STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MERCY HOSPITAL ADA INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MERCY HOSPITAL ADA INC (EIN 46-2288155)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-19
IRS object ID
201521399349300127
Schema version
2013v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-19T13:27:38-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN562632458PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLEUS AND COMPANY LLCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line114323 S OUTER FORTY STE 310NAddressLine1
CityCHESTERFIELDCity
StateMOState
ZIP Code63017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN462288155EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ADA INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMERCBusinessNameControlTxt
Phone5804211412PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 N MONTE VISTA STREETAddressLine1
CityADACity
StateOKState
ZIP Code74820ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJON VITIELLOPersonNm
Person TitleCFOPersonTitleTxt
Phone5804211412PhoneNum
Signature2015-05-19SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDOUGLAS G PLEUSPreparerPersonNm
PTINP00013488PTIN
Phone3143179916PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Initial ReturnYes (X)InitialReturnInd
Principal OfficerLORI WIGHTMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 N MONTE VISTA STREETAddressLine1
CityADACity
StateOKState
ZIP Code74820ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$83,923,228GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MERCY.NET/ADAOKWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateOKLegalDomicileStateCd
Activity Or MissionTO 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 Body14VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee702TotalEmployeeCnt
Total Volunteers85TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$103,096CYContributionsGrantsAmt
CY Program Service Revenue$83,578,445CYProgramServiceRevenueAmt
CY Investment Income-$37,116CYInvestmentIncomeAmt
CY Other Revenue$278,803CYOtherRevenueAmt
CY Total Revenue$83,923,228CYTotalRevenueAmt
CY Grants And Similar Paid$20,202CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$35,807,115CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$45,315,183CYOtherExpensesAmt
CY Total Expenses$81,142,500CYTotalExpensesAmt
CY Revenues Less Expenses$2,780,728CYRevenuesLessExpensesAmt
Total Assets EOY$60,230,467TotalAssetsEOYAmt
Total Liabilities EOY$57,450,701TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances EOY$2,779,766NetAssetsOrFundBalancesEOYAmt
MissionMERCY HOSPITAL ADA 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$66,613,449ExpenseAmt
Grant$20,202GrantAmt
Revenue$83,273,326RevenueAmt
DescMERCY HOSPITAL ADA PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FISCAL YEAR END JUNE 30, 2014, ADA PROVIDED SERVICES TO 3,491 INPATIENTS, 58,604 OTHER OUTPATIENTS, AND 17,467 EMERGENCY DEPARTMENT PATIENTS. SERVICES ARE PROVIDED THROUGH A COMMUNITY-BASED HOSPITAL. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2014 WAS $1,478,680.MERCY HOSPITAL ADA'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H.Desc
Total Program Service Expenses$66,613,449TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee702EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOKStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARY GARBERPersonNm
Phone5804211412PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 N MONTE VISTA STREETAddressLine1
CityADACity
StateOKState
ZIP Code74820ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
BOLITHO THOMAS
BOARD MEMBER1.000.00Yes (X)$0$0$0
CARPENTER MD JOANN
BOARD MEMBER1.000.00Yes (X)$0$0$0
HENDRICKS RSM SR REBECCA ANN
BOARD MEMBER1.0014.00Yes (X)$0$0$0
KOORIE RSM SR DIANE
BOARD MEMBER1.001.00Yes (X)$0$0$0
LANCE BILL
BOARD MEMBER1.000.00Yes (X)$0$0$0
MCCORTNEY BARTLEY
BOARD MEMBER1.000.00Yes (X)$0$0$0
METTRY DO CHARLES
BOARD MEMBER1.000.00Yes (X)$0$0$0
NORTHCUTT DAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
PAYTON BECKY J
VP-HUMAN RESOURCES & BOARD MEMBER10.0050.00Yes (X)$0$290,334$49,970
PETERSON DEAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
TILLEY CARLTON
BOARD MEMBER1.000.00Yes (X)$0$0$0
WEEMS DDS MARK
BOARD MEMBER1.000.00Yes (X)$0$0$0
SMALLEY DIANA L
PRESIDENT, WEST COMMUNITIES2.0058.00Yes (X)$0$690,264$225,458Yes (X)
VITIELLO JONATHAN
CHIEF FINANCIAL OFFICER2.0058.00Yes (X)$0$533,310$75,851Yes (X)
ROGERS WILLIAM KENT
CHIEF EXECUTIVE OFFICER, RURAL HOSPITAL40.0020.00$113,169$169,170$25,368Yes (X)
GARBER MARY
VP-FINANCE50.0010.00$72,411$98,973$8,290Yes (X)
LE BICH-VI
REGIONAL VP-GENERAL COUNSEL1.0059.00$0$231,306$46,984Yes (X)
TEW DAVID
CHIEF OPERATING OFFICER2.0058.00$0$483,765$81,249Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$185,580TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,497,122TotReportableCompRltdOrgAmt
Total Other Compensation$513,170TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
ADA ANESTHESIA ASSOCIATES
1621 CRADDUCKADAOK74820ANESTHESIA SERVICES$149,555
LOCUM LEADERS
64 DANBURY RDWILTONCT06897PHYSICIAN SERVICES$117,072
NETWORK HARDWARE RESALE
6500 HOLLISTER AVE STE 210SANTA BARBARACA93117CONSTRUCTION$112,910
GE HEALTHCARE
3000 N GRANDVIEW BLVDWAUKESHAWI53188MAINTENANCE$104,018
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$91,202RelatedOrganizationsAmt
All Other Contributions$11,894AllOtherContributionsAmt
Total Contributions$103,096TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business622110BusinessCd
Total Revenue Column$83,578,445TotalRevenueColumnAmt
Related Or Exempt Func Income$83,578,445RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$83,578,445TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$37,116TotalRevenueColumnAmt
Exclusion-$37,116ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIADesc
Business722210BusinessCd
Total Revenue Column$583,922TotalRevenueColumnAmt
Exclusion$583,922ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column-$305,119TotalRevenueColumnAmt
Related Or Exempt Func Income-$305,119RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$278,803OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,923,228TotalRevenueColumnAmt
Related Or Exempt Func Income$83,273,326RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$546,806ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$20,202TotalAmt
Program Services$20,202ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$465,253TotalAmt
Management And General$465,253ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$94,779TotalAmt
Management And General$94,779ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$28,512,850TotalAmt
Program Services$24,950,041ProgramServicesAmt
Management And General$3,562,809ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,220,229TotalAmt
Program Services$1,079,294ProgramServicesAmt
Management And General$140,935ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,610,338TotalAmt
Program Services$3,168,381ProgramServicesAmt
Management And General$441,957ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,903,666TotalAmt
Program Services$1,660,377ProgramServicesAmt
Management And General$243,289ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,825TotalAmt
Management And General$1,825ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,699,783TotalAmt
Program Services$3,203,745ProgramServicesAmt
Management And General$1,496,038ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,087TotalAmt
Program Services$5,513ProgramServicesAmt
Management And General$2,574ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,757,782TotalAmt
Program Services$1,879,923ProgramServicesAmt
Management And General$877,859ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$439,497TotalAmt
Program Services$312,422ProgramServicesAmt
Management And General$127,075ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$901,070TotalAmt
Program Services$614,241ProgramServicesAmt
Management And General$286,829ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$176,844TotalAmt
Program Services$111,738ProgramServicesAmt
Management And General$65,106ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$818TotalAmt
Program Services$818ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,686,327TotalAmt
Management And General$1,686,327ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,469,282TotalAmt
Program Services$7,644ProgramServicesAmt
Management And General$2,461,638ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBTS$14,830,641$14,830,641
DRUGS & MEDICAL EXPENSE$11,954,696$11,568,140$386,556
SHARED SERVICE FEE$2,925,065$1,521,034$1,404,031
REPAIRS & MAINTENANCE$1,757,933$1,198,347$559,586

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$705,533TotalAmt
Program Services$480,948ProgramServicesAmt
Management And General$224,585ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$81,142,500TotalAmt
Program Services$66,613,449ProgramServicesAmt
Management And General$14,529,051ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$1,443,159EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$4,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$10,588,412EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$60,383EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$2,295,102EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$220,544EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$47,034,200LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,545,749LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$44,488,451EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,129,916EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$60,230,467EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$2,936,953EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$42,587,584EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$11,926,164EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$57,450,701EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
EOY$2,779,766EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$2,779,766EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$60,230,467EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,780,728ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$962OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$8,199GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$8,199TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2014, DUES WERE $31,041 AND $11,043, RESPECTIVELY. APPROXIMATELY 18% OF OKLAHOMA HOSPITAL ASSOCIATION DUES AND 23.65% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED.ExplanationTxt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,224,237OtherCostOrOtherBasisAmt
Depreciation$1,470,703DepreciationAmt
Book Value$32,753,534BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,595,710OtherCostOrOtherBasisAmt
Depreciation$1,075,046DepreciationAmt
Book Value$8,520,664BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,214,253OtherCostOrOtherBasisAmt
Book Value$3,214,253BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$44,488,451TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO TAX-EXEMPT AFFILIATES$9,337,267
OTHER LIABILITIES$2,588,897
FieldValueIRS element (for citing)
Total Liability$11,926,164TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2FormAndLineReferenceDesc
ExplanationTHE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH AND AFFILIATES DO NOT INCLUDE A FOOTNOTE TO REPORT THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER ASC 740, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,227,164TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,227,164NetCommunityBenefitExpnsAmt
Total Expense0.01850TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,417,887TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,166,371DirectOffsettingRevenueAmt
Net Community Benefit Expns$251,516NetCommunityBenefitExpnsAmt
Total Expense0.00380TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,645,051TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,166,371DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,478,680NetCommunityBenefitExpnsAmt
Total Expense0.02230TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$130,320TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$130,320NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$184,615TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$184,615NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$82,401TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$82,401NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$397,336TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$397,336NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,042,387TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,166,371DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,876,016NetCommunityBenefitExpnsAmt
Total Expense0.02830TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$95,818TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$95,818NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,132TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,132NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$101,950TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$101,950NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$5,516,998BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$26,818,962ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$30,215,338CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,396,376MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ADA INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 N MONTE VISTA STREETAddressLine1
CityADACity
StateOKState
ZIP Code74820ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.MERCY.NET/ADAOKWebsiteAddressTxt
State License2286StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ADA INCBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITSOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MERCY HOSPITAL ADA, INC.PART V, SECTION B, LINE 3: COMMUNITY HEALTH NEEDS ASSESSMENTPLEASE REFER TO THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS.
MERCY HOSPITAL ADA, INC.PART V, SECTION B, LINE 20D: ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTSTHE 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.ADDITIONAL FINANCIAL ASSISTANCEAFTER APPROPRIATE DISCOUNTS HAVE BEEN APPLIED, ARRANGEMENTS MAY BE MADE FOR AN INTEREST-FREE MONTHLY PAYMENT PLAN. GENERALLY, NO PATIENT'S FINANCIAL RESPONSIBILITY WILL BE GREATER THAN 20% OF ANNUAL HOUSEHOLD INCOME OR 10% OF NET ASSETS (WHICHEVER IS GREATER), ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 $81,142,500. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $14,830,641. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $5,516,998.
PART I, LINE 6ACOMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050).
PART II, COMMUNITY BUILDING ACTIVITIES:A FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS.
PART III, LINE 2:TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNTING, 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 (REFER TO DISCLOSURE FOR PART III, #9B) 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 ADA THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96).
PART III, LINE 9B:MERCY HOSPITAL ADA'S ("MERCY'S") DEBT COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT BEFORE TURNING AN ACCOUNT TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH MERCY'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO HAVE MET THE MERCY HOSPITAL COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY FOR APPROPRIATE FOLLOW-UP. MERCY REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. MERCY UTILIZES THE "SEARCH AMERICA" TOOL TO ENHANCE THE ABILITY TO DETERMINE CHARITY QUALIFICATION. PRESUMPTIVE CHARITY WILL BE GRANTED IN SITUATIONS WHERE MERCY HOSPITAL HAS BEEN UNABLE TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION. MERCY UTILIZES PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR CHARITY ADJUSTMENTS IN EXCESS OF $6,500. IN THESE CASES, MERCY UTILIZES THE SEARCH AMERICA REPORT STATUS OF "PROBABLE CHARITY" AS THE BASIS FOR ASSIGNING THE CHARITY LEVEL. 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. ADDITIONALLY THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENT, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENFORCE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEWS COMPLIANCE WITH ALL POLICIES.
PART VI, LINE 2:NEEDS ASSESSMENTMERCY HEALTH BELIEVES THAT ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IS COMPREHENSIVE ENOUGH TO CAPTURE SUBSTANTIALLY ALL OF THE COMMUNITY'S NEEDS. THEREFORE NO FURTHER STEPS WERE TAKEN TO IDENTIFY ADDITIONAL NEEDS.
PART VI, LINE 3:THE FILING ORGANIZATION HAS PRINTED MATERIAL AVAILABLE AT EACH POINT OF REGISTRATION IN OUR FACILITY, IN ADDITION TO ELECTRONICALLY AVAILABILITY AT OUR WEB SITE AT MERCY.NET ON HOW TO CONTACT CUSTOMER SERVICE FOR FINANCIAL ASSISTANCE. THE STATEMENT ALSO INCLUDES DIRECTION ON HOW TO REACH OUT TO MERCY FOR FINANCIAL ASSISTANCE AS WELL. FINANCIAL ASSISTANCE INFORMATIONAS A PART OF OUR HEALING MINISTRY, THE FILING ORGANIZATION IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR FINANCIAL SITUATION. WE OFFER PAYMENT ASSISTANCE FOR THOSE WHO DO NOT HAVE INSURANCE OR WHO ARE IN FINANCIAL NEED.UNINSURED PATIENT DISCOUNTSA DISCOUNT FROM THE HOSPITAL'S REGULAR BILLED CHARGES WILL BE PROVIDED TO PATIENTS WHO DO NOT HAVE INSURANCE. THIS INCLUDES PATIENTS WHOSE FINANCIAL SITUATION NORMALLY WOULD NOT OTHERWISE QUALIFY THEM FOR CHARITY CARE DISCOUNTS.PATIENTS WITHOUT INSURANCE WHOSE FINANCIAL SITUATION QUALIFIES THEM FOR CHARITY CARE DISCOUNTS (SEE ELIGIBILITY GUIDELINES BELOW) ARE ASSISTED OR ASKED IN APPLYING FOR MEDICAID BEFORE APPLYING FOR FINANCIAL ASSISTANCE. MERCY WORKS TO EXHAUST ALL EFFORTS TO COORDINATE WITH THE PATIENT TO APPLY FOR MEDICAID, BUT DOES NOT PROHIBIT CHARITY CONSIDERATIONS IF DENIED NOR APPLIED.APPLICATIONS FOR CHARITY CARE DISCOUNTS WILL BE REVIEWED FOR ELIGIBILITY BASED ON THE APPLICANT'S INCOME, FAMILY SIZE, AMOUNT OF PAYMENT DUE AND AVAILABILITY OF OTHER ASSETS OR RESOURCES. PLEASE NOTE THAT CARE MUST BE MEDICALLY NECESSARY TO BE CONSIDERED ELIGIBLE FOR UNINSURED PATIENT DISCOUNTS.
PART VI, LINE 4:COMMUNITY INFORMATIONMERCY HOSPITAL ADA'S PRIMARY SERVICE AREA INCLUDES PONTOTOC, SEMINOLE, HUGHES AND GARVIN COUNTIES, OKLAHOMA. THE FOLLOWING INFORMATION IS BASED ON 2014 TRUVEN DATA. THE AREA'S POPULATION IS 104,313. AVERAGE HOUSEHOLD INCOME IS $55,191. 23% OF THE POPULATION HAS A HOUSEHOLD AVERAGE INCOME OVER $75,000. THE AVERAGE MEDIAN AGE IS 41. 17% OF THE POPULATION IS AGE 65 AND OLDER. 15% OF THE POPULATION IS ON MEDICARE, 15% ON MEDICAID, AND 16% UNINSURED.
PART VI, LINE 5:PROMOTION OF COMMUNITY HEALTHMERCY 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 SERVICE COMMUNITIES.MERCY OFFERS SERVICES AND PROGRAMS WHICH FURTHER HEALTH PROMOTION, MAINTENANCE AND CARE TO THE COMMUNITY. PROGRAMS PROVIDED TO MEET THE COMMUNITY INCLUDE SUPPORT GROUPS FOR VARIOUS SITUATIONS, OUTREACH PROGRAMS, BLOOD DRIVES, ETC.MERCY IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY BOARD MEMBERS ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE, INTERESTS ARE SERVED BY MERCY.SURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MERCY 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 LIFE TO THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2014, MERCY FACILITIES INCLUDED 29 ACUTE CARE HOSPITALS, 4 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2014, MERCY HAD MORE THAN 8 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,000 EMPLOYED PHYSICIANS, AND APPROXIMATELY 38,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE FIFTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES BASED ON NET PATIENT SERVICE REVENUE. 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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
AMERICAN CANCER SOCIETY
2433 RIDGEPOINT DRAUSTINTX78754741185665501(C)(3)$5,475CASHGENERAL SUPPORT
MERCY FOUNDATION ADA
430 N MONTE VISTAADAOK74820463596274501(C)(3)$5,000CASHGENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4FormAndLineReferenceDesc
ExplanationTHE 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

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PAYTON BECKY J
VP-HUMAN RESOURCES & BOARD MEMBER$0$204,799$0$57,827$0$27,708$0$37,214$0$12,756$0$340,304$0$0
SMALLEY DIANA L
PRESIDENT, WEST COMMUNITIES$0$501,629$0$178,441$0$10,194$0$206,897$0$18,561$0$915,722$0$0
VITIELLO JONATHAN
CHIEF FINANCIAL OFFICER$0$318,639$0$85,619$0$129,052$0$58,801$0$17,050$0$609,161$0$0
ROGERS WILLIAM KENT
CHIEF EXECUTIVE OFFICER, RURAL HOSPI$106,046$98,240$0$57,320$7,123$13,610$0$8,922$8,228$8,218$121,397$186,310$0$0
GARBER MARY
VP-FINANCE$64,917$61,514$0$27,852$7,494$9,607$7,014$0$643$633$80,068$99,606$0$0
LE BICH-VI
REGIONAL VP-GENERAL COUNSEL$0$144,261$0$49,152$0$37,893$0$30,986$0$15,998$0$278,290$0$0
TEW DAVID
CHIEF OPERATING OFFICER$0$348,746$0$98,693$0$36,326$0$63,959$0$17,290$0$565,014$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ACHARTER 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. 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 THE EMPLOYEE OF A RELATED ORGANIZATION, JONATHAN VITIELLO. 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 4BMERCY HEALTH, THE 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 INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN: JONATHAN VITIELLO; BICH-VI LE; BECKY PAYTON; DAVID TEW THE INDIVIDUALS LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. THE FOLLOWING INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: DIANA SMALLEY THE INDIVIDUAL LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C).
PART I, LINE 7THE RELATED ORGANIZATION WHICH EMPLOYS THOSE INDIVIDUALS LISTED ON PART VII PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2014 (JULY 1, 2013 - JULY 30, 2014) 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 3THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonCHERYL WEEMSPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY MEMBER OF MARK WEEMS, BOARD MEMBERRelationshipDescriptionTxt
Transaction$94,779TransactionAmt
TransactionEMPLOYMENT ARRANGEMENT, MERCY HOSPITAL ADATransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AMERCY 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 7BMERCY 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 11THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM. THE DRAFT FORM 990 IS ALSO REVIEWED BY THE MERCY HEALTH 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 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 12COFFICERS, 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, 2014. 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 15AFOR 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 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY.
FORM 990, PART XI, LINE 9:OTHER ADJUSTMENTS -962.
PART XII, LINE 2AUDITED 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 2014 (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 3SINGLE AUDIT ACT AND OMB CIRCULAR A-133 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, PART V, LINE 2ASALARIES AND WAGES THE SALARIES AND WAGES REPORTED ON FORM 990, PART IX, LINE 7 REPRESENT AN ALLOCATION OF SALARIES AND WAGES FROM A RELATED ORGANIZATION. EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, ALL REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3'S) WAS REPORTED UNDER THE RELATED ORGANIZATION'S EIN.
FORM 990, SCHEDULE R, PART IIMERCY 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 VSYSTEM LIMITATIONS LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH AND SUBSIDIARIES. THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON VIA INTERCOMPANY JOURNAL ENTRIES. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON THE RELATED ORGANIZATION INFORMATION THAT CAN BE EXTRACTED FROM LAWSON. DUE TO THESE LIMITATIONS, MOST OF THE RELATED ORGANIZATION ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R,PART V, IN LINES P AND Q.
FORM 990, PART V, LINE 1AINDEPENDENT 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 (76 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
CASA DE MISERICORDIA
1602 MCCLELLAND STREETLAREDOTX78044742912461WOMEN'S DOMESTIC VIOLENCE SHELTERTX501C37MERCY MINISTRIES OF LAREDOYes (1)
JEFFERSON LAND COMPANY INC
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017431330360TITLE HOLDING COMPANYMO501C2MERCY HOSPITAL JEFFERSONYes (1)
LAREDO MEDICAL GROUP
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017742764726DISSOLVED 5/5/2014TX501C39MERCY HEALTH SYSTEM TXYes (1)
MCAULEY PORTFOLIO MGMT CO
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017261708048PORTFOLIO MANAGEMENTMO501C311-IIMERCY HEALTHYes (1)
MERCY ACO CLINICAL SERVICES INC
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017464504901VIRTUAL CARE CENTERMO501C33MERCY HEALTHYes (1)
MERCY CLINIC EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100ST LOUISMO63141431771217PHYSICIAN GROUPMO501C39MERCY HEALTH EAST COMMUNITIESYes (1)
MERCY CLINIC FORT SMITH COMM
7301 ROGERS AVENUEFORT SMITHAR72917261318597PHYSICIAN CLINICAR501C39MERCY HEALTH FORT SMITH COMMYes (1)
MERCY CLINIC HOT SPRINGS COMM
1 MERCY LANEHOT SPRINGSAR71913261125131SOLD TO CHI 3/31/2014AR501C39MERCY HEALTH HOT SPRINGS COMMYes (1)
MERCY CLINIC OKLAHOMA COMM
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120270473057PHYSICIAN GROUPOK501C39MERCY HEALTH OK COMMUNITIESYes (1)
MERCY CLINIC SPRINGFIELD COMM
1965 FREMONT STREET SUITE 2950SPRINGFIELDMO65804431560263PHYSICIAN GROUPMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY FAMILY CENTER
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017721069468FAMILY COUNSELING SERVICESMO501C37MERCY HEALTHYes (1)
MERCY FDTN HEALTH INNOV
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017200901499FOUNDATIONMO501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017431423050CORPORATE OFFICEMO501C310N/A
MERCY HEALTH CENTER FOUNDATION INC
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731593024DISSOLVED 5/20/2014OK501C311-IMERCY HOSPITAL OKLAHOMA CITYYes (1)
MERCY HEALTH EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100ST LOUISMO63141431718408HEALTH SYSTEMMO501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH EAST COMMUNITIES - SR
645 MARYVILLE CTR DR STE 100ST LOUISMO63141461412322HEALTH SYSTEMMO501C311-IIMERCY HEALTH EAST COMMUNITIESYes (1)
MERCY HEALTH FORT SMITH COMM
7301 ROGERS AVENUEFORT SMITHAR72917261318515HOLDING COMPANYAR501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH FOUNDATION ADA
430 N MONTE VISTA STREETADAOK74820453596274FOUNDATIONOK501C311-IMERCY HOSPITAL ADAYes (1)
MERCY HEALTH FOUNDATION ARDMORE
1011 14TH AVENUE NWARDMOREOK73401710962525FOUNDATIONOK501C311-IMERCY HOSPITAL ARDMOREYes (1)
MERCY HEALTH FOUNDATION BERRYVILLE
214 CARTER STREETBERRYVILLEAR72616710759301FOUNDATIONAR501C311-IMERCY HOSPITAL BERRYVILLEYes (1)
MERCY HEALTH FOUNDATION FT SCOTT
401 WOODLAND HILLS BLVDFORT SCOTTKS66701481077073FOUNDATIONKS501C311-IIIMERCY KANSAS COMMUNITIES INCYes (1)
MERCY HEALTH FOUNDATION HOT SPRINGS
300 WERNER STREETHOT SPRINGSAR71913710804718FOUNDATIONAR501C311-IIMISSION CLINICAL SERVICESYes (1)
MERCY HEALTH FOUNDATION INDEPENDENCE
800 W MYRTLEINDEPENDENCEKS67301481079981FOUNDATIONKS501C311-IMERCY KANSAS COMMUNITIES INCYes (1)
MERCY HEALTH FOUNDATION JEFFERSON
1400 US HIGHWAY 61 SOUTHFESTUSMO63028462797051FOUNDATIONMO501C311-IIMERCY HEALTH EAST COMMUNITIES - SRYes (1)
MERCY HEALTH FOUNDATION JOPLIN
100 MERCY WAYJOPLINMO64804270906136FOUNDATIONMO501C311-IMERCY HEALTH SW MOKS COMMYes (1)
MERCY HEALTH FOUNDATION NW ARK
2710 RIFE MEDICAL LNROGERSAR72858710601687FOUNDATIONAR501C311-IIIMERCY HOSPITAL ROGERSYes (1)
MERCY HEALTH FOUNDATION OF OK
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120454732301FOUNDATIONOK501C311-IMERCY HEALTH OK COMMUNITIESYes (1)
MERCY HEALTH FOUNDATION OK CITY
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120463184231FOUNDATIONOK501C311-IMERCY HOSPITAL OKLAHOMA CITYYes (1)
MERCY HEALTH FOUNDATION SPRINGFIELD
1235 E CHEROKEE STREETSPRINGFIELDMO65804320195818FOUNDATIONMO501C311-IIMERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HEALTH FOUNDATION STL
615 SOUTH NEW BALLAS ROADST LOUISMO63141562410020FOUNDATIONMO501C311-IIMERCY HEALTH EAST COMMUNITIESYes (1)
MERCY HEALTH FOUNDATION WASHINGTON
901 E FIFTH STREETWASHINGTONMO63090562410022FOUNDATIONMO501C311-IIMERCY HEALTH EAST COMMUNITIESYes (1)
MERCY HEALTH HOT SPRINGS COMM
300 WERNER STREETHOT SPRINGSAR71913261125064SOLD TO CHI 3/31/2014AR501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH NW ARK COMMUNITIES
2710 RIFE MEDICAL LNROGERSAR72758621684203PHYSICIAN GROUPAR501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH OK COMMUNITIES
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731453048HOLDING COMPANYOK501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH SW MOKS COMM
100 MERCY WAYJOPLINMO64804300584463HEALTH SYSTEMMO501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH SPRINGFIELD COMM
1235 E CHEROKEE STREETSPRINGFIELDMO65804431856028HOLDING COMPANYMO501C311-IIMERCY HEALTHYes (1)
MERCY HEALTH SYSTEM TX
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017742764727DISSOLVED 5/15/2014TX501C311-IIMERCY HEALTHYes (1)
MERCY HOME HEALTH BERRYVILLE
804 W FREEMAN SUITE 4BERRYVILLEAR72616870781247HOME HEALTH AND HOSPICE OPERATIONSAR501C311-IIIMERCY HOSPITAL SPRINGFIELDYes (1)
MERCY HOSPITAL ARDMORE
1011 14TH AVENUE NWARDMOREOK73401731500629HOSPITALOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
MERCY HOSPITAL AURORA
500 PORTER AVENUEAURORAMO65605431936696HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HOSPITAL BERRYVILLE
214 CARTER STREETBERRYVILLEAR72616710759299HOSPITALAR501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HOSPITAL BOONEVILLE
880 WEST MAIN STREETBOONEVILLEAR72927463851119HOSPITALAR501C33MERCY HOSPITAL FORT SMITHYes (1)
MERCY HOSPITAL CARTHAGE
3125 DR RUSSELL SMITH WAYCARTHAGEMO64836453808607HOSPITALMO501C33MERCY HEALTH SW MOKS COMMYes (1)
MERCY HOSPITAL CASSVILLE
94 MAIN STREETCASSVILLEMO65625431936699HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HOSPITAL COLUMBUS
220 PENNSYLVANIA AVENUECOLUMBUSKS66725270842031HOSPITALMO501C39MERCY HEALTH SW MOKS COMMYes (1)
MERCY HOSPITAL EL RENO
2115 PARKVIEW DRIVEEL RENOOK73036272716065HOSPITALOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
MERCY HOSPITAL FORT SMITH
7301 ROGERS AVENUEFORT SMITHAR72917710240352HOSPITALAR501C33MERCY HEALTH FORT SMITH COMMYes (1)
MERCY HOSPITAL HEALDTON INC
918 SOUTH 8TH STREETHEALDTONOK73438263173902HOSPITALOK501C33MERCY HOSPITAL ARDMORE INCYes (1)
MERCY HOSPITAL HOT SPRINGS
300 WERNER STREETHOT SPRINGSAR71913710236913SOLD TO CHI 3/31/2014AR501C33MERCY HEALTH HOT SPRINGS COMMYes (1)
MERCY HOSPITAL JEFFERSON
1400 HIGHWAY 61 SOUTHFESTUSMO63028430687077HOSPITALMO501C33MERCY HEALTH EAST COMMUNITIES - SRYes (1)
MERCY HOSPITAL JOPLIN
100 MERCY WAYJOPLINMO64804270814858HOSPITALMO501C33MERCY HEALTH SW MOKS COMMYes (1)
MERCY HOSPITAL KINGFISHER INC
1000 KINGFISHER REGIONAL HOSPITAL DKINGFISHEROK73750463433074HOSPITALOK501C33MERCY HOSPITAL OKLAHOMA CITYYes (1)
MERCY HOSPITAL LEBANON
100 HOSPITAL DRIVELEBANONMO65536431767432HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HOSPITAL LOGAN COUNTY INC
200 SOUTH ACADEMYGUTHRIEOK73044452998842HOSPITALOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
MERCY HOSPITAL OF LAREDO
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017741189682DISSOLVED 5/15/2014TX501C33MERCY HEALTH SYSTEM TXYes (1)
MERCY HOSPITAL OKLAHOMA CITY
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120730579285HOSPITALOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
MERCY HOSPITAL OZARK
801 W RIVER STREETOZARKAR72949710689680HOSPITALAR501C33MERCY HOSPITAL FORT SMITHYes (1)
MERCY HOSPITAL PARIS
500 E ACADEMYPARISAR72855710655753HOSPITALAR501C33MERCY HOSPITAL FORT SMITHYes (1)
MERCY HOSPITAL ROGERS
2710 RIFE MEDICAL LNROGERSAR72758710294390HOSPITALAR501C33MERCY HEALTH NW ARK COMMUNITIESYes (1)
MERCY HOSPITAL SPRINGFIELD
1235 E CHEROKEE STREETSPRINGFIELDMO65804440552485HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY HOSPITAL TISHOMINGO
1000 SOUTH BYRDTISHOMINGOOK73460274433830HOSPITALOK501C33MERCY HOSPITAL ARDMOREYes (1)
MERCY HOSPITAL WALDRON
1341 W 6TH STREETWALDRONAR72958710557895HOSPITALAR501C33MERCY HOSPITAL FORT SMITHYes (1)
MERCY HOSPITAL WATONGA INC
500 CLARENCE NASH BLVDWATONGAOK73772455199762LEASED HOSPITALOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
MERCY HOSPITALS EAST COMM
645 MARYVILLE CTR DR STE 100ST LOUISMO63141430653493HOSPITALMO501C33MERCY HEALTH EAST COMMUNITIESYes (1)
MERCY KANSAS COMMUNITIES INC
401 WOODLAND HILLS BLVDFT SCOTTKS66701480956045HOSPITALKS501C33MERCY HEALTH SW MOKS COMMYes (1)
MERCY MEDICAL RESEARCH INST
1235 E CHEROKEE STREETSPRINGFIELDMO65804870796305RESEARCH - CLINICAL TRIALSMO501C34MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY MINISTRIES OF LAREDO
2500 ZACATECASLAREDOTX78043200198462HEALTHCARE SERVICES,OUTREACH EDUCATION PROGRAMTX501C37MERCY HEALTHYes (1)
MERCY ST FRANCIS HOSPITAL
100 W HIGHWAY 60MOUNTAIN VIEWMO65548440607149HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
MERCY SUPPORT SERVICES
615 S NEW BALLAS ROADST LOUISMO63141431677952INACTIVEMO501C311-IIIMERCY HOSPITALS EAST COMMYes (1)
MHM SUPPORT SERVICES
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017202553101CENTRALIZED HEALTH SYSTEM FUNCTIONSMO501C311-IIMERCY HEALTHYes (1)
MISSION CLINICAL SERVICES
300 WERNER STREETHOT SPRINGSAR71913134239691CHILD ADVOCACY CENTERAR501C39MERCY HEALTHYes (1)
ST EDWARD MERCY FOUNDATION
7301 ROGERS AVENUEFORT SMITHAR72917237330425FOUNDATIONAR501C37MERCY HOSPITAL FORT SMITHYes (1)
ST JOHNS CHILDRENS HOSP
1235 E CHEROKEE STREETSPRINGFIELDMO65804INACTIVEMO501C33MERCY HEALTH SPRINGFIELD COMMYes (1)
ST MARYS HOSP ENID OK
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017730614655INACTIVEOK501C33MERCY HEALTH OK COMMUNITIESYes (1)
THE SR M CORNELIA BLASKO FN
100 W HIGHWAY 60MOUNTAIN VIEWMO65548431873914FOUNDATIONMO501C311-IMERCY ST FRANCIS HOSPITALYes (1)
UNITY AMBULATORY CARE
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017431861745INACTIVEMO501C311-IIIMERCY HEALTH EAST COMMUNITIESYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
SOUTHERN OKLAHOMA DIAG CTR LLC
1011 FOURTEENTH AVENUE NWARDMOREOK73401431971232MRI SERVICESOKMERCY HOSPITAL ARDMORE INCN/A00
RESOURCE OPTIMIZ & INNOVLLC
645 MARYVILLE CTR DRSTE 200ST LOUISMO63141460468368CENTRAL DISTRIBUTION CENTERMOMHN INC - MHNSR INCN/A00
MERCY AMBULATORY SURGERY CENTER LLC
7301 ROGERS AVENUEFORT SMITHAR72917710827721AMBULATORY SURGERY CENTERARMERCY HOSPITAL FORT SMITHN/A00
FORT SMITH EMERGENCY MEDICAL SERVICES
1701 SOUTH GREENWOODFORT SMITHAR72901710416615EMERGENCY MEDICAL SERVICESARMERCY HOSPITAL FORT SMITHN/A00
ST EDWARD MERCY MC M-P OFFICE BLDG
7301 ROGERS AVENUEFORT SMITHAR72903710554050OFFICE BUILDINGARMERCY HOSPITAL FORT SMITHN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
MERCY COMM SERVICES INC
401 WOODLAND HILLS BLVDFORT SCOTTKS66701481078101RETAIL PHARMACYKSMERCY KANSAS COMM INCC0
FRONTENAC PROPERTIES INC
14528 S OUTER FORTY SUITE 100CHESTERFIELDMO63017521914421HOLDS ANCILLARY ASSETS & OWNS AIRCRAFTDEMERCY HEALTHC0
INVENO HEALTH INC
1235 E CHEROKEE STREETSPRINGFIELDMO65804264509571TECHNOLOGY TRANSFER COMPANYMOMERCY HEALTH SPRINGFIELD COMMC0
UNITY SUPPORT SERVICES INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141431797042INACTIVEMOMERCY HEALTH EAST COMMUNITIESC0
UH L CORP INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141742499535HOLDING COMPANYMOMERCY HEALTH SERVICES LLCC0
MHN OF THE SOUTHERN REGION INC
1011 14TH AVENUE NWARDMOREOK73401731580607HOLDING COMPANYOKMERCY MANAGED CARE CORPC0
MERCY HEALTH CENTER CONDOMINIUM INC
4300 W MEMORIAL RDOKLAHOMA CITYOK73120680640970ADMINISTRATOR OF CERTAIN REAL PROPERTY AND IMPROVEMENTSOKMERCY HOSPITAL OKLAHOMA CITYINCC0
MERCY MANAGED CARE CORPORATION
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731441665HOLDING COMPANYOKMERCY HEALTHC0
MERCY HEALTH NETWORK INC
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731381689HOLDING COMPANYOKMERCY MANAGED CARE CORPC0
APOTHECARY SERVICES INC
PO BOX 350CRYSTAL CITYMO63019431627267RETAIL PHARMACYMOMERCY HOSPITAL JEFFERSONC0
MERCY COMMERCIAL SERVICES INC
14528 SOUTH OUTER FORTY SUITE 100CHESTERFIELDMO63017464953543CORP PARENT OF VCC TAXABLE COMMERCIALIZ SVCSOKMHN INC AND MHNSR INCC0
ST JOHNS MERCY MAIL ORDER INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141431014222INACTIVEMOUH HOLDINGS INCC0
ST JOHNS MERCY PBM INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141743089567INACTIVEMOUH L CORP INCC0
UH HOLDINGS INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141431845682INACTIVEMOUH L CORP INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MERCY HEALTH FOUNDATION ADA
B$5,000FMV
MERCY HEALTH FOUNDATION ADA
C$91,202FMV
MERCY CLINIC OKLAHOMA COMMUNITIES INC
Q$2,747,318FMV
MERCY HEALTH
P$61,694FMV
MERCY HEALTH FOUNDATION ADA
Q$91,202FMV
MERCY HEALTH OKLAHOMA COMMUNITIES INC
P$1,664,861FMV
MERCY HOSPITAL OKLAHOMA CITY
Q$53,981,419FMV
MERCY HOSPITAL WATONGA
P$530,752FMV
MHM SUPPORT SERVICES
P$6,013,172FMV
RESOURCE OPTIMIZATION & INNOVATION LLC
P$1,170,700FMV