2011-08-11T10:34:04-05:00 2010-09-30 BKD LLP 190 E Capitol Street Suite 500 Jackson MS 392012190 990 2009-10-01 640926753 Marion Regional Medical Center Inc MARI 6623773977 830 South Gloster Street Tupelo MS 38801 Joe Reppert 2011-08-15 Penny Wood CPA 6019486700 2009 2016-02-24 21:20:13Z Joe Reppert 830 South Gloster Street Tupelo MS 38801 19352218 false X www.nmhs.net/hamilton/ X 2000 DE Marion Regional Medical Center, Inc. operates a 36 bed acute care hospital and a 79 bed nursing home located in Hamilton, Alabama. 5 5 266 32 20239 19239 22537 42912 19830196 18895112 570305 -9126 412695 409437 20835733 19338335 0 0 0 0 11844602 10913086 0 0 0 10778550 11555818 22623152 22468904 -1787419 -3130569 12660934 12247550 3179572 6272551 9481362 5974999 MARION REGIONAL MEDICAL CENTER, INC. OWNS AND OPERATES A 36 BED ACUTE CARE HOSPITAL AND A 79 BED NURSING HOME LOCATED IN HAMILTON, ALABAMA CALLED NORTH MISSISSIPPI MEDICAL CENTER-HAMILTON (NMMC-HAMILTON). NMMC-HAMILTON IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ORGANIZATION. THE MISSION OF NMHS IS TO CONTINUOUSLY IMPROVE THE HEALTH OF THE PEOPLE OF OUR REGION. NMMC-HAMILTON WORKS TO ACHIEVE THIS CORPORATE MISSION TO IMPROVE THE HEALTH OF THE PEOPLE OF THIS REGION BY PROVIDING CONVENIENTLY ACCESSIBLE, COST-EFFECTIVE HEALTH CARE OF THE HIGHEST QUALITY. false false 21014850 18942208 NMMC-Hamilton serves Marion county Alabama and the surrounding area. In fiscal year 2010, there were over 1,000 inpatient admissions, over 7,000 emergency department visits, and over 12,300 outpatient visits. NMMC-Hamilton uses Press Ganey, the largest patient satisfaction survey company in the nation, that works with more than 7,000 healthcare facilities. Randomly selected patients are asked about their experience with inpatient, outpatient, ER, and long term care services. The four-bed Intensive Care Unit offers invasive and non-invasive monitoring for medical and surgical patients. The hospital also has 10 certified swing beds for patients who need extended care. NMMC-Hamilton offers 24-hour emergency services. The Emergency Room is staffed by well-equipped, highly qualified nurses and physicians. Emergency air ambulance services are readily available for critical care transport when needed. Outpatient services include same-day surgery, physical therapy, speech therapy, occupational therapy, laboratory and cardiac monitoring. Cardiac stress tests and holter monitoring are also offered. NMMC-Hamilton is the recipient of the VHA Leadership Award, honoring the hospital for meeting or exceeding national performance standards for clinical care and quality. VHA serves more than 1,400 not-for-profit hospitals and more than 24,000 non-acute health care organizations nationwide. NMMC-Hamilton was one of only 38 VHA member organizations to receive a 2009 Leadership Award for Clinical Excellence. One of the primary ways NMMC-Hamilton serves the community is by providing care to various populations for which it receives no compensation or receives compensation at rates significantly less than established rates. The board of directors of NMMC-Hamilton has established a policy under which the hospital provides care, without charge, to needy members of its community. The charity care policy states that NMMC-Hamilton will provide necessary hospital services to patients free of charge with household income levels based on the median income for Mississippi compared to the median income nationally. NMMC-Hamilton believes this adjustment is also appropriate for the geographic area of Alabama, where its hospital facility is located. The Mississippi Adjusted Poverty Guidelines is approximately 75% of the federal poverty rate. The policy further provides patients with household income levels above the Mississippi Adjusted Poverty Guidelines will be liable for no more than the amount that their household income exceeds the applicable federal poverty guidelines. The policy applies to individuals who reside in Marion County. Patients from outside the county may also be granted charity care based on the judgment of NMMC-Hamilton management depending on their individual circumstances. The policy also requires the patient to cooperate fully with NMMC-Hamilton's request for information with which to verify the patient's eligibility. Following that policy, the hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. Charges forgone, based on established rates, totaled approximately $2,044,000 in fiscal year 2010. Based on the gross charges provided to charity patients compared to total hospital gross charges, 4% of all services in fiscal year 2010 were provided on a charity basis. The net cost of charity care provided by NMMC-Hamilton was approximately $772,000 in fiscal year 2010. The total cost estimate is based on the ratio of costs to charges for NMMC-Hamilton. All of the forgone charges mentioned above are netted against patient service revenue to arrive at net patient service revenue as reflected as program service revenue on Part VIII on Form 990 in order to be consistent with financial statement reporting and are not reported as functional expenses on the tax return. 21014850 true true false false false false false false false true true false false false false false false false false false true false false true false false false false false false false false false false false false false true false false false true 48 0 true 266 true true true false false false false false false false false 5 5 false false false false true true true true true false false false true true true true true true true true true X JOE REPPERT 6623773977 830 SOUTH GLOSTER STREET Tupelo MS 38801 Ken Hammitte 1.0 X 0 0 0 Sonny Nix 1.0 X 0 0 0 Al Tidwell 1.0 X 0 0 0 Bobby Wallace 1.0 X 0 0 0 Judy Wilson 1.0 X 0 0 0 Gerald Wages 1.0 X 0 848369 8020 Bruce Toppin 1.0 X 0 298009 8020 Joe Reppert 1.0 X 0 452988 2860 Donald Jones 40.0 X 145332 0 5604 Cynthia Otts 40.0 X 120717 0 2928 Jeannie Miller 40.0 X 102537 0 5233 Robert Jones X 0 223281 6430 368586 1822647 39095 3 true true false Stephen Sanders MD 1139 Harbor Light Trail JASPER AL 35504 Physician Services 336000 4MD2 Inc PO Box 1952 TRAVERSE CITY MI 496851952 Physician Services 316496 Thomas J Overman 229 General Screven Way Suite 5 HINESVILLE GA 313133054 Physician Services 234400 Alliance Healthcare PO Box 96485 CHICAGO IL 60693 MRI Services 172827 4 5309 8948 28655 42912 Net Patient service Revenue 900099 18842615 18842615 Related Rental Income 900099 52497 52497 18895112 1747 1747 0 0 3010 13883 -10873 -10873 -10873 0 0 0 Employee Drugs 900099 324750 324750 Cafeteria Revenue 900099 47096 47096 EQUITY IN MARION REGIONAL LLC 621610 20239 20239 17352 17352 409437 19338335 18942208 20239 332976 0 0 0 0 0 0 7869985 7001534 868451 398058 398058 2086167 2086167 558876 497660 61216 374664 374664 4088 4088 40705 40705 0 0 0 2547774 2547774 26392 26392 3134920 3134920 179183 179183 0 724243 724243 13260 13260 0 16768 16768 0 0 969053 969053 100066 100066 Bad Debt Expense 2770082 2770082 Taxes and Licenses 197814 197814 Repairs and Maintenance 183197 183197 RECRUITMENT EXPENSE 93800 93800 Dues and Subscriptions 58065 58065 121744 116880 4864 22468904 21014850 1454054 0 1325 69116 877475 546105 2902154 3496256 353474 342238 25083 25083 15126621 7447060 8367465 7679561 791 15244 133167 73947 12660934 12247550 2959629 3503472 219943 2769079 3179572 6272551 X 9458041 5947456 23321 27543 9481362 5974999 12660934 12247550 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 216557 216557 0 5741696 2670887 3070809 0 8865649 4694896 4170753 0 302719 81277 221442 7679561 0 Due to Affiliates 2556165 Asset Retirement Obligation 212914 2769079 19338335 22468904 -3130569 -375794 -375794 -3506363 19379439 41104 41104 19338335 19338335 22468904 22468904 22468904 Schedule D, Part X, Line 2: Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. Schedule D, Part XI, Line 8: Book/Tax Difference in Marion Regional, LLC $41,104 Pension-related changes other than net periodic pension cost <$421,120> Increase in interest in net assets of affiliated foundation $4,222 Schedule D, Part XII, Line 2d: Book/Tax Difference in Marion Regional, LLC $41,104 true true X true X 75. false false true true false true true 743834 743834 0.03780 3188540 4857871 -1669331 0.08470 3932374 4857871 -925497 0.04690 3932374 4857871 -925497 0.04690 false 1008164 0 5116734 5420920 -304186 X true true Marion Regional Medical Center

1256 Military Street Hamilton AL 35570

X Marion Regional Medical Ctr Nursing Home

1256 Military Street Hamilton AL 35570

Long Term Acute Care Facility Marion Regional Medical Center, Inc. does not use the Federal Poverty Guidelines to determine eligibility for discounted care. The Federal Poverty Guidelines are used only for free care. Discounted care is given to anyone regardless of income level if they do not have insurance. Marion Regional Medical Center will provide its prevalent managed care discount to any patient that meets Marion Regional Medical Center's definition of uninsured (an individual having no third party coverage by commercial third party insurer, an ERISA plan, Medicare, Medicaid, SCHIP, Champus or other coverage for all or part of their bill). Marion Regional Medical Center's community benefit information is included in the community benefit report of its parent company, North Mississippi Health Services, Inc. North Mississippi Health Services (NMHS) is a diversified regional health care organization, which serves 24 counties in north Mississippi and northwest Alabama from headquarters in Tupelo, MS. The NMHS organization covers a broad range of acute diagnostic and therapeutic services, offered through North Mississippi Medical Center in Tupelo; a community hospital system with locations in Eupora, Iuka, Pontotoc, West Point, MS, and Hamilton AL; North Mississippi Medical Clinics, a regional network of more than 30 primary and specialty clinics; and nursing homes. NMHS offers a comprehensive portfolio of managed care plans. A cost to charge ratio was used for the amounts reported in the table for Line 7. The cost to charge ratio for Line 7 was calculated using Worksheet 2. Not Applicable Bad Debt Expense of $2,770,082 was included in total expense on Form 990, Part IX, Line 25, Column (A), but was subtracted from total expense for purposes of calculating the percentage of total expense in column (F). Marion Regional Medical Center's financial statements do not include a footnote specifically concerning bad debt. Bad debt is shown as a separate line item on the face of the income statement. The amount of bad debt booked each year is based on a review of outstanding receivables and their age from date of service. The older the account, the higher the reserve percentage used to estimate bad debt. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluations and specific circumstances of the account. The bad debt expense at cost in Part III Line 2 was calculated using the cost to charge ratio from Worksheet 2. Marion Regional Medical Center (MRMC) follows the Catholic Health Association guidelines and does not include bad debt in any community benefit amounts. MRMC, however, believes that some portion of bad debt results from patients who could qualify for charity care but has no way of making an estimate of the amount and therefore has answered "zero" for Part III Line 3. The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. Lines 5, 6, & 7 do not include certain Medicare programs and costs and thus do not reflect all of the organization's revenues and costs associated with its participation in Medicare programs. Additional revenues and costs not reported on Lines 5, 6, & 7 include those associated with the organization's Medicare outpatient lab, ambulance and therapy services. Total revenues from these activities were $231,910 and total costs were $432,214 for a net shortfall of $200,304. When combined with the shortfall reported on Line 7, the net shortfall from all Medicare programs is $504,490. Marion Regional Medical Center does not pursue collection of amounts determined to qualify as charity care. Marion Regional Medical Center utilizes varied but complimentary methods to assess the health care needs of the community it serves. Marion Regional Medical Center and Marion County are included in the North Mississippi Health Services Community Health Assessment which is performed every three years and provides information on health status, utilization of health services, healthy beliefs and satisfaction with health care services. The North Mississippi Health Services Community Health Assessment covers the 24 county service area including Marion County and provides information by county. In addition, the North Mississippi Health Services Community Relations Facilitator conducts routine visits with our internal and external stakeholders across the entire service area including Marion County. The information gathered through several qualitative survey questions is used to determine our community's needs for the entire service area as well as the local service area for each hospital such as Marion Regional Medical Center. Explanations of the Marion Regional Medical Center charity care policy are communicated in a variety of forms including signage at all admission and registration areas, on the web site, on bills and statements, and in admission packets. Financial counselors assist the patient and responsible parties with determining eligibility for government programs, primarily Medicaid, and charity care status. The patient can apply for charity care at any time from the date of service through the collection process and once qualified and approved all collection efforts are stopped. Marion Regional Medical Center serves more than 29,000 people in Marion County, Alabama and the surrounding area. The population for the service area is projected to remain essentially flat over the next five years. Age demographics for the service area show that approximately 22% of the population is under 18 years of age, approximately 59% is between 18 and 64 years of age and that 19% is 65 or older. Caucasians make up 93% of the service area's population while African Americans make up 4% and Hispanics and others make up 3%. Median household income of $31,602 for the service area is below the overall average for Alabama and significantly less than the nationwide average. The patient population for Marion Regional Medical Center is covered by insurance or is uninsured as follows: 41.06% Medicare, 15.93% Medicaid, and 30.87% private insurance with 12.14% being uninsured. Not Applicable How the organization's hospitals further its exempt purpose by promoting the health of the community: Marion Regional Medical Center has a commitment to a wide variety of community health outreach activities, which are coordinated by the community health coordinator and are staffed by Marion Regional Medical Center employees who volunteer their time to help with these events and activities. The community health coordinator assists in educating the community on health-related issues by organizing and presenting various health fairs and seminars. These events are held at local businesses, schools and community organizations and address a variety of health-related topics. In addition, the hospital sponsors cholesterol, blood pressure, vision, memory, and heart-risk screening events, through which tests are made available to the public for a nominal fee or at no charge with the majority of the costs incurred absorbed by the hospital. As noted above, Marion Regional Medical Center (MRMC) is part of North Mississippi Health Services (NMHS). NMHS operates North Mississippi Medical Center and four other community hospitals in addition to MRMC, as well as, North Mississippi Medical Clinics, which operates more than 30 medical clinics. Some of these facilities operate at an ongoing financial loss and NMHS provides operating funds in the form of working capital loans that have no set repayment date. These working capital loans have historically been converted to capital transfers in many cases, and therefore, the loans are forgiven such that the facility never makes repayment. NMHS does this in order to provide access to a variety of services across the service area and is an intentional part of its business model. The Community Health department that is part of NMMC coordinates a variety of community health activities across the service area as well. States Community Benefit Report Filed: Marion Regional Medical Center does not file a community benefit report with the state of Mississippi as there is no requirement to do so. The community benefit report is available online at nmhs.net. X X X X X false true false false false false false false false Gerald Wages 0 444917 0 177119 0 226333 0 4900 0 3120 0 856389 Bruce Toppin 0 224620 0 66958 0 6431 0 4900 0 3120 0 306029 Joe Reppert 0 336586 0 96866 0 19536 0 0 0 2860 0 455848 Donald Jones 128590 0 13223 0 3519 0 2484 0 3120 0 150936 0 Robert Jones 0 173881 0 47898 0 1502 0 3310 0 3120 0 229711 Part I, Line 4b: Participants: Gerald Wages $208,380 Joseph A. Reppert $8,461 Terms & Conditions: North Mississippi Health Services, Inc. (NMHS) Adopted the management deferred annuity plan (the Plan) on October 1, 1998. Participants in the plan are designated by the compensation committee of the board of directors of NMHS. At the beginning of each plan year, NMHS shall pay a contribution, less witholding for taxes, to the participant's annuity contract, which is a deferred annuity contract selected, owned, and controlled by the participant. The contribution is determined by multiplying the participant's compensation in the preceding plan year by a percentage set forth in appendix b of the plan. A participant is terminated from the plan on the earliest of: (1) the date the board determines the employee is no longer a participant; (2) the date the participant retires; (3) the date that the participant dies; or (4) the date the participant no longer is employed by NMHS for reasons other than retirement or death. Form 990, Page 6, Part VI, Section A, Line 6: Marion Regional Medical Center, Inc. is a not-for-profit, nonstock, membership corporation of which North Mississippi Health Services, Inc. is the sole member and has sole voting control. Form 990, Page 6, Part VI, Section A, Line 7a: The Governance Committee of North Mississippi Health Services, Inc. (NMHS), which is made up of past Chairmen, nominate candidates for the Board. These candidates are then approved by the Board of NMHS. Form 990, Page 6, Part VI, Section A, Line 7b: The Board of North Mississippi Health Services, Inc. approves all transactions that exceed $1 million. Form 990, Page 6, Part VI, Section B, Line 11A: The Form 990 goes through a review process in the Accounting Department. The accountant for each facility reviews the returns for reasonableness and accuracy. All totals are tied to the audit reports, and all amounts are cross-referenced to schedules or other parts of the actual return. Once the accountant reviews, the Accounting Supervisor and the Director of Accounting reviews. The Supervisor does a detailed review by checking the return for the same items that the accountant checked for. Then the Director does a more high level review, reading the return for reasonableness and comparing prior year amounts to current year amounts. Finally, the VP of Finance reviews the return for reasonableness. The returns are then sent to the Executive VP/Treasurer to be reviewed. The Treasurer signs the return and it is then sent to the IRS. Form 990, Page 6, Part VI, Section 12c: An annual conflict of interest questionnaire is required to be completed by all officers and directors of the organization. The questionnaire is reviewed by North Mississippi Health Services, Inc.'s compliance officer and Conflict Committee. The Conflict Committee reviews conflict transactions and makes recommendations to the board of directors regarding conflict transactions in accordance with the organization's conflict of interest policy. All members of the Conflict Committee are prohibited from engaging in transactions with the organization or its affiliates during their tenure on the Conflict Committee and one year after their service concludes. Form 990, Page 6, Part VI, Section B, Line 15 a&b: An independent compensation consulting firm, The Hay Group, is used to help establish the compensation of the CEO, Executive Director, other officers, and key employees. The firm presents their independent analysis, which contains comparability data, to the Compensation Committee of North Mississippi Health Services, Inc. (NMHS). In addition to this, the VP of Human Resources obtains another independent analysis from another compensation consulting firm in order to verify the information provided by The Hay Group. The compensation of the individuals are then approved by the Compensation Committee. The salaries of NMHS' CEO and senior leadership are then reviewed by the NMHS Board of Directors. The individual whose compensation is being discussed is not present during the discussion or approval of their compensation. The discussions and decisions regarding the compensation are documented in the minutes of the meetings. Compensation of these individuals is approved annually. Form 990, Page 6, Part VI, Section C, Line 19: The governing documents, conflict of interest policy, and financial statements are available to the public upon request. A consolidated statement of operations is available on the organization's website. Form 990, Page 7, Part VII, Column (E): Estimate of average hours worked per week devoted to related organization: Gerald Wages 1 hr Tishomingo Health Services, Inc. 1 hr Clay County Medical Corporation 1 hr Webster Health Services, Inc. 1 hr Pontotoc Health Services, Inc. 35 hrs North Mississippi Health Services, Inc. Bruce Toppin 1 hr North Mississippi Medical Clinics, Inc. 1 hr Tupelo Service Finance 1 hr Tishomingo Health Services, Inc. 1 hr Clay County Medical Corporation 1 hr Webster Health Services, Inc. 1 hr Pontotoc Health Services, Inc. 1 hr North Mississippi Medical Center, Inc. 1 hr North Mississippi Emergency Services, Inc. 1 hr North Mississippi Management Services, Inc. 30 hrs North Mississippi Health Services, Inc. Robert Jones 1 hr Clay County Medical Corporation 39 hrs Webster Health Services, Inc. Joe Reppert 1 hr North Mississippi Medical Clinics, Inc. 1 hr Tupelo Service Finance 1 hr Tishomingo Health Services, Inc. 1 hr Clay County Medical Corporation 1 hr Webster Health Services, Inc. 1 hr Pontotoc Health Services, Inc. 1 hr North Mississippi Medical Center, Inc. 1 hr North Mississippi Emergency Services, Inc. 1 hr North Mississippi Management Services, Inc. 30 hrs North Mississippi Health Services, Inc. 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