2021-11-01T18:41:45-05:00 2020-12-31 721396621 CARR RIGGS & INGRAM LLC 400 W PKWY PL SUITE 300 RIDGELAND MS 39157 990 2020-01-01 640655993 RUSH HOSPITAL - BUTLER INC RUSH 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 DAVID L BUTLER CFO 6017039992 2021-10-21 1 DAVID BUTLER 999009999 DAWN STEED P01279118 6018537050 2021-10-21 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAVID BUTLER 1314 19TH AVENUE MERIDIAN MS 39301 19170258 0 X RUSHHEALTHSYSTEMS.ORG X 1983 AL HOSPITAL AND CLINIC PATIENT SERVICE 7 6 143 6 0 0 842697 3952756 15925859 14975932 -3130486 -1050 639644 242620 14277714 19170258 0 0 0 0 6099289 6581505 0 0 0 11077963 11414297 17177252 17995802 -2899538 1174456 22071957 30145280 24755324 31654191 -2683367 -1508911 X ACUTE-CARE HOSPITAL PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES TO THE CHOCTAW COUNTY AREA AND SURROUNDING COMMUNITIES. 0 0 15215981 15022637 CHOCTAW GENERAL HOSPITAL IS A 25-BED ACUTE-CARE, CRITICAL ACCESSHOSPITAL LOCATED IN BUTLER, ALABAMA IN CHOCTAW COUNTY. BUTLER HAS APOPULATION OF 1,639 AND CHOCTAW COUNTY HAS A POPULATION OF 13,188.CHOCTAW GENERAL HOSPITAL IS AFFILIATED WITH RUSH HEALTH SYSTEMS OFMERIDIAN, MISSISSIPPI.CHOCTAW GENERAL HOSPITAL'S SCOPE OF CARE INCLUDES A RANGE OF INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. A VARIETY OF OTHER SERVICES ARE AVAILABLE ON AN INPATIENT AND OUTPATIENT BASIS THROUGH THE HOSPITAL'S IMAGING, LABORATORY AND REHABILITATIVE SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. A 24-HOUR EMERGENCY DEPARTMENT IS STAFFED WITH QUALIFIED EMERGENCY ROOM HOSPITALISTS AND FAMILY NURSE PRACTITIONERS AND IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK. THE HOSPITAL, WHICH OPENED IN MARCH, 2012, ALSO HAS A HELIPAD AND MAINTAINS AFFILIATIONS WITH AIR AMBULANCE SERVICES IN ALABAMA FOR THE TRANSFER OF PATIENTS REQUIRING HIGHER ACUITY OR MORE SPECIALIZED CARE. SKILLED NURSING AND REHABILITATIVE CARE ARE AVAILABLE AT CHOCTAW GENERAL HOSPITAL THROUGH THE SWING BED PROGRAM. THOSE RECOVERING FROM SURGERY, A STROKE, A FRACTURE OR AN EXTENDED MEDICAL ILLNESS AND HOSPITALIZATION CAN RECEIVE REHABILITATIVE CARE AT CHOCTAW GENERAL HOSPITAL, WHETHER OR NOT THEY WERE HOSPITALIZED IN ANOTHER LOCATION. ADDITIONALLY, THEY OFFER AN INTENSIVE OUTPATIENT PROGRAM DESIGNED TO PROVIDE CARE FOR SENIOR ADULTS SUFFERING FROM CHRONIC ANXIETY, DEPRESSION AND GRIEF.IN 2019, CHOCTAW GENERAL HOSPITAL LAUNCHED A CHRONIC VENTILATOR PROGRAM TO MEET THE COMPLEX RESPIRATORY NEEDS OF THOSE ENTRUSTED TO THEIR CARE. THE PROGRAM IS DESIGNED TO PROVIDE HIGH-QUALITY CARE FOR INDIVIDUALS WITH CHRONIC VENTILATORS AND THOSE WHO ARE ABLE TO BE WEANED.IN 2020, CHOCTAW GENERAL HOSPITAL CONTINUED IMPLEMENTATION OF A 340B DRUG PROGRAM DESIGNED TO HELP PATIENTS, PARTICULARLY THOSE WHO DO NOT HAVE PRESCRIPTION DRUG COVERAGE UNDER THEIR INSURANCE PROGRAMS OR WHO ARE UNINSURED RECEIVE SIGNIFICANT DISCOUNTS ON PRESCRIPTION MEDICATIONS.AS PRESENTED IN THE ATTACHED SCHEDULE H, CHOCTAW GENERAL HOSPITAL PROVIDED FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS DURING 2020 AT A COST OF $3,364,228. ALTHOUGH EQUITABLE PAYMENT FOR SERVICES IS ESSENTIAL TO THE ORGANIZATION'S FINANCIAL VIABILITY, CHOCTAW GENERAL HOSPITAL RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE RESOURCES REQUIRED TO REIMBURSE THE HOSPITAL FOR ALL SERVICES PROVIDED. KEEPING ITS COMMITMENT TO THE COMMUNITY, CHOCTAW GENERAL HOSPITAL PROVIDES FREE CARE AND SUBSIDIZED CARE WITHIN EXISTING RESOURCES WHERE THE NEED FOR SUCH CARE EXISTS. ALONG WITH BEING THE ONE OF THE COUNTY'S LARGEST EMPLOYERS AND A MAJOR ECONOMIC STIMULUS BY VIRTUE OF ITS PAYROLL, CHOCTAW GENERAL HOSPITAL ALSO PROVIDES MANY BENEFITS TO THE BROADER COMMUNITY IN THE AREAS OF CIVIC INVOLVEMENT AND GIVING INCLUDING ACTIVELY SUPPORTING THE AMERICAN CANCER SOCIETY, CONDUCTING COMMUNITY EDUCATION CLASSES AND PROVIDING FREE MEDICAL SCREENING TESTS AND DISSEMINATION OF HEALTH INFORMATION AT CIVIC CLUB MEETINGS AND OTHER COMMUNITY FUNCTIONS. 15215981 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 19 0 1 143 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAVID BUTLER 6017033082 1314 19TH AVENUE MERIDIAN MS 39301 CLIFF BRYAN BOARD MEMBER 1.00 X 0 0 0 DR LEE ARMISTEAD BOARD MEMBER 40.00 X 0 439314 33323 DUANE JOHNSON BOARD MEMBER 1.00 X 0 0 0 RUBY SINGLEY BOARD CHAIRMAN 1.00 X 0 0 0 S TODD LOWERY BOARD MEMBER 1.00 X 0 0 0 SEKETHA MITCHELL BOARD MEMBER 1.00 X 0 0 0 SHEILA SKELTON BOARD MEMBER 1.00 X 0 0 0 DARRELL WILDMAN TREASURER 1.00 60.00 X 0 357120 23444 DAVID BUTLER CFO 1.00 48.00 X 0 256800 21828 FRED DUGGAN MD CMA 1.00 45.00 X 0 735872 33079 JW COWAN ADMINISTRATOR 40.00 X 0 105164 23793 LARKIN KENNEDY PRESIDENT 1.00 65.00 X 0 475270 25780 RICK BARRY SECRETARY 1.00 13.00 X 0 18000 0 ALLEN TYRA COO 1.00 48.00 X 0 274830 24557 DAWN REYNOLDS COMPLIANCE 1.00 48.00 X 0 118479 21486 AIMEE MCWILLIAMS COMPLIANCE DIRECTOR 1.00 48.00 X 0 71133 21820 KATHERINE A HENSLEIGH PHYSICIAN 40.00 X 0 287811 12233 VERNADETTE L HORN PHYSICIAN 40.00 X 0 102656 16011 0 3242449 257354 0 0 1 0 CC&C INC 409 ZARA STREET BUTLER AL 36904 ER PHYSICIAN SERVICES 1558900 MEDICOMP INC PO BOX 426 MAGEE MS 39111 PHYSICAL THERAPY SERVICES 725517 2 3949540 3216 3952756 PATIENT FEES 621990 14975932 14975932 14975932 -1050 -1050 CAFETERIA 722210 195915 195915 MISCELLANEOUS 900099 46705 46705 242620 19170258 15022637 0 194865 5341794 5033894 307900 39189 39189 833527 833517 10 366995 343995 23000 1928705 1928705 1649527 1649527 2660815 2660815 16564 13054 3510 567957 567957 490308 490308 97371 97371 PURCHASED SERVICES 1906255 1782096 124159 TAXES & LICENSES 668151 667357 794 ALL OTHER EXPENSES 585771 592053 -6282 SUPPLIES 476185 405667 70518 366688 39181 327507 17995802 15215981 2779821 0 31312 74706 2371126 1660994 721 718 145343 155485 51456 78257 17550649 4357754 13664891 13192895 375 0 5806733 14982225 22071957 30145280 820169 1112937 16348976 15799953 7586179 14741301 24755324 31654191 X -2683367 -1508911 -2683367 -1508911 22071957 30145280 1174456 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1590 1590 0 PART II-B, LINE 1: RUSH HOSPITAL - BUTLER, INC. PAYS DUES TO ALABAMA HOSPITAL ASSOCIATION TOTALING $9,099, OF WHICH 17.47% IS ATTRIBUTABLE TO LOBBYING. 400000 400000 16213802 3443371 12770431 19598 6400 13198 917249 907983 9266 13192895 DUE FROM AFFILIATES 14982225 14982225 DUE TO AFFILIATES 11060953 DEFERRED REVENUE - COVID 952176 THIRD PARTY PAYORS 2728172 14741301 X PART X, LINE 2: RUSH HEALTH SYSTEMS, INC., SUBSIDIARIES, AND AFFILIATES, WITH THE EXCEPTION OF PHYSICIAN MANAGEMENT SERVICES, INC., MERIDIAN ANESTHESIA GROUP, INC., MANAGED HEALTHCARE, INC., AND THE MEDICAL STORE, ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON THEIR INCOME UNDER SECTION 501(A) OF THE CODE. PHYSICIAN MANAGEMENT SERVICES, INC., MERIDIAN ANESTHESIA GROUP, INC., MANAGED HEALTHCARE, INC., AND THE MEDICAL STORE, HOWEVER, ARE TAXABLE CORPORATIONS AND FILE CORPORATE INCOME TAX RETURNS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE HEALTH SYSTEM TO EVALUATE TAX POSITIONS TAKEN BY THE HEALTH SYSTEM AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE HEALTH SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE HEALTH SYSTEM HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2017, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. DEFERRED TAXES ARE PROVIDED ON A LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASES. THE SUBSIDIARIES' TEMPORARY DIFFERENCES RELATE PRIMARILY TO PROPERTY AND EQUIPMENT AND NET OPERATING LOSS CARRYFORWARDS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE-LIKELY-THAN-NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN TAX LAWS AND RATES ON THE DATE OF ENACTMENT. 1 1 1 X 1 X 1 1 1 0 0 1810241 1810241 0.10060 2157650 1530818 626832 0.03480 1392 1831 0 0.00000 3969283 1532649 2437073 0.13540 7675 7675 0.00040 756 756 0.00000 2159918 1241194 918724 0.05110 2168349 1241194 927155 0.05150 6137632 2773843 3364228 0.18690 549 549 0.00000 549 549 0.00000 1 7054548 6854084 200464 X 1 1 1 1 RUSH HOSPITAL - BUTLER INC 401 VANITY FAIR LANE BUTLER AL 36904 X X CHOCTAW GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/HOSPITALS/CHOCTAW-GENERAL-HOSPITAL/ X 1 19 1 HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/INDEX.CFM/_API/RENDER/FILE/?METHOD=INLINE 0 1 X 150.000000000000 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PR X HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PR X HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PR X X X X X X X 1 X 0 X X X 1 X 0 0 CHOCTAW GENERAL HOSPITAL PART V, SECTION B, LINE 5: PLEASE SEE THE COMMUNITY INPUT SECTION OF THECHNA, FOUND AT:HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/INDEX.CFM/_API/RENDER/FILE/?METHOD=INLINE&FILEID=71ED4262-023D-4935-A7E03C435CCC012A CHOCTAW GENERAL HOSPITAL PART V, SECTION B, LINE 11: SEE IMPLEMENTATION STRATEGY:HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/INDEX.CFM/_API/RENDER/FILE/?METHOD=INLINE&FILEID=3B0F58FA-0E31-4D1C-9BF8D427D85B85D7 CHOCTAW GENERAL HOSPITAL PART V, SECTION B, LINE 16J: HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL-ASSISTANCE-POLICY/HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAM/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM-APPLICATION/HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAM/RUSH-PLAIN-LANGUAGE-SUMMARY/ 2 1 - CHOCTAW URGENT CARE CENTER 1404 EAST PUSHMATHA ST BUTLER AL 36904 URGENT CARE CLINIC 2 - GILBERTOWN FAMILY MEDICAL CLINIC 12731 AL-17 GILBERTOWN AL 36908 FAMILY MEDICAL CENTER PART I, LINE 7: COSTING METHODOLOGY USED IN THE TABLE ON LINE 7 IS THE RATIO OF PATIENTCARE COST TO CHARGES DERIVED FROM WORKSHEET 2. PART II, COMMUNITY BUILDING ACTIVITIES: ALL ACTIVITIES ENGAGED IN BY RUSH HOSPITAL - BUTLER, INC. ARE GEAREDTOWARD PROMOTION AND IMPROVEMENT OF THE WELLBEING OF THE CITIZENS OF OURPRIMARY SERVICE AREA. RUSH HOSPITAL-BUTLER PROMOTES HEALTH EDUCATION THROUGH SUPPORT OFITS COMMUNITY BASED NURSING AND ALLIED HEALTH PROGRAMS AS WELL ASCOMMUNITY HEALTH EDUCATION AND TRAINING SESSIONS. RUSH HOSPITAL-BUTLER ALSO SUPPORTSTHE COMMUNITY BY ENSURING THE PROVISION OF MUCH NEEDED EMERGENCY MEDICINE.PART III, PART III, LINE 4: BAD DEBT EXPENSE IS AS AMOUNT OF CHARGES PER TRIAL BALANCE, THIS AMOUNT ISNETTED WITH REVENUE ON AUDITED FINANCIALS AS AN IMPLICIT PRICE CONCESSION.FOR TAX PURPOSES, BAD DEBT EXPENSE IS MOVED DOWN TO THE EXPENSE SECTION.PER NOTE 1 OF THE FINANCIAL STATEMENTS, PATIENT ACCOUNTS RECEIVABLE AREREPORTED AT ESTIMATED NET REALIZABLE VALUE TAKING INTO ACCOUNT ESTIMATEDIMPLICIT AND EXPLICIT PRICE CONCESSIONS. THE ESTIMATED IMPLICIT PRICECONCESSIONS ARE BASED UPON MANAGEMENT'S JUDGMENTAL ASSESSMENT OFHISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERALECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTHCARE COVERAGE,AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICESPROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE (WHICH INCLUDESPATIENTS WITH DEDUCTIBLE AND PAYMENT BALANCES FOR WHICH THIRD-PARTYCOVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM ANALYZESCONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR EXPLICIT PRICECONCESSIONS, IF NECESSARY. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THEADEQUACY OF THE PRICE CONCESSIONS BASED UPON ITS REVIEW OF ACCOUNTSRECEIVABLE PAYOR COMPOSITION AND AGING, TAKING INTO CONSIDERATION RECENTEXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHERFACTORS. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MAKE MODIFICATIONSTO PATIENT SERVICE REVENUE AND TO ESTABLISH AN APPROPRIATE ESTIMATE FORPRICE CONCESSIONS. THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FORPLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTIONAGENCIES. PART III, LINE 8: ALTHOUGH NOT THE CASE THIS YEAR, THE COST OF PROVIDING SERVICES TOMEDICARE PATIENTS, HAS HISTORICALLY SIGNIFICANTLY EXCEEDED REVENUE. THISCOST PROVIDES A NECESSARY HEALTH BENEFIT TO THE ELDERLY POPULATION IN THEHOSPITAL'S SERVICE AREA AND SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART III, LINE 9B: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITSCHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAT ITS ESTABLISHEDRATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTSDETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE.ADDITIONALLY, THE HOSPITAL MAY UTILIZE OUTSIDE AGENCIES AS APPROPRIATE TOASSIST IN DETERMINING ACCOUNTS THAT QUALIFY AS CHARITY CARE. ANY ACCOUNTSDETERMINED TO BE CHARITY BASED ON AN AGENCY'S RECOMMENDATION ARE REPORTEDAS CHARITY CARE AND REVENUE REDUCED BY THIS AMOUNT AS OPPOSED TO BEINGREPORTED AS BAD DEBT EXPENSE. PART VI, LINE 2: OUTSIDE CONSULTANTS ARE HIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENTPERIODICALLY.THE CHNA CAN BE ACCESSED VIA THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/HOSPITALS/CHOCTAW-GENERAL-HOSPITAL/ PART VI, LINE 3: PATIENTS ARE PROVIDED AN APPLICATION FOR CHARITY CARE AND A CRITERIA FORCHARITY CARE CHECKLIST AS CLOSE TO POINT OF SERVICE AS POSSIBLE.ADDITIONALLY, THE HOSPITAL UTILIZES AN OUTSIDE ELIGIBILITY COMPANY THATREVIEWS ALL NO INSURANCE PATIENTS FOR POTENTIAL QUALIFICATION FOR OTHERGOVERNMENTAL PROGRAMS SUCH AS MEDICAID. PART VI, LINE 4: RUSH HOSPITAL - BUTLER IS A CRITICAL ACCESS ACUTE-CARE MEDICAL CENTER THATSERVES INPATIENTS AND OUTPATIENTS, PRIMARILY IN THE DEKALB, ALABAMA AREA.AS A CRITICAL ACCESS HOSPITAL, BUTLER TRANSFERS THE EMERGENT AND MORECOMPLICATED CASES THAT REQUIRE SPECIALISTS PRIMARILY TO THE LARGER ACUTECARE HOSPITALS IN THE MERIDIAN, MS AREA. OF THE COUNTIES SERVED, THEFOLLOWING ARE COUNTIES IDENTIFIED BY HEALTH RESOURCES AND SERVICESADMINISTRATION OF THE US DEPT OF HEALTH AND HUMAN SERVICES AS HEALTHPROFESSIONAL SHORTAGE AREAS: CHOCTAW AND SUMTER COUNTIES IN ALABAMA;CLARKE, KEMPER, LAUDERDALE, NESHOBA, NEWTON AND SCOTT COUNTIES INMISSISSIPPI.ADDITIONAL INFORMATION ON THE COMMUNITY SERVED CAN BE FOUND IN THE CHNA.THE CHNA CAN BE ACCESSED VIA THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.RUSHHEALTHSYSTEMS.ORG/INDEX.CFM/_API/RENDER/FILE/?METHOD=INLINE&FILEID=728B8C7B-6AE3-432A-B07D3C25F86F321C PART VI, LINE 5: ALL MEMBERS OF RUSH HOSPITAL - BUTLER, INC.'S BOARD RESIDE IN BUTLER'SPRIMARY SERVICE AREA. THE ORGANIZATION HAS AN OPEN MEDICAL STAFFEXTENDING PRIVILEGES TO ALL QUALIFIED PHYSICIANS AND NON-PHYSICIANPRACTITIONERS THAT APPLY FOR PRIVILEGES AND MEET ALL REQUIREMENTS OFCREDENTIALING AND THE MEDICAL STAFF RULES AND REGS AND BY-LAWS. THEFACILITY UTILIZES SURPLUS FUNDS FOR ADDITIONAL MEDICAL TECHNOLOGY,RECRUITMENT OF MEDICAL STAFF THAT IS OTHERWISE UNAVAILABLE (I.E.NEUROSURGERY, MIDWIFERY, ETC.), FUNDING OF LOCAL AREA HEALTHCARE WORKFORCE TRAINING AND ECONOMIC DEVELOPMENT. PART VI, LINE 6: RUSH HOSPITAL - BUTLER, INC IS WHOLLY OWNED BY RUSH HEALTH SYSTEMS, ANON-PROFIT ORGAINIZATION. WITHIN RUSH HEALTH SYSTEMS ARE THE SPECIALTYHOSPITAL OF MERIDIAN (A LONG TERM ACUTE CARE FACILITY), SCOTT HOSPITAL (ACRITICAL ACCESS HOSPITAL, HC WATKINS HOSPITAL (A CRITICAL ACCESSHOSPITAL), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL), MEDICAL FOUNDATIONINC. (A CLINIC ORGANIZATION), AND RUSH MEDICAL GROUP (A CLINICORGANIZATION). EACH OF THESE ENTITES COORDINATE TO IMPROVE THE HEALTHCAREOF EAST MISSISSIPPI AND WEST ALABAMA. CLINICAL INTEGRATION BETWEENOUTLYING CRITICAL ACCESS HOSPITALS, SPECIALIST PHYSICIANS AND THE GENERALACUTE CARE HOSPITAL PROVIDE FOR IMPROVED ACCESS AND IMPROVED OUTCOMES FORTHE POPULATION WE SERVE. X X X X X X 0 1 0 0 0 0 0 0 0 FRED DUGGAN MD CMA 0 727072 0 0 0 8800 0 8400 0 24679 0 768951 0 0 LARKIN KENNEDY PRESIDENT 0 475270 0 0 0 0 0 3500 0 22280 0 501050 0 0 DR LEE ARMISTEAD BOARD MEMBER 0 439314 0 0 0 0 0 8400 0 24923 0 472637 0 0 DARRELL WILDMAN TREASURER 0 357120 0 0 0 0 0 8400 0 15044 0 380564 0 0 KATHERINE A HENSLEIGH PHYSICIAN 0 287811 0 0 0 0 0 0 0 12233 0 300044 0 0 ALLEN TYRA COO 0 274830 0 0 0 0 0 0 0 24557 0 299387 0 0 DAVID BUTLER CFO 0 256800 0 0 0 0 0 0 0 21828 0 278628 0 0 PART I, LINE 4B RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). FOR 2019, THERE WERE NO CONTRIBUTIONS OR DISTRIBUTIONS FOR THOSE LISTED ON SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 6 RUSH HEALTH SYSTEMS, INC. IS THE PARENT ORGANIZATION AND SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPOINTS BOARD MEMBERS FOR THE ORGANIZATION ANNUALLY FOR A ONE YEAR TERM. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPROVES AND RATIFIES THE ACTIONS OF THE ORGANIZATION'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF THE ORGANIZATION) REVIEWED AND APPROVED THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE OFFICERS AND DIRECTORS OF THE ORGANIZATION REVIEW THE POLICY ANNUALLY AND SIGN A CONFLICT OF INTEREST STATEMENT STATING THEY HAVE READ AND UNDERSTAND THE POLICY AND ARE IN COMPLIANCE. EDUCATION IS GIVEN TO THE STAFF ON THE CONFLICT OF INTEREST POLICY WHICH INCLUDES DIRECTION TO VOICE ANY QUESTIONS OR CONCERNS THEY HAVE AND TO BRING FORTH ANY POTENTIAL CONFLICT OR CONCERN TO THE ATTENTION OF THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FOR THE AFFILIATED GROUP OF RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) IS REVIEWED ANNUALLY BY INDEPENDENT CONSULTANTS. CONSULTANTS COMPARE COMPENSATION ORDINARILY PROVIDED BY SIMILAR ORGANIZATIONS, UNDER LIKE CIRCUMSTANCES, AND ADJUSTED TO REFLECT CURRENT MARKET RATES. CONSULTANTS MEET WITH THE COMPENSATION COMMITTEE AND MAKE RECOMMENDATIONS WHICH ARE APPROVED AND RATIFIED BY THE BOARD. THE INDEPENDENT CONSULTANTS REGULARLY CONTRACTED TO PERFORM SUCH REVIEWS ARE SULLIVAN, COTTER & ASSOCIATES, INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XII, LINE 2C: THE AUDIT/COMPENSATION COMMITTEE OF RUSH HEALTH SYSTEMS OVERSEES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. RUSH MEDICAL FOUNDATION DBA RUSH FOUNDATION HOSPITAL 1314 19TH AVENUE MERIDIAN MS 39301 640345119 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH MEDICAL GROUP OF NEWTON 1314 19TH AVENUE MERIDIAN MS 39301 640783323 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HOME CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640670314 PROVIDING HOME HEALTH CARE MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 LAIRD HOSPITAL INC 25117 HWY 15 UNION MS 39365 201835779 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640833381 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 MERIDIAN SPEECH AND HEARING CENTER 1314 19TH AVENUE MERIDIAN MS 39301 640529831 PROVIDING AUDIOLOGY AND DYSLEXIA TESTING AND TREATMENT MS 501(C)(3) 509(A)(2) RUSH HEALTH SYSTEMS INC 0 SCOTT REGIONAL MEDICAL CENTER INC 1314 19TH AVENUE MERIDIAN MS 39301 260792328 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 MEDICAL FOUNDATION INC PO BOX 5183 MERIDIAN MS 39302 640834532 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 KEMPER CAH INC 1314 19TH AVENUE MERIDIAN MS 39301 271757642 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 NEWCA CAH INC 1314 19TH AVENUE MERIDIAN MS 39301 201254928 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HEALTH SYSTEMS INC PO BOX 5187 MERIDIAN MS 39301 640664988 PROVIDING SUPPORT TO HEALTH CARE AFFILIATES MS 501(C)(3) 509(A)(3) N/A 0 FOUNDATION FOR RUSH INC 1314 19TH AVENUE MERIDIAN MS 39301 473716882 FOUNDATION/FUNDRAISING MS 501(C)(3) 170(B)(1)(A)(IV) RUSH HEALTH SYSTEMS INC 0 MERIDIAN SURGERY CENTER LLC 2100 13TH STREET MERIDIAN MS 39301 300160065 AMBULATORY SURGERY CENTER MS N/A N/A 0 0 RUSH SERVICE COMPANY INC PO BOX 5188 MERIDIAN MS 39302 640670493 PROPERTY RENTAL MS N/A 0 MANAGED HEALTH CARE 1314 19TH AVENUE MERIDIAN MS 39301 640862241 MANAGE HEALTHCARE MS N/A 0 PHYSICIAN MANAGEMENT SERVICES INC 1314 19TH AVENUE MERIDIAN MS 39301 710927411 HEALTHCARE MANAGEMENT MS N/A 0 MERIDIAN ANESTHESIOLOGY GROUP PA 4700 26TH AVENUE MERIDIAN MS 39305 640675511 ANESTHESIOLOGY SERVICES MS N/A 0 THE MEDICAL STORE #1 1314 19TH AVENUE MERIDIAN MS 39301 640756777 DURABLE MEDICAL EQUIPMENT SALES MS N/A 0 RURAL HEALTHCARE MANAGEMENT INC 1314 19TH AVENUE MERIDIAN MS 39301 811641843 HEALTHCARE MANAGEMENT MS N/A 0 PEAVEY INVESTMENT COMPANY INC 1220 16TH AVENUE MERIDIAN MS 39301 640412267 SUBSIDIARY OF RUSH SERVICE COMPANY MS N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0