MERCY HOSPITAL KINGFISHER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL KINGFISHER INC (EIN 46-3433074)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-14
- IRS object ID
- 201831349349309158
- Schema version
- 2016v3.0
- 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 | 2018-05-14T16:31:52-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 562632458 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLEUS AND COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14500 SOUTH OUTER 40 RD STE 201A | AddressLine1Txt |
| City | CHESTERFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463433074 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL KINGFISHER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 4059365649 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRACY ENLOE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4057523161 | PhoneNum |
| Signature | 2018-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUGLAS G PLEUS | PreparerPersonNm |
| PTIN | P00013488 | PTIN |
| Phone | 3143179916 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DIANA SMALLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,592,687 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCY.NET/KINGFISHEROK | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | TO CARRY OUT THE HEALING MINISTRY OF JESUS BY PROMOTING HEALTH AND WELLNESS THROUGH OUR COMMUNITIES. TO PROVIDE QUALITY HEALTH SERVICES THROUGH A WISE USE OF RESOURCES AND EXCEPTIONAL MERCY SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 31 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $71,014 | PYContributionsGrantsAmt |
| CY Contributions Grants | $31,721 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,454,305 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,393,078 | CYProgramServiceRevenueAmt |
| PY Investment Income | $55 | PYInvestmentIncomeAmt |
| CY Investment Income | -$54 | CYInvestmentIncomeAmt |
| PY Other Revenue | $144,359 | PYOtherRevenueAmt |
| CY Other Revenue | $121,815 | CYOtherRevenueAmt |
| PY Total Revenue | $13,669,733 | PYTotalRevenueAmt |
| CY Total Revenue | $13,546,560 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $108,027 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $122,613 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,285,027 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,727,311 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,408,820 | PYOtherExpensesAmt |
| CY Other Expenses | $5,351,433 | CYOtherExpensesAmt |
| PY Total Expenses | $13,801,874 | PYTotalExpensesAmt |
| CY Total Expenses | $12,201,357 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$132,141 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,345,203 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,414,080 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,274,926 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,510,951 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,808,177 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $903,129 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,466,749 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MERCY HOSPITAL KINGFISHER IS ROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH. THIS TRADITION IS MARKED BY VALUES OF JUSTICE, EXCELLENCE, STEWARDSHIP AND RESPECT FOR THE DIGNITY OF EACH PERSON. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,439,074 | ExpenseAmt |
| Grant | $122,613 | GrantAmt |
| Revenue | $13,459,554 | RevenueAmt |
| Desc | MERCY HOSPITAL KINGFISHER PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FISCAL YEAR END JUNE 30, 2017, KINGFISHER PROVIDED SERVICES TO 306 INPATIENTS, 15,018 OTHER OUTPATIENTS, AND 4,003 EMERGENCY DEPARTMENT PATIENTS. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2017 WAS $1,015,442.MERCY HOSPITAL KINGFISHER'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H. | Desc |
| Total Program Service Expenses | $9,439,074 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 | 0 | 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 | LYNN PINAROC | PersonNm |
| Phone | 4057523536 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 WEST MEMORIAL ROAD | AddressLine1Txt |
| City | OKLAHOMA CITY | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73120 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CHEAP PAT | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| DENTON BRIAN | ||||||||||
| ADMINISTRATOR RURAL FACILITIES & BM | 50.00 | 0.00 | Yes (X) | $127,058 | $0 | $19,934 | ||||
| DIXSON MD JAMES D | ||||||||||
| PHYSICIAN & BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $574,014 | $54,600 | ||||
| HALLOCK DOROTHY | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| KNECHT GERALD | ||||||||||
| BOARD MEMBER-THRU 10/16 | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| PINAROC LYNN | ||||||||||
| VP-FINANCE & BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $208,806 | $12,584 | ||||
| THOMAS MAX | ||||||||||
| BOARD MEMBER-THRU 10/16 | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| VOTH JOE | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| WALTA BRENDA | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| ENLOE TRACY | ||||||||||
| CHIEF FINANCIAL OFFICER & BM | 2.00 | 58.00 | Yes (X) | $0 | $222,972 | $30,412 | Yes (X) | |||
| RAJU GARY | ||||||||||
| CHIEF FINANCIAL OFFICER-THRU 04/17 | 1.00 | 59.00 | $0 | $435,519 | $57,128 | Yes (X) | ||||
| SMALLEY DIANA L | ||||||||||
| PRESIDENT, WEST COMMUNITIES | 1.00 | 59.00 | $0 | $1,683,326 | $109,182 | Yes (X) | ||||
| GEBHART JIM R | ||||||||||
| PRESIDENT, MERCY HOSPITAL OKC | 5.00 | 55.00 | $0 | $684,131 | $233,892 | Yes (X) | ||||
| LE BICH-VI | ||||||||||
| REGIONAL VP-GENERAL COUNSEL | 1.00 | 59.00 | $0 | $290,673 | $58,111 | Yes (X) | ||||
| STEINLICHT MELVIN E | ||||||||||
| REGISTERED NURSE II | 50.00 | 0.00 | $109,374 | $0 | $9,222 | Yes (X) | ||||
| WILCOX DAVE M | ||||||||||
| PHYSICIAN ASSISTANT | 50.00 | 0.00 | $193,898 | $0 | $7,863 | Yes (X) | ||||
| VITIELLO JONATHAN | ||||||||||
| FORMER OFFICER | 0.00 | 60.00 | $0 | $762,976 | $107,820 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $430,330 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,862,417 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $700,748 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | 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 (3 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 | $257,616 |
| WOUND CARE SPECIALISTS | |||||
| 3445 N CAUSEWAY BLVD SUITE 600 | METAIRIE | LA | 70002 | STAFF CONTRACT SERVICES | $126,550 |
| STAFF CARE | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | STAFFING SERVICES | $116,707 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $4,321 | RelatedOrganizationsAmt |
| Government Grants | $27,400 | GovernmentGrantsAmt |
| Total Contributions | $31,721 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $13,393,078 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,393,078 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,393,078 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$54 | TotalRevenueColumnAmt |
| Exclusion | -$54 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $61,339 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $46,127 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,212 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,212 | TotalRevenueColumnAmt |
| Exclusion | $15,212 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $40,127 | TotalRevenueColumnAmt |
| Exclusion | $40,127 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,476 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,476 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $106,603 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,546,560 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,459,554 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $55,285 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,613 | TotalAmt |
| Program Services | $122,613 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,216 | TotalAmt |
| Management And General | $138,216 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,417 | TotalAmt |
| Management And General | $129,417 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,225,537 | TotalAmt |
| Program Services | $4,911,354 | ProgramServicesAmt |
| Management And General | $314,183 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,686 | TotalAmt |
| Program Services | $232,879 | ProgramServicesAmt |
| Management And General | $14,807 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,047 | TotalAmt |
| Program Services | $547,943 | ProgramServicesAmt |
| Management And General | $51,104 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $387,408 | TotalAmt |
| Program Services | $347,815 | ProgramServicesAmt |
| Management And General | $39,593 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219 | TotalAmt |
| Management And General | $219 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $797,457 | TotalAmt |
| Program Services | $434,812 | ProgramServicesAmt |
| Management And General | $362,645 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,773 | TotalAmt |
| Program Services | $3,693 | ProgramServicesAmt |
| Management And General | $3,080 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,761 | TotalAmt |
| Program Services | $300,302 | ProgramServicesAmt |
| Management And General | $250,459 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,453 | TotalAmt |
| Program Services | $1,900 | ProgramServicesAmt |
| Management And General | $7,553 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,426 | TotalAmt |
| Program Services | $287,033 | ProgramServicesAmt |
| Management And General | $239,393 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,242 | TotalAmt |
| Program Services | $39,471 | ProgramServicesAmt |
| Management And General | $5,771 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,291 | TotalAmt |
| Program Services | $2,057 | ProgramServicesAmt |
| Management And General | $177,234 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,754 | TotalAmt |
| Management And General | $73,754 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SHARED SERVICE FEE | $1,235,121 | $642,263 | $592,858 |
| BAD DEBTS | $771,033 | $771,033 | |
| DRUGS & MEDICAL EXPENSE | $761,958 | $741,476 | $20,482 |
| REPAIRS & MAINTENANCE | $355,456 | $31,443 | $324,013 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,489 | TotalAmt |
| Program Services | $20,987 | ProgramServicesAmt |
| Management And General | $17,502 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,201,357 | TotalAmt |
| Program Services | $9,439,074 | ProgramServicesAmt |
| Management And General | $2,762,283 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,526,723 | BOYAmt |
| EOY | $1,403,742 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,089,434 | BOYAmt |
| EOY | $1,225,937 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $215,491 | BOYAmt |
| EOY | $184,551 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,224 | BOYAmt |
| EOY | $10,497 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,315,523 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $882,532 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $568,208 | BOYAmt |
| EOY | $432,991 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $17,208 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,080 | BOYAmt |
| EOY | $3,274,926 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,101 | BOYAmt |
| EOY | $678,962 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $13,917 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,538,850 | BOYAmt |
| EOY | $1,115,298 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,510,951 | BOYAmt |
| EOY | $1,808,177 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $903,129 | BOYAmt |
| EOY | $1,466,749 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $903,129 | BOYAmt |
| EOY | $1,466,749 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,080 | BOYAmt |
| EOY | $3,274,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,345,203 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$781,583 | 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 | $3,525 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,525 | 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 CATHOLIC HOSPITAL ASSOCIATION, OKLAHOMA HOSPITAL ASSOCIATION, AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2017, DUES WERE $1,989, $12,789 AND $4,1558, RESPECTIVELY. APPROXIMATELY 3.76% OF THE CATHOLIC HOSPITAL ASSOCIATION DUES, 19.90% OF OKLAHOMA HOSPITAL ASSOCIATION DUES, AND 21.78% 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 | $16,114 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,834 | DepreciationAmt |
| Book Value | $11,280 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,299,409 | OtherCostOrOtherBasisAmt |
| Depreciation | $877,698 | DepreciationAmt |
| Book Value | $421,711 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $432,991 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO TAX-EXEMPT AFFILIATES | Desc |
| Amt | $1,115,298 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,115,298 | TotalLiabilityAmt |
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, 2017 OR 2016. | 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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $770,028 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $770,028 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06740 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,487,957 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,242,543 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $245,414 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,257,985 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,242,543 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,015,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08890 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,257,985 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,242,543 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,015,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08890 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $375,417 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,920,377 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,077,970 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$157,593 | 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 KINGFISHER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 KINGFISHER REGIONAL HOSPITAL | AddressLine1Txt |
| Address Line2 | DRIVE | AddressLine2Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 2226 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| 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 KINGFISHER 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 | 15 | 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 | WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | 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 | WWW.MERCY.NET/OPEN-PAGES/MERCY-FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MERCY.NET/OPEN-PAGES/MERCY-FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MERCY.NET/OPEN-PAGES/MERCY-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 |
| 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 |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 5: WHEN CONDUCTING ITS MOST RECENT CHNA, MERCY HOSPITAL KINGFISHER WORKED CLOSELY WITH THE FOLLOWING:- SOONER SUCCESS - KINGFISHER COUNTY HEALTH DEPARTMENT REPRESENTATIVES- OSU COOPERATIVE EXTENSION SERVICE STAFF- DHS STAFF- CHISHOLM TRAIL TECHNOLOGY CENTER REPRESENTATIVES- FAMILY AND CHILDREN'S CONSULTANTS - OKLAHOMA STATE UNIVERSITY CENTER FOR RURAL HEALTH STAFF- MERCY HOSPITAL KINGFISHER LEADERSPLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 6B: SEE PART V, SECTION B, LINE 5 RESPONSE |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 11: THE STRUCTURE OF THIS CHIP REVOLVES AROUND THE KEY STRATEGIES OF EDUCATION, PREVENTION, AND COLLABORATION. THE HEALTH NEEDS THAT HAVE BEEN PRIORITIZED IN THIS CHIP ARE:- ACCESS TO CARE INCLUDING SPECIALISTS - MENTAL HEALTH AND SUICIDE - FOCUS ON A HEALTHY LIFESTYLE PLEASE REFER TO THE COMMUNITY HEALTH IMPLEMENTATION PLAN WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - MHK OUTPATIENT REHAB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | REHABILITATION SERVICES | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICESTHE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINIC COSTS ON LINE 7G. |
| PART I, LN 7 COL(F): | TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $12,201,357. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $771,033. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $375,417. |
| 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 KINGFISHER (MHK) 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, MHK 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 MHK PARTICIPATES/SERVES ARE:- HOSTED THE MERCY HOSPITAL KINGFISHER STUDENT GOVERNING BOARD- PARTICIPATION IN OBI BLOOD DRIVES- PARTICIPATED IN THE CHAPTER OF KINGFISHER ROTARY CLUB- PARTICIPATED IN AMBUCS/AMTRYKE LOCAL CHAPTER AND FUND RAISERS FOR BIKES, TRIKES, AND WHEELCHAIR RAMPS FOR THE DISABLED- CO-SPONSORED 8TH GRADE HEALTH FAIR, INCLUDING HEALTH SCREENING, WHICH WAS ATTENDED BY 350 PARTICIPANTS.- ACTIVE INVOLVEMENT IN KINGFISHER COUNTY COLLABORATIVE FOR YOUTH-RELATED ISSUES IMPACTING 165 YOUTH THIS YEAR.- LION'S CLUB PARTICIPATION AND PRESENTATIONS- KINGFISHER CHAMBER BOARD EXECUTIVE COMMITTEE MEMBER- RELAY FOR LIFE PARTICIPANT- KINGFISHER CHRISTMAS PARADE PARTICIPATION- COMPASSION CLINIC BOARD MEMBER- CO-SPONSORED COLD TURKEY TROT 5K, TO HELP PROMOTE THE GREAT AMERICAN SMOKE-OUT AND BEING TOBACCO FREE- SPONSORED AND HOSTED A 5K NIGHTTIME GLOW RUN IN APRIL WITH 300 PARTICIPANTS. - SPONSORED TWO FAMILIES FOR THANKSGIVING MEALS- SPONSORED TWO FAMILIES FOR CHRISTMAS MEALS AND GIFTS |
| 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: "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 KINGFISHER 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'S; INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS, AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR 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; 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. 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 $6500. 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. |
| PART VI, LINE 2: | A SURVEY WAS DESIGNED TO GAUGE HOSPITAL USAGE, SATISFACTION, AND COMMUNITY HEALTH NEEDS. THE SURVEY WAS AVAILABLE IN BOTH PAPER AND WEB FORMAT. THE SURVEY WAS MADE AVAILABLE AT THE HOSPITAL AND CLINIC. THE ELECTRONIC SURVEY LINK WAS SHARED WITH COMMUNITY MEMBERS THROUGH A COMMUNITY EMAIL DATABASE. SURVEYS WERE ALSO DISTRIBUTED AT THE FIRST COMMUNITY MEETING ON OCTOBER 8, 2015. COMMUNITY MEMBERS IN ATTENDANCE ALSO RECEIVED A FOLLOW-UP EMAIL WITH A PDF COPY OF THE SURVEY AND THE ELECTRONIC SURVEY LINK. A COPY OF THE SURVEY FORM AND RESULTS CAN BE FOUND IN APPENDIX E OF THE CHNA. COMMUNITY MEMBERS WERE ASKED TO RETURN THEIR COMPLETED SURVEYS TO MERCY HOSPITAL EL RENO. THE SURVEY RAN FROM OCTOBER 8, 2015 TO OCTOBER 22, 2015. A TOTAL OF 108 SURVEYS FROM THE MERCY HOSPITAL EL RENO MEDICAL SERVICE AREA WERE COMPLETED. OF THE SURVEYS RETURNED, 75 WERE ELECTRONIC RESPONSES, AND 33 WERE HARD COPY SURVEYS. THE SURVEY RESULTS WERE PRESENTED AT THE NOVEMBER 5, 2015, COMMUNITY MEETING.MERCY HOSPITAL EL RENO HOSTED FOUR COMMUNITY MEETINGS BETWEEN OCTOBER 8, 2015 AND NOVEMBER 12, 2015. THE OKLAHOMA OFFICE OF RURAL HEALTH FACILITATED THESE MEETINGS.AVERAGE ATTENDANCE AT THE COMMUNITY MEETINGS WAS 10-15 COMMUNITY MEMBERS. A LETTER AND E-VITES WERE SENT OUT TO COMMUNITY MEMBERS INVITING THEM TO BE PARTICIPANTS IN THE COMMUNITY MEETINGS. THE HOSPITAL MADE SIGNIFICANT EFFORTS TO REACH A DIVERSE AND REPRESENTATIVE POPULATION OF THE MEDICAL SERVICE AREA AND PATIENTS SERVED INCLUDING LOW INCOME AND RACIALLY DIVERSE POPULATIONS. REPRESENTATIVES FROM THE PUBLIC HEALTH SECTOR WERE INCLUDED TO PROVIDE INSIGHT INTO WHAT THEY SEE FROM A PUBLIC HEALTH AND UNDERSERVED POPULATION PERSPECTIVE OF COMMUNITY NEEDS.VARIOUS SOURCES OF HEALTH DATA WERE UTILIZED INCLUDING DATA FROM THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM THROUGH THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE, AND THE ROBERT WOODS JOHNSON FOUNDATION AND THE 2014 OKLAHOMA STATE OF THE STATE'S HEALTH REPORT COMPILED BY THE OKLAHOMA STATE DEPARTMENT OF HEALTH.PLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS A SURVEY WAS DESIGNED TO GAUGE HOSPITAL USAGE, SATISFACTION, AND COMMUNITY HEALTH NEEDS. THE SURVEY WAS AVAILABLE IN BOTH PAPER AND WEB FORMAT. THE ELECTRONIC SURVEY WAS SHARED WITH MEMBERS OF THE KINGFISHER COMMUNITY COLLABORATIVE WHO WERE ENCOURAGED TO PASS ALONG THE LINK. HARD COPY SURVEYS WERE MAILED TO RESIDENTS WITHIN THE MEDICAL SERVICE AREA ZIP CODES. A COPY OF THE SURVEY FORM AND RESULTS CAN BE FOUND IN APPENDIX C OF THE CHNA. COMMUNITY MEMBERS WERE ASKED TO RETURN THEIR COMPLETED SURVEYS TO MERCY HOSPITAL KINGFISHER.THE SURVEY RAN FROM MARCH 1 THROUGH MARCH 25, 2016. A TOTAL OF 86 SURVEYS FROM THE MERCY HOSPITAL KINGFISHER MEDICAL SERVICE AREA WERE COMPLETED. OF THE SURVEYS RETURNED, 65 WERE ELECTRONIC RESPONSES. THE SURVEY RESULTS WERE PRESENTED AT THE APRIL 11, 2016, COMMUNITY MEETING. COMMUNITY MEMBERS WERE INVITED TO PARTICIPATE THROUGH THEIR WORK WITHIN THE KINGFISHER COMMUNITY COLLABORATIVE. MERCY HOSPITAL KINGFISHER BOARD MEMBERS WERE INVITED TO ATTEND FROM HOSPITAL LEADERSHIP. COMMUNITY MEMBERS PRESENT REPRESENTED A CROSS SECTION OF THE COMMUNITY. THESE INDIVIDUALS WORK WITH DIVERSE POPULATIONS AND LOW-INCOME POPULATIONS, AND THEY PROVIDE GREAT INSIGHT INTO THE NEEDS OF THE COMMUNITY. REPRESENTATIVES FROM THE PUBLIC HEALTH SECTOR WERE INCLUDED TO PROVIDE INSIGHT INTO WHAT THEY SEE FROM A PUBLIC HEALTH AND UNDERSERVED POPULATION PERSPECTIVE OF COMMUNITY NEEDS.VARIOUS SOURCES OF HEALTH DATA WERE UTILIZED INCLUDING DATA FROM THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM THROUGH THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE, AND THE ROBERT WOODS JOHNSON FOUNDATION AND THE 2014 OKLAHOMA STATE OF THE STATE'S HEALTH REPORT COMPILED BY THE OKLAHOMA STATE DEPARTMENT OF HEALTH.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, IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL. |
| PART VI, LINE 4: | MERCY HOSPITAL KINGFISHER'S PRIMARY SERVICE AREA IS KINGFISHER COUNTY, OKLAHOMA. THE FOLLOWING INFORMATION IS DERIVED FROM 2016 SG2 ANALYTICS DATA AND SG2 INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 17,495. 35% OF THE POPULATION'S AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 43% OF THE POPULATION IS 45 AND OLDER. 20% OF THE HOUSEHOLDS IS ON MEDICARE, 10% ON MEDICAID, AND 11% 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 PROGRAM 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 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, 2017, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 4 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2017, MERCY HAD MORE THAN 9.6 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,100 EMPLOYED PHYSICIANS, AND APPROXIMATELY 40,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE FIFTH 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH FOUNDATION OF OKLAHOMA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 W MEMORIAL RD | AddressLine1Txt |
| City | OKLAHOMA CITY | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73120 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 454732301 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $12,383 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | 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 WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE NONPROFIT ORGANIZATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DIXSON MD JAMES D | ||||||||||||||
| PHYSICIAN & BOARD MEMBER | $0 | $352,780 | $0 | $133,768 | $0 | $87,466 | $0 | $42,753 | $0 | $11,847 | $0 | $628,614 | $0 | $0 |
| PINAROC LYNN | ||||||||||||||
| VP-FINANCE & BOARD MEMBER | $0 | $155,597 | $0 | $34,971 | $0 | $18,238 | $0 | $6,404 | $0 | $6,180 | $0 | $221,390 | $0 | $0 |
| ENLOE TRACY | ||||||||||||||
| CHIEF FINANCIAL OFFICER & BM | $0 | $165,758 | $0 | $38,939 | $0 | $18,275 | $0 | $14,347 | $0 | $16,065 | $0 | $253,384 | $0 | $0 |
| RAJU GARY | ||||||||||||||
| CHIEF FINANCIAL OFFICER-THRU 04/17 | $0 | $289,325 | $0 | $91,736 | $0 | $54,458 | $0 | $50,796 | $0 | $6,332 | $0 | $492,647 | $0 | $0 |
| SMALLEY DIANA L | ||||||||||||||
| PRESIDENT, WEST COMMUNITIES | $0 | $1,146,703 | $0 | $455,148 | $0 | $81,475 | $0 | $92,814 | $0 | $16,368 | $0 | $1,792,508 | $0 | $582,108 |
| GEBHART JIM R | ||||||||||||||
| PRESIDENT, MERCY HOSPITAL OKC | $0 | $428,057 | $0 | $230,908 | $0 | $25,166 | $0 | $217,565 | $0 | $16,327 | $0 | $918,023 | $0 | $0 |
| LE BICH-VI | ||||||||||||||
| REGIONAL VP-GENERAL COUNSEL | $0 | $203,999 | $0 | $63,021 | $0 | $23,653 | $0 | $41,711 | $0 | $16,400 | $0 | $348,784 | $0 | $0 |
| WILCOX DAVE M | ||||||||||||||
| PHYSICIAN ASSISTANT | $166,984 | $0 | $40 | $0 | $26,874 | $0 | $7,727 | $0 | $136 | $0 | $201,761 | $0 | $0 | $0 |
| VITIELLO JONATHAN | ||||||||||||||
| FORMER OFFICER | $0 | $452,764 | $0 | $255,091 | $0 | $55,121 | $0 | $91,167 | $0 | $16,653 | $0 | $870,796 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO AN EMPLOYEE OF A RELATED ORGANIZATION, GARY RAJU. 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, LINE 4B | PART I, LINE 4B: MERCY HEALTH, THE ULTIMATE PARENT COMPANY, 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 FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLANS. DIANA SMALLEY; JAMES DIXSON; JONATHAN VITIELLO; BICH-VI LE; JIM GEBHART THE AMOUNT REPORTED FOR DIANA SMALLEY IN COLUMN (F) IS INCLUDED IN COLUMN B (I) AS BASE COMPENSATION. THIS IS A PAYOUT OF THE SUPPLEMENTAL RETIREMENT PLAN AND WAS INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). |
| PART I, LINE 3 | MERCY HEALTH (PARENT COMPANY) IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THE FOLLOWING METHODS WERE USED BY MERCY HEALTH TO ESTABLISH COMPENSATION: -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KAYLA VOTH | |||
| FAMILY MEMBER OF BOARD MEMBER (JOE VOTH) | $70,060 | EMPLOYMENT | 0 |
| CARMEN MCALEXANDER | |||
| FAMILY MEMBER OF BOARD MEMBER (BRENDA WALTA) | $59,357 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 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, INCLUDING THE MANAGER OF ACCOUNTING 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' 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, 2017. 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 15 | 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 -781,584. ROUNDING 1. |
| 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 2017 (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, LINE 3 | SINGLE AUDIT ACT AND OMB CIRCULAR A-133 MERCY HEALTH UNDERGOES A CONSOLIDATED A-133 AUDIT EVERY YEAR AND DID SO FOR THE FISCAL YEAR ENDING JUNE 30, 2017. 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, 2017, WAS INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, WAS ALSO INCLUDED IN THE POPULATION AVAILABLE FOR 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 B AND C. |
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (73 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 | |||||||||||
| 1602 MCCLELLAND STREET | LAREDO | TX | 78044 | 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 | MO | 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 EAST COMMUNITIES - SR | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 461412322 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | 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 HOT SPRINGS | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 710804718 | FOUNDATION | AR | 501C3 | 11-II | MISSION CLINICAL SERVICES | Yes (1) | |
| MERCY HEALTH FOUNDATION INDEPENDENCE | |||||||||||
| 800 W MYRTLE | INDEPENDENCE | KS | 67301 | 481079981 | FOUNDATION; DISSOLVED 6/30/17 | KS | 501C3 | 11-I | MERCY KANSAS COMMUNITIES INC | Yes (1) | |
| MERCY HEALTH FOUNDATION JEFFERSON | |||||||||||
| 1400 US HIGHWAY 61 SOUTH | FESTUS | MO | 63028 | 462797051 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES - SR | 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 ADA INC | |||||||||||
| 430 N MONTE VISTA STREET | ADA | OK | 74820 | 462288155 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 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 SPRINGFIELD COMM | 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 | 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 - SR | 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 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) | |
| ST ANTHONY'S CHARITABLE FOUNDATION | |||||||||||
| 10010 KENNERLY ROAD | ST LOUIS | MO | 63128 | 261516789 | FOUNDATION | MO | 501C3 | 11-II | ST ANTHONY'S MEDICAL CENTER | Yes (1) | |
| ST ANTHONY'S MEDICAL CENTER | |||||||||||
| 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 | ST ANTHONY'S MEDICAL CENTER | 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) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 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 | ST ANTHONY'S MEDICAL CENTER | N/A | 0 | 0 |
| RESOURCE OPTIMIZ & INNOVLLC | ||||||||||
| 645 MARYVILLE CTR DRSTE 200 | ST LOUIS | MO | 63141 | 460468368 | CENTRAL DISTRIBUTION CENTER | MO | MHN INC - MHNSR INC | 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 |
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 |
|---|---|---|---|---|---|---|---|---|---|
| MERCY COMM SERVICES INC | |||||||||
| 401 WOODLAND HILLS BLVD | FORT SCOTT | KS | 66701 | 481078101 | RETAIL PHARMACY | KS | MERCY KANSAS COMM INC | C | 0 |
| 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 | 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 | 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 | ST ANTHONY'S MEDICAL CENTER | C | 0 |
| 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 (13 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MERCY HEALTH FOUNDATION OF OKLAHOMA | ||
| B | $12,383 | FMV |
| MERCY HEALTH FOUNDATION OF OKLAHOMA | ||
| C | $4,321 | FMV |
| MERCY ACO CLINICAL SERVICES INC | ||
| Q | $78,186 | FMV |
| MERCY CLINIC OKLAHOMA COMMUNITIES INC | ||
| Q | $112,271 | FMV |
| MERCY HEALTH OKLAHOMA COMMUNITIES INC | ||
| Q | $278,275 | FMV |
| MERCY HOSPITAL OKLAHOMA CITY INC | ||
| P | $354,742 | FMV |
| MERCY HOSPITAL WATONGA INC | ||
| P | $71,868 | FMV |
| MHM SUPPORT SERVICES | ||
| Q | $4,326,042 | FMV |
| RESOURCE OPTIMIZATION & INNOVATION LLC | ||
| P | $111,413 | FMV |
| (no name) | ||
| FMV | ||
| (no name) | ||
| FMV | ||
| (no name) | ||
| FMV | ||
| (no name) | ||
| FMV | ||