2026-05-13T12:09:23+00:00 2025-06-30 440160260 Forvis Mazars LLP PO Box 3667 Little Rock AR 722033667 990 2024-07-01 821820277 Jefferson Regional Medical Center Foundation JEFF 8705417100 1600 West 40th Avenue Pine Bluff AR 71603 DEBE HOLLINGSWORTH EXECUTIVE DIRECTOR 2026-05-13 true Amber Sherrill P00748683 5013721040 2026-05-15 2024 2025-03-06 01:10:19Z DEBE HOLLINGSWORTH 1600 West 40th Avenue Pine Bluff AR 71603 228064 false X N/A X 2017 AR TO MAKE DISTRIBUTIONS OF PROPERTY FROM THE FOUNDATION TO ORGANIZATIONS THAT THEN QUALIFY AS EXEMPT ORGANIZATIONS 12 10 1 26 0 0 389472 183729 0 0 10979 12635 26647 5948 427098 202312 441072 180911 0 0 80142 76774 0 0 0 55164 55360 576378 313045 -149280 -110733 471065 445947 22445 102448 448620 343499 THE FOUNDATION RAISES FUNDS THAT DIRECTLY SUPPORT JEFFERSON REGIONAL MEDICAL CENTER AND THE COMMUNITIES WE SERVE. TOGETHER WE ARE BRINGING THE HIGHEST QUALITY HEALTHCARE TO SOUTHEAST ARKANSAS. false false 180911 180911 0 THE FOUNDATION HOSTED ITS ANNUAL GOLF TOURNAMENT. THE PROCEEDS BENEFIT PROJECTS AND SERVICES AT JEFFERSON REGIONAL. ALSO, THE PINK LUNCHEON AND PINK OUT 5K BOTH BENEFIT THE JEFFERSON REGIONAL BREAST CENTER. ADDITIONALLY, THE FOUNDATION AUTHORIZED GRANTS TO JEFFERSON REGIONAL FOR NURSING SCHOLARSHIPS, PATIENT ASSISTANCE AND CANCER CENTER PATIENTS. 180911 true true false false false false false false false false false false false false true true false true false false false false false false true false false true true true false false false false false false false false false false false false false false false true true false false false true X 6 0 true 1 true false false false false false true true false false false false false false X 12 10 false false false false true true false true true false false false true true true true true true false false false false AR X JEREMY JEFFERY 8705417100 1600 WEST 40TH AVENUE PINE BLUFF AR 71603 B THOMAS - SEE SCH O PRESIDENT, EX-OFFICIO 1.0 40.0 X X 0 0 0 D HOLLINGSWORTH - SEE SCH O MEMBER, EX OFFICIO 1.0 0.0 X X 0 0 0 J Jeffery - SEE SCH O Treasurer 1.0 40.0 X X 0 0 0 J SIMPSON - SEE SCH O CHAIR 1.0 0.0 X X 0 0 0 B JONES - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 C TROTTER - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 D TERRELL - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 G DUNKLIN - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 L KOSMITIS - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 L RANDLE - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 N OUDIN - SEE SCH O MEMBER 0.3 0.0 X 0 0 0 N TODD - SEE SCH O MEMBER (AS OF 11/24) 0.3 0.0 X 0 0 0 0 0 0 0 true true false 0 26797 156932 183729 0 0 0 0 0 12635 12635 0 0 0 0 31490 26797 25752 5738 5738 FOUNDATION MISC. INCOME 900099 210 210 0 0 0 0 210 202312 0 0 18583 172011 172011 8900 8900 0 0 67225 67225 9549 9549 155 155 5257 5257 17153 0 17153 0 1815 1815 2200 2200 2244 2244 267 267 BANK CHARGES 5283 5283 DUES/FEES 1073 1073 19913 0 19913 0 313045 180911 132134 0 157484 114117 0 0 0 0 0 0 0 0 0 0 0 0 313581 331830 0 0 0 0 471065 445947 954 0 0 22445 101494 22445 102448 X 162438 222421 286182 121078 448620 343499 471065 445947 -110733 5612 0 X false true true false X X X 1 JEFFERSON HOSPITAL ASSOCIATION 710329353 3 true 167911 0 1 167911 0 true false false false false true false false false false false false false false false true false Schedule A, Part IV, Section A, Line 6 Support to other supported orgs A SMALL DONATION WAS PROVIDED TO THE ALS ASSOCIATION TO DELIVER MORE FUNDING FOR ALS RESEARCH. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Federal Income Taxes DUE TO AFFILIATE 101494 101494 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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. 2025 GOLF EVENT 31760 16515 15245 1537 5814 666 282 2025 PINK-OUT RACE 7416 3178 4238 389 300 3626 2 19111 7104 12007 8244 500 4394 58287 26797 31490 1926 5814 8910 800 8302 25752 5738 true JEFFERSON HOSPITAL ASSOCIATION 1600 W 40TH AVE PINE BLUFF AR 71603 710329353 501(C)(3) 167911 CANCER CENTER OPERATIONS; PATIENT TRANSPORT ASSISTANCE 1 0 NURSING SCHOOL SCHOLARSHIPS 13 8900 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds JEFFERSON REGIONAL MEDICAL CENTER FOUNDATION MAINTAINED RECORDS TO SUBSTANTIATE THE AMOUNT OF THE GRANTS OR ASSISTANCE, THE GRANTEES' ELIGIBILITY FOR THE GRANTS OR ASSISTANCE, AND THE SELECTION CRITERIA USED TO AWARD GRANTS OR ASSISTANCE. true true false false false false false false false B JACKSON - SEE SCH O FORMER EX-OFFICIO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 J Jeffery - SEE SCH O Treasurer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 B THOMAS - SEE SCH O PRESIDENT, EX-OFFICIO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment BRYAN JACKSON RECEIVED A SEVERANCE PAYMENT IN CONNECTION WITH HIS SEPARATION FROM SERVICE, PURSUANT TO THE TERMS OF HIS EMPLOYMENT/SEVERANCE AGREEMENT. BRYAN JACKSON $248,829 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan PARTICIPANTS IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: Amount reported in W-2: Brian Thomas $154,193 Jeremy Jeffery $310,800 Bryan Jackson $34,844 CERTAIN AMOUNTS REPORTED WERE CREDITED TO PRIOR YEARS OF SERVICE DUE TO MULTI-YEAR VESTING REQUIRMENTS. Schedule J, Part I, Line 3 METHOD TO DETERMINE EXECUTIVE COMPENSATION JEFFERSON HOSPITAL ASSOCIATION, INC., A RELATED ENTITY, UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. Schedule J, Part II Compensation Table COMPENSATION INFORMATION REQUIRED IN FORM 990, PART VII, SECTION A AND SCHEDULE J, PART II IS PROVIDED IN A TABLE ATTACHED TO THE TAX RETURN DOCUMENT FOLLOWING SCHEDULE R. THE AMOUNTS ARE INCLUDED IN THE ATTACHMENT. Form 990, Part V, Line 2a EMPLOYEES REPORTED ON FORM W-3 JEFFERSON HOSPITAL ASSOCIATION, INC IS THE COMMON PAY MASTER FOR THE FOUNDATION. ALL W-2S ARE FILED BY THE HOSPITAL WITH PAYROLL EXPENSE ALLOCATIONS REPORTED ON THE FOUNDATION. Form 990, Part VI, Line 15 COMPENSATION REVIEW THE PRESIDENT AND TREASURER OF THE ORGANIZATION ARE COMPENSATED BY JEFFERSON HOSPITAL ASSOCIATION, INC. (JHA), A RELATED ORGANIZATION. COMPENSATION IS DETERMINED BY JHA. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER IS JEFFERSON HOSPITAL ASSOCIATION, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER WILL ELECT THE BOARD OF DIRECTORS Form 990, Part VI, Line 11b Review of form 990 by governing body THE BOARD HAS DELEGATED THE REVIEW OF THE 990 TO AN AD HOC COMMITTEE MADE UP OF THE PRESIDENT, TREASURER, AND EXECUTIVE DIRECTOR OF THE FOUNDATION. THE FINAL 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. Form 990, Part VI, Line 12c Conflict of interest policy ALL BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS. THE BOARD ANNUALLY REVIEWS POTENTIAL CONFLICTS IN ACCORDANCE WITH ITS POLICY. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. Form 990, Part VII, Section A COMPENSATION TABLE COMPENSATION INFORMATION REQUIRED IN FORM 990, PART VII, SECTION A AND SCHEDULE J, PART II IS PROVIDED IN A TABLE ATTACHED TO THE TAX RETURN DOCUMENT FOLLOWING SCHEDULE R. THE AMOUNTS ARE INCLUDED IN THE ATTACHMENT. JEFFERSON HOSPITAL ASSOCIATION 1600 WEST 40TH AVE PINE BLUFF AR 71603 710329353 HOSPITAL AR 501(c)(3) 3 NA false Jefferson Regional R&B Hospital 330 Seven Springs Way Brentwood TN 71603 REHAB HOSPITAL TN NA N/A JEFFERSON MANAGEMENT SERVICES INC 1600 W 40TH AVE PINE BLUFF AR 71603 710582753 PHY PRACTICE AR JHA C Corporation 0 false JHA HEALTH AFFILIATES INC 1600 W 40TH AVE PINE BLUFF AR 71603 710766959 REAL EST RENT AR JHA C Corporation 0 false false true false false false false false false false false false false true false false true false false false