2023-06-12T11:52:32-05:00 2022-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-10-01 273274203 ANDERSON PHYSICIAN ALLIANCE INC ANDE 6015536000 2124 14TH STREET MERIDIAN MS 39301 STEVEN BROWN VP OF FINANCE 6015536000 2023-06-12 1 STEVEN BROWN 999009999 AMY BIBBY P00445891 8282542254 2023-06-12 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z STEVEN BROWN 2124 14TH STREET MERIDIAN MS 39301 5312069 0 X WWW.ANDERSONREGIONAL.ORG X 2010 MS ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. 5 0 61 0 0 0 0 0 5053666 5312067 3 -459707 0 0 5053669 4852360 0 0 0 0 5489614 5538631 0 0 0 1821636 1453594 7311250 6992225 -2257581 -2139865 2357545 723173 35163272 35668765 -32805727 -34945592 X SEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. THE SPECIFIC PURPOSES AND OBJECTIVES OF THE CORPORATION SHALL INCLUDE BUT NOT BE LIMITED TO EMPLOYING PHYSICIANS AND OTHER MEDICAL PERSONNEL TO CARRY OUT THE PURPOSES AND OBJECTIVES OF ANDERSON REGIONAL MEDICAL CENTER, AS FOLLOWS:1.) TO ESTABLISH AND MAINTAIN AN INSTITUTION OR INSTITUTIONS, WITHIN OR WITHOUT THE STATE WHERE INCORPORATED, WITH PERMANENT FACILITIES TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS2.) TO CARRY ON ANY EDUCATION ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH3.) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED4.) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY 0 0 6745362 5312067 SEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. THE PHYSICIANS, NURSE PRACTITIONERS AND STAFF FOCUS ON PRIMARY HEALTHCARE NEEDS OF THE COMMUNITY.ANDERSON EAR, NOSE & THROAT CENTER - CLOSED 6/30/2022DIAGNOSES, TREATS AND MANAGES PATIENTS WITH DISORDERS AND CONDITIONS OF THE EAR, NOSE AND THROAT REGION, AND RELATED AREAS OF THE HEAD AND NECK.ANDERSON NEUROLOGY CENTER - CLOSED 7/31/2022TREATS DISORDERS THAT AFFECT THE BRAIN, SPINAL CORD AND NERVES. DIAGNOSES COMPLEX CONDITIONS THROUGH DETAILED HISTORY AND PHYSICAL EXAMINATION, INCLUDING TESTING OF MENTAL STATUS, VISION, SPEECH, STRENGTH, SENSATION, COORDINATION, REFLEXES, AND GAIT. ANDERSON UROLOGY CLINIC OF MERIDIANTREATS A WIDE VARIETY OF CONDITIONS THAT AFFECT THE URINARY SYSTEM AND THE MALE REPRODUCTIVE SYSTEM.ANDERSON CARDIAC SURGICAL ASSOCIATESOFFERS A WEALTH OF KNOWLEDGE AND EXPERIENCE, MODERN SURGICAL EQUIPMENT, ADVANCED TECHNIQUES, AND HIGH-QUALITY CARE FOR COMPLEX OPEN HEART AND VASCULAR SURGERIES. PEDIATRIC HOSPITALISTSTHE PEDIATRIC HOSPITALIST PARTNERS WITH PRIMARY CARE PEDIATRICIANS AND OTHER SUB-SPECIALISTS AND NURSE PRACTITIONERS TO PROVIDE COMPREHENSIVE, FAMILY CENTERED CARE DURING AN ACUTE HOSPITALIZATION.THE PURVIS CLINICFROM PUBERTY THROUGH CHILD-BEARING YEARS, MENOPAUSE AND BEYOND, THE PRACTICE PROVIDES PERSONAL AND HIGH QUALITY CARE FOR WOMEN. WOMEN'S MEDICAL CLINIC OF MERIDIANTHE WOMEN'S MEDICAL CENTER OF MERIDIAN SERVE PATIENTS RANGING IN AGE FROM ADOLESCENCE TO ELDERLY, BELIEVING ALL ARE ENTITLED TO THE VERY BEST IN HEALTHCARE, UTILIZING STATE-OF-THE-ART MEDICAL TREATMENT AND SURGICAL PROCEDURES.ANDERSON PREMIER WOMEN'S CENTEROBSTETRIC AND GYNECOLOGIC SERVICES FOR WOMEN OF ALL AGES- FROM ADOLESCENCE THROUGH CHILDBEARING YEARS AND BEYOND. THE PROVIDER IS BOARD CERTIFIED BY THE AMERICAN BOARD OF OBSTETRICS AND GYNECOLOGY AND PROVIDES KNOWLEDGEABLE, COMPASSIONATE CARE THAT IS PERSONALIZED TO EACH PATIENT'S NEEDS. 6745362 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 61 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X STEVEN BROWN 6015536647 2124 14TH STREET MERIDIAN MS 39301 X GEORGE D FARR JR DIRECTOR (CHAIRMAN) 1.00 47.00 X X 0 193124 51541 WANDA B COOPER DIRECTOR (SECRETARY) 1.00 47.00 X X 0 225687 9597 SHAWN C ANDERSON DIRECTOR 1.00 5.00 X X 0 22000 0 STEVEN W BROWN DIRECTOR 1.00 47.00 X X 0 262820 79584 THURMAN K EVERETT DIRECTOR 1.00 47.00 X X 0 364505 51752 JAMES H WALLACE PHYSICIAN 40.00 X 901584 0 71584 DANIEL J MCKIEVER JR PHYSICIAN 40.00 X 1019436 0 26039 RONNY E PURVIS PHYSICIAN 40.00 X 543443 0 12797 DAVID A GEER PHYSICIAN 40.00 X 451448 0 19358 CODY B AULL PHYSICIAN 40.00 X 576912 0 26181 3492823 1068136 348433 10 0 1 0 NTT DATA SERVICES LLC POB 534118 ATLANTA GA 303534118 EMR - BILLING SOFTWARE 175615 LOCUMTENENSCOM 2655 NORTHWINDS PARKWAY ATLANTA GA 30384 CONTRACT PHYSICIAN SERVICES 145568 2 NET PATIENT 621990 5004358 5004358 PROVIDER RELIEF FUNDS 900099 307709 307709 5312067 2 2 459709 -459709 -459709 -459709 4852360 5312067 0 -459707 5100737 4915871 184866 52433 50426 2007 183518 179310 4208 201943 199322 2621 442353 427699 14654 178686 154872 23814 323785 323695 90 16732 16098 634 4630 4630 83524 70375 13149 139394 139394 MEDICAL SUPPLIES 151088 150268 820 BAD DEBT EXPENSE 113402 113402 6992225 6745362 246863 0 -7 12787 8540 458894 2809 26667 26667 1943439 1258275 1859197 685164 2357545 723173 333104 254579 34830168 35414186 35163272 35668765 X -32805727 -34945592 -32805727 -34945592 2357545 723173 -2139865 0 X X 0 0 0 X 838715 367503 471212 29777 29004 773 1074947 861768 213179 685164 DUE TO AFFILIATES 35414186 35414186 X PART X, LINE 2: ANDERSON PHYSICIAN ALLIANCE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. ANDERSON PHYSICIAN ALLIANCE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2022 AND 2021. X 0 0 X X X X X 0 1 0 0 0 0 0 0 0 DANIEL J MCKIEVER JR PHYSICIAN 599768 0 416611 0 3057 0 0 0 26039 0 1045475 0 0 0 JAMES H WALLACE PHYSICIAN 621709 0 259193 0 20682 0 57953 0 13631 0 973168 0 0 0 CODY B AULL PHYSICIAN 362625 0 214057 0 230 0 13154 0 13027 0 603093 0 145404 0 RONNY E PURVIS PHYSICIAN 481314 0 55591 0 6538 0 0 0 12797 0 556240 0 0 0 DAVID A GEER PHYSICIAN 441510 0 0 0 9938 0 5700 0 13658 0 470806 0 0 0 THURMAN K EVERETT DIRECTOR 0 350002 0 0 0 14503 0 51752 0 0 0 416257 0 0 STEVEN W BROWN DIRECTOR 0 260722 0 0 0 2098 0 61464 0 18120 0 342404 0 0 GEORGE D FARR JR DIRECTOR (CHAIRMAN) 0 191214 0 0 0 1910 0 36135 0 15406 0 244665 0 0 WANDA B COOPER DIRECTOR (SECRETARY) 0 217050 0 0 0 8637 0 2700 0 6897 0 235284 0 0 PART I, LINE 1A CEO, VICE PRESIDENTS AND BOARD MEMBERS ARE OFFERED FREE MEMBERSHIPS TO ANDERSON HEALTH AND FITNESSS CENTER. WANDA B. COOPER AND GEORGE D. FARR, JR. RECEIVED FREE MEMBERSHIPS. PART I, LINE 3 THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE INC (APA) ARE COMPENSATED BY ARMC. AS SUCH, APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE (3) PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS AND HAS CONTRACTED FOR AND USED THE PROFESSIONAL SERVICES OF LOCKTON FOR THE CEO AND VICE PRESIDENTS. PART I, LINE 4B ARMC PROVIDES TO CERTAIN EXECUTIVES AN IRS SEC. 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE PURPOSE OF THIS PLAN IS TO OFFER PARTICIPATING EXECUTIVES TAXABLE DEFERRED COMPENSATION BENEFITS TO SUPPLEMENT SUCH EXECUTIVE'S RETIREMENT UNDER ARMC'S TAX-QUALIFIED RETIREMENT PLAN. THE PLAN SHALL BE UNFUNDED FOR TAX PURPOSES AND FOR PURPOSE OF TITLE I OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1975 ("ERISA"). SEE COMPENSATION SECTION FOR DETAIL INFORMATION ON PERSONS AND AMOUNTS. DURING THE 2021 CALENDAR YEAR DR. CODY AULL RECEIVED A PAYOUT OF HIS SUPPLEMENT RETIREMENT PLAN IN THE AMOUNT OF 145,404. THIS AMOUNT WAS INCLUDED IN HIS FORM W-2. FORM 990, PART VI, SECTION A, LINE 1A UNLESS PROHIBITED OR LIMITED BY THE ARTICLES OF INCORPORATION OR THESE BYLAWS, THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE AND ONE OR MORE THAN OTHER COMMITTEES OF THE BOARD AND APPOINT MEMBERS OF THE BOARD OF DIRECTORS TO SERVE ON THEM. FORM 990, PART VI, SECTION A, LINE 6 ANDERSON REGIONAL MEDICAL CENTER (ARMC) IS THE SOLE MEMBER OF ANDERSON PHYSICIAN ALLIANCE, INC. FORM 990, PART VI, SECTION A, LINE 7A ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCISE ALL VOTING RIGHTS OF THE MEMBERS FORM 990, PART VI, SECTION A, LINE 7B ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APRROVE APA'S PHYSICIAN COMPENSATION MODELS, PHYSICIAN COMPENSATION AND PHYSICIAN COMPENSATION POLICIES, (2) TO APPROVE PHYSICIAN EMPLOYMENT AGREEMENTS, AND (3) TO INITIATE AND/OR APPROVE VARIOUS OTHER ACTIONS AND POLICIES AS ENUMERATED IN APA'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND AS REQUIRED BY STATE LAW. FORM 990, PART VI, SECTION B, LINE 11B EACH BOARD MEMBER WAS PROVIDED A COPY OF THE FORM 990. THE BOARD MEMBERS WERE ASKED TO REVIEW THE FORM AND SUBMIT QUESTIONS AND COMMENTS PROIR TO THE FORM 990 BEING FINALIZED. AFTER REVIEW, THE FINALIZED FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REQUESTS ALL BOARD MEMBERS TO ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER (ARMC). OFFICERS AND DIRECTORS OF ANDERSON PHYSICIAN ALLIANCE (APA) ARE COMPENSATED BY ARMC. AS SUCH APA FOLLOWS THE POLICIES OF ARMC. ARMC HAS A DESIGNATED THREE PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS AND HAS CONTRACTED FOR AND USED THE PROFESSIONAL SERVICES OF LOCKTON FOR THE CEO AND VICE PRESIDENTS. FORM 990, PART VI, SECTION C, LINE 18 IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ARTICLES OF INCORPORATION ARE ON FILE AND ARE AVAILABLE TO THE PUBLIC AT THE MISSISSIPPI SECRETARY OF STATE'S OFFICE. THE BYLAWS AND THE CONFLICT OF INTEREST POLICY ARE NOT PUBLICLY AVAILABLE. THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AS A PART OF THE 990 FORM AS CONSOLIDATED FINANCIALS OF ARMC. FORM 990, PART VI, LINE 1: INDEPENDENCE OF VOTING BOARD MEMBERS: THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE SOLE MEMBER ORGANIZATION HAS A FIFTY PERCENT INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER AND ITS AUTHORITY. FORM 990; PART XII; LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ANDERSON REGIONAL MEDICAL CENTER 2124 14TH STREET MERIDIAN MS 39301 640362400 HEALTHCARE MS 501(C)(3) LINE 3 N/A 0 MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION 122 WOODMONT WAY RIDGELAND MS 39157 640722433 SUPPORTING ORGANIZATION MS 501(C)(3) LINE 12C, III-FI ANDERSON REGIONAL MEDICAL CENTER 0 ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION 7651 POPLAR SPRINGS DR MERIDIAN MS 39305 640730109 SUPPORTING ORGANIZATION MS 501(C)(3) LINE 12D, III-O ANDERSON REGIONAL MEDICAL CENTER 0 MIRACLES OF GRACE FOUNDATION 1827 SUNRISE LANE TOOMSUBA MS 39364 640730366 SUPPORTING ORGANIZATION MS 501(C)(3) LINE 12C, III-FI ANDERSON REGIONAL MEDICAL CENTER 0 CARE CONSISTENCY FOUNDATION INC 7761 MEADOW CIRCLE MERIDIAN MS 39305 640730846 SUPPORTING ORGANIZATION MS 501(C)(3) LINE 12D, III-O ANDERSON REGIONAL MEDICAL CENTER 0 EAST MISSISSIPPI ENDOSCOPY CENTER 1926 23RD AVENUE MERIDIAN MS 39301 440884792 HEALTHCARE MS N/A 0 0 ARMC HOSPITAL PROF & GEN LLFT 512 22ND AVENUE MERIDIAN MS 39301 206131090 TRUST MS N/A T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0