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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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T16:12:52-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN562632458EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line114323 S OUTER FORTY STE 310NAddressLine1
CityCHESTERFIELDCity
StateMOState
ZIP Code63017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN731500629EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ARDMOREBusinessNameLine1
Business Name Line2F/K/A MERCY MEMORIAL HEALTH CENTER INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone4057523724Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11011 14TH AVENUE NWAddressLine1
CityARDMORECity
StateOKState
ZIP Code73401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJON VITIELLOName
TitleCFOTitle
Phone4057523724Phone
Date Signed2013-05-17DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00013488PTIN
Phone3143179916Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMALINDA BURDICKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11011 14TH AVENUE NWAddressLine1
CityARDMORECity
StateOKState
ZIP Code73401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts144997643GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.MERCY.NET/ARDMOREOKWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileOKStateLegalDomicile
Activity Or Mission DescriptionTO 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 Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees1379TotalNbrEmployees
Total Nbr Volunteers60TotalNbrVolunteers
Total Gross UBI61310TotalGrossUBI
Net Unrelated Business Txbl Income13879NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6933916ContributionsGrantsPriorYear
Contributions Grants Current Year2485825ContributionsGrantsCurrentYear
Program Service Revenue Prior Year121890600ProgramServiceRevenuePriorYear
Program Service Revenue CY143151625ProgramServiceRevenueCY
Investment Income Prior Year24514InvestmentIncomePriorYear
Investment Income Current Year-5861InvestmentIncomeCurrentYear
Other Revenue Prior Year2171271OtherRevenuePriorYear
Other Revenue Current Year-1299658OtherRevenueCurrentYear
Total Revenue Prior Year131020301TotalRevenuePriorYear
Total Revenue Current Year144331931TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year235607GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY458438GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49123121SalariesEtcPriorYear
Salaries Etc Current Year48784005SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year74593727OtherExpensePriorYear
Other Expenses Current Year82478535OtherExpensesCurrentYear
Total Expenses Prior Year123952455TotalExpensesPriorYear
Total Expenses Current Year131720978TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7067846RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12610953RevenuesLessExpensesCY
Total Assets BOY115393489TotalAssetsBOY
Total Assets EOY119933470TotalAssetsEOY
Total Liabilities BOY14457370TotalLiabilitiesBOY
Total Liabilities EOY6966606TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY100936119NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY112966864NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMERCY 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense92460969Expense
Grants458438Grants
Revenue141231584Revenue
DescriptionMERCY 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 Expense92460969TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1379NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledOKStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JON VITIELLOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4057523724TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14300 WEST MEMORIAL ROADAddressLine1
CityOKLAHOMA CITYCity
StateOKState
ZIP Code73120ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ABU-ESHEH MD BAHA
BOARD MEMBER; CHIEF OF MEDICAL STAFF (EFFECTIVE 0140.00X3600000
BURKE RSM SR RICHARD MARY
BOARD MEMBER1.00X000
BURNS GLEN C
BOARD MEMBER1.00X000
DUBEA ALLEN J
BOARD MEMBER1.00X000
HENDRICKS RSM SR REBECCA
BOARD MEMBER1.00X000
HISEY BARBARA
BOARD MEMBER1.00X000
LODES CLAYTON R
BOARD MEMBER1.00X000
MOORE JOHN L
BOARD MEMBER1.00X000
ROTHER MD JEFFREY
BOARD MEMBER40.00X025215212392
WILSON DVM CADE
BOARD MEMBER1.00X000
WOERZ DAVID A
BOARD MEMBER1.00X000
SMALLEY DIANA L
CEO, MERCY OKLAHOMA40.00X0556630199937X
BURDICK MALINDA
PRESIDENT, MERCY HOSPITAL ARDMORE40.00X039802160149X
VITIELLO JONATHAN
CFO, MERCY OKLAHOMA40.00043976761898X
BARNARD RYAN W
VP-OPERATIONS40.00186297021315X
HANAN RHONDA
VP-NURSING40.00176614021635X
LE BICH-VI
REGIONAL VP-GENERAL COUNSEL40.00018628325644X
PAYTON BECKY J
VP-HR MERCY OKLAHOMA40.00025735539603X
TEW DAVID
COO, MERCY OKLAHOMA40.00042684069452X
BARKER RICHARD D
REGIONAL ADMINISTRATOR, RURAL FACILITIES40.00157948012951X
CRAM ROY S
INFORMATICS PHARMACIST40.00144547021237X
HALL TAD
CHIEF PHYSICIAN ASSISTANT40.00220457020971X
O'CONNOR JOHN T
PHYSICIAN40.00145197022223X
POWELL LARRY D
PHYSICIAN40.00160637011754X
NEWMAN JAMES
FORMER OFFICER0.0001943773063X
CARMICHAEL CINDY
FORMER KEY EMPLOYEE0.00020146611770X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1227697TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2912891TotalReportableCompFrmRltdOrgs
Total Other Compensation615994TotalOtherCompensation
Number Individuals GT100 K38NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ELEKTA INC
PO BOX 404199ATLANTAGA30384CONSTRUCTION2056825
ARDMORE ANESTHESIA INC
PO BOX 1983ARDMOREOK73402MEDICAL SERVICES882357
JE DUNN CONSTRUCTION
929 HOLMESKANSAS CITYMO64106CONSTRUCTION825780
ARDMORE DIALYSIS RANCH INC
2617 CROSSROADS DR PO BOX 637ARDMOREOK73401MEDICAL SERVICES591600
ENTECH
PO BOX 650110DALLASTX75265REPAIRS402758
FieldValueIRS element (for citing)
Number Of Contractors GT100 K26NumberOfContractorsGT100K
Related Organizations2485825RelatedOrganizations
Total Contributions2485825TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE622110143010427143010427
JOINT VENTURE INCOME900099141198141198
FieldValueIRS element (for citing)
Total Program Service Revenue143151625TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-5861TotalRevenueColumn
Exclusion-$5,861ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real619254Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real665712Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-46458Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-46458TotalRevenueColumn
Exclusion-$46,458ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA722210605531$605,531
LABORATORY SERVICE6215006131061310

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-1920041TotalRevenueColumn
Related Or Exempt Function Income-1920041RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-1253200TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column144331931TotalRevenueColumn
Related Or Exempt Function Income141231584RelatedOrExemptFunctionIncome
Unrelated Business Revenue61310UnrelatedBusinessRevenue
Exclusion$553,212ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total342082Total
Program Services342082ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total116356Total
Program Services116356ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total434558Total
Management And General434558ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38298649Total
Program Services31739090ProgramServices
Management And General6559559ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1738680Total
Program Services1543821ProgramServices
Management And General194859ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5672742Total
Program Services5009370ProgramServices
Management And General663372ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2639376Total
Program Services2318428ProgramServices
Management And General320948ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12388Total
Program Services1844ProgramServices
Management And General10544ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4524614Total
Program Services3720230ProgramServices
Management And General804384ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total5257Total
Program Services4322ProgramServices
Management And General935ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total82063Total
Program Services67474ProgramServices
Management And General14589ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total51856Total
Program Services51856ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2785566Total
Program Services2290349ProgramServices
Management And General495217ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total213177Total
Program Services163745ProgramServices
Management And General49432ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total11522Total
Program Services9474ProgramServices
Management And General2048ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total51Total
Management And General51ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8900080Total
Program Services2482999ProgramServices
Management And General6417081ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total862868Total
Management And General862868ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES30579428251430335436395
SHARED SERVICE FEES1677144145184916319592
BAD DEBTS1388939113889391
REPAIRS & MAINTENANCE14572471198178259069

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2331586Total
Program Services1917078ProgramServices
Management And General414508ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total131720978Total
Program Services92460969ProgramServices
Management And General39260009ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY531131BOY
EOY3000093EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15769404BOY
EOY18362103EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY130182BOY
EOY47159EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1921570BOY
EOY1781060EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY73936BOY
EOY69572EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis194010902LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec103107206LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY96830016BOY
EOY90903696EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY137250BOY
EOY137250EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY5632537EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY115393489BOY
EOY119933470EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7569855BOY
EOY6675703EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6887515BOY
EOY290903EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14457370BOY
EOY6966606EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY100936119BOY
EOY112966864EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY100936119BOY
EOY112966864EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY115393489BOY
EOY119933470EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses12610953ReconcilationRevenueExpenses
Reconcilation Other Changes-580208ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$9,018GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB9018TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHE 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

FieldValueIRS element (for citing)
Other Cost Or Other Basis2849325OtherCostOrOtherBasis
Book Value2849325BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis97346437OtherCostOrOtherBasis
Depreciation33212088Depreciation
Book Value64134349BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis89795002OtherCostOrOtherBasis
Depreciation68639485Depreciation
Book Value21155517BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4020138OtherCostOrOtherBasis
Depreciation1255633Depreciation
Book Value2764505BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings90903696TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LONG TERM LIABILITIESDescription
Amount$290,903Amount
FieldValueIRS element (for citing)
Total Of Amounts290903TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE 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

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7145070TotalCommunityBenefitExpense
Net Community Benefit Expense7145070NetCommunityBenefitExpense
Percent Of Total Expense0.06060PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4516000TotalCommunityBenefitExpense
Direct Offsetting Revenue5175626DirectOffsettingRevenue
Net Community Benefit Expense-659626NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense11661070TotalCommunityBenefitExpense
Direct Offsetting Revenue5175626DirectOffsettingRevenue
Net Community Benefit Expense6485444NetCommunityBenefitExpense
Percent Of Total Expense0.06060PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense70981TotalCommunityBenefitExpense
Net Community Benefit Expense70981NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense124810TotalCommunityBenefitExpense
Net Community Benefit Expense124810NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense920015TotalCommunityBenefitExpense
Net Community Benefit Expense920015NetCommunityBenefitExpense
Percent Of Total Expense0.00780PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense86829TotalCommunityBenefitExpense
Net Community Benefit Expense86829NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1202635TotalCommunityBenefitExpense
Net Community Benefit Expense1202635NetCommunityBenefitExpense
Percent Of Total Expense0.01020PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12863705TotalCommunityBenefitExpense
Direct Offsetting Revenue5175626DirectOffsettingRevenue
Net Community Benefit Expense7688079NetCommunityBenefitExpense
Percent Of Total Expense0.07080PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense4176TotalCommunityBuildingExpense
Net Community Building Expense4176NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense59594TotalCommunityBuildingExpense
Net Community Building Expense59594NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense2362TotalCommunityBuildingExpense
Net Community Building Expense2362NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense14945TotalCommunityBuildingExpense
Net Community Building Expense14945NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense20823TotalCommunityBuildingExpense
Net Community Building Expense20823NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense101900TotalCommunityBuildingExpense
Net Community Building Expense101900NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,024,498BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare53769099AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare62631289CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8862190MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ARDMOREBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11011 14TH AVENUE NWAddressLine1
CityARDMORECity
StateOKState
ZIP Code73401ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL ARDMOREBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MERCY CANCER CENTER
1220 HALL PLACEARDMOREOK73401CANCER TREATMENT
SOUTHERN OKLAHOMA DIAGNOSTIC CENTER LLC
1111 WALNUTARDMOREOK73401MRI SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
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

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARCH OF DIMESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 932852AddressLine1
CityATLANTACity
StateGAState
ZIP Code31193ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient131846366EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant5500AmountOfCashGrant
Purpose Of GrantGENERAL OPERATIONSPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantTUITIONS SCHOLARSHIPSTypeOfGrant
Number Of Recipients37NumberOfRecipients
Amount Of Cash Grant116356AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
ExplanationTHE ORGANIZATION USES AN APPROVAL PROCESS TO DETERMINE WHICH ORGANIZATIONS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE NONPROFIT ORGANIZATION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROTHER MD JEFFREY
021729102074001412101533010859026454400
SMALLEY DIANA L
04326830114881090660184144015793075656700
BURDICK MALINDA
029001108063002738005250507644045817000
VITIELLO JONATHAN
0278936069300091531046475015423050166500
BARNARD RYAN W
158889011220016188063950149200207612000
HANAN RHONDA
150660011203014751066800149550198249000
LE BICH-VI
0133043017417035823010643015001021192700
PAYTON BECKY J
0187406041724028225027819011784029695800
TEW DAVID
0323301069230034309053898015554049629200
BARKER RICHARD D
13328809899014761011662012890170899000
CRAM ROY S
123477000210700109960102410165784000
HALL TAD
19971900020738011946090250241428000
O'CONNOR JOHN T
110341000348560117930104300167420000
POWELL LARRY D
11183302500002380405624061300172391000
NEWMAN JAMES
000001943770306300019744000
CARMICHAEL CINDY
01656880123240234540516506605021323600

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1ACHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. 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-BJAMES 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 7THE 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 IIITHE 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 ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AMERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AT ANY TIME AT THE MEMBER'S DISCRETION.
FORM 990, PART VI, SECTION A, LINE 7BMERCY HEALTH OKLAHOMA COMMUNITIES HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -TO APPROVE 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 11THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM. THE DRAFT FORM 990 IS ALSO REVIEWED BY THE MERCY HEALTH TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 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 15AFOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE 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 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY.
FORM 990, PART XI, LINE 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 2THE 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 3THE 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 IIMERCY 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 VLAWSON 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 VIISEVERAL 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 1AINDEPENDENT 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 BDURING 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/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ADVANCE CARE HOSPITAL
300 WERNER ST 3RD FLOORHOT SPRINGSAR71913710816634LONG TERM ACUTE-CARE HOSPITALAR501C33MERCY HEALTH0
CASA DE MISERICORDIA
1602 MCCLELLAND STREETLAREDOTX78044742912461WOMEN'S DOMESTIC VIOLENCE SHELTERTX501C37MERCY MINISTRIES OF LAREDO0
LAREDO MEDICAL GROUP
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017742764726INACTIVETX501C39MERCY HEALTH SYSTEM TX0
MCAULEY PORTFOLIO MGMT CO
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017261708048PORTFOLIO MANAGEMENTMO501C311-IIMERCY HEALTH0
MERCY CLINIC EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100ST LOUISMO63141431771217PHYSICIAN GROUPMO501C39MERCY HEALTH EAST COMMUNITIES0
MERCY CLINIC FORT SMITH COMM
7301 ROGERS AVENUEFORT SMITHAR72917261318597PHYSICIAN CLINICAR501C39MERCY HEALTH FORT SMITH COMM0
MERCY CLINIC HOT SPRINGS COMM
1 MERCY LANEHOT SPRINGSAR71913261125131PHYSICIAN CLINICAR501C39MERCY HEALTH HOT SPRINGS COMM0
MERCY CLINIC OKLAHOMA COMM
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120270473057PHYSICIAN GROUP/CLINICOK501C39MERCY HEALTH OK COMMUNITIES0
MERCY CLINIC SPRINGFIELD COMM
1965 FREMONT STREET SUITE 2950SPRINGFIELDMO65804431560263PHYSICIAN GROUPMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY FAMILY CENTER
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017721069468FAMILY COUNSELING SERVICESMO501C37MERCY HEALTH0
MERCY FDTN HEALTH INNOV
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017200901499FOUNDATIONMO501C311-IIMERCY HEALTH0
MERCY HEALTH
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017431423050HEALTH SYSTEM - CORPORATE OFFICEMO501C310N/A
MERCY HEALTH EAST COMMUNITIES
645 MARYVILLE CTR DR STE 100ST LOUISMO63141431718408HEALTH SYSTEMMO501C311-IIMERCY HEALTH0
MERCY HEALTH FORT SMITH COMM
7301 ROGERS AVENUEFORT SMITHAR72917261318515HOLDING COMPANYAR501C311-IIMERCY HEALTH0
MERCY HEALTH FOUNDATION ARDMORE
1011 14TH AVENUE NWARDMOREOK73401710962525FOUNDATIONOK501C311-IMERCY HOSPITAL ARDMORE0
MERCY HEALTH FOUNDATION BERRYVILLE
214 CARTER STREETBERRYVILLEAR72616710759301FOUNDATIONAR501C311-IMERCY HOSPITAL BERRYVILLE0
MERCY HEALTH FOUNDATION FT SCOTT
401 WOODLAND HILLS BLVDFORT SCOTTKS66701481077073FOUNDATIONKS501C311-IIIMERCY KANSAS COMMUNITIES INC0
MERCY HEALTH FOUNDATION HOT SPRINGS
300 WERNER STREETHOT SPRINGSAR71913710804718FOUNDATIONAR501C311-IIMERCY HOSPITAL HOT SPRINGS0
MERCY HEALTH FOUNDATION INDEPENDENCE
800 W MYRTLEINDEPENDENCEKS67301481079981FOUNDATIONKS501C311-IMERCY KANSAS COMMUNITIES INC0
MERCY HEALTH FOUNDATION JOPLIN
2817 ST JOHNS BLVDJOPLINMO64804270906136FOUNDATIONMO501C311-IMERCY HEALTH SW MOKS COMM0
MERCY HEALTH FOUNDATION NW ARK
2710 RIFE MEDICAL LNROGERSAR72858710601687FOUNDATIONAR501C311-IIIMERCY HOSPITAL ROGERS0
MERCY HEALTH FOUNDATION OK CITY
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731593024FOUNDATIONOK501C311-IMERCY HOSPITAL OKLAHOMA CITY0
MERCY HEALTH FOUNDATION OF OK
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120454732301FOUNDATIONOK501C311-IMERCY HEALTH OK COMMUNITIES0
MERCY HEALTH FOUNDATION SPRINGFIELD
1235 E CHEROKEE STREETSPRINGFIELDMO65804320195818FOUNDATIONMO501C311-IIMERCY HEALTH SPRINGFIELD COMM0
MERCY HEALTH FOUNDATION STL
615 SOUTH NEW BALLAS ROADST LOUISMO63141562410020FOUNDATIONMO501C311-IIMERCY HEALTH EAST COMMUNITIES0
MERCY HEALTH FOUNDATION WASHINGTON
901 E FIFTH STREETWASHINGTONMO63090562410022FOUNDATIONMO501C311-IIMERCY HEALTH EAST COMMUNITIES0
MERCY HEALTH HOT SPRINGS COMM
300 WERNER STREETHOT SPRINGSAR71913261125064HOLDING COMPANYAR501C311-IIMERCY HEALTH0
MERCY HEALTH NW ARK COMMUNITIES
2710 RIFE MEDICAL LNROGERSAR72758621684203PHYSICIAN GROUPAR501C311-IIMERCY HEALTH0
MERCY HEALTH OK COMMUNITIES
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731453048HOLDING COMPANYOK501C311-IIMERCY HEALTH0
MERCY HEALTH SW MOKS COMM
2817 ST JOHNS BLVDJOPLINMO64804300584463HEALTH SYSTEMMO501C311-IIMERCY HEALTH0
MERCY HEALTH SPRINGFIELD COMM
1235 E CHEROKEE STREETSPRINGFIELDMO65804431856028HOLDING COMPANYMO501C311-IIMERCY HEALTH0
MERCY HEALTH SYSTEM TX
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017742764727INACTIVETX501C311-IIMERCY HEALTH0
MERCY HOME HEALTH BERRYVILLE
804 W FREEMAN SUITE 4BERRYVILLEAR72616870781247HOME HEALTH AND HOSPICE OPERATIONS.AR501C311-IIIMERCY HOSPITAL SPRINGFIELD0
MERCY HOSPITAL AURORA
500 PORTER AVENUEAURORAMO65605431936696OPERATING CO FOR LEASED HOSPMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY HOSPITAL BERRYVILLE
214 CARTER STREETBERRYVILLEAR72616710759299HOSPITALAR501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY HOSPITAL CARTHAGE
3125 DR RUSSELL SMITH WAYCARTHAGEMO64836453808607HOSPITALMO501C33MERCY HEALTH SW MOKS COMM0
MERCY HOSPITAL CASSVILLE
94 MAIN STREETCASSVILLEMO65625431936699OPERATING CO FOR LEASED HOSPMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY HOSPITAL COLUMBUS
220 PENNSYLVANIA AVENUECOLUMBUSKS66725270842031CRITICAL ACCESS HOSPITALMO501C39MERCY HEALTH SW MOKS COMM0
MERCY HOSPITAL EL RENO
2115 PARKVIEW DRIVEEL RENOOK73036272716065OPERATING CO FOR LEASED HOSPOK501C33MERCY HEALTH OK COMMUNITIES0
MERCY HOSPITAL FORT SMITH
7301 ROGERS AVENUEFORT SMITHAR72917710240352HOSPITALAR501C33MERCY HEALTH FORT SMITH COMM0
MERCY HOSPITAL HEALDTON
918 SOUTH STREETHEALDTONOK73438263173902HOSPITALOK501C33MERCY HOSPITAL ARDMORE0
MERCY HOSPITAL HOT SPRINGS
300 WERNER STREETHOT SPRINGSAR71913710236913HOSPITALAR501C33MERCY HEALTH HOT SPRINGS COMM0
MERCY HOSPITAL JOPLIN
2817 ST JOHNS BLVDJOPLINMO64804270814858HOSPITALMO501C39MERCY HEALTH SW MOKS COMM0
MERCY HOSPITAL LEBANON
100 HOSPITAL DRIVELEBANONMO65536431767432HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY HOSPITAL LOGAN COUNTY INC
200 SOUTH ACADEMYGUTHRIEOK73044452998842HOSPITALOK501C33MERCY HEALTH OK COMMUNITIES0
MERCY HOSPITAL OF LAREDO
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017741189682INACTIVETX501C33MERCY HEALTH SYSTEM TX0
MERCY HOSPITAL OKLAHOMA CITY
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120730579285HOSPITALOK501C33MERCY HEALTH OK COMMUNITIES0
MERCY HOSPITAL OZARK
801 W RIVER STREETOZARKAR72949710689680HOSPITALAR501C33MERCY HOSPITAL FORT SMITH0
MERCY HOSPITAL PARIS
500 E ACADEMYPARISAR72855710655753HOSPITALAR501C33MERCY HOSPITAL FORT SMITH0
MERCY HOSPITAL ROGERS
2710 RIFE MEDICAL LNROGERSAR72758710294390HOSPITALAR501C33MERCY HEALTH NW ARK COMMUNITIES0
MERCY HOSPITAL SPRINGFIELD
1235 E CHEROKEE STREETSPRINGFIELDMO65804440552485HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY HOSPITAL TISHOMINGO
1000 SOUTH BYRDTISHOMINGOOK73460274433830HOSPITALOK501C33MERCY HOSPITAL ARDMORE0
MERCY HOSPITAL WALDRON
1341 W 6TH STREETWALDRONAR72958710557895HOSPITALAR501C33MERCY HOSPITAL FORT SMITH0
MERCY HOSPITAL WATONGA INC
500 CLARENCE NASH BLVDWATONGAOK73772455199762LEASED HOSPITALOK501C33MERCY HEALTH OK COMMUNITIES0
MERCY HOSPITALS EAST COMM
645 MARYVILLE CTR DR STE 100ST LOUISMO63141430653493HOSPITALMO501C33MERCY HEALTH EAST COMMUNITIES0
MERCY KANSAS COMMUNITIES INC
401 WOODLAND HILLS BLVDFT SCOTTKS66701480956045HOSPITAL;RURAL HEALTH CLINICSKS501C33MERCY HEALTH SW MOKS COMM0
MERCY MEDICAL RESEARCH INST
1235 E CHEROKEE STREETSPRINGFIELDMO65804870796305RESEARCH - CLINICAL TRIALSMO501C34MERCY HEALTH SPRINGFIELD COMM0
MERCY MINISTRIES OF LAREDO
2500 ZACATECASLAREDOTX78043200198462HEALTHCARE, OUTREACH,FOOD PANTRY.TX501C37MERCY HEALTH0
MERCY ST FRANCIS HOSPITAL
100 W HIGHWAY 60MOUNTAIN VIEWMO65548440607149HOSPITALMO501C33MERCY HEALTH SPRINGFIELD COMM0
MERCY SUPPORT SERVICES
615 S NEW BALLAS ROADST LOUISMO63141431677952INACTIVEMO501C311-IIIMERCY HOSPITALS EAST COMM0
MHM SUPPORT SERVICES
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017202553101CENTRALIZED HEALTH SYSTEM FUNCTIONSMO501C311-IIMERCY HEALTH0
MISSION CLINICAL SERVICES
300 WERNER STREETHOT SPRINGSAR71913134239691PHYSICIAN CLINICSAR501C39MERCY HEALTH HOT SPRINGS COMM0
ST EDWARD MERCY FOUNDATION
PO BOX 17000FORT SMITHAR72917237330425FOUNDATIONAR501C37MERCY HOSPITAL FORT SMITH0
ST JOHNS CHILDRENS HOSP
1235 E CHEROKEE STREETSPRINGFIELDMO65804INACTIVEMO501C33MERCY HEALTH SPRINGFIELD COMM0
ST MARYS HOSP ENID OK
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017730614655INACTIVEOK501C33MERCY HEALTH OK COMMUNITIES0
THE SR M CORNELIA BLASKO FN
100 W HIGHWAY 60MOUNTAIN VIEWMO65548431873914FOUNDATIONMO501C311-IMERCY ST FRANCIS HOSPITAL0
UNITY AMBULATORY CARE
14528 S OUTER FORTY ST 100CHESTERFIELDMO63017431861745INACTIVEMO501C311-IIIMERCY HEALTH EAST COMMUNITIES0

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
SOUTHERN OKLAHOMA DIAG CTR LLC
1011 FOURTEENTH AVENUE NWARDMOREOK73401431971232MRI SERVICESOKMERCY HOSPITAL ARDMORE INCRELATED14119831740700
RESOURCE OPTIMIZ & INNOVLLC
645 MARYVILLE CTR DRSTE 200ST LOUISMO63141460468368CENTRAL DISTRIBUTION CENTERMOMHN INC - MHNSR INCN/A00
MERCY AMBULATORY SURGERY CENTER LLC
7301 ROGERS AVENUEFORT SMITHAR72917710827721AMBULATORY SURGERY CENTERARMERCY HOSPITAL FORT SMITHN/A00
FORT SMITH EMERGENCY MEDICAL SERVICES
1701 SOUTH GREENWOODFORT SMITHAR72901710416615EMERGENCY MEDICAL SERVICESARMERCY HOSPITAL FORT SMITHN/A00
ST EDWARD MERCY MC M-P OFFICE BLDG
7301 ROGERS AVENUEFORT SMITHAR72903710554050OFFICE BUILDINGARMERCY HOSPITAL FORT SMITHN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
MERCY COMM SERVICES INC
401 WOODLAND HILLS BLVDFORT SCOTTKS66701481078101RETAIL PHARMACYKSMERCY KANSAS COMM INCC
FRONTENAC PROPERTIES INC
14528 S OUTER FORTY SUITE 100CHESTERFIELDMO63017521914421HOLDS ANCILLARY ASSETS & OWNS AIRCRAFTDEMERCY HEALTHC
INVENO HEALTH INC
1235 E CHEROKEE STREETSPRINGFIELDMO65804264509571TECHNOLOGY TRANSFER COMPANYMOMERCY HEALTH SPRINGFIELD COMMC
UNITY SUPPORT SERVICES INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141431797042INACTIVEMOMERCY HEALTH EAST COMMUNITIESC
UH L CORP INC
645 MARYVILLE CENTRE DRIVE SUITE 10ST LOUISMO63141742499535HOLDING COMPANYMOMERCY HEALTH SERVICES LLCC
MHN OF THE SOUTHERN REGION INC
1011 14TH AVENUE NWARDMOREOK73401731580607HOLDING COMPANYOKMERCY MANAGED CARE CORPC
MERCY HEALTH CENTER CONDOMINIUM INC
4300 W MEMORIAL RDOKLAHOMA CITYOK73120680640970ADMINISTRATOR OF CERTAIN REAL PROPERTY AND IMPROVEMENTSOKMERCY HOSPITAL OKLAHOMA CITYINCC
MERCY MANAGED CARE CORPORATION
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731441665HOLDING COMPANYOKMERCY HEALTHC
MERCY HEALTH NETWORK INC
4300 W MEMORIAL ROADOKLAHOMA CITYOK73120731381689HOLDING COMPANYOKMERCY MANAGED CARE CORPC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MERCY CLINIC OKLAHOMA COMMUNITIES INC
N98687
MERCY CLINIC OKLAHOMA COMMUNITIES INC
O2621114
MERCY HEALTH
P375864
MERCY HEALTH FOUNDATION ARDMORE INC
O422593
MERCY HEALTH OKLAHOMA COMMUNITIES INC
O4009639
MERCY HOSPITAL OKLAHOMA CITY INC
P131334424
MERCY HOSPITAL TISHOMINGO
P468342
MERCY HOSPITALS EAST COMMUNITIES
O356141
MHM SUPPORT SERVICES
O74276801
RESOURCE OPTIMIZATION & INNOVATION LLC
O4695320
MERCY HEALTH FOUNDATION ARDMORE INC
C2485825