2020-07-13T09:57:17-05:00 2019-06-30 ERNST & YOUNG US LLP 221 E 4TH ST SUITE 2900 CINCINNATI OH 45202 990 2018-07-01 710759299 MERCY HOSPITAL BERRYVILLE % KELLI HUNTLEY MERC 3145796100 214 Carter Street Berryville AR 72616 KELLI HUNTLEY VP Finance 4793382155 2020-07-10 true JULIE L SPARKS P01268401 5136121400 108.206.163.59 31049020201955000002 2020-07-13 P 770194AAF055F9EA87E64CA02E08FE540289067F 47CCE9F19DA6832300AFC0DC75FEB109EC0143B4 2018 2021-01-29 14:40:06Z ERIC PIANALTO 2710 S RIFE MEDICAL LN ROGERS AR 727581452 19599426 false 0928 X WWW.MERCY.NET X 1993 AR AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 10 7 0 75 0 0 162370 65748 19966213 19397315 0 0 126940 136363 20255523 19599426 10566 29574 0 0 9721577 9691844 0 0 0 9755903 10235585 19488046 19957003 767477 -357577 8871139 7358622 166984 2874185 8704155 4484437 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 1944185 0 1795124 ER PHYSICIANS: MERCY HOSPITAL BERRYVILLE PROVIDED ER SERVICES FROM 3 PHYSICIANS OVER THE COURSE OF FISCAL YEAR 2019. THOSE PHYSICIANS COVERED 9,492 VISITS FOR FISCAL YEAR ENDED JUNE 30, 2019. 1130794 0 3647281 EMERGENCY DEPARTMENT: THE HOSPITAL PROVIDED A BROAD SCOPE OF EMERGENCY SERVICES TO THE COMMUNITY DURING THE FISCAL YEAR ENDED JUNE 30, 2019. SERVICES INCLUDED 401 ER ADMISSIONS AND 9,091 ER OUTPATIENT VISITS. 1041831 0 2747795 LABORATORY SERVICES: THE HOSPITAL PROVIDES LAB SERVICES AND PROCEDURES FOR BOTH THE INPATIENT AND OUTPATIENT AREAS OF THE HOSPITAL. DURING THE FISCAL YEAR ENDED JUNE 30, 2019, THE HOSPITAL PERFORMED 11,051 INPATIENT BILLED TESTS AND 60,138 OUTPATIENT BILLED TESTS. 12014929 29574 11049410 16131739 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 1 0 true 0 true true false false false false false false false false false false false X 10 7 false false false false true true true true true false false false true true true true true false false false X KELLI HUNTLEY 4793382155 2710 S RIFE MEDICAL LN ROGERS AR 727581452 Barnum Harley Board Member 1.0 0.0 X 0 0 0 Flake MD William Physician & Board Member 1.0 59.0 X 0 202578 47950 Goss Stephen President & Board member 1.0 59.0 X X 0 0 0 Harp Richard Board Member 1.0 0.0 X 0 0 0 Koelsch RSM Sr Cabrini Board Member 1.0 3.0 X 0 0 0 Powell Lacey Board Member 1.0 1.0 X 0 0 0 Taylor MD Richard Physician & Board Member 1.0 59.0 X 0 207519 46064 Tennnant Jason Board Member 1.0 0.0 X 0 0 0 Thurman Bobby Board Member 1.0 1.0 X 0 0 0 Walker Deretha Board Member 1.0 0.0 X 0 0 0 Hannasch Susan VP-Regional General Counsel 4.0 56.0 X 0 442523 64864 Huntley Kelli VP Finance 30.0 30.0 X 0 171756 16053 Reynolds Scott CFO-Central Commun (Thru 5/18) 2.0 58.0 X 0 532036 109754 Swope Jon President, Central Communities 2.0 58.0 X 0 1291161 173577 Marion Tanya Regional VP - Human Resources 3.0 57.0 X 0 368698 67324 Hill Jodie L Manager, Therapy Services 60.0 0.0 X 109635 0 9701 Phillippe Robert Nurse Anesthetist 60.0 0.0 X 0 170439 8006 Clouse Day Sherry VP-Finance 0.0 60.0 X 0 278727 24016 Davison Justin VP Finance 0.0 60.0 X 0 257638 23449 Scarrow MD Alan Pres,Sprg Comm Thru 9/17 2.0 58.0 X 0 1379969 43189 109635 5303044 633947 47 true true false 360 DEGREE MEDICINE LLC 800 Hwy 248 Suite 2E BRANSON MO 65616 Physician Services 486240 PSYCHIATRIC MEDICAL CARE LLC PO Box 734606 DALLAS TX 753734606 MANAGEMENT FEES 334011 2 56748 9000 0 65748 NET PATIENT SERVICE REVENUE 621110 19239608 19239608 OTHER OPERATING REVENUE 900099 106989 106989 RENTAL INCOME FROM RELATED ORGS 531120 50718 50718 19397315 0 0 0 2053 2053 0 2053 2053 0 0 0 0 0 0 0 0 0 0 CAFE & VENDING 900099 134310 134310 134310 19599426 19239608 294070 29574 29574 0 0 0 0 0 8037845 6945890 1091955 299615 264830 34785 884460 770470 113990 469924 414768 55156 0 0 0 4343 4343 0 0 957678 884595 73083 1239 1239 405144 284836 120308 0 0 239629 34439 205190 17480 12947 4533 0 0 0 0 732080 337084 394996 221496 85548 135948 BAD DEBT 3134628 3134628 SHARED SERVICE FEES 2797716 1370881 1426835 DRUGS & MEDICAL EXPENSES 1526202 1510489 15713 REPAIRS & MAINTENANCE 118286 17558 100728 79664 33202 46462 19957003 16131739 3825264 0 247905 250579 0 0 0 0 1945858 2160892 0 0 0 0 0 0 303973 301285 27539 17800 16956245 12546980 4989203 4409265 0 0 0 0 0 0 0 0 1356661 218801 8871139 7358622 143984 0 0 0 23000 23000 0 0 0 0 0 0 0 0 0 0 0 2851185 166984 2874185 X 8704155 4484437 0 0 0 0 8704155 4484437 8871139 7358622 X -357577 -3862141 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4343 4343 false FORM 990, SCHEDULE C, PART II-B, LINE 1 (I) LOBBYING PORTION OF DUES THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: ARKANSAS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND CATHOLIC HEALTH ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2019, DUES WERE $9,164, $5,395 AND $5,235, RESPECTIVELY. APPROXIMATELY 32% OF ARKANSAS HOSPITAL ASSOCIATION DUES AND 22.73% OF AMERICAN HOSPITAL ASSOCIATION DUES AND 3.52% OF CATHOLIC HEALTH ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS. 432810 432810 9964630 6821934 3142696 12765 12765 6402633 5584299 818334 143407 127982 15425 4409265 0 DUE TO AFFILIATES 2851185 2851185 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE PRIMARILY ALL OF THE MERCY HEALTH ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS CHARITABLE ORGANIZATIONS QUALIFYING UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), BY VIRTUE OF IRS DETERMINATION LETTERS OR INCLUSION IN THE OFFICIAL CATHOLIC DIRECTORY. MERCY COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2019 OR 2018. true true X true X true X true true true false true true 251147 251147 0.01490 2457813 2276790 181023 0.01080 2708960 2276790 432170 0.02570 8283 8283 0.00050 18383 18383 0.00110 19266 19266 0.00110 45932 45932 0.00270 2754892 2276790 478102 0.02840 217 217 2400 2400 2617 2617 true 1003081 5207256 5281880 -74624 X true true 1 1 Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 WWW.MERCY.NET AR4767 X X X X Mercy Hospital Berryville 1 false false true X X X X X X X X X 18 true false false true X See part V, Section C X true 19 true See part V, Section C false true X 100 300. X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false FORM 990, SCHEDULE H, PART V, SECTION B, LINE 3e YES, THE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN ITS CHNA REPORT. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 THE HOSPITAL GATHERED DATA IN 2018 FOR ITS CHNA. IN THE MOST RECENT CHNA, MERCY HOSPITAL BERRYVILLE DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. MERCY HOSPITAL PARTICIPATED IN A GROUP OF HEALTH CARE AND PUBLIC HEALTH AGENCIES FROM ACROSS THE FOUR-COUNTY NORTHWEST ARKANSAS REGION TO CONDUCT A COMPREHENSIVE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY. THE COLLABORATION WAS MADE UP OF THE FOLLOWING ORGANIZATIONS WHO PROVIDED INPUT ON THE CHNA: COMMUNITY CLINIC NWA, A FEDERALLY QUALIFIED HEALTH CENTER, OZARK GUIDANCE CENTER, A MENTAL HEALTH SERVICE PROVIDER, THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES NORTHWEST ARKANSAS, BENTON COUNTY HEALTH DEPARTMENT, WASHINGTON COUNTY HEALTH DEPARTMENT, CARROLL COUNTY HEALTH DEPARTMENT, MADISON COUNTY HEALTH DEPARTMENT, HARK NWA, ARKANSAS COALITION OF MARSHALLESE. THE 25-QUESTION ANONYMOUS SURVEY WAS AVAILABLE IN ENGLISH, SPANISH, AND MARSHALLESE. THE SURVEY FOCUSED ON COMMUNITY MEMBERS' PERCEPTIONS OF THE GREATEST COMMUNITY HEALTH NEEDS, PERSONAL HEALTH NEEDS, PERCEPTIONS OF RISKY BEHAVIORS AND HEALTH RISK FACTORS, AND SOCIAL DETERMINANTS OF HEALTH. THE SURVEY WAS DISTRIBUTED ONLINE AND IN-PERSON BY PARTNER ORGANIZATIONS TO THEIR PATIENTS, CLIENTS, AND STAFF; BY CIVIC ORGANIZATIONS AND BUSINESSES; AT COMMUNITY EVENTS LIKE IMMUNIZATIONS EVENTS AND COUNTY FAIRS; AND WAS PUBLICIZED BY MEDIA COVERAGE AND SOCIAL MEDIA. INTENTIONAL AND SUCCESSFUL EFFORTS WERE MADE TO OVER-SAMPLE HISPANIC AND MARSHALLESE GROUPS IN ORDER TO ADEQUATELY UNDERSTAND THEIR NEEDS. THE NWA MINORITY HISPANIC AND MARSHALLESE POPULATIONS ARE MEDICALLY UNDERSERVED AND VERY LOW-INCOME. MERCY ALSO SOLICITED INPUT AND PARTICIPATION FROM THE CARROLL COUNTY HEALTH DEPARTMENT. OTHER PUBLIC HEALTH SOURCES OF DATA ARE DESCRIBED IN THE CHNA. Form 990, Schedule H, Part V, Section B, Line 6A THE CHNA WAS NOT CONDUCTED WITH ANOTHER HOSPITAL FACILITY. MERCY HOSPITAL BERRYVILLE PARTICIPATED IN THE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY IN COLLABORATION WITH MERCY HOSPITAL ROGERS. Form 990, Schedule H, Part V, Section B, Line 6B THE CHNA ITSELF WAS NOT CONDUCTED WITH ANOTHER ORGANIZATION. THE OTHER ORGANIZATIONS WHO PARTICIPATED IN THE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY WERE: ARKANSAS COALITION OF MARSHALLESE, ARKANSAS DEPARTMENT OF HEALTH, BENTON COUNTY HEALTH UNIT, CARROLL COUNTY HEALTH UNIT, COMMUNITY CLINIC NORTHWEST ARKANSAS, HARK AT THE CENTER FOR COLLABORATIVE CARE, MADISON COUNTY HEALTH COALITION, MADISON COUNTY HEALTH UNIT, OZARK GUIDANCE CENTER, WASHINGTON COUNTY HEALTH UNIT, UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES NORTHWEST. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7A https://www.mercy.net/content/dam/mercy/en/pdf/chna/Berryville-CHNA-2019.p df FORM 990, SCHEDULE H, PART V, SECTION B, LINE 10A https://www.mercy.net/content/dam/mercy/en/pdf/chip/mercy-berryville-chip- 2019.pdf FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 MERCY HOSPITAL BERRYVILLE IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY FOCUSING PROGRAMMING, SERVICES AND EDUCATION OR AWARENESS AROUND: (1) ACCESS TO CARE; AND (2) OBESITY & OVERWEIGHT. 1. ACCESS TO CARE: MERCY HOSPITAL BERRYVILLE LOOKS TO INCREASE ACCESS TO HEALTH CARE AND COMMUNITY RESOURCES FOR UNINSURED AND AT-RISK PERSONS THROUGH THE FOLLOWING PROGRAMS: - COMMUNITY HEALTH WORKER PROGRAM: COMMUNITY HEALTH WORKERS WILL WORK ONE-ON-ONE WITH AT-RISK PATIENTS AND COMMUNITY MEMBERS, ACTING AS PATIENT ADVOCATES, ASSISTING PATIENTS IN APPLYING FOR INSURANCE, MEDICAID, AND FINANCIAL ASSISTANCE AND CONNECTING PATIENTS WITH COMMUNITY RESOURCES. - SCHOOL-BASED CLINIC: MERCY HOSPITAL BERRYVILLE INTENDS TO OPERATE A PRIMARY CARE CLINIC 1/2-1 DAY PER WEEK AT THE LEARNING CENTER OF NORTH ARKANSAS (A NONPROFIT ORGANIZATION SERVING CHILDREN WITH DEVELOPMENTAL AND OTHER DISABILITIES IN CARROLL AND BOONE COUNTIES) TO PROVIDE ACCESS TO PRIMARY CARE TO THESE CHILDREN AND THEIR FAMILIES. - SENIOR LIFE SOLUTIONS: MERCY HOSPITAL BERRYVILLE LOOKS TO INCREASE ACCESS TO BEHAVIORAL HEALTH CARE FOR ELDERLY AND AT-RISK PATIENTS BY PROMOTING THE SENIOR LIFE SOLUTIONS PROGRAMS TO MERCY AND COMMUNITY PROVIDERS, AS WELL AS OTHER PROVIDERS TO ACHIEVE AND MAINTAIN MAXIMUM CAPACITY FOR CURRENT TRACK. SENIOR LIFE SOLUTIONS IS AN INTENSIVE OUTPATIENT GERIATRIC BEHAVIORAL HEALTH PROGRAM FOCUSED ON MEETING THE UNIQUE NEEDS OF ADULTS AGE 65 AND OVER WHO ARE STRUGGLING WITH TRAUMA, STRESS, GRIEF, SLEEP DISORDERS, AND/OR OTHER AGE-RELATED FACTORS CONTRIBUTING TO BEHAVIORAL HEALTH ISSUES BY PROVIDING SCREENING, EDUCATION, AND GROUP THERAPY. 2. OBESITY & OVERWEIGHT: MERCY HOSPITAL BERRYVILLE LOOKS TO DECREASE/MAINTAIN OBESITY RATES IN CARROLL COUNTY THROUGH THE FOLLOWING PROGRAMS: - HEALTH FAIRS: MERCY HOSPITAL BERRYVILLE WILL PARTICIPATE IN THE ANNUAL TYSON EMPLOYEE HEALTH FAIR LOCATED AT BERRYVILLE AND GREEN FOREST PLANTS AND THE ANNUAL CARROLL COUNTY SENIOR HEALTH FAIR BY PROVIDING SCREENINGS AND HEALTH EDUCATION RELATED TO OBESITY AND OVERWEIGHT AND CO-MORBIDITIES, INCLUDING CARIDOVASCULAR DISEASE AND DIABETES. TWO ASSESSED HEALTH ISSUES IDENTIFIED IN THE CHNA PROCESS - MENTAL/BEHAVIORLAL HEALTH AND STROKE - WILL NOT BE ADDRESSED WITHIN THE MERCY BERRYVILLE STRATEGIC PLAN FOR COMMUNITY HEALTH IMPROVEMENT. DUE TO MERCY BERRYVILLE'S LACK OF RESOURCES REQUIRED TO DIRECTLY ADDRESS THESE ISSUES, THEY WERE NOT CHOSEN AS FOCUS AREAS FOR THE CHNA. MERCY BERRYVILLE WILL CONSIDER FOCUSING ON THESE ISSUES SHOULD RESOURCES AND IMPLEMENTATION STRATEGIES BECOME AVAILABLE. UNTIL THEN, MERCY BERRYVILLE WILL SUPPORT, AS ABLE, THE EFFORTS OF PARTNER AGENCIES AND ORGANIZATIONS CURRENTLY WORKING TO ADDRESS THESE NEEDS WITHIN THE COMMUNITY. Form 990, Schedule H, Part V, Section B, Lines 16A, 16B & 16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT https://www.mercy.net/patients/billing/financial-assistance/ 1 MERCY THERAPY SERVICES BERRYVILLE 735 HIGHWAY 62 WEST BERRYVILLE AR 72616 OUTPATIENT REHAB FORM 990, SCHEDULE H, PART I, LINE 6A THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $19,957,003. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $3,134,628. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $16,822,375. FORM 990, SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES WORK TOWARD IMPROVING THE HEALTH, WELLNESS AND SAFETY OF THE COMMUNITY. COMMUNITY SUPPORT AND COALITION BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE THROUGH THEIR PARTICIPATION IN COMMUNITY-BASED EVENTS, MEETINGS AND BY SERVING ON COMMUNITY BOARDS. MERCY HOSPITAL BERRYVILLE PARTICIPATED IN COALITION BUILDING AND COMMUNITY SUPPORT. FORM 990, SCHEDULE H, PART III, SECTION A, 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. FORM 990, SCHEDULE H, PART III, SECTION A, 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. FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4 IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. FORM 990, SCHEDULE H, PART III, SECTION B, LINE 8 IT IS THE POSITION OF MERCY THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). Form 990, Schedule H, 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 THIRD-PARTY TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY; USING HOUSEHOLD SIZE AND INCOME. 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. IN ADDITION, MERCY UTILIZES 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. 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 A 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 OCCURS PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED. Form 990, Schedule H, Part VI, Line 2 MERCY HOSPITAL BERRYVILLE BELIEVES THAT ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IS COMPREHENSIVE ENOUGH TO CAPTURE SUBSTANTIALLY ALL OF THE COMMUNITY'S NEEDS. THEREFORE, NO FURTHER STEPS WERE TAKEN TO IDENTIFY ADDITIONAL NEEDS. MERCY HOSPITAL BERRYVILLE MEASURES ALL COMMUNITY HEALTH INDICATORS AS SET FORTH BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND MEASURES ALL UTILIZATION ACTIVITY (PARTICULARLY FOR VULNERABLE POPULATIONS) TO FIRST UNDERSTAND THE STATUS OF THE COMMUNITY'S HEALTH ON AN ANNUAL BASIS. BASED ON THESE FINDINGS, MERCY REFINES ITS IMPLEMENTATION STRATEGIES TO MEET THE NEEDS OF THE COMMUNITY AND MONITORS PROGRESS THROUGH BY PERIODIC REVIEW BY THE HOSPITAL'S COMMUNITY BOARD. Form 990, Schedule H, 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, the patient has signage about the policy at the access points, and all staff working with the patient at Point of Service, Scheduling, Customer Service, and even through the Medicaid Eligibility Screening, have the means to send the account for review. There is the plain language summary that is being provided to all whom express hardship, in addition to the web address providing the application, policies, and even how uninsured accounts are handled. Lastly, the Statements (billing) includes messaging 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. Form 990, Schedule H, Part VI, Line 4 MERCY HOSPITAL BERRYVILLE'S PRIMARY SERVICE AREA INCLUDES CARROLL COUNTY, ARKANSAS AND BARRY COUNTY, MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM 2018 IBM/WATSON'S DEMOGRAPHICS AND FY2018 DECISION RESOURCE GROUP'S INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 86,570. 22%% OF THE POPULATION'S AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 47% OF THE POPULATION IS 45 AND OLDER. 20% OF THE HOUSEHOLDS ARE ON MEDICARE, 15% ON MEDICAID, AND 11% UNINSURED. Form 990, Schedule H, Part VI, Line 5 MERCY HOSPITAL BERRYVILLE 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 FOR VARIOUS SITUATIONS, OUTREACH PROGRAMS, EDUCATIONAL PROGRAMS, HEALTH RESOURCE COORDINATION, COMMUNITY BLOOD DRIVES AND HEALTH FAIRS, ETC. MERCY HOSPITAL BERRYVILLE IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY BOARD MEMBERS ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE, INTERESTS ARE SERVED BY MERCY. SURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MERCY HOSPITAL BERRYVILLE 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. FORM 990, SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE 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, 2019, 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, 2019, MERCY HAD MORE THAN 10.2 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,400 EMPLOYED PHYSICIANS, AND APPROXIMATELY 45,000 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. Form 990, Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT: AR X X true true false true false false false false false false false Clouse Day Sherry VP-Finance 0 191121 0 32020 0 55586 0 11296 0 12720 0 302743 0 0 Davison Justin VP Finance 0 207915 0 29288 0 20435 0 7312 0 16137 0 281087 0 0 Flake MD William Physician & Board Member 0 171872 0 0 0 30706 0 45997 0 1953 0 250528 0 0 Hannasch Susan VP-Regional General Counsel 0 298125 0 109458 0 34940 0 51300 0 13564 0 507387 0 0 Huntley Kelli VP Finance 0 145832 0 19566 0 6358 0 4199 0 11854 0 187809 0 0 Marion Tanya Regional VP - Human Resources 0 253097 0 81371 0 34230 0 49942 0 17382 0 436022 0 0 Phillippe Robert Nurse Anesthetist 0 150983 0 40 0 19416 0 7103 0 903 0 178445 0 0 Reynolds Scott CFO-Central Commun (Thru 5/18) 0 373817 0 113290 0 44929 0 96403 0 13351 0 641790 0 0 Scarrow MD Alan Pres,Sprg Comm Thru 9/17 0 987061 0 207113 0 185795 0 21755 0 21434 0 1423158 0 0 Swope Jon President, Central Communities 0 728214 0 507077 0 55870 0 155788 0 17789 0 1464738 0 0 Taylor MD Richard Physician & Board Member 0 172643 0 9552 0 25324 0 43882 0 2182 0 253583 0 0 FORM 990, SCHEDULE J, PART I, LINE 1 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 ONE LISTED INDIVIDUAL (FORMER KEY EMPLOYEE). FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HOSPITAL BERRYVILLE RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY HEALTH OFFERS SUPPLEMENTAL RETIREMENT PLANS 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 PLANS ARE CLOSED TO NEW ENTRANTS. THE INDIVIDUALS REPORTABLE ON THIS RETURN WHO PARTICIPATE IN THE SUPPLEMENTAL RETIREMENT PLANS INCLUDE: STEPHEN GOSS, SUSAN HANNASCH, TANYA MARION, SCOTT REYNOLDS, AND JON SWOPE. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). FORM 990, PART III, QUESTION 4D MERCY HOSPITAL BERRYVILLE PROVIDES QUALITY CARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. MERCY HOSPITAL BERRYVILLE PROVIDED 1,543 INPATIENT SERVICE DAYS OF ACUTE OR SUB-ACUTE CARE. THE HOSPITAL RESPONDED TO APPROXIMATELY 9,492 EMERGENCY ROOM ENCOUNTERS, AND COMPLETED 22,349 OUTPATIENT VISITS. COMMUNITY OUTREACH/BENEFIT PROGRAMS INCLUDE SUPPORT GROUPS FOR CURRENT AND PAST PATIENTS (DIABETIC, CARDIAC, ETC), VARIOUS SUPPORT GROUPS, ETC), EMPLOYEES (EDUCATIONAL ASSISTANCE PROGRAMS, ETC), AND LOCAL/SURROUNDING COMMUNITY (HEALTH AND WELLNESS PROGRAMS, HEALTH FAIRS, HOME HEALTH PROGRAMS, ETC). RELIEF FROM THE FINANCIAL BURDEN OF HEALTH CARE SERVICES TO THE INDIGENT CONSISTS OF CHARGES OF $784,834 FOR CHARITY CARE PROVIDED. FORM 990, PART V, QUESTION 1A FORM 1099/1096 FILING VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART V, QUESTION 2A W-3 FILING MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3S) WAS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES, EIN 20-2553101. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SPRINGFIELD COMMUNITIES. SUBJECT TO CONSULTATION WITH THE BOARD OF DIRECTORS, THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY TO THE CORPORATE MEMBER: -TO REVIEW, AMEND, AND APPROVE THE MISSION, VISION, AND VALUES OF THE CORPORATION AS RECOMMENDED BY THE BOARD; -TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS, SUBJECT TO RESTRICTIONS SET FORTH IN ARTICLES XI AND XII; -TO APPOINT MEMBERS OF THE BOARD, AS NOMINATED BY THE BOARD OF THE CORPORATION, SUBJECT TO THE RESTRICTIONS SET FORTH IN ARTICLE V HEREIN; -TO APPOINT, SUBJECT TO RECOMMENDATIONS BY THE BOARD, OR REMOVE THE PRESIDENT OF THE CORPORATION, SUBJECT TO THE REQUIREMENTS SET FORTH IN ARTICLE VII HEREIN; -TO REVIEW, AMEND, AND APPROVE THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF MERCY HOSPITAL BERRYVILLE (EIN: 71-0759299) OF THE CORPORATION; -TO REVIEW, AMEND, AND APPROVE THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; -TO REVIEW OR APPROVE ANY CAPITAL EXPENDITURES OR RECOMMENDATIONS NOT PREVIOUSLY APPROVED AS PART OF THE CORPORATION'S BUDGETS AND/OR STRATEGIC PLAN; -TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION SUBJECT TO THRESHOLDS ESTABLISHED FROM TIME TO TIME BY MERCY HEALTH AND ANY APPLICABLE LEASE AGREEMENT WITH CARROLL COUNTY ARKANSAS; -TO ENCUMBER THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION, EXCEPT FOR MERCY HEALTH FOUNDATION BERRYVILLE. -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 THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, CONSOLIDATE, OR DISSOLVE THE CORPORATION; -TO LEASE, MANAGE, PURCHASE, OR AFFILIATE WITH ANOTHER HEALTH FACILITY OR HEALTH CARE SYSTEM; AND, -TO RESIGN AS CORPORATE MEMBER. FORM 990, PART VI, QUESTION 11B DSCR OF PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 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, INCLUDING THE DIRECTOR OF FINANCE AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORMS 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS MADE AVAILABLE TO THE FILING ORGANIZATION'S LEADERSHIP TEAM FOR THEIR REVIEW. THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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, 2019. 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, QUESTION 15A & 15B OFFICERS AND POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE 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 RELIES UPON MERCY HEALTH, WHICH 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, QUESTION 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART XI, LINE 9 OTHER CHANGE IN NET ASSETS NET TRANSFERS TO/FROM AFFILIATES: $(3,815,281) FORM 990, PART XII, QUESTION 2C AUDIT OF FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2019 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. FORM 990, PART XII, QUESTION 3A AND 3B SINGLE AUDIT ACT AND OMB CIRCULAR A133 MERCY HEALTH UNDERGOES A CONSOLIDATED UNIFORM GUIDANCE AUDIT EVERY YEAR AND DID SO FOR THE FISCAL YEAR ENDING JUNE 30, 2019. 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 AVAILABLE FOR AUDIT. THE FILING ENTITY RECEIVED FEDERAL FUNDS DURING THE YEAR ENDED JUNE 30, 2019, WAS INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, WAS ALSO INCLUDED IN THE POPULATION AVAILABLE FOR AUDIT. Casa de Misericordia 1000 MIER STREET Laredo TX 78040 742912461 SHELTER TX 501c3 7 MM LAREDO true McAuley Portfolio Management Company 14528 S Outer Forty Suite 100 Chesterfield MO 63017 261708048 PORT MGMT MO 501c3 12b Mercy Health true Mercy ACO Clinical Services Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 464504901 VIRTUAL CARE MO 501c3 3 Mercy Health true Mercy Clinic East Communities 645 Maryville Ctr Ste 100 St Louis MO 63141 431771217 PHYS GROUP MO 501c3 10 MH EAST COMM true Mercy Clinic Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72903 261318597 PHYS CLINIC AR 501c3 3 MH FS COMM true Mercy Clinic Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 270473057 PHYS GROUP OK 501c3 3 MH OK COMM true Mercy Clinic Springfield Communities 1965 Fremont Street Suite 2950 Springfield MO 65804 431560263 PHYS GROUP MO 501c3 3 MH SF COMM true Mercy Family Center 14528 S Outer Forty Suite 100 Chesterfield MO 63017 721069468 COUNSELING LA 501c3 7 Mercy Health true Mercy Health 14528 S Outer Forty Suite 100 Chesterfield MO 63017 431423050 CORP OFFICE MO 501c3 1 NA false Mercy Health East Communities 14528 S Outer Forty Suite 100 Chesterfield MO 63017 431718408 HLTH SYSTEM MO 501c3 12a Mercy Health true Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Co AR 501c3 12b Mercy Health true Mercy Health Foundation 14528 S Outer Forty Suite 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 12b Mercy Health true Mercy Health Foundation Ada 430 N Monte Vista Street Ada OK 74820 463596274 Foundation OK 501c3 12a MH ADA Inc true Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 12a MH ARDMORE true Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 12a MH BERRYVILL true Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 7 M KS COMM true Mercy Health Foundation Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 237330425 Foundation AR 501c3 7 MH FS COMM true Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 Foundation MO 501c3 12b MH JEFFERSON true Mercy Health Foundation Joplin 100 Mercy Way Joplin MO 64804 270906136 Foundation MO 501c3 7 MH SW MOKS true Mercy Health Foundation Lebanon 100 Hospital Drive Lebanon MO 65536 822514567 Foundation MO 501c3 12b MH LEBANON true Mercy Health Foundation Lincoln 1000 East Cherry Street Troy MO 63379 811477159 Foundation MO 501c3 12b MH EAST COMM true Mercy Health Foundation Nw Arkansas 2710 Rife Medical Lane Rogers AR 72758 710601687 Foundation AR 501c3 7 MH ROGERS true Mercy Health Foundation of Oklahoma 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 12a MH OK COMM true Mercy Health Foundation Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 463184231 Foundation OK 501c3 12a MH OK City true Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 12b MH SF COMM true Mercy Health Foundation St Francis 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 12a M St Francis true Mercy Health Foundation St Louis 14528 S Outer Forty Suite 100 Chesterfield MO 63017 562410020 Foundation MO 501c3 12b MH EAST COMM true Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 12b MH EAST COMM true Mercy Health NW Arkansas Communities 2710 Rife Medical Lane Rogers AR 72758 621684203 PHYS GROUP AR 501c3 10 Mercy Health true Mercy Health Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 731453048 HLTH SYSTEM OK 501c3 12a Mercy Health true Mercy Health Plans of Missouri Inc 3265 S National Avenue Springfield MO 65807 320481419 HMO MO 501c4 N/A Mercy Health true Mercy Health Plans Inc 3265 S National Avenue Springfield MO 65807 320486150 PPO MO 501c4 N/A MH PLANS MO true Mercy Health SW MOKS Communities 100 Mercy Way Joplin MO 64804 300584463 HLTH SYSTEM MO 501c3 12b Mercy Health true Mercy Health Springfield Communities 1235 E Cherokee Street Springfield MO 65804 431856028 HLTH SYSTEM MO 501c3 12b Mercy Health true Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 Inactive AR 501c3 12a MH SPRINGFLD true Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 Hospital OK 501c3 3 MH OK COMM true Mercy Hospital Ardmore Inc 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501c3 3 MH OK COMM true Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 501c3 3 MH SF COMM true Mercy Hospital Booneville 880 West Main Street Booneville AR 72927 463851119 Hospital AR 501c3 3 MH FT SMITH true Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 Hospital MO 501c3 3 MH SW MOKS true Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 501c3 3 MH SF COMM true Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital KS 501c3 3 MH SW MOKS true Mercy Hospital El Reno Inc 2115 Parkview Drive El Reno OK 73036 272716065 Hospital OK 501c3 3 MH OK City true Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72903 710240352 Hospital AR 501c3 3 MH FS COMM true Mercy Hospital Healdton Inc 3462 Hospital Rd Healdton OK 73438 263173902 Hospital OK 501c3 3 MH ARDMORE true Mercy Hospital Jefferson 1400 Highway 61 South Festus MO 63028 430687077 Hospital MO 501c3 3 MH EAST COMM true Mercy Hospital Joplin 100 Mercy Way Joplin MO 64804 270814858 Hospital MO 501c3 3 MH SW MOKS true Mercy Hospital Kingfisher Inc 1000 Kingfisher Regional Hospital C Kingfisher OK 73750 463433074 Hospital OK 501c3 3 MH OK City true Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501c3 3 MH SF COMM true Mercy Hospital Lincoln 1000 East Cherry Street Troy MO 63379 472219204 Hospital MO 501c3 3 MH EAST COMM true Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 Hospital OK 501c3 3 MH OK City true Mercy Hospital Oklahoma City Inc 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501c3 3 MH OK COMM true Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501c3 3 MH FT Smith true Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501c3 3 MH FT Smith true Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 Hospital AR 501c3 3 MH NW AK COM true Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501c3 3 MH SF COMM true Mercy Hospital Tishomingo Inc 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501c3 3 MH ADA Inc true Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501c3 3 MH FT Smith true Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 Hospital OK 501c3 3 MH OK City true Mercy Hospitals East Communities 615 S New Ballas Road St Louis MO 63141 430653493 Hospital MO 501c3 3 MH EAST COMM true Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501c3 3 MH SW MOKS true Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78046 200198462 Outreach TX 501c3 7 Mercy Health true Mercy Research 524 North Booneville Avenue Springfield MO 65802 870796305 Research MO 501c3 4 Mercy Health true Mercy St Francis HosPital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501c3 3 MH FS COMM true MHM Support Services 14528 S Outer Forty Suite 100 Chesterfield MO 63017 202553101 CTRL SYS FUNC MO 501c3 12a Mercy Health true Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 CHILD ADVOC AR 501c3 3 Mercy Health true Mercy Hlth Fdn S-fka St Anthonys Ch FDN 10010 Kennerly Road St Louis MO 63128 261516789 Fundraising MO 501c3 12a MH SOUTH true MERCY HOSP SOUTH-FKA ST ANTHONY MED CTR 10010 Kennerly Road St Louis MO 63128 430980256 Hospital MO 501c3 3 MH EAST COMM true St Anthony's Physician Organization 10010 Kennerly Road St Louis MO 63128 431784536 Health care MO 501c3 3 MH SOUTH true St Mary's Hospital of Enid Oklahoma Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 MH OK COMM true Unity Ambulatory Care 14528 S Outer Forty Suite 100 Chesterfield MO 63017 431861745 Inactive MO 501c3 12c MH EAST COMM true Fort Smith Emergency Medical Services 1701 S Greenwood FT SMITH AR 72901 710416615 Emergency Medical AR NA Mercy Ambulatory Surgery Center LLC 7301 Rogers FT SMITH AR 72917 710827721 AMBUL SURG CT AR NA Plaza Surgery Services Company LLC 12700 Southfork RD St Louis MO 63128 204709312 INACTIVE MO NA Resource Optimization & Innovation LLC 645 Maryville St Louis MO 63141 460468368 CENTRAL DIST. MO NA St Edward Mercy Med Ctr Multi-Purp BLDG 7301 Rogers FT SMITH AR 72903 710554050 OFFICE BUILDING AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 Holding co DE NA C-Corp Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 Product Commerce MO NA C-Corp Mercy Commercial Services Inc 14528 South Outer Forty Suite 100 Chesterfield MO 63017 464953543 PARENT OF VCC MO NA C-Corp Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 Real estate OK NA C-Corp Mercy Health Network of the Southern Reg 14528 S Outer Forty Suite 100 Chesterfield MO 63017 731580607 HOLDING CO OK NA C-Corp Mercy Health Network Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 731381689 HOLDING CO OK NA C-Corp Mercy Managed Care Corporation 14528 S Outer Forty Suite 100 Chesterfield MO 63017 731441665 HOLDING CO OK NA C-Corp UHL Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 Holding co MO NA C-Corp Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 Inactive MO NA C-Corp St Anthony's Physician Org of Illinois 10010 Kennerly Road St Louis MO 63128 320457168 Health Care MO NA C-Corp false false false false false false false false false false false false false false false true true false false ENTERPRISE LAUNDRY Q 54363 FMV Mercy Health Foundation Berryville Q 66112 FMV Mercy ACO Clinical Services Q 82894 FMV Mercy Hospital Springfield Q 149740 FMV Mercy Health NW Arkansas Communities Q 1023927 FMV Mercy Health Springfield Communities Q 1467125 FMV Mercy Hospital Rogers Q 2961705 FMV MHM Support Services Q 3124590 FMV Form 990, Schedule R, Part II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITAL ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITAL WASHINGTON, EIN 43-1066883. Form 990, Schedule R, Part V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON VIA INTERCOMPANY JOURNAL ENTRIES. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON THE RELATED ORGANIZATION INFORMATION THAT CAN BE EXTRACTED FROM LAWSON. DUE TO THESE LIMITATIONS, MOST OF THE RELATED ORGANIZATION ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R, PART V, IN LINES P, AND Q.