PONTOTOC HEALTH SERVICES INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
PONTOTOC HEALTH SERVICES INC (EIN 64-0751410)
Tax period
2021-10-01 to 2022-09-30
Filed
2023-08-15
IRS object ID
202302279349301525
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-08-15T09:42:24-05:00ReturnTs
Tax Period End2022-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11400 Meadowbrook Road Suite 300AddressLine1Txt
CityJacksonCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392116349ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN640751410EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pontotoc Health Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% KRISTY DUKEInCareOfNm
Business Name ControlPONTBusinessNameControlTxt
Phone6623773978PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 South Gloster StreetAddressLine1Txt
CityTupeloCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHARON NOBLESPersonNm
Person TitleCHIEF FINANCIAL OFF.PersonTitleTxt
Phone6623773978PhoneNum
Signature2023-06-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSHARONPersonFirstNm
Person LastNOBLESPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAmber Sherrill CPAPreparerPersonNm
PTINP00748683PTIN
Phone6019486700PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSHARON NOBLESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 South Gloster StreetAddressLine1Txt
CityTupeloCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,633,440GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.nmhs.net/pontotoc/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateDELegalDomicileStateCd
Activity Or MissionPontotoc Health Services, Inc. operates a 25 bed hospital and a 44 bed nursing home located in Pontotoc, Mississippi.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee310TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,819,698PYContributionsGrantsAmt
CY Contributions Grants$1,263,422CYContributionsGrantsAmt
PY Program Service Revenue$27,377,122PYProgramServiceRevenueAmt
CY Program Service Revenue$27,110,236CYProgramServiceRevenueAmt
PY Investment Income$38,176PYInvestmentIncomeAmt
CY Investment Income-$52,483CYInvestmentIncomeAmt
PY Other Revenue$209,995PYOtherRevenueAmt
CY Other Revenue$257,409CYOtherRevenueAmt
PY Total Revenue$29,444,991PYTotalRevenueAmt
CY Total Revenue$28,578,584CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,161,360PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,846,624CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,801,626PYOtherExpensesAmt
CY Other Expenses$8,481,245CYOtherExpensesAmt
PY Total Expenses$26,962,986PYTotalExpensesAmt
CY Total Expenses$25,327,869CYTotalExpensesAmt
PY Revenues Less Expenses$2,482,005PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,250,715CYRevenuesLessExpensesAmt
Total Assets BOY$22,119,690TotalAssetsBOYAmt
Total Assets EOY$24,257,090TotalAssetsEOYAmt
Total Liabilities BOY$13,264,077TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,714,458TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,855,613NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,542,632NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPONTOTOC HEALTH SERVICES, INC. OPERATES A 25 BED HOSPITAL AND A 44 BED NURSING HOME LOCATED IN PONTOTOC, MISSISSIPPI CALLED NORTH MISSISSIPPI MEDICAL CENTER-PONTOTOC(NMMC-PONTOTOC). NMMC-PONTOTOC 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-PONTOTOC 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$24,800,550ExpenseAmt
Grant$0GrantAmt
Revenue$27,110,236RevenueAmt
DescNMMC-Pontotoc serves Pontotoc County and the surrounding area. In fiscal year 2022, there were 461 inpatient admissions, 9,488 emergency department visits, 50,090 outpatient visits, 31,890 rural health clinic visits, and 470 hospital based clinic visits. NMMC-Pontotoc 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. The hospital offers paramedic-level ambulance service and 24-hour physician coverage in its Emergency Department. Radiology services include x-ray, computed tomography (CT) and ultrasound. Area residents can stay close to home and take advantage of the Mobile Mammography Unit on designated days each month at NMMC-Pontotoc. The 44-bed nursing home offers a variety of rehabilitation services and amenities to residents. One of the primary ways NMMC-Pontotoc 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-Pontotoc has established a policy under which the hospital provides care, without charge, to needy members of its community. THE FINANCIAL ASSISTANCE POLICY STATES THAT NMMC-PONTOTOC WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS FREE OF CHARGE WITH HOUSEHOLD INCOME LEVELS AT OR BELOW 150% OF THE FEDERAL POVERTY LEVEL. The policy applies to individuals who reside in Pontotoc County. Patients from outside the county may also be granted charity care based on the judgment of NMMC-Pontotoc management depending on their individual circumstances. The policy also requires the patient to cooperate fully with NMMC-Pontotoc'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 $2,591,355 in fiscal year 2022. Based on the gross charges provided to charity patients compared to total hospital gross charges, 6.99% of all services in fiscal year 2022 were provided on a charity basis. The net cost of charity care provided by NMMC-Pontotoc was approximately $1,703,491 in fiscal year 2022. The total cost estimate is based on the ratio of costs to charges for NMMC-Pontotoc. All 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.Desc
Total Program Service Expenses$24,800,550TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee310EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKRISTY DUKEPersonNm
Phone6623773977PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 SOUTH GLOSTER STREETAddressLine1Txt
CityTupeloCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38801ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndKey EmployeeKeyEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Michael S Spees
President & CEO0.539.5Yes (X)$0$2,719,746$24,518
Sharon Nobles
Treasurer & CFO1.039.0Yes (X)$0$1,217,017$15,756
Bruce Toppin
Secretary1.039.0Yes (X)$0$913,073$14,472
Brad J Bowlin
Physician40.00.0$437,423$0$22,068Yes (X)
Justin Smith
Physician40.00.0$373,623$0$13,547Yes (X)
Curtis Glidewell
Physician40.00.0$372,294$0$12,377Yes (X)
ANDREA WARREN
PHYSICIAN40.00.0$286,009$0$28,586Yes (X)
Stephen Montgomery
Physician40.00.0$275,234$0$25,677Yes (X)
Leslia D Carter
Administrator40.00.0$221,597$0$10,809Yes (X)
Mariam B Clark PhD
Director1.00.0$0$0$0Yes (X)
Conwell Duke
Chairman1.00.0Yes (X)$0$0$0Yes (X)
David High
Director1.00.0$0$0$0Yes (X)
Mitch Montgomery
Director1.00.0$0$0$0Yes (X)
Scott Uithoven
Director1.00.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,966,180TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,849,836TotReportableCompRltdOrgAmt
Total Other Compensation$167,810TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K21IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RELIAS EMERGENCY MED
PO BOX 7058TUPELOMS38802ER PHYSICIAN$910,696
RELIA HOSPITALIST
PO BOX 7058TUPELOMS38802HOSPITALIST$450,836
TRILOGY HEALTHCARE SOLUTIONS
911 FLYNT DRIVEFLOWOODMS39232BILLING/COLLECTION$412,017
CROTHALL HEALTHCARE
13028 COLLECTIONS CENTER DRIVECHICAGOIL60693HOUSEKEEPING SERVICE$108,879
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Government Grants$1,253,422GovernmentGrantsAmt
All Other Contributions$10,000AllOtherContributionsAmt
Total Contributions$1,263,422TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue622110$27,094,210$27,094,210
Related Rental Income531120$16,026$16,026
FieldValueIRS element (for citing)
Total Program Service Revenue$27,110,236TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,373TotalRevenueColumnAmt
Exclusion$2,373ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$54,851SecuritiesAmt
Other$5OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$54,851SecuritiesAmt
Other-$5OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$54,856TotalRevenueColumnAmt
Exclusion-$54,856ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Employee Drugs446110$257,409$257,409
OTHER$0$0
FieldValueIRS element (for citing)
Other Revenue Total$257,409OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,578,584TotalRevenueColumnAmt
Related Or Exempt Func Income$27,110,236RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$204,926ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$233,346TotalAmt
Management And General$233,346ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,364,104TotalAmt
Program Services$13,364,104ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$437,431TotalAmt
Program Services$437,431ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,898,391TotalAmt
Program Services$1,898,391ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$913,352TotalAmt
Program Services$842,161ProgramServicesAmt
Management And General$71,191ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$162,544TotalAmt
Management And General$162,544ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,900TotalAmt
Management And General$12,900ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$30,980TotalAmt
Management And General$30,980ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,793,882TotalAmt
Program Services$2,793,882ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$14,656TotalAmt
Program Services$14,656ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$308,113TotalAmt
Program Services$308,113ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$414,292TotalAmt
Program Services$414,292ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$793,663TotalAmt
Program Services$793,663ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$40,914TotalAmt
Program Services$40,914ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$47,962TotalAmt
Program Services$47,962ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$400,027TotalAmt
Program Services$400,027ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$16,358TotalAmt
Management And General$16,358ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$2,702,617$2,702,617
Taxes and Licenses$305,941$305,941
REPAIRS & MAINTENANCE$208,780$208,780
DUES & SUBSCRIPTIONS$98,128$98,128

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$129,488TotalAmt
Program Services$129,488ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,327,869TotalAmt
Program Services$24,800,550ProgramServicesAmt
Management And General$527,319ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,590BOYAmt
EOY$2,790EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,598,754BOYAmt
EOY$1,172,022EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,372,029BOYAmt
EOY$1,651,586EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$392,287BOYAmt
EOY$354,455EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$74,992BOYAmt
EOY$5,074EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,379,409LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,933,790LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,215,176BOYAmt
EOY$2,445,619EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,463,862BOYAmt
EOY$18,625,544EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,119,690BOYAmt
EOY$24,257,090EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,014,245BOYAmt
EOY$6,739,972EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,249,832BOYAmt
EOY$4,974,486EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,264,077BOYAmt
EOY$11,714,458EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,718,900BOYAmt
EOY$12,507,607EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$136,713BOYAmt
EOY$35,025EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,855,613BOYAmt
EOY$12,542,632EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,119,690BOYAmt
EOY$24,257,090EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,250,715ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$436,304OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$60,613OtherCostOrOtherBasisAmt
Book Value$60,613BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,879,778OtherCostOrOtherBasisAmt
Depreciation$6,061,117DepreciationAmt
Book Value$818,661BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,279,085OtherCostOrOtherBasisAmt
Depreciation$9,872,673DepreciationAmt
Book Value$1,406,412BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$159,933OtherCostOrOtherBasisAmt
Book Value$159,933BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,445,619TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Deferred Compensation$842,036
Intrst in NA of Affiliated FDN$116,198
Other Receivable$170,904
Due from Affiliates$16,779,990
Right of Use Leases$716,416
FieldValueIRS element (for citing)
Total Book Value Other Assets$18,625,544TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Due to Related Parties$12,639
Due to Third Party Payors$4,245,431
Lease Liability$716,416
FieldValueIRS element (for citing)
Total Liability$4,974,486TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$29,003,946TotalRevEtcAuditedFinclStmtAmt
Other Revenue$425,362OtherRevenueAmt
Revenue Not Reported$425,362RevenueNotReportedAmt
Revenue Subtotal$28,578,584RevenueSubtotalAmt
Total Revenue Per Form990$28,578,584TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$25,753,231TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$425,362OtherExpensesIncludedAmt
Expenses Not Reported$425,362ExpensesNotReportedAmt
Expenses Subtotal$25,327,869ExpensesSubtotalAmt
Total Expenses Per Form990$25,327,869TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE D, Part X, Line 2:MANAGEMENT HAS EVALUATED ITS INCOME TAX POSITIONS UNDER GUIDANCE INCLUDED IN ASC 740. BASED ON ITS REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
FORM 990, SCHEDULE D, Part XI, Line 2d:PENSION COSTS INCLUDED IN REVENUE PER AUDIT $425,362
FORM 990, SCHEDULE D, Part XII, Line 2b:PENSION COSTS INCLUDED IN REVENUE PER AUDIT $425,362

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,703,491TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,703,491NetCommunityBenefitExpnsAmt
Total Expense0.06730TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,165,154TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,117,494DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,868,645TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,117,494DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,703,491NetCommunityBenefitExpnsAmt
Total Expense0.06730TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,868,645TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,117,494DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,703,491NetCommunityBenefitExpnsAmt
Total Expense0.06730TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Reimbursed By Medicare$9,634,911ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,516,473CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$118,438MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pontotoc Health Services IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1176 South Main StreetAddressLine1Txt
CityPontotocCityNm
State AbbreviationMSStateAbbreviationCd
ZIP38863ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://www.nmhs.net/pontotoc/WebsiteAddressTxt
State License16-091StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Pontotoc Health Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5:INPUT FROM THE COMMUNITY WAS RECEIVED VIA INFORMANT INTERVIEWS, STANDARDIZED ELECTRONIC SURVEYS FROM KEY ORGANIZATIONS/STAKEHOLDERS, HEALTHCARE ADVOCATES/LEADERS, AND INTERESTED COMMUNITY PARTNERS RESIDING IN THE SERVICE AREAS SERVED BY NORTH MISSISSIPPI MEDICAL CENTER-PONTOTOC AND THE HEALTH SYSTEM. ADDITIONAL INPUT WAS SOLICITED FROM COMMUNITY RESIDENTS WHO REPRESENT BROADLY DIVERSE INTERESTS OF THE SERVICE AREA RANGING FROM NONPROFIT COMMUNITY VOLUNTEERS TO RETIRED EDUCATORS, BANKERS, AND PRIVATE BUSINESS LEADERS.
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A:Pontotoc Health Services is part of the North Mississippi Health Services' diversified regional healthcare system. North Mississippi Health Services operates six community hospitals in addition to Pontotoc Health Services. The CHNA included Pontotoc Health Services, Clay County Medical Corporation, North Mississippi Medical Center, Webster Health Services, Tishomingo Health Services, Monroe Health Services, and Marion Regional Medical Center.
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7B & 10Awww.nmhs.net/about-us/community-benefit/
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11:THE NEEDS OF THE COMMUNITY GO BEYOND THE RESOURCES OF THE ORGANIZATION WITH THE NON-EXPANSION OF MEDICAID IN THE STATE AND THE REDUCTION IN MEDICAID PAYMENTS AS WELL AS A SIGNIFICANT INCREASE IN UNINSURED. THE ORGANIZATION FOCUSES ON PROVIDING ACCESS TO BASIC HEALTHCARE NEEDS INCLUDING: A. INCREASE ACCESS TO PREVENTIVE SERVICE - EXPAND VIRTUAL/TELEHALTH OFFERINGS - COLLABORATE TO EXPLORE TRANSPORTATION NEEDS - INITIATE INNOVATIVE LISTEN-TO-LEARN COMMUNITY SESSIONS - UTILIZE PARTNERS TO ASSIST THOSE WITH LIMITED OR NO INSURANCE - INCREASE AFFORDABLE AFTER-HOURS CARE - IMPROVE ACCESS TO SPECIALTY CARE B. INCREASE PHYSICAL ACTIVITY AND PROMOTE EXERCISE AS MEDICINE - PARTNER WITH LOCAL WELLNESS CENTERS & GYMS - DEVELOP PARTNERSHIPS WITH LOCAL PARKS/RECREATION FACILITIES - UTILIZE EXERCISE "PRESCRIPTIONS" - ORGANIZE WALKING CLUBS - PROMOTE CORPORATE WELLNESS PROGRAMS - IDENTIFY COMMUNITY RESOURCES, E.G. TRAILS, WALKINGS TRACKS, ETC. C. DEVELOP A NUTRITIONALLY AWARE COMMUNITY CULTURE - SCREEN FOR AND CREATE ACCESS TO NUTRITIOUS FOODS - DEVELOP CULTURALLY-APPROPRIATE EDUCATIONAL PROGRAMS - DEVELOP COMMUNITY COALITIONS TO PROVIDE FRESH FOOD/PROMOTE COMMUNITY GARDENS - TEACH FOOD PRESERVATION SKILLS - UTILIZE ESTABLISHED NETWORKS TO PROMOTE NUTRITION D. DEVELOP PARTNERSHIPS WITH PUBLIC ENTITIES - PUBLIC HEALTH -- STATE AND REGIONAL OFFICES - EDUCATIONAL INSTITUTIONS -- EARLY CHILDHOOD, PRIMARY, SECONDARY, AND POST-SECONDARY - GOVERNMENT -- STATE, REGIONAL, AND LOCAL
PART V, SECTION B, LINE 13h:THE FAP DOES NOT COVER CHARGES FOR PATIENTS OR TREATMENTS WITH THE FOLLOWING CONDTIONS: I. THE PATIENT HAS ANY THIRD-PARTY INSURANCE COVERAGE. A DISCRETIONARY EXCEPTION MAY BE MADE FOR INSURED PATIENTS IS THE PROVISOIN FOR THE MEDICALLY UNDER-INSURED II. THE PATIENTS PRIMARY RESIDENCE IS OUTSIDE THE SERVICE AREA III. THE PATIENT IS CURRENTLY IN CUSTODY OF A CORRECTIONAL FACILITY IV. THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ANOTHER CITY, COUNTY, STATE, FEDERAL OR OTHER ASSISTANCE PROGRAM WHICH SUPERSEDES THE FAP. V. IF PATIENTS CHARGES RESULTED FROM A WORK-RELATED ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE. VI. IF PATIENT CHARGES RESULTED FROM AN AUTO ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE THE FINANCIAL ASSISTANCE POLICY IS NOT APPLICABLE TO PHYSICIANS OR THEIR IMMEDIATE FAMILY MEMBERS.
PART V, SECTION B, LINE 16A, 16B, & 16Cwww.nmhs.net/patient-family-information/financial-assistance/
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Pontotoc Health Services Nursing Home
176 South Main StreetPontotocMS38863Long Term Acute Care Facility
Pontotoc Outpatient Counseling
185 North Main StreetPontotocMS38863Outpatient Counseling
Pontotoc Medical Clinic
345 HWY 15 NORTHPontotocMS38863Rural Health clinic
ECRU MEDICAL CLINIC
202 MAIN STREETECRUMS38841RURAL HEALTH CLINIC
NEW ALBANY MEDICAL CLINIC
400 DOCTORS DRIVENEW ALBANYMS38652RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE H, Part I, Line 3c:WEBSTER HEALTH SERVICES, INC. USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE CARE. IF THE PATIENT'S INCOME LEVEL IS 0-150% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 200% OF THE FPL, THE HOSPITAL MAY OFFER DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.
FORM 990, SCHEDULE H, PART I, LINE 6APONTOTOC HEALTH SERVICES, INC. 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, AMORY, MS, AND HAMILTON AL; NORTH MISSISSIPPI MEDICAL CLINICS, A REGIONAL NETWORK OF 27 PRIMARY AND SPECIALTY CLINICS; AND NURSING HOMES. NMHS OFFERS A COMPREHENSIVE PORTFOLIO OF MANAGED CARE PLANS.
FORM 990, SCHEDULE H, PART I, LINE 7A 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.
FORM 990 SCHEDULE H, PART III, LINE 2-4PONTOTOC HEALTH SERVICES' 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. PONTOTOC HEALTH SERVICES (PHS) FOLLOWS THE CATHOLIC HEALTH ASSOCIATION GUIDELINES AND DOES NOT INCLUDE BAD DEBT IN ANY COMMUNITY BENEFIT AMOUNTS. PHS 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 HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2022.
FORM 990, SCHEDULE H, PART III, LINE 8: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 $12,257 AND TOTAL COSTS WERE $33,948 FOR A NET SHORTFALL OF $21,691. WHEN COMBINED WITH THE SURPLUS REPORTED ON LINE 7, THE NET SURPLUS FROM ALL MEDICARE PROGRAMS IS $96,747.
FORM 990, SCHEDULE H, PART III, LINE 9BPONTOTOC HEALTH SERVICES DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE HOSPITALS MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS.
FORM 990, SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT PONTOTOC HEALTH SERVICES UTILIZES VARIED BUT COMPLIMENTARY METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. PONTOTOC HEALTH SERVICES AND PONTOTOC 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 PONTOTOC 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 PONTOTOC 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 PONTOTOC HEALTH SERVICES.
FORM 990, SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE EXPLANATIONS OF THE PONTOTOC HEALTH SERVICES 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.
FORM 990, SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION PONTOTOC HEALTH SERVICES SERVES MORE THAN 32,000 PEOPLE IN PONTOTOC COUNTY, MS, AND THE SURROUNDING AREA. THE POPULATION FOR THE SERVICE AREA IS PROJECTED TO REMAIN ESSENTIALLY FLAT OVER THE NEXT FIVE YEARS. ACCORDING TO THE U.S. CENSUS BUREAU, AGE DEMOGRAPHICS FOR THE SERVICE AREA SHOW THAT APPROXIMATELY 22% OF THE POPULATION IS UNDER 18 YEARS OF AGE, APPROXIMATELY 60% IS BETWEEN 18 AND 64 YEARS OF AGE AND THAT 18% IS 65 OR OLDER. CAUCASIANS MAKE UP 76% OF THE SERVICE AREA'S POPULATION WHILE AFRICAN AMERICANS MAKE UP 15% AND HISPANICS AND OTHERS MAKE UP 9%. MEDIAN HOUSEHOLD INCOME WAS $53,272 FOR THE SERVICE AREA, WHICH IS ABOVE THE OVERALL AVERAGE FOR MISSISSIPPI BUT SIGNIFICANTLY LESS THAN THE NATIONWIDE AVERAGE. THE PATIENT POPULATION FOR PONTOTOC HEALTH SERVICES THAT IS UNINSURED IS 15.5%.
FORM 990, SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH PONTOTOC HEALTH SERVICES HAS A COMMITMENT TO A WIDE VARIETY OF COMMUNITY HEALTH OUTREACH ACTIVITIES, WHICH ARE COORDINATED BY THE COMMUNITY HEALTH COORDINATOR AND ARE STAFFED BY PONTOTOC HEALTH SERVICES 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.
FORM 990, SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM AS NOTED ABOVE, PONTOTOC HEALTH SERVICES (PHS) IS PART OF NORTH MISSISSIPPI HEALTH SERVICES (NMHS). NMHS OPERATES NORTH MISSISSIPPI MEDICAL CENTER, FIVE OTHER COMMUNITY HOSPITALS IN ADDITION TO PHS, AS WELL AS, NORTH MISSISSIPPI MEDICAL CLINICS, WHICH OPERATES MORE THAN 36 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.
FORM 990, SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT PONTOTOC HEALTH SERVICES DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF MISSISSIPPI AS THERE IS NO REQUIREMENT TO DO SO.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Bruce Toppin
Secretary$0$335,156$0$348,018$0$229,899$0$5,800$0$8,672$0$927,545$0$0
Brad J Bowlin
Physician$417,324$0$239$0$19,860$0$17,400$0$4,668$0$459,491$0$0$0
Michael S Spees
President & CEO$0$1,006,122$0$1,522,351$0$191,273$0$17,400$0$7,118$0$2,744,264$0$0
Leslia D Carter
Administrator$175,866$0$43,229$0$2,502$0$3,861$0$6,948$0$232,406$0$0$0
Sharon Nobles
Treasurer & CFO$0$541,246$0$653,770$0$22,001$0$8,700$0$7,056$0$1,232,773$0$0
Stephen Montgomery
Physician$197,496$0$76,154$0$1,584$0$19,005$0$6,672$0$300,911$0$0$0
Justin Smith
Physician$216,705$0$137,226$0$19,692$0$8,700$0$4,847$0$387,170$0$0$0
Curtis Glidewell
Physician$196,419$0$165,663$0$10,212$0$7,949$0$4,428$0$384,671$0$0$0
ANDREA WARREN
PHYSICIAN$203,496$0$82,153$0$360$0$21,914$0$6,672$0$314,595$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 3NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ESTABLISHES THE PAY OF THE CEO AND COMPENSATES HIM. NMHS USES THE FOLLOWING METHODS FOR ESTABLISHING THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
FORM 990, SCHEDULE J, PART I, LINE 4B:The following people participated in or received payment from a supplemental nonqualified retirement plan: Michael Shane Spees - $131,709 Bruce Toppin - $197,951
FORM 990, SCHEDULE J, PART I, LINE 7PHYSICIAN BONUSES ARE ALL CONTINGENT INCOME DEPENDING UPON EITHER THE NUMBER OF SERVICES PROVIDED OR THE QUALITY OF PERFORMANCE PERFORMED. ALL ARE SPECIFIED IN THEIR CONTRACTS. ANY OTHER INCENTIVES ARE PAID OUT AS CONTINGENT INCOME ALSO BASED ON QUALITY AND FINANCIAL PERFORMANCE METRICS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 6:Pontotoc Health Services, Inc. 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, Part VI, Section A, Line 7a:The Governance Committee of North Mississippi Health Services, Inc., which is made up of past Chairmen, nominate candidates for the Board. These candidates are then approved by the Board of North Mississippi Health Services, Inc.
Form 990, Part VI, Section A, Line 7b:The Board of North Mississippi Health Services, Inc. approves all transactions that exceed $1 million.
Form 990, Part VI, Section b, Line 11b: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 return, 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. The Director then does a higher level review, reading the return for reasonableness and comparing prior year amounts to current year amounts. Finally, the Vice President of Finance reviews the return for reasonableness. The returns are then sent to the Executive VP/Treasurer to be reviewed. The Chief Financial Officer signs the return and it is then sent to the IRS.
Form 990, 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, Part VI, Section B, Line 15A & 15BAN INDEPENDENT COMPENSATION CONSULTING FIRM, KORN FERRY, IS USED TO HELP ESTABLISH THE COMPENSATION OF THE SENIOR EXECUTIVES. THE FIRM PRESENTS THEIR INDEPENDENT ANALYSIS, WHICH CONTAINS COMPARABILITY DATA, TO THE COMPENSATION COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS). THE COMPENSATION OF THE INDIVIDUALS ARE THEN APPROVED BY THE COMPENSATION COMMITTEE. THE SALARIES OF NMHS' SENIOR EXECUTIVES 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 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, Part XI, Line 9:Pension-related changes 102,402 Interest in net assets of affiliated foundation: (20,515) Contributed Capital: 354,417 -------------------------------------------------------------------- Total other changes in net assets or fund balance 436,304
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:1253445
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:1540437

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
North MS Management Services Inc
830 S Gloster StreetTupeloMS38801640762694Mgmt & AdminDE501(c)(3)12-INMHSYes (true)
North MS Health Services Inc
830 S Gloster StreetTupeloMS38801640653269Mgmt ServicesDE501(c)(3)12-IINAfalse
Clay County Medical Corporation
830 S Gloster StreetTupeloMS38801640668465HospitalDE501(c)(3)3NMHSYes (true)
Tishomingo Health Services Inc
830 S Gloster StreetTupeloMS38801640741047HospitalDE501(c)(3)3NMHSYes (true)
North MS Medical Center Inc
830 S Gloster StreetTupeloMS38801640662976HospitalDE501(c)(3)3NMHSYes (true)
North MS Medical Clinics Inc
830 S Gloster StreetTupeloMS38801640787918Med ClinicsDE501(c)(3)3NMHSYes (true)
Tupelo Service Finance Inc
830 S GLOSTER STREETTupeloMS38801640508308CollectionsDE501(c)(3)3NMHSYes (true)
Webster Health Services Inc
830 S Gloster StreetTupeloMS38801640819193HospitalDE501(c)(3)3NMHSYes (true)
Marion Regional Medical Center Inc
830 S Gloster StreetTupeloMS38801640926753HospitalDE501(c)(3)3NMHSYes (true)
North MS Emergency Services Inc
830 S Gloster StreetTupeloMS38801640780130ER PhysiciansDE501(c)(3)10NMHSYes (true)
Monroe Health Services
830 South Gloster StreetTupeloMS38801320583236HospitalDE501(c)(3)3NMHSYes (true)
Health Care Foundation of North MS
830 S Gloster StreetTupeloMS38801640914704FUNDRAISINGDE501(C)(3)7NMHSYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
North MS Ambulatory
Surgery Center LLCTupeloMS38801200145190Ambulatory SurgMSNAfalsefalse
Medical Imaging
LLCTupeloMS38801770647210Medical ImagiNGMSNAfalse
Cntr for Digestive
Health LLCTupeloMS38801201606438Digestive CarEMSNAfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
North MS Health Link Inc
830 S Gloster StreetTupeloMS38801640715886Medical ServiCESDENAC CorpYes (true)
North MS Enterprises Inc
830 S Gloster StreetTupeloMS38801640658059Medical ServiCESDENAC CorpYes (true)
Professional Practice Management Inc
830 S Gloster StreetTupeloMS38801721390014Med Serv MgmtDENAC CorpYes (true)
Acclaim Inc
830 S Gloster StreetTupeloMS38801721356116Hlth Care ClaIMSDENAC CorpYes (true)
North MS Support Services Inc
830 S Gloster StreetTupeloMS38801260718275Support ServiCESDENAC CorpYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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