MAINLINE HEALTH SYSTEMS INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MAINLINE HEALTH SYSTEMS INC (EIN 71-0623643)
Tax period
2011-02-01 to 2012-01-31
Filed
2012-07-09
IRS object ID
201231919349300718
Schema version
2011v1.2
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)
Timestamp2012-07-09T16:09:48-05:00Timestamp
Tax Period End Date2012-01-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3667AddressLine1
CityLITTLE ROCKCity
StateARState
ZIP Code722033667ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-02-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN710623643EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MAINLINE HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MAINLINE HEALTH SYSTEMS INCInCareOfName
Name ControlMAINNameControl
Phone8705385414Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 100AddressLine1
CityPORTLANDCity
StateARState
ZIP Code71663ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY ALLAN NICHOLSName
TitleEXECUTIVE DIRECTORTitle
Date Signed2012-06-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5013721040Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonG ALLAN NICHOLSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 100AddressLine1
CityPORTLANDCity
StateARState
ZIP Code71663ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6634299GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MAINLINEHEALTH.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileARStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees76TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4814669ContributionsGrantsPriorYear
Contributions Grants Current Year4108904ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2069818ProgramServiceRevenuePriorYear
Program Service Revenue CY2522245ProgramServiceRevenueCY
Investment Income Prior Year2930InvestmentIncomePriorYear
Investment Income Current Year-7863InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year900OtherRevenueCurrentYear
Total Revenue Prior Year6887417TotalRevenuePriorYear
Total Revenue Current Year6624186TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3199667SalariesEtcPriorYear
Salaries Etc Current Year3286604SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3308475OtherExpensePriorYear
Other Expenses Current Year2674461OtherExpensesCurrentYear
Total Expenses Prior Year6508142TotalExpensesPriorYear
Total Expenses Current Year5961065TotalExpensesCurrentYear
Revenues Less Expenses Prior Year379275RevenuesLessExpensesPriorYear
Revenues Less Expenses CY663121RevenuesLessExpensesCY
Total Assets BOY4651818TotalAssetsBOY
Total Assets EOY5180794TotalAssetsEOY
Total Liabilities BOY1728520TotalLiabilitiesBOY
Total Liabilities EOY1594375TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2923298NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3586419NetAssetsOrFundBalancesEOY
Mission DescriptionTO IMPROVE THE QUALITY OF LIFE FOR THE POPULATION WITHIN THE SCOPE OF OPERATION THROUGH THE DELIVERY OF HIGH QUALITY ACCESSIBLE COMPREHENSIVE HEALTH CARE. SERVICES INCLUDE MEDICAL, DENTAL, MENTAL HEALTH AND PREVENTIVE HEALTH SERVICES FOR THE ENTIRE FAMILY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4075398Expense
Grants0Grants
Revenue2522245Revenue
DescriptionPROVIDED MEDICAL SERVICES TO 7,837 PATIENTS AND DENTAL SERVICES TO 2,189 PATIENTS IN SOUTHEAST ARKANSAS; SERVED RESIDENTS OF BOTH ASHLEY AND CHICOT COUNTIES.Description
Total Program Service Expense4075398TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109629NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees76NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMAINLINE HEALTH SYSTEMS INCNamePerson
Telephone Number8705385414TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1108 E SPEEDWAYAddressLine1
CityDERMOTTCity
StateARState
ZIP Code71638ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
CHARLIE KENNEDY
PRESIDENT1.0XX000
MARILYN NEWCOME
MEMBER0.25X000
MARY HOLLINS-SCOTT RN
SECRETARY0.25XX000
FRANK HENRY JR
VICE PRESIDENT0.25XX000
GERALD MERCER
MEMBER0.25X000
ROBERT THOMAS
MEMBER0.25X000
NANCY O'NEAL
MEMBER0.25X000
LEILA ALSTON
MEMBER0.25X000
RICHARD STOCK
MEMBER0.25X000
RON MILLER
MEMBER0.25X000
JIMMY PARKERSON
MEMBER0.5X000
GARY ALLAN NICHOLS
EXECUTIVE DIRECTOR40.0X7686007180
MARY ANN SCOTT
CFO40.0X5759505971
DR FAUZIA QADIR
MEDICAL DOCTOR40.0179741010249X
DR MICHAEL MCDANIELS
DENTIST & CLINICAL DIRECTOR40.012971208346X
DR GARY DALTON
DENTIST40.010183107715X
BRENDA JACOBS
NURSE PRACTIONER40.010823007576X
DR TEJASWI B THIPPESWAMY
MEDICAL DOCTOR40.015443108028X
FieldValueIRS element (for citing)
Total Reportable Comp From Org808400TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation55065TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonNONENamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants3301377GovernmentGrants
All Other Contributions807527AllOtherContributions
Noncash Contributions687156NoncashContributions
Total Contributions4108904TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PATIENT REVENUE621110252189425218940$0
OB EXPENSE REIMBURSEMENT6211103513510$0
FieldValueIRS element (for citing)
Total Program Service Revenue2522245TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2250TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,250ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real900Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real900Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column900TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other10113Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-10113Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-10113TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6624186TotalRevenueColumn
Related Or Exempt Function Income2522245RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,250ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total148483Total
Program Services0ProgramServices
Management And General148483ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2616218Total
Program Services1692790ProgramServices
Management And General923428ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total66330Total
Program Services42918ProgramServices
Management And General23412ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total244654Total
Program Services158300ProgramServices
Management And General86354ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total210919Total
Program Services136472ProgramServices
Management And General74447ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6100Total
Program Services3947ProgramServices
Management And General2153ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total71862Total
Program Services46497ProgramServices
Management And General25365ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total387998Total
Program Services251049ProgramServices
Management And General136949ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total24894Total
Program Services16107ProgramServices
Management And General8787ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total208732Total
Program Services135057ProgramServices
Management And General73675ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total211364Total
Program Services136760ProgramServices
Management And General74604ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total68736Total
Program Services44475ProgramServices
Management And General24261ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total57948Total
Program Services37494ProgramServices
Management And General20454ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total243332Total
Program Services157445ProgramServices
Management And General85887ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total53322Total
Program Services34501ProgramServices
Management And General18821ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES68715668715600
REPAIRS & MAINTENANCE13074584597461480
BAD DEBTS20371020371000
SUPPLIES210807136400744070

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total107755Total
Program Services69723ProgramServices
Management And General38032ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5961065Total
Program Services4075398ProgramServices
Management And General1885667ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY778035BOY
EOY1403484EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY346282BOY
EOY310133EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY351212BOY
EOY242417EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY116256BOY
EOY151685EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY75789BOY
EOY54256EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4385386LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1757077LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2871239BOY
EOY2628309EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY113005BOY
EOY390510EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4651818BOY
EOY5180794EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY344593BOY
EOY240161EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY12994BOY
EOY33EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1370933BOY
EOY1354181EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1728520BOY
EOY1594375EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2923298BOY
EOY3586419EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2923298BOY
EOY3586419EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4651818BOY
EOY5180794EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses663121ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3451755CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3408882CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3952908CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4814669CurrentTaxYearMinus1Year
Current Tax Year4108904CurrentTaxYear
Total19737118Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3451755CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3408882CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3952908CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4814669CurrentTaxYearMinus1Year
Current Tax Year4108904CurrentTaxYear
Total19737118Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total3726423AmountsSubstContributorsTotal
Public Support Total17016010695PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3490CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years450CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1873CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2930CurrentTaxYearMinus1Year
Current Tax Year2250CurrentTaxYear
Total10993Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years41CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total41Total
FieldValueIRS element (for citing)
Total Support19748152TotalSupport
Public Support Pertcentage1700.81074PublicSupportPertcentage170
Public Support Pertcent Prior Year0.79351PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2785175OtherCostOrOtherBasis
Depreciation846756Depreciation
Book Value1938419BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1600211OtherCostOrOtherBasis
Depreciation910321Depreciation
Book Value689890BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings2628309TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionFQHC COST REPORT RECEIVABLEDescription
Book Value390510BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets390510TotalBookValueOtherAssets
Total Revenue6624186TotalRevenue
Total Expenses5961065TotalExpenses
Excess Or Deficit For Year663121ExcessOrDeficitForYear
Excess Or Deficit Per FS663121ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6430589TotRevenueEtcAuditedFinclStmt
Other Revenues-203710OtherRevenues
Revenue Not Rptd F990-203710RevenueNotRptdF990
Revenue Subtotal6634299RevenueSubtotal
Other Revenues Not Included-10113OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-10113RevenueNotRptdOnFinStmt
Total Revenue Per Form9906624186TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5767468TotExpensesEtcAuditedFinclStmt
Other Expenses Included10113OtherExpensesIncluded
Expenses Not Rptd F99010113ExpensesNotRptdF990
Expenses Subtotal5757355ExpensesSubtotal
Other Expenses Not Included203710OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt203710ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905961065TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER REVENUE ON BOOKS NOT ON RETURNSCH. D, PART XII, LINE 2DPROVISION FOR UNCOLLECTIBLE ACCOUNTS $(203,710)
OTHER REVENUE ON RETURN NOT ON BOOKSSCH. D, PART XII, LINE 4BLOSS ON SALE OF ASSETS $(10,113)
OTHER EXPENSES ON RETURN NOT ON BOOKSSCH. D, PART XIII, LINE 4BPROVISION FOR UNCOLLECTIBLE ACCOUNTS $203,710
OTHER EXPENSES ON BOOKS NOT ON RETURNSCH. D, PART XIII, LINE 2DLOSS ON SALE OF ASSETS $10,113

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base 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
DR FAUZIA QADIR
179741000005562046870189990000
DR TEJASWI B THIPPESWAMY
154431000003720043080162459000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierNON-FIXED PAYMENTSIdentifier
Return ReferenceSCH. J, PART 1, LINE 7ReturnReference
ExplanationINCENTIVE PAY IS OFFERED FOR PROVIDERS WHO MEET 100% OF THEIR OFFICE GOALS. PROVIDERS RECEIVE INCENTIVE PAYMENTS AS FOLLOWS FOR REACHING GOAL IN CLINICS: 100% GOAL..........4% COLLECTIONS 105% GOAL..........5% COLLECTIONS 110% GOAL..........6% COLLECTIONS 115% GOAL..........7% COLLECTIONS 120% GOAL..........8% COLLECTIONSExplanation

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990687156NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REVIEW OF FORM 990FORM 990, PART VI, SECTION B, LINE 11BCFO REVIEWS FORM 990 AND PRESENTS IT TO THE BOARD FOR REVIEW PRIOR TO FILING.
MONITORING AND ENFORCING CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12(C)MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES APPROPRIATE ACTION AS NECESSARY.
BUSINESS RELATIONSHIP AMONG DIRECTORSFORM 990, PART VI, SECTION A, LINE 2RICHARD STOCK AND RON MILLER ARE DIRECTORS AT BOTH MAINLINE HEALTH SYSTEMS AND BAYOU GRAIN.
DETERMINATION OF COMPENSATIONFORM 990, PART VI, SECTION B, LINE 15(A) AND 15(B)15(A): COMPENSATION COMMITTEE BASES EXECUTIVE DIRECTOR'S COMPENSATION ON THE NUMBER OF SITES SERVED. THE COMMITTEE COMPARES TO OTHER SYSTEMS IN THE STATE WITH REGARD TO THE NUMBER OF SITES SERVED TO DETERMINE COMPENSATION. COMPENSATION COMMITTEE PRESENTS PROPOSED COMPENSATION TO THE BOARD FOR APPROVAL. THERE IS A WRITTEN EMPLOYMENT CONTRACT WHICH PROVIDES FOR AN INCREASE IN PAY AFTER 90 DAYS OF EMPLOYMENT. 15(B): THE EXECUTIVE DIRECTOR DETERMINES THE CFO'S SALARY. THE LAST REVIEW WAS IN 2007.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

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