2013-05-14T15:28:47-04:00 2012-06-30 ERNST & YOUNG US LLP 190 CARONDELET PLAZA SUITE 1300 CLAYTON MO 63105 990 2011-07-01 621684203 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES % Benny J Stover CPA MERC 3145796100 2710 Rife Medical Lane Rogers AR 72758 Benny Stover 2013-05-10 3142901000 2011 2016-02-24 21:20:13Z Scott Street 2710 Rife Medical Lane Rogers AR 72758 62285423 false 0928 X www.mercy.net X 1997 AR As the Sisters of Mercy before us, we bring to life the healing ministry of Jesus through our compassionate care and exceptional service. 11 8 712 0 0 0 0 58695633 62087740 -50792 15342 417373 182341 59062214 62285423 0 500 0 0 54614704 58414319 0 0 0 18000387 20486652 72615091 78901471 -13552877 -16616048 10751653 12569127 60049053 78478829 -49297400 -65909702 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 25411896 0 23335630 FAMILY MEDICINE PHYSICIAN SERVICES: MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES FAMILY MEDICINE PHYSICIAN SERVICES ARE COMPRISED OF 33 BOARD CERTIFIED FAMILY MEDICINE PHYSICIANS AND 8 MID-LEVELS, WHO PROVIDE PRIMARY MEDICINE SERVICES TO PATIENTS RANGING FROM ONE YEAR OLD THROUGH ADULTHOOD. THESE SERVICES ARE OFFERED IN APPROXIMATELY 10 LOCATIONS THROUGHOUT BENTON COUNTY ARKANSAS, AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 180,235 OFFICE VISITS WERE PROVIDED TO PATIENTS. 11979703 0 7088001 CARDIOVASCULAR PHYSICIAN SERVICES: MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES CARDIOVASCULAR PHYSICIAN SERVICES ARE COMPRISED OF 6 CARDIOLOGISTS, 2 CARDIOVASCULAR SURGIONS, AND 7 MID-LEVEL PROVIDERS. THESE PROVIDERS SERVE PATIENTS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA, WHO HAVE HEART RELATED MEDICAL NEEDS. DURING THE YEAR, 20,331 OFFICE VISITS WERE PROVIDED TO PATIENTS. 4954742 0 4486435 PEDIATRIC PHYSICIAN SERVICES: MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES PEDIATRIC PHYSICIAN SERVICES ARE COMPRISED OF 6 BOARD CERTIFIED PEDIATRICIANS AND 2 MID-LEVELS, WHO PROVIDED PRIMARY MEDICINE SERVICES TO PATIENTS RANGING IN AGE FROM INFANTS THROUGH EIGHTEEN YEARS. SERVICES ARE PROVIDED TO PATIENTS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 35,342 OFFICE VISITS WERE PROVIDED TO PATIENTS. 27268595 500 27360015 69614936 true false false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 0 0 712 true false false false false false false false false false false X 11 8 false false false false true true true true true false false true true true true true true true true false X Benny J Stover CPA 4793382903 2710 Rife Medical Lane Rogers AR 72758 X Paul Bergant 1.0 X 0 0 0 Wayne Callahan 1.0 X 0 0 0 Hugh Donnell 60.0 X 324687 0 37798 Sr Gayle Evans RSM 1.0 X 0 0 0 Sr Chabanel Finnegan RSM 1.0 X 0 0 0 Dr Donna Johnson 60.0 X 504423 0 33074 Rollin Ford 1.0 X 0 0 0 Sr Teresa Kelone RSM 1.0 X 0 0 0 Tabitha Lipscomb 1.0 X 0 0 0 Paul Mahan 1.0 X 0 0 0 Miguel Rivera 1.0 X 0 0 0 Steve Stewart 1.0 X 0 0 0 Robert Stuppy 60.0 X 744102 0 29565 Scott Street 60.0 X X 0 547813 113902 Jonathan Vitiello 60.0 X 0 439767 61898 Bradley Kim Day 60.0 X 0 833159 436266 Stephen Goss 60.0 X 350072 0 73751 Steven Hughes 60.0 X 213163 0 17363 Tanya Marion 60.0 X 0 160391 16041 Michael Merrigan 60.0 X 0 320923 65228 Benny Stover 60.0 X 171481 0 19523 Amr El-Shafei 40.0 X 1293110 0 13237 Philip Riley 40.0 X 763134 0 15616 Christopher Simpson 40.0 X 763410 0 25427 Kuntal Thaker 40.0 X 939446 0 29575 Larry Weathers 40.0 X 741643 0 23662 Susan Barrett 40.0 X 0 300000 0 George Flynn 60.0 X 0 571155 192126 Karen Little-Smith 40.0 X 122416 0 11553 Jerri L Lynne Mitchell X 0 106757 0 Richard Barclay 60.0 X 200796 0 14609 Michele Stewart 60.0 X 291030 0 67596 7422913 3279965 1297810 101 true true false QUEST DIAGNOSTICS PO BOX 740709 ATLANTA GA 30374 LAB DIAGNOSTICS 290050 BERLIN WHEELER INC PO BOX 463 JEFFERSON CITY MO 65102 COLLECTIONS 173401 TIMELINE RECRUITING LLC 13841 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 RECRUITING 147730 EMDEON PO Box 572490 MURRAY UT 84127 Claims processing 134609 4 0 NET PATIENT SERVICE REVENUE 621111 61517881 61517881 RENTAL INCOME FROM RELATED ORGS 531120 178321 178321 OTHER OPERATING REVENUE 900099 391538 391538 62087740 15342 15342 0 0 0 0 0 0 HOSPITAL SUPPORT REVENUE 621111 181530 181530 CAFETERIA & VENDING 900099 811 811 182341 62285423 62270081 15342 0 500 500 0 0 2546459 2546459 0 46004350 40060793 5943557 1816815 1577128 239687 5434653 4752688 681965 2612042 2290689 321353 0 177467 177467 159 159 0 0 0 1953944 1713555 240389 64944 37788 27156 881068 447304 433764 802573 703835 98738 0 4341057 3652887 688170 230487 137741 92746 0 622 119 503 38651 33896 4755 0 758215 664934 93281 1439197 1317176 122021 REPAIRS & MAINTENANCE 165961 128602 37359 SHARED SERVICES 678414 594949 83465 BAD DEBT EXPENSES 3264174 3264174 MEDICAL SUPPLIES 5689719 5689719 78901471 69614936 9286535 0 687001 481493 0 0 0 0 5410088 6027356 0 0 0 0 630789 1236480 428120 453516 111222 13086 10981878 6624682 3484433 4357196 0 0 0 0 0 0 0 0 0 0 10751653 12569127 7672388 9496494 0 0 0 0 0 0 0 0 0 0 0 0 2484565 1998906 49892100 66983429 60049053 78478829 X -49297400 -65909702 0 0 0 0 -49297400 -65909702 10751653 12569127 X -16616048 3746 X X false true true X false X 58003 0 0 0 0 58003 86990336 95352882 54103144 58695633 61696202 356838197 87048339 95352882 54103144 58695633 61696202 356896200 356896200 874009 41511 27879 -18223 15342 940518 874009 41511 27879 -18223 15342 940518 1765506 1237480 533693 417373 573879 4527931 89687854 96631873 54664716 59094783 62285423 362364649 0.98491 0.98084 0.00260 0.00501 X OTHER INCOME INCLUDED SERVICES PROVIDED TO SUPPORT THE HOSPITAL, SUCH AS CAFETERIA INCOME AND OTHER SERVICE REVENUE. 125000 125000 1453944 1040021 413923 4005650 2120675 1884975 4911483 3452337 1459146 485801 11649 474152 4357196 0 DEPOSITORY ACCOUNTS-BOA 23313854 DUE TO AFFILIATES 43223509 MISCELLANEOUS RESERVES 446066 66983429 Form 990, Schedule D, Part X, Line 2 ASC 740 FOOTNOTE THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH AND AFFILIATES DO NOT INCLUDE A FOOTNOTE TO REPORT THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER ASC 740, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE. X X X true true true true false false false false false true false Hugh Donnell 296172 0 0 28515 0 17639 0 20159 0 362485 0 0 0 Dr Donna Johnson 436446 0 0 67977 0 12606 0 20468 0 537497 0 0 0 Robert Stuppy 583294 0 100000 0 60808 0 8224 0 21341 0 773667 0 0 0 Scott Street 0 373434 0 154052 0 20327 0 97848 0 16054 0 661715 0 0 Jonathan Vitiello 0 278936 0 69300 0 91531 0 46475 0 15423 0 501665 0 0 Bradley Kim Day 0 598570 0 203887 0 30702 0 422839 0 13427 0 1269425 0 0 Stephen Goss 235960 0 60650 0 53462 0 53444 0 20307 0 423823 0 0 0 Steven Hughes 164286 0 23972 0 24905 0 5803 0 11560 0 230526 0 0 0 Tanya Marion 0 111560 0 30030 0 18801 0 3958 0 12083 0 176432 0 0 Michael Merrigan 0 214349 0 66366 0 40208 0 49457 0 15771 0 386151 0 0 Benny Stover 132505 0 27256 0 11720 0 4751 0 14772 0 191004 0 0 0 Amr El-Shafei 1254150 0 0 0 38960 0 3320 0 9917 0 1306347 0 0 0 Philip Riley 716688 0 0 0 46446 0 5872 0 9744 0 778750 0 0 0 Christopher Simpson 716790 0 0 0 46620 0 4061 0 21366 0 788837 0 0 0 Kuntal Thaker 904281 0 26500 0 8665 0 8134 0 21441 0 969021 0 0 0 Larry Weathers 621687 0 0 0 119956 0 6921 0 16741 0 765305 0 0 0 Susan Barrett 0 300000 0 0 0 0 0 0 0 0 0 300000 0 0 George Flynn 0 410520 0 133860 0 26775 0 176339 0 15787 0 763281 0 0 Karen Little-Smith 92053 0 7774 0 22589 0 5613 0 5940 0 133969 0 0 0 Jerri L Lynne Mitchell 0 0 0 0 0 106757 0 0 0 0 0 106757 0 0 Richard Barclay 138835 0 30031 0 31930 0 8213 0 6396 0 215405 0 0 0 Michele Stewart 205916 0 65038 0 20076 0 52390 0 15206 0 358626 0 0 0 FORM 990, Schedule J, Part I, Question 1 Charter travel is provided to certain employees as and when appropriate, and as deemed necessary for business travel. After charter travel approval has been granted in accordance with the financial justification process, the approved charter travel for business is a reimbursable expense which is not taxable to the employees. Travel for companions is provided in rare instances and in accordance with the co-worker travel and other expense policy and procedures. Where companion travel has resulted in a taxable event, the employees are taxed for such travel. Limited instances of tax gross-ups may have occurred with respect to executives. Form 990, Schedule J, Part I, Question 3 Mercy Health Northwest Arkansas Communities relies on a related organization; refer to Schedule O, Part VI, Question 15a and 15b for the process the related organization follows. Form 990, Schedule J, Part I, Question 4a The following individual received a severance payment during calendar 2011: Jerri (Lynne) Mitchell, $106,757. FORM 990, Schedule J, Part I, Question 4b Mercy Health Northwest Arkansas Communities offers supplemental retirement plans to certain executives which provide benefits upon retirement based on compensation, age at the time of benefit commencement, length of service with the company and/or its affiliates, and length of tenure in the plan. The individuals reportable on this return who participate in the supplemental retirement plans include: Scott Street, Jonathan Vitiello, Bradley Day, Stephen Goss, Michael Merrigan, and George Flynn. The amount of all accrued benefits is included in compensation amounts provided in Schedule J, Part II, Column (C). FORM 990, Schedule J, Part I, Question 7 Mercy Health Northwest Arkansas Communities provides a non-fixed bonus plan for which certain tiers of its employees are eligible. For fiscal year 2012 (July 1, 2011 - June 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 is reviewed by the Executive Compensation Committee of Mercy Health and is then taken into account when analyzing executive compensation for reasonableness. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES (MHNWAC) AND ITS MEMBER HEALTH CARE FACILITIES PROVIDE QUALITY CARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. IN ACTIVE PURSUIT OF THE ABOVE STATED MISSION, MHNWAC PROVIDED 31,651 INPATIENT SERVICE DAYS OF ACUTE OR SUB-ACUTE CARE. MHNWAC HAD ACUTE NEWBORN DISCHARGES OF 1,250, NEWBORN PATIENT DATS DAYS WERE 2,154, RESPONDED TO APPROXIMATELY 39,611 EMERGENCY ROOM ENCOUNTERS, MADE OVER 22,500 HOME HEALTH CARE VISITS AND COMPLETED 68,183 OUTPATIENT VISITS. COMMUNITY OUTREACH/BENEFIT PROGRAMS INCLUDE SUPPORT GROUPS FOR CURRENT AND PAST PATIENTS (DIABETIC, CARDIAC, ETC.), EXPECTING/NEW PARENTS (CHILD BIRTH CLASSES, VARIOUS SUPPORT GROUPS, ETC.), AND EMPLOYEES (EDUCATIONAL ASSISTANCE PROGRAMS, ETC.), LOCAL/SURROUNDING COMMUNITY (WELLNESS PROGRAMS, HEALTH FAIRS, HOME HEALTH PROGRAMS, ETC.) RELIEF FROM FINANCIAL BURDEN OF HEALTH CARE SERVICES TO THE INDIGENT CONSISTS OF CHARGES OF $12,792,362 FOR CHARITY CARE PROVIDED WITH A COST OF RELATED SERVICES. EXPENSES $ 27,268,595 INCLUDING GRANTS OF $500 REVENUE $ 27,360,015 FORM 990, PART V, QUESTION 1A FORMS 1099 AND FORM 1096 VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART VI, QUESTION 6, 7A, AND 7B DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: -TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL CORPORATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF MERCY HOSPITAL ROGERS; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION, EXCEPT THAT: -ANY AND ALL AMENDMENTS TO THE BYLAWS OF THE CORPORATION THAT MATERIALLY AFFECT THE EXISTENCE OR OPERATIONS OF THE MEDICAL GROUP BOARD, AS PROVIDED IN SECTION 8.2, MUST BE APPROVED BY THE MEDICAL GROUP BOARD, AND II. ANY AND ALL AMENDMENTS TO THE BYLAWS OF THE CORPORATION THAT MATERIALLY AFFECT THOSE POWERS RESERVED SOLELY TO THE MEDICAL GROUP, AS DESCRIBED IN SECTION 8.3, MUST BE APPROVED BY THE MEDICAL GROUP BOARD; -TO APPROVE AND APPOINT THE THREE (3) MEDICAL GROUP PHYSICIAN DIRECTORS AND ALL COMMUNITY REPRESENTATIVE DIRECTORS ON THE BOARD FROM NOMINATIONS SUBMITTED BY THE NOMINATING COMMITTEE; -TO APPOINT THE (2) MERCY HEALTH DIRECTORS ON THE BOARD; -TO APPOINT THE PRESIDENT/CEO OF THE CORPORATION, WHO SHALL SERVE AS AN EX-OFFICIO DIRECTOR ON THE BOARD WITH VOTE; -TO REMOVE ALL DIRECTORS ON THE BOARD WITH OR WITHOUT CAUSE; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, AND HEALTH MANPOWER DEVELOPMENT PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; -TO APPROVE THE CONSOLIDATED OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS (INCLUDING AGGREGATE PHYSICIAN COMPENSATION LEVELS) FOR THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION AND CHANGES IN THE BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -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 CORPORATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DSCR PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE MANAGER OF ACCOUNTING AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' 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, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 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, QUESTION 15A AND 15B OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, MERCY HEALTH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, PART VI, QUESTION 19 AVAIL GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART VII, SECTION A, COLUMN B AVERAGE HOURS PER WEEK SEVERAL INDIVIDUALS LISTED IN PART VII ARE DISCLOSED AS TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ON MULTIPLE FORM 990S OF ENTITIES INCLUDED WITHIN MERCY HEALTH. THE AVERAGE HOURS PER WEEK DISCLOSED IN PART VII IS AN ESTIMATE OF THE HOURS PER WEEK THAT THE LISTED INDIVIDUAL SPENDS ON BOTH THE FILING ORGANIZATION AND ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 5 RECONCILIATION OF NET ASSETS PRIOR PERIOD ADJUSTMENT = $3,746 TOTAL OTHER CHANGES IN NET ASSETS = $3,746 FORM 990, PART XII, QUESTION 2C THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 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 MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. Advance Care Hospital 300 Werner Street Hot Springs AR 71913 710816634 Hospital AR 501(C)(3) 3 Mercy Health true Casa de Misericordia 1602 MCCLELLAND STREET Laredo TX 78044 742912461 Shelter TX 501(C)(3) 7 MM Laredo true Laredo Medical Group 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764726 Inactive TX 501(C)(3) 9 MHS-TX true McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 Port Mgmt MO 501(C)(3) 11b Mercy Health true Mercy Clinic East Communites 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431771217 Phys Group MO 501(C)(3) 9 MHEC true Mercy Clinic Fort Smith Communitites 7301 Rogers Avenue Fort Smith AR 72917 261318597 Phys Clinic AR 501(C)(3) 9 MHFSC true Mercy Clinic Hot Springs Communitites 1 Mercy Lane Hot Springs AR 71913 261125131 Phys Clinic AR 501(C)(3) 9 MHHSC true Mercy Clinic Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 270473057 Phys Group OK 501(C)(3) 9 MHOC true Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 Phys Group MO 501(C)(3) 9 MHSC true Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 counseling MO 501(C)(3) 7 Mercy Health true Mercy Foundation for Health Innovation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 501(C)(3) 11b Mercy Health true Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 Sup Hlth Sys MO 501(C)(3) 1 NA false Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 Hlth System MO 501(C)(3) 11b Mercy Health true Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Co AR 501(C)(3) 11b Mercy Health true Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501(C)(3) 11a MH Ardmore true Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501(C)(3) 11a MH Berryvill true Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501(C)(3) 11c Mercy KS Com true Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501(C)(3) 11b MHHS true Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501(C)(3) 11a Mercy KS Com true Mercy Health Foundation Joplin 2817 St Johns Blvd Joplin MO 64804 270906136 Foundation MO 501(C)(3) 11a MHSMKC true Mercy Health Foundation NW Arkansas 2710 Rife Medical Lane Rogers AR 72758 710601687 Foundation AR 501(C)(3) 11c MH Rogers true Mercy Health Foundation OF Oklahoma 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501(C)(3) 11a MHOC true Mercy Health Foundation OK City 4300 W Memorial Road Oklahoma City OK 73120 731593024 Foundation OK 501(C)(3) 11a MHOC true Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501(C)(3) 11b MHSC true Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 Foundation MO 501(C)(3) 11b MHEC true Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501(C)(3) 11b MHEC true Mercy Health Hot Springs Communities 300 Werner Street Hot Springs AR 71913 261125064 Holding Co AR 501(C)(3) 11b Mercy Health true Mercy Health Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 731453048 Holding co OK 501(C)(3) 11b Mercy Health true Mercy Health Springfield Communitites 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Co MO 501(C)(3) 11b Mercy Health true Mercy Health SW MOKS Communitites 2817 St Johns Blvd Joplin MO 64804 300584463 Hlth System MO 501(C)(3) 11b Mercy Health true Mercy Health System of Texas Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764727 Inactive TX 501(C)(3) 11b Mercy Health true Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 Home Health AR 501(C)(3) 11c MH Sprngfld true Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501(C)(3) 3 MHOC true Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 501(C)(3) 3 MHSC true Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501(C)(3) 3 MHSC true Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 Hospital MO 501(C)(3) 3 MHSMKC true Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 501(C)(3) 3 MHSC true Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 501(C)(3) 3 MHSMKC true Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 272716065 Hospital OK 501(C)(3) 3 MHOC true Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501(C)(3) 3 MHFSC true Mercy Hospital Healdton 918 South 8TH Street Healdton OK 73438 263173902 Hospital OK 501(C)(3) 3 MH Ardmore true Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 Hospital AR 501(C)(3) 3 MHHSC true Mercy Hospital Joplin 2817 St Johns Blvd Joplin MO 64804 270814858 Hospital MO 501(C)(3) 3 MHSMKC true Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501(C)(3) 3 MHSC true Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 Hospital OK 501(C)(3) 3 MHOC true Mercy Hospital of Laredo 14528 S Outer Forty Ste 100 Chesterfield MO 63017 741189682 Inactive TX 501(C)(3) 3 MHS-TX true Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501(C)(3) 3 MHOC true Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501(C)(3) 3 MHFS true Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501(C)(3) 3 MHFS true Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 Hospital AR 501(C)(3) 3 MHNWAC true Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501(C)(3) 3 MHSC true Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501(C)(3) 3 MH Ardmore true Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501(C)(3) 3 MHFS true Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 Hospital OK 501(C)(3) 3 MHOC true Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 Hospital MO 501(C)(3) 3 MHEC true Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501(C)(3) 3 MHSMKC true Mercy Medical Research Institute 1235 E Cherokee Street Springfield MO 65804 870796305 Research MO 501(C)(3) 4 MHSC true Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78046 200198462 outreach TX 501(C)(3) 7 Mercy Health true Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501(C)(3) 3 MHSC true Mercy Support Services 14528 S OUTER FORTY STE 100 CHESTERFIELD MO 63017 431677952 Inactive MO 501(C)(3) 11c MHEC true MHM SUPPORT SERVICES 14528 S OUTER FORTY STE 100 CHESTERFIELD MO 63017 202553101 Hlth System MO 501(C)(3) 11B MERCY HEALTH true Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 nursing home AR 501(C)(3) 9 MHHSC true St Edward Mercy Foundation PO Box 17000 Fort Smith AR 72917 237330425 Foundation AR 501(C)(3) 7 MHFS true St John's Children's Hospital Inc 1235 E Cherokee Street Springfield MO 65804 Inactive MO 501(C)(3) 3 MHSC true St Mary's Hospital of Enid Oklahoma 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 501(C)(3) 3 MHOC true The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501(C)(3) 11a MSFH true Unity Ambulatory Care 14528 S OUTER FORTY STE 100 CHESTERFIELD MO 63017 431861745 Inactive MO 501(C)(3) 11c MHEC true Merc Ambu Surg CTR 7301 Rogers Av Fort Smith AR 72903 710827721 AMBUL SURG CENTER AR NA RES OPT & INNOV 645 Maryville Centre Dr 200 St Louis MO 63141 460468368 CENTRAL DIST. MO NA SO OK DIAG CTR 1011 14TH Ave NW Ardmore OK 73401 431971232 MRI Services OK NA Fort Smith EMS 1701 S Greenwood Fort Smith AR 72901 710416615 Emergency Med AR NA St Ed Mer Med MOB 7301 Rogers Ave Fort Smith AR 72903 710554050 Office BUILDING AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 HOLDING COMP DE NA C-Corp Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 IT SERVICES MO NA C-Corp Mercy Community Services Inc 401 Woodland Hills Blvd Fort SCOTT KS 66701 481078101 RETAIL PHARMACY KS NA C-Corp Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 REAL ESTATE OK NA C-Corp Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 HEALTH CARE OK NA C-Corp Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 HEALTH CARE OK NA C-Corp Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 HOLDING COMP OK NA C-Corp UH L Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 HOLDING COMP MO NA C-Corp Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 PRACTICE MGT MO NA C-Corp false false false false false false false false false false false false false true true true false false Mercy Hospital Fort Smith o 65270 FMV Mercy Hospital Rogers n 90121 FMV Mercy Hospital Rogers o 106768 FMV Mercy Hospital Rogers p 7008611 FMV MHM Support Services o 21685626 FMV Resource Optimization & Innovation LLC o 517140 FMV FORM 990, SCHEDULE R, PART VI SUPPLEMENTAL INFORMATION FOR SCHEDULE R LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH AND AFFILIATES. 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 ORGANIZATIONS ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R, PART V, IN LINES O AND P.