,185,895 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,253,349 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $88,183 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $1,448 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,448 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | THE PERCENTAGE OF 2021 MEMBERSHIP DUES PAID TO THE ARKANSAS HOSPITAL ASSOCIATION ALLOCABLE TO LOBBYING EXPENSE IS $1,448. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,307,966 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,646,492 | DepreciationAmt |
| Book Value | $5,661,474 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $122,688 | OtherCostOrOtherBasisAmt |
| Book Value | $122,688 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,690,940 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,423,386 | DepreciationAmt |
| Book Value | $1,267,554 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $176,714 | OtherCostOrOtherBasisAmt |
| Depreciation | $95,473 | DepreciationAmt |
| Book Value | $81,241 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,132,957 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM THIRD PARTY PAYORS | $549,966 |
| BENEFICIAL INTEREST IN TRUST | $734,663 |
| SHORT TERM INVESTMENTS | $10,885 |
| Building - Annex | $138,000 |
| Right to Use Asset | $567,585 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,001,099 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $141,768 |
| Lease Liability | $59,296 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $201,064 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $18,614,739 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $18,614,739 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $18,614,739 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,868,088 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $19,868,088 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $19,868,088 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $199,084 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $199,084 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,242,264 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,297,852 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,441,348 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,297,852 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $199,084 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,155,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $728,249 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $427,305 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,155,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $728,249 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $427,305 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,596,902 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,026,101 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $626,389 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,438,353 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,438,353 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,779,282 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,697,739 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $81,543 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 811 HWY 65 SOUTH | AddressLine1Txt |
| City | DUMAS | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DELTAMEM.ORG | WebsiteAddressTxt |
| State License | AR4392 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 | DUE TO THE SIZE OF THE SERVICE AREA, THE STEERING COMMITTEE CHOSE TO CONDUCT THEIR ASSESSMENT THROUGH A FOCUS GROUP OF COMMUNITY LEADERS AND INDIVIDUALS IN HEALTH-RELATED FIELDS. APPROXIMATELY 40 INDIVIDUALS FROM THE COMMUNITY WERE SELECTED FOR INVITATION TO THE FOCUS GROUP, OR COMMUNITY ADVISORY COMMITTEE, BY THE DELTA MEMORIAL HOSPITAL SYSTEM STAFF STEERING COMMITTEE. THOSE ACCEPTING THE INVITATION - APPROXIMATELY 25 - ATTENDED THE ADVISORY COMMITTEE'S FIRST MEETING. A FEW ADDITIONAL ADVISORY COMMITTEE MEMBERS, WHO WERE UNABLE TO ATTEND THE FIRST MEETING, JOINED THE SECOND MEETING AFTER BEING BRIEFED. THESE COMMUNITY ADVISORY COMMITTEE MEMBERS MET INITIALLY TO DISCUSS HEALTH STATISTICS AFFECTING THE HOSPITAL SERVICE AREA AND TO INDIVIDUALLY COMPLETE THE 2022 HEALTH NEEDS SURVEY. ADVISORY COMMITTEE MEMBERS ASSISTED IN DISTRIBUTING THE SURVEY QR CODE AND FLYERS TO NEIGHBORS, COLLEAGUES, AND FRIENDS PRIOR TO THE SECOND MEETING. SURVEYS WERE ALSO AVAILABLE ELECTRONICALLY ON THE DELTA MEMORIAL HOSPITAL WEBSITE, THE ARHP WEBSITE, AND VARIOUS SITES THROUGHOUT THE SERVICE AREA. AT THE SECOND COMMITTEE MEETING, MEMBERS WERE PRESENTED WITH THE RESULTS OF THE SURVEYS AND DISCUSSED SOME OF THE QUESTIONS AND RESPONSES AS A GROUP, AND PRIORITIZED COMMUNITY HEALTH CONCERNS. THESE PRIORITIES LED THE STAFF STEERING COMMITTEE TO DEVELOP A MORE DETAILED IMPLEMENTATION PLAN TO ADDRESS THOSE ISSUES AND CREATE COMMUNITY BENEFIT. OVER THE NEXT THREE YEARS, THE ACTION PLANS WILL BE IMPLEMENTED FOR EACH ISSUE, AND THE HOSPITAL STEERING COMMITTEE WILL MEET ANNUALLY WITH THE ADVISORY COMMITTEE TO ASSESS PROGRESS. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7A & 10A | www.deltamem.org/?sub=About+Us |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 | AN IMPLEMENTATION STRATEGY WAS DEVELOPED AND APPROVED BY THE BOARD OF DIRECTORS. SEVERAL ISSUES WERE IDENTIFIED FOR CONSIDERATION AND PRIORITIZED IN THE PLAN. 1. CHRONIC DISEASE OBJECTIVE 1 : CONTINUE TO IMPROVE ACCESS TO CHRONIC DISEASE MANAGEMENT, PROGRAMS, AND SERVICES - INVESTIGATE THE POSSIBILITY OF ESTABLISHING A FORMAL PULMONARY REHABILITATION PROGRAM. A FINAL DECISION WILL BE MADE NOT LATER THAN DECEMBER 31, 2022. - DELTA HEALTH SERVICES HAS DEVELOPED WILL EXPAND ITS CHRONIC CARE MANAGEMENT PROGRAM WITH A GOAL REACHING 300 PATIENTS PER MONTH. - MAINTAIN OPERATION OF A HOME HEALTH AGENCY AND TO PROVIDE CHRONIC CARE SERVICES INCLUDING: CERTIFIED NURSING ASSISTANTS, PHYSICAL THERAPY, CHEMO CERTIFIED NURSING, IV ANTIBIOTICS, FOLEY CATHETER AND COLOSTOMY CARE, TUBE FEEDING, TOTAL PARENTERAL NUTRITION, AND SKILLED NURSING SERVICES. - CONTINUE TO GROW THE SWING-BED PROGRAM WHICH OFFERS SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, IV ANTIBIOTICS, AND WOUND CARE TO PATIENTS RECENTLY DISCHARGED FROM A HOSPITAL, BUT NEEDING CONTINUING CARE FROM CHRONIC CONDITIONS. THE ARKANSAS RURAL HEALTH PATNERSHIP (ARHP) WILL ASSIST WITH MARKETING THE PROGRAM TO LARGER HOSPITAL FACILITIES. - DEVELOP AN AGGRESSIVE PUBLIC INFORMATION PROGRAM DESIGNED TO EDUCATE PATIENTS AND THE COMMUNITY OF THE SERVICES AVAILABLE AT DMH AND DELTA HEALTH SERVICES. THE PROGRAM WILL INCLUDE NEWSPAPER ADVERTISING, BILLBOARDS, HANDOUTS TO PATIENTS, FACEBOOK, AND COMMUNITY EVENTS AND HEALTH FAIRS. OBJECTIVE 2: CONTINUE TO PROVIDE PATIENT NAVIGATION TO CHRONIC DISEASE SERVICES, RESOURCES, AND PROGRAMS - PROVIDE COMMUNTIY BENEFITS COUSNELING TO PATIENTS AND THE COMMUNITY THROUGH A PARTNERSHIP WITH THE ARHP TO PROVIDE ASSISTANCE WITH INSURANCE ENROLLMENT, MEDICARE, MEDICAID, PRESCRIPTION ASSISTANCE, AND OTHER ASSISTANCE PROGRAMS AS AVAILABLE. - MAINTAIN A MEDICAL SOCIAL WORKER TO BE AVAILABLE TO INPATIENT AND OUTPATIENTS TO PROVIDE NECESSARY ASSISTANCE. - PARTNER WITH THE ARHP TO DISTRIBUTE THE ARHP HEALTH RESOURCE DIRECTORY. 2. MENTAL HEALTH & BEHAVIORAL HEALTH OBJECTIVE 1: INCREASE EFFORTS FOR MENTAL AND BEHAVIORAL HEALTH NAVIGATION, PROGRAMS, AND TRAINING OPPORTUNITIES - MAINTAIN PART-TIME PSYCHIATRIST TO PROVIDE MENTAL AND BEHAVIROAL HEALTH SERVICES. - EXPLORE THE POSSIBILITY OF ESTABLISHING INPATIENT AND OUTPATIENT TREATMENT PROGRAMS FOR OPIOID AND ALCOHOL ADDICTD PATIENTS. - PARTNER WITH THE ARHP TO DISTRIBUTE THE ARHP HEALTH RESOURCE DIRECTORY. - CONTINUE TO PARTNER WITH ARHP TO PROVIDE OUTREACH AND PROGRAMS TO REDUCE THE STIGMA OF MENTAL AND BEHAVIORAL HEALTH ISSUES IN THE SERVICE AREA. OBJECTIVE 2: CONTINUE TO COLLABORATE AND BUILD PARTNERSHIPS TO INCREASE MENTAL AND BEHAVIORAL HEALTH SERVICES AND PROGRAMS IN THE SERVICE AREA - MAINTAIN THE PSYCHIATRICT AND MEDICAL SOCIAL WORKER TO INCREASE AND IPROVE MENTAL AND BEHAVIORAL HEALTH SERVICES. - GROW PARTNERSHSIP WITH DELTA COUNSELING SERVICES TO ASSIT WITH EMBEERGENCY PSYCHIATRIC SERVICES. - GROW THE PAIN MANAGEMENT PROGRAM TO HELP PATIENTS ALLEVIATE PAING WITHOUT BECOMING ADDICTED TO OPIOID AND OTHER ADDICTIVE DRUGS. - DEVELOP A KETAMINE INFUSION PROGRAM TO ASSIT PATIENTS WITH CHRONIC PAIN AND EMOTIONAL ISSUES. - CONTINUE TO PARTICIPATE IN THE ARKANSAS RURAL HEALTH PARTNERSHIP'S MENTAL/BEHAVIORAL HEALTH TASK FORCE. - PROVIDE MENTAL HEALTH FIRST AID TRAINING TO LOCAL SCHOOLS, COLLEGES, AND COMMUNITY ORGANIZATIONS THROUGH PARTNERSHIP WITH ARHP. 3. TRANSPORTATION OBJECTIVE 1. IMPROVE/INCREASE TRANSPORTATION OPPORTUNITIES FOR PATIENTS IN THE SERVICE AREA - EXPLORE GROWING THE PARTNERSHIP WITH LOCAL EMS TO AID IN PATIENT TRANSPORTATION - INVESTIGATE THE POSSIBILITY OF DEVELOPING A PUBLIC TRANPORATION SERVICE TO ASSIST PATIENTS WITH TRANSPORTATION TO AND FROM HEALTH CARE PROVIDERS WITHING DUMAS AND THE SURROUNDING AREAS. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C | www.deltamem.org/getpage.php?name=financial_assistance&sub=Applicat ion+and+Policy |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 803 HIGHWAY 65 SOUTH | AddressLine1Txt |
| City | DUMAS | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71639 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, SCHEDULE H, PART I, LINE 3C | AMOUNTS GENERALLY BILLED (AGB) IS DEFINED AS THE AMOUNTS THAT ARE GENERALLY BILLED FOR CARE TO INDIVIDUALS WHO HAVE THIRD PARTY COVERAGE. DELTA MEMORIAL HOSPITAL DETERMINES AGB BY UTILIZING THE "LOOK-BACK" METHOD. THE AGB PERCENTAGE IS CALCULATED BY USING CLAIMS ALLOWED BY MEDICARE, MEDICAID AND PRIVATE HEALTH INSURERS DURING THE MOST RECENT FISCAL YEAR. |
| FORM 990, SCHEDULE H, PART I, LINE 7 | UNDER THE ADOPTION OF REVENUE RECOGNITION STANDARD ASU 2014-09 ALL OF THE ORGANIZATION'S BAD DEBT EXPENSE REPORTED ON SCHEDULE H, PART III, LINE 2 IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. |
| FORM 990, SCHEDULE H, PART III, SECTION A, LINE 2 | THE HOSPITAL HAS ADOPTED REVENUE RECOGNITION STANDARD ASU 2014-09. THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO COLLECT ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND AS SUCH ARE RECORDED AS A DEDUCTION FROM GROSS PATIENT REVENUE. THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SHCEDULE H, PART III, SECTION A, LINE 2. |
| FORM 990, SCHEDULE H, PART III, SECTION A, LINE 3 | UNDER THE ADOPTION OF REVENUE RECOGNITION STANDARD ASU 2014-09 ALL OF THE ORGANIZATION'S BAD DEBT EXPENSE REPORTED ON SCHEDULE H, PART III, LINE 2 IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. |
| FORM 990, SCHEDULE H, PART III, LINE 8 | MEDICARE COST TO CHARGE RATIO |
| FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B | IF DURING THE COURSE OF COLLECTIONS FOLLOW-UP, A PATIENT OR GUARANTOR REQUESTS FINANCIAL ASSISTANCE OR INDICATES THAT THEY ARE UNINSURED AND CANNOT PAY FOR THEIR CARE, THEY WILL BE REFERRED TO DMH'S FINANCIAL ASSISTANCE TEAM TO BE SCREENED FOR POTIENTIAL FINANCIAL ASSISTANCE ELIGIBILITY. IF IT IS DETERMINED A PATIENT MAY BE ELIGIBLE FOR ASSISTANCE, COLLECTION ACTIVITIY WILL CONTINUE UNTIL THE PATIENT RETURNS THE APPROPRIATE APPLICATION. ONCE THE APPLICATION IS RECEIVED, REGARDLESS OF COMPLETENESS, ALL FURTHER COLLECTION ACTIVITY WILL BE STOPPED PENDING A DECISION FROM THE FINANCIAL ASSISTANCE TEAM ON ASSISTANCE ELIGIBILITY. |
| FORM 990, SCHEDULE H, PART VI, LINE 2 | IN ADDITION TO THE CHNA, DELTA MEMORIAL HOSPITAL USES A VARIETY OF OTHER SOURCES TO COLLECT DATA, ANALYZE IT, AND PRIORITIZE FUTURE ACTION ITEMS. THESE INCLUDE: - HAVING AN ACTIVE BOARD OF DIRECTORS MADE UP OF COMMUNITY MEMBERS WHO GIVE INPUT. - PARTICIPATING INTHE LOCAL CHAMBER OF COMMERCE AND GETTING FEEDBACK. - INPUT FROM PHYSICIANS ON NEEDS OF THEIR PATIENTS AND ON THEIR REFERRAL PATTERNS FOR SERVICES NOT PROCIDED LOCALLY. - INPUT ON SOCIAL MEDIA. - DIRECT INPUT FROM INDIVIDUAL PATIENTS AND EMPLOYEES, AS WELLS AS LOCAL INDUSTRY AND EMS. - PATIENT EXPERIENCE SURVEYS. - EVALUATION OF HEALTH DATA AND REPORTS, SUCH AS THE COUNTY HEALTH RANKINGS IN HEALTH OUTCOMES. - DIRECT INPUT FROM DMH AUXILIARY WHO ARE MEMBERS OF THE COMMUNITY. |
| FORM 990, SCHEDULE H, PART VI, LINE 3 | DMH STAFF SHALL ATTEMPT TO IDENTIFY THOSE PATIENTS IN NEED OF FINANCIAL ASSISTANCE AT THE TIME OF REGISTRATION. THE PATIENT'S INSURANCE INFORMAITON AND/OR PAYMENT ARRANGEMENTS SHALL BE DISCUSSED BEFORE SERVICES ARE RENDERED, EXCEPT IN THE CASE OF EMERGENCY SERVICES IN ACCORDANCE WITH EMTALA REGULATIONS. PATIENTS REQUIRING EMERGENT OR URGENT MEDICAL CARE AND PREGNANT WOMEN IN ACTIVE LABOR SHALL BE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY IN ACCORDANCE WITH EMTALA REGUATIONS. DMH WILL PROVIDE A COPY OF THE PLAIN LANGUAGE SUMMARY DOCUMENT OF THE FINANCIAL ASSISTANCE POLICY TO ALL UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE PATIENT WILL BE REQUIRED TO SIGN THE DOCUMENT TO BE SCANNED INTO DMH'S DOCUMENT IMAGING SYSTEM FOR EACH ENCOUNTER. THIS WILL DOCUMENT THAT THE PATIENT WAS MADE AWARE OF THE FINANCIAL ASSITANCE POLICY. PATIENTS IDENTIFIED AS NEEDING FINANCIAL ASSISTANCE SHALL BE ENCOURAGED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. |
| FORM 990, SCHEDULE H, PART VI, LINE 4 | DELTA MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES THE COMMUNITIES OF DESHA COUNTY THAT ARE LOCATED NEAR DUMAS. DUMAS RESIDENTS MAKE UP THE MAJORITY OF BOTH INPATIENT AND EMERGENCY ROOM PATIENTS. THOSE REMAINING, FOR THE MOST PART, RESIDENTS OF LINCOLN, ARKANSAS, AND DREW COUNTIES ARE CONSIDERED THE SECONDARY SERVICE AREA. DESHA COUNTY IS LOCATED IN THE SOUTHEAST CORNER OF THE STATE OF ARKANSAS ON THE BORDER OF MISSISSIPPI AND THE MISSISSIPPI RIVER. ACCORDING TO THE 2020 CENSUS DESHA HAS A POPULATION OF 11,395 RESIDENTS COMPARED TO THE 2017 CENSUS WHICH WAS 13,008 RESIDENTS - A LOSS OF 1,613 IN POPULATION OVER THE COURSE OF THREE YEARS. ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS AND ROADMAP STUDY, DESHA RANKS IN OVERALL HEALTH OUTCOMES AT #72 IN OVERALL HEALTH FACTORS OUT OF 75 COUNTIES IN ARKANSAS. DESHA COUNTY IS CONSIDERED ONE OF THE UNHEALTHIEST COUNTIES IN THE STATE OF ARKANSAS, RANKING #69 WITHIN THE 75 COUNTIES. THE OVERALL DEMOGRAPHICS OF DESHA COUNTY ARE 42.5% WHITE, 47.4% AFRICAN AMERICAN, AND 6.8% HISPANIC OR LATINO ORIGIN. MEDIAN HOUSEHOLD INCOME FOR THE COUNTY IS $31,893, COMPARED TO $48,952 FOR THE STATE OF ARKANSAS. 29.1% OF PEOPLE ARE LIVING BELOW THE FEDERAL POVERTY LINE, COMPARED TO 16.2% STATEWIDE. |
| FORM 990, SCHEDULE H, PART VI, LINE 5 | DELTA MEMORIAL HOSPITAL IS AN ACTIVE MEMBER OF THE ARKANSAS RURAL HEALTH PARTNERSHIP (ARHP), WHICH IS COMPRISED OF 14 INDEPENDENTLY OWNED RURAL HOSPITALS, 2 MEDICAL TEACHING INSTITUTIONS, AND 2 FQHC'S. THE ARHP IS COMMITTED TO WORKING TOGETHER THROUGHOUT THE 21 SOUTH ARKANSAS COUNTIES TO: IMPROVE THE DELIVERY OF HEALTHCARE SERVICES, INCREASE ACCESS TO HEALTH CARE SERVICES AND PROGRAMS, PROVIDE HEALTHCARE PROVIDER EDUCATION OPPORTUNITIES, INCREASE THE UTILIZATION OF TELEHEALTH AND TELEMEDICINE TECHNOLOGY, PROMOTE HEALTH LIFESTYLES, ASSIST COMMUNITY MEMBERS WITH PATIENT ASSISTANCE PROGRAMS, AND REDUCE SERVICE AND OPERATION COSTS FOR HOSPITAL MEMBERS THROUGH COLLABORATIVE NEGOTIATION AND PURCHASING. ARHP CURRENTLY PROVIDES THE FOLLOWING OUTREACH AND EDUCATION PROGRAMS TO ITS MEMBERS, PATIENTS, AND COMMUNITIES: OPIOID USE DISORDER EDUCATION AND NAVIGATION, FREE BREAST SCREENING AND DIAGNOSTIC SERVICES, INSURANCE AND MEDICARE ASSISTANCE AND ENROLLMENT, DIABETES EMPOWERMENT EDUCATION PROGRAM, EMERGENCY DEPARTMENT MENTAL HEALTH ASSESSMENTS, PRESCRIPTION ASSISTANCE SERVICES, COOKING MATTERS CLASSES, DIABETES PREVENTION PROGRAM, AND PATIENT NAVIGATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FRANKLIN CHAMBERS | ||||||||||||||
| PHYSICIAN | $986,833 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,321 | $0 | $992,154 | $0 | $0 | $0 |
| RALPH MAXWELL | ||||||||||||||
| PHYSICIAN | $672,012 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,111 | $0 | $687,123 | $0 | $0 | $0 |
| SARAH FRANKLIN | ||||||||||||||
| PHYSICIAN | $519,201 | $0 | $0 | $0 | $0 | $0 | $2,900 | $0 | $5,508 | $0 | $527,609 | $0 | $0 | $0 |
| DEREK WHITE | ||||||||||||||
| NURSE PRACTITIONER | $222,579 | $0 | $0 | $0 | $0 | $0 | $2,340 | $0 | $5,536 | $0 | $230,455 | $0 | $0 | $0 |
| TRISHA BLAIR | ||||||||||||||
| NURSE PRACTITIONER | $153,924 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $153,924 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DAVID CHAMBERS | |||||||
| TOP 5 HIGHEST PAID | SALE OF CLINIC | Yes (X) | $77,000 | $27,000 | false | Yes (true) | Yes (true) |
| GRAYCORP LLC | |||||||
| MORE THAN 35% OWNED | ER CONTRACTED LABOR | Yes (X) | $759,331 | $197,219 | false | Yes (true) | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $224,219 | TotalBalanceDueAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE L, PART II | FormAndLineReferenceDesc |
| Explanation | ON SEPTEMBER 27, 2019, THE HOSPITAL FORMALIZED A VERBAL AGREEMENT WITH THE LENDER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | COMMITTEES ACTING ON BEHALF OF THE GOVERNING BODY REPORT TO THE GOVERNING BODY AT MONTHLY BOARD MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS EMAILED TO ALL BOARD MEMBERS FOR REVIEW BEFORE FILING. THE FORM 990 IS DISCUSSED AND APPROVED DURING THE NEXT BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S BYLAWS REQUIRE BOARD MEMBERS TO ABSTAIN FROM CONFLICTS OF INTEREST. BOARD MEMBERS ARE REQUIRED TO ANNUALLY SUBMIT A WRITTEN STATEMENT AND ANSWER A QUESTIONNAIRE. THE COMPLIANCE OFFICER INVESTIGATES ANY POTENTIAL CONFLICTS AND DETERMINES THE NATURE OF THE CONFLICT. A SUBCOMMITTEE REVIEWS ANY CONFLICTS AND DETERMINES THE APPROPRIATE ACTION DEPENDING ON THE NATURE OF THE CONFLICT. BOARD MEMBERS ARE ASKED TO ABSTAIN FROM CONFLICT OF INTERESTS OR ABSTAIN FROM VOTING IF A CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS REVIEWED THE CEO'S COMPENSATION IN 2022. |
| FORM 990, 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. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:3636610 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:715036 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING & COLLECTION SERVICES TOTAL FEES:134858 |
Comments