2022-12-05T11:18:45-06:00 2022-01-31 FORVIS LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2021-02-01 710623643 MAINLINE HEALTH SYSTEMS INC % MAINLINE HEALTH SYSTEMS INC MAIN 8705385414 PO BOX 509 DERMOTT AR 71638 GARY ALLAN NICHOLS CEO 8705385414 2022-12-02 true GARY ALLAN NICHOLS 000000000 AMBER SHERRILL P00748683 5013721040 2 2021 2022-09-23 18:48:47Z GARY ALLAN NICHOLS PO BOX 509 DERMOTT AR 71638 27648337 false X WWW.MAINLINEHEALTH.NET X 1986 AR TO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE. 12 12 263 12 0 10053958 6629500 16310550 21018303 1080 534 28377 0 26393965 27648337 15000 15100 0 0 12661936 14691087 0 0 0 8409430 9421054 21086366 24127241 5307599 3521096 21118709 29379904 5128664 9307345 15990045 20072559 TO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE. SERVICES INCLUDE MEDICAL, DENTAL, MENTAL HEALTH AND PREVENTIVE HEALTH SERVICES FOR THE ENTIRE FAMILY. false false 19692724 15100 21018303 PROVIDED MEDICAL SERVICES TO 21,149 PATIENTS AND DENTAL SERVICES TO 1,706 PATIENTS AND BEHAVORIAL HEALTH SERVICES TO 1,475 PATIENTS IN SOUTHEAST ARKANSAS; SERVED RESIDENTS OF CHICOT, BRADLEY, ASHLEY, DREW, LINCOLN, & CLEVELAND COUNTIES. 19692724 true true false false false false false false false false true false false true false false true false false false false false false false false false false true false true false false false false false false false false true false false false false false false false false true 74 0 true 263 true false false false false false false false false false false false false X 12 12 false false false false false false false true true false false true true true true true true true true false X MAINLINE HEALTH SYSTEMS INC 8705385414 108 E SPEEDWAY DERMOTT AR 71638 X KERRY PENNINGTON MD MEDICAL DOCTOR 40.0 0.0 X 411380 0 15336 GARY ALLAN NICHOLS CEO 40.0 0.0 X 332809 0 20175 JOE WHARTON MD MEDICAL DOCTOR 40.0 0.0 X 248561 0 17585 KIMBERLY GOLDEN MD MEDICAL DOCTOR 40.0 0.0 X 249995 0 14770 PAUL WHIPPLE MD MEDICAL DOCTOR 40.0 0.0 X 240019 0 13015 CRYSTAL LITTLE MD PEDIATRICIAN 41.09 0.0 X 232818 0 15966 TAFTA MCCAIN CFO 40.0 0.0 X 170556 0 15611 BYRON MONTGOMERY CIO 40.0 0.0 X 156952 0 15104 JENI BARHAM CQO 40.0 0.0 X 134192 0 12771 DAVID MANTZ COO 40.0 0.0 X 107391 0 12419 ASHLEY ANTHONY COO 40.0 0.0 X 70696 0 8575 AMANDA GILBERT CPO 40.0 0.0 X 52535 0 10618 CHARLES CARR CCO 40.0 0.0 X 14231 0 8575 MARY HOLLINS-SCOTT RN BOARD MEMBER 0.25 0.0 X 0 0 0 FRANK HENRY JR SECRETARY 0.25 0.0 X X 0 0 0 ROBERT THOMAS BOARD MEMBER 0.25 0.0 X 0 0 0 RON MILLER BOARD VICE CHAIR 0.25 0.0 X X 0 0 0 EUGENE BUTLER BOARD MEMBER 0.25 0.0 X 0 0 0 MICHELLE DUNBAR BOARD MEMBER 0.25 0.0 X 0 0 0 IRMA BERNAL BOARD MEMBER 0.25 0.0 X 0 0 0 KEITH SHEPHERD BOARD MEMBER 0.25 0.0 X 0 0 0 BRANDI POOLE BOARD MEMBER 0.25 0.0 X 0 0 0 ALICIA WHITAKER BOARD CHAIR 0.25 0.0 X X 0 0 0 BECKY PHILIPS TREASURER 0.25 0.0 X X 0 0 0 SHANNA KNOWLES BOARD MEMBER 0.25 0.0 X 0 0 0 2422135 0 180520 20 false true false EDAFIO TECHNOLOGIES 5400 NORTHSHORE DRIVE NORTH LITTLE ROCK AR 72118 IT SERVICES 206776 NAVCARE LLC PO BOX 200 AUGUSTA GA 30901 CONTRACT SERVICES 141888 DR JEFFREY REINHART 777 JORDAN DRIVE MONTICELLO AR 71655 PHYSICIAN SERVICES 117000 CPI 340B LLC PO BOX 7 MAMMOTH SPRING AR 72554 340B CONTRACT 205650 4 6072212 557288 458345 6629500 PATIENT REVENUE 621110 13676777 13676777 340B REVENUE 621110 6965316 6965316 SHARED SAVINGS REVENUE 621110 332347 332347 MEDICAL OFFICE BUILDING RENT 531120 43863 43863 21018303 534 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 All Other Misc Revenue 900099 0 0 0 0 0 27648337 21018303 0 534 15100 15100 0 0 0 1152026 1152026 0 10910167 9194684 1715483 251743 212160 39583 1542041 1299575 242466 835110 703800 131310 0 8505 7168 1337 161270 135912 25358 0 0 0 1489892 1255626 234266 151901 128017 23884 629439 530468 98971 0 0 539708 454846 84862 106260 89552 16708 0 0 159301 134253 25048 0 430252 362600 67652 80928 68203 12725 340b EXPENSES 2899177 2443319 455858 MEDICAL SUPPLIES 2084057 2084057 REPAIRS & MAINTENANCE 216958 182844 34114 EQUIPMENT EXPENSE 118118 99545 18573 345288 290995 54293 24127241 19692724 4434517 0 5997430 4596623 2413576 5148417 0 0 2665381 3402854 0 0 0 0 0 0 800925 539310 129549 252518 16175093 4708772 6746013 11466321 0 0 0 0 0 0 0 633454 2365835 3340407 21118709 29379904 1415061 1665405 0 0 0 0 0 0 0 0 0 0 3713603 7641940 0 0 0 0 5128664 9307345 X 15990045 20072559 0 0 15990045 20072559 21118709 29379904 3521096 506842 54576 X false true X true true true X 5450861 4926213 5276625 10053958 6629500 32337157 0 0 5450861 4926213 5276625 10053958 6629500 32337157 1029247 31307910 1465 1516 1222 1080 534 5817 0 902258 1522216 2750712 210504 0 5385690 37728664 60399487 0.82982 0.81678 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 881297 881297 12100655 2471547 9629108 3004869 2237225 767644 188272 188272 11466321 FQHC COST REPORT RECEIVABLE 3340407 3340407 28209755 506842 54576 561418 27648337 27648337 24127241 24127241 24127241 FORM 990, SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true CHICOT MEMORIAL MEDICAL CENTER 2729 HWY 65 82 SOUTH LAKE VILLAGE AR 71653 716056774 501(C)(3) 15000 0 N/A N/A COMMUNITY CENTER 1 0 FORM 990, SCHEDULE I, PART I, LINE 2 WE MAKE CONTRIBUTIONS TO LOCAL SCHOOLS AND OTHER LOCAL ORGANIZATIONS. THESE ARE APPROVED BY THE MARKETING MANAGER BASED ON HER BUDGET. X X X false false false false false false false true false GARY ALLAN NICHOLS CEO 180049 0 152760 0 0 0 11600 0 8575 0 352984 0 0 0 TAFTA MCCAIN CFO 133131 0 37425 0 0 0 7036 0 8575 0 186167 0 0 0 CRYSTAL LITTLE MD PEDIATRICIAN 226634 0 6184 0 0 0 7391 0 8575 0 248784 0 0 0 BYRON MONTGOMERY CIO 135503 0 21449 0 0 0 6529 0 8575 0 172056 0 0 0 KIMBERLY GOLDEN MD MEDICAL DOCTOR 249495 0 500 0 0 0 6195 0 8575 0 264765 0 0 0 KERRY PENNINGTON MD MEDICAL DOCTOR 290699 0 120681 0 0 0 6761 0 8575 0 426716 0 0 0 JOE WHARTON MD MEDICAL DOCTOR 248061 0 500 0 0 0 9010 0 8575 0 266146 0 0 0 PAUL WHIPPLE MD MEDICAL DOCTOR 239719 0 300 0 0 0 4440 0 8575 0 253034 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 7 INCENTIVE PAY IS OFFERED FOR PROVIDERS AND CLINICAL STAFF WHO MEET VARIOUS PRODUCTIVITY GOALS AND FINANCIAL AND QUALITY MEASURES ON A QUARTERLY BASIS. CLINICAL STAFF: LEVEL 1 = $200 LEVEL 2 = $400 LEVEL 3 = $600 LEVEL 4 = $800 INCENTIVE PAY WAS OFFERED TO THE CEO BASED ON LEVEL OF PCMH REACHED, PATIENT GROWTH, AND BOARD EVALUATION. INCENTIVE PAY WAS OFFERED TO THE MEDICAL DIRECTOR BASED ON LEVEL OF PCMH REACHED, PATIENT GROWTH, PATIENT SATISFACTION, AND QUALITY PERFORMANCE. INCENTIVE PAY WAS OFFERED TO THE CFO BASED ON LEVEL OF PCMH REACHED, LEVEL OF PROFIT, AUDIT PERFORMANCE, AND EVALUATION BY THE CEO. PROVIDER BONUSES ARE BASED ON THE NUMBER OF ENCOUNTERS OVER THE MINIMUM REQUIREMENT AND AVERAGE QUALITY METRICS FOR THE QUARTER. X 1 458345 FAIR MARKET VALUE false false false FORM 990, SCHEDULE M, PART I, LINE 20 COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS MADE. FORM 990, PART VI, SECTION B, LINE 11B CFO REVIEWS FORM 990 AND PRESENTS IT TO THE BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES APPROPRIATE ACTION AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION COMMITTEE BASES CEO'S COMPENSATION ON THE NUMBER OF SITES SERVED. THE COMMITTEE COMPARES TO OTHER SYSTEMS IN THE STATE WITH REGARD TO THE NUMBER OF SITES SERVED TO DETERMINE COMPENSATION. COMPENSATION COMMITTEE PRESENTS PROPOSED COMPENSATION TO THE BOARD FOR APPROVAL. THERE IS A WRITTEN EMPLOYMENT CONTRACT WHICH PROVIDES FOR AN INCREASE IN PAY AFTER 90 DAYS OF EMPLOYMENT. THE CEO DETERMINES THE CFO'S SALARY. A COMPENSATION REVIEW IS COMPLETED EVERY JUNE/JULY. 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.