2016-05-13T15:23:25-05:00 2015-06-30 562632458 PLEUS AND COMPANY LLC 14500 S OUTER 40 SUITE 201A CHESTERFIELD MO 63017 990 2014-07-01 431718408 MERCY HEALTH EAST COMMUNITIES MERC 3143642400 645 MARYVILLE CENTRE DRIVE NO 100 ST LOUIS MO 63141 CHERYL MATEJKA CHIEF FINANCIAL OFFICER 3143643532 2016-05-12 1 DOUGLAS G PLEUS P00013488 3143179916 2014 2016-08-17 19:52:53Z DONN SORENSEN 645 MARYVILLE CENTRE DRIVE NO 100 ST LOUIS MO 63141 209782240 0 X WWW.MERCY.NET/STLOUISMO X 1995 MO MERCY HEALTH EAST COMMUNITIES ("MHEC") IS A SUPPORTING ORGANIZATION OF MERCY HOSPITALS EAST COMMUNITIES AND MERCY CLINIC EAST COMMUNITIES. MHEC ALSO PROVIDES SUPPORT SERVICES TO MERCY HEALTH FOUNDATION ST. LOUIS AND MERCY HEALTH FOUNDATION WASHINGTON. MHEC IS THE PARENT OF THE MERCY HOSPITALS EAST COMMUNITIES, AND PROVIDES MANAGEMENT AND SUPPORT SERVICES WITHIN THE SYSTEM. 20 14 373 15 0 0 0 0 189126919 209782074 0 0 735622 166 189862541 209782240 217039 398170 0 0 16833705 18779569 0 0 0 172811798 190604347 189862542 209782086 -1 154 383863094 280129801 334381118 316178401 49481976 -36048600 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 0 0 122731161 398170 209782240 MERCY HEALTH EAST COMMUNITIES ("MHEC") IS EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN IRC SECTION 501(C)(3) AND QUALIFIES AS A PUBLIC CHARITY UNDER IRC SECTION 509(A)(3).MHEC IS A SUPPORTING ORGANIZATION OF MERCY HOSPITALS EAST COMMUNITIES AND MERCY CLINIC EAST COMMUNITIES. MHEC ALSO PROVIDES SUPPORT SERVICES TO MERCY FOUNDATION ST. LOUIS AND MERCY FOUNDATION WASHINGTON. THE SUPPORT SERVICES INCLUDE FUNCTIONS THAT, BUT FOR MHEC, WOULD BE CONDUCTED BY EACH SEPARATE SUPPORTED ORGANIZATION AND INCLUDE, BUT ARE NOT LIMITED TO:ADMINISTRATIONACCOUNTS PAYABLEGENERAL ACCOUNTINGFINANCE AND ANALYSISHEALTH INFORMATION SERVICESMANAGED CARE CONTRACTINGPHYSICIAN REFERRAL SERVICESPRE-REGISTRATION AND PATIENT SCHEDULINGSTRATEGIC PLANNINGPURCHASINGREAL ESTATE MANAGEMENTOTHER SERVICES INCLUDE SUCH SUPPORT SERVICES AS DETERMINED NECESSARY BY MHEC FROM TIME TO TIME. 122731161 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 0 0 373 1 0 0 0 0 0 0 0 0 0 0 X 20 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X DENISE SCOFFIC 3143642959 645 MARYVILLE CENTERSTE 100 ST LOUIS MO 63141 X BOLSTER MD PATRICIA BOARD MEMBER 1.00 0.00 X 0 0 0 BUSCH STEVEN BOARD MEMBER 0.50 2.00 X 0 0 0 CAREY RSM SR JUDITH BOARD MEMBER 1.50 0.00 X 0 0 0 GLOSENGER RSM SR KATHERINE BOARD MEMBER 0.50 32.00 X X 0 0 0 KAHN MD JOSEPH PRES MERCY CHILD SVCS & BOARD MEMBER 1.00 59.00 X 0 531721 132030 MARTIN MD DANIEL BOARD MEMBER 1.00 0.00 X 0 0 0 MCKENNA BILL BOARD MEMBER 0.30 1.00 X 0 0 0 MILLER SR WILLIAM BOARD MEMBER 1.00 1.00 X 0 0 0 MURRAY TERI BOARD MEMBER 1.50 0.00 X 0 0 0 MUSICK III DON BOARD MEMBER 1.00 0.00 X 0 0 0 O'CONNOR SUSAN BOARD MEMBER 1.00 0.00 X 0 0 0 PURNELL JACK BOARD MEMBER 0.50 0.50 X 0 0 0 REHM MD CHARLES CAO & BOARD MEMBER 5.00 55.00 X 0 590414 145617 ROMAN GEORGE BOARD MEMBER 1.00 0.00 X 0 0 0 SANDERS MD STEPHEN PHYSICIAN & BOARD MEMBER 1.00 51.00 X 0 623671 43858 SWYERS STEVE BOARD MEMBER 1.00 0.00 X 0 0 0 TRELZ TESSA BOARD MEMBER 0.30 0.00 X 0 0 0 VERA RSM SR MARIA LUISA BOARD MEMBER 1.00 59.00 X 0 0 0 WEICK MD RAYMOND PHYSICIAN & BOARD MEMBER 5.00 47.00 X 0 515919 16120 SORENSEN DONN PRES EAST COMM & BOARD MEMBER 35.00 29.00 X X 0 821625 404141 HANNASCH SUSAN REG VP-GENERAL COUNSEL 10.00 50.00 X 0 295944 62257 JOHNSTON JEFFREY A PRESIDENT, MERCY HOSP STL 1.00 61.00 X 0 610565 326759 MATEJKA CHERYL L CHIEF FINANCIAL OFFICER 12.00 45.00 X 0 435540 103616 HUBERT MD JOHN W PRESIDENT, MERCY CLINIC 5.00 55.00 X 892032 0 198306 KALICAK DONALD VP - BUSINESS DEV & PLANNING 20.00 40.00 X 399859 0 100853 PETERSON BILL VP-HR 50.00 0.00 X 0 273183 43557 SCOFFIC DENISE VP-FINANCE 25.00 30.00 X 230141 0 26472 VARNER ANN M VP-MISSION 10.00 50.00 X 0 193774 31321 FAHEY THOMAS ED-PHYS PRACTICE INFORMATICS 50.00 0.00 X 193264 0 28946 FRONCZAK THEODORE K VP-OPERATIONS 60.00 0.00 X 233316 0 25561 RUNGE ANDREW COO, CLINICS 5.00 45.00 X 370053 0 88959 STIFFLER MARK R VP-OPERATIONS 2.00 55.00 X 215585 0 14238 VESPA JANICE M VP-OPERATIONS 2.00 55.00 X 235326 0 38725 CANTALIN JEANNE L FORMER OFFICER 0.00 0.00 X 0 280135 12531 MCCURRY MICHAEL FORMER OFFICER 0.00 60.00 X 0 1098042 276839 MOORE ELAINE FORMER KEY EMPLOYEE 0.00 0.00 X 0 306000 109173 2769576 6576533 2229879 22 1 1 0 ALBERICI HEALTHCARE 8800 PAGE AVE ST LOUIS MO 63114 CONSTRUCTION 6510072 CENTAUR BUILDING SERVICES INC PO BOX 66726 ST LOUIS MO 63166 HOUSEKEEPING SERVICES 796714 LANDCO CONSTRUCTION CITYPLACE TWO SUITE 10 CREVE COEUR MO 63141 CONSTRUCTION 380386 MODERN BUSINESS INTERIORS 1023 PORTWEST DR ST CHARLES MO 63303 CONSTRUCTION SERVICES 292472 ARCHIMAGES 143 W CLINTON PL ST LOUIS MO 63122 CONSTRUCTION 282142 17 CORPORATE & MGMT FEES 561110 184045910 184045910 RENTAL FROM AFFILIATED EXEMPT ORG 531120 24349543 24349543 OTHER OPERATING REVENUE 622110 1386621 1386621 209782074 166 166 166 209782240 209782240 0 0 398170 398170 1870528 1870528 12256106 7905522 4350584 655168 322314 332854 2875131 1950385 924746 1122636 766065 356571 411297 411297 4233048 3550232 682816 111696 93679 18017 1052878 883042 169836 35000 29354 5646 14888010 12486484 2401526 142045 119132 22913 166 139 27 2086231 2086231 5783808 5520553 263255 158294 132760 25534 SHARED SERVICE FEES 159941671 83169669 76772002 REPAIRS & MAINTENANCE 1269716 1064903 204813 DRUGS AND MEDICAL EXPEN 730 612 118 489757 381387 108370 209782086 122731161 87050925 0 15892482 2360749 2618742 286382696 117704955 169913382 168677741 12068935 12068935 183627546 96764383 383863094 280129801 8134249 6401264 400690 360621 37184414 13601523 288661765 295814993 334381118 316178401 X 49481976 -36048600 49481976 -36048600 383863094 280129801 X 154 -85530730 X X 0 1 X 1 1 1 X X 2 MERCY HOSPITALS EAST COMMUNITIES 430653493 3 1 0 0 MERCY CLINIC EAST COMMUNITIES 431771217 9 1 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART I, LINE 11G, COLUMN V MERCY HEALTH CARE EAST COMMUNITIES (MHEC) IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED TO SUPPORT THE OPERATIONS OF ALL ITS RELATED ORGANIZATIONS LISTED ON SCHEDULE A, PART I, LINE 11(G). (MHEC OPERATES SIMILARLY TO MANY TAX-EXEMPT HEALTH CARE ORGANIZATIONS SUPPORTING ORGANIZATIONS, BY OPERATING AS A "PARENT-TYPE" ENTITY, NOT AS A PROVIDER OF MONETARY SUPPORT.) THE AMOUNT OF SUPPORT PROVIDED TO THESE ORGANIZATIONS, REPORTED ON SCHEDULE A, PART I, LINE 11(G)(V), DOES NOT INCLUDED EXPENSES PAID ON BEHALF OF BUT NOT DIRECTLY TO THE ENTITIES MHEC SUPPORTS. THESE EXPENSES TOTALED $209,782,086. PART IV, SECTION A, LINE 1: MHEC IS THE PARENT ORGANIZATION OF THE ST. LOUIS AREA COMMUNITY, MERCY HEALTH EAST COMMUNITIES. THIS IS A HEALTH SYSTEM OF WHICH ALL SUPPORTED ORGANIZATIONS ARE SUBSIDIARIES. MERCY HEALTH, THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, HAS RESERVE POWERS TO APPOINT AND REMOVE ALL DIRECTORS AND OFFICERS FOR MERCY HEALTH EAST COMMUNITIES. THE PURPOSE OF MHEC IS TO PROVIDE, EITHER DIRECTLY OR IN CONJUNCTION WITH OTHER PERSONS OR ORGANIZATIONS, ADMINISTRATION, ACCOUNTS PAYABLE, GENERAL ACCOUNTING, FINANCE AND ANALYSIS, HEALTH INFORMATION SERVICES, MANAGED CARE CONTRACTING, PHYSICIAN REFERRAL SERVICES, PRE-REGISTRATION AND PATIENT SCHEDULING,STRATEGIC PLANNING,PURCHASING, AND REAL ESTATE MANAGEMENT. OTHER SERVICES INCLUDE SUCH SUPPORT SERVICES AND CHARITABLE ACTIVITIES AS DETERMINED NECESSARY BY MHEC FROM TIME TO TIME. MHEC, IN CONJUNCTION WITH ITS SOLE MEMBER, HAS DETERMINED THAT THE SUPPORTED ORGANIZATIONS LISTED ON SCHEDULE A, PART I, LINE 11(G) ALLOW THE CORPORATION TO FULFILL ITS MISSION. PART IV, SECTION B, LINE 1: SEE RESPONSES TO PART I, LINE 11G, COLUMN V AND PART IV, SECTION A, LINE 1 FOR INFORMATION REGARDING THE POWERS AND CONTROL OF MHEC AND THE SUPPORTED ORGANIZATIONS. 0 0 0 0 0 1 782 0 0 0 782 0 PART II-B, LINE 1: THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING ASSOCIATION: CATHOLIC HEALTH ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2015, DUES WERE $26,240. APPROXIMATELY 2.98% OF CATHOLIC HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS. 74006341 74006341 123793356 32883437 90909919 5229124 3128523 2100601 83400136 81593965 1806171 -46261 99030 -145291 168677741 INVESTMENT IN SUBSIDIARIES 96370571 OTHER LONG TERM ASSETS 393812 96764383 DUE TO AFFILIATES 295814993 295814993 PART X, LINE 2 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, 2015 OR 2014. 1 COMMUNITY FOUNDATION OF OZARKS 411 N SHERMAN PKWY SPRINGFIELD MO 65802 237290968 501(C)(3) 20000 FMV STIRRUPS FOR STUDENTS- TROPHY PRESENTATION SPONSOR. AKA CARE TO LEARN - ST. LOUIS FAIR ST LOUIS FOUNDATION 301 PROSPECT AVE ST LOUIS MO 63110 431218720 501(C)(3) 125000 FMV 2014/2015 DONATIONS - HEALTH/INFORMATION BOOTHS FOR FAIR ST. LOUIS JACKIE JOYNER-KERSEE FOUNDATION AKA HEPTATHLON 101 JACKIE JOYNER-KERSEE CIRCLE EAST ST LOUIS IL 62204 134250914 501(C)(3) 10000 FMV BENEFITS THE JACKIE JOYNER-KERSEE CENTER - TO EQUIP CHILDREN AND THEIR FAMILES WITH TOOLS THEY NEED TO ACHIEVE THEIR GOALS/DREAMS COMMUNITY COUNCIL OF ST CHARLES 427 SPENCER ROAD SUITE 255 ST PETERS MO 63376 436051722 501(C)(3) 6170 FMV SUPPORT OF COLLABERATIVE EFFORTS TO IMPROVE HUMAN SERVICES IN THE TRI-COUNTY REGION OF ST. CHARLES, WARREN AND LINCOLN COUNTIES OF MISSOURI THE COTTLEVILLE ST PATRICK'S DAY RUN & PARADE FOUNDATION 1385 MOTHERHEAD ROAD ST CHARLES MO 63368 454315179 501(C)(3) 10000 FMV SUPPORT OF COMMUNITY EVENT THAT PROMOTES CIVIC UNITY WHILE RAISING FUNDS FOR OTHER LOCAL 501(C)(3) CHARITABLE ORGANIZATIONS MAKE-A-WISH FOUNDATION 600 KELLWOOD PARKWAY CHESTERFIELD MO 63141 431550697 501(C)(3) 46000 FMV SUPPORT OF MAKE-A-WISH FOUNDATION TO HELP GRANT THE WISHES OF CHILDREN WITH LIFE-THREATENING ILLNESSES MAYORS CHARITY BALL INC 200 NORTH 2ND STREET ST CHARLES MO 63301 431726611 501(C)(3) 7500 FMV SUPPORT OF ST. CHARLES COUNTY CHARITABLE ORGANIZATIONS INCLUDING VOLUNTEERS IN MEDICINE, BOYS AND GIRLS CLUB OF ST. CHARLES, COUNTY, THE CENTER FOR AUTISM EDUCATION AND HABITAT FOR HUMANITY YOUTH IN NEED 1815 BOONES LICK ROAD ST CHARLES MO 63301 431033862 501(C)(3) 5000 FMV 2014 CHILDREN'S PARTNERSHIP PROGRAM DONATION TO SUPPORT YOUTH IN NEED, A NONPROFIT CHILD AND FAMILY SERVICES AGENCY, HEADQUARTERED IN ST. CHARLES, MO. ST CHARLES COUNTY ECONOMIC DEVELOPMENT COUNCIL 5988 MID RIVERS MALL DRIVE ST CHARLES MO 63366 431545618 501(C)(3) 40500 FMV TO HELP BUILD A STRONGER, THRIVING AND SELF SUPPORTING ECONOMY FOR ST. CHARLES COUNTY THROUGH INVESTMENT, JOB GROWTH AND RETENTION. CHESTERFIELD FOOTBALL ASSOCIATION PO BOX 255 CHESTERFIELD MO 63006 510538089 501(C)(3) 20000 FMV SUPPORT/SPONSORSHIP OF THE CHESTERFIELD FOOTBALL ASSOCIATION CITY OF O'FALLON 100 NORTH MAIN STREET OFALLON MO 63366 436012246 501(C)(3) 8000 FMV SPONSORSHIP FOR THE CITY OF O'FALLON, INCLUDING THE O'FALLON SLIDE THE CITY EVENT, AND HERITAGE AND FREEDOM FESTIVAL GATEWAY BASKETBALL CLUB PO BOX 274 WASHINGTON MO 63090 431775880 501(C)(3) 12500 FMV SPONSORSHIP FOR THE GATEWAY BASKETBALL CLUB BOY SCOUTS OF AMERICA - GREATER ST LOUIS COUNCIL 4568 WEST PINE BLVD ST LOUIS MO 63108 430652676 501(C)(3) 5000 FMV PROVIDES EDUCATIONAL PROGRAMS WITH CHARACTER DEVELOPMENT AND VALUES-BASED LEADERSHIP TRAINING ISAAC BRUCE FOUNDATION 1919 HOMEFIELD ESTATES DR OFALLON MO 63366 208066845 501(C)(3) 5000 FMV ANNUAL DONATION TO ISAAC BRUCE FOUNDATION KIDSMART - TOOLS FOR LEARNING 12175 BRIDGETON SQUARE DRIVE BRIDGETON MO 63044 431906392 501(C)(3) 5000 FMV ANNUAL DONATION/SPONSORSHIP FOR THE JOE BUCK BEE MISSOURI YOUTH SOCCER ASSOCIATION 2230 BLUESTONE DRIVE ST CHARLES MO 63303 431282394 501(C)(3) 5000 FMV ANNUAL MYSA-MERCY SPONSORSHIP MISSOURI SPORTS HALL OF FAME 3861 EAST STAN MUSIAL DRIVE SPRINGFIELD MO 65809 431624519 501(C)(3) 12500 FMV MISSOURI SPORTS HALL OF FAME REGIONAL ENSHRINEMENT - ST. CHARLES PARKWAY WEST JR LONGHORNS PO BOX 31753 ST LOUIS MO 63131 270900035 501(C)(3) 5000 FMV SUPPORT THE FOOTBALL PROGRAM AT PARKWAY SCHOOLS ST CHARLES CITY-COUNTY LIBRARY FOUNDATION 77 BOONE HILLS DR ST PETERS MO 63376 431860793 501(C)(3) 15000 FMV SUPPORT THE READ TO READ PARTNERSHIP STS JOACHIM AND ANN CARE SERVICES 4116 MCCLAY ROAD ST CHARLES MO 63304 352203101 501(C)(3) 5000 FMV ANNUAL GOLF OUTING TO HELP FURTHER THE MISSION TO SERVE THOSE IN CRISIS AND PREVENT HOMELESSNESS FIRST AND GOAL FOOTBALL 695 TRADE CENTER BLVD STE 110 CHESTERFIELD MO 63005 353402100 501(C)(3) 5000 FMV DONATION/ADVERTISEMENT ST CHARLES COMMUNITY COLLEGE FOUNDATION 4610 MID RIVERS MALL DRIVE COTTLEVILLE MO 63376 431591959 501(C)(3) 5000 FMV DONATION/SPONSORSHIP FOR ST. CHARLES COMMUNITY COLLEGE FOUNDATION ST CHARLES OKTOBERFEST 1635 ROSEWALL DRIVE ST CHARLES MO 63303 272880402 501(C)(3) 15000 FMV SPONSORSHIP OF THE "KIDS FREE ZONE" SYNERGY PRODUCTIONS 52 ARUNDEL PLACE ST LOUIS MO 63105 223863636 501(C)(3) 5000 FMV ANNUAL SPONSORSHIP AT BLACK AND WHITE BALL 24 0 PART I, LINE 2: GRANTS ARE MADE TO ORGANIZATIONS WHICH HAVE AN ESTABLISHED HISTORY OF PROVIDING HEALTH CARE SUPPORT ANDOR COMMUNITY BENEFIT. IF NECESSARY, PERIODIC REPORTS ARE PROVIDED TO US. GRANTS ARE MADE TO RELATED ORGANIZATIONS, WHICH PROVIDE REPORTING ON THE USE OF THE FUNDS AND WORK CLOSELY WITH OUR ORGANIZATION. X X X 1 1 1 1 0 0 0 0 0 1 0 KAHN MD JOSEPH PRES MERCY CHILD SVCS & BOARD MEMBER 0 414527 0 75492 0 41702 0 117747 0 14283 0 663751 0 0 REHM MD CHARLES CAO & BOARD MEMBER 0 443406 0 85847 0 61161 0 131467 0 14150 0 736031 0 0 SANDERS MD STEPHEN PHYSICIAN & BOARD MEMBER 0 584784 0 0 0 38887 0 25340 0 18518 0 667529 0 0 WEICK MD RAYMOND PHYSICIAN & BOARD MEMBER 0 453341 0 30366 0 32212 0 14056 0 2064 0 532039 0 0 SORENSEN DONN PRES EAST COMM & BOARD MEMBER 0 599644 0 184629 0 37352 0 391525 0 12616 0 1225766 0 0 HANNASCH SUSAN REG VP-GENERAL COUNSEL 0 221883 0 47655 0 26406 0 48801 0 13456 0 358201 0 0 JOHNSTON JEFFREY A PRESIDENT, MERCY HOSP STL 0 451859 0 138500 0 20206 0 308299 0 18460 0 937324 0 0 MATEJKA CHERYL L CHIEF FINANCIAL OFFICER 0 306071 0 77645 0 51824 0 85473 0 18143 0 539156 0 0 HUBERT MD JOHN W PRESIDENT, MERCY CLINIC 679114 0 156990 0 55928 0 183333 0 14973 0 1090338 0 0 0 KALICAK DONALD VP - BUSINESS DEV & PLANNING 215468 0 137407 0 46984 0 87453 0 13400 0 500712 0 0 0 PETERSON BILL VP-HR 0 185540 0 47625 0 40018 0 26306 0 17251 0 316740 0 0 SCOFFIC DENISE VP-FINANCE 154838 0 32750 0 42553 0 18993 0 7479 0 256613 0 0 0 VARNER ANN M VP-MISSION 0 137922 0 26357 0 29495 0 17310 0 14011 0 225095 0 0 FAHEY THOMAS ED-PHYS PRACTICE INFORMATICS 130649 0 18722 0 43893 0 16422 0 12524 0 222210 0 0 0 FRONCZAK THEODORE K VP-OPERATIONS 169762 0 37419 0 26135 0 14752 0 10809 0 258877 0 0 0 RUNGE ANDREW COO, CLINICS 272199 0 64676 0 33178 0 71003 0 17956 0 459012 0 0 0 STIFFLER MARK R VP-OPERATIONS 164338 0 35673 0 15574 0 7098 0 7140 0 229823 0 0 0 VESPA JANICE M VP-OPERATIONS 169911 0 38597 0 26818 0 25741 0 12984 0 274051 0 0 0 CANTALIN JEANNE L FORMER OFFICER 0 25649 0 0 0 254486 0 11143 0 1388 0 292666 0 0 MCCURRY MICHAEL FORMER OFFICER 0 836596 0 196715 0 64731 0 261658 0 15181 0 1374881 0 0 MOORE ELAINE FORMER KEY EMPLOYEE 0 252414 0 0 0 53586 0 102493 0 6680 0 415173 0 0 PART I, LINE 1A CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. SPOUSAL TRAVEL WAS PROVIDED FOR THE FOLLOWING EMPLOYEES OF RELATED ORGANIZATIONS: MICHAEL MCCURRY; CHARLES REHM. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO AN EMPLOYEE, ANDREW RUNGE, AND TO THE EMPLOYEE OF A RELATED ORGANIZATION, WILLIAM PETERSON. PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE. PART I, LINES 4A-B JEANNE CANTALIN RECEIVED $205,717 OF SEVERANCE COMPENSATION FROM A RELATED ORGANIZATION. ELAINE MOORE RECEIVED $2,310 OF SEVERANCE COMPENSATION FROM A RELATED ORGANIZATION. 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 FOLLOWING INDIVIDUALS PARTICIPATED IN THE FOLLOWING PLANS. THERE WERE NO PAYMENTS FOR THE FISCAL YEAR ENDED 6/30/2015. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) MCCURRY,MICHAEL (DB); JOHNSTON,JEFFREY (DC); SORENSEN,DONN (DC) SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN (SMRP) KALICAK,DON; MATEJKA,CHERYL L; REHM,CHARLES; JOHNSTON,JEFFREY; SORENSEN,DON; HUBERT,JOHN; MOORE,ELAINE; KAHN MD,JOSEPH; HANNASCH,SUSAN; RUNGE,ANDREW; PETERSON,BILL THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). PART I, LINE 7 THE RELATED ORGANIZATION WHICH EMPLOYS THOSE INDIVIDUALS LISTED ON PART VII, AND THE FILING ORGANIZATION WHEN APPLICABLE, PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2015 (JULY 1, 2014 - JULY 30, 2015) PAYMENT OF ALL OR PART OF THE BONUS WAS CONTINGENT UPON ATTAINMENT OF CERTAIN FINANCIAL TARGETS AND NON-FINANCIAL GOALS DEEMED NECESSARY BY MERCY. PAYMENTS ARE MADE ANNUALLY IN OCTOBER FOLLOWING (I) THE CONCLUSION OF THE FISCAL YEAR AND (II) DETERMINATION OF GOAL ACHIEVEMENT. BONUS OPPORTUNITIES ARE TIERED PERCENTAGES AND ARE DEPENDENT UPON THE LEADERSHIP LEVEL AND ATTAINMENT PERCENTAGE. MERCY'S ATTAINMENT OF FINANCIAL TARGETS AND NON-FINANCIAL GOALS IS REVIEWED BY THE COMPENSATION COMMITTEE OF MERCY HEALTH AND IS TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS. 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 -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE MUSICK CONSTRUCTION COMPANY BOARD MEMBER IS OWNER 778558 MERCY HEALTH EAST COMMUNITIES MADE PAYMENTS DURING THE ORDINARY COURSE OF BUSINESS AND ON AN ARMS LENGTH BASIS TO MUSICK CONSTRUCTION COMPANY. MERCY HEALTH EAST COMMUNITIES BOARD MEMBER DON MUSICK III OWNS 100% INTEREST IN MUSICK CONSTRUCTION COMPANY. IN FY15, PMTS CODED TO MERCY HOSPITALS EAST COMMUNITIES AND MERCY CLINIC EAST COMMUNITIES, NONE TO PARENT. 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBER OF MERCY HEALTH EAST COMMUNITIES IS MERCY HEALTH. FORM 990, PART VI, SECTION A, LINE 7A MERCY HEALTH, THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, HAS RESERVE POWERS TO APPOINT AND REMOVE ALL DIRECTORS AND OFFICERS FOR MERCY HEALTH EAST COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 7B MERCY HEALTH, THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, RESERVES THE FOLLOWING POWERS AND RESPONSIBILIES: -TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION OR ANY AFFILIATE SHALL OPERATE; -TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS AND TO AMEND THE ORGANIZATIONAL AND GOVERNANCE DOCUMENTS OF EACH AFFILIATE; -TO APPROVE OR AMEND THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF THE CORPORATION AND EACH AFFILIATE; -TO APPROVE OR AMEND THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION AND EACH AFFILIATE; -TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE IN EXCESS OF THREE MILLION DOLLARS ($3,000,000); -TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION AND EACH AFFILIATE CONTROLLED BY THE CORPORATION; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION AND EACH AFFILIATE (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTY ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION AND EACH AFFILIATE; AND, -TO APPROVE THE CREATION, OWNERSHIP, OR ACQUISITION OF, OF AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 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, 2015. 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, SECTION B, LINE 15B FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), MERCY HEALTH (PARENT COMPANY) USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND ANNUAL REVIEW/APPROVAL OF COMPENSATION BY THE COMPENSATION COMMITTEE OF THE MERCY HEALTH BOARD. 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 AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY; WE ARE NOT REQUIRED TO MAKE THESE DOCUMENTS AVAILABLE TO THE PUBLIC. FINANCIAL RESULTS ARE AVAILABLE VIA REQUEST OF COPY OF FORM 990. 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: ELIMINATE RELATED ORGANIZATION NET INCOME (LOSS) -85,704,078. TRANSFER FROM MERCY HEALTH 173,347. 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 2015 (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 (FORMERLY FINANCE, AUDIT, AND COMPLIANCE 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 THE CONSOLIDATED GROUP OF MERCY HEALTH IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE SINGLE AUDIT WAS CONDUCTED ON A CONSOLIDATED BASIS. FORM 990, SCHEDULE R, PART V SYSTEM LIMITATIONS MERCY HEALTH (MERCY) HAS A COMPLEX LEGAL STRUCTURE WITH OVER 60 LEGAL ENTITIES. LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY AND THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON EXTRACTING THE INTERCOMPANY/RELATED ORGANIZATION INFORMATION 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. WE HAVE CAPTURED AND REPORTED THE KNOWN MATERIAL TRANSACTIONS BETWEEN ENTITIES. THERE MAY BE MINOR AMOUNTS OF RELATED ORGANIZATION TRANSACTION ACTIVITY WHICH IS NOT REFLECTED IN THIS SCHEDULE. FORM 990, PART V, QUESTION 1A INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS FOR THE FILING ORGANIZATION ARE PAID BY THE 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. 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