JACKSONVILLE MEDICAL CENTER INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- JACKSONVILLE MEDICAL CENTER INC (EIN 71-0769555)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201141369349301794
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T09:20:49-04:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3667 | AddressLine1 |
| City | LITTLE ROCK | City |
| State | AR | State |
| ZIP Code | 722033667 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710769555 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH METRO MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 5019857000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 159 | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72078 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LYNN MULLER | Name |
| Title | CFO | Title |
| Date Signed | 2011-05-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5013721040 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAY QUEBEDEAUX CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 159 | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72078 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 36920337 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.northmetromed.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | AR | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION IS TO PROVIDE PERSONAL HEALTHCARE TO YOUR FAMILY THROUGH OUR COMMUNITY HOSPITAL. SEE SCHEDULE O FOR FURTHER DETAILS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 548 | TotalNbrEmployees |
| Total Nbr Volunteers | 65 | TotalNbrVolunteers |
| Total Gross UBI | -342390 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 38383 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5157 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 82754259 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 36309835 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 139615 | InvestmentIncomePriorYear |
| Investment Income Current Year | 222937 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 426351 | OtherRevenuePriorYear |
| Other Revenue Current Year | 357496 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 83358608 | TotalRevenuePriorYear |
| Total Revenue Current Year | 36895425 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 67458 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3474 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 19791644 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16214999 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 71269402 | OtherExpensePriorYear |
| Other Expenses Current Year | 22538388 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 91128504 | TotalExpensesPriorYear |
| Total Expenses Current Year | 38756861 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -7769896 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1861436 | RevenuesLessExpensesCY |
| Total Assets BOY | 23478374 | TotalAssetsBOY |
| Total Assets EOY | 19779166 | TotalAssetsEOY |
| Total Liabilities BOY | 16070132 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13889307 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7408242 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5889859 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION IS TO PROVIDE PERSONAL HEALTHCARE TO YOUR FAMILY THROUGH OUR COMMUNITY HOSPITAL. SEE SCHEDULE O FOR FURTHER DETAILS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 21202509 | Expense |
| Grants | 3474 | Grants |
| Revenue | 36309835 | Revenue |
| Description | PROVIDING ACCESS TO A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES TO INDIVIDUALS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. | Description |
| Total Program Service Expense | 21202509 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | true | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 548 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | AR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LYNN MULLER | NamePerson |
| Telephone Number | 5019857447 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 BRADEN | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72076 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| TOMMY SWAIM | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| PAT BOND | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MURICE GREEN | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MIKE WILSON | |||||||
| BOARD CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | |
| MACK MCALISTER | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| HAROLD SHORT | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| GARY FLETCHER | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| SCOTT LANDRUM | |||||||
| CEO | 40.0 | 188878 | 0 | 415 | X | ||
| JANE ROCKWELL | |||||||
| DIRECTOR OF SUPPORT SERVICES | 40.0 | 87519 | 0 | 7642 | X | ||
| CINDY STAFFORD | |||||||
| DIRECTOR - QUALITY/RISK | 40.0 | 90141 | 0 | 11295 | X | ||
| LYNN MULLER | |||||||
| CFO | 40.0 | 72093 | 0 | 10769 | X | ||
| JACQUELINE DAVIDSON | |||||||
| CNO | 40.0 | 91236 | 0 | 10986 | X | ||
| STEVEN BONDS | |||||||
| CNO | 40.0 | 80660 | 0 | 4882 | X | ||
| MICHAEL SCHIMMING | |||||||
| CEO | 40.0 | 126417 | 0 | 197 | X | ||
| MIKHAIL IVANOVSKY | |||||||
| ANESTHESIOLOGIST | 40.0 | 310033 | 0 | 15344 | X | ||
| JUCELLE OCCIDENTAL | |||||||
| ANESTHESIOLOGIST | 40.0 | 226829 | 0 | 13726 | X | ||
| ROBERT HENDERSON | |||||||
| CRNA | 40.0 | 142039 | 0 | 10581 | X | ||
| TAMMY COPELAND | |||||||
| CRNA | 40.0 | 165701 | 0 | 14613 | X | ||
| MARK SMITH | |||||||
| HOSPITALIST/PHYSICIAN | 40.0 | 280696 | 0 | 7242 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1862242 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 107692 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| SERVICE PROFESSIONALS | |
| NUTRI/ENVIRON SVCS | 1095900 |
| PULASKI EMERGENCY GROUP LLC | |
| ER CONTRACT | 228443 |
| ALLEGIANCE HEALTH MANAGEMENT | |
| MANAGEMENT CONTRACT | 763756 |
| BKD LLP | |
| CPA/AUDITORS | 108253 |
| PINNACLE HOME THERAPY | |
| HH PHYSICAL THERAPY | 102661 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 5157 | AllOtherContributions |
| Total Contributions | 5157 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 611600 | BusinessCode |
| Total Revenue Column | 36309835 | TotalRevenueColumn |
| Related Or Exempt Function Income | 36309835 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 36309835 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 974 | TotalRevenueColumn |
| Exclusion | $974 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 691494 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24912 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 666582 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 666582 | TotalRevenueColumn |
| Exclusion | $666,582 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 221963 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 221963 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 221963 | TotalRevenueColumn |
| Exclusion | $221,963 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| LOSS ON INVESTMENT IN EQUITY INVESTEES | 900099 | -314922 | -$314,922 | |
| CABOT IMAGING CENTER LLC | 900099 | -342390 | -342390 | |
| CAFETERIA SALES | 900099 | 256183 | $256,183 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 92043 | TotalRevenueColumn |
| Exclusion | $92,043 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -309086 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36895425 | TotalRevenueColumn |
| Related Or Exempt Function Income | 36309835 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -342390 | UnrelatedBusinessRevenue |
| Exclusion | $922,823 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3474 | Total |
| Program Services | 3474 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 654135 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 654135 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13038882 | Total |
| Program Services | 5415271 | ProgramServices |
| Management And General | 7623611 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1453814 | Total |
| Program Services | 603794 | ProgramServices |
| Management And General | 850020 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1068168 | Total |
| Program Services | 443628 | ProgramServices |
| Management And General | 624540 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367817 | Total |
| Program Services | 152761 | ProgramServices |
| Management And General | 215056 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76000 | Total |
| Program Services | 31564 | ProgramServices |
| Management And General | 44436 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3246090 | Total |
| Program Services | 1348157 | ProgramServices |
| Management And General | 1897933 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63525 | Total |
| Program Services | 26383 | ProgramServices |
| Management And General | 37142 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4384628 | Total |
| Program Services | 1821011 | ProgramServices |
| Management And General | 2563617 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1122738 | Total |
| Program Services | 466292 | ProgramServices |
| Management And General | 656446 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107125 | Total |
| Program Services | 44491 | ProgramServices |
| Management And General | 62634 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 499206 | Total |
| Program Services | 207329 | ProgramServices |
| Management And General | 291877 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1682959 | Total |
| Program Services | 698962 | ProgramServices |
| Management And General | 983997 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 663270 | Total |
| Program Services | 275467 | ProgramServices |
| Management And General | 387803 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBTS | 9194322 | 9194322 | 0 | 0 |
| REPAIRS & MAINTENANCE | 604638 | 251117 | 353521 | 0 |
| LEASE & RENTAL EXPENSES | 526070 | 218486 | 307584 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38756861 | Total |
| Program Services | 21202509 | ProgramServices |
| Management And General | 17554352 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189417 | BOY |
| EOY | 73981 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4053221 | BOY |
| EOY | 3822502 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1288719 | BOY |
| EOY | 1326197 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 805157 | BOY |
| EOY | 678985 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 44962135 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 33343736 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14292088 | BOY |
| EOY | 11618399 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2614311 | BOY |
| EOY | 2124729 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 235461 | BOY |
| EOY | 134373 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23478374 | BOY |
| EOY | 19779166 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5349629 | BOY |
| EOY | 4478447 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10440000 | BOY |
| EOY | 9205000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 280503 | BOY |
| EOY | 205860 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16070132 | BOY |
| EOY | 13889307 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7408242 | BOY |
| EOY | 5889859 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7408242 | BOY |
| EOY | 5889859 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23478374 | BOY |
| EOY | 19779166 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 939180 | OtherCostOrOtherBasis |
| Book Value | 939180 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 28298947 | OtherCostOrOtherBasis |
| Depreciation | 19731142 | Depreciation |
| Book Value | 8567805 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14876883 | OtherCostOrOtherBasis |
| Depreciation | 13214187 | Depreciation |
| Book Value | 1662696 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 847125 | OtherCostOrOtherBasis |
| Depreciation | 398407 | Depreciation |
| Book Value | 448718 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11618399 | TotalOfBookValueLandBuildings |
| Total Revenue | 36895425 | TotalRevenue |
| Total Expenses | 38756861 | TotalExpenses |
| Excess Or Deficit For Year | -1861436 | ExcessOrDeficitForYear |
| Other | $343,053 | OtherAmount |
| Total Adjustments | 343053 | TotalAdjustments |
| Excess Or Deficit Per FS | -1518383 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 37263390 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 663 | OtherRevenues |
| Revenue Not Rptd F990 | 663 | RevenueNotRptdF990 |
| Revenue Subtotal | 37262727 | RevenueSubtotal |
| Other Revenues Not Included | -367302 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -367302 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 36895425 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 38781773 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 24912 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 24912 | ExpensesNotRptdF990 |
| Expenses Subtotal | 38756861 | ExpensesSubtotal |
| Total Expenses Per Form990 | 38756861 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | FORM 990, SCHEDULE D, PART X | THE MEDICAL CENTER ADOPTED THE PROVISIONS OF ASC TOPIC 740 (ASC 740), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ON JULY 30, 2010. NO AMOUNTS WERE RECORDED AS A RESULT OF THE IMPLEMENTATION OF ASC 740. |
| RECONCILIATION OF CHANGE IN NET ASSETS | FORM 990, SCHEDULE D, PART XI | CHANGE IN NET ASSETS OF REBSAMEN MEDICAL FOUNDATION $663 CABOT IMAGING CENTER, LLC K-1 LOSS $342,390 TOTAL $343,053. |
| RECONCILIATION OF REVENUE | FORM 990, SCHEDULE D, PART XII | CHANGE IN NET ASSETS OF REBSAMEN MEDICAL FOUNDATION $663 TOTAL INCLUDED IN AUDITED FINANCIAL STATEMENTS BUT NOT INCLUDED ON FORM 990 $663 CABOT IMAGING CENTER, LLC K-1 LOSS $(342,390) RENTAL EXPENSE $(24,912) TOTAL INCLUDED ON FORM 990 BUT NOT INCLUDED ON AUDITED FINANCIAL STATEMENTS $(367,302) |
| RECONCILIATION OF EXPENSES | FORM 990, SCHEDULE D, PART XIII | RENTAL EXPENSE $24,912 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 125. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 308804 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 308804 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2550767 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3872778 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2859571 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3872778 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 308804 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2436 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2436 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4197817 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4180372 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17445 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3180 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3180 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4203433 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4180372 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 23061 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7063004 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8053150 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 331865 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $3,534,297 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 13229941 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12918161 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 311780 | MedicareSurplusOrShortfall |
| Costing Methodology Used | CostingMethodologyUsed | |
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CABOT IMAGING CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | 50% JOINT VENTURE WITH RAPA | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.50000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.00000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Metro Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 Braden Street | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72076 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | THE COST TO CHANGE RATIO AS CALCULATED USING WORKSHEET 2 WAS USED TO DETERMINE THE COSTS ON LINE 7. | CostingMethodUsed |
| Percent Of Total Expense Expln | BAD DEBT EXPENSE IN THE AMOUNT OF $9,194,322 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | THE MEDICAL CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS 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 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 CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST TO CHARGE RATIO. | BadDebtFootnote |
| Shortfall As Community Benefit | LINE 6 WAS CALCULATED USING THE MEDICARE COST REPORT. | ShortfallAsCommunityBenefit |
| Needs Assessment | NMMC BOARD AND MANAGEMENT SERVE TO MEET THE NEEDS OF THE SURROUNDING COMMUNITIES. SERVICES ARE EVALUATED ON A CONSISTENT BASIS TO ASSURE THE CENTER IS A PROPER FIT FOR THE AREA. | NeedsAssessment |
| Patient Education Assistance | EVERY PATIENT RECEIVES A HANDBOOK WITH INFORMATION REGARDING OUR CHARITY POLICY. UNINSURED PATIENTS ARE PUT IN CONTACT WITH MASH FOR MEDICAID ELIGIBILTY POTENTIAL. | PatientEducationAssistance |
| Community Information | NMMC PRIMARILY SERVES THE JACKSONVILLE AND CABOT COMMUNITIES. THESE ARE GROWING POPULATIONS, AND THE CENTER STRIVES TO MAINTAIN SERVICES NEEDED BY THE COMMUNITIES. | CommunityInformation |
| Community Building Activities | NMMC PERSONNEL ATTEND NUMEROUS EVENTS THROUGHOUT THE YEAR PROMOTING HEALTH AND WELLNESS. THE CENTER CONDUCTS SCREENINGS, HANDS OUT INFORMATION AND ANSWERS QUESTIONS ON RELATED TOPICS. | CommunityBuildingActivities |
| Other Information | NMMC CONDUCTS QUARTERLY BLOOD DRIVES AND PROVIDES SEMINARS ON HEALTH RELATED TOPICS OPEN TO THE COMMUNITY. WE EDUCATE FACILITIES ABOUT SERVICES AVAILABLE TO THEIR RESIDENTS. | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT LANDRUM | |||||||||||||
| 188878 | 0 | 0 | 0 | 0 | 0 | 351 | 0 | 64 | 0 | 189293 | 0 | 0 | 0 |
| JANE ROCKWELL | |||||||||||||
| 87519 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7642 | 0 | 95161 | 0 | 0 | 0 |
| MIKHAIL IVANOVSKY | |||||||||||||
| 310033 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15344 | 0 | 325377 | 0 | 0 | 0 |
| JUCELLE OCCIDENTAL | |||||||||||||
| 226829 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 13726 | 0 | 240555 | 0 | 0 | 0 |
| ROBERT HENDERSON | |||||||||||||
| 142039 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 10581 | 0 | 152620 | 0 | 0 | 0 |
| TAMMY COPELAND | |||||||||||||
| 165701 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 14613 | 0 | 180314 | 0 | 0 | 0 |
| MARK SMITH | |||||||||||||
| 280696 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7242 | 0 | 287938 | 0 | 0 | 0 |
| MICHAEL SCHIMMING | |||||||||||||
| 126417 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 197 | 0 | 126614 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| CITY OF JACKSONVILLE ARKANSAS | ||||||
| 716042693 | 469234DJ4 | 2005-12-01 | 9344386 | REFUND BONDS ISSUED 8/27/96 & 2/10 | false | false |
| CITY OF JACKSONVILLE ARKANSAS | ||||||
| 716042693 | 469234DX3 | 2006-04-01 | 3596549 | REFUND BONDS ISSUED 10/8/92 & 6/5/ | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Amount DefeasedAmountDefeased | Amount UnspentAmountUnspent | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 9344386 | 937500 | 8252106 | 0 | 154780 | 0 | 0 | 2006 | true | true | true | true |
| 3596549 | 43026 | 3553323 | 0 | 43026 | 0 | 0 | 2006 | true | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
| false | false | false | false | true | 0.00000 | 0.00000 | 0.00000 | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| false | false | false | false | false | false |
| false | false | false | false | false | false |
Schedule L IRS990ScheduleL
Form990 Schedule L Part III Form990ScheduleLPartIII (2 entries)
| Name Of Interested PersonNameOfInterestedPerson | Relationship With OrganizationRelationshipWithOrganization | Amount Of GrantAmountOfGrant | Type Of AssistanceTypeOfAssistance |
|---|---|---|---|
| CINDY STAFFORD | OFFICER/DIRECTOR | 1830 | TUITION REIMB |
| JACQUELINE DAVIDSON | OFFICER | 501 | TUITION REIMB |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MIKE WILSON | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD CHAIRMAN | Relationship |
| Amount Of Transaction | 890732 | AmountOfTransaction |
| Description Of Transaction | BROTHER OWNS 1ST ARKANSAS BANK | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CONTROL OF MANAGEMENT DUTIES | FORM 990, PART VI, SECTION A, LINE 3 | THE CEO,CFO,CNO, AND DIRECTOR OF SUPPORT SERVICES ARE ALLEGIANCE EMPLOYEES. (CFO & CNO PAID BY NMMC, BUT SALARY EXPENSE DEDUCTED FROM ALLEGIANCE MONTHLY MGMT FEE.) |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| REVIEW PROCESS FOR FORM 990 | FORM 990, PART VI, SECTION B, LINE 11A | THE CEO AND CFO OF THE ORGANIZATION WILL REVIEW FORM 990. THEY WILL THEN PROVIDE A COPY OF FORM 990 TO THE BOARD OF DIRECTORS OF THE ORGANIZATION PRIOR TO FILING. |
| MONITORING & ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY APPLIES TO INDIVIDUALS WHO SERVE AS DIRECTORS, MANAGERS, CHAIRS OF CLINICAL DEPARTMENTS OR ANY OTHER MEDICAL STAFF MEMBER OR OTHER LICENSED INDEPENDENT PRACTITIONER THAT HAS THE ABILITY TO AFFECT THE SAFETY OR QUALITY OF CARE, TREATMENT, OR SERVICES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST. DISCLOSURE WILL OCCUR THROUGH AN ANNUAL CONFLICT OF INTEREST STATEMENT AND THE DISCLOSURE OF OTHER ACTUAL OR POTENTIAL CONFLICTS AS THEY ARISE. ANY PERSONAL OR BUSINESS ACTIVITIES THAT MAY RAISE CONCERNS REGARDING CONFLICTS OF INTEREST MUST BE REVIEWED WITH, AND APPROVED IN ADVANCE, BY THE EMPLOYEE'S IMMEDIATE SUPERVISOR OR THE COMPLIANCE OFFICER. IF A COLLEAGUE BELIEVES THAT A CONFLICT OF INTEREST MAY EXIST, THE COLLEAGUE IS OBLIGATED TO REPORT THE SUSPECTED CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR OR THE COMPLIANCE OFFICER. |
| COMPENSATION DETERMINATION PROCESS | FORM 990, PART VI, SECTION B, LINES 15A & 15B | THE BOARD OF DIRECTORS DETERMINES COMPENSATION FOR ALL OFFICERS USING COMPARABILITY DATA. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBSAMEN REGIONAL MEDICAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 159 | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72078 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 716048978 | EIN |
| Primary Activities | SUPPORT | PrimaryActivities |
| Legal Domicile State | AR | LegalDomicileState |
| Exempt Code Section | 3 | ExemptCodeSection |
| Public Charity Status | 11 TYPE I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBSAMEN ANESTHESIA INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 BRADEN STREET | AddressLine1 |
| City | JACKSONVILLE | City |
| State | AR | State |
| ZIP Code | 72076 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710860208 | EIN |
| Primary Activity | BILLING SERVICES | PrimaryActivity |
| Legal Domicile State | AR | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Share Of Total Income | 372935 | ShareOfTotalIncome |
| Share Of EOY Assets | 30006 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |