2019-11-21T09:55:11-06:00 2019-01-31 BKD LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2018-02-01 710623643 MAINLINE HEALTH SYSTEMS INC % MAINLINE HEALTH SYSTEMS INC MAIN 8705385414 PO BOX 509 DERMOTT AR 71638 GARY ALLAN NICHOLS CEO 8705385414 2019-11-06 true AMBER SHERRILL P00748683 5013721040 167.68.126.162 71015520193255000001 2019-11-21 P 8B484ADD3177755575C2D061B48861D965F12CF4 3F910C2EA158F392107FD01EE4BF28EF5850A170 2018 2020-04-17 16:48:07Z X GARY ALLAN NICHOLS PO BOX 509 DERMOTT AR 71638 13531188 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. 14 14 168 14 0 5501048 4926213 6940738 7081243 1465 1516 902258 1522216 13345509 13531188 50000 0 0 0 7375232 8435869 0 0 4500 4927082 4832362 12352314 13268231 993195 262957 12662574 12889693 3334349 3376445 9328225 9513248 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 9880996 7081243 PROVIDED MEDICAL SERVICES TO 13,271 PATIENTS AND DENTAL SERVICES TO 3,019 PATIENTS AND BEHAVORIAL HEALTH SERVICES TO 884 PATIENTS IN SOUTHEAST ARKANSAS; SERVED RESIDENTS OF DREW, CLEVELAND, LINCOLN, ASHLEY AND CHICOT COUNTIES. 9880996 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 false false true false false false false false false false false true false false false false false false false false true 30 0 true 168 true false false false false false false false false false false false false X 14 14 true 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 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 RICHARD STOCK BOARD MEMBER 0.25 0.0 X 0 0 0 RON MILLER BOARD 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 KEITH WILLIAMS BOARD MEMBER 0.25 0.0 X 0 0 0 IRMA BERNAL BOARD MEMBER 0.25 0.0 X 0 0 0 DON GLOVER 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 VICE CHAIR 0.25 0.0 X X 0 0 0 GARY ALLAN NICHOLS CEO 44.0 0.0 X 204454 0 12686 TAFTA MCCAIN CFO 44.0 0.0 X 130495 0 12300 DON BALL MEDICAL DOCTOR 40.0 0.0 X 189561 0 12399 CRYSTAL LITTLE MD PEDIATRICIAN 40.0 0.0 X 200128 0 13212 BYRON MONTGOMERY APRN 40.0 0.0 X 168214 0 13720 FREDY CORDOVA PHYSICIAN 40.0 0.0 X 224166 0 9401 ABU HASME DDS 40.0 0.0 X 159526 0 7145 1276544 0 80863 12 false true false BG PLUMBING PO BOX 389 HAMBURG AR 71646 PLUMBING 100500 SCOTT ARK CONSTRUCTION 2177 MIDWAY ROUTE MONTICELLO AR 71655 CONSTRUCTION 219172 RAY RYBURN CUSTOM CABINETS 417 W MCCLOY MONTICELLO AR 71655 CABINETRY 156755 CONTRACT PHARMACY INSIGHT PO BOX 7 MAMMOTH SPRINGS AR 72554 PHARMACY 142675 4 4319852 606361 548514 4926213 PATIENT REVENUE 621110 7081243 7081243 7081243 1516 1516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PHARMACY REVENUE 900099 1374514 1374514 All Other Misc Revenue 900099 147702 147702 147702 147702 1522216 13531188 7081243 1523732 0 0 0 0 336501 336501 0 6575702 4819157 1752045 4500 143852 105497 38355 861626 631895 229731 518188 380026 138162 0 6240 4576 1664 84062 61649 22413 0 0 0 959876 703949 255927 0 55284 40544 14740 594561 436036 158525 0 0 262786 192721 70065 117069 85856 31213 0 0 106305 77961 28344 0 281936 206765 75171 52392 38423 13969 MEDICAL SUPPLIES 1106696 1106696 REPAIRS & MAINTENANCE 213458 156545 56913 BAD DEBTS 395360 395360 MEMBERSHIP 74527 54656 19871 521810 382684 139126 13268231 9880996 3382735 4500 3077241 1456048 2093545 2015611 0 0 712873 1286700 0 0 0 0 0 0 374581 436536 154612 151346 9016991 3525456 5136684 5491535 0 0 0 0 0 0 0 0 1113038 2051917 12662574 12889693 707194 554776 0 0 0 0 0 0 0 0 0 0 2627155 2821669 0 0 0 0 3334349 3376445 X 9328225 9513248 0 0 0 0 9328225 9513248 12662574 12889693 262957 -77934 X false true X true true true X 1 4270846 4498287 4973940 5450861 4926213 24120147 0 0 4270846 4498287 4973940 5450861 4926213 24120147 544803 23575344 2922 1899 1730 1465 1516 9532 0 342628 305223 558050 902258 1522216 3630375 27760054 27749686 0.84925 0.86387 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 91113 91113 6588411 1712297 4876114 2337467 1813159 524308 5491535 FQHC COST REPORT RECEIVABLE 2051917 2051917 13121250 -77934 63356 -14578 13135828 395360 395360 13531188 12936227 63356 63356 12872871 395360 395360 13268231 FIN 48 DISCLOSURE 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. EXPENSE INCLUDED IN REVENUE PER AUDIT, INCLUDED AS EXPENSE PER RETURN FORM 990, SCHEDULE D, PART XI, LINE 4B BAD DEBT EXPENSE $395,360 EXPENSE INCLUDED IN REVENUE PER AUDIT, INCLUDED AS EXPENSE PER RETURN FORM 990, SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE $395,360 X X X false false false false false false false true false GARY ALLAN NICHOLS CEO 117408 0 87046 0 0 0 5475 0 7211 0 217140 0 0 0 DON BALL MEDICAL DOCTOR 189561 0 0 0 0 0 5254 0 7145 0 201960 0 0 0 CRYSTAL LITTLE MD PEDIATRICIAN 200128 0 0 0 0 0 6067 0 7145 0 213340 0 0 0 BYRON MONTGOMERY APRN 168214 0 0 0 0 0 6575 0 7145 0 181934 0 0 0 FREDY CORDOVA PHYSICIAN 224166 0 0 0 0 0 2256 0 7145 0 233567 0 0 0 ABU HASME DDS 159526 0 0 0 0 0 0 0 7145 0 166671 0 0 0 NON-FIXED PAYMENTS 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 542107 FAIR MARKET VALUE false false false FORM 990, SCHEDULE M, PART I, LINE 20 COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS MADE. BUSINESS RELATIONSHIP AMONG DIRECTORS FORM 990, PART VI, SECTION A, LINE 2 RICHARD STOCK AND RON MILLER HAVE A BUSINESS RELATIONSHIP. 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, LINE 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.