2011-05-13T14:41:18-05:00 2010-06-30 HORNE LLP 1020 Highland Colony Pkwy Ste 400 Ridgeland MS 39157 990 2009-07-01 710230218 ARKANSAS METHODIST HOSPITAL CORPORATION DBA ARKANSAS METHODIST MEDICAL CENTER ARKA 8702397000 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 RONALD K ROONEY 8702397000 2011-05-12 1 MARSHA H DIECKMAN CPA 6013261000 2011-05-12 2009 2016-02-24 21:20:13Z ARKANSAS METHODIST MEDICAL CENTER RONALD K ROONEY 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 117477813 0 X WWW.ARKANSASMETHODIST.ORG X 1949 AR AMMC is a community-focused organization that provides overall leadership for meeting the healthcare needs of Paragould and Greene County, Arkansas, as well as surrounding areas of northeast Arkansas and southeast Missouri. 12 12 818 150 0 0 19775 182652 115252758 115658341 417294 204640 1240177 1332011 116930004 117377644 14308 11900 0 27105624 28494067 0 0 89148142 89131362 116268074 117637329 661930 -259685 54640988 53803740 18309578 17249333 36331410 36554407 Arkansas Methodist Medical Center is a BEACON of Health, Hope, and Healing. Our Vision is, through dedication, we will provide quality healthcare and promote wellness to the people and communities we serve; thus establishing AMMC as your first choice for healthcare. The core of the services offered by AMMC is our general acute care hospital, which saw over 5,200 inpatient discharges and over 24,000 emergency room visits in fiscal year 2010. AMMC operates one of the oldest home health agencies in the state of Arkansas, making over 14,200 visits last year. We also provide the ambulance service for Greene County and portions of Clay County. Our ambulances made over 5,600 runs in fiscal year 2010. 0 0 102162893 11900 116395128 AMMC is a community-focused organization that provides overall leadership for meeting the healthcare needs of Paragould and Greene County, Arkansas, as well as surrounding areas of northeast Arkansas and southeast Missouri. In recognition of its unique role, AMMC was designated a Rural Referral Center by the Centers for Medicare and Medicaid Services in August 2004. AMMC is the only hospital in Greene County, Arkansas, and provides a significant amount of care and service to indigent patients covered by the Medicaid program as well as other uninsured and underinsured patients. As a result, AMMC is identified as a Disproportionate Share Hospital by the Centers for Medicare and Medicaid Services.During fiscal year 2010, AMMC discharged 4,710 adult and pediatric inpatients and delivered 524 newborns. There were approximately 63,542 outpatient visits ranging from outpatient surgery and cardiac cath lab procedures to diagnostic radiology and laboratory visits. In addition, our emergency room saw 24,802 visits last year and our home health agency made 14,256 visits. The AMMC ambulance service, with bases in Paragould, Corning and Rector, made 5,600 runs.Uncompensated care, which includes charity care, bad debt expense and Medicaid services provided below cost, are estimated at approximately $11 million, based on cost.As the healthcare leader in our community, acute care services are only the beginning of what we offer. AMMC provides a full range of wellness, educational and preventative services. CPR training is offered to various groups in the community that totaled over 3,500 individuals last year. Health fairs are conducted throughout the community at a number of local employers as well as two major health fairs, one for women and one for men, at the hospital itself. The AMMC certified diabetic education program is a vital outreach to those in our community to help them live with and successfully manage their chronic disease. And finally, the AMMC sports medicine program helps coordinate with local physicians to provide hundreds of physicals to local high school athletes. 102162893 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 65 0 818 1 0 0 0 0 0 0 0 0 0 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AR X STACI WILLIAMS CONTROLLER 8702397102 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 Dr Dwight Williams 1.00 X 0 0 0 Mr Paul Hill 1.50 X 0 0 0 Mr Tom Kirk 1.50 X 0 0 0 Mr Bill Fisher 1.50 X 0 0 0 Dr JD Bonner 1.50 X 0 0 0 Mr George Cook 1.50 X 0 0 0 Mr WT Shewmaker 1.50 X 0 0 0 Ms Jannie Distretti 1.00 X 0 0 0 Mr Pat Quinn 1.50 X 0 0 0 Rhonda Davis 1.50 X 0 0 0 Mr Sherland Hamilton 1.00 X 0 0 0 ALBERT FONTICIELLA MD 1.00 X 0 0 0 RONALD K ROONEY 40.00 X 243222 0 43079 BRYAN G JACKSON 40.00 X 154712 0 3752 BARRY L DAVIS 40.00 X 167819 0 10578 STANLEY E CARMACK 40.00 X 133338 0 9301 CHRISTOPHER N DUTY 40.00 X 118233 0 8620 CARL D PARRISH 40.00 X 113498 0 9860 DEBRA J VASSAR 40.00 X 108587 0 8289 PAUL K MOORE 40.00 X 108288 0 3752 1147697 0 97231 10 0 1 0 REHABCARE GROUP INC PO BOX 502096 ST LOUIS MO 63150 REHAB UNIT MANAGEMENT 1168836 Anesthesia Associates of Paragould Arka 2507 South Wind PARAGOULD AR 72450 DIRECTOR OF ANESTHESIA 481250 GREENE EMERGENCY GROUP LLC PO BOX 82368 LAFAYETTE LA 70598 ER PHYSICIAN GROUP 298027 David M Quinn PC 3107 Norman Rockwell PARAGOULD AR 72450 DIRECTOR OF PATHOLOGY 275000 SWEET DREAMS ANESTHESIA 4301 LOCHMOOR CIR JONESBORO AR 72404 ANESTHESIA SERVICES 205000 17 49669 132983 182652 PATIENT SERVICE REVENU 621990 115658341 115658341 115658341 222150 222150 403809 403809 403809 403809 82659 100169 -17510 -17510 -17510 CAFETERIA REVENUE 722210 355419 355419 OTHER REVENUE 900099 350488 350488 WELLNESS CTR REVENUE 624100 119431 119431 102864 102864 928202 117377644 116395128 0 799864 11900 11900 623162 623162 22039643 16193343 5846300 532967 380823 152144 3665408 2619058 1046350 1632887 1166753 466134 147403 147403 100340 100340 78278 55932 22346 93819 67037 26782 587517 419801 167716 3413386 2438980 974406 569493 406922 162571 CONTRACTUAL ADJUSTMENTS 51527618 51527618 SUPPLIES 10122997 7233225 2889772 BAD DEBTS 8706245 8706245 PURCHASED SERVICES 5142466 3674466 1468000 CHARITY CARE 3804060 3804060 4837740 3456730 1381010 117637329 102162893 15474436 0 3753364 1190413 7782068 8023271 1137159 1363104 1156800 1650097 69648029 44285825 26475226 25362204 14024300 13694795 312071 2519856 54640988 53803740 4002926 4289808 11555000 10470000 2509555 2342920 242097 146605 18309578 17249333 X 36331410 36554407 36331410 36554407 54640988 53803740 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6041 6041 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: A PERCENTAGE OF THE DUES PAID BY THE HOSPITAL TO AMERICAN HOSPITAL ASSOCIATION AND ARKANSAS HOSPITAL ASSOCIATION ARE DEEMED TO BE USED FOR LOBBYING PURPOSES. PART OF THE WORK DONE BY THESE ASSOCIATIONS IS LOBBYING ON BEHALF OF HOSPITALS FOR LEGISLATION THAT WILL BENEFIT THE HEALTHCARE COMMUNITY. 5073883 5073883 33232603 20066199 13166404 27531920 22785079 4746841 3809623 1434547 2375076 25362204 ASSETS LIMITED AS TO USE,DESIGNATED FOR CAPITAL ACQ.: CASH & S-T INVESTMENTS 4322509 F ASSETS LIMITED AS TO USE, DESIGNATED FOR CAPITAL ACQ.: EQUITIES 3859041 F ASSETS LIMITED AS TO USE,DESIGNATED FOR CAPITAL ACQ.:CERTIFICATES OF DEPOSIT 3083063 F ASSETS HELD BY TRUSTEE UNDER INDENTURE AGREEMENT: CASH & S-T INVESTMENTS 2430182 F 13694795 INTEREST PAYABLE 146605 146605 Part X: Description of Uncertain Tax Positions Under FIN 48: The Medical Center, the Foundation and Physician Services are exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. However, the Medical Center, the Foundation and Physician Services are subject to federal income tax on any unrelated business taxable income. In July 2006, the Financial Accounting Standards Board ("FASB") issued Interpretation No. 48, Accounting for Uncertainty in Income Taxes, codified in FASB ASC Topic 740 ("ASC 740"). This standard clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements and prescribes a recognition threshold and measurement attribute for the tax positions taken or expected to be taken on tax return including the entity's status as a tax-exempt not-for-profit entity. Additionally, ASC 740 provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. The Medical Center adopted this standard effective July 1, 2009. The Medical Center had no significant uncertain tax positions at the date of adoption or at June 30, 2010. Accordingly, the adoption did not have a material effect on the Medical Center's financial position or changes in net assets. If interest and penalties are incurred related to uncertain tax positions, such amounts would be recognized in income tax expense. Tax periods for all fiscal years after 2005 remain open to examination by the federal and state taxing jurisdictions to which the Medical Center is subject. 1 1 1 X 1 X 205.000000000000 1 1 0 1 1 1760394 1760394 0.01500 8284194 6827792 1456402 0.01240 10044588 6827792 3216796 0.02740 10044588 6827792 3216796 0.02740 1 4022682 2011341 22324442 19700108 2624334 X 1 1 ARKANSAS METHODIST HOSPITAL CORPORATION

900 WEST KINGSHIGHWAY PARAGOULD AR 72450

X X X Part I, Line 7: Worksheet 2 cost to charge ratio was used by the organization. Part III, Line 4: The cost of bad debt expense was calculated using the cost to charge ratio from worksheet 2.The Medical Center reports patient accounts receivable for services rendered at net realizable amounts from patients, third-party payors and others. The Medical Center provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Medical Center bills third-party payors directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Balances past due more than 150 days are considered delinquent. Accounts are subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Part III, Line 9b: No collection efforts are taken on patients qualifying for charity care or financial assistance. Part VI, Line 2: Arkansas Methodist Medical Center conducts health fairs throughout the communities we serve. The health fairs give the citizens the opportunity to have cholesterol and glucose screenings as well as other wellness screenings. For FY 2010, we conducted 28 health fairs with over 2000 attendees. The Hospital also performs athletic physicals for the athletes at 5 area schools. Over 726 physicals were performed in 2010. The hospital also has a diabetes clinic that helps newly diagnosed diabetics gain the skills to effectively manage their diabetes including cooking classes and group discussions. In FY 2010, the diabetes clinic assisted 272 patients. The Mission Outreach Charitable clinic provided assistance to 975 underprivileged individuals, and AMMC administered more than 500 free H1N1 vaccines to local business employees as well as AMMC staff and families. Part VI, Line 3: Private Pay inpatients are visited by our Social Service director to determine what needs the patient might have. The director then gives the patient information regarding the assistance that is available to them. Patients who she feels may qualify for Medicaid or charity are referred to a financial counselor who helps the patient with the completion of the applications. Part VI, Line 4: AMMC serves the rural communities of Greene and Clay Counties in Arkansas and Dunklin County, Missouri, as well as the city of Paragould. Part VI, Line 5: COMMUNITY BUILDINIG ACTIVITIES HAVE NOT BEEN QUANTIFIED BY AMMC INTO A DOLLAR BENEFIT TO THE COMMUNITY. HOWEVER, AS DESCRIBED ABOVE, AMMC IS ACTIVELY INVOLVED IN COMMUNITY HEALTH IMPROVEMENT ADVOCACY THROUGH HEALTH FAIRS, DIABETES CLINICS, PHYSICALS FOR STUDENT ATHLETES AND MISSION OUTREADH CHARITABLE CLINIC. Part VI, Line 6: The AMMC Board of Directors is comprised of members of the community who are employed or retired from many of the industries in the community. AMMC works to recruit physicians in order to better serve the community and extends privileges to the qualified physicians in our communities. Through a partnership with the Arkansas SAVES (Stroke Assistance Through Virtual Emergeny Support) program, AMMC is helping save the lives of stroke victims. Using high-speed live video communications, top neurologists across the state provide time-crucial communciations with AMMC emergency room doctors, speeding response times and improving patient outcomes. AMMC is also the only participating hospital in Northeast Arkansas admininstering the clot-busting drug t-PA which can dramatically reduce the effects of a stroke. 1 X Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Contributions from the Medical Center consist of donations to local charities and schools to sponsor events used to fulfill their missions. X X X 0 0 0 0 0 1 0 0 0 RONALD K ROONEY 243222 0 0 0 0 0 39327 0 3752 0 286301 0 0 0 BRYAN G JACKSON 154712 0 0 0 0 0 0 0 3752 0 158464 0 0 0 BARRY L DAVIS 167819 0 0 0 0 0 6826 0 3752 0 178397 0 0 0 Part I, Line 6 The CEO, COO and CFO have an incentive plan that has a component based upon EBIDA margin of the organization. Targets for EBIDA margin are set by the Executive Committee OF THE BOARD each year as well as the amount of incentive available to be earned if those targets are achieved. Arkansas Hospital Equipment Finance Authority 521447822 04086RBF5 2003-08-14 4000000 Equipment purchases 0 0 City of Paragould Arkansas 716009633 699129CH3 2007-12-19 9380991 refinancing 0 0 4000000 236368 311368 75000 12974 3377264 2003 0 1 1 1 9380991 9263178 117813 20624 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Form 990, Part VI, Section B, line 11 The Form 990 is prepared by the Controller and CFO of the organization, working with the organization's outside accounting firm. When a draft Form 990 is ready, it is presented for review to the Audit Committee of the Board of Directors. The Audit Committee makes the final review and approves the Form 990 to be filed with the IRS. Form 990, Part VI, Section B, line 12c All Board Members, Officers, Directors and Department Managers review and sign conflict of interest policy each year. Form 990, Part VI, Section B, line 15 The Executive Committee of the Board of Directors, which is made up completely of independent directors, reviews the compensation of the CEO, COO and CFO on an annual basis. In addition to reviewing each individual's performance, the Committee reviews independent survey data for comparison to market. The Committee determines a recommendation that is then presented to the full Board of Directors for approval. Contemporaneous minutes document the deliberations, recommendations and decisions of both the Executive Committee and the Board of Directors. Form 990, Part VI, Section C, line 18 THE FORM 990 AND FORM 1023 ARE AVAILABLE TO PUBLIC UPON REQUEST. Form 990, Part VI, Section C, line 19 AMMC makeS its governing documentS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS available to the public UPON REQUEST. FORM 990, PART XI, LINE 2C AUDIT COMMITTEE THE AUDIT COMMITTEE OF THE HOSPITAL'S BOARD OVERSEES THE AUDIT AND SELECTION OF INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED. ARKANSAS METHODIST MEDICAL CENTER FOUNDATION 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 721562468 PROVIDE FUNDS TO AR METHODIST MEDICAL CENTER AR 501(C)(3) 509(A)(3)(1) ARKANSAS METHODIST MEDICAL CENTER RETIRMENT COMMUNITY INC 900 WEST KINGSHIGHWAY PARAGOULD AR 72450 263215294 OPERATION OF RETIREMENT COMMUNITY AR 501(C)(3) 509(A)(2) arkANSAS METHODIST PHYSICIAN SERVICES 1000 WEST KINGSHIGHWAY PARAGOULD AR 72450 270392274 MEDICAL CARE FOR COMMUNITY AR 501(C)(3) APPLIED FOR 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 0 AMMC PHYSICIAN SERVICES Q 1361863 ARKANSAS METHODIST MEDICAL CENTER FOUNDATION C 49669 arKANSAS METHODIST MEDICAL CENTER FOUNDATION L 0 ARKANSAS METHODIST MEDICAL CENTER FOUNDATION M 0 arKANSAS METHODIST MEDICAL CENTER FOUNDATION N 0 AMMC RETIREMENT COMMUNITY INC D 417563 ARKANSAS METHODIST MEDICAL CENTER FOUNDATION P 77784