CHIEF EXECUTIVE OFFICER

2013-05-22T13:48:41-07:00 2013-01-31 TERRY HORNE CPA & ASSOCIATES PC 732 WEST MAIN STREET LEBANON TN 37087 990 2012-02-01 640625076 SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC SOUT 6015458700 5488 US HWY 49/PO BOX 1729 HATTIESBURG MS 394031729 GEROLDEAN DYSE CHIEF EXECUTIVE OFFICER 6015458700 2013-05-22 true TERRY HORNE 6154447293 2013-05-22 2012 2016-02-25 16:41:14Z GEROLDEAN DYSE 5488 US HWY 49 HATTIESBURG MS 39403 17258849 false X N/A X 1979 MS THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. 11 11 260 0 0 7099390 7780469 9178833 9447201 39763 31179 0 16317986 17258849 0 0 10401456 11085716 0 0 4840042 5361432 15241498 16447148 1076488 811701 10811167 11255394 4370890 4003416 6440277 7251978 THE ORGANIZATION PROVIDES HEALTH CARE false false 13154060 9447201 THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 90,900 VISITS WERE PROVIDED DURING THE YEAR. 13154060 true true false false false false false false false false true false false true false false true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false true 18 0 true 260 true false false false false false false false false false false false false false X 11 11 false false false false false false false true true false false false true true true true true true true false MS X POLLY EUBANKS 6015458700 5488 US HWY 49 HATTIESBURG MS 39403 KERMIT RAYBORN BOARD MEMBER 1.00 X 0 0 0 BILL FOLKES PRESIDENT 1.00 X 0 0 0 KAREN SPEED BOARD MEMBER 1.00 X 0 0 0 JOYCE WOULLARD TREASURER 1.00 X 0 0 0 GINGER BURKS VICE PRESIDENT 1.00 X 0 0 0 NANNI T FREEMAN BOARD MEMBER 1.00 X 0 0 0 DESSIE WILLIAMS BOARD MEMBER 1.00 X 0 0 0 SHARENE CONERLY SECRETARY 1.00 X 0 0 0 HULDAH INGRAM BOARD MEMBER 1.00 X 0 0 0 FRANKIE THOMAS BOARD MEMBER 1.00 X 0 0 0 WILLIAM RESTER BOARD MEMBER 1.00 X 0 0 0 GEROLDEAN DYSE CHIEF EXECUTIVE OFFICER 40.00 X 120699 0 49017 BRANDON COLEMAN MEDICAL DIRECTOR (TERMINATED) 40.00 X 110693 0 20515 JAMES GRIFFIN MEDICAL DIRECTOR 40.00 X 180965 0 49893 POLLY EUBANKS CHIEF FINANCIAL OFFICER 40 X 73599 46429 NATHANIEL SONES CHIEF INFORMATION OFFICER 40 X 66606 43475 JANICE ROBINSON CHIEF HUMAN RESOURCE OFFICER 40 X 64475 43247 KEITH KERSTEN PHYSICIAN 40 X 195681 54835 HOSSEIN BEHNIAYE PHYSICIAN 40 X 158583 56952 HASSAN BEHNIAY PHYSICIAN 40 X 157307 55554 QUENYATTA ECHOLS-WILLIAMS PHYSICIAN 40 X 153125 52342 PATRICIA THOMPSON CFNP 40 X 120117 11509 1401850 483768 8 false true false LABCORP OF AMERICA 231 MAPLE AVENUE BURLINGTON NC 27215 LAB SERVICES 364497 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 606731246 COMPUTER SERVICES 210357 FOREST GENERAL HOSPITAL PO BOX 16389 HATTIESBURG MS 39404 CONTRACT PHYSICIAN 148025 3 6420550 1359919 501145 7780469 PATIENT FEES 624100 9447201 9447201 31179 31179 17258849 9447201 31179 617037 291658 325379 0 8152558 7274079 878479 0 791725 688792 102933 0 1005654 858714 146940 0 518742 451306 67436 0 4088 0 4088 0 32480 0 32480 0 1159300 801683 357617 0 2522506 1766614 755892 0 745804 450768 295036 0 286711 97031 189680 0 597184 461392 135792 0 13359 12023 1336 0 16447148 13154060 3293088 0 1731783 2764652 4439 4993 921355 726103 427617 478642 78262 75197 10993872 4909155 6555980 6084717 1091731 1121090 10811167 11255394 1179917 1289510 3190973 2713906 4370890 4003416 X 6258252 7043656 182025 208322 6440277 7251978 10811167 11255394 811701 X X false true X true true true X 5611133 6324528 7178218 7099390 7780469 33993738 5611133 6324528 7178218 7099390 7780469 33993738 33993738 44779 45373 55845 39763 31179 216939 34210677 44113092 0.99370 0.99270 X 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 260525 260525 8783867 3398605 5385262 1949480 1510550 438930 6084717 INVESTMENT 1113362 DEPOSITS 7728 1121090 17258849 17258849 17258849 16447148 16447148 16447148 X X false false false false false false false false false GEROLDEAN DYSE 120699 39076 9941 169716 JAMES GRIFFIN 180965 44443 5450 230858 KEITH KERSTEN 195681 45242 9593 250516 HOSSEIN BEHNIAYE 158583 44246 12706 215535 HASSAN BEHNIAY 157307 42725 12830 212862 QUENYATTA ECHOLS-WILLIAMS 153125 43399 8942 205466 X 5522 276098 # OF CONTRIBUTIONS ARE EST @ FMV X DONATED PHARMACIST & 2 TECHS 3 225047 FMV false false false Pt VI, Line 12c CONFLICT OF INTEREST IS MONITORED THROUGH VARIOUS COMPANIES SUCH AS: ACCOUNTING POLICIES, EMPLOYMENT POLICIES AND COMPLIANCE POLICIES. WE CONSTANTLY MONITOR TO IDENTIFY CONFLICTS OF INTEREST AND ADDRESS THOSE ISSUES AS THEY RISE. Pt VI, Line 15a SALARY SURVEYS SUCH AS NACHC's ANNUAL SALARY SURVEY, HORNE LLP SALARY SURVEY Pt VI, Line 15b AND OTHER FQHC's HAVE BEEN CONTACTED FOR COMPARABLE SALARY INFORMATION. Pt VI, Line 11b EACH BOARD MEMBER IS PROVIDED A COPY OF THE FINAL AUDIT REPORT AND THE REPORT IS DISCUSSED DURING THE BOARD MEETING. THE CEO AND CFO PROVIDE THE INFORMATION FOR THE 990 TO BE COMPLETED AND REVIEW THE 990. Pt VI, Line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. Pt XII, Line 2c THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT.