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MERCY KANSAS COMMUNITIES INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MERCY KANSAS COMMUNITIES INC (EIN 48-0956045)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201131339349302173
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)
Timestamp2011-05-13T09:56:19-05:00Timestamp
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)
EIN480956045EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mercy Health System of Kansas IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone6202237057Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Woodland Hills BlvdAddressLine1
CityFort ScottCity
StateKSState
ZIP Code66701ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameShelly HunterName
TitlecfoTitle
Date Signed2011-05-05DateSigned

Preparer Preparer

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

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTerri Del ChiaroNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1401 Woodland Hills BlvdAddressLine1
CityFort ScottCity
StateKSState
ZIP Code66701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts70506230GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.mercykansas.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionSee Schedule O.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees824TotalNbrEmployees
Total Nbr Volunteers248TotalNbrVolunteers
Total Gross UBI475759TotalGrossUBI
Net Unrelated Business Txbl Income183145NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year110680ContributionsGrantsPriorYear
Contributions Grants Current Year98245ContributionsGrantsCurrentYear
Program Service Revenue Prior Year177405931ProgramServiceRevenuePriorYear
Program Service Revenue CY66735423ProgramServiceRevenueCY
Investment Income Prior Year134574InvestmentIncomePriorYear
Investment Income Current Year596878InvestmentIncomeCurrentYear
Other Revenue Prior Year1431777OtherRevenuePriorYear
Other Revenue Current Year3075684OtherRevenueCurrentYear
Total Revenue Prior Year179082962TotalRevenuePriorYear
Total Revenue Current Year70506230TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year18171GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY22657GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40116146SalariesEtcPriorYear
Salaries Etc Current Year36614921SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year137696854OtherExpensePriorYear
Other Expenses Current Year32632536OtherExpensesCurrentYear
Total Expenses Prior Year177831171TotalExpensesPriorYear
Total Expenses Current Year69270114TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1251791RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1236116RevenuesLessExpensesCY
Total Assets BOY64874410TotalAssetsBOY
Total Assets EOY64666968TotalAssetsEOY
Total Liabilities BOY10601124TotalLiabilitiesBOY
Total Liabilities EOY8498244TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY54273286NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY56168724NetAssetsOrFundBalancesEOY
Mission DescriptionSee Schedule O.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense16608767Expense
Grants3760Grants
Revenue24235990Revenue
DescriptionSee Schedule O.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense22642042Expense
Grants11477Grants
Revenue34981356Revenue
DescriptionSee Schedule O.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense10429003Expense
Grants7420Grants
Revenue8740453Revenue
DescriptionMercy Physician Group - Fort Scott / Independence - Local physician services are essential to the health and well-being of the communities. The integrated physician group consists of the following mix of specialties: family practice, internal medicine, OB/GYN, general surgery, orthopedics and mid-level providers.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp663451TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense50343263TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
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 OrganizationstrueGrantsToOrganizations
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 OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
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 With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees824NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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 Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
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 BodyfalseForm990ProvidedToGoverningBody
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 PersonTERRI DEL CHIARONamePerson
Telephone Number6202237057TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1401 WOODLAND HILLS BLVDAddressLine1
CityFort ScottCity
StateKSState
ZIP Code66701ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Sr Annrene Brau RSM
Trustee1.0X000
Sr Mary Jeremy Buckman RSM
Trustee1.0X000
Herbert G Grantham MD
Trustee1.0X000
Sr Rebecca Ann Hendricks RSM
Trustee1.0X000
Rodney Holter
Trustee1.0X000
M Victoria Kearney
Trustee1.0X000
Christopher G Lewis
Trustee40.0X430119021026
Fred Meier
Trustee1.0X000
Robert Nichols
Trustee40.0X269279047997
Larry D Nuss
Trustee1.0X000
David Shepherd
Trustee1.0X000
Clayton N Tatro
Trustee1.0X000
Sr Claudia S Ward RSM
Trustee1.0X000
Carl E Ammons
President - Mercy Hospital40.0162454025993X
Reta Baker
President - Mercy Health CTR40.0024932878636X
John Woodrich
CEO (thru 11/18/09)40.00352751113599X
Terri Del Chiaro
Vice President - Finance40.0021355758727X
John M Fox
Physician40.0419788026839X
Ralph W Hall
Physician40.0312005027643X
Roger D Parris
Physician40.0381417041799X
Larry E Seals
Physician40.0403837020455X
Soheila Sohaei
Physician40.0465534023588X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2844433TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs815636TotalReportableCompFrmRltdOrgs
Total Other Compensation486302TotalOtherCompensation
Number Individuals GT100 K34NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Acute Care Inc
1609 N Ankeny Blvd Ste 200AnkeyIA50023ER coverage1068649
General Anesthesia Services PA
PO Box 263FORT SCOTTKS66701Anesthetist services796771
Sodexo Inc and Affiliates
4880 Payshpere CirChicagoIL60674Food service labor788186
Westar Energy
PO Box 758500TopekaKS66675Utility643931
Gold Mechanical Inc
4735 W DivisionSpringfieldMO65802Construction610100
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Government Grants98245GovernmentGrants
All Other Contributions0AllOtherContributions
Total Contributions98245TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Services6221106565493065654930
Reference Lab6215001080493853485227008
FieldValueIRS element (for citing)
Total Program Service Revenue66735423TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column537464TotalRevenueColumn
Exclusion$537,464ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1377549Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1377549Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1377549TotalRevenueColumn
Exclusion$1,377,549ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other59414Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other59414Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column59414TotalRevenueColumn
Exclusion$59,414ExclusionAmount

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

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Cafeteria/Food Service722212542545542545
Fitness Center713940248751248751
MEDICAL TRANSCRIPTION FEES5614104955249552

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column857287TotalRevenueColumn
Related Or Exempt Function Income857287RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1698135TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column70506230TotalRevenueColumn
Related Or Exempt Function Income67957799RelatedOrExemptFunctionIncome
Unrelated Business Revenue475759UnrelatedBusinessRevenue
Exclusion$1,974,427ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total22657Total
Program Services22657ProgramServices

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)
Total1017235Total
Program Services712597ProgramServices
Management And General304638ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29074465Total
Program Services24453970ProgramServices
Management And General4620495ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1227164Total
Program Services1032144ProgramServices
Management And General195020ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3396742Total
Program Services2856934ProgramServices
Management And General539808ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1899315Total
Program Services1597477ProgramServices
Management And General301838ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3932Total
Program Services2244ProgramServices
Management And General1688ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total2440Total
Program Services2440ProgramServices

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)
Total3136695Total
Program Services2228524ProgramServices
Management And General908171ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total396885Total
Program Services179277ProgramServices
Management And General217608ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total6941947Total
Program Services6194192ProgramServices
Management And General747755ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3329729Total
Program Services1778ProgramServices
Management And General3327951ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1597307Total
Program Services233315ProgramServices
Management And General1363992ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total65603Total
Program Services38150ProgramServices
Management And General27453ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total15254Total
Program Services11871ProgramServices
Management And General3383ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4467250Total
Program Services2125607ProgramServices
Management And General2341643ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total732207Total
Program Services396675ProgramServices
Management And General335532ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt45394554539455
System Fees40434863536103689876
Physician Purchased Services21287642128764
All other expenses12315821231582

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total69270114Total
Program Services50343263ProgramServices
Management And General18926851ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8128BOY
EOY1402850EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10620235BOY
EOY13688965EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5463142BOY
EOY3582867EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY406088BOY
EOY361680EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1186915BOY
EOY1213410EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY693723BOY
EOY495777EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis103533423LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec61834293LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY44555403BOY
EOY41699130EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1940776BOY
EOY2222289EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY64874410BOY
EOY64666968EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9239131BOY
EOY8243375EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY520819BOY
EOY254869EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY841174BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10601124BOY
EOY8498244EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY54092710BOY
EOY55753051EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY180576BOY
EOY415673EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54273286BOY
EOY56168724EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64874410BOY
EOY64666968EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

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 OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$6,221GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB6221TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER Lobbying ActivitiesIdentifier
Return ReferenceSchEDULE C, Part II-B, Line 1FReturnReference
ExplanationThe filing organization is a member of and pays dues to the following hospital associations: American Hospital Association, Kansas Hospital Association, and Catholic Health Association. For the year ended June 30, 2010, dues were $8,088, $25,318, and $10,524, respectively. Approximately 24% of American Hospital Association dues, 15% of Kansas 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 Basis2770583OtherCostOrOtherBasis
Book Value2770583BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis58406212OtherCostOrOtherBasis
Depreciation27869933Depreciation
Book Value30536279BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis953544OtherCostOrOtherBasis
Depreciation311942Depreciation
Book Value641602BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis41295303OtherCostOrOtherBasis
Depreciation33652418Depreciation
Book Value7642885BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis107781OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value107781BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings41699130TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
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

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.FreeOtherPercentage
FieldValueIRS element (for citing)
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 Expense2649808TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2649808NetCommunityBenefitExpense
Percent Of Total Expense0.04090PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2681062TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2681062NetCommunityBenefitExpense
Percent Of Total Expense0.04140PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense5330870TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5330870NetCommunityBenefitExpense
Percent Of Total Expense0.08230PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served3554PersonsServed
Total Community Benefit Expense141867TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense141867NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served15PersonsServed
Total Community Benefit Expense70541TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense70541NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense30739TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense30739NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1500PersonsServed
Total Community Benefit Expense523623TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense523623NetCommunityBenefitExpense
Percent Of Total Expense0.00810PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served5069PersonsServed
Total Community Benefit Expense766770TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense766770NetCommunityBenefitExpense
Percent Of Total Expense0.01190PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served5069PersonsServed
Total Community Benefit Expense6097640TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6097640NetCommunityBenefitExpense
Percent Of Total Expense0.09420PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense484TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense484NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served30PersonsServed
Total Community Building Expense273TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense273NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served16PersonsServed
Total Community Building Expense1678TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense1678NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served4PersonsServed
Total Community Building Expense2207TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense2207NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served237PersonsServed
Total Community Building Expense8818TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense8818NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served287PersonsServed
Total Community Building Expense13460TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense13460NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,372,614BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare16380550AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare19062231CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2681681MedicareSurplusOrShortfall

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 (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
Mercy Health Center
401 Woodland Hills BlvdFort ScottKS66701XXX
Mercy Hospital
800 W MyrtleIndependenceKS67301XXX

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaThe 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. Charity/Medical Indigence Parameters. Charity/Medical Indigence parameters are based on Federal Income Poverty (FPL) Guidelines which are updated annually. Generally, no patient's financial responsibility shall be greater than 10% of the household adjusted gross income, subject to an asset test. This determination shall be made per episode of care where income exceeds 300% of the FPL, and, when warranted, in aggregate for multiple episodes. The parameters will be reviewed annually with the FPL updates. The review will include assessment of the sliding scale ranges, maximum out of pockets, and overall impact to the facilities and system. Revisions will be completed as warranted.IncomeBasedCriteria
Annual Community Benefit ExplnN/AAnnualCommunityBenefitExpln
Costing Method UsedN/ACostingMethodUsed
Subsidized Health Services ExplnMercy Health System of Kansas did include as subsidized health services a portion of the costs of the physician clinic. For the fiscal year of 2010 those costs amounted to $2,041,760.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnOUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $69,270,114. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $4,539,455. THIS LEFT A TOTAL EXPENSE OF $64,730,659 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).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 assessES 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 BenefitUnreimbursed costs of Medicare are calculated by the gross charges net of the cost to charge ratio less any payments, deductions or reimbursements. It is the position of MHS-KS 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 PolicyMercy 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 utilizes presumptive charity prior to bad debt placement for charity adjustments in excess of $6,500. In these cases, Mercy utilizes the Search America report status of "probably charity" as the basis for assigning the charity level. Mercy will pursue appropriate means in the collection of delinquent accounts from patients with an established ability to pay or an unwillingness to validate 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 and annually review collection agency compliance with all policies.DebtCollectionPolicy
Number Of Facility Type ExplnN/ANumberOfFacilityTypeExpln
Needs AssessmentMercy Health System of Kansas' objectives of community needs assessment are to identify health needs in Fort Scott and Independence and the surrounding communities, and to involve the community in the health planning efforts. The information gathered is used to plan strategically, and better meet the health and human service needs of these communities. Mercy Health System of Kansas looks at community needs assessment as an opportunity to build relationships, educate the community and identify resources that are available to meet identified needs. Basic discussion forums have been utilized to foster conversation with key stakeholders. Examples of forums include an advisory board, focus groups, opinion surveys, and community round table discussions. Stakeholder participants include board members, community/civic leaders, local employers, other health care providers, former patients, and co-workers.NeedsAssessment
Patient Education AssistanceThe filing organization has printed material available at each point of registration in our facility, in addition to electronic 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 InformationMercy Hospital - Independence serves a four county region located in Southeast Kansas comprised of Montgomery, Wilson, Howard and Chautauqua. The population of this region is just under 52,000 residents. Per the US Census Bureau based on 2008 data, the median income in Montgomery County was approximately $31,000 per household and 12.4% of the residents in Montgomery County live below the poverty level. In 2009 the unemployment rate was 9.8% as compared to 4.7% in 2008. Mercy Hospital - Fort Scott serves a six county region located in Southeast Kansas and Southwest Missouri comprised of Bourbon, Linn, Allen and Crawford Counties in Kansas and Vernon and Cedar in Missouri. The population of this region is just under 110,000 residents. Per the US Census Bureau based on 2008 data, the median income in Bourbon County was approximately $37,375 per household and 15.6% of the residents in Bourbon County live below the poverty level. In 2009 the unemployment rate was 8.7% as compared to 5.1% in 2008. Southeast Kansas is the oldest quadrant of the State of Kansas which is classified as the 13th oldest population state in the country.CommunityInformation
Community Building ActivitiesMercy Health System of Kansas engages in numerous collaborative efforts to improve community health. Major collaborative projects are outlined in this section. Community Support Business Education Partnership: We offer a variety of educational opportunities related to healthcare for students and provide support to both our public high school and the local faith-based schools. Community Services & Non-Profit Organization Support: Mercy Health System of Kansas supports local organizations by assisting with donations and networked activities to organizations that belong to healthy communities. High School Student Shadow Program: High school students interested in a health related profession shadow a clinically trained person to gain insight into the career. United Way Board: Staff serves on the United Way Board of Directors and various committees. The United Way assists many of the non-profit organizations in the surrounding communities and has a new focus of advancing the common good in healthcare, education and income. Coalition Building Visioning a Healthier Bourbon County Committee: The collaborative assesses healthcare needs, prioritizes issues and plans and implements specific programs to address health needs in Bourbon County. Workforce Development Recruitment of Physicians and Other Health Professionals: Mercy Health System of Kansas actively seeks to recruit physicians and other health professionals to increase access to high quality healthcare for rural southeast Kansas. Health Professions Education Physician/Medical Students Medical Student Training: Mercy Health System of Kansas provides hospital settings along with guidance to medical students who are seeking their MD/DO and performing their mandatory clinical rotations. Nurses/Nursing Students Student Nurse Clinical Rotations: Mercy Health System of Kansas collaborates with Fort Scott Community College to provide multiple learning opportunities for students completing their LPN and RN coursework. Other Health Professional Education Student Respiratory Technician Clinical Rotations: The Student Respiratory Technician are mentored in the respiratory care program and provided in-service education on respiratory care. Student Radiology Technician Clinical Rotations: Mercy Health System of Kansas collaborates with Allen County Community College to provide multiple learning opportunities for students completing their radiology technician training.CommunityBuildingActivities
Other InformationHealth Care Support & Other Community Health Services Memorial Service: Family members are invited to a special quarterly memorial service in remembrance of Mercy Health System of Kansas patients who have recently died. Pastoral Education & Outreach: Programs provide education to targeted populations regarding pastoral care issues as well as assistance in completing advance directives. Community Health Education Prenatal & Postnatal Education: Prenatal and Postnatal classes are designed to educate pregnant women and their significant other on the birthing process. Also included is instruction about wellness and care for the newborn child. Community-Based Clinical Services Rural Health Community Clinics: Mercy Health - Independence provides support to help the freestanding Montgomery County Clinic of Independence. Health Care Support Services Financial Counseling: Financial Counselors are dedicated to helping patients determine sources of reimbursement for hospital services. As a private, non-profit charitable institution, Mercy Health System of Kansas relies on patient care revenues, whether from commercial insurance, government programs, or direct patient payments. Financial Counselors identify and assist patients who are unable to pay their estimated liability prior to treatments or who have large existing balances. This assistance includes assessing the patient's liability, linking patients to available funding sources such as Medicaid and Medicare, and determining whether they are eligible for charity care or financial hardship treatment. Patients requesting payment plans or financial hardship considerations are identified as early as possible in the registration/admission process so the necessary documentation, research, and approval can be completed thereby reducing the financial and emotional stress on the patient and family. Transportation of Families & Patients: Many times families are unable to afford get from their home to the hospital or patients are unable to get home after a hospital stay. To support our patients and their families, we provide transportation service to those in need. Community Health Education Area School Health & Sport Education & Support: Co-workers from our Physical Therapy departments provide support for students and coaches during sports tournaments, practices and games. Alzheimer's Support Group: Mercy Health System of Kansas assists with a monthly support group meeting for caregivers of Alzheimer's patients. Bereavement Support Group: Mercy Health System of Kansas provides bereavement support to community members who have had a loved one pass. The support group offers support to persons dealing with grief, death, and major loss. Community Based Health Seminar Coordination: Community broad-based education seminars on heart, stroke, oncology and other chronic diseases are organized and coordinated throughout the year. Stroke Club: The Stroke Club provides community education for stroke survivors, their families, or other interested persons. Lectures to Nursing Schools & Professional Organizations: Mercy Health System of Kansas supports hands-on educational lectures to nurses, nursing students and professional organizations to increase knowledge of disease states, patient care issues and interventions and treatment options. Brain Injury Support Group: Mercy Health System of Kansas sponsors a support group meeting for persons suffering from brain injuries, their family members and caregivers. Spirit of Women: We want to promote women's understanding of how to make better lifestyle and treatment choices across their entire lifespan. Mercy Health System of Kansas clinicians discuss the latest issues, and showcase new technologies in some of the most important health areas for women. Breast Cancer Support Group: Mercy Health System of Kansas sponsors a monthly support group meeting for breast cancer survivors, their families, or other interested persons.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 I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationTHE ASSISTANCE PROVIDED BY THE FILING ORGANIZATION IS DONATIONS TO THE LISTED ORGANIZATIONS (IN ADDITION TO VARIOUS OTHER MISCELLANEOUS DONATIONS) THAT ARE INTENDED TO BE USED FOR GENERAL OPERATING PURPOSES OF THE DONEE.Explanation

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 OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 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
Christopher G Lewis
36239000067729099320110940451145000
Robert Nichols
23228900036990038130098670317276000
Carl E Ammons
123679011189027586016275097180188447000
Reta Baker
0192262031119025947068243010393032796400
John Woodrich
02196720735310595480103595010004046635000
Terri Del Chiaro
0168895024927019735048625010102027228400
John M Fox
402670000171180163940104450446627000
Ralph W Hall
242980000690250162870113560339648000
Roger D Parris
34637100035046032012097870423216000
Larry E Seals
37354900030288098950105600424292000
Soheila Sohaei
426517000390170118950116930489122000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSCHEDULE J, PART I, QUESTION 3ReturnReference
ExplanationTHE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTIONS 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. 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: RETA BAKER, TERRI DEL CHIARO, AND JOHN WOODRICH. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). NO PERSONS LISTED ON THIS RETURN RECEIVED PAYMENT UNDER THE PLANS DURING THE TAX YEAR. SCHEDULE J, PART I, QUESTION 6A&B THE FILING ORGANIZATION PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2009 (JULY 1, 2008-JUNE 30, 2009), PAYMENT OF ALL OR PART OF THE BONUS IS CONTINGENT UPON PERCENTAGE ATTAINMENT OF (I) PERSONAL GOALS AND (II) CERTAIN FINANCIAL TARGETS. FOR FISCAL YEAR 2010 (JULY 1, 2009-JUNE 30, 2010), PAYMENT OF ALL OR PART OF THE BONUS IS CONTINGENT UP ON ATTAINMENT OF CERTAIN FINANCIAL TARGETS. PAYMENTS ARE MADE ANNUALLY IN OCTOBER FOLLOWING (I) THE CONCLUSION OF THE FISCAL YEAR AND (II) DETERMINATION OF GOAL ACHIEVEMENT (APPLICABLE ONLY FOR FISCAL YEAR 2009). BONUS OPPORTUNITIES ARE TIERED PERCENTAGES AND ARE DEPENDENT UPON THE LEADERSHIP LEVEL AND ATTAINMENT PERCENTAGE. MERCY'S ATTAINMENT OF FINANCIAL GOALS ARE VALIDATED BY AN EXTERNAL CONSULTING FIRM AND ARE THEN TAKEN INTO ACCOUNT BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE SISTERS OF MERCY HEALTH SYSTEM WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Janice Baker
See Schedule O38814Employmentfalse
Christina Chapman
See Schedule O49184Employmentfalse
Chris Ammons
See Schedule O19575Independent Contractorfalse
Midwest Pathology Consultants
See Schedule O126816Independent Contractorfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSION STATEMENTFORM 990, PART I & PART III, LINE 1ROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH, AND FAITHFUL TO CATHERINE MCAULEY'S SERVICE TRADITION MARKED BY JUSTICE, EXCELLENCE, STEWARDSHIP AND RESPECT FOR THE DIGNITY OF EACH PERSON, THE SISTERS OF MERCY HEALTH SYSTEM IMPLEMENTS AND ADVOCATES FOR INNOVATIVE HEALTH AND SOCIAL SERVICES TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF COMMUNITIES SERVED, WITH PARTICULAR CONCERN FOR PEOPLE WHO ARE ECONOMICALLY POOR. IN DOING SO, WE MAKE A DIFFERENCE BY TOUCHING LIVES OF THOSE WE SERVE WITH COMPASSION AND EXCEPTIONAL MERCY SERVICE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A MERCY HOSPITAL - INDEPENDENCE - HEALTH CARE SERVICES PROVIDED ARE ESSENTIAL TO THE HEALTH AND WELL-BEING OF THE INDIVIDUALS RESIDING IN THE CITY OF INDEPENDENCE AND MONTGOMERY COUNTY. THE HOSPITAL PROVIDES BASIC PRIMARY CARE SERVICES WHICH INCLUDE: INPATIENT ACUTE, SWING BED, EMERGENCY ROOM, GENERAL SURGERY, OUTPATIENT DIAGNOSTIC, OUTPATIENT PHYSICAL THERAPY AND HOME HEALTH SERVICES. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATE 1,307 DISCHARGES, 7,882 EMERGENCY ROOM VISITS, 1,828 SURGERIES, 7,769 HOME HEALTH VISITS AND NUMEROUS OUTPATIENT PROCEDURES. NECESSARY TERTIARY CARE IS TRANSPORTED OUT OF THE COMMUNITY TO A LARGER HOSPITAL. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4B MERCY HOSPITAL - FORT SCOTT - HEALTHCARE SERVICES PROVIDED ARE ESSENTIAL TO THE HEALTH AND WELL-BEING OF THE INDIVIDUALS RESIDING IN THE CITY OF FORT SCOTT AND BOURBON COUNTY. THE HOSPITAL PROVIDES BASIC PRIMARY CARE SERVICES WHICH INCLUDE; INPATIENT ACUTE, SWING BED, INPATIENT REHAB, EMERGENCY ROOM, GENERAL SURGERY, OUPATIENT DIAGNOSTIC, OUTPATIENT PHYSICAL THERAPY AND HOME HEALTH SERVICES. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATE 2,062 DISCHARGES, 7,499 EMERGENCY ROOM VISITS, 2,037 SURGERIES, 8,731 HOME HEALTH VISITS AND NUMEROUS OUTPATIENT PROCEDURES. NECESSARY TERTIARY CARE IS TRANSPORTED OUT OF THE COMMUNITY TO A LARGER HOSPITAL. OTHER PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4D MERCY HEALTH SYSTEM OF KANSAS, INC. ("MHSK") PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. MHSK PROVIDES INPATIENT DAY SERVICES, OUTPATIENT SERVICES, EMERGENCY SERVICES, HOME HEALTH VISITS AND OFFICE VISITS. HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY INCLUDE LOW COST PRENATAL CARE, BIRTHING CENTER FOR PATIENTS REQUIRING SPECIAL CARE AND, AT TIMES, OPERATIVE INTERVENTION FOR FETAL DISTRESS, CARE DESIGNED FOR MERCY EMPLOYEE'S SICK CHILDREN WHILE THE EMPLOYEE WORKS, GERIATRIC SITTER SERVICES, RURAL HEALTH CLINICS, EXPANDED TRANSPORTATION SERVICES, AMBULANCE SERVICE, SAFE KIDS PROGRAMS, MERCY 55 MATURE DRIVING CLASSES, MERCY COMPASSIONATE CARE PROGRAM, AND 34 HEALTH PROGRAMS. FORM 1099/1096 FILING FORM 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. THE NUMBER REPORTED IN PART V, QUESTION 1A FOR THE FILING ORGANIZATION ONLY INCLUDES THE FORM 1099S FILED TO REPORT PHYSICIAN DEBT FORGIVENESS. DESCRIPTIONS OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTIONS 6, 7A, 7B THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SYSTEM-JOPLIN, INC. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: 1) TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION SHALL OPERATE; 2) TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; 3) TO APPOINT MEMBERS OF THE BOARD; 4) TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; 5) TO APPROVE THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF THE CORPORATION; 6) TO APPROVE THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; 7) TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; 8) TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; 9) TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; 10) TO MERGE, DISSOLVE, OR ABANDON THE MHSK CORPORATION; AND 11) TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. REVIEW OF FORM 990 FORM 990, PART VI, LINE 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 DIRECTOR OF FINANCE 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, FOR REVIEW. IN ADDITION, THE FORM 990 IS PROVIDED TO THE MERCY HEALTH SYSTEM-JOPLIN, INC. BOARD OF DIRECTORS FOR THEIR REVIEW, AS MERCY HEALTH SYSTEM-JOPLIN, INC. IS THE SOLE CORPORATE MEMBER OF MERCY HEALTH SYSTEM OF KANSAS, INC. AND HAS ULTIMATE RESPONSIBILITY TO APPOINT THE MHS-KS BOARD (WHICH IS PRIMARILY ADVISORY IN NATURE) AND LEADERSHIP TEAM AND POWER TO APPROVE SIGNIFICANT FINANCIAL AND OPERATIONAL DECISIONS. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS SIGNED AND FILED WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE COMPLIANCE POLICY COVERAGE INCLUDES: CO-WORKERS, LEADERS, PROVIDERS, BOARD MEMBERS, AND ADMINISTRATORS. THE DETERMINATION OF A CONFLICT OF INTEREST IS MADE AND REVIEWED AT ALL LEVELS. A CORPORATE COMPLIANCE COMMITTEE MEETS TO REVIEW ANY CONFLICTS AND PROVIDES A REASONABLE ALTERNATIVE TO RESOLVE THE CONFLICT OF INTEREST. THESE MAY INCLUDE SUPERVISORY PROCEDURES OR TRANSFER OF A DECISION MAKING ROLE. FOR BOARD MEMBERS THEY ARE EXCLUDED FROM THE DELIBERATIONS AND DECISION MAKING PROCESS. OFFFICES & 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 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 SISTER 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. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 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 WEEKFORM 990, PART VII, SECTION A, COLUMN BSEVERAL INDIVIDUALS LISTED IN PART VII ARE DISCLOSED AS TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ON MULTIPLE FORM 990S OF ENTITIES INCLUDED WITHIN THE SISTERS OF MERCY HEALTH SYSTEM. THE AVERAGE HOURS PER WEEK DISCLOSED IN PART VII IS AN ESTIMATE OF THE HOURS PER WEEK THAT THE LISTED INDIVIDUAL SPENDS ON BOTH THE FILING ORGANIZATION AND ALL RELATED ORGANIZATIONS. AUDIT OF FINANCIAL STATEMENTS FORM 990, PART XI, QUESTION 2B 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. BUSINESS TRANSACTIONS WITH INTEREST PERSONS: SCHEDULE L, PART IV JANICE BAKER - FAMILY MEMBER TO RETA BAKER, OFFICER CHRISTINA CHAPMAN - FAMILY MEMBER TO RETA BAKER, OFFICER CHRIS AMMONS - FAMILY MEMBER TO CARL (ERIC) AMMONS, OFFICER MIDWEST PATHOLOGY CONSULTANTS - HERBERT GRANTHAM, TRUSTEE SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY THE 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.

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 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 Cassville Inc
94 Main StreetCassvilleMO65625431936699Lease 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 StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Consolidated Logistics Inc
2710 Rife Medical LaneRogersAR72758710474406DISSOLVED 8/4/09ARN/AC-Corp
Frontenac Properties Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017521914421HOLDING COMPDEN/AC-Corp
Inveno Health Inc
1235 E Cherokee StreetSpringfieldMO65804264509571IT SERVICESMON/AC-Corp
Mercy Community Services Inc
401 Woodland Hills BlvdFort SCOTTKS66701481078101RETAIL PHARMACIESKSC-CorpMHS KANSAS INC-417659024431.00000
Mercy Health Center Condominium Inc
4300 W Memorial RdOklahoma CityOK73120680640970REAL ESTATEOKN/AC-Corp
Mercy Health Network of the Southern Reg
1011 14th Avenue NWArdmoreOK73401731580607HEALTH CAREOKN/AC-Corp
Mercy Health Network Inc
4300 W Memorial RoadOklahoma CityOK73120731381689HEALTH CAREOKN/AC-Corp
Mercy Managed Care Corporation
4300 W Memorial RoadOklahoma CityOK73120731441665HOLDING COMPOKN/AC-Corp
Mercy Medical Services Inc
14528 S Outer Forty Suite 300ChesterfieldMO63017710641246DISSOLVED 7/1/09MON/AC-Corp
MHP Inc
14528 S Outer Forty Suite 300ChesterfieldMO63017431697084HOLDING COMPDEN/AC-Corp
St Edward Medical Services Inc
7301 Rogers AvenueFort SmithAR72903202965518DISSOLVED 5/5/10ARN/AC-Corp
UH L Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535HOLDING COMPMON/AC-Corp
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042MANAGEMENTMON/AC-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 EmployeesfalseSharingOfPaidEmployees
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 (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MERCY COMMUNITY SERVICES INC
O3018669
MHM SUPPORT SERVICES
O9253683
MHM SUPPORT SERVICES
P53782
MHP INC
O150337
MHP INC
P1118630
RESOURCE OPTIMIZATION & INNOVATION LLC
O2073206
SISTERS OF MERCY HEALTH SYSTEM
O993384
ST JOHN'S MERCY HEALTH SYSTEM
O90912
MERCY HEALTH CENTER FOUNDATION
P221851