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MERCY HOSPITAL CASSVILLE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MERCY HOSPITAL CASSVILLE (EIN 43-1936699)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201101339349301345
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-13T09:56:20-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1190 CARONDELET PLAZA SUITE 1300AddressLine1
CityCLAYTONCity
StateMOState
ZIP Code63105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN431936699EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1St John's Cassville IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTJONameControl
Phone4178476000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line194 Main StreetAddressLine1
CityCassvilleCity
StateMOState
ZIP Code65625ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameScott R ReynoldsName
Titlevice president- financeTitle
Date Signed2011-05-06DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1ST JOHN'S HOSPITAL - CASSVILLEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonSherry Clouse-DayNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line194 Main StreetAddressLine1
CityCassvilleCity
StateMOState
ZIP Code65625ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17409556GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH, OUR MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE HEALTH CARE SERVICES IN A PERSONALIZED CHRISTIAN ENVIRONMENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees166TotalNbrEmployees
Total Nbr Volunteers28TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8498ContributionsGrantsPriorYear
Contributions Grants Current Year8282ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14342902ProgramServiceRevenuePriorYear
Program Service Revenue CY17398378ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year2896InvestmentIncomeCurrentYear
Other Revenue Prior Year989OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14352389TotalRevenuePriorYear
Total Revenue Current Year17409556TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1444GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1314GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6933147SalariesEtcPriorYear
Salaries Etc Current Year7557545SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5888168OtherExpensePriorYear
Other Expenses Current Year5780524OtherExpensesCurrentYear
Total Expenses Prior Year12822759TotalExpensesPriorYear
Total Expenses Current Year13339383TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1529630RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4070173RevenuesLessExpensesCY
Total Assets BOY8462829TotalAssetsBOY
Total Assets EOY6522781TotalAssetsEOY
Total Liabilities BOY2140645TotalLiabilitiesBOY
Total Liabilities EOY2151632TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6322184NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4371149NetAssetsOrFundBalancesEOY
Mission DescriptionROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH, OUR MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE HEALTH CARE SERVICES IN A PERSONALIZED CHRISTIAN ENVIRONMENT. WE SEEK TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF COMMUNITIES WE SERVE, WITH PARTICULAR CONCERN FOR PEOPLE WHO ARE ECONOMICALLY POOR.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense9457708Expense
Grants1314Grants
Revenue17398378Revenue
DescriptionST. JOHN'S HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE HIGH-QUALITY, COMPASSIONATE, FAITH-BASED HEALTH CARE IN A VARIETY OF TRADITIONAL MEDICAL SETTINGS. THIS ORGANIZATION, AS PART OF ST. JOHN'S HEALTH SYSTEM, PROVIDES SERVICES TO THE COMMUNITIES WE SERVE, WITH PARTICULAR CONCERN FOR THE ECONOMICALLY POOR, IN THE WAY OF INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES, EMERGENCY ROOM CARE, HOME HEALTH SERVICES, AND PHYSICIAN CLINIC OFFICE VISITS.Description
Total Program Service Expense9457708TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees166NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSherry Clouse-DayNamePerson
Telephone Number4178476000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line194 Main StreetAddressLine1
CityCassvilleCity
StateMOState
ZIP Code65625ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Michele M Schaefer
Sr VP - Regional Ops40.0X042807559810
David O Barbe
Board Member40.0X037132276001
Connie L Butler
Physician Member40.0X035675120887
Michael Collison
Board Member40.0X029036243657
Gale Pate
Community Member1.0X000
John Rice
Community Member1.0X000
Marcia Sadler
Community Member1.0X000
Mike McCracken
Community Member1.0X000
Benjamin Leavitt
board member40.0X020418232227
Sherry L Clouse Day
CFO, VP - Finance40.0014438112187X
Gary W Jordan
President40.0020110127729X
Jon D Swope
President/CEO - SJHS40.00644028215997X
Scott R Reynolds
SECRETARY/TREAS/CFO (INTERIM)40.0025770237022X
Joe Himes
Physician40.0232701047973X
Lisa Trotter
Physician40.0208546029743X
Victor Mangler
Physician40.0193081024890X
K D Cox
Physician32.0170688022510X
Catherine Primrose
Pharmacist40.011261109032X
FieldValueIRS element (for citing)
Total Reportable Comp From Org917627TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2897904TotalReportableCompFrmRltdOrgs
Total Other Compensation659665TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions8282AllOtherContributions
Total Contributions8282TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Service Revenue6221101734462117344621
RELATED ORG RENT53112011001100
Other Operating Revenue9000995265752657
FieldValueIRS element (for citing)
Total Program Service Revenue17398378TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column396TotalRevenueColumn
Exclusion$396ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2500Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other2500Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2500TotalRevenueColumn
Exclusion$2,500ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17409556TotalRevenueColumn
Related Or Exempt Function Income17398378RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,896ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1314Total
Program Services1314ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6116856Total
Program Services4926022ProgramServices
Management And General1190834ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total241251Total
Management And General241251ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total828042Total
Program Services8972ProgramServices
Management And General819070ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total371396Total
Program Services2892ProgramServices
Management And General368504ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total276224Total
Management And General276224ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total772077Total
Program Services637804ProgramServices
Management And General134273ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total24743Total
Program Services180ProgramServices
Management And General24563ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1106511Total
Program Services972707ProgramServices
Management And General133804ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total27526Total
Management And General27526ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total278020Total
Program Services96ProgramServices
Management And General277924ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total65088Total
Program Services36420ProgramServices
Management And General28668ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total29566Total
Program Services24054ProgramServices
Management And General5512ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total411236Total
Program Services200608ProgramServices
Management And General210628ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total104497Total
Management And General104497ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt Expense26097292609729
MISCELLANEOUS753073691038397

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13339383Total
Program Services9457708ProgramServices
Management And General3881675ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3728451BOY
EOY1453491EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY996600BOY
EOY1011452EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY68864BOY
EOY72985EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY6699EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9090196LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5131523LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3668914BOY
EOY3958673EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY19481EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8462829BOY
EOY6522781EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2140645BOY
EOY2151632EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2140645BOY
EOY2151632EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6322184BOY
EOY4371149EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6322184BOY
EOY4371149EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8462829BOY
EOY6522781EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$4,104OtherActivitiesAmount
Total Lobbying Expenditures IIB4104TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of Other Lobbying ActivitiesIdentifier
Return ReferenceSchedule C, Part II-BReturnReference
ExplanationThe filing organization is a member of and pays dues to the following hospital associations: American Hospital Association, Missouri Hospital Association, and Catholic Health Association. For the year ended June 30, 2010, dues were $3,283, $10,849, and $1,582, respectively. Approximately 25% of American Hospital Association dues, 30% of Missouri Hospital Association dues, and 5% of Catholic Health Association dues were attributable to lobbying activities performed by these associations.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis423246OtherCostOrOtherBasis
Book Value423246BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5169662OtherCostOrOtherBasis
Depreciation3113698Depreciation
Book Value2055964BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3346996OtherCostOrOtherBasis
Depreciation1936889Depreciation
Book Value1410107BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis150292OtherCostOrOtherBasis
Depreciation80936Depreciation
Book Value69356BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3958673TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 FOOTNOTEIdentifier
ExplanationThe consolidated audited financial statements of the Sisters of Mercy Health System, Inc. and Subsidiaries do not include a footnote to report the organization's liability for uncertain tax provisions under FIN 48, as they are deemed immaterial for disclosure.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense136155TotalCommunityBenefitExpense
Net Community Benefit Expense136155NetCommunityBenefitExpense
Percent Of Total Expense0.01260PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2876593TotalCommunityBenefitExpense
Direct Offsetting Revenue4485516DirectOffsettingRevenue
Net Community Benefit Expense-1608923NetCommunityBenefitExpense
Percent Of Total Expense0.14990PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3012748TotalCommunityBenefitExpense
Direct Offsetting Revenue4485516DirectOffsettingRevenue
Net Community Benefit Expense-1472768NetCommunityBenefitExpense
Percent Of Total Expense0.13730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense5317TotalCommunityBenefitExpense
Net Community Benefit Expense5317NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense104TotalCommunityBenefitExpense
Net Community Benefit Expense104NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense18941TotalCommunityBenefitExpense
Net Community Benefit Expense18941NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense24362TotalCommunityBenefitExpense
Net Community Benefit Expense24362NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3037110TotalCommunityBenefitExpense
Direct Offsetting Revenue4485516DirectOffsettingRevenue
Net Community Benefit Expense-1448406NetCommunityBenefitExpense
Percent Of Total Expense0.13500PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense52TotalCommunityBuildingExpense
Net Community Building Expense52NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense487TotalCommunityBuildingExpense
Net Community Building Expense487NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense539TotalCommunityBuildingExpense
Net Community Building Expense539NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,399,075BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare4028626AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare3996619CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall32007MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1St John's Cassville IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line194 Main StreetAddressLine1
CityCassvilleCity
StateMOState
ZIP Code65625ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaOur organization uses Federal Poverty Guidelines (FPG) as the criteria for determining eligibility for free or discounted care. Free care is provided at 0-100% of the FPG. Discounted care is provided up to 300% of FPG. An asset test that does not include the applicant's primary residence is included in the application process for charity care.IncomeBasedCriteria
Annual Community Benefit ExplnThe organization's community benefit report is prepared by its parent entity, St. John's Health System.AnnualCommunityBenefitExpln
Costing Method UsedN/ACostingMethodUsed
Subsidized Health Services ExplnN/ASubsidizedHealthServicesExpln
Percent Of Total Expense ExplnTotal expenses from Form 990, Part IX, Line 25, Column (A) are $13,339,383. Included in this amount was is bad debt expense of $2,609,729. Expenses for the purpose of calculating Line 7, Column (f) are $10,729,654.PercentOfTotalExpenseExpln
Bad Debt FootnoteThe text of the footnote that is included in the Sisters of Mercy Health System, Inc. 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 for uncollectible accounts in accordance with collections policies of the Health System and, in certain cases, are reclassified to charity care if deemed to otherwise meet the health system's charity care policy. The provision for uncollectible receivables is based on management's assessment of historical and expected net collections considering business and economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assess the adequacy of the allowance for uncollectible receivables based upon the payor composition and aging of receivables as of the reporting date with consideration of the historical payment and write-off experience by payor category. The results of these reviews are then used to make any modifications to the provision for uncollectible receivables to establish an appropriate allowance for uncollectible receivables. After satisfaction of amounts due from insurance, the health system follows established guidelines for placing 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 the organization's charity care policy is $0. Although the charity care policy requires the participation of the patient requesting assistance, we have a process under presumptive charity (refer to disclosure for Part III, #9b) to address accounts for patients who do not provide the information. We believe that our charity policy is comprehensive enough to capture almost all patients who qualify for charity care.BadDebtFootnote
Shortfall As Community BenefitThe Medicare shortfall was computed using the annual Medicare Cost Report (CMS Form 2552-96). It is the position of the filing organization that 100% of the short fall should be treated as community benefit. This amount represents cost of providing services that remain uncompensated to the provider.ShortfallAsCommunityBenefit
Debt Collection PolicyPresumptive Charity Mercy will utilize the Search America tool to enhance our ability to determine charity qualification. Presumptive charity will be granted in situations where we have been unable to obtain information from our patients or the information provided is not complete enough to make a charity determination. Mercy will utilize presumptive charity prior to bad debt placement for charity adjustments in excess of $10,000. In these cases, Mercy will utilize the Search American report status of "probable charity" as the basis for the 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, including legal action consistent with Mercy mission and values, which may include liens upon real property and reasonable wage garnishments. Legal actions will generally not include bank garnishment, repossession of assets or foreclosures to enforce satisfaction of lien. Mercy has policies and procedures established to address the initiation of legal action. Mercy annually reviews collection agency compliance with all policies.DebtCollectionPolicy
Number Of Facility Type ExplnN/ANumberOfFacilityTypeExpln
Needs Assessment*Springfield Community Focus Report 2009 *Buxton/Sg2 Community and Organizational Assessment 2010 *County Health Rankings 2010 *Missouri Hospital Association Southwest Region Assessing the Health of our Communities Report 2010 *Springfield Health Commission Report 2010 *Missouri Information for Community Assessment (MICA) *Community Roundtable/Event Information 2010. Our organization hosted community roundtables to ask our community what they perceive as needs in the community and to listen to what they thought we needed to be doing as a health care organization.NeedsAssessment
Patient Education AssistanceThe 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 10% of annual household income, adjusted to consider availability of other assets that could be used toward making payments.PatientEducationAssistance
Community Information*The primary service area for St. John's Springfield is comprised of 13 counties with a population of 694,000. The city of Springfield has two major not-for-profit health systems, St. John's and CoxHealth. Our community also has one Federally Qualified Health Center (Jordan Valley), one Free Clinic (the Kitchen Clinic), and one small hospital (Ozark Community Health Center). *St. John's includes 6 acute care hospitals, 72 clinics, and 8 urgent care sites. Collectively, we serve 40 communities in Missouri and Arkansas. *Leading cause of death is attributed to injuries for residents under age 45 and cancer and heart disease for residents over age 45. Tobacco use and obesity are prevalent health concerns in our community. *In 2008, Greene County had 15.9% of the population living at or below the federal poverty level. This was above the national average of 13.4 for Missouri and 12.7 for the U.S *According to the Greene County Health Department, the city of Springfield has approximately 40,000 individuals currently without insurance.CommunityInformation
Community Building Activities*Isabel's House - Greene County has a high child abuse rate. Isabel's House is dedicated to the prevention of child abuse and neglect and to strengthening families. It provides immediate refuge for children from birth to 12 whose families are in crisis. St. John's works with other community partners to support this community need. *The Kitchen Clinic - The Kitchen Clinic is Springfield's only Free Clinic. It serves individuals at or below 133% FPL with needed health care, medications, and some dental care. St. John's provides financial, in-kind, and administrative support to the Kitchen Clinic. St. John's physicians and nurses also volunteer their services at the Kitchen Clinic. *St. John's developed a program called "Project Access". This program provides health care and primary preventions services to individuals without insurance. These individuals qualify for our charity care, but we wanted to make sure that they were receiving comprehensive care, rather that fragmented Emergency Care visits for non-emergent needs. This program is being replicated in other parts of Mercy and has been shared with individuals at CoxHealth. *One Air Alliance - St. John's is part of a community collaborative effort to address smoking and clean air in our community. *St. Jude's affiliation - St. John's Children's Hospital is Southwest Missouri's only comprehensive Children's Hospital. The formal affiliation with St. Jude's Children's Hospital in Memphis and the recruitment of the region's first pedicatric Hematologic/oncology physician are part of ongoing efforts to continue to grow and collaborate regionally and nationally.CommunityBuildingActivities
Other InformationSt. John's Health System and its subsidiaries (SJHS) 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 SJHS's commitment to serve all members of the communities it serves, SJHS provides care to patients regardless of ability to pay. As defined by the institution's charity policy, SJHS does not pursue collection of amounts determined to qualify for charity care. In addition, SJHS 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. SJHS 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 Interest survey. 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 are served by SJHS. Surplus funds and unrestricted assets held by SJHS are reinvested in patient care, medical education and research initiatives which support the organization's mission to deliver compassionate care and exceptional health care services to the communities it serves.OtherInformation
Affiliated Health Care SystemThe filing organization is part of the Sisters of Mercy Health System ("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, 2010, Mercy facilities included 28 hospitals with 3,718 acute licensed beds (3,300 acute available beds). Mercy facilities offer a wide range of health care services across the system, including inpatient and outpatient care, rehabilitation services, cancer care, trauma care, burn care, skilled nursing, home health and hospice, sports medicine, and neonatal and pediatric intensive care. For the fiscal year ended June 30, 2010, Mercy had more than 6.3 million outpatient visits, more than 1,200 employed physicians, and approximately 28,000 employees, making Mercy the eighth 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.AffiliatedHealthCareSystem
Reports Filed With StatesARReportsFiledWithStates
Reports Filed With StatesMOReportsFiledWithStates
Reports Filed With StatesOKReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Michele M Schaefer
030506907998004302605114708663048788500
David O Barbe
0225470010453504131706641509586044732300
Connie L Butler
029209401831004634709546011341037763800
Michael Collison
020680304117004238903466608991033401900
Sherry L Clouse Day
0994180204740244890340508782015656800
Gary W Jordan
0153746029926017429015292012437022883000
Jon D Swope
041228701816990500420201960014037086002500
Joe Himes
196191028650078600196700283030280674000
Lisa Trotter
18449502365004010102080195350238289000
Victor Mangler
1694030227310947097380151520217971000
K D Cox
1582170120960375052700172400193198000
Scott R Reynolds
016066005292904411303086206160029472400
Benjamin Leavitt
014546404854301017505569026658023640900

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL COMPENSATION INFORMATIONIdentifier
ExplanationSCHEDULE J, PART I, QUESTION 3 The filing organization relies on a related organization; refer to Schedule O, Part VI, question 15a and 15b for the process the related organization follows. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, QUESTION 4B SISTERS OF MERCY HEALTH SYSTEM 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: MICHELE SCHAEFER, DAVID BARBE, AND JON SWOPE. NO ONE RECEIVED PAYMENTS UNDER THE PLANS DURING THE CALENDAR YEAR ENDING DURING THE TAX YEAR. THE AMOUNT OF ALL ACCRUED BENEFITS ARE INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C).Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationFORM 990, PART V, QUESTION 1A Vendors for the filing organization are paid by the Sisters of Mercy Health System (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 SMHS EIN. FORM 990, PART VI, QUESTIONS 6, 7A, & 7B THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, ST. JOHN'S HEALTH SYSTEM, INC. SUBJECT TO CONSULTATION WITH THE BOARD OF DIRECTORS, THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY TO THE CORPORATE MEMBER: -TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS IN ACCORDANCE WITH ARTICLES XII OF THESE BYLAWS; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, A MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF OPERATING OFFICER OF THE CORPORATION; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, AND HEALTH MANPOWER DEVELOPMENT PLANS, GOALS AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPROVE OR AMEND THE CONSOLIDATED OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND CHANGES IN BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY SMHS; -TO AUTHORIZE AND APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -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 OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, SUBJECT TO APPROVAL BY THE BOARD AS REQUIRED PURSUANT TO CHAPTER 355 OF THE REVISED STATUTES OF MISSOURI FOR GENERAL NOT-FOR-PROFIT CORPORATIONS ("THE ACT"); -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS. DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11A 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 Controller and the Vice-President of Finance. The draft Form 990 is also reviewed by the Sisters of Mercy Health System'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. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF ST. JOHN'S HEALTH SYSTEM, INC. AND ALL OF ITS SUBSIDIARY CORPORATIONS (COLLECTIVELY REFERRED TO AS "SJHS") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF A CO-WORKER, A MEMBER OF MANAGEMENT OR BOARD MEMBER OF SJHS. THE PRESIDENT OF EACH CORPORATION AND SUB-DIVISION SHALL BE RESPONSIBLE FOR ADMINISTERING THE ANNUAL STATEMENTS OF DISCLOSURE FOR THEIR BOARD MEMBERS AND EXECUTIVE LEADERSHIP TEAM. THE SJHS VICE-PRESIDENT OF HUMAN RESOURCES OR HIS/HER DESIGNEE SHALL BE RESPONSIBLE FOR ADMINISTERING ANNUAL STATEMENTS OF DISCLOSURE FOR SYSTEM SENIOR MANAGEMENT AND ADMINISTRATIVE COUNCIL. TO ENSURE THAT SJHS OPERATES IN A MANNER CONSISTENT WITH THE CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTIONS 15A & 15B FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON SISTERS OF MERCY HEALTH SYSTEM, 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 THE SISTERS OF MERCY HEALTH SYSTEM. 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. PUBLIC AVAILABILITY OF GOVERNING POLICIES FORM 990, PART VI, LINE 19 Governing documents, conflict of interest policy, and financial statements have been made available from time to time but are not published publicly. AVERAGE HOURS PER WEEK FORM 990, PART VII, SECTION A AVERAGE HOURS PER WEEK DEVOTED TO ST. JOHN'S HEALTH SYSTEM AND ITS SUBSIDIARIES IS DETERMINED TO BE 40.0 FOR EMPLOYEE BOARD MEMBERS AND 1.0 FOR NON-EMPLOYEE BOARD MEMBERS, UNLESS STATED OTHERWISE. OVERSIGHT OR SELECTION PROCESS FORM 990, PART XI, QUESTION 2C The filing organization's financial statements were included in the Sisters of Mercy Health System, Inc. and Subsidiaries annual financial statement audit. The Sisters of Mercy Health System, Inc. and Subsidiaries received 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 the Sisters of Mercy Health System Board of Directors. Audit results are communicated to this committee. SUPPLEMENTAL INFORMATION FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY SISTERS OF MERCY HEALTH SYSTEM, INC. 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.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (64 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Advance Care Hospital
300 Werner St 3rd FloorHot SpringsAR71913710816634HospitalAR501(C)(3)3SMHS
Breech Regional Medical Center
100 Hospital DriveLebanonMO65536431767432HospitalMO501(C)(3)3St Johns HS
Carroll Health Foundation
214 Carter StreetBerryvilleAR72616710759301FoundationAR501(C)(3)11aOzark RG HS
Casa de Misericordia
1602 McClelland StreetLaredoTX78044742912461ShelterTX501(C)(3)7MM Laredo
Healdton Mercy Hospital Corporation
918 South StreetHealdtonOK73438263173902HospitalOK501(C)(3)3MMHC
Laredo Medical Group
14528 S Outer Forty Ste 100ChesterfieldMO63017742764726InactiveTX501(C)(3)9MHS-TX
McAuley Portfolio Management Company
14528 S Outer Forty Ste 100ChesterfieldMO63017261708048Invst MgmtMO501(C)(3)11bSMHS
Mercy El Reno Hospital Corporation
2115 Parkview DriveEl RenoOK73036736617948LEASED HOSPTOK501(C)(3)3MHS
Mercy Emergency Medical Services Inc
4300 W Memorial RoadOklahoma CityOK73120810627035InactiveOK501(C)(3)9MHC
Mercy Foundation for Health Innovation
14528 S Outer Forty Ste 100ChesterfieldMO63017200901499FoundationMO501(C)(3)11bSMHS
Mercy Health Center Foundation
401 Woodland Hills BlvdFort ScottKS66701481077073FoundationKS501(C)(3)11cMHS-KS
Mercy Health Center Foundation Inc
4300 W Memorial RoadOklahoma CityOK73120731593024FoundationOK501(C)(3)11aMHC
Mercy Health Center Inc
4300 W Memorial RoadOklahoma CityOK73120730579285HospitalOK501(C)(3)3MHS
Mercy Health MHMCH Inc
220 Pennsylvania AvenueColumbusKS66725270842031HospitalMO501(C)(3)9MHS-Joplin
Mercy Health of Joplin Foundation
2727 McClelland BlvdJoplinMO64804270906136FoundationMO501(C)(3)11aMHS-Joplin
Mercy Health of Joplin Inc
2727 McClelland BlvdJoplinMO64804270814858HospitalMO501(C)(3)9MHS-Joplin
Mercy Health Services Inc
4300 W Memorial RoadOklahoma CityOK73120141838609DISV 6/30/10OK501(C)(3)9MHC
Mercy Health System-Joplin Inc
2727 McClelland BlvdJoplinMO64804300584463Hlth SystemMO501(C)(3)11bSMHS
Mercy Health System of Kansas Inc
401 Woodland Hills BlvdFt ScottKS66701480956045HospitalKS501(C)(3)3MHS-JOPLIN
Mercy Health System Northwest Arkansas
2710 Rife Medical DriveRogersAR72758621684203Phys GroupAR501(C)(3)11bSMHS
Mercy Health System of Texas Inc
14528 S Outer Forty Ste 100ChesterfieldMO63017742764727InactiveTX501(C)(3)11bSMHS
Mercy Health System Inc
4300 W Memorial RoadOklahoma CityOK73120731453048Holding co.OK501(C)(3)11bSMHS
Mercy Hosp Foundation of Independence
800 W MyrtleIndependenceKS67301481079981FoundationKS501(C)(3)11aMHS-KS
Mercy Hospital of Laredo
14528 S Outer Forty Ste 100ChesterfieldMO63017741189682InactiveTX501(C)(3)3MHS-TX
Mercy Medical Group
645 Maryville Centre Dr St 100St LouisMO63141431771217Phys GroupMO501(C)(3)9ST JOHN MHC
Mercy Memorial Health Center Foundation
1011 14th Avenue NWArdmoreOK73401710962525FoundationOK501(C)(3)11aMMHC
Mercy Memorial Health Center Inc
1011 14th Avenue NWArdmoreOK73401731500629HospitalOK501(C)(3)3MHS
Mercy Ministries of Laredo
2500 ZacatecasLaredoTX78043200198462OutreachTX501(C)(3)7SMHS
Mercy Physicians of Oklahoma Inc
4300 W Memorial RoadOklahoma CityOK73120270473057Phys GroupOK501(C)(3)9MHS
MHM Support Services
14528 S Outer Forty Ste 100ChesterfieldMO63017202553101Sup Hlth SysMO501(C)(3)11bSMHS
Mission Clinical Services
300 Werner StreetHot SpringsAR71913134239691Phys GroupAR501(C)(3)9ST JOS MHS
Ozarks Regions Health Systems Inc
214 Carter StreetBerryvilleAR72616710759299HospitalAR501(C)(3)3ST JOHNS HS
Sisters of Mercy Health System
14528 S Outer Forty Ste 100ChesterfieldMO63017431423050Sup Hlth SysMO501(C)(3)1NA
Sisters of Mercy Ministries
14528 S Outer Forty Ste 100ChesterfieldMO63017721069468OutreachMO501(C)(3)7SMHS
St Edward Hlth Fac-Franklin Co
801 W River StreetOzarkAR72949710689680HospitalAR501(C)(3)3SEMMC
St Edward Hlth Fac-Logan Co
500 E AcademyParisAR72855710655753HospitalAR501(C)(3)3SEMMC
St Edward Hlth Fac-Scott Co
1341 W 6th StreetWaldronAR72958710557895HospitalAR501(C)(3)3SEMMC
St Edward Mercy Clinic Inc
7301 Rogers AvenueFort SmithAR72917261318597Phys ClinicAR501(C)(3)9SEMHS
St Edward Mercy Foundation
PO Box 17000Fort SmithAR72917237330425FoundationAR501(C)(3)7SEMMC
St Edward Mercy Health System Inc
7301 Rogers AvenueFort SmithAR72917261318515Holding Co.AR501(C)(3)11bSMHS
St Edward Mercy Medical Center
7301 Rogers AvenueFort SmithAR72917710240352HospitalAR501(C)(3)3SEMHS
St Francis Hospital
100 W Highway 60Mountain ViewMO65548440607149HospitalMO501(C)(3)3ST JOHNS HS
St John's Aurora Inc
500 Porter AvenueAuroraMO65605431936696Lease HospMO501(C)(3)3St Johns HS
St John's Children's Hospital Inc
1235 E Cherokee StreetSpringfieldMO65804InactiveMO501(C)(3)3St Johns HS
St John's Clinic Inc
1965 Fremont Street Ste 2950SpringfieldMO65804431560263Phys GroupMO501(C)(3)9St Johns HS
St John's Foundation for Community Hlth
1235 E Cherokee StreetSpringfieldMO65804320195818FoundationMO501(C)(3)11bSt Johns HS
St John's Health System Inc
1235 E Cherokee StreetSpringfieldMO65804431856028Holding CoMO501(C)(3)11bSMHS
St John's Home Care of Berryville Inc
214 Carter StreetBerryvilleAR72616870781247Home HealthAR501(C)(3)11cST JOHN RHC
St John's Medical Research Institute
1235 E Cherokee StreetSpringfieldMO65804870796305ResearchMO501(C)(3)4ST JOHNS HS
St John's Mercy Foundation
645 Maryville Centre Dr St 100St LouisMO63141562410020FoundationMO501(C)(3)11bST JOHN MHC
St John's Mercy Health Care
645 Maryville Centre Dr St 100St LouisMO63141431718408Hlth SystemMO501(C)(3)11bSMHS
St John's Mercy Health System
645 Maryville Centre Dr St 100St LouisMO63141430653493HospitalMO501(C)(3)3ST JOHN MHC
St John's Mercy Hospital Foundation
901 E Fifth StreetWashingtonMO63090562410022FoundationMO501(C)(3)11bST JOHN MHC
St John's Mercy Support Services
615 S New Ballas RoadSt LouisMO63141431677952InactiveMO501(C)(3)11cST JOHN MHS
St John's Regional Health Center
1235 E Cherokee StreetSpringfieldMO65804440552485HospitalMO501(C)(3)3St Johns HS
St Joseph's Mercy Clinic Inc
1 Mercy LaneHot SpringsAR71913261125131Phys ClinicAR501(C)(3)9ST JOS MHS
St Joseph's Mercy Health Center
300 Werner StreetHot SpringsAR71913710236913HospitalAR501(C)(3)3ST JOS MHS
St Joseph's Mercy Health Foundation
300 Werner StreetHot SpringsAR71913710804718FoundationAR501(C)(3)11bST JOS MHC
St Joseph's Mercy Health System Inc
300 Werner StreetHot SpringsAR71913261125064Holding CoAR501(C)(3)11bSMHS
St Mary-Rogers Memorial Hospital Inc
2710 Rife Medical LaneRogersAR72758710294390HospitalAR501(C)(3)3MHS-NWA
St Mary's Hospital Foundation
2710 Rife Medical LaneRogersAR72858710601687FoundationAR501(C)(3)11cST MARY RMC
St Mary's Hospital of Enid Oklahoma I
14528 S Outer Forty Ste 100ChesterfieldMO63017730614655InactiveOK501(C)(3)3MHS
The Sister M Cornelia Blasko Foundation
100 W Highway 60Mountain ViewMO65548431873914FoundationMO501(C)(3)11aST FRAN HOS
Unity Ambulatory Care
645 Maryville Centre Dr St 100St LouisMO63141431861745InactiveMO501(C)(3)11cST JOHN MHC

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOT SPRINGS EQUIP
300 Werner StreetHot SpringsAR71913204340915DISSOLVED 9/30/09ARNA
Hot Springs MRI
100 Ridgeway PlaceHot SpringsAR72901710675196DISSOLVED 8/5/09ARNA
Merc Ambu Surg CTR
7301 Rogers AvenueFort SmithAR72903710827721AMBULATORY S. CTRARNA
RES OPT & INNOV
645 Maryville Centre Drive SuiteSt LouisMO63141460468368CENTRAL DIST. CTRMONA
SO OK DIAG CTR
1011 Fourteeth Avenue NWArdmoreOK73401431971232MRI ServicesOKNA
Fort Smith Emergency Medical Services
1701 South GreenwoodFort SmithAR72901710416615Emergency Med SEVARNA
Southern Oklahoma PHO LLC
1011 Fourteeth Avenue NWArdmoreOK73401731462104DISSLV 12/31/09OKNA
HORIZONTAL PROPERTY
7301 Rogers AvenueFort SmithAR72903710554050Office BuildingARNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
Consolidated Logistics Inc
2710 Rife Medical LaneRogersAR72758710474406DISSOLVED 8/4/09ARC-Corp
Frontenac Properties Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017521914421HOLDING COMPDEC-Corp
Inveno Health Inc
1235 E Cherokee StreetSpringfieldMO65804264509571IT SERVICESMOC-Corp
Mercy Community Services Inc
401 Woodland Hills BlvdFort SCOTTKS66701481078101CATERINGKSC-Corp
Mercy Health Center Condominium Inc
4300 W Memorial RdOklahoma CityOK73120680640970REAL ESTATEOKC-Corp
Mercy Health Network of the Southern Reg
1011 14th Avenue NWArdmoreOK73401731580607HEALTH CAREOKC-Corp
Mercy Health Network Inc
4300 W Memorial RoadOklahoma CityOK73120731381689HEALTH CAREOKC-Corp
Mercy Managed Care Corporation
4300 W Memorial RoadOklahoma CityOK73120731441665HOLDING COMPOKC-Corp
Mercy Medical Services Inc
14528 S Outer Forty Suite 300ChesterfieldMO63017710641246DISSOLVED 7/1/09MOC-Corp
MHP Inc
14528 S Outer Forty Suite 300ChesterfieldMO63017431697084HOLDING COMPDEC-Corp
St Edward Medical Services Inc
7301 Rogers AvenueFort SmithAR72903202965518DISSOLVED 5/5/10ARC-Corp
UH L Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535HOLDING COMPMOC-Corp
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042MANAGEMENTMOC-Corp
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MHM SUPPORT SERVICES
O446963
MHP INC
P407268
RESOURCE OPTIMIZATION & INNOVATION LLC
O292743
ST JOHN'S CLINIC INC
N98395
ST JOHN'S CLINIC INC
O200405
ST JOHN'S REGIONAL HEALTH CENTER
O3339626
ST JOHN'S REGIONAL HEALTH CENTER
P6877383