2013-05-15T12:35:36-07:00 2012-06-30 Hughes Welch & MilliganCPASLTD PO Box 2094 Batesville AR 725032094 990 2011-07-01 710276839 DELTA MEMORIAL HOSPITAL DELT 8703824303 811 HWY 65 S DUMAS AR 71639 DON LIVINGSTON 2013-05-15 true WILLIAM T COUCH 8707935231 2011 2016-02-24 21:20:13Z CRIS BOLIN 16640242 false false X WWW.DELTAMEM.ORG X 1975 AR DELTA MEMORIAL HOSPITAL IS COMMITTED TO AID HEALING AND PROMOTE WELLNESS FOR SOUTHEAST ARKANSAS 6 6 213 32 0 329934 70604 16776240 16024521 3413 -31670 230889 540395 17340476 16603850 0 0 8123428 7981664 0 0 8674634 9629751 16798062 17611415 542414 -1007565 15620689 16454428 5760936 7602240 9859753 8852188 DELTA MEMORIAL HOSPITAL IS COMMITTED TO AID HEALING AND PROMOTE WELLNESS FOR SOUTHEAST ARKANSAS false false 13884400 DELTA MEMORIAL HOSPITAL PROVIDES MEDICAL HEALTH CARE SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. 13884400 true true false false false false false false false false true false false false true false false false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false false false false false false 18 0 false 213 true false false false false false false false false false false false 0 false false false false false false false false false false false X 6 6 false false false false false false false true false false false false true true true true true true false false false false X CRIS BOLIN 8703924303 811 HWY 65 S DUMAS AR 71639 SHIRLEY TEETER 1.00 X 0 0 0 ROBIN SHEA 1.00 X 0 0 0 DR DAVID CHAMBERS 40.00 X 587650 0 0 GLENN CROW 1.00 X 0 0 0 TIMOTHY JONES 1.00 X 0 0 0 HEATH MONICRIEF 1.00 X 0 0 0 DON LIVINGSTON 1.00 X 0 0 0 CRIS BOLIN 40.00 X 127319 0 0 ROGER MASON 40.00 X 292311 0 0 RALPH MAXWELL 40.00 X 505250 0 0 1512530 8 false true false MARGARET ISHEE 5120 LODS FIELD RD GRAND BAY AL 36541 CRNA 267813 LEWIS NELSON BALLARD III 100 RAVENWOOD PLACE HOT SPRINGS AR 71901 CRNA 267813 DELTA SURGERY PA PO BOX 399 DUMAS AR 71639 ER PHYSICAN 146300 DELTA MEDICAL SERVICES LLC 130 DAY DR MONTICELLO AR 71655 BILLINGS 175953 CPP WOUND CARE 3017 N CAUSEWAY BLVD METAIRE LA 70002 WOUND CARE 152925 5 25036 45568 70604 STATE ASSESSMENT REVENUE 890056 890056 PATIENT SERVICE REVENUE 15134465 15134465 16024521 4722 4722 0 0 1350 1350 1350 1350 36392 -36392 -36392 -36392 0 0 0 MISCELLANEOUS 64577 64577 GUEST AND EMPLOYEE MEALS 48019 48019 ELECTRONIC HEALTH RECORDS 415675 415675 10774 10774 539045 16603850 16527174 6072 0 0 0 0 714969 587650 127319 0 6149953 4958808 1191145 12191 9875 2316 643121 520928 122193 461430 373758 87672 0 76564 76564 42867 42867 0 0 0 0 0 0 0 0 264035 25074 238961 68674 64865 3809 0 0 193059 193059 0 736012 736012 232801 232801 REPAIRS & MAINTENANCE 209366 133344 76022 SUPPLIES & OTHER 1215261 818992 396269 PURCHASED SERVICES 2694871 1923276 771595 PROVISION FOR BAD DEBTS 3612716 3612716 283525 119102 164423 17611415 13884400 3727015 0 51544 3435 201477 0 0 4621448 4833638 0 0 0 223647 204178 73508 217884 17912901 6884662 10269809 11028239 0 0 0 0 179256 167054 15620689 16454428 2388607 2825770 3044043 3972503 328286 594164 209803 5760936 7602240 X 1988813 1375616 7870940 7476572 9859753 8852188 15620689 16454428 -1007565 X false false false false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 105910 105910 12407371 3559114 8848257 3814960 3325548 489412 1584660 1584660 11028239 DELINQUENT PAYROLL TAXES PAYABLE 209803 209803 true true true X true X true true false false true true 121065 121065 0.00690 121065 121065 0.00690 121065 121065 0.00690 true 3612716 1762879 4648062 4397975 250087 true false 1 0 DELTA MEMORIAL HOSPITAL

811 HWY 65 S DUMAS AR 71639

X X DELTA MEMORIAL HOSPITAL 1 false true true 100.0000 true 200.0000 true X X X X true true X X X X true X X true X X X X X true X false true Part VI - Explanation Of How Organization Furthers Its Exempt Purpose PROVIDES DUMAS SCHOOL ATHLETES PHYSICALS FREE OF CHARGE, PARTICIPATES IN NUMEROUS COMMUNITY HEALTH FAIRS AND PROVIDES HEALTH SCREENINGS, NEW MOM/BIRTHING CLASSES, CAR SEAT SAFETY TRAINING, BABYSITTING TRAINING CLASSES,AND MEALS FOR COMMUNITY EVENTS Part VI - Community Information RURAL SETTING, PREDOMINANTLY AGRICULTURAL BASE. AVERAGE INCOME AT OR BELOW FEDERAL POVERTY GUIDELINES. PREDOMINANTLY CAUCASIAN, HIGH SCHOOL EDUCATED AND GERIATRIC IN NATURE. Part VI - Patient Education of Eligibility for Assistance INFORMS PATIENTS UPON ADMISSION AND POSTS NOTICES IN CONSPICUOUS AREAS. Part VI - Needs Assessment UTILIZES ANNUAL STATISTICAL REPORT WITH DEMOGRAPHIC INFORMATION FORM DHS AS WELL AS REPORTS SHOWING PERCENT OF ACTIVITY OF COMMUNITY BY PAYOR SOURCE. Number of Hospital Faciltiy - 0 Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services THE HOSPITAL CHARGES EVERY PATIENT THE SAME AMOUNT FOR EVERY SERVICE. THEY APPLY DISCOUNTS AS DETERMINED BASED ON THE FINANCIAL ASSISTANCE APPLICATIONS. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance CHARGE EVERY PATIENT THE SAME AMOUNT FOR EVERY SERVICE false false false false false false false false false false ROGER MASON 292311 292311 RALPH MAXWELL 505250 505250 DR DAVID CHAMBERS 587650 587650 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available No documents available to the public. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts ANNUAL CONFLICT OF INTEREST FORM COMPLETED BY EACH BOARD MEMBER Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process No review was or will be conducted.