MERCY KANSAS COMMUNITIES INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MERCY KANSAS COMMUNITIES INC (EIN 48-0956045)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-06-24
IRS object ID
202031769349301818
Schema version
2018v3.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-06-24T17:44:36-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1221 E 4TH ST SUITE 2900AddressLine1Txt
CityCINCINNATICityNm
State AbbreviationOHStateAbbreviationCd
ZIP45202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN480956045EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MERCY KANSAS COMMUNITIESBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% THOMAS P MATHEWSInCareOfNm
Business Name ControlMERCBusinessNameControlTxt
Phone3145796100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Woodland Hills BlvdAddressLine1Txt
CityFort ScottCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS P MATHEWSPersonNm
Person TitleVP - FINANCEPersonTitleTxt
Phone4175562459PhoneNum
Signature2020-06-23SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIE L SPARKSPreparerPersonNm
PTINP01268401PTIN
Phone5136121400PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address108.206.163.59IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id34033020201765000005FederalOriginalSubmissionId
Federal Original Submission Id2020-06-24FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id770194AAF055F9EA87E64CA02E08FE540289067FAtSubmissionCreationDeviceId
At Submission Filing Device Id770194AAF055F9EA87E64CA02E08FE540289067FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS P MATHEWSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Mercy WayAddressLine1Txt
CityJoplinCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64804ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,330,021GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.mercy.netWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionAS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee12TotalEmployeeCnt
Total Volunteers58TotalVolunteersCnt
Total Gross UBI$90,696TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$12,543NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$109,791PYContributionsGrantsAmt
CY Contributions Grants$254,293CYContributionsGrantsAmt
PY Program Service Revenue$37,094,180PYProgramServiceRevenueAmt
CY Program Service Revenue$19,648,971CYProgramServiceRevenueAmt
PY Investment Income-$5,707PYInvestmentIncomeAmt
CY Investment Income$47,939CYInvestmentIncomeAmt
PY Other Revenue$586,021PYOtherRevenueAmt
CY Other Revenue$378,818CYOtherRevenueAmt
PY Total Revenue$37,784,285PYTotalRevenueAmt
CY Total Revenue$20,330,021CYTotalRevenueAmt
PY Grants And Similar Paid$10,930PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$385,896CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$22,229,149PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,242,984CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$17,986,009PYOtherExpensesAmt
CY Other Expenses$38,062,769CYOtherExpensesAmt
PY Total Expenses$40,226,088PYTotalExpensesAmt
CY Total Expenses$52,691,649CYTotalExpensesAmt
PY Revenues Less Expenses-$2,441,803PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$32,361,628CYRevenuesLessExpensesAmt
Total Assets BOY$26,797,772TotalAssetsBOYAmt
Total Assets EOY$844,396TotalAssetsEOYAmt
Total Liabilities BOY$4,758,830TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,564,232TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$22,038,942NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$719,836NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$14,985,036ExpenseAmt
Grant$382,921GrantAmt
Revenue$15,492,763RevenueAmt
DescMERCY HOSPITAL - FORT SCOTT CLOSED AT THE END OF JANUARY 2019. PRIOR TO CLOSING, HEALTHCARE SERVICES WERE PROVIDED THAT BENEFITED THE HEALTH AND WELL-BEING OF THE INDIVIDUALS RESIDING IN THE CITY OF FORT SCOTT AND BOURBON COUNTY. THE HOSPITAL PROVIDED BASIC PRIMARY CARE SERVICES WHICH INCLUDED; INPATIENT ACUTE, SWING BED, EMERGENCY ROOM, GENERAL SURGERY, OUTPATIENT DIAGNOSTIC, OUTPATIENT PHYSICAL THERAPY AND HOME HEALTH SERVICES. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATE 378 DISCHARGES, 4,571 EMERGENCY ROOM VISITS, 642 SURGERIES, 7,688 HOME HEALTH VISITS AND NUMEROUS OUTPATIENT PROCEDURES. NECESSARY TERTIARY CARE IS TRANSPORTED OUT OF THE COMMUNITY TO A LARGER HOSPITAL.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$5,173,917ExpenseAmt
Grant$2,975GrantAmt
Revenue$4,270,008RevenueAmt
DescMERCY PHYSICIAN GROUP - FORT SCOTT CLOSED AT THE END OF JANUARY 2019. PRIOR TO CLOSING, LOCAL PHYSICIAN SERVICES WERE PROVIDED THAT BENEFITED THE HEALTH AND WELL-BEING OF THE COMMUNITIES. THE INTEGRATED PHYSICIAN GROUP CONSISTED OF THE FOLLOWING MIX OF SPECIALTIES: FAMILY PRACTICE, INTERNAL MEDICINE, OB/GYN, GENERAL SURGERY, ORTHOPEDICS AND ADVANCED PRACTICE PROVIDERS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$20,158,953TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee12EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTHOMAS P MATHEWSPersonNm
Phone4175562459PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MERCY WAYAddressLine1Txt
CityJOPLINCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64804ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Ballou Paul
Board Member1.00.0Yes (X)$0$0$0
Baker Reta
President-Fort Scott & Bd Mbr55.05.0Yes (X)$339,697$0$57,178Yes (X)
Brau RSM Sr Annrene
Board Member1.02.0Yes (X)$0$0$0
Campbell Sharon
Board Member1.00.0Yes (X)$0$0$0
Drake Billie Jo
Board Member1.01.0Yes (X)$0$0$0
Pulsipher Gary W
CEO & Board Member15.045.0Yes (X)$0$652,520$84,040Yes (X)
Secrest Jesse
Board Member1.00.0Yes (X)$0$0$0
Self Do Maxwell
Physician & Board Member60.00.0Yes (X)$304,055$0$45,656
Yarick Cliff
Board Member1.00.0Yes (X)$0$0$0
Mathews Thomas P
VP Finance10.050.0$0$287,150$7,377Yes (X)
Reynolds Scott
CFO - Central Communities2.058.0$0$532,036$109,754Yes (X)
Marion Tanya
Regional VP - Human Resources3.057.0$0$368,698$67,324Yes (X)
Swope Jon
President-Central Communities2.058.0$0$1,291,161$173,577Yes (X)
Burke Katrina
Physician60.00.0$340,958$0$24,657Yes (X)
Fox John M
Physician60.00.0$437,038$0$42,268Yes (X)
Gugnani Pankaj K
Physician60.00.0$320,635$0$34,632Yes (X)
Hall Ralph W
Physician60.00.0$380,956$0$41,967Yes (X)
Seals DO Larry E
Physician30.030.0$403,146$0$34,277Yes (X)
Hennessey III William
Former Key Employee0.060.0$0$252,349$49,575Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,526,485TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,383,914TotReportableCompRltdOrgAmt
Total Other Compensation$772,282TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K20IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
General Anesthesia Services PA
PO Box 263FORT SCOTTKS66701ANESTHETIC SERVICES$711,404
DOCS WHO CARE
800 W FRONTIER LANDOLATHEKS66061PHYSICIAN STAFFING$1,099,879
CASCADE HEALTH SERVICES
1045 SWIFT AVENUENORTH KANSAS CITYMO64116CLINICAL STAFFING$139,874
GE PRECISION HEALTHCARE
300 N GRANDVIEW BLVDWAUKESHAWI53188PREVENTIVE MAINT.$122,377
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$213,114RelatedOrganizationsAmt
Government Grants$41,179GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$213,114NoncashContributionsAmt
Total Contributions$254,293TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE621110$12,269,719$12,269,719
OTHER OPERATING REVENUE900099$325,189$325,189
RENTAL INCOME FROM RELATED ORGS532000$32,725$32,725
CAPITATION BONUS531120$458$458
REFERENCE LAB900099$7,020,880$6,999,014$21,866
FieldValueIRS element (for citing)
Total Program Service Revenue$19,648,971TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$47,939TotalRevenueColumnAmt
Exclusion$47,939ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$32,862RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$32,862RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,862TotalRevenueColumnAmt
Exclusion$32,862ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFE & VENDING722514$163,326$163,326
FITNESS CENTER713940$80,035$11,205$68,830
NON-OPERATING LOSS900099-$20,861-$20,861

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$123,456TotalRevenueColumnAmt
Related Or Exempt Func Income$123,456RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$345,956OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,330,021TotalRevenueColumnAmt
Related Or Exempt Func Income$19,740,905RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$90,696UnrelatedBusinessRevenueAmt
Exclusion$244,127ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$385,896TotalAmt
Program Services$385,896ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$681,953TotalAmt
Program Services$578,948ProgramServicesAmt
Management And General$103,005ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$102,626TotalAmt
Program Services$87,125ProgramServicesAmt
Management And General$15,501ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,875,240TotalAmt
Program Services$9,232,598ProgramServicesAmt
Management And General$1,642,642ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$402,035TotalAmt
Program Services$341,310ProgramServicesAmt
Management And General$60,725ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,443,144TotalAmt
Program Services$1,225,167ProgramServicesAmt
Management And General$217,977ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$737,986TotalAmt
Program Services$626,518ProgramServicesAmt
Management And General$111,468ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$114TotalAmt
Management And General$114ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total-$114TotalAmt
Management And General-$114ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,958TotalAmt
Management And General$1,958ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,537,196TotalAmt
Program Services$1,329,983ProgramServicesAmt
Management And General$207,213ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$21,547TotalAmt
Program Services$11,866ProgramServicesAmt
Management And General$9,681ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$501,993TotalAmt
Program Services$235,894ProgramServicesAmt
Management And General$266,099ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total-$15TotalAmt
Program Services-$375ProgramServicesAmt
Management And General$360ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$952,419TotalAmt
Program Services$511,080ProgramServicesAmt
Management And General$441,339ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$18,359TotalAmt
Program Services$13,765ProgramServicesAmt
Management And General$4,594ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$354TotalAmt
Program Services$275ProgramServicesAmt
Management And General$79ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$392,465TotalAmt
Program Services$672,642ProgramServicesAmt
Management And General-$280,177ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$397,851TotalAmt
Program Services$89,755ProgramServicesAmt
Management And General$308,096ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
RESTRUCTURING/IMPAIRMENT$27,337,660$27,337,660
BAD DEBT$2,279,570$2,279,570
SHARED SERVICE FEES$2,658,168$1,355,666$1,302,502
DRUGS & MEDICAL EXPENSES$1,168,117$18,270$1,149,847

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$795,127TotalAmt
Program Services$84,587ProgramServicesAmt
Management And General$710,540ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$52,691,649TotalAmt
Program Services$20,158,953ProgramServicesAmt
Management And General$32,532,696ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$773,710BOYAmt
EOY$18,800EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,172BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,941,003BOYAmt
EOY$122,878EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$422,369BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$108,134BOYAmt
EOY$3,780EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$616,978LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$128,958LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$22,753,907BOYAmt
EOY$488,020EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$393,722BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$177,000BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY-$775,245BOYAmt
EOY$210,918EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,797,772BOYAmt
EOY$844,396EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,098,258BOYAmt
EOY$283,300EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$8,292BOYAmt
EOY$17EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$731,385BOYAmt
EOY$895EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,920,895BOYAmt
EOY$1,280,020EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,758,830BOYAmt
EOY$1,564,232EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,645,220BOYAmt
EOY-$719,836EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$393,722BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,038,942BOYAmt
EOY-$719,836EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,797,772BOYAmt
EOY$844,396EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$32,361,628ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$9,602,850OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$1,958OtherActivitiesAmt
Total Lobbying Expenditures$1,958TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE C, PART II-B, LINE 1(I)FormAndLineReferenceDesc
ExplanationSUPPLEMENTAL LOBBYING INFORMATION THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: KANSAS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND CATHOLIC HEALTH ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2018, DUES WERE $28,471, $7,897 AND $13,182, RESPECTIVELY. APPROXIMATELY 22.98% OF KANSAS HOSPITAL ASSOCIATION DUES, 22.98% OF AMERICAN HOSPITAL ASSOCIATION DUES AND 3.93% OF CATHOLIC HEALTH ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$99,845OtherCostOrOtherBasisAmt
Depreciation$13,647DepreciationAmt
Book Value$86,198BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$517,133OtherCostOrOtherBasisAmt
Depreciation$115,311DepreciationAmt
Book Value$401,822BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$488,020TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
MISCELLANEOUS RECEIVABLES$184,839
GRANT EARNED UNBILLED$1,271
DUE FROM AFFILIATES$24,808
FieldValueIRS element (for citing)
Total Book Value Other Assets$210,918TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$1,280,020Amt
FieldValueIRS element (for citing)
Total Liability$1,280,020TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationASC 740 FOOTNOTE PRIMARILY ALL OF THE HEALTH SYSTEM ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) 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. THE HEALTH SYSTEM COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2019 OR 2018.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$217,401TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$217,401NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,146,426TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,309,426DirectOffsettingRevenueAmt
Net Community Benefit Expns$837,000NetCommunityBenefitExpnsAmt
Total Expense0.01660TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,363,827TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,309,426DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,054,401NetCommunityBenefitExpnsAmt
Total Expense0.02090TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,895TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,895NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,895TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,895NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,366,722TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,309,426DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,057,296NetCommunityBenefitExpnsAmt
Total Expense0.02090TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$865,361BadDebtExpenseAmt
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL FORT SCOTTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 WOODLAND HILLS BLVDAddressLine1Txt
CityFORT SCOTTCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66701ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MERCY.NETWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mercy Hospital Fort ScottBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITSOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITSStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 3eTHE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITYS SIGNIFICANT HEALTH NEEDS IN ITS MOST RECENT CHNA REPORT. PART V, SECTION B, LINES 4 AND 9 A 2019 CHNA AND IMPLEMENTATION PLAN WAS NOT COMPLETED DUE TO CLOSURE. FORT SCOTT CLOSED AT THE END OF JANUARY 2019. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS THEY SERVE, MERCY HOSPITAL FORT SCOTT REACHED OUT TO COMMUNITY STAKEHOLDERS, SOUTH EAST KANSAS MULTI COUNTY HEALTH DEPARTMENT PUBLIC NURSE, THE VULNERABLE AND THE UNDERSERVED TO COLLABORATE ON A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE NEEDS ASSESSMENT PROCESS INVOLVED REVIEW OF BOTH QUANTITATIVE AND QUALITATIVE DATA IN ORDER TO PLAN AND ACT UPON PRIORITY COMMUNITY HEALTH NEEDS. THE VOICES OF THE PEOPLE OF BOURBON COUNTY, PARTICULARLY THOSE IN POVERTY AND VULNERABLE POPULATIONS, WERE CENTRAL TO THE HEALTH NEEDS ASSESSMENT. MERCY HOSPITAL FORT SCOTT GATHERED COMMUNITY INPUT THROUGH A FOCUS GROUP LOCATED IN FORT SCOTT CITY HALL. THERE WAS REPRESENTATION OF THE MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS. COMMUNITY PARTNERS ATTENDING AND ADVOCATING ON THEIR CLIENTS BEHALF CONSISTED OF PUBLIC HEALTH, LOCAL FOOD PANTRY, LOCAL COALITION, MENTAL HEALTH, SCHOOL DISTRICT, AND MEDICAID CASE MANAGERS FOR PEOPLE WITH DISABILITIES. EACH MEMBER OF THE GROUP PROVIDED MEANINGFUL AND REFLECTIVE INFORMATION. THIRTEEN INDIVIDUALS IN THE BOURBON COUNTY AREA EXPRESSED INTEREST IN PARTICIPATING IN THE FOCUS GROUP. ALL 13 OF THE INTERESTED INDIVIDUALS WERE ELIGIBLE. OF THE INTERESTED PEOPLE; THREE WERE MEN AND 10 WERE WOMEN; 1 WAS A YOUNG ADULT (26-36 YEARS OLD), NINE WERE MIDDLE AGED ADULTS (37-64 YEARS OLD), THREE WERE OLDER ADULTS (65-84 YEARS OLD); FIVE HAD PRIVATE INSURANCE COVERAGE, ONE HAD MEDICAID COVERAGE, TWO HAD MEDICARE COVERAGE, ONE HAD BOTH MEDICAID AND MEDICARE COVERAGE, ONE HAD BOTH MEDICARE AND PRIVATE COVERAGE, THREE HAD NO INSURANCE COVERAGE; AND TWO HAD SOUGHT BEHAVIORAL HEALTH CARE SERVICES IN THE PAST YEAR. A TOTAL OF 7 PARTICIPANTS SHOWED FOR THE FOCUS GROUP, ALL WHITE, SIX FEMALES, ONE MALE, FOUR WITH PRIVATE INSURANCE, TWO WITH MEDICARE COVERAGE AND ONE THAT WAS UNINSURED IN ATTENDANCE. SUFFICIENT REPRESENTATION OF MEDICAID, LOW INCOME, AND VULNERABLE POPULATIONS WERE REPRESENTED. EVERY ATTEMPT WAS MADE TO HAVE AT LEAST 2 MEN IN ATTENDANCE. ONE GENTLEMAN HAD A MEDICAL EMERGENCY, AND ANOTHER WAS SICK ON THE DAY OF THE FOCUS GROUP MEETING. IN ORDER TO ALIGN OUR COMMUNITY NEEDS WITH MERCY HOSPITAL FORT SCOTTS STRATEGIC PLAN AND MISSION, A HOSPITAL LEVEL FOCUS GROUP WAS CONDUCTED. HOSPITAL, CLINIC, HEALTH FOR LIFE, HOME HEALTH, HOSPICE, AND PHARMACY LEADERSHIP PARTICIPATED AND PROVIDED FEEDBACK. PRIMARY AND SECONDARY DATA WERE PRESENTED. THE GROUP WAS TASKED TO PRIORITIZE THE HEALTH INDICATORS BASED ON LEVEL OF COMMUNITY CONCERN AND POTENTIAL TO COLLABORATE AROUND THE HEALTH ISSUE. FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT, WE DID NOT SOLICIT WRITTEN COMMENTS. WE DID NOT HAVE A PROCESS YET IN PLACE. SINCE THE COMPLETION OF THE CHNA, WE HAVE BEEN ABLE TO IDENTIFY A PROCESS FOR SOLICITING WRITTEN COMMENTS FROM THE COMMUNITY IN THE FORM OF A PERCEPTION SURVEY. THIS PERCEPTION SURVEY WILL BE UTILIZED TO EVALUATE THE PROGRESS OF OUR CURRENT CHIP.
Form 990, Schedule H, Part V, Section B, Line 6BMERCY HOSPITAL FORT SCOTT CONDUCTED THE CHNA WITH THE SOUTH EAST KANSAS MULTI COUNTY HEALTH DEPARTMENT.
Form 990, Schedule H, Part V, Section B, Line 11Mercy Hospital Fort Scott is addressing the significant needs identified in the most recent CHNA through systems, environmental, and policy change in the places where our community members spend most of their time. Our goal is to create sustainable programs that will have the largest impact. "The environments where we live, learn, work, and play affect access to healthy food and opportunities for physical activity which, along with genetic factors and personal choices, shape health and risk of overweight and obesity" (Institute, 2016). The health needs that have been identified as priorities are: Diabetes, Cardiovascular Disease, & Lung Disease. Other identified needs not being addressed and why not: Mental Illness Mercy Hospital Fort Scott acknowledges the needs associated with persons who have been diagnosed with Mental Illness. We do not have the resources to adequately address this need in the healthcare setting. We have working relationships with mental health providers and counselors who are able to address this need in the community setting. The local South East Kansas Mental Health facility is government funded, accepts Medicaid, and has a sliding scale for those who are uninsured or living in poverty. Maternal Child Health Our Mother and Infants Program bring a much needed service to the community to ensure expecting mothers receive quality prenatal care, education, and support. The program targets the vulnerable and underserved. Secondary data indicate our community has a lower rate of women receiving inadequate prenatal care when compared to state and national percentages. Mercy will continue to address issues through collaborative work regarding teenage pregnancy but there are limitations as a Catholic Health System and will not take a lead role on this issue. Cancer: Currently, there are several community organizations who are addressing this indicator. Mercy will continue our collaboration with these organizations as well as continue internal efforts through home health and palliative care programs. Mercy Hospital Fort Scott leaders felt our continued involvement was important but the issues of diabetes, cardiovascular disease and lung disease demanded more of our focus at this time.
FORM 990, SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CTHE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT HTTPS://WWW.MERCY.NET/OPEN-PAGES/MERCY-FINANCIAL-ASSISTANCE/
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Mercy Arma
601 E WashingtonArmaKS66712Physician Clinic/Practice Closed Jan 31,2019
Mercy Physician Building
403 Woodland Hills BoulevardFort ScottKS66701Physician Clinic/Practice Closed Jan 31,2019
Mercy Medical Plaza
902 S HortonFort ScottKS66701Physician Clinic/Practice Closed Jan 31,2019
Mercy Health for Life Fort Scott
405 Woodland Hills BoulevardFort ScottKS66701Rehab/Fitness Center Closed Dec 31,2019
Mercy Convenient Care Fort Scott
1624 S NationalFort ScottKS66701Urgent Care Closed Jan 31,2019
Mercy Linn County
11155 Tucker RoadPleasantonKS66075Primary Care Small Closed Jan 31,2019

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE H, PART I, LINE 6ATHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $52,691,648. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $2,279,570. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $50,412,078.
FORM 990, SCHEDULE H, PART IIMercy Hospital Fort Scott contributes to community building activities with the intent to improve the community's health and safety by addressing the root cause of health problems, such as poverty, homelessness and other social determinants of health. Leadership participates in the Bourbon County Economic Development Council, Fort Scott Visioning Steering Committee, and Fort Scott Area Chamber of Commerce on issues impacting the communitys health and safety. Efforts are focused to establish or enhance community support networks, such as The Good Neighbor Action Team (GNAT), Circles out of Poverty Group, High School Mentor Program, and Presbyterian Village Board activities. These activities include both community-based initiatives and facility-based initiatives.
FORM 990, SCHEDULE H, PART III, SECTION A, LINE 2TO 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.
FORM 990, SCHEDULE H, PART III, SECTION A, LINE 3The 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.
FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.
FORM 990, SCHEDULE H, PART III, SECTION B, LINE 8IT IS THE POSITION OF MERCY THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96).
FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9BMERCYS 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. 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 $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. 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.
FORM 990, SCHEDULE H, PART VI, LINE 2Mercy Hospital strives to continually assess the health needs of our community. In addition to the collaborative work described in the CHNA, Mercy Hospital Leadership and coworkers attended coalition meetings, served as board members on various committees, and were actively involved in community events. Mercy Hospital worked with various other organizations in the Healthy Bourbon County Action Team to survey community members on their perception of the health and wellness of our community. This perception survey had a high response rate. The results from this survey will be used in implementing policy and environmental change as well as direct our focus to the most pressing priorities.
FORM 990, SCHEDULE H, PART VI, LINE 3Mercy 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 organizations financial assistance policy through several means. If at any time a patient expresses hardship and inability to pay, the account is placed for review. In addition, patients 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, in addition to the web address providing the application, policies, and even how uninsured accounts are handled. Lastly, the statements message 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.
FORM 990, SCHEDULE H, PART VI, LINE 4MERCY HOSPITAL KANSAS COMMUNITIES' PRIMARY SERVICE AREA INCLUDES THE FOLLOWING THREE COUNTIES IN SOUTHEAST KANSAS: LINN, BOURBON, AND CRAWFORD. THE FOLLOWING INFORMATION IS DERIVED FROM 2018 IBM/WATSONS DEMOGRAPHICS AND FY2018 DECISION RESOURCE GROUPS INSURANCE COVERAGE ESTIMATES. THE AREAS POPULATION IS 627,914. 33% OF THE POPULATIONS AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 37% OF THE POPULATION IS 45 AND OLDER. 15% OF THE HOUSEHOLDS ARE ON MEDICARE, 20% ON MEDICAID, AND 10% UNINSURED.
FORM 990, SCHEDULE H, PART VI, LINE 5MERCY HOSPITAL FORT SCOTT AND EACH OF ITS FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF OUR COMMUNITY. THROUGH COLLABORATIVE EFFORTS WITH LOCAL COALITIONS AND ORGANIZATIONS WE WILL SEE A CHANGE IN THE CULTURE OF OUR COMMUNITY. AS A RURAL HOSPITAL, MERCY HOSPITAL FORT SCOTT HAS LIMITED RESOURCES AND MUST CARRY AN ENTERPRISING SPIRIT TO BETTER SERVE OUR COMMUNITY. NETWORKING AND JOINING FORCES WITH AREA BUSINESSES, ORGANIZATIONS, NON-PROFIT ENTITIES, AND OTHERS HAS HELPED EXTEND OUR REACH. SURVEY RESULTS SHOW OUR COMMUNITY WAS IN NEED OF A FORM OF EXERCISE FOR THOSE WHO ARE HAVE PHYSICAL LIMITATIONS. IN 2016 MERCY HOSPITAL RAISED MONEY THROUGH THE MERCY FOUNDATION AND A GOLF TOURNAMENT TO BUY AN UNDERWATER TREADMILL. THE MERCY FOUNDATION, COMMUNITY SUPPORT, FUNDRAISING, AND COWORKER SUPPORT HAS ALSO LED US TO THE PURCHASE OF A NEW MAMMOGRAPHY MACHINE. THIS WAS A MUCH NEEDED REPLACEMENT TO ENHANCE PREVENTATIVE SERVICES FOR OUR COMMUNITY. THE HOSPITAL HOLDS WELLNESS FAIRS AT MULTIPLE BUSINESSES WITHIN THE COMMUNITY. MERCY PHYSICIANS CLINIC HELD AN ANNUAL TEDDY BEAR CLINIC. THIS IS A HEALTH FAIR HELD IN COLLABORATION WITH MANY NON-PROFIT AND HELPING AGENCIES TO HELP FAMILIES GET THE REFERRALS AND RESOURCES THEY NEED. MERCY HOSPITAL HAS PARTICULAR CONCERN FOR THE VULNERABLE AND UNDERSERVED. AN EXAMPLE OF A LONG STANDING PROGRAM, THE MOTHERS AND INFANTS CLINIC, WHERE SOON TO BE MOTHERS WHO HAVE LITTLE OR NO INSURANCE RECEIVE NEEDED PRENATAL CARE, IS A PRIME EXAMPLE OF OUR COMMITMENT TO PROMOTING HEALTH AND WELLNESS IN THE COMMUNITY. THESE WOMENS SOCIAL, NUTRITION, AND SPIRITUAL NEEDS ARE ALSO ADDRESSED WITH COMMUNITY PARTNERS. COWORKERS AND LEADERS GATHER COATS DURING AN ANNUAL COAT DRIVE, OR CANNED GOODS DURING THE ANNUAL CANNED GOOD DRIVE, AND THE ITEMS ARE DONATED TO THE LOCAL FOOD PANTRY.
FORM 990, SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM 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, 2018, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 5 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, MERCY HAD MORE THAN 10.3 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.
FORM 990, SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT: KANSAS

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ASCENSION VIA CHRISTI HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 MOUNT CARMEL WAYAddressLine1Txt
CityPITTBURGCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66762ZIPCd
FieldValueIRS element (for citing)
Recipient EIN480543778RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Non Cash Assistance$382,821NonCashAssistanceAmt
Valuation Method UsedBOOK VALUEValuationMethodUsedDesc
Non Cash AssistanceEQUIPMENTNonCashAssistanceDesc
Purpose Of GrantDONATION OF FIXED ASSET(EQUIPMENT)PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, SCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ASSISTANCE PROVIDED IS INTENDED TO BE USED FOR THE GENERAL OPERATING PURPOSES OF THE DONEE. THE USE OF GRANT FUNDS IS NOT MONITORED AFTER GRANTS ARE GIVEN. FORM 990, Schedule I, Part II, Line 1 BOOK VALUE WAS USED FOR THE DEPRECIABLE ASSET AS FMV WAS THOUGHT TO NOT BE MATERIALLY DIFFERENT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Baker Reta
President-Fort Scott & Bd Mbr$259,568$0$39,349$0$40,780$0$49,657$0$7,521$0$396,875$0$0$0
Burke Katrina
Physician$311,501$0$10,686$0$18,771$0$9,450$0$15,207$0$365,615$0$0$0
Fox John M
Physician$414,069$0$3,758$0$19,211$0$24,918$0$17,350$0$479,306$0$0$0
Gugnani Pankaj K
Physician$301,659$0$0$18,976$0$17,929$0$16,703$0$355,267$0$0$0
Hall Ralph W
Physician$315,138$0$23,042$0$42,776$0$24,757$0$17,210$0$422,923$0$0$0
Hennessey III William
Former Key Employee$170,460$0$29,588$0$52,301$0$32,989$0$16,586$0$301,924$0$0
Marion Tanya
Regional VP - Human Resources$253,097$0$81,371$0$34,230$0$49,942$0$17,382$0$436,022$0$0
Mathews Thomas P
VP Finance$0$154,899$0$26,675$0$105,576$0$0$0$7,377$0$294,527$0$0
Pulsipher Gary W
CEO & Board Member$385,273$0$239,864$0$27,383$0$70,308$0$13,732$0$736,560$0$0
Reynolds Scott
CFO - Central Communities$373,817$0$113,290$0$44,929$0$96,403$0$13,351$0$641,790$0$0
Seals DO Larry E
Physician$365,469$0$17,697$0$19,980$0$17,432$0$16,845$0$437,423$0$0$0
Self Do Maxwell
Physician & Board Member$278,979$0$0$25,076$0$28,810$0$16,846$0$349,711$0$0$0
Swope Jon
President-Central Communities$728,214$0$507,077$0$55,870$0$155,788$0$17,789$0$1,464,738$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 1HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO THE 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. ONE LISTED INDIVIDUAL (OFFICER) RECEIVED THIS BENEFIT DURING THE YEAR.
FORM 990, SCHEDULE J, PART I, QUESTION 3MERCY HOSPITAL KANSAS COMMUNITIES RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS.
FORM 990, SCHEDULE J, PART I, QUESTION 4BMERCY OFFERS SUPPLEMENTAL RETIREMENT PLANS 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 PLANS ARE CLOSED TO NEW ENTRANTS. THE INDIVIDUALS REPORTABLE ON THIS RETURN WHO PARTICIPATE IN THE SUPPLEMENTAL RETIREMENT PLANS INCLUDE: GARY PULSIPHER, SCOTT REYNOLDS, TANYA MARION, AND JON SWOPE. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C).

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JANICE BAKER
FAMILY MEMBER OF OFFICER$45,407EMPLOYMENTfalse
SHAWN YOUNG
FAMILY MEMBER OF OFFICER$48,473EMPLOYMENTfalse

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp
Drugs And Medical SuppliesDrugsAndMedicalSuppliesGrp
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)MEDICAL EQUIPMENT3$147,314BOOK VALUE
Yes (X)Savi Scout medical device1$65,800BOOK VALUE
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule N IRS990ScheduleN

FieldValueIRS element (for citing)
Liquidation Of Assets TableLiquidationOfAssetsTableGrp

Disposition Of Assets Detail DispositionOfAssetsDetail (3 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
ASCENSION VIA CHRISTI HOSPITAL
DONATION OF FIXED ASSETS (EQUIPMENT)2019-03-31$382,821BOOK VALUE4805437781 MOUNT CARMEL WAYPITTSBURGHPA66762501(C)(3)
(no name)
DISPOSAL/WRITE-OFF OF ASSETS2019-06-30$20,295,700BOOK VALUEN/A
(no name)
ASSET TRNSFR TO OTHER MERCY COMMUNITIES$1,224,118BOOK BASIS501(c)(3)
FieldValueIRS element (for citing)
Director Of Successor2falseDirectorOfSuccessor2Ind
Employee Of Successor2falseEmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, QUESTION 1AFORM 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, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES ARE RESERVED SOLELY FOR THE SOLE CORPORATE MEMBER: -TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION SHALL OPERATE; -TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; -TO APPOINT MEMBERS OF THE BOARD; -TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; -TO APPROVE THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF THE CORPORATION; -TO APPROVE THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; -TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; -TO ENCUMBER ANY OR ALL THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, DISSOLVE, OR ABANDON THE MERCY HOSPITAL KANSAS COMMUNITIES CORPORATION; AND -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION.
FORM 990, PART VI, QUESTION 11BDSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE DIRECTOR OF ACCOUNTING AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORMS 990. 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. IN ADDITION, THE FORM 990 IS MADE AVAILABLE TO THE MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES BOARD OF DIRECTORS FOR THEIR REVIEW, AS MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES IS THE SOLE CORPORATE MEMBER OF MERCY HOSPITAL KANSAS COMMUNITIES AND HAS ULTIMATE RESPONSIBILITY TO APPOINT THE MERCY HOSPITAL KANSAS COMMUNITIES BOARD (WHICH IS PRIMARILY ADVISORY IN NATURE) AND LEADERSHIP TEAM AND POWER TO APPROVE SIGNIFICANT FINANCIAL AND OPERATIONAL DECISIONS. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS.
FORM 990, PART VI, QUESTION 12CDESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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, QUESTIONS 15A & 15BOFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH 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 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, QUESTION 19AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS NET TRANSFERS TO/FROM AFFILIATES $9,602,850
FORM 990, PART XII, QUESTION 2CAUDIT 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, QUESTION 3A AND 3BSINGLE 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (71 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Casa de Misericordia
1000 Mier StreetLaredoTX78040742912461SHELTERTX501c37MM LAREDOYes (true)
McAuley Portfolio Management Company
14528 S Outer Forty Suite 100ChesterfieldMO63017261708048PORT MGMTMO501c312bMercy HealthYes (true)
Mercy ACO Clinical Services Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017464504901VIRTUAL CAREMO501c33Mercy HealthYes (true)
Mercy Clinic East Communities
645 Maryville Ctr Ste 100St LouisMO63141431771217PHYS GROUPMO501c310MH EAST COMMYes (true)
Mercy Clinic Fort Smith Communities
7301 Rogers AvenueFort SmithAR72903261318597PHYS CLINICAR501c33MH FS COMMYes (true)
Mercy Clinic Oklahoma Communities Inc
4300 W Memorial RoadOklahoma CityOK73120270473057PHYS GROUPOK501c33MH OK COMMYes (true)
Mercy Clinic Springfield Communities
1965 Fremont Street Suite 2950SpringfieldMO65804431560263PHYS GROUPMO501c33MH SF COMMYes (true)
Mercy Family Center
14528 S Outer Forty Suite 100ChesterfieldMO63017721069468COUNSELINGLA501c37Mercy HealthYes (true)
Mercy Health
14528 S Outer Forty Suite 100ChesterfieldMO63017431423050CORP OFFICEMO501c31NAfalse
Mercy Health East Communities
14528 S Outer Forty Suite 100ChesterfieldMO63017431718408HLTH SYSTEMMO501c312aMercy HealthYes (true)
Mercy Health Fort Smith Communities
7301 Rogers AvenueFort SmithAR72917261318515Holding CoAR501c312bMercy HealthYes (true)
Mercy Health Foundation
14528 S Outer Forty Suite 100ChesterfieldMO63017200901499FoundationMO501c312bMercy HealthYes (true)
Mercy Health Foundation Ada
430 N Monte Vista StreetAdaOK74820463596274FoundationOK501c312aMH ADA IncYes (true)
Mercy Health Foundation Ardmore
1011 14th Avenue NWArdmoreOK73401710962525FoundationOK501c312aMH ARDMOREYes (true)
Mercy Health Foundation Berryville
214 Carter StreetBerryvilleAR72616710759301FoundationAR501c312aMH BERRYVILLYes (true)
Mercy Health Foundation Fort Scott
401 Woodland Hills BlvdFort ScottKS66701481077073FoundationKS501c37M KS COMMYes (true)
Mercy Health Foundation Fort Smith
7301 Rogers AvenueFort SmithAR72917237330425FoundationAR501c37MH FS COMMYes (true)
Mercy Health Foundation Jefferson
1400 US Highway 61 SouthFestusMO63028462797051FoundationMO501c312bMH JEFFERSONYes (true)
Mercy Health Foundation Joplin
100 Mercy WayJoplinMO64804270906136FoundationMO501c37MH SW MOKSYes (true)
Mercy Health Foundation Lebanon
100 Hospital DriveLebanonMO65536822514567FoundationMO501c312bMH LEBANONYes (true)
Mercy Health Foundation Lincoln
1000 East Cherry StreetTroyMO63379811477159FoundationMO501c312bMH EAST COMMYes (true)
Mercy Health Foundation Nw Arkansas
2710 Rife Medical LaneRogersAR72758710601687FoundationAR501c37MH ROGERSYes (true)
Mercy Health Foundation of Oklahoma
4300 W Memorial RoadOklahoma CityOK73120454732301FoundationOK501c312aMH OK COMMYes (true)
Mercy Health Foundation Oklahoma City
4300 W Memorial RoadOklahoma CityOK73120463184231FoundationOK501c312aMH OK CityYes (true)
Mercy Health Foundation Springfield
1235 E Cherokee StreetSpringfieldMO65804320195818FoundationMO501c312bMH SF COMMYes (true)
Mercy Health Foundation St Francis
100 W Highway 60Mountain ViewMO65548431873914FoundationMO501c312aM St FrancisYes (true)
Mercy Health Foundation St Louis
14528 S Outer Forty Suite 100ChesterfieldMO63017562410020FoundationMO501c312bMH EAST COMMYes (true)
Mercy Health Foundation Washington
901 E Fifth StreetWashingtonMO63090562410022FoundationMO501c312bMH EAST COMMYes (true)
Mercy Health NW Arkansas Communities
2710 Rife Medical LaneRogersAR72758621684203PHYS GROUPAR501c310Mercy HealthYes (true)
Mercy Health Oklahoma Communities Inc
4300 W Memorial RoadOklahoma CityOK73120731453048HLTH SYSTEMOK501c312aMercy HealthYes (true)
Mercy Health Plans of Missouri Inc
3265 S National AvenueSpringfieldMO65807320481419HMOMO501c4N/AMercy HealthYes (true)
Mercy Health Plans Inc
3265 S National AvenueSpringfieldMO65807320486150PPOMO501c4N/AMH PLANS MOYes (true)
Mercy Health SW MOKS Communities
100 Mercy WayJoplinMO64804300584463HLTH SYSTEMMO501c312bMercy HealthYes (true)
Mercy Health Springfield Communities
1235 E Cherokee StreetSpringfieldMO65804431856028HLTH SYSTEMMO501c312bMercy HealthYes (true)
Mercy Home Health Berryville
804 W Freeman Suite 4BerryvilleAR72616870781247InactiveAR501c312aMH SPRINGFLDYes (true)
Mercy Hospital Ada Inc
430 N Monte Vista StreetAdaOK74820462288155HospitalOK501c33MH OK COMMYes (true)
Mercy Hospital Ardmore Inc
1011 14th Avenue NWArdmoreOK73401731500629HospitalOK501c33MH OK COMMYes (true)
Mercy Hospital Aurora
500 Porter AvenueAuroraMO65605431936696HospitalMO501c33MH SF COMMYes (true)
Mercy Hospital Berryville
214 Carter StreetBerryvilleAR72616710759299HospitalAR501c33MH NW AK COMYes (true)
Mercy Hospital Booneville
880 West Main StreetBoonevilleAR72927463851119HospitalAR501c33MH FT SMITHYes (true)
Mercy Hospital Carthage
3125 Dr Russell Smith WayCarthageMO64836453808607HospitalMO501c33MH SW MOKSYes (true)
Mercy Hospital Cassville
94 Main StreetCassvilleMO65625431936699HospitalMO501c33MH SF COMMYes (true)
Mercy Hospital Columbus
220 Pennsylvania AvenueColumbusKS66725270842031HospitalKS501c33MH SW MOKSYes (true)
Mercy Hospital El Reno Inc
2115 Parkview DriveEl RenoOK73036272716065HospitalOK501c33MH OK CityYes (true)
Mercy Hospital Fort Smith
7301 Rogers AvenueFort SmithAR72903710240352HospitalAR501c33MH FS COMMYes (true)
Mercy Hospital Healdton Inc
3462 Hospital RdHealdtonOK73438263173902HospitalOK501c33MH ARDMOREYes (true)
Mercy Hospital Jefferson
1400 Highway 61 SouthFestusMO63028430687077HospitalMO501c33MH EAST COMMYes (true)
Mercy Hospital Joplin
100 Mercy WayJoplinMO64804270814858HospitalMO501c33MH SW MOKSYes (true)
Mercy Hospital Kingfisher Inc
1000 Kingfisher Regional Hospital CKingfisherOK73750463433074HospitalOK501c33MH OK CityYes (true)
Mercy Hospital Lebanon
100 Hospital DriveLebanonMO65536431767432HospitalMO501c33MH SF COMMYes (true)
Mercy Hospital Lincoln
1000 East Cherry StreetTroyMO63379472219204HospitalMO501c33MH EAST COMMYes (true)
Mercy Hospital Logan County Inc
200 South AcademyGuthrieOK73044452998842HospitalOK501c33MH OK CityYes (true)
Mercy Hospital Oklahoma City Inc
4300 W Memorial RoadOklahoma CityOK73120730579285HospitalOK501c33MH OK COMMYes (true)
Mercy Hospital Ozark
801 W River StreetOzarkAR72949710689680HospitalAR501c33MH FT SmithYes (true)
Mercy Hospital Paris
500 E AcademyParisAR72855710655753HospitalAR501c33MH FT SmithYes (true)
Mercy Hospital Rogers
2710 Rife Medical LaneRogersAR72758710294390HospitalAR501c33MH NW AK COMYes (true)
Mercy Hospital Springfield
1235 E Cherokee StreetSpringfieldMO65804440552485HospitalMO501c33MH SF COMMYes (true)
Mercy Hospital Tishomingo Inc
1000 South ByrdTishomingoOK73460274433830HospitalOK501c33MH ADA IncYes (true)
Mercy Hospital Waldron
1341 W 6th StreetWaldronAR72958710557895HospitalAR501c33MH FT SmithYes (true)
Mercy Hospital Watonga Inc
500 Clarence Nash BlvdWatongaOK73772455199762HospitalOK501c33MH OK CityYes (true)
Mercy Hospitals East Communities
615 S New Ballas RoadSt LouisMO63141430653493HospitalMO501c33MH EAST COMMYes (true)
Mercy Ministries of Laredo
2500 ZacatecasLaredoTX78046200198462OutreachTX501c37Mercy HealthYes (true)
Mercy Research
524 North Booneville AvenueSpringfieldMO65802870796305ResearchMO501c34Mercy HealthYes (true)
Mercy St Francis HosPital
100 W Highway 60Mountain ViewMO65548440607149HospitalMO501c33MH SF COMMYes (true)
MHM Support Services
14528 S Outer Forty Suite 100ChesterfieldMO63017202553101CTRL SYS FUNCMO501c312aMercy HealthYes (true)
Mission Clinical Services
300 Werner StreetHot SpringsAR71913134239691CHILD ADVOCAR501c33Mercy HealthYes (true)
Mercy Hlth Fdn S-fka St Anthonys Ch FDN
10010 Kennerly RoadSt LouisMO63128261516789FundraisingMO501c312aMH SOUTHYes (true)
MERCY HOSP SOUTH-FKA ST ANTHONY MED CTR
10010 Kennerly RoadSt LouisMO63128430980256HospitalMO501c33MH EAST COMMYes (true)
St Anthony's Physician Organization
10010 Kennerly RoadSt LouisMO63128431784536Health careMO501c33MH SOUTHYes (true)
St Mary's Hospital of Enid Oklahoma Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017730614655InactiveOK501c33MH OK COMMYes (true)
Unity Ambulatory Care
14528 S Outer Forty Suite 100ChesterfieldMO63017431861745InactiveMO501c312cMH EAST COMMYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Fort Smith Emergency Medical Services
1701 S GreenwoodFT SMITHAR72901710416615Emergency MedicalARNA
Mercy Ambulatory Surgery Center LLC
7301 RogersFT SMITHAR72917710827721AMBUL SURG CTARNA
Plaza Surgery Services Company LLC
12700 Southfork RDSt LouisMO63128204709312INACTIVEMONA
Resource Optimization & Innovation LLC
645 MaryvilleSt LouisMO63141460468368CENTRAL DIST.MONA
St Edward Mercy Med Ctr Multi-Purp BLDG
7301 RogersFT SMITHAR72903710554050OFFICE BUILDINGARNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxt
Frontenac Properties Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017521914421Holding coDENAC-Corp
Inveno Health Inc
1235 E Cherokee StreetSpringfieldMO65804264509571Product CommerceMONAC-Corp
Mercy Commercial Services Inc
14528 South Outer Forty Suite 100ChesterfieldMO63017464953543PARENT OF VCCMONAC-Corp
Mercy Health Center Condominium Inc
4300 W Memorial RdOklahoma CityOK73120680640970Real estateOKNAC-Corp
Mercy Health Network of the Southern Reg
14528 S Outer Forty Suite 100ChesterfieldMO63017731580607HOLDING COOKNAC-Corp
Mercy Health Network Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017731381689HOLDING COOKNAC-Corp
Mercy Managed Care Corporation
14528 S Outer Forty Suite 100ChesterfieldMO63017731441665HOLDING COOKNAC-Corp
UHL Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535Holding coMONAC-Corp
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042InactiveMONAC-Corp
St Anthony's Physician Org of Illinois
10010 Kennerly RoadSt LouisMO63128320457168Health CareMONAC-Corp
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Mercy Health Foundation Joplin
P$65,800FMV
Mercy Clinic Springfield Communities
P$138,738FMV
MHM Support Services
P$9,381,552FMV
MERCY COMMUNITY SERVICES INC
Q$868,249FMV
Mercy Hospital Joplin
Q$7,937,228FMV

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE R, PART IIMERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITAL ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITAL WASHINGTON, EIN 43-1066883.
FORM 990, SCHEDULE R, PART VLAWSON 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.

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