2021-12-03T10:35:53-06:00 2021-01-31 BKD LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2020-02-01 710623643 MAINLINE HEALTH SYSTEMS INC % MAINLINE HEALTH SYSTEMS INC MAIN 8705385414 PO BOX 509 DERMOTT AR 71638 GARY ALLAN NICHOLS CEO 8705385414 2021-12-01 true GARY ALLAN NICHOLS 000000000 AMBER SHERRILL P00748683 5013721040 2 2020 2022-09-23 18:48:47Z GARY ALLAN NICHOLS PO BOX 509 DERMOTT AR 71638 26393965 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 12 230 12 0 5276625 10053958 9057304 16310550 1222 1080 2750712 28377 17085863 26393965 2250 15000 0 0 9460449 12661936 0 0 0 6986930 8409430 16449629 21086366 636234 5307599 15190642 21118709 4771207 5128664 10419435 15990045 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 17215284 15000 16310550 PROVIDED MEDICAL SERVICES TO 22,064 PATIENTS AND DENTAL SERVICES TO 1,331 PATIENTS AND BEHAVORIAL HEALTH SERVICES TO 1,323 PATIENTS IN SOUTHEAST ARKANSAS; SERVED RESIDENTS OF DREW, CLEVELAND, LINCOLN, ASHLEY AND CHICOT COUNTIES. 17215284 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 65 0 true 230 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 KERRY PENNINGTON MD MEDICAL DOCTOR 40.6 0.0 X 266936 0 7566 KIMBERLY GOLDEN MD MEDICAL DOCTOR 47.1 0.0 X 248223 0 9349 JOE WHARTON MD MEDICAL DOCTOR 40.82 0.0 X 241238 0 7566 CRYSTAL LITTLE MD PEDIATRICIAN 40.27 0.0 X 228510 0 14710 GARY ALLAN NICHOLS CEO 40.45 0.0 X 197716 0 15910 BYRON MONTGOMERY CIO 45.19 0.0 X 131500 0 13025 TAFTA MCCAIN CFO 41.76 0.0 X 129810 0 12797 DAVID MANTZ COO 41.53 0.0 X 105378 0 7566 JENI BARHAM CQO 41.23 0.0 X 91264 0 10423 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 GERALD MERCER BOARD MEMBER 0.25 0.0 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 BOARD MEMBER 0.25 0.0 X 0 0 0 1640575 0 98912 20 false true false CONTRACT PHARMACY INSIGHT PO BOX 7 MAMMOTH SPRINGS AR 72554 PHARMACY 180900 1 9499058 554900 526046 10053958 PATIENT REVENUE 621110 10677192 10677192 340B REVENUE 621110 5451231 5451231 ALEDADE SHARED SAVINGS REVENUES 621110 182127 182127 16310550 1080 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 All Other Misc Revenue 900099 28377 28377 28377 28377 28377 26393965 16310550 29457 15000 15000 0 0 0 715391 715391 0 0 9754012 8043486 1710526 162851 134292 28559 1353600 1116224 237376 676082 557520 118562 0 2520 2078 442 76444 63038 13406 0 0 0 1278530 1054319 224211 122145 100725 21420 595651 491194 104457 0 0 371622 306452 65170 92309 76121 16188 0 0 137897 113714 24183 0 410867 338815 72052 74976 61828 13148 340b EXPENSES 2340180 1929791 410389 MEDICAL SUPPLIES 1187835 1187835 BAD DEBTS 1173279 1173279 REPAIRS & MAINTENANCE 210890 173907 36983 334285 275666 58619 21086366 17215284 3871082 0 1928777 5997430 2150565 2413576 0 0 1959606 2665381 0 0 0 0 0 0 284894 800925 265615 129549 11024533 4278520 7049065 6746013 0 0 0 0 0 0 0 0 1552120 2365835 15190642 21118709 919352 1415061 0 0 0 0 0 0 0 0 0 0 3851855 3713603 0 0 0 0 4771207 5128664 X 10419435 15990045 0 0 10419435 15990045 15190642 21118709 5307599 263011 X false true X true true true X 4973940 5450861 4926213 5276625 10053958 30681597 0 0 4973940 5450861 4926213 5276625 10053958 30681597 909597 29772000 1730 1465 1516 1222 1080 7013 0 558050 902258 1522216 2750712 28377 5761613 36450223 44714178 0.81678 0.78065 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 149913 149913 8231460 2252752 5978708 2643160 2025768 617392 6746013 FQHC COST REPORT RECEIVABLE 2365835 2365835 25538273 263011 54576 317587 25220686 1173279 1173279 26393965 19967663 54576 54576 19913087 1173279 1173279 21086366 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 UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, SCHEDULE D, PART XI, LINE 4B BAD DEBT EXPENSE $1,173,279 FORM 990, SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE $1,173,279 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 148482 0 49234 0 0 0 8344 0 7566 0 213626 0 0 0 CRYSTAL LITTLE MD PEDIATRICIAN 223170 0 5340 0 0 0 7144 0 7566 0 243220 0 0 0 KIMBERLY GOLDEN MD MEDICAL DOCTOR 233218 0 15005 0 0 0 1783 0 7566 0 257572 0 0 0 KERRY PENNINGTON MD MEDICAL DOCTOR 265674 0 1262 0 0 0 0 0 7566 0 274502 0 0 0 JOE WHARTON MD MEDICAL DOCTOR 240938 0 300 0 0 0 0 0 7566 0 248804 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 EXECUTIVE DIRECTOR. PROVIDER BONUSES ARE BASED ON THE NUMBER OF ENCOUNTERS OVER THE MINIMUM REQUIREMENT AND AVERAGE QUALITY METRICS FOR THE QUARTER. X 1 471470 FAIR MARKET VALUE false false false FORM 990, SCHEDULE M, PART I, LINE 20 COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS MADE. REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B CFO REVIEWS FORM 990 AND PRESENTS IT TO THE BOARD FOR REVIEW PRIOR TO FILING. MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12(C) MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES APPROPRIATE ACTION AS NECESSARY. DETERMINATION OF COMPENSATION FORM 990, PART VI, SECTION B, LINES 15(A) AND 15(B) COMPENSATION COMMITTEE BASES EXECUTIVE DIRECTOR'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. 15(B): THE EXECUTIVE DIRECTOR DETERMINES THE CFO'S SALARY. A COMPENSATION REVIEW IS COMPLETED EVERY JUNE/JULY. AVAILABILITY OF DOCUMENTS 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.