efile Public Visual Render
ObjectId: 202002279349302780 - Submission: 2020-08-14
TIN: 64-0926753
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
18
Open to Public Inspection
Name of the organization
Marion Regional Medical Center Inc
Employer identification number
64-0926753
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
North MS Management Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0762694
Mgmt & Admin
DE
501(c)(3)
12-I
NMHS
No
(2)
North MS Health Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0653269
Mgmt Services
DE
501(c)(3)
12-II
NMHS
No
(3)
Clay County Medical Corporation
830 S Gloster Street
Tupelo
,
MS
38801
64-0668465
Hospital
DE
501(c)(3)
3
NMHS
No
(4)
Tishomingo Health Services
830 S Gloster Street
Tupelo
,
MS
38801
64-0741047
Hospital
DE
501(c)(3)
3
NMHS
No
(5)
Pontotoc Health Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0751410
Hospital
DE
501(c)(3)
3
NMHS
No
(6)
North MS Medical Clinics Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0787918
Med Clinics
DE
501(c)(3)
3
NMHS
No
(7)
Tupelo Service Finance Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0508308
Collections
DE
501(c)(3)
3
NMHS
No
(8)
Webster Health Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0819193
Hospital
DE
501(c)(3)
3
NMHS
No
(9)
North MS Medical Center Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0662976
Hospital
DE
501(c)(3)
3
NMHS
No
(10)
North MS Emergency Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0780130
ER Physicians
DE
501(c)(3)
10
NMHS
No
(11)
Monroe Health Services
830 South Gloster Street
Tupelo
,
MS
38801
32-0583236
Hospital
DE
501(c)(3)
3
NMHS
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Page 2
Schedule R (Form 990) 2018
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
North MS Health Link Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0715886
Medical Servi
DE
NMHS
C Corp
No
(2)
North MS Enterprises Inc
830 S Gloster Street
Tupelo
,
MS
38801
64-0658059
Medical Servi
DE
NMHS
C Corp
No
(3)
Professional Practice Management Inc
830 S Gloster Street
Tupelo
,
MS
38801
72-1390014
Med Serv Mgmt
DE
NMMCI
C Corp
No
(4)
Acclaim Inc
830 S Gloster Street
Tupelo
,
MS
38801
72-1356116
Hlth Care Cla
DE
Healthlink
C Corp
No
(5)
North MS Support Services Inc
830 S Gloster Street
Tupelo
,
MS
38801
26-0718275
Support Servi
DE
NMHS
C Corp
No
Schedule R (Form 990) 2018
Page 3
Schedule R (Form 990) 2018
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2018
Page 4
Schedule R (Form 990) 2018
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2018
Page 5
Schedule R (Form 990) 2018
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2018
Additional Data
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