2015-05-15T11:15:37-05:00 2014-06-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2013-07-01 710329353 Jefferson Hospital Association Inc % BRYAN G JACKSON JEFF 8705417100 1600 West 40th Avenue Suite Pine Bluff AR 71603 BRYAN G JACKSON VP & CFO 8705417100 2015-05-15 true Jeanette Verrelli P00742631 8705417100 2013 2016-04-25 22:37:26Z Walter Johnson 1600 West 40th Avenue pine bluff AR 71603 311614870 false X www.jrmc.org X 1959 AR Jefferson Hospital Association, inc. provides a wide range of health care services to patients from jefferson county and surrounding areas in southeast arkansas. 15 9 2164 66 104530 -77734 1537684 1505726 170702750 157725867 3533843 9793206 4842247 5578196 180616524 174602995 554025 546433 0 0 93907944 87030571 0 0 0 85872702 81010749 180334671 168587753 281853 6015242 243604272 251256686 63603958 62331269 180000314 188925417 X JEFFERSON REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING MEASURABLE QUALITY HEALTH SERVICES IN A CARING ENVIRONMENT, WHICH FULFILL THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES AND COMMUNITY. false false 152967869 546433 157725867 JEFFERSON HOSPITAL ASSOCIATION, INC. (JHA) OPERATES JEFFERSON REGIONAL MEDICAL CENTER (JRMC), A 471 BED TERTIARY CARE FACILITY LOCATED IN SOUTHEAST ARKANSAS THAT SERVES A POPULATION BASE OF 222,000 PEOPLE LIVING IN 11 COUNTIES. JRMC IS A NOT-FOR-PROFIT, SOLE COMMUNITY HOSPITAL, LICENSED BY THE ARKANSAS STATE HEALTH DEPARTMENT AND ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. JRMC HAS A LONG TRADITION OF PROVIDING SIGNIFICANT BENEFITS TO OUR COMMUNITY WHICH IS ROOTED IN OUR MISSION, "TO PROVIDE MEASURABLE QUALITY HEALTH SERVICES IN A CARING ENVIRONMENT WHICH FULFILL THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES AND COMMUNITY" AND VISION, "TO BE WIDELY RECOGNIZED AS THE HEALTH CARE LEADER AND REFERRAL CENTER OF CHOICE FOR SOUTH ARKANSAS BY PROVIDING QUALITY HEALTH CARE SERVICES IN A COST EFFECTIVE MANNER." DURING fiscal year 2013, JRMC CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE NEEDS OF THE COMMUNITY, IN ACCORDANCE WITH IRS CODE SECTION 501(R)(3). IN MANY CASES, JRMC AND OTHER ORGANIZATIONS ALREADY ADDRESSED COMMUNITY HEALTH NEEDS OF SOUTHEAST ARKANSAS, BUT CONDUCTING THE CHNA GAVE JRMC THE OPPORTUNITY TO STUDY HEALTH CARE NEEDS, WITH INPUT FROM VARIOUS SOURCES, WHICH CONFIRMED OUR CONTINUED AND IMPORTANT ROLE IN THE COMMUNITY. WE ARE PROUD THAT WE CAN CONTINUE TO PROVIDE LEADING HEALTHCARE SERVICES TO EVERYONE IN SOUTHEAST ARKANSAS, REGARDLESS OF ABILITY TO PAY. JRMC PROVIDES SEVERAL CENTERS OF EXCELLENCE PROVIDING A WIDE RANGE OF PROGRAMS AND MEDICAL SERVICES. THESE INCLUDE CARDIOLOGY, SURGERY, CRITICAL CARE, REHABILITATION, PSYCHIATRY, LABORATORY, GASTROENTEROLOGY, ORTHOPEDICS, NEUROLOGY, EMERGENCY, OBSTETRICS/GYNECOLOGY, RADIOLOGY, HOSPICE, AND MANY MORE. WE OPERATE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; HAVE A GOVERNING BODY COMPRISED OF INDIVIDUALS WHO ARE REPRESENTATIVE OF THE COMMUNITY; ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS; AND PARTICIPATES IN MEDICAID, MEDICARE CHAMPUS, TRICARE AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. JRMC ALSO OPERATES AND MANAGES SEVERAL SATELLITE CLINICS WHICH PROVIDE PRIMARY AND SPECIALTY HEALTHCARE TO THE COMMUNITY AND OUTLYING AREAS. COMMUNITY SERVICE AND EDUCATION CONTINUE TO BE A SIGNIFICANT PART OF OUR MISSION. JRMC PROVIDES NUMEROUS SPONSORSHIPS WITHIN THE COMMUNITY, AND OFFERS DOZENS OF FREE HEALTH SCREENINGS AND EDUCATIONAL EVENTS EACH YEAR. NOT ONLY IS INFORMATION SHARED ABOUT HEALTHCARE RELATED ISSUES, BUT PARTICIPANTS ARE GIVEN THE OPPORTUNITY TO VISIT ONE-ON-ONE WITH PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. WE BELIEVE EVERYONE IN SOUTHEAST ARKANSAS IS IMPACTED, EITHER DIRECTLY OR INDIRECTLY, THROUGH THE COMMUNITY HEALTH EFFORTS AND COMMUNITY BUILDING ACTIVITIES CHAMPIONED BY JRMC. OUR COMMITMENT TO BRING NEW AND INNOVATIVE PROGRAMS AND SERVICES TO SOUTHEAST ARKANSAS IS EVIDENT. DURING FISCAL YEAR 2014, JRMC INVESTED APPROXIMATELY $5.1 MILLION IN CAPITAL ADDITIONS AND IMPROVEMENTS TO OUR FACILITIES AND EQUIPMENT. THIS WAS ACCOMPLISHED BY CONNECTING THOUGHTFUL, DELIBERATE, DISCIPLINED PLANNING, BUDGETING AND SPENDING WITH THE NEED TO PROVIDE STATE-oF-THE-ART TECHNOLOGIES IN A CARING ENVIRONMENT. JRMC CONTINUES TO BE A LEADER IN ELECTRONIC MEDICAL RECORD SYSTEM ADVANCEMENT, CONTINUING TO MEET STAGE 1 MEANINGFUL USE REQUIREMENTS SET FORTH AS PART OF THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 and preparing to meet Stage 2 during fiscal year 2015. SINCE THE BEGINNING OF THE PROGRAM, JRMC HAS RECEIVED MONETARY INCENTIVES FROM THE ARKANSAS MEDICAID QUALITY PROGRAM BY ACHIEVING PERFORMANCE GOALS IN QUALITY, DOCUMENTATION AND VALIDATION EXCELLENCE. OUR ORGANIZATION WAS RECOGNIZED FOR ENTERING OUTCOMES MEASURE DATA IN ALL APPICABLE AREAS, AND IMPROVING PATIENT SAFETY AND QUALITY AS PART OF THE AHA/HRET HOSPITAL ENGAGEMENT NETWORK PROGRAM. JRMC CONTINUES TO PARTICIPATE IN THE HCAHPS PATIENT PERSPECTIVES ON CARE. WE HAVE CHOSEN THE PHONE METHODOLOGY WHICH ENSURES A HIGHER RESPONSE RATE IN OUR SERVICE AREA. WE CONTINUALLY ANALYZE THE HCAHPS SURVEY RESULTS AND MAKE ADJUSTMENTS, WHEN NEEDED, TO IMPROVE THE OVERALL PATIENT EXPERIENCE AT JRMC. DURING THE PAST SEVERAL YEARS, THE BOARD OF DIRECTORS VIA ITS AUDIT COMMITTEE HAS FOCUSED ON MAINTAINING RECOMMENDATIONS MADE BY FITCH RATING WHICH URGED NOT-FOR-PROFIT HEALTHCARE PROVIDERS TO ADOPT NINE SPECIFIC PROVISIONS OF SARBANES-OXLEY COMPLIANCE. DURING THIS PERIOD WE HAVE CONTINUED TO MAINTAIN COMPLIANCE WITH ALL NINE OF THE FITCH/SOX PROVISIONS. THESE INCLUDE: PROHIBITION OF SPECIFIED NON-AUDIT SERVICES BY AUDITORS, FIVE YEAR AUDIT PARTNER ROTATION, AUDITOR COMMUNICATIONS, AUDIT COMMITTEE STANDARDS, MANAGEMENT CERTIFICATION OF FINANCIAL STATEMENTS, BONUS FORFEITURE, ADOPTION OF A CODE OF ETHICS, AUDIT COMMITTEE FINANCIAL EXPERT, AND INTERNAL CONTROL EVALUATION. IN ADDITION TO THE COMPLETE ADOPTION OF THE FITCH/SOX PROVISIONS, THE JHA BOARD OF DIRECTORS HAS UNDERTAKEN A COMPREHENSIVE SELF-ASSESSMENT REGARDING ITS NOT-FOR-PROFIT STATUS UTILIZING A COMPLIANCE CHECK TOOL AND PROPOSED GUIDELINES PUBLISHED BY THE IRS. JHA HAS NO REASON TO BELIEVE ITS TAX EXEMPT STATUS HAS EVER BEEN IN JEOPARDY. THIS INITIATIVE IS PART OF A LARGER COMPLIANCE PROGRAM INTENDED TO ENSURE JHA CONTINUALLY SELF EVALUATES ITS REGULATORY COMPLIANCE. TODAY'S PUBLIC DEMANDS MORE INFORMATION IN A FULLY TRANSPARENT MANNER. TO BE TRANSPARENT, WE MUST PROVIDE INFORMATION OPENLY, CANDIDLY, AND ACCURATELY. WE PROVIDE INFORMATION ON THE FOLLOWING TOPICS: INPATIENT PRICING, OUTPATIENT PRICING, QUALITY OUTCOMES, AND PATIENT SATISFACTION. THIS GOES OVER AND BEYOND THE EFFORTS AND REQUIREMENTS OF THE ARKANSAS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. THE COMPLETE INFORMATION CAN BE VIEWED AT WWW.JRMC.ORG. 152967869 true true false true false false false false false false true false false true true false false true false false false false false false false false true true true true true true false false false false false false false true true true false false false false false true true true false false true 207 0 true 2164 true true true false false false false false false false false false X 15 9 true false false false true true false true true false false true true true true true true true true true true X BRYAN G JACKSON 8705417100 1600 WEST 40TH AVENUE PINE BLUFF AR 71603 X FRANK ANTHONY DIRECTOR 1.0 0.0 X DREW ATKINSON DIRECTOR 1.0 0.0 X JERREL BOAST DIRECTOR 1.0 0.0 X DAVID BROWN DIRECTOR 1.0 0.0 X JAMES A CAMPBELL MD DIRECTOR 1.0 0.0 X MARTY CASTEEL VICE CHAIRMAN 1.0 0.0 X X MICHELLE ECKERT MD FACS DIRECTOR 1.0 0.0 X 418263 0 0 ANNETTE KLINE DIRECTOR 1.0 0.0 X GEORGE MAKRIS CHAIRMAN 1.0 0.0 X X JOANN B MAYS MD DIRECTOR 1.0 0.0 X CHUCK MORGAN SECRETARY 1.0 0.0 X X SCOTT PITTILLO DIRECTOR 1.0 0.0 X CLIFTON ROAF DDS DIRECTOR 1.0 0.0 X HENRY FORD TROTTER III DIRECTOR 1.0 0.0 X OT GORDON MD DIRECTOR/JRMC CHIEF OF STAFF 15.0 0.0 X 30000 JOHN O LYTLE MD DIRECTOR/JRMC CHIEF OF STAFF 40.0 0.0 X 701097 0 35086 WALTER JOHNSON PRESIDENT/CEO 40.0 0.0 X X 745819 0 29492 THOMAS HARBUCK EXECUTIVE VP 40.0 0.0 X 674625 0 30692 BRIAN THOMAS SENIOR VP/COO 40.0 0.0 X 386068 0 30472 BRYAN G JACKSON VP/CFO 40.0 0.0 X 291795 0 81053 LOUISE HICKMAN VP/CNO 40.0 0.0 X 314275 0 28472 NICHOLAS WILLIS PHYSICIAN 40.0 0.0 X 1003512 0 14410 JAMES ALAN POLLARD PHYSICIAN 40.0 0.0 X 454650 0 24310 ALI ALNASHIF PHYSICIAN 40.0 0.0 X 445044 0 23578 AARON KUPERMAN PHYSICIAN 40.0 0.0 X 338828 0 17965 GIRINDRA RAVAL PHYSICIAN 40.0 0.0 X 310658 0 23536 6114634 0 339066 62 false true false EMUrgent Care Inc 8 Shackleford Plaza LITTLE ROCK AR 72211 physician services 3699379 Rehab Care Group Inc PO Box 502096 ST LOUIS MO 63150 Therapy SErvices 2319327 Sodexho Inc Affiliates PO Box 536922 ATLANTA GA 30353 nutritional services 2729187 uams - ahec 4010 mulberry st PINE BLUFF AR 71603 physician services 2042610 jefferson anesthesiology associates PO Box 1272 PINE BLUFF AR 71603 professional service 2164416 41 X 1126836 378890 1505726 PATIENT SERVICE REVENUE 621400 157295450 157295450 EHR INCENTIVE REVENUE 900099 430417 430417 157725867 9770441 -5990 9776431 0 0 528893 528893 0 528893 2485 526408 137007615 20555 136967538 37867 40077 -17312 22765 22765 11485 6470 5015 5015 0 0 CAFETERIA REVENUE 722320 989170 989170 WELLNESS CENTER 713940 958590 958590 PATHOLOGY/OUTSIDE LAB BILLING REVENUE 900099 108035 108035 2988493 2988493 5044288 174602995 157725867 104530 15266872 X 79596 79596 466837 466837 0 0 3821020 1063760 2757260 211436 156443 54993 69252474 63405746 5846728 2257867 1976809 281058 6104173 5308232 795941 5383601 4713454 670147 4579813 4271805 308008 646163 592875 53288 236561 236561 25655 25655 0 0 26401120 24226722 2174398 56545 15275 41270 5452296 4251501 1200795 1623729 1468980 154749 0 2736060 2489423 246637 183286 117526 65760 0 122681 108411 14270 962022 925681 36341 0 8362339 8046444 315895 1517376 1496935 20441 MEDICAL SUPPLIES 22777538 22777538 LICENSE & TAXES 2318481 2296214 22267 PAYMENTS TO RELATED PARTIES 1871985 1836733 35252 BAD DEBT EXPENSE 717540 717540 419559 157389 262170 168587753 152967869 15619884 0 -361052 -246027 10893481 11673827 0 0 23934247 24294434 0 0 0 0 1467006 984644 4724705 3595755 2999683 2198505 195333631 143260158 55470804 52073473 108576141 119089053 2220107 2580206 0 0 0 0 33679150 35012816 243604272 251256686 35871605 35646125 0 0 2714498 2116902 24181006 23471232 0 0 0 0 0 0 0 0 836849 1097010 63603958 62331269 X 180000314 188925417 0 0 0 0 180000314 188925417 243604272 251256686 6015242 2324822 585039 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 25655 25655 false schedule c, part ii-b, line 1i lobbying activities: A PORTION OF DUES PAID TO ARKANSAS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING EXPENSES. ADDITIONAL LOBBYING EXPENSES WERE PAID TO MCDERMOTT WILL & EMORY FOR THE SOLE COMMUNITY HOSPITAL COALITION AND RELATED MEDIA ADVOCACY. 4805853 4805853 82957972 57672283 25285689 1727368 1346380 380988 104743876 84241495 20502381 1098562 1098562 52073473 DEFERRED FINANCING COSTS 505111 457 PLAN - FMV 1097010 DUE FROM AFFILIATES 33008161 PREMIER CONV MV EXS OF BV 402534 35012816 0 457 PLAN 1097010 1097010 X schedule d, part x, line 2 liability for uncertain tax positions: The Association has been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Association is subject to federal income tax on any unrelated business taxable income. Jefferson Management Services, Inc. and Jefferson Regional Medical Center Development, Inc. are taxable entities and had no material deferred tax balances at June 30, 2014 and 2013. The Associations majority owned professional limited liability company, Jefferson Surgery Center, PLLC, is treated as a partnership for federal income tax purposes. Consequently, federal income taxes are not provided for or payable by Jefferson Surgery Center, PLLC. The Associations income tax returns are subject to review and examination by federal, state and local authorities. The Association is not aware of any activities that would jeopardize its tax-exempt status. The Association is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes that are not currently being recognized. The tax returns for tax years 2011 to 2013 are open to examination by federal, local and state authorities. The Associations 2011 IRS Forms 990 and 990-T are currently under examination. The examination is ongoing and potential outcomes are not known. true true X true X true X true true false true true 12600 8932463 8932463 0.05300 24400 2563186 2563186 0.01520 37000 11495649 11495649 0.06820 34 85700 165095 69585 95510 0.00060 18 7493923 2753764 4740159 0.02810 3 2988302 987527 2000775 0.01190 546433 478743 67690 0.00040 55 85700 11193753 4289619 6904134 0.04100 55 122700 22689402 4289619 18399783 0.10920 51 295100 108465 108465 0.00060 51 295100 108465 108465 0.00060 true 9954435 53060976 51982406 1078570 X true true Jefferson Surgery Center PLLC Ambulatory surgery Center 0.66500 0.07000 0.26500 1 1 JEFFERSON REGIONAL MEDICAL CENTER 1600 W 40TH AVENUE PINE BLUFF AR 71603 WWW.JRMC.ORG AR4213 X X X X JEFFERSON REGIONAL MEDICAL CENTER 1 true X X X X X X X X 12 true false true X see part v, section c X X X X X X false false true true 150. true 300. true X X X X X true true X X X X X true false X X X X true X false false schedule h, part v, section b, line 3 consulting representatives of the community: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM ALL THREE GROUPS OUTLINED IN IRS NOTICE 2011-52. THE HOSPITAL CONSULTED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: THE CENTER FOR BUSINESS AND ECONOMIC RESEARCH, SAM M. WALTON COLLEGE OF BUSINESS,UNIVERSITY OF ARKANSAS; THE ARKANSAS DEPARTMENT OF HEALTH; AND THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL ALSO ENGAGED FIVE FOCUS GROUPS WITH BUSINESS AND COMMUNITY LEADERS, HEALTH CARE CONSUMERS, SOUTHEAST ARKANSAS COMMUNITY MEMBERS, AND PHYSICIANS FROM ITS PRIMARY AND SECONDARY SERVICE AREAS. THERE WERE OVER 100 INDIVIDUALS CONSULTED. Their names can be found in the CHNA report. schedule h, part v, section b, line 5 CHNA and Implementation strategy: The CHNA and implementation strategy is available upon request and at the following website: http://www.jrmc.org/Community/index.htm schedule h, part v, section b, line 7 needs not addressed from chna: ONE COMMUNITY HEALTH NEED IDENTIFIED IN THE CHNA WAS DETERMINED TO BE OUTSIDE THE SCOPE OF THE ORGANIZATION. OTHER ORGANIZATIONS, INCLUDING THE ARKANSAS DEPARTMENT OF HEALTH, SCHOOLS AND OTHER HEALTHCARE ORGANIZATIONS HAVE TAKEN ON THE RESPONSIBILITY OF EDUCATION AND PREVENTION OF SEXUALLY TRANSMITTED DISEASES IN THE YOUTH OF THE COMMUNITY. schedule h, part v, section b, line 20d financial assistance policy eligibility: AMOUNTS CHARGED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ARE DETERMINED BASED ON A SLIDING-SCALE THAT CONSIDERS INCOME AS COMPARED TO FEDERAL POVERTY GUIDELINES. 9 Health care Plus 209 N Blake Pine Bluff AR 71603 Physician Clinic Center On Aging 4747 Dusty Lake Dr Suite 101 Pine Bluff AR 71603 Physician Clinic Pine Bluff Specialty Clinic 1601 W 40th ave suite 301 pine bluff AR 71603 physician clinic Cardiology Associates 1601 W 40th ave suite 301 pine bluff AR 71603 physician clinic endocrinology of south arkansas 7500 dollarway rd white hall AR 71603 physician clinic south arkansas orthopeadics center 1609 w 40th ave suite 501 pine bluff AR 71603 physician clinic south arkansas cardiovascular surgery 1609 w 40th ave pine bluff AR 71603 physician clinic surgical associates of southeast ar 1609 w 40th ave pine bluff AR 71603 physician clinic neurosurgery associates of southeast ar 1609 w 40th ave suite 501 pine bluff AR 71603 physician clinic Schedule H, part i, line 6b availability of community benefit report: THE ORGANIZATION MAKES ITS ANNUAL COMMUNITY BENEFIT REPORT AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. Schedule h, part ii community building activities: See statement of program service accomplishments on form 990, part iii, line 4a. schedule h, part iii, section a, line 2 bad debt methodology: THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. schedule h, part iii, section a, line 3 bad debt attributable to patients eligible for financial assistance: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE OTHERWISE ATTRIBUTABLE TO ACCOUNTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE UTILIZING HISTORIC INFORMATION AND HAS EXCLUDED THESE AMOUNTS FROM BAD DEBT EXPENSE, OFFSETTING NET PATIENT SERVICE REVENUE ACCORDINGLY. schedule h, part iii, section a, line 4 Bad debt footnote: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, the Association analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Association analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Association records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. For the years ended June 30, 2014 and 2013, there were no significant changes in the underlying assumptions used in estimating the allowance for uncollectible and charity accounts or in the policies regarding uncollectible accounts for charity care. schedule h, part iii, section b, line 8 costing methodology: THE ORGANIZATION MAINTAINS A COST ACCOUNTING SYSTEM THAT COMPUTES COSTS AT THE PATIENT LEVEL. THE COSTING METHODOLOGIES ARE APPLIED TO THE ORGANIZATION'S MEDICARE PATIENTS TO DETERMINE THE COST OF PROVIDING CARE. AS A SAFETY NET HOSPITAL, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT; THEREFORE, COSTS TO PROVIDE CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT TO THE EXTENT COSTS EXCEED MEDICARE REIMBURSEMENT. schedule h, part iii, section c, line 9b collections policy: PATIENT ACCOUNTS QUALIFYING FOR CHARITY CARE WOULD NOT INTENTIONALLY BE PLACED WITH A DEBT COLLECTION SERVICE. FROM TIME TO TIME, INFORMATION THAT RESULTS IN THE DETERMINATION OF CHARITY QUALIFICATION IS OBTAINED SUBSEQUENT TO A PATIENT'S ACCOUNT BEING PLACED WITH A DEBT COLLECTION AGENCY. THE ORGANIZATION'S "COLLECTION AGENCY POLICY" REQUIRES CONTRACTED COLLECTION AGENTS, IN ADDITION TO MANY OTHER PRUDENT PROCEDURES, TO INFORM THE DEBTOR OF THE APPROPRIATE HOSPITAL FINANCIAL ASSISTANCE PROFESSIONAL TO CONTACT IF THE COLLECTION AGENT IS MADE AWARE OF A PATIENT'S FINANCIAL HARDSHIP. THE COLLECTION AGENT IS ALSO REQUIRED TO NOTIFY THE ORGANIZATION OF THE PATIENT'S FINANCIAL HARDSHIP SO THE ORGANIZATION CAN ASSIST THE PATIENT IN ACCESSING THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS. schedule h, part vi, line 2 needs assessment: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. schedule h, part vi, line 3 patient education of eligibilty for assistance: A FINANCIAL COUNSELOR INITIATES A FINANCIAL SCREENING ON ALL INPATIENTS, OBSERVATION PATIENTS AND OUTPATIENTS OCCUPYING A BED HAVING NO INSURANCE INDICATED ON THEIR ACCOUNT. THIS PROCESS INCLUDES SCREENING FOR CHARITY CARE ASSISTANCE, MEDICAID COVERAGE AND OTHER THIRD PARTY COVERAGE. OUTPATIENTS RECEIVE A FINANCIAL ASSISTANCE GUIDE SHEET SUMMARIZING ASSISTANCE OFFERED BY JRMC AT THE TIME OF REGISTRATION. schedule h, part vi, line 4 community information: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. schedule h, part vi, line 5 promotion of community health: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. schedule h, part vi, line 6 affiliated health care system: this is not applicable for tax year 2013. schedule h, part vi, line 7 state filing of community benefit report: arkansas true University of AR - Pine Bluff 1200 N University Mail Slot 4891 Pine Bluff AR 71601 716010030 501(c)(3) 25000 Athletic Sponsorship United Way of SE Arkansas PO Box 8702 Pine Bluff AR 71611 710236869 501(c)(3) 70000 2012-2013 campaign pledge AR Trauma Education & Research Fdn 415 N Mckinley ST Suite 350 little rock AR 72205 433250912 501(c)(3) 10000 trauma education 3 Federal Pell Grants (US Dept of Education) 71 329066 Academic Challenge Scholarships (State of AR) 7 9778 Rehabilitation Grants (State of AR) 21 71933 WIA Adult Program Grants (US Dept of Labor) 26 42294 Go! Opportunities Grants (State of AR) 7 3816 Scholarships - Jefferson School of Nursing 13 9950 schedule i, part i, line 2 procedures for monitoring the use of grant funds in the U.S.: Jefferson HOSPITAL ASSOCIATION, INC. MAINTAINED RECORDS TO SUBSTANTIATE THE AMOUNT OF THE GRANTS OR ASSISTANCE, THE GRANTEES' ELIGIBILITY FOR THE GRANTS OR ASSISTANCE, AND THE SELECTION CRITERIA USED TO AWARD GRANTS OR ASSISTANCE. form 990, part ix, line 1 & schedule i, part ii, line 1 Difference between schedule i & statement of functional expenses: THE ORGANIZATION IS REPORTING THE CONTRIBUTIONS PAID ON SCHEDULE I, WHICH IS NOT NECESSARILY ON THE ACCRUAL BASIS BECAUSE THE ORGANIZATION RECORDS LONG-TERM PLEDGES AT THEIR NPV AND RECORDS ACCRETION OF INTEREST OVER TIME. THE PLEDGES, WHEN PAID, ARE A REDUCTION OF THIS LIABILITY AND NOT CURRENT YEAR EXPENSE WHICH MAY CAUSE A DIFFERENCE BETWEEN AMOUNT REPORTED ON FORM 990, PAGE 10 AND SCHEDULE I, PART II. X X X false true X X X X X false true false false false false false true false MICHELLE ECKERT MD FACS DIRECTOR 418263 0 0 0 0 0 0 0 0 0 418263 0 0 0 JOHN O LYTLE MD DIRECTOR/JRMC CHIEF OF STAFF 266498 0 433766 0 833 0 10346 0 26319 0 737762 0 0 0 WALTER JOHNSON PRESIDENT/CEO 413683 0 93375 0 238761 0 10900 0 21235 0 777954 0 0 0 THOMAS HARBUCK EXECUTIVE VP 370983 0 98044 0 205598 0 10900 0 22235 0 707760 0 0 0 BRIAN THOMAS SENIOR VP/COO 249453 0 46023 0 90592 0 10900 0 21444 0 418412 0 0 0 BRYAN G JACKSON VP/CFO 228483 0 39848 0 23464 0 61261 0 21518 0 374574 0 0 0 LOUISE HICKMAN VP/CNO 186922 0 34453 0 92900 0 10900 0 18994 0 344169 0 0 0 NICHOLAS WILLIS PHYSICIAN 649088 0 353984 0 440 0 12001 0 4118 0 1019631 0 0 0 JAMES ALAN POLLARD PHYSICIAN 316496 0 137751 0 403 0 10900 0 14867 0 480417 0 0 0 ALI ALNASHIF PHYSICIAN 412231 0 32467 0 346 0 10900 0 15080 0 471024 0 0 0 AARON KUPERMAN PHYSICIAN 278007 0 60650 0 171 0 10900 0 8520 0 358248 0 0 0 GIRINDRA RAVAL PHYSICIAN 245797 0 64722 0 139 0 10963 0 13932 0 335553 0 0 0 schedule j, part i, line 1a Description of Benefits: - TAX GROSS-UP PAYMENTS ARE INCLUDED IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IDENTIFIED BELOW. - A DISCRETIONARY SPENDING ACCOUNT IS PROVIDED FOR THE CEO. - COUNTRY CLUB MEMBERSHIPS ARE MAINTAINED BY THE ORGANIZATION FOR THE USE OF SPECIFIC EMPLOYEES AS DESIGNATED BY THE BOARD OF DIRECTORS. schedule j, part i, line 1b written policy regarding payment or reimbursement: THERE IS NO WRITTEN POLICY REGARDING PROVISION OF COUNTRY CLUB MEMBERSHIPS. THE BOARD OF DIRECTORS DESIGNATES WHICH EMPLOYEES MAY USE MEMBERSHIPS MAINTAINED BY THE ORGANIZATION. schedule j, part i, line 4b participants in supplemental nonqualified retirement plan: PARTICIPANTS IN SERP PLAN REPORTED IN W-2 -------------------------- ----------------- WALTER JOHNSON $ 136,033 THOMAS HARBUCK $ 118,983 BRIAN THOMAS $ 52,380 Louise Hickman $ 53,989 Bryan G. Jackson NONE schedule j, part i, line 7 non-fixed payments: THE ORGANIZATION PROVIDES DEFINED MEMBERS OF MANAGEMENT A NON-FIXED PERFORMANCE BASED INCENTIVE PLAN. THE PLAN'S COMPONENTS ARE ESTABLISHED AND EVALUATED BY THE ORGANIZATION'S EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A Jefferson County AR 716009958 472705Df6 2011-12-15 26013416 Refund 2001 Bonds false false false A 510000 0 26013416 0 0 25395168 372172 246076 0 0 0 0 2012 true false false true A false false false false 0 false false false true A false true false false false false 0 false 0 false true A true Richard Morgan see schedule o see schedule o false Rebecca Pittillo see schedule o see schedule o false lindsay Makris see schedule o see schedule o false arkansas hospital association see schedule o see schedule o false form 990, part vi, section a, line 1a delegation of authority: AN EXECUTIVE COMMITTEE MAY BE ELECTED BY THE BOARD OF DIRECTORS TO CONSIST OF NOT LESS THAN THREE DIRECTORS. THE COMMITTEE IS ABLE TO EXERCISE ALL AUTHORITY OF THE BOARD DURING INTERVALS BETWEEN MEETINGS OF THE BOARD WITH RESPECT TO THE AFFAIRS OF THE CORPORATION, BUT SHALL BE SUBJECT TO THE CONTROL AND DIRECTION OF THE FULL BOARD. THE COMMITTEE SHALL ALSO CONDUCT AN EVALUATION OF THE CHIEF EXECUTIVE OFFICER ANNUALLY FOR THE FULL BOARD OF DIRECTORS TO REVIEW. form 990, part vi, section a, line 2 relationships of officers, directors, and trustees: Chuck Morgan (JHA Director) and Annette Kline (JHA Director) have a business relationship. Marty Casteel (JHA Director) and Dr. Clifton Roaf (JHA Director) have a business relationship. George Makris (JHA Director) and Dr. Clifton Roaf (JHA Director) have a business relationship. George Makris (JHA Director) and Marty Casteel (JHA Director) have a business relationship. H. Ford Trotter III (JHA Director) and Dr. Clifton Roaf (JHA Director) have a business relationship. H. Ford Trotter III (JHA Director) and Marty Casteel (JHA Director) have a business relationship. H. Ford Trotter III (JHA Director) and George Makris (JHA Director) have business relationships. H. Ford Trotter III (JHA Director) and David Brown (JHA Director) have a business relationship. H. Ford Trotter III (JHA Director) and Walter Johnson (JHA President and CEO) have a business relationship. George Makris (JHA Director) and David Brown (JHA Director) have a business relationship. Marty Casteel (JHA Director) and John Lytle (JHA Chief of Staff & Director) have a business relationship. Marty Casteel (JHA Director) and Chuck Morgan (JHA Director) have a business relationship. Scott Pittillo (JHA Director) and Annette Kline (JHA Director) have a business relationship. Scott Pittillo (JHA Director) and Chuck Morgan (JHA Director) have a business relationship. Drew Atkinson (JHA Director) and Frank Anthony (JHA Director) have a business relationship. George Makris (JHA Director) and John Lytle (JHA Chief of Staff & Director) have a business relationship. Drew Atkinson (JHA Director) and Bryan Jackson (JHA VP & CFO) have a business relationship. Frank Anthony (JHA Director) and Bryan Jackson (JHA VP & CFO) have a business relationship. Clifton Roaf (JHA Director) and John Lytle (JHA Chief of Staff & Director) have a business relationship. H. Ford Trotter III (JHA Director) and John Lytle (JHA Chief of Staff & Director) have a business relationship. form 990, part vi, section a, line 6 members or stockholders: THE ORGANIZATION HAS A MEMBERSHIP CONSISTING OF 30 JEFFERSON COUNTY ARKANSAS RESIDENTS. form 990, part vi, section a, line 7a power to elect or appoint members of governing body: THE MEMBERSHIP OF THE ORGANIZATION HAS THE RESPONSIBILITY OF ELECTING THE BOARD OF DIRECTORS AT THE ANNUAL MEMBERSHIP MEETING. form 990, part vi, section b, line 11b process to review form 990: THE FORM 990 AND FORM 990-T ARE PREPARED AND REVIEWED UNDER THE DIRECTION OF THE CHIEF FINANCIAL OFFICER. FINAL DRAFTS OF THE RETURNS ARE PRESENTED TO THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS DESIGNATED BY THE BOARD OF DIRECTORS TO FULFILL THE FIDUCIARY RESPONSIBILITY OF THE GOVERNING BODY TO REVIEW AND APPROVE THE RETURNS BEFORE THEY ARE FILED WITH THE IRS. AFTER ANY FINAL REVISIONS ARE MADE AND THE RETURNS ARE APPROVED BY THE GOVERNANCE COMMITTEE AND THE BOARD OF DIRECTORS, A FINAL VERSION IS POSTED TO AN INTERNAL SECURE WEBSITE WITH A LINK E-MAILED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS. form 990, part vi, section b, line 12c process to monitor and enforce compliance with conflict of interest policy: THE ORGANIZATION REQUIRES NOT ONLY AN ANNUAL CONFLICT OF INTEREST DISCLOSURE, BUT ALSO DISCLOSURE WHEN SITUATIONS SUBSEQUENT TO THE ANNUAL DISCLOSURE DEVELOP THAT WOULD POTENTIALLY PLACE THE INDIVIDUAL IN A CONFLICT OF INTEREST. IN THOSE SITUATIONS, IMMEDIATE DISCLOSURE Is REQUIRED. THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTS THE ANNUAL REVIEW OF CONFLICT OF INTEREST DISCLOSURES. IN THE EVENT THE GOVERNANCE COMMITTEE DETERMINES THAT A CONFLICT EXISTS, LEGAL COUNSEL IS CONSULTED. IF LEGAL COUNSEL DETERMINES THAT A CONFLICT EXISTS, THE PERSON IS INFORMED AND THE MATTER IS REPORTED TO THE BOARD FOR ACTION. ANY DIRECTOR OR OFFICER WHOSE TRANSACTIONS ARE BEING REVIEWED WOULD ABSENT HIMSELF/HERSELF FROM THE REVIEW. form 990, part vi, section b, lines 15a & 15b compensation of ceo and other officers: The Board of Directors has established a separate compensation committee charged with performing an annual performance and compensation review of the CEO and other officers. The Compensation Committee most recently engaged a third-party global human capital consulting firm in 2013 for a limited engagement to review and validate the findings and report provided to the Compensation Committee in 2012. The Compensation Committee engages the third-party global human capital consulting firm to develop and maintain a compensation package that is reasonable as compared to similar positions at non-profit healthcare organizations of similar size and complexity. The Compensation Committee then makes a report to the full Board of Directors of any compensation adjustments. form 990, part vi, section c, line 19 availability of documents: THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST ONE OR MORE OF THE ITEMS. form 990, part ix, line 11g other fees for services: Physician Fees $ 9,123,855 Purchased Services 8,432,206 Professional Fees 4,809,205 Other Fees 2,442,020 Contract Labor 1,593,834 --------------------- total $ 26,401,120 schedule l, part iv, columns b, c & d business transactions involving interested persons: (A) NAME OF PERSON: RICHARD MORGAN (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF CHUCK MORGAN (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: REBECCA PITTILLO (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF SCOTT PITTILLO (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: LINDSAY MAKRIS (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF GEORGE MAKRIS (JHA DIRECTOR) (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: ARKANSAS HOSPITAL ASSOCIATION (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: WALTER JOHNSON (JHA PRESIDENT & CEO) IS A BOARD MEMBER (C) TRANSACTION AMOUNTS REPORTED ARE GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: HOSPITAL MEMBERSHIP DUES jefferson surgery center pllc 1600 W 40th Ave Pine bluff AR 71603 710810564 amb surgery AR jha related -45753 1097439 false 0 true 0.66500 jrmc development inc 1600 W 40th ave pine bluff AR 71603 710664723 Real estate mgmt AR jha c-corporation -218850 15675671 1.00000 true Jefferson management services inc 1600 w 40th ave pine bluff AR 71603 710582753 phys practice mgt AR jha c-corporation 0 478798 1.00000 true true false false false false false false false false false true true true false false false false true true Jefferson surgery center pllc L 1298100 G/L Activity Jefferson surgery center pllc M 1263045 G/L Activity Jefferson surgery center pllc R 1206105 G/L Activity Jefferson surgery center pllc S 1318847 G/L Activity Jefferson Management Services INc L 277845 G/L Activity Jefferson Management Services INc S 765223 G/L Activity JRMC Development Inc K 675926 G/L Activity JRMC Development Inc L 331409 G/L Activity JRMC Development Inc A 1683773 G/L Activity JRMC Development Inc R 344517 G/L Activity JRMC Development Inc S 474274 G/L Activity