ANDERSON PHYSICIAN ALLIANCE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ANDERSON PHYSICIAN ALLIANCE INC (EIN 27-3274203)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201422279349302852
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-08-15T11:16:06-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560747981EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN273274203EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ANDERSON PHYSICIAN ALLIANCE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlANDENameControl
Phone6015536000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameA KEITH HEARTSILLName
TitleCFOTitle
Phone6015536000Phone
Date Signed2014-08-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMY BIBBYName
PTINP00445891PTIN
Phone8282542254Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonA KEITH HEARTSILLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6489437GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.JARMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2010YearFormation
State Legal DomicileMSStateLegalDomicile
Activity Or Mission DescriptionANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees138TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6653066ProgramServiceRevenuePriorYear
Program Service Revenue CY6374350ProgramServiceRevenueCY
Investment Income Prior Year427InvestmentIncomePriorYear
Investment Income Current Year-2059InvestmentIncomeCurrentYear
Other Revenue Prior Year46812OtherRevenuePriorYear
Other Revenue Current Year115052OtherRevenueCurrentYear
Total Revenue Prior Year6700305TotalRevenuePriorYear
Total Revenue Current Year6487343TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7558542SalariesEtcPriorYear
Salaries Etc Current Year6564023SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4481747OtherExpensePriorYear
Other Expenses Current Year3574168OtherExpensesCurrentYear
Total Expenses Prior Year12040289TotalExpensesPriorYear
Total Expenses Current Year10138191TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5339984RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3650848RevenuesLessExpensesCY
Total Assets BOY2721683TotalAssetsBOY
Total Assets EOY1421162TotalAssetsEOY
Total Liabilities BOY12631438TotalLiabilitiesBOY
Total Liabilities EOY14981765TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-9909755NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-13560603NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. THE SPECIFIC PURPOSES AND OBJECTIVES OF THE CORPORATION SHALL INCLUDE BUT NOT BE LIMITED TO EMPLOYING PHYSICIANS AND OTHER MEDICAL PERSONNEL TO CARRY OUT THE PURPOSES AND OBJECTIVES OF ANDERSON REGIONAL MEDICAL CENTER, AS FOLLOWS:1.) TO ESTABLISH AND MAINTAIN AN INSTITUTION OR INSTITUTIONS, WITHIN OR WITHOUT THE STATE WHERE INCORPORATED, WITH PERMANENT FACILITIES TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS2.) TO CARRY ON ANY EDUCATION ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH3.) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED4.) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITYMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8626504Expense
Grants0Grants
Revenue6374350Revenue
DescriptionSEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA.ANDERSON PHYSICIAN ALLIANCE, INC. OPERATES 5 PRIMARY CARE CLINICS IN THE EAST MISSISSIPPI AND WEST ALABAMA AREA. THE PHYSICIANS, NURSE PRACTITIONERS AND STAFF FOCUS ON PRIMARY HEALTHCARE NEEDS OF THE COMMUNITY.THE CLINICS IN MISSISSIPPI INCLUDE:ANDERSON FAMILY MEDICAL CENTER - RIVERBIRCHANDERSON FAMILY MEDICAL CENTER - AIRPARK (PHILADELPHIA, MS)ANDERSON FAMILY MEDICAL CENTER - ENTERPRISE (ENTERPRISE, MS)THE ALABAMA CLINICS INCLUDE:ANDERSON FAMILY MEDICAL CENTER - BUTLER (BUTLER, ALABAMA)ANDERSON FAMILY MEDICAL CENTER - LIVINGSTON (LIVINGSTON, AL) ANDERSON PHYSICIAN ALLIANCE, INC. OPERATES 7 MEDICAL SPECIALTY CLINICS INCLUDING:ANDERSON ARTHRITIS AND RHEUMATOLOGY, FOCUSES ON PROVIDING PATIENTS WITH ASSISTANCE IN ACHIEVING A HIGHER QUALITY OF LIFE THROUGH AGGRESSIVE ATTENTION TO RHEUMATOLOGIC DISEASE AND ARTHRITIC CONDITIONS. THE CLINIC SPECIALIZES IN THE DIAGNOSIS AND TREATMENT OF RHEUMATOID ARTHRITIS, LUPUS AND MIXED CONNECTIVE TISSUE DISEASES, SJORGENS SYNDROME, MYOSITIS, VACUITIES AND OSTEOARTHRITIS.ANDERSON INFECTIOUS DISEASE CENTER OFFERS TREATMENT IN THE DIAGNOSIS AND TREATMENT OF INFECTIOUS DISEASES. THE PHYSICIAN AND NURSE PRACTITIONERS EXTENSIVE TRAINING GUIDES PATIENTS IN THE TREATMENT OF INFECTIONS, INCLUDING THOSE CAUSED BY BACTERIA, VIRUSES, FUNGI, PARASITES AND HUMAN IMMUNODEFICIENCY VIRUS, THE CAUSE OF AIDS.ANDERSON NEUROLOGY CENTER FOCUSES ON THE DIAGNOSIS AND TREATMENT OF ALZHEIMER'S DISEASE, PARKINSON'S DISEASE, STROKE AND NEUROLOGICAL DISORDERS.ANDERSON ENDOCRINOLOGY CENTER PROVIDES TREATMENT OF DIABETES, THYROID DISEASE, METABOLIC DISORDERS, CHOLESTEROL DISORDERS AND ENDOCRINE DISORDERS.ANDERSON UROLOGY CENTER OF MERIDIAN PROVIDES UROLOGIC CARE SPECIALIZING IN OVERACTIVE BLADDER, KIDNEY STONES, AND URINARY TRACT INFECTIONS. SURGICAL TREATMENTS INCLUDE: MINIMALLY INVASIVE PROSTATECTOMY SURGERY USING THE DAVINCI SURGICAL ROBOT.ANDERSON PREMIER WOMEN'S CLINIC PROVIDES QUALITY CARE TO WOMEN IN MERIDIAN AND THE SURROUNDING COMMUNITIES. THE DEDICATED PHYSICIAN'S AND STAFF TAKE PRIDE IN PROVIDING A GENUINE CONCERNED ENVIRONMENT FOR WOMEN FROM ADOLESCENCE, TO CHILD BEARING YEARS AND THROUGH MATERNITY.ANDERSON CHILDREN'S MEDICAL CLINIC IS DEVOTED TO PROVIDING THE HIGHEST QUALITY CARE FOR NEWBORNS, YOUNG CHILDREN AND ADOLESCENTS SEVEN DAYS A WEEK.EFFECTIVE JUNE 2013, THE FOLLOWING CLINIC DEPARTMENTS WERE MOVED FROM THE ANDERSON PHYSICIAN ALLIANCE, INC. TO ANDERSON REGIONAL MEDICAL CENTER:ANDERSON FAMILY MEDICAL CENTER - RIVERBIRCHANDERSON FAMILY MEDICAL CENTER - AIRPARK (PHILADELPHIA, MS)ANDERSON FAMILY MEDICAL CENTER - ENTERPRISE (ENTERPRISE, MS)ANDERSON CHILDREN'S MEDICAL CLINICTHESE CLINICS ARE OPERATED AS RURAL HEALTH CLINICS UNDER ANDERSON REGIONAL MEDICAL CENTER SOUTH HOSPITAL FACILITY.EFFECTIVE JANUARY 2014, ANDERSON FAMILY MEDICAL CENTER - BUTLER (BUTLER, ALABAMA) CLINIC CEASED OPERATIONS AS AN ANDERSON PHYSICIAN ALLIANCE, INC. CLINIC.Description
Total Program Service Expense8626504TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109632NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees138NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1A KEITH HEARTSILLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6015536000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12124 14TH STREETAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JOHN ANDERSON
CHAIRMAN1.00XX019217252703
WANDA COOPER
SECRETARY/TREASURER1.00XX019548553143
PHILLIP BROOKS
DIRECTOR1.00X0156820
LELAND RAY HUMPHREYS
PRESIDENT1.00X0426219128773
MARK T PHILLIPS
PHYSICIAN40.00490458064584X
JESSE P PENICO
PHYSICIAN40.00484630033128X
JIMMY V WOLFE
PHYSICIAN40.00343730020374X
DREW M HUFFMAN
PHYSICIAN40.00332935023736X
LINDA M DALES
PHYSICIAN40.00306267051552X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1958020TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs829558TotalReportableCompFrmRltdOrgs
Total Other Compensation427993TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MED 3000 HEALTH SOLUTIONSBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15 E ALVON ROAD SUITE 7AddressLine1
CityWHITE SULPHUR SPRINGSCity
StateWVState
ZIP Code24986ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesBILLING SERVICESDescriptionOfServices
Compensation131776Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT62199063664496366449
OTHER OPERATING REVENU62199079017901
FieldValueIRS element (for citing)
Total Program Service Revenue6374350TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column35TotalRevenueColumn
Exclusion$35ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2094Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-2094Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2094TotalRevenueColumn
Exclusion-$2,094ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column115052TotalRevenueColumn
Exclusion$115,052ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue115052TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6487343TotalRevenueColumn
Related Or Exempt Function Income6374350RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$112,993ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total57282Total
Program Services57282ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5763962Total
Program Services5027442ProgramServices
Management And General736520ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total83509Total
Program Services72943ProgramServices
Management And General10566ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total339872Total
Program Services296870ProgramServices
Management And General43002ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total319398Total
Program Services278987ProgramServices
Management And General40411ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1147549Total
Program Services500528ProgramServices
Management And General647021ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total57465Total
Program Services56825ProgramServices
Management And General640ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total302399Total
Program Services286420ProgramServices
Management And General15979ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total555012Total
Program Services555012ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total10805Total
Program Services6227ProgramServices
Management And General4578ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total25946Total
Program Services25946ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total38933Total
Program Services38933ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total366679Total
Program Services366679ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total309215Total
Program Services309215ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES56337255040212970
BAD DEBT EXPENSE196793196793

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10138191Total
Program Services8626504ProgramServices
Management And General1511687ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2446BOY
EOY2200EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY274488BOY
EOY553696EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY584695BOY
EOY353333EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY50381BOY
EOY113510EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis759062LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec361965LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1809673BOY
EOY397097EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY1326EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2721683BOY
EOY1421162EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY883559BOY
EOY721430EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11747879BOY
EOY14260335EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY12631438BOY
EOY14981765EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-9909755BOY
EOY-13560603EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-9909755BOY
EOY-13560603EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2721683BOY
EOY1421162EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-3650848ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis759062OtherCostOrOtherBasis
Depreciation361965Depreciation
Book Value397097BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings397097TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$14,260,335Amount
FieldValueIRS element (for citing)
Total Of Amounts14260335TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationANDERSON PHYSICIAN ALLIANCE 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. ANDERSON PHYSICIAN ALLIANCE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013 AND 2012. YEARS ENDING ON OR AFTER SEPTEMBER 30, 2010, REMAIN SUBJECT TO EXAMINIATION BY FEDERAL AND STATE TAX AUTHORITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN ANDERSON
CHAIRMAN01906950001477039800012903024487500
WANDA COOPER
SECRETARY/TREASURER01930110002474039823013320024862800
LELAND RAY HUMPHREYS
PRESIDENT0411741000144780113447015326055499200
MARK T PHILLIPS
PHYSICIAN450153038415018900466310179530555042000
JESSE P PENICO
PHYSICIAN3458010137281015480166750164530517758000
JIMMY V WOLFE
PHYSICIAN343133000597012500191240364104000
DREW M HUFFMAN
PHYSICIAN21687401157440317057490179870356671000
LINDA M DALES
PHYSICIAN30428700019800407500108020357819000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationARMC PROVIDES CERTAIN EXEUCTIVES AN IRC SEC 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) PLAN: - LELAND RAY HUMPHREYS $67,257 - JOHN ANDERSON 34,755 - WANDA COOPER 33,257Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonCASEY CHESTNUTT HAARALANamePerson
FieldValueIRS element (for citing)
RelationshipFAMILY RELATIONSHIP WITH A BOARD MEMBERRelationship
Amount Of Transaction57282AmountOfTransaction
Description Of TransactionCLINIC MANAGER OF THE ORGANIZATIONDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 1UNLESS PROHIBITED OR LIMITED BY THE ARTICLES OF INCORPORATION OR THESE BYLAWS, THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE AND ONE OR MORE THAN OTHER COMMITTEES OF THE BOARD AND APPOINT MEMBERS OF THE BOARD OF DIRECTORS TO SERVE ON THEM.
FORM 990, PART VI, SECTION A, LINE 3MEDICAL MANAGEMENT SERVICES IS RESPONSIBLE FOR THE DAILY MANAGEMENT OPERATIONS OF THE APA CLINICS AND APA BUSINESS OFFICE INCLUDING PERFOMRING BUDGETS AND EXPENSE APPROVAL. MEDICAL MANAGEMENT SERVICES RECOMMENDS STAFFING PERSONNAL TO THE FACILITY BUT THE FACILITY HAS THE FINAL APPROVAL FOR ALL HIRING AND FIRING OF EMPLOYEES INCLUDING PHYSICIANS.
FORM 990, PART VI, SECTION A, LINE 6ANDERSON REGIONAL MEDICAL CENTER (ARMC) IS THE SOLE MEMBER OF ANDERSON PHYSICIAN ALLIANCE, INC.
FORM 990, PART VI, SECTION A, LINE 7AANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCICE ALL VOTING RIGHTS OF THE MEMBERS
FORM 990, PART VI, SECTION A, LINE 7BANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APRROVE APA'S PHYSICIAN COMPENSATION MODELS, PHYSICIAN COMPENSATION AND PHYSICIAN COMPENSATION POLICIES, (2) TO APPROVE PHYSICIAN EMPLOYMENT AGREEMENTS, AND (3) TO INITIATE AND/OR APPROVE VARIOUS OTHER ACTIONS AND POLICIES AS ENUMERATED IN APA'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND AS REQUIRED BY STATE LAW.
FORM 990, PART VI, SECTION B, LINE 11EACH BOARD MEMBER WAS PROVIDED A COPY OF THE FORM 990. THE BOARD MEMBERS WERE ASKED TO REVIEW THE FORM AND SUBMIT QUESTIONS AND COMMENTS PROIR TO THE FORM 990 BEING FINALIZED. AFTER REVIEW, THE FINALIZED FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REQUESTS ALL BOARD MEMBERS TO ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST.
THE BOARD OF ARMC HAS A DESIGNATED THREE (3) PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS TO REVIEW AND APPROVE COMPENSATION. THE BOARD ALSO HAD A CONTRACT FOR PROFESSIONAL SERVICES WITH MERCER UNTIL JULY 1, 2013 AND CURRENTLY USES SULLIVAN COTTER TO STUDY AND RECOMMEND COMPENSATION FOR THE CEO, THE VICE PRESIDENTS, AND THE DIRECTORS OF THE HOSPITAL.
FORM 990, PART VI, SECTION C, LINE 18IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GPHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,900. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,900. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 493,628. MANAGEMENT AND GENERAL EXPENSES 647,021. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,140,649.OTHER FEES

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ANDERSON REGIONAL MEDICAL CENTER
2124 14TH STREETMERIDIANMS39301640362400HEALTHCAREMS501(C)(3)LINE 3N/A0
MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION
122 WOODMONT WAYRIDGELANDMS39157640722433SUPPORTING ORGANIZATIONMS501(C)(3)LINE 11C, III-FI0ANDERSON REGIONAL MEDICAL CENTER
ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION
7651 POPLAR SPRINGS DRMERIDIANMS39305640730109SUPPORTING ORGANIZATIONMS501(C)(3)LINE 11D, III-O0ANDERSON REGIONAL MEDICAL CENTER
MIRACLES OF GRACE FOUNDATION
1827 SUNRISE LANETOOMSUBAMS39364640730366SUPPORTING ORGANIZATIONMS501(C)(3)LINE 11C, III-FI0ANDERSON REGIONAL MEDICAL CENTER
CARE CONSISTENCY FOUNDATION INC
7761 MEADOW CIRCLEMERIDIANMS39305640730846SUPPORTING ORGANIZATIONMS501(C)(3)LINE 11D, III-O0ANDERSON REGIONAL MEDICAL CENTER
ANDERSON HOSPITAL PROVIDERS INC
2124 14TH STREETMERIDIANMS39301461305481PHYSICIAN BILLINGMS501(C)(3)LINE 30ANDERSON REGIONAL MEDICAL CENTER

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
EAST MISSISSIPPI ENDOSCOPY CENTER
1926 23RD AVENUEMERIDIANMS39301440884792HEALTHCAREMSN/A
JARMC LEVERAGE LLC
2124 14TH STREETMERIDIANMS39301272284311INVESTMENTSMSN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ARMC HOSPITAL PROF & GEN LLFTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1512 22ND AVENUEAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode
FieldValueIRS element (for citing)
EIN206131090EIN
Primary ActivityTRUSTPrimaryActivity
Legal Domicile StateMSLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityTTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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