2013-05-15T16:12:52-05:00 2012-06-30 562632458 PLEUS AND COMPANY LLC 14323 S OUTER FORTY STE 310N CHESTERFIELD MO 63017 990 2011-07-01 731500629 MERCY HOSPITAL ARDMORE F/K/A MERCY MEMORIAL HEALTH CENTER INC MERC 4057523724 1011 14TH AVENUE NW ARDMORE OK 73401 JON VITIELLO 4057523724 2013-05-17 1 P00013488 3143179916 2011 2016-02-25 16:41:14Z MALINDA BURDICK 1011 14TH AVENUE NW ARDMORE OK 73401 144997643 0 0928 X WWW.MERCY.NET/ARDMOREOK X 1996 OK 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. 13 9 1379 60 61310 13879 6933916 2485825 121890600 143151625 24514 -5861 2171271 -1299658 131020301 144331931 235607 458438 0 0 49123121 48784005 0 0 0 74593727 82478535 123952455 131720978 7067846 12610953 115393489 119933470 14457370 6966606 100936119 112966864 X 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. 0 0 92460969 458438 141231584 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. 92460969 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1379 1 1 1 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 OK X JON VITIELLO 4057523724 4300 WEST MEMORIAL ROAD OKLAHOMA CITY OK 73120 ABU-ESHEH MD BAHA 40.00 X 36000 0 0 BURKE RSM SR RICHARD MARY 1.00 X 0 0 0 BURNS GLEN C 1.00 X 0 0 0 DUBEA ALLEN J 1.00 X 0 0 0 HENDRICKS RSM SR REBECCA 1.00 X 0 0 0 HISEY BARBARA 1.00 X 0 0 0 LODES CLAYTON R 1.00 X 0 0 0 MOORE JOHN L 1.00 X 0 0 0 ROTHER MD JEFFREY 40.00 X 0 252152 12392 WILSON DVM CADE 1.00 X 0 0 0 WOERZ DAVID A 1.00 X 0 0 0 SMALLEY DIANA L 40.00 X X 0 556630 199937 BURDICK MALINDA 40.00 X X 0 398021 60149 VITIELLO JONATHAN 40.00 X 0 439767 61898 BARNARD RYAN W 40.00 X 186297 0 21315 HANAN RHONDA 40.00 X 176614 0 21635 LE BICH-VI 40.00 X 0 186283 25644 PAYTON BECKY J 40.00 X 0 257355 39603 TEW DAVID 40.00 X 0 426840 69452 BARKER RICHARD D 40.00 X 157948 0 12951 CRAM ROY S 40.00 X 144547 0 21237 HALL TAD 40.00 X 220457 0 20971 O'CONNOR JOHN T 40.00 X 145197 0 22223 POWELL LARRY D 40.00 X 160637 0 11754 NEWMAN JAMES 0.00 X 0 194377 3063 CARMICHAEL CINDY 0.00 X 0 201466 11770 1227697 2912891 615994 38 1 1 0 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 26 2485825 2485825 NET PATIENT REVENUE 622110 143010427 143010427 JOINT VENTURE INCOME 900099 141198 141198 143151625 -5861 -5861 619254 665712 -46458 -46458 -46458 CAFETERIA 722210 605531 605531 LABORATORY SERVICE 621500 61310 61310 -1920041 -1920041 -1253200 144331931 141231584 61310 553212 342082 342082 116356 116356 434558 434558 38298649 31739090 6559559 1738680 1543821 194859 5672742 5009370 663372 2639376 2318428 320948 12388 1844 10544 4524614 3720230 804384 5257 4322 935 82063 67474 14589 51856 51856 2785566 2290349 495217 213177 163745 49432 11522 9474 2048 51 51 8900080 2482999 6417081 862868 862868 MEDICAL SUPPLIES 30579428 25143033 5436395 SHARED SERVICE FEES 16771441 451849 16319592 BAD DEBTS 13889391 13889391 REPAIRS & MAINTENANCE 1457247 1198178 259069 2331586 1917078 414508 131720978 92460969 39260009 0 531131 3000093 15769404 18362103 130182 47159 1921570 1781060 73936 69572 194010902 103107206 96830016 90903696 137250 137250 0 5632537 115393489 119933470 7569855 6675703 6887515 290903 14457370 6966606 X 100936119 112966864 100936119 112966864 115393489 119933470 X 12610953 -580208 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 9018 0 0 0 9018 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: 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. 2849325 2849325 97346437 33212088 64134349 89795002 68639485 21155517 4020138 1255633 2764505 90903696 OTHER LONG TERM LIABILITIES 290903 290903 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 7145070 7145070 0.06060 4516000 5175626 -659626 0.00000 11661070 5175626 6485444 0.06060 70981 70981 0.00060 124810 124810 0.00110 920015 920015 0.00780 86829 86829 0.00070 1202635 1202635 0.01020 12863705 5175626 7688079 0.07080 4176 4176 0.00000 59594 59594 0.00050 2362 2362 0.00000 14945 14945 0.00010 20823 20823 0.00020 101900 101900 0.00080 1 4024498 0 53769099 62631289 -8862190 X 1 1 1 1 MERCY HOSPITAL ARDMORE

1011 14TH AVENUE NW ARDMORE OK 73401

X X X MERCY HOSPITAL ARDMORE 1 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 2 MERCY CANCER CENTER

1220 HALL PLACE ARDMORE OK 73401

CANCER TREATMENT SOUTHERN OKLAHOMA DIAGNOSTIC CENTER LLC

1111 WALNUT ARDMORE OK 73401

MRI SERVICES 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. MERCY HOSPITAL ARDMORE 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%. 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. 1 MARCH OF DIMES PO BOX 932852 ATLANTA GA 31193 131846366 501(C)(3) 5500 GENERAL OPERATIONS 1 0 TUITIONS SCHOLARSHIPS 37 116356 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. X X 1 1 1 1 0 0 0 0 0 1 0 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 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. SUPPLEMENTAL INFORMATION 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. 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. CHANGES IN NET ASSETS OR FUND BALANCES: 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. AUDITED FINANCIAL STATEMENTS 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. SINGLE AUDIT ACT AND OMB CIRCULAR A-133 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. MERCY HOSPITALS EAST COMMUNITIES 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. SYSTEM LIMITATIONS 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. HOURS PER WEEK 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. INDEPENDENT CONTRACTORS 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. 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. 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 N/A 0 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 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 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 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 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