2014-05-14T14:00:13-05:00 2013-06-30 ERNST & YOUNG US LLP 190 CARONDELET PLAZA SUITE 1300 CLAYTON MO 63105 990 2012-07-01 621684203 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES % BENNY J STOVER CPA VP OF F MERC 3145796100 2710 Rife Medical Lane Suite Rogers AR 72758 Benny J Stover 2014-05-09 3142901000 2012 2015-11-30 17:44:51Z ERIC PIANALTO 2710 Rife Medical Lane Rogers AR 72758 66196353 false 0928 X www.mercy.net X 1997 AR AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL service. 15 11 719 0 0 0 0 62087740 64912062 15342 64245 182341 1220046 62285423 66196353 500 1750 0 0 58414319 60769442 0 0 0 20486652 22827920 78901471 83599112 -16616048 -17402759 12569127 12912480 78478829 95414940 -65909702 -82502460 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 26728662 24703885 FAMILY MEDICINE PHYSICIAN SERVICES: MERCY HEALTH SYSTEM OF NWA'S FAMILY MEDICINE PHYSICIAN SERVICES ARE COMPRISED OF 34 BOARD CERTIFIED FAMILY MEDICINE PHYSICIANS AND 9 MID-LEVELS, WHO PROVIDED PRIMARY MEDICINE SERVICES TO PATIENTS RANGING FROM ONE YEAR OLD THROUGH ADULTHOOD. THESE SERVICES ARE OFFERED IN APPROXIMATELY 11 LOCATIONS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 187,218 OFFICE VISITS WERE PROVIDED TO PATIENTS. 11600625 6617774 CARDIOVASCULAR SERVICES: MERCY HEALTH SYSTEM OF NWA'S CARDIOVASCULAR PHYSICIAN SERVICES ARE COMPRISED OF 7 CARDIOLOGISTS, 2 CARDIOVASCULAR SURGEONS, AND 9 MID-LEVEL PROVIDERS. THESE PROVIDERS SERVE PATIENTS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA, WHO HAVE HEART RELATED MEDICAL NEEDS. DURING THE YEAR, 22,231 OFFICE VISITS WERE PROVIDED TO PATIENTS. 4757930 4499701 PEDIATRIC PHYSICIAN SERVICES: MERCY HEALTH SYSTEM OF NWA'S PEDIATRIC PHYSICIAN SERVICES ARE COMPRISED OF 6 BOARD CERTIFIED PEDIATRICIANS AND 1.5 MID LEVELS, WHO PROVIDED PRIMARY MEDICINE SERVICES TO PATIENTS RANGING IN AGE FROM INFANTS THROUGH EIGHTEEN YEARS. SERVICES ARE PROVIDED TO PATIENTS THROUGHOUT BENTON COUNTY ARKANSAS AND THE SURROUNDING SERVICE AREA. DURING THE YEAR, 32,657 OFFICE VISITS WERE PROVIDED TO PATIENTS. 32773346 1750 30310748 75860563 true false false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true true true false false true X 0 0 719 true false false false false false false false false false false X 15 11 false false false false true true true true true false false true true true true true true false true false X BENNY J STOVER CPA VP OF F 4793382903 2710 RIFE MEDICAL LANE ROGERS AR 72758 Bergant Paul 1.0 1.0 X 0 0 0 Callahan Wayne 1.0 1.0 X 0 0 0 Donnell Hugh G 59.0 1.0 X 328514 0 39685 Evans RSM Sr Gayle 1.0 35.0 X 0 0 0 Faddis MD Lance 60.0 0.0 X 264805 0 25457 Finnegan RSM Sr Chabanel 1.0 34.0 X 0 0 0 Ford Rollin 1.0 0.0 X 0 0 0 Kelone RSM Sr Teresa 1.0 0.0 X 0 0 0 Lawson Randy 1.0 0.0 X 0 0 0 Lipscomb Tabitha 1.0 0.0 X 0 0 0 Mahan Paul 1.0 0.0 X 0 0 0 Rogers Chris 1.0 0.0 X 0 0 0 Stuppy Robert J 60.0 0.0 X 799645 0 30010 Trammel Dick 1.0 1.0 X 0 0 0 Street Scott 20.0 40.0 X X 0 529683 115769 Vitiello Jonathan 2.0 58.0 X 0 493118 64006 Day Bradley Kim 1.0 59.0 X 0 987614 348680 Goss Stephen 60.0 0.0 X 322299 0 72481 Halstead John 20.0 40.0 X 152406 0 15864 Hughes Steven L 60.0 0.0 X 218261 0 18465 Marion Tanya 3.0 57.0 X 0 232635 43308 Merrigan Michael 2.0 58.0 X 0 378450 56809 Stover Benny J 20.0 40.0 X 175634 0 20594 Swope Jon 2.0 58.0 X 0 758712 230689 El-Shafei Amr 60.0 0.0 X 1389303 0 18240 Riley Philip 60.0 0.0 X 827153 0 16837 Simpson Christopher 60.0 0.0 X 827431 0 28916 Weathers Larry W 60.0 0.0 X 774491 0 24028 Wigington William C 60.0 0.0 X 777921 0 19845 Barrett Susan 0.0 40.0 X 0 216667 0 Flynn George 0.0 0.0 X 0 3297507 140483 Little-Smith Karen 60.0 0.0 X 124596 0 12375 Stewart Michele 0.0 60.0 X 223325 109236 67910 Barclay RicK 0.0 60.0 X 199052 0 21415 7404836 7003622 1431866 114 true true false QUEST DIAGNOSTICS PO BOX 740709 ATLANTA GA 30374 LAB DIAGNOSTICS 355507 M MODAL 9009 CAROTHERS PARKWAY SUITE C2 FRANKLIN TN 37067 TRANSCRIPTION SERV 194246 MERCY MEDICAL CENTER PO BOX 504664 ST LOUIS MO 63150 LAB SERVICES 169941 TIMELINE RECRUITING LLC 13841 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 RECRUITING 136253 4 0 0 0 Net Patient Service Reven 621111 64599930 64599930 0 0 PCIP/HPSA Revenue 900099 312132 312132 0 0 64912062 64245 64245 0 0 0 0 0 0 0 0 0 0 DIALYSIS CENTER REVENUE 900099 330962 330962 0 0 COMP PRIM CARE PILOT PROG 900099 452497 452497 0 0 HUMAN PRACTICE REWARDS 900099 271956 271956 0 0 164631 164631 0 0 1220046 66196353 66132108 0 64245 1750 1750 0 0 0 0 0 0 3704729 3704729 0 0 114941 114941 0 0 46904591 42305399 4599192 0 1833933 1653928 180005 0 5638624 5107147 531477 0 2572624 2337863 234761 0 0 0 0 0 144874 144874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1518527 1013823 504704 0 246755 111348 135407 0 956186 868930 87256 0 40235 36563 3672 0 0 0 0 0 4160313 3795477 364836 0 230099 129787 100312 0 0 0 0 0 774 0 774 0 28756 26132 2624 0 0 0 0 0 883182 535904 347278 0 1445150 1313275 131875 0 Repairs & Maintenance 193585 157905 35680 0 Shared Service fees 2066496 1877921 188575 0 Drugs & Medical Supplies 6497012 6459949 37063 0 Bad Debt 3379837 3379837 0 0 1036139 927955 108184 83599112 75860563 7738549 0 0 481493 482034 0 0 0 0 6027356 5299779 0 0 0 0 1236480 897017 453516 447585 13086 92262 13058544 7368058 4357196 5690486 0 0 0 0 0 0 0 0 0 3317 12569127 12912480 9496494 8423859 0 0 0 0 0 0 0 0 0 0 0 0 1998906 1625001 66983429 85366080 78478829 95414940 X -65909702 -82502460 0 0 0 0 -65909702 -82502460 12569127 12912480 X -17402759 810001 X X false true X true false X 0 0 0 0 0 0 95352882 54103144 58695633 61696202 64599930 334447791 0 0 0 95352882 54103144 58695633 61696202 64599930 334447791 0 0 0 0 0 0 334447791 41511 27879 -18223 15342 64245 130754 0 41511 27879 -18223 15342 64245 130754 0 1237480 533693 417373 573879 1532178 4294603 96631873 54664716 59094783 62285423 66196353 338873148 0.98694 0.98491 0.00039 0.00260 X OTHER INCOME INCLUDED SERVICES PROVIDED TO SUPPORT THE HOSPITAL, SUCH AS CAFETERIA INCOME AND OTHER SERVICE REVENUE. 935000 935000 1453944 1166123 287821 4358031 2454590 1903441 5705575 3677749 2027826 605994 69596 536398 5690486 0 DEPOSITORY ACCOUNTS-BOA 35924204 DUE TO AFFILIATES 49441876 85366080 Form 990, Schedule D, Part X, Line 2 ASC 740 FOOTNOTE 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. X X X true true true true false false false false false true false Donnell Hugh G 281391 0 27018 0 20105 0 18710 0 20975 0 368199 0 0 0 Faddis MD Lance 228615 0 21498 0 14692 0 5081 0 20376 0 290262 0 0 0 Stuppy Robert J 580290 0 175000 0 44355 0 8801 0 21209 0 829655 0 0 0 Street Scott 0 388618 0 120181 0 20884 0 98296 0 17473 0 645452 0 0 Vitiello Jonathan 0 294647 0 102118 0 96353 0 47736 0 16270 0 557124 0 0 Day Bradley Kim 0 630366 0 322225 0 35023 0 334446 0 14234 0 1336294 0 0 Goss Stephen 233046 0 45473 0 43780 0 53115 0 19366 0 394780 0 0 0 Halstead John 129542 0 21848 0 1016 0 1158 0 14706 0 168270 0 0 0 Hughes Steven L 171465 0 21144 0 25652 0 6829 0 11636 0 236726 0 0 0 Marion Tanya 0 137188 0 70088 0 25359 0 28325 0 14983 0 275943 0 0 Merrigan Michael 0 227959 0 96337 0 54154 0 49389 0 7420 0 435259 0 0 Stover Benny J 130156 0 25143 0 20335 0 5691 0 14903 0 196228 0 0 0 Swope Jon 0 481585 0 249457 0 27670 0 212960 0 17729 0 989401 0 0 El-Shafei Amr 1222473 0 129260 0 37570 0 6863 0 11377 0 1407543 0 0 0 Riley Philip 715688 0 75000 0 36465 0 6930 0 9907 0 843990 0 0 0 Simpson Christopher 715790 0 75000 0 36641 0 7643 0 21273 0 856347 0 0 0 Weathers Larry W 607187 0 75000 0 92304 0 7429 0 16599 0 798519 0 0 0 Wigington William C 655017 0 58450 0 64454 0 6030 0 13815 0 797766 0 0 0 Barclay RicK 151314 0 27703 0 20035 0 9853 0 11562 0 220467 0 0 0 Barrett Susan 0 216667 0 0 0 0 0 0 0 0 0 216667 0 0 Flynn George 0 24154 0 136500 0 3136853 0 139018 0 1465 0 3437990 0 2299930 Little-Smith Karen 94859 0 6229 0 23508 0 6340 0 6035 0 136971 0 0 0 Stewart Michele 135431 86463 50220 0 37674 22773 52172 0 10406 5332 285903 114568 0 0 FORM 990, SCHEDULE J, PART I, LINE 1 CHARTER TRAVEL IS PROVIDED TO CERTAIN EMPLOYEES AS AND WHEN APPROPRIATE, AND AS DEEMED NECESSARY FOR BUSINESS TRAVEL. AFTER CHARTER TRAVEL APPROVAL HAS BEEN GRANTED IN ACCORDANCE WITH THE FINANCIAL JUSTIFICATION PROCESS, THE APPROVED CHARTER TRAVEL FOR BUSINESS IS A REIMBURSABLE EXPENSE WHICH IS NOT TAXABLE TO THE EMPLOYEES. TRAVEL FOR COMPANIONS IS PROVIDED IN RARE INSTANCES AND IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. WHERE COMPANION TRAVEL HAS RESULTED IN A TAXABLE EVENT, THE EMPLOYEES ARE TAXED FOR SUCH TRAVEL. LIMITED INSTANCES OF TAX GROSS-UPS MAY HAVE OCCURRED WITH RESPECT TO EXECUTIVES. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2012: GEORGE FLYNN, $720,175 FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY HEALTH 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 INDIVIDUALS REPORTABLE ON THIS RETURN WHO PARTICIPATE IN THE SUPPLEMENTAL RETIREMENT PLANS INCLUDE: SCOTT STREET, JONATHAN VITIELLO, BRADLEY DAY, STEPHEN GOSS, TANYA MARION, MICHAEL MERRIGAN, JON SWOPE, MICHELE STEWART, AND GEORGE FLYNN. THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). FORM 990, SCHEDULE J, PART I, QUESTION 7 MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2013 (JULY 1, 2012 - JUNE 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 IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF MERCY HEALTH AND IS THEN TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS. FORM 990, SCHEDULE J, PART II THE AMOUNT FOR GEORGE FLYNN IN COLUMN (F) IS INCLUDED IN COLUMN BIII AS OTHER REPORTABLE COMPENSATION. THIS IS A PAYOUT OF THE SUPPLEMENTAL RETIREMENT PLAN AND WAS INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990. Ashley Goss Family of key employee 114941 Employment false FORM 990, PART III, QUESTION 4D DESCRIPTION OF OTHER PROGRAM SERVICES MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES (MHNWAC) AND ITS MEMBER HEALTH CARE FACILITIES PROVIDE QUALITY CARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. IN ACTIVE PURSUIT OF THE ABOVE STATED MISSION, MHNWAC PROVIDED 32,078 INPATIENT SERVICE DAYS OF ACUTE OR SUB-ACUTE CARE. MHNWAC HAD ACUTE NEWBORN DISCHARGES OF 1,302, NEWBORN PATIENT DAYS WERE 2,286, RESPONDED TO APPROXIMATELY 44,700 EMERGENCY ROOM ENCOUNTERS, MADE OVER 34,100 HOME HEALTH CARE VISITS AND COMPLETED 153,456 OUTPATIENT VISITS. COMMUNITY OUTREACH/BENEFIT PROGRAMS INCLUDE SUPPORT GROUPS FOR CURRENT AND PAST PATIENTS (DIABETIC, CARDIAC, ETC.), EXPECTING/NEW PARENTS (CHILD BIRTH CLASSES, VARIOUS SUPPORT GROUPS, ETC.), AND EMPLOYEES (EDUCATIONAL ASSISTANCE PROGRAMS, ETC.), LOCAL/SURROUNDING COMMUNITY (WELLNESS PROGRAMS, HEALTH FAIRS, HOME HEALTH PROGRAMS, ETC.) RELIEF FROM FINANCIAL BURDEN OF HEALTH CARE SERVICES TO THE INDIGENT CONSISTS OF CHARGES OF $23,474,932 FOR CHARITY CARE PROVIDED WITH A COST OF RELATED SERVICES. FORM 990, PART V, QUESTION 1A FORM 1099/1096 FILING VENDORS 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 MERCY HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART VI, LINE 6A, LINE 7A, 7B CLASSES OF MEMBERS OR STOCKHOLDERS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: -TO APPROVE AND ESTABLISH THE MISSION AND PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ALL CORPORATIONS CONTROLLED BY THE CORPORATION SHALL OPERATE; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF MERCY HOSPITAL ROGERS; -TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION, EXCEPT THAT: -ANY AND ALL AMENDMENTS TO THE BYLAWS OF THE CORPORATION THAT MATERIALLY AFFECT THE EXISTENCE OR OPERATIONS OF THE MEDICAL GROUP BOARD, AS PROVIDED IN SECTION 8.2, MUST BE APPROVED BY THE MEDICAL GROUP BOARD, AND ANY AND ALL AMENDMENTS TO THE BYLAWS OF THE CORPORATION THAT MATERIALLY AFFECT THOSE POWERS RESERVED SOLELY TO THE MEDICAL GROUP, AS DESCRIBED IN SECTION 8.3, MUST BE APPROVED BY THE MEDICAL GROUP BOARD; -TO APPROVE AND APPOINT THE THREE (3) MEDICAL GROUP PHYSICIAN DIRECTORS AND ALL COMMUNITY REPRESENTATIVE DIRECTORS ON THE BOARD FROM NOMINATIONS SUBMITTED BY THE NOMINATING COMMITTEE; -TO APPOINT THE (2) MERCY HEALTH DIRECTORS ON THE BOARD; -TO APPOINT THE PRESIDENT/CEO OF THE CORPORATION, WHO SHALL SERVE AS AN EX-OFFICIO DIRECTOR ON THE BOARD WITH VOTE; -TO REMOVE ALL DIRECTORS ON THE BOARD WITH OR WITHOUT CAUSE; -TO APPROVE OR AMEND THE OVERALL STRATEGIC, LONG RANGE, AND HEALTH MANPOWER DEVELOPMENT PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; -TO APPROVE THE CONSOLIDATED OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS (INCLUDING AGGREGATE PHYSICIAN COMPENSATION LEVELS) FOR THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION AND CHANGES IN THE BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; -TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; -TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY CORPORATION CONTROLLED BY THE CORPORATION; AND, -TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE MANAGER OF ACCOUNTING AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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, QUESTIONS 15A & 15B OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE 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, QUESTION 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMT TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART VII, SECTION A, COLUMN B AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII IS THE AVERAGE HOURS THE LISTED PERSON WORKED OR DEVOTED PER WEEK WHILE EMPLOYED OR ASSOCIATED WITH THE FILING ORGANIZATION AND RELATED ORGANIZATIONS (IF APPLICABLE). FORM 990, PART XI, QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE TRANSFER TO/FROM AFFILIATES- $810,001 FORM 990, PART XII, QUESTION 2C AUDIT OF FINANCIAL STATEMENTS THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2013 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE (FORMERLY FINANCE, AUDIT, AND COMPLIANCE COMMITTEE) OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 SHELTER TX 501(C)(3) 7 MM LAREDO true Laredo Medical Group 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764726 INACTIVE TX 501(C)(3) 9 MHS TEXAS true McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 PORT MGMT MO 501(C)(3) 11b MERCY HEALTH true Mercy Clinic East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431771217 PHYS GROUP MO 501(C)(3) 9 MH EAST COMM true Mercy Clinic Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72903 261318597 PHYS CLINIC AR 501(C)(3) 9 MH FS COMM true Mercy Clinic Hot Springs Communities 1 Mercy Lane Hot Springs AR 71913 261125131 PHYS CLINIC AR 501(C)(3) 9 MH HS COMM true Mercy Clinic Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 270473057 PHYS GROUP OK 501(C)(3) 9 MH OK COMM true Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 PHYS GROUP MO 501(C)(3) 9 MH SF COMM true Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 COUNSELING MO 501(C)(3) 7 MERCY HEALTH true Mercy Foundation for Health Innovation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 FOUNDATION MO 501(C)(3) 11b MERCY HEALTH true Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 CORP OFFICE MO 501(C)(3) 1 NA false Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 HLTH SYSTEM MO 501(C)(3) 11b MERCY HEALTH true Mercy Health East Communities South Reg 14528 S Outer Forty Ste 100 Chesterfield MO 63017 461412322 HLTH SYSTEM MO 501(C)(3) 11b MH EAST COMM true Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 HOLDING CO AR 501(C)(3) 11b MERCY HEALTH true Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 FOUNDATION OK 501(C)(3) 11a MH ARDMORE true Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 FOUNDATION AR 501(C)(3) 11a MH BRYVILLE true Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 FOUNDATION KS 501(C)(3) 11c M KS COMM true St Edward Mercy Foundation 7301 Rogers Avenue Fort Smith AR 72917 237330425 FOUNDATION AR 501(C)(3) 7 MH FT SMITH true Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 FOUNDATION AR 501(C)(3) 11b MH H SPRINGS true Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 FOUNDATION KS 501(C)(3) 11a M KS COMM true Mercy Health Foundation Jefferson 1400 US Highway 61 South Festus MO 63028 462797051 FOUNDATION MO 501(C)(3) 11b MH E COMM SR true Mercy Health Foundation Joplin 2817 St Johns Blvd Joplin MO 64804 270906136 FOUNDATION MO 501(C)(3) 11a MH SWMK COMM true Mercy Health Foundation NW Arkansas 2710 Rife Medical Lane Rogers AR 72758 710601687 FOUNDATION AR 501(C)(3) 11c MH ROGERS true Mercy Health Foundation Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 731593024 FOUNDATION OK 501(C)(3) 11a MH OK CITY true Mercy Health Foundation of Oklahoma 4300 W Memorial Road Oklahoma City OK 73120 454732301 FOUNDATION OK 501(C)(3) 11a MH OK COMM true Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 FOUNDATION MO 501(C)(3) 11b MH SF COMM true Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 FOUNDATION MO 501(C)(3) 11b MH EAST COMM true Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 FOUNDATION MO 501(C)(3) 11b MH EAST COMM true Mercy Health Hot Springs Communities 300 Werner Street Hot Springs AR 71913 261125064 HOLDING CO AR 501(C)(3) 11b MERCY HEALTH true Mercy Health Oklahoma Communities Inc 4300 W Memorial Road Oklahoma City OK 73120 731453048 HOLDING CO OK 501(C)(3) 11b MERCY HEALTH true Mercy Health Southwest MOKS Communities 2817 St Johns Blvd Joplin MO 64804 300584463 HLTH SYSTEM MO 501(C)(3) 11b MERCY HEALTH true Mercy Health Springfield Communities 1235 E Cherokee Street Springfield MO 65804 431856028 HLTH SYSTEM MO 501(C)(3) 11b MERCY HEALTH true Mercy Health System of Texas Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764727 INACTIVE TX 501(C)(3) 11b MERCY HEALTH true Mercy Home Health Berryville 804 W Freeman Suite 4 Berryville AR 72616 870781247 HOME HEALTH AR 501(C)(3) 11c MH SF true Mercy Hospital Ada Inc 430 N Monte Vista Street Ada OK 74820 462288155 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospital Ardmore Inc 1011 14th Avenue NW Ardmore OK 73401 731500629 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 HOSPITAL MO 501(C)(3) 3 MH SF COMM true Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 HOSPITAL AR 501(C)(3) 3 MH SF COMM true Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 HOSPITAL MO 501(C)(3) 3 MH SWMK COMM true Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 HOSPITAL MO 501(C)(3) 3 MH SF COMM true Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 HOSPITAL MO 501(C)(3) 3 MH SWMK COMM true Mercy Hospital El Reno Inc 2115 Parkview Drive El Reno OK 73036 272716065 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 HOSPITAL AR 501(C)(3) 3 MH FS COMM true Mercy Hospital Healdton Inc 918 South 8th Street Healdton OK 73438 263173902 HOSPITAL OK 501(C)(3) 3 MH ARDMORE true Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 HOSPITAL AR 501(C)(3) 3 MH HS COMM true Mercy Hospital Jefferson 1400 Highway 61 South Festus MO 63028 430687077 HOSPITAL MO 501(C)(3) 3 MH E COMM SR true Mercy Hospital Joplin 2817 St Johns Blvd Joplin MO 64804 270814858 HOSPITAL MO 501(C)(3) 3 MH SWMK COMM true Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 HOSPITAL MO 501(C)(3) 3 MH SF COMM true Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospital of Laredo 14528 S Outer Forty Ste 100 Chesterfield MO 63017 741189682 INACTIVE TX 501(C)(3) 3 MHS TEXAS true Mercy Hospital Oklahoma City Inc 4300 W Memorial Road Oklahoma City OK 73120 730579285 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 HOSPITAL AR 501(C)(3) 3 MH FT SMITH true Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 HOSPITAL AR 501(C)(3) 3 MH FT SMITH true Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 HOSPITAL AR 501(C)(3) 3 MH NWAR COMM true Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 HOSPITAL MO 501(C)(3) 3 MH SF COMM true Mercy Hospital Tishomingo Inc 1000 South Byrd Tishomingo OK 73460 274433830 HOSPITAL OK 501(C)(3) 3 MH ARDMORE true Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 HOSPITAL AR 501(C)(3) 3 MH FT SMITH true Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 HOSPITAL OK 501(C)(3) 3 MH OK COMM true Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 HOSPITAL MO 501(C)(3) 3 MH EAST COMM true Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 HOSPITAL KS 501(C)(3) 3 MH SWMK COMM true Mercy Medical Research Institute 1235 E Cherokee Street Springfield MO 65804 870796305 RESEARCH MO 501(C)(3) 4 MH SF COMM true Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78046 200198462 OUTREACH TX 501(C)(3) 7 MERCY HEALTH true Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 HOSPITAL MO 501(C)(3) 3 MH SF COMM true Mercy Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431677952 INACTIVE MO 501(C)(3) 11c MH EAST COMM true MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 HLTH SYSTEM MO 501(C)(3) 11b MERCY HEALTH true Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 NURSING HOME AR 501(C)(3) 9 MH HS COMM true St John's Children's Hospital Inc 1235 E Cherokee Street Springfield MO 65804 INACTIVE MO 501(C)(3) 3 MH SF COMM true St Mary's Hospital of Enid Oklahoma 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 INACTIVE OK 501(C)(3) 3 MH OK COMM true The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 FOUNDATION MO 501(C)(3) 11a M ST FRANCIS true Unity Ambulatory Care 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431861745 INACTIVE MO 501(C)(3) 11c MH EAST COMM true Merc Ambu Surg CTR 7301 Rogers Av Fort Smith AR 72903 710827721 AMBUL SURG CTR AR NA RES OPT & INNOV 645 Maryville Centre Dr 200 St Louis MO 63141 460468368 CENTRAL DIST. MO NA SO OK DIAG CTR 1011 14TH Ave NW Ardmore OK 73401 431971232 MRI Services OK NA Fort Smith EMS 1701 S Greenwood Fort Smith AR 72901 710416615 Emergency Med AR NA St Ed Mer Med MOB 7301 Rogers Ave Fort Smith AR 72903 710554050 Office Building AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 HOLDING COMP DE NA C-Corp true Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 RESEARCH MO NA C-Corp true Mercy Community Services Inc 401 Woodland Hills Blvd Fort Scott KS 66701 481078101 RETAIL PHARMACY KS NA C-Corp true Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 REAL ESTATE OK NA C-Corp true Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 HEALTH CARE OK NA C-Corp true Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 HEALTH CARE OK NA C-Corp true Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 HOLDING COMP OK NA C-Corp true UH L Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 HOLDING COMP MO NA C-Corp true Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 PRACTICE MGT MO NA C-Corp true Jefferson Land Company Inc 14528 South Outer Forty Suite 100 Chesterfield MO 63017 431330360 HOLDING COMP MO NA C-Corp true The Apothecary Services Inc PO Box 350 Crystal City MO 63019 431627267 RETAIL PHARMACY MO NA C-Corp true false false false false false false false false false false false false false false false true true false false Mercy Clinic Springfield Communities p 171474 FMV Mercy Health East Communities p 92351 FMV Mercy Health Springfield Communities p 83523 FMV Mercy Hospital Joplin p 97071 FMV Mercy Hospital Logan County Inc p 64150 FMV Mercy Hospital Rogers p 288354 FMV Mercy Hospital Rogers q 18933625 FMV MHM Support Services p 29629527 FMV Resource Optimization & Innovation LLC p 372597 FMV FORM 990, SCHEDULE R, PART VI SUPPLEMENTAL INFORMATION FOR SCHEDULE R LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH AND AFFILIATES. 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 ORGANIZATIONS ACTIVITY FOR THE FILING ORGANIZATION HAS BEEN CLASSIFIED ON SCHEDULE R, PART V, IN LINES P AND Q.