MERCY HOSPITAL LOGAN COUNTY INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL LOGAN COUNTY INC (EIN 45-2998842)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201401349349304050
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T12:21:04-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562632458 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLEUS AND COMPANY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14323 S OUTER FORTY STE 310N | AddressLine1 |
| City | CHESTERFIELD | City |
| State | MO | State |
| ZIP Code | 63017 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452998842 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL LOGAN COUNTY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 4057523495 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S ACADEMY ROAD | AddressLine1 |
| City | GUTHRIE | City |
| State | OK | State |
| ZIP Code | 73044 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JON VITIELLO | Name |
| Title | CFO | Title |
| Phone | 4057523495 | Phone |
| Date Signed | 2014-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOUGLAS G PLEUS | Name |
| PTIN | P00013488 | PTIN |
| Phone | 3143179916 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DIANA SMALLEY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S ACADEMY ROAD | AddressLine1 |
| City | GUTHRIE | City |
| State | OK | State |
| ZIP Code | 73044 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22473203 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCY.NET/LOGANOK | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2011 | YearFormation |
| State Legal Domicile | OK | StateLegalDomicile |
| Activity Or Mission Description | TO CARRY OUT THE HEALING MINISTRY OF JESUS BY PROMOTING HEALTH AND WELLNESS THROUGH OUR COMMUNITIES. TO PROVIDE QUALITY HEALTH SERVICES THROUGH A WISE USE OF RESOURCES AND EXCEPTIONAL MERCY SERVICE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 387 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 21105 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 36013 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15036411 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22323694 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 776 | InvestmentIncomePriorYear |
| Investment Income Current Year | 287 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 74461 | OtherRevenuePriorYear |
| Other Revenue Current Year | 113209 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15132753 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22473203 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 799 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 800 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8601694 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12219804 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7240827 | OtherExpensePriorYear |
| Other Expenses Current Year | 10351773 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15843320 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22572377 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -710567 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -99174 | RevenuesLessExpensesCY |
| Total Assets BOY | 11509655 | TotalAssetsBOY |
| Total Assets EOY | 9324237 | TotalAssetsEOY |
| Total Liabilities BOY | 1333019 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 544430 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10176636 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8779807 | NetAssetsOrFundBalancesEOY |
| Mission Description | MERCY HOSPITAL LOGAN COUNTY IS ROOTED IN THE MISSION OF JESUS AND THE HEALING MINISTRY OF THE CHURCH. THIS TRADITION IS MARKED BY VALUES OF JUSTICE, EXCELLENCE, STEWARDSHIP AND RESPECT FOR THE DIGNITY OF EACH PERSON. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 19048691 | Expense |
| Grants | 800 | Grants |
| Revenue | 22370661 | Revenue |
| Description | MERCY HOSPITAL LOGAN COUNTY PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. DURING FISCAL YEAR END JUNE 30, 2013, LOGAN COUNTY PROVIDED SERVICES TO 835 INPATIENTS, 58,821 OTHER OUTPATIENTS, AND 8,660 EMERGENCY DEPARTMENT PATIENTS. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2013 WAS $1,988,078.MERCY HOSPITAL LOGAN COUNTY'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H. | Description |
| Total Program Service Expense | 19048691 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 1 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 387 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OK | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PATRICIA ROBERTSON | NamePerson |
| Telephone Number | 4057523495 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 WEST MEMORIAL ROAD | AddressLine1 |
| City | OKLAHOMA CITY | City |
| State | OK | State |
| ZIP Code | 73120 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| JOHNSON MARK | |||||||||
| BOARD DIRECTOR | 1.00 | 51.00 | X | 0 | 421376 | 53001 | |||
| LE BICH-VI | |||||||||
| REGIONAL VP-GENERAL COUNSEL | 2.00 | 58.00 | X | 0 | 240502 | 36699 | |||
| MOUNTFORD DEREK | |||||||||
| BOARD DIRECTOR | 1.00 | 58.00 | X | 0 | 174693 | 22261 | |||
| SMALLEY DIANA L | |||||||||
| CHIEF EXECUTIVE OFFICER | 2.00 | 58.00 | X | 0 | 671252 | 200438 | X | ||
| VITIELLO JONATHAN | |||||||||
| CHIEF FINANCIAL OFFICER | 1.00 | 59.00 | X | 0 | 493118 | 64006 | X | ||
| TUCKER JOSH | |||||||||
| REGIONAL ADMINISTRATOR, RURAL FACILITIES | 49.00 | 1.00 | 0 | 167288 | 19811 | X | |||
| PAYTON BECKY J | |||||||||
| VP-HUMAN RESOURCES | 2.00 | 58.00 | 0 | 294127 | 40333 | X | |||
| TEW DAVID | |||||||||
| CHIEF OPERATING OFFICER | 2.00 | 58.00 | 0 | 483905 | 67702 | X | |||
| BRYANT MARGARET A | |||||||||
| HOUSE SUPERVISOR | 42.00 | 0.00 | 104355 | 0 | 8373 | X | |||
| LEUNG KAI G | |||||||||
| MANAGER, PHARMACY SERVICES | 60.00 | 0.00 | 139892 | 0 | 1173 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 244247 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2946261 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 513797 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| GUTHRIE EMERGENCY PLLC | |||||
| 211 S 36TH STREET SUITE F | MUSKOGEE | OK | 74401 | PHYSICIAN SERVICES | 1105523 |
| FASTAFF INC | |||||
| 6399 S FIDDLERS GREEN CIRCLE SUITE | GREENWOOD VILLAGE | CO | 80111 | STAFF SERVICES | 325971 |
| JAMESONBRETTON | |||||
| 7 CHAMPIONS PLACE | STILLWATER | OK | 74074 | PHYSICIAN SERVICES | 231668 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | MISC CONTRACT SERVICES | 227504 |
| DIAGNOSTIC HEALTH SERV | |||||
| PO BOX 972288 | DALLAS | TX | 75397 | RADIOLOGY SERVICES | 224196 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Related Organizations | 36013 | RelatedOrganizations |
| Noncash Contributions | 35000 | NoncashContributions |
| Total Contributions | 36013 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 22323694 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22323694 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22323694 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 287 | TotalRevenueColumn |
| Exclusion | $287 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 22506 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 22506 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22506 | TotalRevenueColumn |
| Exclusion | $22,506 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAFE & VENDING | Description |
| Business Code | 722210 | BusinessCode |
| Total Revenue Column | 43736 | TotalRevenueColumn |
| Exclusion | $43,736 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46967 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46967 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 90703 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22473203 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22370661 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $66,529 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 800 | Total |
| Program Services | 800 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9981125 | Total |
| Program Services | 9119693 | ProgramServices |
| Management And General | 861432 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 409333 | Total |
| Program Services | 359886 | ProgramServices |
| Management And General | 49447 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1215584 | Total |
| Program Services | 1068741 | ProgramServices |
| Management And General | 146843 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 613762 | Total |
| Program Services | 539620 | ProgramServices |
| Management And General | 74142 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1745487 | Total |
| Program Services | 1422019 | ProgramServices |
| Management And General | 323468 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15629 | Total |
| Program Services | 12733 | ProgramServices |
| Management And General | 2896 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 768459 | Total |
| Program Services | 626051 | ProgramServices |
| Management And General | 142408 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10130 | Total |
| Program Services | 10130 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316543 | Total |
| Program Services | 257882 | ProgramServices |
| Management And General | 58661 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39486 | Total |
| Program Services | 28025 | ProgramServices |
| Management And General | 11461 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -91 | Total |
| Program Services | -74 | ProgramServices |
| Management And General | -17 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1009246 | Total |
| Program Services | 695691 | ProgramServices |
| Management And General | 313555 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200218 | Total |
| Program Services | 82771 | ProgramServices |
| Management And General | 117447 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 2903827 | 2903827 | |
| DRUGS & MEDICAL EXPENSE | 1812590 | 1476686 | 335904 |
| SHARED SERVICE FEES | 1272761 | 234439 | 1038322 |
| REPAIRS & MAINTENANCE | 142496 | 116089 | 26407 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114992 | Total |
| Program Services | 93682 | ProgramServices |
| Management And General | 21310 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22572377 | Total |
| Program Services | 19048691 | ProgramServices |
| Management And General | 3523686 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 613543 | BOY |
| EOY | 91605 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -7504 | BOY |
| EOY | 6700 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3922420 | BOY |
| EOY | 2631690 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 309416 | BOY |
| EOY | 326956 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77503 | BOY |
| EOY | 30091 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7201671 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1686229 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6294239 | BOY |
| EOY | 5515442 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | -88789 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300038 | BOY |
| EOY | 810542 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11509655 | BOY |
| EOY | 9324237 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1333019 | BOY |
| EOY | 544430 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1333019 | BOY |
| EOY | 544430 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10176636 | BOY |
| EOY | 8779807 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10176636 | BOY |
| EOY | 8779807 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11509655 | BOY |
| EOY | 9324237 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -99174 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1297655 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $4,149 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 4149 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION, CATHOLIC HOSPITAL ASSOCIATION, AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2013, DUES WERE $16,181, $3,542, AND $7,427, RESPECTIVELY. APPROXIMATELY 13.98% OF OKLAHOMA HOSPITAL ASSOCIATION DUES, 3.00% OF CATHOLIC HOSPITAL ASSOCIATION DUES, AND 23.98% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 380000 | OtherCostOrOtherBasis |
| Book Value | 380000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3114220 | OtherCostOrOtherBasis |
| Depreciation | 634406 | Depreciation |
| Book Value | 2479814 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3095900 | OtherCostOrOtherBasis |
| Depreciation | 944548 | Depreciation |
| Book Value | 2151352 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 611551 | OtherCostOrOtherBasis |
| Depreciation | 107275 | Depreciation |
| Book Value | 504276 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5515442 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER LONG TERM ASSETS | 2326 |
| DUE FROM TAX EXEMPT AFFILIATES | 808216 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 810542 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 570403 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 570403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02900 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3051018 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1633343 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1417675 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07210 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3621421 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1633343 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1988078 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5124 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5124 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2817 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2817 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7941 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7941 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3629362 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1633343 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1996019 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10150 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6593 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6593 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5675 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5675 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 12268 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12268 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,501,279 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8382773 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8489661 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -106888 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL LOGAN COUNTY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 SOUTH ACADEMY | AddressLine1 |
| City | GUTHRIE | City |
| State | OK | State |
| ZIP Code | 73044 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MERCY.NET/LOGANOK | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL LOGAN COUNTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| SOUTH DIVISION CLINIC | ||||
| 2919 S DIVISION | GUTHRIE | OK | 73044 | OUTPATIENT CLINIC |
| CRESCENT CLINIC | ||||
| 400 S GRAND | CRESCENT | OK | 73028 | OUTPATIENT CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2903827. | |
| PART II: MERCY HOSPITAL LOGAN COUNTY (MHLC) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH PARTICIPATION IN NEIGHBORHOOD/COMMUNITY MEETINGS, COMMUNITY BOARDS, AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHLC DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE. SOME OF THE COMMUNITY BUILDING ACTIVITIES IN WHICH MHLC PARTICIPATES/SERVES ARE:- PARTICIPATION ON THE LOGAN COUNTY BOARD OF HEALTH-BOARD MEMBER- LOGAN COMMUNITY SERVICES-BOARD MEMBER- PARTICIPATION IN OBI BLOOD DRIVE- VOLUNTARY CONTRIBUTIONS TO THE UNITED WAY- ST. MARY CATHOLIC SCHOOL VOLUNTEER AND PARTICIPANT IN THE ANGEL TREE- CHAPTER OF GUTHRIE ROTARY CLUB- PARTICIPATION IN LOGAN COUNTY MULTIDISCIPLINARY TEAM-DA TASK FORCE- INVOLVED IN THE HANDS OF JESUS ASSOCIATION- BOARD MEMBER FOR LOGAN COUNTY YOUTH AND FAMILY SERVICES- PARTICIPATION IN SUMMER SPORTS CAMP- INVOLVED IN GET FIT GUTHRIE: WALK TO SCHOOL PROGRAM- DIABETES EDUCATION: PHYSICAL FITNESS PRESENTATION- MEMBER OF THE OKLAHOMA STATE STROKE SYSTEMS ADVISORY COMMITTEE- HOPE VOLUNTEER- INVOLVED IN LOGAN COUNTY ECONOMIC DEVELOPMENT COUNCIL- ONE HARVEST FOOD MINISTRY PARTNER- LEPC (LOGAN EMERGENCY PREPAREDNESS COUNCIL)- GUTHRIE CHAMBER BOARD MEMBER | |
| 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 FOLLOWS: "PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FORUNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THEHEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CAREIF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY.THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED ON MANAGEMENT'SASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERINGBUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, ANDOTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR,MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLERECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLESAS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENTAND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESEREVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FORUNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FORUNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROMINSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FORPLACING PAST-DUE BALANCES WITH COLLECTION AGENCIES." 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. 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 8: IT IS THE POSITION OF MERCY HOSPITAL LOGAN COUNTY 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 CHARGESNET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS ORREIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96) | |
| PART III, LINE 9B: MERCY HOSPITAL LOGAN COUNTY ("MERCY") 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 MET THE MERCY HOSPITAL COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY FOR APROPRIATE 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 UTILITIZES 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 V, SECTION B, LINE 3: REFER TO PART VI, LINE 2 RESPONSE. | MERCY HOSPITAL LOGAN COUNTY |
| 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. | MERCY HOSPITAL LOGAN COUNTY |
| PART VI, LINE 2: MERCY HOSPITAL LOGAN COUNTY PARTNERED WITH THE OKLAHOMA OFFICE OF RURAL HEALTH AND OKLAHOMA COOPERATIVE EXTENSION SERVICE TO CONDUCT ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. A TOTAL OF FOUR COMMUNITY MEETINGS WERE HELD BETWEEN MAY 2, 2013 AND JUNE 18, 2013. THE AVERAGE ATTENDANCE AT THE COMMUNITY MEETINGS WAS 15-20 COMMUNITY MEMBERS. COMMUNITY MEMBERS IN ATTENDANCE WERE SOUGHT OUT DUE TO THEIR EXPERTISE IN PUBLIC HEALTH, DIVERSE INCOME AND RACIAL OUTREACH, AND OVERALL EXPERTISE OF THEIR LOCAL COMMUNITY. GUTHRIE AND CRESCENT CHAMBER OF COMMERCE WERE BOTH CONTACTED TO INFORM THEIR MEMBERS AND THE INDIVIDUALS THEY REACH ABOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT. CHAMBER MEMBERS RECEIVED AN EMAIL INVITATION AND WERE INFORMED OF THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH THEIR CHAMBER COFFEES. LOCAL BUSINESS OWNERS WHO ARE ACTIVE IN THE COMMUNITY WERE ALSO INVITED TO SHARE THEIR INPUT. A SURVEY WAS DESIGNED TO GAUGE HOSPITAL USAGE, SATISFACTION, AND COMMUNITY HEALTH NEEDS. THE SURVEY WAS AVAILABLE IN BOTH PAPER AND WEB FORMAT. COMMUNITY MEMBERS IN ATTENDANCE AT THE MAY 2, 2013, MEETING RECEIVED A HARD-COPY OF THE SURVEY TO COMPLETE AT THE MEETING. THE ATTENDEES WERE ALSO EMAILED AN ELECTRONIC LINK TO THE SURVEY AND WERE ENCOURAGED TO SHARE IT WITH OTHERS. THE GUTHRIE CHAMBER OF COMMERCE SENT OUT THE SURVEY LINK TO THEIR MEMBERS. THE SURVEY LINK WAS ALSO SHARED WITH MERCY HOSPITAL LOGAN COUNTY EMPLOYEES, AND THEY WERE ENCOURAGED TO SHARE THE LINK WITHIN THE COMMUNITY. COMMUNITY MEMBERS WERE ASKED TO RETURN THEIR COMPLETED SURVEYS TO MERCY HOSPITAL LOGAN COUNTY. THE SURVEY RAN FROM MAY 2, 2013 TO MAY 17, 2013. A TOTAL OF 66 SURVEYS FROM THE MERCY HOSPITAL LOGAN COUNTY MEDICAL SERVICE AREA WERE COMPLETED. THE SURVEY RESULTS WERE PRESENTED AT THE MAY 24, 2013 COMMUNITY MEETING.MAJOR NEEDS AND HOW PRIORITIES WERE ESTABLISHEDAS A RESULT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT MEETINGS AND DISCUSSION WITH COMMUNITY MEMBERS, MERCY HOSPITAL LOGAN COUNTY IDENTIFIED THE FOLLOWING ISSUES: 1. OBESITY/NUTRITION2. MENTAL HEALTH3. ADULT DAY CARE4. SMOKING5. SEXUALLY TRANSMITTED DISEASES (STDS)6. HEALTH EDUCATION & HEALTHY LIFESTYLES FOR COMMUNITY ENGAGEMENT AND PROMOTION OF WELLNESSDESCRIPTION OF WHAT MERCY HOSPITAL LOGAN COUNTY WILL DO TO ADDRESS COMMUNITY NEEDSACTION PLANS:1. OBESITY/NUTRITIONGUTHRIE PUBLIC SCHOOLS CURRENTLY OFFERS A BACKPACK PROGRAM WHERE IDENTIFIED STUDENTS IN NEED RECEIVE CANNED FOOD ON THE WEEKEND. THE PROGRAM OPERATES THROUGHOUT THE SCHOOL YEAR BUT IS NOT ABLE TO CONTINUE IN THE SUMMER MONTHS BECAUSE OF A LACK OF GETTING THE FOOD TO THE STUDENTS INVOLVED IN THE PROGRAM. MERCY HOSPITAL LOGAN COUNTY WILL WORK WITH THE GUTHRIE PUBLIC SCHOOLS TO DETERMINE HOW THIS PROGRAM CAN BE MAINTAINED AND STRIVE THROUGHOUT THE SUMMER MONTHS. OPTIONS INCLUDE (BUT ARE NOT LIMITED TO) PROVIDING TRANSPORTATION TO DELIVER FOOD TO A CENTRAL LOCATION, MAKING THE HOSPITAL AVAILABLE FOR "AFTER HOURS" PICKUP BY PARENTS, OR DETERMINING THE FEASIBILITY OF TRANSPORTING FOOD TO EACH CHILD'S HOME. WE WILL WORK WITH THE REGIONAL FOOD BANK, LOCAL FOOD PANTRIES, CIVIC GROUPS, COMMUNITY CHURCHES, THE TROLLEY SYSTEM, AND COMMUNITY LEADERS TO DETERMINE THE PROCESS THAT CAN BE BUILT TO ACHIEVE THE BEST OUTCOME FOR THIS ISSUE. MERCY HOSPITAL LOGAN COUNTY WILL ALSO BE WORKING WITH THE COMMUNITY SCHOOLS TO PROVIDE SUPPORT AND EDUCATION TO THE SCHOOLS' DIETARY PROGRAM THROUGH THE USE OF THE HOSPITAL'S REGISTERED DIETICIAN IN ORDER TO ENSURE HEALTHY MEAL OPTIONS ARE AVAILABLE FOR STUDENTS. IN ADDITION, MERCY HOSPITAL LOGAN COUNTY IS EXPLORING WAYS TO SET UP A COMMUNITY WIDE HEALTHY OPTIONS FOOD CO-OP TO PROMOTE HEALTHY FOOD CHOICES. 2. HEALTH EDUCATION & HEALTHY LIFESTYLES FOR COMMUNITY ENGAGEMENT AND PROMOTION OF WELLNESSTHE IMPORTANCE OF EARLY SCREENINGS, DETECTIONS, AND REGULAR DENTAL VISITS WERE NOTED FOR THE LOGAN COUNTY COMMUNITY. IN ADDITION, FINDING NEW WAYS TO ENGAGE THE COMMUNITY TO BE MORE EFFECTIVE IN TERMS OF HEALTH EDUCATION/PREVENTION WERE NOTED. MORE EDUCATION ON PREVENTATIVE CARE/REGULAR CHECK-UPS (DENTAL AND VISION) AND CREATING THE AWARENESS OF THE IMPORTANCE OF HEALTHY LIFESTYLES- ESPECIALLY THE ROLE THAT EMPLOYERS CAN PLAY IN PROMOTING WELLNESS ARE A COMMUNITY NEED. IN ORDER TO ADDRESS THESE CONCERNS, MERCY HOSPITAL LOGAN COUNTY WILL CARRY OUT HEALTH FAIRS FOR THE LOGAN COUNTY COMMUNITY. THESE HEALTH FAIRS (FIRST HELD IN OCTOBER 2013) WILL INVITE HEALTHCARE PROVIDERS IN GUTHRIE, CRESCENT, AND THE SURROUNDING COMMUNITIES TO PRESENT EDUCATIONAL MATERIALS, SCREENINGS, ETC. TO HELP EDUCATION THE PUBLIC. MERCY HOSPITAL LOGAN COUNTY IS WORKING WITH THE LOCAL HEALTH DEPARTMENT TO BECOME THE FIRST EMPLOYER-SPONSORED ORGANIZATION IN LOGAN COUNTY THAT MODELS HEALTH AND WELLNESS FOR THE COMMUNITY AND WILL BE ADVOCATING THEIR PROGRAMS TO ENCOURAGE AND ENGAGE OTHER EMPLOYERS. MERCY'S INTERNAL HEALTH EDUCATION PROGRAM, HEALTHIFICATION, WILL ALSO BE USED FOR WAYS TO ENGAGE EMPLOYERS TO BECOME MORE HEALTH CONSCIOUS IN THEIR BENEFIT PLANS FOR THEIR CO-WORKERS. MERCY WILL BE SETTING UP OUTREACH CLASSES ON VARIOUS TOPICS TO EDUCATE THE COMMUNITY IN AREAS OF CONCERN. MERCY ALSO PROVIDES TO THE LOCAL SCHOOL DISTRICTS A PROGRAM CALLED HEALTH TEACHER, WHICH IS A COMPREHENSIVE K-12 CURRICULUM THAT INTEGRATES HEALTH SKILLS INTO ONLINE LESSON PLANS. MERCY WILL WORK WITH THE LOCAL SCHOOLS TO ENSURE EDUCATION AND TRAINING OF HEALTH TEACHER IS BEING AVAILABLE AND UTILIZED. 3. SMOKINGTOBACCO PREVENTION WILL BE ADDRESSED THROUGH THE TOBACCO CESSATION INITIATIVE FOR OKLAHOMA HOSPITALS. THE PROGRAM SERVICES WILL INCLUDE ASSESSING AND ASSISTING THE ADOPTION AND IMPLEMENTATION OF A SUSTAINABLE SYSTEM FOR PATIENTS AND CO-WORKERS FOR TOBACCO CESSATION. MERCY HOSPITAL LOGAN COUNTY IS A SMOKE-FREE FACILITY AND CAMPUS. MERCY HOSPITAL LOGAN COUNTY IS ENGAGED WITH MERCY WEST COMMUNITY TO BEGIN A SMOKING CESSATION IMPLEMENTATION TEAM TO SERVE THE COMMUNITIES SERVED BY MERCY IN OKLAHOMA. MERCY HOSPITAL LOGAN COUNTY & MERCY CLINICS ARE ALSO INVOLVED IN ASKING PATIENTS ABOUT THEIR SMOKING AND TOBACCO HABITS AND REFERRING THEM TO THE OKLAHOMA TOBACCO HOTLINE TO AID IN STOPPING TOBACCO USE. AS PART OF COMMUNITY OUTREACH AND AWARENESS, MERCY WILL ALSO REACH OUT TO COMMUNITY BUSINESSES THAT WOULD LIKE ONSITE SMOKING CESSATION EDUCATION. | |
| 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. SPECIFIC INFORMATION PROVIDED: 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. 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, ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS. | |
| PART VI, LINE 4: MERCY HOSPITAL LOGAN COUNTY'S PRIMARY SERVICE AREA INCLUDES LOGAN COUNTY, OKLAHOMA. BASED ON TRUVEN 2012 DATA, THE AREA'S POPULATION IS 83,043. THE AVERAGE HOUSEHOLD INCOME FOR THE AREA IS $45,664. 14% OF THE POPULATION IS AGE 65 AND OLDER. 15% OF THE POPULATION IS ON MEDICARE, 16% ON MEDICAID, AND 18% UNINSURED, BASED ON 2012 TRUVEN INSURANCE ESTIMATES. | |
| PART VI, LINE 5: MERCY HOSPITAL LOGAN COUNTY (MHLC) 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. IN KEEPING WITH MHLC'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITIES, MHLC PROVIDES CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS DEFINED BY THE INSTITUTION'S CHARITY POLICY, MHLC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR CHARITY CARE. IN ADDITION, MHLC PROVIDES SERVICES TO OTHER PATIENTS UNDER THE MEDICARE PROGRAM AND VARIOUS STATE MEDICAID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS THAT ARE SUBSTANTIALLY LESS THAN BILLED CHARGES, AND FREQUENTLY, LESS THAN THE COST OF THE SERVICES PROVIDED TO THE RECIPIENTS.MHLC HAS AN ADVISORY BOARD WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY BOARD MEMBERS ARE SCREENED BY GENERAL COUNSEL AND REVIEWED BY THE BOARD CHAIRPERSON AND CEO. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARE SERVED BY MHLC.SURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MHLC ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTHCARE SERVICES TO THE COMMUNITIES IT SERVES. AN EXAMPLE INCLUDES CONTINUING CONVERSION TO THE EPIC ELECTRONIC HEALTH RECORD SYSTEM. THIS PLATFORM ALLOWS CONTINUITY OF PATIENT MEDICAL RECORD ACCESS BY PROVIDERS THROUGHOUT THE MERCY SYSTEM AND ALSO ALLOWS THE PATIENT TO ACCESS INFORMATION FROM THEIR OWN RECORDS, ALLOWING MORE COMPLETE AND MEANINGFUL COMMUNICATION, INFORMATION AND HEALTH EDUCATION FOR THE COMMUNITY. | |
| PART VI, LINE 6: 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, 2013, MERCY FACILITIES INCLUDED 28 ACUTE CARE HOSPITALS, 4 MANAGED HOSPITALS, 4 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS AND 2 REHAB HOSPITALS. FOR THE FISCAL YEAR ENDED JUNE 30, 2013, MERCY HAD 5.5 MILLION PROVIDER VISITS, MORE THAN 1,900 EMPLOYED PHYSICIANS, AND APPROXIMATELY 39,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SEVENTH 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, 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHNSON MARK | ||||||||||||||
| BOARD DIRECTOR | 0 | 333522 | 0 | 80462 | 0 | 7392 | 0 | 45223 | 0 | 7778 | 0 | 474377 | 0 | 0 |
| LE BICH-VI | ||||||||||||||
| REGIONAL VP-GENERAL COUNSEL | 0 | 136596 | 0 | 57951 | 0 | 45955 | 0 | 21562 | 0 | 15137 | 0 | 277201 | 0 | 0 |
| MOUNTFORD DEREK | ||||||||||||||
| BOARD DIRECTOR | 0 | 124474 | 0 | 23648 | 0 | 26571 | 0 | 7437 | 0 | 14824 | 0 | 196954 | 0 | 0 |
| SMALLEY DIANA L | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 0 | 459480 | 0 | 202287 | 0 | 9485 | 0 | 182822 | 0 | 17616 | 0 | 871690 | 0 | 0 |
| VITIELLO JONATHAN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 0 | 294647 | 0 | 102118 | 0 | 96353 | 0 | 47736 | 0 | 16270 | 0 | 557124 | 0 | 0 |
| TUCKER JOSH | ||||||||||||||
| REGIONAL ADMINISTRATOR, RURAL FACILI | 0 | 117330 | 0 | 22274 | 0 | 27684 | 0 | 5088 | 0 | 14723 | 0 | 187099 | 0 | 0 |
| PAYTON BECKY J | ||||||||||||||
| VP-HUMAN RESOURCES | 0 | 195331 | 0 | 71727 | 0 | 27069 | 0 | 28314 | 0 | 12019 | 0 | 334460 | 0 | 0 |
| TEW DAVID | ||||||||||||||
| CHIEF OPERATING OFFICER | 0 | 336099 | 0 | 116358 | 0 | 31448 | 0 | 51644 | 0 | 16058 | 0 | 551607 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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. SPOUSAL TRAVEL WAS PROVIDED FOR AN EMPLOYEE OF A RELATED ORGANIZATION, VI LE. 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 ARE SUBJECT TO TAX TO THE EMPLOYEE OF A RELATED ORGANIZATION JOSHUA TUCKER. 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 | MERCY HEALTH, THE PARENT COMPANY, OFFERS SUPPLEMENTAL RETIREMENT PLANS TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON RETIREMENT 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 INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN: JONATHAN VITIELLO; BICH-VI LE; BECKY PAYTON; DAVID TEW THE INDIVIDUALS LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. THE FOLLOWING INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: DIANA SMALLEY THE INDIVIDUAL LISTED ABOVE DID NOT RECEIVE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING THE YEAR FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS. 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 PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2013 (JULY 1, 2012 - JULY 30, 2013) PAYMENT OF ALL OR PART OF THE BONUS WAS CONTINGENT UPON ATTAINMENT OF CERTAIN FINANCIAL TARGETS. 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 GOALS ARE REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF MERCY HEALTH AND ARE THEN TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS. | |
| PART III | PART I, LINE 3 THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. | SUPPLEMENTAL INFORMATION |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 35000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MERCY HEALTH OKLAHOMA COMMUNITIES IS THE SOLE MEMBER OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MERCY HEALTH OKLAHOMA COMMUNITIES (THE MEMBER) MAY APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS AT ANY TIME AT THE MEMBER'S DISCRETION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | MERCY HEALTH OKLAHOMA COMMUNITIES HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL ORGANIZATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND TO AMEND THE ORGANIZATIONAL DOCUMENTS OF ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; -TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CEO OF THE CORPORATION OR ANY ORGANZIATION CONTROLLED BY THE CORPORATION AFTER CONSULTATION WITH THE SYSTEM; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, BUSINESS PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; -TO APPROVE OR AMEND THE CONSOLIDATED OPERATING, CAPITAL AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND CHANGES IN BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -TO AUTHORIZE AND APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF ANY AMOUNT ESTABLISHED FROM TIME TO TIME BY MERCY; -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 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; AND -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, SUBJECT TO APPROVAL BY THE BOARD AS REQUIRED PURSUANT TO THE OKLAHOMA NONPROFIT CORPORATION ACT. -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS. | |
| 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. THE DRAFT FORM 990 IS ALSO REVIEWED BY THE MERCY HEALTH 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 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, 2013. 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 15A | FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE EXECUTIVE 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, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY. | |
| FORM 990, PART XI, LINE 9: | TRANSFERS TO MCS (LOGAN COUNTY PURCHASE) -1,297,655. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| PART XII, LINE 2 | THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2013 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION IS 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. | AUDITED FINANCIAL STATEMENTS |
| PART XII, LINE 3 | MERCY HEALTH IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE SINGLE AUDIT WAS CONDUCTED ON A CONSOLIDATED BASIS. | SINGLE AUDIT ACT AND OMB CIRCULAR A-133 |
| FORM 990, PART V, LINE 2A | THE SALARIES AND WAGES REPORTED ON FORM 990, PART IX, LINE 7 REPRESENT AN ALLOCATION OF SALARIES AND WAGES FROM A RELATED ORGANIZATION. EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, ALL REQUIRED PAYROLL FILING (INCLUDING W-2 AND W-3'S) WAS REPORTED UNDER THE RELATED ORGANIZATION'S EIN. | SALARIES AND WAGES |
| FORM 990, SCHEDULE R, PART II | MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883. | MERCY HOSPITALS EAST COMMUNITIES |
| FORM 990, SCHEDULE R, PART V | 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. | SYSTEM LIMITATIONS |
| FORM 990, PART V, LINE 1A | 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. | INDEPENDENT CONTRACTORS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (71 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | INACTIVE | 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 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 | PHYSICIAN CLINIC | AR | 501C3 | 9 | MERCY HEALTH HOT SPRINGS COMM | 1 | |
| MERCY CLINIC OKLAHOMA COMM | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 270473057 | PHYSICIAN GROUP/CLINIC | 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 | HEALTH SYSTEM - CORPORATE OFFICE | MO | 501C3 | 1 | 0 | N/A | |
| MERCY HEALTH EAST COMMUNITIES | |||||||||||
| 645 MARYVILLE CTR DR STE 100 | ST LOUIS | MO | 63141 | 431718408 | HEALTH SYSTEM | MO | 501C3 | 11-II | MERCY HEALTH | 1 | |
| 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 | 1 | |
| 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 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 FT SMITH | |||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 237330425 | FOUNDATION | AR | 501C3 | 7 | MERCY HOSPITAL FORT SMITH | 1 | |
| MERCY HEALTH FOUNDATION HOT SPRINGS | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 710804718 | FOUNDATION | AR | 501C3 | 11-II | MERCY HOSPITAL HOT SPRINGS | 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 | |||||||||||
| 2817 ST JOHNS BLVD | 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 OK CITY | |||||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 731593024 | FOUNDATION | OK | 501C3 | 11-I | MERCY HOSPITAL OKLAHOMA CITY | 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 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 | HOLDING COMPANY | 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 | 0 | |
| MERCY HEALTH SW MOKS COMM | |||||||||||
| 2817 ST JOHNS BLVD | 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 | INACTIVE | 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 | OPERATING CO FOR LEASED HOSP | 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 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 | OPERATING CO FOR LEASED HOSP | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 1 | |
| MERCY HOSPITAL COLUMBUS | |||||||||||
| 220 PENNSYLVANIA AVENUE | COLUMBUS | KS | 66725 | 270842031 | CRITICAL ACCESS HOSPITAL | MO | 501C3 | 9 | MERCY HEALTH SW MOKS COMM | 1 | |
| MERCY HOSPITAL EL RENO | |||||||||||
| 2115 PARKVIEW DRIVE | EL RENO | OK | 73036 | 272716065 | OPERATING CO FOR LEASED HOSP | 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 | OPERATING CO FOR HOSP | OK | 501C3 | 3 | MERCY HOSPITAL ARDMORE INC | 1 | |
| MERCY HOSPITAL HOT SPRINGS | |||||||||||
| 300 WERNER STREET | HOT SPRINGS | AR | 71913 | 710236913 | HOSPITAL | AR | 501C3 | 3 | MERCY HEALTH HOT SPRINGS COMM | 1 | |
| MERCY HOSPITAL JEFFERSON | |||||||||||
| 1400 HIGHWAY 61 SOUTH | FESTUS | MO | 63028 | 430687077 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH EAST COMMUNITIES - SR | 1 | |
| MERCY HOSPITAL JOPLIN | |||||||||||
| 2817 ST JOHNS BLVD | JOPLIN | MO | 64804 | 270814858 | HOSPITAL | MO | 501C3 | 9 | MERCY HEALTH SW MOKS COMM | 1 | |
| MERCY HOSPITAL LEBANON | |||||||||||
| 100 HOSPITAL DRIVE | LEBANON | MO | 65536 | 431767432 | HOSPITAL | MO | 501C3 | 3 | MERCY HEALTH SPRINGFIELD COMM | 1 | |
| MERCY HOSPITAL OF LAREDO | |||||||||||
| 14528 S OUTER FORTY ST 100 | CHESTERFIELD | MO | 63017 | 741189682 | INACTIVE | 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;RURAL HEALTH CLINICS | 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, OUTREACH,FOOD PANTRY | 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 | PHYSICIAN CLINICS | AR | 501C3 | 9 | MERCY HEALTH HOT SPRINGS COMM | 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 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | INACTIVE, DISSOLVED | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 |
| ST EDWARD MERCY MC M-P OFFICE BLDG | ||||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72903 | 710554050 | OFFICE BUILDING | AR | MERCY HOSPITAL FORT SMITH | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (15 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MERCY CLINIC EAST COMMUNITIES | ||
| Q | 159746 | FMV |
| MERCY CLINIC HOT SPRINGS COMMUNITIES | ||
| Q | 59653 | FMV |
| MERCY CLINIC OKLAHOMA COMMUNITIES INC | ||
| P | 509087 | FMV |
| MERCY CLINIC SPRINGFIELD COMMUNITIES | ||
| Q | 247772 | FMV |
| MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES | ||
| Q | 64150 | FMV |
| MERCY HEALTH OKLAHOMA COMMUNITIES INC | ||
| P | 680193 | FMV |
| MERCY HOSPITAL ARDMORE INC | ||
| P | 516319 | FMV |
| MERCY HOSPITAL EL RENO INC | ||
| P | 67458 | FMV |
| MERCY HOSPITAL HEALDTON INC | ||
| P | 172649 | FMV |
| MERCY HOSPITAL OKLAHOMA CITY INC | ||
| Q | 9618195 | FMV |
| MERCY HOSPITAL SPRINGFIELD | ||
| Q | 82721 | FMV |
| MERCY KANSAS COMMUNITIES INC | ||
| Q | 53416 | FMV |
| MHM SUPPORT SERVICES | ||
| P | 3103801 | FMV |
| RESOURCE OPTIMIZATION & INNOVATION LLC | ||
| P | 410482 | FMV |
| MERCY HEALTH FOUNDATION OF OKLAHOMA | ||
| C | 35000 | FMV |