TY 2023 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
CORRECT CARE INC 229 SAINT JOHN LANE COVINGTON,LA70433	ER PROVIDER COVERAGE	888,353
ORTHO-CLINICAL DIAGNOSTICS 1001 US-202 RARITAN,NJ08869	NURSING SERVICES	247,724
ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO,IL606936485	NURSING SERVICES	233,498
MORRISON HEALTHCARE 400 NORTHRIDGE ROAD SUITE 600 ATLANTA,GA30350	CAFETERIA PROVIDER	143,167

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 4

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SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
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Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
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Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	588,004		588,004
b	Buildings ....	12,922,661	7,408,560	5,514,101
c	Leasehold improvements	171,769		171,769
d	Equipment ....	10,882,229	9,251,724	1,630,505
e	Other .....	237,674	157,021	80,653
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				7,985,032

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO RELATED PARTIES	14,030,412
LEASE LIABILITY	27,939







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	14,058,351
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	18,924,564
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	0
e	Add lines 2a through 2d .....................			2e	0
3	Subtract line 2e from line 1..................			3	18,924,564
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	25,329
c	Add lines 4a and 4b....................			4c	25,329
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	18,949,893

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	18,999,136
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	18,999,136
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b	25,329
c	Add lines 4a and 4b.....................			4c	25,329
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	19,024,465

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part X, Line 2	MANAGEMENT HAS EVALUATED ITS INCOME TAX POSITIONS UNDER GUIDANCE INCLUDED IN ASC 740. BASED ON ITS REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements	PENSION COSTS - 25329
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements	PENSION COSTS - 25329

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			599,696		599,696	3.15 %
b	Medicaid (from Worksheet 3, column a) . . . . .			1,882,748	2,476,168	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	2,482,444	2,476,168	599,696	3.15 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).					0	0 %
f	Health professions education (from Worksheet 5) . . .					0	0 %
g	Subsidized health services (from Worksheet 6) . . . .					0	0 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	0	0	0	0 %
k	Total. Add lines 7d and 7j .	0	0	2,482,444	2,476,168	599,696	3.15 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

5,222,022

Enter Medicare allowable costs of care relating to payments on line 5.....

7,554,038

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,332,016

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	TISHOMINGO HEALTH SERVICES 1777 CURTIS DRIVE IUKA,MS38852 HTTP:/WWW.NMHS.NET/IUKA/ 13-221	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	TISHOMINGO HEALTH SERVICES
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url):

Other website (list url): https://www.nmhs.net/about-us/community-health-needs-asssessments

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.nmhs.net/about-us/community-health-needs-asssessments

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TISHOMINGO HEALTH SERVICES
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.0%
and FPG family income limit for eligibility for discounted care of 200.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance

The FAP application form was widely available on a website (list url):

https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	TISHOMINGO HEALTH SERVICES
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	TISHOMINGO HEALTH SERVICES
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - TISHOMINGO HEALTH SERVICES, INC.. INPUT FROM THE COMMUNITY WAS RECEIVED VIA INFORMANT INTERVIEWS, STANDARDIZED ELECTRONIC SURVEYS FROM KEY ORGANIZATIONS/STAKEHOLDERS, HEALTHCARE ADVOCATES/LEADERS, AND INTERESTED COMMUNITY PARTNERS RESIDING IN THE SERVICE AREAS SERVED BY NORTH MISSISSIPPI MEDICAL CENTER-PONTOTOC AND THE HEALTH SYSTEM. ADDITIONAL INPUT WAS SOLICITED FROM COMMUNITY RESIDENTS WHO REPRESENT BROADLY DIVERSE INTERESTS OF THE SERVICE AREA RANGING FROM NONPROFIT COMMUNITY VOLUNTEERS TO RETIRED EDUCATORS, BANKERS, AND PRIVATE BUSINESS LEADERS.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - TISHOMINGO HEALTH SERVICES, INC.. TISHOMINGO HEALTH SERVICES IS PART OF THE NORTH MISSISSIPPI HEALTH SERVICES' DIVERSIFIED REGIONAL HEALTHCARE SYSTEM. NORTH MISSISSIPPI HEALTH SERVICES OPERATES SIX COMMUNITY HOSPITALS IN ADDITION TO TISHOMINGO HEALTH SERVICES. THE CHNA INCLUDED TISHOMINGO HEALTH SERVICES, CLAY COUNTY MEDICAL CORPORATION, PONTOTOC HEALTH SERVICES, WEBSTER HEALTH SERVICES, NORTH MISSISSIPPI MEDICAL CENTER, MARION REGIONAL MEDICAL CENTER, AND MONROE HEALTH SERVICES.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - TISHOMINGO HEALTH SERVICES, INC.. THE NEEDS OF THE COMMUNITY GO BEYOND THE RESOURCES OF THE ORGANIZATION WITH THE NON-EXPANSION OF MEDICAID IN THE STATE AND THE REDUCTION IN MEDICAID PAYMENTS AS WELL AS A SIGNIFICANT INCREASE IN UNINSURED. THE ORGANIZATION FOCUSES ON PROVIDING ACCESS TO BASIC HEALTHCARE NEEDS INCLUDING: A. INCREASE ACCESS TO PREVENTIVE SERVICE - EXPAND VIRTUAL/TELEHALTH OFFERINGS - COLLABORATE TO EXPLORE TRANSPORTATION NEEDS - INITIATE INNOVATIVE LISTEN-TO-LEARN COMMUNITY SESSIONS - UTILIZE PARTNERS TO ASSIST THOSE WITH LIMITED OR NO INSURANCE - INCREASE AFFORDABLE AFTER-HOURS CARE - IMPROVE ACCESS TO SPECIALTY CARE B. INCREASE PHYSICAL ACTIVITY AND PROMOTE EXERCISE AS MEDICINE - PARTNER WITH LOCAL WELLNESS CENTERS & GYMS - DEVELOP PARTNERSHIPS WITH LOCAL PARKS/RECREATION FACILITIES - UTILIZE EXERCISE "PRESCRIPTIONS" - ORGANIZE WALKING CLUBS - PROMOTE CORPORATE WELLNESS PROGRAMS - IDENTIFY COMMUNITY RESOURCES, E.G. TRAILS, WALKINGS TRACKS, ETC. C. DEVELOP A NUTRITIONALLY AWARE COMMUNITY CULTURE - SCREEN FOR AND CREATE ACCESS TO NUTRITIOUS FOODS - DEVELOP CULTURALLY-APPROPRIATE EDUCATIONAL PROGRAMS - DEVELOP COMMUNITY COALITIONS TO PROVIDE FRESH FOOD/PROMOTE COMMUNITY GARDENS - TEACH FOOD PRESERVATION SKILLS - UTILIZE ESTABLISHED NETWORKS TO PROMOTE NUTRITION D. DEVELOP PARTNERSHIPS WITH PUBLIC ENTITIES - PUBLIC HEALTH -- STATE AND REGIONAL OFFICES - EDUCATIONAL INSTITUTIONS -- EARLY CHILDHOOD, PRIMARY, SECONDARY, AND POST-SECONDARY - GOVERNMENT -- STATE, REGIONAL, AND LOCAL
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - TISHOMINGO HEALTH SERVICES, INC.. THE FAP DOES NOT COVER CHARGES FOR PATIENTS OR TREATMENTS WITH THE FOLLOWING CONDTIONS: I. THE PATIENT HAS ANY THIRD-PARTY INSURANCE COVERAGE. A DISCRETIONARY EXCEPTION MAY BE MADE FOR INSURED PATIENTS IS THE PROVISOIN FOR THE MEDICALLY UNDER-INSURED II. THE PATIENTS PRIMARY RESIDENCE IS OUTSIDE THE SERVICE AREA III. THE PATIENT IS CURRENTLY IN CUSTODY OF A CORRECTIONAL FACILITY IV. THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ANOTHER CITY, COUNTY, STATE, FEDERAL OR OTHER ASSISTANCE PROGRAM WHICH SUPERSEDES THE FAP. V. IF PATIENTS CHARGES RESULTED FROM A WORK-RELATED ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE. VI. IF PATIENT CHARGES RESULTED FROM AN AUTO ACCIDENT, PATIENTS ARE NOT ELIGIBLE TO APPLY UNLESS THEY CAN PROVIDE PROOF OF NO THIRD-PARTY COVERAGE THE FINANCIAL ASSISTANCE POLICY IS NOT APPLICABLE TO PHYSICIANS OR THEIR IMMEDIATE FAMILY MEMBERS.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address		Type of Facility (describe)
1	TISHOMINGOIUKA WELLNESS CENTER 619 BATTLE GROUND DRIVE IUKA,MS38852	WELLNESS CENTER
2	BELMONT FAMILY MEDICAL CLINIC 26 3RD STREET BELMONT,MS38827	PRIMARY CARE
3	BURNSVILLE MEDICAL CLINIC 296 HIGHWAY 72 BURNSVILLE,MS38833	PRIMARY CARE
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part I, Line 3c	TISHOMINGO HEALTH SERVICES, INC. USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. IF THE PATIENT'S INCOME LEVEL IS 0-150% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 200% OF THE FPL, THE HOSPITAL MAY OFFER DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.
Schedule H, Part I, Line 6a	TISHOMINGO HEALTH SERVICES INC. COMMUNITY BENEFIT INFORMATION IS INCLUDED IN THE COMMUNITY BENEFIT REPORT OF ITS PARENT COMPANY, NORTH MISSISSIPPI HEALTH SERVICES, INC. NORTH MISSISSIPPI HEALTH SERVICES (NMHS) IS A DIVERSIFIED REGIONAL HEALTH CARE ORGANIZATION, WHICH SERVES 24 COUNTIES IN NORTH MISSISSIPPI AND NORTHWEST ALABAMA FROM HEADQUARTERS IN TUPELO, MS. THE NMHS ORGANIZATION COVERS A BROAD RANGE OF ACUTE DIAGNOSTIC AND THERAPEUTIC SERVICES, OFFERED THROUGH NORTH MISSISSIPPI MEDICAL CENTER IN TUPELO; A COMMUNITY HOSPITAL SYSTEM WITH LOCATIONS IN EUPORA, IUKA, PONTOTOC, WEST POINT, AMORY, MS, AND HAMILTON AL; NORTH MISSISSIPPI MEDICAL CLINICS, A REGIONAL NETWORK OF 27 PRIMARY AND SPECIALTY CLINICS; AND NURSING HOMES. NMHS OFFERS A COMPREHENSIVE PORTFOLIO OF MANAGED CARE PLANS.
Schedule H, Part I, Line 7a	COST TO CHARGE RATIO WAS USED FOR THE AMOUNTS REPORTED IN THE TABLE FOR LINE 7. THE COST TO CHARGE RATIO FOR LINE 7 WAS CALCULATED USING WORKSHEET 2.
Schedule H, Part III, Line 2 LINES 2-4	TISHOMINGO HEALTH SERVICES' FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE SPECIFICALLY CONCERNING BAD DEBT. BAD DEBT IS SHOWN AS A SEPARATE LINE ITEM ON THE FACE OF THE INCOME STATEMENT. THE AMOUNT OF BAD DEBT BOOKED EACH YEAR IS BASED ON A REVIEW OF OUTSTANDING RECEIVABLES AND THEIR AGE FROM DATE OF SERVICE. THE OLDER THE ACCOUNT, THE HIGHER THE RESERVE PERCENTAGE USED TO ESTIMATE BAD DEBT. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATIONS AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. TISHOMINGO HEALTH SERVICES (THS) FOLLOWS THE CATHOLIC HEALTH ASSOCIATION GUIDELINES AND DOES NOT INCLUDE BAD DEBT IN ANY COMMUNITY BENEFIT AMOUNTS. THS BELIEVES THAT SOME PORTION OF BAD DEBT RESULTS FROM PATIENTS WHO COULD QUALIFY FOR CHARITY CARE BUT HAS NO WAY OF MAKING AN ESTIMATE OF THE AMOUNT AND THEREFORE HAS ANSWERED "ZERO" FOR PART III LINE 3. THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2024.
Schedule H, Part III, Line 8	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
Schedule H, Part III, Line 9b	TISHOMINGO HEALTH SERVICES DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE HOSPITALS MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS.
Schedule H, Part VI, Line 2	NEEDS ASSESSMENT TISHOMINGO HEALTH SERVICES UTILIZES VARIED BUT COMPLIMENTARY METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. TISHOMINGO HEALTH SERVICES AND TISHOMINGO COUNTY ARE INCLUDED IN THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY HEALTH ASSESSMENT WHICH IS PERFORMED EVERY THREE YEARS AND PROVIDES INFORMATION ON HEALTH STATUS, UTILIZATION OF HEALTH SERVICES, HEALTHY BELIEFS AND SATISFACTION WITH HEALTH CARE SERVICES. THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY HEALTH ASSESSMENT COVERS THE 24 COUNTY SERVICE AREA INCLUDING TISHOMINGO COUNTY AND PROVIDES INFORMATION BY COUNTY. IN ADDITION, THE NORTH MISSISSIPPI HEALTH SERVICES COMMUNITY RELATIONS FACILITATOR CONDUCTS ROUTINE VISITS WITH ITS INTERNAL AND EXTERNAL STAKEHOLDERS ACROSS THE ENTIRE SERVICE AREA INCLUDING TISHOMINGO COUNTY. THE INFORMATION GATHERED THROUGH SEVERAL QUALITATIVE SURVEY QUESTIONS IS USED TO DETERMINE ITS COMMUNITY'S NEEDS FOR THE ENTIRE SERVICE AREA AS WELL AS THE LOCAL SERVICE AREA FOR EACH HOSPITAL SUCH AS TISHOMINGO HEALTH SERVICES.
Schedule H, Part VI, Line 3	PATIENT EDUCATION ELIGIBILITY FOR ASSISTANCE EXPLANATIONS OF THE TISHOMINGO HEALTH SERVICES CHARITY CARE POLICY ARE COMMUNICATED IN A VARIETY OF FORMS INCLUDING SIGNAGE AT ALL ADMISSION AND REGISTRATION AREAS, ON THE WEB SITE, ON BILLS AND STATEMENTS, AND IN ADMISSION PACKETS. FINANCIAL COUNSELORS ASSIST THE PATIENT AND RESPONSIBLE PARTIES WITH DETERMINING ELIGIBILITY FOR GOVERNMENT PROGRAMS, PRIMARILY MEDICAID, AND CHARITY CARE STATUS. THE PATIENT CAN APPLY FOR CHARITY CARE AT ANY TIME FROM THE DATE OF SERVICE THROUGH THE COLLECTION PROCESS AND ONCE QUALIFIED AND APPROVED ALL COLLECTION EFFORTS ARE STOPPED.
Schedule H, Part VI, Line 4	COMMUNITY INFORMATION TISHOMINGO HEALTH SERVICES SERVES MORE THAN 19,000 PEOPLE IN TISHOMINGO COUNTY, MS AND THE SURROUNDING AREA. THE POPULATION FOR THE SERVICE AREA IS PROJECTED TO REMAIN ESSENTIALLY FLAT OVER THE NEXT FIVE YEARS. ACCORDING TO THE U.S. CENSUS BUREAU, AGE DEMOGRAPHICS FOR THE SERVICE AREA SHOW THAT APPROXIMATELY 22% OF THE POPULATION IS UNDER 18 YEARS OF AGE, APPROXIMATELY 60% IS BETWEEN 18 AND 64 YEARS OF AGE AND THAT 18% IS 65 OR OLDER. CAUCASIANS MAKE UP 93% OF THE SERVICE AREA'S POPULATION WHILE AFRICAN AMERICANS MAKE UP 3% AND HISPANICS AND OTHERS MAKE UP 4%. MEDIAN HOUSEHOLD INCOME WAS $48,897 FOR THE SERVICE AREA, WHICH IS ABOVE THE OVERALL AVERAGE FOR MISSISSIPPI. THE PATIENT POPULATION FOR TISHOMINGO HEALTH SERVICES IS 16.2% UNINSURED.
Schedule H, Part VI, Line 5	PROMOTION OF COMMUNITY HEALTH TISHOMINGO HEALTH SERVICES HAS A COMMITMENT TO A WIDE VARIETY OF COMMUNITY HEALTH OUTREACH ACTIVITIES, WHICH ARE COORDINATED BY THE COMMUNITY HEALTH COORDINATOR AND ARE STAFFED BY TISHOMINGO HEALTH SERVICES EMPLOYEES WHO VOLUNTEER THEIR TIME TO HELP WITH THESE EVENTS AND ACTIVITIES. THE COMMUNITY HEALTH COORDINATOR ASSISTS IN EDUCATING THE COMMUNITY ON HEALTH-RELATED ISSUES BY ORGANIZING AND PRESENTING VARIOUS HEALTH FAIRS AND SEMINARS. THESE EVENTS ARE HELD AT LOCAL BUSINESSES, SCHOOLS AND COMMUNITY ORGANIZATIONS AND ADDRESS A VARIETY OF HEALTH-RELATED TOPICS. IN ADDITION, THE HOSPITAL SPONSORS CHOLESTEROL, BLOOD PRESSURE, VISION, MEMORY, AND HEART-RISK SCREENING EVENTS, THROUGH WHICH TESTS ARE MADE AVAILABLE TO THE PUBLIC FOR A NOMINAL FEE OR AT NO CHARGE WITH THE MAJORITY OF THE COSTS INCURRED ABSORBED BY THE HOSPITAL. BLOOD PRESSURE, VISION, MEMORY, AND HEART-RISK SCREENING EVENTS, THROUGH WHICH TESTS ARE MADE AVAILABLE TO THE PUBLIC FOR A NOMINAL FEE OR AT NO CHARGE WITH THE MAJORITY OF THE COSTS INCURRED ABSORBED BY THE HOSPITAL.
Schedule H, Part VI, Line 6	AFFILIATED HEALTH CARE SYSTEM AS NOTED ABOVE, TISHOMINGO HEALTH SERVICES (THS) IS PART OF NORTH MISSISSIPPI HEALTH SERVICES (NMHS). NMHS OPERATES NORTH MISSISSIPPI MEDICAL CENTER, FIVE OTHER COMMUNITY HOSPITALS IN ADDITION TO THS, AS WELL AS, NORTH MISSISSIPPI MEDICAL CLINICS, WHICH OPERATES MORE THAN 30 MEDICAL CLINICS. SOME OF THESE FACILITIES OPERATE AT AN ONGOING FINANCIAL LOSS AND NMHS PROVIDES OPERATING FUNDS IN THE FORM OF WORKING CAPITAL LOANS THAT HAVE NO SET REPAYMENT DATE. THESE WORKING CAPITAL LOANS HAVE HISTORICALLY BEEN CONVERTED TO CAPITAL TRANSFERS IN MANY CASES, AND THEREFORE, THE LOANS ARE FORGIVEN SUCH THAT THE FACILITY NEVER MAKES REPAYMENT. NMHS DOES THIS IN ORDER TO PROVIDE ACCESS TO A VARIETY OF SERVICES ACROSS THE SERVICE AREA AND IS AN INTENTIONAL PART OF ITS BUSINESS MODEL. THE COMMUNITY HEALTH DEPARTMENT THAT IS PART OF NMMC COORDINATES A VARIETY OF COMMUNITY HEALTH ACTIVITIES ACROSS THE SERVICE AREA AS WELL.
Schedule H, Part VI, Line 7	STATE FILING OF COMMUNITY BENEFIT REPORT TISHOMINGO HEALTH SERVICES DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF MISSISSIPPI AS THERE IS NO REQUIREMENT TO DO SO.
Schedule H, Part V, Section B, Line 16a FAP website	- TISHOMINGO HEALTH SERVICES: Line 16a URL: https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- TISHOMINGO HEALTH SERVICES: Line 16b URL: https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- TISHOMINGO HEALTH SERVICES: Line 16c URL: https://www.nmhs.net/patients-and-visitors/billing-and-insurance/financial-assistance;

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MICHAEL S SPEES PRESIDENT	(i) (ii)	0 ------------- 1,110,231	0 ------------- 1,032,676	0 ------------- 176,615	0 ------------- 19,800	0 ------------- 7,428	0 ------------- 2,346,750	0 ------------- 0
2SHARON NOBLES TREASURER	(i) (ii)	0 ------------- 568,363	0 ------------- 359,729	0 ------------- 79,430	0 ------------- 19,800	0 ------------- 9,448	0 ------------- 1,036,770	0 ------------- 0
3BRUCE TOPPIN SECRETARY	(i) (ii)	0 ------------- 399,862	0 ------------- 208,113	0 ------------- 59,597	0 ------------- 6,600	0 ------------- 8,392	0 ------------- 682,564	0 ------------- 0
4BARRY KEEL ADMINISTRATOR	(i) (ii)	0 ------------- 239,379	0 ------------- 102,142	0 ------------- 30,907	0 ------------- 12,160	0 ------------- 1,674	0 ------------- 386,262	0 ------------- 0
5BRADLEY MURRAY PHYSICIAN	(i) (ii)	162,995 ------------- 0	81,712 ------------- 0	40,810 ------------- 0	7,218 ------------- 0	3,105 ------------- 0	295,840 ------------- 0	0 ------------- 0
6WALTER MAYFIELD PHYSICIAN	(i) (ii)	252,808 ------------- 0	21 ------------- 0	552 ------------- 0	15,475 ------------- 0	6,672 ------------- 0	275,528 ------------- 0	0 ------------- 0
7THOMAS DRAPER PHYSICIAN	(i) (ii)	235,168 ------------- 0	21 ------------- 0	714 ------------- 0	21,726 ------------- 0	4,668 ------------- 0	262,297 ------------- 0	0 ------------- 0
8NATHANIEL SPARKS PHYSICIAN	(i) (ii)	101,400 ------------- 38,500	59,722 ------------- 25,006	74 ------------- 0	554 ------------- 0	3,520 ------------- 4,384	165,270 ------------- 67,890	0 ------------- 0
9LACY ESTES NURSE PRACTITIONER	(i) (ii)	88,108 ------------- 0	63,349 ------------- 0	0 ------------- 0	7,970 ------------- 0	7,368 ------------- 0	166,795 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 3	NORTH MISSISSIPPI HEALTH SERVICES (NMHS) ESTABLISHES THE PAY OF THE CEO AND COMPENSATES HIM. NMHS USES THE FOLLOWING METHODS FOR ESTABLISHING THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b	THE FOLLOWING PEOPLE PARTICIPATED IN OR RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SHARON NOBLES - $54,519 MICHAEL SHANE SPEES - $111,507 BRUCE TOPPIN - $40,061
Schedule J, Part I, Line 7	PHYSICIAN BONUSES ARE ALL CONTINGENT INCOME DEPENDING UPON EITHER THE NUMBER OF SERVICES PROVIDED OR THE QUALITY OF PERFORMANCE PERFORMED. ALL ARE SPECIFIED IN THEIR CONTRACTS. ANY OTHER INCENTIVES ARE PAID OUT AS CONTINGENT INCOME ALSO BASED ON QUALITY AND FINANCIAL PERFORMANCE METRICS.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

Return Reference	Explanation
Form 990, Part III, Line 4a PROGRAM SERVICE	NMMC-IUKA SERVES TISHOMINGO COUNTY AND THE SURROUNDING AREA. IN FISCAL YEAR 2024, THERE WERE 785 INPATIENT ADMISSIONS, 7,877 EMERGENCY DEPARTMENT VISITS, 45,875 OUTPATIENT VISITS AND 17,222 RURAL HEALTH CLINIC VISITS. NMMC-IUKA USES PRESS GANEY, THE LARGEST PATIENT SATISFACTION SURVEY COMPANY IN THE NATION, THAT WORKS WITH MORE THAN 7,000 HEALTHCARE FACILITIES. RANDOMLY SELECTED PATIENTS ARE ASKED ABOUT THEIR EXPERIENCE WITH INPATIENT, OUTPATIENT, ER, AND LONG TERM CARE SERVICES. INPATIENT CARE INCLUDES 24 HOUR DIRECT PATIENT CARE WITH MULTI-DISCIPLINARY SERVICES, INCLUDING: NURSING, RADIOLOGY, LABORATORY, ULTRASONOGRAPHY, NUCLEAR MEDICINE, CT, MAGNETIC RESONANCE IMAGING (MRI), PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RESPIRATORY THERAPY, FOOD AND NUTRITIONAL SERVICES, AND SOCIAL SERVICES. THE HOSPITAL ALSO HAS 10 CERTIFIED SWING BEDS FOR PATIENTS WHO NEED EXTENDED CARE BASED ON AVAILABILITY AND RESOURCES. NMMC-IUKA OFFERS 24-HOUR EMERGENCY SERVICES AND PARAMEDIC-LEVEL AMBULANCE SERVICES. OUTPATIENT SERVICES INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, LABORATORY, RADIOLOGY, RESPIRATORY CARE, INFUSION, WOUND CARE AND CARDIAC MONITORING. NMMC-IUKA IS THE RECIPIENT OF TWO VHA LEADERSHIP AWARDS, HONORING THE HOSPITAL FOR MEETING OR EXCEEDING NATIONAL PERFORMANCE STANDARDS FOR CLINICAL CARE AND QUALITY. VHA SERVES MORE THAN 1,400 NOT-FOR-PROFIT HOSPITALS AND MORE THAN 24,000 NON-ACUTE HEALTH CARE ORGANIZATIONS NATIONWIDE. NMMC-IUKA WAS ONE OF ONLY 38 VHA MEMBER ORGANIZATIONS TO RECEIVE A 2009 LEADERSHIP AWARD FOR CLINICAL EXCELLENCE. ONE OF THE PRIMARY WAYS NMMC-IUKA SERVES THE COMMUNITY IS BY PROVIDING CARE TO VARIOUS POPULATIONS FOR WHICH IT RECEIVES NO COMPENSATION OR RECEIVES COMPENSATION AT RATES SIGNIFICANTLY LESS THAN ESTABLISHED RATES. THE BOARD OF DIRECTORS OF THE NMMC-IUKA HAS ESTABLISHED A POLICY UNDER WHICH THE HOSPITAL PROVIDES CARE, WITHOUT CHARGE, TO NEEDY MEMBERS OF ITS COMMUNITY. THE FINANCIAL ASSISTANCE POLICY STATES THAT NMMC WILL PROVIDE EMERGENCY AND MEDICALLY NECESSARY INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS FREE OF CHARGE WITH HOUSEHOLD INCOME LEVELS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. THE POLICY FURTHER PROVIDES, PATIENTS WITH HOUSEHOLD INCOME LEVELS BETWEEN 101% AND 150% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE TO RECEIVE SERVICES AT A DISCOUNTED RATE. THE DISCOUNT WILL BE PRO-RATED BASED ON THE PATIENT'S GROSS FAMILY INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY LEVEL. THE POLICY APPLIES TO INDIVIDUALS WHO RESIDE IN TISHOMINGO COUNTY. PATIENTS FROM OUTSIDE THE COUNTY MAY ALSO BE GRANTED CHARITY CARE BASED ON THE JUDGMENT OF NMMC-IUKA MANAGEMENT DEPENDING ON THEIR INDIVIDUAL CIRCUMSTANCES. THE POLICY ALSO REQUIRES THE PATIENT TO COOPERATE FULLY WITH NMMC-IUKA'S REQUEST FOR INFORMATION WITH WHICH TO VERIFY THE PATIENT'S ELIGIBILITY. FOLLOWING THAT POLICY, THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. CHARGES FORGONE, BASED ON ESTABLISHED RATES, TOTALED APPROXIMATELY $577,278 IN FISCAL YEAR 2024. BASED ON THE GROSS CHARGES PROVIDED TO CHARITY PATIENTS COMPARED TO TOTAL HOSPITAL GROSS CHARGES, 3.47% OF ALL SERVICES IN FISCAL YEAR 2024 WERE PROVIDED ON A CHARITY BASIS. THE NET COST OF CHARITY CARE PROVIDED BY NMMC-IUKA WAS APPROXIMATELY $599,696 IN FISCAL YEAR 2024. THE TOTAL COST ESTIMATE IS BASED ON THE RATIO OF COSTS TO CHARGES FOR NMMC-IUKA. ALL OF THE FORGONE CHARGES MENTIONED ABOVE ARE NETTED AGAINST PATIENT SERVICE REVENUE TO ARRIVE AT NET PATIENT SERVICE REVENUE AS REFLECTED AS PROGRAM SERVICE REVENUE ON PART VIII OF FORM 990 IN ORDER TO BE CONSISTENT WITH FINANCIAL STATEMENT REPORTING AND ARE NOT REPORTED AS FUNCTIONAL EXPENSES ON THE TAX RETURN.
Form 990, Part VI, Line 6 Classes of members or stockholders	TISHOMINGO HEALTH SERVICES, INC. IS A NOT-FOR-PROFIT, NONSTOCK, MEMBERSHIP CORPORATION OF WHICH NORTH MISSISSIPPI HEALTH SERVICES, INC. IS THE SOLE MEMBER AND HAS SOLE VOTING CONTROL.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE GOVERNANCE COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS), WHICH IS MADE UP OF PAST CHAIRMEN, NOMINATE CANDIDATES FOR THE BOARD. THESE CANDIDATES ARE THEN APPROVED BY THE BOARD OF NMHS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE BOARD OF NORTH MISSISSIPPI HEALTH SERVICES, INC. APPROVES ALL TRANSACTIONS THAT EXCEED $1 MILLION.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 GOES THROUGH A REVIEW PROCESS IN THE ACCOUNTING DEPARTMENT. THE ACCOUNTANT FOR EACH FACILITY REVIEWS THE RETURNS FOR REASONABLENESS AND ACCURACY. ALL TOTALS ARE TIED TO THE AUDIT REPORTS, AND ALL AMOUNTS ARE CROSS-REFERENCED TO SCHEDULES OR OTHER PARTS OF THE ACTUAL RETURN. ONCE THE ACCOUNTANT REVIEWS, THE ACCOUNTING SUPERVISOR AND THE DIRECTOR OF ACCOUNTING REVIEWS. THE SUPERVISOR DOES A DETAILED REVIEW BY CHECKING THE RETURN FOR THE SAME ITEMS THAT THE ACCOUNTANT CHECKED FOR. THEN THE DIRECTOR DOES A MORE HIGH LEVEL REVIEW, READING THE RETURN FOR REASONABLENESS AND COMPARING PRIOR YEAR AMOUNTS TO CURRENT YEAR AMOUNTS. FINALLY, THE VP OF FINANCE REVIEWS THE RETURN FOR REASONABLENESS. THE RETURNS ARE THEN SENT TO THE EXECUTIVE VP/TREASURER TO BE REVIEWED. THE CHIEF FINANCIAL OFFICER SIGNS THE RETURN AND IT IS THEN SENT TO THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE IS REQUIRED TO BE COMPLETED BY ALL OFFICERS AND DIRECTORS OF THE ORGANIZATION. THE QUESTIONNAIRE IS REVIEWED BY NORTH MISSISSIPPI HEALTH SERVICES, INC.'S COMPLIANCE OFFICER AND CONFLICT COMMITTEE. THE CONFLICT COMMITTEE REVIEWS CONFLICT TRANSACTIONS AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING CONFLICT TRANSACTIONS IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ALL MEMBERS OF THE CONFLICT COMMITTEE ARE PROHIBITED FROM ENGAGING IN TRANSACTIONS WITH THE ORGANIZATION OR ITS AFFILIATES DURING THEIR TENURE ON THE CONFLICT COMMITTEE AND ONE YEAR AFTER THEIR SERVICE CONCLUDES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	AN INDEPENDENT COMPENSATION CONSULTING FIRM, KORN FERRY, IS USED TO HELP ESTABLISH THE COMPENSATION OF THE SENIOR EXECUTIVES. THE FIRM PRESENTS THEIR INDEPENDENT ANALYSIS, WHICH CONTAINS COMPARABILITY DATA, TO THE COMPENSATION COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS). THE COMPENSATION OF THE INDIVIDUALS ARE THEN APPROVED BY THE COMPENSATION COMMITTEE. THE SALARIES OF NMHS' SENIOR EXECUTIVES ARE THEN REVIEWED BY THE NMHS BOARD OF DIRECTORS. THE INDIVIDUAL WHOSE COMPENSATION IS BEING DISCUSSED IS NOT PRESENT DURING THE DISCUSSION OR APPROVAL OF THEIR COMPENSATION. THE DISCUSSIONS AND DECISIONS REGARDING THE COMPENSATION ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS. COMPENSATION OF THESE INDIVIDUALS IS APPROVED ANNUALLY.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	AN INDEPENDENT COMPENSATION CONSULTING FIRM, KORN FERRY, IS USED TO HELP ESTABLISH THE COMPENSATION OF THE SENIOR EXECUTIVES. THE FIRM PRESENTS THEIR INDEPENDENT ANALYSIS, WHICH CONTAINS COMPARABILITY DATA, TO THE COMPENSATION COMMITTEE OF NORTH MISSISSIPPI HEALTH SERVICES, INC. (NMHS). THE COMPENSATION OF THE INDIVIDUALS ARE THEN APPROVED BY THE COMPENSATION COMMITTEE. THE SALARIES OF NMHS' SENIOR EXECUTIVES ARE THEN REVIEWED BY THE NMHS BOARD OF DIRECTORS. THE INDIVIDUAL WHOSE COMPENSATION IS BEING DISCUSSED IS NOT PRESENT DURING THE DISCUSSION OR APPROVAL OF THEIR COMPENSATION. THE DISCUSSIONS AND DECISIONS REGARDING THE COMPENSATION ARE DOCUMENTED IN THE MINUTES OF THE MEETINGS. COMPENSATION OF THESE INDIVIDUALS IS APPROVED ANNUALLY.
Form 990, Part VI, Line 19 Required documents available to the public	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. A CONSOLIDATED STATEMENT OF OPERATIONS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	- Total Revenue: 2029, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 2029;
Form 990, Part IX, Line 11g Other Fees	PURCHASED SERVICES - Total Expense: 886846, Program Service Expense: 886846, Management and General Expenses: , Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 1049469, Program Service Expense: 1049469, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CONTRIBUTED CAPITAL - 249068; PENSION RELATED CHANGES - 242461; INTEREST IN NET ASSETS OF AFFILITED FOUNDATION - 2803;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

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

2023

Open to Public Inspection

Name of the organization

Tishomingo Health Services

Employer identification number

64-0741047

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?
(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	Yes	No
(1)NORTH MS MANAGEMENT SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0762694	MGMT & ADMIN	DE	501(c)(3)	Type I	NMHS	Yes
(2)NORTH MS HEALTH SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0653269	MGMT SERVICES	DE	501(c)(3)	Type II	NA		No
(3)CLAY COUNTY MEDICAL CORPORATION 830 S GLOSTER STREET TUPELO,MS38801 64-0668465	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(4)NORTH MS MEDICAL CENTER INC 830 S GLOSTER STREET TUPELO,MS38801 64-0662976	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(5)PONTOTOC HEALTH SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0751410	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(6)NORTH MS MEDICAL CLINICS INC 830 S GLOSTER STREET TUPELO,MS38801 64-0787918	MED CLINICS	DE	501(c)(3)	3	NMHS	Yes
(7)TUPELO SERVICE FINANCE INC 830 S GLOSTER STREET TUPELO,MS38801 64-0508308	COLLECTIONS	DE	501(c)(3)	3	NMHS	Yes
(8)WEBSTER HEALTH SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0819193	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(9)MARION REGIONAL MEDICAL CENTER INC 830 S GLOSTER STREET TUPELO,MS38801 64-0926753	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(10)NORTH MS EMERGENCY SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0780130	ER PHYSICIANS	DE	501(c)(3)	10	NMHS	Yes
(11)MONROE HEALTH SERVICES 830 S GLOSTER STREET TUPELO,MS38801 32-0583236	HOSPITAL	DE	501(c)(3)	3	NMHS	Yes
(12)HEALTH CARE FOUNDATION OF NORTH MS 830 S GLOSTER STREET TUPELO,MS38801 64-0914704	FUNDRAISING	DE	501(c)(3)	7	NMHS	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) MEDICAL IMAGING LLC 830 S GLOSTER STREET TUPELO,MS38801 77-0647210	MEDICAL IMAGING	MS	NA				No			No
(2) CENTER FOR DIGESTIVE HEALTH LLC 589 GARFIELD ST TUPELO,MS38801 20-1606438	DIGESTIVE CARE	MS	NA				No			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?
(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	Yes	No
(1) NORTH MISSISSIPPI HEALTH LINK INC 830 S GLOSTER STREET TUPELO,MS38801 64-0715886	MEDICAL SERVICES	DE	NMHS	C Corporation				Yes
(2) NORTH MS ENTERPRISES INC 830 S GLOSTER STREET TUPELO,MS38801 64-0658059	MEDICAL SERVICES	DE	NMHS	C Corporation				Yes
(3) PROFESSIONAL PRACTICE MANAGEMENT INC 830 S GLOSTER STREET TUPELO,MS38801 72-1390014	MED SERV MGMT	DE	NMMCL	C Corporation				Yes
(4) ACCLAIM INC 830 S GLOSTER STREET TUPELO,MS38801 72-1356116	HLTH CARE CLAIMS	DE	HEALTHLINK	C Corporation				Yes
(5) NORTH MS SUPPORT SERVICES INC 830 S GLOSTER STREET TUPELO,MS38801 26-0718275	SUPPORT SERVICES	DE	NMHS	C Corporation				Yes

Schedule R (Form 990) 2023

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

1	Briefly describe the organization’s mission or most significant activities: TISHOMINGO HEALTH SERVICES, INC. OPERATES A 48 BED ACUTE CARE HOSPITAL LOCATED IN IUKA, MISSISSIPPI.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	5
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	5
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	182
6	Total number of volunteers (estimate if necessary) .............	6	5
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	19,000	885,000
9	Program service revenue (Part VIII, line 2g) .........	15,920,999	17,305,467
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	48,208	44,536
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,001,722	714,890
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	16,989,929	18,949,893
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	11,397,418	11,710,359
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	7,153,244	7,314,106
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	18,550,662	19,024,465
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,560,733	-74,572
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	11,091,651	9,685,213
21	Total liabilities (Part X, line 26).............	21,410,800	19,584,602
22	Net assets or fund balances. Subtract line 21 from line 20.....	-10,319,149	-9,899,389

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 17,799,074 including grants of $ 0 ) (Revenue $ 17,305,467 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses17,799,074

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) JAMES TENNYSON...................................................................... CHAIRMAN	1.0 ................. 0.0	X	X			0	0	0
(2) ART GAINES...................................................................... DIRECTOR	1.0 ................. 0.0	X				0	0	0
(3) HEATH CASTILE...................................................................... DIRECTOR	1.0 ................. 0.0	X				0	0	0
(4) JENA MCNATT...................................................................... DIRECTOR	1.0 ................. 0.0	X				0	0	0
(5) STEVE MCANALLY...................................................................... DIRECTOR	1.0 ................. 0.0	X				0	0	0
(6) BRUCE TOPPIN...................................................................... SECRETARY	1.0 ................. 38.0		X			0	667,572	14,992
(7) MICHAEL S SPEES...................................................................... PRESIDENT	0.5 ................. 39.5		X			0	2,319,522	27,228
(8) SHARON NOBLES...................................................................... TREASURER	1.0 ................. 38.0		X			0	1,007,522	29,248
(9) BARRY KEEL...................................................................... ADMINISTRATOR	40.0 ................. 20.0			X		0	372,428	13,834
(10) BRADLEY MURRAY...................................................................... PHYSICIAN	40.0 ................. 0.0				X	285,517	0	10,323
(11) LACY ESTES...................................................................... NURSE PRACTITIONER	40.0 ................. 0.0				X	151,457	0	15,338
(12) NATHANIEL SPARKS...................................................................... PHYSICIAN	40.0 ................. 0.0				X	161,196	63,506	8,458
(13) THOMAS DRAPER...................................................................... PHYSICIAN	40.0 ................. 0.0				X	235,903	0	26,394
(14) WALTER MAYFIELD...................................................................... PHYSICIAN	40.0 ................. 0.0				X	253,381	0	22,147

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	1,087,454	4,430,550	167,962

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	885,000

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		885,000

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	17,192,928	17,192,928
b	WELLNESS CENTER REVENUE	621111	107,919	107,919
c	RELATED RENTAL REVENUE	531120	4,620	4,620
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		17,305,467

3 Investment income (including dividends, interest, and othersimilar amounts) ......			5,030			5,030
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	39,506
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c	39,506	0
d	Net gain or (loss).........			39,506			39,506
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	EMPLOYEE DRUGS		446110	658,417			658,417
b	REBATE INCOME		900099	54,444			54,444
c
d	All other revenue ....			2,029	0	0	2,029
e	Total. Add lines 11a–11d ......			714,890
12	Total revenue. See instructions.....			18,949,893	17,305,467	0	759,426

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0	0
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	0	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0	0
7	Other salaries and wages........	9,024,561	8,107,983	916,578
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	587,577	587,577
9	Other employee benefits .......	1,476,035	1,476,035
10	Payroll taxes ...........	622,186	583,278	38,908
11	Fees for services (non-employees):
a	Management ......	149,956		149,956
b	Legal .........	7,176		7,176
c	Accounting ...........	31,040		31,040
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	1,936,315	1,936,315	0	0
12	Advertising and promotion ....	11,212	11,212
13	Office expenses .......	210,952	210,952
14	Information technology ......	402,603	402,603
15	Royalties ..
16	Occupancy ...........	493,471	493,471
17	Travel ............	49,159	49,159
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	21,686	21,686
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	832,724	832,724
23	Insurance ...	81,733		81,733
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	2,699,967	2,699,967
b	REPAIRS AND MAINTENANCE	120,045	120,045
c	COLLECTION FEES	107,358	107,358
d	TAXES AND LICENSES	59,086	59,086
e	All other expenses	99,623	99,623	0	0
25	Total functional expenses. Add lines 1 through 24e	19,024,465	17,799,074	1,225,391	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,410	1	1,310
2	Savings and temporary cash investments .........			526,394	2	191,394
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			772,825	4	733,121
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			422,627	8	392,739
9	Prepaid expenses and deferred charges ......			15,741	9	260
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	24,802,337
b	Less: accumulated depreciation	10b	16,817,305	8,616,417	10c	7,985,032
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			736,237	15	381,357
16	Total assets. Add lines 1 through 15 (must equal line 33)...			11,091,651	16	9,685,213

17	Accounts payable and accrued expenses .....	6,012,180	17	5,526,251
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	15,398,620	25	14,058,351
26	Total liabilities. Add lines 17 through 25..	21,410,800	26	19,584,602

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-10,389,276	27	-9,972,319
28	Net assets with donor restrictions ...........	70,127	28	72,930
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-10,319,149	32	-9,899,389
33	Total liabilities and net assets/fund balances ........	11,091,651	33	9,685,213