2025-05-12T13:31:02-05:00 2024-06-30 562632458 PLEUS AND COMPANY LLC 2200 WEST PORT PLAZA DR STE 203 ST LOUIS MO 63146 990 2023-10-01 923065473 MERCY HOSPITAL PERRY MERC 3145796100 434 N WEST STREET PERRYVILLE MO 63775 SHERRY CLOUSE DAY VP FINANCE 3145796100 2025-05-12 1 1 DOUGLAS G PLEUS CPA P00013488 3143178900 2023 2025-03-06 01:10:19Z X CHRIS WIBBENMEYER 434 N WEST ST PERRYVILLE MO 63775 51527067 0 X WWW.MERCY.NET X 2023 MO AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 12 8 0 35 0 0 113259 51357076 87 48482 51518904 4829 0 36809743 0 0 17658899 54473471 -2954567 15460621 6780806 8679815 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 0 0 7387832 7537201 MERCY HOSPITAL PERRY PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY BY OFFERING ESSENTIAL HEALTH SERVICES TO ITS COMMUNITY. IN ACTIVE PURSUIT OF THIS MISSION, MERCY HOSPITAL PERRY PROVIDES A WIDE VARIETY OF SERVICES IN THEIR 25 BED FACILITY AND IN FY24, HAD 104,679 TOTAL CASES. MERCY HOSPITAL PERRY HAS A TEAM OF PEDIATRICIANS, FAMILY MEDICINE AND INTERNAL MEDICINE DOCTORS WHO CAN HANDLE ALL YOUR ROUTINE HEALTH CARE NEEDS. MERCY'S PRIMARY CARE PROVIDERS HELP WITH ANNUAL CHECKUPS, PREVENTIVE CARE AND HEALTH SCREENINGS, VACCINATIONS AND IMMUNIZATIONS, DIAGNOSIS AND CARE FOR COMMON ILLNESSES AND MINOR INJURIES, AND MANAGING MEDICINES. IN FY24, MERCY HOSPITAL PERRY HAD 32,181 CASES FOR THIS SERVICE LINE. 5637302 5751278 MERCY HOSPITAL PERRY HAS A TEAM OF EXPERT DOCTORS, NURSES AND TECHNICIANS THAT BLEND COMPASSIONATE CARE WITH THE LATEST, MOST ADVANCED DIAGNOSTIC AND TREATMENT RESOURCES IN PROVIDING EMERGENCY CARE. MERCY HOSPITAL PERRY'S EMERGENCY DEPARTMENT IS READY 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR WITH FAST, EXPERIENCED AND PROFESSIONAL CARE. IN FY24, MERCY HOSPITAL PERRY HAD 5,208 CASES FOR THIS SERVICE LINE. 5315573 5423045 MERCY HOSPITAL PERRY'S ORTHOPEDIC PHYSICIANS SHARE A PASSION FOR PROTECTING AND PRESERVING YOUR MOBILITY AND STRENGTH AND CAN CARE FOR NEARLY ANY MEDICAL CONDITION OR INJURY THAT AFFECTS THE MUSCULOSKELETAL SYSTEM. MERCY'S ORTHOPEDIC SPECIALISTS AND SURGEONS TREAT EVERYTHING FROM ACHY JOINTS AND SPORTS INJURIES TO HAND INJURIES AND TRAUMA. IN FY24, MERCY HOSPITAL PERRY HAD 6,838 CASES AND 419 PATIENT DAYS FOR THIS SERVICE LINE. 32000173 4829 32647157 IN ADDITION TO THE PROGRAM SERVICES DESCRIBED ABOVE, MERCY HOSPITAL PERRY ALSO SERVES PATIENTS IN ADDITIONAL SERVICE LINES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING AREAS: GASTROENTEROLOGY; LAB; PULMONARY; REHABILITATION; WOMEN & INFANTS. 32000173 4829 32647157 50340880 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X SHERRY CLOUSE DAY 4178203400 3265 S NATIONAL AVENUE SPRINGFIELD MO 65807 ECKENFELS DANIEL PRESIDENT, MERCY JEFFERSON COMMUNITIES & BOARD MEM 20.00 40.00 X 0 413568 29460 RAO MD SANDEEP HOSPITALIST & BOARD MEMBER 50.00 0.00 X 0 194272 4032 GAETA MD MATTHEW PHYSICIAN & BOARD MEMBER 50.00 0.00 X 0 176037 3324 JOHNSTON RYAN EXECUTIVE DIRECTOR & BOARD MEMBER 40.00 0.00 X 0 126697 18929 BUERCK LINDA BOARD MEMBER 1.00 0.00 X 0 0 0 HAYDEN CRAIG BOARD MEMBER 1.00 0.00 X 0 0 0 NAEGER PATRICK BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK ROBERT BOARD MEMBER 1.00 0.00 X 0 0 0 SCHUMER GARY BOARD MEMBER 1.00 0.00 X 0 0 0 SIMMS ROBIN BOARD MEMBER 1.00 0.00 X 0 0 0 TAYLOR KAY BOARD MEMBER 1.00 0.00 X 0 0 0 UNGER GREGORY BOARD MEMBER 1.00 0.00 X 0 0 0 CLOUSE DAY SHERRY VP, FINANCE & TREASURER 2.00 48.00 X 0 399588 26705 WILKE JAMIE ASSOCIATE COUNSEL & SECRETARY 2.00 58.00 X 0 223989 12297 WIBBENMEYER CHRISTOPHER ADMINISTRATOR & BOARD MEMBER 25.00 25.00 X 0 106384 2424 AMMONS CARL E ERIC REGIONAL PRESIDENT, SOUTHEAST MISSOURI 15.00 40.00 X 0 945191 114804 BYRNE JOSEPH PHYSICIAN 50.00 0.00 X 0 235722 3294 ROGERS THEODORE PHYSICIAN 50.00 0.00 X 0 180404 3969 SCHABBING MARK PHYSICIAN 50.00 0.00 X 0 151430 3248 KAPP DAVID PHYSICIAN 50.00 0.00 X 0 149234 4724 0 3302516 227210 0 0 1 0 MID AMERICA REHAB PC 206 HOSPITAL LANE PERRYVILLE MO 63775 LABOR MANAGEMENT SOLUTIONS 395679 QUALIVIS LLC 434 NORTH WEST STREET PERRYVILLE MO 63775 LABOR MANAGEMENT SOLUTIONS 190651 2 65131 48128 113259 NET PATIENT SERVICE REVENUE 621110 51150636 51150636 OTHER OPERATING REVENUE 621110 203369 203369 RENTAL INCOME FROM RELATED ORGANI 531120 3071 3071 51357076 87 87 18931 8163 10768 10768 10768 CAFE & VENDING 722212 36110 36110 1604 1604 37714 51518904 51358680 0 46965 4829 4829 91853 85020 6833 31329497 29100118 2229379 1061163 940804 120359 2535447 2284255 251192 1791783 1649342 142441 14615 14615 1539710 1475785 63925 29433 29433 861984 739676 122308 55873 35209 20664 1009760 880506 129254 87317 31872 55445 711 300 411 512984 461686 51298 402759 402759 DRUGS & MEDICAL EXPENSE 7694921 7694921 BAD DEBT 3879655 3879655 REPAIRS & MAINTENANCE 789826 783234 6592 SHARED SERVICE FEES 511997 168959 343038 267354 124709 142645 54473471 50340880 4132591 0 14073 10007519 1648571 335399 3949257 512984 0 3436273 13116 5670 0 15460621 5930121 0 850685 0 6780806 X 8547241 132574 0 8679815 0 15460621 X -2954567 11634382 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 14615 0 0 0 14615 0 PART II-B, LINE 1: THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: AMERICAN HOSPITAL ASSOCIATION, CATHOLIC HEALTH ASSOCIATION, AND MISSOURI HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2024, DUES WERE $11,045, $8,451, AND $33,246, RESPECTIVELY. APPROXIMATELY 32.00% OF AMERICAN HOSPITAL ASSOCIATION DUES, 3.65% OF CATHOLIC HEALTH ASSOCIATION DUES, AND 32.40% OF MISSOURI HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS. 121754 2461 119293 3827503 510523 3316980 3436273 DUE TO AFFILIATES 850685 850685 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE PRIMARILY ALL OF THE HEALTH SYSTEM ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS CHARITABLE ORGANIZATIONS QUALIFYING UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), BY VIRTUE OF IRS DETERMINATION LETTERS OR INCLUSION IN THE OFFICIAL CATHOLIC DIRECTORY. THE HEALTH SYSTEM COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2024 OR 2023. 1 1 X 1 X 1 X 1 1 1 0 0 446804 446804 0.00820 6429772 4272071 2157701 0.03960 6876576 4272071 2604505 0.04780 6876576 4272071 2604505 0.04780 1 1373330 0 16595064 17848800 -1253736 X 1 1 1 1 MERCY HOSPITAL PERRY 434 N WEST STREET PERRYVILLE MO 63775 WWW.MERCY.NET 572-0 X X X X MERCY HOSPITAL PERRY 1 1 1 0 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 0 X X X X X 1 X 0 0 MERCY HOSPITAL PERRY PART V, SECTION B, LINE 2: ON OCTOBER 1, 2023, THE HEALTH SYSTEM EXECUTED A HOSPITAL LEASE AND OPERATIONS TRANSFER AGREEMENT ACQUIRING MERCY HOSPITAL PERRY AND RELATED PHYSICIANS (FORMERLY PERRY COUNTY MEMORIAL HOSPITAL). THE ACQUISITION PROVIDED MERCY'S PATIENTS WITH ACCESS TO A GREATER NUMBER OF SPECIALISTS AND ENHANCED THE COORDINATION OF HEALTH SERVICES. MERCY HOSPITAL PERRY PART V, SECTION B, LINE 20E: OTHER AREAS FROM A NOTICE PERSPECTIVE: FAP IS POSTED IN ALL REGISTRATION AREAS, FULL POLICY AND PLAIN LANGUAGE DOCUMENT POSTED ON WEBSITE, PLAIN LANGUAGE DOCUMENT IS AVAILABLE WHEN REQUESTED, THERE IS A NOTICE ON STATEMENT, AND ALL PATIENTS GET THREE STATEMENTS BEFORE THEY CAN GO TO A COLLECTION AGENCY. FORM 990, SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ 5 1 - MERCY WOUND CARE 12 N KINGSHIGHWAY PERRYVILLE MO 63775 HOSPITAL BASED OUTPATIENT DEPTS: WOUND CARE SERVICES 2 - MERCY CONVENIENT CARE 1508 EDGEMONT BLVD PERRYVILLE MO 63775 HOSPITAL BASED OUTPATIENT DEPTS: CONVIENIENT CARE SERVICES 3 - MERCY ORTHOPEDICS AND SPORTS MEDICINE 206 HOSPITAL LANE PERRYVILLE MO 63775 HOSPITAL BASED OUTPATIENT DEPTS: ORTHOPEDIC AND SPORTS MEDICINE SERVICES 4 - MERCY SERVICES 210 HOSPITAL LANE PERRYVILLE MO 63775 HOSPITAL BASED OUTPATIENT DEPTS: INFUSION THERAPY SERVICES 5 - MERCY SERVICES 212 HOSPITAL LANE PERRYVILLE MO 63775 HOSPITAL BASED OUTPATIENT DEPTS: PRIMARY CARE SERVICES PART I, LINE 7: TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $54,473,471. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $3,879,655. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $50,593,816. FORM 990, PART I, LINE 1 THE HOSPITAL FACILITY BEING REPORTED IN SCHEDULE H WAS ACQUIRED BY MERCY DURING THE TAX YEAR, AND IS NOW OPERATING AS PART OF THE MERCY HEALTH SYSTEM WITHIN THE EAST COMMUNITY, AND THE POLICIES DESCRIBED HEREIN ARE ALSO APPLICABLE TO MERCY HOSPITAL PERRY. PART III, LINE 2: TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNT, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. PART III, LINE 3: THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE. PART III, LINE 4: IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS.BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. PART III, LINE 8: IT IS THE POSITION OF MERCY THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). PART III, LINE 9B: MERCY'S COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE COMMUNICATION AND/OR REVIEW OF PATIENT ACCOUNTS AS IT RELATES TO ANY SERVICE PROVIDED AT OUR FACILITIES BEFORE TURNING THE ACCOUNT TO BAD DEBT FOR NONPAYMENT. MERCY ACTIVELY SCRUBS ACCOUNTS FOR PAYOR PLAN COVERAGE, INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR PATIENT IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS.MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY FOR ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE, SOUTHEAST KANSAS, CAPE GIRARDEU AND STODDARD. THIS PRESUMPTIVE SCREENING PROCESS DETAILS EVALUATIONS THAT TAKE PLACE PRIOR TO PATIENT BILLING AND ADDITIONALLY PRIOR TO BAD DEBT PLACEMENT. THE PRESUMPTIVE SCREENING WAS PER ENCOUNTER AND DID NOT PROMOTE ANY LOOK-BACK ADJUSTMENTS.MERCY WILL GRANT CHARITY IN SITUATIONS WHERE THERE HAS BEEN AN INABILITY TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION WHEN A PATIENT HAS SUBMITTED AN APPLICATION.MERCY WILL PURSUE APPROPRIATE MEANS IN THE COLLECTION OF DELINQUENT ACCOUNTS FROM PATIENTS WITH AN ESTABLISHED ABILITY TO PAY OR AN UNWILLINGNESS TO COOPERATE IN VALIDATING ELIGIBILITY FOR FINANCIAL ASSISTANCE. THESE APPROPRIATE MEANS MAY INCLUDE PLACEMENT WITH A COLLECTION AGENCY CONSISTENT WITH MERCY MISSION AND VALUES. THIS OCCURS AFTER 3 MONTHLY STATEMENTS HAVE BEEN SENT WITH THE FINAL STATEMENT INCLUDING NOTIFICATION OF PLACEMENT WITH A COLLECTION AGENCY. WHILE MERCY USES THE COLLECTION FOLLOW-UP SERVICES OF COLLECTION AGENCIES, MERCY WILL NOT UTILIZE ANY TYPE OF EXTRAORDINARY COLLECTION ACTIVITY. THE DEFINITION OF EXTRAORDINARY COLLECTION ACTIVITY IS TAKEN FROM THE 501(R) DESCRIPTION. PART VI, LINE 3: MERCY 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 THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNT IS PLACED FOR REVIEW. IN ADDITION, PATIENTS HAVE SIGNAGE ABOUT THE POLICY AT THE ACCESS POINTS, AND ALL STAFF WORKING WITH THE PATIENT AT POINT OF SERVICE, SCHEDULING, CUSTOMER SERVICE, AND EVEN THROUGH THE MEDICAID ELIGIBILITY SCREENING HAVE THE MEANS TO SEND THE ACCOUNT FOR REVIEW. THERE IS THE PLAIN LANGUAGE SUMMARY THAT IS BEING PROVIDED TO ALL WHOM EXPRESS HARDSHIP, IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFF'S INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL PERRY IS A RURAL COMMUNITY THAT INCLUDES PERRY COUNTY, MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND U.S. CENSUS INFORMATION. THE AREA'S POPULATION IS 18,950 AND 20.6% OF THE POPULATION IS 65 AND OLDER. 87.9% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 39. THE MEDIAN HOUSEHOLD INCOME IS $63,356. 10.0% OF THE POPULATION IS IN POVERTY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE FILING ORGANIZATION IS PART OF MERCY HEALTH ("MERCY"). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS ("MINISTRY OFFICE") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN ARKANSAS, LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2024, MERCY FACILITIES INCLUDED 32 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 7 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 3 ORTHOPEDIC HOSPITALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2024, MERCY HAD MORE THAN 11.9 MILLION CLINIC AND OUTPATIENT VISITS, APPROXIMATELY 2,600 EMPLOYED PHYSICIANS, AND APPROXIMATELY 52,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES. MERCY IS SPONSORED BY MERCY HEALTH MINISTRY, WHICH IS GOVERNED BY MEMBERS THAT INCLUDE SISTERS OF MERCY. MANY SERVICES THAT ARE ESSENTIAL TO FULFILLING MERCY'S MISSION ARE CENTRALIZED AT THE MINISTRY OFFICE. SUCH CENTRALIZED SERVICES INCLUDE: FINANCE (INCLUDING TREASURY, FINANCIAL ACCOUNTING AND REPORTING, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTS PAYABLE AND PAYROLL OPERATIONS, ANALYTICS AND DECISION SUPPORT); ENVIRONMENTAL SERVICES SUPPORT; CLINICAL INTEGRATION; CARE MANAGEMENT; CLINICAL PERFORMANCE ACCELERATION; CLINICAL ENGINEERING; CLINICAL QUALITY MANAGEMENT; COMPLIANCE; GRANTS AND RESEARCH SERVICES; LEGAL AND COMPLIANCE COUNSEL; MARKETING AND COMMUNICATIONS; PLANNING, DESIGN AND CONSTRUCTION; PRODUCT DEVELOPMENT INFORMATICS; REAL ESTATE; SUPPLY CHAIN MANAGEMENT; MANAGED CARE STRATEGY SUPPORT; HUMAN RESOURCES (INCLUDING COMPENSATION, BENEFITS AND RECRUITING); MISSION SERVICES AND ETHICS; PHILANTHROPY SUPPORT; INFORMATION TECHNOLOGY; AND, COMMUNITY RELATIONS. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. 0 0 0 0 0 0 0 0 0 AMMONS CARL E ERIC REGIONAL PRESIDENT, SOUTHEAST MISSOU 0 352460 0 425134 0 167597 0 99689 0 15115 0 1059995 0 149016 ECKENFELS DANIEL PRESIDENT, MERCY JEFFERSON COMMUNITI 0 320871 0 58983 0 33714 0 9356 0 20104 0 443028 0 0 CLOUSE DAY SHERRY VP, FINANCE & TREASURER 0 217555 0 67178 0 114855 0 11820 0 14885 0 426293 0 0 BYRNE JOSEPH PHYSICIAN 0 224100 0 0 0 11622 0 0 0 3294 0 239016 0 0 WILKE JAMIE ASSOCIATE COUNSEL & SECRETARY 0 175315 0 32753 0 15921 0 2183 0 10114 0 236286 0 0 RAO MD SANDEEP HOSPITALIST & BOARD MEMBER 0 184338 0 0 0 9934 0 0 0 4032 0 198304 0 0 ROGERS THEODORE PHYSICIAN 0 120293 0 60000 0 111 0 0 0 3969 0 184373 0 0 GAETA MD MATTHEW PHYSICIAN & BOARD MEMBER 0 163590 0 0 0 12447 0 0 0 3324 0 179361 0 0 SCHABBING MARK PHYSICIAN 0 82035 0 60000 0 9395 0 0 0 3248 0 154678 0 0 KAPP DAVID PHYSICIAN 0 70506 0 60000 0 18728 0 0 0 4724 0 153958 0 0 PART I, LINE 3 MERCY HOSPITAL PERRY RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART II THE AMOUNT REPORTED FOR CARL E. AMMONS IN COLUMN (F) IS EITHER INCLUDED IN B(I) BASE COMPENSATION, B(II) AS BONUS AND INCENTIVE COMPENSATION, OR B(III) AS OTHER REPORTABLE COMPENSATION. THIS AMOUNT IS A PAYOUT OF THE EXECUTIVE RETENTION PLAN AND WAS INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990. DEBORAH AYDEN FAMILY MEMBER OF BOARD MEMBER 91852 EMPLOYMENT 0 FORM 990, PART V, QUESTION 1A FORM 1099/1096 FILING VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART V, QUESTION 2A W-3 FILING MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3'S) IS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES, EIN 20-2553101. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS MERCY HEALTH EAST COMMUNITIES, A SUPPORTING ORGANIZATION UNDER SECTION 509(A)(3). THE MEMBER OF MERCY HEALTH EAST COMMUNITIES IS MERCY HEALTH. FORM 990, PART VI, SECTION A, LINE 7A MERCY HEALTH, THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, HAS RESERVE POWERS TO APPOINT AND REMOVE ALL DIRECTORS AND OFFICERS FOR MERCY HOSPITAL PERRY. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED TO THE SOLE CORPORATE MEMBER: -REVISIONS TO THE MISSION, PHILOSOPHY, VISION AND OPERATING VALUES PURSUANT TO WHICH THE CORPORATION OPERATES; -SUBJECT TO ARTICLE XII, ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THESE BYLAWS AND ANY AMENDMENTS TO THE CORPORATE DOCUMENTS OF ANY AFFILIATE OF THE CORPORATION; -ADOPTION OF THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION AND ANY AFFILIATE OF THE CORPORATION; -ADOPTION OF THE OPERATING, CAPITAL, CONSTRUCTION AND ALL OTHER BUDGETS FOR THE CORPORATION AND ANY AFFILIATE OF THE CORPORATION; -ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -ANY ACTION WHICH MAY BE REQUIRED TO CAUSE MERCY HEALTH OR THE CORPORATION TO COMPLY WITH THE TERMS AND CONDITIONS OF THE MASTER TRUST INDENTURE DATED AS OF NOVEMBER 15, 1995 BETWEEN SISTERS OF MERCY HEALTH SYSTEM, ST. LOUIS, INC. AND MERCANTILE BANK OF ST. LOUIS NATIONAL ASSOCIATION (AND THEIR RESPECTIVE SUCCESSORS AND ASSIGNS) AND ANY PRIOR OR SUBSEQUENT SUPPLEMENTS, AMENDMENTS, REPLACEMENTS, RESTATEMENTS OR SUCCESSOR INDENTURES THERETO; -ADOPTION OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION; -LEASE, MANAGEMENT OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HOSPITAL SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION; -EXPENDITURES NOT AUTHORIZED BY, OR INCLUDED WITHIN BUDGETS APPROVED BY, THE CORPORATE MEMBER WHICH ARE IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER. -ENTERING INTO ANY CONTRACT NOT INCLUDED WITHIN BUDGETS APPROVED BY, OR WITHIN GUIDELINES ESTABLISHED FROM TIME TO TIME BY, THE CORPORATE MEMBER. -THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED DIRECTLY OR INDIRECTLY BY THE CORPORATION; AND -OVERSEE, APPROVE AND MONITOR HUMAN RESOURCE PROGRAMS, WHICH SHALL PROMOTE AN ORGANIZATIONAL ENVIRONMENT THAT: -PROVIDES FOR THE RECRUITMENT AND RETENTION OF CO-WORKERS WHO ARE SERVICE ORIENTATED, COMPASSIONATE, ENGAGED, AND WHO FIND MEANING AND PURPOSE IN WORKING IN A FAITH-BASED ORGANIZATION; -ENABLES PEOPLE TO RELATE TO ONE ANOTHER WITH RESPECT AND ACCEPTANCE IN A SPIRIT OF COMMUNITY; -PROMOTES CO-WORKER PARTICIPATION AND VOICE IN THEIR WORK LIVES; -GIVES CO-WORKERS A FAIR OPPORTUNITY TO DEVELOP THEIR SKILLS AND TALENTS, AND A MEANS BY WHICH THEIR CONTRIBUTIONS ARE RECOGNIZED; -PROVIDES CO-WORKERS WITH THE MATERIALS AND EQUIPMENT TO PROPERLY DO THEIR WORK; AND -ENSURES CO-WORKER SAFETY AND WELL-BEING. FORM 990, PART VI, SECTION B, LINE 11B DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY MERCY HEALTH'S TAX DEPARTMENT, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE DIRECTOR OF FINANCE AND THE CHIEF FINANCIAL OFFICER. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT AND AN INDEPENDENT ACCOUNTING FIRM, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORMS 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2024. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S CORPORATE COMPLIANCE DEPARTMENT. THE CONFLICTS AND THEIR RESPECTIVE RESOLUTIONS ARE SHARED AT THE MERCY LEVEL WITH A TEAM INCLUDING MERCY'S SENIOR VICE PRESIDENT OF FINANCIAL OPERATIONS & PLANNING, CHIEF COMPLIANCE OFFICER AND OTHER MEMBERS OF FINANCE, LEGAL AND HR. THE QUESTIONNAIRES ARE THEN REVIEWED WITH LEADERSHIP AT THE LOCAL LEVEL AND POTENTIAL CONFLICTS DISCUSSED AND RESOLVED. SUMMARY RESULTS ARE REVIEWED WITH MERCY'S STEWARDSHIP COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY EMPLOYEES FOR THE TOP MANAGEMENT OFFICIALS, THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS) AND KEY EMPLOYEES, THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT. FOR CERTAIN EXECUTIVES AND PHYSICIANS THE COMPENSATION IS REVIEWED/APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR ALL OTHER CAREGIVERS COMPENSATION IS REVIEWED/APPROVED BY THE TOTAL REWARDS OVERSIGHT COMMITTEE. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS AND REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART XI, LINE 9: NET TRANSFERS (TO)/FROM AFFILIATES 11,494,982. CHANGE IN RESTRICTED NET ASSETS 139,399. ROUNDING 1. FORM 990, PART XII, QUESTION 2C AUDIT OF FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2024 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. FORM 990, PART XII, QUESTION 3A AND 3B SINGLE AUDIT ACT AND 2 CFR 200 AUDIT MERCY HEALTH UNDERGOES A CONSOLIDATED 2 CFR 200 AUDIT EVERY YEAR AND THIS AUDIT WAS COMPLETED FOR THE FISCAL YEAR ENDING JUNE 30, 2024 BY DECEMBER 13, 2024. EACH ENTITY THAT RECEIVES FEDERAL FUNDS DURING THE YEAR IS INCLUDED ON THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) AND IS ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. IF THE FILING ENTITY RECEIVED FEDERAL FUNDS DURING THE YEAR ENDED JUNE 30, 2024, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. CASA DE MISERICORDIA 1000 MIER ST LAREDO TX 78040 742912461 WOMEN'S DOMESTIC VIOLENCE SHELTER TX 501(C)(3) LINE 7 MERCY MINISTRIES OF LAREDO 1 MCAULEY PORTFOLIO MANAGEMENT COMPANY 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 261708048 PORTFOLIO MANAGEMENT. MO 501(C)(3) LINE 12B, II MERCY HEALTH 1 MERCY ACO CLINICAL SERVICES INC 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 464504901 VIRTUAL CARE CENTER MO 501(C)(3) LINE 3 MERCY HEALTH 1 MERCY CLINIC EAST COMMUNITIES 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 431771217 PHYSICIAN GROUP MO 501(C)(3) LINE 10 MERCY HEALTH EAST COMMUNITIES 1 MERCY CLINIC FORT SMITH COMMUNITIES 7301 ROGERS AVENUE FORT SMITH AR 72903 261318597 PHYSICIAN CLINIC AR 501(C)(3) LINE 3 MERCY HEALTH FORT SMITH COMMUNITIES 1 MERCY CLINIC OKLAHOMA COMMUNITIES INC 4300 W MEMORIAL ROAD OKLAHOMA CITY OK 73120 270473057 PHYSICIAN GROUP OK 501(C)(3) LINE 3 MERCY HEALTH OKLAHOMA COMMUNITIES INC 1 MERCY CLINIC SPRINGFIELD COMMUNITIES 1965 S FREMONT SUITE 200 SPRINGFIELD MO 65804 431560263 PHYSICIAN GROUP MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY FAMILY CENTER 110 VETERANS BLVD METAIRIE LA 70005 721069468 FAMILY COUNSELING SERVICE LA 501(C)(3) LINE 7 MERCY HEALTH 1 MERCY HEALTH 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 431423050 CORPORATE OFFICE MO 501(C)(3) LINE 1 N/A 0 MERCY HEALTH EAST COMMUNITIES 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 431718408 HEALTH SYSTEM MO 501(C)(3) LINE 12A, I MERCY HEALTH 1 MERCY HEALTH FORT SMITH COMMUNITIES 7301 ROGERS AVENUE FORT SMITH AR 72917 261318515 HOLDING COMPANY AR 501(C)(3) LINE 12B, II MERCY HEALTH 1 MERCY HEALTH FOUNDATION 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 200901499 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HEALTH 1 MERCY HEALTH FOUNDATION ADA 430 N MONTE VISTA STREET ADA OK 74820 463596274 FOUNDATION OK 501(C)(3) LINE 12A, I MERCY HOSPITAL ADA INC 1 MERCY HEALTH FOUNDATION ARDMORE 1011 14TH AVENUE NW ARDMORE OK 73401 710962525 FOUNDATION OK 501(C)(3) LINE 12A, I MERCY HOSPITAL ARDMORE INC 1 MERCY HEALTH FOUNDATION BERRYVILLE 214 CARTER STREET BERRYVILLE AR 72616 710759301 FOUNDATION AR 501(C)(3) LINE 12A, I MERCY HOSPITAL BERRYVILLE 1 MERCY HEALTH FOUNDATION FORT SCOTT 401 WOODLAND HILLS BLVD FORT SCOTT KS 66701 481077073 FOUNDATION KS 501(C)(3) LINE 7 MERCY KANSAS COMMUNITIES INC 1 MERCY HEALTH FOUNDATION FORT SMITH 7301 ROGERS AVENUE FORT SMITH AR 72917 237330425 FOUNDATION AR 501(C)(3) LINE 7 MERCY HEALTH FORT SMITH COMMUNITIES 1 MERCY HEALTH FOUNDATION JEFFERSON 1400 US HIGHWAY 61 SOUTH FESTUS MO 63028 462797051 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HOSPITAL JEFFERSON 1 MERCY HEALTH FOUNDATION JOPLIN 100 MERCY WAY JOPLIN MO 64804 270906136 FOUNDATION MO 501(C)(3) LINE 7 MERCY HEALTH SW MOKS COMMUNITIES 1 MERCY HEALTH FOUNDATION LEBANON 100 HOSPITAL DRIVE LEBANON MO 65536 822514567 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HOSPITAL LEBANON 1 MERCY HEALTH FOUNDATION LINCOLN 1000 EAST CHERRY STREET TROY MO 63379 811477159 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HOSPITALS EAST COMMUNITIES 1 MERCY HEALTH FOUNDATION NORTHWEST ARKANSAS 2710 RIFE MEDICAL LANE ROGERS AR 72758 710601687 FOUNDATION AR 501(C)(3) LINE 7 MERCY HOSPITAL ROGERS 1 MERCY HEALTH FOUNDATION OF OKLAHOMA 4300 W MEMORIAL ROAD OKLAHOMA CITY OK 73120 454732301 FOUNDATION OK 501(C)(3) LINE 12A, I MERCY HEALTH OKLAHOMA COMMUNITIES INC 1 MERCY HEALTH FOUNDATION OKLAHOMA CITY 4300 W MEMORIAL ROAD OKLAHOMA CITY OK 73120 463184231 FOUNDATION OK 501(C)(3) LINE 12A, I MERCY HOSPITAL OKLAHOMA CITY INC 1 MERCY HEALTH FOUNDATION SPRINGFIELD 1235 E CHEROKEE STREET SPRINGFIELD MO 65804 320195818 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY HEALTH FOUNDATION ST FRANCIS 100 W US HIGHWAY 60 MOUNTAIN VIEW MO 65548 431873914 FOUNDATION MO 501(C)(3) LINE 12A, I MERCY ST FRANCIS HOSPITAL 1 MERCY HEALTH FOUNDATION ST LOUIS 615 SOUTH NEW BALLAS ROAD ST LOUIS MO 63141 562410020 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HEALTH EAST COMMUNITIES 1 MERCY HEALTH FOUNDATION WASHINGTON 901 E FIFTH STREET WASHINGTON MO 63090 562410022 FOUNDATION MO 501(C)(3) LINE 12B, II MERCY HEALTH EAST COMMUNITIES 1 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES 2710 RIFE MEDICAL LANE ROGERS AR 72758 621684203 PHYSICIAN GROUP AR 501(C)(3) LINE 10 MERCY HEALTH 1 MERCY HEALTH OKLAHOMA COMMUNITIES INC 4300 W MEMORIAL ROAD OKLAHOMA CITY OK 73120 731453048 HEALTH SYSTEM OK 501(C)(3) LINE 12A, I MERCY HEALTH 1 MERCY HEALTH SOUTHWEST MISSOURIKANSAS COMMUNITIES 100 MERCY WAY JOPLIN MO 64804 300584463 HEALTH SYSTEM MO 501(C)(3) LINE 12B, II MERCY HEALTH 1 MERCY HEALTH SPRINGFIELD COMMUNITIES 1235 E CHEROKEE STREET SPRINGFIELD MO 65804 431856028 HEALTH SYSTEM MO 501(C)(3) LINE 12B, II MERCY HEALTH 1 MERCY HOSPITAL ADA INC 430 N MONTE VISTA STREET ADA OK 74820 462288155 HOSPITAL OK 501(C)(3) LINE 3 MERCY HEALTH OKLAHOMA COMMUNITIES INC 1 MERCY HOSPITAL ARDMORE INC 1011 14TH AVENUE NW ARDMORE OK 73401 731500629 HOSPITAL OK 501(C)(3) LINE 3 MERCY HEALTH OKLAHOMA COMMUNITIES INC 1 MERCY HOSPITAL AURORA 500 PORTER AVENUE AURORA MO 65605 431936696 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY HOSPITAL BERRYVILLE 214 CARTER STREET BERRYVILLE AR 72616 710759299 HOSPITAL AR 501(C)(3) LINE 3 MERCY HEALTH NW ARK COMMUNITIES 1 MERCY HOSPITAL BOONEVILLE 880 WEST MAIN STREET BOONEVILLE AR 72927 463851119 HOSPITAL AR 501(C)(3) LINE 3 MERCY HOSPITAL FORT SMITH 1 MERCY HOSPITAL CARTHAGE 3125 DR RUSSELL SMITH WAY CARTHAGE MO 64836 453808607 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SW MOKS COMMUNITIES 1 MERCY HOSPITAL CASSVILLE 94 MAIN STREET CASSVILLE MO 65625 431936699 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY HOSPITAL COLUMBUS 220 PENNSYLVANIA AVENUE COLUMBUS KS 66725 270842031 HOSPITAL KS 501(C)(3) LINE 3 MERCY HEALTH SW MOKS COMMUNITIES 1 MERCY HOSPITAL EL RENO INC 2115 PARKVIEW DRIVE EL RENO OK 73036 272716065 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL OKLAHOMA CITY INC 1 MERCY HOSPITAL FORT SMITH 7301 ROGERS AVENUE FORT SMITH AR 72903 710240352 HOSPITAL AR 501(C)(3) LINE 3 MERCY HEALTH FORT SMITH COMMUNITIES 1 MERCY HOSPITAL HEALDTON INC 3462 HOSPITAL RD HEALDTON OK 73438 263173902 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL ARDMORE INC 1 MERCY HOSPITAL JEFFERSON 1400 HIGHWAY 61 SOUTH FESTUS MO 63028 430687077 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH EAST COMMUNITIES 1 MERCY HOSPITAL JOPLIN 100 MERCY WAY JOPLIN MO 64804 270814858 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SW MOKS COMMUNITIES 1 MERCY HOSPITAL KINGFISHER INC 1000 KINGFISHER REGIONAL HOSPITAL C KINGFISHER OK 73750 463433074 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL OKLAHOMA CITY INC 1 MERCY HOSPITAL LEBANON 100 HOSPITAL DRIVE LEBANON MO 65536 431767432 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY HOSPITAL LINCOLN 1000 EAST CHERRY STREET TROY MO 63379 472219204 HOSPITAL MO 501(C)(3) LINE 3 MERCY HOSPITALS EAST COMMUNITIES 1 MERCY HOSPITAL LOGAN COUNTY INC 200 SOUTH ACADEMY GUTHRIE OK 73044 452998842 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL OKLAHOMA CITY INC 1 MERCY HOSPITAL OKLAHOMA CITY INC 4300 W MEMORIAL ROAD OKLAHOMA CITY OK 73120 730579285 HOSPITAL OK 501(C)(3) LINE 3 MERCY HEALTH OKLAHOMA COMMUNITIES INC 1 MERCY HOSPITAL OZARK 801 W RIVER STREET OZARK AR 72949 710689680 HOSPITAL AR 501(C)(3) LINE 3 MERCY HOSPITAL FORT SMITH 1 MERCY HOSPITAL PARIS 500 E ACADEMY PARIS AR 72855 710655753 HOSPITAL AR 501(C)(3) LINE 3 MERCY HOSPITAL FORT SMITH 1 MERCY HOSPITAL ROGERS 2710 RIFE MEDICAL LANE ROGERS AR 72758 710294390 HOSPITAL AR 501(C)(3) LINE 3 MERCY HEALTH NW ARK COMMUNITIES 1 MERCY HOSPITAL SPRINGFIELD 1235 E CHEROKEE STREET SPRINGFIELD MO 65804 440552485 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MERCY HOSPITAL TISHOMINGO INC 1000 SOUTH BYRD TISHOMINGO OK 73460 274433830 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL ADA INC 1 MERCY HOSPITAL WALDRON 1341 W 6TH STREET WALDRON AR 72958 710557895 HOSPITAL AR 501(C)(3) LINE 3 MERCY HOSPITAL FORT SMITH 1 MERCY HOSPITAL WATONGA INC 500 CLARENCE NASH BLVD WATONGA OK 73772 455199762 HOSPITAL OK 501(C)(3) LINE 3 MERCY HOSPITAL OKLAHOMA CITY INC 1 MERCY HOSPITALS EAST COMMUNITIES 615 S NEW BALLAS ROAD ST LOUIS MO 63141 430653493 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH EAST COMMUNITIES 1 MERCY KANSAS COMMUNITIES INC 401 WOODLAND HILLS BLVD FT SCOTT KS 66701 480956045 HOSPITAL KS 501(C)(3) LINE 3 MERCY HEALTH SW MOKS COMMUNITIES 1 MERCY MINISTRIES OF LAREDO 2500 ZACATECAS ST LAREDO TX 78046 200198462 OUTREACH TX 501(C)(3) LINE 7 MERCY HEALTH 1 MERCY RESEARCH 524 NORTH BOONEVILLE AVENUE SPRINGFIELD MO 65802 870796305 RESEARCH MO 501(C)(3) LINE 4 MERCY HEALTH 1 MERCY ST FRANCIS HOSPITAL 100 W US HIGHWAY 60 MOUNTAIN VIEW MO 65548 440607149 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH SPRINGFIELD COMMUNITIES 1 MHM SUPPORT SERVICES 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 202553101 CENTRALIZED HEALTH SYSTEM FUNCTIONS MO 501(C)(3) LINE 12A, I MERCY HEALTH 1 MISSION CLINICAL SERVICES 216 MCAULEY COURT HOT SPRINGS AR 71913 134239691 CHILD ADVOCACY CENTER AR 501(C)(3) LINE 3 MERCY HEALTH 1 MERCY HEALTH FOUNDATION SOUTH 10010 KENNERLY ROAD ST LOUIS MO 63128 261516789 FUNDRAISING MO 501(C)(3) LINE 12A, I MERCY HOSPITAL SOUTH 1 MERCY HOSPITAL SOUTH 10010 KENNERLY ROAD ST LOUIS MO 63128 430980256 HOSPITAL MO 501(C)(3) LINE 3 MERCY HEALTH EAST COMMUNITIES 1 ST ANTHONY'S PHYSICIAN ORGANIZATION 10010 KENNERLY ROAD ST LOUIS MO 63128 431784536 HEALTH CARE MO 501(C)(3) LINE 3 MERCY HOSPITAL SOUTH 1 MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS 1619 W 7TH STREET GALENA KS 66739 843730625 HOSPITAL KS 501(C)(3) LINE 3 MERCY HEALTH SW MOKS COMMUNITIES 1 SOUTHEAST HOSPITAL DBA MERCY HOSPITAL SOUTHEAST 1701 LACEY STREET CAPE GIRARDEAU MO 63701 430654874 HOSPITAL MO 501(C)(3) LINE 3 SOUTHEASTHEALTH SYSTEM 1 SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY 1701 LACEY STREET CAPE GIRARDEAU MO 63701 273868479 HOSPITAL MO 501(C)(3) LINE 3 SOUTHEAST HOSPITAL 1 SOUTHEASTHEALTH SYSTEM 1701 LACEY STREET CAPE GIRARDEAU MO 63701 474890906 HEALTH SYSTEM MO 501(C)(3) LINE 12C, III-FI MERCY HEALTH 1 SOUTHEAST MISSOURI HOSPITAL FOUNDATION 1849 BROADWAY CAPE GIRARDEAU MO 63701 431122759 FOUNDATION MO 501(C)(3) LINE 7 SOUTHEAST HOSPITAL 1 PLAZA SURGERY SERVICES COMPANY LLC 12700 SOUTHFORK ROAD ST LOUIS MO 63128 204709312 INACTIVE MO MERCY HOSPITAL SOUTH 0 0 ST EDWARD MERCY MC M-P OFFICE BLDG 7301 ROGERS AVENUE FORT SMITH AR 72903 710554050 OFFICE BUILDING AR MERCY HOSPITAL FORT SMITH 0 0 PLATINUM CPS HOLDINGS LLC 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 842493007 HOLDING COMPANY MO MERCY MANAGED CARE CORP MERCY HEALTH 0 0 FRONTENAC PROPERTIES INC 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 521914421 HOLDING COMPANY DE MERCY HEALTH C 0 MERCY HEALTH CENTER CONDOMINIUMS INC 4300 W MEMORIAL RD OKLAHOMA CITY OK 73120 680640970 REAL ESTATE OK MERCY HOSPITAL OKLAHOMA CITY INC C 0 MERCY MANAGED CARE CORPORATION 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 731441665 HOLDING COMPANY OK MERCY HEALTH C 0 UHL CORP INC 15740 SOUTH OUTER 40 RD CHESTERFIELD MO 63017 742499535 HOLDING COMPANY MO MERCY HOSPITALS EAST COMMUNITIES C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 MHM SUPPORT SERVICES Q 61365942 FMV MERCY HEALTH EAST COMMUNITIES Q 31909205 FMV MERCY HOSPITALS EAST COMMUNITIES Q 736774 FMV MERCY HOSPITAL JEFFERSON P 243970 FMV MERCY HOSPITAL SOUTHEAST P 236827 FMV FORM 990, SCHEDULE R, PART II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITAL ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITAL WASHINGTON, EIN 43-1066883. FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON VIA INTERCOMPANY JOURNAL ENTRIES. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON THE RELATED ORGANIZATION INFORMATION THAT CAN BE EXTRACTED FROM LAWSON. DUE TO THESE LIMITATIONS, MOST OF THE RELATED ORGANIZATION ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R, PART V, IN LINES P AND Q.