2015-05-14T13:05:27-05:00 2014-06-30 562632458 Pleus and Company LLC 14323 S Outer Forty Ste 310N Chesterfield MO 63017 990 2013-07-01 430687077 Mercy Hospital Jefferson MERC 6369331136 PO Box 350 Crystal City MO 63109 Cheryl Matejka Treasurer 3143643532 2015-05-13 1 DOUGLAS G PLEUS P00013488 3143179916 2013 2016-04-25 22:37:26Z Carl E Eric Ammons PO Box 350 Crystal City MO 63109 152862434 0 X www.mercy.net/crystalcitymo X 1953 MO A community based integrated healthcare system consisting of a 251 bed licensed facility which provides a full range of diagnostic, preventative and healthcare services along with 24 hour emergency room care. 9 6 1575 150 17987 -140602 84734 64971 107570543 150380513 1336448 70779 3325656 1071279 112317381 151587542 96303 91670 0 0 52107208 68227289 0 0 0 57613651 79709354 109817162 148028313 2500219 3559229 165273390 174796943 10624816 16371853 154648574 158425090 X As the Sisters of Mercy before us, we bring to Life the healing ministry of Jesus through our compassionate care and exceptional service. 0 0 140452898 91670 150927834 Mercy Hospital Jefferson consists of a 251 bed licensed facility which provides a wide range of services. In fiscal year 2014, the following services were provided - 43,730 patient days, 423 deliveries, 30,960 emergency visits, 1,750 inpatient surgeries and 2,174 outpatient surgery procedures. It is the policy of Mercy Hospital Jefferson to provide uncompensated care to patients in need of financial assistance in accordance with the hospital's established guidelines and without regard to race, religion, sex, age, or national origin. Charity and uncompensated care for the year totaled $21,420,815. Mercy HospitalJefferson is committed to providing educational programs to the community. Free seminars and presentations are provided on a wide variety of health issues which impact patients and their families. Free services are also offered to the community such as lipid, cholesterol, bone density and glucose screenings as well as hearing and memory screenings. 140452898 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 76 0 1 1575 1 1 1 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Daniel Eckenfels 6369331107 PO Box 350 Crystal City MO 63019 Ammons Carl E Eric President, Mercy Hospital Jefferson & Board member 50.00 10.00 X 240974 83289 37745 Breeze Tonda Board member 0.50 1.00 X 0 0 0 Carron RSM Sr Judith Ann Board member 1.00 1.00 X 0 0 0 Enger MD Kevin Board member 0.50 1.00 X 0 0 0 Gannon Dennis Board member 0.50 1.00 X 0 0 0 Ginsburg MD Gregg Board member 0.50 0.00 X 0 0 0 King BA M Div Rev Jack Board member 0.50 1.00 X 0 0 0 Patel MD Ash Board member 0.50 1.00 X 27338 0 0 Rehm MD Charles Chief admin officer & Board member 5.00 55.00 X 0 548612 95565 Cantalin Jeanne L Reg VP-General counsel-thru 2/14 10.00 50.00 X 0 263916 46705 Hannasch Susan Reg VP-General counsel-start 3/14 4.00 56.00 X 0 275484 52671 Matejka Cheryl L Chief financial officer 10.00 47.00 X 0 413101 78538 Sorensen Donn President-East Communities 5.00 59.00 X 0 811498 245528 Eckenfels Daniel VP Finance 40.00 1.50 X 244984 0 12241 Julien Sheila CNO 40.00 0.00 X 75325 100081 16595 Meyer Michele VP Operations 60.00 0.00 X 246726 0 12241 Alam Tariq Physician 40.00 0.00 X 223949 202546 11660 Albano Benjamin Y Physician 40.00 0.00 X 267972 164775 12696 Barakat Ammar Physician 40.00 0.00 X 256725 138085 8578 Kennen E William Physician 40.00 0.00 X 357426 258692 10423 Newhall Phillip Physician 40.00 0.00 X 197641 200043 79 Pigg Timothy J Former officer 0.00 0.00 X 149777 0 7226 Johnson Beverly E Former key employee 40.00 0.00 X 152823 0 2127 2441660 3460122 650618 38 1 1 0 Acuity Anesthesiology LLC 1734 Clarkson Road Suite 147 Chesterfield MO 63017 Physician and CRNA professional services 2832530 Rehabcare Group Inc 7733 Forsyth Blvd Ste 1700 St Louis MO 63105 Management and therapy services 1690915 PATRIOT MED TECH OF OHIO 7100 Commerce Way Ste 280 Brentwood TN 37027 Equipment maintenance services 415169 EXECUTIVE HEALTH RESOURCES PO Box 822688 Philadelphia PA 19182 Physician advisory and compliance servic 401822 Sodexo Inc & Affiliates 9801 Washington Blvd Suite 500 Gaithersburg MD 20878 Dietary management services 227772 20 64971 64971 Net Patient Service Re 621110 148873428 148873428 Meaningful use 519100 1323385 1323385 Rental From Affiliated 531120 142523 142523 Lab Services 621500 41177 26321 14856 150380513 70779 70779 897605 1243577 -345972 -345972 -345972 34446 31315 3131 3131 Cafe & vending 722210 851943 851943 Gift shop sales 900099 353556 353556 Pharmacy Revenue 624100 101758 101758 106863 106863 1414120 151587542 150927834 17987 576750 X 91670 91670 1153094 1153094 52057259 50416362 1640897 2432350 2415700 16650 8818136 8430068 388068 3766450 3579549 186901 7539 7539 2805 2805 16286361 15795239 491122 1083025 832913 250112 5600408 5471108 129300 29818 29818 1596367 1420767 175600 253203 207516 45687 231 231 48911 48911 6175639 5905327 270312 1148949 1125519 23430 Drugs & medical expense 21938426 21841673 96753 Bad debt expense 18859401 18859401 Shared service fees 5614584 2919584 2695000 Repairs and maintenance 570377 568232 2145 493310 493310 148028313 140452898 7575415 0 14379604 23950238 25253868 422513 0 2743342 2835929 1236881 545025 81601064 8141364 66360951 73459700 54057672 53013039 2122189 19689382 165273390 174796943 10243088 15996784 41273 34864 340455 340205 10624816 16371853 X 154648574 158425090 154648574 158425090 165273390 174796943 X 3559229 217287 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 31402 0 0 0 31402 0 Part II-B, Line 1: The filing organization is a member of and pays dues to the following hospital associations: American Hospital Association and the Missouri Hospital Association. For the year ended June 30, 2014, dues were $74,086. Approximately 23.65% of the American Hospital Association dues and 47.12% of Missouri Hospital Association dues were attributable to lobbying activities performed by this association. 3509000 3509000 44372607 2675043 41697564 29238308 5147511 24090797 4481149 318810 4162339 73459700 Other Assets 7095318 Due from Affiliates 12594064 19689382 Other Liabilities 340205 340205 Part X, Line 2 The consolidated audited financial statements of Mercy Health and Affiliates do not include a footnote to report the organization's liability for uncertain tax provisions under ASC 740, as they are deemed immaterial for disclosure. 1 1 X 1 X 1 X 1 1 0 1 1 3715294 3715294 0.02880 14276378 8688344 5588034 0.04330 17991672 8688344 9303328 0.07210 177149 26128 151021 0.00120 28547 28547 0.00020 166458 38687 127771 0.00100 372154 64815 307339 0.00240 18363826 8753159 9610667 0.07450 2250 2250 0.00000 21107 21107 0.00020 255 255 0.00000 23612 23612 0.00020 1 5084495 0 52327734 63158500 -10830766 X 1 1 1 1 Mercy Hospital Jefferson PO Box 350 Crystal City MO 63019 www.mercy.net/crystalcitymo 529-2 X JEFFERSON REGIONAL MEDICAL CENTER 1 1 X X X X X X X X 13 1 0 1 X www.mercy.net/about/community/benefits X X X X X X X X 1 0 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X 1 0 1 X 0 0 JEFFERSON REGIONAL MEDICAL CENTER Part V, Section B, Line 3: COMMUNITY HEALTH NEEDS ASSESSMENTPLEASE REFER TO THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS. JEFFERSON REGIONAL MEDICAL CENTER Part V, Section B, Line 20d: ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTS THE FEDERAL POVERTY GUIDELINES FOR INCOME ARE THE BASIS FOR DETERMINING ELIGIBILITY FOR CHARITY CARE DISCOUNTS. FOR EXAMPLE, INDIVIDUALS WITH INCOMES BELOW 100% OF THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 100% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. ADDITIONAL FINANCIAL ASSISTANCE AFTER APPROPRIATE DISCOUNTS HAVE BEEN APPLIED, ARRANGEMENTS MAY BE MADE FOR AN INTEREST-FREE MONTHLY PAYMENT PLAN. GENERALLY, NO PATIENT'S FINANCIAL RESPONSIBILITY WILL BE GREATER THAN 20% OF ANNUAL HOUSEHOLD INCOME OR 10% OF NET ASSETS (WHICH EVER IS GREATER), ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS. 6 JMH Rehabilitation Unit PO Box 350 Crystal City MO 63019 Rehabilitation services JMH Psychiatric Unit PO Box 350 Crystal City MO 63019 Psychiatric services Jefferson Regional Home Care 5 Industrial Drive Festus MO 62028 Home care services Jefferson Regional Hospice 5 Industrial Drive Festus MO 62028 Hospice services Jefferson Multi-Specialty Group 1400 Highway 61 South Crystal City MO 63019 Outpatient physician clinic Jefferson Regional Outpatient Facilities 1400 Highway 61 South Crystal City MO 63019 Urgent care services Part I, Line 7g: SUBSIDIZED HEALTH SERVICESTHE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINIC COSTS ON LINE 7G. Part I, Ln 7 Col(f): TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $148,028,313. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $18,859,401. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $5,084,495. PART I, LINE 6A COMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). Part II, Community Building Activities: Mercy Hospital Jefferson's (MHJ) community building activities promote the health, wellness, and safety of the community it serves. Through active participation on community boards, neighborhood/community coalitions, and involvement in community-based events, Mercy builds partnerships to develop collaborative solutions to address community needs. Community building activities serve as a link to engage Mercy co-workers to look beyond the walls of the facilities in which they serve. Some of the community building activities in which Mercy Hospital Jefferson participates/serves are:- St. Francois County Community Partnership- Jefferson County Growth Association- Jefferson College Board- Mineral Area College Foundation- Support of the Quad City Senior Center- Participation in the DeSoto, Hillsboro, Twin City Area, and Ste. Genevieve chambers of commerce activitiesA FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT WWW.MERCY.NET/COMMUNITY-BENEFITS. Part III, Line 2: TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNTING, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. Part III, Line 3: THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY (REFER TO DISCLOSURE FOR PART III, #9B) TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE. Part III, Line 4: THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: "PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTIONS POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES AS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES." Part III, Line 8: IT IS THE POSITION OF MERCY HOSPITAL JEFFERSON THAT 100% OF ANY SHORT FALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). Part III, Line 9b: MERCY HOSPITAL JEFFERSON ("MERCY'S") DEBT COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT BEFORE TURNING AN ACCOUNT TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH MERCY'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO HAVE MET THE MERCY HOSPITAL COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY FOR APPROPRIATE FOLLOW-UP. MERCY REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. MERCY UTILIZES THE "SEARCH AMERICA" TOOL TO ENHANCE THE ABILITY TO DETERMINE CHARITY QUALIFICATION. PRESUMPTIVE CHARITY WILL BE GRANTED IN SITUATIONS WHERE MERCY HOSPITAL HAS BEEN UNABLE TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION. MERCY UTILIZES PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR CHARITY ADJUSTMENTS IN EXCESS OF $6,500. IN THESE CASES, MERCY UTILIZES THE SEARCH AMERICA REPORT STATUS OF "PROBABLE CHARITY" AS THE BASIS FOR ASSIGNING THE CHARITY LEVEL. 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. ADDITIONALLY THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENT, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENFORCE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEWS COMPLIANCE WITH ALL POLICIES. Part VI, Line 2: NEEDS ASSESSMENTMERCY HEALTH BELIEVES THAT ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IS COMPREHENSIVE ENOUGH TO CAPTURE SUBSTANTIALLY ALL OF THE COMMUNITY'S NEEDS. THEREFORE NO FURTHER STEPS WERE TAKEN TO IDENTIFY ADDITIONAL NEEDS. Part VI, Line 3: THE FILING ORGANIZATION HAS PRINTED MATERIAL AVAILABLE AT EACH POINT OF REGISTRATION IN OUR FACILITY, IN ADDITION TO ELECTRONICALLY AVAILABILITY AT OUR WEB SITE AT MERCY.NET ON HOW TO CONTACT CUSTOMER SERVICE FOR FINANCIAL ASSISTANCE. THE STATEMENT ALSO INCLUDES DIRECTION ON HOW TO REACH OUT TO MERCY FOR FINANCIAL ASSISTANCE AS WELL. FINANCIAL ASSISTANCE INFORMATION AS A PART OF OUR HEALING MINISTRY, THE FILING ORGANIZATION IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR FINANCIAL SITUATION. WE OFFER PAYMENT ASSISTANCE FOR THOSE WHO DO NOT HAVE INSURANCE OR WHO ARE IN FINANCIAL NEED. UNINSURED PATIENT DISCOUNTS A DISCOUNT FROM THE HOSPITAL'S REGULAR BILLED CHARGES WILL BE PROVIDED TO PATIENTS WHO DO NOT HAVE INSURANCE. THIS INCLUDES PATIENTS WHOSE FINANCIAL SITUATION NORMALLY WOULD NOT OTHERWISE QUALIFY THEM FOR CHARITY CARE DISCOUNTS. PATIENTS WITHOUT INSURANCE WHOSE FINANCIAL SITUATION QUALIFIES THEM FOR CHARITY CARE DISCOUNTS (SEE ELIGIBILITY GUIDELINES BELOW) ARE ASSISTED OR ASKED IN APPLYING FOR MEDICAID BEFORE APPLYING FOR FINANCIAL ASSISTANCE. MERCY WORKS TO EXHAUST ALL EFFORTS TO COORDINATE WITH THE PATIENT TO APPLY FOR MEDICAID, BUT DOES NOT PROHIBIT CHARITY CONSIDERATIONS IF DENIED NOR APPLIED. APPLICATIONS FOR CHARITY CARE DISCOUNTS WILL BE REVIEWED FOR ELIGIBILITY BASED ON THE APPLICANT'S INCOME, FAMILY SIZE, AMOUNT OF PAYMENT DUE AND AVAILABILITY OF OTHER ASSETS OR RESOURCES. PLEASE NOTE THAT CARE MUST BE MEDICALLY NECESSARY TO BE CONSIDERED ELIGIBLE FOR UNINSURED PATIENT DISCOUNTS. Part VI, Line 4: MERCY HOSPITAL JEFFERSON INCLUDES FOUR COUNTIES IN MISSOURI - JEFFERSON, WASHINGTON, STE. GENEVIEVE AND ST. FRANCOIS. BASED ON TRUVEN 2014 DATA, THE AREA'S POPULATION IS 302,706. 26% OF THE POPULATION HAS INCOME OVER $75,000. AVERAGE HOUSEHOLD INCOME IS $57,139. 14% OF THE POPULATION IS AGE 65 AND OLDER. 16% OF THE POPULATION IS ON MEDICARE, 13% ON MEDICAID, AND 12% UNINSURED, BASED ON 2014 TRUVEN INSURANCE ESTIMATES. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTHMercy Hospital Jefferson (MHJ) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay. In active pursuit of this mission, MHJ provided services to 9,852 inpatients, 30,960 emergency room visits, 123,021 outpatient visits, and 23,045 home health visits.MHJ is a Catholic health care corporation that, pursuant to the organizational core belief that health care services are a vital and integral part of the Church's healing mission, engages in a ministry which provides general acute care, ambulatory, long-term and home care health services to individuals and families in its service communities. Consistent with the organization's commitment to social accountability and the provision of community benefit, MHEC offers other services and programs which further health promotion, maintenance and care. Although reimbursement for services rendered is critical to the continued ability to provide healthcare services to all patients, MHJ recognizes that not all individuals possess the ability to purchase essential medical services and, further, that part of our mission is to provide healthcare services and healthcare education to the communities in which our facilities are located. In keeping with MHJ's commitment to serve all members of the communities it serves, MHJ provides (i) free care and/or subsidized care; (ii) care to persons covered by governmental programs at below cost; (iii) health activities and programs to support the community; and, (iv) a variety of broad community support activities. Open Medical Staff Medical staff privileges are extended to all qualified physicians in the community for nearly all of our departments. Mercy Hospital Jefferson has exclusive contracts with physician groups for the following services: radiology, pathology, anesthesia, and emergency medicine. This means that greater than 90% of the physicians on staff are in categories that are open to qualified physicians in the community.Use of Surplus FundsSurplus funds and unrestricted assets held by Mercy Hospital Jefferson are reinvested in patient care, medical education and research initiatives which support the organization's mission to deliver compassionate care and exceptional health care services to the communities it serves. Examples include the following:- New patient tower planned to convert Mercy Hospital Jefferson to a private room campus as well as to expand women's health services and oncology services in the region, regardless of ability to pay.- Expansion of primary care and specialty care physicians to the Mercy Hospital Jefferson service area with a focus to reach the underserved populations closer to their homes.- Continued partnering with area education programs to help promote the training of critically needed services for the community including schools of nursing, radiology and pharmacy.Additional Community Health Initiatives/InformationPhysiciansMuch work in terms of prevention/wellness education takes place in collaboration with our integrated physician practices. Tobacco cessation, nutrition (weight loss education and exercise) are just a few examples of critical work that our physicians engage in through their practices and in the communities through outreach. In addition, many hours of time have been spent preparing to become and Accountable Care Organization (ACO) and implementing Meaningful Use. These activities are not reflected in this report.Community EngagementAs Mercy works to continue to improve its community benefit program, a greater focus is being placed on recording involvement by leadership and clinical co-workers on boards, coalitions, and other organizations. We believe this is a vital part of our work and one that is significantly underreported. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM: THE FILING ORGANIZATION IS PART OF MERCY HEALTH ("MERCY"). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS ("MINISTRY OFFICE") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING LIFE TO THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2014, MERCY FACILITIES INCLUDED 29 ACUTE CARE HOSPITALS, 4 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS AND 3 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2014, MERCY HAD MORE THAN 8 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,000 EMPLOYED PHYSICIANS, AND APPROXIMATELY 38,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE FIFTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES BASED ON NET PATIENT SERVICE REVENUE. 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 TREASURY, INFORMATION TECHNOLOGY, CLINICAL QUALITY MANAGEMENT, LEGAL AND COMPLIANCE COUNSEL, COMPENSATION AND BENEFITS, CONSULTING, PERFORMANCE MANAGEMENT, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTING AND REPORTING, CAPITAL MANAGEMENT, CLINICAL ENGINEERING, AND CLINICAL SAFETY. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. Part VI, Line 7, Reports Filed With States MO 1 Desoto Public Schools 815 Amvets Drive DeSoto MO 63020 436001005 501(c)(3) 12200 General support Jefferson College 1000 Viking Dr Hillsboro MO 63050 431611153 501(c)(3) 5760 57500 FMV Medical Equipment General support and educational training Greater St Louis Area Council Boy Scouts of America 4568 West Pine St Louis MO 63108 430652676 501(c)(3) 5000 General support Archdiocese of St Louis 1030 St Pius Dr Festus MO 63028 430653242 501(c)(3) 5150 General support Reorganized School District R-6 1515 Mid-Meadow Lane Festus MO 63028 436002980 501(c)(3) 6060 General support 5 0 Schedule I, Part I, Line 2 The organization awards assistance to preapproved local charity-based organizations, the amounts of $5,000 to $20,000 are approved by the CFO and amounts over $20,000 are approved by the CEO. X X 1 1 0 1 0 0 0 0 0 1 0 Ammons Carl E Eric President, Mercy Hospital Jefferson 151821 62605 25527 0 63626 20684 24965 0 7610 5170 273549 88459 0 0 Rehm MD Charles Chief admin officer & Board member 0 425727 0 80320 0 42565 0 81444 0 14121 0 644177 0 0 Cantalin Jeanne L Reg VP-General counsel-thru 2/14 0 201873 0 44431 0 17612 0 36274 0 10431 0 310621 0 0 Hannasch Susan Reg VP-General counsel-start 3/14 0 195919 0 52882 0 26683 0 36277 0 16394 0 328155 0 0 Matejka Cheryl L Chief financial officer 0 300405 0 74056 0 38640 0 61337 0 17201 0 491639 0 0 Sorensen Donn President-East Communities 0 560884 0 175609 0 75005 0 232962 0 12566 0 1057026 0 0 Eckenfels Daniel VP Finance 200809 0 33922 0 10253 0 0 0 12241 0 257225 0 0 0 Julien Sheila CNO 69561 70603 0 22596 5764 6882 9906 0 3107 3582 88338 103663 0 0 Meyer Michele VP Operations 187431 0 33924 0 25371 0 0 0 12241 0 258967 0 0 0 Alam Tariq Physician 127053 122628 96788 79702 108 216 0 0 4304 7356 228253 209902 0 0 Albano Benjamin Y Physician 215180 144563 40559 14440 12233 5772 0 0 4954 7742 272926 172517 0 0 Barakat Ammar Physician 169235 121673 71540 14514 15950 1898 0 0 3732 4846 260457 142931 0 0 Kennen E William Physician 310980 242434 27040 8983 19406 7275 0 0 4239 6184 361665 264876 0 0 Newhall Phillip Physician 197620 200000 0 0 21 43 0 0 27 52 197668 200095 0 0 Pigg Timothy J Former officer 120090 0 19064 0 10623 0 0 0 7226 0 157003 0 0 0 Johnson Beverly E Former key employee 97024 0 26416 0 29383 0 0 0 2127 0 154950 0 0 0 Part I, Line 1a 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. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS WERE SUBJECT TO TAX TO CARL AMMONS. 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. Part I, Line 4b Part I, Line 4B: Mercy Health, the ultimate parent company, 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 following individuals participated in the following plans. There were no payments for the fiscal year ended 6/30/2014 Supplemental Executive Retirement Plan (SERP) Sorensen, Donn; Ammons,Carl Supplemental Management Retirement Plan (SMRP) Sorensen, Donn; Cantalin, Jeanne; Hannasch, Susan; Matejka,Cheryl L; Rehm MD, Charles; The amount of all accrued benefits is included in compensation amounts provided in Schedule J, Part II, Column (C). Part I, Line 7 The related organization which employs those individuals listed on Part VII, and the filing organization PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2014 (JULY 1, 2013 - JULY 30, 2014) PAYMENT OF ALL OR PART OF THE BONUS WAS CONTINGENT UPON ATTAINMENT OF CERTAIN FINANCIAL TARGETS AND NON-FINANCIAL GOALS DEEMED NECESSARY BY MERCY. PAYMENTS ARE MADE ANNUALLY IN OCTOBER FOLLOWING (I) THE CONCLUSION OF THE FISCAL YEAR AND (II) DETERMINATION OF GOAL ACHIEVEMENT. BONUS OPPORTUNITIES ARE TIERED PERCENTAGES AND ARE DEPENDENT UPON THE LEADERSHIP LEVEL AND ATTAINMENT PERCENTAGE. MERCY'S ATTAINMENT OF FINANCIAL TARGETS AND NON-FINANCIAL GOALS IS REVIEWED BY THE COMPENSATION COMMITTEE OF MERCY HEALTH AND IS TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS. Part I, Line 3 Mercy Health (parent company) is responsible for establishing the compensation of the organization's CEO/Executive Director. The following methods were used by Mercy Health to establish compensation: -Independent compensation consultant -written employment contract -compensation survey or study -approval by the board or compensation committee Form 990, Part VI, Section A, line 6 THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH EAST COMMUNITIES - SOUTHERN REGION, a supporting organization under Section 509(a)(3). The member of MERCY HEALTH EAST COMMUNITIES - SOUTHERN REGION is Mercy Health East Communities, a supporting organization under Section 509(a)(3). The member of Mercy Health East Communities is Mercy Health. Form 990, Part VI, Section A, line 7a Mercy Health, the member of Mercy Health East Communities, has reserve powers to appoint and remove all directors and officers for Mercy Hospital Jefferson. Form 990, Part VI, Section A, line 7b THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO THE CORPORATE MEMBER (AND WITH REGARD TO CERTAIN POWERS AND RESPONSIBILITIES, TO MERCY HEALTH EAST COMMUNITIES AS THE CORPORATE MEMBER OF THE CORPORATE MEMBER): A. APPROVAL OF REVISIONS TO THE MISSION, VISION AND OPERATING VALUES PURSUANT TO WHICH THE CORPORATION OPERATES; B. APPROVAL OF ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THESE BYLAWS AND ANY AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE OF THE CORPORATION; C. APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD; D. APPROVAL OF THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE HOSPITAL SUBJECT TO THE CONSENT OF MERCY HEALTH EAST COMMUNITIES; E. ADOPTION OF THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION; F. ADOPTION OF THE OPERATING, CAPITAL AND ALL OTHER BUDGETS FOR THE CORPORATION; G. APPROVAL OF THE ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000) IN ANY ONE OR SERIES OF RELATED TRANSACTIONS OCCURRING WITHIN ANY TWELVE (12) MONTH PERIOD; H. AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; I. APPROVAL OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR ANY AFFILIATE; J. APPROVAL OF THE LEASE, MANAGEMENT OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HOSPITAL SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION; AND, K. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. L. OVERSEE, APPROVE AND MONITOR HUMAN RESOURCE PROGRAMS, WHICH SHALL PROMORTE AN ORGANIZATIONAL ENVIRONMENT THAT: 1. PROVIDES FOR THE RECRUITMENT AND RENTION OF CO-WORKERS WHO ARE SERVICE ORIENTED, COMPASSIONATE, ENGAGED, AND WHO FIND MEANING AND PURPOSE IN WORKING IN A FAITH-BASED ORGANIZATION; 2. ENABLES PEOPLE TO RELATE TO ONE ANOTHER WITH RESPECT AND ACCEPTANCE IN A SPIRIT OF COMMUNITY; 3. PROMOTES CO-WORKER PARTIICPATION AND VOICE IN THEIR WORK LIVES; 4. GIVES CO-WORKERS A FAIR OPPORTUNITY TO DEVLEOP THEIR SKILLS AND TALENTS, AND A MEANS BY WHICH THEIR CONTRIBUTIONS ARE RECOGNIZED; 5. PROVIDES CO-WORKERS WITH THE MATERIALS AND EQUIPMENT TO PROPERLY DO THEIR WORK;AND, 6. ENSURES CO-WORKER SAFETY AND WELL-BEING. Form 990, Part VI, Section B, line 11 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 MANAGER 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' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. Form 990, Part VI, Section B, line 12c OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2014. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S BUSINESS RISK (INTERNAL AUDIT) 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 (FORMERLY FINANCE, AUDIT AND COMPLIANCE COMMITTEE) OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 15 FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), MERCY HEALTH (ultimate parent company) 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 MERCY HEALTH BOARD. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS, AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. Form 990, Part VI, Section C, line 19 Governing documents and financial statements are made available from time to time but are not published publicly; we are not required to make these documents available to the public. Financial results are available via request of copy of Form 990. Form 990, Part IX, line 11g Contracted Services: Program service expenses 12,584,864. Management and general expenses 391,302. Fundraising expenses 0. Total expenses 12,976,166. Purchased Services: Program service expenses 604,802. Management and general expenses 18,805. Fundraising expenses 0. Total expenses 623,607. Other Services: Program service expenses 2,605,573. Management and general expenses 81,015. Fundraising expenses 0. Total expenses 2,686,588. Form 990, Part XI, line 9: Transfer of Jefferson Physician Network funds 987,880. Transfer of unrestricted equity foundation -770,592. Rounding -1. Part XII, Line 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 2014 (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 (FORMERLY FINANCE, AUDIT, AND COMPLIANCE COMMITTEE) OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. Form 990, Part XII, Line 3 Single Audit Act and OMB Circular A-133 The organization was included in a consolidated audit of Mercy Health as required by the Single Audit Act and OMB Circular A-133. The single audit was conducted on a consolidated basis. FORM 990, SCHEDULE R, PART V SYSTEM LIMITATIONS Lawson ERP software is the primary accounting software used by Mercy Health 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. Form 990, Part V, Question 1a Independent Contractors Independent contractors 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 health system (with limited exceptions) under the Mercy Health EIN. FORM 990, SCHEDULE R, PART II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883. Jefferson Cardiovascular and Thoracic Services LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 454423688 Healthcare services MO 0 0 Mercy Hospital Jefferson Mercy Clinic Adult Hospitalists - Jefferson LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 462913068 Managed care contracting MO 0 0 Mercy Hospital Jefferson Mercy Labs Jefferson LLC 14528 S Outer Forty Suite 100 Chesterfield MO 63017 463478362 Laboratory Services MO 0 0 Mercy Hospital Jefferson Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 Women's domestic violence shelter TX 501c3 7 Mercy Ministries of Laredo 1 Jefferson Land Company Inc 14528 S Outer Forty St 100 Chesterfield MO 63017 431330360 Title Holding Company MO 501c2 Mercy Hospital Jefferson 1 Laredo Medical Group 14528 S Outer Forty St 100 Chesterfield MO 63017 742764726 Dissolved 5/5/2014 TX 501c3 9 Mercy Health System TX 1 McAuley Portfolio Mgmt Co 14528 S Outer Forty St 100 Chesterfield MO 63017 261708048 Portfolio management MO 501c3 11-II Mercy Health 1 Mercy ACO Clinical Services Inc 14528 S Outer Forty St 100 Chesterfield MO 63017 464504901 Virtual Care Center MO 501c3 3 Mercy Health 1 Mercy Clinic East Communities 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 431771217 Physician Group MO 501c3 9 Mercy Health East Communities 1 Mercy Clinic Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318597 Physician Clinic AR 501c3 9 Mercy Health Fort Smith Comm 1 Mercy Clinic Hot Springs Comm 1 Mercy Lane Hot Springs AR 71913 261125131 Sold to CHI 3/31/2014 AR 501c3 9 Mercy Health Hot Springs Comm 1 Mercy Clinic Oklahoma Comm 4300 W Memorial Road Oklahoma City OK 73120 270473057 Physician Group OK 501c3 9 Mercy Health OK Communities 1 Mercy Clinic Springfield Comm 1965 Fremont Street Suite 2950 Springfield MO 65804 431560263 Physician Group MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Family Center 14528 S Outer Forty St 100 Chesterfield MO 63017 721069468 Family counseling services MO 501c3 7 Mercy Health 1 Mercy Fdtn Health Innov 14528 S Outer Forty St 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 11-II Mercy Health 1 Mercy Health 14528 S Outer Forty St 100 Chesterfield MO 63017 431423050 Corporate Office MO 501c3 1 N/A 0 Mercy Health Center Foundation Inc 4300 W Memorial Road Oklahoma City OK 73120 731593024 Dissolved 5/20/2014 OK 501c3 11-I Mercy Hospital Oklahoma City 1 Mercy Health East Communities 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 431718408 Health System MO 501c3 11-II Mercy Health 0 Mercy Health East Communities - SR 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 461412322 Health System MO 501c3 11-II Mercy Health East Communities 0 Mercy Health Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Company AR 501c3 11-II Mercy Health 1 Mercy Health Foundation Ada 430 N Monte Vista Street Ada OK 74820 453596274 Foundation OK 501c3 11-I Mercy Hospital Ada 1 Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 11-I Mercy Hospital Ardmore 1 Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 11-I Mercy Hospital Berryville 1 Mercy Health Foundation Ft Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 11-III Mercy Kansas Communities Inc 1 Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501c3 11-II Mission Clinical Services 1 Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501c3 11-I Mercy Kansas Communities Inc 1 Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 Foundation MO 501c3 11-II Mercy Health East Communities - SR 1 Mercy Health Foundation Joplin 100 Mercy Way Joplin MO 64804 270906136 Foundation MO 501c3 11-I Mercy Health SW MOKS Comm 1 Mercy Health Foundation NW Ark 2710 Rife Medical Ln Rogers AR 72858 710601687 Foundation AR 501c3 11-III Mercy Hospital Rogers 1 Mercy Health Foundation of OK 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 11-I Mercy Health OK Communities 1 Mercy Health Foundation OK City 4300 W Memorial Road Oklahoma City OK 73120 463184231 Foundation OK 501c3 11-I Mercy Hospital Oklahoma City 1 Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 11-II Mercy Health Springfield Comm 1 Mercy Health Foundation STL 615 South New Ballas Road St Louis MO 63141 562410020 Foundation MO 501c3 11-II Mercy Health East Communities 1 Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 11-II Mercy Health East Communities 1 Mercy Health Hot Springs Comm 300 Werner Street Hot Springs AR 71913 261125064 Sold to CHI 3/31/2014 AR 501c3 11-II Mercy Health 1 Mercy Health NW Ark Communities 2710 Rife Medical Ln Rogers AR 72758 621684203 Physician Group AR 501c3 11-II Mercy Health 1 Mercy Health OK Communities 4300 W Memorial Road Oklahoma City OK 73120 731453048 Holding company OK 501c3 11-II Mercy Health 1 Mercy Health SW MOKS Comm 100 Mercy Way Joplin MO 64804 300584463 Health System MO 501c3 11-II Mercy Health 1 Mercy Health Springfield Comm 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Company MO 501c3 11-II Mercy Health 1 Mercy Health System TX 14528 S Outer Forty St 100 Chesterfield MO 63017 742764727 Dissolved 5/15/2014 TX 501c3 11-II Mercy Health 1 Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 Home Health and Hospice operations AR 501c3 11-III Mercy Hospital Springfield 1 Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Booneville 880 West Main Street Booneville AR 72927 463851119 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 501c3 9 Mercy Health SW MOKS Comm 1 Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 272716065 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501c3 3 Mercy Health Fort Smith Comm 1 Mercy Hospital Healdton Inc 918 South 8th Street Healdton OK 73438 263173902 Hospital OK 501c3 3 Mercy Hospital Ardmore Inc 1 Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 Sold to CHI 3/31/2014 AR 501c3 3 Mercy Health Hot Springs Comm 1 Mercy Hospital Joplin 100 Mercy Way Joplin MO 64804 270814858 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Hospital Kingfisher Inc 1000 Kingfisher Regional Hospital D Kingfisher OK 73750 463433074 Hospital OK 501c3 3 Mercy Hospital Oklahoma City 1 Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital of Laredo 14528 S Outer Forty St 100 Chesterfield MO 63017 741189682 Dissolved 5/15/2014 TX 501c3 3 Mercy Health System TX 1 Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Rogers 2710 Rife Medical Ln Rogers AR 72758 710294390 Hospital AR 501c3 3 Mercy Health NW Ark Communities 1 Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501c3 3 Mercy Hospital Ardmore 1 Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501c3 3 Mercy Hospital Fort Smith 1 Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 Leased Hospital OK 501c3 3 Mercy Health OK Communities 1 Mercy Hospitals East Comm 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 430653493 Hospital MO 501c3 3 Mercy Health East Communities 1 Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501c3 3 Mercy Health SW MOKS Comm 1 Mercy Medical Research Inst 1235 E Cherokee Street Springfield MO 65804 870796305 Research - Clinical Trials MO 501c3 4 Mercy Health Springfield Comm 1 Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78043 200198462 Healthcare services,outreach education program TX 501c3 7 Mercy Health 1 Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501c3 3 Mercy Health Springfield Comm 1 Mercy Support Services 615 S New Ballas Road St Louis MO 63141 431677952 Inactive MO 501c3 11-III Mercy Hospitals East Comm 1 MHM Support Services 14528 S Outer Forty St 100 Chesterfield MO 63017 202553101 Centralized Health System Functions MO 501c3 11-II Mercy Health 1 Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 Child Advocacy Center AR 501c3 9 Mercy Health 1 St Edward Mercy Foundation 7301 Rogers Avenue Fort Smith AR 72917 237330425 Foundation AR 501c3 7 Mercy Hospital Fort Smith 1 St Johns Childrens Hosp 1235 E Cherokee Street Springfield MO 65804 Inactive MO 501c3 3 Mercy Health Springfield Comm 1 St Marys Hosp Enid Ok 14528 S Outer Forty St 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 Mercy Health OK Communities 1 The Sr M Cornelia Blasko Fn 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 11-I Mercy St Francis Hospital 1 Unity Ambulatory Care 14528 S Outer Forty St 100 Chesterfield MO 63017 431861745 Inactive MO 501c3 11-III Mercy Health East Communities 1 Southern Oklahoma Diag Ctr LLC 1011 Fourteenth Avenue NW Ardmore OK 73401 431971232 MRI Services OK Mercy Hospital Ardmore Inc N/A 0 0 Resource Optimiz & InnovLLC 645 Maryville Ctr DrSte 200 St Louis MO 63141 460468368 Central Distribution Center MO MHN INC - MHNSR INC N/A 0 0 Mercy Ambulatory Surgery Center LLC 7301 Rogers Avenue Fort Smith AR 72917 710827721 Ambulatory Surgery Center AR Mercy Hospital Fort Smith N/A 0 0 Fort Smith Emergency Medical Services 1701 South Greenwood Fort Smith AR 72901 710416615 Emergency Medical Services AR Mercy Hospital Fort Smith N/A 0 0 St Edward Mercy Med Ctr M-P Off Bldg 7301 Rogers Avenue Fort Smith AR 72903 710554050 Office building AR Mercy Hospital Fort Smith N/A 0 0 Mercy Comm Services Inc 401 Woodland Hills Blvd Fort Scott KS 66701 481078101 Retail pharmacy KS MERCY KANSAS COMM INC C 0 Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 Holds ancillary assets & owns aircraft DE MERCY HEALTH C 0 Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 Technology transfer company MO MERCY HEALTH SPRINGFIELD COMM C 0 Unity Support Services Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 431797042 Inactive MO MERCY HEALTH EAST COMMUNITIES C 0 UH L Corp Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 742499535 Holding company MO MERCY HEALTH SERVICES LLC C 0 MHN of the Southern Region Inc 1011 14th Avenue NW Ardmore OK 73401 731580607 holding company OK MERCY MANAGED CARE CORP C 0 Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 Administrator of certain real property and improvements OK MERCY HOSPITAL OKLAHOMA CITYINC C 0 Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 Holding company OK MERCY HEALTH C 0 Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 holding company OK MERCY MANAGED CARE CORP C 0 Apothecary Services Inc PO Box 350 Crystal City MO 63019 431627267 Retail pharmacy MO Mercy Hospital Jefferson C 1.00000 0 Mercy Commercial Services Inc 14528 South Outer Forty Suite 100 Chesterfield MO 63017 464953543 Corp Parent of VCC taxable commercializ svcs OK MHN Inc and MHNSR INC C 0 St Johns Mercy Mail Order Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 431014222 Inactive MO UH Holdings Inc C 0 St Johns Mercy PBM Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 743089567 Inactive MO UH L Corp Inc C 0 UH Holdings Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 431845682 Inactive MO UH L Corp Inc C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 Mercy Clinic East Communities P 126958 Mercy Health East Communities P 4720655 FMV Mercy Hospital Ardmore P 60232 FMV Mercy Hospitals East Communities Q 1057642 FMV MHM Support Services P 9231900 FMV Resource Optimization & Innovation LLC P 2413103 FMV