2026-08-17T12:47:26+00:00 2025-09-30 440160260 FORVIS MAZARS LLP PO BOX 3667 LITTLE ROCK AR 722033667 990 2024-10-01 273970823 FIVE RIVERS MEDICAL CENTER INC FIVE 8708926000 2801 MEDICAL CENTER DR POCAHONTAS AR 72455 B BARYLSKE CFO 8702074100 2026-08-17 true AMBER SHERRILL P00748683 5013721040 2026-08-17 2024 2025-03-06 01:10:19Z CHRIS BARBER 2801 MEDICAL CENTER DR POCAHONTAS AR 72455 15317749 false X WWW.STBERNARDS.INFO X 2010 AR FIVE RIVERS MEDICAL CENTER IS DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR COMMUNITY AS ITS PRIMARY CARE PROVIDER THROUGH A NETWORK OF QUALITY SERVICES. 3 0 215 9 0 0 1627508 710090 15357385 14437171 3688 12788 241497 157700 17230078 15317749 0 0 0 12238231 11112184 0 0 0 7122181 6720560 19360412 17832744 -2130334 -2514995 11600364 9919341 7569125 8403097 4031239 1516244 FIVE RIVERS MEDICAL CENTER SHALL BE DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF OUR COMMUNITY AS ITS PRIMARY CARE PROVIDER THROUGH A NETWORK OF QUALITY SERVICES. false false 14861822 0 14437171 THE HOSPITAL PROVIDES OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN POCAHONTAS, ARKANSAS AND THE SURROUNDING AREA. IT ALSO OPERATES A HOME HEALTH AGENCY IN THE SAME GEOGRAPHIC REGION. THE HOME HEALTH DEPARTMENT AT FRMC HAD OVER 12,349 SKILLED NURSING, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND AIDE VISITS IN FISCAL YEAR 2025. THE EMERGENCY DEPARTMENT AT FRMC TREATED OVER 8,526 PATIENTS IN FISCAL YEAR 2025 AND IS A LEVEL 4 TRAUMA DESIGNATED ER. 14861822 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false true true true false false true 0 0 215 true false false false false false false false false false false false false X 3 0 false false false false true true true true true false false false false true true true true true true true false false X BENJAMIN BARYLSKE 8702074100 225 EAST WASHINGTON JONESBORO AR 72401 BENJAMIN BARYLSKE CFO 1.0 47.0 X X 0 509721 23672 CHRIS BARBER PRESIDENT & CEO 1.0 48.0 X X 0 955960 45899 RANDALL BARYMON ADMINISTRATOR 40.0 0 X X 174354 0 18005 JODY AYERS CHIEF NURSING OFFICER 40.0 0 X 92096 0 13920 LAUREN FISHER PHYSICIAN 40.0 0 X 310469 0 14081 MICKEY DEEL PHYSICIAN 40.0 0 X 352213 0 3576 MISTY SHATLEY PHYSICIAN ASSISTANT 40.0 0 X 151946 0 2279 RONALD BARNETT PHYSICIAN 40.0 0 X 306542 0 15130 WILLIAM LEWIS PHYSICIAN 40.0 0 X 344836 0 0 1732456 1465681 136562 7 false true false TEGRIA SERVICES GROUP PO BOX 735734 DALLAS TX 75373 PHYSICIAN SERVICES 324127 MEDHOST OF TENNESSEE INC 6550 CAROTHERS PKWY SUITE 160 FRANKLIN TN 37067 COMPUTER SERVICES 176271 RURAL HEALTH PAIN MANAGEMENT LLC 6998 WOODLAND MEADOW DRIVE POPLAR BLUFF MO 63901 PAIN MANAGEMENT SERVICES 131500 MSCB INC 1410 INDUSTRIAL PARK DR PARIS TN 38242 COLLECTIONS 121180 4 7917 673576 28597 710090 PATIENT SERVICES 622110 14260354 14260354 OTHER PROGRAM REVENUE 622110 102585 102585 MOB RENTAL INCOME 531120 68286 68286 PHARMACY 622110 5946 5946 0 0 0 0 14437171 12788 12788 0 0 0 0 CAFETERIA REVENUE 900099 132769 132769 LAUNDRY & VENDING 900099 24821 24821 PURCHASE DISCOUNTS 900099 110 110 0 0 0 0 157700 15317749 14437171 0 170488 288530 288530 8929272 7453586 1475686 62783 52407 10376 1192434 995368 197066 639165 533534 105631 1220784 1019032 201752 13695 11432 2263 45453 37941 7512 3478 2903 575 991100 827307 163793 0 28206 23545 4661 234507 195751 38756 330970 276273 54697 245180 204661 40519 141027 117720 23307 6059 5058 1001 255926 213631 42295 1231371 1027870 203501 249271 208076 41195 MEDICAL SUPPLIES 1264611 1264611 DIETARY EXPENSES 141637 118230 23407 EQUIPMENT RENTAL 101180 84459 16721 REPAIRS & MAINTENANCE 91848 76669 15179 124257 111758 12499 0 17832744 14861822 2970922 0 639844 680344 1021839 482254 0 0 1669435 1395484 0 0 0 0 0 0 184710 215786 21023 29935 5372840 3787060 2293370 1585780 0 0 0 0 0 0 5770143 5529758 11600364 9919341 1451985 1162206 0 0 0 0 0 0 0 0 0 0 44290 10483 0 0 6072850 7230408 7569125 8403097 X 4031239 1516244 0 0 0 0 0 0 0 0 4031239 1516244 11600364 9919341 -2514995 0 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8400 8400 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE HOSPITAL IS A MEMBER OF THE ARKANSAS AND AMERICAN HOSPITAL ASSOCIATION. THE HOSPITAL PAID DUES OF $8,426 TO THE ARKANSAS ASSOCIATION DURING 2025, 19% OF WHICH RELATED TO LOBBYING. THE HOSPITAL ALSO PAID DUES OF $8,515 TO THE AMERICAN ASSOCIATION DURING 2025, 39% OF WHICH RELATED TO LOBBYING. 254633 254633 272800 227333 45467 1026740 730594 296146 3801954 2814498 987456 16713 14635 2078 1585780 ROU ASSET 5529758 5529758 FEDERAL INCOME TAXES LEASE LIABILITY 5923274 DUE TO AFFILIATES 1307134 7230408 15317749 0 0 15317749 0 0 15317749 17832744 0 0 17832744 0 0 17832744 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 TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true true true false true true 3771 432929 0 432929 0.02428 4508 2961251 1075992 1885259 0.10572 0 0.0 0 8279 3394180 1075992 2318188 0.13000 3 273 6986 6986 0.00039 1 33 60 60 0.00000 0 0.0 0 0.0 0 0.0 4 306 7046 0 7046 0.00040 4 8585 3401226 1075992 2325234 0.13039 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 true 3537336 0 1636152 2318114 -681962 X true true 1 1 FIVE RIVERS MEDICAL CENTER 2801 MEDICAL CENTER DRIVE POCAHONTAS AR 72455 WWW.STBERNARDS.INFO AR4270 X X X HOME HEALTH FIVE RIVERS MEDICAL CENTER 1 false false true X X X X X X X X X 24 true false false true X WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X true 24 false true false true X 100.0 300.0 X X true true X X X X true X WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 FACILITY , 1 - . SURVEYS TAKEN BY KEY INTERVIEWEES (COMMUNITY STAKEHOLDERS THAT REPRESENT THE BROAD INTEREST OF THE COMMUNITY WITH KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH) IS A TECHNIQUE EMPLOYED TO ASSESS PUBLIC PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THESE SURVEYS ARE INTENDED TO ASCERTAIN OPINIONS AMONG INDIVIDUALS LIKELY TO BE KNOWLEDGEABLE ABOUT THE COMMUNITY AND INFLUENTIAL OVER THE OPINIONS OF OTHERS ABOUT HEALTH CONCERNS IN THE COMMUNITY. KEY INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE KNOWLEDGEABLE ABOUT POPULATIONS WITHIN THE COMMUNITY WHOSE HEALTH AND QUALITY OF LIFE MAY NOT BE AS GOOD AS OTHERS, SUCH AS REPRESENTATIVES OF ORGANIZATIONS SERVING THE ETHNIC MINORITIES, OR THE ELDERLY. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 FACILITY , 1 - . THE NEEDS THAT WILL BE ADDRESSED IN THE MOST RECENT IMPLEMENTATION STRATEGY INCLUDE THE FOLLOWING: 1. HEALTH AND WELLNESS EDUCATION A. FRMC WILL CONTINUE TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY THROUGH EDUCATION AND WELLNESS ACTIVITIES. - FRMC WILL PARTNER WITH BRTC, BRAD, AND LOCAL CLINICS IN ANNUAL HEALTH FAIRS AND OUTREACH FOR KEY EMPLOYERS AND THE COMMUNITY. - FRMC WILL INCREASE THE NUMBER OF TELEVISION AND SOCIAL MEDIA MESSAGES AIMED AT GENERAL PREVENTATIVE MEASURES, TYPICAL SCREENING TIMELINES, AND AVAILABLE RESOURCES. FRMC WILL DISPLAY TELEVISION MESSAGES IN EACH ROOM OF OUR RURAL HEALTH CLINIC AND WITHIN OUR WAITING AREAS OF THE HOSPITAL. MAINTAIN A MEDIA PRESENCE OUTSIDE OF THE ORGANIZATION WITH THE LOCAL RADIO, NEWSPAPER B. PARTNER WITH KEY STAKEHOLDERS IN THE MARSHALLESE COMMUNITY TO PROMOTE HEALTH AND WELLNESS EDUCATION AND PROVIDE SUPPORT IN A CULTURALLY SENSITIVE WAY TO THIS HIGH RISK PATIENT POPULATION. - IMPLEMENT PARTNERSHIP WITH PECO TO PROVIDE HEALTH SERVICES AND EDUCATION TO THEIR MARSHALLESE EMPLOYEES THROUGH OUR RURAL HEALTH CLINIC. - CONTINUE TO RECRUIT AND RETAIN MARSHALLESE EMPLOYEES AT BOTH THE RURAL HEALTH CLINIC AND THE MEDICAL CENTER TO HELP WITH CULTURAL SUPPORT OF THE MARSHALLESE COMMUNITY. - ATTEND ANNUAL PACIFIC ISLANDER EVENT TO PROMOTE HEALTH AND WELLNESS INITIATIVES TO THE MARSHALLESE POPULATION. 2. OBESITY A. PARTICIPATE IN COMMUNITY HEALTH FAIRS TO PROMOTE A HEALTHY DIET. - PROVIDE EDUCATIONAL MATERIAL TO OUTLINE A HEALTHY LIFESTYLE TO THE COMMUNITY. B. IMPLEMENT A "KNOW YOUR NUMBERS" CAMPAIGN WITHIN THE RURAL HEALTH CLINIC FOR OBESITY. - PROVIDE NUTRITIONAL FOOD LISTS, RECIPES, AWARENESS, AND EXERCISE REGIMENS FOR PATIENTS IN THE "KNOW YOUR NUMBERS" CAMPAIGN. C. IMPROVE AWARENESS OF OBESITY AND HEALTHY LIFESTYLE. - THE MARKETING STAFF AT FRMC WILL INCREASE THE NUMBER OF TELEVISION AND SOCIAL MEDIA MESSAGES AIMED AT NUTRITIONAL HEALTH. TELEVISION MESSAGES WILL BE DISPLAYED IN EACH ROOM OF OUR RURAL HEALTH CLINIC, AND WITHIN OUR WAITING AREAS OF THE HOSPITAL. 3. DIABETES A. IMPLEMENT A "KNOW YOUR NUMBERS" CAMPAIGN WITHIN THE RURAL HEALTH CLINIC FOR DIABETIC PATIENTS. - IMRP RESIDENTS AND CARE MANAGER TO COORDINATE THE KNOW YOUR NUMBERS. BEGIN A MONTHLY QUALITY IMPROVEMENT PROGRAM THAT MONITORS PATIENT OUTCOMES BY DESIGNING AND ADJUSTING AN INDIVIDUAL CARE PLAN. MONITOR PATIENT PROGRESS BY ALLOCATING RESPONSIBILITY TO THE CARE MANAGER TO CONTACT THE PROGRAM'S PATIENTS WEEKLY. B. IMPLEMENT TRACKING OF CARDIO PROTECTIVE ANTI-HYPOGLYCEMIC MEDICATION. - EDUCATE PROVIDERS IN THE FRMC HEALTH SYSTEM ON THE IMPORTANCE OF PRESCRIBING CARDIO PROTECTIVE ANTI-HYPOGLYCEMIC MEDICATIONS FOR DIABETES TREATMENT. IDENTIFY AND TRACK PATIENTS AT DISCHARGE PLACED ON CARDIO PROTECTIVE ANTI- HYPOGLYCEMIC MEDICATIONS AND COORDINATE AN APPOINTMENT WITH THE PATENTS PRIMARY CARE PHYSICIAN. C. EMPOWER THE PATIENTS TO BETTER MANAGE THEIR DISEASE TO AVOID THE COMPLICATIONS OF DIABETES AND ACHIEVE OPTIMAL HEALTH STATUS - PROVIDED PRIMARY AND SKILLED CARE FOR HOMEBOUND PATIENTS IN THE COUNTIES WE SERVE. THIS INCLUDES EDUCATION REGARDING MANAGING MEDICATIONS, DIABETIC DIET, GENERAL HEALTH CARE, AND INCORPORATING SECONDARY DIAGNOSIS. D. EMPOWER PATIENTS FROM THE POPULATION OF RANDOLPH COUNTY TO INCREASE DIABETES MANAGEMENT TO AVOID COMPLICATIONS OF DIABETES AND ACHIEVE OPTIMAL HEALTH STATUS. - BEGIN MONTHLY DIABETIC EDUCATION SESSIONS WITH A CERTIFIED DIABETES EDUCATOR FROM POPULATION HEALTH. 4. HEART DISEASE A. IMPROVE ACCESS TO SCREENING FOR HEART DISEASE - TO INCREASE AWARENESS AND THE PURPOSE OF SCREENINGS, THE MARKETING STAFF AT FRMC WILL INCREASE THE NUMBER OF TELEVISION AND SOCIAL MEDIA MESSAGES AIMED AT GENERAL PREVENTATIVE MEASURES, TYPICAL SCREENING TIMELINES, AND AVAILABLE RESOURCES. FRMC WILL DISPLAY TELEVISION MESSAGES IN EACH ROOM OF OUR RURAL HEALTH CLINIC AND WITHIN OUR WAITING AREAS OF THE HOSPITAL. B. IMPROVE ACCESS TO SCREENING FOR HEART DISEASE FRMC WILL PARTNER WITH BRTC, BRAD, AND LOCAL CLINICS IN ANNUAL HEALTH FAIRS AND OUTREACH FOR KEY EMPLOYERS AND THE COMMUNITY. 5. SUBSTANCE ABUSE TREATMENT AND PREVENTION A. STRENGTHENING OF A COMPREHENSIVE, PATIENT CENTERED APPROACH TO SUBSTANCE ABUSE PREVENTION AND TREATMENT - ALL ADULT PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WILL BE PROVIDED WITH MENTAL HEALTH CONTACT INFORMATION AND RESOURCES, REGARDLESS OF THE REASON FOR THEIR VISIT, TO ENSURE ACCESS TO SUPPORT SERVICES AS NEEDED. PROVIDE ONGOING EDUCATION TO OUR COMMUNITY BY UTILIZING SOCIAL MEDIA PLATFORMS AS A TOOL TO SHARE RELIABLE HEALTH INFORMATION, PROMOTE WELLNESS INITIATIVES, AND INCREASE AWARENESS OF AVAILABLE SERVICES AND RESOURCES. 1 RURAL HEALTH CENTER 2018 HIGHWAY 67 POCAHONTAS AR 72455 RURAL HEALTH CENTER SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES THE AMOUNTS ON LINE 7A WERE CALCULATED USING THE COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT THE HOSPITAL HAS ADOPTED REVENUE RECOGNITION STANDARD ASU 2014-09. THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO COLLECT ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND AS SUCH ARE RECORDED AS A DEDUCTION FROM GROSS PATIENT REVENUE. THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY UNLIKE CHARITY CARE, BAD DEBT ARISES IN SITUATIONS WHERE THE PATIENT HAS EITHER NOT REQUESTED FINANCIAL ASSISTANCE OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. IT IS DIFFICULT TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO COULD QUALIFY FOR CHARITY CARE DUE TO THE LIMITED NUMBER OF FINANCIAL APPLICATIONS COMPLETED BY PATIENTS. AN ESTIMATE OF 50% WAS CALCULATED AS THE BAD DEBT EXPENSE THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE SEE ATTACHED AUDIT REPORT FOOTNOTE #2. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS THE AMOUNTS WERE PULLED FROM THE MOST RECENT AND AS FILED MEDICARE COST REPORT. THE ORGANIZATION FOLLOWS CHA COMMUNITY BENEFIT GUIDELINES AND DOES NOT COUNT MEDICARE SHORTFALL AS COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THE HOSPITAL WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION EFFORTS BEFORE MAKING AND DOCUMENTING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL MAY CONTRACT WITH EXTERNAL COLLECTION AGENCIES (AND TAKE OTHER ACTIONS AS NECESSARY) IN ORDER TO COLLECT ON DELINQUENT ACCOUNTS. PRIOR TO DOING SO, HOWEVER, THE HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: 1) SEND A STATEMENT TO THE PATIENT AT THE PATIENT'S MOST CURRENT ADDRESS ON FILE. 2) NOTIFY THE PATIENT OF OUTSTANDING ACCOUNT(S) AND PROVIDING THE PATIENT WITH INFORMATION REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE. THIS INITIAL CONTACT WILL ALSO INCLUDE AN APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS CONTACT INFORMATION FOR HOSPITAL STAFF MEMBERS WHO CAN ANSWER PATIENT QUESTIONS AN PROVIDE FURTHER INFORMATION AS NEEDED. 3) SUCCESSIVE STATEMENTS ARE SENT AT A MINIMUM OF 21 DAYS, BUT NOT GREATER THAN 30 DAYS. AFTER 90 DAY PERIOD HAS LAPSED, A NOTIFICATION LETTER IS SENT STATING A DEADLINE THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED AT WHICH TIME THE ACCOUNT WILL BE ASSIGNED TO COLLECTION AGENCY AND REPORTED AS A NEGATIVE ITEM WITH A CREDIT BUREAU. AFTER THE 120 DAY NOTIFICATION PERIOD, FRMC BUSINESS OFFICE DIRECTOR OR ASSIGNED MANAGER WILL REVIEW ACCOUNTS TO ENSURE ALL REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY HAVE BEEN MADE AND APPROVE ACCOUNTS PRIOR TO ASSIGNING TO A COLLECTION AGENCY. 4) FRMC WILL ACCEPT AND PROCESS FINANCIAL ASSISTANCE APPLICATIONS FROM AN INDIVIDUAL THAT HAS NOT PREVIOUSLY BEEN DETERMINED AS FAP ELIGIBLE FROM DAY 121 TO DAY 240 FROM FI POST-DISCHARGE STATMENT. 5) FRMC WILL ALSO MAKE A REASONABLE EFFORT TO ORALLY COMMUNICATE WITH THE PATIENT/GUARANTOR ABOUT ITS FAP AND HOW ASSISTANCE MAY BE OBTAINED BEFORE AN ACCOUNT IS TURNED OVER TO COLLECTIONS. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - FIVE RIVERS MEDICAL CENTER: LINE 16A URL: WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - FIVE RIVERS MEDICAL CENTER: LINE 16B URL: WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - FIVE RIVERS MEDICAL CENTER: LINE 16C URL: WWW.STBERNARDS.INFO/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT FRMC COLLABORATES WITH OTHER LOCAL HEALTHCARE PROVIDERS TO ASSESS THE NEEDS OF THE COMMUNITY. FRMC ALSO PARTICIPATES IN ANNUAL HEALTH FAIRS TO GATHER FEEDBACK REGARDING HEALTH ISSUES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL SENDS A STATEMENT TO THE PATIENT (AT THE PATIENT'S MOST CURRENT ADDRESS ON FILE), NOTIFYING THE PATIENT OF OUTSTANDING ACCOUNT(S) AND PROVIDES THE PATIENT WITH INFORMATION REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE. THIS INITIAL CONTACT WILL ALSO INCLUDE AN APPLICATION FOR FINANCIAL ASSISTANCE. SUCH INFORMATION WILL ALSO INCLUDE CONTACT INFORMATION FOR HOSPITAL STAFF MEMBER CAN ANSWER PATIENT QUESTIONS AND PROVIDE FURTHER INFORMATION AS NEEDED. THE GOAL OF THE HOSPITAL IS TO ESTABLISH A REASONABLE PAYMENT PLAN THAT THE PATIENT CAN MANAGE. IF THEY DO NOT QUALIFY FOR 100% FINANCIAL ASSISTANCE, ALL PAYMENT PLAN PROPOSALS WILL BE CONSIDERED. THE PATIENT WILL RECEIVE AT LEAST TWO ADDITIONAL LETTERS (AT NO LESS THAN 20 DAYS' INTERVALS) REQUESTING PAYMENT AND NOTIFYING THE PATIENT OF THE POTENTIAL AVAILABILITY OF FINANCIAL ASSISTANCE AND STAFF CONTACT INFORMATION AS DESCRIBED ABOVE. THE PATIENT WILL ALSO RECEIVE A PHONE CALL DURING THE PROCESS DURING WHICH THE PATIENT WILL BE ADVISED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION THE MEDICAL CENTER IS LOCATED IN POCAHONTAS, ARKANSAS, IN RANDOLPH COUNTY. POCAHONTAS IS APPROXIMATELY 40 MILES NORTH OF JONESBORO, ARKANSAS, THE CLOSEST METROPOLITAN AREA. THE COMMUNITY SERVED BY THE MEDICAL CENTER IS A PRIMARILY RURAL AREA IN NORTHEAST ARKANSAS. ACCORDING TO THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2019-23 FIVE-YEAR ESTIMATES, APPROXIMATELY 47,100 PEOPLE LIVE IN THE COMMUNITY'S SERVICE AREA. ACCORDING TO THE U.S. CENSUS BUREAU, APPROXIMATELY 48% OF THE COMMUNITY'S POPULATION IS OVER AGE 45, WHICH IS HIGHER THAN IN ARKANSAS (42%), MISSOURI (43%), AND HIGHER THAN IN THE UNITED STATES (42%) AS A WHOLE. AS THIS AGE GROUP USES MORE HEALTH SERVICES THAN ANY OTHER, THIS COULD LEAD TO INCREASED PATIENT VOLUME IN THE FUTURE. SOCIOECONOMICALLY, THE COMMUNITY SERVED BY THE MEDICAL CENTER IS SIMILAR TO MANY OTHER PARTS OF RURAL ARKANSAS. ABOUT 13% OF THE POPULATION AGE 25 AND OLDER HAS OBTAINED A BACHELOR'S DEGREE OR HIGHER, COMPARED TO ABOUT 35% OF THE U.S., WHILE ABOUT 15% OF THE POPULATION AGE 25 AND OLDER DOES NOT HAVE A HIGH SCHOOL DIPLOMA, COMPARED TO ABOUT 11% IN THE COUNTRY AS A WHOLE. LOWER LEVELS OF EDUCATION HAVE BEEN LINKED TO NEGATIVE HEALTH OUTCOMES, SO THE EDUCATIONAL ATTAINMENT OF THE COMMUNITY IS RELEVANT TO THE CONSIDERATION OF THE HEALTH NEEDS OF THE COMMUNITY. THE INCOME LEVELS OF INDIVIDUALS WITHIN THE COMMUNITY ALSO HAVE A SIGNIFICANT EFFECT ON THEIR ABILITY TO ACCESS HEALTH SERVICES. THE MEDIAN HOUSEHOLD INCOME IN THE MEDICAL CENTER'S COMMUNITY IS $52,838 IN RANDOLPH COUNTY, $42,950 IN SHARP COUNTY, AND $43,898 IN RIPLEY COUNTY, COMPARED TO $58,773 FOR THE STATE OF ARKANSAS, $68,920 FOR THE STATE OF MISSOURI, AND $78,538 FOR THE UNITED STATES. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH FRMC MAINTAINS AN OPEN MEDICAL STAFF AND THE GOVERNING BODY IS MADE UP OF VOLUNTARY LOCAL COMMUNITY MEMBERS ALONG WITH PHYSICIANS. THE HOSPITAL CARES FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND PROACTIVELY SEEKS TO ENROLL ALL ELIGIBLE PATIENTS INTO APPROPRIATE PROGRAMS TO IMPROVE ACCESS TO CARE. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM SBHC SYSTEM FOCUSES ITS ENERGIES AND RESOURCES ON PARTNERSHIPS THAT HAVE THE GREATEST POTENTIAL FOR A POSITIVE IMPROVEMENT IN THE HEALTH AND QUALITY OF LIFE FOR INDIVIDUALS AND COMMUNITIES. AREAS WHERE CONSIDERABLE ACTIVITY IS EXPENDED INCLUDE: - COMMUNITY HEALTH EDUCATION, PREVENTION, EARLY DETECTION, AND INTERVENTION ACTIVITIES THAT WOULD REDUCE THE INCIDENCE AND SERIOUSNESS OF ILLNESS, THEREBY MINIMIZING THE NEED FOR PREVENTABLE AND EXPENSIVE MEDICAL INTERVENTIONS. - CHRONIC DISEASE MANAGEMENT ACTIVITIES, WHICH, WHEN DONE EFFECTIVELY, MINIMIZE THE NEED FOR MEDICAL INTERVENTIONS. - PROACTIVE HEALTH GRANT PROGRAMS THAT FUND COMMUNITY BASED HEALTH PROGRAMS AND INITIATIVES. - INCREASING ACCESS TO HEALTH COVERAGE FOR ELIGIBLE RESIDENTS IN PROGRAMS SUCH AS AR KIDS FIRST. - INCREASING ACCESS TO HEALTHCARE SERVICES FOR THOSE IN NEED REGARDLESS OF ABILITY TO PAY. - COLLABORATIVE PARTNERSHIPS THAT SUPPORT THE PURPOSE OF INCREASING INDIVIDUAL AND COMMUNITY CAPACITY TO ACHIEVE THE HEALTHY COMMUNITY VISION. - HEALTH RESEARCH, EDUCATION AND TRAINING PROGRAMS. - DONATIONS OF FOOD, SURPLUS EQUIPMENT AND STAFF TIME TO ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF THE COMMUNITY. - PARTNERSHIPS WHICH MOTIVATE RESIDENTS TO GIVE BACK TO THEIR COMMUNITIES TO MOVE THE COMMUNITY CLOSER TO THE HEALTHY COMMUNITY VISION. X false true false false false false false false false false false CHRIS BARBER PRESIDENT & CEO 0 908787 0 0 0 47173 0 30500 0 15399 0 1001859 0 0 BENJAMIN BARYLSKE CFO 0 500877 0 0 0 8844 0 13791 0 9881 0 533393 0 0 RANDALL BARYMON ADMINISTRATOR 167996 0 0 0 6358 0 2606 0 15399 0 192359 0 0 0 RONALD BARNETT PHYSICIAN 306542 0 0 0 0 0 0 0 15130 0 321672 0 0 0 MICKEY DEEL PHYSICIAN 352213 0 0 0 0 0 3576 0 0 0 355789 0 0 0 LAUREN FISHER PHYSICIAN 310469 0 0 0 0 0 4677 0 9404 0 324550 0 0 0 WILLIAM LEWIS PHYSICIAN 344836 0 0 0 0 0 0 0 0 0 344836 0 0 0 MISTY SHATLEY PHYSICIAN ASSISTANT 151946 0 0 0 0 0 2279 0 0 0 154225 0 0 0 SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS RANDALL BARYMON - GROSS-UPS OF $57 FOR GROUP TERM LIFE INSURANCE. SCHEDULE J, PART I, LINE 3 ST. BERNARDS HEALTHCARE, A RELATED ORGANIZATION, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD TO ESTABLISH COMPENSATION OF THE CEO. SCHEDULE J, PART II, COLUMN (D) THE INCREASE IN ACTUARIAL VALUE OF THE DEFINED BENEFIT PENISON PLAN IS NOT CALCULATED ON AN INDIVIDUAL EMPLOYEE BASIS BUT RATHER ON THE EMPLOYEE GROUP TAKEN AS A WHOLE. THE INCREASE IN EACH INDIVIDUAL'S BALANCE WOULD HAVE TO BE ESTIMATED USING ASSUMPTIONS UNIQUE TO THAT INDIVIDUAL RATHER THAN THE PLAN AS A WHOLE. THIS INFORMATION IS NOT AVAILABLE AT THIS TIME. HOWEVER, WE BELIEVE THE INCREASE TO EACH INDIVIDUAL'S ACCOUNT WOULD NOT MATERIALLY CHANGE THE COMPENSATION REPORTED. WE WILL WORK WITH OUR ACTUARY TO DETERMINE THE ANNUAL INCREASE IN FUTURE PERIODS. FORM 990, PART VI, LINE 15 A & B THE BOARD OF DIRECTORS SELECTS DIRECTORS TO SERVE ON THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES THE INITIAL SALARY AND ANY SUBSEQUENT SALARY ADJUSTMENTS OF ALL MANAGEMENT. THE COMPENSATION COMMITTEE OBTAINS AN INDEPENDENT SALARY SURVEY FROM A COMPENSATION CONSULTING FIRM ON AN EVERY OTHER YEAR BASIS FOR USE IN DETERMINING THE APPROPRIATE SALARY RANGES FOR MANAGEMENT. THE COMPENSATION COMMITTEE PRESENTS THE INFORMATION TO THE BOARD FOR APPROVAL. A COMPENSATION REVIEW WAS CONDUCTED BY GALLAGHER'S HUMAN RESOURCES AND COMPENSATION CONSULTING IN OCTOBER OF 2024. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST BERNARDS HEALTHCARE - SOLE MEMBER FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY ST BERNARDS HEALTHCARE - SOLE MEMBER, APPOINTS ALL DIRECTORS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS ST. BERNARDS HEALTHCARE, SOLE MEMBER, APPROVES THE CREATION OF EACH COMMITTEE, APPOINTMENT OF MEMBERS TO THOSE COMMITTEES AND ALL AMENDMENTS TO THE BYLAWS ARE SUBJECT TO THE FINAL APPROVAL OF THE MEMBER. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 IS REVIEWED BY THE FOLLOWING PERSONS OR GROUPS: CONTROLLER OF ST BERNARDS HEALTHCARE, INC, VICE PRESIDENT OF FINANCE OF ST BERNARDS HEALTHCARE, INC, REGIONAL CFO OF ST BERNARDS HEALTHCARE, INC, CFO OF FIVE RIVERS MEDICAL CENTER. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY EACH DIRECTOR SHALL, AT THEIR FIRST REGULAR BOARD MEETING OF THE CALENDAR YEAR, EXECUTE AND DELIVER TO THE SECRETARY, A CONFLICT OF INTEREST STATEMENT PURSUANT TO THE CORPORATION'S CONFLICT OF INTEREST POLICY. EACH DIRECTOR SHALL, AT ALL TIMES, COMPLY FULLY WITH THE PROVISIONS OF THE CORPORATION'S CONFLICT OF INTEREST POLICY. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART V, LINE 1A FIVE RIVERS MEDICAL CENTER, INC. DOES NOT REPORT ANY 1099 FILINGS ON PART V, LINE 1A. ALL 1099S ARE FILED BY THE HOSPITAL SYSTEM'S COMMON PAYMASTER, ST. BERNARDS HEALTHCARE, INC. 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