2020-11-12T17:50:27-06:00 2020-06-30 710355269 LANDMARK PLC CPAS P O BOX 10148 FORT SMITH AR 729170148 990 2019-07-01 237237381 ARKANSAS FOUNDATION FOR MEDICAL CARE INC ARKA 5012128631 PO BOX 180001 FORT SMITH AR 729180001 PHYLLIS ROGERS CHIEF FINANCIAL OFFICER 5012128631 2020-11-12 1 BARBARA HAMBRICK P00387600 4794845740 2020-11-12 40.133.38.90 2020-11-12 09:31:54 CS P F8CC22ACD47BD09EA0A02C06965D6C6924927829 77DAD9D9559A628258FA7A97E536D89EF7D5BE30 2019 2021-01-29 14:40:06Z PHYLLIS ROGERS PO BOX 180001 FORT SMITH AR 729180001 34280464 0 X WWW.AFMC.ORG X 1972 AR ARKANSAS FOUNDATION FOR MEDICAL CARE, INC. DEVELOPS AND PROMOTES COOPERATIVE QUALITY IMPROVEMENT PROJECTS INVOLVING HOSPITALS, NURSING HOMES, HOME HEALTH AGENCIES, PHYSICIANS, AND OTHER STAKEHOLDERS IN ORDER TO IMPROVE THE DELIVERY, QUALITY, AND COST-EFFECTIVENESS OF HEALTH CARE PROVIDED FOR MEDICARE AND MEDICAID BENEFICIARIES. 14 14 302 0 0 0 16582486 26523253 4264937 4870969 323178 952297 -4018 39969 21166583 32386488 23684 91097 0 0 15701502 22296187 0 0 0 6003212 9080604 21728398 31467888 -561815 918600 29402830 33011636 2723071 6524923 26679759 26486713 X TO PROMOTE EXCELLENCE IN HEALTH CARE THROUGH EVALUATION AND EDUCATION 0 0 721468 CMS QIN/QIO 11TH AND 12TH SOW WHICH WE PARTICIPATE IN AS A SUB TO TMF (TEXAS MEDICAL FOUNDATION) - PROVIDED QUALITY CONTROL PEER REVIEW SERVICES IN ACORDANCE WITH SECTION 1154 OF THE SOCIAL SECURITY ACT IN ACCORDANCE WITH THE REQUIREMENTS AND DELIVERABLES OF THE 11TH AND 12TH SCOPE OF WORK. 5677589 ARKANSAS MEDICAID REVIEW - PROVIDED REVIEW SERVICES AS REQUIRED BY CONTRACT:PRIOR AUTHORIZATION OF ASSISTANT SURGEON - 555PRIOR AUTHORIZATION OF MUMPS - 20,542PRIOR AUTHORIZATION OF DME - 25.491TARGETED CASE MANAGEMENT REVIEW - 67PHYSICIAN DRUG REVIEW - 3,656RETRO EMERGENCY ROOM REVIEW - 48,518RETRO INPATIENT REVIEW - 31,525OUT OF STATE - 68EMERGENCY MEDICAID NON-COVERED - 210EXTENSION OF BENEFIT/MOLECULAR PATHOLOGY REVIEW - 40,804MOLECULAR PATHOLOGY - 2,390ORGAN TRANSPLANT REVIEW - 73PVT OPTION REVIEWS - 21NICU - 1,401THERAPY PERSONAL CARE - 1,320PRIVATE DUTY NURSING - 200SUSPENDED CLAIMS - 295AMBULANCE - 5EPSDT - 1LONG TERM CARE - 2,430FORMULA - 51MEDICAL SUPPLIES - 26 13687441 MEDICAID BENEFICIARY RELATIONS - A CONTRACT TO MAINTAIN ACTIVE FEEDBACK AND PROFESSIONAL RELATIONS WITH MEDICAID BENEFICIARIES. IT ALSO INCLUDES MAINTAINING A CALL SERVICE CENTER TO ASSIST INDIVIDUALS WITH MEDICAID AND PRIVATE OPTION COVERAGE. SURVEYS AND MONITORING OF THE NON-EMERGENCY TRANSPORTATION (NET) SERVICES ARE ADDITIONAL DELIVERABLES UNDER THIS CONTRACT. PROVIDER RELATIONS AND CONNECTCARE ACTIVITIES WERE ALSO ADDED TO THIS CONTRACT THIS YEAR. 9608396 91097 4870888 9608396 91097 4870888 29694894 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 54 0 1 302 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AR X JENNA CLEMMONS 5012128631 PO BOX 180001 FORT SMITH AR 72918 STACY C ZIMMERMAN MD CHAIRMAN OF BOARD 1.00 X X 12200 0 0 HARVEY POTTS MD MPH VICE CHAIRMAN 1.00 X X 8500 0 0 JENNIFER STRYON TREASURER 1.00 X X 8200 0 0 ALAN WILSON MD SECRETARY 1.00 X X 5150 0 0 LADELL DOUGLAS MD MEMBER-AT-LARGE 1.00 X X 10158 0 0 CAROLYN HOOD RN BSN BOD 1.00 X 8300 0 0 GARY PAXSON BOD 1.00 X 8600 0 0 AMY JOHNSON JD BOD 1.00 X 9650 0 0 TOM BUTLER BOD 1.00 X 8900 0 0 KAREN PETTIT RNP CPHQ BOD 1.00 X 8600 0 0 MELISSA PIERCE RNP BOD 1.00 X 7750 0 0 JANE SNEED MD BOD 1.00 X 7450 0 0 DANNY WILKERSON MD BOD 1.00 X 8100 0 0 MARCUS OSBORNE BOD 1.00 X 8250 0 0 WALLACE R HANLEY CEO/PRESIDENT 38.00 X 400290 0 26560 MARILYN LITTLE CHIEF OPERATING OFFICER 40.00 X 216087 0 6566 CHAD T RODGERS MD VP & CHIEF MEDICAL OFFICER 26.00 X 212040 0 12652 MARY S MOORE CHIEF COMPLIANCE OFFICER 43.00 X 172795 0 23495 PHYLLIS ROGERS CHIEF FINANCIAL OFFICER 38.00 X 125057 0 13714 NATHAN RAY CHIEF BUSINESS OFFICER 44.00 X 198093 0 12259 HANNAH RAY GOVERNMENT AFFAIRS EXECUTI 39.00 X 89666 0 2699 GLORIA BOONE CHIEF MEMBER SERVICES OFFI 50.00 X 168076 0 18265 PEGGY STARLING CHIEF OUTREACH OFFICER 44.00 X 206331 0 12521 CATHY BAIN CHIEF ADMINISTRATIVE OFFIC 50.00 X 177633 0 11660 THOMAS D TINSMAN ASSOCIATE MEDICAL DIRECTOR 33.00 X 196475 0 19132 SHANNON EDWARDS DDEPUTY MEDICAL DIRECTOR 25.00 X 195087 0 15839 JAMES GREENE ASSOCIATE MEDICAL DIRECTOR 29.00 X 166066 0 23293 JARROD MCCLAIN DIRECTOR CLINICAL REVIEW 39.00 X 167312 0 17360 WILLIAM MASON ASSOCIATE MEDICAL DIRECTOR 42.00 X 220504 0 19859 3031320 0 235874 30 0 1 0 CLIENT FIRST STAFFING 10 CORPORATE HILL STE 200 LITTLE ROCK AR 722033546 TEMPORARY STAFFING 805722 SKILLS UNLIMITED 10802 EXECUTIVE CENTER DRIVE 207 LITTLE ROCK AR 72211 TEMPORARY STAFFING 741222 V-K GROUP INC 659 OUACHITA AVENUE HOT SPRINGS AR 71901 TEMPORARY STAFFING 623033 SALESFORCECOM INC PO BOX 3370 TUPELO MS 38803 CUSTOMER RELATIONSHIP MGMT 441674 OFFICE TEAM 12400 COLLECTIONS CENTER DR CHICAGO IL 60693 TEMPORARY STAFFING 366523 16 26523253 26523253 PRIVATE REVENUE FROM OPERATIONS 900099 4870969 4870969 4870969 313456 313456 213568 173599 39969 39969 39969 2359218 1720296 81 638922 -81 638841 -81 638922 32386488 4870888 0 992347 X 91097 91097 2265460 2265460 13291873 12628782 663091 428927 428927 5026277 4726613 299664 1283650 1283650 72982 72982 70916 70916 3467759 3331791 135968 67959 13676 54283 1433905 1088990 344915 1623059 1622782 277 558702 558529 173 407905 389621 18284 187607 35451 152156 795985 763770 32215 206123 206123 PASS THROUGH COSTS 185625 185625 PARKING 976 976 1101 -70867 71968 31467888 29694894 1772994 0 1100 1100 2807068 7511695 4231767 5262368 667413 709409 13602866 6389131 7516120 7213735 14179362 12313329 29402830 33011636 2364349 2786595 358722 3738328 2723071 6524923 X 26679759 26486713 26679759 26486713 29402830 33011636 918600 -1111646 0 X X 0 1 X 1 1 1 X 28627730 25029850 23399932 16582486 26523253 120163251 671258 3919768 5815958 4264937 4870969 19542890 29298988 28949618 29215890 20847423 31394222 139706141 0 0 0 139706141 435506 449393 488247 474885 527024 2375055 435506 449393 488247 474885 527024 2375055 29734494 29399011 29704137 21322308 31921246 142081196 0.98330 0.98350 0.01670 0.01650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 X 84000 84000 31383888 31467888 1000000 250000 0 0 PART I-A, LINE 1: THE CEO WAS INVOLVED IN EDUCATING LEGISLATORS ON PRIVATE OPTION IMPACT DURING THIS YEAR'S SESSION. 1060000 1060000 6725437 1907051 4818386 424668 231971 192697 1364320 623685 740635 4028441 3626424 402017 7213735 X 31274842 -1111646 -1111646 32386488 0 32386488 31467888 0 31467888 0 31467888 PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) CODIFICATION TOPIC INCOME TAXES. FASB CODIFICATION TOPIC INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES AND REQUIRES THE ORGANIZATION TO RECOGNIZE IN THEIR FINANCIAL STATEMENTS THE IMPACT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED UNDER AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS ASSESSED THE TAX POSITIONS OF THE ORGANIZATION AND DETERMINED THAT NO POSITIONS EXIST THAT REQUIRE ADJUSTMENT OR DISCLOSURE UNDER THE PROVISIONS OF FASB CODIFICATION TOPIC INCOME TAXES. ARKANSAS FOUNDATION FOR MEDICAL CARE, INC. (AFMC) FILES INFORMATIONAL "RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX" (FORM 990) IN THE U.S. FEDERAL JURISDICTION AND ARKANSAS. 1 THE PCTE FELLOWS GRANT-FUNDED THROUGH HRSA PCTE GRANT 9 79200 PART I, LINE 2: THE PCTE FELLOWS PARTICIPATE IN OUR ARKANSAS GOOD MEDICINE PROGRAM WHICH IS FUNDED THROUGH THE HRSA PCTE GRANT. THEY PARTICIPATE BY COMPLETING A 12-WEEK ONLINE TRAINING CURRICULUM ON ADVERSE CHILDHOOD EXPERIENCES (ACES) AND TRAUMA-INFORMED CARE IN PRIMARY HEALTH CARE. THIS TRAINING IS THEN FOLLOWED UP WITH A 9-MONTH TRANSFORMATION PROJECT IN WHICH EACH FELLOW CONDUCTS RESEARCH AND IMPLEMENTS PRACTICE TRANSFORMATIONS WITHIN THEIR OWN CLINIC. THE GOALS OF THEIR RESEARCH VARY PENDING THE SPECIFIC TOPIC THEY HAVE CHOSEN (OBESITY, SUBSTANCE USE, OR MENTAL HEALTH), BUT ALL CENTER AROUND HOW THEIR TOPIC RELATES TO ACES AND TRAUMA-INFORMED CARE. AT THE END OF THEIR PROJECTS, EACH FELLOW WILL WRITE A FINAL REPORT ON THE FINDINGS OF THEIR PROJECT AND WILL PRESENT THOSE FINDINGS TO THE AFMC PCTE STAFF AND OUR PCTE PARTNERS, ARCOM, AND ARCARE. X 0 0 0 0 0 0 0 0 0 WALLACE R HANLEY CEO/PRESIDENT 400290 0 0 0 0 0 8400 0 18160 0 426850 0 0 0 MARILYN LITTLE CHIEF OPERATING OFFICER 216087 0 0 0 0 0 6566 0 0 0 222653 0 0 0 CHAD T RODGERS MD VP & CHIEF MEDICAL OFFICER 212040 0 0 0 0 0 6389 0 6263 0 224692 0 0 0 MARY S MOORE CHIEF COMPLIANCE OFFICER 172795 0 0 0 0 0 5335 0 18160 0 196290 0 0 0 NATHAN RAY CHIEF BUSINESS OFFICER 198093 0 0 0 0 0 5996 0 6263 0 210352 0 0 0 GLORIA BOONE CHIEF MEMBER SERVICES OFFI 168076 0 0 0 0 0 5114 0 13151 0 186341 0 0 0 PEGGY STARLING CHIEF OUTREACH OFFICER 206331 0 0 0 0 0 6258 0 6263 0 218852 0 0 0 CATHY BAIN CHIEF ADMINISTRATIVE OFFIC 177633 0 0 0 0 0 5397 0 6263 0 189293 0 0 0 THOMAS D TINSMAN ASSOCIATE MEDICAL DIRECTOR 196475 0 0 0 0 0 5981 0 13151 0 215607 0 0 0 SHANNON EDWARDS DDEPUTY MEDICAL DIRECTOR 195087 0 0 0 0 0 5976 0 9863 0 210926 0 0 0 JAMES GREENE ASSOCIATE MEDICAL DIRECTOR 166066 0 0 0 0 0 5133 0 18160 0 189359 0 0 0 JARROD MCCLAIN DIRECTOR CLINICAL REVIEW 167312 0 0 0 0 0 4209 0 13151 0 184672 0 0 0 WILLIAM MASON ASSOCIATE MEDICAL DIRECTOR 220504 0 0 0 0 0 6708 0 13151 0 240363 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS A PRELIMINARY 990 AT THEIR BOARD MEETING. ANY QUESTIONS ARE ANSWERED. THE RETURN IS THEN APPROVED BY THE BOARD FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICER OF THE ORGANIZATION CONTINOUSLY MONITORS THESE POLICIES. THEY ALSO PROVIDE TRAINING AND EDUCATION RELATED TO CONFLICTS OF INTEREST AND REQUIRE THAT ALL EMPLOYEES AND BOARD MEMBERS SIGN A CONFLICTS OF INTEREST FORM ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE HIRING COMMITTEE OF THE BOARD OF DIRECTORS SET THE MAXIMUM DOLLAR AMOUNT OF SALARY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 3,331,791. MANAGEMENT AND GENERAL EXPENSES 135,968. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,467,759. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.