2018-08-14T09:21:06-05:00 2017-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2016-10-01 464069816 ANDERSON ANESTHESIA PROVIDERS ANDE 6015536000 2124 14TH ST MERIDAN MS 39301 STEVEN BROWN VP OF FINANCE 6015536000 2018-08-14 1 Amy Bibby P00445891 8282542254 2018-08-10 2016 2022-09-23 18:48:47Z STEVEN BROWN 2124 14TH ST MERIDAN MS 39301 1181401 0 X WWW.ANDERSONREGIONAL.ORG X 2013 MS PROVISION OF ANESTHESIA SERVICES AS A COMPONENT OF MEDICAL CARE PROVIDED BY ARMC. 3 0 0 0 0 0 0 0 1748857 1181401 0 0 0 0 1748857 1181401 0 0 0 0 3027835 1224836 0 0 0 515473 1441250 3543308 2666086 -1794451 -1484685 117116 520 4850341 6218431 -4733225 -6217911 TO PROVIDE ANESTHESIA SERVICES TO OUR PARENT ORGANIZATION, ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) HOSPITAL. 0 0 2656142 1181401 PROVIDED MEDICAL SERVICES, CARE, AND TREATMENT TO PATIENTS, INCLUDING, BUT NOT LIMITED TO, THE PROVISION OF AND MANAGEMENT OF ANESTHESIA SERVICES AND RELATED CARE. 2656142 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X STEVEN BROWN 6015536647 2124 14TH STREET MERIDIAN MS 39301 X DENTON FARR DIRECTOR (CHAIRMAN) 1.00 47.00 X X 0 154181 6587 BETTY CRYER DIRECTOR (SECRETARY) 1.00 47.00 X X 0 128030 7280 STEVEN BROWN DIRECTOR 1.00 47.00 X 0 155711 15520 DUSTIN B IVEY CRNA 40.00 X 210779 0 13131 JOE R MARTIN JR CRNA 40.00 X 199222 0 19260 JASON W COLEMAN CRNA 40.00 X 212289 0 19447 RUSSELL N WILLIAMSON CRNA 40.00 X 243490 0 18000 GREGG T WILLIAMS CRNA 40.00 X 206577 0 15607 JOHN ANDERSON FORMER DIRECTOR (CEO OF AR 0.00 50.00 X 0 392603 78947 MATT EDWARDS FORMER DIRECTOR (SEC/TREAS) 1.00 X 0 265054 5038 1072357 1095579 198817 5 1 1 0 LIFELINC ANESTHESIA PLLC 3340 PLAYERS CLUB PKWY STE 350 MEMPHIS TN 38125 PHYSICIAN, CRNA CONTRACT SERVICES 356692 LOCUMTENENSCOM 2655 NORTHWINDS PKWY ATLANTA GA 303845547 CRNA CONTRACT SERVICES 208040 CHG COMPANIES INC DBA COPHEALTH PO BOX 972651 DALLAS TX 753972651 Contract Physician Fees 200562 ONEBILLING SERVICES LLC 4700 26TH AVE MERIDIAN MS 39301 BILLING SERVICES 110617 4 NET PATIENT REVENUE 621990 1181401 1181401 1181401 1181401 1181401 0 0 X 1146778 1137468 9310 13558 13448 110 64500 63976 524 1218261 1218261 114500 114500 15878 15878 BAD DEBT EXPENSE 92611 92611 2666086 2656142 9944 0 2807 520 114309 117116 520 6086 4844255 6218431 4850341 6218431 X -4733225 -6217911 -4733225 -6217911 117116 520 -1484685 0 X X 0 1 X 1 0 X 0 DUE TO RELATED ORGANIZATION 6218431 6218431 X Part X, Line 2: 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. 1 1 0 0 0 0 0 0 0 DENTON FARR DIRECTOR (CHAIRMAN) 0 153407 0 0 0 774 0 24269 0 6587 0 185037 0 0 BETTY CRYER DIRECTOR (SECRETARY) 0 127396 0 0 0 634 0 21199 0 2604 0 151833 0 0 STEVEN BROWN DIRECTOR 0 154989 0 0 0 722 0 22898 0 9884 0 188493 0 0 DUSTIN B IVEY CRNA 210663 0 0 0 116 0 0 0 13131 0 223910 0 0 0 JOE R MARTIN JR CRNA 199106 0 0 0 116 0 0 0 19260 0 218482 0 0 0 JASON W COLEMAN CRNA 212150 0 0 0 139 0 0 0 19447 0 231736 0 0 0 RUSSELL N WILLIAMSON CRNA 242969 0 0 0 521 0 0 0 18000 0 261490 0 0 0 GREGG T WILLIAMS CRNA 205690 0 0 0 887 0 0 0 15607 0 222184 0 0 0 JOHN ANDERSON FORMER DIRECTOR (CEO OF AR 0 381701 0 0 0 10902 0 66447 0 12500 0 471550 0 0 MATT EDWARDS FORMER DIRECTOR (SEC/TREAS) 0 145134 0 0 0 119920 0 0 0 7001 0 272055 0 0 Part I, Lines 4a-b 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 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. 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 ANDERSON REGIONAL MEDICAL CENTER 0 ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION 7651 POPLAR SPRINGS DR MERIDIAN MS 39305 640730109 SUPPORTING ORGANIZATION MS 501(c)(3) Line 12d, III-O ANDERSON REGIONAL MEDICAL CENTER 0 MIRACLES OF GRACE FOUNDATION 1827 SUNRISE LANE TOOMSUBA MS 39364 640730366 SUPPORTING ORGANIZATION MS 501(c)(3) Line 12c, III-FI ANDERSON REGIONAL MEDICAL CENTER 0 CARE CONSISTENCY FOUNDATION INC 7761 MEADOW CIRCLE MERIDIAN MS 39305 640730846 SUPPORTING ORGANIZATION MS 501(c)(3) Line 12d, III-O ANDERSON REGIONAL MEDICAL CENTER 0 ANDERSON PHYSICIAN ALLIANCE INC 2124 14TH STREET MERIDIAN MS 39301 273274203 MEDICAL SERVICES MS 501(c)(3) Line 3 ANDERSON REGIONAL MEDICAL CENTER 0 ANDERSON HOSPITAL PROVIDERS INC 2124 14TH STREET MERIDIAN MS 39301 461305481 MEDICAL SERVICES MS 501(c)(3) Line 3 ANDERSON REGIONAL MEDICAL CENTER 0 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 ARMC HOSPITAL PROF & GEN LLFT 512 22ND AVENUE MERIDIAN MS 39301 206131090 TRUST MS N/A T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1