KEMPER CAH: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
KEMPER CAH (EIN 27-1757642)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-11
IRS object ID
201323169349302557
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)
Timestamp2013-11-11T15:46:59-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN201941244EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HORNE LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11020 HIGHLAND COLONY PKWY STE 400AddressLine1
CityRIDGELANDCity
StateMSState
ZIP Code39157ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN271757642EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KEMPER CAH INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKEMPNameControl
Phone6017039992Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11314 19TH AVENUEAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDARRELL WILDMANName
TitleTREASURERTitle
Phone6017039992Phone
Date Signed2013-11-05DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARSHA H DIECKMAN CPAName
PTINP00246741PTIN
Phone6013261000Phone
Date Prepared2013-11-05DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDARRELL WILDMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11314 19TH AVENUEAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11457485GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteRUSHHEALTHSYSTEMS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileMSStateLegalDomicile
Activity Or Mission DescriptionHOSPITAL AND CLINIC PATIENT SERVICEActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees191TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4125110ContributionsGrantsPriorYear
Contributions Grants Current Year2288313ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4725980ProgramServiceRevenuePriorYear
Program Service Revenue CY9072067ProgramServiceRevenueCY
Investment Income Prior Year58InvestmentIncomePriorYear
Investment Income Current Year309InvestmentIncomeCurrentYear
Other Revenue Prior Year74241OtherRevenuePriorYear
Other Revenue Current Year96796OtherRevenueCurrentYear
Total Revenue Prior Year8925389TotalRevenuePriorYear
Total Revenue Current Year11457485TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year250GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3313939SalariesEtcPriorYear
Salaries Etc Current Year4485401SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5611113OtherExpensePriorYear
Other Expenses Current Year6914177OtherExpensesCurrentYear
Total Expenses Prior Year8925302TotalExpensesPriorYear
Total Expenses Current Year11399578TotalExpensesCurrentYear
Revenues Less Expenses Prior Year87RevenuesLessExpensesPriorYear
Revenues Less Expenses CY57907RevenuesLessExpensesCY
Total Assets BOY3347755TotalAssetsBOY
Total Assets EOY3680412TotalAssetsEOY
Total Liabilities BOY3347668TotalLiabilitiesBOY
Total Liabilities EOY3622417TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY87NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY57995NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionACUTE-CARE HOSPITAL PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES SERVICES TO THE KEMPER COUNTY AREA AND SURROUNDING COMMUNITIES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9841034Expense
Revenue9082087Revenue
DescriptionJOHN C. STENNIS MEMORIAL HOSPITAL IS A 25-BED ACUTE-CARE, CRITICAL ACCESS HOSPITAL LOCATED IN DEKALB, MS. DEKALB, MS IS LOCATED IN KEMPER COUNTY, MS. DEKALB HAS A POPULATION OF 972 AND KEMPER COUNTY HAS A POPULATION OF 10,456. JOHN C. STENNIS MEMORIAL HOSPITAL'S SCOPE OF CARE INCLUDES A RANGE OF INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. A VARIETY OF OTHER SERVICES ARE AVAILABLE ON AN INPATIENT AND OUTPATIENT BASIS THROUGH THE HOSPITAL'S IMAGING, LABORATORY AND REHABILITATIVE SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. A 24-HOUR EMERGENCY DEPARTMENT IS STAFFED WITH QUALIFIED EMERGENCY ROOM HOSPITALISTS AND FAMILY NURSE PRACTITIONERS AND IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK. SKILLED NURSING AND REHABILITATIVE CARE ARE AVAILABLE AT JOHN C. STENNIS MEMORIAL HOSPITAL THROUGH THE SWING BED PROGRAM. THOSE RECOVERING FROM SURGERY, A STROKE, A FRACTURE OR AN EXTENDED MEDICAL ILLNESS AND HOSPITALIZATION CAN RECEIVE REHABILITATIVE CARE AT JOHN C. STENNIS MEMORIAL HOSPITAL, WHETHER OR NOT THEY WERE HOSPITALIZED IN ANOTHER LOCATION. JOHN C. STENNIS MEMORIAL HOSPITAL IS AFFILIATED WITH RUSH HEALTH SYSTEMS OF MERIDIAN, MS. ADDITIONALLY, THE INTENSIVE OUTPATIENT PROGRAM DESIGNED TO PROVIDE CARE FOR SENIOR ADULTS SUFFERING FROM CHRONIC ANXIETY, DEPRESSION AND GRIEF.AS PRESENTED IN THE ATTACHED SCHEDULE H, JOHN C. STENNIS MEMORIAL HOSPITAL PROVIDED FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS DURING 2012 AT A COST OF $2,067,956. ALTHOUGH EQUITABLE PAYMENT FOR SERVICES IS ESSENTIAL TO THE ORGANIZATION'S FINANCIAL VIABILITY, JOHN C. STENNIS MEMORIAL HOSPITAL RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE RESOURCES REQUIRED TO REIMBURSE THE HOSPITAL FOR ALL SERVICES PROVIDED. KEEPING ITS COMMITMENT TO THE COMMUNITY, JOHN C. STENNIS MEMORIAL HOSPITAL PROVIDES FREE CARE AND SUBSIDIZED CARE WITHIN EXISTING RESOURCES WHERE THE NEED FOR SUCH CARE EXISTS. ALONG WITH BEING THE ONE OF THE COUNTY'S LARGEST EMPLOYERS AND A MAJOR ECONOMIC STIMULUS BY VIRTUE OF ITS PAYROLL, JOHN C. STENNIS MEMORIAL HOSPITAL ALSO PROVIDES MANY BENEFITS TO THE BROADER COMMUNITY IN THE AREAS OF CIVIC INVOLVEMENT AND GIVING INCLUDING ACTIVELY SUPPORTING THE AMERICAN CANCER SOCIETY, SUPPORTING THE COMMUNITY WITH IT'S ANNUAL KEMPER DAY PROGRAM CONDUCTING AND ATTENDING COMMUNITY HEALTH FAIRS AND PROVIDING FREE MEDICAL SCREENING TESTS AND DISSEMINATION OF HEALTH INFORMATION AT CIVIC CLUB MEETINGS AND OTHER COMMUNITY FUNCTIONS.Description
Total Program Service Expense9841034TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
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
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
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 Member0BsnssRltnshpThruFamilyMember
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 With109616NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees191NumberOfEmployees
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 Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
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 CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DARRELL WILDMANBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6017039992TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11314 19TH AVENUEAddressLine1
CityMERIDIANCity
StateMSState
ZIP Code39301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ART NESTER
BOARD CHAIRMAN1.000.00X000
MARGARET WOMBLE
BOARD MEMBER1.000.00X000
CINDY CUMBERLAND
BOARD MEMBER1.000.00X000
JAMES GRANGER
BOARD MEMBER1.000.00X000
FRED ROGERS
BOARD MEMBER1.0049.00X013441756064
CHUCK REECE
PRESIDENT3.0057.000282563163755X
LARKIN KENNEDY
EVP/COO10.0043.00016825645319X
RICK BARRY
SECRETARY1.0013.00000X
DARRELL WILDMAN
TREASURER1.0059.00021744083474X
CATHY ROBINSON
CORPORATE COMPLIANCE OFFIC3.0047.00014710542300X
DALE ARMOUR
CFO1.0049.00019962039112X
JASON PAYNE
ADMINISTRATOR40.000.00013142715794X
RICHARD E HOLMES
ADM PHYSICIAN40.000.00222021016384X
JUANTINA M JOHNSON
ADM PHYSICIAN40.000.00324290013541X
PATRICIA D DUNLAP
ADM PHYSICIAN40.000.0028601900X
FieldValueIRS element (for citing)
Total Reportable Comp From Org832330TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1280828TotalReportableCompFrmRltdOrgs
Total Other Compensation475743TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EMCARE INC
7032 COLLECTIONS CENTER DRCHICAGOIL60693ER PHYSICIAN COVERAGE341650
GREAT SOUTH MANAGEMENT INC
PO BOX 745MARIONMS39342HOUSEKEEPING SERVICES155250
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations2288313RelatedOrganizations
Total Contributions2288313TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT FEESDescription
Business Code621990BusinessCode
Total Revenue Column9072067TotalRevenueColumn
Related Or Exempt Function Income9072067RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9072067TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column309TotalRevenueColumn
Exclusion$309ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA72221086776$86,776
MISCELLANEOUS9000991002010020
FieldValueIRS element (for citing)
Total Other Revenue96796TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11457485TotalRevenueColumn
Related Or Exempt Function Income9082087RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$87,085ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3863101Total
Program Services3758686ProgramServices
Management And General104415ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total364565Total
Program Services351876ProgramServices
Management And General12689ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total257735Total
Program Services252390ProgramServices
Management And General5345ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1337209Total
Management And General1337209ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1255936Total
Program Services1224784ProgramServices
Management And General31152ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total61Total
Program Services61ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2223335Total
Program Services2223335ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total7203Total
Program Services6876ProgramServices
Management And General327ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1824Total
Program Services1824ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total94360Total
Program Services94360ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBT556316556316
PROFESSIONAL FEES44297242958913383
SUPPLIES4178684136424226
UTILITIES186598186598

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total390495Total
Program Services340697ProgramServices
Management And General49798ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11399578Total
Program Services9841034ProgramServices
Management And General1558544ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY140339BOY
EOY215112EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3024642BOY
EOY3158678EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY133988BOY
EOY140739EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY48129BOY
EOY95270EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis290761LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec232767LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY657BOY
EOY57994EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY12619EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3347755BOY
EOY3680412EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY414572BOY
EOY709007EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2933096BOY
EOY2913410EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3347668BOY
EOY3622417EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY87BOY
EOY57995EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87BOY
EOY57995EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3347755BOY
EOY3680412EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses57907ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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 B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis46528OtherCostOrOtherBasis
Depreciation12773Depreciation
Book Value33755BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis244233OtherCostOrOtherBasis
Depreciation219994Depreciation
Book Value24239BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings57994TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$2,882,035
OTHER LIABILITIES$31,375
FieldValueIRS element (for citing)
Total Of Amounts2913410TotalOfAmounts
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
ExplanationRUSH HEALTH SYSTEMS, INC. AND THE AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON THEIR INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE SUBSIDIARIES, HOWEVER, ARE TAXABLE CORPORATIONS AND FILE CORPORATE INCOME TAX RETURNS. THE HEALTH SYSTEM FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HEALTH SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS GUIDANCE HAD NO MATERIAL EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE HEALTH SYSTEM'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN GENERAL AND ADMINISTRATIVE EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2009, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. DEFERRED TAXES ARE PROVIDED ON A LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASES. THE SUBSIDIARIES' TEMPORARY DIFFERENCES RELATE PRIMARILY TO PROPERTY AND EQUIPMENT AND NET OPERATING LOSS CARRYFORWARDS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE-LIKELY-THAN-NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN TAX LAWS AND RATES ON THE DATE OF ENACTMENT.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense808395TotalCommunityBenefitExpense
Net Community Benefit Expense808395NetCommunityBenefitExpense
Percent Of Total Expense0.07460PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense851305TotalCommunityBenefitExpense
Direct Offsetting Revenue323737DirectOffsettingRevenue
Net Community Benefit Expense527568NetCommunityBenefitExpense
Percent Of Total Expense0.04870PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense46043TotalCommunityBenefitExpense
Direct Offsetting Revenue44811DirectOffsettingRevenue
Net Community Benefit Expense1232NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1705743TotalCommunityBenefitExpense
Direct Offsetting Revenue368548DirectOffsettingRevenue
Net Community Benefit Expense1337195NetCommunityBenefitExpense
Percent Of Total Expense0.12340PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1687201TotalCommunityBenefitExpense
Direct Offsetting Revenue956695DirectOffsettingRevenue
Net Community Benefit Expense730506NetCommunityBenefitExpense
Percent Of Total Expense0.06740PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense579TotalCommunityBenefitExpense
Net Community Benefit Expense579NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1687780TotalCommunityBenefitExpense
Direct Offsetting Revenue956695DirectOffsettingRevenue
Net Community Benefit Expense731085NetCommunityBenefitExpense
Percent Of Total Expense0.06750PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3393523TotalCommunityBenefitExpense
Direct Offsetting Revenue1325243DirectOffsettingRevenue
Net Community Benefit Expense2068280NetCommunityBenefitExpense
Percent Of Total Expense0.19090PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense446TotalCommunityBuildingExpense
Net Community Building Expense446NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense592TotalCommunityBuildingExpense
Net Community Building Expense592NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1038TotalCommunityBuildingExpense
Net Community Building Expense1038NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$556,316BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare6176829AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5715644CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall461185MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1KEMPER CAH INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line114365 HIGHWAY 16 WESTAddressLine1
CityDEKALBCity
StateMSState
ZIP Code39328ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JOHN C STENNIS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Provided On AdmissionXProvidedOnAdmission
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: COSTING METHODOLOGY USED IN THE TABLE ON LINE 7 IS THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED FROM WORKSHEET 2.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 556316.
PART II: ALL ACTIVITIES ENGAGED IN BY KEMPER CAH, INC. ARE GEARED TOWARD PROMOTION AND IMPROVEMENT OF THE WELLBEING OF THE CITIZENS OF OUR PRIMARY SERVICE AREA. KEMPER PROMOTES HEALTH EDUCATION THROUGH SUPPORT OF ITS COMMUNITY BASED NURSING AND ALLIED HEALTH PROGRAMS AS WELL AS COMMUNITY HEALTH EDUCATION AND TRAINING SESSIONS. KEMPER ALSO SUPPORTS THE COMMUNITY BY ENSURING THE PROVISION OF MUCH NEEDED EMERGENCY MEDICINE.
PART III, LINE 4: BAD DEBT EXPENSE IS REFLECTED AS AMOUNT OF CHARGES ACTUALLY WRITTEN OFF. PER NOTE 1 OF THE FINANCIAL STATEMENTS, PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT ESTIMATED NET REALIZABLE VALUE AFTER DEDUCTION OF ALLOWANCES FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON HISTORICAL LOSSES AND AN ANALYSIS OF CURRENTLY OUTSTANDING AMOUNTS. THIS ACCOUNT IS GENERALLY INCREASED BY CHARGES TO A PROVISION FOR BAD DEBTS AND DECREASED BY WRITE OFFS OF ACCOUNTS DETERMINED BY MANAGEMENT TO BE UNCOLLECTIBLE. THE HEALTH SYSTEM ENGAGED A FIRM TO ANALYZE PATIENT ACCOUNTS RECEIVABLE TO DETERMINE WHICH ACCOUNTS QUALIFIED AS CHARITY CARE IN ORDER THAT THEY WERE PROPERLY CLASSIFIED.
PART III, LINE 8: THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS, AS EVIDENCED ON LINE 7, SIGNIFICANTLY EXCEEDS REVENUE. THIS COST PROVIDES A NECESSARY HEALTH BENEFIT TO THE ELDERLY POPULATION IN THE HOSPITAL'S SERVICE AREA AND SHOULD BE CONSIDERED COMMUNITY BENEFIT.
PART III, LINE 9B: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAT ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. ADDITIONALLY, THE HOSPITAL MAY UTILIZE OUTSIDE AGENCIES AS APPROPRIATE TO ASSIST IN DETERMINING ACCOUNTS THAT QUALIFY AS CHARITY CARE. ANY ACCOUNTS DETERMINED TO BE CHARITY BASED ON AN AGENCY'S RECOMMENDATION ARE REPORTED AS CHARITY CARE AND REVENUE REDUCED BY THIS AMOUNT AS OPPOSED TO BEING REPORTED AS BAD DEBT EXPENSE.
PART V, SECTION B, LINE 20D: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR A 100% DISCOUNT TO ELIGIBLE INDIVIDUALS (THOSE AT 200% OF FEDERAL POVERTY GUIDELINES); THEREFORE, PATIENTS MEETING THIS REQUIREMENT ARE NOT CHARGED FOR SERVICES PROVIDED.JOHN C. STENNIS HOSPITAL
PART VI, LINE 2: OUTSIDE CONSULTANTS ARE HIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENT PERIODICALLY.
PART VI, LINE 3: PATIENTS ARE PROVIDED AN APPLICATION FOR CHARITY CARE AND A CRITERIA FOR CHARITY CARE CHECKLIST AS CLOSE TO POINT OF SERVICE AS POSSIBLE. ADDITIONALLY, THE HOSPITAL UTILIZES AN OUTSIDE ELIGIBILITY COMPANY THAT REVIEWS ALL NO INSURANCE PATIENTS FOR POTENTIAL QUALIFICATION FOR OTHER GOVERNMENTAL PROGRAMS SUCH AS MEDICAID.
PART VI, LINE 4: KEMPER CAH, INC. IS A CRITICAL ACCESS ACUTE-CARE MEDICAL CENTER THAT SERVES INPATIENTS AND OUTPATIENTS, PRIMARILY IN THE MORTON, MISSISSIPPI AREA. AS A CRITICAL ACCESS HOSPITAL, KEMPER TRANSFERS THE EMERGENT AND MORE COMPLICATED CASES THAT REQUIRE SPECIALISTS PRIMARILY TO THE LARGER ACUTE CARE HOSPITALS IN THE MERIDIAN, MS AREA. OF THE COUNTIES SERVED, THE FOLLOWING ARE COUNTIES IDENTIFIED BY HEALTH RESOURCES AND SERVICES ADMINISTRATION OF THE US DEPT OF HEALTH AND HUMAN SERVICES AS HEALTH PROFESSIONAL SHORTAGE AREAS: CHOCTAW AND SUMTER COUNTIES IN ALABAMA; CLARKE, KEMPER, LAUDERDALE, NESHOBA, NEWTON AND SCOTT COUNTIES IN MISSISSIPPI.
PART VI, LINE 5: ALL MEMBERS OF KEMPER CAH, INC.'S BOARD RESIDE IN KEMBER'S PRIMARY SERVICE AREA. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF EXTENDING PRIVILEGES TO ALL QUALIFIED PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS THAT APPLY FOR PRIVILEGES AND MEET ALL REQUIREMENTS OF CREDENTIALING AND THE MEDICAL STAFF RULES AND REGS AND BY-LAWS. THE FACILITY UTILIZES SURPLUS FUNDS FOR ADDITIONAL MEDICAL TECHNOLOGY, RECRUITMENT OF MEDICAL STAFF THAT IS OTHERWISE UNAVAILABLE (I.E. NEUROSURGERY, MIDWIFERY, ETC.), FUNDING OF LOCAL AREA HEALTHCARE WORKFORCE TRAINING AND ECONOMIC DEVELOPMENT.
PART VI, LINE 6: KEMPER CAH, INC IS WHOLLY OWNED BY RUSH HEALTH SYSTEMS, A NON-PROFIT ORGAINIZATION. WITHIN RUSH HEALTH SYSTEMS ARE THE SPECIALTY HOSPITAL OF MERIDIAN (A LONG TERM ACUTE CARE FACILITY), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL, HC WATKINS HOSPITAL (A CRITICAL ACCESS HOSPITAL), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL), MEDICAL FOUNDATION INC. (A CLINIC ORGANIZATION), AND RUSH MEDICAL GROUP (A CLINIC ORGANIZATION). EACH OF THESE ENTITES COORDINATE TO IMPROVE THE HEALTHCARE OF EAST MISSISSIPPI AND WEST ALABAMA. CLINICAL INTEGRATION BETWEEN OUTLYING CRITICAL ACCESS HOSPITALS, SPECIALIST PHYSICIANS AND THE GENERAL ACUTE CARE HOSPITAL PROVIDE FOR IMPROVED ACCESS AND IMPROVED OUTCOMES FOR THE POPULATION WE SERVE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (9 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
FRED ROGERS
BOARD MEMBER01318770002540029256026808019048100
CHUCK REECE
PRESIDENT027696800055950111100052655044631800
LARKIN KENNEDY
EVP/COO015221901000006037027750017569021357500
DARRELL WILDMAN
TREASURER02111280006312045949037525030091400
CATHY ROBINSON
CORPORATE COMPLIANCE OFFIC01415200005585029067013233018940500
DALE ARMOUR
CFO017982001500004800027750011362023873200
RICHARD E HOLMES
ADM PHYSICIAN2220210000045630118210238405000
JUANTINA M JOHNSON
ADM PHYSICIAN3242900000000135410337831000
PATRICIA D DUNLAP
ADM PHYSICIAN286019000000000286019000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationRUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). CONTRIBUTIONS TOTALED $542,380 FOR 2012, AND DISTRIBUTIONS TOTALED $946,210.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6RUSH HEALTH SYSTEMS, INC. IS THE PARENT ORGANIZATION AND SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPOINTS BOARD MEMBERS FOR THE ORGANIZATION ANNUALLY FOR A ONE YEAR TERM.
FORM 990, PART VI, SECTION A, LINE 7BTHE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPROVES AND RATIFIES THE ACTIONS OF THE ORGANIZATION'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF THE ORGANIZATION) REVIEWED AND APPROVED THE FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE OFFICERS AND DIRECTORS OF THE ORGANIZATION REVIEW THE POLICY ANNUALLY AND SIGN A CONFLICT OF INTEREST STATEMENT STATING THEY HAVE READ AND UNDERSTAND THE POLICY AND ARE IN COMPLIANCE. EDUCATION IS GIVEN TO THE STAFF ON THE CONFLICT OF INTEREST POLICY WHICH INCLUDES DIRECTION TO VOICE ANY QUESTIONS OR CONCERNS THEY HAVE AND TO BRING FORTH ANY POTENTIAL CONFLICT OR CONCERN TO THE ATTENTION OF THE CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15EXECUTIVE COMPENSATION FOR THE AFFILIATED GROUP OF RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) IS REVIEWED ANNUALLY BY INDEPENDENT CONSULTANTS. CONSULTANTS COMPARE COMPENSATION ORDINARILY PROVIDED BY SIMILAR ORGANIZATIONS, UNDER LIKE CIRCUMSTANCES, AND ADJUSTED TO REFLECT CURRENT MARKET RATES. CONSULTANTS MEET WITH THE COMPENSATION COMMITTEE AND MAKE RECOMMENDATIONS WHICH ARE APPROVED AND RATIFIED BY THE BOARD. THE INDEPENDENT CONSULTANTS REGULARLY CONTRACTED TO PERFORM SUCH REVIEWS ARE HORNE LLP AND SULLIVAN, COTTER & ASSOCIATES, INC.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,224,784. MANAGEMENT AND GENERAL EXPENSES 26,042. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,250,826. OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,110. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,110.OTHER FEES
PART XII, LINE 2CTHE AUDIT/COMPENSATION COMMITTEE OF RUSH HEALTH SYSTEMS OVERSEES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
RUSH MEDICAL FOUNDATION DBA RUSH FOUNDATION HOSPITAL
1314 19TH AVENUEMERIDIANMS39301640345119PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
MEDICAL FOUNDATION INC
PO BOX 5183MERIDIANMS39302640834532PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
RUSH CARE INC DBA SPECIALTY HOSPITAL OF MERIDIAN
1314 19TH AVENUEMERIDIANMS39301640833381PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
LAIRD HOSPITAL INC
25117 HWY 15UNIONMS39365201835779PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
RUSH MEDICAL GROUP OF NEWTON PA
PO BOX 5187MERIDIANMS39302640783323PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
MERIDIAN SPEECH AND HEARING CENTER
1314 19TH STREETMERIDIANMS39301640529831PROVIDING AUDIOLOGY SERVICES AND TREATMENTMS501(C)(3)509(A)(2)RUSH HEALTH SYSTEMS INC0
RUSH HEALTH SYSTEMS INC
PO BOX 5187MERIDIANMS39301640664988PROVIDING SUPPORT TO HEALTH CARE AFFILIATESMS501(C)(3)509(A)(3)0N/A
RUSH HOME CARE INC
1314 19TH AVENUEMERIDIANMS39301640670314PROVIDING HOME HEALTH CAREMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
NEWCA CAH INC
1314 19TH AVENUEMERIDIANMS39301201254928PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
RUSH HOSPITAL - BUTLER INC
1314 19TH AVENUEMERIDIANMS39301640655993PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0
SCOTT REGIONAL MEDICAL CENTER INC
1314 19TH AVENUEMERIDIANMS39301260792328PROVIDING HEALTH CARE SERVICESMS501(C)(3)170(B)(1)(A)(III)RUSH HEALTH SYSTEMS INC0

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
MANAGED HEALTH CARE INC
1314 19TH AVENUEMERIDIANMS39301640862241MANAGEMENT OF HEALTHCAREMSRUSH HEALTH SYSTEMS INCC0
RUSH SERVICE COMPANY INC
PO BOX 5188MERIDIANMS39302640670493PROPERTY RENTALMSRUSH HEALTH SYSTEMS INCC0
PHYSICIAN MANAGEMENT SERVICES INC
1314 19TH AVENUEMERIDIANMS39301710927411HEALTHCARE MANAGEMENTMSRUSH HEALTH SYSTEMS INCC0
RUSH MEDICAL GROUP INC
1314 19TH AVENUEMERIDIANMS39301640524545PHYSICIAN SERVICESMSRUSH HEALTH SYSTEMS INCC0
CLINIC EQUIPMENT INC
1314 19TH AVENUEMERIDIANMS39301640479520EQUIPMENT LEASINGMSRUSH HEALTH SYSTEMS INCC0
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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