2016-02-05T09:21:57-06:00 2015-06-30 621073578 FRASIER DEAN & HOWARD PLLC 3310 WEST END AVE STE 550 NASHVILLE TN 37203 990 2014-07-01 621781969 MERCY HEALTH SERVICES INC MERC 6157900567 1113 MURFREESBORO ROAD NO 319 FRANKLIN TN 37064 MARGARET OWENS CEO 6157900567 2016-02-05 1 SARA G MOON P00034774 6153836592 X 2014 2016-08-17 19:52:53Z MARGARET OWENS 1113 MURFREESBORO ROAD NO 319 FRANKLIN TN 37064 5951248 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. 13 13 85 300 0 0 1431222 1303837 3535306 4428606 2775 0 290046 95643 5259349 5828086 0 0 0 0 4139509 3806034 0 0 168096 1438571 1729979 5578080 5536013 -318731 292073 1095360 1239405 1023324 875296 72036 364109 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 4652511 4407352 MERCY HEALTH SERVICES CONTINUES TO PROVIDE PRIMARY HEALTHCARE AND MENTAL HEALTH SERVICES TO MORE THAN 3800 UNINSURED AND UNDERINSURED FAMILIES FROM MORE THAN 30 COUNTIES IN TENNESSEE. ADDITIONALLY, MERCY CERTIFIED APPLICATION COUNSELORS MET WITH NEARLY 1,500 INDIVIDUALS WHILE ENROLLING 170 INDIVIDUAL/FAMILIES IN THE MARKETPLACE INSURANCE PROGRAMS OF THE AFFORDABLE CARE ACT.THIS YEAR, MERCY ALSO COLLABORATED WITH BRENTWOOD BAPTIST CHURCH TO FACILITATE COMMUNITY OUTREACH, BY JOINING THEIR MOBILE UNIT WITH PRIMARY MEDICAL CARE, CASE MANAGEMENT AND CARE COORDINATION SERVICES. 4652511 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 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 8 0 1 85 1 0 0 0 0 0 1 1 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TN X MARGARET OWENS 6157900567 1113 MURFREESBORO ROAD STE 319 FRANKLIN TN 37064 JANE ALLEN BOARD MEMBER 1.00 X 0 0 0 KAREN SCHORKOPF BOARD MEMBER 1.00 X 0 0 0 ANDY OLIVER BOARD MEMBER 1.00 X 0 0 0 DEDRICK MOULTON BOARD MEMBER 1.00 X 0 0 0 JAMES MARTIN BOARD MEMBER 1.00 X 0 0 0 LUIS SURA BOARD MEMBER 1.00 X 0 0 0 CRAIG BALLENTINE BOARD MEMBER 1.00 X 0 0 0 REBECCA DYER BOARD MEMBER 1.00 X 0 0 0 JOHN SMITH BOARD MEMBER 1.00 X 0 0 0 SCOTT THOMPSON BOARD MEMBER 1.00 X 0 0 0 LANCE BRIDGESMITH CHAIRMAN 1.00 X X 0 0 0 NANCY REECE CHAIR/VICE CHAIR 1.00 X X 0 0 0 MIRELLA NEELY SECRETARY 1.00 X X 0 0 0 MARGARITA CASTRO BOARD MEMBER 1.00 X 0 0 0 DAVID WINNINGHAM CEO 40.00 X 93477 0 10443 MARGARET OWENS COO/INTERIM CEO 40.00 X 65127 0 10443 ALEX BRUNNER MD CHIEF MED OFFIC 40.00 X 127929 0 15242 JONATHAN BOYE CHIEF BEH HLTH 40.00 X 53164 0 15242 DOROTHY BULLARD CHF CARE COORD 40.00 X 48366 0 9196 RHONDA SIZEMORE CFO 40.00 X 43125 0 0 AMY VEHEC DOCTOR 40.00 X 115237 0 4707 ANNE FOTTRELL PSYCHIATRIST 40.00 X 123881 0 5222 670306 0 70495 3 0 0 0 0 802505 501332 1303837 SERVICE REVENUE 624100 4407352 4407352 TN INCENTIVE PROGRAM 900099 21254 21254 4428606 218805 123162 95643 95643 5828086 4428606 0 95643 474247 431565 28455 14227 2708247 2464504 162495 81248 350032 299586 41025 9421 273508 234738 29494 9276 92920 47411 45509 43732 1919 41813 113720 86551 15101 12068 168152 152312 919 14921 221581 202501 9295 9785 12051 2391 9594 66 91995 90002 72 1921 60482 59582 900 BAD DEBT EXPENSE 379356 149898 229458 MEDICAL SUPPLIES 275795 275795 CONTRACT LABOR 94993 24281 70179 533 REPAIRS & MAINTENANCE 79244 76086 1379 1779 95958 53389 30618 11951 5536013 4652511 715406 168096 690122 897134 700 1052 1187736 846517 404538 341219 1095360 1239405 403657 378790 2500 565000 464505 54667 29501 1023324 875296 X 72036 364109 72036 364109 1095360 1239405 X 292073 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 770220 542493 227727 386855 282218 104637 30661 21806 8855 341219 CHECKS WRITTEN IN EXCESS OF DEPOSITS 29501 29501 X 5951248 123162 123162 5828086 0 5828086 5659175 123162 123162 5536013 0 5536013 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, 2012 THROUGH JUNE 30, 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 123,162. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 123,162. FRANKLIN CLASSIC 115070 115070 2387 89 58193 AMERICAN GIRL 86969 86969 5870 14053 31526 1 16766 16766 8025 3019 218805 218805 2387 13895 14142 92738 123162 95643 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 OPERATIONS/FINANCE 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. 990 PART XI, LINE 8 - PRIOR PERIOD ADJUSTMENTS DURING FISCAL YEAR 2013, CERTAIN JUNE 30, 2012 BALANCES WERE RESTATED TO PROPERLY RECORD ACCRUED EXPENSES AND NET ASSETS.