2012-06-12T16:17:29-05:00 2011-07-31 BKD LLP 190 E Capitol Street Ste 500 Jackson MS 392012190 990 2010-08-01 721379812 Prentiss Regional Hospital and Extended Care Facility Inc PREN 6017924276 Post Office Box 1288 Prentiss MS 394741288 Reggie Magee 2012-06-15 Penny Wood CPA 6019486700 2010 2016-02-24 21:20:13Z Jefferson Davis Community Hospital Reggie Magee 1102 Rose Street Prentiss MS 39474 13017519 false X N/A X 1997 MS Prentiss Regional Hospital & Extended Care Facility, Inc. D/B/A Jefferson Davis Community Hospital (The Hospital) is an acute care hospital located in Prentiss, MS. 7 7 253 0 0 0 21630 8815 12762497 12671914 -57596 72 289461 336718 13015992 13017519 0 0 0 0 5889506 5043946 0 0 0 7846610 7180969 13736116 12224915 -720124 792604 5160132 3985857 3602676 1744225 1557456 2241632 X PRENTISS REGIONAL HOSPITAL & EXTENDED CARE FACILITY, INC. D/B/A JEFFERSON DAVIS COMMUNITY HOSPITAL, (THE HOSPITAL) LOCATED IN PRENTISS, MS, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES PRIMARILY FOR LOCAL RESIDENTS AND RESIDENTS OF THE SURROUNDING AREA. THE HOSPITAL IS LICENSED FOR 25 ACUTE CARE BEDS, 10 GERIATRIC PSYCHIATRIC UNIT BEDS, AND 60 NURSING HOME BEDS. THE HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT A REDUCED CHARGE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. false true 8491871 12678622 Inpatient, outpatient, and emergency care services The hospital provides medical care without charge or at a reduced charge to patients who meet certain criteria under its charity care policy. The amount of charges foregone for services and supplies furnished under the Hospital's charity care policy aggregated approximately $19,000 during fiscal year 2011. Charges foregone are netted against patient service revenue to arrive at net patient service revenue and are not reported as functional expenses on the tax return. 1764218 The Hospital grants credit without collateral to its patients. Charges deemed uncollectible during fiscal year 2011 were approximately $1,764,218. 10256089 true true false false false false false false false true true 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 true 9 0 true 253 true false false false false false false false false false false X 7 7 false true false false false false false true true false false false true true true true true true true false X CHARLIE PHILLIPS 6017924276 1102 ROSE STREET Prentiss MS 39474 Jack Berry 1.0 X 1277 0 0 Keith Bridges 1.0 X 1100 0 0 Kathy Cloyd 1.0 X 1100 0 0 Willis Graves 1.0 X 1315 0 0 Lola Bass 1.0 X 1425 0 0 Ralph Fortenberry 1.0 X 1177 0 0 Reggie Magee 1.0 X 1064 0 0 Lee McCall 40.0 X 97198 0 11483 Paul Black 40.0 X 84000 0 0 Mary Curtis 40.0 X 72708 0 0 Earl Mahaffey MD 40.0 X 157429 0 6442 Joe Taylor 40.0 X 185114 0 7123 604907 0 25048 2 false true true Correct Care 17438 Hard Hat Drive COVINGTON LA 70435 ER Physician 616637 Healthcare Services Group 3220 Tillman Drive BENSALEM PA 19020 Housekeeping 476622 Valley PO Box 5454 JACKSON MS 392885454 Food Services 347300 Physical Rehab Management Inc 1106 Pointe Cove BRANDON MS 39042 Physical Therapy 315809 4 8815 8815 PATIENT SERVICE REVENUE 900099 12577320 12577320 RELATED RENTAL INCOME 900099 94594 94594 12671914 72 72 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 86107 86107 CAFETERIA REVENUE 722210 6708 6708 WELLNESS CENTER REVENUE 713940 37279 37279 206624 206624 336718 13017519 12678622 0 330082 0 0 0 0 97449 97449 0 4189392 3704752 484640 39301 35438 3863 388847 339401 49446 328957 285111 43846 0 36880 36880 166874 166874 0 0 0 2625627 2475865 149762 11104 11104 1270968 991184 279784 50173 2868 47305 0 158260 158260 11421 5113 6308 0 2740 1635 1105 118350 118350 0 284083 284083 261304 261304 BAD DEBT EXPENSE 1764218 1764218 TAXES AND LICENSES 315246 697 314549 REPAIRS AND MAINTENANCE 85298 85298 DUES AND SUBSCRIPTIONS 17871 3816 14055 BANK FEES 552 552 12224915 10256089 1968826 0 138192 394618 46000 0 1417834 326698 108896 0 30119 0 7446450 5001765 2728768 2444685 690323 819856 5160132 3985857 1533429 12474 1144979 973762 924268 757989 3602676 1744225 X 1557456 2241632 1557456 2241632 5160132 3985857 X 792604 -108428 X false false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 97900 97900 3454482 1494460 1960022 38629 35223 3406 3805975 3427528 378447 49464 44554 4910 2444685 INVESTMENT IN HPIC 819856 C 819856 0 THIRD-PARTY PAYOR SETTLEMENTS 412980 DUE TO FGH 345009 757989 Schedule D, Part X, Line 2: Management has evaluated the company's income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. true true X false true X true false false 11428 0 11428 0.00110 2895151 1979983 915168 0.08750 2906579 1979983 926596 0.08860 2906579 1979983 926596 0.08860 false 1050744 0 4195885 4149644 46241 X true false 1 1 Prentiss Regional Hospital & ECF

1102 Rose Street Prentiss MS 39474

X X X Prentiss Regional Hospital & ECF 1 Part I, Line 7, Column f: Bad debt expense of $1,764,218 was included in total expense on Form 990, Part IX, Line 25, Column (a), but was subtracted from total expense for purposes of calculating the percentage of total expense in Column (f). Part I, Line 7: The cost-to-charge ratio per the organization's cost report was used to determine the amounts reported in Part I, Line 7a and b. Part III, Line 4: The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific cirmcumstances of the account. The Hospital offers a charity assistance application to patients upon admission. Accounts of patients who choose not to apply for charity care but who are unable to pay their medical bills are ultimately written off as bad debt based on the Hospital's bad debt policy. This policy does not include provisions for those patients who are known to qualify for charity care but do not apply for the assistance. The Hospital is unable to quantify the amount of bad debt that is related to patients who would qualify for charity care if applied for, but consider a majority of bad debt to consist of these accounts. The organization's bad debt expense at cost was calculated using the cost-to-charge ratio per the organization's cost report. Part III, Line 8: The Hospital uses its medicare cost report to determine the amount reported on Schedule H, Part III, Line 6. Part V: All health care facilities operated by the hospital are reported in Schedule H, Part V. The organization does not operate facilities that are not required to be licensed, registered or similarly recognized as a health care facility under state law. Part VI, Line 2: Needs Assessment The Hospital assesses the needs of the community it serves by engaging in community programs, conducting and participating in community meetings, through dialogue with constituents, and by receiving feedback through evaluations of its services. Part VI, Line 3: Patient Education of eligibility for assistance Patients are informed about their eligibility for government and charity care assistance during the registration process. Part VI, Line 4: Community Information The Hospital serves Jefferson Davis County, a rural area located in south central Mississippi with a population of approximately 12,000 and median household income of approximatley $27,000. Part VI, Line 5: Promotion of community health The Hospital educates and informs community members of various programs and services which increases community accessibility and involvement in healthcare programs offered by the Hospital. Part VI, Line 6: Affiliated health care system The organization is not part of an affiliated health care system. Part VI, Line 7: State filing of community benefit report The organization does not file a community benefit report with the state of Mississippi as there is no requirement to do so. X X X false false false false false false false false false Paul Black 84000 0 0 0 0 0 0 0 0 0 84000 0 Mary Curtis 72708 0 0 0 0 0 0 0 0 0 72708 0 Earl Mahaffey MD 157429 0 0 0 0 0 3120 0 3322 0 163871 0 Joe Taylor 185114 0 0 0 0 0 2496 0 4627 0 192237 0 Schedule J, Part II: Paul Black, CFO, was paid $84,000 by Rural Health Management, Inc., an unrelated organization, for services rendered to the hospital. Mary Curtis, Interim Administrator, was paid $72,708 by Curtis Management, Inc., an unrelated organization, for services rendered to the hospital. Form 990, Page 2, Part III, Line 3: As of July 1, 2011, Prentiss Regional Hospital & Extended Care Facility, Inc. d/b/a Jefferson Davis Community Hospital (the Hospital) entered into a five year lease agreement with Forrest County General Hospital (FGH). As a result of this agreement, the Hospital subleased the assets previously under lease by the Hospital from Jefferson Davis County as well as personal property owned by the Hospital outside the lease with the County to FGH (this includes the main hospital facilities). During the lease term, FGH will operate and manage the Hospital. Form 990, Page 3, Part IV, Line 12: The Hospital obtained separate, independent audited financial statements for the period ending June 30,2011. The Hospital was then part of a consolidated, independent audited financial statement for the period ending September 30, 2011, the year end of a related entity, Forrest County General Hospital. The Form 990 reports activity through July 31, 2011, the Hospital's current fiscal year end. Form 990, Page 3, Part IV, Line 20b: The Hospital entered into a lease agreement with Forrest County General Hospital (FGH) as of July 1, 2011. In accordance with generally accepted auditing standards, Hospital activity occuring after June 30, 2011 will be included in the audited financial statements of FGH. Therefore, the Hospital's audited financial statements attached to the Form 990 are as of June 30, 2011. Form 990, Page 6, Part VI, Section A, Line 3: As a result of the lease agreement described in Part III, Line 3, FGH manages the day-to-day operations of the Hospital. Form 990, Page 6, Part VI, Section B, Line 11B: The Form 990 is reviewed by the Hospital's CEO and CFO prior to filing with the IRS. Form 990, Page 6, Part VI, Section B, Line 12: Annual disclosure forms are required to be completed by all board members, officers, and highest compensated employees. The questionnaires are reviewed by the organization's CEO and any persons with conflicts of interest are prohibited from participating in the board's deliberations and decisions in the transaction in which the conflict exists. Form 990, Page 6, Part VI, Section B, Line 15: Compensation of top management officials and other officers of the organization is determined by the Board of Directors based on comparability data received from salary surveys conducted by the Mississippi Hospital Association. Form 990, Page 6, Part VI, Section C, Line 19: The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Page 12, Part XI, Line 5: Transfer of assets to Forrest County General Hospital <108,428> Form 990, Page 12, Part XII, Line 2B: The organization's financial statements were audited by an independent auditor. However, due to the lease agreement with Forrest County General Hospital (FGH), the financial statements of the organization were audited through June 30, 2011, and not July 31, 2011, the organization's fiscal year end. Activity for the month of July 2011 is included in a consolidated financial statement of FGH. Since all information reported on the organization's 2010 Form 990 was not included in the organization's separate audited financial statement, Line 2b is being answered "no."