MERCY HOSPITAL ARDMORE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL ARDMORE INC (EIN 73-1500629)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201321379349300722
- Schema version
- 2011v1.5
- 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 | 2013-05-15T16:12:52-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562632458 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLEUS AND COMPANY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14323 S OUTER FORTY STE 310N | AddressLine1 |
| City | CHESTERFIELD | City |
| State | MO | State |
| ZIP Code | 63017 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731500629 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL ARDMORE | BusinessNameLine1 |
| Business Name Line2 | F/K/A MERCY MEMORIAL HEALTH CENTER INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 4057523724 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1011 14TH AVENUE NW | AddressLine1 |
| City | ARDMORE | City |
| State | OK | State |
| ZIP Code | 73401 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JON VITIELLO | Name |
| Title | CFO | Title |
| Phone | 4057523724 | Phone |
| Date Signed | 2013-05-17 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00013488 | PTIN |
| Phone | 3143179916 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MALINDA BURDICK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1011 14TH AVENUE NW | AddressLine1 |
| City | ARDMORE | City |
| State | OK | State |
| ZIP Code | 73401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 144997643 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCY.NET/ARDMOREOK | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | OK | StateLegalDomicile |
| Activity Or Mission Description | TO CARRY OUT THE HEALING MINISTRY OF JESUS BY PROMOTING HEALTH AND WELLNESS THROUGH OUR COMMUNITIES. TO PROVIDE QUALITY HEALTH SERVICES THROUGH A WISE USE OF RESOURCES AND EXCEPTIONAL MERCY SERVICE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1379 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 61310 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 13879 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 6933916 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2485825 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 121890600 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 143151625 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 24514 | InvestmentIncomePriorYear |
| Investment Income Current Year | -5861 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2171271 | OtherRevenuePriorYear |
| Other Revenue Current Year | -1299658 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 131020301 | TotalRevenuePriorYear |
| Total Revenue Current Year | 144331931 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 235607 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 458438 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 49123121 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 48784005 | 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 | 74593727 | OtherExpensePriorYear |
| Other Expenses Current Year | 82478535 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 123952455 | TotalExpensesPriorYear |
| Total Expenses Current Year | 131720978 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7067846 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 12610953 | RevenuesLessExpensesCY |
| Total Assets BOY | 115393489 | TotalAssetsBOY |
| Total Assets EOY | 119933470 | TotalAssetsEOY |
| Total Liabilities BOY | 14457370 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6966606 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 100936119 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 112966864 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MERCY HOSPITAL ARDMORE IS ROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH. THIS TRADITION IS MARKED BY VALUES OF JUSTICE, EXCELLENCE, STEWARDSHIP AND RESPECT FOR THE DIGNITY OF EACH PERSON.MERCY HOSPITAL ARDMORE IMPLEMENTS AND ADVOCATES FOR INNOVATIVE HEALTH AND SOCIAL SERVICES TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF COMMUNITIES SERVED, WITH PARTICULAR CONCERN FOR PEOPLE WHO ARE ECONOMICALLY POOR.IN SERVING OTHERS WE MAKE A DIFFERENCE BY TOUCHING THEIR LIVES WITH COMPASSION AND EXCEPTIONAL MERCY SERVICE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 92460969 | Expense |
| Grants | 458438 | Grants |
| Revenue | 141231584 | Revenue |
| Description | MERCY HOSPITAL ARDMORE ("MERCY") PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FY2012, MERCY PROVIDED SERVICES TO 9,606 INPATIENTS, 37,760 EMERGENCY DEPARTMENT PATIENTS, AND 141,184 OUTPATIENTS. SERVICES ARE PROVIDED THROUGH A COMMUNITY-BASED, ACUTE CARE HOSPITAL, AND A REHABILITATION CENTER. OUR OUTPATIENT SERVICES INCLUDE A HOME HEALTH AGENCY, OUTPATIENT SURGERY AND DIAGNOSTICS AND VARIOUS PRIMARY PHYSICIAN CLINICS/SERVICES. THE INSTITUTION CONTINUES TO FOCUS ON THE PROVISION OF PRIMARY HEALTH SERVICES THROUGH THE ENHANCEMENT OF PRIMARY CLINICS AND EDUCATION TO THE COMMUNITY, REGARDLESS OF THEIR MEANS TO PAY FOR THESE SERVICES. MERCY RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND, FURTHER, THAT PART OF OUR MISSION IS TO PROVIDE HEALTH CARE SERVICES AND HEALTH CARE EDUCATION TO THE COMMUNITIES IN WHICH OUR FACILITIES ARE LOCATED. IN KEEPING WITH MERCY'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, MERCY PROVIDES; (I) FREE CARE AND/OR SUBSIDIZED CARE, (II) CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, (III) HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY, (IV) HEALTH EDUCATION PROGRAMS, AND (V) A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. AMONG THE COMMUNITY SUPPORT ACTIVITIES OFFERED BY MERCY ARE THE FOLLOWING:1) HEALTH EDUCATION AND WELLNESS PROGRAMS AND OTHER SUPPORT GROUP MEETINGS OFFERED TO THE COMMUNITY.2) HEALTH SERVICES SUCH AS HEALTH FAIRS AND SCREENINGS, FREE CLINICS, PRE-NATAL AND WELL BABY CARE. 3) HEALTH PROFESSIONALS ARE PROVIDED EDUCATION, INCLUDING OPPORTUNITIES FOR CLINICAL INTERNSHIPS.4) SUBSIDIZED HEALTH SERVICES INCLUDING HOSPICE, HOME HEALTH SERVICES, AND DISASTER READINESS.5) COMMUNITY HEALTH RESEARCH6) CASH AND IN-KIND DONATIONS FOR EVENTS AND FUND-RAISING7) COMMUNITY BUILDING ACTIVITIES, IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS MERCY PROVIDES CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED TO BE MEDICALLY INDIGENT AND DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. IN ADDITION, MERCY PROVIDES SERVICES TO OTHER PATIENTS UNDER THE MEDICARE PROGRAM AND VARIOUS STATE MEDICAID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS THAT ARE LESS THAN BILLED CHARGES OF THE SERVICES PROVIDED TO THE RECIPIENTS. CARE IS PROVIDED TO THOSE WITH LIMITED OR NO ABILITY TO PAY. RELIEF FOR THE FINANCIAL BURDEN OF HEALTH CARE SERVICES RENDERED TO THE INDIGENT TOTALED $6,485,444 IN FY2012.THE ABOVE AMOUNT DOES NOT REFLECT THE COST OF HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY HEALTH EDUCATION PROGRAMS AND OTHER COMMUNITY SUPPORT ACTIVITIES. THE SERVICES PROVIDED BY MERCY, AS WELL AS THE AMOUNT OF CHARITY CARE PROVIDED, DEMONSTRATES THE ONGOING COMMITMENT OF THE ORGANIZATION TO SERVE IN A LEADERSHIP ROLE AS AN ADVOCATE FOR RESPONSIVE HEALTHCARE SERVICES FOR THE COMMUNITY, WITH A DEEP COMMITMENT AND SENSITIVITY TO MEETING THE NEEDS OF THE POOR. | Description |
| Total Program Service Expense | 92460969 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1379 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OK | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JON VITIELLO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4057523724 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 WEST MEMORIAL ROAD | AddressLine1 |
| City | OKLAHOMA CITY | City |
| State | OK | State |
| ZIP Code | 73120 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| ABU-ESHEH MD BAHA | |||||||||
| BOARD MEMBER; CHIEF OF MEDICAL STAFF (EFFECTIVE 01 | 40.00 | X | 36000 | 0 | 0 | ||||
| BURKE RSM SR RICHARD MARY | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| BURNS GLEN C | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| DUBEA ALLEN J | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| HENDRICKS RSM SR REBECCA | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| HISEY BARBARA | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| LODES CLAYTON R | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| MOORE JOHN L | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| ROTHER MD JEFFREY | |||||||||
| BOARD MEMBER | 40.00 | X | 0 | 252152 | 12392 | ||||
| WILSON DVM CADE | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| WOERZ DAVID A | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| SMALLEY DIANA L | |||||||||
| CEO, MERCY OKLAHOMA | 40.00 | X | 0 | 556630 | 199937 | X | |||
| BURDICK MALINDA | |||||||||
| PRESIDENT, MERCY HOSPITAL ARDMORE | 40.00 | X | 0 | 398021 | 60149 | X | |||
| VITIELLO JONATHAN | |||||||||
| CFO, MERCY OKLAHOMA | 40.00 | 0 | 439767 | 61898 | X | ||||
| BARNARD RYAN W | |||||||||
| VP-OPERATIONS | 40.00 | 186297 | 0 | 21315 | X | ||||
| HANAN RHONDA | |||||||||
| VP-NURSING | 40.00 | 176614 | 0 | 21635 | X | ||||
| LE BICH-VI | |||||||||
| REGIONAL VP-GENERAL COUNSEL | 40.00 | 0 | 186283 | 25644 | X | ||||
| PAYTON BECKY J | |||||||||
| VP-HR MERCY OKLAHOMA | 40.00 | 0 | 257355 | 39603 | X | ||||
| TEW DAVID | |||||||||
| COO, MERCY OKLAHOMA | 40.00 | 0 | 426840 | 69452 | X | ||||
| BARKER RICHARD D | |||||||||
| REGIONAL ADMINISTRATOR, RURAL FACILITIES | 40.00 | 157948 | 0 | 12951 | X | ||||
| CRAM ROY S | |||||||||
| INFORMATICS PHARMACIST | 40.00 | 144547 | 0 | 21237 | X | ||||
| HALL TAD | |||||||||
| CHIEF PHYSICIAN ASSISTANT | 40.00 | 220457 | 0 | 20971 | X | ||||
| O'CONNOR JOHN T | |||||||||
| PHYSICIAN | 40.00 | 145197 | 0 | 22223 | X | ||||
| POWELL LARRY D | |||||||||
| PHYSICIAN | 40.00 | 160637 | 0 | 11754 | X | ||||
| NEWMAN JAMES | |||||||||
| FORMER OFFICER | 0.00 | 0 | 194377 | 3063 | X | ||||
| CARMICHAEL CINDY | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0 | 201466 | 11770 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1227697 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2912891 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 615994 | TotalOtherCompensation |
| Number Individuals GT100 K | 38 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ELEKTA INC | |||||
| PO BOX 404199 | ATLANTA | GA | 30384 | CONSTRUCTION | 2056825 |
| ARDMORE ANESTHESIA INC | |||||
| PO BOX 1983 | ARDMORE | OK | 73402 | MEDICAL SERVICES | 882357 |
| JE DUNN CONSTRUCTION | |||||
| 929 HOLMES | KANSAS CITY | MO | 64106 | CONSTRUCTION | 825780 |
| ARDMORE DIALYSIS RANCH INC | |||||
| 2617 CROSSROADS DR PO BOX 637 | ARDMORE | OK | 73401 | MEDICAL SERVICES | 591600 |
| ENTECH | |||||
| PO BOX 650110 | DALLAS | TX | 75265 | REPAIRS | 402758 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 26 | NumberOfContractorsGT100K |
| Related Organizations | 2485825 | RelatedOrganizations |
| Total Contributions | 2485825 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | 143010427 | 143010427 |
| JOINT VENTURE INCOME | 900099 | 141198 | 141198 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 143151625 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5861 | TotalRevenueColumn |
| Exclusion | -$5,861 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 619254 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 665712 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -46458 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -46458 | TotalRevenueColumn |
| Exclusion | -$46,458 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| CAFETERIA | 722210 | 605531 | $605,531 | |
| LABORATORY SERVICE | 621500 | 61310 | 61310 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1920041 | TotalRevenueColumn |
| Related Or Exempt Function Income | -1920041 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -1253200 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 144331931 | TotalRevenueColumn |
| Related Or Exempt Function Income | 141231584 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 61310 | UnrelatedBusinessRevenue |
| Exclusion | $553,212 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342082 | Total |
| Program Services | 342082 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116356 | Total |
| Program Services | 116356 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 434558 | Total |
| Management And General | 434558 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38298649 | Total |
| Program Services | 31739090 | ProgramServices |
| Management And General | 6559559 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1738680 | Total |
| Program Services | 1543821 | ProgramServices |
| Management And General | 194859 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5672742 | Total |
| Program Services | 5009370 | ProgramServices |
| Management And General | 663372 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2639376 | Total |
| Program Services | 2318428 | ProgramServices |
| Management And General | 320948 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12388 | Total |
| Program Services | 1844 | ProgramServices |
| Management And General | 10544 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4524614 | Total |
| Program Services | 3720230 | ProgramServices |
| Management And General | 804384 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5257 | Total |
| Program Services | 4322 | ProgramServices |
| Management And General | 935 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82063 | Total |
| Program Services | 67474 | ProgramServices |
| Management And General | 14589 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51856 | Total |
| Program Services | 51856 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2785566 | Total |
| Program Services | 2290349 | ProgramServices |
| Management And General | 495217 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213177 | Total |
| Program Services | 163745 | ProgramServices |
| Management And General | 49432 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11522 | Total |
| Program Services | 9474 | ProgramServices |
| Management And General | 2048 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51 | Total |
| Management And General | 51 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8900080 | Total |
| Program Services | 2482999 | ProgramServices |
| Management And General | 6417081 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 862868 | Total |
| Management And General | 862868 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 30579428 | 25143033 | 5436395 |
| SHARED SERVICE FEES | 16771441 | 451849 | 16319592 |
| BAD DEBTS | 13889391 | 13889391 | |
| REPAIRS & MAINTENANCE | 1457247 | 1198178 | 259069 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2331586 | Total |
| Program Services | 1917078 | ProgramServices |
| Management And General | 414508 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131720978 | Total |
| Program Services | 92460969 | ProgramServices |
| Management And General | 39260009 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 531131 | BOY |
| EOY | 3000093 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15769404 | BOY |
| EOY | 18362103 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130182 | BOY |
| EOY | 47159 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1921570 | BOY |
| EOY | 1781060 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73936 | BOY |
| EOY | 69572 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 194010902 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 103107206 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96830016 | BOY |
| EOY | 90903696 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 137250 | BOY |
| EOY | 137250 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 5632537 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115393489 | BOY |
| EOY | 119933470 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7569855 | BOY |
| EOY | 6675703 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6887515 | BOY |
| EOY | 290903 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14457370 | BOY |
| EOY | 6966606 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100936119 | BOY |
| EOY | 112966864 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100936119 | BOY |
| EOY | 112966864 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115393489 | BOY |
| EOY | 119933470 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 12610953 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -580208 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $9,018 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 9018 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION, CATHOLIC HOSPITAL ASSOCIATION, AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2012, DUES WERE $39,197, $22,927, AND $17,502, RESPECTIVELY. APPROXIMATELY 9.0% OF OKLAHOMA HOSPITAL ASSOCIATION DUES, 5.15% OF CATHOLIC HOSPITAL ASSOCIATION DUES, AND 24.6% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2849325 | OtherCostOrOtherBasis |
| Book Value | 2849325 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 97346437 | OtherCostOrOtherBasis |
| Depreciation | 33212088 | Depreciation |
| Book Value | 64134349 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 89795002 | OtherCostOrOtherBasis |
| Depreciation | 68639485 | Depreciation |
| Book Value | 21155517 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4020138 | OtherCostOrOtherBasis |
| Depreciation | 1255633 | Depreciation |
| Book Value | 2764505 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 90903696 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER LONG TERM LIABILITIES | Description |
| Amount | $290,903 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 290903 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH AND SUBSIDIARIES DO NOT INCLUDE A FOOTNOTE TO REPORT THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7145070 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7145070 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06060 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4516000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5175626 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -659626 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11661070 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5175626 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6485444 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06060 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 70981 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 70981 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 124810 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 124810 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 920015 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 920015 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 86829 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 86829 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1202635 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1202635 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01020 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12863705 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5175626 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7688079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07080 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4176 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4176 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 59594 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 59594 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2362 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2362 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 14945 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 14945 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20823 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20823 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 101900 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 101900 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $4,024,498 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 53769099 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 62631289 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8862190 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| 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 ARDMORE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1011 14TH AVENUE NW | AddressLine1 |
| City | ARDMORE | City |
| State | OK | State |
| ZIP Code | 73401 | 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 ARDMORE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | 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 | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MERCY CANCER CENTER | ||||
| 1220 HALL PLACE | ARDMORE | OK | 73401 | CANCER TREATMENT |
| SOUTHERN OKLAHOMA DIAGNOSTIC CENTER LLC | ||||
| 1111 WALNUT | ARDMORE | OK | 73401 | MRI SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 13889391. | |
| PART II: MERCY HOSPITAL ARDMORE (MHARD) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH ACTIVE PARTICIPATION IN COMMUNITY BOARDS, NEIGHBORHOOD/COMMUNITY MEETINGS AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHARD DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE. MERCY CO-WORKERS PARTICIPATE AS BOARD MEMBERS, VOLUNTEERS GIVING HOURS OF HANDS-ON ASSISTANCE, PROGRAM DEVELOPMENT AND FUND RAISING. SOME OF THE COMMUNITY BUILDING ACTIVITIES IN WHICH MHARD SERVES ARE:- SOUP KITCHEN AND GOOD SHEPHERD CLINIC.- YMCA, GRACE CENTER, BOYS AND GIRLS CLUB, ADULT DAY CENTER, C-SARA FOUNDATION AND RELAY FOR LIFE.- UNITED WAY, CROSS TIMBERS HOSPICE, MARCH OF DIMES, TURNING POINT AND TOBACCO COALITION.THROUGH THESE PROGRAMS THOSE IN NEED RECEIVE DAY CARE AT REDUCED RATES, THOSE WITHOUT HEALTHCARE INSURANCE OR GOVERNMENTAL SUPPORT RECEIVE CARE AND ADULTS AND CHILDREN RECEIVE EDUCATION AND MENTORING TO ACHIEVE HEALTH AND IMPROVED LIFE QUALITY. PROGRAMS ARE FUNDED WHICH PROMOTE POSITIVE LIFESTYLE CHOICES. | |
| 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 FOLLOWS: "PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FORUNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THEHEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CAREIF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY.THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED ON MANAGEMENT'SASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERINGBUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, ANDOTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR,MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLERECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLESAS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENTAND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESEREVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FORUNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FORUNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROMINSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FORPLACING PAST-DUE BALANCES WITH COLLECTION AGENCIES." 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. THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THEORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CAREPOLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY (REFER TODISCLOSURE FOR PART III, #9B) TO ADDRESS ACCOUNTS FOR PATIENTS WHO DONOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY ISCOMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FORCHARITY CARE. | |
| PART III, LINE 8: IT IS THE POSITION OF MERCY HOSPITAL ARDMORE THAT 100% OF ANY SHORT FALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96) | |
| PART III, LINE 9B: MERCY HOSPITAL ARDMORE ("MERCY") 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 MET THE MERCY HOSPITAL COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY FOR APROPRIATE 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 UTILITIZES 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 WILLGENERALLY NOT INCLUDE BANK GARNISHMENT, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENFORCE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEWS COMPLIANCE WITH ALL POLICIES. | |
| PART V, SECTION B, LINE 19D: EACH HOSPITAL FACILITY USED THE AVERAGE DISCOUNT OF THE HIGHEST (BEST PAYING) THREE COMMERCIAL MANAGED CARE PAYERS AS THE BASIS FOR ESTABLISHING UNINSURED DISCOUNT RATES FOR FAP ELIGIBLE INDIVIDUALS. UNDER NO CIRCUMSTANCES, WILL THIS UNINSURED DISCOUNT BE LESS THAN 15%. | MERCY HOSPITAL ARDMORE |
| PART VI, LINE 2: MERCY HOSPITAL ARDMORE, INC. CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. OUR NEEDS ASSESSMENT PROCESS INVOLVED THE FOLLOWING FIVE STEPS USING BOTH QUANTITATIVE AND QUALITATIVE INFORMATION TO ATTAIN THE FULL SCOPE OF OUR COMMUNITY'S NEEDS.1. EXAMINING EXISTING COMMUNITY HEALTH NEEDS ASSESSMENTS. THE NEEDS ASSESSMENT EXAMINATION PROCESS INCLUDED THE COLLECTION AND ANALYSIS OF QUANTITATIVE DATA AVAILABLE IN COMMUNITY/PUBLIC HEALTH RESOURCES.- OKLAHOMA HEALTH IMPROVEMENT PLAN (OHIP) THIS IS A COMPREHENSIVE PLAN TO IMPROVE THE HEALTH OF ALL OKLAHOMANS DEVELOPED BY THE OKLAHOMA STATE BOARD OF HEALTH, 2010-2014.- COUNTY READINESS ASSESSMENT REPORT, 2011 THIS ASSESSMENT WAS COMPLETED BY THE CARTER COUNTY COMMUNITY UNDER THE DIRECTION OF THE CARTER COUNTY HEALTH DEPARTMENT AND THE TURNING POINT COALITION TO ASSESS THE LEVEL OF COMMUNITY READINESS IN ADDRESSING NUTRITION AND FITNESS.- WELLNESS NOW-2011-2012 THIS COMMUNITY HEALTH IMPROVEMENT INITIATIVE ADDRESSES FITNESS AND NUTRITION. IT IS DESIGNED TO POOL COMMUNITY RESOURCES AND EXPAND PARTNERSHIPS TO TARGETED AREAS WITH THE MOST NEEDS AS A UNITED FORCE AND ACHIEVE REAL RESULTS.- DATA FROM MERCY'S HEALTH INFORMATION SYSTEMS DEPARTMENTDATA FROM MERCY'S OWN RECORDS WAS USED TO ASSESS THE NEEDS OF THE COMMUNITY. - 2011 STATE OF THE STATE HEALTH REPORTTHIS REPORT REVIEWS MULTIPLE INDICATORS THAT CONTRIBUTE TO OKLAHOMA'S OVERALL HEALTH STATUS. IT SUMMARIZES OKLAHOMA HEALTH AS A WHOLE AND IDENTIFIES COUNTY SPECIFIC TRENDS.- 2012 COUNTY HEALTH RANKINGSTHE COUNTY HEALTH RANKINGS & ROADMAPS PROGRAM HELPS COMMUNITIES CREATE SOLUTIONS THAT MAKE IT EASIER FOR PEOPLE TO BE HEALTHY IN THEIR OWN COMMUNITIES, FOCUSING ON SPECIFIC FACTORS THAT AFFECT HEALTH, SUCH AS EDUCATION AND INCOME.- OKLAHOMA TURNING POINTTURNING POINT STARTS AT THE LOCAL LEVEL, BUILDING BROAD COMMUNITY SUPPORT AND PARTICIPATION IN PUBLIC HEALTH PRIORITY SETTING AND ACTION, ENGAGING AND LINKING AFFECTED PEOPLE AT THE LOCAL LEVEL. LOCAL FIELD CONSULTANTS IN EACH COUNTY OF OKLAHOMA PROVIDE LEADERSHIP IN ASSESSING LOCAL PUBLIC HEALTH NEEDS AND IDENTIFYING KEY PRIORITIES.2. CONDUCT ROUNDTABLE DISCUSSION WITH COMMUNITY MEMBERS. COMMUNITY INDIVIDUALS AS WELL AS EXPERTS IN THE PUBLIC HEALTH ARENA WERE INVITED TO ATTEND COMMUNITY ROUND TABLES FOR INPUT ON NEEDS OF THE COMMUNITY. MERCY HELD COMMUNITY ROUNDTABLE EVENTS TO DIALOGUE DIRECTLY WITH LOCAL COMMUNITY MEMBERS REGARDING THEIR NEEDS, IDEAS, AND CONCERNS RELATED TO HEALTHCARE. COMMUNITY ROUNDTABLE MEETINGS WERE HELD IN ARDMORE, WHICH IS LOCATED IN THE MERCY HOSPITAL ARDMORE, INC. SERVICE AREA. PARTICIPANTS SHARED THEIR VIEWS ON BOTH THE CURRENT AND FUTURE STATE OF HEALTH IN THEIR COMMUNITIES.ONE STEP IN THE NEEDS ASSESSMENT PROCESS INCLUDED RECEIVING AND ASSESSING INFORMATION FROM THE TURNING POINT COALITION WHICH REPRESENTS CARTER COUNTY AND THE SURROUNDING COUNTIES AS WELL. THROUGH THIS COALITION MERCY HOSPITAL ARDMORE STAYS APPRISED OF CURRENT NEEDS AND WORKS BOTH INDEPENDENTLY AND COLLABORATIVELY TO MEET THESE NEEDS. MHARD CONTINUES TO BE INVOLVED IN THE TURNING POINT COALITION AND COLLABORATED ON A TSET GRANT, WHICH RESULTED IN A COMMUNITIES OF EXCELLENCE IN NUTRITION AND FITNESS PROGRAM FOR CARTER, JOHNSTON AND LOVE COUNTIES. PHASE ONE, YEAR ONE OF THE FIVE YEAR GRANT, INCLUDED HIRING A FULL-TIME COORDINATOR, INCREASING COLLABORATIVE PARTNERSHIPS, AND GATHERING DEMOGRAPHIC, SCIENTIFIC, STATISTICAL AND PROGRAMMATIC INFORMATION. A STRATEGIC PLAN FOR THE NEXT FOUR YEARS IS CURRENTLY IN DEVELOPMENT.3. ANALYZED AND SUMMARIZED THE DATA TO PRIORITIZE NEEDS. AFTER CAREFUL ANALYSIS OF THE DATA, SEVEN HEALTH PRIORITIES WERE IDENTIFIED: OBESITY, PHYSICAL INACTIVITY, SMOKING, CANCER, CHRONIC LOWER RESPIRATORY DISEASE, STROKE AND DIABETES. 4. REVIEW CURRENT COMMUNITY BENEFIT ACTIVITIES IN PLACE. USING LYON SOFTWARE'S CBISA TOOL, A REVIEW WAS CONDUCTED OF CURRENT COMMUNITY BENEFIT ACTIVITIES AND WHAT MERCY WAS PRESENTLY DOING TO MEET THE IDENTIFIED PRIORITIES.5. CREATE AN ACTION PLAN. IN COLLABORATION WITH OTHER MERCY DEPARTMENTS AND COMMUNITY ORGANIZATION, PROGRAMS ARE BEING CREATED AND IMPLEMENTED BASED ON THE RESULTS OF THE NEEDS ASSESSMENT. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS UPDATED ON AN ONGOING BASIS AS ANNUAL COMMUNITY/PUBLIC HEALTH DATA IS RELEASED. | |
| 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. SPECIFIC INFORMATION PROVIDED: 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) MUST FIRST FIND OUT IF THEY ARE ELIGIBLE FOR MEDICAID BEFORE APPLYING FOR FINANCIAL ASSISTANCE. PATIENTS DENIED MEDICAID ELIGIBILITY THEN MUST PROVIDE CERTAIN INFORMATION TO SHOW FINANCIAL NEED. 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. 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, ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS. | |
| PART VI, LINE 4: MERCY HOSPITAL ARDMORE, INC. IS LOCATED IN ARDMORE, OKLAHOMA AND PRIMARILY SERVES THOSE IN URBAN/SUBURBAN ARDMORE AND A SIX-COUNTY AREA WITH A POPULATION OF CLOSE TO 110,000; CARTER, JEFFERSON, JOHNSTON, LOVE, MARSHALL AND MURRAY COUNTIES. ARDMORE IS A COMMUNITY OF APPROXIMATELY 35,000 PEOPLE, AND IS THE CENTER OF BUSINESS AND TRADE FOR SOUTHERN OKLAHOMA. - A REVIEW OF THE COMMUNITY HEALTH STATUS FOR CARTER COUNTY FOUND ISSUES RELATED TO POVERTY AND THE UNINSURED RATE; DRUG AND ALCOHOL ABUSE; CHILD NEGLECT AND ABUSE; INJURIES RELATING TO FALLS AND WORK-RELATED ACTIVITIES ARE ALL PRESENT.- RISK FACTORS THAT CONTRIBUTE TO PREMATURE DEATH ARE HIGH BLOOD PRESSURE, SMOKING, DIABETES AND ADULT OBESITY.- IDENTIFIED HEALTH NEEDS: TOBACCO USE IS HIGH, INCREASING POPULATION IS OVERWEIGHT, HEALTH INSURANCE COVERAGE IS LOW, CHRONIC DISEASE RATES ARE HIGH AND CANCER SCREENING RATES ARE LOW.- A CARTER COUNTY READINESS ASSESSMENT MEASURED COMMUNITY MEMBER'S READINESS TO ADDRESS NUTRITION AND PHYSICAL ACTIVITY ISSUES. THE RESULT OF A "VAGUE AWARENESS" INDICATES A HIGH PRIORITY BE PLACED ON EDUCATING THE COMMUNITY OF THIS NEED.- OTHER PRIORITY AREAS FOR COMMUNITIES OF EXCELLENCE IN NUTRITION AND FITNESS PROGRAM ARE DRIVEN BY POLICY DEVELOPMENT AND ADHERENCE IN SCHOOLS, WORKPLACE AND COMMUNITY. THESE INCLUDE: - ENCOURAGING PHYSICAL ACTIVITY - IMPROVING ACCESS TO AND CONSUMPTION OF HEALTHY, SAFE AND AFFORDABLE FOODS AND BEVERAGES ADDITIONAL DEMOGRAPHICS FOR THE CITY OF ARDMORE AND SURROUNDING AREA ARE BELOW. ALL INFORMATION IS BASED ON 2011 DATA:BREAKDOWN OF AGE GROUPS WITH THE PERCENTAGE OF THE POPULATION THEY COMPRISE:0-17 33%18-64 52%65+ 15%FEMALE PERSONS 52%MEDIAN HOUSEHOLD INCOME: $37,094PERSONS BELOW POVERTY LEVEL: 19.5%RACE/ETHNICITY:WHITE PERSONS NOT HISPANIC: 66%HISPANIC: 7.4%BLACK: 10%AMERICAN INDIAN: 9%ASIAN: 2%ADULT EDUCATION LEVEL (AGE 25+): HIGH SCHOOL GRADUATE OR HIGHER: 83%BACHELOR'S DEGREE OR HIGHER: 21% | |
| PART VI, LINE 5: MERCY HOSPITAL ARDMORE, INC. (MHARD) PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN ACTIVE PURSUIT OF THIS MISSION, MHARD PROVIDED SERVICES TO 9,606 INPATIENTS, 30,588 EMERGENCY ROOM VISITS, AND 141,184 OUTPATIENT VISITS. MHARD IS A CATHOLIC HEALTH CARE CORPORATION THAT, PURSUANT TO THE ORGANIZATIONAL CORE BELIEF THAT HEALTH CARE SERVICES ARE A VITAL AND INTEGRAL PART OF THE CHURCH'S HEALING MISSION, ENGAGES IN A MINISTRY WHICH PROVIDES GENERAL ACUTE CARE, AMBULATORY, LONG-TERM AND HOME CARE HEALTH SERVICES TO INDIVIDUALS AND FAMILIES IN ITS SERVICE COMMUNITIES. IN KEEPING WITH MHARD'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITIES IT SERVES, MHARD PROVIDES CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS DEFINED BY THE INSTITUTION'S CHARITY POLICY, MHARD DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR CHARITY CARE. IN ADDITION, MHARD PROVIDES SERVICES TO OTHER PATIENTS UNDER THE MEDICARE PROGRAM AND VARIOUS STATE MEDICAID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS THAT ARE SUBSTANTIALLY LESS THAN BILLED CHARGES, AND FREQUENTLY LESS THAN THE COST, OF THE SERVICES PROVIDED TO THE RECIPIENTS.MHARD IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTERESTSURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY BOARD MEMBERS ARE SCREENED BY GENERAL COUNSEL AND REVIEWED BY THE BOARD CHAIRPERSON AND CEO. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARESERVED BY MHARD.SURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MHARD ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONALHEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES. EXAMPLES INCLUDE THE FOLLOWING: - IN 2011 ARDMORE CHAMBER OF COMMERCE FOUNDATION FINISHED CONSTRUCTION OF A FULL SERVICE CANCER CENTER ON THE CAMPUS OF MERCY HOSPITAL ARDMORE. THE HOSPITAL EQUIPPED THE CENTER WITH STATE OF THE ART EQUIPMENT INCLUDING A LINEAR ACCELERATOR TO PROVIDE RADIATION THERAPY AND A PET SCANNER FOR DIAGNOSTIC AND PLANNING STUDIES. THE CANCER CENTER PROVIDES SERVICES TO PATIENTS IN CARTER COUNTY AS WELL AS THE 5 SURROUNDING COUNTIES- "SMART" INFUSION PUMPS WERE PURCHASED AND PLACED IN SERVICE LATE IN 2011. THESE PUMPS HAVE BECOME THE INDUSTRY STANDARD IN THE AREA OF PATIENT SAFETY. THEY INCLUDE SUCH FEATURES AS CLOSE ERROR REDUCTION SOFTWARE, COMMONLY REFERRED TO AS DRUG LIBRARIES. THIS TECHNOLOGY ALLOWS INFUSION PUMPS TO PERFORM FUNCTIONS THAT ASSIST HEALTHCARE PROVIDERS WITH PROGRAMMING AND CALCULATING DOSE AND DELIVERY RATES. WHEN USED PROPERLY, THESE FEATURES HELP PREVENT I.V. MEDICATION ERRORS AND REDUCE PATIENT HARM. | |
| PART VI, LINE 6: THE FILING ORGANIZATION IS PART OF MERCY HEALTH ("MERCY"). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS ("MINISTRY OFFICE") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING LIFE TO THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2012, MERCY FACILITIES INCLUDED 26 ACUTE CARE HOSPITALS, 5 MANAGED HOSPITALS, 3 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS AND 1 REHAB HOSPITAL WITH 3,864 ACUTE LICENSED BEDS. FOR THE FISCAL YEAR ENDED JUNE 30, 2012, MERCY HAD 4.8 MILLION PROVIDER VISITS AND 2.7 MILLION OUTPATIENT VISITS, MORE THAN 1,600 EMPLOYED PHYSICIANS, AND APPROXIMATELY 38,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES BASED ON NET PATIENT SERVICE REVENUE. MERCY IS SPONSORED BY MERCY HEALTH MINISTRY, WHICH IS GOVERNED BY MEMBERS THAT INCLUDE SISTERS OF MERCY. MANY SERVICES THAT ARE ESSENTIAL TO FULFILLING MERCY'S MISSION ARE CENTRALIZED AT THE MINISTRY OFFICE. SUCH CENTRALIZED SERVICES INCLUDE TREASURY, INFORMATION TECHNOLOGY, CLINICAL QUALITY MANAGEMENT, LEGAL AND COMPLIANCE COUNSEL, COMPENSATION AND BENEFITS, CONSULTING, PERFORMANCE MANAGEMENT, REVENUE MANAGEMENT, CAPITAL MANAGEMENT, CLINICAL ENGINEERING, AND CLINICAL SAFETY. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCH OF DIMES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 932852 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 31193 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 131846366 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 5500 | AmountOfCashGrant |
| Purpose Of Grant | GENERAL OPERATIONS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | TUITIONS SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 37 | NumberOfRecipients |
| Amount Of Cash Grant | 116356 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE ORGANIZATION USES AN APPROVAL PROCESS TO DETERMINE WHICH ORGANIZATIONS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE NONPROFIT ORGANIZATION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROTHER MD JEFFREY | |||||||||||||
| 0 | 217291 | 0 | 20740 | 0 | 14121 | 0 | 1533 | 0 | 10859 | 0 | 264544 | 0 | 0 |
| SMALLEY DIANA L | |||||||||||||
| 0 | 432683 | 0 | 114881 | 0 | 9066 | 0 | 184144 | 0 | 15793 | 0 | 756567 | 0 | 0 |
| BURDICK MALINDA | |||||||||||||
| 0 | 290011 | 0 | 80630 | 0 | 27380 | 0 | 52505 | 0 | 7644 | 0 | 458170 | 0 | 0 |
| VITIELLO JONATHAN | |||||||||||||
| 0 | 278936 | 0 | 69300 | 0 | 91531 | 0 | 46475 | 0 | 15423 | 0 | 501665 | 0 | 0 |
| BARNARD RYAN W | |||||||||||||
| 158889 | 0 | 11220 | 0 | 16188 | 0 | 6395 | 0 | 14920 | 0 | 207612 | 0 | 0 | 0 |
| HANAN RHONDA | |||||||||||||
| 150660 | 0 | 11203 | 0 | 14751 | 0 | 6680 | 0 | 14955 | 0 | 198249 | 0 | 0 | 0 |
| LE BICH-VI | |||||||||||||
| 0 | 133043 | 0 | 17417 | 0 | 35823 | 0 | 10643 | 0 | 15001 | 0 | 211927 | 0 | 0 |
| PAYTON BECKY J | |||||||||||||
| 0 | 187406 | 0 | 41724 | 0 | 28225 | 0 | 27819 | 0 | 11784 | 0 | 296958 | 0 | 0 |
| TEW DAVID | |||||||||||||
| 0 | 323301 | 0 | 69230 | 0 | 34309 | 0 | 53898 | 0 | 15554 | 0 | 496292 | 0 | 0 |
| BARKER RICHARD D | |||||||||||||
| 133288 | 0 | 9899 | 0 | 14761 | 0 | 11662 | 0 | 1289 | 0 | 170899 | 0 | 0 | 0 |
| CRAM ROY S | |||||||||||||
| 123477 | 0 | 0 | 0 | 21070 | 0 | 10996 | 0 | 10241 | 0 | 165784 | 0 | 0 | 0 |
| HALL TAD | |||||||||||||
| 199719 | 0 | 0 | 0 | 20738 | 0 | 11946 | 0 | 9025 | 0 | 241428 | 0 | 0 | 0 |
| O'CONNOR JOHN T | |||||||||||||
| 110341 | 0 | 0 | 0 | 34856 | 0 | 11793 | 0 | 10430 | 0 | 167420 | 0 | 0 | 0 |
| POWELL LARRY D | |||||||||||||
| 111833 | 0 | 25000 | 0 | 23804 | 0 | 5624 | 0 | 6130 | 0 | 172391 | 0 | 0 | 0 |
| NEWMAN JAMES | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 194377 | 0 | 3063 | 0 | 0 | 0 | 197440 | 0 | 0 |
| CARMICHAEL CINDY | |||||||||||||
| 0 | 165688 | 0 | 12324 | 0 | 23454 | 0 | 5165 | 0 | 6605 | 0 | 213236 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. SPOUSAL TRAVEL WAS PROVIDED FOR THE FOLLOWING: RYAN BARNARD; RHONDA HANAN. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO THE EMPLOYEE. PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE. | |
| PART I, LINES 4A-B | JAMES NEWMAN RECEIVED $194,377 OF SEVERANCE COMPENSATION FROM MERCY HEALTH. PART I, LINE 4B: MERCY HEALTH, THE PARENT COMPANY, 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 FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN: MINDY BURDICK; JONATHAN VITIELLO; BICH-VI LE; BECKY PAYTON; DAVID TEW THE INDIVIDUALS LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. THE FOLLOWING INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: DIANA SMALLEY THE INDIVIDUAL LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). | |
| PART I, LINE 7 | THE RELATED ORGANIZATION WHICH EMPLOYS THOSE INDIVIDUALS LISTED ON PART VII, AND THE FILING ORGANIZATION WHEN APPLICABLE, PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2012 (JULY 1, 2011 - JULY 30, 2012) 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 ARE REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF MERCY HEALTH AND ARE THEN TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS. | |
| PART III | THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AT ANY TIME AT THE MEMBER'S DISCRETION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | MERCY HEALTH OKLAHOMA COMMUNITIES HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION SHALL OPERATE; -TO AMEND AND APPROVE THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND TO AMEND AND APPROVE THE ARTICLES OF INCORPORATION AND BYLAWS OF ANY CORPORATION CONTROLLED BY THE CORPORATION; -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 FOR 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 AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTY ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, 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, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM. THE DRAFT FORM 990 IS ALSO REVIEWED BY THE MERCY HEALTH TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2012. 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 FINANCE, AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 15A | FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE 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, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY. | |
| FORM 990, PART XI, LINE 5: | AWARDS FROM MH FOUNDATION ARDMORE ADJUSTMENT -8,273. TRANSFERS TO AFFILIATES/OTHERS -375,348. NET CONTRIBUTIONS -55,389. INCOME FROM JOINT VENTURE -141,198. TOTAL TO FORM 990, PART XI, LINE 5: -580,208. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| PART XI, LINE 2 | THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2012 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION IS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE FINANCE, AUDIT, AND COMPLIANCE COMMITTEE OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. | AUDITED FINANCIAL STATEMENTS |
| PART XI, LINE 3 | THE CONSOLIDATED GROUP OF MERCY HEALTH IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE SINGLE AUDIT WAS CONDUCTED ON A CONSOLIDATED BASIS. | SINGLE AUDIT ACT AND OMB CIRCULAR A-133 |
| FORM 990, SCHEDULE R, PART II | MERCY HOSPITALS EAST COMMUNITIES HEALTH SYSTEM CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-065393, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883. | MERCY HOSPITALS EAST COMMUNITIES |
| FORM 990, SCHEDULE R, PART V | 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 O & P. | SYSTEM LIMITATIONS |
| FORM 990, PART VII | SEVERAL INDIVIDUALS ARE DISCLOSED AS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ON MULTIPLE FORM 990S THAT ARE FILED BY ORGANIZATIONS INCLUDED IN THE MERCY HEALTH OKLAHOMA COMMUNITIES SYSTEM. THE AVERAGE HOURS PER WEEK REPORTED INCLUDES HOURS WORKED FOR ALL OF THESE ORGANIZATIONS. | HOURS PER WEEK |
| FORM 990, PART V, LINE 1A | INDEPENDENT CONTRACTORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. | INDEPENDENT CONTRACTORS |
| SCHEDULE O DISCLOSURE FORM 990, HEADING, BOX B | DURING THE TAX YEAR ENDED JUNE 30, 2012, SISTERS OF MERCY HEALTH SYSTEM ("MERCY HEALTH") BEGAN A SYSTEM-WIDE REBRANDING INITIATIVE TO HELP PATIENTS, PHYSICIANS, CO-WORKERS, AND THE PUBLIC BETTER UNDERSTAND THE FULL SCOPE AND LOCATIONS OF MERCY HEALTH'S SERVICES. SEVERAL OF THE MERCY HEALTH AFFILIATES HAVE CHANGED OR ARE IN THE PROCESS OF CHANGING LEGAL NAMES. PRIOR TO FILING THE 2011 FORMS 990 (DUE MAY 15, 2013), MERCY HEALTH NOTIFIED THE IRS OF THESE NAME CHANGES, THEREFORE BOX B "NAME CHANGE" HAS NOT BEEN CHECKED ON THIS FORM 990. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (67 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCE CARE HOSPITAL | |||||||||||
| 300 WERNER ST 3RD FLOOR | HOT SPRINGS | AR | 71913 | 710816634 | LONG TERM ACUTE-CARE HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH | 0 | |
| CASA DE MISERICORDIA | |||||||||||
| 1602 MCCLELLAND STREET | LAREDO | TX | 78044 | 742912461 | WOMEN'S DOMESTIC VIOLENCE SHELTER | TX | 501C3 | 7 | MERCY MINISTRIES OF LAREDO | 0 | |
| LAREDO MEDICAL GROUP | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 742764726 | INACTIVE | TX | 501C3 | 9 | MERCY HEALTH SYSTEM TX | 0 | |
| MCAULEY PORTFOLIO MGMT CO | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 261708048 | PORTFOLIO MANAGEMENT | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY CLINIC EAST COMMUNITIES | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 431771217 | PHYSICIAN GROUP | MO | 501C3 | 9 | MERCY HEALTH EAST COMMUNITIES | 0 | |
| MERCY CLINIC FORT SMITH COMM | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 261318597 | PHYSICIAN CLINIC | AR | 501C3 | 9 | MERCY HEALTH FORT SMITH COMM | 0 | |
| MERCY CLINIC HOT SPRINGS COMM | |||||||||||
| 1 MERCY LANE | HOT SPRINGS | AR | 71913 | 261125131 | PHYSICIAN CLINIC | AR | 501C3 | 9 | MERCY HEALTH HOT SPRINGS COMM | 0 | |
| MERCY CLINIC OKLAHOMA COMM | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 270473057 | PHYSICIAN GROUP/CLINIC | OK | 501C3 | 9 | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY CLINIC SPRINGFIELD COMM | |||||||||||
| 1965 FREMONT STREET SUITE 2950 | SPRINGFIELD | MO | 65804 | 431560263 | PHYSICIAN GROUP | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY FAMILY CENTER | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 721069468 | FAMILY COUNSELING SERVICES | MO | 501C3 | 7 | MERCY HEALTH | 0 | |
| MERCY FDTN HEALTH INNOV | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 200901499 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 431423050 | HEALTH SYSTEM - CORPORATE OFFICE | MO | 501C3 | 1 | 0 | N/A | |
| MERCY HEALTH EAST COMMUNITIES | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 431718408 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH FORT SMITH COMM | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 261318515 | HOLDING COMPANY | AR | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH FOUNDATION ARDMORE | |||||||||||
| 1011 14TH AVENUE NW | ARDMORE | OK | 73401 | 710962525 | FOUNDATION | OK | 501C3 | 11-I | MERCY HOSPITAL ARDMORE | 0 | |
| MERCY HEALTH FOUNDATION BERRYVILLE | |||||||||||
| 214 CARTER STREET | BERRYVILLE | AR | 72616 | 710759301 | FOUNDATION | AR | 501C3 | 11-I | MERCY HOSPITAL BERRYVILLE | 0 | |
| MERCY HEALTH FOUNDATION FT SCOTT | |||||||||||
| 401 WOODLAND HILLS BLVD | FORT SCOTT | KS | 66701 | 481077073 | FOUNDATION | KS | 501C3 | 11-III | MERCY KANSAS COMMUNITIES INC | 0 | |
| MERCY HEALTH FOUNDATION HOT SPRINGS | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 710804718 | FOUNDATION | AR | 501C3 | 11-II | MERCY HOSPITAL HOT SPRINGS | 0 | |
| MERCY HEALTH FOUNDATION INDEPENDENCE | |||||||||||
| 800 W MYRTLE | INDEPENDENCE | KS | 67301 | 481079981 | FOUNDATION | KS | 501C3 | 11-I | MERCY KANSAS COMMUNITIES INC | 0 | |
| MERCY HEALTH FOUNDATION JOPLIN | |||||||||||
| 2817 ST JOHNS BLVD | JOPLIN | MO | 64804 | 270906136 | FOUNDATION | MO | 501C3 | 11-I | MERCY HEALTH SW MOKS COMM | 0 | |
| MERCY HEALTH FOUNDATION NW ARK | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72858 | 710601687 | FOUNDATION | AR | 501C3 | 11-III | MERCY HOSPITAL ROGERS | 0 | |
| MERCY HEALTH FOUNDATION OK CITY | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731593024 | FOUNDATION | OK | 501C3 | 11-I | MERCY HOSPITAL OKLAHOMA CITY | 0 | |
| MERCY HEALTH FOUNDATION OF OK | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 454732301 | FOUNDATION | OK | 501C3 | 11-I | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY HEALTH FOUNDATION SPRINGFIELD | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 320195818 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HEALTH FOUNDATION STL | |||||||||||
| 615 SOUTH NEW BALLAS ROAD | ST LOUIS | MO | 63141 | 562410020 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | 0 | |
| MERCY HEALTH FOUNDATION WASHINGTON | |||||||||||
| 901 E FIFTH STREET | WASHINGTON | MO | 63090 | 562410022 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | 0 | |
| MERCY HEALTH HOT SPRINGS COMM | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 261125064 | HOLDING COMPANY | AR | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH NW ARK COMMUNITIES | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72758 | 621684203 | PHYSICIAN GROUP | AR | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH OK COMMUNITIES | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731453048 | HOLDING COMPANY | OK | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH SW MOKS COMM | |||||||||||
| 2817 ST JOHNS BLVD | JOPLIN | MO | 64804 | 300584463 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH SPRINGFIELD COMM | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 431856028 | HOLDING COMPANY | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HEALTH SYSTEM TX | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 742764727 | INACTIVE | TX | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MERCY HOME HEALTH BERRYVILLE | |||||||||||
| 804 W FREEMAN SUITE 4 | BERRYVILLE | AR | 72616 | 870781247 | HOME HEALTH AND HOSPICE OPERATIONS. | AR | 501C3 | 11-III | MERCY HOSPITAL SPRINGFIELD | 0 | |
| MERCY HOSPITAL AURORA | |||||||||||
| 500 PORTER AVENUE | AURORA | MO | 65605 | 431936696 | OPERATING CO FOR LEASED HOSP | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HOSPITAL BERRYVILLE | |||||||||||
| 214 CARTER STREET | BERRYVILLE | AR | 72616 | 710759299 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HOSPITAL CARTHAGE | |||||||||||
| 3125 DR RUSSELL SMITH WAY | CARTHAGE | MO | 64836 | 453808607 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | 0 | |
| MERCY HOSPITAL CASSVILLE | |||||||||||
| 94 MAIN STREET | CASSVILLE | MO | 65625 | 431936699 | OPERATING CO FOR LEASED HOSP | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HOSPITAL COLUMBUS | |||||||||||
| 220 PENNSYLVANIA AVENUE | COLUMBUS | KS | 66725 | 270842031 | CRITICAL ACCESS HOSPITAL | MO | 501C3 | 9 | MERCY HEALTH SW MOKS COMM | 0 | |
| MERCY HOSPITAL EL RENO | |||||||||||
| 2115 PARKVIEW DRIVE | EL RENO | OK | 73036 | 272716065 | OPERATING CO FOR LEASED HOSP | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY HOSPITAL FORT SMITH | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 710240352 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH FORT SMITH COMM | 0 | |
| MERCY HOSPITAL HEALDTON | |||||||||||
| 918 SOUTH STREET | HEALDTON | OK | 73438 | 263173902 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL ARDMORE | 0 | |
| MERCY HOSPITAL HOT SPRINGS | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 710236913 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH HOT SPRINGS COMM | 0 | |
| MERCY HOSPITAL JOPLIN | |||||||||||
| 2817 ST JOHNS BLVD | JOPLIN | MO | 64804 | 270814858 | HOSPITAL | MO | 501C3 | 9 | MERCY HEALTH SW MOKS COMM | 0 | |
| MERCY HOSPITAL LEBANON | |||||||||||
| 100 HOSPITAL DRIVE | LEBANON | MO | 65536 | 431767432 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HOSPITAL LOGAN COUNTY INC | |||||||||||
| 200 SOUTH ACADEMY | GUTHRIE | OK | 73044 | 452998842 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY HOSPITAL OF LAREDO | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 741189682 | INACTIVE | TX | 501C3 | 3 | MERCY HEALTH SYSTEM TX | 0 | |
| MERCY HOSPITAL OKLAHOMA CITY | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 730579285 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY HOSPITAL OZARK | |||||||||||
| 801 W RIVER STREET | OZARK | AR | 72949 | 710689680 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | 0 | |
| MERCY HOSPITAL PARIS | |||||||||||
| 500 E ACADEMY | PARIS | AR | 72855 | 710655753 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | 0 | |
| MERCY HOSPITAL ROGERS | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72758 | 710294390 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH NW ARK COMMUNITIES | 0 | |
| MERCY HOSPITAL SPRINGFIELD | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 440552485 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY HOSPITAL TISHOMINGO | |||||||||||
| 1000 SOUTH BYRD | TISHOMINGO | OK | 73460 | 274433830 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL ARDMORE | 0 | |
| MERCY HOSPITAL WALDRON | |||||||||||
| 1341 W 6TH STREET | WALDRON | AR | 72958 | 710557895 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | 0 | |
| MERCY HOSPITAL WATONGA INC | |||||||||||
| 500 CLARENCE NASH BLVD | WATONGA | OK | 73772 | 455199762 | LEASED HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 0 | |
| MERCY HOSPITALS EAST COMM | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 430653493 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES | 0 | |
| MERCY KANSAS COMMUNITIES INC | |||||||||||
| 401 WOODLAND HILLS BLVD | FT SCOTT | KS | 66701 | 480956045 | HOSPITAL;RURAL HEALTH CLINICS | KS | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | 0 | |
| MERCY MEDICAL RESEARCH INST | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 870796305 | RESEARCH - CLINICAL TRIALS | MO | 501C3 | 4 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY MINISTRIES OF LAREDO | |||||||||||
| 2500 ZACATECAS | LAREDO | TX | 78043 | 200198462 | HEALTHCARE, OUTREACH,FOOD PANTRY. | TX | 501C3 | 7 | MERCY HEALTH | 0 | |
| MERCY ST FRANCIS HOSPITAL | |||||||||||
| 100 W HIGHWAY 60 | MOUNTAIN VIEW | MO | 65548 | 440607149 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | |
| MERCY SUPPORT SERVICES | |||||||||||
| 615 S NEW BALLAS ROAD | ST LOUIS | MO | 63141 | 431677952 | INACTIVE | MO | 501C3 | 11-III | MERCY HOSPITALS EAST COMM | 0 | |
| MHM SUPPORT SERVICES | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 202553101 | CENTRALIZED HEALTH SYSTEM FUNCTIONS | MO | 501C3 | 11-II | MERCY HEALTH | 0 | |
| MISSION CLINICAL SERVICES | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 134239691 | PHYSICIAN CLINICS | AR | 501C3 | 9 | MERCY HEALTH HOT SPRINGS COMM | 0 | |
| ST EDWARD MERCY FOUNDATION | |||||||||||
| PO BOX 17000 | FORT SMITH | AR | 72917 | 237330425 | FOUNDATION | AR | 501C3 | 7 | MERCY HOSPITAL FORT SMITH | 0 | |
| ST JOHNS CHILDRENS HOSP | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | INACTIVE | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 0 | ||
| ST MARYS HOSP ENID OK | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 730614655 | INACTIVE | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | 0 | |
| THE SR M CORNELIA BLASKO FN | |||||||||||
| 100 W HIGHWAY 60 | MOUNTAIN VIEW | MO | 65548 | 431873914 | FOUNDATION | MO | 501C3 | 11-I | MERCY ST FRANCIS HOSPITAL | 0 | |
| UNITY AMBULATORY CARE | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 431861745 | INACTIVE | MO | 501C3 | 11-III | MERCY HEALTH EAST COMMUNITIES | 0 | |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHERN OKLAHOMA DIAG CTR LLC | ||||||||||||
| 1011 FOURTEENTH AVENUE NW | ARDMORE | OK | 73401 | 431971232 | MRI SERVICES | OK | MERCY HOSPITAL ARDMORE INC | RELATED | 141198 | 317407 | 0 | 0 |
| RESOURCE OPTIMIZ & INNOVLLC | ||||||||||||
| 645 MARYVILLE CTR DRSTE 200 | ST LOUIS | MO | 63141 | 460468368 | CENTRAL DISTRIBUTION CENTER | MO | MHN INC - MHNSR INC | N/A | 0 | 0 | ||
| MERCY AMBULATORY SURGERY CENTER LLC | ||||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 710827721 | AMBULATORY SURGERY CENTER | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 | ||
| FORT SMITH EMERGENCY MEDICAL SERVICES | ||||||||||||
| 1701 SOUTH GREENWOOD | FORT SMITH | AR | 72901 | 710416615 | EMERGENCY MEDICAL SERVICES | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 | ||
| ST EDWARD MERCY MC M-P OFFICE BLDG | ||||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72903 | 710554050 | OFFICE BUILDING | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| MERCY COMM SERVICES INC | ||||||||
| 401 WOODLAND HILLS BLVD | FORT SCOTT | KS | 66701 | 481078101 | RETAIL PHARMACY | KS | MERCY KANSAS COMM INC | C |
| FRONTENAC PROPERTIES INC | ||||||||
| 14528 S OUTER FORTY SUITE 100 | CHESTERFIELD | MO | 63017 | 521914421 | HOLDS ANCILLARY ASSETS & OWNS AIRCRAFT | DE | MERCY HEALTH | C |
| INVENO HEALTH INC | ||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 264509571 | TECHNOLOGY TRANSFER COMPANY | MO | MERCY HEALTH SPRINGFIELD COMM | C |
| UNITY SUPPORT SERVICES INC | ||||||||
| 645 MARYVILLE CENTRE DRIVE SUITE 10 | ST LOUIS | MO | 63141 | 431797042 | INACTIVE | MO | MERCY HEALTH EAST COMMUNITIES | C |
| UH L CORP INC | ||||||||
| 645 MARYVILLE CENTRE DRIVE SUITE 10 | ST LOUIS | MO | 63141 | 742499535 | HOLDING COMPANY | MO | MERCY HEALTH SERVICES LLC | C |
| MHN OF THE SOUTHERN REGION INC | ||||||||
| 1011 14TH AVENUE NW | ARDMORE | OK | 73401 | 731580607 | HOLDING COMPANY | OK | MERCY MANAGED CARE CORP | C |
| MERCY HEALTH CENTER CONDOMINIUM INC | ||||||||
| 4300 W MEMORIAL RD | OKLAHOMA CITY | OK | 73120 | 680640970 | ADMINISTRATOR OF CERTAIN REAL PROPERTY AND IMPROVEMENTS | OK | MERCY HOSPITAL OKLAHOMA CITYINC | C |
| MERCY MANAGED CARE CORPORATION | ||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731441665 | HOLDING COMPANY | OK | MERCY HEALTH | C |
| MERCY HEALTH NETWORK INC | ||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731381689 | HOLDING COMPANY | OK | MERCY MANAGED CARE CORP | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| MERCY CLINIC OKLAHOMA COMMUNITIES INC | |
| N | 98687 |
| MERCY CLINIC OKLAHOMA COMMUNITIES INC | |
| O | 2621114 |
| MERCY HEALTH | |
| P | 375864 |
| MERCY HEALTH FOUNDATION ARDMORE INC | |
| O | 422593 |
| MERCY HEALTH OKLAHOMA COMMUNITIES INC | |
| O | 4009639 |
| MERCY HOSPITAL OKLAHOMA CITY INC | |
| P | 131334424 |
| MERCY HOSPITAL TISHOMINGO | |
| P | 468342 |
| MERCY HOSPITALS EAST COMMUNITIES | |
| O | 356141 |
| MHM SUPPORT SERVICES | |
| O | 74276801 |
| RESOURCE OPTIMIZATION & INNOVATION LLC | |
| O | 4695320 |
| MERCY HEALTH FOUNDATION ARDMORE INC | |
| C | 2485825 |