2017-05-12T18:21:39-05:00 2016-06-30 ERNST & YOUNG US LLP 1900 SCRIPPS CENTER 312 WALNUT ST CINCINNATI OH 45202 990 2015-07-01 453808607 MERCY HOSPITAL CARTHAGE % SHELLY HUNTER CFO MERC 3145796100 3125 Dr Russell Smith Way Carthage MO 64836 SCOTT REYNOLDS CFO 2017-05-12 true JULIE L SPARKS P01268401 5136121400 2015 2021-01-29 14:40:06Z GARY PULSIPHER 3125 DR RUSSELL SMITH WAY CARTHAGE MO 64836 51017427 false 0928 X www.mercy.net X 2011 MO AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 9 7 0 76 85331 47121 1649560 245000 40188519 50556692 0 -5547 247148 226829 42085227 51022974 2288 0 0 0 16185547 20514603 0 0 0 29535911 27466949 45723746 47981552 -3638519 3041422 48061732 52470421 54081005 19985508 -6019273 32484913 AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 34765770 0 50142001 MERCY HOSPITAL CARTHAGES IN-PATIENT BEDS REMAINS AT 25; SAME AS LAST YEAR. THE HOSPITAL SERVICES INCLUDE ACUTE/SKILLED CARE, SURGICAL SERVICES, 24 HOUR EMERGENCY ROOM CARE, LABORATORY SERVICES, IMAGING SERVICES, PHYSICAL THERAPY, RESPIRATORY THERAPY, AND VISITING SPECIALTY PHYSICIANS. THE COMMUNITY NEED IS REPRESENTED BY 814 DISCHARGES, 16,882 EMERGENCY ROOM VISITS, 808 SURGERIES AND 87,816 OUTPATIENT VISITS. MERCY MCCUNE-BROOKS HOSPITAL HAS 6 OUTSTANDING PHYSICIANS PRACTICING IN THE CARTHAGE AREA. PHYSICIAN SERVICES ARE ESSENTIAL TO THE HEALTH AND WELL-BEING OF ANY COMMUNITY. THIS GROUP INCLUDES OBGYN PHYSICIANS, FAMILY PRACTICE AND PEDIATRICIANS. 357846 0 414691 MERCY HOSPITAL CARTHAGE OFFERS A HOME HEALTH PROGRAM. THIS PROGRAM HELPS TRANSITION PATIENTS FROM THE HOSPITAL TO THE HOME. SERVICES INCLUDE WOUND CARE, PERSONAL CARE, INJECTIONS, SPEECH THERAPY, TERMINAL CARE, ONCOLOGY NURSING CARE, REHABILITATION NURSING, IV THERAPY, PHYSICIAN THERAPY, BLOOD PRESSURE MONITORING AND EDUCATION AND CARE FOR DIABETES. 35123616 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 0 0 0 true true false false false false false false false false false X 9 7 false false false false true true true true true false false true true true true true true false false false X SHELLY HUNTER CFO 4175562459 100 MERCY WAY JOPLIN MO 64804 X Crandall Douglas Board member 1.0 0.0 X 0 0 0 Crusa Jack Board member 1.0 1.0 X 0 0 0 Desalvo RSM Sr Anita Board member 1.0 0.0 X 0 0 0 Keisler MD Lydia Physician & Board member 5.0 55.0 X 0 428966 7383 Kennedy Rick Board member 1.0 0.0 X 0 0 0 Petersen Ronald Board member 1.0 0.0 X 0 0 0 Roderique Cheryl Board member 1.0 0.0 X 0 0 0 Schaeffer Bonnie Board member 1.0 0.0 X 0 0 0 Pulsipher Gary W CEO & BOARD MEMBER 5.0 55.0 X X 0 589317 206562 Hunter Shelly Chief financial officer 5.0 55.0 X 0 275753 50257 Reynolds Scott CFO-Central Communities 1.0 59.0 X 0 465895 104383 Burke James Regional VP-Legal 1.0 59.0 X 0 359195 61541 Hennessey III William Regional VP-Marketing 5.0 55.0 X 0 252013 71756 Marion Tanya Regional VP-Human Resources 2.0 58.0 X 0 281923 57609 Swope Jon President, Central Communities 1.0 59.0 X 0 1230428 172840 Watson Robert S Administrator 30.0 30.0 X 0 260847 29677 Crissinger William M Pharmacist 60.0 0.0 X 109327 0 18438 Oberzan Michael J Manager, pharmacy services 60.0 0.0 X 164915 0 17270 Olvera Rhonda J Nurse practitioner 60.0 0.0 X 140593 0 14988 Winemiller Mark A Pharmacist 60.0 0.0 X 109268 0 8237 Copeland Jr Robert Former officer 0.0 0.0 X 0 350142 16712 524103 4494479 837653 4 true true false GE Healthcare 3000 N Grandview Blvd WAUKESHA WI 53188 Construction 2181640 PREMIER SPECIALTY NETWORK 3610 BUTTONWOOD DRIVE SUITE 200 COLUMBIA MO 65201 Physician staffing 1253861 DeWitt and Associates PO Box 3378 GS SPRINGFIELD MO 65808 Construction 620716 NUCLEAR DIAGNOSIS INC 19600 E 39TH STREET INDEPENDENCE MO 64057 MISC CONTRACT SVCS 298586 ULTRASOUND SERV INC 21275 Kettle Rd WEBB CITY MO 64870 Radiology services 220995 9 0 245000 0 245000 NET PATIENT SERVICE REVENUE 621110 48664129 48578798 85331 OTHER OPERATING REVENUE 900099 1892563 1892563 0 0 50556692 0 0 0 10993 10993 0 10993 10993 -5547 5547 -5547 -5547 0 0 0 CAFE & VENDING 722514 215836 215836 215836 51022974 50471361 85331 221282 0 0 0 0 0 0 16619419 15188835 1430584 678182 619805 58377 2257253 2062951 194302 959749 877135 82614 0 0 0 13807 13807 0 0 3266537 2970403 296134 333 333 1012003 468254 543749 118552 36538 82014 0 816118 231848 584270 44810 42403 2407 0 0 2700176 2700176 0 3703115 748782 2954333 514351 280520 233831 DRUGS & MEDICAL EXPENSES 7700315 7680033 20282 SHARED SERVICE FEES 3652724 265450 3387274 BAD DEBT 3598044 3598044 REPAIRS & MAINTENANCE 169787 29268 140519 156277 23014 133263 47981552 35123616 12857936 0 1068169 1124057 0 0 0 0 5893409 4720465 0 0 0 0 0 0 1096857 1094585 465695 66081 58917708 16039663 35516630 42878045 0 0 0 0 0 0 0 0 4020972 2587188 48061732 52470421 12347965 1050023 0 0 0 0 0 0 0 0 0 0 41733040 0 0 0 0 18935485 54081005 19985508 X -6446932 32307254 427659 177659 0 0 -6019273 32484913 48061732 52470421 X 3041422 0 0 0 0 35462764 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 13807 13807 false FORM 990, SCHEDULE C, PART II-B, LINE 1(I) SUPPLEMENTAL LOBBYING INFORMATION THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: CATHOLIC HEALTH ASSOCIATION, MISSOURI HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2016, DUES WERE $8,366, $31,107 AND $10,615. APPROXIMATELY 3.11% OF CATHOLIC HEALTH ASSOCIATION DUES, 36.0% OF MISSOURI HOSPITAL ASSOCIATION DUES AND 22.12% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THIS ASSOCIATION. 2108000 2108000 46984204 11706380 35277824 10096 6108 3988 9351547 4270280 5081267 463861 56895 406966 42878045 0 DUE TO AFFILIATES 18935485 18935485 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE Primarily all of the Mercy Health entities are recognized by the Internal Revenue Service (IRS) as exempt from federal income tax under Section 501(a) of the Internal Revenue Code as charitable organizations qualifying under Internal Revenue Code Section 501(c)(3), by virtue of IRS determination letters or inclusion in the Official Catholic Directory. Mercy completed an analysis of its tax positions in accordance with applicable accounting guidance and determined that no amounts were required to be recognized on the consolidated financial statements at June 30, 2016 or 2015. true true X true X true X true true true false true true 2573101 2573101 0.05800 9223650 8513995 709655 0.01600 11796751 8513995 3282756 0.07400 11796751 8513995 3282756 0.07400 true 1659983 17640741 17657847 -17106 X true true 1 1 MERCY HOSPITAL CARTHAGE 3125 DR RUSSELL SMITH WAY CARTHAGE MO 64836 www.mercy.net 523-2 X X X X MERCY HOSPITAL CARTHAGE 1 false false true X X X X X X X X X 15 true true true true X WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS X www.ozarkshealthcommission.org/joplin X true 15 true WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS false false true X 100 400. X true true X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X true X false false FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 IN EARLY 2015, A VARIETY OF ORGANIZATIONS ACROSS THE OZARKS CAME TOGETHER TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS THEY SERVE. UNDER THE UMBRELLA OF THE LOCAL OZARKS HEALTH COMMISSION, THIS FIRST-TIME COLLABORATION IS THE LARGEST IN THE REGION SPANNING FOUR STATES - MISSOURI, OKLAHOMA, ARKANSAS AND KANSAS - 51 COUNTIES AND FOUR HOSPITAL SYSTEMS. THE WORKING GROUP SAW THE VALUE OF USING A SYSTEMATIC, DATA-DRIVEN ASSESSMENT TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS ON A REGIONAL LEVEL. THIS LARGER, CONCERTED APPROACH WILL LEVERAGE COMMON STRENGTHS AND STRATEGIES TO MOVE IN THE SAME DIRECTION ON SIGNIFICANT HEALTH CONCERNS. THE FOLLOWING GROUPS TOOK PART IN SOME PHASE OF THE WORK THAT GENERATED JOPLINS COMMUNITY HEALTH NEEDS ASSESSMENT: (THE JOPLIN COMMUNITY CONSISTS OF JOPLIN, MO., CARTHAGE, MO., AND COLUMBUS, KS.) - MERCY COWORKERS WHO SERVED ON TEAMS, ORGANIZED ROUNDTABLES AND DEVELOPED PROGRAMS TO RESPOND TO IDENTIFIED NEEDS. - MERCY HOSPITAL CARTHAGE BOARD OF TRUSTEES, AND ITS COMMUNITY BENEFIT SUBCOMMITTEE, WHO REVIEWED AND APPROVED THE PROPOSED INITIATIVES. - THE OZARKS HEALTH COMMISSION, WHICH CONSISTS OF: BURRELL BEHAVIORAL HEALTH, CITIZENS MEMORIAL HEALTHCARE, COXHEALTH, FREEMAN HEALTH SYSTEM, JASPER COUNTY HEALTH DEPT., CARTHAGE HEALTH DEPT., MERCY, POLK COUNTY HEALTH CENTER, SPRINGFIELD-GREENE COUNTY HEALTH DEPT., AND THE TANEY COUNTY HEALTH DEPT. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A THE CHNA WAS CONDUCTED IN CONJUNCTION WITH THE FOLLOWING HOSPITAL FACILITIES: BURRELL BEHAVIORAL HEALTH, CITIZENS MEMORIAL HEALTHCARE, COXHEALTH, AND FREEMAN HEALTH SYSTEM. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6B THE CHNA WAS CONDUCTED IN CONJUNCTION WITH THE FOLLOWING NON-HOSPITAL FACILITIES: BURRELL BEHAVIORAL HEALTH, JASPER COUNTY HEALTH DEPARTMENT, JOPLIN HEALTH DEPARTMENT, POLK COUNTY HEALTH CENTER, SPRINGFIELD-GREEN COUNTY HEALTH DEPARTMENT AND TANEY COUNTY HEALTH DEPARTMENT. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 MERCY CARTHAGE IDENTIFIED THE HEALTH NEEDS ESTABLISHED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND DETERMINED THAT IT WAS BEST TO ENGAGE IN PROGRAMS AND PARTNERSHIPS THAT ALREADY EXIST. THOSE PROGRAMS INVOLVE MEETING THE NEEDS OF OUR COMMUNITY WITH DIABETES THAT LACK ACCESS TO HEALTH CARE THROUGH SCHOOL BASED HEALTH CLINICS AND PROVIDING HEALTH CARE NEEDS FOR WOMEN, SPECIFICALLY TEEN PREGNANCY. DURING THIS CYCLE OF THE COMMUNITY HEALTH IMPROVEMENT PLAN, MERCY CARTHAGE WILL NOT BE ADDRESSING THE FOLLOWING IDENTIFIED HEALTH NEEDS: - CARDIOVASCULAR DISEASE: CARDIOVASCULAR DISEASE IS AN IDENTIFIED NEED IN OUR COMMUNITY, BUT THERE ARE MANY FACTORS RELATED TO THIS DISEASE THAT WILL BE ADDRESSED THOUGH COMMUNITY COLLABORATIONS. MERCY CARTHAGE REPRESENTATIVES ARE ACTIVELY ENGAGED IN COMMUNITY COLLABORATIONS THAT PROMOTE HEALTHIER LIFESTYLES TO FIGHT THIS DISEASE. ADDITIONALLY, THIS DISEASE WILL NOT BE RESOLVED AS QUICKLY AS OTHER HEALTH NEEDS THAT ARE CURRENTLY IDENTIFIED IN THIS CHIP. - LUNG DISEASE: LUNG DISEASE IS OUR SECOND HIGHEST IDENTIFIED HEALTH NEED IN OUR COMMUNITY, BUT THERE ARE MANY FACTORS RELATED TO THIS DISEASE THAT WILL BE ADDRESSED THOUGH COMMUNITY COLLABORATIONS. MERCY CARTHAGE REPRESENTATIVES ARE ACTIVELY ENGAGED IN COMMUNITY COLLABORATIONS THAT PROMOTE A TOBACCO FREE LIFESTYLE TO FIGHT THIS DISEASE. ADDITIONALLY, THIS DISEASE WILL NOT BE RESOLVED AS QUICKLY AS OTHER HEALTH NEEDS THAT ARE CURRENTLY IDENTIFIED IN THIS CHIP. - MENTAL HEALTH: MENTAL HEALTH IS OUR THIRD HIGHEST IDENTIFIED HEALTH NEED IN OUR COMMUNITY, DETERMINED BY OUR CHNA, BUT THERE ARE MANY FACTORS RELATED TO THIS HEALTH PROBLEM THAT WILL BE ADDRESSED THOUGH COMMUNITY COLLABORATIONS. MERCY CARTHAGE REPRESENTATIVES ARE ACTIVELY ENGAGED IN COMMUNITY COLLABORATIONS, SUCH AS THE COMMUNITY HEALTH COALITION, THAT WILL BE ADDRESSING THIS HEALTH NEED IN CURRENT PROJECTS AND IMPLEMENTATION STRATEGIES. ADDITIONALLY, THIS HEALTH ISSUE WILL NOT BE RESOLVED AS QUICKLY AS OTHER HEALTH NEEDS THAT ARE CURRENTLY IDENTIFIED IN THIS CHIP. - CANCER: CANCER IS A SIGNIFICANT HEALTH NEED IN OUR COMMUNITY, BUT THERE ARE MANY FACTORS RELATED TO THIS DISEASE THAT WILL BE ADDRESSED THOUGH OUR LOCAL HOSPITAL ONCOLOGY DEPARTMENTS AND COMMUNITY COLLABORATIONS. MERCY CARTHAGE REPRESENTATIVES ARE ACTIVELY ENGAGED IN COMMUNITY COLLABORATIONS THAT PROMOTE HEALTHIER LIFESTYLES THAT EFFECT THE VARIOUS DISEASES OF CANCER. MERCY COLUMBUS' MOBILE MAMMOGRAPHY UNIT WILL CONTINUE TO PROVIDE SCREENINGS IN THE CARTHAGE COMMUNITY AND LOOK TO NEW OPPORTUNITIES TO REACH THOSE THAT ARE UNDERSERVED OR UNDERINSURED. ADDITIONALLY, THIS DISEASE WILL NOT BE RESOLVED AS QUICKLY AS OTHER HEALTH NEEDS THAT ARE CURRENTLY IDENTIFIED IN THIS CHIP. PART 990, SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT HTTPS://WWW.MERCY.NET/MERCY-FINANCIAL-ASSISTANCE. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 22 ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTS THE FEDERAL POVERTY GUIDELINES FOR INCOME ARE THE BASIS FOR DETERMINING ELIGIBILITY FOR CHARITY CARE DISCOUNTS. FOR EXAMPLE, INDIVIDUALS WITH INCOMES BELOW 100% OF THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 100% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS. THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS. 5 MERCY PHYSICIANS FOR WOMEN'S HEALTH 1515 HAZEL AVENUE CARTHAGE MO 64836 PHYSICIAN CLINIC/PRACTICE MERCY - DR JON HAFFNER 3116 MEDICAL PARK DRIVE CARTHAGE MO 64836 PHYSICIAN CLINIC/PRACTICE MERCY CARTHAGE PEDIATRICS 1911 BUENA VISTA CARTHAGE MO 64836 PRIMARY CARE SMALL MERCY 3114 MEDICAL PARK DRIVE CARTHAGE MO 64836 OTHER (CARDIOLOGY AND NEUROLOGY) MERCY PRIMARY CARE 1515 HAZEL AVE CARTHAGE MO 64836 PRIMARY CARE SMALL FORM 990, SCHEDULE H, PART I, LINE 6A THE ORGANIZATIONS COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $47,981,552. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $3,598,044. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $44,383,508. FORM 990, SCHEDULE H, PART I, LINE 7G THE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINIC COSTS ON LINE 7G. FORM 990, SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES ADDRESS ROOT CAUSES OF HEALTH RELATED PROBLEMS. MULTIDISCIPLINARY COMMUNITY PARTNERSHIPS AND COLLABORATION ADDRESS SYSTEMIC MALFUNCTION AND ROOT CAUSES OF ISSUES LIKE POVERTY, VIOLENCE AND HOMELESSNESS AMONG OTHERS. THEY STRENGTHEN THE COMMUNITYS ABILITY TO PROMOTE HEALTH AND WELL-BEING. IN THE CARTHAGE COMMUNITY, MERCY HAS A WIDE RANGE OF EXPERTISE TO BRING TO THE TABLE AS EACH COMMUNITY TACKLES THESE SYSTEMIC CHALLENGES. ONE EXAMPLE OF THIS COLLABORATION IS WORKING WITH LIFECHOICE TO PROVIDE BETTER CARE FOR WOMEN'S SERVICES. MERCY CARTHAGE CONTINUES TO PROVIDE VOLUNTEERS TO AID IN THE SUCCESS OF THIS PROGRAM. THE CARTHAGE COMMUNITY HAS NOTABLE POVERTY RATES AND HIGH NUMBERS OF CHILDREN WITH REDUCED OR FREE LUNCHES IN OUR SCHOOLS. PAST COMMUNITY NEED DISCUSSIONS CONFIRMED REPEATEDLY THAT A HEALTHY COMMUNITY SUPPORTS WELL BEING OF RESIDENTS. LIKEWISE, ACCESS TO A FAIR FAMILY WAGE AFFORDS FAMILIES OPPORTUNITIES TO GAIN EDUCATION THAT IN TURN HAS SHOWN TO LEAD TO LEVERAGING HEALTH OPPORTUNITIES. SOLID INFRASTRUCTURE AND A STABLE ECONOMY SET A CONTEXT FOR CITIZENS TO REACH POTENTIAL AND IN TURN CONTRIBUTE TO SOCIETY FOR FUTURE GENERATIONS. COMMUNITY BUILDING ACTIVITY NEEDS TO BE A PRIORITY FOR THIS COMMUNITY. FORM 990, SCHEDULE H, PART III, SECTION A, LINE 2 TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNTING, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. FORM 990, SCHEDULE H, PART III, SECTION A, LINE 3 THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE. FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4 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 SYSTEMS CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES." FORM 990, SCHEDULE H, PART III, SECTION B, LINE 8 IT IS THE POSITION OF MERCY THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B MERCYS COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE COMMUNICATION AND/OR REVIEW OF PATIENT ACCOUNTS AS IT RELATES TO ANY SERVICE PROVIDED AT OUR FACILITIES BEFORE TURNING THE ACCOUNT TO BAD DEBT OR TAKING LEGAL ACTION FOR NONPAYMENT. MERCY ACTIVELY SCRUBS ACCOUNTS FOR PAYOR PLAN COVERAGE, INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS. MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY. MERCY WILL GRANT CHARITY IN SITUATIONS WHERE THERE HAS BEEN AN INABILITY TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION WHEN A PATIENT HAS SUBMITTED AN APPLICATION. IN ADDITION, MERCY UTILIZES THE SAME TOOL TO QUALIFY ACCOUNTS PER THE PRACTICE OF PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR BALANCES IN EXCESS OF $6,500. ALL ACCOUNT BALANCES RELATING TO ACCOUNTS IDENTIFIED BY THE HIGHER BALANCES WILL BE CONSIDERED AND FLAGGED FOR CHARITY IF THERE IS AN INABILITY TO PAY AFTER A RETURN FROM THE COLLECTION AGENCY AT APPROXIMATELY 120 DAYS. MERCY WILL PURSUE APPROPRIATE MEANS IN THE COLLECTION OF DELINQUENT ACCOUNTS FROM PATIENTS WITH AN ESTABLISHED ABILITY TO PAY OR AN UNWILLINGNESS TO COOPERATE IN VALIDATING ELIGIBILITY FOR FINANCIAL ASSISTANCE. THESE APPROPRIATE MEANS MAY INCLUDE LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES AFTER A SENDING 3 MONTHLY STATEMENTS WITH THE FINAL INCLUDING NOTIFICATION; IF NO RESOLUTION THEY WILL BE TURNED TO COLLECTIONS. ADDITIONALLY, THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENTS, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENSURE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEW COMPLIANCE WITH POLICIES BUT ENSURE 120 DAYS OF BILLING AND COLLECTIONS OCCURS PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED. FORM 990, SCHEDULE H, PART VI, LINE 2 IN ADDITION TO OUR COLLABORATION WITH THE OZARKS HEALTH COMMISSION FOR OUR RECENT CHNA, MERCY CARTHAGE CONTINUES TO PLAY AN INTEGRAL PART IN THE LOCAL COMMUNITY HEALTH COLLABORATIVE, TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. MERCY CARTHAGE ALSO EXAMINES THE CURRENT HEALTH NEEDS AND COMPARES THEM TO RECENT HOSPITAL PATIENT VISIT DATA IN THE EMERGENCY DEPARTMENT, AND COUNTY HEALTH RANKINGS. NEXT, A REPRESENTATIVE FROM MERCY CARTHAGE SERVES ON A COMMUNITY BENEFIT SUB-COMMITTEE (ROUNDTABLE DISCUSSIONS) IN AN EFFORT TO GAIN INPUT FROM COMMUNITY MEMBERS. WE THEN ANALYZE THE CURRENT DATA TO PRIORITIZE NEW OR EXISTING NEEDS, REVIEW CURRENT ACTIVITIES IN PLACE, AND THEN END WITH CREATING AN ACTION PLAN IN COLLABORATION WITH THE COMMUNITY. FORM 990, SCHEDULE H, PART VI, LINE 3 MERCY INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNTS IS PLACED FOR REVIEW. IN ADDITION, 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. FORM 990, SCHEDULE H, PART VI, LINE 4 MERCY HOSPITAL CARTHAGE'S PRIMARY SERVICE AREAS ARE JASPER AND NEWTON COUNTIES IN MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM 2016 Sg2 ANALYTICS DATA AND Sg2 INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 176,240. 24% OF THE POPULATIONS AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 41% OF THE POPULATION IS 45 AND OLDER. 24% OF HOUSEHOLDS ARE ON MEDICARE, 19% ON MEDICAID, AND 11% UNINSURED. FORM 990, SCHEDULE H, PART VI, LINE 5 TO CONTINUE PROMOTING COMMUNITY HEALTH, MERCY CARTHAGE COLLABORATES WITH COMMUNITY LEADERS INVOLVED IN IDENTIFYING COMMUNITY HEALTH NEEDS TO RESOLVE LOCAL HEALTH CHALLENGES. OUR EFFORTS IN COMMUNITY BENEFIT FOCUS ON IMPLEMENTING PROGRAMS TO TACKLE UNHEALTHY BEHAVIORS RESULTING IN IMPROVED HEALTH STATUS. SOME PROGRAMS WERE ACCOMPLISHED IN PARTNERSHIP WITH OTHERS, WHILE WE SELECTED SPECIFICALLY BECAUSE MERCY HOSPITAL CARTHAGE HAD AN EXPERTISE TO OFFER, AND THE CLINICAL ABILITY TO MANAGE THE NATURE OF ITS OPERATION. MERCY HOSPITAL CARTHAGE HAS PARTICULAR CONCERN FOR THE VULNERABLE AND UNDERSERVED. OUR MISSION IS TO DELIVER "COMPASSIONATE CARE AND EXCEPTIONAL SERVICE" TO EVERY COMMUNITY MEMBER. IN DEDICATION TO THIS MISSION, MERCY HAS BEEN AN INITIAL PARTNER WITH THE COMMUNITY HEALTH COLLABORATIVE TO CREATE A SHARED ENVIRONMENT IN WHICH THE COMMUNITY CAN FLOURISH. THE TARGET AREAS OF THIS COLLABORATION ARE PHYSICAL/MENTAL HEALTH AND HUMAN SERVICES. COMMUNITY LEADERS MEET ON A REGULAR BASIS TO ASSESS, IDENTIFY, AND EVALUATE PROGRAMS THAT MEET THE NEEDS OF THE UNDERSERVED POPULATION. IT IS OUR HOPE THAT THE WORK THAT IS ACCOMPLISHED THROUGH THESE COLLABORATIONS, WILL LEAD TO BETTER HEALTH AND HUMAN SERVICES FOR THE CARTHAGE COMMUNITY. FORM 990, SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE FILING ORGANIZATION IS PART OF MERCY HEALTH ("MERCY"). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS ("MINISTRY OFFICE") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2016, MERCY FACILITIES INCLUDED 33 ACUTE CARE HOSPITALS, 3 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2016, MERCY HAD MORE THAN 9.2 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 TREASURY, INFORMATION TECHNOLOGY, CLINICAL QUALITY MANAGEMENT, LEGAL AND COMPLIANCE COUNSEL, COMPENSATION AND BENEFITS, CONSULTING, PERFORMANCE MANAGEMENT, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTING AND REPORTING, CAPITAL MANAGEMENT, CLINICAL ENGINEERING, AND CLINICAL SAFETY. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. FORM 990, SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: MISSOURI. X true true true true false false false false false false false Keisler MD Lydia Physician & Board member 0 371976 0 0 0 56990 0 1170 0 6213 0 436349 0 0 Pulsipher Gary W CEO & BOARD MEMBER 0 385012 0 167797 0 36508 0 189632 0 16930 0 795879 0 0 Hunter Shelly Chief financial officer 0 199677 0 47978 0 28098 0 38849 0 11408 0 326010 0 0 Reynolds Scott CFO-Central Communities 0 317099 0 93883 0 54913 0 89876 0 14507 0 570278 0 0 Burke James Regional VP-Legal 0 245591 0 92752 0 20852 0 43214 0 18327 0 420736 0 0 Hennessey III William Regional VP-Marketing 0 150078 0 51998 0 49937 0 54955 0 16801 0 323769 0 0 Marion Tanya Regional VP-Human Resources 0 185233 0 59500 0 37190 0 39676 0 17933 0 339532 0 0 Swope Jon President, Central Communities 0 651753 0 524380 0 54295 0 153276 0 19564 0 1403268 0 0 Watson Robert S Administrator 0 189993 0 33403 0 37451 0 11919 0 17758 0 290524 0 0 Oberzan Michael J Manager, pharmacy services 130764 0 8669 0 25482 0 10068 0 7202 0 182185 0 0 0 Olvera Rhonda J Nurse practitioner 86291 0 22552 0 31750 0 3947 0 11041 0 155581 0 0 0 Copeland Jr Robert Former officer 0 97820 0 38302 0 214020 0 9100 0 7612 0 366854 0 0 FORM 990, SCHEDULE J, PART I, LINE 1 CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HOSPITAL CARTHAGE RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR 2015: Robert Copeland, $163,266. FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY OFFERS SUPPLEMENTAL RETIREMENT PLANS TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON VESTING DATE BASED ON COMPENSATION, AGE AT THE TIME OF BENEFIT COMMENCEMENT, LENGTH OF SERVICE WITH THE COMPANY AND/OR ITS AFFILIATES, AND LENGTH OF TENURE IN THE PLAN. THE PLANS ARE CLOSED TO NEW ENTRANTS. THE INDIVIDUALS REPORTABLE ON THIS RETURN WHO PARTICIPATE IN THE SUPPLEMENTAL RETIREMENT PLANS INCLUDE: GARY PULSIPHER, SHELLY HUNTER, JAMES BURKE, TANYA MARION, WILLIAM HENNESSEY III, AND JON SWOPE. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). FORM 990, PART V, QUESTION 1A FORM 1099/1096 FILING VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART V, QUESTION 2A W-3 FILING MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3S) WAS REPORTED UNDER THE RELATED ORGANIZATION, MHM SERVICES, EIN 20-2553101. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY TO THE CORPORATE MEMBER: -TO APPROVE THE MISSION AND ESTABLISH THE 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; -TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD; -THROUGH THE SOLE ACTION OF THE PRESIDENT OF MH, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER WHO SHALL SERVE AS PRESIDENT OF THE CORPORATION; -TO APPROVE OR AMEND THE STRATEGIC, LONG RANGE, AND HEALTH MANPOWER DEVELOPMENT PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION; -TO APPROVE OR AMEND THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; -TO ASSIGN, TRANSFER, LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION; -TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION; -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION; AND, -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE DIRECTOR OF 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' FORMS 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2016. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S BUSINESS RISK (INTERNAL AUDIT) 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 (FORMERLY FINANCE, AUDIT AND COMPLIANCE COMMITTEE) OF THE BOARD OF DIRECTORS. FORM 990, PART VI, QUESTIONS 15A & 15B OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, MERCY HEALTH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, PART VI, QUESTION 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART VII, SECTION A, COLUMN B AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII ARE 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 OTHER CHANGES IN NET ASSETS TRANSFERS TO/FROM AFFILIATES - $35,462,764 FORM 990, PART XII, QUESTION 2C AUDIT OF FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2016 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE (FORMERLY FINANCE, AUDIT, AND COMPLIANCE COMMITTEE) OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 SHELTER TX 501c3 7 MM LAREDO true Jefferson Land Company Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431330360 HOLDING CO MO 501c2 N/A MH JFFRSON true McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 PORT MGMT MO 501c3 11b Mercy Health true Mercy ACO Clinical Services Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 464504901 VIRTUAL CARE MO 501c3 3 Mercy Health true Mercy Clinic East Communities 645 Maryville Center Drive Suite 1 St Louis MO 63141 431771217 PHYS GROUP MO 501c3 9 MH EAST COMM true Mercy Clinic Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72903 261318597 PHYS CLINIC AR 501c3 3 MH FS COMM true Mercy Clinic Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 270473057 PHYS GROUP OK 501c3 3 MH OK COMM true Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 PHYS GROUP MO 501c3 3 MH SF COMM true Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 COUNSELING MO 501c3 7 Mercy Health true Mercy Health Foundation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 11b Mercy Health true Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 CORP OFFICE MO 501c3 1 NA false Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 HLTH SYSTEM MO 501c3 11b Mercy Health true Mercy Health East Communities - Southern 14528 S Outer Forty Ste 100 Chesterfield MO 63017 461412322 HLTH SYSTEM MO 501c3 11b MH EAST COMM true Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 HOLDING CO AR 501c3 11b Mercy Health true Mercy Health Foundation Ada 430 N Monte Vista Street Ada OK 74820 463596274 Foundation OK 501c3 11a MH ADA INC true Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 11a MH ARDMORE true Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 11a MH FT SMITH true Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 11c M KS COMM true Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501c3 11b MC SRVCS true Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501c3 11a M ST FRANCIS true Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 Foundation MO 501c3 11b MH E COMM SR true Mercy Health Foundation Joplin 100 Mercy Way Joplin MO 64804 270906136 Foundation MO 501c3 11a MH SWMK COMM true Mercy Health Foundation Lincoln 1000 East Cherry Street Troy MO 63379 811477159 Foundation MO 501c3 11b MH EAST COMM true Mercy Health Foundation NW Arkansas 2710 Rife Medical Lane Rogers AR 72758 710601687 Foundation AR 501c3 11c MH ROGERS true Mercy Health Foundation of Oklahoma 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 11a MH OK COMM true Mercy Health Foundation Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 463184231 Foundation OK 501c3 11a MH OK COMM true Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 11b MH SF COMM true Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 Foundation MO 501c3 11b MH EAST COMM true Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 11b MH EAST COMM true Mercy Health NW Arkansas Communities 2710 Rife Medical Lane Rogers AR 72758 621684203 PHYS GROUP AR 501c3 9 Mercy Health true Mercy Health Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 731453048 HLTH SYSTEM OK 501c3 11b Mercy Health true Mercy Health Plans of Missouri Inc 3265 S National Avenue Springfield MO 65807 320481419 HMO MO 501c4 N/A Mercy Health true Mercy Health Plans Inc 3265 S National Avenue Springfield MO 65807 320486150 PPO MO 501c4 N/A MH PLANS MO true Mercy Health Southwest MOKS Communities 100 Mercy Way Joplin MO 64804 300584463 HLTH SYSTEM MO 501c3 11b Mercy Health true Mercy Health Springfield Communities 1235 E Cherokee Street Springfield MO 65804 431856028 HLTH SYSTEM MO 501c3 11b Mercy Health true Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 HOME HEALTH AR 501c3 11c MM LAREDO true Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Ardmore Inc 1011 14th Avenue NW Ardmore OK 73401 731500629 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 HOSPITAL AR 501c3 3 MH SF COMM true Mercy Hospital Booneville 880 West Main Street Booneville AR 72927 463851119 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 HOSPITAL MO 501c3 3 MH SWMK COMM true Mercy Hospital El Reno Inc 2115 Parkview Drive El Reno OK 73036 272716065 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 HOSPITAL AR 501c3 3 MH NWAR COMM true Mercy Hospital Healdton Inc 3462 Hospital Rd Healdton OK 73438 263173902 HOSPITAL OK 501c3 3 MH ARDMORE true Mercy Hospital Jefferson 1400 Highway 61 South Festus MO 63028 430687077 HOSPITAL MO 501c3 3 MH E COMM SR true Mercy Hospital Joplin 100 Mercy Way Joplin MO 64804 270814858 HOSPITAL MO 501c3 3 MH SWMK COMM true Mercy Hospital Kingfisher Inc 1000 Kingfisher Regional Hosp Kingfisher OK 73750 463433074 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Lincoln 1000 East Cherry Street Troy MO 63379 472219204 HOSPITAL MO 501c3 3 MH EAST COMM true Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Oklahoma City Inc 4300 W Memorial Road Oklahoma City OK 73120 730579285 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 HOSPITAL AR 501c3 3 MH NWAR COMM true Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Tishomingo Inc 1000 South Byrd Tishomingo OK 73460 274433830 HOSPITAL OK 501c3 3 MH ARDMORE true Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 HOSPITAL MO 501c3 3 MH EAST COMM true Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 HOSPITAL KS 501c3 3 MH SWMK COMM true Mercy Research 1235 E Cherokee Street Springfield MO 65804 870796305 HOSPITAL MO 501c3 4 MH SF COMM true Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78046 200198462 HOSPITAL TX 501c3 7 Mercy Health true Mercy St Francis Hopsital 100 W Highway 60 Mountain View MO 65548 440607149 HOSPITAL MO 501c3 3 MH SF COMM true MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 CTRL SYS FUNC MO 501c3 11b Mercy Health true Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 CHILD ADVOC AR 501c3 9 Mercy Health true St Edward Mercy Foundation 7301 Rogers Avenue Fort Smith AR 72917 237330425 Foundation AR 501c3 7 MH FT SMITH true St Mary's Hospital of Enid Oklahoma 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 MH OK COMM true The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 11a M ST FRANCIS true MERC AMBU SURG CTR 7301 Rogers FT SMITH AR 72917 710827721 AMBUL SURG CT AR NA RES OPT & INNOV 645 MARYVILLE St Louis MO 63141 460468368 CENTRAL DIST. MO NA SO OK DIAG CTR 1011 14TH Ardmore OK 73401 431971232 MRI Services OK NA FORT SMITH EMS 1701 S GREENWOOD FT SMITH AR 72901 710416615 Emergency Medical AR NA ST ED MER MED MOB 7301 Rogers FT SMITH AR 72903 710554050 Office Building AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 Holding company DE NA C-Corp true Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 PRODUCT COMMER MO NA C-Corp true Mercy Commercial Services Inc 14528 South Outer Forty Suite 100 Chesterfield MO 63017 464953543 PARENT OF VCC MO NA C-Corp true Mercy Community Services Inc 401 Woodland Hills Blvd Fort Scott KS 66701 481078101 Retail pharmacy KS NA C-Corp true Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 Real estate OK NA C-Corp true Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 Holding company OK NA C-Corp true Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 Holding company OK NA C-Corp true Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 Holding company OK NA C-Corp true UHL Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 Holding company MO NA C-Corp true Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 INACTIVE MO NA C-Corp true false false false false false false false false false false false false false false false true true false false MERCY HEALTH P 62862 FMV MERCY HOSPITAL JOPLIN Q 20002088 FMV MHM SUPPORT SERVICES Q 6038532 FMV MERCY ACO CLINICAL SERVICES INC P 108531 FMV RESOURCE OPTIMIZATION & INNOVATION LLC P 883685 FMV FORM 990, SCHEDULE R, PART II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITAL ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITAL WASHINGTON, EIN 43-1066883. FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON VIA INTERCOMPANY JOURNAL ENTRIES. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON THE RELATED ORGANIZATION INFORMATION THAT CAN BE EXTRACTED FROM LAWSON. DUE TO THESE LIMITATIONS, MOST OF THE RELATED ORGANIZATION ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R, PART V, IN LINES P AND Q.