2023-09-22T13:59:45-05:00 2023-07-31 205857627 TMH P O DRAWER 15099 HATTIESBURG MS 394045099 990 2022-08-01 721379812 PRENTISS REGIONAL HOSPITAL AND EXTENDED CARE FACILITY INC PREN 6017924276 POST OFFICE BOX 1288 PRENTISS MS 394741288 REGGIE MAGEE CHAIRMAN 6017924276 2023-09-22 1 REGGIE MAGEE 999009999 1 RICHARD G TOPP CPA P00144777 6012643519 2023-09-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z REGGIE MAGEE POST OFFICE BOX 1288 PRENTISS MS 39474 0 0 1 X N/A X 1997 MS PRENTISS REGIONAL HOSPITAL & EXTENDED CARE FACILITY, INC. D/B/A JEFFERSON DAVIS COMMUNITY HOSPITAL LEASES ITS FACILITY TO FORREST COUNTY GENERAL HOSPITAL, A NOT FOR PROFIT ORGANIZATION, WHICH IN TURN OPERATES AND MANAGES THE ACUTE CARE HOSPITAL. 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61877 61692 61877 61692 -61877 -61692 1287236 1225544 0 0 1287236 1225544 PRENTISS REGIONAL HOSPITAL & EXTENDED CARE FACILITY, INC. D/B/A JEFFERSON DAVIS COMMUNITY HOSPITAL LEASES ITS FACILITY TO FORREST COUNTY GENERAL HOSPITAL, A NOT FOR PROFIT ORGANIZATION, WHICH IN TURN OPERATES AND MANAGES THE ACUTE CARE HOSPITAL. 0 0 61692 PRENTISS REGIONAL HOSPITAL & EXTENDED CARE FACILITY, INC. D/B/A JEFFERSON DAVIS COMMUNITY HOSPITAL LEASES ITS FACILITY TO FORREST COUNTY GENERAL HOSPITAL, A NOT FOR PROFIT ORGANIZATION, WHICH IN TURN OPERATES AND MANAGES THE ACUTE CARE HOSPITAL. 61692 1 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BRYAN MAXIE 6017924276 1102 ROSE STREET PRENTISS MS 39474 X REGGIE MAGEE CHAIRMAN 1.00 X X 0 0 0 KATHY CLOYD TRUSTEE 0.50 X 0 0 0 WILLIS GRAVES TRUSTEE 0.50 X 0 0 0 SHANELL WILLIAMSON TRUSTEE 0.50 X 0 0 0 HUGH DYESS TRUSTEE 0.50 X 0 0 0 JUDY COLE TRUSTEE 0.50 X 0 0 0 JANICE BRIDGES TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61692 61692 61692 61692 0 0 7446450 6220906 1287236 1225544 1287236 1225544 0 0 X 1287236 1225544 1287236 1225544 1287236 1225544 -61692 0 X 0 0 0 X 97900 97900 3454482 2338572 1115910 38629 38629 0 3805975 3794241 11734 49464 49464 0 1225544 FORM 990, PART VI, SECTION A, LINE 3 LINE 3 EXPLANATION - AS OF JULY 1, 2011, JEFFERSON DAVIS COMMUNITY HOSPITAL (THE HOSPITAL) ENTERED INTO A FIVE YEAR LEASE AGREEMENT WITH FORREST COUNTY GENERAL HOSPITAL (FGH) WHICH WAS EXTENDED UNTIL JULY 30, 2026. AS A RESULT OF THIS AGREEMENT, THE HOSPITAL SUBLEASED THE ASSETS PREVIOUSLY UNDER LEASE BY THE HOSPITAL FROM JEFFERSON DAVIS COUNTY AS WELL AS PERSONAL PROPERTY OWNED BY THE HOPSITAL OUTSIDE THE LEASE WITH THE COUNTY TO FGH (THIS INLUDES THE MAIN HOSPITAL FACILITIES). DURING THE LEASE TERM, FGH WILL OPERATE AND MANAGE THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE HOSPITAL'S ADMINISTRATOR AND CHAIRMAN OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE PROCESS OF MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS ONGOING AS EACH DIRECTOR AND MEMBERS OF THE GENERAL PUBLIC, UPON REQUEST, ARE PROVIDED A COPY OF THE POLICY WITH THE ABILITY TO SCRUTINIZE EACH PROCUREMENT AT BOARD MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.