2023-11-15T09:00:14-06:00 2022-12-31 FORVIS LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2022-01-01 710707450 WASHINGTON REGIONAL MEDICORP % ACCOUNTING DEPARTMENT WASH 4794631120 3215 N NORTH HILLS BLVD FAYETTEVILLE AR 72703 DJ BURROWS VP & CAO 4794631120 2023-11-11 true DJ BURROWS 999009999 AMBER SHERRILL P00748683 5013721040 2022 2023-04-26 12:10:37Z LARRY SHACKELFORD 3215 N NORTH HILLS BLVD FAYETTEVILLE AR 72703 10404252 false X N/A X 1991 AR WASHINGTON REGIONAL MEDICORP HOLDS A LICENSE TO OPERATE A PACE PROGRAM AND CONTRACT WITH PACE OF THE OZARKS, LLC TO CARRY OUT OPERATIONS. 9 3 0 3 0 0 0 8891046 10404252 0 0 0 0 8891046 10404252 0 0 0 0 0 0 0 0 0 8891094 10404265 8891094 10404265 -48 -13 46 33 0 0 46 33 THE ORGANIZATION IS LICENSED TO OPERATE A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). THE ORGANIZATION HAS CONTRACTED WITH NWA PACE MANAGEMENT, LLC TO OPERATE THE PACE PROGRAM. false false 10404265 10404252 EXPENSES INCURRED IN THE PROVISION AND OPERATION OF A PACE PROGRAM 10404265 true false false false false false false false false false false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false false false false false false false X 9 3 false true false false true true true true true false false true true true true true true false false false X ACCOUNTING DEPARTMENT 4794631120 3215 N NORTH HILLS BLVD FAYETTEVILLE AR 72703 LARRY SHACKELFORD VICE CHAIR 0.0 40.0 X X 0 1014949 23503 THOMAS OLMSTEAD GENERAL COUNSEL 0.0 40.0 X 0 561575 26076 DAVID RATCLIFF MD BOARD MEMBER 0.0 0.0 X 0 535024 23455 DANIEL ECKELS CHAIR 0.0 40.0 X X 0 527091 26066 JACK MORRIS BOARD MEMBER 0.0 0.0 X 0 181116 17053 ANGELIC FLACK EXECUTIVE DIRECTOR - PACE 0.0 40.0 X 0 153206 1744 BRAD BAILEY SECRETARY 0.0 0.0 X X 0 0 0 HANS SAUNDERS BOARD MEMBER 0.0 0.0 X 0 0 0 AMY WENGER BOARD MEMBER 0.0 0.0 X 0 0 0 0 2972961 117897 0 false true false 0 0 MEDICARE & MEDICAID REV FOR PACE PROGRAM 621498 10404252 10404252 10404252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10404252 10404252 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 FUNDS FOR PACE PROGRAM 10403700 10403700 0 0 SERVICE CHARGES 565 565 0 0 . 0 0 0 0 . 0 0 0 0 10404265 10404265 0 0 46 33 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 46 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 46 33 0 0 46 33 46 33 -13 X false true X true false X 0 0 0 0 0 0 0 1122855 5699615 8891046 10404252 26117768 0 0 0 0 1122855 5699615 8891046 10404252 26117768 0 0 0 26117768 0 0 0 0 0 0 1122855 5699615 8891046 10404252 26117768 1.00000 1.00000 0.00000 0.00000 X false true false false false false false false false LARRY SHACKELFORD VICE CHAIR 0 741018 0 65963 0 207968 0 15250 0 8253 0 1038452 0 199417 THOMAS OLMSTEAD GENERAL COUNSEL 0 447482 0 35125 0 78968 0 15250 0 10826 0 587651 0 76548 DANIEL ECKELS CHAIR 0 431187 0 35470 0 60434 0 15250 0 10816 0 553157 0 57869 ANGELIC FLACK EXECUTIVE DIRECTOR - PACE 0 137210 0 4183 0 11813 0 0 0 1744 0 154950 0 0 DAVID RATCLIFF MD BOARD MEMBER 0 419837 0 34283 0 80904 0 15250 0 8205 0 558479 0 77810 JACK MORRIS BOARD MEMBER 0 167513 0 12507 0 1096 0 9001 0 8052 0 198169 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 A RELATED ENTITY, WASHINGTON REGIONAL MEDICAL CENTER, USED THE FOLLOWING TO ESTABLISH THE ORGANIZATION'S CEO'S COMPENSATION: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, SCHEDULE J, PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM PARTICIPATION IN A 457(F) PLAN: LARRY SHACKELFORD - $199,417 TOM OLMSTEAD - $76,548 DAVID RATCLIFF - $77,810 DAN ECKELS - $57,869 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A MEMBER AS PERMITTED UNDER THE ARKANSAS NONPROFIT CORPORATION ACT OF 1993. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS A MEMBER WHO IS AUTHORIZED TO ELECT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY AS PRMITTED UNDER THE ARKANSAS NONPROFIT CORPORATION ACT OF 1993. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER OF THE ORGANIZATION HAS THE RIGHT TO APPROVE CERTAIN ACTIONS OF THE ORGANIZATIONS'S GOVERNING BODY AS ARE RESERVED TO THE MEMBER UNDER THE ARKANSAS NONPROFIT CORPORATION ACT OF 1993. FORM 990, PART VI, SECTION B, LINE 11B AT A DULY CALLED MEETING OF THE ORGANIZATION'S AUDIT AND FINANCE COMMITTEE, WHICH IS COMPRISED OF THE ORGANIZATION'S BOARD OF DIRECTORS, HELD IN NOVEMBER 2023, COPIES OF THE PROPOSED FORM 990 FILING PREPARED ON BEHALF OF THE ORGANIZATION WERE PRESENTED AND REVIEWED WITH THE BOARD MEMBERSHIP BY THE ORGANIZATION'S CHIEF ACCOUNTING OFFICER AND GENERAL COUNSEL. FORM 990, PART VI, SECTION B, LINE 12C THE TERMS OF THE CONFLICT OF INTEREST POLICY ARE INCORPORATED WITHIN THE BYLAWS OF THE ORGANIZATION AND ARE REVIEWED ANNUALLY WITH THE BOARD OF DIRECTORS, EACH OF WHOM ARE REQUIRED TO SIGN AN ACKNOWLEDGMENT THAT THEY HAVE REVIEWED THE POLICY AND ARE AWARE OF ITS TERMS. THE POLICY IS ALSO REVIEWED IN DETAIL AT THE TIME OF NEW BOARD MEMBER ORIENTATION. AS POTENTIAL CONFLICTS ARISE, THOSE CONFLICTS ARE ADDRESSED PURSUANT TO THE POLICY. FORM 990, PART VI, SECTION B, LINES 15A & 15B OFFICERS OF THE ORGANIZATION ARE COMPENSATED FOR THEIR SERVICES ON BEHALF OF THE ORGANIZATION BY A RELATED ORGANIZATION (WASHINGTON REGIONAL MEDICAL CENTER). THE BOARD OF DIRECTORS OF THE MEMBER ORGANIZATION HAS A STANDING COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS OF THE MEMBER ORGANIZATION THAT REGULARLY REVIEW THE PERFORMANCE OF THE MEMBERS OF SENIOR MANAGEMENT OF THE ORGANIZATION, ENGAGE INDEPENDENT COMPENSATION CONSULTANT, TAX AND LEGAL ADVISORS TO ASCERTAIN AND OPINE AS TO THE REASONABLENESS OF TOTAL COMPENSATION PAID TO MEMBERS OF SENIOR MANAGEMENT, AS DETERMINED ON THE BASIS OF COMPENSATION SURVEYS PREPARED BY SUCH ADVISORS, AND WHO DETERMINE THE TOTAL COMPENSATION PAID MEMBERS OF SENIOR MANAGEMENT OF THE ORGANIZATION IN CONFORMANCE WITH THE REBUTTABLE PRESUMPTION REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 FILING, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CERTAIN FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. 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