MERCY HOSPITAL KINGFISHER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL KINGFISHER INC (EIN 46-3433074)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202201339349308665
- Schema version
- 2020v4.2
- 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 B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T15:41:11-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 264532849 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PURK & ASSOCIATES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1034 SOUTH BRENTWOOD BLVD STE 2000 | AddressLine1Txt |
| City | SAINT LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63117 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463433074 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL KINGFISHER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 4059365649 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY CLOUSEDAY | PersonNm |
| Person Title | VP FINANCE | PersonTitleTxt |
| Phone | 4057523536 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHERRY | PersonFirstNm |
| Person Last | CLOUSEDAY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUGLAS G PLEUS CPA | PreparerPersonNm |
| PTIN | P00013488 | PTIN |
| Phone | 3148844000 | PhoneNum |
| Preparation | 2022-05-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM GEBHART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,957,558 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCY.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,086 | PYContributionsGrantsAmt |
| CY Contributions Grants | $102,504 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,319,316 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,643,514 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $231,939 | PYOtherRevenueAmt |
| CY Other Revenue | $210,272 | CYOtherRevenueAmt |
| PY Total Revenue | $14,561,341 | PYTotalRevenueAmt |
| CY Total Revenue | $14,956,290 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $132,235 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,865,241 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,242,716 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,348,749 | PYOtherExpensesAmt |
| CY Other Expenses | $4,741,347 | CYOtherExpensesAmt |
| PY Total Expenses | $13,213,990 | PYTotalExpensesAmt |
| CY Total Expenses | $13,116,298 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,347,351 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,839,992 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,606,269 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,781,535 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,784,438 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $431,522 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,821,831 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,350,013 | NetAssetsOrFundBalancesEOYAmt |
| Mission | AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,686,706 | ExpenseAmt |
| Grant | $132,235 | GrantAmt |
| Revenue | $7,613,800 | RevenueAmt |
| Desc | MERCY HOSPITAL KINGFISHER PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY BY OFFERING ESSENTIAL HEALTH SERVICES TO ITS RURAL COMMUNITY. DURING THE FISCAL YEAR ENDED JUNE 30, 2021, KINGFISHER PROVIDED INPATIENT SERVICES TO 329 PATIENTS WITH 139 OF THOSE UTILIZING A SWING BED IN ORDER TO HAVE ADDITIONAL TIME TO RECOVER WITH SKILLED CARE AFTER AN ACUTE STAY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,078,433 | ExpenseAmt |
| Revenue | $4,082,915 | RevenueAmt |
| Desc | MERCY HOSPITAL KINGFISHER PROVIDES ANCILLARY SERVICES TO THE RURAL COMMUNITY INCLUDING LAB, RADIOLOGY, PHARMACY AND THERAPY SERVICES WHICH ACCUMULATED 15,439 OUTPATIENT VISITS IN FISCAL YEAR 2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,352,819 | ExpenseAmt |
| Revenue | $3,120,535 | RevenueAmt |
| Desc | MERCY HOSPITAL KINGFISHER OPERATES AN EMERGENCY DEPARTMENT OPEN TO THE COMMUNITY 24/7 AN ACCESS POINT TO CRITICAL HEALTHCARE NEEDS. 3,089 PATIENTS UTILIZED KINGFISHER'S ED SERVICES IN FISCAL YEAR 2021. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,117,958 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY CLOUSEDAY | PersonNm |
| Phone | 4057523536 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 WEST MEMORIAL ROAD | AddressLine1Txt |
| City | OKLAHOMA CITY | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73120 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| SMITH CHAD | |||||||||
| VP - MEDICAL AFFAIRS & BOARD MEMBER | 1.00 | 49.00 | Yes (X) | $0 | $369,295 | $24,906 | |||
| PINAROC LYNN | |||||||||
| VP-FINANCE & BOARD MEMBER | 1.00 | 49.00 | Yes (X) | $0 | $208,687 | $15,555 | |||
| DUFFY DIANE | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| HALLOCK DOROTHY | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| VOTH JOE | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GEBHART JIM | |||||||||
| PRESIDENT, MERCY HOSPITAL OKLAHOMA CITY | 2.00 | 48.00 | $0 | $2,261,244 | $86,045 | Yes (X) | |||
| STITT BOBBY J | |||||||||
| PRESIDENT & ADMINISTRATOR | 20.00 | 20.00 | $0 | $193,312 | $21,345 | Yes (X) | |||
| HAHNE CHRISTOPHER | |||||||||
| VP FINANCE | 5.00 | 45.00 | $0 | $196,621 | $24,372 | Yes (X) | |||
| GRANTZ JAMI W | |||||||||
| ADVANCED PRACTICE RN - CERT NP | 40.00 | 0.00 | $0 | $199,686 | $23,466 | Yes (X) | |||
| HENDERSON TODD | |||||||||
| MANAGER-SURGERY, CRNA | 40.00 | 0.00 | $0 | $203,457 | $13,475 | Yes (X) | |||
| HARRIS DANIEL | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $0 | $194,867 | $21,948 | Yes (X) | |||
| BERTUS MATTHEW | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $0 | $199,428 | $5,025 | Yes (X) | |||
| SEAY PAUL | |||||||||
| REGISTERED NURSE II | 40.00 | 0.00 | $0 | $112,690 | $14,958 | Yes (X) | |||
| VITIELLO JONATHAN | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $1,992,513 | $93,661 | Yes (X) | |||
| SMALLEY DIANA L | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $1,440,039 | $23,309 | Yes (X) | |||
| RAJU GARY | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $567,977 | $48,154 | Yes (X) | |||
| ENLOE TRACY | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $406,070 | $57,792 | Yes (X) | |||
| LE BICH-VI | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 50.00 | $0 | $640,252 | $31,773 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $9,186,138 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $505,784 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMN HEALTHCARE | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12400 HIGH BLUFF DR | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | STAFFING SERVICES | ServicesDesc |
| Compensation | $118,921 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $102,504 | AllOtherContributionsAmt |
| Total Contributions | $102,504 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $14,039,117 | $14,039,117 |
| OTHER OPERATING REVENUE | 622110 | $560,691 | $560,691 |
| RENTAL INCOME | 531120 | $43,706 | $43,706 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,643,514 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,807 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,268 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,539 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,539 | TotalRevenueColumnAmt |
| Exclusion | $15,539 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| OTHER MEDICAL REVENUE | 622110 | $173,736 | $173,736 | |
| CAFETERIA | 722210 | $20,997 | $20,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $194,733 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,956,290 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,817,250 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,536 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,658 | TotalAmt |
| Program Services | $4,658 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,577 | TotalAmt |
| Program Services | $127,577 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,995,189 | TotalAmt |
| Program Services | $6,283,104 | ProgramServicesAmt |
| Management And General | $712,085 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,012 | TotalAmt |
| Program Services | $128,454 | ProgramServicesAmt |
| Management And General | $14,558 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $649,799 | TotalAmt |
| Program Services | $583,652 | ProgramServicesAmt |
| Management And General | $66,147 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,716 | TotalAmt |
| Program Services | $408,428 | ProgramServicesAmt |
| Management And General | $46,288 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,800 | TotalAmt |
| Management And General | $6,800 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,438 | TotalAmt |
| Management And General | $3,438 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,757 | TotalAmt |
| Program Services | $269,471 | ProgramServicesAmt |
| Management And General | $102,286 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875 | TotalAmt |
| Management And General | $875 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,231 | TotalAmt |
| Program Services | $150,707 | ProgramServicesAmt |
| Management And General | $156,524 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,200 | TotalAmt |
| Management And General | $2,200 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $723,658 | TotalAmt |
| Program Services | $723,317 | ProgramServicesAmt |
| Management And General | $341 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,685 | TotalAmt |
| Program Services | $24,738 | ProgramServicesAmt |
| Management And General | $1,947 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,644 | TotalAmt |
| Program Services | $123,879 | ProgramServicesAmt |
| Management And General | $26,765 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,060 | TotalAmt |
| Management And General | $84,060 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $1,123,397 | $1,123,397 | |
| SHARED SERVICE FEE | $935,388 | $346,094 | $589,294 |
| DRUGS & MEDICAL EXPENSE | $782,066 | $772,818 | $9,248 |
| REPAIRS & MAINTENANCE | $192,614 | $32,385 | $160,229 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,534 | TotalAmt |
| Program Services | $15,279 | ProgramServicesAmt |
| Management And General | $15,255 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,116,298 | TotalAmt |
| Program Services | $11,117,958 | ProgramServicesAmt |
| Management And General | $1,998,340 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,511,593 | BOYAmt |
| EOY | $1,539,537 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,499 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,298,261 | BOYAmt |
| EOY | $1,446,904 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,874 | BOYAmt |
| EOY | $152,618 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,055,626 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,420,495 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $562,042 | BOYAmt |
| EOY | $635,131 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $7,345 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,606,269 | BOYAmt |
| EOY | $3,781,535 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,375 | BOYAmt |
| EOY | $427,607 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,915 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,451,063 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,784,438 | BOYAmt |
| EOY | $431,522 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,821,831 | BOYAmt |
| EOY | $3,350,013 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,821,831 | BOYAmt |
| EOY | $3,350,013 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,606,269 | BOYAmt |
| EOY | $3,781,535 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,839,992 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | -$171,726 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | -$140,084 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $3,438 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,438 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2021, DUES WERE $11,767 AND $3,968, RESPECTIVELY. APPROXIMATELY 20.60% OF OKLAHOMA HOSPITAL ASSOCIATION DUES AND 25.56% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $106,478 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,223 | DepreciationAmt |
| Book Value | $78,255 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,949,148 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,392,272 | DepreciationAmt |
| Book Value | $556,876 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $635,131 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | FEDERAL INCOME TAX PRIMARILY ALL OF THE MERCY HEALTH ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS CHARITABLE ORGANIZATIONS QUALIFYING UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), BY VIRTUE OF IRS DETERMINATION LETTERS OR INCLUSION IN THE OFFICIAL CATHOLIC DIRECTORY. MERCY COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2021 OR 2020. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| Most Hospitals Policy | Yes (X) | MostHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $409,162 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $409,162 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03410 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,277,025 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $917,326 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $359,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,686,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $917,326 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $768,861 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06410 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,686,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $917,326 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $768,861 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06410 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $459,553 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,957,508 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,939,075 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $18,433 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL KINGFISHER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MERCY.NET | WebsiteAddressTxt |
| State License | 2226 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL KINGFISHER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.MERCY.NET/COMMUNITYBENEFITS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MERCY.NET/COMMUNITYBENEFITS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MERCY.NET/BILLING/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MERCY.NET/BILLING/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MERCY.NET/BILLING/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN ITS MOST RECENT CHNA REPORT.THE CHNA HAS ALL THE SECTIONS REFERENCED ABOVE AND INCLUDES AN EXECUTIVE SUMMARY, POTENTIALLY AVAILABLE RESOURCES, EVALUATION OF IMPACT, REFERENCES, AND APPENDICES. |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 5: WHEN CONDUCTING ITS MOST RECENT CHNA, MERCY HOSPITAL, KINGFISHER WORKED CLOSELY WITH THE FOLLOWING:- SOONER SUCCESS- KINGFISHER COUNTY HEALTH DEPARTMENT REPRESENTATIVES- OSU COOPERATIVE EXTENSION SERVICE STAFF- DHS STAFF- CHISHOLM TRAIL TECHNOLOGY CENTER REPRESENTATIVES- FAMILY AND CHILDREN'S CONSULTANTS- OKLAHOMA STATE UNIVERSITY CENTER FOR RURAL HEALTH STAFF- MERCY HOSPITAL, KINGFISHER LEADERSPLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 6B: OKLAHOMA OFFICE OF RURAL HEALTH, OSU CENTER FOR RURAL HEALTH |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 11: THE FOLLOWING LISTS THE CONCERNS ALONG WITH STEPS THE HOSPITAL AND COMMUNITY PLAN TO TAKE TO REMEDY THE SITUATION. - MENTAL HEALTH INCLUDING SUICIDE AND OPIOIDS - EMERGENCY DEPARTMENT SCREENINGS/ASSESSMENTS- MERCY HOSPITAL KINGFISHER ADMINISTERS A SCREENING QUESTIONNAIRE TO ALL PATIENTS SEEN THROUGH THE EMERGENCY DEPARTMENT TO DETERMINE MENTAL HEALTH NEEDS. FROM THERE, PATIENTS WHO ARE IDENTIFIED AS NEEDING SERVICES OR CARE ARE THEN REFERRED TO THE APPROPRIATE PROVIDER OR FACILITY. MERCY HOSPITAL KINGFISHER AVERAGES ROUGHLY 3,300 PATIENTS SEEN THROUGH THE EMERGENCY DEPARTMENT ON AN ANNUAL BASIS (SOME OF THESE ARE DUPLICATE PATIENTS). - THE HOSPITAL HAS A STRONG RELATIONSHIP WITH RED ROCK BEHAVIORAL HEALTH SERVICES FOR REFERRALS AND SERVICES FOR PATIENTS. RED ROCK DOES COLLABORATE WITH THE EMERGENCY DEPARTMENT AT MERCY HOSPITAL KINGFISHER TO COMPLETE EVALUATIONS AND ASSIST IN PLACING PATIENTS. THIS IS A CONTINUED PARTNERSHIP. - SMOKING AND TOBACCO USE - MERCY KINGFISHER CLINIC REFERS PATIENTS WHO SMOKE TO THE OKLAHOMA TOBACCO HELPLINE WHERE THEY CAN GET FREE RESOURCES INCLUDING PATCHES, COACHING CALLS, QUIT GUIDES, AND SUPPORTIVE MESSAGES THROUGH TEXTING AND EMAILS - OBESITY AND DIABETES - SUPPORTED AND PARTICIPATED IN KINGFISHER COMMUNITY COLLABORATIVE WALK-TOBER EVENT PROMOTING HEALTH AND EXERCISE. MERCY KINGFISHER HAD OVER 20 COWORKERS PARTICIPATE AND OVER 100 LOCALS PARTICIPATED FROM THE KINGFISHER COMMUNITY.MERCY HOSPITAL KINGFISHER (MHK) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH PARTICIPATION IN NEIGHBORHOOD/COMMUNITY MEETINGS, COMMUNITY BOARDS, AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHK DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE. SOME OF THE COMMUNITY BUILDING ACTIVITIES IN WHICH MHK PARTICIPATES/SERVES ARE: - PARTICIPATION IN FOUR OBI BLOOD DRIVES ANNUALLY (2-3 HOSPITAL SPONSORED BLOOD DRIVES ANNUALLY AVERAGING 13-15 DONORS PER DRIVE) - PARTICIPATED IN AMBUCS LOCAL CHAPTER AND FUNDRAISERS FOR PLAYGROUND OF DREAMS - KINGFISHER CHAMBER BOARD EXECUTIVE COMMITTEE MEMBER-YES - PROVIDED 11 VOLUNTEERS FOR KINGFISHER WINTER NIGHTS CHRISTMAS LIGHTS DISPLAY - COMPASSION CLINIC SUPPORT BY PROVIDING LAB AND MEDICAL SERVICES TO 225 PERSONS EACH QUARTER. - PARTICIPATED IN KINGFISHER COMMUNITY COLLABORATIVE WALK-TOBER EVENT PROMOTING HEALTH AND EXERCISE - SPONSORED TWO FAMILIES FROM KINGFISHER FOR THANKSGIVING MEALS - SUMMER BLOWOUT CHARITY FUNDRAISER - CHAMBER BACK TO SCHOOL BASH - DONATED BLANKETS TO 40 RESIDENTS AT FIRST SHAMROCK NURSING CENTER IN KINGFISHER - DONATED MONEY TO PROVIDE 40 DESSERTS TO MEALS ON WHEELS - DONATED $500 TO SANTA'S TOY LAND - DONATED $600 WORTH OF CHRISTMAS GIFTS TO 2 LOCAL FOSTER KIDS - ORGANIZED ATTITUDE FOR GRATITUDE CLOTHING DRIVE |
| MERCY HOSPITAL KINGFISHER, INC. | PART V, SECTION B, LINE 20E: OTHER AREAS FROM A NOTICE PERSPECTIVE: FAP IS POSTED IN ALL REGISTRATION AREAS, FULL POLICY AND PLAIN LANGUAGE DOCUMENT POSTED ON WEBSITE, PLAIN LANGUAGE DOCUMENT IS AVAILABLE WHEN REQUESTED, THERE IS A NOTICE ON STATEMENT, AND ALL PATIENTS GET THREE STATEMENTS BEFORE THEY CAN GO TO A COLLECTION AGENCY. |
| FORM 990, SCHEDULE H, PART V, SECTION B, LINE 22 | 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 200% OR BELOW, THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE IN ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE AND SOUTHEAST KANSAS. INDIVIDUALS WITH INCOMES GREATER THAN 200% OF THE FEDERAL POVERTY GUIDELINES FOR MOST COMMUNITIES, MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - MHK OUTPATIENT REHAB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 HOSPITAL CIRCLE | AddressLine1Txt |
| City | KINGFISHER | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 73750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | REHABILITATION SERVICES | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LN 7 COL(F): | TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $13,116,298. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $1,123,397. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $11,992,901. |
| PART I, LINE 6A | COMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES ADDRESS THE ROOT CAUSES OF HEALTH-RELATED PROBLEMS. MULTIDISCIPLINARY COMMUNITY PARTNERSHIPS AND COLLABORATION ADDRESS THE SYSTEMIC MALFUNCTION AND THE ROOTS CAUSES OF ISSUES SUCH AS POVERTY, VIOLENCE, AND HOMELESSNESS. THEY STRENGTHEN THE COMMUNITY'S ABILITY TO PROMOTE HEALTH AND WELL-BEING. MERCY HOSPITAL KINGFISHER (MHK) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH PARTICIPATION IN NEIGHBORHOOD/COMMUNITY MEETINGS, COMMUNITY BOARDS, AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHK DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE.A FULL DESCRIPTION OF COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT: HTTPS://WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS/ |
| PART III, LINE 2: | 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 ACCOUNT, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. |
| PART III, LINE 3: | 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 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. |
| PART III, LINE 4: | THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION 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 UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE 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 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 PATIENT BALANCES WITH COLLECTION AGENCIES. |
| PART III, LINE 8: | IT IS THE POSITION OF MERCY HOSPITAL KINGFISHER THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). |
| PART III, LINE 9B: | MERCY'S COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE COMMUNICATION AND/OR REVIEW OF PATIENT ACCOUNTS AS IT RELATES TO ANY SERVICE PROVIDED AT OUR FACILITIES BEFORE TURNING THE ACCOUNT TO BAD DEBT OR TAKING LEGAL ACTION FOR NONPAYMENT. MERCY ACTIVELY SCRUBS ACCOUNTS FOR PAYOR PLAN COVERAGE, INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS. MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY FOR ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE AND SOUTHEAST KANSAS. THIS PRESUMPTIVE SCREENING PROCESS DETAILS EVALUATIONS THAT TAKE PLACE PRIOR TO PATIENT BILLING AND ADDITIOANLLY PRIOT TO BAD DEBT PLACEMENT. THE PRESUMPTIVE SCREENING WAS PER ENCOUNTER AND DID NOT PROMOTE ANY LOOK-BACK ADJUSTMENTS.MERCY WILL GRANT CHARITY IN SITUATIONS WHERE THERE HAS BEEN AN INABILITY TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION WHEN A PATIENT HAS SUBMITTED AN APPLICATION. MERCY WILL PURSUE APPROPRIATE MEANS IN THE COLLECTION OF DELINQUENT ACCOUNTS FROM PATIENTS WITH AN ESTABLISHED ABILITY TO PAY OR AN UNWILLINGNESS TO COOPERATE IN VALIDATING ELIGIBILITY FOR FINANCIAL ASSISTANCE. THESE APPROPRIATE MEANS MAY INCLUDE LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES AFTER SENDING 3 MONTHLY STATEMENTS WITH THE FINAL INCLUDING NOTIFICATION; IF NO RESOLUTION THEY WILL BE TURNED TO COLLECTIONS. ADDITIONALLY, THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENTS, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENSURE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEW COMPLIANCE WITH POLICIES BUT ENSURE 120 DAYS OF BILLING AND COLLECTIONS OCCUR PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED. |
| PART VI, LINE 2: | THE KINGFISHER COMMUNITY COLLABORATIVE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING 2019 ALONG WITH A COMMUNITY HEALTH IMPROVEMENT PLAN DURING THE 3RD QUARTER 2019. THIS THROUGH ASSESSMENT IDENTIFIED CONCERNS IN THE COMMUNITY. THIS PROCESS AND FINDINGS WERE USED AS THE BASELINE DATA FOR THE CHNA FOR MERCY HOSPITAL, KINGFISHER. THE KINGFISHER COMMUNITY COLLABORATIVE IS A LOCAL HEALTH COALITION AND A CERTIFIED HEALTH IMPROVEMENT ORGANIZATION THAT MEETS QUARTERLY. THIS GROUP IS COMPOSED OF REPRESENTATIVES FROM SERVICE PROVIDERS, HEALTHCARE PROVIDERS, EDUCATION, SAFETY, FAITH-BASED GROUPS, AND COMMUNITY MEMBERS WHO ALL HAVE THE SAME DESIRE TO IMPROVE THE QUALITY OF LIFE IN THE COMMUNITY. MERCY HOSPITAL, KINGFISHER IS AN ACTIVE AND ENGAGED MEMBER OF THE COALITION. A COMMUNITY MEETING FOR THE HOSPITAL'S CHNA WAS HOSTED BY THE KINGFISHER COMMUNITY COLLABORATIVE ON JANUARY 14, 2019. STEPS TAKEN TO CONDUCT A CHNA FOR MERCY HOSPITAL, KINGFISHER BEGAN WITH A DESCRIPTION OF THE HOSPITAL'S MEDICAL SERVICE AREA, INCLUDING A DEMOGRAPHIC ANALYSIS AND A SUMMARY OF THE COMMUNITY MEETING. THE CHNA PROCESS IS FACILITATED BY STAFF OF THE OKLAHOMA OFFICE OF RURAL HEALTH AND MERCY HOSPITAL, KINGFISHER. COMMUNITY MEMBERS PRESENT REPRESENTED A CROSS SECTION OF THE COMMUNITY. THESE INDIVIDUALS WORK WITH DIVERSE, LOW-INCOME, AND UNDERSERVED POPULATIONS. THEY PROVIDE GREAT INSIGHT INTO THE NEEDS OF THE COMMUNITY. A SURVEY WAS DESIGNED TO GAUGE HOSPITAL USAGE, SATISFACTION, AND COMMUNITY HEALTH NEEDS FROM JANUARY 14 THROUGH MARCH 11, 2019. A TOTAL OF 152 SURVEYS WERE COMPLETED. OF THOSE SURVEYS, 148 WERE ELECTRONIC RESPONSES. |
| PART VI, LINE 3: | MERCY INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNTS IS PLACED FOR REVIEW. IN ADDITION, PATIENT HAVE SIGNAGE ABOUT THE POLICY AT THE ACCESS POINTS, AND ALL STAFF WORKING WITH THE PATIENT AT POINT OF SERVICE, SCHEDULING, CUSTOMER SERVICE, AND EVEN THROUGH THE MEDICAID ELIGIBILITY SCREENING, HAVE THE MEANS TO SEND THE ACCOUNT FOR REVIEW. THERE IS THE PLAIN LANGUAGE SUMMARY THAT IS BEING PROVIDED TO ALL WHOM EXPRESS HARDSHIPWHEN PRESENTING IN THE FACILITIES. IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS (BILLING) MESSAGING TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL. |
| PART VI, LINE 4: | THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL KINGFISHER INCLUDES KINGFISHER COUNTY, OKLAHOMA. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND THE OK DEPARTMENT OF HEALTH 2018-2019 ANALYTICS. THE AREA'S POPULATION IS 17,466. THE MEDIAN HOUSEHOLD INCOME IS $75,000. 41.8% OF THE POPULATION IS 45 AND OLDER. 88% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 39. |
| PART VI, LINE 5: | PROMOTION OF COMMUNITY HEALTH ERCY PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. MERCY IS A CATHOLIC HEALTH CARE CORPORATION THAT, PURSUANT TO THE ORGANIZATIONAL CORE BELIEF, THAT HEALTH CARE SERVICES ARE A VITAL AND INTEGRAL PART OF THE CHURCH'S HEALING MISSION, ENGAGES IN A MINISTRY WHICH PROVIDES GENERAL ACUTE CARE, AMBULATORY, LONG-TERM AND HOME CARE HEALTH SERVICES TO INDIVIDUALS AND FAMILIES IN ITS COMMUNITIES. MERCY OFFERS SERVICES AND PROGRAM WHICH FURTHER HEALTH PROMOTION, MAINTENANCE AND CARE TO THE COMMUNITY. PROGRAMS PROVIDED TO MEET THE COMMUNITY INCLUDE SUPPORT GROUPS, OUTREACH EVENTS, BLOOD DRIVES, ETC.MERCY IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS FROM A VARIETY OF SECTORS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARE SERVED BY MERCY.SURPLUS FUND AND UNRESTRICTED ASSETS HELD ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES. |
| PART VI, LINE 6: | AFFILIATED HEALTH CARE SYSTEMTHE FILING ORGANIZATION IS PART OF MERCY HEALTH ("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 ARKANSAS, LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2021, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 5 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPTIALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2021, MERCY HAD MORE THAN 10.9 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,300 EMPLOYED PHYSICIANS, AND APPROXIMATELY 43,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES. 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: FINANCE (INCLUDING TREASURY, FINANCIAL ACCOUNTING AND REPORTING, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTS PAYABLE AND PAYROLL OPERATIONS, ANALYTICS AND DECISION SUPPORT); ENVIRONMENTAL SERVICES SUPPORT; CLINICAL INTEGRATION; CARE MANAGEMENT; CLINICAL PERFORMANCE ACCELERATION; CLINICAL ENGINEERING; CLINICAL QUALITY MANAGEMENT; COMPLIANCE; GRANTS AND RESEARCH SERVICES; LEGAL AND COMPLIANCE COUNSEL; MARKETING AND COMMUNICATIONS; PLANNING, DESIGN AND CONSTRUCTION; PRODUCT DEVELOPMENT INFORMATICS; REAL ESTATE; SUPPLY CHAIN MANAGEMENT; MANAGED CARE STRATEGY SUPPORT; HUMAN RESOURCES (INCLUDING COMPENSATION, BENEFITS AND RECRUITING); MISSION SERVICES AND ETHICS; PHILANTHROPY SUPPORT; INFORMATION TECHNOLOGY; AND, COMMUNITY RELATIONS. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OK |
| COVID-19 | PLEASE SEE SCHEDULE O FOR INFORMATION RELATED TO COVID-19. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | FREE MEDICAL CARE FOR COMPASSION CLINIC | GrantTypeTxt |
| Recipient | 292 | RecipientCnt |
| Cash Grant | $127,577 | CashGrantAmt |
| Valuation Method Used | COST | ValuationMethodUsedDesc |
| Non Cash Assistance | FREE MEDICAL CARE | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS ARE SOMETIMES MADE TO ORGANIZATIONS WHICH HAVE AN ESTABLISHED HISTORY OF PROVIDING HEALTH CARE SUPPORT AND\OR COMMUNITY BENEFIT. IF NECESSARY, PERIODIC REPORTS ARE PROVIDED TO US. GRANTS ARE MADE TO RELATED ORGANIZATIONS, WHICH PROVIDE REPORTING ON THE USE OF THE FUNDS AND WORK CLOSELY WITH OUR ORGANIZATION. THE ORGANIZATION USES AN APPROVAL PROCESS, WHEN APPLICABLE, TO DETERMINE WHICH INDIVIDUALS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE INDIVIDUALS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GEBHART JIM | ||||||||||||||
| PRESIDENT, MERCY HOSPITAL OKLAHOMA C | $0 | $515,926 | $0 | $766,982 | $0 | $978,336 | $0 | $74,813 | $0 | $11,232 | $0 | $2,347,289 | $0 | $543,897 |
| VITIELLO JONATHAN | ||||||||||||||
| FORMER OFFICER | $0 | $246,208 | $0 | $770,882 | $0 | $975,423 | $0 | $86,998 | $0 | $6,663 | $0 | $2,086,174 | $0 | $441,629 |
| SMALLEY DIANA L | ||||||||||||||
| FORMER OFFICER | $0 | $407,399 | $0 | $400,221 | $0 | $632,419 | $0 | $16,676 | $0 | $6,633 | $0 | $1,463,348 | $0 | $100,221 |
| LE BICH-VI | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $354,608 | $0 | $155,045 | $0 | $130,599 | $0 | $16,451 | $0 | $15,322 | $0 | $672,025 | $0 | $0 |
| RAJU GARY | ||||||||||||||
| FORMER OFFICER | $0 | $99,783 | $0 | $159,624 | $0 | $308,570 | $0 | $42,431 | $0 | $5,723 | $0 | $616,131 | $0 | $102,659 |
| ENLOE TRACY | ||||||||||||||
| FORMER OFFICER | $0 | $321,136 | $0 | $64,894 | $0 | $20,040 | $0 | $42,686 | $0 | $15,106 | $0 | $463,862 | $0 | $0 |
| SMITH CHAD | ||||||||||||||
| VP - MEDICAL AFFAIRS & BOARD MEMBER | $0 | $331,038 | $0 | $18,396 | $0 | $19,861 | $0 | $9,800 | $0 | $15,106 | $0 | $394,201 | $0 | $0 |
| PINAROC LYNN | ||||||||||||||
| VP-FINANCE & BOARD MEMBER | $0 | $153,055 | $0 | $9,716 | $0 | $45,916 | $0 | $9,489 | $0 | $6,066 | $0 | $224,242 | $0 | $0 |
| GRANTZ JAMI W | ||||||||||||||
| ADVANCED PRACTICE RN - CERT NP | $0 | $176,676 | $0 | $3,640 | $0 | $19,370 | $0 | $8,682 | $0 | $14,784 | $0 | $223,152 | $0 | $0 |
| HAHNE CHRISTOPHER | ||||||||||||||
| VP FINANCE | $0 | $163,975 | $0 | $6,008 | $0 | $26,638 | $0 | $9,200 | $0 | $15,172 | $0 | $220,993 | $0 | $0 |
| HENDERSON TODD | ||||||||||||||
| MANAGER-SURGERY, CRNA | $0 | $184,152 | $0 | $640 | $0 | $18,665 | $0 | $7,427 | $0 | $6,048 | $0 | $216,932 | $0 | $0 |
| HARRIS DANIEL | ||||||||||||||
| PHYSICIAN ASSISTANT | $0 | $159,658 | $0 | $3,640 | $0 | $31,569 | $0 | $7,378 | $0 | $14,570 | $0 | $216,815 | $0 | $0 |
| STITT BOBBY J | ||||||||||||||
| PRESIDENT & ADMINISTRATOR | $0 | $173,877 | $0 | $5,942 | $0 | $13,493 | $0 | $6,182 | $0 | $15,163 | $0 | $214,657 | $0 | $0 |
| BERTUS MATTHEW | ||||||||||||||
| PHYSICIAN ASSISTANT | $0 | $186,926 | $0 | $640 | $0 | $11,862 | $0 | $0 | $0 | $5,025 | $0 | $204,453 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION: JONATHAN VITIELLO $403,390; DIANA SMALLEY $393,851; GARY RAJU $206,823. PART I, LINE 4B: MERCY HEALTH, THE ULTIMATE PARENT COMPANY, OFFERS A SUPPLEMENTAL RETIREMENT PLAN TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON VESTING DATE 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 FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN. DIANA SMALLEY; JONATHAN VITIELLO; BICH-VI LE; JIM GEBHART; TRACY ENLOE; GARY RAJU THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). THE AMOUNTS REPORTED FOR JIM GEBHART, JONATHAN VITIELLO, GARY RAJU, AND DIANA SMALLEY IN COLUMN (F) ARE EITHER INCLUDED IN B(I) BASE COMPENSATION, B(II) AS BONUS AND INCENTIVE COMPENSATION, OR B(III) AS OTHER REPORTABLE COMPENSATION. THESE AMOUNTS ARE A PAYOUT OF THE SUPPLEMENTAL RETIREMENT PLAN AND EXECUTIVE RETENTION PLAN AND WERE INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990. |
| PART I, LINE 3 | MERCY HEALTH (PARENT COMPANY) IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THE FOLLOWING METHODS WERE USED BY MERCY HEALTH TO ESTABLISH COMPENSATION: -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAYLA VOTH | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF BOARD MEMBER (JOE VOTH) | RelationshipDescriptionTxt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AT ANY TIME AT THE MEMBER'S DISCRETION. |
| FORM 990, PART VI, SECTION A, LINE 7B | MERCY HEALTH OKLAHOMA COMMUNITIES HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL ORGANIZATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND TO AMEND THE ORGANIZATIONAL DOCUMENTS OF ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CEO OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AFTER CONSULTATION WITH THE SYSTEM; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, BUSINESS PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPROVE OR AMEND THE CONSOLIDATED OPERATING, CAPITAL AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND CHANGES IN BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -TO AUTHORIZE AND APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF ANY AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS 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; AND -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, SUBJECT TO APPROVAL BY THE BOARD AS REQUIRED PURSUANT TO THE OKLAHOMA NONPROFIT CORPORATION ACT. -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | 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. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2021. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S CORPORATE COMPLIANCE DEPARTMENT. THE QUESTIONNAIRES ARE REVIEWED WITH LEADERSHIP AT THE LOCAL LEVEL AND POTENTIAL CONFLICTS DISCUSSED AND RESOLVED. THE CONFLICTS AND THEIR RESPECTIVE RESOLUTIONS ARE SHARED AT THE MERCY LEVEL WITH A TEAM INCLUDING MERCY'S CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER AND OTHER MEMBERS OF FINANCE, LEGAL AND HR. SUMMARY RESULTS ARE REVIEWED WITH MERCY'S STEWARDSHIP COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15B | FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION 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 COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. 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. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY. |
| FORM 990, PART VII, SECTION A, COLUMN B | AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII IS THE AVERAGE HOURS THE LISTED PERSON WORKED OR DEVOTED PER WEEK WHILE EMPLOYED OR ASSOCIATED WITH THE FILING ORGANIZATION AND RELATED ORGANIZATIONS (IF APPLICABLE). |
| FORM 990, PART XI, LINE 9: | NET TRANSFERS TO/FROM AFFILIATES -140,091. ROUNDING 7. |
| PART XII, LINE 2 | AUDITED FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2021 (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 STEWARDSHIP COMMITTEE OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. |
| PART XII, QUESTION 3A AND 3B | SINGLE AUDIT ACT AND 2 CFR 200 AUDIT MERCY HEALTH UNDERGOES A CONSOLIDATED 2 CFR 200 AUDIT EVERY YEAR. THIS AUDIT IS UNDERWAY FOR THE FISCAL YEAR ENDING JUNE 30, 2021 AND WILL BE COMPLETED BY SEPTEMBER 30, 2022. EACH ENTITY THAT RECEIVES FEDERAL FUNDS DURING THE YEAR IS INCLUDED ON THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) AND IS ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. IF THE FILING ENTITY RECEIVED FEDERAL FUNDS DURING THE YEAR ENDED JUNE 30, 2021, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. |
| FORM 990, PART V, LINE 2A | W-3 FILING SALARIES AND WAGES WITH LIMITED EXCEPTIONS, THE SALARIES AND WAGES REPORTED ON FORM 990, PART IX, LINE 7 REPRESENT AN ALLOCATION OF SALARIES AND WAGES FROM A RELATED ORGANIZATION. MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, ALL REQUIRED PAYROLL FILING FOR THESE EMPLOYEES (INCLUDING W-2 AND W-3'S) IS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES,EIN 20-2553101. |
| FORM 990, SCHEDULE R, PART II | MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883. |
| FORM 990, SCHEDULE R, PART V | SYSTEM LIMITATIONS LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY 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 P AND Q. |
| FORM 990, PART V, LINE 1A | INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. |
| COVID-19 | EARLY IN 2020, THE MERCY HEALTH SYSTEM WAS CALLED TO SERVE AS THE COVID-19 PANDEMIC SWEPT ACROSS THE WORLD. DURING FY 2021, IT CONTINUED TO BE A DIFFICULT TIME FOR ALL HEALTHCARE PROVIDERS. ALL MERCY FACILITIES ADJUSTED OPERATIONS FOR THE IMPACTS OF THE PANDEMIC WHICH MEANT MAKING CHANGES TO PATIENT CARE AREAS AND CANCELLING MOST OF OUR OUTPATIENT PROCEDURES FOR PERIODS OF TIME. IN ADDITION, MERCY FOUNDATIONS AND OUTREACH MINISTRIES EXPERIENCED LIMITATIONS IN FUNDRAISING FOR PROGRAM AND CAPITAL SUPPORT EFFORTS THAT ASSIST THE UNDERSERVED IN OUR COMMUNITIES. MERCY'S TOTAL SYSTEM NET PATIENT REVENUES WERE REDUCED DURING THE YEAR DUE TO SURGES IN THE COMMUNITIES WE SERVE. MERCY DID RECEIVE FUNDING FROM THE CORONAVIRUS AID RELIEF AND ECONOMIC SECURITY ACT ("CARES ACT"). MERCY RECEIVED CARES ACT FUNDING ACROSS VARIOUS ENTITIES FOR THE YEAR ENDED JUNE 30, 2021 AND RECOGNIZED A PORTION OF THIS FUNDING IN OTHER OPERATING REVENUE. THESE FUNDS HELPED TO OFFSET REVENUE LOSSES AND ADDITIONAL EXPENSES INCURRED DUE TO THE PANDEMIC; HOWEVER, THESE FUNDS FELL SHORT OF THE SYSTEM LOSSES EXPERIENCED SINCE THE START OF THE PANDEMIC. THE IMPACT OF COVID-19 WAS SIGNIFICANT TO OUR COMMUNITIES AND COWORKERS AS UNEMPLOYMENT RATES SOARED AND MERCY ACTED QUICKLY TO PROVIDE CONTINUOUS CARE TO PATIENTS AND THE COMMUNITY. MERCY CONTINUES TO MONITOR THE IMPACTS OF THE PANDEMIC BOTH TO THE HEALTH SYSTEM AND THE COMMUNITIES SERVED AS WE CONTINUE TO PROVIDE ASSISTANCE AND MAINTAIN ACCESS TO CARE WITHIN OUR COMMUNITIES. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (71 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CASA DE MISERICORDIA | |||||||||||
| 1000 MIER ST | LAREDO | TX | 78040 | 742912461 | WOMEN'S DOMESTIC VIOLENCE SHELTER | TX | 501C3 | 7 | MERCY MINISTRIES OF LAREDO | Yes (1) | |
| MCAULEY PORTFOLIO MGMT CO | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 261708048 | PORTFOLIO MANAGEMENT | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY ACO CLINICAL SERVICES INC | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 464504901 | VIRTUAL CARE CENTER | MO | 501C3 | 3 | MERCY HEALTH | Yes (1) | |
| MERCY CLINIC EAST COMMUNITIES | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 431771217 | PHYSICIAN GROUP | MO | 501C3 | 9 | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY CLINIC FORT SMITH COMM | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 261318597 | PHYSICIAN CLINIC | AR | 501C3 | 9 | MERCY HEALTH FORT SMITH COMM | Yes (1) | |
| MERCY CLINIC OKLAHOMA COMM | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 270473057 | PHYSICIAN GROUP | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY CLINIC SPRINGFIELD COMM | |||||||||||
| 1965 FREMONT STREET SUITE 2950 | SPRINGFIELD | MO | 65804 | 431560263 | PHYSICIAN GROUP | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY FAMILY CENTER | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 721069468 | FAMILY COUNSELING SERVICES | LA | 501C3 | 7 | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 431423050 | CORPORATE OFFICE | MO | 501C3 | 1 | 0 | N/A | |
| MERCY HEALTH EAST COMMUNITIES | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 431718408 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH FORT SMITH COMM | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 261318515 | HOLDING COMPANY | AR | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH FOUNDATION | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 200901499 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH FOUNDATION ADA | |||||||||||
| 430 N MONTE VISTA STREET | ADA | OK | 74820 | 463596274 | FOUNDATION | OK | 501C3 | 11-I | MERCY HOSPITAL ADA | Yes (1) | |
| MERCY HEALTH FOUNDATION ARDMORE | |||||||||||
| 1011 14TH AVENUE NW | ARDMORE | OK | 73401 | 710962525 | FOUNDATION | OK | 501C3 | 11-I | MERCY HOSPITAL ARDMORE | Yes (1) | |
| MERCY HEALTH FOUNDATION BERRYVILLE | |||||||||||
| 214 CARTER STREET | BERRYVILLE | AR | 72616 | 710759301 | FOUNDATION | AR | 501C3 | 11-I | MERCY HOSPITAL BERRYVILLE | Yes (1) | |
| MERCY HEALTH FOUNDATION FT SCOTT | |||||||||||
| 401 WOODLAND HILLS BLVD | FORT SCOTT | KS | 66701 | 481077073 | FOUNDATION | KS | 501C3 | 11-III | MERCY KANSAS COMMUNITIES INC | Yes (1) | |
| MERCY HEALTH FOUNDATION FORT SMITH | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 237330425 | FOUNDATION | AR | 501C3 | 7 | MERCY HOSPITAL FORT SMITH | Yes (1) | |
| MERCY HEALTH FOUNDATION LEBANON | |||||||||||
| 100 HOSPITAL DRIVE | LEBANON | MO | 65536 | 822514567 | FOUNDATION | MO | 501C3 | 11-II | MERCY HOSPITAL LEBANON | Yes (1) | |
| MERCY HEALTH FOUNDATION JEFFERSON | |||||||||||
| 1400 US HIGHWAY 61 SOUTH | FESTUS | MO | 63028 | 462797051 | FOUNDATION | MO | 501C3 | 11-II | MERCY HOSPITAL JEFFERSON | Yes (1) | |
| MERCY HEALTH FOUNDATION JOPLIN | |||||||||||
| 100 MERCY WAY | JOPLIN | MO | 64804 | 270906136 | FOUNDATION | MO | 501C3 | 11-I | MERCY HEALTH SW MOKS COMM | Yes (1) | |
| MERCY HEALTH FOUNDATION LINCOLN | |||||||||||
| 1000 EAST CHERRY STREET | TROY | MO | 63379 | 811477159 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY HEALTH FOUNDATION NW ARK | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72858 | 710601687 | FOUNDATION | AR | 501C3 | 11-III | MERCY HOSPITAL ROGERS | Yes (1) | |
| MERCY HEALTH FOUNDATION OF OK | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 454732301 | FOUNDATION | OK | 501C3 | 11-I | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY HEALTH FOUNDATION OK CITY | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 463184231 | FOUNDATION | OK | 501C3 | 11-I | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY HEALTH FOUNDATION SPRINGFIELD | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 320195818 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY HEALTH FOUNDATION ST FRANCIS | |||||||||||
| 100 W HIGHWAY 60 | MOUNTAIN VIEW | MO | 65548 | 431873914 | FOUNDATION | MO | 501C3 | 11-I | MERCY ST FRANCIS HOSPITAL | Yes (1) | |
| MERCY HEALTH FOUNDATION STL | |||||||||||
| 615 SOUTH NEW BALLAS ROAD | ST LOUIS | MO | 63141 | 562410020 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY HEALTH FOUNDATION WASHINGTON | |||||||||||
| 901 E FIFTH STREET | WASHINGTON | MO | 63090 | 562410022 | FOUNDATION | MO | 501C3 | 11-II | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY HEALTH NW ARK COMMUNITIES | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72758 | 621684203 | PHYSICIAN GROUP | AR | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH OK COMMUNITIES | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731453048 | HEALTH SYSTEM | OK | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH PLANS OF MISSOURIINC | |||||||||||
| 3265 S NATIONAL AVENUE | SPRINGFIELD | MO | 65807 | 320481419 | HMO | MO | 501C4 | MERCY HEALTH | Yes (1) | ||
| MERCY HEALTH PLANSINC | |||||||||||
| 3265 S NATIONAL AVENUE | SPRINGFIELD | MO | 65807 | 320486150 | PPO | MO | 501C4 | MERCY HEALTH PLANS OF MISSOURIINC | Yes (1) | ||
| MERCY HEALTH SW MOKS COMM | |||||||||||
| 100 MERCY WAY | JOPLIN | MO | 64804 | 300584463 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH SPRINGFIELD COMM | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 431856028 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MERCY HOSPITAL ADA INC | |||||||||||
| 430 N MONTE VISTA STREET | ADA | OK | 74820 | 462288155 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL ARDMORE | |||||||||||
| 1011 14TH AVENUE NW | ARDMORE | OK | 73401 | 731500629 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL AURORA | |||||||||||
| 500 PORTER AVENUE | AURORA | MO | 65605 | 431936696 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY HOSPITAL BERRYVILLE | |||||||||||
| 214 CARTER STREET | BERRYVILLE | AR | 72616 | 710759299 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH NW ARK COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL BOONEVILLE | |||||||||||
| 880 WEST MAIN STREET | BOONEVILLE | AR | 72927 | 463851119 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | Yes (1) | |
| MERCY HOSPITAL CARTHAGE | |||||||||||
| 3125 DR RUSSELL SMITH WAY | CARTHAGE | MO | 64836 | 453808607 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | Yes (1) | |
| MERCY HOSPITAL CASSVILLE | |||||||||||
| 94 MAIN STREET | CASSVILLE | MO | 65625 | 431936699 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY HOSPITAL COLUMBUS | |||||||||||
| 220 PENNSYLVANIA AVENUE | COLUMBUS | KS | 66725 | 270842031 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | Yes (1) | |
| MERCY HOSPITAL EL RENO | |||||||||||
| 2115 PARKVIEW DRIVE | EL RENO | OK | 73036 | 272716065 | HOSPITAL - INACTIVE | OK | 501C3 | 3 | MERCY HOSPITAL OKLAHOMA CITY | Yes (1) | |
| MERCY HOSPITAL FORT SMITH | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 710240352 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH FORT SMITH COMM | Yes (1) | |
| MERCY HOSPITAL HEALDTON INC | |||||||||||
| 3462 HOSPITAL RD | HEALDTON | OK | 73438 | 263173902 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL ARDMORE INC | Yes (1) | |
| MERCY HOSPITAL JEFFERSON | |||||||||||
| 1400 HIGHWAY 61 SOUTH | FESTUS | MO | 63028 | 430687077 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL JOPLIN | |||||||||||
| 100 MERCY WAY | JOPLIN | MO | 64804 | 270814858 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | Yes (1) | |
| MERCY HOSPITAL LEBANON | |||||||||||
| 100 HOSPITAL DRIVE | LEBANON | MO | 65536 | 431767432 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY HOSPITAL LINCOLN | |||||||||||
| 1000 EAST CHERRY STREET | TROY | MO | 63379 | 472219204 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL LOGAN COUNTY INC | |||||||||||
| 200 SOUTH ACADEMY | GUTHRIE | OK | 73044 | 452998842 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL OKLAHOMA CITY | Yes (1) | |
| MERCY HOSPITAL OKLAHOMA CITY | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 730579285 | HOSPITAL | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL OZARK | |||||||||||
| 801 W RIVER STREET | OZARK | AR | 72949 | 710689680 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | Yes (1) | |
| MERCY HOSPITAL PARIS | |||||||||||
| 500 E ACADEMY | PARIS | AR | 72855 | 710655753 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | Yes (1) | |
| MERCY HOSPITAL ROGERS | |||||||||||
| 2710 RIFE MEDICAL LN | ROGERS | AR | 72758 | 710294390 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH NW ARK COMMUNITIES | Yes (1) | |
| MERCY HOSPITAL SPRINGFIELD | |||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 440552485 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MERCY HOSPITAL TISHOMINGO | |||||||||||
| 1000 SOUTH BYRD | TISHOMINGO | OK | 73460 | 274433830 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL ADA | Yes (1) | |
| MERCY HOSPITAL WALDRON | |||||||||||
| 1341 W 6TH STREET | WALDRON | AR | 72958 | 710557895 | HOSPITAL | AR | 501C3 | 3 | MERCY HOSPITAL FORT SMITH | Yes (1) | |
| MERCY HOSPITAL WATONGA INC | |||||||||||
| 500 CLARENCE NASH BLVD | WATONGA | OK | 73772 | 455199762 | HOSPITAL | OK | 501C3 | 3 | MERCY HOSPITAL OKLAHOMA CITY | Yes (1) | |
| MERCY HOSPITALS EAST COMM | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 430653493 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY KANSAS COMMUNITIES INC | |||||||||||
| 401 WOODLAND HILLS BLVD | FT SCOTT | KS | 66701 | 480956045 | HOSPITAL | KS | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | Yes (1) | |
| MERCY MINISTRIES OF LAREDO | |||||||||||
| 2500 ZACATECAS | LAREDO | TX | 78043 | 200198462 | OUTREACH | TX | 501C3 | 7 | MERCY HEALTH | Yes (1) | |
| MERCY RESEARCH | |||||||||||
| 524 NORTH BOONEVILLE AVENUE | SPRINGFIELD | MO | 65802 | 870796305 | RESEARCH | MO | 501C3 | 4 | MERCY HEALTH | Yes (1) | |
| MERCY ST FRANCIS HOSPITAL | |||||||||||
| 100 W HIGHWAY 60 | MOUNTAIN VIEW | MO | 65548 | 440607149 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | Yes (1) | |
| MHM SUPPORT SERVICES | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 202553101 | CENTRALIZED HEALTH SYSTEM FUNCTIONS | MO | 501C3 | 11-II | MERCY HEALTH | Yes (1) | |
| MISSION CLINICAL SERVICES | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 134239691 | CHILD ADVOCACY CENTER | AR | 501C3 | 9 | MERCY HEALTH | Yes (1) | |
| MERCY HEALTH FOUNDATION SOUTH | |||||||||||
| 10010 KENNERLY ROAD | ST LOUIS | MO | 63128 | 261516789 | FOUNDATION | MO | 501C3 | 11-II | MERCY HOSPITAL SOUTH | Yes (1) | |
| MERCY HOSPITAL SOUTH | |||||||||||
| 10010 KENNERLY ROAD | ST LOUIS | MO | 63128 | 430980256 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| ST ANTHONY'S PHYSICIAN ORGANIZATION | |||||||||||
| 10010 KENNERLY ROAD | ST LOUIS | MO | 63128 | 431784536 | HEALTH CARE | MO | 501C3 | 3 | MERCY HOSPITAL SOUTH | Yes (1) | |
| ST MARYS HOSP ENID OK | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 730614655 | INACTIVE | OK | 501C3 | 3 | MERCY HEALTH OK COMMUNITIES | Yes (1) | |
| UNITY AMBULATORY CARE | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 431861745 | INACTIVE | MO | 501C3 | 11-III | MERCY HEALTH EAST COMMUNITIES | Yes (1) | |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS | |||||||||||
| 1619 W 7TH STREET | GALENA | KS | 66739 | 843730625 | HOSPITAL | KS | 501C3 | 3 | MERCY HEALTH SW MOKS COMM | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PLAZA SURGERY SERVICES COMPANY LLC | ||||||||||
| 12700 SOUTHFORK ROAD | ST LOUIS | MO | 63128 | 204709312 | INACTIVE | MO | MERCY HOSPITAL SOUTH | N/A | 0 | 0 |
| MERCY AMBULATORY SURGERY CENTER LLC | ||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 710827721 | AMBULATORY SURGERY CENTER | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 |
| FORT SMITH EMERGENCY MEDICAL SERVICES | ||||||||||
| 1701 SOUTH GREENWOOD | FORT SMITH | AR | 72901 | 710416615 | EMERGENCY MEDICAL SERVICES | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 |
| ST EDWARD MERCY MC M-P OFFICE BLDG | ||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72903 | 710554050 | OFFICE BUILDING | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 |
| PLATINUM CPS HOLDINGS LLC | ||||||||||
| 14528 S OUTER FORTY SUITE 100 | CHESTERFIELD | MO | 63017 | HOLDING COMPANY | MO | MERCY MANAGED CARE CORPMERCY HEALTH | N/A | 0 | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FRONTENAC PROPERTIES INC | ||||||||||||||
| 14528 S OUTER FORTY SUITE 100 | CHESTERFIELD | MO | 63017 | 521914421 | HOLDS ANCILLARY ASSETS & OWNS AIRCRAFT | DE | MERCY HEALTH | C | 0 | |||||
| INVENO HEALTH INC | ||||||||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | 264509571 | TECHNOLOGY TRANSFER COMPANY | MO | MERCY HEALTH SPRINGFIELD COMM | C | 0 | |||||
| UNITY SUPPORT SERVICES INC | ||||||||||||||
| 645 MARYVILLE CENTRE DRIVE SUITE 10 | ST LOUIS | MO | 63141 | 431797042 | INACTIVE | MO | MERCY HEALTH EAST COMMUNITIES | C | 0 | |||||
| UH L CORP INC | ||||||||||||||
| 645 MARYVILLE CENTRE DRIVE SUITE 10 | ST LOUIS | MO | 63141 | 742499535 | HOLDING COMPANY | MO | MERCY HEALTH SERVICES LLC | C | 0 | |||||
| MERCY HEALTH CENTER CONDOMINIUM INC | ||||||||||||||
| 4300 W MEMORIAL RD | OKLAHOMA CITY | OK | 73120 | 680640970 | ADMINISTRATOR OF CERTAIN REAL PROPERTY AND IMPROVEMENTS | OK | MERCY HOSPITAL OKLAHOMA CITYINC | C | 0 | |||||
| MERCY MANAGED CARE CORPORATION | ||||||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731441665 | HOLDING COMPANY | OK | MERCY HEALTH | C | 0 | |||||
| MERCY COMMERCIAL SERVICES INC | ||||||||||||||
| 14528 SOUTH OUTER FORTY SUITE 100 | CHESTERFIELD | MO | 63017 | 464953543 | CORP PARENT OF VCC TAXABLE COMMERCIALIZ SVCS | OK | MHN INC AND MHNSR INC | C | 0 | |||||
| ST ANTHONY'S PHYSICIAN ORGANIZATION OF ILLINOIS | ||||||||||||||
| 10010 KENNERLY ROAD | ST LOUIS | MO | 63128 | 320457168 | HEALTH CARE | MO | MERCY HOSPITAL SOUTH | C | 0 | |||||
| MCAULEY INSURANCE COMPANY LTD | ||||||||||||||
| INACTIVE | MERCY HEALTH | C | 0 | AON HOUSE 30 WOODBOURNE AVENUE | PEMBROKE | BD | HM 08 | BD | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MERCY ACO CLINICAL SERVICES | ||
| Q | $94,507 | FMV |
| MERCY CLINIC OKLAHOMA COMMUNITIES INC | ||
| P | $43,878 | FMV |
| MERCY HEALTH EAST COMMUNITIES | ||
| Q | $16,024 | FMV |
| MERCY HEALTH FOUNDATION OKLAHOMA CITY | ||
| Q | $1,361 | FMV |
| MERCY HEALTH OKLAHOMA COMMUNITIES | ||
| Q | $248,492 | FMV |
| MERCY HEALTH SPRINGFIELD COMMUNITIES | ||
| Q | $2,847 | FMV |
| MERCY HOSPITAL ADA INC | ||
| Q | $0 | FMV |
| MERCY HOSPITAL OKLAHOMA CITY | ||
| Q | $192,454 | FMV |
| MERCY HOSPITALS EAST COMMUNITIES | ||
| Q | $2,328 | FMV |
| MHM SUPPORT SERVICES | ||
| Q | $4,003,381 | FMV |
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