MERCY HOSPITAL FORT SMITH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL FORT SMITH (EIN 71-0240352)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201431349349305333
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T14:00:13-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 190 CARONDELET PLAZA SUITE 1300 | AddressLine1 |
| City | CLAYTON | City |
| State | MO | State |
| ZIP Code | 63105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710240352 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Hospital Fort Smith | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % GRETA WILCHER VP OF FINANCE | InCareOfName |
| Name Control | MERC | NameControl |
| Phone | 3145796100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 17000 | AddressLine1 |
| Address Line2 | 7301 ROGERS AVENUE Suite | AddressLine2 |
| City | FORT SMITH | City |
| State | AR | State |
| ZIP Code | 729177000 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GRETA WILCHER | Name |
| Title | VP OF FINANCE | Title |
| Date Signed | 2014-05-08 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3142901000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GRETA WILCHER VP OF FINANCE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 17000 | AddressLine1 |
| City | FORT SMITH | City |
| State | AR | State |
| ZIP Code | 729177000 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 219803584 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCY.NET | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | AR | StateLegalDomicile |
| Activity Or Mission Description | AS 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 Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2082 | TotalNbrEmployees |
| Total Nbr Volunteers | 320 | TotalNbrVolunteers |
| Total Gross UBI | 2334766 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 230976 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1158657 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2002016 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 221246627 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 212384021 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 554130 | InvestmentIncomePriorYear |
| Investment Income Current Year | 436420 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -15671752 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3102278 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 207287662 | TotalRevenuePriorYear |
| Total Revenue Current Year | 217924735 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 413792 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 86420811 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 85648579 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 130148906 | OtherExpensePriorYear |
| Other Expenses Current Year | 154629608 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 216569717 | TotalExpensesPriorYear |
| Total Expenses Current Year | 240691979 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -9282055 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -22767244 | RevenuesLessExpensesCY |
| Total Assets BOY | 293083369 | TotalAssetsBOY |
| Total Assets EOY | 287753062 | TotalAssetsEOY |
| Total Liabilities BOY | 69076711 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 86910124 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 224006658 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 200842938 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | AS 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 Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 16644656 | Expense |
| Revenue | 47631264 | Revenue |
| Description | SURGERY - THE SURGICAL AREA OF MERCY FORT SMITH PERFORMED 8,813 PROCEDURES. MERCY FORT SMITH HAS TAKEN STATE-OF-THE-ART TECHNOLOGY, STAFF EXPERIENCE, BEST PRACTICES, AND PATIENT SAFETY INITIATIVES AND CREATED AN EXCEPTIONAL SURGICAL SERVICES DEPARTMENT MAINTAINED WITHIN AN ATMOSPHERE OF CARING FOR THE PATIENT AND THEIR FAMILY. THE SURGERY UNIT OPERATES ON A TWENTY-FOUR (24) HOUR A DAY BASIS, 365 DAYS PER YEAR. THE SURGERY UNIT IS STAFFED WITH REGISTERED NURSES, LICENSED PRACTICAL NURSES, CERTIFIED SCRUB TECHNICIANS, OPERATING ROOM TECHNICIANS, AND OTHER SUPPORT STAFF. UTILIZING A COMBINED TWENTY-ONE (21) OPERATING SUITES, ST. EDWARD MERCY MEDICAL CENTER OFFERS A MULTITUDE OF SURGICAL PROCEDURES IN AN ARRAY OF SURGICAL SERVICE LINES INCLUDING: ENT, CARDIOVASCULAR, OBSTETRICS/GYNECOLOGY, NEUROSURGERY, AMONG OTHERS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5123694 | Expense |
| Revenue | 20399234 | Revenue |
| Description | INTENSIVE CARE UNIT (ICU) - THE ICU AREA HAS 38 BEDS, AND HAD 6,824 DAYS OF PATIENT CARE. ALL ICU ROOMS ARE EQUIPPED FOR CARDIAC MONITORING AND PROVIDE MAXIMUM SURVEILLANCE, SUPPORT OF VITAL FUNCTIONS, AND DEFINITIVE THERAPY FOR SURGICAL, MEDICAL, CARDIAC, AND TRAUMA CRITICAL PATIENTS. MERCY HOSPITAL FORT SMITH UTILIZES MERCY SAFEWATCH. MERCY SAFEWATCH IS A TELEMEDICINE PROGRAM THAT CONNECTS CRITICAL CARE PATIENT ROOMS TO A CENTRALIZED INTENSIVE CARE UNIT (ELECTRONIC ICU). USING MICROPHONES, CAMERAS, AND HIGH-SPEED COMPUTER DATA LINES INSTALLED IN ICU PATIENT ROOMS, MERCY SAFE WATCH SUPPORTS THE PATIENT'S PHYSICIANS AND BEDSIDE CARE TEAM AROUND-THE-CLOCK WITH BOARD CERTIFIED INTENSIVE CARE PHYSICIANS AND EXPERIENCED ICU NURSES WHO MONITOR MERCY FORT SMITH ICU PATIENTS REMOTELY. MERCY SAFEWATCH ADDS ANOTHER LAYER OF SERVICE AND PROTECTION FOR ICU PATIENTS AT MERCY FORT SMITH. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4729318 | Expense |
| Revenue | 22402092 | Revenue |
| Description | CARDIAC CATH LAB - CARDIOVASCULAR IMAGING PROVIDES IMAGES OF THE HEART AND THE SURROUNDING ARTERIES THAT ARE USED IN DIAGNOSING DISEASE AND THE APPROPRIATE CARE TO FOLLOW. THE CATH LAB AT MERCY FORT SMITH HOPITAL IS EQUIPPED WITH THE LATEST CARDIAC AND VASCULAR IMAGING TECHNOLOGY AVAILABLE. OUR CATH LABS WERE THE FIRST IN THE AREA TO UTILIZE "FLAT PLATE" DIGITAL TECHNOLOGY TO OBTAIN THE HIGHEST QUALITY IMAGES POSSIBLE. THIS COMBINED WITH OUR PROFESSIONAL CARING STAFF MAKES MERCY FORT SMITH HOSPITAL AND THE HEART CENTER THE HOSPITAL OF CHOICE FOR CARDIOVASCULAR SERVICES. 37,920 RVU (RELATIVE VALUE UNITS) WERE PERFORMED DURING FY2013. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 118828352 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 413792 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 121951431 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 145326020 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 2082 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | GRETA WILCHER VP OF FINANCE | NamePerson |
| Telephone Number | 4793146104 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7301 ROGERS AVENUE | AddressLine1 |
| City | FORT SMITH | City |
| State | AR | State |
| ZIP Code | 72903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|
| Bean MD Paul | ||||||||||
| Physician & Board member | 1.0 | 59.0 | X | 0 | 337855 | 24382 | ||||
| Brau RSM Sr Annrene | ||||||||||
| Board member | 1.0 | 7.0 | X | 0 | 0 | 0 | ||||
| Buckman RSM Sr Mary Jeremy | ||||||||||
| Board member | 1.0 | 2.0 | X | 0 | 0 | 0 | ||||
| Grobmyer Susan | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Hahn Richard R | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Hembree Lawson | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Hendrickson MD Jon | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Koorie RSM Sr Diane | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Phillips MD Don | ||||||||||
| Board member | 1.0 | 0.0 | X | 0 | 0 | 0 | ||||
| Wilcher Greta | ||||||||||
| Board member & VP-Finance | 25.0 | 35.0 | X | 0 | 228357 | 42154 | ||||
| Gehrig Ryan | ||||||||||
| Chief executive officer | 25.0 | 35.0 | X | 0 | 305463 | 10001 | X | |||
| Vitiello Jonathan | ||||||||||
| Chief financial officer | 3.0 | 57.0 | 0 | 493118 | 64006 | X | ||||
| Day Bradley Kim | ||||||||||
| Pres- Central Comm Thru 3/1/13 | 2.0 | 58.0 | 0 | 987614 | 348680 | X | ||||
| Hennessey III William | ||||||||||
| Regional VP-Marketing | 10.0 | 50.0 | 0 | 257186 | 50175 | X | ||||
| Marion Tanya | ||||||||||
| Regional VP-Human Resources | 2.0 | 58.0 | 0 | 232635 | 43308 | X | ||||
| Merrigan Michael | ||||||||||
| Regional VP-General Counsel | 4.0 | 56.0 | 0 | 378450 | 56809 | X | ||||
| Rataj RN Marianne | ||||||||||
| Chief nursing officer | 60.0 | 0.0 | 201053 | 0 | 16709 | X | ||||
| Swope Jon | ||||||||||
| Pres-Central Comm Start 3/1/13 | 4.0 | 56.0 | 0 | 758712 | 230689 | X | ||||
| Adams Eric B | ||||||||||
| Pharmacist | 60.0 | 0.0 | 149892 | 0 | 13814 | X | ||||
| Gusdorf Michael A | ||||||||||
| Pharmacist | 60.0 | 0.0 | 153363 | 0 | 25290 | X | ||||
| Pearce Larry W | ||||||||||
| VP-Clinical operations | 60.0 | 0.0 | 465748 | 0 | 55697 | X | ||||
| Thomas Jennifer | ||||||||||
| EPIC Accountable executive | 60.0 | 0.0 | 191818 | 0 | 16094 | X | ||||
| James Joel | ||||||||||
| VP-Clinical operations | 60.0 | 0.0 | 173516 | 0 | 19160 | X | ||||
| Johnston Jeffrey A | ||||||||||
| Former key employee | 0.0 | 60.0 | 0 | 652475 | 186039 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1335390 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4631865 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1203007 | TotalOtherCompensation |
| Number Individuals GT100 K | 45 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| DEWITT AND ASSOC INC | |||||
| PO BOX 3378 GS | SPRINGFIELD | MO | 65808 | CONSTRUCTION | 3142425 |
| WEAR CONSTRUCTION MGT INC | |||||
| PO BOX 3218 | FORT SMITH | AR | 72913 | CONSTRUCTION | 1356366 |
| WESTERN AR OBSTETRIC ANESTHESIA | |||||
| PO BOX 11880 | FORT SMITH | AR | 72917 | PHYSICIAN SERVICES | 1062498 |
| WESTERN AR ANESTHESIOLOGY ASSC | |||||
| PO BOX 11880 | FORT SMITH | AR | 72917 | ANESTHESIOLOGY SERVS | 750004 |
| SUPERIOR LINEN SERV | |||||
| PO BOX 580787 | TULSA | OK | 74158 | LINEN SERVICES | 733331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 41 | NumberOfContractorsGT100K |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 1042294 | RelatedOrganizations |
| Government Grants | 722481 | GovernmentGrants |
| All Other Contributions | 237241 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 2002016 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| NET PATIENT CARE REVENUE | 621111 | 203248239 | 202219497 | 1028742 | $0 |
| RENT INCOME FROM RELATED ORGS | 531120 | 1953419 | 1953419 | 0 | $0 |
| OTHER OPERATING REVENUE | 900099 | 7182363 | 7182363 | 0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 212384021 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 416288 | TotalRevenueColumn |
| Unrelated Business Revenue | 226 | UnrelatedBusinessRevenue |
| Exclusion | $416,062 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1783364 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1313536 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 469828 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 469828 | TotalRevenueColumn |
| Exclusion | $469,828 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 20132 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 20132 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20132 | TotalRevenueColumn |
| Exclusion | $20,132 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Direct Expenses | 0 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 997439 | GrossSalesOfInventory |
| Cost Of Goods Sold | 565313 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 432126 | TotalRevenueColumn |
| Exclusion | $432,126 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Cafe & Vending | 921110 | 894526 | 0 | 0 | $894,526 |
| FITNESS CENTER | 713940 | 1305798 | 0 | 1305798 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2200324 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 217924735 | TotalRevenueColumn |
| Related Or Exempt Function Income | 211355279 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2334766 | UnrelatedBusinessRevenue |
| Exclusion | $2,232,674 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 413792 | Total |
| Program Services | 413792 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235098 | Total |
| Program Services | 235098 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66068621 | Total |
| Program Services | 49340892 | ProgramServices |
| Management And General | 16727729 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2970119 | Total |
| Program Services | 2214518 | ProgramServices |
| Management And General | 755601 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11615990 | Total |
| Program Services | 8682352 | ProgramServices |
| Management And General | 2933638 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4758751 | Total |
| Program Services | 3557620 | ProgramServices |
| Management And General | 1201131 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229426 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 229426 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49000 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 49000 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18428 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 18428 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8229362 | Total |
| Program Services | 5857182 | ProgramServices |
| Management And General | 2372180 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 230015 | Total |
| Program Services | 18795 | ProgramServices |
| Management And General | 211220 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4751653 | Total |
| Program Services | 2516284 | ProgramServices |
| Management And General | 2235369 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7362 | Total |
| Program Services | 6367 | ProgramServices |
| Management And General | 995 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3537639 | Total |
| Program Services | 189750 | ProgramServices |
| Management And General | 3347889 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 379541 | Total |
| Program Services | 235511 | ProgramServices |
| Management And General | 144030 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 980 | Total |
| Program Services | 980 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562579 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 562579 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20735568 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 20735568 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10460237 | Total |
| Program Services | 5195535 | ProgramServices |
| Management And General | 5264702 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1874437 | Total |
| Management And General | 1874437 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|---|
| BAD DEBT | 20344339 | 20344339 | 0 | |
| REPAIRS & MAINTENANCE | 4094799 | 259004 | 0 | 3835795 |
| SHARED SERVICE FEES | 32437202 | 726635 | 0 | 31710567 |
| DRUGS & MEDICAL SUPPLIES | 45665161 | 45410757 | 0 | 254404 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1021880 | Total |
| Program Services | 120609 | ProgramServices |
| Management And General | 901271 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240691979 | Total |
| Program Services | 145326020 | ProgramServices |
| Management And General | 95365959 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24182203 | BOY |
| EOY | 445643 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 23556 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29827497 | BOY |
| EOY | 26154733 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9714807 | BOY |
| EOY | 7904402 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3823287 | BOY |
| EOY | 5455037 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104723 | BOY |
| EOY | 491796 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 362141589 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 208659784 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 149281362 | BOY |
| EOY | 153481805 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9380041 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3523966 | BOY |
| EOY | 3523229 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63245483 | BOY |
| EOY | 90272861 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 293083369 | BOY |
| EOY | 287753062 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15193349 | BOY |
| EOY | 16073074 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37981 | BOY |
| EOY | 15594 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6454 | BOY |
| EOY | 7410 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7396720 | BOY |
| EOY | 7178514 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46442207 | BOY |
| EOY | 63635532 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69076711 | BOY |
| EOY | 86910124 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 223539343 | BOY |
| EOY | 200772100 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 467315 | BOY |
| EOY | 70838 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224006658 | BOY |
| EOY | 200842938 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 293083369 | BOY |
| EOY | 287753062 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -22767244 | ReconcilationRevenueExpenses |
| Reconcilation Prior Adjustment | -396476 | ReconcilationPriorAdjustment |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Media Advertisements | $0 | MediaAdvertisementsAmount |
| Mailings Members | false | MailingsMembers |
| Mailings Members | $0 | MailingsMembersAmount |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmount |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmount |
| Other Activities | true | OtherActivities |
| Other Activities | $18,428 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 18428 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE C, PART II-B, LINE 1(I) | Identifier |
| Explanation | LOBBYING PORTION OF DUES THE 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 $71,593, $20,966 AND $40,995, RESPECTIVELY. APPROXIMATELY 17% OF ARKANSAS HOSPITAL ASSOCIATION DUES, 23.98% OF AMERICAN HOSPITAL ASSOCIATION DUES AND 3.00% OF CATHOLIC HEALTH ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10765119 | OtherCostOrOtherBasis |
| Book Value | 10765119 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 170603451 | OtherCostOrOtherBasis |
| Depreciation | 68007535 | Depreciation |
| Book Value | 102595916 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2158729 | OtherCostOrOtherBasis |
| Depreciation | 1532757 | Depreciation |
| Book Value | 625972 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 155395476 | OtherCostOrOtherBasis |
| Depreciation | 134464494 | Depreciation |
| Book Value | 20930982 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23218814 | OtherCostOrOtherBasis |
| Depreciation | 4654998 | Depreciation |
| Book Value | 18563816 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 153481805 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| MISCELLANEOUS RECEIVABLES | 1005420 |
| EXCHANGE ACCOUNT | 332593 |
| DUE FROM AFFILIATES | 83612557 |
| LAND FOR FUTURE DEVELOPMENT | 5238791 |
| OTHER NON CURRENT ASSETS | 83500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 90272861 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| OTHER NON CURRENT LIABILITIES | $325,096 |
| INVESTMENT IN SUBSIDIARIES | $63,310,436 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 63635532 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE D, PART X, LINE 2 | Identifier |
| Return Reference | ASC 740 FOOTNOTE | ReturnReference |
| Explanation | THE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7063708 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7063708 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03210 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27361346 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24029073 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3332273 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01510 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34425054 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24029073 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10395981 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04720 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 504284 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 504284 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23910 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 23910 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1244732 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1244732 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 212883 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 212883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1059708 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1059708 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3045517 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3045517 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01380 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37470571 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24029073 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13441498 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06100 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 76892 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 76892 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1757851 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1757851 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00800 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 107657 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 107657 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1942400 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1942400 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00880 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $6,864,018 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 66161536 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 75728752 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -9567216 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|
| MERCY OUTPATIENT CTR | ||
| OUTPATIENT SURGERY | 0.52120 | 0.47880 |
| FORT SMITH EMS | ||
| AMBULANCE SERVICES | 0.50000 | 0.50000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL FORT SMITH | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7301 ROGERS AVENUE | AddressLine1 |
| City | FORT SMITH | City |
| State | AR | State |
| ZIP Code | 72903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL FORT SMITH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Mercy Therapy Services | ||||
| 107 S Logan | Charleston | AR | 72933 | Other |
| Mercy Sleep Center | ||||
| 3100 S 70th | Fort Smith | AR | 72903 | Sleep Center |
| Mercy Outpatient Surgery Center | ||||
| 3601 W E Knight Drive | Fort Smith | AR | 72903 | Other |
| Mercy Urgent Care | ||||
| 3500 WE Knight Drive | Fort Smith | AR | 72903 | Urgent Care |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE H, PART I, LINE 6A | Identifier |
| Explanation | THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $240,691,979. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $20,344,339. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $220,347,640. FORM 990, 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 II A FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS. 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 FORT SMITH THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). FORM 990, SCHEDULE H, PART III, LINE 9B MERCY HOSPITAL FORT SMITH'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. FORM 990, 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. FORM 990, 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 FOR THOSE WHO DO NOT HAVE INSURANCE OR WHO ARE IN FINANCIAL NEED. UNINSURED PATIENT DISCOUNTS A 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. FORM 990, SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION MERCY HOSPITAL FORT SMITH'S PRIMARY SERVICE AREA INCLUDES 13 COUNTIES ACROSS THE BORDER OF ARKANSAS AND OKLAHOMA. THESE INCLUDE CRAWFORD, FRANKLIN, JOHNSON, LOGAN, POLK, SCOTT, SEBASTIAN AND YELL IN ARKANSAS; AND ADAIR, HASKELL, LATIMER, LE FLORE AND SEQUOYAH IN OKLAHOMA. BASED ON TRUVEN 2012 DATA, THE AREA'S POPULATION IS 456,000. 15% OF THE POPULATION HAS AN AVERAGE HOUSEHOLD INCOME GREATER THAN $75,000. 14% OF THE PO | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Arkansas Department of Health | |||||||
| 419 NATURAL RESRCS DR | LITTLE ROCK | AR | 72205 | 710306406 | GOV'T | 388435 | ASSISTANCE FOR TRAUMA CERTIFICATION |
| Ozark Affiliate of Susan G Komen | |||||||
| 1709 TOWSON AVE | FORT SMITH | AR | 72901 | 710743123 | 501(C)(3) | 20576 | ASSISTS IN PROVIDING BREAST CARE IN THE COMMUNITY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE I, PART I, LINE 2 | Identifier |
| Return Reference | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANTS | ReturnReference |
| Explanation | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bean MD Paul | ||||||||||||||
| Physician & Board member | 0 | 248736 | 0 | 44511 | 0 | 44608 | 0 | 8566 | 0 | 15816 | 0 | 362237 | 0 | 0 |
| Wilcher Greta | ||||||||||||||
| Board member & VP-Finance | 0 | 169467 | 0 | 29855 | 0 | 29035 | 0 | 30427 | 0 | 11727 | 0 | 270511 | 0 | 0 |
| Gehrig Ryan | ||||||||||||||
| Chief executive officer | 0 | 225569 | 0 | 54583 | 0 | 25311 | 0 | 0 | 0 | 10001 | 0 | 315464 | 0 | 0 |
| Vitiello Jonathan | ||||||||||||||
| Chief financial officer | 0 | 294647 | 0 | 102118 | 0 | 96353 | 0 | 47736 | 0 | 16270 | 0 | 557124 | 0 | 0 |
| Day Bradley Kim | ||||||||||||||
| Pres- Central Comm Thru 3/1/13 | 0 | 630366 | 0 | 322225 | 0 | 35023 | 0 | 334446 | 0 | 14234 | 0 | 1336294 | 0 | 0 |
| Hennessey III William | ||||||||||||||
| Regional VP-Marketing | 0 | 136234 | 0 | 65059 | 0 | 55893 | 0 | 35029 | 0 | 15146 | 0 | 307361 | 0 | 0 |
| Marion Tanya | ||||||||||||||
| Regional VP-Human Resources | 0 | 137188 | 0 | 70088 | 0 | 25359 | 0 | 28325 | 0 | 14983 | 0 | 275943 | 0 | 0 |
| Merrigan Michael | ||||||||||||||
| Regional VP-General Counsel | 0 | 227959 | 0 | 96337 | 0 | 54154 | 0 | 49389 | 0 | 7420 | 0 | 435259 | 0 | 0 |
| Rataj RN Marianne | ||||||||||||||
| Chief nursing officer | 131086 | 0 | 27864 | 0 | 42103 | 0 | 10162 | 0 | 6547 | 0 | 217762 | 0 | 0 | 0 |
| Swope Jon | ||||||||||||||
| Pres-Central Comm Start 3/1/13 | 0 | 481585 | 0 | 249457 | 0 | 27670 | 0 | 212960 | 0 | 17729 | 0 | 989401 | 0 | 0 |
| Adams Eric B | ||||||||||||||
| Pharmacist | 105383 | 0 | 0 | 0 | 44509 | 0 | 7747 | 0 | 6067 | 0 | 163706 | 0 | 0 | 0 |
| Gusdorf Michael A | ||||||||||||||
| Pharmacist | 124590 | 0 | 0 | 0 | 28773 | 0 | 10662 | 0 | 14628 | 0 | 178653 | 0 | 0 | 0 |
| Pearce Larry W | ||||||||||||||
| VP-Clinical operations | 244119 | 0 | 174043 | 0 | 47586 | 0 | 43365 | 0 | 12332 | 0 | 521445 | 0 | 0 | 0 |
| Thomas Jennifer | ||||||||||||||
| EPIC Accountable executive | 148706 | 0 | 26551 | 0 | 16561 | 0 | 1089 | 0 | 15005 | 0 | 207912 | 0 | 0 | 0 |
| James Joel | ||||||||||||||
| VP-Clinical operations | 137243 | 0 | 23706 | 0 | 12567 | 0 | 4665 | 0 | 14495 | 0 | 192676 | 0 | 0 | 0 |
| Johnston Jeffrey A | ||||||||||||||
| Former key employee | 0 | 410525 | 0 | 190493 | 0 | 51457 | 0 | 168505 | 0 | 17534 | 0 | 838514 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE J, PART I, LINE 1 | Identifier |
| Explanation | CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HOSPITAL FORT SMITH RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY HOSPITAL FORT SMITH 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: RYAN GEHRIG, JEFFREY JOHNSTON, JONATHAN VITIELLO, BRADLEY DAY, TANYA MARION, MICHAEL MERRIGAN, WILLIAM HENNESSEY III, MARIANNE RATAJ, LARRY PEARCE, JON SWOPE, AND GRETA WILCHER. 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, PART I, LINE 6 | Identifier |
| Explanation | MERCY HOSPITAL FORT SMITH UTILIZES AN AUXILIARY PROGRAM FOR VOLUNTEERS TO PERFORM VARIOUS FUNCTIONS. SUCH FUNCTIONS INCLUDE FLOWER DELIVERY, INFORMATION DESK, AND PATIENT TRANSPORT. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES OTHER SERVICES INCLUDE OUTPATIENT DIAGNOSTICS AND TESTING, SURGERY SERVICES, A WOMEN'S CENTER THAT PROVIDES NEONATOLOGY, OB ANESTHESIA, DIGITAL MAMMOGRAPHY, AND LABOR AND DELIVERY, A CANCER CENTER WITH A COMPREHENSIVE TREATMENT APPROACH INCLUDING RADIATION THERAPY, HOME CARE, HOSPICE, PALLIATIVE CARE, A SLEEP DISORDERS CENTER, AND WOUND CARE WITH HYPERBARIC MEDICINE. FORM 990, PART V, QUESTION 1A FORM 1099/1096 FILING VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH FORT SMITH COMMUNITIES. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES ARE RESERVED SOLELY FOR THE SOLE CORPORATE MEMBER: - TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION SHALL OPERATE; - TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS; - TO APPOINT AND REMOVE MEMBERS OF THE BOARD; - TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; - TO APPROVE OR AMEND THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION; - TO APPROVE OR AMEND THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS OF THE CORPORATION; - TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000); - TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; - TO AUTHORIZE OR APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY CORPORATION 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 EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; - TO MERGE, DISSOLVE OR ABANDON THE CORPORATION; AND, - TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE MANAGER OF ACCOUNTING AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORMS 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 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, QUESTIONS 15A & 15B OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE EXECUTIVE 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, 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 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/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Casa de Misericordia | ||||||||||
| 1602 McClelland Street | Laredo | TX | 78044 | 742912461 | SHELTER | TX | 501(C)(3) | 7 | MM LAREDO | true |
| Laredo Medical Group | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 742764726 | INACTIVE | TX | 501(C)(3) | 9 | MHS TEXAS | true |
| McAuley Portfolio Management Company | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 261708048 | PORT MGMT | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Clinic East Communities | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 431771217 | PHYS GROUP | MO | 501(C)(3) | 9 | MH EAST COMM | true |
| Mercy Clinic Fort Smith Communities | ||||||||||
| 7301 Rogers Avenue | Fort Smith | AR | 72903 | 261318597 | PHYS CLINIC | AR | 501(C)(3) | 9 | MH FS COMM | true |
| Mercy Clinic Hot Springs Communities | ||||||||||
| 1 Mercy Lane | Hot Springs | AR | 71913 | 261125131 | PHYS CLINIC | AR | 501(C)(3) | 9 | MH HS COMM | true |
| Mercy Clinic Oklahoma Communities Inc | ||||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 270473057 | PHYS GROUP | OK | 501(C)(3) | 9 | MH OK COMM | true |
| Mercy Clinic Springfield Communities | ||||||||||
| 1965 Fremont Street Ste 2950 | Springfield | MO | 65804 | 431560263 | PHYS GROUP | MO | 501(C)(3) | 9 | MH SF COMM | true |
| Mercy Family Center | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 721069468 | COUNSELING | MO | 501(C)(3) | 7 | MERCY HEALTH | true |
| Mercy Foundation for Health Innovation | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 200901499 | FOUNDATION | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 431423050 | CORP OFFICE | MO | 501(C)(3) | 1 | NA | false |
| Mercy Health East Communities | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 431718408 | HLTH SYSTEM | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health East Communities South Reg | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 461412322 | HLTH SYSTEM | MO | 501(C)(3) | 11b | MH EAST COMM | true |
| Mercy Health Fort Smith Communities | ||||||||||
| 7301 Rogers Avenue | Fort Smith | AR | 72917 | 261318515 | HOLDING CO | AR | 501(C)(3) | 11b | MERCY HEALTH | false |
| Mercy Health Foundation Ardmore | ||||||||||
| 1011 14th Avenue NW | Ardmore | OK | 73401 | 710962525 | FOUNDATION | OK | 501(C)(3) | 11a | MH ARDMORE | true |
| Mercy Health Foundation Berryville | ||||||||||
| 214 Carter Street | Berryville | AR | 72616 | 710759301 | FOUNDATION | AR | 501(C)(3) | 11a | MH BRYVILLE | true |
| Mercy Health Foundation Fort Scott | ||||||||||
| 401 Woodland Hills Blvd | Fort Scott | KS | 66701 | 481077073 | FOUNDATION | KS | 501(C)(3) | 11c | M KS COMM | true |
| St Edward Mercy Foundation | ||||||||||
| 7301 Rogers Avenue | Fort Smith | AR | 72917 | 237330425 | FOUNDATION | AR | 501(C)(3) | 7 | MH FT SMITH | true |
| Mercy Health Foundation Hot Springs | ||||||||||
| 300 Werner Street | Hot Springs | AR | 71913 | 710804718 | FOUNDATION | AR | 501(C)(3) | 11b | MH H SPRINGS | true |
| Mercy Health Foundation Independence | ||||||||||
| 800 W Myrtle | Independence | KS | 67301 | 481079981 | FOUNDATION | KS | 501(C)(3) | 11a | M KS COMM | true |
| Mercy Health Foundation Jefferson | ||||||||||
| 1400 US Highway 61 South | Festus | MO | 63028 | 462797051 | FOUNDATION | MO | 501(C)(3) | 11b | MH E COMM SR | true |
| Mercy Health Foundation Joplin | ||||||||||
| 2817 St Johns Blvd | Joplin | MO | 64804 | 270906136 | FOUNDATION | MO | 501(C)(3) | 11a | MH SWMK COMM | true |
| Mercy Health Foundation NW Arkansas | ||||||||||
| 2710 Rife Medical Lane | Rogers | AR | 72758 | 710601687 | FOUNDATION | AR | 501(C)(3) | 11c | MH ROGERS | true |
| Mercy Health Foundation Oklahoma City | ||||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 731593024 | FOUNDATION | OK | 501(C)(3) | 11a | MH OK CITY | true |
| Mercy Health Foundation of Oklahoma | ||||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 454732301 | FOUNDATION | OK | 501(C)(3) | 11a | MH OK COMM | true |
| Mercy Health Foundation Springfield | ||||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | 320195818 | FOUNDATION | MO | 501(C)(3) | 11b | MH SF COMM | true |
| Mercy Health Foundation St Louis | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 562410020 | FOUNDATION | MO | 501(C)(3) | 11b | MH EAST COMM | true |
| Mercy Health Foundation Washington | ||||||||||
| 901 E Fifth Street | Washington | MO | 63090 | 562410022 | FOUNDATION | MO | 501(C)(3) | 11b | MH EAST COMM | true |
| Mercy Health Hot Springs Communities | ||||||||||
| 300 Werner Street | Hot Springs | AR | 71913 | 261125064 | HOLDING CO | AR | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health NW Arkansas Communities | ||||||||||
| 2710 Rife Medical Lane | Rogers | AR | 72758 | 621684203 | PHYS GROUP | AR | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health Oklahoma Communities Inc | ||||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 731453048 | HOLDING CO | OK | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health Southwest MOKS Communities | ||||||||||
| 2817 St Johns Blvd | Joplin | MO | 64804 | 300584463 | HLTH SYSTEM | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health Springfield Communities | ||||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | 431856028 | HLTH SYSTEM | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Health System of Texas Inc | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 742764727 | INACTIVE | TX | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mercy Home Health Berryville | ||||||||||
| 804 W Freeman Suite 4 | Berryville | AR | 72616 | 870781247 | HOME HEALTH | AR | 501(C)(3) | 11c | MH SF | true |
| Mercy Hospital Ada Inc | ||||||||||
| 430 N Monte Vista Street | Ada | OK | 74820 | 462288155 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospital Ardmore Inc | ||||||||||
| 1011 14th Avenue NW | Ardmore | OK | 73401 | 731500629 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospital Aurora | ||||||||||
| 500 Porter Avenue | Aurora | MO | 65605 | 431936696 | HOSPITAL | MO | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Hospital Berryville | ||||||||||
| 214 Carter Street | Berryville | AR | 72616 | 710759299 | HOSPITAL | AR | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Hospital Carthage | ||||||||||
| 3125 Dr Russell Smith Way | Carthage | MO | 64836 | 453808607 | HOSPITAL | MO | 501(C)(3) | 3 | MH SWMK COMM | true |
| Mercy Hospital Cassville | ||||||||||
| 94 Main Street | Cassville | MO | 65625 | 431936699 | HOSPITAL | MO | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Hospital Columbus | ||||||||||
| 220 Pennsylvania Avenue | Columbus | KS | 66725 | 270842031 | HOSPITAL | MO | 501(C)(3) | 3 | MH SWMK COMM | true |
| Mercy Hospital El Reno Inc | ||||||||||
| 2115 Parkview Drive | El Reno | OK | 73036 | 272716065 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospital Healdton Inc | ||||||||||
| 918 South 8th Street | Healdton | OK | 73438 | 263173902 | HOSPITAL | OK | 501(C)(3) | 3 | MH ARDMORE | true |
| Mercy Hospital Hot Springs | ||||||||||
| 300 Werner Street | Hot Springs | AR | 71913 | 710236913 | HOSPITAL | AR | 501(C)(3) | 3 | MH HS COMM | true |
| Mercy Hospital Jefferson | ||||||||||
| 1400 Highway 61 South | Festus | MO | 63028 | 430687077 | HOSPITAL | MO | 501(C)(3) | 3 | MH E COMM SR | true |
| Mercy Hospital Joplin | ||||||||||
| 2817 St Johns Blvd | Joplin | MO | 64804 | 270814858 | HOSPITAL | MO | 501(C)(3) | 3 | MH SWMK COMM | true |
| Mercy Hospital Lebanon | ||||||||||
| 100 Hospital Drive | Lebanon | MO | 65536 | 431767432 | HOSPITAL | MO | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Hospital Logan County Inc | ||||||||||
| 200 South Academy | Guthrie | OK | 73044 | 452998842 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospital of Laredo | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 741189682 | INACTIVE | TX | 501(C)(3) | 3 | MHS TEXAS | true |
| Mercy Hospital Oklahoma City Inc | ||||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 730579285 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospital Ozark | ||||||||||
| 801 W River Street | Ozark | AR | 72949 | 710689680 | HOSPITAL | AR | 501(C)(3) | 3 | MH FT SMITH | true |
| Mercy Hospital Paris | ||||||||||
| 500 E Academy | Paris | AR | 72855 | 710655753 | HOSPITAL | AR | 501(C)(3) | 3 | MH FT SMITH | true |
| Mercy Hospital Rogers | ||||||||||
| 2710 Rife Medical Lane | Rogers | AR | 72758 | 710294390 | HOSPITAL | AR | 501(C)(3) | 3 | MH NWAR COMM | true |
| Mercy Hospital Springfield | ||||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | 440552485 | HOSPITAL | MO | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Hospital Tishomingo Inc | ||||||||||
| 1000 South Byrd | Tishomingo | OK | 73460 | 274433830 | HOSPITAL | OK | 501(C)(3) | 3 | MH ARDMORE | true |
| Mercy Hospital Waldron | ||||||||||
| 1341 W 6th Street | Waldron | AR | 72958 | 710557895 | HOSPITAL | AR | 501(C)(3) | 3 | MH FT SMITH | true |
| Mercy Hospital Watonga Inc | ||||||||||
| 500 Clarence Nash Blvd | Watonga | OK | 73772 | 455199762 | HOSPITAL | OK | 501(C)(3) | 3 | MH OK COMM | true |
| Mercy Hospitals East Communities | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 430653493 | HOSPITAL | MO | 501(C)(3) | 3 | MH EAST COMM | true |
| Mercy Kansas Communities Inc | ||||||||||
| 401 Woodland Hills Blvd | Ft Scott | KS | 66701 | 480956045 | HOSPITAL | KS | 501(C)(3) | 3 | MH SWMK COMM | true |
| Mercy Medical Research Institute | ||||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | 870796305 | RESEARCH | MO | 501(C)(3) | 4 | MH SF COMM | true |
| Mercy Ministries of Laredo | ||||||||||
| 2500 Zacatecas | Laredo | TX | 78046 | 200198462 | OUTREACH | TX | 501(C)(3) | 7 | MERCY HEALTH | true |
| Mercy St Francis Hospital | ||||||||||
| 100 W Highway 60 | Mountain View | MO | 65548 | 440607149 | HOSPITAL | MO | 501(C)(3) | 3 | MH SF COMM | true |
| Mercy Support Services | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 431677952 | INACTIVE | MO | 501(C)(3) | 11c | MH EAST COMM | true |
| MHM Support Services | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 202553101 | HLTH SYSTEM | MO | 501(C)(3) | 11b | MERCY HEALTH | true |
| Mission Clinical Services | ||||||||||
| 300 Werner Street | Hot Springs | AR | 71913 | 134239691 | NURSING HOME | AR | 501(C)(3) | 9 | MH HS COMM | true |
| St John's Children's Hospital Inc | ||||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | INACTIVE | MO | 501(C)(3) | 3 | MH SF COMM | true | |
| St Mary's Hospital of Enid Oklahoma | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 730614655 | INACTIVE | OK | 501(C)(3) | 3 | MH OK COMM | true |
| The Sister M Cornelia Blasko Foundation | ||||||||||
| 100 W Highway 60 | Mountain View | MO | 65548 | 431873914 | FOUNDATION | MO | 501(C)(3) | 11a | M ST FRANCIS | true |
| Unity Ambulatory Care | ||||||||||
| 14528 S Outer Forty Ste 100 | Chesterfield | MO | 63017 | 431861745 | INACTIVE | MO | 501(C)(3) | 11c | MH EAST COMM | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Merc Ambu Surg CTR | |||||||||||||
| 7301 Rogers Av | Fort Smith | AR | 72903 | 710827721 | AMBUL SURG CTR | AR | MH FT SMITH | RELATED | 710 | 3030 | false | false | 0.50900 |
| RES OPT & INNOV | |||||||||||||
| 645 Maryville Centre Dr 200 | St Louis | MO | 63141 | 460468368 | CENTRAL DIST. | MO | NA | ||||||
| SO OK DIAG CTR | |||||||||||||
| 1011 14TH Ave NW | Ardmore | OK | 73401 | 431971232 | MRI Services | OK | NA | ||||||
| Fort Smith EMS | |||||||||||||
| 1701 S Greenwood | Fort Smith | AR | 72901 | 710416615 | Emergency Med | AR | MH FT SMITH | RELATED | 0 | 1856 | false | false | 0.50000 |
| St Ed Mer Med MOB | |||||||||||||
| 7301 Rogers Ave | Fort Smith | AR | 72903 | 710554050 | Office Building | AR | MH FT SMITH | RELATED | 0 | 27220 | false | true | 0.85955 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Frontenac Properties Inc | |||||||||
| 14528 S Outer Forty Suite 100 | Chesterfield | MO | 63017 | 521914421 | HOLDING COMP | DE | NA | C-Corp | true |
| Inveno Health Inc | |||||||||
| 1235 E Cherokee Street | Springfield | MO | 65804 | 264509571 | RESEARCH | MO | NA | C-Corp | true |
| Mercy Community Services Inc | |||||||||
| 401 Woodland Hills Blvd | Fort Scott | KS | 66701 | 481078101 | RETAIL PHARMACY | KS | NA | C-Corp | true |
| Mercy Health Center Condominium Inc | |||||||||
| 4300 W Memorial Rd | Oklahoma City | OK | 73120 | 680640970 | REAL ESTATE | OK | NA | C-Corp | true |
| Mercy Health Network of the Southern Reg | |||||||||
| 1011 14th Avenue NW | Ardmore | OK | 73401 | 731580607 | HEALTH CARE | OK | NA | C-Corp | true |
| Mercy Health Network Inc | |||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 731381689 | HEALTH CARE | OK | NA | C-Corp | true |
| Mercy Managed Care Corporation | |||||||||
| 4300 W Memorial Road | Oklahoma City | OK | 73120 | 731441665 | HOLDING COMP | OK | NA | C-Corp | true |
| UH L Corp Inc | |||||||||
| 645 Maryville Centre Drive Suite 1 | St Louis | MO | 63141 | 742499535 | HOLDING COMP | MO | NA | C-Corp | true |
| Unity Support Services Inc | |||||||||
| 645 Maryville Centre Drive Suite 1 | St Louis | MO | 63141 | 431797042 | PRACTICE MGT | MO | NA | C-Corp | true |
| Jefferson Land Company Inc | |||||||||
| 14528 South Outer Forty Suite 100 | Chesterfield | MO | 63017 | 431330360 | HOLDING COMP | MO | NA | C-Corp | true |
| The Apothecary Services Inc | |||||||||
| PO Box 350 | Crystal City | MO | 63019 | 431627267 | RETAIL PHARMACY | MO | NA | C-Corp | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Mercy Ambulatory Surgery Center LLC | ||
| q | 6100560 | FMV |
| Mercy Clinic Fort Smith Communities | ||
| p | 16759440 | FMV |
| Mercy Hospital Ozark | ||
| p | 2541904 | FMV |
| Mercy Hospital Paris | ||
| p | 1377640 | FMV |
| Mercy Hospital Springfield | ||
| p | 51824 | FMV |
| Mercy Hospital Waldron | ||
| p | 1311638 | FMV |
| Mercy Hospitals East Communities | ||
| p | 768810 | FMV |
| MHM Support Services | ||
| p | 41543117 | FMV |
| Resource Optimization & Innovation LLC | ||
| p | 8881960 | FMV |
| St Edward Mercy Foundation | ||
| c | 957934 | FMV |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE R, PART V | Identifier |
| Explanation | 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 C, K, P AND Q. | Explanation |