MERCY HOSPITAL ADA INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: MERCY HOSPITAL ADA INC (EIN 46-2288155)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-05-14
IRS object ID: 202131349349303688
Schema version: 2019v5.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-05-14T12:58:16-05:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	264532849	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PURK & ASSOCIATES PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1034 SOUTH BRENTWOOD BLVD STE 2000	AddressLine1Txt
City	SAINT LOUIS	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	63117	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	462288155	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HOSPITAL ADA INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MERC	BusinessNameControlTxt
Phone	5804211412	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 N MONTE VISTA STREET	AddressLine1Txt
City	ADA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	74820	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TAMMI HARMONING	PersonNm
Person Title	VP FINANCE	PersonTitleTxt
Phone	5802206239	PhoneNum
Signature	2021-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DOUGLAS G PLEUS CPA	PreparerPersonNm
PTIN	P00013488	PTIN
Phone	3148844000	PhoneNum
Preparation	2021-05-08	PreparationDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DONN SORENSEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 N MONTE VISTA STREET	AddressLine1Txt
City	ADA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	74820	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$102,251,380	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MERCY.NET	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2013	FormationYr
Legal Domicile State	OK	LegalDomicileStateCd
Activity Or Mission	AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	51	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,118,185	PYContributionsGrantsAmt
CY Contributions Grants	$1,012,280	CYContributionsGrantsAmt
PY Program Service Revenue	$105,483,068	PYProgramServiceRevenueAmt
CY Program Service Revenue	$100,667,461	CYProgramServiceRevenueAmt
PY Investment Income	$32,977	PYInvestmentIncomeAmt
CY Investment Income	$79,323	CYInvestmentIncomeAmt
PY Other Revenue	$556,483	PYOtherRevenueAmt
CY Other Revenue	$492,316	CYOtherRevenueAmt
PY Total Revenue	$107,190,713	PYTotalRevenueAmt
CY Total Revenue	$102,251,380	CYTotalRevenueAmt
PY Grants And Similar Paid	$266,830	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$196,613	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$48,811,556	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$46,962,080	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$56,103,412	PYOtherExpensesAmt
CY Other Expenses	$51,379,582	CYOtherExpensesAmt
PY Total Expenses	$105,181,798	PYTotalExpensesAmt
CY Total Expenses	$98,538,275	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,008,915	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$3,713,105	CYRevenuesLessExpensesAmt
Total Assets BOY	$63,003,401	TotalAssetsBOYAmt
Total Assets EOY	$58,995,230	TotalAssetsEOYAmt
Total Liabilities BOY	$43,281,844	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$42,871,268	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$19,721,557	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$16,123,962	NetAssetsOrFundBalancesEOYAmt
Mission	AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$78,586,792	ExpenseAmt
Grant	$196,613	GrantAmt
Revenue	$100,701,792	RevenueAmt
Desc	MERCY HOSPITAL ADA PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FISCAL YEAR END JUNE 30, 2020, ADA PROVIDED SERVICES TO 3,754 INPATIENTS, 69,650 OTHER OUTPATIENTS, AND 17,091 EMERGENCY DEPARTMENT PATIENTS. SERVICES ARE PROVIDED THROUGH A COMMUNITY-BASED HOSPITAL. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2020 WAS $9,202,348.MERCY HOSPITAL ADA'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H.	Desc
Total Program Service Expenses	$78,586,792	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	OK	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	TAMMI HARMONING	PersonNm
Phone	5802206239	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1011 14TH AVENUE NW	AddressLine1Txt
City	ARDMORE	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	73401	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ANDERSON MIKE D
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
HARGRAVE JOHN
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
HENDRICKS RSM SR REBECCA ANN
BOARD MEMBER	1.00	14.00	Yes (X)	$0	$0	$0
JONES BRIGETTE
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
JONES LAVONDA
BOARD MEMBER	1.00	1.00	Yes (X)	$0	$0	$0
KOORIE RSM SR DIANE
BOARD MEMBER	1.00	1.00	Yes (X)	$0	$0	$0
METTRY DO CHARLES
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
MOORING MD JOHN
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
NABERHAUS CAROL
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
PRINCE CALVIN
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
ROBERTSON REGINA
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
LASSITER DAVID
BOARD MEMBER	1.00	14.00	Yes (X)	$0	$0	$0
SORENSEN DONN
EXECUTIVE VP - OPERATIONS	5.00	55.00		$0	$1,655,506	$133,861	Yes (X)
VITIELLO JONATHAN
CFO	2.00	58.00		$0	$1,161,374	$120,902	Yes (X)
ENLOE TRACY
CHIEF FINANCIAL OFFICER	0.00	60.00		$0	$399,736	$68,717	Yes (X)
FARRELL TERENCE
PRESIDENT	50.00	10.00		$464,734	$0	$24,945		Yes (X)
LE BICH-VI
REGIONAL VP - GENERAL COUNSEL	5.00	55.00		$0	$387,893	$64,268		Yes (X)
COATS DANIEL P
VP-OPERATIONS	60.00	0.00		$215,986	$0	$12,263		Yes (X)
O'GRADY S M
PHYSICIAN	60.00	0.00		$172,596	$0	$23,342			Yes (X)
BROWN BRADLEY
PHYSICIAN ASSISTANT	60.00	0.00		$169,492	$0	$10,812			Yes (X)
CARTWRIGHT CHARLES
PHARMACIST	60.00	0.00		$150,233	$0	$18,953			Yes (X)
STEWART STEPHEN
ADMINISTRATOR - RURAL FACILITIES	60.00	0.00		$145,544	$0	$6,547			Yes (X)
HUDSONJAMES
PHARMACIST	60.00	0.00		$145,201	$0	$21,872			Yes (X)
SMALLEY DIANA L
FORMER OFFICER	0.00	0.00		$0	$1,232,512	$28,742				Yes (X)
RAJU GARY
FORMER OFFICER	0.00	60.00		$0	$738,517	$19,159				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,463,786	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,575,538	TotReportableCompRltdOrgAmt
Total Other Compensation	$554,383	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	40	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
AMN HEALTHCARE
12400 HIGH BLUFF DR	SAN DIEGO	CA	92130	STAFFING SERVICES	$5,228,192
JE DUNN CONSTRUCTION
929 HOLMES	KANSAS CITY	MO	64106	CONSTRUCTION SERVICES	$2,944,175
GREAT PLAINS ANESTHESIA
1012 14TH AVE NW	ARDMORE	OK	73401	ANESTHESIA SERVICES	$884,288
JACKSON AND COKER LOCUM TENENS
3000 OLD ALABAMA RD STE 119 608	ALPHARETTA	GA	30022	STAFFING SERVICES	$512,737
ADA VALLEY ANESTHESIA
PO BOX 21228 DEPT 75	TULSA	OK	74121	ANESTHESIA SERVICES	$383,250

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	21	CntrctRcvdGreaterThan100KCnt
Related Organizations	$991,590	RelatedOrganizationsAmt
All Other Contributions	$20,690	AllOtherContributionsAmt
Total Contributions	$1,012,280	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE	622110	$92,773,330	$92,773,330
OTHER OPERATING REVENUE	622110	$7,894,098	$7,894,098
CAPITATION BONUS	622110	$33	$33

Field	Value	IRS element (for citing)
Total Program Service Revenue	$100,667,461	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,221	TotalRevenueColumnAmt
Exclusion	$5,221	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$74,102	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$74,102	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$74,102	TotalRevenueColumnAmt
Exclusion	$74,102	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA	Desc
Business	722210	BusinessCd
Total Revenue Column	$457,985	TotalRevenueColumnAmt
Exclusion	$457,985	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$34,331	TotalRevenueColumnAmt
Related Or Exempt Func Income	$34,331	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$492,316	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$102,251,380	TotalRevenueColumnAmt
Related Or Exempt Func Income	$100,701,792	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$537,308	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$196,613	TotalAmt
Program Services	$196,613	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$703,094	TotalAmt
Program Services	$703,094	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$39,104,074	TotalAmt
Program Services	$34,470,175	ProgramServicesAmt
Management And General	$4,633,899	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$699,362	TotalAmt
Program Services	$612,527	ProgramServicesAmt
Management And General	$86,835	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,099,673	TotalAmt
Program Services	$3,619,982	ProgramServicesAmt
Management And General	$479,691	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,355,877	TotalAmt
Program Services	$2,081,216	ProgramServicesAmt
Management And General	$274,661	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$2,400	TotalAmt
Management And General	$2,400	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$17,060	TotalAmt
Management And General	$17,060	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,006,332	TotalAmt
Program Services	$3,563,296	ProgramServicesAmt
Management And General	$443,036	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$32,126	TotalAmt
Management And General	$32,126	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,960,212	TotalAmt
Program Services	$1,855,673	ProgramServicesAmt
Management And General	$1,104,539	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$80,995	TotalAmt
Program Services	$74,112	ProgramServicesAmt
Management And General	$6,883	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$889,205	TotalAmt
Program Services	$161,814	ProgramServicesAmt
Management And General	$727,391	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$80,874	TotalAmt
Program Services	$28,329	ProgramServicesAmt
Management And General	$52,545	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$54	TotalAmt
Management And General	$54	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,607,594	TotalAmt
Management And General	$1,607,594	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,779,391	TotalAmt
Program Services	$2,052,986	ProgramServicesAmt
Management And General	$2,726,405	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$663,108	TotalAmt
Program Services	$131,316	ProgramServicesAmt
Management And General	$531,792	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
DRUGS & MEDICAL EXPENSE	$14,571,545	$14,571,545
SHARED SERVICE FEE	$12,078,541	$5,314,558	$6,763,983
BAD DEBTS	$8,631,425	$8,631,425
REPAIRS & MAINTENANCE	$830,539	$369,950	$460,589

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$148,181	TotalAmt
Program Services	$148,181	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$98,538,275	TotalAmt
Program Services	$78,586,792	ProgramServicesAmt
Management And General	$19,951,483	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,431,614	BOYAmt
EOY	$2,362,522	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$5,884	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$11,095,838	BOYAmt
EOY	$9,460,620	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$127,000	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,077,169	BOYAmt
EOY	$2,911,863	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$71,543,034	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$28,644,506	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$45,828,735	BOYAmt
EOY	$42,898,528	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$570,045	BOYAmt
EOY	$1,228,813	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$63,003,401	BOYAmt
EOY	$58,995,230	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,909,169	BOYAmt
EOY	$1,758,204	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$4,320	BOYAmt
EOY	$4,320	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$41,368,355	BOYAmt
EOY	$41,108,744	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$43,281,844	BOYAmt
EOY	$42,871,268	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$19,727,403	BOYAmt
EOY	$16,112,179	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$5,846	BOYAmt
EOY	$11,783	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$19,721,557	BOYAmt
EOY	$16,123,962	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$63,003,401	BOYAmt
EOY	$58,995,230	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$3,713,105	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$7,310,700	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$17,060	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$17,060	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2020, DUES WERE $36,967 AND $11,491, RESPECTIVELY. APPROXIMATELY 38.90% OF OKLAHOMA HOSPITAL ASSOCIATION DUES, AND 23.32% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED.	ExplanationTxt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$46,960,323	OtherCostOrOtherBasisAmt
Depreciation	$10,122,194	DepreciationAmt
Book Value	$36,838,129	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,224	OtherCostOrOtherBasisAmt
Depreciation	$5,628	DepreciationAmt
Book Value	$12,596	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,564,487	OtherCostOrOtherBasisAmt
Depreciation	$18,516,684	DepreciationAmt
Book Value	$6,047,803	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$42,898,528	TotalBookValueLandBuildingsAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2	FormAndLineReferenceDesc
Explanation	FEDERAL INCOME TAX PRIMARILY ALL OF THE MERCY HEALTH ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE 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. MERCY COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2020 OR 2019.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,759,917	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,759,917	NetCommunityBenefitExpnsAmt
Total Expense	0.06410	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,721,968	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,279,536	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,442,432	NetCommunityBenefitExpnsAmt
Total Expense	0.03830	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,481,885	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,279,536	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,202,349	NetCommunityBenefitExpnsAmt
Total Expense	0.10240	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	4404	PersonsServedCnt
Total Community Benefit Expns	$186,490	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$186,490	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	6297	PersonsServedCnt
Total Community Benefit Expns	$69,343	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$69,343	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	14237	PersonsServedCnt
Total Community Benefit Expns	$67,750	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$67,750	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	24938	PersonsServedCnt
Total Community Benefit Expns	$323,583	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$323,583	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	24938	PersonsServedCnt
Total Community Benefit Expns	$21,805,468	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,279,536	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,525,932	NetCommunityBenefitExpnsAmt
Total Expense	0.10610	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Persons Served	14433	PersonsServedCnt
Total Community Benefit Expns	$127,765	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$127,765	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	14433	PersonsServedCnt
Total Community Benefit Expns	$127,765	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$127,765	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,578,570	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$34,125,745	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$36,213,474	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,087,729	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HOSPITAL ADA INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 N MONTE VISTA STREET	AddressLine1Txt
City	ADA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	74820	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MERCY.NET/ABOUT	WebsiteAddressTxt
State License	2286	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HOSPITAL ADA INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://WWW.MERCY.NET/COMMUNITYBENEFITS	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.MERCY.NET/COMMUNITYBENEFITS	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MERCY HOSPITAL ADA, INC.	PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN ITS MOST RECENT CHNA REPORT.
MERCY HOSPITAL ADA, INC.	PART V, SECTION B, LINE 5: WHEN CONDUCTING THE CHNA, MERCY HOSPITAL, ADA WORKED CLOSELY WITH THE FOLLOWING:- ADA HOMELESS SERVICES- ADA PUBLIC SCHOOLS- ADA REGIONAL UNITED WAY- CHICKASAW NATION MEMBERS- COMPASSION OUTREACH CENTER (MEDICAL CARE FOR THE UNINSURED.)- EAST CENTRAL UNIVERSITY - PONTOTOC COUNTY HEALTH DEPARTMENT- PONTOTOC TECHNOLOGY CENTER REPRESENTATIVES- MERCY ADA COMMUNITY PARAMEDIC- VALLEY VIEW HEALTH AND WELLNESS FOUNDATION- MEMBERS OF AREA FAITH BASED COMMUNITIES- MERCY HOSPITAL, ADA LEADERSHIPPLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS
MERCY HOSPITAL ADA, INC.	PART V, SECTION B, LINE 6B: SEE PART V, SECTION B, LINE 5 RESPONSE
MERCY HOSPITAL ADA, INC.	PART V, SECTION B, LINE 11: BASED ON THE FINDINGS OF ITS MOST RECENTLY CONDUCTED CHNA, MERCY HOSPITAL, ADA HAS CHOSEN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS:- SINCE HEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH FOR ALL AGES IN PONTOTOC COUNTY AND CARDIAC SERVICES ARE VERY LIMITED, MHA HAS BEGUN THE PROCESS OF EXPANDING CARDIAC SERVICES. MHA IS EXPLORING A NUMBER OF OPTIONS THAT WILL RESULT IN INCREASED CARDIAC SERVICES AVAILABLE ESPECIALLY TO THOSE WHO DO NOT HAVE THE RESOURCES TO PURSUE THESE SERVICES IN A MORE METROPOLITAN AREAS OF OKLAHOMA. - CANCER IS THE SECOND HIGHEST CAUSE OF DEATH IN PONTOTOC COUNTY. SINCE EARLY DETECTION RESULTS IN INCREASED SURVIVAL, MERCY HOSPITAL ADA ORGANIZES AND OFFERS CANCER SCREENINGS BASED ON THE TARGETED SCREENING NEEDS OF OUR COMMUNITY AND PATIENT POPULATION. THESE SCREENINGS ARE DESIGNED TO DECREASE THE NUMBER OF PATIENTS WITH LATE-STAGE DISEASE, ARE CONSISTENT WITH EVIDENCE-BASED NATIONAL GUIDELINES/INTERVENTIONS AND HAVE A FORMAL PROCESS DEVELOPED TO FOLLOW-UP ON ALL POSITIVE FINDINGS. PLANNED SCREENINGS INCLUDE: - SKIN CANCER -SKIN EXAMINATION BY QUALIFIED HEALTH PROFESSIONAL - COLORECTAL CANCER -DISTRIBUTION OF COLORECTAL OCCULT-BLOOD KIT - PROSTATE CANCER -PSA AND DIGITAL EXAM BY QUALIFIED HEALTH PROFESSIONAL.- MERCY ADA AREA STOP THE BLEED CAMPAIGN WHICH IS INTENDED TO CULTIVATE AND ENCOURAGE BYSTANDERS TO BECOME TRAINED, EQUIPPED, AND EMPOWERED TO HELP IN BLEEDING EMERGENCIES BEFORE PROFESSIONAL HELP ARRIVES. THIS PROGRAM WILL BE ESPECIALLY BENEFICIAL IN THE RURAL SERVICE AREA OF MERCY ADA.- THE MERCY ADA DIABETES EDUCATOR WILL PROVIDE DIABETES AWARENESS AND SUPPORT FOR UNINSURED INDIVIDUALS WHO UTILIZE THE COMPASSION OUTREACH CENTER FOR THEIR MEDICAL NEEDS. THESE INDIVIDUALS LACK THE RESOURCES TO AFFORD DIABETES SELF-MANAGEMENT CLASSES HELD AT MERCY OR ELSEWHERE LEADING TO A GAP IN WHICH THESE INDIVIDUALS HAVE INCREASED VISITS TO THE COMPASSION OUTREACH CENTER. - IN AN EFFORT TO INSPIRE\EXPAND THE NUMBER OF YOUTH WISHING TO EXPLORE A MEDICAL CAREER, MHA AND THE ADA PUBLIC SCHOOLS HAVE ENTERED INTO THE MERCY SCHOOL PARTNERSHIP FOR CAREER PATHWAYS WHICH IS A PROGRAM THAT WILL PROVIDE THE INCENTIVE AND INFORMATION NEEDED FOR STUDENTS (AND THEIR PARENTS) IN ADA AND IN THE SURROUNDING AREA PUBLIC SCHOOLS TO CONSIDER SERIOUSLY A CAREER IN THE MEDICAL FIELD. THE TWO PILLARS OF THE PROGRAM ALREADY UNDERWAY INCLUDE: MERCY HOSPITAL ADA'S MEDICAL PROVIDERS, SUCH AS, PHYSICIANS, NURSE PRACTITIONERS, NURSES, PHARMACISTS IMAGING, LAB AND SURGERY TECHS HAVE DEVELOPED A CURRICULUM AND ARE NOW SERVING AS GUEST LECTURERS IN CLASSES IN THE LOCAL PUBLIC SCHOOLS. MHA HAS ALSO INITIATED A VOLUNTEER AND MENTORSHIP PROGRAM WITH HIGH SCHOOL STUDENTS WHO EXHIBIT INTEREST IN MEDICAL CAREERS.- MERCY VIRTUAL CARE CENTER AND MERCY ADA PRIMARY CARE CLINICS ARE IN THE FINAL STAGES OF PLANNING A PARTNERSHIP WHEREBY MERCY VIRTUAL CARE WILL ASSIST PRIMARY CARE PHYSICIANS IN CARING FOR ER PATIENTS AND OTHERS IN NEED OF BEHAVIORAL HEALTH ASSISTANCE. - $40,000 SUPPLIED ANNUALLY BY THE MERCY HOSPITAL FOUNDATION ADA FOR UNDER/UNINSURED PATIENTS WITH LIMITED RESOURCES FOR TRANSPORTATION, DISCHARGE MEDICATIONS AND MEDICAL EQUIPMENT. - THE DIABETES SUPPORT GROUP IS A JOINT COLLABORATION BETWEEN MERCY HOSPITAL ADA AND THE STAFF OF THE DIABETES CENTER OF THE CHICKASAW NATION MEDICAL CENTER. MONTHLY MEETINGS OFFER EDUCATION AND SUPPORT FOR ALL DIABETICS AND THEIR FAMILY MEMBERS IN A GROUP SETTING. 194 PATIENTS HAVE PARTICIPATED.- MHA COORDINATES THE MEALS ON WHEELS PROGRAM WHICH PROVIDES MEALS TO SENIORS AND DISABLED MEMBERS OF THE COMMUNITY. WHEN THERE ARE NOT ENOUGH DRIVERS, CO WORKERS FROM MERCY HOSPITAL ADA VOLUNTEER TO DELIVER TRAYS.- NINE MONTHS TO COUNTDOWN IS A 1.5 HOUR CLASS OFFERED AT NO CHARGE FOR ALL MOTHERS-TO-BE IN THE FIRST TRIMESTER OF PREGNANCY, PROVIDING EDUCATION ON NUTRITION, EXERCISE AND PERSONAL CARE DURING THE PREGNANCY. - TOURS ARE HELD TO PREPARE FAMILY MEMBERS FOR A NEW ADDITION TO THE FAMILY. SIBLING TOURS ARE HELD UPON REQUEST. - CANCER-RELATED EDUCATIONAL PROGRAMS ARE HELD ANNUALLY FOR THE COMMUNITY.- ON EACH TUESDAY, WEDNESDAY AND THURSDAY, MERCY HOSPITAL ADA TRANSPORTS OUR WOUND CARE PATIENTS WHO LIVE OUT OF TOWN OR HAVE NO ACCESS TO TRANSPORTATION TO THE HOSPITAL. - VOLUNTARY CONTRIBUTIONS TO THE UNITED WAY- SENIOR LEADER IS SERVING ON THE ADA CHAMBER OF COMMERCE. - PARTICIPATION IN OBI BLOOD DRIVE- MERCY CO-WORKERS HELP AT THE COMPASSION OUTREACH CENTER, A FREE HEALTHCARE CLINIC FOR THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY.- MERCY CO-WORKERS HELP AT ABBA'S TABLE, A COMMUNITY FOOD-KITCHEN.- MERCY EMS PROVIDES AN AMBULANCE ON STAND-BY AT HIGH-RISK COMMUNITY EVENTS INCLUDING, BUT NOT LIMITED TO, JUNIOR HIGH, HIGH SCHOOL AND COLLEGE FOOTBALL GAMES, MARATHON EVENTS, RODEOS AND BULL-RIDING COMPETITIONS.A SIGNIFICANT NEED NOT BEING ADDRESSED IS SUBSTANCE ABUSE PREVENTION WHICH IS BEING ADDRESSED THROUGH THE PONTOTOC COUNTY DRUG FREE COALITION. MHA IS A MEMBER OF THE COALITION AND WILL CONTINUE TO PROVIDE SUPPORT AND COMMITMENT BUT NOT DIRECT REHABILITATION. THESE NEEDS ARE BEING ADDRESSED IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH CAN BE ACCESSED HERE: HTTPS://WWW.MERCY.NET/SITES/DEFAULT/FILES/VENDOR-RESOURCES/MHJ_CHIP_161003.PDF.
MERCY HOSPITAL ADA, INC.	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, LINE 22	ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTS THE FEDERAL POVERTY GUIDELINES FOR INCOME ARE THE BASIS FOR DETERMINING ELIGIBILITY FOR CHARITY CARE DISCOUNTS. FOR EXAMPLE, INDIVIDUALS WITH INCOMES 200% OR BELOW, THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 200% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - MHADA OUTPATIENT REHAB
500 N MONTE VISA SUITES 145	ADA	OK	74820	REHABILITATION SERVICES
2 - MHADA OUTPATIENT LAB
500 N MONTE VISA SUITES 145	ADA	OK	74820	LABORATORY SERVICES

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LN 7 COL(F):	TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $98,538,275. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $8,631,425. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $89,906,850.
PART I, LINE 6A	COMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050).
PART II, COMMUNITY BUILDING ACTIVITIES:	MERCY HOSPITAL ADA (MHA) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH PARTICIPATION IN NEIGHBORHOOD/COMMUNITY MEETINGS, COMMUNITY BOARDS, AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHA DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE. SOME OF THE COMMUNITY BUILDING ACTIVITIES IN WHICH MHA ADDRESSES THE PRIORITIZED HEALTH NEEDS OF INCREASED CARDIAC CARE, INCREASE RATE OF CANCER SURVIVAL THROUGH EARLY DETECTION, EQUIP NON-MEDICAL CITIZENS TO PROVIDE EMERGENCY RELIEF, INCREASE AWARENESS OF AND PROVIDE DIABETES SUPPORT FOR UNINSURED AND AT-RISK PERSONS, INCREASE THE NUMBER OF MEDICAL CARE PROVIDERS FOR THE ADA, IMPLEMENT AN INTEGRATED CARE MODEL APPROACH TO BEHAVIORAL HEALTH IN THE PRIMARY CARE SETTING AREA. A FULL DESCRIPTION OF THE COMMUNITY'S BUILDING ACTIVITIES CAN BE FOUND AT: HTTPS://WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS/
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:	THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: 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. 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 HOSPITAL ADA 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 OR TAKING LEGAL ACTION 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 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. 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. FOR A PORTION OF THE FISCAL YEAR, 7/1/19 - 10/13/19, MERCY UTILIZED THE SAME TOOL TO QUALIFY ACCOUNTS PER THE PRACTICE OF PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR BALANCES IN EXCESS OF $6,500. ALL ACCOUNT BALANCES RELATING TO ACCOUNTS IDENTIFIED BY THE HIGHER BALANCES WILL BE CONSIDERED AND FLAGGED FOR CHARITY IF THERE IS AN INABILITY TO PAY AFTER A RETURN FROM THE COLLECTION AGENCY AT APPROXIMATELY 120 DAYS. STARTING ON 10/14/19, MERCY IMPLEMENTED PRESUMPTIVE CHARITY FOR ALL BALANCES, IRREGARDLESS OF ACCOUNT BALANCE, WHERE THE EVALUATION TOOK 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. PRIOR TO GO-LIVE ON 10/14/19, MERCY DID A ONE TIME EVALUTION OF ALL BAD DEBT ACCOUNTS BILLED IN THE LAST 240 DAYS THAT MET NEW PRESUMPTIVE CRITIERA AND ADJUSTED PER A TERMINAL PRESUMPTIVE ADJUSTMENT.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 LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES AFTER SENDING 3 MONTHLY STATEMENTS WITH THE FINAL INCLUDING NOTIFICATION; IF NO RESOLUTION THEY WILL BE TURNED TO COLLECTIONS. ADDITIONALLY, THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENTS, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENSURE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEW COMPLIANCE WITH POLICIES BUT ENSURE 120 DAYS OF BILLING AND COLLECTIONS OCCUR PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED.
PART VI, LINE 2:	ON JANUARY 30, 2018, MHA HELD ITS FIRST MEETING OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT TASK FORCE. THE TASK FORCE MET MONTHLY WELL INTO FALL 2018. THE TASK FORCE WHICH CONSISTED OF A BROAD REPRESENTATION OF THE ADA AND BEYOND COMMUNITY DID THE FOLLOWING: FORMULATED A HEALTH NEEDS SURVEY AND THEN ADMINISTERED IT TO SOME 685 PARTICIPANTS; PLANNED AND CONDUCTED FOUR FOCUS GROUPS WHICH TOOK PLACE AT CHICKASAW COMMUNITY CENTER, HOLDENVILLE COMMUNITY CENTER, WITH FRIENDS AND FAMILIES OF ADDICTION AND ST. JOSEPH'S CHURCH WHICH WAS CONDUCTED IN SPANISH. AFTER COLLECTING THE DATA FROM THE MHA CHNA TASK FORCE ANALYZED THE DATA AND THEN COMPARED IT WITH BOTH INTERNAL AND EXTERNAL DEMOGRAPHICS, UTILIZATION, CHRONIC CONDITIONS AND HEALTH STATUS. THE LATER DATA WAS SUPPLIED BY THE MERCY MARKETING AND COMMUNICATION DEPARTMENT. THE NEEDS ASSESSMENT PROCESS INVOLVED REVIEW OF BOTH QUANTITATIVE AND QUALITATIVE INFORMATION TO ATTAIN THE FULL SCOPE OF THE COMMUNITY'S NEEDS. PLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS
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 ACCOUNTS IS PLACED FOR REVIEW. IN ADDITION, PATIENT 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 WHEN PRESENTING IN THE FACILITIES. IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS (BILLING) MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL.
PART VI, LINE 4:	THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL ADA INCLUDES 39 ZIP CODES ACROSS OKLAHOMA. THE FOLLOWING INFORMATION IS DERIVED FROM 2019 IBM/WATSON'S DEMOGRAPHICS AND FY19 CLARIVATE ANALYTICS INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 120,879. 26% OF THE POPULATION'S AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 43% OF THE POPULATION IS 45 AND OLDER. 22% OF THE HOUSEHOLDS ARE ON MEDICARE, 21% ON MEDICAID, AND 16% UNINSURED.
PART VI, LINE 5:	MERCY PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. MERCY IS A CATHOLIC HEALTH CARE CORPORATION THAT, PURSUANT TO THE ORGANIZATIONAL CORE BELIEF, THAT HEALTH CARE SERVICES ARE A VITAL AND INTEGRAL PART OF THE CHURCH'S HEALING MISSION, ENGAGES IN A MINISTRY WHICH PROVIDES GENERAL ACUTE CARE, AMBULATORY, LONG-TERM AND HOME CARE HEALTH SERVICES TO INDIVIDUALS AND FAMILIES IN ITS COMMUNITIES. MERCY OFFERS SERVICES AND PROGRAMS WHICH FURTHER HEALTH PROMOTION, MAINTENANCE AND CARE TO THE COMMUNITY. PROGRAMS PROVIDED TO MEET THE COMMUNITY INCLUDE SUPPORT GROUPS, OUTREACH EVENTS, BLOOD DRIVES, AND CO-WORKER WORK DAYS.MERCY IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS FROM A VARIETY OF SECTORS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARE SERVED.SURPLUS FUND AND UNRESTRICTED ASSETS HELD ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES.
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 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, 2020, MERCY FACILITIES INCLUDED 29 ACUTE CARE HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2020, MERCY HAD MORE THAN 10.8 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,400 EMPLOYED PHYSICIANS, AND APPROXIMATELY 44,000 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.
PART VI, LINE 7, REPORTS FILED WITH STATES	OK
COVID-19	PLEASE SEE SCHEDULE O FOR INFORMATION RELATED TO COVID-19.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
MERCY HEALTH FOUNDATION ADA
430 N MONTE VISTA	ADA	OK	74820	463596274	501(C)(3)	$158,511	CASH	GENERAL SUPPORT
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVE	DALLAS	TX	75231	135613797	501(C)(3)	$7,500	CASH	GENERAL SUPPORT
MERCY HEALTH FOUNDATION OKLAHOMA
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	454732301	501(C)(3)	$27,657	CASH	GENERAL SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION USES AN APPROVAL PROCESS TO DETERMINE WHICH ORGANIZATIONS AND INDIVIDUALS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE NONPROFIT ORGANIZATION AND INDIVIDUALS. GRANTS ARE FREQUENTLY MADE TO RELATED ORGANIZATIONS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Housing Allowance Or Residence	Yes (X)	HousingAllowanceOrResidenceInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SORENSEN DONN
EXECUTIVE VP - OPERATIONS	$0	$867,782	$0	$758,598	$0	$29,126	$0	$123,637	$0	$10,224	$0	$1,789,367	$0	$0
VITIELLO JONATHAN
CFO	$0	$610,068	$0	$478,788	$0	$72,518	$0	$104,541	$0	$16,361	$0	$1,282,276	$0	$0
ENLOE TRACY
CHIEF FINANCIAL OFFICER	$0	$282,794	$0	$86,401	$0	$30,541	$0	$53,271	$0	$15,446	$0	$468,453	$0	$0
FARRELL TERENCE
PRESIDENT	$231,929	$0	$115,946	$0	$116,859	$0	$13,548	$0	$11,397	$0	$489,679	$0	$0	$0
LE BICH-VI
REGIONAL VP - GENERAL COUNSEL	$0	$270,330	$0	$79,090	$0	$38,473	$0	$48,465	$0	$15,803	$0	$452,161	$0	$0
COATS DANIEL P
VP-OPERATIONS	$18,793	$0	$10,529	$0	$186,664	$0	$11,199	$0	$1,064	$0	$228,249	$0	$0	$0
O'GRADY S M
PHYSICIAN	$142,323	$0	$5,774	$0	$24,499	$0	$8,120	$0	$15,222	$0	$195,938	$0	$0	$0
BROWN BRADLEY
PHYSICIAN ASSISTANT	$146,300	$0	$4,540	$0	$18,652	$0	$2,277	$0	$8,535	$0	$180,304	$0	$0	$0
CARTWRIGHT CHARLES
PHARMACIST	$117,455	$0	$40	$0	$32,738	$0	$8,347	$0	$10,606	$0	$169,186	$0	$0	$0
STEWART STEPHEN
ADMINISTRATOR - RURAL FACILITIES	$126,334	$0	$6,587	$0	$12,623	$0	$938	$0	$5,609	$0	$152,091	$0	$0	$0
HUDSONJAMES
PHARMACIST	$127,224	$0	$40	$0	$17,937	$0	$6,807	$0	$15,065	$0	$167,073	$0	$0	$0
SMALLEY DIANA L
FORMER OFFICER	$0	$767,644	$0	$394,548	$0	$70,320	$0	$16,963	$0	$11,779	$0	$1,261,254	$0	$94,548
RAJU GARY
FORMER OFFICER	$0	$296,634	$0	$409,457	$0	$32,426	$0	$9,625	$0	$9,534	$0	$757,676	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. IN ANY CIRCUMSTANCE IN WHICH CHARTER TRAVEL IS MADE AVAILABLE TO EMPLOYEES AND/OR SPOUSES/GUESTS FOR PERSONAL REASONS, MERCY POLICY REQUIRES TRACKING OF SUCH USE AND TAXATION OF THE EMPLOYEE(S) ACCORDINGLY. TRAVEL FOR COMPANIONS FOR NONBUSINESS REASONS IS PROVIDED IN CERTAIN INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. SPOUSAL TRAVEL WAS PROVIDED FOR A HIGHLY COMPENSATED EMPLOYEE AND AN OFFICER. LIMITED INSTANCES OF TAX GROSS-UPS OCCURRED WITH RESPECT TO EXECUTIVES. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO TWO HIGHLY COMPENSATED EMPLOYEES PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE.
PART I, LINES 4A-B	THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY: DANIEL COATS $142,112; LORI WIGHTMAN $91,504. MERCY HEALTH, THE PARENT COMPANY, OFFERS A SUPPLEMENTAL RETIREMENT PLAN TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON VESTING DATE BASED ON COMPENSATION, AGE AT THE TIME OF BENEFIT COMMENCEMENT, LENGTH OF SERVICE WITH THE COMPANY AND/OR ITS AFFILIATES, AND LENGTH OF TENURE IN THE PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN: JONATHAN VITIELLO; BICH-VI LE; DIANA SMALLEY; TRACY ENLOE; GARY RAJU; DONN SORENSEN; TERENCE FARRELL; LORI WIGHTMAN THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). DIANA SMALLEY RECEIVED PAYMENT FROM RETIREMENT PLAN(S) DURING THE YEAR FROM A RELATED ORGANIZATION. THE AMOUNT REPORTED FOR DIANA SMALLEY IN COLUMN (F) IS INCLUDED IN COLUMN B (I) AS BASE COMPENSATION. THIS PAYOUT WAS INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990.
PART I, LINE 3	THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	MISTY HARVEY	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY MEMBER OF BOARD MEMBER (CALVIN PRINCE)	RelationshipDescriptionTxt
Transaction	$29,939	TransactionAmt
Transaction	EMPLOYMENT ARRANGEMENT, MERCY HOSPITAL ADA	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	MERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AT ANY TIME AT THE MEMBER'S DISCRETION.
FORM 990, PART VI, SECTION A, LINE 7B	MERCY HEALTH OKLAHOMA COMMUNITIES HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL ORGANIZATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND TO AMEND THE ORGANIZATIONAL DOCUMENTS OF ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CEO OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AFTER CONSULTATION WITH THE SYSTEM; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, BUSINESS PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPROVE OR AMEND THE CONSOLIDATED OPERATING, CAPITAL AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND CHANGES IN BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -TO AUTHORIZE AND APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF ANY AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS 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; AND -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, SUBJECT TO APPROVAL BY THE BOARD AS REQUIRED PURSUANT TO THE OKLAHOMA NONPROFIT CORPORATION ACT. -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. 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, 2020. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S CORPORATE COMPLIANCE DEPARTMENT. THE QUESTIONNAIRES ARE REVIEWED WITH LEADERSHIP AT THE LOCAL LEVEL AND POTENTIAL CONFLICTS DISCUSSED AND RESOLVED. THE CONFLICTS AND THEIR RESPECTIVE RESOLUTIONS ARE SHARED AT THE MERCY LEVEL WITH A TEAM INCLUDING MERCY'S CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER AND OTHER MEMBERS OF FINANCE, LEGAL AND HR. SUMMARY RESULTS ARE REVIEWED WITH MERCY'S STEWARDSHIP COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15B	FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS, AND A 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 FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY.
FORM 990, PART VII, SECTION A, COLUMN B	AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII IS THE AVERAGE HOURS THE LISTED PERSON WORKED OR DEVOTED PER WEEK WHILE EMPLOYED OR ASSOCIATED WITH THE FILING ORGANIZATION AND RELATED ORGANIZATIONS (IF APPLICABLE).
FORM 990, PART XI, LINE 9:	NET TRANSFERS TO/FROM AFFILIATES -7,328,329. RESTRICTED SPECIFIC PURPOSE EMPLOYEE CRISIS FUND 17,629.
PART XII, LINE 2	AUDITED FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2020 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION IS 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.
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. THIS AUDIT IS UNDERWAY FOR THE FISCAL YEAR ENDING JUNE 30, 2020 AND WILL BE COMPLETED BY JUNE 30, 2021. 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, 2020, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT.
FORM 990, PART V, LINE 2A	W-3 FILING SALARIES AND WAGES WITH LIMITED EXCEPTIONS, THE SALARIES AND WAGES REPORTED ON FORM 990, PART IX, LINE 7 REPRESENT AN ALLOCATION OF SALARIES AND WAGES FROM A RELATED ORGANIZATION. MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, ALL REQUIRED PAYROLL FILING FOR THESE EMPLOYEES (INCLUDING W-2 AND W-3'S) IS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES,EIN 20-2553101.
FORM 990, SCHEDULE R, PART II	MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883.
FORM 990, SCHEDULE R, PART V	SYSTEM LIMITATIONS 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.
FORM 990, PART V, LINE 1A	INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS 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 HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN.
COVID-19	EARLY IN 2020, THE MERCY HEALTH SYSTEM WAS CALLED TO SERVE AS THE COVID-19 PANDEMIC SWEPT ACROSS THE WORLD. THIS CONTINUES TO BE A DIFFICULT TIME FOR ALL HEALTHCARE PROVIDERS. ALL MERCY FACILITIES ADJUSTED OPERATIONS FOR THE IMPACTS OF THE PANDEMIC WHICH MEANT MAKING CHANGES TO PATIENT CARE AREAS AND CANCELLING MOST OF OUR OUTPATIENT PROCEDURES FOR PERIODS OF TIME. IN ADDITION, MERCY FOUNDATIONS AND OUTREACH MINISTRIES EXPERIENCED LIMITATIONS IN FUNDRAISING FOR PROGRAM AND CAPITAL SUPPORT EFFORTS THAT ASSIST THE UNDERSERVED IN OUR COMMUNITIES. MERCY'S TOTAL SYSTEM REVENUES WERE REDUCED BY OVER $550 MILLION DOLLARS DURING THE FOUR MONTHS ENDING JUNE 30, 2020, AND THIS FIGURE DOES NOT INCLUDE THE IMPACT OF ANY CORONAVIRUS AID RELIEF AND ECONOMIC SECURITY ACT ("CARES ACT") FUNDING. MERCY RECEIVED CARES ACT FUNDING ACROSS VARIOUS ENTITIES FOR THE YEAR ENDED JUNE 30, 2020 AND RECOGNIZED A PORTION OF THIS FUNDING IN OTHER OPERATING REVENUE. THESE FUNDS HELPED TO OFFSET REVENUE LOSSES AND ADDITIONAL EXPENSES INCURRED DUE TO THE PANDEMIC; HOWEVER, THESE FUNDS FELL SHORT OF THE SYSTEM LOSSES EXPERIENCED IN THESE MONTHS DUE TO THE PANDEMIC. THE IMPACT OF COVID-19 WAS SIGNIFICANT TO OUR COMMUNITIES AND COWORKERS AS UNEMPLOYMENT RATES SOARED AND MERCY ACTED QUICKLY TO PROVIDE CONTINUOUS CARE TO PATIENTS AND THE COMMUNITY. MERCY CONTINUES TO MONITOR THE IMPACTS OF THE PANDEMIC BOTH TO THE HEALTH SYSTEM AND THE COMMUNITIES SERVED AS WE CONTINUE TO PROVIDE ASSISTANCE AND MAINTAIN ACCESS TO CARE WITHIN OUR COMMUNITIES.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (72 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
CASA DE MISERICORDIA
1000 MIER ST	LAREDO	TX	78040	742912461	WOMEN'S DOMESTIC VIOLENCE SHELTER	TX	501C3	7	MERCY MINISTRIES OF LAREDO	Yes (1)
MCAULEY PORTFOLIO MGMT CO
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	261708048	PORTFOLIO MANAGEMENT	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY ACO CLINICAL SERVICES INC
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	464504901	VIRTUAL CARE CENTER	MO	501C3	3	MERCY HEALTH	Yes (1)
MERCY CLINIC EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100	ST LOUIS	MO	63141	431771217	PHYSICIAN GROUP	MO	501C3	9	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY CLINIC FORT SMITH COMM
7301 ROGERS AVENUE	FORT SMITH	AR	72917	261318597	PHYSICIAN CLINIC	AR	501C3	9	MERCY HEALTH FORT SMITH COMM	Yes (1)
MERCY CLINIC OKLAHOMA COMM
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	270473057	PHYSICIAN GROUP	OK	501C3	3	MERCY HEALTH OK COMMUNITIES	Yes (1)
MERCY CLINIC SPRINGFIELD COMM
1965 FREMONT STREET SUITE 2950	SPRINGFIELD	MO	65804	431560263	PHYSICIAN GROUP	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY FAMILY CENTER
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	721069468	FAMILY COUNSELING SERVICES	LA	501C3	7	MERCY HEALTH	Yes (1)
MERCY HEALTH
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	431423050	CORPORATE OFFICE	MO	501C3	1		0	N/A
MERCY HEALTH EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100	ST LOUIS	MO	63141	431718408	HEALTH SYSTEM	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH FORT SMITH COMM
7301 ROGERS AVENUE	FORT SMITH	AR	72917	261318515	HOLDING COMPANY	AR	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH FOUNDATION
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	200901499	FOUNDATION	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH FOUNDATION ADA
430 N MONTE VISTA STREET	ADA	OK	74820	463596274	FOUNDATION	OK	501C3	11-I	MERCY HOSPITAL ADA	Yes (1)
MERCY HEALTH FOUNDATION ARDMORE
1011 14TH AVENUE NW	ARDMORE	OK	73401	710962525	FOUNDATION	OK	501C3	11-I	MERCY HOSPITAL ARDMORE	Yes (1)
MERCY HEALTH FOUNDATION BERRYVILLE
214 CARTER STREET	BERRYVILLE	AR	72616	710759301	FOUNDATION	AR	501C3	11-I	MERCY HOSPITAL BERRYVILLE	Yes (1)
MERCY HEALTH FOUNDATION FT SCOTT
401 WOODLAND HILLS BLVD	FORT SCOTT	KS	66701	481077073	FOUNDATION	KS	501C3	11-III	MERCY KANSAS COMMUNITIES INC	Yes (1)
MERCY HEALTH FOUNDATION FORT SMITH
7301 ROGERS AVENUE	FORT SMITH	AR	72917	237330425	FOUNDATION	AR	501C3	7	MERCY HOSPITAL FORT SMITH	Yes (1)
MERCY HEALTH FOUNDATION LEBANON
100 HOSPITAL DRIVE	LEBANON	MO	65536	822514567	FOUNDATION	MO	501C3	11-II	MERCY HOSPITAL LEBANON	Yes (1)
MERCY HEALTH FOUNDATION JEFFERSON
1400 US HIGHWAY 61 SOUTH	FESTUS	MO	63028	462797051	FOUNDATION	MO	501C3	11-II	MERCY HOSPITAL JEFFERSON	Yes (1)
MERCY HEALTH FOUNDATION JOPLIN
100 MERCY WAY	JOPLIN	MO	64804	270906136	FOUNDATION	MO	501C3	11-I	MERCY HEALTH SW MOKS COMM	Yes (1)
MERCY HEALTH FOUNDATION LINCOLN
1000 EAST CHERRY STREET	TROY	MO	63379	811477159	FOUNDATION	MO	501C3	11-II	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY HEALTH FOUNDATION NW ARK
2710 RIFE MEDICAL LN	ROGERS	AR	72858	710601687	FOUNDATION	AR	501C3	11-III	MERCY HOSPITAL ROGERS	Yes (1)
MERCY HEALTH FOUNDATION OF OK
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	454732301	FOUNDATION	OK	501C3	11-I	MERCY HEALTH OK COMMUNITIES	Yes (1)
MERCY HEALTH FOUNDATION OK CITY
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	463184231	FOUNDATION	OK	501C3	11-I	MERCY HEALTH OK COMMUNITIES	Yes (1)
MERCY HEALTH FOUNDATION SPRINGFIELD
1235 E CHEROKEE STREET	SPRINGFIELD	MO	65804	320195818	FOUNDATION	MO	501C3	11-II	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY HEALTH FOUNDATION ST FRANCIS
100 W HIGHWAY 60	MOUNTAIN VIEW	MO	65548	431873914	FOUNDATION	MO	501C3	11-I	MERCY ST FRANCIS HOSPITAL	Yes (1)
MERCY HEALTH FOUNDATION STL
615 SOUTH NEW BALLAS ROAD	ST LOUIS	MO	63141	562410020	FOUNDATION	MO	501C3	11-II	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY HEALTH FOUNDATION WASHINGTON
901 E FIFTH STREET	WASHINGTON	MO	63090	562410022	FOUNDATION	MO	501C3	11-II	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY HEALTH NW ARK COMMUNITIES
2710 RIFE MEDICAL LN	ROGERS	AR	72758	621684203	PHYSICIAN GROUP	AR	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH OK COMMUNITIES
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	731453048	HEALTH SYSTEM	OK	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH PLANS OF MISSOURIINC
3265 S NATIONAL AVENUE	SPRINGFIELD	MO	65807	320481419	HMO	MO	501C4		MERCY HEALTH	Yes (1)
MERCY HEALTH PLANSINC
3265 S NATIONAL AVENUE	SPRINGFIELD	MO	65807	320486150	PPO	MO	501C4		MERCY HEALTH PLANS OF MISSOURIINC	Yes (1)
MERCY HEALTH SW MOKS COMM
100 MERCY WAY	JOPLIN	MO	64804	300584463	HEALTH SYSTEM	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HEALTH SPRINGFIELD COMM
1235 E CHEROKEE STREET	SPRINGFIELD	MO	65804	431856028	HEALTH SYSTEM	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MERCY HOME HEALTH BERRYVILLE
804 W FREEMAN SUITE 4	BERRYVILLE	AR	72616	870781247	HOME HEALTH AND HOSPICE OPERATIONS	AR	501C3	11-III	MERCY HOSPITAL SPRINGFIELD	Yes (1)
MERCY HOSPITAL ARDMORE
1011 14TH AVENUE NW	ARDMORE	OK	73401	731500629	HOSPITAL	OK	501C3	3	MERCY HEALTH OK COMMUNITIES	Yes (1)
MERCY HOSPITAL AURORA
500 PORTER AVENUE	AURORA	MO	65605	431936696	HOSPITAL	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY HOSPITAL BERRYVILLE
214 CARTER STREET	BERRYVILLE	AR	72616	710759299	HOSPITAL	AR	501C3	3	MERCY HEALTH NW ARK COMMUNITIES	Yes (1)
MERCY HOSPITAL BOONEVILLE
880 WEST MAIN STREET	BOONEVILLE	AR	72927	463851119	HOSPITAL	AR	501C3	3	MERCY HOSPITAL FORT SMITH	Yes (1)
MERCY HOSPITAL CARTHAGE
3125 DR RUSSELL SMITH WAY	CARTHAGE	MO	64836	453808607	HOSPITAL	MO	501C3	3	MERCY HEALTH SW MOKS COMM	Yes (1)
MERCY HOSPITAL CASSVILLE
94 MAIN STREET	CASSVILLE	MO	65625	431936699	HOSPITAL	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY HOSPITAL COLUMBUS
220 PENNSYLVANIA AVENUE	COLUMBUS	KS	66725	270842031	HOSPITAL	MO	501C3	3	MERCY HEALTH SW MOKS COMM	Yes (1)
MERCY HOSPITAL EL RENO
2115 PARKVIEW DRIVE	EL RENO	OK	73036	272716065	HOSPITAL - INACTIVE	OK	501C3	3	MERCY HOSPITAL OKLAHOMA CITY	Yes (1)
MERCY HOSPITAL FORT SMITH
7301 ROGERS AVENUE	FORT SMITH	AR	72917	710240352	HOSPITAL	AR	501C3	3	MERCY HEALTH FORT SMITH COMM	Yes (1)
MERCY HOSPITAL HEALDTON INC
3462 HOSPITAL RD	HEALDTON	OK	73438	263173902	HOSPITAL	OK	501C3	3	MERCY HOSPITAL ARDMORE INC	Yes (1)
MERCY HOSPITAL JEFFERSON
1400 HIGHWAY 61 SOUTH	FESTUS	MO	63028	430687077	HOSPITAL	MO	501C3	3	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY HOSPITAL JOPLIN
100 MERCY WAY	JOPLIN	MO	64804	270814858	HOSPITAL	MO	501C3	3	MERCY HEALTH SW MOKS COMM	Yes (1)
MERCY HOSPITAL KINGFISHER INC
1000 HOSPITAL CIRCLE	KINGFISHER	OK	73750	463433074	HOSPITAL	OK	501C3	3	MERCY HOSPITAL OKLAHOMA CITY	Yes (1)
MERCY HOSPITAL LEBANON
100 HOSPITAL DRIVE	LEBANON	MO	65536	431767432	HOSPITAL	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY HOSPITAL LINCOLN
1000 EAST CHERRY STREET	TROY	MO	63379	472219204	HOSPITAL	MO	501C3	3	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY HOSPITAL LOGAN COUNTY INC
200 SOUTH ACADEMY	GUTHRIE	OK	73044	452998842	HOSPITAL	OK	501C3	3	MERCY HOSPITAL OKLAHOMA CITY	Yes (1)
MERCY HOSPITAL OKLAHOMA CITY
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	730579285	HOSPITAL	OK	501C3	3	MERCY HEALTH OK COMMUNITIES	Yes (1)
MERCY HOSPITAL OZARK
801 W RIVER STREET	OZARK	AR	72949	710689680	HOSPITAL	AR	501C3	3	MERCY HOSPITAL FORT SMITH	Yes (1)
MERCY HOSPITAL PARIS
500 E ACADEMY	PARIS	AR	72855	710655753	HOSPITAL	AR	501C3	3	MERCY HOSPITAL FORT SMITH	Yes (1)
MERCY HOSPITAL ROGERS
2710 RIFE MEDICAL LN	ROGERS	AR	72758	710294390	HOSPITAL	AR	501C3	3	MERCY HEALTH NW ARK COMMUNITIES	Yes (1)
MERCY HOSPITAL SPRINGFIELD
1235 E CHEROKEE STREET	SPRINGFIELD	MO	65804	440552485	HOSPITAL	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MERCY HOSPITAL TISHOMINGO
1000 SOUTH BYRD	TISHOMINGO	OK	73460	274433830	HOSPITAL	OK	501C3	3	MERCY HOSPITAL ADA	Yes (1)
MERCY HOSPITAL WALDRON
1341 W 6TH STREET	WALDRON	AR	72958	710557895	HOSPITAL	AR	501C3	3	MERCY HOSPITAL FORT SMITH	Yes (1)
MERCY HOSPITAL WATONGA INC
500 CLARENCE NASH BLVD	WATONGA	OK	73772	455199762	HOSPITAL	OK	501C3	3	MERCY HOSPITAL OKLAHOMA CITY	Yes (1)
MERCY HOSPITALS EAST COMM
645 MARYVILLE CTR DR STE 100	ST LOUIS	MO	63141	430653493	HOSPITAL	MO	501C3	3	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY KANSAS COMMUNITIES INC
401 WOODLAND HILLS BLVD	FT SCOTT	KS	66701	480956045	HOSPITAL	KS	501C3	3	MERCY HEALTH SW MOKS COMM	Yes (1)
MERCY MINISTRIES OF LAREDO
2500 ZACATECAS	LAREDO	TX	78043	200198462	OUTREACH	TX	501C3	7	MERCY HEALTH	Yes (1)
MERCY RESEARCH
524 NORTH BOONEVILLE AVENUE	SPRINGFIELD	MO	65802	870796305	RESEARCH	MO	501C3	4	MERCY HEALTH	Yes (1)
MERCY ST FRANCIS HOSPITAL
100 W HIGHWAY 60	MOUNTAIN VIEW	MO	65548	440607149	HOSPITAL	MO	501C3	3	MERCY HEALTH SPRINGFIELD COMM	Yes (1)
MHM SUPPORT SERVICES
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	202553101	CENTRALIZED HEALTH SYSTEM FUNCTIONS	MO	501C3	11-II	MERCY HEALTH	Yes (1)
MISSION CLINICAL SERVICES
300 WERNER STREET	HOT SPRINGS	AR	71913	134239691	CHILD ADVOCACY CENTER	AR	501C3	9	MERCY HEALTH	Yes (1)
MERCY HEALTH FOUNDATION SOUTH
10010 KENNERLY ROAD	ST LOUIS	MO	63128	261516789	FOUNDATION	MO	501C3	11-II	MERCY HOSPITAL SOUTH	Yes (1)
MERCY HOSPITAL SOUTH
10010 KENNERLY ROAD	ST LOUIS	MO	63128	430980256	HOSPITAL	MO	501C3	3	MERCY HEALTH EAST COMMUNITIES	Yes (1)
ST ANTHONY'S PHYSICIAN ORGANIZATION
10010 KENNERLY ROAD	ST LOUIS	MO	63128	431784536	HEALTH CARE	MO	501C3	3	MERCY HOSPITAL SOUTH	Yes (1)
ST MARYS HOSP ENID OK
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	730614655	INACTIVE	OK	501C3	3	MERCY HEALTH OK COMMUNITIES	Yes (1)
UNITY AMBULATORY CARE
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	431861745	INACTIVE	MO	501C3	11-III	MERCY HEALTH EAST COMMUNITIES	Yes (1)
MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS
14528 S OUTER FORTY ST 100	CHESTERFIELD	MO	63017	843730625	HOSPITAL	KS	501C3	3	MERCY HEALTH SW MOKS COMM	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
PLAZA SURGERY SERVICES COMPANY LLC
12700 SOUTHFORK ROAD	ST LOUIS	MO	63128	204709312	INACTIVE	MO	MERCY HOSPITAL SOUTH	N/A	0	0
RESOURCE OPTIMIZ & INNOVLLC
645 MARYVILLE CTR DRSTE 200	ST LOUIS	MO	63141	460468368	CENTRAL DISTRIBUTION CENTER	MO	MERCY MANAGED CARE CORPMERCY HEALTH	N/A	0	0
MERCY AMBULATORY SURGERY CENTER LLC
7301 ROGERS AVENUE	FORT SMITH	AR	72917	710827721	AMBULATORY SURGERY CENTER	AR	MERCY HOSPITAL FORT SMITH	N/A	0	0
FORT SMITH EMERGENCY MEDICAL SERVICES
1701 SOUTH GREENWOOD	FORT SMITH	AR	72901	710416615	EMERGENCY MEDICAL SERVICES	AR	MERCY HOSPITAL FORT SMITH	N/A	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	N/A	0	0
PLATINUM CPS HOLDINGS LLC
14528 S OUTER FORTY SUITE 100	CHESTERFIELD	MO	63017	842493007	HOLDING COMPANY	MO	MERCY MANAGED CARE CORPMERCY HEALTH	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
FRONTENAC PROPERTIES INC
14528 S OUTER FORTY SUITE 100	CHESTERFIELD	MO	63017	521914421	HOLDS ANCILLARY ASSETS & OWNS AIRCRAFT	DE	MERCY HEALTH	C	0
INVENO HEALTH INC
1235 E CHEROKEE STREET	SPRINGFIELD	MO	65804	264509571	TECHNOLOGY TRANSFER COMPANY	MO	MERCY HEALTH SPRINGFIELD COMM	C	0
UNITY SUPPORT SERVICES INC
645 MARYVILLE CENTRE DRIVE SUITE 10	ST LOUIS	MO	63141	431797042	INACTIVE	MO	MERCY HEALTH EAST COMMUNITIES	C	0
UH L CORP INC
645 MARYVILLE CENTRE DRIVE SUITE 10	ST LOUIS	MO	63141	742499535	HOLDING COMPANY	MO	MERCY HEALTH SERVICES LLC	C	0
MHN OF THE SOUTHERN REGION INC
1011 14TH AVENUE NW	ARDMORE	OK	73401	731580607	HOLDING COMPANY;DISSOLVED 10/15/18	OK	MERCY MANAGED CARE CORP	C	0
MERCY HEALTH CENTER CONDOMINIUM INC
4300 W MEMORIAL RD	OKLAHOMA CITY	OK	73120	680640970	ADMINISTRATOR OF CERTAIN REAL PROPERTY AND IMPROVEMENTS	OK	MERCY HOSPITAL OKLAHOMA CITYINC	C	0
MERCY MANAGED CARE CORPORATION
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	731441665	HOLDING COMPANY	OK	MERCY HEALTH	C	0
MERCY HEALTH NETWORK INC
4300 W MEMORIAL ROAD	OKLAHOMA CITY	OK	73120	731381689	HOLDING COMPANY;DISSOLVED 10/15/18	OK	MERCY MANAGED CARE CORP	C	0
MERCY COMMERCIAL SERVICES INC
14528 SOUTH OUTER FORTY SUITE 100	CHESTERFIELD	MO	63017	464953543	CORP PARENT OF VCC TAXABLE COMMERCIALIZ SVCS	OK	MHN INC AND MHNSR INC	C	0
ST ANTHONY'S PHYSICIAN ORGANIZATION OF ILLINOIS
10010 KENNERLY ROAD	ST LOUIS	MO	63128	320457168	HEALTH CARE	MO	MERCY HOSPITAL SOUTH	C	0
MCAULEY INSURANCE COMPANY LTD
					INACTIVE		MERCY HEALTH	C	0	AON HOUSE 30 WOODBOURNE AVENUE	PEMBROKE	BD	HM 08	BD

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (18 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MERCY HEALTH FOUNDATION ADA
B	$158,511	FMV
MERCY HEALTH FOUNDATION OF OKLAHOMA
B	$27,657	FMV
MERCY HEALTH FOUNDATION ADA
C	$991,590	FMV
MERCY ACO CLINICAL SERVICES
Q	$1,727,168	FMV
MERCY CLINIC OKLAHOMA COMMUNITIES INC
P	$181	FMV
MERCY HEALTH EAST COMMUNITIES
Q	$31,979	FMV
MERCY HEALTH FOUNDATION ADA
Q	$5,037	FMV
MERCY HEALTH FOUNDATION OKLAHOMA CITY
Q	$74,778	FMV
MERCY HEALTH OKLAHOMA COMMUNITIES
Q	$6,152,701	FMV
MERCY HEALTH SPRINGFIELD COMMUNITIES
Q	$26,424	FMV
MERCY HOSPITAL ARDMORE
P	$17,541	FMV
MERCY HOSPITAL KINGFISHER INC
P	$2,364	FMV
MERCY HOSPITAL OKLAHOMA CITY
Q	$80,775	FMV
MERCY HOSPITAL ROGERS
P	$685	FMV
MERCY HOSPITAL SPRINGFIELD
Q	$673	FMV
MERCY HOSPITAL TISHOMINGO
P	$2,153	FMV
MERCY HOSPITALS EAST COMMUNITIES
Q	$12,998	FMV
MHM SUPPORT SERVICES
Q	$28,862,970	FMV