MERCY HOSPITAL WATONGA INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: MERCY HOSPITAL WATONGA INC (EIN 45-5199762)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-06-25
IRS object ID: 202021779349300917
Schema version: 2018v3.2
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 J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-06-25T14:02:15-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	562632458	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PLEUS AND COMPANY LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	14500 SOUTH OUTER 40 RD STE 201A	AddressLine1Txt
City	CHESTERFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	63017	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	455199762	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HOSPITAL WATONGA INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MERC	BusinessNameControlTxt
Phone	4057523495	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	500 CLARENCE NASH BLVD	AddressLine1Txt
City	WATONGA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	73772	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	J DAVID THOMPSON	PersonNm
Person Title	SVP STRATEGIC FINANCE	PersonTitleTxt
Phone	4057523161	PhoneNum
Signature	2020-06-25	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DOUGLAS G PLEUS	PreparerPersonNm
PTIN	P00013488	PTIN
Phone	3143179916	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	107.143.157.123	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-06-25	IPDt
IP Tm	14:02:05	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	10DBDE78D88D9177EE19B17DBA986A17B1D29D69	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-22 18:59:49Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DONN SORENSEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	500 CLARENCE NASH BLVD	AddressLine1Txt
City	WATONGA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	73772	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$9,049,916	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	2012	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	6	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	20	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$11,841	PYContributionsGrantsAmt
CY Contributions Grants	$18,315	CYContributionsGrantsAmt
PY Program Service Revenue	$8,472,759	PYProgramServiceRevenueAmt
CY Program Service Revenue	$9,009,533	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$1,262,154	PYOtherRevenueAmt
CY Other Revenue	$22,068	CYOtherRevenueAmt
PY Total Revenue	$9,746,754	PYTotalRevenueAmt
CY Total Revenue	$9,049,916	CYTotalRevenueAmt
PY Grants And Similar Paid	$114,910	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$3,678	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,744,869	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,523,818	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$4,050,597	PYOtherExpensesAmt
CY Other Expenses	$4,074,750	CYOtherExpensesAmt
PY Total Expenses	$8,910,376	PYTotalExpensesAmt
CY Total Expenses	$8,602,246	CYTotalExpensesAmt
PY Revenues Less Expenses	$836,378	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$447,670	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,476,053	TotalAssetsBOYAmt
Total Assets EOY	$1,735,155	TotalAssetsEOYAmt
Total Liabilities BOY	$107,576	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$391,263	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,368,477	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,343,892	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	$7,367,759	ExpenseAmt
Grant	$3,678	GrantAmt
Revenue	$9,009,533	RevenueAmt
Desc	MERCY HOSPITAL WATONGA INC. PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FISCAL YEAR END JUNE 30, 2019, WATONGA PROVIDED SERVICES TO 133 INPATIENTS, 5,707 OTHER OUTPATIENTS, AND 3,743 EMERGENCY DEPARTMENT PATIENTS. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2019 WAS $558,139.MERCY HOSPITAL WATONGA INC.'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H.	Desc
Total Program Service Expenses	$7,367,759	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
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	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	0	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	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
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	6	GoverningBodyVotingMembersCnt
Independent Voting Member	5	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	Yes (1)	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	LYNN PINAROC	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 (17 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
GAUER WILLIAM
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
JAMES KARYL
CHIEF NURSING OFFICER (OKC) & BM	1.00	59.00	Yes (X)	$0	$272,574	$55,036
LUCAS JOYCE
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
PARHAM LOREN
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
SCHENK MARY
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
SCHENKEL CURTIS
BOARD MEMBER	1.00	0.00	Yes (X)	$0	$0	$0
ENLOE TRACY
CFO THRU MARCH 31	1.00	59.00		$0	$358,704	$69,181	Yes (X)
GEBHART JIM
PRESIDENT, MERCY HOSPITAL OKLAHOMA CITY	5.00	55.00		$0	$807,744	$91,866	Yes (X)
VITIELLO JONATHAN
CFO AS OF MARCH 31	1.00	59.00		$0	$982,465	$115,819	Yes (X)
LE BICH-VI
REGIONAL VP-GENERAL COUNSEL	2.00	58.00		$0	$353,258	$64,721		Yes (X)
DINAN JEROME D
PHYSICIAN ASSISTANT	60.00	0.00		$252,706	$0	$12,722			Yes (X)
HUDSON CHAD N
PHYSICIAN ASSISTANT	60.00	0.00		$138,791	$0	$20,705			Yes (X)
JOHNSTON JEFFREY N
PHYSICIAN ASSISTANT	60.00	0.00		$292,923	$0	$23,640			Yes (X)
RIDENHOUR DEENA
CHARGE RN II	60.00	0.00		$110,325	$0	$20,737			Yes (X)
VENEGAS CARLOS
ADVANCED PRACTICE RN - CERT NP	60.00	0.00		$183,994	$0	$23,547			Yes (X)
RAJU GARY
FORMER OFFICER	0.00	60.00		$0	$651,112	$11,195				Yes (X)
SMALLEY DIANA L
PRESIDENT, WEST COMMUNITIES	0.00	60.00		$0	$1,260,277	$23,854				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$978,739	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,686,134	TotReportableCompRltdOrgAmt
Total Other Compensation	$533,023	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	7	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	$102,318	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$18,315	AllOtherContributionsAmt
Total Contributions	$18,315	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU	622110	$7,660,985	$7,660,985
TAX REFUND REVENUE	622110	$1,348,112	$1,348,112
OTHER OPERATING REVENU	622110	$436	$436

Field	Value	IRS element (for citing)
Total Program Service Revenue	$9,009,533	TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA & VENDING	Desc
Business	722210	BusinessCd
Total Revenue Column	$22,068	TotalRevenueColumnAmt
Exclusion	$22,068	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$22,068	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,049,916	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,009,533	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$22,068	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$3,678	TotalAmt
Program Services	$3,678	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$752,908	TotalAmt
Program Services	$752,908	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,078,769	TotalAmt
Program Services	$2,660,898	ProgramServicesAmt
Management And General	$417,871	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$126,476	TotalAmt
Program Services	$109,011	ProgramServicesAmt
Management And General	$17,465	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$332,518	TotalAmt
Program Services	$289,216	ProgramServicesAmt
Management And General	$43,302	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$233,147	TotalAmt
Program Services	$207,139	ProgramServicesAmt
Management And General	$26,008	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,900	TotalAmt
Management And General	$3,900	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$1,972	TotalAmt
Management And General	$1,972	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$355,485	TotalAmt
Program Services	$295,482	ProgramServicesAmt
Management And General	$60,003	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$10,041	TotalAmt
Program Services	$907	ProgramServicesAmt
Management And General	$9,134	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$503,796	TotalAmt
Program Services	$392,852	ProgramServicesAmt
Management And General	$110,944	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,820	TotalAmt
Management And General	$8,820	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$134,712	TotalAmt
Program Services	$1,628	ProgramServicesAmt
Management And General	$133,084	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$19,906	TotalAmt
Program Services	$16,868	ProgramServicesAmt
Management And General	$3,038	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$70,658	TotalAmt
Program Services	$58,273	ProgramServicesAmt
Management And General	$12,385	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$43,056	TotalAmt
Management And General	$43,056	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
BAD DEBTS	$1,933,033	$1,933,033
SHARED SERVICE FEES	$513,692	$251,709	$261,983
DRUGS & MEDICAL EXPENSE	$382,513	$373,142	$9,371
REPAIRS & MAINTENANCE	$71,138	$6,796	$64,342

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$22,028	TotalAmt
Program Services	$14,219	ProgramServicesAmt
Management And General	$7,809	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,602,246	TotalAmt
Program Services	$7,367,759	ProgramServicesAmt
Management And General	$1,234,487	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$417	BOYAmt
EOY	$414	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$906,543	BOYAmt
EOY	$995,814	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$108,132	BOYAmt
EOY	$127,790	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,267	BOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$838,536	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$542,517	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$259,211	BOYAmt
EOY	$296,019	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$199,483	BOYAmt
EOY	$315,118	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,476,053	BOYAmt
EOY	$1,735,155	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$102,121	BOYAmt
EOY	$390,095	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$5,455	BOYAmt
EOY	$1,168	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$107,576	BOYAmt
EOY	$391,263	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,368,477	BOYAmt
EOY	$1,343,892	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,368,477	BOYAmt
EOY	$1,343,892	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,476,053	BOYAmt
EOY	$1,735,155	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$447,670	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$472,255	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	$1,972	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$1,972	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, 2019, DUES WERE $5,295 AND $2,573, RESPECTIVELY. APPROXIMATELY 26.20% OF OKLAHOMA HOSPITAL ASSOCIATION DUES AND 22.73% 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	$56,287	OtherCostOrOtherBasisAmt
Depreciation	$38,658	DepreciationAmt
Book Value	$17,629	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$727,077	OtherCostOrOtherBasisAmt
Depreciation	$503,859	DepreciationAmt
Book Value	$223,218	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$55,172	OtherCostOrOtherBasisAmt
Book Value	$55,172	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$296,019	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
OTHER LONG TERM ASSETS	$76,843
DUE FROM TAX EXEMPT AFFILIATES	$238,275

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$315,118	TotalBookValueOtherAssetsAmt

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, 2019 OR 2018.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
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	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
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	$447,215	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$447,215	NetCommunityBenefitExpnsAmt
Total Expense	0.06710	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$979,055	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$868,131	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$110,924	NetCommunityBenefitExpnsAmt
Total Expense	0.01660	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,426,270	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$868,131	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$558,139	NetCommunityBenefitExpnsAmt
Total Expense	0.08370	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,426,270	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$868,131	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$558,139	NetCommunityBenefitExpnsAmt
Total Expense	0.08370	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$899,953	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$3,060,548	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$3,316,770	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$256,222	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 WATONGA INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	500 CLARENCE NASH BLVD	AddressLine1Txt
City	WATONGA	CityNm
State Abbreviation	OK	StateAbbreviationCd
ZIP	73772	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MERCY.NET/ABOUT	WebsiteAddressTxt
State License	2214	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 WATONGA 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	18	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	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	WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS	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	100.000000000000	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	WWW.MERCY.NET/PATIENTS/BILLING/FINANCIAL-ASSISTANCE/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.MERCY.NET/PATIENTS/BILLING/FINANCIAL-ASSISTANCE/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.MERCY.NET/PATIENTS/BILLING/FINANCIAL-ASSISTANCE/	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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MERCY HOSPITAL WATONGA, INC.	PART V, SECTION B, LINE 5: WHEN CONDUCTING ITS MOST RECENT CHNA, MERCY HOSPITAL, WATONGA WORKED CLOSELY WITH THE FOLLOWING:- BLAINE COUNTY HEALTH DEPARTMENT- OPTOMETRIST- CITY COUNCIL MEMBERS- RETIRED COMMUNITY MEMBERS- OPPORTUNITIES, INC.- WATONGA CHAMBER OF COMMERCE- OKLAHOMA STATE UNIVERSITY CENTER FOR RURAL HEALTH STAFF- MERCY HOSPITAL AND MERCY CLINIC, WATONGA LEADERSHIPPLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS
MERCY HOSPITAL WATONGA, INC.	PART V, SECTION B, LINE 6A: MET AND SHARED RESULTS WITH OKEENE MUNICIPAL HOSPITAL
MERCY HOSPITAL WATONGA, INC.	PART V, SECTION B, LINE 6B: OKLAHOMA OFFICE OF RURAL HEALTH, OSU CENTER FOR RURAL HEALTH
MERCY HOSPITAL WATONGA, INC.	PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY: THE FOLLOWING LISTS THE CONCERNS ALONG WITH STEPS THE HOSPITAL AND COMMUNITY PLAN TO TAKE TO REMEDY THE SITUATION.- PHYSICAL ACTIVITY-THE HOSPITAL IS LOOKING TO PARTNER WITH OPPORTUNITIES, INC., THE LOCAL COMMUNITY ACTION AGENCY, WHO ALREADY HAS PHYSICAL ACTIVITY EQUIPMENT IN THE PARK. - THE BLOCK PARTY WILL HAVE A MORE INTENTIONAL EMPHASIS ON PHYSICAL ACTIVITY. THE BLOCK PARTY ALREADY PROVIDES SPORTS EQUIPMENT TO ENCOURAGE PLAY.- MENTAL HEALTH-THIS IS A PRIORITY FOR MERCY AS A HEALTH SYSTEM. MERCY IS STARTING A PROGRAM, ZERO SUICIDE, WHICH IS A MINISTRY-WIDE ENDEAVOR. THIS HAS STARTED BY INCLUDING SCREENING QUESTIONS WITHIN THE EMR. THERE ARE PLANS TO HAVE IPADS IN THE EMERGENCY ROOM TO PROVIDE SCREENING AND CONSULTS. THERE ARE ALSO PLANS TO HAVE OUTPATIENT SERVICES THROUGH TELEMEDICINE. - THERE IS STILL A CONCERN FOR INPATIENT BEDS; HOWEVER, THIS IS NOT A SERVICE THE HOSPITAL WILL BE ABLE TO PROVIDE.- HEALTH EATING AND CHILDHOOD NUTRITION-THE HOSPITAL WILL PARTNER WITH OPPORTUNITIES, INC. BECAUSE THEY OWN THE LOCAL FOOD BANK. - THE BLOCK PARTY PROVIDES HEALTHY SNACKS AND NUTRITION EDUCATION. - THE HOSPITAL WILL ALSO WORK WITH THE SCHOOL TO PROVIDE NUTRITION EDUCATION FOR THE CHILDREN THROUGH EDUCATIONAL MATERIALS BEING SENT HOME. - THE MERCY DIETICIAN WILL PRESENT NUTRITION EDUCATION TO THE LOCAL SCHOOL. CHILDCARE AS A NEED FOR ALL OF BLAINE COUNTY. - SINCE THIS WAS A JOINT ASSESSMENT, THIS PRIORITY FELL MORE AS AN ACTIVITY THE COUNTY-WIDE COALITION TO ADDRESS. THIS IS ALSO BEYOND THE SCOPE OF SERVICES THE HOSPITAL PROVIDES. HOWEVER, THE HOSPITAL IS WILLING TO COLLABORATE WITH CHILDCARE PROVIDERS TO PROVIDE EDUCATION ON NUTRITION AND PHYSICAL ACTIVITY AS PREVIOUSLY MENTIONED.
MERCY HOSPITAL WATONGA, 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.

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 $8,602,246. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $1,933,033. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $899,953.
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 WATONGA (MHW) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH ACTIVE PARTICIPATION IN COMMUNITY BOARDS, NEIGHBORHOOD/COMMUNITY MEETINGS AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHW 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 MHW PARTICIPATES/SERVES ARE:- PROVIDES PHYSICALS AT HIGH SCHOOL, CAREER DAY, AND HEALTH EDUCATION PROGRAMS, SERVED 350+ STUDENTS- PROVIDE BLOOD PRESSURE SCREENING AND GLUCOSE SCREENING TO AN AVERAGE OF 23 SENIOR CITIZENS PER MONTH- SMOKING CESSATION INFORMATION AND HOTLINE, 16 PATIENTS WERE SERVED- COMMUNITY EDUCATION PROGRAMS AND YEARLY HEALTH FAIR- VOLUNTARY CONTRIBUTIONS TO THE UNITED WAY- PARTNERED WITH THE LOCAL FOOD PANTRY AND SUPPORT COMMUNITY FOOD DRIVES- ORGANIZED A HOLIDAY SEASON BASKET DRIVE AND COLLECTS FOOD, CLOTHES AND TOYS FOR AREA FAMILIES IN NEED. - HOSTS A NEIGHBORHOOD BLOCK PARTY EACH SUMMER, COMPLETE WITH A BOUNCY HOUSE, FOOD AND GAMES, ATTENDANCE IS 100- THROUGH A PROGRAM CALLED "LIFE WISE," COWORKERS HELP MIDDLE SCHOOL STUDENTS DEVELOP LIFE SKILLS SUCH AS BETTER DECISION-MAKING, COMMUNICATIONS AND RELATIONSHIP-BUILDING, SERVE 65 STUDENTS FOR 6 WEEKS EACH SEMESTER- THE NATIONAL ORGANIZATION OF STATE OFFICES OF RURAL HEALTH (NOSORH) SELECTED MHW AS A "COMMUNITY STAR" FOR ITS COMMITMENT TO AREA RESIDENTS.
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 UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTIONS POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED 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 WATONGA 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'S; INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS, AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR 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 THIRD PARTY TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY; USING HOUSEHOLD SIZE AND INCOME. 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. IN ADDITION, MERCY UTILIZES THE SAME TOOL TO QUALIFY ACCOUNTS PER THE PRACTICE OF PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR BALANCES IN EXCESS OF $6500. 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. 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 A 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 OCCURS PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED.
PART VI, LINE 2:	A SURVEY WAS DESIGNED TO CAPTURE THREE NEEDS THROUGH ONE FORM. THE SURVEY INCLUDED THEMES AND STRENGTHS SPECIFIC TO BLAINE COUNTY TO MEET THE NEEDS OF THE BLAINE COUNTY HEALTH DEPARTMENT. QUESTIONS WERE ALSO INCLUDE TO GAUGE HOSPITAL USAGE, SATISFACTION, AND COMMUNITY HEALTH NEEDS FOR BOTH MERCY HOSPITAL WATONGA AND OKEENE MUNICIPAL HOSPITAL. THE SURVEY WAS FIRST MADE AVAILABLE MARCH 16, 2018 AND CLOSED ON MAY 17, 2018. THE SURVEY WAS MADE AVAILABLE AT THE FIRST COMMUNITY MEETING AND WAS DISTRIBUTED THROUGH THE COMMUNITY VIA ELECTRONIC LINK AND WAS DISTRIBUTED TO ALL OF THE CIVIC ORGANIZATIONS IN THE COMMUNITY. THE PAPER SURVEY WAS MADE AVAILABLE AT THE HOSPITAL, CLINICS, SENIOR CITIZENS' CENTER AND VARIOUS ESTABLISHMENTS ACROSS WATONGA. THREE ENTITIES (MERCY HOSPITAL WATONGA, OKEENE MUNICIPAL HOSPITAL, AND BLAINE COUNTY HEALTH DEPARTMENT) SHARED RESPONSIBILITY IN DISTRIBUTING THE SURVEY. A COPY OF THE SURVEY FORM AND RESULTS CAN BE FOUND IN APPENDIX E. COMMUNITY MEMBERS WERE ASKED TO RETURN THEIR COMPLETE SURVEYS TO MERCY HOSPITAL WATONGA, OKEENE MUNICIPAL HOSPITAL, OR BLAINE COUNTY HEALTH DEPARTMENT.MERCY HOSPITAL WATONGA HOSTED THREE COMMUNITY MEETINGS BETWEEN MAY 3, 2018 AND MAY 31, 2019. THE OKLAHOMA OFFICE OF RURAL HEALTH FACILITATED THESE MEETINGS. THESE COMMUNITY MEETINGS WERE HELD DURING THE SAME TIME PERIOD AS COMMUNITY MEETINGS IN OKEENE. EACH COMMUNITY HELD AND HOSTED THEIR OWN MEETINGS WITH THE PLAN OF COMING TOGETHER TO DISCUSS COMMONALITIES THAT SPAN ACROSS THE COUNTY. AVERAGE ATTENDANCE AT THE COMMUNITY MEETINGS WAS 9-12 COMMUNITY MEMBERS. THE HOSPITAL TRIED TO INVITE ANYONE WHO WANTED TO ATTEND WITHIN THE COMMUNITY. THIS WAS MADE THROUGH TELEPHONE CALLS, EMAILS, SOCIAL MEDIA POSTS, AND THE CHAMBER OF COMMERCE ASSISTED WITH INVITING INDIVIDUALS. THE HOSPITAL MADE SIGNIFICANT EFFORTS TO REACH A DIVERSE AND REPRESENTATIVE POPULATION OF THE MEDICAL SERVICE AREA AND PATIENTS SERVED INCLUDING LOW INCOME AND RACIALLY DIVERSE POPULATIONS. REPRESENTATIVES FROM THE PUBLIC HEALTH SECTOR WERE INCLUDED TO PROVIDE INSIGHT INTO WHAT THEY SEE FROM A PUBLIC HEALTH AND UNDERSERVED POPULATION PERSPECTIVE OF COMMUNITY NEEDS.PLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS
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) INCLUDES 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:	MERCY HOSPITAL WATONGA'S PRIMARY SERVICE AREA IS BLAINE COUNTY, OKLAHOMA. THE FOLLOWING INFORMATION IS DERIVED FROM 2018 IBM/WATSTON'S DEMOGRAPHICS AND FY2018 DECISION RESOURCE GROUP'S INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 9,637. 27% OF THE POPULATION'S AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 46% OF THE POPULATION IS 45 AND OLDER. A PRIOR SURVEY INDICATED THAT 40% OF THE HOUSEHOLDS IS ON MEDICARE, 12% ON MEDICAID, AND 11% UNINSURED.
PART VI, LINE 5:	MERCY 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, AND CO-WORKER WORK DAYS.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.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 SYSTEM: THE 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, 2019, 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, 2019, MERCY HAD MORE THAN 10.2 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,400 EMPLOYED PHYSICIANS, AND APPROXIMATELY 45,000 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

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	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 (11 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
JAMES KARYL
CHIEF NURSING OFFICER (OKC) & BM	$0	$192,596	$0	$58,645	$0	$21,333	$0	$38,447	$0	$16,589	$0	$327,610	$0	$0
ENLOE TRACY
CFO THRU MARCH 31	$0	$272,952	$0	$66,795	$0	$18,957	$0	$52,494	$0	$16,687	$0	$427,885	$0	$0
GEBHART JIM
PRESIDENT, MERCY HOSPITAL OKLAHOMA C	$0	$473,783	$0	$312,571	$0	$21,390	$0	$79,373	$0	$12,493	$0	$899,610	$0	$0
VITIELLO JONATHAN
CFO AS OF MARCH 31	$0	$567,172	$0	$354,458	$0	$60,835	$0	$98,030	$0	$17,789	$0	$1,098,284	$0	$0
LE BICH-VI
REGIONAL VP-GENERAL COUNSEL	$0	$248,763	$0	$76,735	$0	$27,760	$0	$47,787	$0	$16,934	$0	$417,979	$0	$0
DINAN JEROME D
PHYSICIAN ASSISTANT	$231,361	$0	$4,415	$0	$16,930	$0	$3,145	$0	$9,577	$0	$265,428	$0	$0	$0
HUDSON CHAD N
PHYSICIAN ASSISTANT	$126,045	$0	$4,165	$0	$8,581	$0	$5,022	$0	$15,683	$0	$159,496	$0	$0	$0
JOHNSTON JEFFREY N
PHYSICIAN ASSISTANT	$264,099	$0	$4,415	$0	$24,409	$0	$8,300	$0	$15,340	$0	$316,563	$0	$0	$0
VENEGAS CARLOS
ADVANCED PRACTICE RN - CERT NP	$178,181	$0	$4,415	$0	$1,398	$0	$7,700	$0	$15,847	$0	$207,541	$0	$0	$0
RAJU GARY
FORMER OFFICER	$0	$298,567	$0	$330,021	$0	$22,524	$0	$9,450	$0	$1,745	$0	$662,307	$0	$0
SMALLEY DIANA L
PRESIDENT, WEST COMMUNITIES	$0	$668,153	$0	$537,906	$0	$54,218	$0	$10,911	$0	$12,943	$0	$1,284,131	$0	$170,999

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 4B

MERCY HEALTH, THE 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 INDIVIDUAL PARTICIPATED IN THE PLAN: JONATHAN VITIELLO; BICH-VI LE; DIANA SMALLEY; JIM GEBHART; KARYL JAMES; TRACY ENLOE; GARY RAJU THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). DIANA SMALLEY RECEIVED A PAYMENT FROM RETIREMENT PLAN(S) DURING THE YEAR FROM A RELATED ORGANIZATION. THE AMOUNT REPORTED FOR DIANA SMALLEY IN COLUMN (F) IS INCLUDED IN COLUMN B (I) AS BASE COMPENSATION. THIS PAYOUT WAS INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990.

PART I, LINE 3

THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH OKLAHOMA COMMUNITIES, INC.
FORM 990, PART VI, SECTION A, LINE 7A	MERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AS PROVIDED BY THE BYLAWS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7B	THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO 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; C. APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD, AS PROVIDED IN SECTIONS 5.2 AND 5.9 OF THE BYLAWS; D. APPROVAL OF THE APPOINTMENT AND REMOVAL OF THE ADMINISTRATOR OF THE CORPORATION, AS PROVIDED IN SECTION 6.2.1 OF THE BYLAWS; 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 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 (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; 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. APPROVAL OF THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION.
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 PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; 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, 2019. 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 -472,255.
FORM 990, PART XII, QUESTION 2C	AUDIT OF 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 2019 (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 3	SINGLE AUDIT ACT AND OMB CIRCULAR A-133 MERCY HEALTH UNDERGOES A CONSOLIDATED A-133 AUDIT EVERY YEAR AND DID SO FOR THE FISCAL YEAR ENDING JUNE 30, 2019. 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 AVAILABLE FOR AUDIT. THE FILING ENTITY RECEIVED FEDERAL FUNDS DURING THE YEAR ENDED JUNE 30, 2019, WAS INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, WAS ALSO INCLUDED IN THE POPULATION AVAILABLE FOR AUDIT.
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, PART V, LINE 2A	W-3 FILING SALARIES AND WAGES WITH LIMITED EXEPTIONS, 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, PART V, QUESTION 1A	FORM 1099/1096 FILING VENDORS 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 MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN.
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.

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	822414567	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 HOME HEALTH BERRYVILLE
804 W FREEMAN SUITE 4	BERRYVILLE	AR	72616	870781247	HOME HEALTH AND HOSPICE OPERATIONS	AR	501C3	11-III	MERCY HOSPITAL SPRINGFIELD	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	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 KINGFISHER INC
1000 HOSPITAL CIRCLE	KINGFISHER	OK	73750	463433074	HOSPITAL	OK	501C3	3	MERCY HOSPITAL OKLAHOMA CITY	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 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)

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
RESOURCE OPTIMIZ & INNOVLLC
645 MARYVILLE CTR DRSTE 200	ST LOUIS	MO	63141	460468368	CENTRAL DISTRIBUTION CENTER	MO	MERCY MANAGED CARE CORP	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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 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
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 ANTHONY'S PHYSICIAN ORGANIZATION OF ILLINOIS
10010 KENNERLY ROAD	ST LOUIS	MO	63128	320457168	HEALTH CARE	MO	MERCY HOSPITAL SOUTH	C	0

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 (13 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MHM SUPPORT SERVICES
Q	$674,264	FMV
MERCY HEALTH SPRINGFIELD COMMUNITIES
Q	$5,777	FMV
MERCY HEALTH OKLAHOMA COMMUNITIES
Q	$1,486,081	FMV
MERCY HEALTH FOUNDATION OKLAHOMA CITY
Q	$3,678	FMV
MERCY HOSPITAL OKLAHOMA CITY
P	$771,702	FMV
MERCY HOSPITAL ARDMORE
Q	$202,738	FMV
MERCY HOSPITAL LOGAN COUNTY INC
Q	$2,613	FMV
MERCY HOSPITAL ADA INC
Q	$100,279	FMV
MERCY HOSPITAL KINGFISHER INC
Q	$12,911	FMV
MERCY HOSPITAL HEALDTON
P	$905	FMV
MERCY HOSPITAL EL RENO
Q	$23,886	FMV
MERCY CLINIC OKLAHOMA COMMUNITIES INC
Q	$24,889	FMV
MERCY ACO CLINICAL SERVICES
Q	$82,482	FMV