‘A For the 2015 calendar year, or toxyear beamning MAY 1, 2015 andending APR 30, 2011 De Information about EXTENDED TO MARCH 15, 2017 Return of Organization Exempt From Income Tax Under section 601), 527, or 447(aK1) ofthe Internal Revenve Code except private foundations} ~ Be Donot enter socal securty numbers on this form a t may be made publ. foo Focm 990 and its instructions is st www is govlorm90. inspection B owas, [OName of oganzaton 'D_ Employer identification number MISSISSIPPI HOSPITAL ASSOCIATION = | “bong business as 64-0411249 "Number and stroot (oP, boxifmalis not iwered Yo sea adress) Reamute | E Telephone number | Tax exempt status POST OFFICE BOX 1909 MADISON, MS 39130 J Website: » WHW. MHANET.. ORG. Form of xganzavor; [3] Coporauon_( [Trust Parti] Summary City or town, state or pounce, countty, and ZIP ork 601-368-3208 p postal code H{a) Is this 2 group retum F Name and address of pnnoipal offeer TIMOTHY MOORE tor subordinates? _]ves [XINo “* |116 WOODGREEN PLACE, MADISON, MS 39110 Hib) west avasnses eeucee—lves [_INo- sou) Elson 6 insercoy [Te8e79y} 0127] No atach att (coe metuctons) | fc) Group exemption numer Pe ‘ssoeution one 1. Year of formation, 19°31] ma State of egal éomsie: MS | 1 Broly desorte the oganwaton's mason ormost saniicant actwoee PROMOTE EXCELLENCE IN HEALTH 2) SERVICES THROUGH SERVICES IN ADVOCACY, EDUCATION AND INFORMATION E| 2 Check ns box Be L_] he erganaton discontinued ts operations or disposed of more than 25% ofits net assets 3 | 3. Number of wong members of the governing body (Part Vl, be Ya) 3 16 $4 Number otimdependent votng member of the governing body (Pa Vt ne 15) 4 15 | Total number of mwas employed n calendar year 2015 Par V, hoe 28) 5 2a | © Total number of volunters (estimate # necessary) el Q auc | 7 Totalunoated busness revenue rom Pa Vil okima (0), ne 12 7a 379,030. = b Net unrelated business taxable income from Form 9907, ine 34 - to] <217,389.> & Pror Ye Current Year = g| 8 Conlnbuttons and arants (Part Vl tne 1h) o. O. pe ; 9 Program service revenue (Part Vil, ine 2a) 12,262,533.| 10,260,305. E810 tovestmentncome (Par Vil, cols (A) nes 3,4, and 70) 316,615. 212,371. “<1 41 otner revenue (Part Vil column (A), nes 5, 64,8, Se, 10¢, and 116) 197,721. 187,540. 6 [12 Teta evenue aad ines 8 through 11 (rst equal Par Vl, coum (A be 12) 12,776,869.| 10,660,216. YB Tis Gents ane simiar amounts pas (Part, column (ines 3 [5/930,263.| 4,360,356. 14 Benois pad to ar for members (Pat column (toe 4) | 0. oe é | 15. Salanes, other compensation omployee bones (Part IX, cokima (bes 5:10) 3, 283,483.| 3,768,512. 8 | 160 Professional funating fees (Pat X, column (A), ne 110) _0-| oO. B | “ Ttaltundeaang oxpenoee Part coun (0), me 25) Be . 7 5 47 other expenses (Part, column fl) nes Va t1d, 194240) 2,938 ,286.| 2,577,750. 48. Total expenses Ada ines 197 (rust equal Parf Oh 12,152,032.| 10,706,618. 19. fomoenosaxpnaee Sustad ne Otani 1a FEC EI VED 24,837. <46,402.> x | [Benning ot cane ver | End of oor B3| 20. Total assts (Par x, ne 16) < 8 20,154,531.[ 20,019,384. $2) 21 Totaluabives (Par x, bne 26) By MAR 37 2097 2 3,743,280.) 3,972,752. 32 | 20 Notascatsortund balances Subtract ine 21 oly MBE © 16,411,251.) 16,046,632. [Part if [Signature Block OGDEN UT Under penates of erry, I dca at Rave examined ts tur, MUG SECOMPaTI MN SEWGARS A slater and fo he best of my knowledge and bleh, tis L on |b tes - yp 3/6 foe |) RICHARD GRIMES, CHIEF FINANCIAL, OFFICER Sooo Dat ean Prnt/Type preparer's name Preparers signature 7 a Joe CI] Pw fad ROBERTA. CUNNINGHAM, CPAROBERT A. CUNNINGHAMO3/16/17 ‘son P00019428 rrewer [fumsnane_y. GRANTHAM POOLE BT AL, PLLC ramsey 64-0803390 Use Only [Frm’sadiressy 1062 HIGHLAND COLONY PRKWY STE 201 RIDGELAND, MS 39157 _ Phone no.601-499-2400 May the IRS discuss this return wath the preparer shown above? (see instructions) Dilves _[] No teow ee LAB For Paperork Reduction Act Notwe, se the spate navuSons rm D002) GR 2‘Statomont of Program Service Accompitsnmonte Check Schedule 0 contains a response or note to any he ths Part I Ga “1 Bhety descnbe the organization's msn THE MISSION OF THE ASSOCIATION IS TO SERVE ITS HOSPITAL MEMBERS IN PROMOTING EXCELLENCE, EFFICIENCY AND ECONOMY IN ALL HEALTHCARE INSTITUTIONS IN MISSISSIPPI, TO IMPROVE THE SERVICES RENDERED TO PATIENTS BY SUCH INSTITUTIONS AND GENERALLY TO PROMOTE, PROTECT AND 2 Dal the organization undertake any sgniicant program services dunng the year which were not sted on the pnor Form 980 or 990.£27 (Wes [xno Wes," describe these new services on Schedule O 3 Dad the organization cease conducting, or make signiicant changes im how # conducts, any program services? (Clves Cito tes," descbe these changes on Schedule O 4 Describe the organzation’s program seruice accomplishments for each of is thee largest program senwces, as measured by expenses ‘Section $01(0),9) and 501(c)4) ergantations are requred 10 report the amount of grants and alacations to others, the total expenses, and raverue,¥ any for each program service reported 43° (Coo Newnes 10,706,618. wcuarggmeve 4,360,356.) (rows 10,660,216.) PROMOTE EXCELLENCE IN HEALTH SERVICES THROUGH SERVICES IN ADVOCACY. EDUCATION AND INFORMATION 4 (cme Veperees euang guns 7 fawn ? 4¢ (cous Veoenaees snewora ganaers 7 Won y “4d_ Other program serncas (Descnbe in Schedule O) rn sneudnp iba 1 foe's 1 “Ae Total progiam serve expenses 10,706,618. orm 890 (2075)Part IV | Checklist of Required Schedules 990 2015) MISSISSIPPI HOSPITAL ASSOCIATION 640411249 Page3 ‘Yes | No 1 Is the organzabon descnbed in section $01(c)(3} of 4947(a(1) other than a prwate foundation)? Fes," complete Schedule A 1 x 2 Is the organization required to complete Schedule B, Schedule of Cantnbutor? x Did the organization engage in direct or mdrect political campaign activities on behalf of or n opposition to candidates for public office” If "Yes," complete Schedule C, Part x 4 Section 501(¢)3) organizations. Did the organization engage in lobbying actwties, or have a section $01(h) election n effect ‘dung the tax year? If "Yes," complete Schedule C, Part It 4 ‘5 Is the organization a section 5014), 501(c}5), or $01(6X6) oxganzation that recewes membership dues, assessments, oF ‘similar amounts as defined in Revenue Procedure 98 197 If "Yes," complete Schedule C, Part il 5 |x {6 Od the organization maintain any donor advised funds or any sila funds or accounts for which donors have the nght to provide advice on the distibution or mvestment of amounts in such funds or accounts? if “Ves,” complete Schedule O, Part | |_6 x 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, ‘the environment, histone land areas, or histone structures? If “Yes,” complete Schedule D, Part i! 7 x 8 Did the organzation mantan collections of works of at, hstoncal treasures, or other simiar assets? "Yes," complote ‘Schedule O, Part i 8 x 8 Did the organcation report an amount n Part X, ine 21, for escrow or custodial account labilty, serve asa custodian for — | ‘amounts not sted i Part X, o provide credit counseling, debt management, credit repar, or debt negotiation services? 1"Yes, complete Schedule D, Part IV 8 x 10 Did the erganaaton, directly or through a related organization, hold assets 1n temporaniy restncted endowments, permanent ‘endowments, or quasrendowments? If "Yes," complete Schedule D, Part V 10 ace 111. Ifthe organization's answer to any of the folowing questions is "Yes," then complete Schedule O, Parts VI, Vil, Vil, IX, OFX | 8 applicable | {2 Did the organization report an amount for land, buildings, and equipment in Pat X, ine 107 If "Yes," compete Schedule D, Part vt asa] X 1b Dad the organization report an amount for investments - other secunties in Part X,bne 12 that 1s 5% or more of ts total assets reported m Part X, ine 167 /f "Yes," complete Schedule D, Part Vil 1tp| X ‘© Did the organization eport an amount for vestments - program related in Part X, ine 13 that 1s 5% or more of ts total ‘assets reported in Patt X, ine 167 /f "Yes," complete Schedule O, Part Vil tte x 4 Dd the organization report an amount for other assets in Part X, ne 15 that 5% or more of ts total assots roportad in Part x, ne 167 I "Yes," complete Schedule D, Part X s14| X ‘¢ Did the organization report an amount for other habalties in Part X, ine 25? f "Yes," complete Schodule D, Part X tte] X id the organization's separate or consolidated financial statements forthe tax year nclude a footnote that addrossos | the organization's labity for uncertain tax positions under FIN 48 (ASC 740)? if "Yes," camplete Schedule D, Part X aw] x | 412d the organtzation obtain separate, dependent audited financial statements forthe tax year? f "Yes," complete Schedule 0, Parts X1and XI! 42a} bb Was the organization nckuded in consolidated, independent aucited financal statements forthe tax year? | Yes,” and i the organcation answered "No" to ine 12a, then completing Schedule D, Parts XIand Xilis optional 1a | X 13s the oxganzaton a school described in section 170(b)(1WANW? If "Yes," complete Schedule E ir eelexe ‘14a_Dd the organzaton mantan an office, employees, of agents outside of the United States? 14a, x 'b_ Dad the organtzation have aggregate revenues or expenses of more than $10,000 from grantmakong, fundraising, business, investment, and program service actutes outside the United States, or aggregate forexgn investments valued at $100,000 ‘0F more? if “Yes,” complete Schedule F, Parts land IV [rao |__| x 15 Did the organization report on Part IX, column (A) ne 3, more than $5,000 of grants or other assistance to or for any | ‘foreign organization? If "Yes," complete Schedule F, Parts i! and iV las | |x 16 Othe organization report on Part IX, column (A ine 3, more than $5,000 of aggregate grants or other assistance to | ‘oF for foreign individuale? “Yes,” complete Schedule F, Parts Mand IV Le. x 17 016 the organation report a total of more than $15,000 of expenses for professional fundraising services on Part IX, ‘column (A, ines 6 and 1127 if Yes," complete Schedule G, Part 7 x 18 Did the organuzation report more than $15,000 total of fundraising event gross income and contnbutions on Part Vil. nos. ‘e and 8a? if "Yes," complete Schedule G, Part I! EIB ¢ 19 Dd the organation report more than $15,000 of gross income from gaming actwities on Part Vil, ne Ga? If "Yes," complete Schedule G, Pati 19 x Form 990 (2015)Form 990 2015} MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 _ paged [Part IV [Checklist of Required Schedules contrived) Tyee | No_ ‘20a Did the organzation operate one or more hospital faites? if "Yes," complete Schedule H 200) | X bb if Yes" tone 20a, dic the erganzaton attach a copy of ts audited fnancal statements to ths roturn? oo || 21. Did the organaation report more than $5,000 of grants or other assstance to any domestic organaation or ‘domestic government on Part X, column (A, ina 12 1f "Yes," complete Schedule, Parte J and 22 Did the organaation report more than $5,000 of grants or other assistance to or for domestic ndivcals on ar IK, Cokin (nw 2? IF "Yes," compte Schedule |, Parts and 2 x 23 Did the organzation answer “Yes" to Par Vil, Section Aline 3,4, or 5 about compensation of the organtzabon's current and former offcors, directors, trustees, key employees, and highest compensated employees? if "Yes," complete Schedule J as | x ‘24a, Did the organzation havea tax-exempt bond issue with an outstanding pancypal amount of more than $100,000 as ofthe last day ofthe year, that was sued after Dacember 31, 20027 I Yas,” answer ines 24D through 24d and complete Schedule K IN" 90 to ine 258 240 x 'b Oud the organcation invest any proceeds of tax-exempt bonds beyond a temporary pened excepton”” [2a {© Od the organization mantan an escrow account other than a refunding escrow at any ime dunng the year to detease any taxexempt bonds? 28e 01d the organzation act as an “on behalf of issue’ fr bonds outstanding at any tme dunng the year? ‘ad £259 Section 601(¢)9), 601(¢K4}, and 601(cK28) organizations. id the organzaton engage mn an excess benefit transaction vath a eisqualted person dung the year? If "Yes," complete SchoduleL, Part 25a bb Is the organization aware that & engaged in an excess benett transaction witha dsqualiteg person a por year, and that the transaction has not been repartad on any ofthe erganzaton's prior Forms 990 or 990.77 I "Yes," completo Schedule L, Part) 25 26 Did the ergancation report any amount on Part X, ine 5, 6, oF 2 fo ecewables rom or payables 10 any current oF former oficers, drectors, trustees, key employees, highest compensated employoes, or disqualified porsons? if "Yes, complete Schedule L, Part! 2 | x 27 Did the organczation prove a grant or other assistance to an officer, director, tustes, key employee, substantial Ccontroutor or employee thereot, a grant selaction commattee member, or 1 @ 35% controles entty or famiy member of any ofthese persone? If "Yes," complete SehedueL, Pat Il a x 28 Was the organization a party to business transaction wth one ofthe folowing partes (see Schedule L, Part instructions for applicable fig thresholds, conditions, and exceptions) {8 Acuent or former oftcer, rector, truste, or key employee” If "Yes," complete Schedule L, Part 280 x b Atarnly member ofa cunt or former oficer, rector, trustee, or key employee? If "Yes," complete Schedule L, Pativ [28 x © An entity of which a curent or former officer, dector, rust, or key employee (ora family member thoreof was an oftcer, ‘rector, trustee, oF direct or indirect owner? if "Yes," complete Schedule L, Pat IV 280 x £29 Did the organzation recewe moce than $25,000 non-cash contrbutions? If Yes,” complete Schedule Mt 29 x 20 Did the organization racene contnbutons of a, historical treasures o other amar assets, or qualiad conservation ceontnbutions? if Yes," complete Schedule M 20 x 81. Did the organization iquidate, terminate, or dissoWve and cease operations? 11 "¥es," complete Schedule N, Part! or| |x 32 Did the organzation so, exchange, dispose ot, or transter more than 25% of ts not assots?/f*Yes," complete Schedlle Parti 2 x 89 Did the organtzaton own 100% of an entty disregarded as separate ftom the organization under egulations sections 301 7701-2 and 201 770137 "Yas," camplate Schedule R, Pat | x ‘34 Was the organization related to any taxexemps or taxable entity? If "Yes," complete Schedule, Part Il, Or, and Part V, tne 1 sa | x ‘36a Dud the organization hve a controlled enty wath the meaning of section 512(0K13)? asa| X IF"%ec" to ine 35a, did the organization racanve ary payment from or engage in any transacton wih a controled entity ‘ttn the meaning of section 512(0\13) Yes,” complote Schedule R Part V, Ino 2 5p | X 36 Section 601(cKS) organizations. Did the organation make any transfers to an exempt ron chantable related organization? Yes," complete Schedule R, Pat V, ine 2 96 37d the erganzation conduct more than 5% of ts actwties through an entiy that isnot a related arganation and thats treated as a partnership for federal ncome tax purposes? "Yes," complete Schedule A, Part VI an x '98 Did the organaation complete Schedule O and provide explanations n Schedule O for Part VI, ines 11band 197 Note. Al Form 260 fers are requted to compete Schadule O so X For 990 2015)Form 990 2015), MISSISSTPPI_HOSPITAL ASSOCIATION 64-0411249 Pane Part V] Statements Regarding Other IRS Filings and Tax Compliance Chock i Schedule O contans a response or note to any he nth Pat go Yes] No 12 Enter the number reported in Box 3 of Form 1086 Enter 0-f not applicable [1a 5| 1b Enter the number of Forms W2G included in ne ta Enter 0-if not appicable Le | «Did the organzaton comply wth Backup witnhekig rls for reportable payments to vendors and reporable gaming (Gambing) wengs opie mers? se} | 2a Enter the number of employees reported on Form W.3, Transmital of Wage and Tax Statements, le ‘oc or the calendar year ering wh or wt he year covered by hs return | b atleast one 1s reported on ine 2a ei the e Did any taxable pany noty the organaton that Was ors pary toa profited tax het transacton? | [x € If*¥es. to ne 5a 05, ch he oxganzaton te Form 8896777 self 60 Does te oganzaton have annua oss receipts hat are normaly greater han $100,000, and diate organization sake | any contnbutons that were not tax deauctble a chartablecontrbutens? calli » i1°¥es. aid the exganeaton clude wath ever sootation an expres statement that such contabutons or gts wore not tax deouee? & 7 Organizabons that may receive deductible contributions under section 170\¢). 2 Did the organization ecevea payment im excess of $75 made partly a a cantrbuton and partly for goods and seruces proved tothe pay? | 7a bb IF*¥es," aid the organzaton notly the donor of te value ofthe goods or servces proved? {© Did the organzation sel, exchange, or otherwise dispose of tangbe personal property fr which & was required to te Form 8282? "Yes," indicate the number of Forms 8262 fed dunng the year La | a {Did the erganzaton racewe any funds, dvectly or ndrectly, to pay premums on a personal benefit contract? Te _ Did the erganzaton,dunng the year, pay premums, directly oF ndrecly, on a parsonal benefit contract? i «9 the organzation receved a contrbuton of qualified intelectual property, did the organization fle Form 8889 as requree? | 7 Fr Ifthe organzaton rcavved a contrbuton of cas, boats, axplanes, or other vehicls, ch the organization fe a Forrn 1096.67 | Zh 8 Sponsoring organizations maintaining donor adviged funds. Did a donor advised fund maintained by the sponsonng organization have excess business holdings at any tme dunng the year? 8 8 Sponsoring organizations maintaining donor advised funds. i ‘2 Did the sponsonng organzation make ary taxable dstnbutions under section 4966? oa 'b Dad the sponsonng organzation make a distribution to a donor, donor advisor, oF related person? 9 10 Section 501(¢)7) organizations. Enter ‘2 Insiaton foes and capital contnbutions included on Part Vl ne 12 10a Gross receps, included on Form 990, Part Vil ine 12, for uble use of club facies 100 41 Section 601(¢X12) organizations. Enter ‘2 Gross income from members or shareholders wa 'b Grose income from other sources (D9 not net amounts due or pad to other sources against amounts dus oF received from thorn) eT ‘28. Section 4847(a)1) non-exempt charitable trust. Is the organzation fing Form 990 mn heu of Form 1081? 2a bb I1"¥es." enter the amount of tax-exempt ntorestrecowed or accrued dunng the year 120 18 Section 501(¢}20) qualified nonprofit health insurance issuers 1 ‘Is the organwzaton icensed to issue qualified heath plans in moe than one state? ae Note. See the structions for addtional nformatin the oxganzation must report on Schedule O »b Entor the amount of resorves the organizations raqurad to mantan by the states in which the organization i icensed totue qualified heath plans 1 © Enter the amount of reserves on hand 18e “4a. the organzaton recewe ary payments for ndoor tanning serices dunng the tax year? 4a. x bb it-Ves,"has i fled a Form 720 to report these payments? If "No," prowl an explanation m Schedule © 4b Form 990 (2015)Foum $00 (2015 MISSISSIPPI_HOSPITAL ASSOCIATION 64-0411249 _Page6 [Part VI [Governance, Management, and Disclosure For each "Yes" wosponse to mes 2 thravgh Tb below, and fora No exponse tone 8, 8b, or 10b below, descrbe tho creumsances, processes, or changes m Schedule O See msruchons check if Schedule O contans a response or note to any ine nthe Part Vi Cx) Section A. Governing Body and Management Yes | No 1a. Enter the number of voting members ofthe governing body athe end ofthe tax year ete are mater atierences n voung rights among menbers of he governing body, he governing | body delegates broad auton oan executive comme or simiar commie, expla n Schedule bb Enter the numberof voting members nclided in ine Ta, above, whe are independent 2 Did any otter, director, trustee, or ey employee havea family relationship of a business relationship with any other oftcer, director, ruster, or key employee? |X ‘2 Od the organaation delogate conta over management duties customanly performed by or unde the direct superusion of officers. directors, or trustees, or kay empoyees toa management company of other person? 3 x 4 Dd the organization make any signrficant changes to tts gaveering documents sine the pnor Form 990 was fled” La x ‘5 Ddithe organzation become aware dunng the year ofa significant dversion ofthe organvation’s assets? 5 x 6 Dd the organization have members or stockholders? o |x ‘7a Did the organization have members, stockholders, or other persons wha had the pawerta slact or appomt one or | more members ofthe governing body? ral ca ee 'b Are any governance decisions ofthe organization eserved to or subject to approval by} members, stockholders, oF ‘persons other than the governing body? » x {8 Did ne crganaation contemporaneousy document the mestigs helé ar vnten actos undertaken during the yer by te fallowng: ‘8 The governng body? eo | X 'b Each commatoe with authonty to act on behalf ofthe governing body? | x | 9 Is there any otieor,drector, tustee, or key employee ised n Pat Vl, Secon A, who cannot be reached at he ‘organzation's mating address? if "Yes," prove the names andl addresses n Schedule O 8 x ‘Section B. Policies (7h Secton 6 requests nformaton about potcwes not required by the Internal Revenue Code —[yes | No 10a Oid the organzation have local chapters, branches, or aftates? 108 x bb 11"Yes." eid the organzation have wrtten polcies and procedures governing the actwites of such chapters, affiates, ‘and branches to ensure ther operations are consstent with the orgareaton’s exempt purpose? 100 “11a Has the organization provided a complete copy ofthis Form 990 to all members of as governing body before fing the tom? | 4ta| X | 'b_ Descnbe in Schedule Othe process, any, used by the organization to revew this Form 990 ‘2a. Ds the organization have a wnition contiet of interest policy? I "No,” go to ine 13 val x | 'b Were oficers, directors, or tustees, and kay employees requred to dscose annually ees that could averse to conics? [hae [x {© Did the organization reguarly and consistently mentor and enferce compliance withthe polcy? If "Yes," descnbe (in Schedule O how ths wes done s20| X 48 Old the organization have a wntten whvatleblower pokey? +3 | x 14 Od the organcation havea werten document retention and destucton policy? ul x 15 Od the process fr determining compensation ofthe folowing persons chide a rewew and approval by ndependent 7 persons, comparabty data, and contemporaneous substantiation ofthe deliberation and deession? 19 The organuzation's CEO, Execute rector o top management offi 150| X bb Other otfices or key employees ofthe oxganization 0 | x. 17Yes"toline 15a or 15b, descnde the process in Schedule 0 (e00 instructions) 16a Did the organeation nvest m, contrbute assets to, or paricpate mat venture or similar arrangement with a taxable entity dung the year? 16a x »b If7¥es," ded the organization folow a wntten polcy or procedure requieng the organzation to evaluate its partrpaton inant venture arrangements under applicable federal ax aw, and take etens to eafequard the organization's ‘exempt status wih spect to such arrangements? 16 Section C. Disclosure ‘17 Lt the states wth which a copy of this Form 990 6 requrred to be fied PMS. 18 Section 6104 requrres an organzation to make its Forms 1023 (or 1024 i appieable), 990, and 890°F (Section 501(6\@)s only) available or pubke mspection Indicate how you made these available Check all that apply [Jownwebste — [_Janotner's webste [XJ Uponrequest. —[_] other fexpiain in Schedule 0) 19 _Descnbe in Schedule O whether (and $0, how) the organization made its governing documents, confict of interest policy, and financial ‘statements available to the pubic dunng the tax year 120 State the name, address, and telephone number of the person who possesses the organization's books and records D> RICHARD GRIMES - 601-368-3204 _ 116 WOODGREEN CROSSING, MADISON, MS 39110 008 21818 Form 990 (2015) 6Fam 990 2015 MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 _ Page7 [Part Vil Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors check f Schedule O contans a response ornots to any nen this Part VI f=] ‘Seeton A. Oficere, Directors, Trustees, Key Employees, and Highest Compensated Empl = 1a Complete ths abe fra persons requ tobe Isted Report compensaton forthe calendar year ending with ov win the orpanaaton's Wx year 4 Lst al of he organization's current fica, directors, trustee (whether ndiduals or organtations| regardless of amount of compensation * Omeoumas (3h (and (46 componsaton was pad a ee ee st lof te organzaton's current key employees, any See mstuctons for demon of "key employee " * List he crganzanon' five erent highest componsated employes (other Han an ote, director tee o¢ Key employee) whe receved port able compotion (ox 5 of Form W2 andlor Box Fo Form 40S6ANS) ot more than $ 100/000 trom the rgaricaton and ay fated organcatone * Lt al ofthe organzaton’ former ofices, Key employees, and highest compensated employees who receved mare han $100.00 of reporable compensation rom tha organaton and any Vlog erganzavona * List al ete organzaton's former rectors or tustees that ecewed,m the capacty 2s a former drector or tuste of the organzaton, ‘more than $10,000 of eportabe compensation om he organtzaton and ay ated engancatons Lt porsons nthe fotowng order induualrstees or rectors, msttutonal ustees, tices, key employees, highest compensated employees sa former such parsons CF oneck ths box t nether the exganzaton nor any ested eiganzaton compensated any cuent oficer, drector or tustee & “) ® ©) o © o Name and ile average | eonnEO enone | _Repetabe Reportable | estmatod hours per |Set"hScsewcstdsarm | compensation | compensaton | amount of eg ie trom from rites thee (istany the crgarations | compensation hours for organeaton | (w2/t090NISC) | frome rolated ew2rrosemise) organization lrganizatons and related baiow organizations toe) - eam Buack 0.00 NORTHERN JUDICAL orstRECT x 0. 0, _o (2) Avi Hoover 0.00 CHATRIAN x oe 0. o. (3) Danie BiaKiock [0-00] ] CENTRAL JUDICAL DISTRICT ale 0. o. oO. (4) EVAN s.DTDLARD 0.00 SOUMIEAST COUNCIL/ALTERKATE. AHA DELS eae) Ole o (5) BRENDA WALTE 0.00 SOUNMERN_JUDICAL DISTarcT x 0. 0. 0. (6) AMES H. JACKSON 0.00 cman ELECT x o 0. 0. (7) scorr REED 0.00 {RUSTEE_REERESENTATIVE __ |x 0. 0. 0. (8) cHUCK REECE 0.00 PAST CHATRIAN i x S 0. 0. oO. (9) Davi curr |_0.00 DELIA COUNCHL. AKA DELEGATE x 0. == 0 o. (20) LESTER x. DTAHOND 0.00 JACKSON-VICKSHURG_COUNCTL, x 0. 0. o. (11) SEMNES ROSS, JR : SONNET coUNCrL x 0. _o| _o. (22) CLTNTON EVANS EAST CENTRAL COUNCIL x 0. o. 0. (23) WANDA BROOKS cooPER 0.00 FercI0 x o. 0. 0. (20) games WoPRIA 0.00 NORTHEAST COUNCIL x 0. 0. (25) DARYL W. WEAVER ‘CENTRAL COUNCIL . x) __o. (28) PAUL cADE PRATRIE COUNCIL x oO. (7) TEMOTY H, WOORE 40.00 ‘ERESEDEMTLGEO xl Ix 584,224.) 61,299. saz se-88 Form 990 (2015)Form 990 (2015) MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 Paae8 [Part VIl| section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) “) 6 © © © © Name an ie average | su POSH, | Reportabio Reportable Estimates hours per Ser “msseawn’seaiin| compensation | compensaton | amount of week | stun ahanl ‘torn from related other stany | the corganczations | compensation hours for exganzaton | w2rroagmaisc | ~ tromtne rolted cw 2n09smisc) ‘oxganzation| lvgaratone and rates below organizations, ne) (18) RICHARD GRIMES [20.00 CHOWMHA, EXEC DIR — MEA 20.00 x __241,253. o.| 40,672. (19) MARCELLA MCKAY CIEE OPERATING OFFICER _|x 402,944. o.| 57,847. (20) STEPHEN DIeKsoR | Ye OF GOVT RELATIONS = 3 417,097. __0.| 58,448. (2i) DEBBIE Loca PROJECT DIRECTOR HCQH x] 113,283. 0.| 16,545. (22) sunt Ross V,P,_OP EDUCATION x 118,268. o.| 23,297. (23) uawenLe wees CLINICAL DIRECTOR oF COW x 114,360. 19,499. (24) MENDAL KEMP DIRECTOR OP CENTER FOR RURAL. HEALTH x 146,690.| io. 14,531. (25) STEVE LesuEY DIRECTOR OF DATA sERVICES x 128,144 | o.| 16,900. 1b Sub-total » [2,266,263] 0.[ 309,038. © Total rom continuation sheets to Part Vil, Section A i 0. 0. Oo. A Total (add tines 1b and 1c) » [ 2,266,263. —_0.| 309,038. 2 Total number of ncnnduals (pcluding But not Med Yo those ised above) who recerved mare than $100,000 of eparable _compensation from the organization D> 2 Yes | No. 30d the oranzation ist any former ofcer, director, oF rstee, key employe, oF highest compensated employee on [ Ine 12° if "es," complete Schedule J for such meludual 3 x 4 For any mdiidual sted on ine ta, the sum of reporable compensation and ether compensation from the organization and rlatod organzatons greater than $150,000? if "Yes," complete Schedule Jfr such mdhncual 41x {8 Did any person iste on ine 1a recewe or accrue compensation from any unclates organzation oF ndwidual for services | rendore to the oranzaton? “Yes,” complete Schedule J for such perzan si |x ‘Section B. Independent Contractors _ 11 Compete ths table for your ve highest compensated independent contactors hal recewed more than $700,000 of compensation fram the erganzation Report compensation fr the calendar year ending wth or within the organization's tax year “ ®) ~@ Name and business edsress NONE. Desenpton of serves Compensation ‘2 Total number of independent contractors (ncluding but not lmtad to those Isted above) who recewed more than $100,000 of compensation from the organzation_P> 9 Form 990 2015)Fox 990 2015), MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 _ Pape9 Part Vill | Statement of Revenue Check i Schedule O contans a response of note to any nem ths Pan Vi a G, Gy, @ Totaevense | Reeder | unpiats | Rene treused exempt toneton | business | Wom fax under revenue ‘evenuo SBC Federated campaigns 10 Memeorshp dves tb Fundraising events te Related organizations, 10 Government grants (contibutions) [42] ‘other controutons, ots, rans and sear amounisnot nccedavove a4 Total, Add ines ta. > usiness Cod MEMBERSHTP_SPECIAL, DUES Ast 0088 5,147,856 5,147,856 MEMBERSHIP DUES 900089, 3.29/00 3/229 000 SOUERNMRIET GRANTS 900099) sat a7) e147 ADMINISTRATIVE. SERVICES 0098 765. 870 464 840, 302,030, PROGRAM CONFERENCE 900039, 261,815 261575 Allother program service revenue | Tspooss 1153) 1433 Total Add inos 2024 0, 260_308. "3 Investment come including dvionds, mtorest, and ‘other sinter amounts) “4 Income trom investment of tax 5 Royahies 58466 358 466 ‘mpl bond procoods Rea |) Personal Ga Goss rents 62 bb Less rental expenses ° Rental come or fose) 162,925 1d Not rental ncome or oss) > 162,925 34,928, 78,000, 7/9 Gross amount tom sales of [(()Secunties |W) Other assets other than inventory [3,179,316 250. bb Lose cost or other basis and sales expenses 3,325.61 ° © Gain or (ass) S146 945, 230 4. Net gan or (oss) > 148,095. 2146.09 18 a Gross income from fundraising events (not noting $ of contnbutions reported on ine Te) See Par y,hne 18 2 b Less drect expenses . {© Not ncome or foss from fundraising events > 9.2 Gross income trom gaming actwites See Part, lne 19 | bb Lass direct expenses »| ‘© Nat income of oss rom gaming actuties > 10 a Gross sales of mventory, less eturas and alowances a bb Less cost of goods sold a Not come oF (oss) rom sales of ventory > Miscolancous Reveruo| ness Code YESCELLANBOUS REVENUE 500085) 4.615. 4.61: Other Revenue ‘omer revenue Total. Add ines 112.116 2485, 42 _ Total revenve See instructions zosso_ns| 9 s22 220) 399 030 358466 ance wes Form 990 (2018) b d MadForm 990 20151, MISSISSIPPI HOSPITAL ASSOCIATION [Part IX] Statement of Functional Expenses ‘Section 501(6\S) and 501(e)4) arganaabans must Check f Schedule O contans a response oF note toa 64-0411249 Page 10 fe all columns All other organaatons must complete column (A) Lae this Par not elude amount reported on 9) G, 7 70.0 Sb.and Oo ofPat Totalexpenses | Program serwce | | Management and ry ena 1 Geni and ater assent deste organs and domesti goverment. See Part W, ne 21 4,360,356. 2 Grants and other assistance to domestic indole Soo Pat V, ine 22 3. Grants and other asistance to foregn ‘exganzatons,foregn govemments, and foregn indole Soe Part V, ines 18 and 16 “4 Bens paid to or for members 5 Compensation of curert oicers, rectors, trustes, and key employees 1,863,784. |& Compersaon not meuded above, to dsquaied persons as defined under seeton 49581) and persons eseted secon 4956138) 7 Other stanes and wages 1,444, 768. {Pension plan accruals and contrbutons(rcude section 40 (and 409() employer contbutors) 213,172, 9 Othor employee benehts 100,994. Payottaxes 145,794.) 11. Fees for somces(nanemployees) ‘2 Management 28,585. b Legal 205,681. fe Accounting 20,130. 1 Loobyng 15,031, ‘¢Prolessirlfundeasing serves. Seo Pat WY, ne 17 {Investment management foes {8 Other (fine 11g amount exceads 10% o ne 25, lun (A) amount, i ta £19 expenses on Sen 0) 11,534. 42 Advertsing and promotion 585. 49° Office expenses 23,775. 14 Informaton technology 15 Royates 46 Occusancy 154,442, 47 Travel 183,871. 48 Payments of ravelorentertanment expences. for any federal, state, orca! publeofeals 49 Conferences, conventons, and meetings 177,313. 20. Interest 22,346. 21 Payments toatates 122 Deprecston, depletion, and amortzaton 299,503. 23. Insurance 61,526. 24 eerste ges otc Sov. (ist mszelaneous expenses mine 2 thn ‘ae ainout exceeds 1% tne 2 elt (A) Srv st ne 2te expenses on Sched) « CONSULTING EXPENSE 793,013, » DATA PROCESSING 314,690. DUES, SUBSCRIPTIONS & P 43,939. @ SPEAKER FEES 37,231. «@ Allother expenses 183,955. 25 Totalfunctionl expenses, Add bes ituough2ae | 10,706, 618 26 Jointeont Complete ts ine ony Pe organcaton repores column 8) jt costs om acombned tduzatonal campaign and tundasing stetatn, crwrtwe > [vias s0>o:2050 roe 8 Form 980 (2015) 10Four 990 (2015) MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 Paget [Paw [ Balance Shoot e+ HOSPITAL ASSOCIATION 64 04)1249 fase tt _ Check # Se toany = = CI « @ Beginning of year End ot year 1 Gash noninterestbeang 770,393. 1 | 1,289,794. 2 Savings and temporary cash vestments = 2 _ 3 Pledges and grants recewable, net 3 | 4 ecounts ecenrabl, net 423,070.| 4 412,691. 5 Loans and eter recewables from cunt and former oftees, doctors, trustoes, key employees, anc highest compensated employees. Complete Pan of Schedule 89,200.| 5| 241,077. {6 Loans and othr recavabos ftom other squatted porsons (as defined under section 4958hN(), persons desenbed n secon 4958(cK3}), and contnoutng employers and sponsonng orgarwzatons of section 501(cK9] voluntary 2 | employeus'benetciary organzatons (ee mst ComploteParivotsent = |_| | 7 Notes and ans recenabe, net 2 = |e taventones forsale or use 8 = 9 Prepad expenses and deterred charges _43,318.[ 9 | _ 101, 882 10a Land, buidings, and equipment cost or other | basis Complete Part VI of Schedule D soa|__ 8,067,556. b Less accumulated depreciation (hop |"~3,861,818.| _4,343,009.|10c| 4, 205,738. 11 Investments - pubiey traded secures " 42 vestments other secunties So0 Part IV, tne 11 10,642, 893.| 12| 10,082,746. 12° Investments progiamrolated Soo Pat Vine 11 ee a “4 Intangbie assets 48 Other assets See PartV, ne 11 3,842,648. 3,685,456. 16 Total assets, Ads ines 1 hough 15 (must equal hoe 34) 20,154,531. 20,019,384. “7 Accounts payable and accrued expenses 1,301,693. 1,753,492. 18 Grants payable _ 49 Detered roverue _ 140,207. 206,905 20 Taxexempt bond labites 21 Escrow or custodial acount tabity Complete Part V of Schodule — _g | 22 Loans and other payables to cuent and former oficers,drectors, wsto 2 | key employees, highest compensated employees, and disqualified persons 3 | compote Par itor Schacue L = 3 | 25 Secured mortgages and notes payabie to unrelated thd partes = ‘G61, 136. 24 Unsecured notes and leans payable to unrelated thud partas a | 25 omer iabites inckuing federal ncome tax, payabes to relate thd partes, and ote abit not cluded on ines 1728) Compito Par xot | Scheduie D |-2.619,131./ 251,551,219. 28 Total labilties, Add ines 17 through 25. 3,743,280. 3,972, 7526 ‘Orgarizations that follow SFAS 117 (ASC 056), check here ® LI and | 1 g.| complete tines 27 through 29, and tines 33 and 3. 8 | 27 Unvestnctod net assets a | 20 Tomporanlyrestcted net assets 28 $ | 20. Permanontyrestrctod not assets 20 aman é Organizations that do not follow SFAS 117 (ASC 958), check here D> [X] 5 | and complete lines 30 through 34. | 20 Capital stock or trust pmevpal or curent funds 0.| 30 o. 8 a1 Padinor capital surplus or land, bulding, or equpment fund 3,013,132.| a1] 3,013,132. | 32 _otaned earings, endowment, accumulated come, or other nds 13,398,119.| s2[13,033,500. = | 23. Totainet assets or und balances [46,411,251.| 16,046,632. 94 Total kabites and net assetsfund balances 20,154,531. 20,019,384. Form 990 2018) 1.Form $90 2015) MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 page 12 [Part x1] Reconciliation of Net Assets Check Schedule © contans a response or note to any Ine in ths Pat XI = ib] 1 Total venue (must equal Part Vil col be 12) 1|__ 10,660,216 2 Total expenses (rust equal Pat X, column (A, ne 25) [2{ 10,706,618. 3 Revenuolocs expenses Subtract ine 2 from ine + [st <46,402.> 4 Net asses or fun balances at bognnng of year (must equal Part X ine 33, column) «| 46,411,251. ‘5 Netunraatzed gans (osses) on nvestments “s | <493,028.> © Donated sorress and use of facies 6 7 Investment expenses H 8 Prorpenod acstments | —— 9 Ot changes m nat asets or fun balances oxplan n Schedule O} ® 174,811. 40 Net assets or fun balances at end of year Combine ines 8 through 9 (must equal Part Xin 3, coh 8) _[| 16,046,632. Part Xil| Financial Statements and Reporting Chuck Senegl contans a respone ont tary mths Pat oa Yes] No 1 Accounting matted ured to prepaeine Fon 960 Clcasn (Elacena! (omer 7 ite ogancaton change 5 metho of scouring Fam apr year or enoched “‘Oter expla m ScheaeO reviewed by an ndependent accountant? al |x 2a. Wore the organzaton's financial statements comp it "Yos." check a box below to ndicate whether the tnancial statements for tha year were compiled or revewed on a separate bas, consokdated basse, or both Clsseparate bass [I Consoidates basis] noth consotdated and separate basis 'b Wore the erganizaton’sfnancial statements aucited by an mdependant accountant? 19s," check a box below to ndicate whether the nancial statomonts forthe year wore audited on a separate basis, consolidated basis, of bth (CJseparate basis [X] Consolidated basis ©] Both consolidated and separate basis © fe" tone 2a oF 2b, doos the organzaton have a comme that assumes responsity for oversight ofthe aut, review, or compilation of ts nancial statement and selection of an independant accountant? the organization changed attr its oversight process or selection process dunng th tax year, oxplan in Schedule O ‘9a. As a result of a federal award, was the organaation required to undergo an audit oF audits as et forth i the Single Audit ‘ct and OME Circular A123? [20 »b I1"Yes, 66 the organzaton undergo the equed aust of audits? Ifthe organzaton dd not undergo the equred audit ‘ot ucts, explan why m Schedule O and describe any steps taken to undergo such audits 2b Form 990 018) 12SCHEDULE c Political Campaign and Lobbying Activities (Form 990 of 990-€3 u 7)) For Organszations Exempt From Income Tax Under section 50'(¢) and section 627 oe > Complete i the organization described below. Attach to Form 990 or Form 990-E2. Sceearscae'eewce” | Pe Unormation about Schedule C (Form 990 or 990-2) ané ent Pubic inaucionsisatwornirgortomaen, | nen itthe organization anawered "Yes," on Form 890, Part Vine 3, or Form 990-E2, Part, line 46 Poltcal Gampargn Acti *# Section 501(0(8) organzations Complete Parts 'A and ® Do not complete Part :C * Section 501(9 other than section 601(0K3) organzabors Complete Parts 'A and C below Do not complete Part 18 * Secton 527 organzatons Complete Part 'A only ithe organzation answered "Yes," on Form 960, Part IV, line 4, or Form 990:E2, Part Vine 47 (Lobbying Actes), then # Section 501(6(8) organzations tha have fled Form 8768 (electon under section 501th) Complete Part HA Do not complete Part Ih + Section 501(e18) organzations that have NOT fled Form 5768 (election under secton 501(1) Compete Pat iB Do not complete Pat I-A {tthe organization answered "Yes," on Form 980, Part W, ine & (Proxy Tax) (ee separate instructions) or Form 980-€2, Part V ine ¢ (Proxy ‘ax)(e6e separate structions}, then # Secon 501(e, (06 organzatons Complete Par i Tame of organzaton Employer identification number MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 [Part-A|_Complete if the organization is exempt under section 501(6) oF a section 527 organization. then 1 Provide a description ofthe oxganzation's direct and indirect potical campaign acttesm Part 2 Pottica expenaitures ms 2 Volunteer hours Part -6| Complete if the organization is exempt under section 501(0)@)._ 7 “1 Enter the amount of any excise tax mcured by the organzation under section 4955 hs 2. Enter the amount of any excise tax mcurred by organation managers under section 4955 ms 3. Ifthe oxganzaton incurred a section 4955 tax, cc fe Form 4720 for ths year? Tyee [Tne ‘4a Was a correction made? Coves Cino bit"¥es," descnbe m Part V [Parti-C[” Complete if the organization is exempt under section S0T(e), except section SONG). 7 Enter the amount rectly expended by the fing organsation for section S27 exempt function actwtes ms 2. Enter the amount ofthe fkng organization's funds contabuted to other organizations fr section 527 ‘exompt function actwibes ms 2 Total exempt function expenditures Add hnes 1 and 2 Enter here and on Form 1120.POL, ine 170 ms 4. 0d the fing erganzaton tie Ferm 1120-POL for ths year? Yes No 5 Enterthe names, addresses and employer dentitcaton number (EIN) ofall section 627 poltical organizations to whch the fling organization ‘made payments For each organization listed, enter the amount paid fom the tng organization’ funds, Also entrthe amount of potical contnbutionsrecewed that were promptly and drectly delvered toa separate pottical organzaton, such asa separate segregated fund ora poltical action committee (PAC) If addtional space s needed, prowde information in Par IV (a) Name {b) Adéress T EIN {d) Amount pad from | _{e) Amount of political fing organzation’s | contnbutions recewed and funds ttnane, enter-a- | promptly anc dvectly delverad toa separate politcal organization none, enter 0 For Paperwork Reduction Act Notice, see the Instructions for Form 960 or 990-EZ ‘Schedule G (Form 900 or 800-EZ) 2015 Se 13Schedule C Form 990 or 990£7\2015 MISSISSIPPI HOSPITAL ASSOCIATION [Part ii-AT Complete if the organization is exempt under section 50%(c)(@) and n 501(h)). 64-0411249 payor led Form 5768 (election under ‘A Check PL] the ting organiza balongs to an ahated group (and lat m Part IV each aftiated group members name, texpenses, and share of excess lbyng expendtures) Creer. [=] tine ting organization checked box A and “bmted contol prowsions app) Limits on Lobbying Expencitures (The term “expenchtures® means amounts paid or meurred,) (@Fung | (e)Atthatod group organization's totale ‘a. Total lobbying expenditures to uence puble opmon (gras roots WBBWNG) Tota! lobbying expenditures to influence a lagsatve body (rect lobbying) «Total obbying expenditures (add Ines Ya and 1b) 4 Other exempt purpose expenditures «Total exempt purpose expenditures (add bnes Yc and ta) f Lobbying nontaxable amount Entar the amount ftom the folowang table n both cokumne ithe amount on ine fe, column (a)0r(b) is: | The lobbying nontaxable amount i: ‘Not ever $500,000 20% of the amount on ine 1¢ ‘Over $500,000 but not over $1,000,000 | $100,000 plus 15% ofthe excess over $500,000 ‘Over $1,000,000 but not ever $1,500,000 | _ $175,000 plus 10% ofthe excess over $1,000,000, ‘Over $1,500,000 but not aver $17,000,000 | $225,000 plus 5% of the excess over $1,500,000 ‘Over $17,000,000 ‘1,000,000. ‘9 Grassroots nontaxable amount (enter 25% of ine 1) bn Subtact ine 1g trom tne 1a if 260 or loss, onter 0 1 Subtractine if from ine te If zero o ess, entor 0 | If there wan amount other than zeraon ether ine 1h or na 1, dic the organization fe Form 4720 reporting section 4911 tax fr ths year? E . ‘Year Averaging Period Under section 50h) (Some organizations that made a section 501(h) election do not have to complete all ‘See the separate instructions for lines 2a through 24) Clves_) no ‘ofthe five columns below. ‘Labbying Expenditures During 4-Yoar Averaging Period Calendar year (orfiscal year beginning n) (2012 ()2013 fey2014 2a. Lobbyng nontaxable amount (2015 (6) Totat Lobbying celing amount (150% of ine 2a, columnye)) Total obbyng expenditures Grassroots nontaxable amount '¢ Grassroots cating amount _(150% of tne 24, column (e) 1 Grassroots bbyng expenditure! 14 ‘Schedule G (Form 990 or 000-€2) 2015‘Schedule (Form 990 or 99067) 2015 MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 cempt under section 501(c)(3) and has NOT filed Form 5768, (election under section 501(h)). For each “Yes,” response on ines ta through 11 below, prod m Part Va detaied descnpton (a) _b) ofthe 1obbying actuty ves | No ‘Amount 1+ Dunn the year, ch te ting organzaton attempt tofluence foreign, national state or Jocaliegislaton, nchiding any attempt to nfuence pubis opinion on alegslatve matter cor reterendur, though the use of Volunteers? Pad staff or management (cide compensation in expenses repented on tines through 1)? Moca advertsemonts? Maiings to mambers,legstators, othe public? Pubications, or published or broadcast statements? Grants to other orgaruzatons fo lobbying purposes? rest contact with legislators, thew stafs, government oficial, ora lgislative body? Flies, demonstrations, sommnars, conventions speeches, lectures, or any seniar means? Other actives? Total Add hows Ye tough 1) 2a Oud the actvtesin ine 1 cause the organaaton tobe not descabed in section S01)? Its." enter the amount of any tax ncurred under section 412 ¢ fe enter the amount of any tax ncutred by organization managers under section 4912 df the ng omanzaton mcured a section 4912 tax, dt ie Form 4720 for ths year? [Part I-A] Complete if the organization is exempt under section 501(c)(4), section 501(c)(), or section 501(c)(6). Yes [Ne 1. Were eubstantaly al 00% or more) dues received nondeduetibe by members? 1 x 2 Did the erganzation make only «house lobbying expandsures of $2,000 or lass? [2 x 3_Did the organzation agree to carry over lobbyng and poitcal expenditures (rom the pnor year a x [Part II-B} Complete if the organization is exempt under section 501(c)(4), section S01(6)(6), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No," OR (b) Part Ill-A, answered "Yes." ures, assessments and smiar amounts from members 1] 3,229,000. 2 Section 162(e)nondeductle lobbying and poltl expenctures (do not include amounts of political ‘expenses for which the section 527( tax was pale, ‘2 Curent year [2a | 648,376 'b Carryover rom last year pee © Total 2c | 648,376. ‘3 Agoregate amount reported in section 803e)1)(4) notices of nondeductibe section 162(e) dues 3 | 551,513 44 notees were sent andthe amount on ine 2c exceeds the amount on tne 3, what portenof he excess does the organcation agree to caryover tothe reasonable estmate of nondeductbleobbyng and poktcal ‘expenditure next year? 4 96,863. 5 Taxable aroun of otbyng and polical expenditures ee8 nsructons) Part IV Supplemental information = Prove the desentonsrequred fora Aine 1, Pat, hne 4 Par ©, ine 5 Pan IA aad group it Pam FA, ies 1 and (eee istration) and Par 8, ine + Ao, compet hs pat for ay adetonal formation ct “Schedule G (Farm 990 or 090-E2) 2015 15SCHEDULE D Supplemental Financial Statements —Dn- conten Eibriomemamensse aan 2015 nomrt ieey Sraeaetnigenb: futon ae Seo aaa Open to Pubic Semiicsrteves”_| p> informaon about Schedule D (Porm 950) andis instructions is atwwwr:goviiemsoo | _ Inspection Name ofthe organization Employer identification aumber MISSISSIPP1 HOSPITAL ASSOCIATION 64-0411249 Part] Organizations Maintaining Donor Advised Funds or Other Similar Funds or AéSOunts. compat ihe cxganaton answered "Yes" on om 990, Pan Vine 6 as (a) Donor adveed nae Ti Fund and aor aeons Total number a ena ot yar i Aggregate value of eontrbutons to (Gunna yea) ‘Aggregate value of grants re (ung you — Agrepate value at nd of year Othe ganization norm al donors and donor adnsors nw hat the asset eld donor adwsed fonds 210 the oganizaon's propery, subject to the organatens excise legal conto? Cve Cre © Od me oganzaton inform al grantees, donors, and donor advaorsm wring that grant funds cn bo used ony {or chantable purposes and nt fr ne bene of te donor or danor ass. o or anyother purpose conan snpormanble prvate bene? Cove Ol [Partit_| Conservation Easements. Gon 1 Purposes) of conservation easements hel by the eranation (heck ll that apa) Prservaton offend for pubic wee (eg r8ereaton or education) [_] Preservation of ahistoncly portant land ares [1 pctecton of natural habtat Teresenaton ofa corted histone stuctre Tl ereseraton of open space 2 Compiat ines 28 through 24 the oganzaton hed a quatedcorservatoncontbution the frm ofa conservation easement on th ast ay ofthe tax year Held at the End ot th a ‘Total numberof conservation easements 2a 'b Total acreage restncted by conservation easements 2 ‘¢ Number of conservation easements on a certified histone structure mckided mn (a) 20_| |. Number of conservaton easements included in (6) acqured after 8/17/08, and not ona histone structure ated the National Regster 2a 2. Number of conservation easements modified, transfered, leased, extinguished, or terminated by the rganation dunng the year 4 Number f states where property subyct to conservation easement s located De '5 Does the organzation have a wntten policy regarding the penodic monstonng, nspaction, handling of ‘wolatons, and enforcement of the conservation easements it hokis? (yes [Ino 6 Staff and volunteer ours devoted to mentorng, nspecing, handing of wolttons, and enforcing conservation easements dunng the yea? > 7 Amount of expanses incurred in montonng, inspecting, handing of volations, and enforcing conservation easements dung the year ms 8 Does Gach conservation easement reported on in 2) above satily the requrements of section 17%hKA)(BK) and section 170(HK4)(@)4)? Cres [no 9 nPar Xl descnbe how the exganzation reports conservation easements nts revenue and expense statement, and balance sheet, and snchude, appicabia, the text ofthe footnote o the organization's financial statements that describes the organization's accounting for [Part i] Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete the organation answered "Yes" on Form 990, Par IV, ine 8 ‘2 the organzation lected, as permitted under SFAS 176 (ASC 958), not 1o report ins revenue statement and balance shest works ofa, hstoreal teasures, or other similar assets held for pubic exhibtion, education, or research in furtherance of publ: service, prowde, sn Part XI, the tox of the footnote to is fnancal statements that descnbes these toms 'b Ifthe organzation slected, as permttod under SFAS 116 (ASC 958), o report n ts revenue statement and balance sheet works of at, hstoncal ‘weasures, or other sim asset held for ule exhybtion, education, or research in furtherance of auble sence, provide the folowing amounts relating to these toms (i) Revenue included on Form 990, Part Vil, ine 1 ms (a) Assets nctuded in Form 990, Part x ms 2. tthe organzation recowed or held works of art, ustoncal treasures, or other simular asses for nancial gan, prowde the folowmg amounts requred tobe reported under SFAS 176 (ASC 956) celating to these tems ‘2 Revenue cluded on Form 990, Pat Vl hne 1 ms bb Assots included m Form 990, Part x bs — HA. For Paperwork Reduction Act Notice, see the Instructions for Form 900. ‘Schedule D (Form 990) 2015 16Schedule Form 99012015 _MISSISSIPPI_HOSPITAL ASSOCIATION 64-0411249 Page? [Part il | Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assetsconmnuec) ‘Using te organization's aequston, accession, and other recor, check any of he flown that ae a sighficant use of ts colecton tems (cnwek a tat app) 2 Cprnicemtston 4 [team or exchange programs » Fl senoiary research © Clotter J Preservation or ture generanons 44 Proude a deserpton ofthe organcaton®colectons and exp how they fer the organization's exempt purpose n Part XI 5 ung the yar, dit the erganzatin got or ecaive donations of a stoncal easues, or other sia assets : 1o.be eof ors funds thar han to be mactaned as pat ofthe oraanzaton'scolecton? ves _[7]no [Part IV] Escrow and Custodial Arrangements. Compite the organzaton answered "Yes" on Form 890, Par Ane 8,07 reported an amount on Foim 90, Part, hne 21 “ae the organizaton an agent, ruste, custodian or other intermediary for contrbubons or ether assets not cluded ‘on Form 990, Part x? Cores [Ino bb If Yes. expain the arrangement Part Xll and complet the followang table ‘Amount © Begnning balance te - 6 Acditons aunng the year 1a = fe Distbutons dunng the year te + Ending balance rn 2a Dad he organzation mclude an amount on Form 90, Part X, Ine 21, for esrow of estos account haba? Tver Ino "Yo," expan the arangoment Part Xll_ Check hee the explanation has been provded on Pat Xl [Part V_| Endowment Funds. Complete te o;ganzation answered “Yes” on Form $90, Part IV, ine 10 - [-to,.Cumert year | —(b)Pror year | fo) Two ystack [ap Tree yeas back | (a) Fou years tack ta. Beginning of year balance { - b Controutons 7 Net rwestment earings, gans, and losses 4 Grants or sehotarships — f@ Other expenditures for facies ae programs 1 Adrmstatve expenses { End of year balance I - 2° Prowde th estmated percentage ofthe curent ear ond balan (ine Tg, col a) eld as 2 Board dessgnatod or quasrendowment De b Permanent endowment Ea € Temporanlysticted endowment Be _ % ‘he percentages ontnes 2a, 2, and 2c shoua eal TO0% ‘ae there endowment funds not the possession of the organization that are held and admastored forthe organzaton 7 by Yes | No (9, urratedorgancatons sai (i) rates oxganations aun] b "Yes" on ine 3a, ate the related oxganations iste as requred on Schedule R? a 4 _Deserbein Pat Xl the intended uses ofthe oxganzaton's endowment funds [Part vi |Land, Buildings, and Equipment. Complete the organastion answered "Yes" on Form 990, Part Iv, ne 118 Soe Form 990, Pat, ne 10, Desenpton of property (@)Cost oretner | &)Costorather | (@)Accumuated | (@) Book vale bass (nvestmant) | basi (other deprecation ta Land 214,917.) 214,917. b Busdings 5,550,797.| 2,025,570.| 3 a © Leasehold improvements (oa 1 Equament 7 oer 2,301, 642.| 1,836 zig. 465.34. {tal Ads ines Ya trough 1e (Colm (must equal Form 990, Par X column (3), ne 102) 7,205,738. oes (Form 990) 2015 17Schadule D form 990.2015 _ MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 paged [Part Vil Investments - Other Securities. . Competes me crganzation answores "Yes" on Form 990, Part IV. ine 118 See Form 990, Part X. ne 12 “aero of secu OEE evsng rane wc) | (8) BOOK value (el Wethod of vas {7 Francia denvawves (2) Closeiyneid equty terete (0) Other (y INVESTMENTS, AT FAIR — — @)_ VALUE, 10,082,786. =o - o © = =a = = a : a gu (Gob st equaFerm 93, Pon co Ohne 2) | 10,082,746. [Part Vil investments - Program Related. Complete the exganzaton answered "Yes" (a) Deserpten of ewestment iGotyoar market vale 3 Fo1m 980, Part, ine 11e See Form 990, Part X, we 13 _ (©) Book value |e) Method of valuaton Cost a end year market vale o — a — 8) a - a ae. eee | 8) 1 otal (Cot (6) must equal Form 960, Par Xoo! (8) ne 19) [Part Ix] Other Assets. Compete ithe organzation answered "Yes" on Form 990, Par IV, tne 116 See Fo1m 990, Par X, ne 15, : = (@)Deserption iBook value @) INVESTMENT IN SUBSIDIARIES —|- 2,356,680. “@ ASSETS HELD UNDER DEFERRED COMP ~ 916,013. —(@_CSV-MHA OWNED LIFE INSURANCE 224,283. “(a “INTERCOMPANY RECEIVABLES | 188, 480. =. : : ee eae =e =a - @ oo. Tota, (Golunn fb must equal Fam 990, Part X, co! (Blane 15 >| 3,685,456. Part X | Other Liabilities. Complete the organzaton answored “Ye! lon Form 990, Part IV. bne 116 oF 111 See Form 980, Part X,bne 25, (a) Deserption of iabity [oI Book vale fl) Federal ncome taxes = g) CURRENT PORTION OF LONG-TERM DEBT 221,113, @) FUNDS HELD FOR OTHERS 132,39. (4) DEFERRED COMP LIABILITIES 916,012.) s) CASH BALANCE PLAN LIABLITY 14,442, ) ACCRUED EXPENSE - CASH BALANCE 267,257 | ae ee eee = = = 7 —8___ 7 eee [tal (Calum (2) must equal Frm 980, Part x, col (ine 25) >| 1,551,219, = 2 Labi fr unceran tax posters In Part Xl prone ot ove etl Te erates hance Hales Hal povoihe ‘organizaton's liability for uncertain tax postions under FIN 48 (ASC 740) Check here ifthe text of the footnote has been provided in Part xill (X] Sehedle Oar 090)20%8 18Schedule D fom 950,201 _MISSISSIPP1_HOSPTTAL ASSOCIATION 64-0411249 raged [Part xI_| Reconciliation of Revenue per Audited Financial Statements With Revenue per Retum. Compete the erganzaton answered "Yes" on Form 960, Pat Wine 12a _ 1 Tolalvevens, gan, and other suppor por audited inancw! statements +] 40,341,939 2 Amounts included on ie 1 but not on Form $60, Pat Vil ne 12 2 Net unealzed gans fosses) on vestments zaf bb Donated serces and use of facies rs © Recovenes of pror year grants, 20 «Other Descnbe in Pat Xi) za <318, 217.) € Ad ines 2a though 24 [ze | __<318,217.> 3 Sublact ine e fom ine 4 [s |i0,660,216. 44 Amounts mekied on Form 990, Part Vl, ne 12, ut not on ine 1 8 Investment expenses not neuded on Form 990, Par Vl, ine 7 | _| 1 Other (Descnbe in Par XI) Cae © Add tnes 4a and a 40 0. §_Totalrevenue Add ines 3 and 4, (This must equal Form 990, Part | ine 12) s | 10,660,216. Part Xl Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. ‘Compete the organization answered "Ves" on Form 990, Part IV, ine 12a = 11 Total expenses and losses per audited nance statements 4 [10,706 , 61 2 Amounts includes on ine 1 but not on Form $90, Part x, ine 25 8 Donated serces and use of facies > Pnor year adjustments © Otherlosses q be fe Other (Describe n Part Xt) sd ines 2a tough 2d ze| __0. 3 Subtract ine 2e from hoe 4 a | 10,706, 618- 4 Amounts ineuded on Form 990, Part IX. ine 25, but nat on hoe 4 8 Investment expenses not cluded on Form $90, Par Vl ine 78 Ot (Oosenbe m Part Xi) © Ad nes 49 and | ac | o. $_Totalexpenses Add ines 3.and ds, Js must equl Foun 990, Part ne 18 [s |i, 706,618: [Part xill Supplemental Information. Prowde the descpions requred for Pr I ines 3, 5, and 9 Par i nes Ya and 4 Part W, ines To and Zb, Par Vine, Pan X he 2 Pan X lines 24 and 4b, and Part Xi, nes 24 and db Aso completo this part to prove any adetonal nfrmaton ee PART X, LINE 2: = FOOTNOTE IN AUDIT REPORT: MANAGEMENT BELIEVES IT HAS NO MATERIAL. UNCERTAIN TAX POSITIONS OR ANY RELATED PENALTIES AND INTEREST TO ACCRUE FOR THE FOURTEEN MONTHS ENDED JUNE 30, 2016 AND YEAR ENDED APRIL, 30, 2015. ACCORDINGLY, THERE IS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. IF PENALTIES AND INTEREST ARE INCURRED RELATED TO UNCERTAIN TAX POSITIONS SUCH AMOUNTS ARE RECOGNIZED IN INCOME TAX EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS UNREALIZED GAIN (LOSS) ON INVESTMENTS ee EQUITY IN EARNINGS OF SUBSIDIARIES TOTAL TO SCHEDULE D, PART XI, LINE 2D =318,217. ts ‘Schedule D (Form 990) 2015 19Schedule 0 (Form 990) 2015, MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 Pages [Part Xill] Supplemental Information contnueq) ‘Schedule D (Form 990) 2015 20Te (096 wo) | IMPoHS “066 w04 10} su0n 1 241 296 ‘ean0N Yoy UoHINpeY WoMIeded 104 VHT “ET < SET SATS OT PST SOOTEEEIS TOUS JO GUAT IT TGF | ‘2% 1 841 941 psy suonezuebi0 wowsenoS pur (gXd)105 uonaeE Jo saquiTN SORETINE WOO ANS HUTT Ca | setesao-¥9 TOESE SR TUOETTAN —OOE SUNSTIVE HOS SND ALITVAK aap - TwaTasoK AuIeTOaas LowTaS “SRSTIWD wor BHD BETTE] TAT TFS = ase T1Zse aH "ROSIE MOTH NrarAGwE xr srs | psot auins ‘sarec aweraivi 116 SRST Wr SS RIT - T TTT TISTSPS=OE rors Sa “SaaS HOIH ONIGZAONE RE SISSY aananw uiLe Enos o¢z SORTS WOT SWS ATER o TET TOF - FCOLPEO-FS TOES GR RVIOTERR OTH oNTarAoua NI asrss¥ SSONBAY NOTLAUTISNOD ZOTT TERETE War VS IPA aT BIL BE TUONO TRETROV TOE SH HOSINE WOIK oxIaTAO¥S NI UsrSS\ | ~ aaawis auvas °K see - “ORE SIRSTIRE Wor SW KUTA mT Tor TE 7 | arsesi-02 Bee6e BR SPASIOOT OTH suraTaoua AI aszss\ | eve xoa “o"d - sunaosatoav ¥ NaWOTIND Wod WALNAD BAOHO aNOHVIG souesssse souerssse 10 soueysese yseo.uou | “yeu | ued yseo | eeanate uawi9n00 40 ued yo 280ding 4) Je vaaio8eg (6) orunewy(o) | jownowy(e) | _voires oui) Na (@) | vowexuetso jo ssa,ppe pue aweny (e)L poe sr eaede TEUONRE PoveD|CM 6a UE Ue DOO'SE VEU B70 PaNBDaT op “swueuuuuenop Snsewog pue suoneztueB19 ansewoG o1 BouRIsIsSY JOUIO PLE “SETS BST oY FSA WRITS BA BG HOOT Toy SATAPSTOTE SWOTEEUTS BON TES O RTISBC ONE] SACK) c2ounssse 0 sve ou preme 03 pasn eva vor29}96 ain pul “sours 20 SUE 2 901000 a ‘ouerssse 20 S148 ou jo WUNoUWwe 8 0}"12,9uN'A Ue ‘066 wo UO .$9A, povONsUE UONELEB. 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Open to Public Sewikmeuetonce” | pe Inlormaton about Schedule J (Farm 990] and ts Instructions i at was. go/forms0. Inspection Name of he organization Employer identification number MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 Part | Questions Regarding Compensation = [ves No 12 Check the appropnate box(es) ithe organzation provided any ofthe folowing to or fora person sted on Form 390, Part Vl, Section A. ine ta. Complete Part il to prowde any relevant information regarding these tems [2K] Furst ciass or charter travel LJ) Housing allowance or residence for personal use EX) Travet tor companions (1 Payments for business use of personal residence [EX] Texindemnitcation and gross up payments CX Heath or social club dues or itition fs 2 dscretionary spending account J Personal sennces (2g . maid, hautfeur, chef) bb ttany cf the boxes on ine 1a are checked, di the organzation folow a wnten policy regarding payment oF rembursament or prowsion of allot the expenses described above? it "No," complete Part Ilo explan 2 id the organization requte substantiation par to rembursing or allowing expenses incurred by all dectors, trustees, and offoers, cluding the CEOVExecutwve Dracter, regarding the seme checked nine 13 3. Indicate which, any of he following the fing organization used to establish the compensation ofthe oxganation’s (CEOFExecutwe Dvector Check allthat apply De not check any boxes for methods used by a related organzation to staplah compensation of the CEO/Executve Drector, but explain 9 Part [XC] compensation comnttee [XC] watten employment contract [] independent compensation consultant (CJ compensation survey or study [1 Form 990 of other organizations: (1 Approval by the board or compensation commit |4 Dunag the year, did any person listed on Form 990, Pat Vl, Section A, ne Ya, with respect tothe fing ‘organzation of a related organization ‘9 Recewe a severance payment or changect-control payment? 'b Panteipaten,or receive payment trom, a supplemental nonqualfied retrement plan? © Participate, or raceme paymont trom, an equty-based compensation arrangement? IW-Yes" to any of tes 4a, Ist the persons and prove the applicable amounts foreach tem mn Part It ‘Onty section 50119), 501(6KA), and 601(6).20) organizations must complete lines 5-8. 5 For persons listed on Form 990, Pat Vl, Section A, ine 1a, dd the arganzation pay ar accrue ary compensation ‘contingent on the revenues of ‘9 The organzaton? 'b Any olated organcation? I1-Y98" to ine Sa or 5b, describe m Par I 66 Forpersons lated on Form 990, Pat Vl, Section A, ine 12, did the oxganzaton pay or accrue any compensation contingent on the net earrings of ‘9 Theoxganaton? 'b Any lated organcation? 1 Yes" on ne 6a or 6b, desenbe Part I 7 Forpersons lated on Form 990, Part Vl, Section A, ine 1a, dé the organzaton provide any nen xed payments not descnbed on lines § and 6? 1 “Yes,” describe m Par I '8 Were any amounts reported on Form 990, Part Vl, pad or accrued pursuant toa contact that was subject to the sal contract exception described in Regulatons sacton 53 4958-4(aK)? If "Yes," describe in Part I 9 11°Yes" to ne 8, cid the organvation also folow the rebuttable presumption procedure described n Fegulatons section 53.4958 6(ey? w |X ie lee es eis THR For Paperwork Reduction Act Notice, eee the Instructions for Form 900. ‘Schedule J (Form 900) 2015 259z ‘3h02 (o¢6 wo) peInpeues va FO. ro o ro TST RE WO WRN AO WOLSTE “tee’t9t 279 et feiss wassains ano NONGK (5) Fo. Fo FO Fo SOLVE GAO IO aR “SpS"Sly Paves es 5897S 099788 |"eSL"eze osxore naazes ro “0 0 a Fo ESTES SHTPERIO Ftec09y | Lhe’ h €s “sé"Ot [pes "96 | SP "See ROA TIER °O. =O =O Fo Fo. EER EES ORE NOS 0 “See "Tee LBD se rs9'T Forty _ een" zor saniuo aamiore -0. 0 =O 0 Fo FO ‘O3STIREITSSW “0 “ezs"sps "6628 oo0"es —e0e OT 9eT GPT [OBL "ver Bloom “ aiuoRTE (1) 086 wos 10ud vo venesveauce | ay pnunop pried voussusioe oon, | maa co pur cue (@) vuryoo w Co) ‘swoueq anojop sao voqesvaduies (a) |suuryoo,0rei0L (a)) aigexeivon (a) | pueruoworey (0) | vonesuedwoo ogi 860! 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ToREUTOFA HUOUTEINS -Taeg SveTTHO-¥ NOTIVIOOSSY TWLIASOH TaaTSSISSIN SOE TOE OTTransactions With Interested Persons [_owene wasn 2015 SCHEDULE L (orm 990 or 90-€2)] Complete It the arganization answered "Yes" on Form 990, Part IV ne 25, 25b, 26, 27, 28a, ‘28, oF 280, oF Form 990-EZ, Part V, line 8a or 408, npn tite ey ip Aiea ba orm 90 = Foe Ome ‘Open To Public > latrmaton about Schedule (Form 980 of 980-E2 and is mstructons 16 at wwrw.rs.govitorm9s0. | _ Inspection Employer identification number 64-0411249 IPPI_HOSPITAL ASSOCIATION Rare of the oanzaton Missi Excess Benefit Transactions (cection 501(¢(3), section 801(¢)4, and 501 (e(@8) organzavons only), ‘Complete th oxganzation answered "Yes" on Form 990, Par IV, ine 258 of 256, or Form 9902, Part V ne 409 (6) Desenpton of transaction [Pant (0) Relationship between cisquaties person and organzaton * (ay Name of disqualied person 2 Enter the amount of tax meured by the oxganaation managers or lequalfed parsons dunng the year under ps ms section 4958 3. Enter the amount of tax, any. on ine 2, above, rambursed by the organzation Part il] Loans to and/or From Interested Persons. Complete the organization answered "Yes" on Form 990-27, Pan V, tno 38a oF Form 990, Part IV, ne 26, or the arganzaton ) ReBrGeE (Wen “epoded an amount on Form $00, Part X ne 56,022 (a) Name of (ey fetztorsnp | (e)Pupose (@)Lnica] —(e)Orgral | (Balance due | _tg)in fREBOW interested person thorganzaton] “atloan | f=, prnepal amount astaune [212242 steement? Yes No | Yes] No | Yes] No TIMOTHY MOORE CEO BENEFIT x [24i,077.| 241,077.. [xIx x Totat bs 241,077. Part lil] Grants or Assistance Benefiting Interested Parsons, Compt theorganzation answered “Yes on Form 990, Par IV, ne 27 {@) Name of terstod porson (e)Retatonshp between | (@)Amount of | __(@)Typeot (eiPurpose of intrested person and ‘ssrtanee Ssostance "ssstance the organzation ‘Schedule L (Form 990 or 990-€2) 2015 INA For Paperwork Reduction Act Notice, see the Instructions for Form 890 or 980-EZ. SEE PART V FOR CONTINUATIONS 28Complete the orgarwation answered "Yas" on Form 990, Par IV, ine 28a, 280, or 286 (@)Name of terested person (b)Relatonstip between mterested | —)Amount ot | (@)Doserpten ot | e)STanng a person and the organzation ‘ransacton ‘ransacton avenues? yes | no Part V_ | Supplemental Information rode addtional ormation for ponsos to questions on Schedule (eee structions) _ SCHEDULE L, PART IT, LOANS TO AND FROM INTERESTED PERSONS: (A) NAME OF PERSON: TIMOTHY MOORE C) PURPOSE OF LOAN: BENEFIT PLAN PART II, LINE T MISSISSIPPI HOSPITAL ASSOCIATION (MHA) SPONSORS A WELFARE BENEFIT PLAN UNDER ERISA FOR THE BENEFIT OF THE CEO AND PRESIDENT, TIMOTHY MOORE THAT AUTHORIZED THE PURCHASE OF LIFE INSURANCE POLICIES AS A MEANS OF PROVIDING POST-EMPLOYMENT BENEFITS. EACH PREMIUM CONTRIBUTION PAID BY MHA ON BEHALF OF THE CEO IS TREATED FOR TAX, LEGAL AND FINANCIAL PURPOSES AS A LONG TERM LOAN RECEIVABLE. THE RECEIVABLE IS REQUIRED TO BE REPAID BY THE CEO, INCLUDING CUMULATIVE INTEREST AT A RATE ESTABLISHED BY THE IRS. AS SUCH MHA RETAINS A PERMANENT AND PRIMARY IRREVOCABLE INTEREST IN THE DEATH BENEFIT OF THE LIFE INSURANCE POLICIES THAT WILL PROVIDE FULL REPAYMENT OF THE ACCUMULATED LOAN RECEIVABLE AT THE DEATH OF THE CEO. ‘Schedule L (Form 980 or 990-EZ) 2015, 29SCHEDULE 0 ‘Supplemental Information to Form 990 or 990-EZ_ | “Sm sea"— poeese ea pee ereaaear ee eran races 2015 orn 990 or 9901 0" to prove sn adore feration, a De Attch oor 900 or 900-28 Open to Public Stearic” |p women abou sched Ofretn 90 ar 00 Erland sstonsis stews govtomaee. | iapecion Name ofthe organzabon Emplcyer identification naber MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: ADVANCE THE INTERESTS, WELFARE AND PURPOSES OF SUCH INSTITUTIONS. FORM 990, PART VI, SECTION A, LINE 6: THE ASSOCIATION HAS INSTITUTIONAL MEMBERS THAT ARE COMPRISED OF HOSPITALS THROUGHOUT THE STATE OF MISSISSIPPI. FORM 990, PART VI, SECTION A, LINE 7A: HOSPITAL MEMBERS ARE ORGANIZED INTO COUNCILS BASED PRIMARILY ON GEOGRAPHIC AREA WITHIN THE STATE OF MISSISSIPPI. REPRESENTATIVES OF HOSPITALS IN THE COUNCILS NOMINATE AND ELECT MEMBERS TO THE ASSOCIATION'S BOARD OF GOVERNORS. FORM 990, PART VI, SECTION B, LINE 11: INFORMATION FOR FORM 990 IS GATHERED THROUGH A TEAM EFFORT AT MHA. THE CFO AND SENIOR ACCOUNTING STAFF PREPARE THE ORGANIZER QUESTIONAIRE PROVIDED BY THE CPA FIRM. OTHER MHA STAFF MEMBERS ARE CONSULTED AS NEEDED FOR INPUT. RELATED TO POLICIES AND PROCEDURES. THE PRELIMINARY DRAFT OF THE 990 PREPARED BY THE OUTSIDE CPA IS SUBMITTED TO THE CFO FOR REVIEW, FEEDBACK AND FINALIZATION. A FINAL COPY OF THE 990 IS EMAILED TO BOARD MEMBERS FOR APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C: EACH BOARD MEMBER MAKES FULL DISCLOSURE ANNUALLY OF ANY CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO FOLLOW HUMAN RESOURCES POLICY IN THE HUMAN RESOURCES POLICIES AND PROCEDURES HANDBOOK. A CONFLICT OF INTEREST LHiA Far Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ, ‘Schedule 0 (Form 990 or 990-£2) (2015) 30‘Schedule 0 orm 990 oF 990 £7) (2015) Page? Name ofthe orgarvzaton| Employer identification number MISSISSIPPI HOSPITAL ASSOCIATION 64-0411249 MAY BE CONSIDERED TO E: IN THOSE INSTANCES WHERE THE ACTIONS OR ACTIVITIES OF AN INDIVIDUAL ARE INVOLVED ON BEHALF OF THE ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION COMMITTEE COMPRISED OF BOARD MEMBERS CONDUCTS AN ANNUAL APPRAISAL AND EVALUATION OF THE PERFORMANCE OF THE PRESIDENT OF THE ASSOCIATION IN MARCH OR APRIL OF EACH YEAR WITH INPUT FROM AN INDEPENDENT _ COMPENSATION CONSULTANT. SALARIES FOR OTHER OFFICERS AND KEY EMPLOYEES ARE ESTABLISHED BASED ON SUPERVISOR RECOMMENDATIONS WITH POSITIONAL SALARY RANGES BASED ON THE WRITTEN JOB DESCRIPTION AND REVIEW OF INDUSTRY SALARY _ DATA. _ FORM 990, PART VI, SECTION C, LINE 19: - THESE DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. — FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS: _ ——————— eek a ae Pe ee Cc ce cad ceca ceaccacdaecacae 4G anae FORM 990, PART XII, LINE 2B . THE ORGANIZATION IS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIALS FOR THE 14 MONTH PERIOD ENDING JUNE 30, 2016 DUE TO A CHANGE IN THE ACCOUNTING YEAR. : FORM 990, PART XII, LINE 2C = MHA HAS A COMMITTEE THAT ASSUMES RESPONSIBLIITY FOR OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. THE PROCESS FOR SELECTION OF THIS COMMITTEE OR OVERSIGHT AND REVIEW HAVE NOT CHANGED FROM THE PRIOR YEAR. so2ei8 opens ‘Schedule O (Form 990 oF 060-EZ) (2015) 31‘Schadule O (Form $90 oF 990 £7) (2015) Page 2 ‘Name of the organization Employer Identification number a IPPI_HOSPIT? SOCIATION 64-0411249 THE RETURN WAS ELECTRONICALLY FILED ON A TIMELY BASIS AND REJECTED WITH ‘THE CODE F990-911-03 WHICH DOES NOT APPLY TO THIS RETURN; THEREFORE WE ARE PAPER-FILING THE RETURN AND ATTACH A COPY OF THE REJECTION NOTICE RECEIVED. a ‘Schedule © (Form 890 or 980-E2) (2016) 32ee wn 902 (066 w04) ¥ ampouES “066 u04 10) suonan.jsuy 4p 908 “2on0N Y9Y NoRoMBeY MoMseded 104 Tres —noraeeniog reo THTSSISET 5 ETRE ‘ea1280) abeara [NE woruvonag any Howeasa———GH"NOSTERR EDGY WOW OF PELEBOT=EC ~ i raarssisen SUVOHUTAH Lwodans”HOTINTRION WOLLSMGS CNY HSWWASAT RETO WR 909 idw9%3 Soe hug ) @ ene dwoxo-ey payers o1ou 0 avo pey ¥ esne08q Ye OU ’A| Hed "O66 Ue UO .S9A, palonsUe LoREZUREIO ai oleIdwOD sUONEZUEBIO \dwOXS HEL (ane ubas0) Jsiesseveatiopug] wooo. | soon ” ‘Arqus pepreborsp 0 0 807 Ane seus (oxqeoqdde ) nia puE'ssosppe ‘owen, ) @ © {86 2Un I Hee ‘068 Woy UO ,88,, PE!BMSUR UoNEAUEGrO Buy eIeIdWOD SONU PEp.eBE161q Jo UOREDYRUIPL Led SveTIVO-F5 NOTIVIOOSSW TWLTESOW TaaTSSISSIN qua voneannsepaKoeuig ToADeTR "WETTER TE STOTT BT BOE TOE WT HTS WE TOTTI ‘21 woe “096 304 0 Slog 16.0 86956 ‘re '66 aun Heg 066 Wo 100 (085 w03) aT sdiysieuped payejaiun pue suoneziuebio pareja uamneaHos:S102 (086 wi04) ¥ sInp2uoS, ve = aT TOT PEL aT eT oy J TE SL SRE XO UT SCTE SEOTRUIS WATE: aysiouo lebeiweaie ‘Anse Aseun oO @ {20k xe ou Guunp si 0 uoiRsodiGa ese paler SUOIEMIEDIO ye ter 610W 10 Su eu oSnED9q pe BU 'A| UP "O66 UE UO Se, POIONGUE UONEZURELO aig eI8WOD IEMA. JO UOHIeIodIOg Be aIGeXE] SOREAIUEGIO PaIeIeH Jo UAEOHUOPL ows al yosee Son + susiauno [See] seakjopus | ewoou fae | Benet oyeauebio pees 0 anand ens eos” | moors Sayontu0. ong | “ees | Ange Amaia Nig bve ssepoe suet w | o © o o @ @ 280i xe ou; Gunp diusiouued 8 se paseo ete) 920 40 au peu asneoea pe aU As Hed ‘066 U0 UO 58, POIONSUE LONEZUEOLO OM» yeISWIOD dryssOULER e se sexe, SuONERSt02 (066 wie) ¥ ainpaueS SNA LaMaWW WIva 270 a SHSNEdXa SATLVELSININGY GNY TYUENHD YOd WHDWLWYLS CESENENTEY WHA aA THRU WIV" OE" ETT o SASNEdXE SATLVELSININGY WT | P TWHENTD YOs WHN GHSUNEWIAY SNOILNTOS VHW ENIVA THMUWW UIWA"OE0’ECz oF SNOILQIOS ¥HA JO ATWHEE NO SUSNEAxa © ae BAIINWLSININGY ONY TWHENEO GIva WHA Snr Tama ET o00"8L ¥ [SSNS ONWAND90 NOI VHN GHSUNWIY SNOTLNIOS WEN antag TERE ET Wal" 6Be a. oO ~_-« SHAAOTaWA SNOILNIOS WHW Xa W _ fINOd OM YOs SNOTLNTOS WAN GaSUNaWIaY YER 2) 0h enon rou Bunnui jo pouen enon wouy | uses, vaio peo sue ® cc) ‘@) ¥ a] ¥ rr re 4) ><] ><] 9 ‘SOUT VOSS Pu SUSUONEe: PoraTOS BupAga Ba Sy OPATEUOD TO © aN UO UOTEUTO|N TO] SUORAATISG SOE OA, ORO BTU AWE OT TOMEVE STE x ax ¥ ¥ =x x x x ax “envi suegu psy suoneztUeb:0 pee aioU 6 8UD Hn SUOHDRE arf sax 9610968 "ye 84‘ WE '066 0s UO 884, ParONsUE LOHEDUED mj 9]E4I09 BVOREEHIESIO PAREN NAIA SUONDERUEL AVE + Eames EPETTVO-V9 NOTIWISOSSW TWITESOH TagISSISSIN SERS URI TATERES‘3802 (086 wH04) Y ainpouS {envonos ssoi6 20 siasse fio) Kg pasnseow) sayinnse yo w2dr0d ery uM alow payoNpUCD 26 9u A Ue "066 ues UO 82h, posoMsUE UoNEZUED. ordwwoo duysieueg e se oigexey suONeZUEBIO POIEIOUN IA ued var —EPETIVO-PS NOTLWIOOSSW TWLIdSOW IaaISSISSIN SIOZ TORS MATT aMPOS‘Scheoule Form 990) 2015. Mi PPI ASSOCIATION 64-0411249 Pages Part Vil | Supplemental Information Provide addnonal formation for responses to questions on Schedule 37 ‘Schedule R (Form 090) 2015