2014-05-14T12:21:04-05:00 2013-06-30 562632458 PLEUS AND COMPANY LLC 14323 S OUTER FORTY STE 310N CHESTERFIELD MO 63017 990 2012-07-01 272716065 MERCY HOSPITAL EL RENO MERC 4057523495 2115 PARKVIEW DRIVE EL RENO OK 73036 JON VITIELLO 4057523495 2014-05-13 1 DOUGLAS G PLEUS P00013488 3143179916 2012 2015-11-30 17:44:51Z DIANA SMALLEY 2115 PARKVIEW DRIVE EL RENO OK 73036 15323797 0 0928 X WWW.MERCY.NET/ELRENOOK X 2010 OK 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. 5 1 289 14 0 0 0 2670 17649409 14955786 2928 6333 362278 359008 18014615 15323797 0 929 0 0 8510796 7328837 0 0 0 10491704 10323701 19002500 17653467 -987885 -2329670 3437423 3908734 5364761 8165743 -1927338 -4257009 MERCY HOSPITAL EL RENO 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. 0 0 14307778 929 15217302 MERCY HOSPITAL EL RENO 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, EL RENO PROVIDED SERVICES TO 504 INPATIENTS, 15,999 OTHER OUTPATIENTS, AND 8,413 EMERGENCY DEPARTMENT PATIENTS. THE NUMBER OF AMBULANCE TRIPS TOTALLED 3,072. SERVICES ARE PROVIDED THROUGH A COMMUNITY-BASED HOSPITAL. THE AMOUNT OF UNCOMPENSATED CARE FOR FY 2013 WAS $2,034,083.MERCY HOSPITAL EL RENO'S EXEMPT PURPOSE ACHIEVEMENTS ARE EXPANDED UPON IN VARIOUS SECTIONS OF SCHEDULE H. 14307778 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 289 1 0 0 0 0 0 0 0 0 0 0 X 5 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 OK X PATRICIA ROBERTSON 4057523495 4300 WEST MEMORIAL ROAD OKLAHOMA CITY OK 73120 HENDRICKS RSM SR REBECCA ANN 1.00 12.00 X 0 0 0 LE BICH-VI 2.00 58.00 X 0 240502 36699 STEFFENS AARON 10.00 40.00 X 0 248707 20895 SMALLEY DIANA L 2.00 58.00 X X 0 671252 200438 VITIELLO JONATHAN 1.00 59.00 X X 0 493118 64006 CARMICHAEL CINDY 4.00 56.00 X 0 241487 13233 PAYTON BECKY J 2.00 58.00 X 0 294127 40333 TEW DAVID 2.00 58.00 X 0 483905 67702 GOFORTH SHEILA 50.00 0.00 X 149516 0 14745 VANYA RICHARD F 45.00 0.00 X 175444 0 7457 324960 2673098 465508 3 0 1 0 RAYS ILLUMINATE 10901 W TOLLER DRIVE SUITE 105 LITTLETON CO 80127 PHYSICIAN SERVICES 190590 FOREVER YOUNG REHAB LLC 1305 SANDSTONE DR YUKON OK 73099 STAFF SERVICES 188708 ROGERSDONALD E 1310 N THOROUGHBREAD WAY MUSTANG OK 73064 PHYSICIAN SERVICES 136000 SHARED IMAGING 801 PHOENIX LAKE AVE STREAMWOOD IL 60107 RADIOLOGY SERVICES 110277 4 2670 2670 NET PATIENT SERVICE REVENUE 622110 14955786 14955786 14955786 6333 6333 25346 0 25346 25346 25346 OTHER INCOME 622110 261516 261516 CAFETERIA 722210 72146 72146 333662 15323797 15217302 0 103825 929 929 5938382 5306515 631867 241893 210761 31132 746162 650131 96031 402400 350611 51789 3442 3442 91 91 775432 501150 274282 3350 2165 1185 517592 334512 183080 49318 11546 37772 720098 465388 254710 116340 106986 9354 159336 148289 11047 102876 102876 BAD DEBTS 5376273 5376273 SHARED SERVICE FEE 1249772 34808 1214964 DRUGS & MEDICAL EXPENSE 1021649 660276 361373 REPAIRS & MAINTENANCE 171640 110928 60712 56492 36510 19982 17653467 14307778 3345689 0 -262922 339881 -51601 2602190 2092699 196881 160783 210396 11513 1812668 1342426 376233 470242 314645 381117 0 504100 3437423 3908734 288945 464017 5075816 7701726 5364761 8165743 X -1927338 -4257009 -1927338 -4257009 3437423 3908734 X -2329670 -1 X X 0 1 X 1 1 1 X 0 0 0 0 0 1 3867 0 0 0 3867 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: 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 $17,613, $3,542, AND $5,413, 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. 2535 254 2281 1714728 1342172 372556 95405 95405 470242 OTHER LONG TERM ASSETS 504100 504100 DUE TO TAX EXEMPT AFFILIATES 7701726 7701726 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 1 0 0 334842 334842 0.02730 2848027 1148786 1699241 0.13840 3182869 1148786 2034083 0.16570 5124 5124 0.00040 2817 2817 0.00020 7941 7941 0.00060 3190810 1148786 2042024 0.16630 6593 6593 0.00050 5675 5675 0.00050 12268 12268 0.00100 1 1881697 0 3241267 4785978 -1544711 X 1 1 1 1 MERCY HOSPITAL EL RENO

2115 PARKVIEW DRIVE EL RENO OK 73036

WWW.MERCY.NET/ELRENOOK X X X MERCY HOSPITAL EL RENO 1 1 X X X X X X X X X 12 1 0 1 X X X X X 1 0 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 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 $ 5376273. PART II: MERCY HOSPITAL EL RENO (MHER) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH ACTIVE PARTICIPATION IN COMMUNITY BOARDS, NEIGHBORHOOD/COMMUNITY MEETINGS AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHER 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 MHER PARTICIPATES/SERVES ARE: - PROVIDE FREE HEALTH SCREENING AND PHYSICAL FOR EL RENO PUBLIC SCHOOL SYSTEM - AMERICAN CANCER SOCIETY RELAY FOR LIFE - PARTICIPATION AS CABINET MEMBER FOR UNITED WAY OF CANADIAN COUNTY. - VOLUNTARY CONTRIBUTIONS TO THE UNITED WAY - PARTICIPATION IN THE CANADIAN COUNTY COALITION FOR CHILDREN AND FAMILIES. - EL RENO CHAPTER OF LION'S CLUB - EL RENO CHAPTER OF ROTARY. - COMMUNITY EDUCATION PROGRAMS AT OUR FACILITY - ESTABLISH A COMMUNITY ROOM TO PROVIDE EDUCATIONAL OFFERINGS TO COMMUNITY/SURROUNDING AREA. - PARTICIPATION AS BOARD MEMBER FOR THE EL RENO CHAMBER OF COMMERCE. - PARTICIPATION IN EL RENO CHAMBER OF COMMERCE ACTIVITIES. - PARTICIPATION IN EL RENO MAIN STREET ACTIVITIES. - PROMOTION OF CERTIFIED HEALTHY OKLAHOMA CERTIFICATION FOR LOCAL BUSINESSES, SCHOOLS AND ORGANIZATIONS. - PROFESSIONAL WOMEN OF EL RENO - PARTICIPATION AS BOARD MEMBER FOR THE LOCAL SCHOOL MENTORING PROGRAM, STUDENTS STRIVING FOR SUCCESS. - PROVIDE LUNCHES FOR SENIOR CITIZENS OF EL RENO 5 DAYS A WEEK AT A SUBSTANTIALLY REDUCED FEE. - SPECIAL OLYMPICS - CHILDREN'S MIRACLE NETWORK - CARE GIVERS SUPPORT GROUP - COMMUNITY COLLEGE ADVISORY BOARD. - PRACTICAL NURSING ADVISORY BOARD. - EL RENO KIWANIS CLUB - EL RENO BLESSING BASKETS - PROVIDE FOOD AND GIFTS FOR 600 FAMILIES DURING THE CHRISTMAS HOLIDAYS. - PARTICIPATION IN SUMMER NUTRITION PROGRAM TO PROVIDE FOOD TO FAMILIES WITH CHILDREN DURING SUMMER MONTHS. 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 THEORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CAREPOLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY (REFER TODISCLOSURE FOR PART III, #9B) TO ADDRESS ACCOUNTS FOR PATIENTS WHO DONOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY ISCOMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FORCHARITY CARE. PART III, LINE 8: IT IS THE POSITION OF MERCY HOSPITAL EL RENO 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 EL RENO ("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. MERCY HOSPITAL EL RENO PART V, SECTION B, LINE 3: REFER TO PART VI, LINE 2 RESPONSE. MERCY HOSPITAL EL RENO 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 (WHICHEVER IS GREATER), ADJUSTED TO CONSIDER AVAILABILITY OF OTHER ASSETS THAT COULD BE USED TOWARD MAKING PAYMENTS. PART VI, LINE 2: CITIZENS OF THE COMMUNITY WERE CENTRAL IN THE DEVELOPMENT OF THE NEEDS ASSESSMENT. IN 2010 AND AGAIN IN 2011, MERCY HOSPITAL EL RENO HELD A COMMUNITY ROUNDTABLE TO DIALOGUE DIRECTLY WITH COMMUNITY MEMBERS ABOUT THEIR NEEDS, IDEAS, AND CONCERNS RELATED TO HEALTHCARE. COMMON THEMES INCLUDED: BEING INVOLVED IN THE SCHOOLS TO PROMOTE AND EDUCATE ON HEALTH/WELLNESS, ACCESS TO HEALTH CARE SERVICES FOR ALL, OBESITY AND THE HEALTH RISKS ASSOCIATED WITH TOBACCO AND ITS RELATED PROBLEMS, AND DIABETES. A FOCUS ON PARTNERSHIPS, EDUCATION, AND TECHNOLOGY WERE LISTED AS WAYS TO IMPROVE HEALTH/WELLNESS IN THE COMMUNITY.MERCY PLANNING AND RESEARCH PROVIDED ANALYSIS OF INTERNAL AND EXTERNAL DEMOGRAPHICS, HEALTH RESOURCE UTILIZATION, CHRONIC CONDITIONS AND COMMUNITY HEALTH STATUS. CONTRACTED PATIENT SATISFACTION SERVICES ASSIST MERCY ON AN ON-GOING BASIS BY MEASURING AND PROVIDING BENCHMARK DATA ON PATIENT SATISFACTION ON IN-PATIENTS, AMBULATORY SURGERY, AND EMERGENCY ROOM PATIENTS. EXPERTS CONSULTED: 1. TURNING POINT REGIONAL CONSULTANT, DUSTI BRODRICK2. HEALTH EDUCATOR, CANADIAN COUNTY HEALTH DEPARTMENT, NICHOLE MICHAEL3. MENTORING DIRECTOR, EL RENO PUBLIC SCHOOLS, BROOKE STROMAN4. SUPERINTENDANT, EL RENO PUBLIC SCHOOLS, CRAIG MCVAYTHIS COMMUNITY HEALTH ASSESSMENT WAS DEVELOPED USING:1. US CENSUS DATA: A. OKLAHOMA DATA - HTTP://QUICKFACTS.CENSUS.GOV/QFD/STATES/40000.HTML B. CANADIAN COUNTY DATA - HTTP://QUICKFACTS.CENSUS.GOV/QFD/STATES/40/40017.HTML C. EL RENO DATA - HTTP://QUICKFACTS.CENSUS.GOV/QFD/STATES/40/4023700.HTML2. STATE OF THE COUNTY'S HEALTH REPORT - HTTP://WWW.OK.GOV/HEALTH2/DOCUMENTS/CEE-CANADIAN%20COUNTY%202010.PDF3. STATE OF THE STATE'S HEALTH REPORT - HTTP://WWW.OK.GOV/HEALTH/PUB/BOH/STATE/SOSH2011.PDF4. CANADIAN COUNTY COMMUNITY NEEDS ASSESSMENT 2013. THE CANADIAN COUNTY COMMUNITY NEEDS ASSESSMENT 2013 WAS CONDUCTED BY THE CANADIAN COUNTY COALITION FOR CHILDREN AND FAMILIES FOR THE 115,541 RESIDENTS OF CANADIAN COUNTY, OKLAHOMA. 5. MERCY HOSPITAL EL RENO COMMUNITY NEEDS ASSESSMENT, APRIL 2013COMMUNITY HEALTH NEEDS AND PRIORITIES TO SET PRIORITIES, FOCUS WAS ON IDENTIFYING DISPROPORTIONATE UNMET NEEDS AND PROGRAMS THAT ARE COLLABORATIVE AND INVOLVE THE COMMUNITY. THE FOLLOWING PRIORITIES WERE IDENTIFIED: 1. WELLNESS 2. ACCESS TO CARE 3. COLLEGE GRADUATION RATES 4. CHILD HEALTH DESCRIPTION OF WHAT MERCY HOSPITAL, EL RENO WILL DO TO ADDRESS COMMUNITY NEEDSACTION PLANS:1. ACCESS TO CARE: PROVIDER RECRUITMENT, PERIODIC HEALTH SCREENING ACTIVITIES. RECRUITMENT - MERCY IS ACTIVELY ENGAGED IN RECRUITING PRIMARY CARE DOCTORS TO THE EL RENO MARKET. AFTER UNSUCCESSFUL ATTEMPTS TO RECRUIT OVER A PROLONGED PERIOD OF TIME AN OUTSIDE RECRUITMENT FIRM HAS BEEN RETAINED TO ASSIST WITH RECRUITMENT. ADDITIONALLY MERCY IS IMPLEMENTING A "TELEMEDICAL HOSPITALIST" PROGRAM TO REDUCE THE HOSPITAL DUTIES FOR PRIMARY CARE PROVIDERS AS THIS HAS BEEN IDENTIFIED AS A BARRIER TO SUCCESSFUL RECRUITING.PERIODIC HEALTH SCREENING ACTIVITIES: HOME HEALTH AND HOSPITAL STAFF PROVIDE BLOOD PRESSURE AND BLOOD SUGAR SCREENING MONTHLY AT SEVEN COMMUNITY LOCATIONS TARGETING SENIOR CITIZENS. THEY MAKE REFERRALS AND PROVIDE HEALTH INFORMATION AS NECESSARY/REQUESTED. HOME HEALTH PARTICIPATES IN SEVERAL ANNUAL HEALTH FAIRS PROVIDING SCREENINGS AND HEALTH INFORMATION.2. CHILD HEALTH: HEALTH TEACHER, EAT A RAINBOW, SCREENING PHYSICALS.HEALTH TEACHER IS A COMPREHENSIVE K-12 CURRICULUM THAT INTEGRATES HEALTH SKILLS INTO ONLINE LESSON PLANS. A NEW PROGRAM, EAT A RAINBOW, WAS IMPLEMENTED IN THE 2013 SCHOOL YEAR. MERCY SENT A REGISTERED DIETITIAN TO PRESENT THIS PROGRAM TO FIRST AND SECOND GRADERS IN SEPTEMBER 2013.MERCY HOSPITAL EL RENO STAFF CURRENTLY PARTICIPATE IN PROVIDING SCREENING PHYSICALS FOR STUDENTS ENROLLED IN EXTRACURRICULAR ACTIVITIES. THIS ACTIVITY WAS HELD ON JULY 25, 2013 AND ATTENDED BY TWELVE STAFF MEMBERS INCLUDING NURSES, EMT, RT AND PROVIDERS. THERE WERE APPROXIMATELY 70 STAFF HOURS IN CLINIC PROVIDING EXAMS AND 10 HOURS OF PREPARATION. 3. COLLEGE GRADUATION RATES: STUDENTS STRIVING FOR SUCCESS. STUDENTS STRIVING FOR SUCCESS IS A NEW MENTORING PROGRAM IMPLEMENTED FOR EL RENO PUBLIC SCHOOLS IN THE 2013 SCHOOL YEAR. MERCY EL RENO STAFF PARTICIPATED IN PROGRAM DEVELOPMENT BETWEEN JANUARY AND AUGUST 2013. MERCY EL RENO STAFF CONTINUES TO PARTICIPATE IN LEADERSHIP FOR THIS PROGRAM THROUGH MEMBERSHIP ON THE BOARD OVERSEEING THE PROGRAM. FINALLY, MERCY EL RENO SUPPORTS THIS PROGRAM BY ALLOWING HOSPITAL STAFF TO PARTICIPATE AS MENTORS. THERE ARE SEVENTEEN HOSPITAL STAFF MEMBERS PARTICIPATING AS MENTORS. THEY MEET 1:1 WITH A PUBLIC SCHOOL STUDENT ONE HOUR EVERY WEEK TO WORK ON ACADEMIC AND SOCIAL SKILLS. SOME STAFF MEMBERS MENTOR MORE THAN ONE STUDENT, THEREFORE VOLUNTEERING MORE TIME. 4. WELLNESS: HEALTHIFICATION, HEALTH TEACHER, CARE FOR THE CAREGIVER, CANADIAN COUNTY COALITION FOR FAMILIES AND CHILDREN MULTIPLE SERVICES/RESOURCES FOR THE COMMUNITY.HEALTHIFICATION IS THE MINDFUL PURSUIT OF PERSONAL WELL-BEING FOR MERCY CO-WORKERS AND THEIR FAMILIES. IT FOCUSES ON HEALTHY EATING, PHYSICAL ACTIVITY, EMOTIONAL AND SPIRITUAL WELL-BEING, AND TOBACCO CESSATION. CARE FOR THE CAREGIVER IS A MONTHLY SUPPORT GROUP SPONSORED BY MERCY PROVIDING SUPPORT TO INDIVIDUALS IN A CARE GIVING ROLE WITH A FAMILY MEMBER OR LOVED ONE. PARTICIPATION IN THE CANADIAN COUNTY COALITION FOR FAMILIES AND CHILDREN TO IDENTIFY BROADER COMMUNITY FOCUSED ACTIVITIES/NEEDS. LACTATION EDUCATION - MERCY EL RENO HAS BEGUN NEGOTIATIONS WITH CANADIAN COUNTY HEALTH DEPARTMENT TO IMPLEMENT A NEW LACTATION EDUCATION PROGRAM AT MERCY AS A JOINT VENTURE. 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. PART VI, LINE 4: MERCY HOSPITAL EL RENO'S PRIMARY SERVICE AREA INCLUDES CANADIAN COUNTY, OKLAHOMA. BASED ON TRUVEN 2012 DATA, THE AREA'S POPULATION IS 128,959. THE AVERAGE HOUSEHOLD INCOME FOR THE AREA IS $65,732. 12% OF THE POPULATION IS AGE 65 AND OLDER. 11% OF THE POPULATION IS ON MEDICARE, 11% ON MEDICAID, AND 9% UNINSURED, BASED ON 2012 TRUVEN INSURANCE ESTIMATES. PART VI, LINE 5: MERCY HOSPITAL EL RENO (MHER) 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 MHER'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITIES IT SERVES, MHER PROVIDES CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS DEFINED BY THE INSTITUTION'S CHARITY POLICY, MHER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR CHARITY CARE. IN ADDITION, MHER 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.MHER IS GOVERNED BY A BOARD OF DIRECTORS 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 ARESERVED BY MHER.SURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MHER 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: - IMPLEMENTATION OF ONSITE CHAPLIN SERVICES TO MEET THE SPIRITUAL NEEDS OF OUR INPATIENTS, OUTPATIENTS AND STAFF.- HIRED A BOARD CERTIFIED EMERGENCY ROOM PHYSICIAN TO PROVIDE OVER SITE FOR THE EMERGENCY DEPARTMENT AND AMBULANCE SERVICE. HAS IMPROVED BOTH SERVICES QUALITY AND EFFICIENCY. - IMPLEMENTATION OF CLINICAL PATHWAYS FOR NURSE AND PHYSICIANS.- SUPPORT OF PARTICIPATION IN SCHOOL MENTORING PROGRAM BY 20 CO-WORKERS DURING WORK TIME.- RECRUITMENT AND HIRING OF TWO INTEGRATED MID-LEVEL PROVIDERS. 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. 0 1 0 0 0 0 0 1 0 LE BICH-VI 0 136596 0 57951 0 45955 0 21562 0 15137 0 277201 0 0 STEFFENS AARON 0 181053 0 61469 0 6185 0 5699 0 15196 0 269602 0 0 SMALLEY DIANA L 0 459480 0 202287 0 9485 0 182822 0 17616 0 871690 0 0 VITIELLO JONATHAN 0 294647 0 102118 0 96353 0 47736 0 16270 0 557124 0 0 CARMICHAEL CINDY 0 167114 0 46394 0 27979 0 6523 0 6710 0 254720 0 0 PAYTON BECKY J 0 195331 0 71727 0 27069 0 28314 0 12019 0 334460 0 0 TEW DAVID 0 336099 0 116358 0 31448 0 51644 0 16058 0 551607 0 0 GOFORTH SHEILA 143624 0 0 0 5892 0 3417 0 11328 0 164261 0 0 0 VANYA RICHARD F 175143 0 0 0 301 0 1175 0 6282 0 182901 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. SPOUSAL TRAVEL WAS PROVIDED FOR EMPLOYEES OF A RELATED ORGANIZATION, VI LE AND CINDY CARMICHAEL. 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. 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 INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL MANAGEMENT RETIREMENT PLAN: JONATHAN VITIELLO; BICH-VI LE; BECKY PAYTON; DAVID TEW THE INDIVIDUAL 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. SUPPLEMENTAL INFORMATION 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. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ROUNDING -1. AUDITED FINANCIAL STATEMENTS 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. SINGLE AUDIT ACT AND OMB CIRCULAR A-133 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. SALARIES AND WAGES 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. MERCY HOSPITALS EAST COMMUNITIES 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. SYSTEM LIMITATIONS 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 & Q. INDEPENDENT CONTRACTORS 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. 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 N/A 0 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 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 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 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 - 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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 MC M-P OFFICE 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 MERCY CLINIC OKLAHOMA COMMUNITIES INC Q 301450 FMV MERCY HEALTH HOT SPRINGS COMMUNITIES Q 66984 FMV MERCY HEALTH OKLAHOMA COMMUNITIES INC P 652068 FMV MERCY HOSPITAL ARDMORE INC P 285186 FMV MERCY HOSPITAL LOGAN COUNTY INC Q 67458 FMV MERCY HOSPITAL OKLAHOMA CITY INC Q 7649095 FMV MHM SUPPORT SERVICES P 1331799 FMV RESOURCE OPTIMIZATION & INNOVATION LLC P 122675 FMV