2021-05-14T12:58:16-05:00 2020-06-30 264532849 Purk & Associates PC 1034 South Brentwood Blvd Ste 2000 Saint Louis MO 63117 990 2019-07-01 430687077 Mercy Hospital Jefferson MERC 6369331107 PO Box 350 Crystal City MO 63109 Daniel Eckenfels VP Finance 3145251000 2021-05-12 1 Douglas G Pleus CPA P00013488 3148844000 2021-05-11 2019 2022-09-23 18:48:47Z Carl E Eric Ammons PO Box 350 Crystal City MO 63109 227720255 0 X www.mercy.net X 1953 MO A community based integrated healthcare system consisting of a 251 bed licensed facility which provides a full range of diagnostic, preventative and healthcare services along with 24 hour emergency room care. 10 6 75 88 8454 5709 1636435 159486 215272707 225503892 359876 204496 1259909 1260069 218528927 227127943 81284 196967 0 0 90952340 95166215 0 0 0 112292350 124293711 203325974 219656893 15202953 7471050 268056878 252007792 5111480 5970311 262945398 246037481 X As the Sisters of Mercy before us, we bring to Life the healing ministry of Jesus through our compassionate care and exceptional service. 0 0 193372505 196967 225560259 Mercy Hospital Jefferson consists of a 321-bed licensed facility which provides a wide range of services. In fiscal year 2020, the following services were provided 42,842 patient days, 508 deliveries, 34,304 emergency visits, 1,406 inpatient surgeries and 3,201 outpatient surgery procedures. Mercy Hospital Jefferson is committed to providing educational programs to the community. Free seminars and presentations are provided on a wide variety of health issues which impact patients and their families. Free services are also offered to the community such as lipid, cholesterol, bone density and glucose screenings as well as hearing and memory screenings.It is the policy of Mercy Hospital Jefferson to provide uncompensated care to patients in need of financial assistance in accordance with the hospital's established guidelines and without regard to race, religion, sex, age, or national origin. The cost, net of any payment received (net cost), to MHJ of providing care to persons qualifying for Charity or Medicaid totaled ($6,991,272). Additionally, the net cost for services provided to elderly and disabled patients under the Medicare program totaled $2,802,375 in the year ended 6/30/20. These amounts do not include the cost of health activities and programs to support the community, health education programs and other community support activities. 193372505 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 75 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Daniel Eckenfels 3145251000 10010 Kennerly Road St Louis MO 63128 X Rehm MD Charles Chief Administrative Officer & Board Member 1.00 59.00 X 0 1128451 46358 Ammons Carl E Eric President, Mercy Hospital Jefferson 50.00 10.00 X 608592 0 94880 Iyer Karthik Physician & Board Member 1.00 59.00 X 0 633595 28729 Riordan MD Tracy Physician & Board Member 1.00 59.00 X 0 530096 42643 Blair Christine Board Member 1.00 0.00 X 0 0 0 Carron RSM Sr Judith Ann Board Member 1.00 1.00 X 0 0 0 Francis Richard Blake Board Member 1.00 0.00 X 0 0 0 King BA M Div Rev Jack Board Member 1.00 0.00 X 0 0 0 McCaffrey Dena Board Member 1.00 1.00 X 0 0 0 McKenna William Board Member 1.00 2.00 X 0 0 0 Johnston Jeffrey A President - East Communities 5.00 55.00 X 0 1272483 133378 Matejka Cheryl L Chief Financial Officer 1.00 59.00 X 0 731608 95846 Hannasch Susan Regional VP - General Counsel 4.00 56.00 X 0 731691 20345 Richmond Jacquelynn VP Deputy General Counsel 2.00 58.00 X 0 548092 82143 Eckenfels Daniel VP Finance 25.00 35.00 X 0 289079 28284 Meyer Michele VP Operations 60.00 0.00 X 275026 0 28685 Stover Benny J VP - Finance 45.00 15.00 X 253515 0 30708 Blankenship Stacy A CNO 60.00 0.00 X 228772 0 25819 Richards Donn Physician 60.00 0.00 X 368476 0 14049 Jaeger Kurt Physician 60.00 0.00 X 257534 0 19884 Robbins Jill L Registered Nurse 60.00 0.00 X 184047 0 17657 Kennon William D Director - Pharmacy Services 60.00 0.00 X 179759 0 21334 Porterhouse Cheri Registered Nurse 60.00 0.00 X 165396 0 11468 Bryson Jared Former Key Employee 0.00 60.00 X 0 199165 27228 2521117 6064260 769438 77 1 1 0 Acuity Anesthesiology LLC 1734 Clarkson Road Suite 147 Chesterfield MO 63017 Anesthesia Services 4172032 Musick Construction Co 254 Hanley Industrial Ct St Louis MO 63144 Construction 2838425 AMN Healthcare 12400 High Bluff Dr San Diego CA 92130 Staff contract wages 764555 MAYO MEDICAL LABS 200 SW FIRST STREET ROCHESTER MN 55805 Laboratory services 734950 Linen King PO Box 701683 Tulsa OK 74170 Laundry services 386794 16 148738 10748 159486 Net Patient Service Re 621110 218834152 218834152 Other Operating Revenu 621110 4648373 4648373 Rental From Affiliated 531120 2016229 2016229 Lab Services 621500 5014 5014 Capitation Bonus 621110 124 124 225503892 204296 204296 505494 557908 -52414 -52414 -52414 200 0 200 200 200 37844 34404 3440 3440 Cafe & vending 722210 1256116 1256116 52927 52927 1309043 227127943 225551805 8454 1408198 196967 196967 1595423 1595423 76413185 73264302 3148883 1552358 1483414 68944 10278334 9860401 417933 5326915 5111337 215578 35783 35783 7778687 7537068 241619 39479 34898 4581 3450999 2969319 481680 127232 127232 4877798 4876578 1220 231769 222194 9575 159 159 760 760 14302516 13278115 1024401 1028182 1028182 Drugs & medical expense 38856993 38729469 127524 Shared service fees 35285047 15525421 19759626 Bad debt expense 15912312 15912312 Repairs and maintenance 1297416 1272789 24627 1068579 346165 722414 219656893 193372505 26284388 0 4664789 4971216 23805412 18493091 3053089 2586011 110802 88124 239628166 73441841 178096491 166186325 53636770 53636770 4689525 6046255 268056878 252007792 4573956 0 126739 106853 25035 385750 5863458 5111480 5970311 X 262879678 245881872 65720 155609 262945398 246037481 268056878 252007792 X 7471050 -24378967 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 35783 0 0 0 35783 0 Part II-B, Line 1: The filing organization is a member of and pays dues to the following hospital associations: Catholic Hospital Association, American Hospital Association and the Missouri Hospital Association. For the year ended June 30, 2020 dues were $27,152, $16,344, and $60,210, respectively. Approximately 3.55% of the Catholic Hospital Association dues, 23.32% of the American Hospital Association dues, and 51.50% of Missouri Hospital Association dues were attributable to lobbying activities performed by this association. 4268409 4268409 172596246 29827944 142768302 10317 4987 5330 60456883 42049781 18407102 2296311 1559129 737182 166186325 Due to affiliates 5480165 Other Liabilities 383293 5863458 Part X, Line 2 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, 2020 OR 2019. 1 1 X 1 X 1 X 1 1 1 0 1 1 9380742 9380742 0.04600 5997197 5584869 412328 0.00200 15377939 5584869 9793070 0.04800 13 5613 449283 449283 0.00220 2 160 196583 196583 0.00100 2 370 9602506 8459361 1143145 0.00560 3 262 9335 9335 0.00000 20 6405 10257707 8459361 1798346 0.00880 20 6405 25635646 14044230 11591416 0.05680 541 8173 8173 0.00000 394 394 0.00000 541 8567 8567 0.00000 1 3685249 0 52877706 55680081 -2802375 X 1 1 1 1 Mercy Hospital Jefferson PO Box 350 Crystal City MO 63019 www.mercy.net/crystalcitymo 529-2 X X X Mercy Hospital Jefferson 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X https://www.mercy.net/communitybenefits X 1 19 1 https://www.mercy.net/communitybenefits 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X 1 X https://www.mercy.net/patients-visitors/billing/financial-assistance/ X https://www.mercy.net/patients-visitors/billing/financial-assistance/ X https://www.mercy.net/patients-visitors/billing/financial-assistance/ X X X X X X 1 X 0 X X X X X 1 X 0 0 Mercy Hospital Jefferson 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. Mercy Hospital Jefferson Part V, Section B, Line 5: When conducting its most recent CHNA and developing the Community Health Improvement Plan (CHIP), Mercy Hospital Jefferson worked with the Jefferson County Health Department (JCHD), Community Treatment, Inc. (COMTREA), Jefferson County Community Partnership (JCCP) and Jefferson Franklin Community Action Corporation (JFCAC) as a primary community partners. Methods of collecting and analyzing data and information included community focus groups, surveys, organization-specific data and published data. Below are the partnering agencies and the leaders who supported the combined efforts of a joint CHNA: - COMTREA- Sue Curfman - JCCP- Tracy Smith - JCHD- Kelley Vollmar - JFCAC- Loetta Blair - MHJ- Eric AmmonsCommunity focus groups were conducted to dialogue directly with local community members. There was a targeted effort to conduct focus groups in a variety of zip codes and locations so that all Jefferson County residents had the opportunity to attend. Community partners that assisted in data collection for community focus groups included Desoto School District, Jefferson County Library, Arnold Library, Desoto Library, Festus Library, Jefferson College, YMCA, Mapaville Fire Dept., JFCAC Head Start (Hematite and Desoto), Aging Ahead, and St. Andrew's UMC Desoto. The JCHD conducted a county-wide survey during the summer of 2017. Through collaboration with multiple organizations and agencies, surveys were distributed and over 3,500 were completed. The goal of the survey was to gain insight into the perceptions of county residents on the most pressing health issues, risk factors, barriers to care, and health services utilization. Mercy Hospital Jefferson Part V, Section B, Line 11: Based on the findings of its most recently conducted CHNA, Mercy Hospital Jefferson chose to address the following three significant health needs identified in Jefferson County: - Access to care- Mental health- Substance useThese needs are being addressed in the hospital's Community Health Improvement Plan (CHIP), which can be accessed here: https://www.mercy.net/content/dam/mercy/en/pdf/chip/mercy-jefferson-chip-2019.pdf. Some notable achievements in the past year include: - The Crisis Nursery Outreach Center continued to assist families on-site in order to help them navigate crises and create a stable environment for children to thrive. - Through a partnership with the Integrated Health Network, the Community Referral Coordinator (CRC) program at Mercy Hospital Jefferson provides patients without a medical home with assistance in finding a primary care or specialty provider, along with social service support, as appropriate. - In the 2019 calendar year, the CRC connected with 2,091 patients, which represents a 124% increase in encounters from 2018 - 98% of these patients were without a primary care home at the time of the initial encounter, with nearly half (47.5%) being self-pay or uninsured. - The CRC scheduled 902 appointments (referral rate of 40.9%) and maintained a 70% total kept appointment rate at year's end. This is among the highest appointment kept rate in the region and is an increase of 16.1% over 2018.- The Community Health Worker (CHW) program, which was piloted beginning in 2018, was adopted and expanded across Mercy hospitals in 2019. Mercy Hospital Jefferson hired one full-time CHW to connect uninsured and underinsured patients in the Emergency Department to community resources for social needs, address social determinants of health issues, and assist patients with applying for Medicaid, marketplace insurance, disability or hospital charity care. CHWs also collaborate closely with the Care Management team, social workers and Community Referral Coordinators to ensure continuity of care and improve quality of life. - In FY20, Mercy Hospital Jefferson's CHW served 240 patients through 385 encounters - 72% of patients were uninsured and 8% were either Medicaid or Medicaid pending - The CHW successfully achieved Medicaid for 3 patients and connected 50 patients to Mercy financial assistance- Mercy Clinic South Health Leads program, which serves the service area of Mercy Hospital Jefferson, screened nearly 10,000 for social determinants of health needs in 2019. - 13% screened positive for urgent needs including prescription assistance, food pantries, medical transportation and charity care - 495 needs successfully met or equipped for 390 clients- Mercy Hospital Jefferson continued several behavioral health programs; Hospital Community Linkages (HCL) Project, the Youth Emergency Room Enhancement Project which mirrors the Emergency Room Enhancement Project for adults. These programs focus on enhancing support for adult and youth high utilizers of ER with the primary goal of reducing preventable hospital contacts across the region by fostering engagement through support, intensive outreach and improving outcomes through connection to community. Mercy Hospital Jefferson also implemented the Engaging Patients in the Care Coordination Program also known as EPICC, this program provides intensive referral and linkage services by Recovery Coaches, peers with lived experience, to impact those who have overdosed on opioids to establish immediate linkages to substance use and medication assisted treatment services. Additional needs being addressed by the hospital include: - Community Health Improvement ServicesMercy Hospital Jefferson implements and participates in the following programs to work towards community health improvement: - Tobacco Cessation - Support Groups for bariatrics, diabetes, grief support, suicide, palliative care and stroke - Health Fairs, Presentations and Screenings, - Patient Benefit Advisors - Transportation Assistance Programs- Health Professions EducationHealth professions student education is offered at Mercy Hospital Jefferson in the areas of physical therapy, dietary, social work, pharmacy, nursing and other health professionals.- Financial and In-Kind ContributionsMercy Hospital Jefferson continues to support organizations through cash and in-kind donations. Those included but not limited to are through blood drives, the American Heart Association Walk, sponsorships for the Nationals Alliance for Mental Illness, suicide support services for the Hillsboro school district and Meals on Wheels.- Community Building Activities-Workforce & Economic DevelopmentIn an effort to aid in workforce and economic development, Mercy Hospital Jefferson participates in the Disability Inclusion Task Force, the Twin City Chamber of Commerce and the Farmington Chamber of Commerce.- Community Building Activities- Coalition Building & Board MembershipMercy Hospital Jefferson also participates in local coalition building and board membership for the following agencies: Alive and Well Jefferson County, Pony Bird Board of Directors, Jefferson Foundation Board, HEAL Healthcare Access Workgroup, St. Pius X Board, enterprise Advisory Board, Jefferson County Health Network, Integrated Health Network Board and the Jefferson County Drug Prevention Coalition Board.- COVID-19 Pandemic ResponseFY20 brought unprecedented challenges to our nation with the onset of the COVID-19 pandemic, and Mercy's communities were no exception. Recognizing the economic hardship, stress and emotional trauma that the pandemic brought to individuals and families, and understanding that it is often the most vulnerable that are impacted the most in times of crisis, Mercy was proactive in engaging community partners in COVID-19 response from the start of the pandemic. In particular, individuals experiencing homelessness may be at increased risk of infection and complication from the COVID-19 virus. Community Health Leaders across Mercy's hospitals worked with local partner agencies to develop comprehensive plans for safely discharging COVID-19 patients to a designated location if they do not require hospitalization but lack housing. At Mercy Hospital Jefferson, the Community Health Leader convened local social service and homeless serving agencies and healthcare providers to create a COVID-19 Homelessness Task Force for Jefferson and Franklin Counties. Under Mercy's leadership, this task force successfully implemented a plan that aligns local resources with regional protocols. Other community services offered by Mercy Hospital Jefferson during the COVID-19 pandemic include: - Community COVID-19 testing sites - Ongoing Logistical and Pastoral support for Skilled Nursing Facilities and Long-Term Care Facilities impacted by COVID-19 outbreaks - Local guidance and education for agencies, schools, law enforcement and fire departments through ongoing community meetings - Donated supplies, including hand sanitizer for COVID-19 kits distributed to homeless serving agencies, and food to local pantriesThe following need is not being addressed by the hospital:- Environmental: Air/Water Quality MHJ will continue its partnership with the Jefferson County Health Department (JCHD) and will collaborate with any environmental initiatives they develop. However, it was felt by Mercy's Community Health Council (CHC) that while continued attention to this issue was important, Mercy's focus remains on providing quality healthcare. Therefore, the issues of access, and the community's crisis with behavioral health and addiction should take precedence at this time. Mercy Hospital Jefferson 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. INDIVIDUALS WITH INCOMES GREATER THAN 200% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. 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. 7 1 - Mercy Services-Calvary Church Road 1500 Calvary Church Rd Festus MO 62028 Hospital based outpatient depts: Imaging services 2 - Mercy Hospice-Jefferson 5 Industrial Drive Festus MO 62028 Hospital based outpatient depts: Hospice services 3 - Mercy Home Health-Farmington 620 Maple Valley Dr Ste A Farmington MO 63640 Hospital based outpatient depts: Home health services 4 - Mercy Home Health-Jefferson 5 Industrial Drive Festus MO 62028 Hospital based outpatient depts: Home health services 5 - Mercy Hospice-Farmington 620 Maple Valley Dr Ste A Farmington MO 63640 Hospital based outpatient depts: Hospice services 6 - Mercy Clinic Imperial 1250 Main Street Imperial MO 63012 Hospital based outpatient depts: therapy services 7 - Mercy Desoto 702 N Main St DeSoto MO 63020 Hospital based outpatient depts: therapy services Part I, Line 7g: SUBSIDIZED HEALTH SERVICESThe physician clinics are included as a net amount (income less expenses) allocated by the Clinical Service line in the Indirect cost. Part I, Ln 7 Col(f): TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $219,656,893. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $15,912,312. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $203,744,581. 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: Mercy Hospital Jefferson's (MHJ) community building activities promote the health, wellness, and safety of the community it serves. Through active participation on community boards, neighborhood/community coalitions, and involvement in community-based events, Mercy builds partnerships to develop collaborative solutions to address community needs. Some of these community building partnerships and community engagement activities include: - Jefferson County Health Department- Jefferson County Growth Association- Jefferson College Board- Participation in the DeSoto, Hillsboro, Twin City Area, and Ste. Genevieve Chambers of Commerce activities- Kiwanis Club- YMCA Board- COMTREA (Community Treatment, Inc.)In addition, MHJ actively participates in several coalitions that align with the hospital's CHNA top health priority of Substance Abuse, including:- Jefferson County Drug Prevention Coalition- Alive and Well Jefferson County- Jefferson County Opioid Task Force- Jefferson County Drug Education Conference Planning CommitteeEfforts with these coalitions will continue as MHJ determined Substance Abuse to be a top health priority through the 2019-2021 CHNA cycle. Cash/In-Kind DonationsMercy provides cash and in-kind donations through the support of co-worker engagement and community service activities. These community building activities allow Mercy co-workers to look beyond the walls of the facilities in which they serve to better understand and address the needs of the community.During FY20, cash donations were given to organizations throughout the community that included:- Meals on Wheels- Kiwanis Club- Friends of St. Genevieve Hospital Memorial Hospital- Jefferson College Foundation- Pony Bird- AmeriCorps St. LouisA full description of our Community Building activities can be found at www.mercy.net/communitybenefits. 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. PATIENT ACCOUNTS THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTIONS POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED 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 AS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. Part III, Line 8: IT IS THE POSITION OF MERCY HOSPITAL JEFFERSON THAT 100% OF ANY SHORT FALL 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. 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. FOR A PORTION OF THE FISCAL YEAR, 7/1/19 - 10/13/19, MERCY UTILIZED THE SAME TOOL TO QUALIFY ACCOUNTS PER THE PRACTICE OF PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR BALANCES IN EXCESS OF $6,500. ALL ACCOUNT BALANCES RELATING TO ACCOUNTS IDENTIFIED BY THE HIGHER BALANCES WILL BE CONSIDERED AND FLAGGED FOR CHARITY IF THERE IS AN INABILITY TO PAY AFTER A RETURN FROM THE COLLECTION AGENCY AT APPROXIMATELY 120 DAYS. STARTING ON 10/14/19, MERCY IMPLEMENTED PRESUMPTIVE CHARITY FOR ALL BALANCES, IRREGARDLESS OF ACCOUNT BALANCE, WHERE THE EVALUATION TOOK PLACE PRIOR TO PATIENT BILLING AND ADDITIONALLY PRIOR TO BAD DEBT PLACEMENT. THE PRESUMPTIVE SCREENING WAS PER ENCOUNTER AND DID NOT PROMOTE ANY LOOK-BACK ADJUSTMENTS. PRIOR TO GO-LIVE ON 10/14/19, MERCY DID A ONE TIME EVALUTION OF ALL BAD DEBT ACCOUNTS BILLED IN THE LAST 240 DAYS THAT MET NEW PRESUMPTIVE CRITIERA AND ADJUSTED PER A TERMINAL PRESUMPTIVE ADJUSTMENT.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: Through collaborative efforts, Community Treatment, Inc. (dba COMTREA), Jefferson County Community Partnership (JCCP), the Jefferson County Health Department (JCHD), Jefferson Franklin Community Action Corps (JFCAC) And Mercy Hospital Jefferson (MHJ) conducted a community health needs assessment. Methods of collecting and analyzing data and information included community focus groups, surveys, organization-specific data and published data.Community focus groups were conducted to dialogue directly with local community members. There was a targeted effort to conduct focus groups in a variety of zip codes and locations so that all Jefferson County residents had the opportunity to attend. Community partners that assisted in data collection for community focus groups included Desoto School District, Jefferson County Library, Arnold Library, Desoto Library, Festus Library, Jefferson College, YMCA, Mapaville Fire Dept., JFCAC Head Start (Hematite and Desoto), Aging Ahead, and St. Andrew's UMC Desoto.The JCHD conducted a county-wide survey during the summer of 2017. Through collaboration with multiple organizations and agencies, surveys were distributed and over 3,500 were completed. The goal of the survey was to gain insight into the perceptions of county residents on the most pressing health issues, risk factors, barriers to care, and health services utilization. Each participating CHNA partner has an internal entity that guides the needs assessment process for their organization. A Community Health Council, led by Eric Ammons, President of Mercy Hospital Jefferson, guides the needs assessment process for MHJ (Appendix B). The council convenes quarterly and is accountable for ensuring that community benefit activities meet mission compliance and IRS guidelines. It consists of Mercy leaders from various departments, such as behavioral health, finance, care management, philanthropy, etc., and a hospital board member. The Council determines which health initiatives will be put forth in the hospital's three-year Community Health Improvement Plan (CHIP). Co-workers in Mercy's Community Health & Access Department served on the Council and were the primary leads of the 2019 CHNA. External sources of published data are as follows:- County Health Rankings 2018This resource provides county-level data that is updated annually by the University of Wisconsin-Population Health Institute and the Robert Wood Johnson Foundation. www.countyhealthrankings.org - Community CommonsThis resource provides thousands of meaningful data layers to allow mapping and reporting capabilities for exploring community health to foster positive change. The site is managed by Institute for People, Place and Possibility; the Center for Applied Research and Environmental Systems; and Community Initiatives. www.communitycommons.org - Missouri KIDS COUNTThis resource provides data about the children and families in the state of Missouri and focuses on the importance of community in improving the lives of children and families.https://mokidscount.org/missouri-kids-count-data-book-release/ - exploreMOhealth This resource was created in partnership between Missouri Foundation for Health and the MHA Health Institute. It provides data at a granular geographic level to inform targeted resource allocations for community health improvement initiatives.https://exploremohealth.org/ - Missouri Public Health Information Management System (MOPHIMS) - Community Data Profiles & Missouri Information for Community Assessment (MICA) - Environmental Health Public Tracking Program (EPHT)This resource, provided by Missouri Department of Health & Senior Services-Bureau of Health Information, includes some of the most comprehensive community health assessment planning tools available, such as community data profiles on 115 Missouri counties, thirty health indicators, and the capability to create customized tables.https://webapp01.dhss.mo.gov/MOPHIMS/MOPHIMSHome Prioritized Significant Community Health NeedsThe nominal group technique was used in the priority setting process. The Mercy Hospital Jefferson Community Health Council (CHC) was presented with the quantitative and qualitative community health data and members were asked to rank these health issues by level of concern and ability to collaborate on the issue to produce results. The strengths and services of MHJ along with the strategic plan were also considered. Upon review and discussion of the Primary and Secondary data gathered, the hospitals' Strategic Plans, and the resources available at the hospitals and in the communities, the following priorities were selected:Mercy Hospital St. Louis: - Access to Care- Mental Health- Substance UseThe Community Health Councils then created Community Health Improvement Plans (CHIP) for their hospital, identifying specific initiatives related to improving each of these health priorities. The CHIPs were designed with realistic, measurable, and attainable goals that align with the mission and strategy of the organizations. Mercy Hospital Jefferson also assesses the needs of the community through requests by local agencies. Mercy Hospital Jefferson's (MHJ) community building activities promote the health, wellness, and safety of the community it serves. Through active participation on community boards, neighborhood/community coalitions, and involvement in community-based events, Mercy builds partnerships to develop collaborative solutions to address community needs. Some of these community building partnerships and community engagement activities include:- Jefferson County Health Department- Jefferson County Growth Association- Jefferson College Board- Participation in the DeSoto, Hillsboro, Twin City Area, and Ste. Genevieve Chambers of Commerce activities- Kiwanis Club- YMCA Board- COMTREA (Community Treatment, Inc.)In addition, MHJ actively participates in several coalitions that align with the hospital's CHNA top health priorities of Substance Use and Mental Health, including:- Jefferson County Drug Prevention Coalition- Alive and Well Jefferson County- Jefferson County Opioid Task Force- Jefferson County Drug Education Conference Planning CommitteeCash/In-Kind DonationsMercy provides cash and in-kind donations through the support of co-worker engagement and community service activities. These community building activities allow Mercy co-workers to look beyond the walls of the facilities in which they serve to better understand and address the needs of the community.During FY20, cash donations were given to organizations throughout the community that included:- Meals on Wheels- Kiwanis Club- Friends of St. Genevieve Hospital Memorial Hospital- Jefferson College Foundation- Pony Bird- AmeriCorps St. LouisA full description of our Community Building activities can be found at www.mercy.net/communitybenefits. 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 hardship when 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 JEFFERSON INCLUDES 37 ZIP CODES ACROSS MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM 2019 IBM/WATSON'S DEMOGRAPHICS AND FY19 CLARIVATE ANALYTICS INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 306,523. 37% OF THE POPULATION'S AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 43% OF THE POPULATION IS 45 AND OLDER. 21% OF THE HOUSEHOLDS ARE ON MEDICARE, 13% ON MEDICAID, AND 9% UNINSURED. Part VI, Line 5: OPEN MEDICAL STAFF Medical staff membership and privileges are extended to eligible physicians, as defined by the Medical Staff Bylaws, for nearly all of our departments. Mercy Hospital Jefferson has exclusive contracts with physician groups for the following services: radiology, pathology, and anesthesia. This means that the majority of the physicians on staff are in categories that are open to eligible physicians in the community.Community Board FY20 Mercy Health East Communities FY20 Board MembersDon Arnold, M.D.Kelly Bain, M.D.Jon Bauer, PhDCraig Boyd, MDMatuskchka Lindo-BriggsApollo CareyJeff Ciaramita, M.D.Dennis GannonKatherine Glosenger, RSMSr. Michael Mary Gutowski, RSMWendy HenryJeff JohnstonSusan O'Connor, RSMCharles Rehm, M.D.George RomanKevin ShortSteven SwyersMaria Luisa Vera, RSMMercy Hospital Jefferson FY20 Board MembersEric Ammons Briccio Cadiz, MDSr. Judy Carron, RSMRick FrancisDr. Karthik Iyer, MDJeff JohnsonElaine GannonEric KnollDena McCafreyBill McKennaJacob Peyton, MDTracy Riordan, MDBassam Roukoz, MDUse of Surplus Funds Dan Eckenfels, CFO Surplus funds and unrestricted assets held by Mercy Hospital Jefferson 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. Examples include the following:- Expansion of primary care and specialty care physicians to the Mercy Hospital Jefferson service area with a focus to reach the underserved populations closer to their homes.- New primary care clinic locations were opened in Hillsboro and Barnhart offering services to these surrounding communities in Jefferson County.- Continued partnering with area education programs to help promote the training of critically needed services for the community including schools of nursing, radiology and pharmacy.- Opened a new Intensive Outpatient Therapy center in the current year which expanded the current adult offered services to include care for adolescent patients as well. Additional Community Health Initiatives/InformationCurrently not included through the reporting of Community Benefit or Community Building activities are:In keeping with MHJ's commitment to serve all members of the community, MHJ clinics (not under hospital EIN) provide:- Free care and/or subsidized care- Care to persons covered by governmental programs at below cost- Health activities and programs to support the community- Health education programs, and- A variety of broad community support activities.Many of the programs mentioned below are part of our current Community Health Impact Plan (CHIP). These are indicated by asterisks.ACCESS TO CAREHEALTH LEADS*Health Leads is a social enterprise that envisions a healthcare system that addresses all patients' basic resource needs as a standard part of quality care. In the spring of 2016, Mercy Health joined the Health Leads Learning Collaborative to begin integrating the Health Leads program in order to assist patients with health-related social needs through resource referral. This program is designed for Mercy Clinic Jefferson patients and is being funded through Mercy clinics; therefore, the total community benefit of this program cannot be reported under the EIN for Mercy Hospital Jefferson.MENTAL HEALTHALIVE AND WELL COMMUNITIES*Alive and Well Communities is a state-wide effort formed locally by the Regional Health Commission that focuses on reducing the impact of toxic stress and trauma on a person's health and well-being. Mercy acts as a community partner for this initiative and works to create a more trauma aware/informed community through training opportunities and analyzing best practices in the field of behavioral health. As a subset of Alive and Well Communities, Alive and Well Jeff Co was created specifically to address the unique challenges that the Jefferson County community faces. Mercy Hospital Jefferson's local Community Health Leader serves on the steering committee for Alive and Well Jeff Co. In FY20, three additional Mercy co-workers were trained as Alive and Well Trainers and ambassadors, to integrate trauma-informed care more deeply into patient care and the community, and helped to lead trauma awareness trainings, open to the community free of charge.Furthermore, with the support of Mercy Hospital Jefferson's leaders and the ongoing engagement of the Community Health Leader on the Alive and Well steering committee, Alive and Well Jefferson County was a recipient of the Mercy Caritas Grant for $23,900. This funding will support Alive and Well's strategic plan to foster greater resilience in the residents of Jefferson County by working to address underlying factors that cause the transgenerational cycle of trauma and toxic stress, as well as enhancing collaborative community and organizational efforts in a trauma-informed manner. SUBSTANCE USEMERCY ROAD TO FREEDOMThis program was offered to the community and Mercy co-workers as a telephonic, one-on-one support system with a specialty trained counselor. Since 2013, over 80 people have kicked the habit.PHYSICIANSMercy Health System has a large number of clinics, physician offices and other healthcare facilities located in the East Community that are not associated with a hospital EIN. These clinics and facilities provide financial assistance, participate in health professions education (i.e. student shadowing) and provide in-kind contributions to their communities. 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 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, 2020, MERCY FACILITIES INCLUDED 29 ACUTE CARE HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2020, MERCY HAD MORE THAN 10.8 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,400 EMPLOYED PHYSICIANS, AND APPROXIMATELY 44,000 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 MO COVID-19 Please see Schedule O for information related to COVID-19. 1 MERCY HEALTH FOUNDATION JEFFERSON 14528 S OUTER 40 RD STE 100 CHESTERFIELD MO 63017 462797051 501C3 28900 CHARITABLE SUPPORT STL INTEGRATED HEALTH NETWORK 1520 MARKET STREET STE 4034 ST LOUIS MO 63103 203288245 501C3 97367 CHARITABLE SUPPORT 2 0 Schedule I, Part 1, Line 2 THE ORGANIZATION USES AN APPROVAL PROCESS TO DETERMINE WHICH ORGANIZATIONS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE DEPARTMENT, AS THEY ARE EARNED. GRANTS ARE OFTEN MADE TO RELATED ORGANIZATIONS. X X X X 1 1 1 1 0 0 0 0 0 0 0 Rehm MD Charles Chief Administrative Officer & Board 0 337230 0 415020 0 376201 0 40155 0 6203 0 1174809 0 114625 Ammons Carl E Eric President, Mercy Hospital Jefferson 329703 0 241718 0 37171 0 82542 0 12338 0 703472 0 0 0 Iyer Karthik Physician & Board Member 0 520068 0 94047 0 19480 0 12375 0 16354 0 662324 0 0 Riordan MD Tracy Physician & Board Member 0 460826 0 47567 0 21703 0 25930 0 16713 0 572739 0 0 Johnston Jeffrey A President - East Communities 0 720071 0 497179 0 55233 0 119831 0 13547 0 1405861 0 0 Matejka Cheryl L Chief Financial Officer 0 499662 0 174209 0 57737 0 82299 0 13547 0 827454 0 0 Hannasch Susan Regional VP - General Counsel 0 169835 0 350545 0 211311 0 12493 0 7852 0 752036 0 221782 Richmond Jacquelynn VP Deputy General Counsel 0 406788 0 116389 0 24915 0 76559 0 5584 0 630235 0 0 Eckenfels Daniel VP Finance 0 234148 0 42040 0 12891 0 12375 0 15909 0 317363 0 0 Meyer Michele VP Operations 218040 0 33805 0 23181 0 12375 0 16310 0 303711 0 0 0 Stover Benny J VP - Finance 194825 0 26764 0 31926 0 14934 0 15774 0 284223 0 0 0 Blankenship Stacy A CNO 152414 0 24884 0 51474 0 18806 0 7013 0 254591 0 0 0 Richards Donn Physician 343314 0 0 0 25162 0 12375 0 1674 0 382525 0 0 0 Jaeger Kurt Physician 232370 0 164 0 25000 0 9386 0 10498 0 277418 0 0 0 Robbins Jill L Registered Nurse 162180 0 40 0 21827 0 10515 0 7142 0 201704 0 0 0 Kennon William D Director - Pharmacy Services 157130 0 8311 0 14318 0 11657 0 9677 0 201093 0 0 0 Porterhouse Cheri Registered Nurse 154909 0 40 0 10447 0 6952 0 4516 0 176864 0 0 0 Bryson Jared Former Key Employee 0 160107 0 16555 0 22503 0 11253 0 15975 0 226393 0 0 Part I, Line 1a CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. IN ANY CIRCUMSTANCE IN WHICH CHARTER TRAVEL IS MADE AVAILABLE TO EMPLOYEES AND/OR SPOUSES/GUESTS FOR PERSONAL REASONS, MERCY POLICY REQUIRES TRACKING OF SUCH USE AND TAXATION OF THE EMPLOYEE(S) ACCORDINGLY. TRAVEL FOR COMPANIONS FOR NONBUSINESS REASONS IS PROVIDED IN CERTAIN INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, AN OFFICER AND A KEY EMPLOYEE WERE TAXED FOR SUCH TRAVEL. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO A KEY EMPLOYEE. PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE. Part I, Lines 4a-b The following individuals received severance pay: Susan Hannasch $132,947 and Charles Rehm $200,878. 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: Ammons,Carl; Hannasch, Susan; Matejka,Cheryl L; Rehm MD, Charles; Johnston, Jeff; Blankenship, Stacy; Richmond, Jacquelynn The amount of all accrued benefits is included in compensation amounts provided in Schedule J, Part II, Column (C). CHARLES REHM AND SUSAN HANNASCH RECEIVED PAYMENT FROM RETIREMENT PLAN(s) DURING THE YEAR FROM A RELATED ORGANIZATION. THE AMOUNTS REPORTED FOR REHM AND HANNASCH IN COLUMN (F) ARE INCLUDED IN COLUMN B (I) AS BASE COMPENSATION. THESE PAYOUTS 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 -written employment contract -compensation survey or study -approval by the board or compensation committee Form 990, Part VI, Section A, line 6 The member of MERCY Hospital Jefferson is Mercy Health East Communities, a supporting organization under Section 509(a)(3). The member of Mercy Health East Communities is Mercy Health. Form 990, Part VI, Section A, line 7a Mercy Health, the member of Mercy Health East Communities, has reserve powers to appoint and remove all directors and officers for Mercy Hospital Jefferson. Form 990, Part VI, Section A, line 7b THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO THE CORPORATE MEMBER (AND WITH REGARD TO CERTAIN POWERS AND RESPONSIBILITIES, TO MERCY HEALTH EAST COMMUNITIES AS THE CORPORATE MEMBER OF THE CORPORATE MEMBER): A. APPROVAL OF REVISIONS TO THE MISSION, VISION AND OPERATING VALUES PURSUANT TO WHICH THE CORPORATION OPERATES; B. APPROVAL OF ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THESE BYLAWS AND ANY AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE OF THE CORPORATION; C. APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD; D. APPROVAL OF THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE HOSPITAL SUBJECT TO THE CONSENT OF MERCY HEALTH EAST COMMUNITIES; E. ADOPTION OF THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION; F. ADOPTION OF THE OPERATING, CAPITAL AND ALL OTHER BUDGETS FOR THE CORPORATION; G. APPROVAL OF THE ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000) IN ANY ONE OR SERIES OF RELATED TRANSACTIONS OCCURRING WITHIN ANY TWELVE (12) MONTH PERIOD; H. AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; I. APPROVAL OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR ANY AFFILIATE; J. APPROVAL OF THE LEASE, MANAGEMENT OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HOSPITAL SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION; AND, K. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. L. OVERSEE, APPROVE AND MONITOR HUMAN RESOURCE PROGRAMS, WHICH SHALL PROMORTE AN ORGANIZATIONAL ENVIRONMENT THAT: 1. PROVIDES FOR THE RECRUITMENT AND RENTION OF CO-WORKERS WHO ARE SERVICE ORIENTED, COMPASSIONATE, ENGAGED, AND WHO FIND MEANING AND PURPOSE IN WORKING IN A FAITH-BASED ORGANIZATION; 2. ENABLES PEOPLE TO RELATE TO ONE ANOTHER WITH RESPECT AND ACCEPTANCE IN A SPIRIT OF COMMUNITY; 3. PROMOTES CO-WORKER PARTIICPATION AND VOICE IN THEIR WORK LIVES; 4. GIVES CO-WORKERS A FAIR OPPORTUNITY TO DEVLEOP THEIR SKILLS AND TALENTS, AND A MEANS BY WHICH THEIR CONTRIBUTIONS ARE RECOGNIZED; 5. PROVIDES CO-WORKERS WITH THE MATERIALS AND EQUIPMENT TO PROPERLY DO THEIR WORK;AND, 6. ENSURES CO-WORKER SAFETY AND WELL-BEING. 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 LEADERSHIP. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. Form 990, Part VI, 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, 2020. 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), MERCY HEALTH (ultimate parent company) USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE COMPENSATION COMMITTEE OF THE MERCY HEALTH BOARD. 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 and financial statements are made available from time to time but are not published publicly; we are not required to make these documents available to the public. Financial results are available via request of copy of Form 990. 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: Transfer FROM (TO) AFFILIATES -24,512,696. Change in net restricted assets 89,889. Other changes in net assets 43,840. Part XII, Line 2C Audited Financial Statements THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2020 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS 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. Form 990, Part XII, Line 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, 2020 AND WILL BE COMPLETED BY JUNE 30, 2021. 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, 2020, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. 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, Question 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. Form 990, Part V, Question 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. COVID-19 Early in 2020, the Mercy Health System was called to serve as the COVID-19 pandemic swept across the world. This continues 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 revenues were reduced by over $550 million dollars during the four months ending June 30, 2020, and this figure does not include the impact of any Coronavirus Aid Relief and Economic Security Act ("CARES Act") funding. Mercy received CARES Act funding across various entities for the year ended June 30, 2020 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 in these months due to 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. Mercy Clinic Adult Hospitalists - Jefferson LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 462913068 Managed care contracting MO 8155393 0 Mercy Hospital Jefferson Mercy Labs Jefferson LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 463478362 Laboratory Services MO 4671340 0 Mercy Hospital Jefferson Jefferson Regional Outpatient Facilities LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 272196402 outpatient facilities MO 4095251 99689 Mercy Hospital Jefferson Casa de Misericordia 1000 Mier St Laredo TX 78040 742912461 Women's domestic violence shelter TX 501c3 7 Mercy Ministries of Laredo 1 McAuley Portfolio Mgmt Co 14528 S Outer Forty St 100 Chesterfield MO 63017 261708048 Portfolio management MO 501c3 11-II Mercy Health 1 Mercy ACO Clinical Services Inc 14528 S Outer Forty St 100 Chesterfield MO 63017 464504901 Virtual Care Center MO 501c3 3 Mercy Health 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 1 Mercy Clinic Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318597 Physician Clinic AR 501c3 9 Mercy Health Fort Smith Comm 1 Mercy Clinic Oklahoma Comm 4300 W Memorial Road Oklahoma City OK 73120 270473057 Physician Group OK 501c3 3 Mercy Health OK Communities 1 Mercy Clinic Springfield Comm 1965 Fremont Street Suite 2950 Springfield MO 65804 431560263 Physician Group MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Family Center 14528 S Outer Forty St 100 Chesterfield MO 63017 721069468 Family counseling services MO 501c3 7 Mercy Health 1 Mercy Health 14528 S Outer Forty St 100 Chesterfield MO 63017 431423050 Corporate Office MO 501c3 1 N/A 0 Mercy Health East Communities 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 431718408 Health System MO 501c3 11-II Mercy Health 1 Mercy Health Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Company AR 501c3 11-II Mercy Health 1 Mercy Health Foundation 14528 S Outer Forty St 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 11-II Mercy Health 1 Mercy Health Foundation Ada 430 N Monte Vista Street Ada OK 74820 463596274 Foundation OK 501c3 11-I Mercy Hospital Ada 1 Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 11-I Mercy Hospital Ardmore 1 Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 11-I Mercy Hospital Berryville 1 Mercy Health Foundation Ft Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 11-III Mercy Kansas Communities Inc 1 Mercy Health Foundation Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 237330425 Foundation AR 501c3 7 Mercy Hospital Fort Smith 1 Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 Foundation MO 501c3 11-II Mercy Hospital Jefferson 1 Mercy Health Foundation Joplin 100 Mercy Way Joplin MO 64804 270906136 Foundation MO 501c3 11-I Mercy Health SW MOKS Comm 1 Mercy Health Foundation Lincoln 1000 East Cherry Street Troy MO 63379 811477159 Foundation MO 501c3 11-II Mercy Health East Communities 1 Mercy Health Foundation NW Ark 2710 Rife Medical Ln Rogers AR 72858 710601687 Foundation AR 501c3 11-III Mercy Hospital Rogers 1 Mercy Health Foundation of OK 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 11-I Mercy Health OK Communities 1 Mercy Health Foundation OK City 4300 W Memorial Road Oklahoma City OK 73120 463184231 Foundation OK 501c3 11-I Mercy Health OK Communities 1 Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 11-II Mercy Health Springfield Comm 1 Mercy Health Foundation St Francis 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 11-I Mercy St Francis Hospital 1 Mercy Health Foundation STL 615 South New Ballas Road St Louis MO 63141 562410020 Foundation MO 501c3 11-II Mercy Health East Communities 1 Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 11-II Mercy Health East Communities 1 Mercy Health NW Ark Communities 2710 Rife Medical Ln Rogers AR 72758 621684203 Physician Group AR 501c3 11-II Mercy Health 1 Mercy Health OK Communities 4300 W Memorial Road Oklahoma City OK 73120 731453048 Health System OK 501c3 11-II Mercy Health 1 Mercy Health Plans of MissouriInc 3265 S National Avenue Springfield MO 65807 320481419 HMO MO 501c4 Mercy Health 1 Mercy Health PlansInc 3265 S National Avenue Springfield MO 65807 320486150 PPO MO 501c4 Mercy Health Plans of MissouriInc 1 Mercy Health SW MOKS Comm 100 Mercy Way Joplin MO 64804 300584463 Health System MO 501c3 11-II Mercy Health 1 Mercy Health Springfield Comm 1235 E Cherokee Street Springfield MO 65804 431856028 Health System MO 501c3 11-II Mercy Health 1 Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 Home Health and Hospice operations AR 501c3 11-III Mercy Hospital Springfield 1 Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Booneville 880 West Main Street Booneville AR 72927 463851119 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 272716065 Hospital - Inactive OK 501c3 3 Mercy Hospital Oklahoma City 1 Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501c3 3 Mercy Health Fort Smith Comm 1 Mercy Hospital Healdton Inc 3462 Hospital Rd Healdton OK 73438 263173902 Hospital OK 501c3 3 Mercy Hospital Ardmore Inc 1 Mercy Hospital Joplin 100 Mercy Way Joplin MO 64804 270814858 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Hospital Kingfisher Inc 1000 Hospital Circle Kingfisher OK 73750 463433074 Hospital OK 501c3 3 Mercy Hospital Oklahoma City 1 Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Lincoln 1000 East Cherry Street Troy MO 63379 472219204 Hospital MO 501c3 3 Mercy Health East Communities 1 Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 Hospital OK 501c3 3 Mercy Hospital Oklahoma City 1 Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Rogers 2710 Rife Medical Ln Rogers AR 72758 710294390 Hospital AR 501c3 3 Mercy Health NW Ark Communities 1 Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501c3 3 Mercy Hospital Ada 1 Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 Hospital OK 501c3 3 Mercy Hospital Oklahoma City 1 Mercy Hospitals East Comm 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 430653493 Hospital MO 501c3 3 Mercy Health East Communities 1 Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78043 200198462 Outreach TX 501c3 7 Mercy Health 1 Mercy Research 524 North Booneville Avenue Springfield MO 65802 870796305 Research MO 501c3 4 Mercy Health 1 Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 MHM Support Services 14528 S Outer Forty St 100 Chesterfield MO 63017 202553101 Centralized Health System Functions MO 501c3 11-II Mercy Health 1 Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 Child Advocacy Center AR 501c3 9 Mercy Health 1 St Anthony's Charitable Foundation 10010 Kennerly Road St Louis MO 63128 261516789 Foundation MO 501c3 11-II Mercy Hospital South 1 Mercy Hospital South 10010 Kennerly Road St Louis MO 63128 430980256 Hospital MO 501c3 3 Mercy Health East Communities 1 St Anthony's Physician Organization 10010 Kennerly Road St Louis MO 63128 431784536 Health care MO 501c3 3 Mercy Hospital South 1 St Marys Hosp Enid Ok 14528 S Outer Forty St 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 Mercy Health OK Communities 1 Unity Ambulatory Care 14528 S Outer Forty St 100 Chesterfield MO 63017 431861745 Inactive MO 501c3 11-III Mercy Health East Communities 1 Mercy Health Foundation Lebanon 100 Hospital Drive Lebanon MO 65536 822514567 Foundation MO 501c3 11-II Mercy Hospital Lebanon 1 Mercy Specialty Hospital Southeast Kansas 14528 S Outer Forty St 100 Chesterfield MO 63017 843730625 Hospital KS 501c3 3 Mercy Health SW MOKS Comm 1 Plaza Surgery Services Company LLC 12700 Southfork Road St Louis MO 63128 204709312 INactive NM MERCY HOSPITAL SOUTH N/A 0 0 Resource Optimiz & InnovLLC 645 Maryville Ctr DrSte 200 St Louis MO 63141 460468368 Central Distribution Center MO MERCY MANAGED CARE CORPMERCY HEALTH 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 Med Ctr M-P Off 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 842493007 Holding Company MO MERCY MANAGED CARE CORPMERCY HEALTH n/A 0 0 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 MHN of the Southern Region Inc 1011 14th Avenue NW Ardmore OK 73401 731580607 holding company;DISSOLVED 10/15/18 OK MERCY MANAGED CARE CORP 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 Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 holding company;DISSOLVED 10/15/18 OK MERCY MANAGED CARE CORP 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 ANTHONYS PHYSICIAN ORGANIZATION OF ILLINOIS 10010 Kennerly Road St Louis MO 63128 320457168 Health Care MO MERCY HOSPITAL SOUTH C 0 McAuley Insurance Company Ltd Aon House 30 Woodbourne Avenue Pembroke BD HM 08 Inactive BD Mercy Health C 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 Mercy Health Foundation Jefferson B 28900 FMV Mercy Health Foundation Jefferson C 148738 FMV Mercy ACO Clinical Services Q 3582372 FMV Mercy Clinic East Communities Q 955 FMV Mercy Health East Communities Q 20185288 FMV Mercy Health Foundation Jefferson Q 28942 FMV Mercy Health NW Arkansas Communities P 27 FMV Mercy Health Oklahoma Communities Q 71 FMV Mercy Health Springfield Communities Q 1526 FMV Mercy Hospital Ardmore P 1521 FMV Mercy Hospital Aurora P 625 FMV Mercy Hospital Berryville P 24795 FMV Mercy Hospital Cassville P 116 FMV Mercy Hospital Fort Smith Q 10829 FMV Mercy Hospital Joplin P 187 FMV Mercy Hospital Kingfisher Inc P 89 FMV Mercy Hospital Lebanon Q 241 FMV Mercy Hospital Oklahoma City P 2530 FMV Mercy Hospital Rogers P 16713 FMV Mercy Hospital South Q 753 FMV Mercy Hospital Springfield Q 107 FMV Mercy Hospitals East Communities P 320912 FMV MHM Support Services Q 28532084 FMV