2018-05-15T15:08:03-05:00 2017-06-30 ERNST & YOUNG US LLP 950 MAIN AVENUE SUITE 1800 CLEVELAND OH 44113 990 2016-07-01 710294390 MERCY HOSPITAL ROGERS % BENNY J STOVER CPA MERC 3145796100 2710 Rife Medical Lane Rogers AR 72758 BENNY J STOVER VP FINANCE 2018-05-14 true ERICA M YIKE P01608257 2168615000 2018-05-14 2016 2022-09-23 18:48:47Z Eric Pianalto 2710 Rife Medical Lane Rogers AR 72758 269456618 false 0928 X WWW.MERCY.NET X 1995 AR AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 6 4 0 277 0 268647 482820 233881826 266247032 15893 13943 1965247 2285941 236131613 269029736 155355 309241 0 0 86973163 88964853 0 0 0 118750226 137952048 205878744 227226142 30252869 41803594 169100421 187253269 5456132 13860632 163644289 173392637 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 20585181 80186209 SURGICAL SERVICES: THE HOSPITAL PROVIDES A BROAD SCOPE OF SURGICAL SERVICES, ON BOTH AN INPATIENT AND AN OUTPATIENT BASIS. DURING THE FISCAL YEAR ENDED JUNE 30, 2017, THE HOSPITAL PERFORMED 2,523 INPATIENT SURGERIES AND 5,695 OUTPATIENT SURGERIES. 2361183 71123482 LABORATORY SERVICES: THE HOSPITAL PERFORMED 553,837 LABORATORY TESTS IN FISCAL YEAR 2017. THE HOSPITAL OFFERS A FULL RANGE OF LAB TESTING SERVICES. TEST RESULTS ARE IMMEDIATELY TRANSMITTED TO THE PATIENTS PHYSICIANS OFFICE. PATIENTS MAY ALSO HAVE SPECIMENS COLLECTED AND TESTED HERE AND THE RESULTS SENT TO A SPECIALIST IN ANOTHER CITY. IN ADDITION TO ROUTINE LAB TESTS MOST OFTEN REQUESTED BY PHYSICIANS, OUR SERVICES INCLUDE PRE-EMPLOYMENT DRUG SCREENING OR SCREENING FOR WORKERS COMPENSATION INJURIES, FEDERAL DRUG SCREEN COLLECTIONS FOR THE DEPARTMENT OF TRANSPORTATION, HEALTH SCREENS TO PROMOTE WELLNESS AND REDUCE HEALTH RISKS IN OUR COMMUNITY, AND OUTPATIENT TRANSFUSION SERVICES. 1067137 67200770 CT SCAN: THE HOSPITAL PERFORMED 25,619 PROCEDURES IN FY17. CT SCAN, OR COMPUTED TOMOGRAPHY, IS A DIAGNOSTIC TEST THAT USES SPECIAL X-RAY EQUIPMENT TO MAKE CROSS-SECTIONAL PICTURES OF YOUR BODY. ONE MAJOR ADVANTAGE OF CT IS ITS ABILITY TO IMAGE BONE, SOFT TISSUE AND BLOOD VESSELS ALL AT THE SAME TIME. DOCTORS USE CT SCANS TO LOOK FOR BROKEN BONES, CANCER, BLOOD CLOTS, SIGNS OF HEART DISEASE, INTERNAL BLEEDING AND TRAUMA, AND MUSCULOSKETAL DISORDERS. 145959478 309241 48202599 169972979 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true true true false false false false false false false false false false false false false true true true false false true X 0 0 0 false false false false false false false false false false X 6 4 false false false false true true true true true false false true true true true true true false false true true X BENNY J STOVER CPA 4793382903 2710 RIFE MEDICAL LANE Rogers AR 72758 Lawson Randy Board member 1.0 1.0 X 0 0 0 Lipscomb Tabitha Board member 1.0 1.0 X 0 0 0 Rivaldo Craig Board member 1.0 1.0 X 0 0 0 Stuppy Robert J Physician & board member 5.0 55.0 X 0 765009 35390 CALLAHAN WAYNE BOARD MEMBER 1.0 1.0 X 0 0 0 DONNELL HUGH G PHYSICIAN & BOARD MEMBER 5.0 55.0 X 0 540019 50953 Pianalto Eric Chief executive officer 25.0 35.0 X 0 583614 217098 Reynolds Scott CFO - Central Communities 2.0 58.0 X 0 495457 108085 Barclay Richard F VP-Support services 60.0 0.0 X 0 245303 31284 Burke James Regional VP-Legal 2.0 58.0 X 0 375823 61498 Johnson Christopher Chief of staff 60.0 0.0 X 0 490599 50951 Marion Tanya Regional VP-Human resources 3.0 57.0 X 0 295964 58729 Rankin Charlotte Chief nursing officer 60.0 0.0 X 0 297144 49022 Stover Benny J VP-Finance 30.0 30.0 X 0 232675 27651 Swope Jon President, central communities 2.0 58.0 X 0 1335560 387904 Dunham Robert D Director, pharmacy services 60.0 0.0 X 182642 0 28883 Gibbs Eric Clinical pharmacist 60.0 0.0 X 155013 0 19805 Moore Richard E Clinical pharmacist 60.0 0.0 X 150545 0 23985 Mountifield Mary Pharmacist 60.0 0.0 X 145870 0 25704 Slaba Sean M Perfusionist 60.0 0.0 X 152500 0 25489 Vitiello Jonathan Former officer 0.0 60.0 X 0 762976 107820 Hennessey III William Former key employee 0.0 60.0 X 0 246294 49785 Stewart Michele Former key employee 0.0 20.0 X 0 389357 93325 Treptow MD Douglas Former key employee 0.0 60.0 X 0 445624 52362 786570 7501418 1505723 35 true true false Bates and Associates 433 W Walnut SPRINGFIELD MO 65806 Construction 4288497 McCarthy Building Co 1341 North Rock Hill Rd ST LOUIS MO 63124 Construction 2256736 FASTAFF 6399 S FIDDLERS GREEN CIRCLE STE GREENWOOD VILLAGE CO 80111 AGENCY STAFFING 1817604 DEWITT AND ASSOC INC PO Box 3378 GS SPRINGFIELD MO 65808 Construction 1719147 MAYO MEDICAL LABS 200 SW FIRST STREET ROCHESTER MN 55805 LABORATORY SERVICES 1484524 26 336437 133263 13120 482820 NET PATIENT SERVICE REVENUE 621110 265915843 265915843 OTHER OPERATING REVENUE 900099 331189 331189 266247032 13943 13943 0 0 639130 639130 0 639130 639130 0 0 0 0 0 0 0 702556 426882 275674 275674 CAFE & VENDING 900099 798237 798237 INSURANCE PROCEEDS 900099 106872 106872 EMS SERVICE REVENUE 900099 466028 466028 1371137 269029736 266713060 1833856 186969 186969 122272 122272 0 0 0 72612130 64347313 8264817 3342269 2961847 380422 7967680 7060787 906893 5042774 4468798 573976 0 0 0 23115 23115 0 0 11038808 9462347 1576461 370573 21304 349269 4385402 1976382 2409020 123503 118989 4514 0 2567452 761955 1805497 396028 367980 28048 0 610 610 0 0 10724225 5417157 5307068 50134 50134 DRUGS & MEDICAL EXPENSES 51485261 51294362 190899 SHARED SERVICE FEES 35959552 1995820 33963732 BAD DEBT 19038248 19038248 REPAIRS AND MAINTENANCE 1171377 147224 1024153 617760 173091 444669 227226142 169972979 57253163 0 5178110 5449612 0 0 7486 0 24142595 27887126 0 0 0 0 519588 259794 4918780 4671857 508816 82731 261193420 113861572 130713283 147331848 0 0 0 0 2116652 1515926 0 0 995111 54375 169100421 187253269 5456132 11625784 0 9097 0 0 0 0 0 0 0 0 0 0 0 0 0 2225751 5456132 13860632 X 163644289 173392637 0 0 0 0 163644289 173392637 169100421 187253269 X 41803594 -32055246 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 23115 23115 false FORM 990, SCHEDULE C, PART II-B, LINE 1(I) LOBBYING PORTION OF DUES THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: ARKANSAS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND CATHOLIC HEALTH ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2017, DUE WERE $62,511, $18,196 AND $43,854, RESPECTIVELY. APPROXIMATELY 28% OF ARKANSAS HOSPITAL ASSOCIATION DUES, 21.78% OF AMERICAN HOSPITAL ASSOCIATION DUES AND 3.76% OF CATHOLIC HEALTH ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS. 0 4230161 4230161 0 140872691 60381948 80490743 0 4990 540 4450 0 74253187 53246450 21006737 0 41832391 232634 41599757 147331848 0 DUE TO AFFILIATES 2225751 2225751 FORM 990, SCHEDULE D, PART X, LINE 2 ASC 470 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, 2017 OR 2016. true true X true X true X true true true false true true 4733473 4733473 0.02270 21010268 11087635 9922633 0.04770 25743741 11087635 14656106 0.07040 642901 642901 0.00310 1471301 1471301 0.00710 58767 58767 0.00030 2172969 2172969 0.01050 27916710 11087635 16829075 0.08090 12330 12330 93759 4000 89759 0.00040 106089 16330 89759 0.00040 true 8594588 68882903 58786044 10096859 X true true 1 1 Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 www.mercy.net AR 4797 X X X X X MERCY HOSPITAL ROGERS 1 false false true X X X X X X X X 15 true true true true X WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS X ozarkshealthcommission.org X true 16 true WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS false true X 100 400. X true true X X X true X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X true X false X X X X true X false false FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 MERCY CONDUCTED ITS 2016 CHNA IN COLLABORATION WITH OZARKS HEALTH COMMISSION, A REGIONAL COALITION DESCRIBED IN DETAIL BELOW. IN CONDUCTING THE CHNA IN COLLABORATION, MERCY ALSO COLLECTED ITS OWN INPUT AND DATA FROM COMMUNITY MEMBERS AND PUBLIC HEALTH EXPERTS. AN ELECTRONIC COMMUNITY SURVEY WAS DISTRIBUTED TO COMMUNITY MEMBERS FROM AUGUST 2015 TO DECEMBER 2015 REQUESTING INPUT ON PARTICIPANTS HEALTH CONCERNS, PERCEIVED BARRIERS TO IMPROVED HEALTH, AND HEALTH NEEDS OF THE COMMUNITY. 383 RESPONSES (15% OF TOTAL SURVEY) WERE RECEIVED AND EVALUATED FROM RESIDENTS AND ORGANIZATIONS WITHIN THE MERCY HOSPITAL ROGERS COMMUNITY. AN ADDITIONAL COMMUNITY HEALTH SURVEY TARGETED SPECIFICALLY AT MEDICALLY UNDERSERVED AND AT-RISK COMMUNITY MEMBERS WAS CONDUCTED BY THE HOSPITAL IN THE FALL OF 2015 DURING FREE INFLUENZA VACCINE EVENTS. THESE EVENTS TOOK PLACE AT SAMARITAN COMMUNITY CENTER, ST. VINCENT DE PAUL FOOD PANTRY, AND TOWN CENTERS OF PEA RIDGE, AVOCA, AND GARFIELD, AR. 80 SURVEY RESPONSES WERE RECEIVED. A COMMUNITY FOCUS GROUP WAS CONDUCTED IN NOVEMBER 2015 AT THE CENTER FOR NONPROFITS IN ROGERS, AR AND INCLUDED MEMBERS OF HISPANIC MINORITY AND LOW-INCOME POPULATIONS. MERCY ALSO SOLICITED INPUT AND PARTICIPATION FROM THE BENTON COUNTY HEALTH DEPARTMENT, WHOSE ADMINISTRATOR IS A MEMBER OF MERCYS COMMUNITY HEALTH SUBCOMMITTEE OF THE BOARD OF DIRECTORS. OTHER PUBLIC HEALTH SOURCES OF DATA ARE DESCRIBED IN THE CHNA. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A MERCY CONDUCTED ITS CHNA IN COLLABORATION WITH OZARKS HEALTH COMMISSION, A LARGE COLLABORATION OF FOUR HOSPITAL SYSTEMS AND FIVE COUNTY HEALTH DEPARTMENTS, COVERING A 51 COUNTY AREA OF MISSOURI, ARKANSAS, KANSAS, AND OKLAHOMA. THE OZARKS HEALTH COMMISSION WAS ORGANIZED BY THE SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT AND MERCY HOSPITAL SPRINGFIELD AND INCLUDED FOUR HOSPITALS IN THE MERCY HEALTH SYSTEM. FORM 990 SCHEDULE H, PART V, SECTION B, LINE 6B MERCY CONDUCTED ITS CHNA IN COLLABORATION WITH OZARKS HEALTH COMMISSION, A LARGE COLLABORATION OF FOUR HOSPITAL SYSTEMS AND FIVE COUNTY HEALTH DEPARTMENTS, COVERING A 51 COUNTY AREA OF MISSOURI, ARKANSAS, KANSAS, AND OKLAHOMA. THE OZARKS HEALTH COMMISSION WAS ORGANIZED BY THE SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT AND MERCY HOSPITAL SPRINGFIELD AND INCLUDED FOUR HOSPITALS IN THE MERCY HEALTH SYSTEM. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 The 2016 Community Health Needs Assessment identified four priority health areas. A community health improvement plan was developed and implemented to address these significant needs. Mercy developed and implemented a variety of programs and initiatives during tax year 2016. 1. Access to Care for At-Risk Persons. Mercy began a program in collaboration with a local federally qualified health center (FQHC) to provide access to specialty care for uninsured patients of the FGHC in need of such care. Ten Mercy specialty clinics participated in the program. 169 patients were seen in 2016. Services included office visits, testing, and surgery. McAuley Clinic Without Walls is a program to provide access to health care services, particularly primary care and preventive services, to uninsured adults living in Northwest Arkansas who would otherwise not have access to health care. Fourteen primary care physicians participated in this program in the first year, and 74 patients were enrolled. The Mercy Mobile Mammography program continued to serve rural and underserved populations in Benton and Washington counties. 368 women were screened at 9 locations. Four new locations were added during this tax year. 352 free influenza vaccines were provided to medically underserved and rural community residents using the Mercy Mobile Health Unit and hospital volunteers. A new chronic disease screening program was begun in partnership with a local nonprofit service organization. 370 people were screened for high blood pressure, diabetes, and lipid disorders during 19 screening events this year. 7500 people were screened for chronic diseases at nine corporate screening events. Mercy is in its second year of offering an internal medicine residency program in partnership with University of Arkansas for Medical Sciences to increase the number of practicing primary care physicians in the area. The second class of eight residents began this year. 2. Behavioral Health. Mercy, in partnership with the Endeavor Foundation, completed the Join the Solution project, a one-year study assessing mental health services, physical health services, and distribution of basic needs to students in five major area school districts. Based on results obtained from this study, the Center for Collaborative Care, of which Mercy will be a key sponsor and supporter has been developed. This new entity will aim to address the needs identified in the study by use of community liaisons and a technology platform. Behavioral health services were expanded significantly to a total of 4 psychiatrists, 4 psychologists, 5 therapists, and 3 interns, expanding access and the departments ability to provide care to low-income patients. About 280 low income clients were seen for no charge by therapy interns in collaboration with supervising therapists. The physician mentoring program, RAPHA, is in its first year. Twelve physician mentors worked with 100 physicians to increase physician engagement, job satisfaction, and retention. 3. Diabetes. Several programs were developed or continued during this tax year to address diabetes and obesity. The Healthy for Life Weight Management program for families was redesigned during this tax year and has recommenced programming beginning in tax year 2017. A retail nutrition education program was piloted at a local warehouse store using Mercy dieticians consulting with store customers and advising on food and purchasing choices. The pilot ran for three months during this tax year with a total of 28 sessions. Mercy dieticians also conducted an eight week nutrition class at an elementary school with a large proportion of low-income children during a summer meal program offered by the Rogers School District. Twenty four children and their parents attended the program. The Mercy Diabetes Prevention Program began during this tax year and is growing quickly. Four sessions began with a total of 18 participants. Program evaluation will take place when the first year-long session ends in tax year 2017. 4. Homelessness. Goals of Mercy programs aimed at the health priority area of homelessness are to decrease food insecurity among homeless individuals in Northwest Arkansas and to facilitate partnerships to assist homeless individuals and families. The Mercy motel ministry outreach program provided 4255 meals over the year in collaboration with 15 community partners to homeless residents of a local motel. Mercy also provided grant-funded direct assistance to 32 homeless families. Form 990, Schedule H, Part V, Lines 16A, 16B & 16c THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT HTTPS://WWW.MERCY.NET/MERCY-FINANCIAL-ASSISTANCE 2 CENTER FOR NON-PROFITS 1200 W WALNUT ROGERS AR 72756 HOME CARE MERCY WOUND CARE 1194 W WALNUT ROGERS AR 72756 WOUND CARE FORM 990, SCHEDULE H, PART I, LINE 6A THE ORGANIZATIONS 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 WAS $227,226,142. THE BAD DEBT EXPENSE (CHARGES) INCLUDED IN THIS AMOUNT WAS $19,038,248. THE REMAINING EXPENSE OF $208,187,894 WAS UTILIZED FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F). Form 990, Schedule H Part II A FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS. FORM 990, SCHEDULE H, PART III, SECTION A, 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. FORM 990, SCHEDULE H, PART III, SECTION A, 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. FORM 990, SCHEDULE H, PART III, SECTION A, 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: "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 SYSTEMS CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENTS 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 8 IT 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 9B MERCYS 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 2 NEEDS ASSESSMENT Mercy conducted four workforce development activities to promote health professions careers for middle school, high school and college students. 1. In partnership with the University of Arkansas for Medical Sciences, Mercy conducted the Medical Application of Science for Health (MASH) program. This is a two week intensive program for 10 high school students considering medical careers. 2. The Bentonville High School Ignite Program is aimed at high school students interested in careers in health care. 40 students spent a total of 2400 hundred hours at Mercy hospital during the school year learning about health care careers. 3. The Volunteen program is a 6 week summer program allowing high school students to volunteer in the hospital or in an outpatient department to gain exposure to health care careers and to help guide educational and career decisions. 25 teens participated this year. 4. The College Student Volunteer Program provides college students opportunities to gain knowledge and experience in their related fields of study and helps to encourage and educate them about health care careers. 31 students were served this year. Mercy also conducted advocacy efforts at the Arkansas state level to encourage legislators to support a bill that would include Marshallese Islander immigrant children in the states childrens health insurance plan. Mercy Hospital Rogers completed all of its community needs assessment as a part of its CHNA, described in Part V, Section B. FORM 990, SCHEDULE H, PART VI, LINE 3 Patient education of eligibility for assistance 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 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 4 Community Information MERCY HOSPITAL ROGERS' PRIMARY SERVICE AREA INCLUDES FOUR COUNTIES IN NORTHWEST ARKANSAS (BENTON, CARROLL, WASHINGTON AND MADISON) AND TWO COUNTIES IN SOUTHWEST MISSOURI (BARRY AND MCDONALD).THE FOLLOWING INFORMATION IS DERIVED FROM 2016 Sg2 MARKET DEMOGRAPHICS AND Sg2 INSURANCE COVERAGE ESTIMATES. THE AREA'S POPULATION IS 589,563. 31% OF THE POPULATIONS AVERAGE HOUSEHOLD INCOME IS OVER $75,000. 37% OF THE POPULATION IS 45 AND OLDER. 23% OF THE HOUSEHOLDS ARE ON MEDICARE, 15% ON MEDICAID, AND 9% UNINSURED. FORM 990, SCHEDULE H, PART VI, LINE 5 Promotion of Community Health Mercy Hospital, in accordance with its mission and values, provides quality and compassionate health care to patients regardless of race, creed, sex, national origin, disability, age or ability to pay. Mercy views its health care services as a ministry, whether care is provided in the acute care, ambulatory, or home-health environment. Mercy is governed by a Board of Directors comprised of community leaders and representatives of the community. The majority of the Board Members reside in the hospitals primary service area and are neither employees, independent contractors, or family members of employees or independent contractors. All Board Members complete an annual conflict of interest survey and any potential conflicts of interest are reviewed and resolved. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in patient care, medical education, and research initiatives which support the hospitals mission to deliver compassionate care and exceptional health services to its community. Mercy is committed to promoting the health of Northwest Arkansas and the surrounding area by serving as a community health leader and a visible partner in community activities. Mercy participated in 18 community health fairs and screenings and was a significant sponsor of 14 health-related walks and runs. The hospital also provided 210 echocardiogram screenings to University of Arkansas athletes as a health promotion service. Monthly support groups were held for community members with chronic obstructive pulmonary disease. The Safe Sleep Program provided new cribs to any family in need and memory boxes to mothers who have lost their babies during pregnancy. Thirteen physicians gave community talks during the tax year. Mercy hosted the 6th annual coaching summit, offering educational programs and sessions to 500 area junior and senior high school coaches. Mercy is also deeply committed to the education and training of future health care professionals, providing training opportunities for students in medicine, nursing, physical therapy, imaging, nutrition, respiratory therapy, laboratory, pharmacy, and paramedic programs. Mercy coworkers were actively involved in volunteer projects to benefit the local community. These included food and clothing drives, assembling snack packs for low income children, and providing Christmas gifts for needy families. FORM 990, SCHEDULE H, PART VI, LINE 6 Affiliated 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, 2017, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 4 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2017, MERCY HAD MORE THAN 9.6 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,100 EMPLOYED PHYSICIANS, AND APPROXIMATELY 40,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE FIFTH 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 7 STATE FILING OF COMMUNITY BENEFIT REPORT: N/A true Tri State Family YMCA 4701 Chouteau Avenue Neosho MO 64850 431729473 501(c)(3) 106688 FUNDING YMCA AND HEALTH PROGRAMS ROGERS LOWELL CHAMBER OF COMMERCE 317 WEST WALNUT ROGERS AR 72756 710029635 501(c)(6) 30000 PROGRAM SUPPORT AR Hospital Education & Research Trust 419 Natural Resources Dr Little Rock AR 72205 710392458 501(c)(3) 45367 PROGRAM SUPPORT 2 1 Patient assistance - dialysis 35 122272 FORM 990, SCHEDULE I, PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANTS THE 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. X true true false true false false false false false false false Stuppy Robert J Physician & board member 0 626269 0 83418 0 55322 0 14082 0 21308 0 800399 0 0 Pianalto Eric Chief executive officer 0 355971 0 202672 0 24971 0 200840 0 16258 0 800712 0 0 Reynolds Scott CFO - Central Communities 0 344082 0 107538 0 43837 0 95709 0 12376 0 603542 0 0 Barclay Richard F VP-Support services 0 181966 0 36574 0 26763 0 19099 0 12185 0 276587 0 0 Burke James Regional VP-Legal 0 255282 0 102105 0 18436 0 45046 0 16452 0 437321 0 0 Johnson Christopher Chief of staff 0 374588 0 67418 0 48593 0 29697 0 21254 0 541550 0 0 Marion Tanya Regional VP-Human resources 0 194710 0 65017 0 36237 0 42620 0 16109 0 354693 0 0 Rankin Charlotte Chief nursing officer 0 216822 0 56117 0 24205 0 42796 0 6226 0 346166 0 0 Stover Benny J VP-Finance 0 177774 0 36710 0 18191 0 11580 0 16071 0 260326 0 0 Swope Jon President, central communities 0 676314 0 565437 0 93809 0 371536 0 16368 0 1723464 0 0 Dunham Robert D Director, pharmacy services 145375 0 10121 0 27146 0 19194 0 9689 0 211525 0 0 0 Gibbs Eric Clinical pharmacist 139808 0 40 0 15165 0 7963 0 11842 0 174818 0 0 0 Moore Richard E Clinical pharmacist 135914 0 40 0 14591 0 7957 0 16028 0 174530 0 0 0 Mountifield Mary Pharmacist 130777 0 40 0 15053 0 19553 0 6151 0 171574 0 0 0 Slaba Sean M Perfusionist 127866 0 40 0 24594 0 9472 0 16017 0 177989 0 0 0 Vitiello Jonathan Former officer 0 452764 0 255091 0 55121 0 91167 0 16653 0 870796 0 0 Hennessey III William Former key employee 0 153815 0 45773 0 46706 0 33413 0 16372 0 296079 0 0 Stewart Michele Former key employee 0 266070 0 105337 0 17950 0 81077 0 12248 0 482682 0 0 Treptow MD Douglas Former key employee 0 333980 0 59606 0 52038 0 36464 0 15898 0 497986 0 0 DONNELL HUGH G PHYSICIAN & BOARD MEMBER 0 439797 0 64079 0 36143 0 29681 0 21272 0 590972 0 0 FORM 990, SCHEDULE J, PART I, LINE 1 CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. IN ANY CIRCUMSTANCE IN WHICH CHARTER TRAVEL IS MADE AVAILABLE TO EMPLOYEES AND/OR SPOUSES/GUESTS FOR PERSONAL REASONS, MERCY POLICY REQUIRES TRACKING OF SUCH USE AND TAXATION OF THE EMPLOYEE(S) ACCORDINGLY. ONE LISTED INDIVIDUAL (OFFICER) RECEIVED THIS BENEFIT DURING THE YEAR, TOTALING TWO TRIPS. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HOSPITAL ROGERS 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 4B MERCY 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: ERIC PIANALTO, JAMES BURKE, JONATHAN VITIELLO, TANYA MARION, WILLIAM HENNESSEY III, MICHELE STEWART, AND JON SWOPE. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). FORM 990, PART III, QUESTION 4D MERCY HOSPITAL ROGERS (MHR) AND ITS MEMBER HEALTH CARE FACILITIES PROVIDE QUALITY CARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. MHR PROVIDED 40,526 INPATIENT SERVICE DAYS OF ACUTE OR SUB-ACUTE CARE. MHR PERFORMED 1,635 DELIVERIES, RESPONDED TO APPROX. 61,433 EMERGENCY ROOM ENCOUNTERS, AND COMPLETED 220,661 OUTPATIENT VISITS. COMMUNITY OUTREACH/BENEFIT PROGRAMS INCLUDE SUPPORT GROUPS FOR CURRENT AND PAST PATIENTS (DIABETIC, CARDIAC, ETC), EXPECTING/NEW PARENTS (CHILD BIRTH CLASSES, VARIOUS SUPPORT GROUPS, ETC), EMPLOYEES (EDUCATIONAL ASSISTANCE PROGRAMS, ETC), AND LOCAL/SURROUNDING COMMUNITY (HEALTH AND WELLNESS PROGRAMS, HEALTH FAIRS, HOME HEALTH PROGRAMS, ETC). RELIEF FROM THE FINANCIAL BURDEN OF HEALTH CARE SERVICES TO THE INDIGENT CONSISTS OF CHARGES OF $18,432,767 FOR CHARITY CARE PROVIDED. 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, PART V, QUESTION 2A W-3 FILING MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3'S) IS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES, EIN 20-2553101. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: A. TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION SHALL OPERATE; B. TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS; C. TO APPOINT AND REMOVE MEMBERS OF THE BOARD; D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; E. TO APPROVE OR AMEND THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; F. TO APPROVE OR AMEND THE OPERATING, CAPITAL AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; G. TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000); H. TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; I. TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS 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; J. TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION; AND, K. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DSCR 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 FINANCE 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. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION 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, 2017. 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 & 15B OFFICERS & 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, QUESTIONS 16A & 16B PARTICIPATION IN JOINT VENTURE AGREEMENTS MERCY'S APPROACH TO JOINT VENTURES IS INFORMED BY A NUMBER OF COMPANY REQUIREMENTS, INCLUDING MERCY'S CODE OF CONDUCT AND THE ETHICAL AND RELIGIOUS DIRECTIVES IMPOSED BY THE U.S. CATHOLIC BISHOPS SPECIFICALLY GOVERNING HEALTHCARE BUSINESS RELATIONSHIPS WITH THIRD PARTIES. IN ADDITION TO THE FOREGOING, APPROPRIATE SAFEGUARDS ARE INCLUDED IN THE JOINT VENTURE OPERATING AGREEMENTS TO ENSURE COMPLIANCE WITH APPLICABLE LAW, CHURCH TEACHING AND PRESERVATION OF THE HOSPITAL'S TAX EXEMPT-STATUS. SUCH SAFEGUARDS INCLUDE BUT ARE NOT LIMITED TO: REQUIREMENTS THAT THE BUSINESS BE MANAGED IN A MANNER THAT PROMOTES THE BETTERMENT OF THE HEALTH OF THE CITIZENS OF NORTHWEST ARKANSAS, WHICH SHALL OVERRIDE ANY OBLIGATION TO MAXIMIZE PROFITS; CONTRACTS WITH MEMBERS MUST BE APPROVED AND PAYMENTS BASED ON ACTUAL EXPENSES REASONABLY INCURRED; AND, REQUIREMENTS THAT A CHARITY CARE POLICY BE ESTABLISHED AND EFFECTIVELY IMPLEMENTED. FORM 990, PART VI, QUESTION 19 AVAIL 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 VII, SECTION B IT IS POSSIBLE THAT A PORTION OF THE AMOUNTS REPORTED FOR DEWITT AND ASSOCIATES, BATES AND ASSOCIATES AND MCCARTHY BUILDING CO MAY INCLUDE EXPENSE REIMBURSEMENTS, IN ADDITION TO AMOUNTS PAID FOR SERVICES. HOWEVER, THE AMOUNTS ARE NOT DISTINGUISHABLE. FORM 990, PART XI, LINE 9 OTHER CHANGE IN NET ASSETS NET TRANSFERS TO/FROM AFFILIATES (32,055,246) FORM 990, PART XII, QUESTION 2C 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 2017 (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. Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 SHELTER TX 501c3 7 MM LAREDO true McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 PORT MGMT MO 501c3 12b Mercy Health true Mercy ACO Clinical Services Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 464504901 VIRTUAL CARE MO 501c3 3 Mercy Health true Mercy Clinic East Communities 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 431771217 PHYS GROUP MO 501c3 10 MH EAST COMM true Mercy Clinic Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72903 261318597 PHYS CLINIC AR 501c3 3 MH FS COMM true Mercy Clinic Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 270473057 PHYS GROUP OK 501c3 3 MH OK COMM true Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 PHYS GROUP MO 501c3 3 MH SF COMM true Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 COUNSELING MO 501c3 7 Mercy Health true Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 CORP OFFICE MO 501c3 1 NA false Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 HLTH SYSTEM MO 501c3 12a Mercy Health true Mercy Health East Comm - Southern Region 14528 S Outer Forty Ste 100 Chesterfield MO 63017 461412322 HLTH SYSTEM MO 501c3 12a MH EAST COMM true Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 HOLDING CO AR 501c3 12b Mercy Health true Mercy Health Foundation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 12b Mercy Health true Mercy Health Foundation Ada 430 N Monte Vista Street Ada OK 74820 463596274 Foundation OK 501c3 12a MH ADA INC true Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 12a MH ARDMORE true Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 12a MH BERRYVILL true Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 7 M KS COMM true Mercy Health Foundation Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 237330425 Foundation AR 501c3 7 MH FT SMITH true Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501c3 12a MC SRVCS true Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 DSLVD 6/30/17 KS 501c3 7 M KS COMM true Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 Foundation MO 501c3 12b MH E COMM SR true Mercy Health Foundation Joplin 100 Mercy Way Joplin MO 64804 270906136 Foundation MO 501c3 7 MH SWMK COMM true Mercy Health Foundation Lincoln 1000 East Cherry Street Troy MO 63379 811477159 Foundation MO 501c3 12b MH EAST COMM true Mercy Health Foundation Nw Arkansas comm 2710 Rife Medical Lane Rogers AR 72758 710601687 Foundation AR 501c3 7 MH ROGERS true Mercy Health Foundation of Oklahoma 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 12a MH OK COMM true Mercy Health Foundation Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 463184231 Foundation OK 501c3 12a MH OK COMM true Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 12b MH SF COMM true Mercy Health Foundation St Francis 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 12a M ST FRANCIS true Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 Foundation MO 501c3 12b MH EAST COMM true Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 12b MH EAST COMM true Mercy Health Nw Arkansas Communities 2710 Rife Medical Lane Rogers AR 72758 621684203 PHYS GROUP AR 501c3 10 Mercy Health true Mercy Health Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 731453048 HLTH SYSTEM OK 501c3 12a Mercy Health true Mercy Health Plans of Missouri Inc 3265 S National Avenue Springfield MO 65807 320481419 HMO MO 501c4 N/A Mercy Health true Mercy Health Plans Inc 3265 S National Avenue Springfield MO 65807 320486150 PPO MO 501c4 N/A MH PLANS MO true Mercy Health Southwest MOKS Communities 100 Mercy Way Joplin MO 64804 300584463 HLTH SYSTEM MO 501c3 12b Mercy Health true Mercy Health Springfield Communities 1235 E Cherokee Street Springfield MO 65804 431856028 HLTH SYSTEM MO 501c3 12b Mercy Health true Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 HOME HEALTH AR 501c3 12a MH SPRINGFIE true Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Ardmore Inc 1011 14th Avenue NW Ardmore OK 73401 731500629 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 HOSPITAL AR 501c3 3 MH SF COMM true Mercy Hospital Booneville 880 West Main Street Booneville AR 72927 463851119 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 HOSPITAL MO 501c3 3 MH SWMK COMM true Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 HOSPITAL KS 501c3 3 MH SWMK COMM true Mercy Hospital El Reno Inc 2115 Parkview Drive El Reno OK 73036 272716065 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 HOSPITAL AR 501c3 3 MH FS COMM true Mercy Hospital Healdton Inc 3462 Hospital Rd Healdton OK 73438 263173902 HOSPITAL OK 501c3 3 MH ARDMORE true Mercy Hospital Jefferson 1400 Highway 61 South Festus MO 63028 430687077 HOSPITAL MO 501c3 3 MH E COMM SR true Mercy Hospital Joplin 100 Mercy Way Joplin MO 64804 270814858 HOSPITAL MO 501c3 3 MH SWMK COMM true Mercy Hospital Kingfisher Inc 1000 Kingfisher Reg Hospital Dr Kingfisher OK 73750 463433074 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Lincoln 1000 East Cherry Street Troy MO 63379 472219204 HOSPITAL MO 501c3 3 MH EAST COMM true Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospital Oklahoma City Inc 4300 W Memorial Road Oklahoma City OK 73120 730579285 HOSPITAL OK 501c3 3 MH OK COMM true Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 HOSPITAL MO 501c3 3 MH SF COMM true Mercy Hospital Tishomingo Inc 1000 South Byrd Tishomingo OK 73460 274433830 HOSPITAL OK 501c3 3 MH ADA INC true Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 HOSPITAL AR 501c3 3 MH FT SMITH true Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 HOSPITAL OK 501c3 3 MH OK CITY true Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 HOSPITAL MO 501c3 3 MH EAST COMM true Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 HOSPITAL KS 501c3 3 MH SWMK COMM true Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78046 200198462 Outreach TX 501c3 7 Mercy Health true Mercy Research 524 North Booneville Avenue Springfield MO 65802 870796305 Research MO 501c3 4 Mercy Health true Mercy St Francis Hopsital 100 W Highway 60 Mountain View MO 65548 440607149 HOSPITAL MO 501c3 3 MH SF COMM true MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 CTRL SYS FUNC MO 501c3 12a Mercy Health true Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 CHILD ADVOC AR 501c3 3 Mercy Health true St Anthony's Charitable Foundation 10010 Kennerly Road St Louis MO 63128 261516789 Fundraising MO 501c3 12a ST ANTHONY true St Anthony's Medical Center 10010 Kennerly Road St Louis MO 63128 430980256 HOSPITAL MO 501c3 3 MH EAST COMM true St Anthony's Physician Organization 10010 Kennerly Road St Louis MO 63128 431784536 Health care MO 501c3 3 ST ANTHONY true ST MARY'S HOSPITAL OF ENID OK INC 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 MH OK COMM true Unity Ambulatory Care 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431861745 Inactive MO 501c3 12c MH EAST COMM true Fort Smith Emergency Medical Services 1701 S Greenwood Fort Smith AR 72901 710416615 EMERGENCY MEDICAL AR NA Mercy Ambulatory Surgery Center LLC 7301 Rogers Avenue Fort Smith AR 72917 710827721 AMBUL SURG CT AR NA Plaza Surgery Services Company LLC 12700 Southfork Road St Louis MO 63128 204709312 Inactive MO NA Resource Optimization & Innovation LL 645 Maryville Centre Drive Suite St Louis MO 63141 460468368 CENTRAL DIST. MO NA St Edward Mercy Medical Center Multi-Pu 7301 Rogers Avenue Fort Smith AR 72903 710554050 OFFICE BUILDING AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 Holding company DE NA C-Corp Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 PRODUCT COMMER MO NA C-Corp Mercy Commercial Services Inc 14528 South Outer Forty Suite 100 Chesterfield MO 63017 464953543 PARENT OF VCC MO NA C-Corp Mercy Community Services Inc 401 Woodland Hills Blvd Fort Scott KS 66701 481078101 Retail pharmacy KS NA C-Corp Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 Real estate OK NA C-Corp Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 Holding company OK NA C-Corp Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 Holding company OK NA C-Corp Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 Holding company OK NA C-Corp UHL Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 Holding company MO NA C-Corp Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 INACTIVE MO NA C-Corp false false true false false false false false false false false false false false false true true false false Mercy ACO Clinical Services Inc q 1623306 FMV Mercy Health q 257214 FMV Mercy Health Foundation Northwest Arkansas p 333105 FMV Mercy Health Foundation Northwest Arkansas c 867526 FMV Mercy Health Northwest Arkansas Communities q 26650776 FMV Mercy Research q 210327 FMV MHM Support Services q 24279257 FMV Resource Optimization & Innovation LLC p 12825629 FMV Form 990, Schedule R, Part II Mercy 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 VI 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.