JEFFERSON HOSPITAL ASSN INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- JEFFERSON HOSPITAL ASSN INC (EIN 71-0329353)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201311339349303166
- Schema version
- 2011v1.5
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T13:31:43-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1 |
| City | ST LOUIS | City |
| State | MO | State |
| ZIP Code | 63101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710329353 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON HOSPITAL ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JEFF | NameControl |
| Phone | 8705417100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 WEST 40TH AVENUE | AddressLine1 |
| City | PINE BLUFF | City |
| State | AR | State |
| ZIP Code | 71603 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRYAN JACKSON | Name |
| Title | VICE PRESIDENT & CFO | Title |
| Phone | 8705417100 | Phone |
| Date Signed | 2013-05-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFF PARKER | Name |
| PTIN | P00970069 | PTIN |
| Phone | 3149254300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WALTER JOHNSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 WEST 40TH AVENUE | AddressLine1 |
| City | PINE BLUFF | City |
| State | AR | State |
| ZIP Code | 71603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 188813480 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.JRMC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | AR | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE SERVICE PROVIDER | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2188 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 166173 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -21805 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1829103 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1419947 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 176838047 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 176078282 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3109092 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2465169 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 9142934 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8839559 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 190919176 | TotalRevenuePriorYear |
| Total Revenue Current Year | 188802957 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 684521 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 366572 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 87400453 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 89619300 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 10523 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 91302870 | OtherExpensePriorYear |
| Other Expenses Current Year | 90215463 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 179387844 | TotalExpensesPriorYear |
| Total Expenses Current Year | 180201335 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 11531332 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8601622 | RevenuesLessExpensesCY |
| Total Assets BOY | 230604629 | TotalAssetsBOY |
| Total Assets EOY | 241797556 | TotalAssetsEOY |
| Total Liabilities BOY | 61659025 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 64420486 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 168945604 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 177377070 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 161500818 | Expense |
| Grants | 366572 | Grants |
| Revenue | 176887478 | Revenue |
| Description | 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.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."WE PROVIDE 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 ALSO OPERATE AND MANAGE SEVERAL SATELLITE CLINICS WHICH PROVIDE PRIMARY AND SPECIALTY HEALTHCARE TO THE COMMUNITY AND OUTLYING AREAS.JRMC OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; HAS A GOVERNING BODY THAT IS 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.COMMUNITY SERVICE AND EDUCATION CONTINUED TO BE A SIGNIFICANT PART OF OUR MISSION. JRMC PROVIDES NUMEROUS SPONSORSHIPS WITHIN THE COMMUNITY, AND OFFER 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. APPROXIMATELY 336,000 LIVES WERE TOUCHED THROUGH CHARITABLE SOCIOECONIMIC DEVELOPMENT ACTIVITIES, AT AN ESTIMATED COST OF $322,000, WHILE OUTREACH AND COMMUNITY EDUCATION ACTIVITIES TOUCHED APPROXIMATELY 54,000 LIVES AT AN ESTIMATED COST OF $146,000 DURING FISCAL YEAR 2012.OUR COMMITMENT TO BRING NEW AND INNOVATIVE PROGRAMS AND SERVICES TO SOUTHEAST ARKANSAS IS EVIDENT. DURING FISCAL YEAR 2012, JRMC INVESTED APPROXIMATELY $6.8 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 THE FIRST OR ONE OF THE FIRST HOSPITALS IN THE STATE TO ACQUIRE AND IMPLEMENT MANY LEADING HEALTHCARE TECHNOLOGIES. WE ARE PROUD THAT WE CAN CONTINUE TO PROVIDE LEADING HEALTHCARE SERVICES TO EVERYONE IN SOUTHEAST ARKANSAS, REGARDLESS OF ABILITY TO PAY.JRMC CONTINUES TO BE A LEADER IN ELECTRONIC MEDICAL RECORD SYSTEM ADVANCEMENT. THE HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY (HIMSS) MAINTAINS A SYSTEM FOR MEASURING THE PROGRESS AND IMPACT OF ELECTRONIC MEDICAL RECORDS SYSTEMS. THERE ARE A TOTAL OF 8 STAGES (0-7) A HOSPITAL CAN ACHIEVE WITH A GOAL OF REACHING STAGE 7, WHERE PAPER CHARTS ARE NOT USED TO MANAGE THE DELIVERY OF PATIENT CARE AND CLINICAL DATA IS USED FOR THE PERFORMANCE IMPROVEMENT AND ANALYTICS OF HEALTHCARE. HIMSS CURRENTLY RECOGNIZES JRMC AS A STAGE 6 PROVIDER, WHICH PUTS JRMC IN THE TOP 3% OF PROVIDERS NATIONALLY. DURING FISCAL YEAR 2011, JRMC WAS AMONG THE FIRST PROVIDERS IN THE NATION TO MEET STAGE 1 OF THE MEANINGFUL USE REQUIREMENTS SET FORTH AS PART OF THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009. DURING FISCAL YEAR 2012, JRMC CONTINUED TO MEET THE SECOND-YEAR REQUIREMENTS SET FORTH IN THE LAW.JRMC HAS BEEN RECOGNIZED BY THE JOINT COMMISSION AS ONE OF THE NATION'S TOP PERFORMERS ON KEY QUALITY MEASURES FOR HEART ATTACK, HEART FAILURE, AND PNEUMONIA TREATMENT. THE ORGANIZATION HAS BEEN AWARDED MONETARY INCENTIVES IN BOTH ARKANSAS MEDICAID AND CENTERS FOR MEDICARE AND MEDICAID SERVICES QUALITY PROGRAMS BY ACHIEVING PERFORMANCE GOALS IN QUALITY, DOCUMENTATION AND VALIDATION EXCELLENCE. WE CONTINUALLY ANALYZE PATIENT SATISFACTION 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 SEVERAL 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. | Description |
| Total Program Service Expense | 161500818 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 211 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2188 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRYAN JACKSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8705417100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 WEST 40TH STREET | AddressLine1 |
| City | PINE BLUFF | City |
| State | AR | State |
| ZIP Code | 71603 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JERREL BOAST | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| CHUCK MORGAN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DAVID BROWN | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| FRANK ANTHONY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DREW ATKINSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAMES CAMPBELL JR MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARTY CASTEEL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANNETTE KLINE | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| CLIFTON ROAF DDS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| GEORGE ROBERSON MD FACS | |||||||
| DIRECTOR | 1.00 | X | 76650 | 0 | 0 | ||
| WALTER JOHNSON | |||||||
| PRESIDENT & CEO | 40.00 | X | 635712 | 0 | 22924 | X | |
| MICHELLE ECKERT MD FACS | |||||||
| DIRECTOR | 1.00 | X | 56568 | 0 | 0 | ||
| OT GORDON MD | |||||||
| JRMC CHIEF OF STAFF | 15.00 | X | 0 | 0 | 0 | ||
| GEORGE MAKRIS | |||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| JOANN B MAYS MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SCOTT PITTILLO | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| HENRY FORD TROTTER III | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DOUG COLEMAN MD | |||||||
| JRMC CHIEF OF STAFF | 15.00 | X | 27500 | 0 | 0 | ||
| THOMAS HARBUCK | |||||||
| EXECUTIVE VICE PRESIDENT | 40.00 | 581569 | 0 | 25073 | X | ||
| LOUISE HICKMAN | |||||||
| VICE PRESIDENT & CNO | 40.00 | 305261 | 0 | 20354 | X | ||
| BRIAN THOMAS | |||||||
| SENIOR VP & COO | 40.00 | 408757 | 0 | 22130 | X | ||
| BRYAN G JACKSON | |||||||
| VICE PRESIDENT & CFO | 40.00 | 146293 | 0 | 37695 | X | ||
| ALI ALNASIF MD | |||||||
| PHYSICIAN | 40.00 | 396239 | 0 | 14263 | X | ||
| TAMER ALSEBAI MD | |||||||
| PHYSICIAN | 40.00 | 421773 | 0 | 22887 | X | ||
| CHARLES A CLARK | |||||||
| PHYSICIAN | 40.00 | 565996 | 0 | 19411 | X | ||
| JAMES ALAN POLLARD | |||||||
| PHYSICIAN | 40.00 | 630957 | 0 | 22376 | X | ||
| JOHN O LYTLE | |||||||
| PHYSICIAN | 40.00 | 883263 | 0 | 22630 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5136538 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 229743 | TotalOtherCompensation |
| Number Individuals GT100 K | 54 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EMURGENT CARE INC | |||||
| 8 SHACKLEFORD PLAZA | LITTLE ROCK | AR | 72211 | PHYSICIAN SERVICES | 3674512 |
| REHAB CARE GROUP INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | THERAPY SERVICES | 3263135 |
| SODEXHO INC & AFFILIATES | |||||
| PO BOX 536922 | ATLANTA | GA | 30353 | NUTRITIONAL SERVICES | 2486749 |
| UAMS-AHEC | |||||
| 4010 MULBERRY ST | PINE BLUFF | AR | 71603 | PHYSICIAN SERVICES | 2028429 |
| JEFFERSON ANESTHESIOLOGY | |||||
| PO BOX 1272 | PINE BLUFF | AR | 71613 | PROFESSIONAL SERVICES | 1815975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 58 | NumberOfContractorsGT100K |
| Government Grants | 1011148 | GovernmentGrants |
| All Other Contributions | 408799 | AllOtherContributions |
| Total Contributions | 1419947 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 176078282 | TotalRevenueColumn |
| Related Or Exempt Function Income | 176078282 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 176078282 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2465169 | TotalRevenueColumn |
| Exclusion | $2,465,169 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 536065 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 536065 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 536065 | TotalRevenueColumn |
| Exclusion | $536,065 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 22670 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 10523 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12147 | TotalRevenueColumn |
| Exclusion | $12,147 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| EHR INCENTIVE | 900099 | 2196825 | $2,196,825 |
| OP PHARMACY AND GIFT S | 446110 | 1264889 | $1,264,889 |
| CAFETERIA | 722320 | 1004779 | $1,004,779 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3824854 | TotalRevenueColumn |
| Related Or Exempt Function Income | 809196 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 166173 | UnrelatedBusinessRevenue |
| Exclusion | $2,849,485 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 8291347 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188802957 | TotalRevenueColumn |
| Related Or Exempt Function Income | 176887478 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 166173 | UnrelatedBusinessRevenue |
| Exclusion | $10,329,359 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110102 | Total |
| Program Services | 110102 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 256470 | Total |
| Program Services | 256470 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2589340 | Total |
| Program Services | 226014 | ProgramServices |
| Management And General | 2363326 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72574995 | Total |
| Program Services | 65459076 | ProgramServices |
| Management And General | 7115919 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2615955 | Total |
| Program Services | 2287598 | ProgramServices |
| Management And General | 328357 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6403844 | Total |
| Program Services | 5577473 | ProgramServices |
| Management And General | 826371 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5435166 | Total |
| Program Services | 4752939 | ProgramServices |
| Management And General | 682227 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4120677 | Total |
| Program Services | 3747248 | ProgramServices |
| Management And General | 373429 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140084 | Total |
| Program Services | 56971 | ProgramServices |
| Management And General | 83113 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278530 | Total |
| Management And General | 278530 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19986 | Total |
| Management And General | 19986 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25797214 | Total |
| Program Services | 23516157 | ProgramServices |
| Management And General | 2281057 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48710 | Total |
| Program Services | 7010 | ProgramServices |
| Management And General | 41700 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5899005 | Total |
| Program Services | 3980085 | ProgramServices |
| Management And General | 1908397 | ManagementAndGeneral |
| Fundraising | 10523 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1413580 | Total |
| Program Services | 1201543 | ProgramServices |
| Management And General | 212037 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2526355 | Total |
| Program Services | 2207041 | ProgramServices |
| Management And General | 319314 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 273491 | Total |
| Program Services | 163180 | ProgramServices |
| Management And General | 110311 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114959 | Total |
| Program Services | 93492 | ProgramServices |
| Management And General | 21467 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1390814 | Total |
| Program Services | 1278938 | ProgramServices |
| Management And General | 111876 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1662304 | Total |
| Program Services | 1601573 | ProgramServices |
| Management And General | 60731 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9205708 | Total |
| Program Services | 8465206 | ProgramServices |
| Management And General | 740502 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2719514 | Total |
| Program Services | 2626300 | ProgramServices |
| Management And General | 93214 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 24945557 | 24496080 | 449477 |
| PROVISION FOR BAD DEBTS | 6376981 | 6376981 | |
| LICENSE/TAXES | 2483496 | 2461249 | 22247 |
| OTHER MISCELLANEOUS | 425967 | 422959 | 3008 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372531 | Total |
| Program Services | 129133 | ProgramServices |
| Management And General | 243398 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180201335 | Total |
| Program Services | 161500818 | ProgramServices |
| Management And General | 18689994 | ManagementAndGeneral |
| Fundraising | 10523 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60318674 | BOY |
| EOY | 18572418 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19119495 | BOY |
| EOY | 22929527 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8281091 | BOY |
| EOY | 1812431 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4620638 | BOY |
| EOY | 4941179 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2386171 | BOY |
| EOY | 2797891 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 202210644 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 143296367 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60513299 | BOY |
| EOY | 58914277 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42037752 | BOY |
| EOY | 97514664 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2381010 | BOY |
| EOY | 2278826 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30946499 | BOY |
| EOY | 32036343 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 230604629 | BOY |
| EOY | 241797556 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31894107 | BOY |
| EOY | 34845472 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3480502 | BOY |
| EOY | 3355512 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25686548 | BOY |
| EOY | 25483245 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 597868 | BOY |
| EOY | 736257 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61659025 | BOY |
| EOY | 64420486 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168945604 | BOY |
| EOY | 177377070 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168945604 | BOY |
| EOY | 177377070 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 230604629 | BOY |
| EOY | 241797556 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8601622 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -170156 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $19,986 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 19986 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | A PORTION OF DUES PAID TO ARKANSAS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING EXPENSES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4805853 | OtherCostOrOtherBasis |
| Book Value | 4805853 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 82728307 | OtherCostOrOtherBasis |
| Depreciation | 54800414 | Depreciation |
| Book Value | 27927893 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 112903469 | OtherCostOrOtherBasis |
| Depreciation | 88495953 | Depreciation |
| Book Value | 24407516 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1773015 | OtherCostOrOtherBasis |
| Book Value | 1773015 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 58914277 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEFERRED FINANCING COSTS | 589885 |
| 457 PLAN - FMV ASSET | 736257 |
| DUE FROM AFFILIATES | 30710201 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 32036343 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | 457 PLAN | Description |
| Amount | $736,257 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 736257 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE ASSOCIATION HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) 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. THE ASSOCIATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ASSOCIATION'S 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 2009 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FUNDRAISING-WEE CARE COOKIE DOUGH | NameOfEvent1 |
| Gross Receipts Event1 | 11460 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 11460 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 6948 | OtherDirectExpensesEvent1 |
| Name Of Event2 | FUNDRAISING-WEE CARE CANDY | NameOfEvent2 |
| Gross Receipts Event2 | 6943 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 6943 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 3575 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 4 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 4267 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 4267 | GrossRevenueOtherEvents |
| Gross Receipts Total | 22670 | GrossReceiptsTotal |
| Gross Revenue Total Events | 22670 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 10523 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 10523 | DirectExpenseSummaryEvents |
| Net Income Summary | 12147 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9886 | PersonsServed |
| Total Community Benefit Expense | 12349919 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12349919 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06850 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10856 | PersonsServed |
| Total Community Benefit Expense | 2559577 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2559577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01420 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 20742 | PersonsServed |
| Total Community Benefit Expense | 14909496 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 14909496 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08270 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 53828 | PersonsServed |
| Total Community Benefit Expense | 146123 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 146123 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 23800 | PersonsServed |
| Total Community Benefit Expense | 6403710 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2508463 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3895247 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02160 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 10836 | PersonsServed |
| Total Community Benefit Expense | 1936835 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1203752 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 733083 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 366572 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 256470 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 110102 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 85 | NumberOfActivitiesOrPrograms |
| Persons Served | 88464 | PersonsServed |
| Total Community Benefit Expense | 8853240 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3968685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4884555 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 85 | NumberOfActivitiesOrPrograms |
| Persons Served | 109206 | PersonsServed |
| Total Community Benefit Expense | 23762736 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3968685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19794051 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10980 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 80 | NumberOfActivitiesOrPrograms |
| Persons Served | 336347 | PersonsServed |
| Total Community Building Expense | 321802 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 321802 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 80 | NumberOfActivitiesOrPrograms |
| Persons Served | 336347 | PersonsServed |
| Total Community Building Expense | 321802 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 321802 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,144,097 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 56757461 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 58346809 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1589348 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 JEFFERSON SURGERY CENTER PLLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | AMBULATORY SURGERY CENTER | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.62500 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.02000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.35500 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 W 40TH AVE | AddressLine1 |
| City | PINE BLUFF | City |
| State | AR | State |
| ZIP Code | 71603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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 |
| RHUEMATOLOGY CLINIC | ||||
| 1609 W 40TH SUITE 207 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| PINE BLUFF SPECIALTY CLINIC | ||||
| 1601 W 40TH SUITE 301 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
| CARDIOLOGY ASSOCIATES | ||||
| 1601 W 40TH 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 SUITE 501 | PINE BLUFF | AR | 71603 | PHYSICIAN CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 6B: | THE ORGANIZATION MAKES ITS ANNUAL COMMUNITY BENEFIT REPORT AVAILABLE ON THE ORGANIZATION'S WEBSITE AND UPON REQUEST. | |
| PART II: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A | ||
| PART III, LINE 4: ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THERE WERE NO SIGNIFICANT CHANGES IN THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING ALLOWANCE FOR UNCOLLECTIBLE AND CHARITY ACCOUNTS OR IN THE POLICIES REGARDING UNCOLLECTIBLE ACCOUNTS OR CHARITY CARE. THE ORGANIZATION MAINTAINS A COST ACCOUNTING SYSTEM THAT COMPUTES PROGRAM COSTS AT THE PATIENT LEVEL. THE COSTING METHODOLOGIES ARE APPLIED TO THE ORGANIZATION'S BAD DEBT EXPENSE TO DETERMINE THE ORGANIZATION'S COST OF BAD DEBT EXPENSE. AS A SAFETY NET HOSPITAL, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT OR ABILITY / WILLINGNESS TO PAY; THEREFORE, THE COST OF CARE RELATED TO UNCOLLECTIBLE ACCOUNTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT. | ||
| PART III, LINE 8: THE ORGANIZATION MAINTAINS A COST ACCOUNTING SYSTEM THAT COMPUTES COSTS AT THE PATIENT LEVEL. THE COSTING METHODOLOGIES ARE APPLIED TO THE ORGANIZATIONS 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. | ||
| PART III, LINE 9B: 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. | ||
| PART V, SECTION B, LINE 19D: 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. | JEFFERSON REGIONAL MEDICAL CENTER | |
| PART VI, LINE 3: 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. | ||
| PART VI, LINE 4: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A | ||
| PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A | ||
| PART VI, LINE 6: THIS IS NOT APPLICABLE FOR TAX YEAR 2011. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| UNITED WAY OF SE ARKANSAS | |||||||
| PO BOX 8702 | PINE BLUFF | AR | 71611 | 710236869 | 501(C)(3) | 34466 | SUPPORT OF SERVICES PROVIDED TO 16 SOUTHEAST ARKANSAS COUNTIES |
| SEABROOK YMCA | |||||||
| 6808 SOUTH HAZEL | PINE BLUFF | AR | 71603 | 581641894 | 501(C)(3) | 26250 | CAPITAL CAMPAIGN PLEDGE TO STRENGTHEN PHYSICAL ACTIVITIES FOR JEFFERSON COUNTY YOUTH |
| COMMITTEE AGAINST SPOUSE ABUSE | |||||||
| PO BOX 6705 | PINE BLUFF | AR | 71611 | 710562152 | 501(C)(3) | 22150 | SUPPORT SERVICES AND SHELTER PROVIDED TO BATTERED WOMEN AND CHILDREN |
| WHITE HALL ATHLETIC BOOSTER CLUB | |||||||
| 1102 NANCY STREET | WHITE HALL | AR | 71602 | 113725572 | GOVERNMENT | 7775 | GIFT TO HELP SECURE SAFE ENVIRONMENT FOR SOFTBALL TEAMS |
| ARKANSAS AFFILIATE OF KOMEN FOR CURE | |||||||
| 904 AUTUMN ROAD | LITTLE ROCK | AR | 72211 | 710724439 | 501(C)(3) | 7500 | RACE FOR THE CURE BRONZE-LEVEL SPONSORSHIP |
| ARTS & SCIENCE CENTER FOR SOUTHEAST ARKANSAS | |||||||
| 701 MAIN STREET | PINE BLUFF | AR | 71601 | 710401966 | 501(C)(3) | 6579 | SUPPORT OF CENTER'S MISSION OF ENHANCING QUALITY OF LIFE THROUGH ARTS AND SCIENCES |
| ST PETER CATHOLIC SCHOOL | |||||||
| 1515 S STATE STREET | PINE BLUFF | AR | 71601 | 710615521 | 501(C)(3) | 5000 | SPONSORSHIP TO SUPPORT INSTRUCTION ENABLING STUDENTS TO ACTIVELY PARTICIPATE IN COMMUNITY AND SOCIETY |
| LUMBERJACK YAMAHA INC | |||||||
| 1504 S MAIN STREET | WARREN | AR | 71671 | 710600286 | 12924 | SPONSORSHIP TO PROVIDE ATV SAFETY HELMETS TO YOUNG PEOPLE IN SOUTHEAST ARKANSAS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 7 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| FEDERAL PELL GRANTS (US DEPARTMENT OF EDUCATION) | 59 | 199181 |
| ACADEMIC CHALLENGE SCHOLARSHIPS (STATE OF ARKANSAS) | 8 | 9250 |
| REHABILITATION GRANTS (STATE OF ARKANSAS) | 6 | 9157 |
| WIA ADULT PROGRAM GRANTS (US DEPARTMENT OF LABOR) | 9 | 15750 |
Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | PART I, LINE 2: | SCHEDULE I, PART I, LINE 2: 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 GRANDS OR ASSISTANCE. |
| FORM 990, PAGE 10, LINE 1 VS. SCHEDULE I, PAGE 1, PART II AMOUNTS | 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WALTER JOHNSON | |||||||||||||
| 327488 | 0 | 99260 | 0 | 208964 | 0 | 10674 | 0 | 14634 | 0 | 661020 | 0 | 0 | 0 |
| THOMAS HARBUCK | |||||||||||||
| 294430 | 0 | 98418 | 0 | 188721 | 0 | 10674 | 0 | 16712 | 0 | 608955 | 0 | 0 | 0 |
| LOUISE HICKMAN | |||||||||||||
| 165593 | 0 | 41784 | 0 | 97884 | 0 | 10673 | 0 | 11088 | 0 | 327022 | 0 | 0 | 0 |
| BRIAN THOMAS | |||||||||||||
| 224758 | 0 | 57281 | 0 | 126718 | 0 | 10889 | 0 | 12598 | 0 | 432244 | 0 | 0 | 0 |
| BRYAN G JACKSON | |||||||||||||
| 133324 | 0 | 0 | 0 | 12969 | 0 | 29955 | 0 | 8915 | 0 | 185163 | 0 | 0 | 0 |
| ALI ALNASIF MD | |||||||||||||
| 379432 | 0 | 0 | 0 | 16807 | 0 | 10674 | 0 | 6100 | 0 | 413013 | 0 | 0 | 0 |
| TAMER ALSEBAI MD | |||||||||||||
| 327588 | 0 | 79239 | 0 | 14946 | 0 | 10673 | 0 | 14371 | 0 | 446817 | 0 | 0 | 0 |
| CHARLES A CLARK | |||||||||||||
| 224388 | 0 | 329559 | 0 | 12049 | 0 | 11741 | 0 | 9210 | 0 | 586947 | 0 | 0 | 0 |
| JAMES ALAN POLLARD | |||||||||||||
| 430301 | 0 | 188685 | 0 | 11971 | 0 | 10607 | 0 | 13310 | 0 | 654874 | 0 | 0 | 0 |
| JOHN O LYTLE | |||||||||||||
| 316611 | 0 | 554856 | 0 | 11796 | 0 | 11065 | 0 | 13106 | 0 | 907434 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | COUNTRY CLUB MEMBERSHIPS ARE MAINTAINED BY THE ORGANIZATION FOR THE USE OF SPECIFIC EMPLOYEES AS DESIGNATED BY THE BOARD OF DIRECTORS. |
| PART I, LINE 1B | THERE IS NO WRITTEN POLICY REGARDING PAYMENT OF THOSE SPECIFIC DUES. |
| PART I, LINE 4B | WALTER JOHNSON $107,002; THOMAS HARBUCK $90,004; BRIAN THOMAS $48,164; LOUISE HICKMAN $49,467; BRYAN JACKSON $23,565. |
| PART I, LINE 7 | 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. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON COUNTY AR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 716009958 | IssuerEIN |
| CUSIP Number | 472705DF6 | CUSIPNumber |
| Date Issued | 2011-12-15 | DateIssued |
| Issue Price | 26013416 | IssuePrice |
| Description Of Purpose | REFUND 2001 BONDS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 510000 | AmountRetired |
| Total Proceeds | 26013416 | TotalProceeds |
| Refunding Escrow | 25395168 | RefundingEscrow |
| Issuance Costs From Proceeds | 372172 | IssuanceCostsFromProceeds |
| Credit Enhancement | 246076 | CreditEnhancement |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)
| RelationshipRelationship | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|
| CENTRAL MOLONEY | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| LINDSAY MAKRIS | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| RICHARD MORGAN | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| SIMMONS FIRST NAT'L BANK | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| STACY COLEMAN | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| ARKANSAS HOSPITAL ASSOCIATION | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| REBECCA PITTILLO | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| MICHELLE ECKERT | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
| STRONG MANUFACTURING | ||
| SEE SCHEDULE O. | SEE SCH. O | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | 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. DR. DOUG COLEMAN (JHA DIRECTOR) AND JERREL BOAST (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. GEORGE MAKRIS (JHA DIRECTOR) AND DAVID BROWN (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. FRANK ANTHONY (JHA DIRECTOR) AND WALTER JOHNSON (JHA PRESIDENT AND CEO) HAVE A BUSINESS RELATIONSHIP MARTY CASTEEL (JHA DIRECTOR) AND CHUCK MORGAN (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. SCOTT PITILLO (JHA DIRECTOR) AND ANNETTE KLINE (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. SCOTT PITILLO (JHA DIRECTOR) AND CHUCK MORGAN (JHA DIRECTOR) HAVE A BUSINESS RELATIONSHIP. H. FORD TROTTER III (JHA DIRECTOR) AND WALTER JOHNSON (JHA PRESIDENT AND CEO) HAVE A BUSINESS RELATIONSHIP | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS A MEMBERSHIP CONSISTING OF 30 JEFFERSON COUNTY ARKANSAS RESIDENTS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | 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 11 | 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 | THE ORGANIZATION REQUIRES NOT ONLY AN ANNUAL CONFLICT OF INTEREST DISCLOSURE, BUT ALSO 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 EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTS THE ANNUAL REVIEW OF CONFLICT OF INTEREST DISCLOSURES. IN THE EVENT THE EXECUTIVE 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, LINE 15 | 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 2008 AND HAS CONTINUED TO USE THE DATA FROM THAT ENGAGEMENT ALONG WITH UPDATED COMPARABILITY SURVEY DATA 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 | 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 XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -747,357. DONATED SERVICES AND USE OF FACILITIES: 577,201. TOTAL TO FORM 990, PART XI, LINE 5: -170,156. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PAGE 12, PART XII, LINE 2C | THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. | AUDIT COMMITTEE |
| SCHEDULE L, PART IV, COLUMNS B, C, & D | (A) NAME OF PERSON: RICHARD MORGAN (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF CHUCK MORGAN (JHA DIRECTOR) (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: SIMMONS FIRST NATIONAL BANK AND/OR SIMMONS FIRST NATIONAL CORPORATION (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ENTITY IN WHICH DR. CLIFTON ROAF, MARTY CASTEEL, GEORGE MAKRIS AND FORD TROTTER III ARE DIRECTORS AND / OR OFFICERS (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: INTEREST INCOME & BANK/TRUSTEE FEES (A) NAME OF PERSON: CENTRAL MOLONEY (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ENTITY IN WHICH CHUCK MORGAN (JHA DIRECTOR) IS AN OFFICER (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: HEALTH CARE PAYMENTS (A) NAME OF PERSON: STACY COLEMAN (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF DR. DOUG COLEMAN, JHA DIRECTOR. (C) TRANSACTION AMOUNTS ARE REPORTED AS 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 ARE REPORTED AS 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 AND CEO) IS BOARD MEMBER. (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: HOSPITAL MEMBERSHIP DUES. (A) NAME OF PERSON: REBECCA PITTILLO EMPLOYEE OF JRMC (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF SCOTT PITTILLO (JHA DIRECTOR) (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $10,000 (D) DESCRIPTION OF TRANSACTION: EMPLOYEE OF JRMC (A) NAME OF PERSON: DR. MICHELLE ECKERT (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: (JHA DIRECTOR) IS A JOINT OWNER OF JSC, PLLC. COMBINED OWNERSHIP > 10% (C) TRANSACTIONS WITH JSC > $100K; (D) DESCRIPTION OF TRANSACTION: DIRECTOR & CO-OWNER OF JSC (A) NAME OF PERSON: STRONG MANUFACTURING (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ENTITY IN WHICH ANNETTE KLINE (JHA DIRECTOR) IS AN OFFICER (C) TRANSACTION AMOUNTS ARE REPORTED AS GREATER THAN $100,000 (D) DESCRIPTION OF TRANSACTION: HEALTH CARE PAYMENTS | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON SURGERY CENTER PLLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 W 40TH STREET | AddressLine1 |
| City | PINE BLUFF | City |
| State | AR | State |
| ZIP Code | 71602 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710810564 | EIN |
| Primary Activity | AMB SURGERY | PrimaryActivity |
| Legal Domicile State | AR | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | 173662 | ShareOfTotalIncome |
| Share Of EOY Assets | 1104934 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
| Percentage Ownership | 0.62500 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JRMC DEVELOPMENT CORP | |||||||||||
| 1600 W 40TH STREET | PINE BLUFF | AR | 71602 | 710810564 | REAL ESTATE MANAGEMENT | AR | JEFFERSON HOSPITAL ASSOCIATION | C | -189961 | 17887839 | 1.00000 |
| JEFFERSON MANAGEMENT SERVICES INC | |||||||||||
| 1600 W 40TH STREET | PINE BLUFF | AR | 71602 | 710582753 | PHYSICIAN PRACTICE MANAGEMENT | AR | JEFFERSON HOSPITAL ASSOCIATION | C | 89589 | 417906 | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 1 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| JEFFERSON SURGERY CENTER | ||
| K | 1720285 | GL ACTIVITY |
| JEFFERSON SURGERY CENTER | ||
| L | 974160 | GL ACTIVITY |
| JEFFERSON SURGERY CENTER | ||
| Q | 1021870 | GL ACTIVITY |
| JEFFERSON SURGERY CENTER | ||
| R | 1727421 | GL ACTIVITY |
| JEFFERSON SURGERY CENTER | ||
| F | 16190 | GL ACTIVITY |
| JRMC DEVELOPMENT CORPORATION | ||
| J | 691655 | GL ACTIVITY |
| JRMC DEVELOPMENT CORPORATION | ||
| K | 266562 | GL ACTIVITY |
| JRMC DEVELOPMENT CORPORATION | ||
| A | 1534722 | GL ACTIVITY |
| JRMC DEVELOPMENT CORPORATION | ||
| Q | 1019337 | GL ACTIVITY |
| JRMC DEVELOPMENT CORPORATION | ||
| R | 1159345 | GL ACTIVITY |
| JEFFERSON MANAGEMENT SERVICES INC | ||
| K | 304839 | GL ACTIVITY |
| JEFFERSON MANAGEMENT SERVICES INC | ||
| R | 589209 | GL ACTIVITY |