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MERCY HOSPITAL BERRYVILLE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MERCY HOSPITAL BERRYVILLE (EIN 71-0759299)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201421349349307162
Schema version
2012v2.3
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)
Timestamp2014-05-14T16:00:44-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1190 CARONDELET PLAZA SUITE 1300AddressLine1
CityCLAYTONCity
StateMOState
ZIP Code63105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN710759299EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mercy Hospital BerryvilleBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% Sherry Clouse DayInCareOfName
Name ControlMERCNameControl
Phone3145796100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1214 Carter StreetAddressLine1
Address Line2SuiteAddressLine2
CityBerryvilleCity
StateARState
ZIP Code72616ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameScott ReynoldsName
TitleTreasurerTitle
Date Signed2014-05-09DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSherry Clouse DayNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1214 Carter StAddressLine1
CityBerryvilleCity
StateARState
ZIP Code72616ZIPCode
FieldValueIRS element (for citing)
Gross Receipts25764813GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.MERCY.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileARStateLegalDomicile
Activity Or Mission DescriptionAs the Sisters of Mercy before us, we bring to life the healing ministry of Jesus through our compassionate care and exceptional service.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees211TotalNbrEmployees
Total Nbr Volunteers78TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year70632ContributionsGrantsPriorYear
Contributions Grants Current Year196953ContributionsGrantsCurrentYear
Program Service Revenue Prior Year23010327ProgramServiceRevenuePriorYear
Program Service Revenue CY25416280ProgramServiceRevenueCY
Investment Income Prior Year-5304InvestmentIncomePriorYear
Investment Income Current Year1051InvestmentIncomeCurrentYear
Other Revenue Prior Year134994OtherRevenuePriorYear
Other Revenue Current Year150529OtherRevenueCurrentYear
Total Revenue Prior Year23210649TotalRevenuePriorYear
Total Revenue Current Year25764813TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2882GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY10908GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9766974SalariesEtcPriorYear
Salaries Etc Current Year10016063SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year11651464OtherExpensePriorYear
Other Expenses Current Year12107277OtherExpensesCurrentYear
Total Expenses Prior Year21421320TotalExpensesPriorYear
Total Expenses Current Year22134248TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1789329RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3630565RevenuesLessExpensesCY
Total Assets BOY9351333TotalAssetsBOY
Total Assets EOY9509454TotalAssetsEOY
Total Liabilities BOY326277TotalLiabilitiesBOY
Total Liabilities EOY904028TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9025056NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8605426NetAssetsOrFundBalancesEOY
Mission DescriptionAs the Sisters of Mercy before us, we bring to life the healing ministry of Jesus through our compassionate care and exceptional service.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense19507301Expense
Grants10908Grants
Revenue25416280Revenue
DescriptionMERCY HEALTH SPRINGFIELD COMMUNITIES AND ITS SUBSIDIARIES PROVIDE HIGH-QUALITY, COMPASSIONATE, FAITH-BASED HEALTH CARE IN A VARIETY OF TRADITIONAL MEDICAL SETTINGS. THIS ORGANIZATION, AS PART OF MERCY HEALTH SPRINGFIELD COMMUNITIES, PROVIDES SERVICES TO THE COMMUNITIES WE SERVE, WITH PARTICULAR CONCERN FOR THE ECONOMICALLY POOR, IN THE WAY OF INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES, EMERGENCY ROOM CARE, HOME HEALTH SERVICES, AND PHYSICIAN CLINIC OFFICE VISITS.Description
Total Program Service Expense19507301TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees211NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSherry Clouse DayNamePerson
Telephone Number3145796100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1214 Carter StAddressLine1
CityBerryvilleCity
StateARState
ZIP Code72616ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Barbe MD David O
Physician & Board member5.055.0X029991752431
Bland Gene
Board member1.00.0X000
Estrem Kristy K
President50.010.0X018365726456
Harp Richard
Board member1.01.0X000
Koelsch RSM Sr Cabrini
Board member1.040.0X000
McGowen Milton
Board member1.01.0X000
Milam MD Craig
Physician & Board member5.055.0X015973012014
Ray Bill
Board member1.01.0X000
Schaefer Michele M
Sr VP-Regional Operations2.058.0X046490360929
Thurman Greg
Board member1.00.0X000
Villines Suzanne
Board member1.01.0X000
Whiteley Ronnie
Board member1.00.0X000
Steele MD Robert
PRES MERCY SPFD- START 3/1/132.058.0X052347842724X
Swope Jon
PRES CENTRAL COMM START 3/1/131.059.0X0758712230689X
Knackstedt Chris
CFO- THROUGH 12/31/122.058.00108703883106X
Reynolds Scott R
VP-Finance2.058.0030702038103X
Clouse Day Sherry
VP-Finance15.045.0018388816736X
Day Bradley Kim
PRES CENTRAL COMM- Thru 3/1/131.059.00987614348680X
Marion Tanya
Regional VP-Human resources1.059.0023263543308X
Merrigan Michael
Regional VP-General Counsel1.059.0037845056809X
David MD Andrew
Physician60.00.0247595019686X
Phillippe Robert
Nurse anesthetist60.00.016516303106X
Shapter MD Janet
Physician60.00.0247027011609X
Sieg Mike
Director, pharmacy services60.00.0119838013961X
Warner DO Milo
Medical director60.00.0236330018109X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1015953TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5567042TotalReportableCompFrmRltdOrgs
Total Other Compensation1078456TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events0FundraisingEvents
Government Grants196953GovernmentGrants
Noncash Contributions0NoncashContributions
Total Contributions196953TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net Patient Service Reven62211025354977253549770$0
Other Operating Revenue90009943903439030$0
Rent from Related Orgs53112017400174000$0
FieldValueIRS element (for citing)
Total Program Service Revenue25416280TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1051TotalRevenueColumn
Exclusion$1,051ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCafe & VendingDescription
Total Revenue Column150529TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$150,529ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue150529TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column25764813TotalRevenueColumn
Related Or Exempt Function Income25416280RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$151,580ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total10908Total
Program Services10908ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8082187Total
Program Services6686871ProgramServices
Management And General1395316ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total332458Total
Program Services275940ProgramServices
Management And General56518ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1086182Total
Program Services901531ProgramServices
Management And General184651ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total515236Total
Program Services427646ProgramServices
Management And General87590ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total2926Total
Program Services2926ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total683998Total
Program Services671091ProgramServices
Management And General12907ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total327Total
Management And General327ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total455415Total
Program Services388424ProgramServices
Management And General66991ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total274205Total
Program Services226299ProgramServices
Management And General47906ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total29755Total
Program Services17332ProgramServices
Management And General12423ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total6750Total
Program Services6750ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total761404Total
Program Services609123ProgramServices
Management And General152281ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total153661Total
Program Services153661ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad Debt Expense5831324583132400
Repairs & Maint36587497113561630
Shared Service Fees195283817207912320470
Medical Supplies Expense1536397153639700

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total52403Total
Program Services30576ProgramServices
Management And General21827ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total22134248Total
Program Services19507301ProgramServices
Management And General2626947ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY812524BOY
EOY330593EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2242506BOY
EOY2623777EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY320592BOY
EOY342720EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY40821BOY
EOY85481EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis16442692LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10315809LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5934890BOY
EOY6126883EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9351333BOY
EOY9509454EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1277BOY
EOY734028EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY325000BOY
EOY170000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY326277BOY
EOY904028EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9025056BOY
EOY8605426EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9025056BOY
EOY8605426EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9351333BOY
EOY9509454EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3630565ReconcilationRevenueExpenses
Reconcilation Other Changes-4050195ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Media Advertisements$0MediaAdvertisementsAmount
Mailings MembersfalseMailingsMembers
Mailings Members$0MailingsMembersAmount
Publications Or BroadcastfalsePublicationsOrBroadcast
Publications Or Broadcast$0PublicationsOrBroadcastAmount
Grants Other OrganizationsfalseGrantsOtherOrganizations
Grants Other Organizations$0GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Direct Contact Legislators$0DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Rallies Demonstrations$0RalliesDemonstrationsAmount
Other ActivitiestrueOtherActivities
Other Activities$2,926OtherActivitiesAmount
Total Lobbying Expenditures IIB2926TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierFORM 990, PART II-B, LINE 1 (I)Identifier
Return ReferenceLOBBYING PORTION OF DUESReturnReference
ExplanationTHE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: ARKANSAS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND CATHOLIC HEALTH ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2013, DUE WERE $8,934, $5,568 AND $2,401, RESPECTIVELY. APPROXIMATELY 17% OF ARKANSAS HOSPITAL ASSOCIATION DUES, 23.98% OF AMERICAN HOSPITAL ASSOCIATION DUES AND 3.0% OF CATHOLIC HEALTH ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PREFORMED BY THESE ASSOCIATIONS.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis432810OtherCostOrOtherBasis
Book Value432810BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7364353OtherCostOrOtherBasis
Depreciation3941064Depreciation
Book Value3423289BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis11036OtherCostOrOtherBasis
Depreciation11036Depreciation

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis8390005OtherCostOrOtherBasis
Depreciation6260228Depreciation
Book Value2129777BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis244488OtherCostOrOtherBasis
Depreciation103481Depreciation
Book Value141007BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6126883TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionNOTES PAYABLEDescription
Amount$170,000Amount
FieldValueIRS element (for citing)
Total Of Amounts170000TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE D, PART X, LINE 2Identifier
Return ReferenceASC 740 FOOTNOTEReturnReference
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.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense726983TotalCommunityBenefitExpense
Net Community Benefit Expense726983NetCommunityBenefitExpense
Percent Of Total Expense0.04460PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2599660TotalCommunityBenefitExpense
Direct Offsetting Revenue3081490DirectOffsettingRevenue
Net Community Benefit Expense-481830NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3326643TotalCommunityBenefitExpense
Direct Offsetting Revenue3081490DirectOffsettingRevenue
Net Community Benefit Expense245153NetCommunityBenefitExpense
Percent Of Total Expense0.01500PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense39876TotalCommunityBenefitExpense
Net Community Benefit Expense39876NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense32946TotalCommunityBenefitExpense
Net Community Benefit Expense32946NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6324TotalCommunityBenefitExpense
Net Community Benefit Expense6324NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense62899TotalCommunityBenefitExpense
Net Community Benefit Expense62899NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense142045TotalCommunityBenefitExpense
Net Community Benefit Expense142045NetCommunityBenefitExpense
Percent Of Total Expense0.00870PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3468688TotalCommunityBenefitExpense
Direct Offsetting Revenue3081490DirectOffsettingRevenue
Net Community Benefit Expense387198NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense3963TotalCommunityBuildingExpense
Net Community Building Expense3963NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense11158TotalCommunityBuildingExpense
Net Community Building Expense11158NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense651TotalCommunityBuildingExpense
Net Community Building Expense651NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense600TotalCommunityBuildingExpense
Net Community Building Expense600NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense16372TotalCommunityBuildingExpense
Net Community Building Expense16372NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,206,987BadDebtExpenseAmount
Amount Reimbursed By Medicare6565650AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6533946CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall31704MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mercy Hospital BerryvilleBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1214 Carter StreetAddressLine1
CityBerryvilleCity
StateARState
ZIP Code72616ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mercy Hospital BerryvilleBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY THERAPY SERVICES BERRYVILLEBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1735 HIGHWAY 62 WESTAddressLine1
CityBERRYVILLECity
StateARState
ZIP Code72616ZIPCode
FieldValueIRS element (for citing)
Facility TypeOUT PATIENT REHABFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE H, PART I, LINE 6AIdentifier
Return ReferenceCOMMUNITY BENEFIT REPORTReturnReference
ExplanationTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES THE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINIC COSTS ON LINE 7G. FORM 990, SCHEDULE H, PART I, LINE 7, Column F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $22,134,248. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $5,831,324. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $16,302,924. FORM 990, SCHEDULE H, PART II EXPLANATION Describe how community building activities promote the health of the communities we serve. COMMUNITY BUILDING ACTIVITIES WORK TOWARD IMPROVING THE HEALTH, WELLNESS, AND SAFETY OF THE COMMUNITY. COMMUNITY BUILDING AND COALITION BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE THROUGH THEIR PARTICIPATION IN COMMUNITY-BASED EVENTS, MEETINGS AND BY SERVING ON COMMUNITY BOARDS. COMMUNITY BUILDING ACTIVITIES WORK TOWARD IMPROVING THE HEALTH, WELLNESS, AND SAFETY OF THE COMMUNITY. MERCY BERRYVILLE PARTICIPATED IN COALITION BUILDING AND HEALTH PROMOTION WITH PUBLIC AND DIOCESAN SCHOOLS THROUGH THE DISCUSSION AND DEVELOPMENT OF THE HEALTHTEACHER HEALTH AND WELLNESS INITIATIVE. HEALTHTEACHER PROVIDES TOOLS AND RESOURCES FOR TEACHERS, STUDENTS K THRU 12, AND FAMILIES BY INTEGRATING HEALTH INTO THE CLASSROOMS. HEALTH AND WELLNESS EDUCATION, ESPECIALLY FOR CHILDREN, IS ESSENTIAL IN DISEASE PREVENTION AND IN PROMOTING THE HEALTH OF EVERY COMMUNITY. THIS PROGRAM IS OFFERED AT NO CHARGE TO EACH SCHOOL IN THE COMMUNITY. MERCY BERRYVILLE'S COMMUNITY INVOLVEMENT INCLUDES WORKING WITH THE SCHOOLS, BUSINESSES, EMERGENCY SERVICES, AND COMMUNITY NONPROFIT ORGANIZATIONS TO EDUCATE AND IMPROVE THE HEALTH OF THE COMMUNITY. MERCY BERRYVILLE ASSISTS THE FREE CLINIC IN THE COMMUNITY AND PROVIDES SUPPORT TO THE SCHOOL FOOD AND SUPPLY PROGRAMS IN PARTNERSHIP WITH OTHER COMMUNITY GROUPS AND IS THE ONLY HOSPITAL IN THIS RURAL ARKANSAS COMMUNITY. WORKFORCE DEVELOPMENT IS ENHANCED BY BEING A CLINICAL EDUCATION SITE FOR NURSING, PHLEBOTOMY, RADIOLOGY TECHNICIAN, PARAMEDIC, AND LAB STUDENTS. FORM 990, SCHEDULE H, 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. FORM 990, SCHEDULE H, 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. FORM 990, SCHEDULE H, 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 THAT ARE UNCOLLECTED, 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 AS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES." FORM 990, SCHEDULE H, PART III, LINE 8 IT IS THE POSITION OF MERCY HOSPITAL BERRYVILLE THAT 100% OF ANY SHORT FALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). FORM 990, SCHEDULE H, PART III, LINE 9B MERCY HOSPITAL BERRYVILLE'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. SCHEDULE H, PART V, LINE 3 COMMUNITY HEALTH NEEDS ASSESSMENT PLEASE REFER TO THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS. FORM 990, SCHEDULE H, PART V, LINE 20 ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTS THE FEDERAL POVERTY GUIDELINES FOR INCOME ARE THE BASIS FOR DETERMINING ELIGIBILITY FOR CHARITY CARE DISCOUNTS. FOR EXAMPLE, INDIVIDUALS WITH INCOMES BELOW 100% OF THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 100% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. ADDITIONAL FINANCIAL ASSISTANCE AFTER 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 (WHICH EVER IS GREATER), ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT MERCY 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. FORM 990, SCHEDULE H, 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. FINANCIAL ASSISTANCE INFORMATION AS 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 FORExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE I, PART I, LINE 2Identifier
ExplanationDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE ASSISTANCE PROVIDED IS INTENDED TO BE USED FOR THE GENERAL OPERATING PURPOSES OF THE DONEE. THE USE OF GRANT FUNDS IS NOT MONITORED AFTER GRANTS ARE GIVEN.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Barbe MD David O
Physician & Board member0227187053050019680042044010387035234800
Estrem Kristy K
President0137093028230018334012382014074021011300
Milam MD Craig
Physician & Board member014620208625049030462107393017174400
Schaefer Michele M
Sr VP-Regional Operations032225709879704384905307407855052583200
Steele MD Robert
PRES MERCY SPFD- START 3/1/1303572720125072041134026492016232056620200
Swope Jon
PRES CENTRAL COMM START 3/1/13048158502494570276700212960017729098940100
Knackstedt Chris
CFO- THROUGH 12/31/120401605057416801112650711020120040117014400
Reynolds Scott R
VP-Finance0203345043193060482025835012268034512300
Clouse Day Sherry
VP-Finance013308001533903546905177011559020062400
Day Bradley Kim
PRES CENTRAL COMM- Thru 3/1/130630366032222503502303344460142340133629400
Marion Tanya
Regional VP-Human resources0137188070088025359028325014983027594300
Merrigan Michael
Regional VP-General Counsel022795909633705415404938907420043525900
David MD Andrew
Physician21757208548021475056610140250267281000
Phillippe Robert
Nurse anesthetist15766400074990270204040168269000
Shapter MD Janet
Physician2130670852102543906117054920258636000
Warner DO Milo
Medical director2269360628903105012589055200254439000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE J, PART I, LINE 1Identifier
ExplanationCHARTER 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. FORM 990, SCHEDULE J, PART I, QUESTION 3 FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, MERCY HEALTH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS, AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY HEALTH OFFERS SUPPLEMENTAL RETIREMENT PLANS TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON RETIREMENT 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 INDIVIDUALS REPORTABLE ON THIS RETURN WHO PARTICIPATE IN THE SUPPLEMENTAL RETIREMENT PLANS INCLUDE: DAVID BARBE, MICHELE SCHAEFER, ROBERT STEELE, JON SWOPE, CHRISTOPHER KNACKSTEDT, BRADLEY DAY, TANYA MARION, AND MICHAEL MERRIGAN. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). FORM 990, SCHEDULE J, PART I, QUESTION 7 MERCY HEALTH PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2013 (JULY 1, 2012 - JUNE 30, 2013), PAYMENT OF ALL OR PART OF THE BONUS WAS CONTINGENT UPON ATTAINMENT OF CERTAIN FINANCIAL TARGETS. 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 GOALS IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF MERCY HEALTH AND IS THEN TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierFORM 990, PART V, QUESTION 1AIdentifier
Return ReferenceFORM 1099/1096 FILINGReturnReference
ExplanationVENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SPRINGFIELD COMMUNITIES. THE CORPORATE MEMBER SHALL HAVE THE FOLLOWING POWERS AND RESPONSIBILITIES, SUBJECT TO THE RESTRICTIONS SET FORTH UNDER THESE BYLAWS: -TO REVIEW, AMEND, AND APPROVE THE MISSION, VISION, AND VALUES OF THE CORPORATION AS RECOMMENDED BY THE BOARD; -TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS, SUBJECT TO RESTRICTIONS SET FORTH IN ARTICLES XI AND XII; -TO APPOINT MEMBERS OF THE BOARD, AS NOMINATED BY THE BOARD OF THE CORPORATION, SUBJECT TO THE RESTRICTIONS SET FORTH IN ARTICLE V HEREIN; -TO APPOINT, SUBJECT TO RECOMMENDATIONS BY THE BOARD, OR REMOVE THE PRESIDENT OF THE CORPORATION, SUBJECT TO THE REQUIREMENTS SET FORTH IN ARTICLE VII HEREIN; -TO REVIEW, AMEND, AND APPROVE THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF THE CORPORATION; -TO REVIEW, AMEND, AND APPROVE THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; -TO REVIEW OR APPROVE ANY CAPITAL EXPENDITURES OR RECOMMENDATIONS NOT PREVIOUSLY APPROVED AS PART OF THE CORPORATION'S BUDGETS AND/OR STRATEGIC PLAN; -TO LEASE OR SELL OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION SUBJECT TO THRESHOLDS ESTABLISHED FROM TIME TO TIME BY MERCY HEALTH AND ANY APPLICABLE LEASE AGREEMENT WITH CARROLL COUNTY ARKANSAS; -TO ENCUMBER THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION, EXCEPT FOR MERCY HEALTH FOUNDATION BERRYVILLE. -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTY ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, CONSOLIDATE, OR DISSOLVE THE CORPORATION; -TO LEASE, MANAGE, PURCHASE, OR AFFILIATE WITH ANOTHER HEALTH FACILITY OR HEALTH CARE SYSTEM; AND, -TO RESIGN AS CORPORATE MEMBER. FORM 990, PART VI, QUESTION 11B DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE CONTROLLER AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORMS 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS MADE AVAILABLE TO BOTH THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, AND THE BOARD OF DIRECTORS FOR THEIR REVIEW. THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2013. 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, QUESTION 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART VII, SECTION A, COLUMN B AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII 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 OTHER CHANGES IN NET ASSETS TRANSFERS TO MERCY INVESTMENT FUND ($2,950,000) NET TRANSFERS TO/FROM AFFILIATES ($1,100,195) TOTAL ($4,050,195) FORM 990, PART XII, QUESTION 2C AUDIT OF FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2013 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE (FORMERLY FINANCE, AUDIT, AND COMPLIANCE COMMITTEE) OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (70 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Casa de Misericordia
1602 McClelland StreetLaredoTX78044742912461SHELTERTX501(C)(3)7MM LAREDOtrue
Laredo Medical Group
14528 S Outer Forty Ste 100ChesterfieldMO63017742764726INACTIVETX501(C)(3)9MHS TEXAStrue
McAuley Portfolio Management Company
14528 S Outer Forty Ste 100ChesterfieldMO63017261708048PORT MGMTMO501(C)(3)11bMERCY HEALTHtrue
Mercy Clinic East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017431771217PHYS GROUPMO501(C)(3)9MH EAST COMMtrue
Mercy Clinic Fort Smith Communities
7301 Rogers AvenueFort SmithAR72903261318597PHYS CLINICAR501(C)(3)9MH FS COMMtrue
Mercy Clinic Hot Springs Communities
1 Mercy LaneHot SpringsAR71913261125131PHYS CLINICAR501(C)(3)9MH HS COMMtrue
Mercy Clinic Oklahoma Communities Inc
4300 W Memorial RoadOklahoma CityOK73120270473057PHYS GROUPOK501(C)(3)9MH OK COMMtrue
Mercy Clinic Springfield Communities
1965 Fremont Street Ste 2950SpringfieldMO65804431560263PHYS GROUPMO501(C)(3)9MH SF COMMtrue
Mercy Family Center
14528 S Outer Forty Ste 100ChesterfieldMO63017721069468COUNSELINGMO501(C)(3)7MERCY HEALTHtrue
Mercy Foundation for Health Innovation
14528 S Outer Forty Ste 100ChesterfieldMO63017200901499FOUNDATIONMO501(C)(3)11bMERCY HEALTHtrue
Mercy Health
14528 S Outer Forty Ste 100ChesterfieldMO63017431423050CORP OFFICEMO501(C)(3)1NAfalse
Mercy Health East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017431718408HLTH SYSTEMMO501(C)(3)11bMERCY HEALTHtrue
Mercy Health East Communities South Reg
14528 S Outer Forty Ste 100ChesterfieldMO63017461412322HLTH SYSTEMMO501(C)(3)11bMH EAST COMMtrue
Mercy Health Fort Smith Communities
7301 Rogers AvenueFort SmithAR72917261318515HOLDING COAR501(C)(3)11bMERCY HEALTHtrue
Mercy Health Foundation Ardmore
1011 14th Avenue NWArdmoreOK73401710962525FOUNDATIONOK501(C)(3)11aMH ARDMOREtrue
Mercy Health Foundation Berryville
214 Carter StreetBerryvilleAR72616710759301FOUNDATIONAR501(C)(3)11aMH BRYVILLEtrue
Mercy Health Foundation Fort Scott
401 Woodland Hills BlvdFort ScottKS66701481077073FOUNDATIONKS501(C)(3)11cM KS COMMtrue
St Edward Mercy Foundation
7301 Rogers AvenueFort SmithAR72917237330425FOUNDATIONAR501(C)(3)7MH FT SMITHtrue
Mercy Health Foundation Hot Springs
300 Werner StreetHot SpringsAR71913710804718FOUNDATIONAR501(C)(3)11bMH H SPRINGStrue
Mercy Health Foundation Independence
800 W MyrtleIndependenceKS67301481079981FOUNDATIONKS501(C)(3)11aM KS COMMtrue
Mercy Health Foundation Jefferson
1400 US Highway 61 SouthFestusMO63028462797051FOUNDATIONMO501(C)(3)11bMH E COMM SRtrue
Mercy Health Foundation Joplin
2817 St Johns BlvdJoplinMO64804270906136FOUNDATIONMO501(C)(3)11aMH SWMK COMMtrue
Mercy Health Foundation NW Arkansas
2710 Rife Medical LaneRogersAR72758710601687FOUNDATIONAR501(C)(3)11cMH ROGERStrue
Mercy Health Foundation Oklahoma City
4300 W Memorial RoadOklahoma CityOK73120731593024FOUNDATIONOK501(C)(3)11aMH OK CITYtrue
Mercy Health Foundation of Oklahoma
4300 W Memorial RoadOklahoma CityOK73120454732301FOUNDATIONOK501(C)(3)11aMH OK COMMtrue
Mercy Health Foundation Springfield
1235 E Cherokee StreetSpringfieldMO65804320195818FOUNDATIONMO501(C)(3)11bMH SF COMMtrue
Mercy Health Foundation St Louis
14528 S Outer Forty Ste 100ChesterfieldMO63017562410020FOUNDATIONMO501(C)(3)11bMH EAST COMMtrue
Mercy Health Foundation Washington
901 E Fifth StreetWashingtonMO63090562410022FOUNDATIONMO501(C)(3)11bMH EAST COMMtrue
Mercy Health Hot Springs Communities
300 Werner StreetHot SpringsAR71913261125064HOLDING COAR501(C)(3)11bMERCY HEALTHtrue
Mercy Health NW Arkansas Communities
2710 Rife Medical LaneRogersAR72758621684203PHYS GROUPAR501(C)(3)11bMERCY HEALTHtrue
Mercy Health Oklahoma Communities Inc
4300 W Memorial RoadOklahoma CityOK73120731453048HOLDING COOK501(C)(3)11bMERCY HEALTHtrue
Mercy Health Southwest MOKS Communities
2817 St Johns BlvdJoplinMO64804300584463HLTH SYSTEMMO501(C)(3)11bMERCY HEALTHtrue
Mercy Health Springfield Communities
1235 E Cherokee StreetSpringfieldMO65804431856028HLTH SYSTEMMO501(C)(3)11bMERCY HEALTHfalse
Mercy Health System of Texas Inc
14528 S Outer Forty Ste 100ChesterfieldMO63017742764727INACTIVETX501(C)(3)11bMERCY HEALTHtrue
Mercy Home Health Berryville
804 W Freeman Suite 4BerryvilleAR72616870781247HOME HEALTHAR501(C)(3)11cMH SFtrue
Mercy Hospital Ada Inc
430 N Monte Vista StreetAdaOK74820462288155HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospital Ardmore Inc
1011 14th Avenue NWArdmoreOK73401731500629HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospital Aurora
500 Porter AvenueAuroraMO65605431936696HOSPITALMO501(C)(3)3MH SF COMMtrue
Mercy Hospital Carthage
3125 Dr Russell Smith WayCarthageMO64836453808607HOSPITALMO501(C)(3)3MH SWMK COMMtrue
Mercy Hospital Cassville
94 Main StreetCassvilleMO65625431936699HOSPITALMO501(C)(3)3MH SF COMMtrue
Mercy Hospital Columbus
220 Pennsylvania AvenueColumbusKS66725270842031HOSPITALMO501(C)(3)3MH SWMK COMMtrue
Mercy Hospital El Reno Inc
2115 Parkview DriveEl RenoOK73036272716065HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospital Fort Smith
7301 Rogers AvenueFort SmithAR72917710240352HOSPITALAR501(C)(3)3MH FS COMMtrue
Mercy Hospital Healdton Inc
918 South 8th StreetHealdtonOK73438263173902HOSPITALOK501(C)(3)3MH ARDMOREtrue
Mercy Hospital Hot Springs
300 Werner StreetHot SpringsAR71913710236913HOSPITALAR501(C)(3)3MH HS COMMtrue
Mercy Hospital Jefferson
1400 Highway 61 SouthFestusMO63028430687077HOSPITALMO501(C)(3)3MH E COMM SRtrue
Mercy Hospital Joplin
2817 St Johns BlvdJoplinMO64804270814858HOSPITALMO501(C)(3)3MH SWMK COMMtrue
Mercy Hospital Lebanon
100 Hospital DriveLebanonMO65536431767432HOSPITALMO501(C)(3)3MH SF COMMtrue
Mercy Hospital Logan County Inc
200 South AcademyGuthrieOK73044452998842HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospital of Laredo
14528 S Outer Forty Ste 100ChesterfieldMO63017741189682INACTIVETX501(C)(3)3MHS TEXAStrue
Mercy Hospital Oklahoma City Inc
4300 W Memorial RoadOklahoma CityOK73120730579285HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospital Ozark
801 W River StreetOzarkAR72949710689680HOSPITALAR501(C)(3)3MH FT SMITHtrue
Mercy Hospital Paris
500 E AcademyParisAR72855710655753HOSPITALAR501(C)(3)3MH FT SMITHtrue
Mercy Hospital Rogers
2710 Rife Medical LaneRogersAR72758710294390HOSPITALAR501(C)(3)3MH NWAR COMMtrue
Mercy Hospital Springfield
1235 E Cherokee StreetSpringfieldMO65804440552485HOSPITALMO501(C)(3)3MH SF COMMtrue
Mercy Hospital Tishomingo Inc
1000 South ByrdTishomingoOK73460274433830HOSPITALOK501(C)(3)3MH ARDMOREtrue
Mercy Hospital Waldron
1341 W 6th StreetWaldronAR72958710557895HOSPITALAR501(C)(3)3MH FT SMITHtrue
Mercy Hospital Watonga Inc
500 Clarence Nash BlvdWatongaOK73772455199762HOSPITALOK501(C)(3)3MH OK COMMtrue
Mercy Hospitals East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017430653493HOSPITALMO501(C)(3)3MH EAST COMMtrue
Mercy Kansas Communities Inc
401 Woodland Hills BlvdFt ScottKS66701480956045HOSPITALKS501(C)(3)3MH SWMK COMMtrue
Mercy Medical Research Institute
1235 E Cherokee StreetSpringfieldMO65804870796305RESEARCHMO501(C)(3)4MH SF COMMtrue
Mercy Ministries of Laredo
2500 ZacatecasLaredoTX78046200198462OUTREACHTX501(C)(3)7MERCY HEALTHtrue
Mercy St Francis Hospital
100 W Highway 60Mountain ViewMO65548440607149HOSPITALMO501(C)(3)3MH SF COMMtrue
Mercy Support Services
14528 S Outer Forty Ste 100ChesterfieldMO63017431677952INACTIVEMO501(C)(3)11cMH EAST COMMtrue
MHM Support Services
14528 S Outer Forty Ste 100ChesterfieldMO63017202553101HLTH SYSTEMMO501(C)(3)11bMERCY HEALTHtrue
Mission Clinical Services
300 Werner StreetHot SpringsAR71913134239691NURSING HOMEAR501(C)(3)9MH HS COMMtrue
St John's Children's Hospital Inc
1235 E Cherokee StreetSpringfieldMO65804INACTIVEMO501(C)(3)3MH SF COMMtrue
St Mary's Hospital of Enid Oklahoma
14528 S Outer Forty Ste 100ChesterfieldMO63017730614655INACTIVEOK501(C)(3)3MH OK COMMtrue
The Sister M Cornelia Blasko Foundation
100 W Highway 60Mountain ViewMO65548431873914FOUNDATIONMO501(C)(3)11aM ST FRANCIStrue
Unity Ambulatory Care
14528 S Outer Forty Ste 100ChesterfieldMO63017431861745INACTIVEMO501(C)(3)11cMH EAST COMMtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Merc Ambu Surg CTR
7301 Rogers AvFort SmithAR72903710827721AMBUL SURG CTRARNA
RES OPT & INNOV
645 Maryville Centre Dr 200St LouisMO63141460468368CENTRAL DIST.MONA
SO OK DIAG CTR
1011 14TH Ave NWArdmoreOK73401431971232MRI ServicesOKNA
Fort Smith EMS
1701 S GreenwoodFort SmithAR72901710416615Emergency MedARNA
St Ed Mer Med MOB
7301 Rogers AveFort SmithAR72903710554050Office BuildingARNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
Frontenac Properties Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017521914421HOLDING COMPDENAC-Corptrue
Inveno Health Inc
1235 E Cherokee StreetSpringfieldMO65804264509571RESEARCHMONAC-Corptrue
Mercy Community Services Inc
401 Woodland Hills BlvdFort ScottKS66701481078101RETAIL PHARMACYKSNAC-Corptrue
Mercy Health Center Condominium Inc
4300 W Memorial RdOklahoma CityOK73120680640970REAL ESTATEOKNAC-Corptrue
Mercy Health Network of the Southern Reg
1011 14th Avenue NWArdmoreOK73401731580607HEALTH CAREOKNAC-Corptrue
Mercy Health Network Inc
4300 W Memorial RoadOklahoma CityOK73120731381689HEALTH CAREOKNAC-Corptrue
Mercy Managed Care Corporation
4300 W Memorial RoadOklahoma CityOK73120731441665HOLDING COMPOKNAC-Corptrue
UH L Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535HOLDING COMPMONAC-Corptrue
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042PRACTICE MGTMONAC-Corptrue
Jefferson Land Company Inc
14528 South Outer Forty Suite 100ChesterfieldMO63017431330360HOLDING COMPMONAC-Corptrue
The Apothecary Services Inc
PO Box 350Crystal CityMO63019431627267RETAIL PHARMACYMONAC-Corptrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Mercy Clinic Springfield Communities
p188527FMV
Mercy Hospital Aurora
q264638FMV
Mercy Hospital Cassville
q181416FMV
Mercy Hospital Lebanon
q1043241FMV
Mercy Hospital Springfield
p2900640FMV
MHM Support Services
p1744828FMV
Resource Optimization & Innovation LLC
p437463FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE R, PART VIdentifier
ExplanationLAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED 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.Explanation