MERCY RESTORATIVE CARE HOSPITAL INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: MERCY RESTORATIVE CARE HOSPITAL INC (EIN 75-3054855)
Tax period: 2009-08-01 to 2010-07-31
Filed: 2011-03-15
IRS object ID: 201120749349300112
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
Form 990
Schedule A
Schedule D
Schedule H
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-03-15T12:44:41-05:00	Timestamp
Tax Period End Date	2010-07-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LarsonAllen LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	101 N Tryon Street Suite 1000	AddressLine1
City	Charlotte	City
State	NC	State
ZIP Code	28246	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-08-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	753054855	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mercy Restorative Care Hospital Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MERC	NameControl
Phone	7043046025	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10200 Mallard Creek Road No 300	AddressLine1
City	Charlotte	City
State	NC	State
ZIP Code	28262	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Joanne Tyo	Name
Title	CFO	Title
Phone	7043046025	Phone
Date Signed	2011-03-15	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Gregory W Johns	Name
Phone	7049985200	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Joanne Tyo	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	10200 Mallard Creek Road No 300	AddressLine1
City	Charlotte	City
State	NC	State
ZIP Code	28262	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	22772401	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	www.cshnc.com	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2002	YearFormation
State Legal Domicile	NC	StateLegalDomicile
Activity Or Mission Description	to provide long term acute care services.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	201	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	18587224	ProgramServiceRevenuePriorYear
Program Service Revenue CY	22266828	ProgramServiceRevenueCY
Investment Income Prior Year	178789	InvestmentIncomePriorYear
Investment Income Current Year	497599	InvestmentIncomeCurrentYear
Other Revenue Prior Year	13529	OtherRevenuePriorYear
Other Revenue Current Year	7974	OtherRevenueCurrentYear
Total Revenue Prior Year	18779542	TotalRevenuePriorYear
Total Revenue Current Year	22772401	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7610842	SalariesEtcPriorYear
Salaries Etc Current Year	8330915	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	9032469	OtherExpensePriorYear
Other Expenses Current Year	9505503	OtherExpensesCurrentYear
Total Expenses Prior Year	16643311	TotalExpensesPriorYear
Total Expenses Current Year	17836418	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2136231	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	4935983	RevenuesLessExpensesCY
Total Assets BOY	12718165	TotalAssetsBOY
Total Assets EOY	17246276	TotalAssetsEOY
Total Liabilities BOY	4915700	TotalLiabilitiesBOY
Total Liabilities EOY	4104688	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	7802465	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	13141588	NetAssetsOrFundBalancesEOY
Mission Description	To promote and improve the health status of the community by providing long term acute care services.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	15688381	Expense
Revenue	22274802	Revenue
Description	provided long term acute care services through the OPERATION OF A 40 BED hOSPITAL-WITHIN-A-HOSPITAL.	Description
Total Program Service Expense	15688381	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Balance Sheet Amounts Reported	1	BalanceSheetAmountsReported
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	27	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	201	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NC	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Acuity Healthcare LP	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7048877285	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	10200 Mallard Creek Road No 300	AddressLine1
City	Charlotte	City
State	NC	State
ZIP Code	28262	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Curtis Copenhaver
President	1.00	X	0	0	0
David Thomas
Secretary/Treasurer	1.00	X	0	0	0
Robert King
Vice President	1.00	X	0	0	0
Mary Piepenbring
Board Member	1.00	X	0	0	0
Dr Roger Ray
Board Member	1.00	X	0	0	0
Neal Alexander
Board Member	1.00	X	0	0	0
Nancy Geedey
Board Member	1.00	X	0	0	0
Lysa Long
Board Member	1.00	X	0	0	0
Edward Bethea
Board Member	1.00	X	0	0	0
Susan Davis
CEO	40.00		0	0	0	X
Joanne Tyo
CFO	40.00		0	0	0	X
Kimberly H Singleton
RN	40.00		140199	0	1170		X
Hajrudin Begic
RN	40.00		142700	0	11366		X
Halina Brengel
LPN	40.00		137203	0	5837		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	420102	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	18373	TotalOtherCompensation
Number Individuals GT100 K	3	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
CMC Mercy Hospital
PO Box 32861	Charlotte	NC	28232	Medical Services	3815898
Acuity Healthcare LP
10200 Mallard Creek Rd	Charlotte	NC	28262	Labor, Consulting	1299762
Blue Cross Blue Shield
PO Box 580017	Charlotte	NC	28258	Physician Services	749199
Carolinas Healthcare Systems
PO Box 32861 Attn Julie France	charlotte	NC	28232	Medical Services	670996
Charlotte Meck Hospital
2001 Vail Avenue Diane Boney 7th Fl	charlotte	NC	28207	Medical Services	540702

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Patient revenue	Description
Business Code	621400	BusinessCode
Total Revenue Column	22266828	TotalRevenueColumn
Related Or Exempt Function Income	22266828	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	22266828	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	497599	TotalRevenueColumn
Exclusion	$497,599	ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	7974	TotalRevenueColumn
Related Or Exempt Function Income	7974	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	7974	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	22772401	TotalRevenueColumn
Related Or Exempt Function Income	22274802	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$497,599	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	6659524	Total
Program Services	5707516	ProgramServices
Management And General	952008	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	41234	Total
Program Services	35339	ProgramServices
Management And General	5895	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1120100	Total
Program Services	836701	ProgramServices
Management And General	283399	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	510057	Total
Program Services	437142	ProgramServices
Management And General	72915	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	204000	Total
Management And General	204000	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	55700	Total
Management And General	55700	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	18000	Total
Management And General	18000	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	3801078	Total
Program Services	3731291	ProgramServices
Management And General	69787	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	15320	Total
Program Services	14342	ProgramServices
Management And General	978	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	73370	Total
Management And General	73370	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	7662	Total
Management And General	7662	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	683463	Total
Program Services	651631	ProgramServices
Management And General	31832	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	34227	Total
Program Services	30006	ProgramServices
Management And General	4221	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	11322	Total
Program Services	9787	ProgramServices
Management And General	1535	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1388	Total
Management And General	1388	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	158221	Total
Program Services	158221	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	164544	Total
Program Services	143581	ProgramServices
Management And General	20963	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Patient Care Supplies	2736069	2736069
Bad Debt Expense	765761	765761
Patient Care Equipment	430758	430758

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	344620	Total
Program Services	236	ProgramServices
Management And General	344384	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	17836418	Total
Program Services	15688381	ProgramServices
Management And General	2148037	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3930508	BOY
EOY	4053071	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	4471775	BOY
EOY	9663323	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3515911	BOY
EOY	2546019	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	33946	BOY
EOY	25356	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	80621	BOY
EOY	85830	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	1625892	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	873490	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	573977	BOY
EOY	752402	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	111427	BOY
EOY	120275	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	12718165	BOY
EOY	17246276	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1850781	BOY
EOY	1826753	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	3064919	BOY
EOY	2277935	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	4915700	BOY
EOY	4104688	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7802465	BOY
EOY	13141588	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	7802465	BOY
EOY	13141588	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	12718165	BOY
EOY	17246276	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	51911	OtherCostOrOtherBasis
Depreciation	6943	Depreciation
Book Value	44968	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1573981	OtherCostOrOtherBasis
Depreciation	866547	Depreciation
Book Value	707434	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	752402	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	THIRD PARTY RESERVE	Description
Amount	$2,277,935	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	2277935	TotalOfAmounts
Total Revenue	22772401	TotalRevenue
Total Expenses	17836418	TotalExpenses
Excess Or Deficit For Year	4935983	ExcessOrDeficitForYear
Net Unrealized GL On Investments	403140	NetUnrealizedGLOnInvestments
Total Adjustments	403140	TotalAdjustments
Excess Or Deficit Per FS	5339123	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	23175541	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	403140	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	403140	RevenueNotRptdF990
Revenue Subtotal	22772401	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	22772401	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	17836418	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	17836418	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	17836418	TotalExpensesPerForm990

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	722184	TotalCommunityBenefitExpense
Net Community Benefit Expense	722184	NetCommunityBenefitExpense
Percent Of Total Expense	0.04050	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	272982	TotalCommunityBenefitExpense
Net Community Benefit Expense	272982	NetCommunityBenefitExpense
Percent Of Total Expense	0.01530	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	995166	TotalCommunityBenefitExpense
Net Community Benefit Expense	995166	NetCommunityBenefitExpense
Percent Of Total Expense	0.05580	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	500	TotalCommunityBenefitExpense
Net Community Benefit Expense	500	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	500	TotalCommunityBenefitExpense
Net Community Benefit Expense	500	NetCommunityBenefitExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	995666	TotalCommunityBenefitExpense
Net Community Benefit Expense	995666	NetCommunityBenefitExpense
Percent Of Total Expense	0.05580	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$765,761	BadDebtExpenseAmount
Amount Attributable To	217476	AmountAttributableTo
Amount Reimbursed By Medicare	15535033	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	11227194	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	4307839	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	0	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	Acuity Healthcare	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	Hospital Management	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.00000	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.00000	PhysicansProfitOrOwnership

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mercy Restorative Care Inc	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2001 Vail Avenue	AddressLine1
City	CHARLOTTE	City
State	NC	State
ZIP Code	28207	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Subsidized Health Services Expln	Part I, Line 7g: Host hospital performs services then bills Mercy Restorative Care Hospital accordingly	SubsidizedHealthServicesExpln
Shortfall As Community Benefit	Part III, Line 8: Cost Report	ShortfallAsCommunityBenefit
Needs Assessment	Part VI, Line 2: Hospital houses 40 licensed beds for long-term acute care.	NeedsAssessment
Patient Education Assistance	Part VI, Line 3: Hospital has a charity care program for those who qualify based on income standards. Hospital provides financial assistance applications.	PatientEducationAssistance
Community Information	Part VI, Line 4: Mecklenburg County and surrounding regions	CommunityInformation
Community Building Activities	Part VI, Line 5: None	CommunityBuildingActivities
Other Information	Part VI, Line 6: Sponsor of healthcare convention	OtherInformation
Affiliated Health Care System	Part VI, Line 7: Hospital is housed in another hospital but are separate for purposes of sponsorship and community related healthcare events	AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Hajrudin Begic	BusinessNameLine1

Field	Value	IRS element (for citing)
Base Compensation Filing Org	142700	BaseCompensationFilingOrg
Comp Based On Related Orgs	0	CompBasedOnRelatedOrgs
Bonus Filing Org	0	BonusFilingOrg
Bonus Related Orgs	0	BonusRelatedOrgs
Other Compensation Filing Org	0	OtherCompensationFilingOrg
Other Compensation Related Orgs	0	OtherCompensationRelatedOrgs
Deferred Comp Filing Org	0	DeferredCompFilingOrg
Deferred Comp Related Orgs	0	DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org	11366	NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs	0	NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org	154066	TotalCompensationFilingOrg
Total Compensation Related Orgs	0	TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org	0	CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs	0	CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	ExplanationExplanation
Form 990, Part VI, Section A, line 3	CEO and CFO are employed through management contract with Acuity Healthcare, LP. As such, their compensation information is not required on Part VII.
Form 990, Part VI, Section B, line 11	A copy of Form 990 was provided to the board by e-mail. Management performed a complete review.
Form 990, Part VI, Section B, line 12c	if a board member is found to have a conflict, they abstain from the voting process.
Form 990, Part VI, Section B, line 15	a conflict-free board determines appropriate compensation, relying on comparable information. Board reviews and decides CEO annual compensation through closed board session. One board member is an HR respresentative and participates in discussions.
Form 990, Part VI, Section C, line 19	Governing documents and financial statements are not available to the public.
Form 990, Part XI, Line 2c:	No Changes for approving audited financial statemeNTs or selection of independent accountants have occurred from the prior year.