2023-11-14T16:48:53-06:00 2022-12-31 620713250 KRAFTCPAS PLLC 555 GREAT CIRCLE ROAD NASHVILLE TN 37228 990 2022-01-01 621808817 HEALTH SERVICES MANAGEMENT INC HEAL 6158961191 206 FORTRESS BLVD MURFREESBORO TN 37128 SCOTT FISHER VP OF FINANCE 6158961191 2023-11-14 1 SCOTT FISHER 999009999 1 FRANCES E LEAHY P00713593 6152427351 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JAMES SHATZ 206 FORTRESS BLVD MURFREESBORO TN 37128 133717566 0 X N/A X 2000 TN TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 6 3 3843 0 0 0 1724219 1854690 122572362 129025337 203880 348138 54329 -79317 124554790 131148848 0 0 0 0 64358409 71789306 0 0 0 66720125 72158119 131078534 143947425 -6523744 -12798577 127545587 180141587 51504748 117870146 76040839 62271441 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. 0 0 132404877 129554517 TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES IN INDIANA, TENNESSEE, TEXAS, AND FLORIDA. 132404877 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 722 0 1 3843 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X SCOTT FISHER 3524170360 206 FORTRESS BLVD MURFREESBORO TN 37128 JIM SHATZ CEO 40.00 X X 623219 0 12805 SCOTT FISHER CFO 40.00 X X 622192 0 22055 WILLIAM NEELY CHIEF LEGAL OFFICER 40.00 X X 587134 0 8208 TIMOTHY PRIDDY DIRECTOR 1.00 X 88500 0 0 RANDY SHUCK CHAIRMAN, DIRECTOR 1.00 X 88500 0 0 ROBERT CONROY DIRECTOR 1.00 X 81000 0 0 JOSH WHITE CHIEF OPERATING OFFICER 40.00 X 431225 0 2513 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 40.00 X 289729 0 17556 KEVIN BAXTER VP OF OPERATIONS 40.00 X 251498 0 5792 JERALD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 40.00 X 211024 0 13146 ANITA MAMONE CHIEF LEGAL & GOVERNANE OFFICER 40.00 X 179993 0 6537 MARK RICHARDSON CORPORATE DIRECTOR OF COMPLIANCE AND AUDIT 40.00 X 188806 0 4840 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVICES 40.00 X 177322 0 13 CLINT WELLS VP, REVENUE CYCLE MANAGEMENT 40.00 X 176432 0 11371 MATTHEW FILE ADMINISTRATOR 40.00 X 198891 0 13 GLENDA COLVIN ADMINISTRATOR 40.00 X 176874 0 2785 SHELBY JACKSON ADMINISTRATOR 40.00 X 165489 0 2054 JACOB MITCHELL ADMINISTRATOR 40.00 X 156200 0 1938 PAUL WILLIAMS ADMINISTRATOR 40.00 X 136113 0 20117 4830141 0 131743 56 0 1 0 RELIANT REHABILITATION 5800 GRANITE PKWY STE 1000 PLANO TX 75024 THERAPY 10631106 AMERISOURCE FUNDING INC PO BOX 4738 HOUSTON TX 77210 STAFFING AGENCY 2559979 MYSHYFT LLC 429 E VERMONT ST STE 110 INDIANAPOLIS IN 46202 STAFFING AGENCY 1966120 CRESTMARK PHARMACY SERVICES LLC 132 HARRISION AVE PANAMA CITY FL 32401 PHARMACY 1626507 CRESTMARK PHARMACY SERVICES OF TEXAS LL 220 ELLA ST TOMBALL TX 77375 PHARMACY 1491915 34 1842750 11940 1854690 PATIENT SERVICE REVENUE 623000 128461211 128461211 CRESTMARK PHARMACY 456110 344095 344095 MANAGEMENT FEE REVENUE 623000 171920 171920 CABLE & PHONE REVENUE 812900 26106 26106 CAFETERIA & VENDING REVENUE 722514 8580 8580 13425 13425 129025337 451587 451587 1495295 2184367 -689072 -689072 -689072 257859 23043 280733 103618 -22874 -80575 -103449 -80575 -22874 OTHER REVENUE 900099 609755 609755 609755 131148848 129554517 0 -260359 X 4101408 869158 3232250 59522892 59391654 131238 143336 143336 3336707 3280986 55721 4684963 4474523 210440 1051657 1051657 384293 384293 20574160 20153824 420336 2277903 797132 1480771 4076384 2281928 1794456 780456 138847 641609 13831596 13544477 287119 199388 100015 99373 608486 336936 271550 456597 430720 25877 592709 373037 219672 3492382 3268045 224337 4245099 4097543 147556 TAXES 4716640 4261367 455273 FOOD 3980933 3980933 PROGRAM SUPPLIES 3817751 3708719 109032 PHARMACEUTICAL DRUGS 3031519 3031519 4040166 3740178 299988 143947425 132404877 11542548 0 32284925 17817130 8305494 8000168 19879897 18342149 1748909 1712561 378730 410369 719082 948177 116856303 54403615 62993486 62452688 359677 331772 34813 62126 840574 70064447 127545587 180141587 7242650 8741902 719487 656955 37393582 35916978 6149029 72554311 51504748 117870146 X 76040839 62271441 76040839 62271441 127545587 180141587 -12798577 -970821 0 X X 0 1 X 1 0 X 152698 74852 10935145 1724219 1854690 14741604 130781671 133495798 130742072 122572362 129025337 646617240 3384214 3419006 6695020 1549854 1495295 16543389 134318583 136989656 148372237 125846435 132375322 677902233 0 0 0 677902233 418656 530959 296326 221672 451587 1919200 418656 530959 296326 221672 451587 1919200 1039429 690418 1368633 704474 609755 4412709 135776668 138211033 150037196 126772581 133436664 684234142 0.99070 0.99200 0.00280 0.00240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 6339516 6339516 81631753 34627345 47004408 15190060 8984165 6205895 9827866 8010032 1817834 3867108 2782073 1085035 62452688 RESIDENTS' FUNDS HELD IN TRUST 656955 OTHER ASSETS 125439 OPERATING LEASES, RIGHT-OF-USE ASSETS 69282053 70064447 RESIDENT REFUNDS PAYABLE 2434229 DUE TO RELATED PARTIES 122369 CONTRACT LIABILITIES 259 OPERATING LEASE LIABILITIES 69997454 72554311 X PART IV, LINE 2B: THE ORGANIZATION USES A THIRD PARTY ADMINISTRATOR TO MANAGE THE FUNDS HELD IN TRUST FOR RESIDENTS. PART X, LINE 2: MANAGEMENT PERFORMS AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE ORGANIZATION'S INCOME TAX RETURNS TO DETERMINE WHETHER THE INCOME TAX POSITIONS MEET A "MORE LIKELY THAN NOT" STANDARD OF BEING SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL INCOME TAX POSITIONS TAKEN ON ALL OPEN INCOME TAX RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. ACCORDINGLY, THERE ARE NO PROVISIONS FOR INCOME TAXES, PENALTIES OR INTEREST RECEIVABLE OR PAYABLE RELATING TO UNCERTAIN INCOME TAX POSITIONS IN THE ACCOMPANYING FINANCIAL STATEMENTS. X X X X 0 0 0 0 0 1 0 1 0 SCOTT FISHER CFO 586792 0 0 0 35400 0 3813 0 18242 0 644247 0 0 0 JIM SHATZ CEO 590819 0 0 0 32400 0 0 0 12805 0 636024 0 0 0 WILLIAM NEELY CHIEF LEGAL OFFICER 538734 0 0 0 48400 0 0 0 8208 0 595342 0 0 0 JOSH WHITE CHIEF OPERATING OFFICER 398825 0 0 0 32400 0 2500 0 13 0 433738 0 0 0 BRIAN JACKSON CORPORATE COMPLIANCE OFFICER 289729 0 0 0 0 0 3750 0 13806 0 307285 0 0 0 KEVIN BAXTER VP OF OPERATIONS 238498 0 0 0 13000 0 2908 0 2884 0 257290 0 0 0 JERALD ERLANDSON DIRECTOR OF PATIENT AFFAIRS 211024 0 0 0 0 0 1300 0 11846 0 224170 0 0 0 MATTHEW FILE ADMINISTRATOR 194891 0 0 0 4000 0 0 0 13 0 198904 0 0 0 MARK RICHARDSON CORPORATE DIRECTOR OF COMPLIANCE AND 188806 0 0 0 0 0 1956 0 2884 0 193646 0 0 0 CLINT WELLS VP, REVENUE CYCLE MANAGEMENT 176432 0 0 0 0 0 2296 0 9075 0 187803 0 0 0 ANITA MAMONE CHIEF LEGAL & GOVERNANE OFFICER 179993 0 0 0 0 0 2287 0 4250 0 186530 0 0 0 GLENDA COLVIN ADMINISTRATOR 174674 0 0 0 2200 0 2192 0 593 0 179659 0 0 0 RICHARD FLINCHUM REGIONAL DIRECTOR OF CLINICAL SERVIC 177322 0 0 0 0 0 0 0 13 0 177335 0 0 0 SHELBY JACKSON ADMINISTRATOR 163289 0 0 0 2200 0 2041 0 13 0 167543 0 0 0 JACOB MITCHELL ADMINISTRATOR 154000 0 0 0 2200 0 1925 0 13 0 158138 0 0 0 PAUL WILLIAMS ADMINISTRATOR 136113 0 0 0 0 0 1875 0 18242 0 156230 0 0 0 PART I, LINE 6 THE 2022 PLAN INCLUDES AN INCENTIVE PAYMENT TO ADMINISTRATORS, DON, SOCIAL SERVICES, ADMISSIONS DIRECTOR, AND DIETARY FOR CATEGORIES INCLUDING MEDICARE CENSUS, SUPER BONUS, CUSTOMER CARE SATISFACTION SURVEY, TURNOVER, LABOR BUDGET, FOOD BUDGET AND INFECTION CONTROL METRICS. PART I, LINE 7 THE 2022 PLAN INCLUDES AN INCENTIVE PAYMENT TO THE CENTER ADMISSIONS DIRECTOR FOR OVERALL CENSUS PERFORMANCE (BASED ON PERCENTAGE OF AVAILABLE BEDS FROM THE CENTER'S BUDGET) AND FOR MEDICARE PLUS MANAGED CARE CENSUS LEVELS (BASED ON AVERAGE PER PATIENT DAY). FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S GENERAL COUNSEL REVIEWED THE FORM 990 AND PROVIDED COMMENTS AND QUESTIONS TO THE RETURN PREPARER. A COPY OF THE FORM 990 WAS EMAILED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C QUESTIONNAIRES ARE COMPLETED ANNUALLY BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USED THE SERVICES OF AN INDEPENDENT FIRM TO REVIEW THE COMPENSATION OF THE OFFICERS OF THE ORGANIZATION AND RELATED ENTITIES TO DETERMINE IF THEIR COMPENSATION WAS COMPARABLE TO OTHER EXECUTIVES AND ENTITIES IN THE SAME LINE OF BUSINESS. IN ADDITION, INDEPENDENT BOARD MEMBERS REVIEW THE COMPENSATION OF THE INSIDE BOARD MEMBERS, AND THE FULL BOARD THEN APPROVES COMPENSATION PAYABLE TO BOTH THE INSIDE AND INDEPENDENT BOARD MEMBERS. MANAGEMENT DETERMINES THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL DATA, ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 19,072,977. MANAGEMENT AND GENERAL EXPENSES 24,828. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,097,805. CASE MANAGEMENT: PROGRAM SERVICE EXPENSES 255,397. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 255,397. UTILIZATION REVIEW: PROGRAM SERVICE EXPENSES 9,375. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,375. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 816,075. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 816,075. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 395,508. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 395,508. FORM 990, PART IX, LINE 24E REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 2,000,508. MANAGEMENT AND GENERAL EXPENSES 10,992. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,011,500. BAD DEBT EXPENSE: PROGRAM SERVICE EXPENSES 1,737,733. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,737,733. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 1,937. MANAGEMENT AND GENERAL EXPENSES 288,996. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 290,933. FORM 990, PART XII, LINE 2C THE PROCESS IS THE SAME AS IN THE PRIOR YEAR. 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