2012-05-13T12:06:27-05:00 2011-06-30 ERNST & YOUNG US LLP 190 CARONDELET PLAZA SUITE 1300 CLAYTON MO 63105 990 2010-07-01 621684203 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES F/K/A MERCY HEALTH SYS OF NW ARKANSAS INC MERC 3146283557 2710 Rife Medical Lane Rogers AR 72758 Benny J Stover 2012-05-11 3142901000 2010 2016-02-24 21:20:13Z Benny J Stover CPA 2710 Rife Medical Lane Rogers AR 72758 59449214 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. 13 10 740 0 0 0 0 0 54103144 58695633 -57290 -50792 618862 417373 54664716 59062214 0 0 0 0 49384318 54614704 0 0 0 16402838 18000387 65787156 72615091 -11122440 -13552877 10591987 10751653 46336510 60049053 -35744523 -49297400 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 22733829 0 20946089 FAMILY MEDICINE PHYSICIAN SERVICES: MERCY HEALTH NWA COMMUNITIES' FAMILY MEDICINE PHYSICIAN SERVICES ARE COMPRISED OF 32 BOARD CERTIFIED FAMILY MEDICINE PHYSICIANS AND 7 MID-LEVELS, WHO PROVIDED PRIMARY MEDICINE SERVICES TO PATIENTS RANGING FROM ONE YEAR OLD THROUGH ADULTHOOD. THESE SERVICES ARE OFFERED IN APPROXIMATELY 9 LOCATIONS THROUGHOUT BENTON COUNTY ARKANSAS, AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 169,401 OFFICE VISITS WERE PROVIDED TO PATIENTS. 10629565 0 7342524 CARDIOVASCULAR PHYSICIAN SERVICES: MERCY HEALTH NWA COMMUNITIES' CARDIOVASCULAR PHYSICIAN SERVICES ARE COMPRISED OF 6 CARDIOLOGISTS, 2 CARDIOVASCULAR SURGEONS, AND 6 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, 22,316 OFFICE VISITS WERE PROVIDED TO PATIENTS. 5349261 0 5023123 PEDIACTRIC PHYSICIAN SERVICES: MERCY HEALTH NWA COMMUNITIES' PEDIATRIC PHYSCIAN SERVICES ARE COMPRISED OF 7 BOARD CERTIFIED PEDIATRICIANS AND 2 MID-LEVEL PROVIDERS, WHO PROVIDED PRIMARY MEDICINE SERVICES TO PATIENTS RANGING FROM INFANCY THROUGH 18 YEARS OF AGE. SERVICES ARE PROVIDED TO PATIENTS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 40,742 OFFICE VISITS WERE PROVIDED TO PATIENTS. 22231226 0 25801270 60943881 true 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 0 740 true false false false false false false false false false false X 13 10 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 Sister Annrene Brau RSM 1.0 X 0 0 0 Wayne Callahan 1.0 X 0 0 0 Hugh Donnell 60.0 X 299082 0 39918 Sister Gayle Evans RSM 1.0 X 0 0 0 Rollin Ford 1.0 X 0 0 0 Dr Donna Johnson 60.0 X 416666 0 35481 Sister Teresa Kelone RSM 1.0 X 0 0 0 Paul Mahan 1.0 X 0 0 0 Miguel R Rivera 1.0 X 0 0 0 Steve Stewart 1.0 X 0 0 0 Dr Robert Stuppy 1.0 X 802054 0 30349 Scott Street 60.0 X X 0 393573 15127 Jonathan Vitiello 60.0 X 0 375238 49437 Benny J Stover 60.0 X 184464 0 19407 Richard Barclay 60.0 X 189435 0 17399 Steven L Hughes 60.0 X 218530 0 18235 Michele Stewart 60.0 X 306577 0 81951 Brad D Johnson 60.0 X 214625 0 23013 Stephen Gross 60.0 X 349177 0 70872 Larry Weathers 40.0 X 911939 0 23969 David McCoy 40.0 X 798634 0 27745 Kuntal M Thaker 40.0 X 788773 0 30654 Amr El-Shafei 40.0 X 642900 0 10838 Christopher Simpson 40.0 X 601566 0 19206 George Flynn 0.0 X 0 640618 149036 Karen Little-Smith 40.0 X 122327 0 13369 Jerri L Lynne Mitchell 0.0 X 0 400457 23593 Susan Barrett 0.0 X 0 586250 2706 6846749 2396136 702305 98 true true false QUEST DIAGNOSTICS PO BOX 740709 ATLANTA GA 30374 LAB DIAGNOSTICS 352926 BERLIN WHEELER INC PO BOX 463 JEFFERSON CITY MO 65102 COLLECTIONS 232710 EMDEON PO BOX 572490 MURRAY UT 84127 CLAIMS PROCESSING 175824 TIMELINE RECRUITING LLC 13841 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 RECRUITING 128838 NUANCE COMM INC ONE WAYSIDE ROAD BURLINGTON MA 01803 TRANSCRIPTION SVCS 126400 7 0 FAMILY MEDICINE 624100 20946089 20946089 CARDIOVASCULAR SERVICES 624100 7342524 7342524 PEDIATRIC SERVICES 531120 5023123 5023123 RENTAL INCOME FROM RELATED ORGS 624100 170381 170381 All other program service revenue 624100 25213516 25213516 58695633 -18223 -18223 0 0 354431 387000 -32569 -32569 -32569 0 0 0 Hospital Support Revenue 624100 263171 263171 Miscellaneous Revenue 624100 153043 153043 Vending 900099 1159 1159 417373 59062214 59113006 -50792 0 0 0 0 3284746 2806067 478679 0 42404942 36225360 6179582 1770824 1512765 258059 4718127 4030564 687563 2436065 2081062 355003 0 188165 188165 60000 60000 0 0 0 2279302 1031058 1248244 96209 73401 22808 5541421 5342918 198503 4316835 3687752 629083 729054 686 728368 3780715 3463869 316846 240450 173338 67112 0 0 47826 47826 0 877739 600925 276814 1389747 912149 477598 Repairs and Maintenance 233506 119137 114369 Other taxes 405626 346515 59111 Recruitment costs 434612 371277 63335 SHARED SERVICE ALLOCATION -5709941 -4877843 -832098 BAD DEBT EXPENSE 2771814 2771814 317307 271067 46240 72615091 60943881 11671210 0 0 687001 5486523 5410088 368070 630789 358243 428120 141684 111222 9033481 5549048 4237467 3484433 10591987 10751653 17307269 7672388 2761050 2484565 26268191 49892100 46336510 60049053 X -35744523 -49297400 -35744523 -49297400 10591987 10751653 -13552877 X X false true true X false X 18575 58003 0 0 0 76578 88357766 86990336 95352882 54103144 58695633 383499761 88376341 87048339 95352882 54103144 58695633 383576339 383576339 1034334 874009 41511 27879 -18223 1959510 1034334 874009 41511 27879 -18223 1959510 1580164 1765506 1237480 533693 417373 5534216 90990839 89687854 96631873 54664716 59094783 391070065 0.98084 0.97600 0.00501 0.01090 X 25000 25000 1456494 907849 548645 4005650 1789492 2216158 3546336 2851706 694630 3484433 0 DEPOSITORY ACCOUNTS-BOA 15897548 PATIENT REFUND BANK ACCOUNT 35159 DUE TO AFFILIATES 33959393 49892100 asc 740 FOOTNOTE SUPLLEMENTAL INFORMATION THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH AND SUBSIDIARIES DO NOT INCLUDE A FOOTNOTE TO REPORT THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE. X X X X true true X X X X true true false false false false false true false Paul Bergant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Hugh Donnell 273943 0 0 0 25139 0 21567 0 18351 0 339000 0 0 0 Dr Donna Johnson 353589 0 0 0 63077 0 16785 0 18696 0 452147 0 0 0 Dr Robert Stuppy 581290 0 100000 0 120764 0 10294 0 20055 0 832403 0 0 0 Scott Street 0 287145 0 50000 0 56428 0 4900 0 10227 0 408700 0 0 Jonathan Vitiello 0 260553 0 108343 0 6342 0 35784 0 13653 0 424675 0 0 Benny J Stover 128249 0 43724 0 12491 0 6262 0 13145 0 203871 0 0 0 Richard Barclay 119737 0 43455 0 26243 0 11596 0 5803 0 206834 0 0 0 Steven L Hughes 158680 0 36587 0 23263 0 7601 0 10634 0 236765 0 0 0 Michele Stewart 198475 0 87701 0 20401 0 68355 0 13596 0 388528 0 0 0 Brad D Johnson 133584 0 48194 0 32847 0 9147 0 13866 0 237638 0 0 0 Stephen Gross 227096 0 79572 0 42509 0 54370 0 16502 0 420049 0 0 0 Larry Weathers 656187 0 75000 0 180752 0 8474 0 15495 0 935908 0 0 0 David McCoy 719571 0 37500 0 41563 0 8474 0 19271 0 826379 0 0 0 Kuntal M Thaker 717354 0 0 0 71419 0 10209 0 20445 0 819427 0 0 0 Amr El-Shafei 541212 0 100000 0 1688 0 4900 0 5938 0 653738 0 0 0 Christopher Simpson 484878 0 100000 0 16688 0 7350 0 11856 0 620772 0 0 0 George Flynn 0 386994 0 224050 0 29574 0 134777 0 14259 0 789654 0 0 Karen Little-Smith 88708 0 11099 0 22520 0 7892 0 5477 0 135696 0 0 0 Jerri L Lynne Mitchell 0 69418 0 79597 0 251442 0 21145 0 2448 0 424050 0 0 Susan Barrett 0 349117 0 0 0 237133 0 2706 0 0 0 588956 0 0 Supplemental Compensation Information FORM 990, SCHEDULE J, PART I, QUESTION 1A CHARTER TRAVEL IS PROVIDED TO ALL EMPLOYEES AS DEEMED NECESSARY FOR BUSINESS TRAVEL AND PURSUANT TO THE APPROVAL BY THE FINANCE DEPARTMENT. 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 UNDER LIMITED CIRCUMSTANCES 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. 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. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HEALTH NORTHWEST ARKANSAS COMMUMITIES RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR 2010: JERRI MITCHELL $221,881 AND SUSAN BARRETT $237,090. FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY HEALTH NORTHWEST ARKANSAS COMMUMITIES 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 GEORGE FLYNN, STEPHEN GOSS, JON VITIELLO, SCOTT STREET, JERRI MITCHELL, AND MICHELE STEWART. 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 COMMUMITIES PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2011 (JULY 1, 2010 - JUNE 30, 2011) PAYMENT OF ALL OR PART OF THE BONUS IS CONTINGENT UPON ATTAINMENT OF CERTAIN FINACIAL 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. NAME CHANGES DUE TO MERCY HEALTH REBRANDING 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 2010 FORMS 990 (DUE MAY 15, 2012), MERCY HEALTH NOTIFIED THE IRS OF THESE NAME CHANGES, THEREFORE BOX B "NAME CHANGE" HAS NOT BEEN CHECKED ON THIS FORM 990. REFER TO SCHEDULE R, PART VII FOR A LIST OF THE NAME CHANGES. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES (MHNWAC) AND ITS MEMBER HEALTH CARE FACILITIES PROVIDE QUALITY CARE REGARDLESS OF RACE, CREED, SEX, 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 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 $ 22,231,226 INCLUDING GRANTS OF $0 REVENUE $25,801,270 FORMS 1099 AND FORM 1096 FORM 990, PART V, QUESTION 1A 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. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6, 7A, AND 7B THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: A. TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL CORPORATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; B. TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF MERCY HOSPITAL ROGERS; C. TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION, EXCEPT THAT: I. 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; D. 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; E. TO APPOINT THE (2) MERCY HEALTH DIRECTORS ON THE BOARD; F. TO APPOINT THE PRESIDENT/CEO OF THE CORPORATION, WHO SHALL SERVE AS AN EX-OFFICIO DIRECTOR ON THE BOARD WITH VOTE; G. TO REMOVE ALL DIRECTORS ON THE BOARD WITH OR WITHOUT CAUSE; H. 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; I. 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; J. 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; K. TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; L. 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; M. TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; AND, N. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DESCRIBE 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 THE COMPLIANCE POLICY COVERAGE INCLUDES: CO-WORKERS, LEADERS, PROVIDERS, BOARD MEMBERS, AND ADMINISTRATORS. THE DETERMINATION OF A CONFLICT OF INTEREST IS MADE AND REVIEWED AT ALL LEVELS. A CORPORATE COMPLIANCE COMMITTEE MEETS TO REVIEW ANY CONFLICTS AND PROVIDES A REASONABLE ALTERNATIVE TO RESOLVE THE CONFLICT OF INTEREST, WHICH MAY INCLUDE SUPERVISORY PROCEDURES OR TRANSFER A DECISION MAKING ROLE. FOR BOARD MEMBERS, THEY ARE EXCLUDED FROM THE DELIBERATIONS AND DECISION MAKING PROCESS. 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 HAVE BEEN 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 XII, QUESTION 2B THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVE AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2010 (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. 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 St 3rd Floor Hot Springs AR 71913 710816634 Hospital AR 3 Mercy Health Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 3 MHSC Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 11a MH Berryvill Casa de Misericordia 1000 Mier Street Laredo TX 780404653 742912461 Shelter TX 7 MM Laredo Mercy Hospital Healdton 918 South Street Healdton OK 73438 263173902 Hospital OK 3 MH Ardmore Laredo Medical Group 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764726 Inactive TX 9 MHS-TX McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 Port Mgmt MO 11b Mercy Health Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 736617948 Hospital OK 3 Mercy Health Mercy Emergency Medical Services Inc 4300 W Memorial Road Oklahoma City OK 73120 810627035 Inactive OK 9 MHOC Mercy Foundation for Health Innovation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 11b Mercy Health Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 11c Mercy KS Com Mercy Health Foundation OK City 4300 W Memorial Road Oklahoma City OK 73120 731593024 Foundation OK 11a MHOC Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 3 MHOC Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 3 MHSMKC Mercy Health Foundation Joplin 2727 McClelland Blvd Joplin MO 64804 270906136 Foundation MO 11a MHSMKC Mercy Hospital Joplin 2727 McClelland Blvd Joplin MO 64804 270814858 Hospital MO 3 MHSMKC Mercy Health SW MOKS Communitites 2727 McClelland Blvd Joplin MO 64804 300584463 Hlth System MO 11b Mercy Health Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 3 MHSMKC Mercy Health Foundation NW Arkansas 2710 Rife Medical Drive Rogers AR 72758 710601687 FOUNDATION AR 11C MHNWAC Mercy Health System of Texas Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764727 Inactive TX 11b Mercy Health Mercy Health Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 731453048 Holding co. OK 11b Mercy Health Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 11a Mercy KS Com Mercy Hospital of Laredo 14528 S Outer Forty Ste 100 Chesterfield MO 63017 741189682 Inactive TX 3 MHS-TX Mercy Clinic East Communites 645 Maryville Centre Dr St 100 St Louis MO 63141 431771217 Phys Group MO 9 MHEC Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 11a MH Ardmore Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 3 MHOC Mercy Clinic Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 270473057 Phys Group OK 9 MHOC MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 Sup Hlth Sys MO 11b Mercy Health Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 nursing home AR 9 MHHSC Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 3 MHSC Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 Sup Hlth Sys MO 1 NA Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 counseling MO 7 Mercy Health Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 3 MHFS Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 3 MHFS Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 3 MHFS Mercy Clinic Fort Smith Communitites 7301 Rogers Avenue Fort Smith AR 72917 261318597 Phys Clinic AR 9 MHFSC St Edward Mercy Foundation PO Box 17000 Fort Smith AR 72917 237330425 Foundation AR 7 MHFS Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Co. AR 11b Mercy Health Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 3 MHFSC Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 3 MHSC Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 3 MHSC Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 3 MHSC St John's Children's Hospital Inc 1235 E Cherokee Street Springfield MO 65804 431423050 Inactive MO 3 MHSC Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 Phys Group MO 9 MHSC Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 11b MHSC Mercy Health Springfield Communitites 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Co MO 11b Mercy Health Mercy Home Health Berryville 214 Carter Street Berryville AR 72616 870781247 Home Health AR 11c MH Sprngfld Mercy Medical Research Institute 1235 E Cherokee Street Springfield MO 65804 870796305 Research MO 4 MHSC Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 Foundation MO 11b MHEC Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 Hlth System MO 11b Mercy Health Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 Hospital MO 3 MHEC Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 11b MHEC Mercy Support Services 615 S New Ballas Road St Louis MO 63141 431677952 Inactive MO 11c MHEC Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 3 MHSC Mercy Clinic Hot Springs Communitites 1 Mercy Lane Hot Springs AR 71913 261125131 Phys Clinic AR 9 MHHSC Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 Hospital AR 3 MHHSC Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 11b MHHS Mercy Health Hot Springs Communities 300 Werner Street Hot Springs AR 71913 261125064 Holding Co AR 11b Mercy Health Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 Hospital AR 3 MHNWAC St Mary's Hospital of Enid Oklahoma 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 3 MHOC The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 11a MSFH Unity Ambulatory Care 645 Maryville Centre Dr St 100 St Louis MO 63141 431861745 Inactive MO 11c MHEC Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 3 MH Ardmore Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 780466814 200198462 outreach TX 7 Mercy Health 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 Smith KS 66701 481078101 CATERING 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 MHP Inc 14528 S Outer Forty Suite 300 Chesterfield MO 63017 431697084 HOLDING COMP DE 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 INACTIVE MO NA C-Corp false false false false false false false false false false false false false true true true false false MHM SUPPORT SERVICES O 11382051 MERCY HOSPITALS EAST COMMUNITIES O 134562 RESOURCE OPTIMIZATION & INNOVATION LLC O 359304 MERCY HOSPITAL ROGERS P 5035792 MERCY HOSPITAL FORT SMITH O 55749 MERCY HOSPITAL ROGERS N 176209 NAME CHANGES DUE TO MERCY HEALTH REBRANDING FORM 990, SCHEDULE R, PART II MERCY MEDICAL GROUP IS NOW MERCY CLINIC EAST COMMUNITIES ST. EDWARD MERCY CLINIC, INC. IS NOW MERCY CLINIC FORT SMITH COMMUNITIES ST. JOSEPH'S MERCY CLINIC, INC. IS NOW MERCY CLINIC HOT SPRINGS COMMUNITIES MERCY PHYSICIANS OF OKLAHOMA, INC. IS NOW MERCY CLINIC OKLAHOMA COMMUNITIES ST. JOHN'S CLINIC, INC. IS NOW MERCY CLINIC SPRINGFIELD COMMUNITIES SISTERS OF MERCY HEALTH SYSTEM IS NOW MERCY HEALTH ST. JOHN'S MERCY HEALTH CARE IS NOW MERCY HEALTH EAST COMMUNITIES ST. EDWARD MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH FORT SMITH COMMUNITIES MERCY MEMORIAL HEALTH CENTER FOUNDATION IS NOW MERCY HEALTH FOUNDATION ARDMORE CARROLL HEALTH FOUNDATION IS NOW MERCY HEALTH FOUNDATION BERRYVILLE MERCY HEALTH CENTER FOUNDATION IS NOW MERCY HEALTH FOUNDATION FORT SCOTT ST. JOSEPH'S MERCY HEALTH FOUNDATION IS NOW MERCY HEALTH FOUNDATION HOT SPRINGS MERCY HOSPITAL FOUNDATION OF INDEPENDENCE, INC. IS NOW MERCY HEALTH FOUNDATION INDEPENDENCE MERCY HEALTH OF JOPLIN FOUNDATION IS NOW MERCY HEALTH FOUNDATION JOPLIN ST. MARY'S HOSPITAL FOUNDATION IS NOW MERCY HEALTH FOUNDATION NORTHWEST ARKANSAS MERCY HEALTH CENTER FOUNDATION, INC. IS NOW MERCY HEALTH FOUNDATION OKLAHOMA CITY ST. JOHN'S FOUNDATION FOR COMMUNITY HEALTH INC. IS NOW MERCY HEALTH FOUNDATION SPRINGFIELD ST. JOHN'S MERCY FOUNDATION IS NOW MERCY HEALTH FOUNDATION ST. LOUIS ST. JOHN'S MERCY HOSPITAL FOUNDATION IS NOW MERCY HEALTH FOUNDATION WASHINGTON ST. JOSEPH'S MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH HOT SPRINGS COMMUNITIES MERCY HEALTH SYSTEM OF NORTHWEST ARKANSAS, INC. IS NOW MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH OKLAHOMA COMMUNITIES MERCY HEALTH SYSTEM-JOPLIN, INC. IS NOW MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES ST. JOHN'S HEALTH SYSTEM, INC. IS NOW MERCY HEALTH SPRINGFIELD COMMUNITIES ST. JOHN'S HOME CARE OF BERRYVILLE, INC. IS NOW MERCY HOME HEALTH BERRYVILLE MERCY MEMORIAL HEALTH CENTER, INC. IS NOW MERCY HOSPITAL ARDMORE ST. JOHN'S AURORA, INC. IS NOW MERCY HOSPITAL AURORA OZARKS REGIONS HEALTH SYSTEM, INC. IS NOW MERCY HOSPITAL BERRYVILLE ST. JOHN'S CASSVILLE, INC. IS NOW MERCY HOSPITAL CASSVILLE MERCY HEALTH MHMCH, INC. IS NOW MERCY HOSPITAL COLUMBUS MERCY EL RENO HOSPITAL CORPORATION IS NOW MERCY HOSPITAL EL RENO ST. EDWARD MERCY MEDICAL CENTER IS NOW MERCY HOSPITAL FORT SMITH HEALDTON MERCY HOSPITAL CORPORATION IS NOW MERCY HOSPITAL HEALDTON ST. JOSEPH'S MERCY HEALTH CENTER IS NOW MERCY HOSPITAL HOT SPRINGS MERCY HEALTH OF JOPLIN, INC. IS NOW MERCY HOSPITAL JOPLIN BREECH REGIONAL MEDICAL CENTER IS NOW MERCY HOSPITAL LEBANON MERCY HEALTH CENTER, INC. IS NOW MERCY HOSPITAL OKLAHOMA CITY ST. EDWARD HEALTH FACILITIES OF FRANKLIN COUNTY IS NOW MERCY HOSPITAL OZARK ST. EDWARD HEALTH FACILITIES OF LOGAN COUNTY IS NOW MERCY HOSPITAL PARIS ST. EDWARD HEALTH FACILITIES OF SCOTT COUNTY IS NOW MERCY HOSPITAL WALDRON ST. MARY-ROGERS MEMORIAL HOSPITAL, INC. IS NOW MERCY HOSPITAL ROGERS ST. JOHN'S REGIONAL HEALTH CENTER IS NOW MERCY HOSPITAL SPRINGFIELD MERCY TISHOMINGO HOSPITAL CORPORATION IS NOW MERCY HOSPITAL TISHOMINGO ST. JOHN'S MERCY HEALTH SYSTEM IS NOW MERCY HOSPITALS EAST COMMUNITIES ST. JOHN'S MERCY MEDICAL CENTER IS NOW MERCY HOSPITAL ST LOUIS ST. JOHN'S MERCY HOSPITAL IS NOW MERCY HOSPITAL SPRINGFIELD MERCY HEALTH SYSTEM OF KANSAS, INC. IS NOW MERCY KANSAS COMMUNITIES MERCY HEALTH CENTER, INC. IS NOW MERCY HOSPITAL FORT SCOTT MERCY HOSPITAL IS NOW MERCY HOSPITAL INDEPENDENCE ST. JOHN'S MEDICAL RESEARCH INSTITUTE, INC. IS NOW MERCY MEDICAL RESEARCH INSTITUTE ST. FRANCIS HOSPITAL, MOUNTAIN VIEW, MISSOURI IS NOW MERCY ST. FRANCIS HOSPITAL ST. JOHN'S MERCY SUPPORT SERVICES IS NOW MERCY SUPPORT SERVICES 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 AND P.