ANDERSON ANESTHESIA PROVIDERS: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ANDERSON ANESTHESIA PROVIDERS (EIN 46-4069816)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-14
- IRS object ID
- 201842269349300339
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-14T09:21:06-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464069816 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON ANESTHESIA PROVIDERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANDE | BusinessNameControlTxt |
| Phone | 6015536000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH ST | AddressLine1Txt |
| City | MERIDAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN BROWN | PersonNm |
| Person Title | VP OF FINANCE | PersonTitleTxt |
| Phone | 6015536000 | PhoneNum |
| Signature | 2018-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amy Bibby | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2018-08-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH ST | AddressLine1Txt |
| City | MERIDAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,181,401 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ANDERSONREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | PROVISION OF ANESTHESIA SERVICES AS A COMPONENT OF MEDICAL CARE PROVIDED BY ARMC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,748,857 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,181,401 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,748,857 | PYTotalRevenueAmt |
| CY Total Revenue | $1,181,401 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,027,835 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,224,836 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $515,473 | PYOtherExpensesAmt |
| CY Other Expenses | $1,441,250 | CYOtherExpensesAmt |
| PY Total Expenses | $3,543,308 | PYTotalExpensesAmt |
| CY Total Expenses | $2,666,086 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,794,451 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,484,685 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $117,116 | TotalAssetsBOYAmt |
| Total Assets EOY | $520 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,850,341 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,218,431 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,733,225 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$6,217,911 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ANESTHESIA SERVICES TO OUR PARENT ORGANIZATION, ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) HOSPITAL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,656,142 | ExpenseAmt |
| Revenue | $1,181,401 | RevenueAmt |
| Desc | PROVIDED MEDICAL SERVICES, CARE, AND TREATMENT TO PATIENTS, INCLUDING, BUT NOT LIMITED TO, THE PROVISION OF AND MANAGEMENT OF ANESTHESIA SERVICES AND RELATED CARE. | Desc |
| Total Program Service Expenses | $2,656,142 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN BROWN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6015536647 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| DENTON FARR | |||||||||
| DIRECTOR (CHAIRMAN) | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $154,181 | $6,587 | ||
| BETTY CRYER | |||||||||
| DIRECTOR (SECRETARY) | 1.00 | 47.00 | Yes (X) | Yes (X) | $0 | $128,030 | $7,280 | ||
| STEVEN BROWN | |||||||||
| DIRECTOR | 1.00 | 47.00 | Yes (X) | $0 | $155,711 | $15,520 | |||
| DUSTIN B IVEY | |||||||||
| CRNA | 40.00 | $210,779 | $0 | $13,131 | Yes (X) | ||||
| JOE R MARTIN JR | |||||||||
| CRNA | 40.00 | $199,222 | $0 | $19,260 | Yes (X) | ||||
| JASON W COLEMAN | |||||||||
| CRNA | 40.00 | $212,289 | $0 | $19,447 | Yes (X) | ||||
| RUSSELL N WILLIAMSON | |||||||||
| CRNA | 40.00 | $243,490 | $0 | $18,000 | Yes (X) | ||||
| GREGG T WILLIAMS | |||||||||
| CRNA | 40.00 | $206,577 | $0 | $15,607 | Yes (X) | ||||
| JOHN ANDERSON | |||||||||
| FORMER DIRECTOR (CEO OF AR | 0.00 | 50.00 | $0 | $392,603 | $78,947 | Yes (X) | |||
| MATT EDWARDS | |||||||||
| FORMER DIRECTOR (SEC/TREAS) | 1.00 | $0 | $265,054 | $5,038 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,072,357 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,095,579 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $198,817 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LIFELINC ANESTHESIA PLLC | |||||
| 3340 PLAYERS CLUB PKWY STE 350 | MEMPHIS | TN | 38125 | PHYSICIAN, CRNA CONTRACT SERVICES | $356,692 |
| LOCUMTENENSCOM | |||||
| 2655 NORTHWINDS PKWY | ATLANTA | GA | 303845547 | CRNA CONTRACT SERVICES | $208,040 |
| CHG COMPANIES INC DBA COPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | Contract Physician Fees | $200,562 |
| ONEBILLING SERVICES LLC | |||||
| 4700 26TH AVE | MERIDIAN | MS | 39301 | BILLING SERVICES | $110,617 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $1,181,401 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,181,401 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,181,401 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,181,401 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,181,401 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,146,778 | TotalAmt |
| Program Services | $1,137,468 | ProgramServicesAmt |
| Management And General | $9,310 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,558 | TotalAmt |
| Program Services | $13,448 | ProgramServicesAmt |
| Management And General | $110 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,500 | TotalAmt |
| Program Services | $63,976 | ProgramServicesAmt |
| Management And General | $524 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,218,261 | TotalAmt |
| Program Services | $1,218,261 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,500 | TotalAmt |
| Program Services | $114,500 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,878 | TotalAmt |
| Program Services | $15,878 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BAD DEBT EXPENSE | Desc |
| Total | $92,611 | TotalAmt |
| Program Services | $92,611 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,666,086 | TotalAmt |
| Program Services | $2,656,142 | ProgramServicesAmt |
| Management And General | $9,944 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,807 | BOYAmt |
| EOY | $520 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,309 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,116 | BOYAmt |
| EOY | $520 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,086 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,844,255 | BOYAmt |
| EOY | $6,218,431 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,850,341 | BOYAmt |
| EOY | $6,218,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,733,225 | BOYAmt |
| EOY | -$6,217,911 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,733,225 | BOYAmt |
| EOY | -$6,217,911 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,116 | BOYAmt |
| EOY | $520 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,484,685 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED ORGANIZATION | Desc |
| Amt | $6,218,431 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,218,431 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | ANDERSON ANESTHESIA PROVIDERS IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. ANDERSON ANESTHESIA PROVIDERS HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2017 AND 2016. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENTON FARR | ||||||||||||||
| DIRECTOR (CHAIRMAN) | $0 | $153,407 | $0 | $0 | $0 | $774 | $0 | $24,269 | $0 | $6,587 | $0 | $185,037 | $0 | $0 |
| BETTY CRYER | ||||||||||||||
| DIRECTOR (SECRETARY) | $0 | $127,396 | $0 | $0 | $0 | $634 | $0 | $21,199 | $0 | $2,604 | $0 | $151,833 | $0 | $0 |
| STEVEN BROWN | ||||||||||||||
| DIRECTOR | $0 | $154,989 | $0 | $0 | $0 | $722 | $0 | $22,898 | $0 | $9,884 | $0 | $188,493 | $0 | $0 |
| DUSTIN B IVEY | ||||||||||||||
| CRNA | $210,663 | $0 | $0 | $0 | $116 | $0 | $0 | $0 | $13,131 | $0 | $223,910 | $0 | $0 | $0 |
| JOE R MARTIN JR | ||||||||||||||
| CRNA | $199,106 | $0 | $0 | $0 | $116 | $0 | $0 | $0 | $19,260 | $0 | $218,482 | $0 | $0 | $0 |
| JASON W COLEMAN | ||||||||||||||
| CRNA | $212,150 | $0 | $0 | $0 | $139 | $0 | $0 | $0 | $19,447 | $0 | $231,736 | $0 | $0 | $0 |
| RUSSELL N WILLIAMSON | ||||||||||||||
| CRNA | $242,969 | $0 | $0 | $0 | $521 | $0 | $0 | $0 | $18,000 | $0 | $261,490 | $0 | $0 | $0 |
| GREGG T WILLIAMS | ||||||||||||||
| CRNA | $205,690 | $0 | $0 | $0 | $887 | $0 | $0 | $0 | $15,607 | $0 | $222,184 | $0 | $0 | $0 |
| JOHN ANDERSON | ||||||||||||||
| FORMER DIRECTOR (CEO OF AR | $0 | $381,701 | $0 | $0 | $0 | $10,902 | $0 | $66,447 | $0 | $12,500 | $0 | $471,550 | $0 | $0 |
| MATT EDWARDS | ||||||||||||||
| FORMER DIRECTOR (SEC/TREAS) | $0 | $145,134 | $0 | $0 | $0 | $119,920 | $0 | $0 | $0 | $7,001 | $0 | $272,055 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Lines 4a-b | FormAndLineReferenceDesc |
| Explanation | ARMC PROVIDES CERTAIN EXEUCTIVES AN IRC SEC 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) PLAN: - JOHN ANDERSON $66,447 - GEORGE DENTON FARR, JR. 24,269 - BETTY CRYER 21,199 - STEVEN BROWN 22,898 SEVERENCE - MATTHEW EDWARDS $6,915 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | ANDERSON REGIONAL MEDICAL CENTER IS THE SOLE MEMBER OF THE ORGANIZATION. |
| Form 990, Part VI, Section A, line 7a | ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCISE ALL VOTING RIGHTS OF THE MEMBERS AS THE SOLE MEMBER ANDERSON REGIONAL MEDICAL CENTER HAS THE RIGHT TO A) APPROVE THE CORPORATION'S PHYSICIAN/CRNA COMPENSATION MODELS, PHYSICIAN/CRNA COMPENSATION PLANS, PHYSICIAN/CRNA COMPENSATION AND/OR ANY REVIEW OF PHYSICIAN/CRNA COMPENSATION AND PHYSICIAN/CRNA COMPENSATION POLICIES AND ANY AMENDMENTS THERETO, AND B) TO APPROVE PHYSICIAN/CRNA EMPLOYMENT AGREEMENTS AND ANY AMENDMENTS THERETO. |
| Form 990, Part VI, Section A, line 7b | AS THE SOLE MEMBER ANDERSON REGIONAL MEDICAL CENTER HAS THE RIGHT TO: A) APPROVE THE CORPORATION'S PHYSICIAN/CRNA COMPENSATION MODELS, PHYSICIAN/CRNA COMPENSATION PLANS, PHYSICIAN/CRNA COMPENSATION AND/OR ANY REVIEW OF PHYSICIAN/CRNA COMPENSATION AND PHYSICIAN/CRNA COMPENSATION POLICIES AND ANY AMENDMENTS THERETO, AND B) TO APPROVE PHYSICIAN/CRNA EMPLOYMENT AGREEMENTS AND ANY AMENDMENTS THERETO. |
| Form 990, Part VI, Section B, line 11b | Each Board member was provided a copy of the Form 990. The Board members were asked to review the form and submit questions and comments prior to the Form 990 being finalized. After review, the finalized Form 990 was provided to the board. |
| Form 990, Part VI, Section B, line 12c | The organization has a written conflict of interest policy through Andererson Regional Medical Center and requests all board members to annually disclose any possible conlfict of interest. |
| Form 990, Part VI, Section B, line 15 | The organization is a subsidiary of Anderson Regional Medical Center. Officers and Diretors of Anderson Anesthesia Providers are compensated by Anderson Regional Medical Center. As such Anderson Anesthesia Providers follows the policies of Anderson Regional Medical Center. Anderson Regional Medical Center has a designated three person committee and has an outside contracted organization to study and recommend compensation for executives. |
| Form 990, Part VI, Section C, line 18 | IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATIONS ARTICLES OF INCORPORATION ARE AVAILABLE UPON TO THE PUBLIC THROUGH THE MISSISSIPPI SECRETARY OF STATE. THE ORGANIZATION MAKES ITS FINANCIALS STATEMENTS AVAILABLE THROUGH THE CONSOLIDATED FINANCIAL STATEMENTS THAT ARE PART OF THE ANDERSON REGIONAL MEDICAL CENTER'S FORM 990. |
| FORM 990 PART VI, LN 1B | THE BOARD OF DIRECTORS ARE APPOINTED BY ANDERSON REGIONAL MEDICAL CENTER (THE SOLE MEMBER). THE BOARD CURRENTLY CONSISTS OF THE EXECUTIVES OF ANDERSON REGIONAL MEDICAL CENTER BECAUSE THE ACTIVITIES ARE AN INTREGAL COMPONENT OF THE MEDICAL SERVICES PROVIDED BY THE MEDICAL CENTER. |
| FORM 990, PART VI, LINE 1: INDEPENDENCE OF VOTING BOARD MEMBERS: | THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE SOLE MEMBER ORGANIZATION HAS A FIFTY PERCENT INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER AND ITS AUTHORITY. |
| Form 990, Part IX, line 11g | PURCHASE SERVICES: Program service expenses 12,126. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,126. CONTRACT LABOR: Program service expenses 90,318. Management and general expenses 0. Fundraising expenses 0. Total expenses 90,318. PHYSICIAN FEES: Program service expenses 1,115,817. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,115,817. |
| Form 990, Part XII, Line 2c: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDERSON REGIONAL MEDICAL CENTER | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 640362400 | HEALTHCARE | MS | 501(c)(3) | Line 3 | N/A | 0 | |
| MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION | |||||||||||
| 122 WOODMONT WAY | RIDGELAND | MS | 39157 | 640722433 | SUPPORTING ORGANIZATION | MS | 501(c)(3) | Line 12c, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION | |||||||||||
| 7651 POPLAR SPRINGS DR | MERIDIAN | MS | 39305 | 640730109 | SUPPORTING ORGANIZATION | MS | 501(c)(3) | Line 12d, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| MIRACLES OF GRACE FOUNDATION | |||||||||||
| 1827 SUNRISE LANE | TOOMSUBA | MS | 39364 | 640730366 | SUPPORTING ORGANIZATION | MS | 501(c)(3) | Line 12c, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| CARE CONSISTENCY FOUNDATION INC | |||||||||||
| 7761 MEADOW CIRCLE | MERIDIAN | MS | 39305 | 640730846 | SUPPORTING ORGANIZATION | MS | 501(c)(3) | Line 12d, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON PHYSICIAN ALLIANCE INC | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 273274203 | MEDICAL SERVICES | MS | 501(c)(3) | Line 3 | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON HOSPITAL PROVIDERS INC | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 461305481 | MEDICAL SERVICES | MS | 501(c)(3) | Line 3 | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| EAST MISSISSIPPI ENDOSCOPY CENTER | |||||||
| 1926 23RD AVENUE | MERIDIAN | MS | 39301 | 440884792 | HEALTHCARE | MS | N/A |
| JARMC LEVERAGE LLC | |||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 272284311 | INVESTMENTS | MS | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMC HOSPITAL PROF & GEN LLFT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 512 22ND AVENUE | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 206131090 | EIN |
| Primary Activities | TRUST | PrimaryActivitiesTxt |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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