2017-02-14T13:45:58-06:00 2016-06-30 621073578 FRASIER DEAN & HOWARD PLLC 3310 West End Ave Ste 550 Nashville TN 37203 990 2015-07-01 621781969 Mercy Health Services Inc MERC 6157900567 1113 Murfreesboro Road No 319 Franklin TN 37064 Margaret Owens cfo 6157900567 2017-02-03 1 Sara G Moon P00034774 6153836592 X 2015 2021-01-29 14:40:06Z Cindy Siler 1113 Murfreesboro Road No 319 Franklin TN 37064 6726588 0 X www.mercycommunityhealthcare.org X 1999 TN MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED. 11 11 128 300 0 0 1303837 1759533 4428606 4802897 0 0 95643 63406 5828086 6625836 0 0 0 0 3806034 4724791 0 0 185063 1729979 1683194 5536013 6407985 292073 217851 1239405 1580908 875296 998948 364109 581960 X MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED SERVING WILLIAMSON COUNTY AND SURROUNDING COUNTIES. 0 0 5292088 4802897 MERCY HEALTH SERVICES CONTINUES TO PROVIDE PRIMARY HEALTHCARE AND MENTAL HEALTH SERVICES TO UNINSURED AND UNDERINSURED FAMILIES FROM MORE THAN 30 COUNTIES IN TENNESSEE. Mercy Health Services began a Health Center wide remodeling project to enhance service provision for the increasing patient load of pediatric, adult medical and behavioral health services; including the Integrated Health Center, the Counseling Center and a new Patient and Family Support Center. The remodeling will allow an improvement of efficiency and the inclusion of an on-site pharmacy for our patients. The work was augmented when the HRSA HIIP grant was funded. The anticipated completion of the total remodeling is December 31, 2016.Mercy began a new counseling service in each of the Fairview Schools in Williamson County with the assistance of the United Way of Williamson County.In fiscal year 2015-16 Mercy has seen almost 1,000 more patient visits combined between the adult and pediatric clinics which has expanded our patient volumes. Finished the fiscal year with having around 12,800 visits for Pediatrics, which is 100 visits over what was budgeted and 300+ visits over last fiscal year's total;; around 5,650 visits for Adults, which is 100 visits over what was budgeted and 600+ visits over last fiscal year's total and over 3000 referrals, care coordination patient support activities and the institution of the Chronic Care Management Program for both children and adults.In the Behavioral Health area (including Counseling and Psychiatry) Mercy has seen close to 2,600 more patient visits combined between the adult and pediatric clinics over the last fiscal year. We finished the year with 8,926 visits for counseling, which over 100 visits is beyond budgeted and 2,000+ visits over last fiscal year's total. In Psychiatry, we finished the year with having around 3,868 visits, which is 30 visits less than what was budgeted but 600+ visits over last fiscal year's total.Other notable activities:a. Mercy was awarded Outreach & Enrollment Grantb. Mercy conducted other fund-raising events successfully i.e. the Franklin Classic, the American Girl Fashion Show, hosted the Community Christmas Party for over 545 low income people in the service area receiving over $15,000 in toy donations, participated in the first West Haven Balloon Festivalc. Mercy was awarded an expansion grant from HRSA to fund 2 psychiatric nurse practitioners and an adult provider for walk-ins. 5292088 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 128 1 0 0 0 0 0 1 1 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TN X Rhonda Sizemore 6157900567 1113 MURFREESBORO ROAD STE 319 FRANKLIN TN 37064 ANDY OLIVER BOARD MEMBER 1.00 X 0 0 0 CRAIG BALLENTINE Vice Chairman 1.00 X X 0 0 0 JAMES MARTIN BOARD MEMBER 1.00 X 0 0 0 JANE ALLEN Secretary 1.00 X X 0 0 0 JOHN SMITH BOARD MEMBER 1.00 X 0 0 0 Julie Lampley bOARD MEMBER 1.00 X 0 0 0 Kristen Toth bOARD MEMBER 1.00 X 0 0 0 Melora Turner BOARD MEMBER 1.00 X 0 0 0 NANCY REECE Chairman 1.00 X X 0 0 0 REBECCA DYER BOARD MEMBER 1.00 X 0 0 0 Ronnie McCoy BOARD MEMBER 1.00 X 0 0 0 ALEX BRUNNER MD CHIEF MED OFFIC 40.00 X 132470 0 13432 DAVID WINNINGHAM CEO 40.00 X 105434 0 4200 DOROTHY BULLARD CHF CARE COORD 40.00 X 47435 0 7024 JONATHAN BOYE CHIEF BEH HLTH 40.00 X 58110 0 13432 MARGARET OWENS COO/INTERIM CEO 40.00 X 70468 0 7950 RHONDA SIZEMORE CFO 40.00 X 74240 0 202 Mari Garner IT coordinator 40.00 X 40073 0 11232 Cindy Siler CEO 40.00 X 0 0 9351 AMY VEHEC DOCTOR 40.00 X 119321 0 4881 ANNE FOTTRELL PSYCHIATRIST 40.00 X 123502 0 3789 771053 0 75493 4 0 0 0 Old Hillsboro Building Company 237 2nd Ave South Franklin TN 37064 Property Renovations 103162 1 110366 1255529 393638 1759533 SERVICE REVENUE 624100 4713647 4713647 TN INCENTIVE PROGRAM 900099 89250 89250 4802897 164158 100752 63406 63406 6625836 4802897 0 63406 0 651000 551393 82650 16957 3344022 2832366 424551 87105 21506 18678 2496 332 381819 331605 44319 5895 326444 279957 37394 9093 111827 56719 55108 42668 348 41830 490 145993 106808 27841 11344 324023 192444 118783 12796 223172 203332 9367 10473 9433 2310 7007 116 51788 50666 1122 49522 46492 35 2995 MEDICAL SUPPLIES 264899 264899 BAD DEBT EXPENSE 220629 203442 17187 REPAIRS & MAINTENANCE 87467 80383 4688 2396 CONTRACT LABOR 61527 7089 30201 24237 90246 63157 26255 834 6407985 5292088 930834 185063 2399 149893 897134 878281 1052 1505 1447134 898304 341219 548830 1239405 1580908 378790 606974 2500 46974 464505 345000 29501 0 875296 998948 X 364109 581960 364109 581960 1239405 1580908 217851 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 948216 550922 397294 449278 323816 125462 49640 23566 26074 548830 X 6726588 100752 100752 6625836 0 6625836 6508737 100752 100752 6407985 0 6407985 Part X, Line 2: Mercy Health Services, Inc. is a not-for-profit organization that is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Accordingly, the Organization has made no provision for income taxes. The Organization follows Financial Accounting Standards Board Accounting Standard Codification guidance concerning the accounting for income taxes recognized in an entity's financial statements. This guidance prescribes a minimum probability threshold that a tax position must meet before a financial statement benefit is recognized. The minimum threshold is defined as a tax position that is more likely than not to be sustained upon examination by the applicable taxing authority, including resolution of any related appeals or litigation processes, based on the technical merits of the position. The tax benefit to be recognized is measured as the largest amount of benefit that is greater than fifty percent likely of being realized upon ultimate settlement. The Organization has not recognized any tax related interest and penalties in the accompanying financial statements. Federal tax years that remain open for examination include the years ended June 30, 2013 through June 30, 2016. Part XI, Line 2d - Other Adjustments: SPECIAL EVENT EXPENSES 100,752. Part XII, Line 2d - Other Adjustments: SPECIAL EVENT EXPENSES 100,752. Franklin Classic 107532 107532 1158 1600 60219 American Girl 56626 56626 4745 9353 23677 164158 164158 4745 10511 1600 83896 100752 63406 Form 990, Part VI, Section B, line 11 A DRAFT OF FORM 990 WILL BE SENT ELECTRONICALLY TO THE BOARD OF DIRECTORS PRIOR TO FILING. ADDITIONALLY, IT IS REVIEWED IN DETAIL BY THE executive COMMITTEE WHICH REPORTS ITS FINDINGS TO THE FULL BOARD. Form 990, Part VI, Section B, line 12c Policies and procedures for all procurement are in place to discover any potential conflicts of interest for all purchases and contracts. Form 990, Part VI, Section B, line 15 The compensation of the CEO is reviewed and determined each year by the Executive Committee of the Board of Directors of Mercy. Primarily, the committee uses the Compensation Report done every two years by the Tennessee Primary Care Association of all the Federally Qualified Health Centers in Tennessee. This report is very helpful in comparing the budget sizes, patient encounter numbers, and staffing sizes of these centers in order to reach a competitive salary range. The remainder of the top management officials' compensation is determined, primarily using the same Compensation Report by the CEO of Mercy. Each year, budget permitting, a cost of living raise is implemented. Form 990, Part VI, Section C, line 19 THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.