2013-11-11T15:46:03-06:00 2012-12-31 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2012-01-01 640833381 RUSH CARE INC DBA SPECIALTY HOSPITAL OF MERIDIAN RUSH 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 DARRELL WILDMAN 6017039992 2013-11-05 1 MARSHA H DIECKMAN CPA P00246741 6013261000 2013-11-05 2012 2016-03-07 17:11:31Z DARRELL WILDMAN 406 57TH CT MERIDIAN MS 39305 64934203 0 X RUSHHEALTHSYSTEMS.ORG X 1993 MS HOSPITAL AND CLINIC PATIENT SERVICE 12 5 49 0 0 0 9356841 10757341 49357521 54165953 7579 7522 347 3387 58722288 64934203 0 118858 0 0 16826530 19188377 0 0 0 41415485 45239083 58242015 64546318 480273 387885 20904787 23317540 16171062 18195930 4733725 5121610 X HOSPITAL AND CLINIC PATIENT SERVICE 0 0 52389504 118858 54165953 THE SPECIALTY HOSPITAL OF MERIDIAN IS A 49-BED LONG TERM ACUTE CARE HOSPITAL LOCATED IN MERIDIAN, MS IN LAUDERDALE COUNTY WITHIN ITS HOST FACILITY RUSH FOUNDATION HOSPITAL. BOTH THE SPECIALTY HOSPITAL OF MERIDIAN AND RUSH FOUNDATION HOSPITAL ARE AFFILIATED WITH RUSH HEALTH SYSTEMS WHICH ALSO INCLUDES MEDICAL FOUNDATION, INC., RUSH MEDICAL GROUP, LAIRD HOSPITAL, UNION, MISSISSIPPI, H.C. WATKINS HOSPITAL IN QUITMAN, MISSISSIPPI, SCOTT REGIONAL HOSPITAL IN MORTON, MISSISSIPPI, JOHN C. STENNIS MEMORIAL HOSPITAL, DEKALB, MS, AND CHOCTAW GENERAL HOSPITAL IN BUTLER, AL.WHILE THE CITY OF MERIDIAN'S POPULATION IS APPROXIMATELY 38,000 PEOPLE, THE SPECIALTY HOSPITAL OF MERIDIAN AND ITS SISTER FACILITIES IN RUSH HEALTH SYSTEMS SERVE A POPULATION OF 232,900 PEOPLE IN A 45-MILE RADIUS AND 526,500 RESIDENTS IN A 65-MILE RADIUS. NINE COUNTIES IN EAST MISSISSIPPI AND THREE COUNTIES IN WEST ALABAMA, MOST OF WHICH ARE PRIMARILY RURAL COUNTIES, MAKE UP THE MAJORITY OF THE SERVICE REGION. THERE ARE ONLY EIGHT LONG TERM ACUTE CARE HOSPITALS LOCATED IN MISSISSIPPI, SO THE SPECIALTY HOSPITAL OF MERIDIAN FILLS A UNIQUE AND IMPORTANT NICHE IN THE SPECTRUM OF INPATIENT CARE. IN 2012, THE SPECIALTY HOSPITAL SERVED 592 INPATIENTS IN THE LONG TERM ACUTE CARE SETTING AND 143,168 OUTPATIENTS THROUGH ITS AFFILIATED RURAL PROVIDERS WHICH INCLUDED FAMILY MEDICAL GROUP OF UNION, RUSH MEDICAL CLINIC COLLINSVILLE, MEDICAL GROUP OF QUITMAN, MARION PRIMARY CARE CLINIC, CHOCTAW URGENT CARE CENTER, AND SEVEN OTHER CLINICS.AS PRESENTED IN THE ATTACHED SCHEDULE H, SPECIALTY HOSPITAL PROVIDED FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS DURING 2012 AT A COST OF $773,470. ALTHOUGH EQUITABLE PAYMENT FOR SERVICES IS ESSENTIAL TO THE ORGANIZATION'S FINANCIAL VIABILITY, SPECIALTY HOSPITAL RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE RESOURCES REQUIRED TO REIMBURSE THE HOSPITAL FOR ALL SERVICES PROVIDED. KEEPING ITS COMMITMENT TO THE COMMUNITY, SPECIALTY HOSPITAL PROVIDES FREE CARE AND SUBSIDIZED CARE WITHIN EXISTING RESOURCES WHERE THE NEED FOR SUCH CARE EXISTS. THE MISSION STATEMENT OF THE SPECIALTY HOSPITAL OF MERIDIAN AND ITS AFFILIATED RURAL PROVIDERS IS STATED AS FOLLOWS: "AS A LONG-TERM ACUTE-CARE HOSPITAL WITH AFFILIATED RURAL HEALTH PROVIDERS WE ARE COMMITTED TO THE DELIVERY OF EXCELLENCE IN HEALTHCARE. WE WILL MAINTAIN HIGH STANDARDS OF CARE AVAILABILITY OF RESOURCES, CONSISTENT WITH THE EXPECTATIONS OF OUR CUSTOMERS, IN A COST-EFFECTIVE MANNER. OUR MISSION IS TO CARE FOR OUR PATIENTS AS WELL AS OUR COMMUNITIES, AS DEFINED IN OUR MOTTO: RESTORING QUALITY TO LIFE."PROGRAMS DESIGNED TO MEET THE UNIQUE NEEDS OF LONG-TERM CARE PATIENTS PROVIDED BY THE SPECIALTY HOSPITAL OF MERIDIAN INCLUDE SPECIALIZED HOSPITALIST, PULMONARY CARE, WOUND CARE AND MEDICALLY COMPLEX PATIENT CARE PROGRAMS AND THE RELATED SERVICES OF THOSE PROGRAMS SUCH AS VENTILATOR MANAGEMENT AND WEANING, TRACHEOSTOMY CARE, LONG TERM IV ANTIBIOTIC THERAPY, TREATMENT FOR RENAL FAILURE, COMPLICATED FRACTURES, STAGE III OR STAGE IV PRESSURE ULCERS AND A HOST OF OTHER CONDITIONS REQUIRING LONG-TERM HOSPITAL CARE.THE SPECIALTY HOSPITAL OF MERIDIAN PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE. 52389504 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 44 0 1 49 1 0 0 0 0 0 0 0 0 0 0 X 12 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DARRELL WILDMAN 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 ANNETTE DRENNAN 1.00 0.00 X 0 2445 0 CHUCK REECE 1.00 59.00 X X 0 282563 163755 DARRELL WILDMAN 2.00 58.00 X X 0 217440 83474 L V RUSH JR MD 1.00 31.00 X 0 199108 10664 JOE ANN RAMIA 1.00 2.00 X 0 9600 0 RUTH HOLT 1.00 0.00 X 0 0 0 TIM MOORE - PART YEAR 20.00 33.00 X X 0 118606 10120 DALE ARMOUR 1.00 49.00 X X 0 199620 39112 CAROLE GREER 1.00 0.00 X 0 0 0 FRANKIE JONES 1.00 0.00 X 0 0 0 BETTY VISE 1.00 0.00 X 0 0 0 CHRIS RUSH 10.00 41.00 X X 0 183986 51706 LARKIN KENNEDY - PART YEAR 20.00 33.00 X X 0 168256 45319 RICK BARRY 1.00 13.00 X 0 0 0 CATHY ROBINSON 5.00 45.00 X 0 147105 42300 LIBBY MITCHELL 40.00 1.00 X 0 140449 17428 AKHTAR J SIDDIQUI 40.00 0.00 X 376964 0 15476 MIYAKO MCCLOUD 40.00 0.00 X 329899 0 6331 BERNITA M FINLEY MIMS 40.00 0.00 X 189416 0 15476 ARCHIE D HOOPER 40.00 0.00 X 193112 0 15476 SHARON HENSON 40.00 0.00 X 258950 0 6331 1348341 1669178 522968 24 0 1 0 NORTHERN ESCROW INC 1276 S ROBERT STREET WEST ST PAUL MN 55118 CONSTRUCTION SERVICES 1626613 JOHN JOHNSTON MD 722 PARKS ROAD PLACE JACKSON MS 39212 PHYSICIAN SERVICES 364060 ELIAS ABBOUD MD 638 NORTHWEST AVE DURANT MS 39063 PHYSICIAN SERVICES 350290 RENAL CARE GROUP PO BOX 62760 NEW ORLEANS LA 70162 MEDICAL DIALYSIS SERVICES 166957 CROWN HEALTH CARE 1501 N GUILLEMARD ST PENSACOLA FL 32501 LINEN SERVICES 110227 5 10757341 10757341 PROGRAM SERVICES 621110 54165953 54165953 54165953 7522 7522 OTHER INCOME 900099 3387 3387 3387 64934203 54165953 0 10909 X 118858 118858 15852559 15727347 125212 136094 135019 1075 2149056 2112816 36240 1050668 964808 85860 7174174 7174174 37500 37500 28103005 27591748 511257 73301 73301 3310455 3310455 14470 14470 1135 435 700 162085 162085 957191 957191 305356 4515 300841 SUPPLIES 2739878 2696413 43465 BAD DEBT EXPENSE 1214022 1214022 TAXES & LICENSES 373591 127664 245927 EQUIPMENT RENTAL AND MA 329076 327294 1782 443844 338073 105771 64546318 52389504 12156814 0 228531 253066 6965719 6085252 220318 407436 333415 321630 16144274 8343751 7419982 7800523 111277 5625545 8449633 20904787 23317540 1953090 2553241 14217972 15642689 16171062 18195930 X 0 0 0 0 4733725 5121610 4733725 5121610 20904787 23317540 387885 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5304175 2180217 3123958 6858709 4805306 2053403 3981390 1358228 2623162 7800523 DUE FROM AFFILIATES 8432133 GOODWILL 17500 8449633 CURRENT PORTION OF CAPITAL LEASES 154571 CAPITAL LEASES 2960402 DUE TO AFFILIATES 12527716 15642689 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: RUSH 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. 1 1 1 X 1 X 1 1 1 0 0 552179 552179 0.00870 221281 221281 0.00350 773460 773460 0.01220 414 414 0.00000 240 240 0.00000 654 654 774114 774114 0.01220 490 490 0.00000 490 490 1 1214022 0 34784907 41211773 -6426866 X 1 1 1 1 SPECIALTY HOSPITAL

1314 19TH AVENUE MERIDIAN MS 39301

X LONG TERM ACUTE CARE SPECIALTY HOSPITAL MERIDIAN 1 1 1 200.000000000000 1 200.000000000000 1 X X X X 1 1 X 1 0 X X 1 X 0 0 12 CENTRAL MISSISSIPPI FAMILY HEALTH CLINIC

905 C SOUTH FRONTAGE ROAD MERIDIAN MS 39301

OUTPATIENT CLINIC MEDICAL GROUP OF QUITMAN

305 S ARCHUSA AVENUE QUITMAN MS 39355

OUTPATIENT CLINIC IMMEDIATE CARE FAMILY CLINIC

1710 14TH STREET MERIDIAN MS 39301

OUTPATIENT CLINIC LIVINGSTON MEDICAL CLINIC

1221 WASHINGTON STREET LIVINGSTON AL 35470

OUTPATIENT CLINIC FAMILY MEDICAL GROUP OF UNION

24345 HWY 15 UNION MS 39365

OUTPATIENT CLINIC DECATUR MEDICAL CLINIC

14884 HIGHWAY 15 DECATUR MS 39327

OUTPATIENT CLINIC NORTH HILLS CLINIC

4331 HIGHWAY 39N MERIDIAN MS 39305 MERIDIAN MS 39305

OUTPATIENT CLINIC RUSH MEDICAL CLINIC COLLINSVILLE

9097 COLLINSVILLE ROAD COLLINSVILLE MS 39325

OUTPATIENT CLINIC NEWTON FAMILY MEDICAL ASSOCIATES

252 NORTHSIDE DRIVE NEWTON MS 39345

OUTPATIENT CLINIC CHOCTAW URGENT CARE CENTER

1 INDEPENDENCE SQUARE STE 1C BUTLER AL 36904

OUTPATIENT CLINIC MARION PRIMARY CARE CLINIC

5334 DALE DRIVE MARION MS 39342

OUTPATIENT CLINIC RUSH MEDICAL CLINIC - DEKALB

14365 HWY 16 W DEKALB MS 39328

OUTPATIENT CLINIC 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 $ 1214022. PART II: ALL ACTIVITIES ENGAGED IN BY SPECIALTY ARE GEARED TOWARD PROMOTION AND IMPROVEMENT OF THE WELLBEING OF THE CITIZENS OF OUR PRIMARY SERVICE AREA. SPECIALTY PROMOTES EDUCATION THROUGH SUPPORT OF ITS COMMUNITY BASED NURSING AND ALLIED HEALTH PROGRAMS AS WELL AS COMMUNITY HEALTH EDUCATION AND TRAINING SESSIONS. NUMEROUS VOLUNTEER HOURS ARE SPENT WITH ACTIVITIES SUCH AS THE SEXUAL ASSAULT NURSE EXAMINER PROGRAM, AND HEALTH FAIRS. RUSH ALSO SUPPORTS THE COMMUNITY BY ENSURING THE PROVISION OF NEEDED PRIMARY CARE IN MANY UNDERSERVED AREAS. 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. SPECIALTY HOSPITAL MERIDIAN PART V, SECTION B, LINE 20D: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR 100% DISCOUNT TO ELIGIBLE INDIVIDUALS (200% OF FPG), THEREFORE PATIENTS MEETING THIS REQUIREMENT ARE NOT CHARGED FOR THE SERVICES PROVIDED. 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: SPECIALTY IS A COMMUNITY-BASED ENTITY WITH A LONG-TERM ACUTE-CARE HOSPITAL AND RURAL BASED PROVIDER CLINICS IN THE EAST MISSISSIPPI AND WEST ALABAMA AREA. SPECIALTY'S PRIMARY SERVICE AREA EXTENDS TO COMMUNITES IN OVER A 90-MILE RADIUS OF MERIDIAN, MS. THERE IS ONE OTHER LONG-TERM ACUTE CARE FACILITY LOCATED WITHIN THE MERIDIAN, MS SERVICE AREA. THESE FACILITES SERVE AS THE PRIMARY LONG-TERM PROVIDERS FOR THE VERY NEEDY AREAS OF EAST MISSISSIPPI AND WEST ALABAMA. 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 SPECIALTY'S BOARD RESIDE IN SPECIALTY'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. PRIMARY CARE PHYSICIANS, NURSE PRACTICTIONERS, ETC.), FUNDING OF LOCAL AREA HEALTHCARE WORKFORCE TRAINING AND ECONOMIC DEVELOPMENT. PART VI, LINE 6: SPECIALTY IS WHOLLY OWNED BY RUSH HEATLH SYSTEMS, A NON-PROFIT ORGANIZATION. WITHIN RUSH HEALTH SYSTEMS ARE THE SPECIALTY HOSPITAL OF MERIDIAN (A LONG TERM ACUTE CARE FACILITY), LAIRD 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. 1 SCOTT REGIONAL MEDICAL CENTER INC 1314 19TH AVENUE MERIDIAN MS 39301 260792328 501(C)(3) 118858 AFFILIATE SUPPORT 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ORGANZIATION DONATES MONEY TO AFFILIATES. X X X X X X 0 1 0 0 0 0 0 0 0 CHUCK REECE 0 276968 0 0 0 5595 0 111100 0 52655 0 446318 0 0 DARRELL WILDMAN 0 211128 0 0 0 6312 0 45949 0 37525 0 300914 0 0 L V RUSH JR MD 0 194308 0 0 0 4800 0 5530 0 5134 0 209772 0 0 DALE ARMOUR 0 179820 0 15000 0 4800 0 27750 0 11362 0 238732 0 0 CHRIS RUSH 0 178204 0 0 0 5782 0 35100 0 16606 0 235692 0 0 LARKIN KENNEDY - PART YEAR 0 152219 0 10000 0 6037 0 27750 0 17569 0 213575 0 0 CATHY ROBINSON 0 141520 0 0 0 5585 0 29067 0 13233 0 189405 0 0 LIBBY MITCHELL 0 140449 0 0 0 0 0 1952 0 15476 0 157877 0 0 AKHTAR J SIDDIQUI 376964 0 0 0 0 0 0 0 15476 0 392440 0 0 0 MIYAKO MCCLOUD 329899 0 0 0 0 0 0 0 6331 0 336230 0 0 0 BERNITA M FINLEY MIMS 189416 0 0 0 0 0 0 0 15476 0 204892 0 0 0 ARCHIE D HOOPER 193112 0 0 0 0 0 0 0 15476 0 208588 0 0 0 SHARON HENSON 258950 0 0 0 0 0 0 0 6331 0 265281 0 0 0 PART I, LINE 4B RUSH 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. FORM 990, PART VI, SECTION A, LINE 6 RUSH HEALTH SYSTEMS, INC. IS THE PARENT ORGANIZATION AND SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE 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 7B THE 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 11 THE 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 12C THE 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 15 EXECUTIVE 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 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 27,591,748. MANAGEMENT AND GENERAL EXPENSES 511,257. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,103,005. AUDIT COMMITTEE FORM 990, PART XI, LINE 2C THE AUDIT/COMPENSATION COMMITTEE OVERSEES RESPONSIBILITY FOR THE AUDITED FINANCIAL STATEMENTS FOR THE ORGANIZATION. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, QUESTION 12 THE FINANCIAL STATEMENTS OF RUSH HEALTH SYSTEMS, INC., SUBSIDIARIES, & AFFILIATES ARE AUDITED ANNUALLY. THESE FINANCIAL STATEMENTS INCLUDE THE ORGANIZATION'S ACTIVITY. STAND ALONE FINANCIAL STATEMENTS FOR THE ORGANIZATION ARE NOT SEPARATELY AUDITED. AUDITED FINANCIAL STATEMENTS FORM 990, PART XI, QUESTION 2 THE FINANCIAL STATEMENTS OF RUSH HEALTH SYSTEMS, INC., SUBSIDIARIES, & AFFILIATES ARE AUDITED ANNUALLY. THESE FINANCIAL STATEMENTS INCLUDE THE ORGANIZATION'S ACTIVITY. STAND ALONE FINANCIAL STATEMENTS FOR THE ORGANIZATION ARE NOT SEPARATELY AUDITED. RUSH MEDICAL FOUNDATION 1314 19TH AVENUE MERIDIAN MS 39301 640345119 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH MEDICAL GROUP OF NEWTON 1314 19TH AVENUE MERIDIAN MS 39301 640783323 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HOME CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640670314 PROVIDING HOME HEALTH CARE MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 LAIRD HOSPITAL INC 25117 HWY 15 UNION MS 39365 201835779 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HEALTH SYSTEMS INC PO BOX 5187 MERIDIAN MS 39301 640664988 PROVIDING SUPPORT TO HEALTH CARE AFFILIATES MS 501(C)(3) 509(A)(3)(III) N/A 0 MERIDIAN SPEECH AND HEARING CENTER 1314 19TH AVENUE MERIDIAN MS 39301 640529831 PROVIDING AUDIOLOGY SERVICES AND DYSLEXIA TESTING AND TREATMENT MS 501(C)(3) 509(A)(2) RUSH HEALTH SYSTEMS INC 0 SCOTT REGIONAL MEDICAL CENTER INC 1314 19TH AVENUE MERIDIAN MS 39301 260792328 PROVIDING HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 MEDICAL FOUNDATION INC PO BOX 5183 MERIDIAN MS 39302 640834532 PROVIDE HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH HOSPITAL - BUTLER INC 1314 19TH AVENUE MERIDIAN MS 39301 640655993 PROVIDE HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 KEMPER CAH INC 1314 19TH AVENUE MERIDIAN MS 39301 271757642 PROVIDE HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 NEWCA CAH INC 1314 19TH AVENUE MERIDIAN MS 39301 201254928 PROVIDE HEALTH CARE SERVICES MS 501(C)(3) 170(B)(1)(A)(III) RUSH HEALTH SYSTEMS INC 0 RUSH SERVICE COMPANY INC PO BOX 5188 MERIDIAN MS 39302 640670493 PROPERTY RENTAL MS RUSH HEALTH SYSTEMS INC C 0 MANAGED HEALTH CARE 1314 19TH AVENUE MERIDIAN MS 39301 640862241 MANAGE HEALTHCARE MS RUSH HEALTH SYSTEMS INC C 0 CLINIC EQUIPMENT INC 1314 19TH AVENUE MERIDIAN MS 39301 640479520 EQUIPMENT MS RUSH HEALTH SYSTEMS INC C 0 PHYSICIAN MANAGEMENT SERVICES INC 1314 19TH AVENUE MERIDIAN MS 39301 710927411 HEALTHCARE MANAGEMENT MS RUSH HEALTH SYSTEMS INC C 0 RUSH MEDICAL GROUP INC 1314 19TH AVENUE MERIDIAN MS 39301 640524545 MEDICAL SERVICE MS RUSH HEALTH SYSTEMS INC C 0 0 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0