2013-05-14T16:47:02-05:00 2012-06-30 562632458 Pleus and Company LLC 14323 S Outer Forty Ste 310N Chesterfield MO 63017 990 2011-07-01 430653493 MERCY HOSPITALS EAST COMMUNITIES MERC 3142516000 615 S NEW BALLAS ROAD ST LOUIS MO 63141 CHERYL MATEJKA 3143643532 2013-05-14 1 P00013488 3143179916 2011 2016-02-24 21:20:13Z Donn Sorensen 615 S NEW BALLAS ROAD ST LOUIS MO 63141 1009531793 0 0928 X www.mercy.net/stlouismo X 1891 MO Mercy Hospitals East Communities operates two hospitals that are located in Creve Coeur (St. Louis metropolitan area) and Washington, MO. 9 4 8231 1042 2009234 91911 5112600 3475431 952837366 970498008 671888 4059588 19866774 27444916 978488628 1005477943 539313 777523 0 0 425583114 417278055 0 0 0 504093367 521030013 930215794 939085591 48272834 66392352 707772035 791227592 84075966 94913287 623696069 696314305 X As the Sisters of Mercy before us, we bring to Life the healing ministry of Jesus through our compassionate care and exceptional service. 0 0 844433115 777523 985923580 Mercy Hospitals East Communities ("MHEC") provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay. In active pursuit of this mission, MHEC provided services to 45,650 inpatients, 114,110 emergency room visits, 930,951 outpatient visits, and 58,117 clinic visits.MHEC is a Catholic health care corporation that, pursuant to the organizational core belief that health care services are a vital and integral part of the Church's healing mission, engages in a ministry which provides general acute care, ambulatory, long-term and home care health services to individuals and families in its service communities. Consistent with the organization's commitment to social accountability and the provision of community benefit, MHEC offers other services and programs which further health promotion, maintenance and care. MHEC's services include two clinics which were established specifically for individuals who are uninsured or underinsured and do not have a means to pay for healthcare services. These clinics provide a significant focus on prenatal care. Many clinic patients were also treated, on a charitable basis, as inpatients. In response to the increased needs of the underinsured in the St. Louis area, these clinics have continually expanded, offering new services to more patients. The institution continues to focus on the provision of primary health services and education to the community, regardless of their means to pay for these services. The organization also has a continuing commitment to health research and to health education at all levels.Although reimbursement for services rendered is critical to the continued ability to provide healthcare services to all patients, MHEC recognizes that not all individuals possess the ability to purchase essential medical services and, further, that part of our mission is to provide healthcare services and healthcare education to the communities in which our facilities are located. In keeping with MHEC's commitment to serve all members of the communities it serves, MHEC provides (i) free care and/or subsidized care; (ii) care to persons covered by governmental programs at below cost; (iii) health activities and programs to support the community; (iv) health education programs; and, (v) a variety of broad community support activities. Among the community support activities offered by MHEC are the following: -Community Education Programs -Support Group Meetings -Health Fairs and Screenings -Immunizations -Provision of Free Health Information -Home Delivered and Congregate Meals -Indigent Care Clinics -Pre-Natal and Well Baby Care for the Indigent -Health Professions Education Programs -Support of Community Programs, including active United Way participant, Provision of Scholarships, Healthcare for the Homeless Coalition, etc. -Provider of Financial Counseling and Discharge Counseling Services for all Patients -Provision of Chapels in each Hospital and Chaplains/Religious Lay Staff to Minister to the Religious Needs of any Patient and their Families. -Volunteer AssociationMHEC provides care to patients who lack financial resources and are deemed to be medically indigent. As defined by the institution's charity policy, MHEC does not pursue collection of amounts determined to qualify for charity care. In addition, MHEC 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. Care is provided to those with limited or no ability to pay. The cost, net of any payment received (net cost), to MHEC of providing care to persons qualifying for charity or Medicaid totaled $37,409,772 in the year ended 6/30/12. Additionally, the net cost for services provided to elderly and disabled patients under the Medicare program totaled $24,098,097. These amounts do not include the cost of health activities and programs to support the community, health education programs and other community support activities. The services provided by MHEC, as well as the amount of charity care provided, demonstrate the ongoing commitment of the organization to serve in a leadership role as an advocate for responsive healthcare services for the community, with a deep commitment and sensitivity to meeting the needs of the poor.Each activity for which income is reported in column (B) of Part VIII is undertaken in furtherance of the organization's healthcare and community benefit mission described above. 844433115 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 8231 1 1 1 0 0 0 0 0 0 0 0 0 X 9 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 X Denise Scoffic 3143642959 645 MARYVILLE CENTRE STE 100 St Louis MO 63141 John Arnold 3.00 X 0 0 0 Charles Rehm MD 70.00 X 0 440821 49793 Roger Steinbecker 1.00 X 0 0 0 Thomas RiechersMD 65.00 X 0 430463 27514 Richard Pennell 60.00 X 0 0 0 Sr Katherine Marie Glosenger RSM 1.00 X 0 0 0 Dennis Keithly 50.00 X 0 308315 70675 Terri McLain 60.00 X 354040 0 61050 Jeff Johnston 60.00 X X 0 547151 253913 Cheryl Matejka 60.00 X 0 392530 66012 Michael McCurry 60.00 X 0 933189 540015 Keith StarkeMD 75.00 X 0 457503 49134 Christine Crain 60.00 X 307516 0 87052 Eric Eoloff 60.00 X 0 347966 49430 Patricia Geldbach 58.00 X 247074 0 52206 Paul Hintze 60.00 X 408111 0 74770 Joseph Kahn 55.00 X 0 357856 24550 Donald Kalicak 60.00 X 0 291455 45583 Steven Bollin 50.00 X 187793 0 16954 Donna Frazier 60.00 X 241036 0 29411 Frank Lenoir 60.00 X 0 228981 15046 Sally Petito 75.00 X 0 267295 14433 Kathryn Nelson 55.00 X 184179 0 19313 Anthony Rothermich 50.00 X 0 167899 11121 Denise Scoffic 60.00 X 0 178717 17140 Joan Frost 50.00 X 165496 0 12149 Ann Varner 60.00 X 161547 0 11789 Kim Onesko 60.00 X 0 257524 17514 Dionysios Veronikis MD 50.00 X 417376 0 19452 Patricia Arnold 60.00 X 284215 0 17043 Linda Fox 50.00 X 233468 0 10553 Berold Witten 60.00 X 227226 0 38710 Steven Sommer 60.00 X 213662 56501 21502 Randall Combs 60.00 X 0 1603412 214513 Sheri D Beekman 60.00 X 0 353866 61994 3632739 7621444 2000334 158 1 1 0 McCarthy Building Companies 1341 North Rock Hill Road St Louis MO 63124 Construction 14073371 Quest Diagnostics PO Box 740709 Atlanta GA 30374 Lab Testing 3260104 Lawlor Corp 1440 Strassner Drive St Louis MO 63144 Construction 2983555 St Louis University 3635 Vista Ave St Louis MO 63110 Purchased services 2785734 Signature Health Services 9701 Landmark Pkwy Drive St Louis MO 63127 Physician Services 2698713 137 3473901 1530 3475431 NET PATIENT REVENUE 622110 970498008 970498008 970498008 4059588 4059588 7623096 4053850 3569246 3569246 3569246 Cafeteria/Coffee Shop 722212 6440864 6440864 Optical - Retail 624100 939062 939062 Reference Labs 621500 517830 517830 15977914 15425572 552342 23875670 1005477943 985923580 2009234 14069698 777523 777523 2463259 2463259 370440 370440 332245470 325072092 7173378 16239787 15158191 1081596 43327890 42929702 398188 22631209 22055872 575337 321628 321628 10 10 29264390 28788309 476081 670006 659106 10900 4149616 4082109 67507 1831833 1802032 29801 22318659 21955573 363086 1670288 1643115 27173 2213 2177 36 1092206 1092206 57483615 56548456 935159 7966945 7837337 129608 Medical Supplies 185610499 182590938 3019561 Shared Service Fees 162313365 84889159 77424206 Bad Debt Expense 37477067 37477067 Equipment Repairs & Mai 6442106 6337304 104802 2415567 2364397 51170 939085591 844433115 94652476 0 19117239 30161751 112573161 119694442 13470528 14729144 880530 782687 1138667458 627830475 509981979 510836983 250104 2689128 3146353 4955360 16003527 43854006 95872705 707772035 791227592 63650085 74632197 1125588 1341997 4288 -329254 12510499 12344684 6785506 6923663 84075966 94913287 X 620951341 693410523 2744728 2903782 623696069 696314305 707772035 791227592 X 66392352 6225884 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 75876 0 0 0 75876 0 Explanation of Lobbying Activities: Part II-B, Line 1: The filing organization is a member of and pays dues to the following hospital associations: Missouri Hospital Association, Catholic Health Association, and American Hospital Association. For the year ended June 30, 2012, dues were $161,892, $126,659, and $67,674, respectively. Approximately 32.5% of Missouri Hospital Association dues, 5.15% of Catholic Hospital Association dues, and 24.6% of American Hospital Association dues were attributable to lobbying activities performed by these associations. 8896793 8896793 785387183 400121766 385265417 11657157 8959449 2697708 283177643 208689076 74488567 49548682 10060184 39488498 510836983 DEFERRED COMPENSATION 4504325 MISCELLANEOUS RECEIVABLES 4125294 Intercompany Receivables 84343736 Other Assets 2899350 95872705 DEFERRED COMPENSATION 4504325 OTHER LIABILITIES 2419338 6923663 Description of Uncertain Tax Positions Under FIN 48: Part X: The consolidated audited financial statements of Mercy Health and Subsidiaries do not include a footnote to report the organization's liability for uncertain tax provisions under FIN 48, as they are deemed immaterial for disclosure. 1 1 X 1 X 1 X 1 1 1 0 1 1 30714602 30714602 0.03410 112439589 105744419 6695170 0.00740 143154191 105744419 37409772 0.04150 1626436 8920 1617516 0.00180 7603561 142794 7460767 0.00830 889908 37300 852608 0.00090 823757 46234 777523 0.00090 10943662 235248 10708414 0.01190 154097853 105979667 48118186 0.05340 2200 2200 0.00000 333752 333752 0.00040 10031 10031 0.00000 311705 311705 0.00030 9067 9067 0.00000 666755 666755 0.00070 1 10515349 0 178774496 202872593 -24098097 X 1 1 1 St Johns Mercy SRS LLC Medical Equipment Rental 0.40000 0.60000 2 Mercy Equipco-Oncology ServicesLLC Med Equip Rent-dissolved 12/31/11 0.50000 0.50000 4 1 Mercy Hospital St Louis

615 S New Ballas Road St Louis MO 63141

X X X X X 2 Mercy Hospital Washington

901 E Fifth Street Washington MO 63090

X X X 3 SJMDHSLLC(Mercy Continuing Care Hospita

13190 South Outer 40 Chesterfield MO 63017

X 4 Mercy Rehabilitation LLC

14561 North Outer 40 Chesterfield MO 63017

X Mercy Hospital St Louis 1 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 Mercy Hospital Washington 2 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 SJMDHSLLC (Mercy Continuing Care Hospit 3 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 Mercy Rehabilitation LLC 4 1 1 100.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 1 X 0 0 28 Medical & Professional Services

15945 Clayton Road Ballwin MO 63011

Surg\Breast Ctr, C&V Testing, Imaging, Infusion, Nuc Med. RO,IM,N/T S Mercy Urgent Care - O'Fallon

300 Winding Woods Drive OFallon MO 63366

UCC, Sports & Ther, Blood Draw St, Imaging Ctr, Perinatal, Pulmonary Mercy Health Center

641 S New Ballas Road St Louis MO 63141

Child Development Mercy Urgent Care - Piper Hill

107 Piper Hill Drive St Peters MO 63376

Urgent Care, Sports & Therapy, Blood Draw Station Heart Health Center

450 N New Ballas Road St Louis MO 63141

Cardiac Testing, Cardiac Cath Lab Mercy Medical Building

12348 Old Tesson Road StLouis MO 63128

Women's Ctr, Imaging Ctr, Nuc Med, Cardiac Testing, Pulm, Blood Draw Station Mercy Medical Building

11700 Studt Road St Louis MO 63141

Hyberbaric Wound Center, Fertility Services Mercy Endoscopy Center

12990 Manchester Road Des Peres MO 63131

Endoscopy Edgewood

970 Executive Parkway St Louis MO 63141

Outpatient Behavioral Health Mercy Endoscopy Center

200 Brevco Plaza Lake St Louis MO 63367

Endoscopy Mercy Diagnostic Testing

755 Dunn Road Hazelwood MO 63042

Sports & Therapy, Cardiac Testing, Nuc Medicine Mercy Urgent Care

3195 Phoenix Center Drive Washington MO 63090

Medical Services Hazelwood

801 Hazelwest Drive Hazelwood MO 63042

Imaging Center/Blood Draw Station Tesson Rehab

13303 Tesson Ferry Road St Louis MO 63128

Sports & Therapy Olive and Mason

12680 Olive Creve Couer MO 63141

Sports & Therapy, Nutrition Counseling, Chiropratic, Imagine, Blood Draw Sta St Louis Cancer & Breast Institute

6435 Chippewa St Louis MO 63109

Infusion Therapy Mercy Sports Therapy

1176 Town Country Commons St Louis MO 63017

Sports Therapy & Rehab Mercy Cancer Center

901 Patients First Dr Washington MO 63090

Cancer Service Crestwood

10024 Watson Road St Louis MO 63126

Sports & Therapy/Blood Draw Station Mercy Therapy Services

1935 Prairie Dell Road - Suite 300 Union MO 63084

Sports and Therapy Mercy Therapy Services

1713 Heritage Hills Washington MO 63090

Sports and Therapy Grover

16555 Manchester Road Grover MO 63040

Radiology, Sports & Therapy, Blood Draw Station Fenton Medical Office Building

1203 Smizer Mill Road Fenton MO 63026

Imaging, Blood Draw Station Florissant Meadows Shopping Center

572 Highway 67 Florissant MO 63031

Blood Draw Station Mercy Medical Building

2740 Highway 94 St Charles MO 63303

Blood Draw Station Liberty Point Medical Building

2023 Vadalabene Suite 300 Maryville IL 62062

Perinatal Center Mercy Medical Building

1820 Zumbehl Road St Charles MO 63303

Cardiac Testing, Imaging, Blood Draw Station Mercy Therapy Services

735 West Springfield Road Gerald MO 63037

Sports and Therapy 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 $ 37477067. Part II: Mercy Hospital St. Louis/Washington's community building activities promote the health of the communities in which they serve. Through active participation on community boards, neighborhood/community meetings and involvement in community-based events, such as the annual town fair in Washington, Mercy demonstrates its ongoing commitment to the community. Community building activities serve as a link to engage Mercy co-workers to look beyond the walls of the facilities in which they serve. Programs such as the annual Adopt-a-Family Program link Mercy co-workers with those most in need in our community during the holiday season. In addition to providing food, clothing and other basic human needs, mental and emotional health of these families and individuals are supported. Mercy is committed to partnering with both individuals and other agencies to improve the lives of those in our community through a holistic approach that includes mind, body and spirit. St. LouisCommunity SupportHealthTeacher: HealthTeacher is a health literacy program that provides online health lesson plans and resources for educators focused on improving health from kindergarten through 12th grade. Coalition BuildingBoard InvolvementAmerican Diabetes Association (ADA): A nurse clinician in the Diabetes Education department is on the board of directors of the American Diabetes Association spending approximately 3hrs/month on activities for this board.Behavioral Health Network & the Crisis Intervention Team: Executive Director of Behavioral Health participates on various committees.West County Multiple Sclerosis Center: The VP of Mercy Women's Services is an active board memberWorkforce Development: Special Needs Coordinator/Senior Job Coach/PRN Coach: The special needs coordinator, senior job coach, and PRN coaches coordinate services for applicants and co-workers with developmental disabilities. Cash/In-Kind DonationsAdopt-a-Family Program: Numerous Mercy departments took part in the annual holiday Adopt-a-Family Program which provides needed items for families in the St. Louis community.Thanksgiving Meal-Hosea House: Nutrition Services cooked 50 turkeys for Hosea House's annual Thanksgiving dinner. Hosea House provided the turkeys and dropped off and picked up from Mercy Hospital St. Louis.WashingtonEconomic DevelopmentCounty Economic Development Corporation: The VP of Ancillary Services at Mercy Hospital Washington attended County Economic Development Corporation meetings to discuss economic development and the promotion of the county and its services. Washington Civic Industrial Corporation: The VP Ancillary Services at Mercy Hospital Washington serves as a board member and attends monthly board meetings for the Economic Development for City of Washington.Community SupportWashington Town & Country Fair: Co-workers took part in the annual parade kicking off the start of the Washington Town & Country Fair. Participation in this event displayed Mercy's dedication and interest in being part of the Washington community.HealthTeacher: HealthTeacher is a health literacy program that provides online health lesson plans and resources for educators focused on improving health from kindergarten through 12th grade. 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 DEBTEXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OFCOST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ONDETAILED COST ACCOUNTING, WHERE AVAILABLE. WHERE COST ACCOUNTING ISNOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED.THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BADDEBT 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 HOSPITALS EAST COMMUNITIES 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 HOSPITALS EAST COMMUNITIES ("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 St. Louis Part V, Section B, Line 19d: Each hospital facility used the average discount of the highest (best paying) three commercial managed care payers as the basis for establishing uninsured discount rates for FAP eligible individuals. Under no circumstances, will this uninsured discount be less than 15%. Mercy Hospital Washington Part V, Section B, Line 19d: Each hospital facility used the average discount of the highest (best paying) three commercial managed care payers as the basis for establishing uninsured discount rates for FAP eligible individuals. Under no circumstances, will this uninsured discount be less than 15%. SJMDHS,LLC (Mercy Continuing Care Hospit Part V, Section B, Line 19d: Each hospital facility used the average discount of the highest (best paying) three commercial managed care payers as the basis for establishing uninsured discount rates for FAP eligible individuals. Under no circumstances, will this uninsured discount be less than 15%. Mercy Rehabilitation, LLC Part V, Section B, Line 19d: Each hospital facility used the average discount of the highest (best paying) three commercial managed care payers as the basis for establishing uninsured discount rates for FAP eligible individuals. Under no circumstances, will this uninsured discount be less than 15%. Part VI, Line 2: The needs assessment process involves review of both quantitative and qualitative information. The following five step process is used to attain the full scope of our community's needs.1. Examine existing community health needs assessmentsThe needs assessment examination process includes the collection and analysis of quantitative data available in community/public health resources. Mercy staff, with the support of Saint Louis University Master of Public Health students, is focusing on the counties of Franklin, Lincoln, St. Charles, St. Louis, St. Louis City, and Warren in Mercy's service area. Data for the assessment is obtained from a variety of sources:- St. Louis County - 2011 Community Health Needs AssessmentIn December 2010, the St. Louis County Department of Health contracted with the University of New England's Center for Community and Public Health to conduct a countywide community health needs assessment that included an extensive report with data broken down by sub-county regions. The assessment was released at the county's first Public Health Summit in December 2011. - Progress Toward Building a Healthier St. Louis - 2011 Access to Care ReportSt. Louis Regional Health CommissionEach year Mercy's JFK Health Center is cited throughout the report as a major provider of care for the uninsured and underinsured in our region.- Children of Metropolitan St. Louis - 2009-10 Report to the CommunityVision for Children at Risk This report provides valuable health and social service information relating to children and is critical as Mercy plans programs and services for families.- Community Health Status Report 2009 - St. Louis, St. Louis City, St. Charles, Franklin, Lincoln and Warren Counties, MO 2009- The County Health Rankings for 2011 This is a new resource that was unveiled in March 2010. It is county level data that will be updated annually by the University of Wisconsin-Population Health Institute and the Robert Wood Johnson Foundation. - Community Data Profiles & Missouri Information for Community Assessment (MICA) Missouri Department of Health & Senior Services-Bureau of Health Informatics This resource provides some of the best community health assessment planning tools available including community data profiles on 115 Missouri counties, thirty health indicators, and the capability to create customized tables.- Issues in Missouri Health Care 2011Health Management Associates, Inc., Missouri Foundation for Health, Healthcare Foundation for Greater Kansas City- Data from Mercy's Health Information Systems DepartmentData from Mercy's internal records was used to assess the needs of the community. 2. Conduct roundtable discussions with community membersIn an effort to include qualitative data, input from both community individuals served by Mercy and also those with expertise in public health, community roundtable meetings along with follow up sessions, were held in Washington and St. Louis, Missouri. Participants shared their views on both the current and future state of health in their communities. Focus included traditional health care services along with prevention, education and wellness. Ideas for next steps and partnerships emerged along with identifying potential barriers to success. 3. Analyze and summarize the data to prioritize needsAfter careful analysis of the data, five community health priorities were identified: access to care, tobacco use, health literacy/education, injuries, and mental health/substance abuse. 4. Review community benefit activities in placeUsing Lyon Software's CBISA tool, a review will be conducted of current community benefit activities and what Mercy is presently doing to meet the identified priorities. In addition, the community benefit activity of others in the community will be reviewed.5. Create an action planCommunity Health Councils, led by the hospital president, will be formed at both Mercy Hospitals in St. Louis and Washington. These teams, comprised of representatives from Finance, Mission, Physician leadership, Care Management, Philanthropy, Communications, Human Resources, and the Board of Directors, is accountable for ensuring Community Benefit meets mission, compliance, and IRS guidelines through an intentional, strategic, and collaborative approach. Mercy Hospital St. Louis will participate in 2012/13 with the St. Louis County Health Department, area hospitals and agencies on the Mobilizing for Action through Planning and Partnerships (MAPP) model when developing a Community Health Improvement Plan. Mercy Hospital Washington will participate in a similar planning process with the Franklin County Area United Way. Part VI, Line 3: Mercy Hospitals East Communities has printed material available at each point of registration in our facility, in addition to electronically availability at our web site. Specific information provided: Financial Assistance Information As a part of our healing ministry, MHEC 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. The discount for all uninsured patients is 26%. Patients without insurance whose financial situation qualifies them for charity care discounts (see Eligibility Guidelines below) must first find out if they are eligible for Medicaid before applying for financial assistance. Patients denied Medicaid eligibility then must provide certain information to show financial need. 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: Community Information - Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.The service area is comprised of fourteen regions (194 zip codes) with a total population of 2,738,424 in 2011. Additional demographics for St. Louis/Washington service areas are below. All information is based on 2011 data. Median age: 38Breakdown of age groups with the percentage of the population they comprise: 0-17 24% 18-44 (female) 18% 18-44 (male) 17% 45-64 27% 65+ 13%Average household income: $67,147 Population with incomes under $15,000: 11%Race/Ethnicity:White: 75%Black: 18%Native American: <1%Asian: 2%Multiracial and/or any Other Race: 2%Hispanic: 3% Payer mix: Private: 61%Medicare: 14%Uninsured: 13%Medicaid: 12%Adult Education Level: Some high school: 8% High school degree: 28% Some college/associates degree: 31% Bachelor's degree or higher: 29% Part VI, Line 5: Mercy Hospitals East Communities ("MHEC") provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay. In active pursuit of this mission, MHEC provided services to 45,650 inpatients, 114,110 emergency room visits, 930,951 outpatient visits, and 58,117 clinic visits.MHEC is a Catholic health care corporation that, pursuant to the organizational core belief that health care services are a vital and integral part of the Church's healing mission, engages in a ministry which provides general acute care, ambulatory, long-term and home care health services to individuals and families in its service communities. Consistent with the organization's commitment to social accountability and the provision of community benefit, MHEC offers other services and programs which further health promotion, maintenance and care. MHEC's services include two clinics which were established specifically for individuals who are uninsured or underinsured and do not have a means to pay for healthcare services. These clinics provide a significant focus on prenatal care. Many clinic patients were also treated, on a charitable basis, as inpatients. In response to the increased needs of the underinsured in the St. Louis area, these clinics have continually expanded, offering new services to more patients. The institution continues to focus on the provision of primary health services and education to the community, regardless of their means to pay for these services. The organization also has a continuing commitment to health research and to health education at all levels.Although reimbursement for services rendered is critical to the continued ability to provide healthcare services to all patients, MHEC recognizes that not all individuals possess the ability to purchase essential medical services and, further, that part of our mission is to provide healthcare services and healthcare education to the communities in which our facilities are located. In keeping with MHEC's commitment to serve all members of the communities it serves, MHEC provides (i) free care and/or subsidized care; (ii) care to persons covered by governmental programs at below cost; (iii) health activities and programs to support the community; (iv) health education programs; and, (v) a variety of broad community support activities. MHEC 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 are served by MHEC. Medical staff privileges are extended to all qualified physicians in the community for almost all of our departments. The exceptions include Radiology, Pathology, Anesthesiology, Neonatology, and CV surgery. This means that over 90% of the physicians on the staff are in categories that are open to qualified physicians in the community.Surplus funds and unrestricted assets held by Mercy Health East Communities are reinvested in patient care, medical education and research initiatives which support the organization's mission to deliver compassionate care and exceptional health care services to the communities it serves. Examples include the following:- New outpatient ambulatory facility in St. Charles, Missouri - part of Mercy's efforts to expand services available to residents of the 'Tri-County' area which includes St. Charles, Lincoln and Warren County (western suburbs of St. Louis)- New inpatient labor and birth facilities at Mercy Hospital St. Louis to improve the patient experience - Expansion of cardiology services offered at Mercy Hospital Washington, including a second cardiac cath lab to better meet the health care needs of this community- Continued funding and growth of Mercy Research Institute which is dedicated to improving patient outcomes by supporting new and potentially life-changing health research including over 100 active clinical trials at Mercy Hospital St. Louis.- Continued funding of graduate medical education program (provides residency training in family medicine, internal medicine, OB/Gyn, dental medicine, orthopedics and critical care) and schools of radiology, respiratory and clinical laboratory science. 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, 2012, MERCY FACILITIES INCLUDED 26 ACUTE CARE HOSPITALS, 5 MANAGED HOSPITALS, 3 HEART HOSPITALS, 2 CHILDREN'S HOSPITALS AND 1 REHAB HOSPITAL WITH 3,864 ACUTE LICENSED BEDS. FOR THE FISCAL YEAR ENDED JUNE 30, 2012, MERCY HAD 4.8 MILLION PROVIDER VISITS AND 2.7 MILLION OUTPATIENT VISITS, MORE THAN 1,600 EMPLOYED PHYSICIANS, AND APPROXIMATELY 38,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH 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. Reports Filed With States Part VI, Line 7 MO 1 Nurses for Newborns 7259 Lansdowne Suite 100 St Louis MO 63119 431601329 501(c)(3) 52635 Support continuity of health care to high risk infants American Diabetes Association 10820 Sunset Office Dr Suite 220 St Louis MO 63127 131623888 501(c)(3) 6000 Support research for diabetes Mercy Foundation St Louis 615 S New Ballas Road St Louis MO 63141 562410020 501(c)(3) 30000 Support health care The Wellness Program 20 Archbishop May Drive St Louis MO 63119 431297933 501(c)(3) 30000 Support priests in proactively managing their health Youth in Need 1815 Boones Lick Road St Charles MO 63301 431033862 501(c)(3) 9000 Support child and family services agency Operation Food Search 6282 Olive Blvd St Louis MO 63130 431241854 501(c)(3) 62157 FMV Food donation Support to assist in feeding the region's poor West County Multiple Sclerosis Center 621 S New Ballas Rd Ste 5003-B St Louis MO 63141 270067529 501(c)(3) 436783 FMV Office space & construction costs to relocate Support needs of MS patients 7 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grants are made to organizations which have an established history of providing health care support andor community benefit. If necessary, periodic reports are provided to us. Grants are made to related organizations, which provide reporting on the use of the funds and work closely with our organization. X X X X 1 1 0 1 0 0 0 0 0 1 0 Charles Rehm MD 0 342849 0 60120 0 37852 0 34559 0 15234 0 490614 0 0 Thomas RiechersMD 0 317229 0 61760 0 51474 0 11162 0 16352 0 457977 0 0 Dennis Keithly 0 274740 0 0 0 33575 0 60682 0 9993 0 378990 0 0 Terri McLain 246234 0 64084 0 43722 0 48591 0 12459 0 415090 0 0 0 Jeff Johnston 0 356125 0 94747 0 96279 0 237156 0 16757 0 801064 0 0 Cheryl Matejka 0 281624 0 72435 0 38471 0 49820 0 16192 0 458542 0 0 Michael McCurry 0 690577 0 215833 0 26779 0 527385 0 12630 0 1473204 0 0 Keith StarkeMD 0 367315 0 64295 0 25893 0 38258 0 10876 0 506637 0 0 Christine Crain 221209 0 32909 0 53398 0 79526 0 7526 0 394568 0 0 0 Eric Eoloff 0 271447 0 63548 0 12971 0 34885 0 14545 0 397396 0 0 Patricia Geldbach 166128 0 26173 0 54773 0 43042 0 9164 0 299280 0 0 0 Paul Hintze 321861 0 43512 0 42738 0 58512 0 16258 0 482881 0 0 0 Joseph Kahn 0 296313 0 7500 0 54043 0 13997 0 10553 0 382406 0 0 Donald Kalicak 0 192345 0 56503 0 42607 0 33954 0 11629 0 337038 0 0 Steven Bollin 148743 0 21349 0 17701 0 5570 0 11384 0 204747 0 0 0 Donna Frazier 192036 0 25737 0 23263 0 22481 0 6930 0 270447 0 0 0 Frank Lenoir 0 174061 0 27022 0 27898 0 5455 0 9591 0 244027 0 0 Sally Petito 0 206500 0 7500 0 53295 0 12041 0 2392 0 281728 0 0 Kathryn Nelson 125319 0 21006 0 37854 0 4397 0 14916 0 203492 0 0 0 Anthony Rothermich 0 123766 0 17701 0 26432 0 9836 0 1285 0 179020 0 0 Denise Scoffic 0 129865 0 13271 0 35581 0 10193 0 6947 0 195857 0 0 Joan Frost 124100 0 15092 0 26304 0 8385 0 3764 0 177645 0 0 0 Ann Varner 125548 0 16447 0 19552 0 9711 0 2078 0 173336 0 0 0 Kim Onesko 0 186351 0 28574 0 42599 0 14894 0 2620 0 275038 0 0 Dionysios Veronikis MD 416298 0 0 0 1078 0 10282 0 9170 0 436828 0 0 0 Patricia Arnold 209423 0 40120 0 34672 0 7690 0 9353 0 301258 0 0 0 Linda Fox 140127 0 13136 0 80205 0 1960 0 8593 0 244021 0 0 0 Berold Witten 187237 0 0 0 39989 0 32078 0 6632 0 265936 0 0 0 Steven Sommer 191983 53732 0 0 21679 2769 6756 0 11102 3644 231520 60145 0 0 Randall Combs 0 556847 0 176943 0 869622 0 203176 0 11337 0 1817925 0 839230 Sheri D Beekman 0 256877 0 63640 0 33349 0 54290 0 7704 0 415860 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 THE FOLLOWING: TERRI MCLAIN; JEFF JOHNSTON; MICHAEL MCCURRY; DONALD KALICAK; DONNA FRAZIER; FRANK LENOIR; JOAN FROST; KIM ONESKO; PATRICIA ARNOLD; LINDA FOX. 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 LINDA FOX AND TO THE EMPLOYEE OF A RELATED ORGANIZATION JEFF JOHNSTON, FOR PURPOSES OF THIS FORM 990. PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE. Part I, Line 4b Part I, Line 4B: Mercy Health, the ultimate parent company, offers supplemental retirement plans to certain executives which provide benefits upon 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 the following plans. There were no payments for the fiscal year ended 6/30/2012. Supplemental Executive Retirement Plan (SERP) Combs, Randy; McCurry, Michael; Johnston, Jeff Supplemental Management Retirement Plan (SMRP) Beekman, Sheri D; Crain, Christine; Geldbach, Patricia; Eoloff, Eric; Hintze, Paul; Kalicak, Don; Matejka, Cheryl L; McLain, Terri L; Rehm, Charles; Lenior, Frank; Starke,Keith; Frazier,Donna; Johnston, Jeff; Arnold, Patricia The amount of all accrued benefits is included in compensation amounts provided in Schedule J, Part II, Column (C). Part I, Line 7 The related organization which employs those individuals listed on Part VII, and the filing organization when applicable, PROVIDES A NON-FIXED BONUS PLAN FOR WHICH CERTAIN TIERS OF ITS EMPLOYEES ARE ELIGIBLE. FOR FISCAL YEAR 2012 (JULY 1, 2011 - JULY 30, 2012) 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: Mercy Health (parent company) is responsible for establishing the compensation of the organization's CEO/Executive Director. The following methods were used by Mercy Health to establish compensation: -Independent compensation consultant -Written employment contract -Compensation survey or study -Approval by the board or compensation committee Emily Combs Family Member of Randall Combs, Former Officer 98392 Employment arrangement, Mercy Hospitals East Communities 0 Cheryl Crain Family Member of Christine Crain, Key Employee 53624 Employment arrangement, Mercy Hospitals East Communities 0 Janine Ford Family Member of Randall Combs, Former Officer 115809 Employment arrangement, Mercy Hospitals East Communities 0 Christine Bolin Family Member of Steven Bollin, Key Employee 36962 Employment arrangement, Mercy Hospitals East Communities 0 Karie Ramos family Member of Paul Hintze, Key Employee 28003 Employment arrangement, Mercy Hospitals East Communities 0 Lee Varner Family Member of Ann Varner, Key Employee 25923 Employment arrangement, Mercy Hospitals East Communities 0 Form 990, Part VI, Section A, line 6 The member of Mercy Hospitals East Communities is Mercy Health East Communities, a supporting organization under Section 509(a)(3). The member of Mercy Health East Communities is Mercy Health. Form 990, Part VI, Section A, line 7a Mercy Health, the member of Mercy Health East Communities, has reserve powers to appoint and remove all directors and officers for Mercy Hospitals East Communities. Form 990, Part VI, Section A, line 7b THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO THE CORPORATE MEMBER (AND WITH REGARD TO CERTAIN POWERS AND RESPONSIBILITIES, TO MERCY HEALTH, AS THE CORPORATE MEMBER OF THE CORPORATE MEMBER): -APPROVAL OF REVISIONS TO THE MISSION, VISION, AND OPERATING VALUES, PURSUANT TO WHICH THE CORPORATION OPERATES; -APPROVAL OF ANY AMENDEMNTS TO THE ARTICLES OF INCORPORATION AND THESE BYLAWS AND ANY AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE OF THE CORPORATION; -APPROVAL OF THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION, AS PROVIDED IN SECTIONS 7.2.1 AND 7.3 OF THE BYLAWS; -ADOPTION OF THE STRATEGIC PLAN, GOALS AND OBJECTIVES OF THE CORPORATION; -ADOPTION OF THE OPERATING, CAPITAL, AND ALL OTHER BUDGETS FOR THE CORPORATION; -APPROVAL OF THE ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000) IN ANY ONE OR SERIES OF RELATED TRANSACTIONS OCCURRING WITHIN ANY TWELVE (12) MONTH PERIOD; -AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTY ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; -APPROVAL OF A PLAN OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION; -APPROVAL OF THE LEASE, MANAGEMENT, OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HEALTH SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION; AND, -APPROVAL OF THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION. 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 leadership. 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, 2012. 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 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), Mercy Health (ultimate parent company) uses the following to establish the compensation: external market salary surveys, external market salary studies, engagement of an independent compensation consultant, and annual review/approval of compensation by the Executive Compensation Committee of the Mercy Health Board. For those classified as key employees, the organization uses the following to establish the compensation: external market salary surveys, external market salary studies, and review/approval of executive management. Compensation reviews are completed on an annual basis, and a review was completed during the reporting year. Form 990, Part VI, Section C, line 19 Governing documents and financial statements are made available from time to time but are not published publicly; we are not required to make these documents available to the public. Financial results are available via request of copy of Form 990. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Restricted Fund - Investment Income 89,894. Restricted Fund - Donations 830,023. Restricted Fund - Expenses -760,862. Transfers from Mery Health 5,097,654. Net assets released from restrictions 1,163,727. Mercy Health Services, LLC eliminations -194,552. Total to Form 990, Part XI, Line 5: 6,225,884. Audited Financial Statements Part XI, Line 2 The filing organization's financial statements were included in the Mercy Health and Subsidiaries annual financial statement audit. The Mercy Health and Subsidiaries received an unqualified opinion from the external auditors for fiscal 2012 (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 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 Form 990, Part XI, Line 3 The organization was included in a consolidated audit of Mercy Health as required by the Single Audit Act and OMB Circular A-133. The single audit was conducted on a consolidated basis. Federal EINS Listing of included divisions and entities THE OPERATING RESULTS OF THE FOLLOWING ENTITIES, DIVISIONS, AND/OR SUBORDINATE ORGANIZATIONS OF MERCY HOSPITALS EAST COMMUNITIES ARE INCLUDED IN THE INFORMATION PRESENTED IN THE FORM 990 FOR THE YEAR ENDED JUNE 30, 2012: ENTITY FEIN Mercy Hospitals East Communities St. Louis 43-0653493 Mercy Hospitals East Communities Washington 43-1066883 Mercy Support Services 43-1677952 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 O AND P. Independent Contractors Form 990, Part V, Question 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. Hours Per Week Part VII, Section A, Column B Several individuals are disclosed as officers, directors, trustees, and key employees on multiple Form 990s that are filed by organizations included in the Mercy Health East Communities system. The average hours per week reported includes hours worked for all of these organizations. Mercy Clinic Adult Critical Care LLC 615 SNew Ballas Road StLouis MO 63141 201626965 Physician Services MO 3711768 609932 Mercy Hospitals East Communities Mercy Clinic Adult Hospitalists- Washington LLC 901 E Fifth Street Washington MO 63090 262961433 Hospitalist Services MO 559552 0 Mercy Hospitals East Communities Mercy Clinic Adult Hospitalists-St Louis LLC 645 Maryville CentreSte 100 StLouis MO 63141 431854902 Healthcare Services MO 7020651 493512 Mercy Hospitals East Communities Mercy Clinic Anesthesiology-Washington LLC 645 Maryville CentreSte 100 StLouis MO 63141 030597437 Inactive MO 0 0 Mercy Hospitals East Communities Mercy Clinic Children's Critical Care LLC 645 Maryville CentreSte 100 StLouis MO 63141 431854108 Healthcare Services MO 375995 37066 Mercy Hospitals East Communities Mercy Clinic Children's Hospitalists-St Louis LLC 645 Maryville CentreSte 100 StLouis MO 63141 431708560 Healthcare Services MO 767509 92525 Mercy Hospitals East Communities Mercy Family Therapy LLC 645 Maryville CentreSte 100 StLouis MO 63141 431893329 Healthcare Services MO 5242971 0 Mercy Hospitals East Communities Mercy Health Services LLC 645 Maryville CentreSte 100 StLouis MO 63141 431664148 Healthcare Services & Products MO 53865241 7939852 Mercy Hospitals East Communities Mercy Neuropsychology Services LLC 615 SNew Ballas Road StLouis MO 63141 261216912 Neurophsychology Services MO 1134579 340882 Mercy Hospitals East Communities Mercy Orthopaedic Trauma Services LLC 615 SNew Ballas Road StLouis MO 63141 061785022 Healthcare Services MO 1708545 134118 Mercy Hospitals East Communities St John's Mercy Therapy Services LLC 615 SNew Ballas Road StLouis MO 63141 810671798 Inactive MO 0 0 Mercy Hospitals East Communities Triax 14144 LLC 615 SNew Ballas Road StLouis MO 63141 943454464 R E Transactions MO 0 4300274 Mercy Hospitals East Communities Advance Care Hospital 300 Werner St 3rd Floor Hot Springs AR 71913 710816634 Long term acute-care hospital AR 501c3 3 Mercy Health 0 Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 Women's domestic violence shelter TX 501c3 7 Mercy Ministries of Laredo 0 Laredo Medical Group 14528 S Outer Forty St 100 Chesterfield MO 63017 742764726 Inactive TX 501c3 9 Mercy Health System TX 0 McAuley Portfolio Mgmt Co 14528 S Outer Forty St 100 Chesterfield MO 63017 261708048 Portfolio management MO 501c3 11-II Mercy Health 0 Mercy Clinic East Communities 645 Maryville Ctr Dr Ste 100 St Louis MO 63141 431771217 Physician Group MO 501c3 9 Mercy Health East Communities 0 Mercy Clinic Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318597 Physician Clinic AR 501c3 9 Mercy Health Fort Smith Comm 0 Mercy Clinic Hot Springs Comm 1 Mercy Lane Hot Springs AR 71913 261125131 Physician Clinic AR 501c3 9 Mercy Health Hot Springs Comm 0 Mercy Clinic Oklahoma Comm 4300 W Memorial Road Oklahoma City OK 73120 270473057 Physician Group/Clinic OK 501c3 9 Mercy Health OK Communities 0 Mercy Clinic Springfield Comm 1965 Fremont Street Suite 2950 Springfield MO 65804 431560263 Physician Group MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Family Center 14528 S Outer Forty St 100 Chesterfield MO 63017 721069468 Family counseling services MO 501c3 7 Mercy Health 0 Mercy Fdtn Health Innov 14528 S Outer Forty St 100 Chesterfield MO 63017 200901499 Foundation MO 501c3 11-II Mercy Health 0 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 0 Mercy Health Fort Smith Comm 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Company AR 501c3 11-II Mercy Health 0 Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501c3 11-I Mercy Hospital Ardmore 0 Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501c3 11-I Mercy Hospital Berryville 0 Mercy Health Foundation Ft Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501c3 11-III Mercy Kansas Communities Inc 0 Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501c3 11-II Mercy Hospital Hot Springs 0 Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501c3 11-I Mercy Kansas Communities Inc 0 Mercy Health Foundation Joplin 2817 St Johns Blvd Joplin MO 64804 270906136 Foundation MO 501c3 11-I Mercy Health SW MOKS Comm 0 Mercy Health Foundation NW Ark 2710 Rife Medical Ln Rogers AR 72858 710601687 Foundation AR 501c3 11-III Mercy Hospital Rogers 0 Mercy Health Foundation Ok City 4300 W Memorial Road Oklahoma City OK 73120 731593024 Foundation OK 501c3 11-I Mercy Hospital Oklahoma City 0 Mercy Health Foundation of OK 4300 W Memorial Road Oklahoma City OK 73120 454732301 Foundation OK 501c3 11-I Mercy Health OK Communities 0 Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501c3 11-II Mercy Health Springfield Comm 0 Mercy Health Foundation STL 615 South New Ballas Road St Louis MO 63141 562410020 Foundation MO 501c3 11-II Mercy Health East Communities 0 Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501c3 11-II Mercy Health East Communities 0 Mercy Health Hot Springs Comm 300 Werner Street Hot Springs AR 71913 261125064 Holding Company AR 501c3 11-II Mercy Health 0 Mercy Health NW Ark Communities 2710 Rife Medical Ln Rogers AR 72758 621684203 Physician Group AR 501c3 11-II Mercy Health 0 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 0 Mercy Health Springfield Comm 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Company MO 501c3 11-II Mercy Health 0 Mercy Health System TX 14528 S Outer Forty St 100 Chesterfield MO 63017 742764727 Inactive TX 501c3 11-II Mercy Health 0 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 0 Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501c3 3 Mercy Health OK Communities 0 Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Operating co for leased hosp MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501c3 3 Mercy Health Springfield Comm 0 Mercy Hospital Carthage 3125 Dr Russell Smith Way Carthage MO 64836 453808607 Hospital MO 501c3 3 Mercy Health SW MOKS Comm 0 Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Operating co for leased hosp MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Critical Access Hospital MO 501c3 9 Mercy Health SW MOKS Comm 0 Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 272716065 Operating co for leased hosp OK 501c3 3 Mercy Health OK Communities 0 Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501c3 3 Mercy Health Fort Smith Comm 0 Mercy Hospital Healdton 918 South Street Healdton OK 73438 263173902 hospital OK 501c3 3 Mercy Hospital Ardmore 0 Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 Hospital AR 501c3 3 Mercy Health Hot Springs Comm 0 Mercy Hospital Joplin 2817 St Johns Blvd Joplin MO 64804 270814858 Hospital MO 501c3 9 Mercy Health SW MOKS Comm 0 Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Hospital Logan County Inc 200 South Academy Guthrie OK 73044 452998842 Hospital OK 501c3 3 Mercy Health OK Communities 0 Mercy Hospital of Laredo 14528 S Outer Forty St 100 Chesterfield MO 63017 741189682 Inactive TX 501c3 3 Mercy Health System TX 0 Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501c3 3 Mercy Health OK Communities 0 Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501c3 3 Mercy Hospital Fort Smith 0 Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501c3 3 Mercy Hospital Fort Smith 0 Mercy Hospital Rogers 2710 Rife Medical Ln Rogers AR 72758 710294390 Hospital AR 501c3 3 Mercy Health NW Ark Communities 0 Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501c3 3 Mercy Hospital Ardmore 0 Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501c3 3 Mercy Hospital Fort Smith 0 Mercy Hospital Watonga Inc 500 Clarence Nash Blvd Watonga OK 73772 455199762 Leased Hospital OK 501c3 3 Mercy Health OK Communities 0 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 0 Mercy Medical Research Inst 1235 E Cherokee Street Springfield MO 65804 870796305 Research - Clinical Trials MO 501c3 4 Mercy Health Springfield Comm 0 Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78043 200198462 healthcare, outreach,food pantry. TX 501c3 7 Mercy Health 0 Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501c3 3 Mercy Health Springfield Comm 0 Mercy Support Services 615 S New Ballas Road St Louis MO 63141 431677952 Inactive MO 501c3 11-III Mercy Hospitals East Comm 0 MHM Support Services 14528 S Outer Forty St 100 Chesterfield MO 63017 202553101 Centralized Health System Functions MO 501c3 11-II Mercy Health 0 Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 Physician Clinics AR 501c3 9 Mercy Health Hot Springs Comm 0 St Edward Mercy Foundation PO Box 17000 Fort Smith AR 72917 237330425 Foundation AR 501c3 7 Mercy Hospital Fort Smith 0 St Johns Childrens Hosp 1235 E Cherokee Street Springfield MO 65804 Inactive MO 501c3 3 Mercy Health Springfield Comm 0 St Marys Hosp Enid Ok 14528 S Outer Forty St 100 Chesterfield MO 63017 730614655 Inactive OK 501c3 3 Mercy Health OK Communities 0 The Sr M Cornelia Blasko Fn 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501c3 11-I Mercy St Francis Hospital 0 Unity Ambulatory Care 14528 S Outer Forty St 100 Chesterfield MO 63017 431861745 Inactive MO 501c3 11-III Mercy Health East Communities 0 Southern Oklahoma Diag Ctr LLC 1011 Fourteenth Avenue NW ARDMORE OK 73401 431971232 MRI Services OK MERCY HOSPITAL ARDMORE INC N/A 0 0 Resource Optimiz & InnovLLC 645 Maryville Ctr DrSte 200 ST LOUIS MO 63141 460468368 Central Distribution Center MO MHN INC - MHNSR INC N/A 0 0 Mercy Ambulatory Surgery Center LLC 7301 Rogers Avenue FORT SMITH AR 72917 710827721 Ambulatory Surgery Center AR MERCY HOSPITAL FORT SMITH N/A 0 0 Fort Smith Emergency Medical Services 1701 South Greenwood Fort SMITH AR 72901 710416615 Emergency Medical Services AR MERCY HOSPITAL FORT SMITH n/A 0 0 St Edward Mercy Med Ctr M-P Off Bldg 7301 Rogers Avenue FORT SMITH AR 72903 710554050 Office building AR MERCY HOSPITAL FORT SMITH n/A 0 0 Mercy Comm Services Inc 401 Woodland Hills Blvd Fort Scott KS 66701 481078101 Retail pharmacy KS MERCY KANSAS COMM INC C Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 Holds ancillary assets & owns aircraft DE MERCY HEALTH C Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 Technology transfer company MO MERCY HEALTH SPRINGFIELD COMM C Unity Support Services Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 431797042 Inactive MO MERCY HEALTH EAST COMMUNITIES C UH L Corp Inc 645 Maryville Centre Drive Suite 10 St Louis MO 63141 742499535 Holding company MO MERCY HEALTH SERVICES LLC C 28225 221088 1.00000 MHN of the Southern Region Inc 1011 14th Avenue NW Ardmore OK 73401 731580607 Holding company OK MERCY MANAGED CARE CORP C 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 Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 Holding company OK MERCY HEALTH C Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 Holding company OK MERCY MANAGED CARE CORP C 0 1 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 Mercy Clinic East Communities N 346290 Mercy Clinic East Communities P 17018482 Mercy Foundation for Health Innovation C 50000 Mercy Health O 2367944 Mercy Health East Communities P 77912009 Mercy Health Foundation Washington P 113176 Mercy Health Springfield Communities P 3630942 Mercy Hospital Ardmore Inc P 356141 Mercy Hospital Fort Smith P 603618 Mercy Hospital Hot Springs P 583908 Mercy Hospital Oklahoma City Inc P 837304 Mercy Hospital Rogers P 469437 Mercy Hospital Springfield O 54340 MHM Support Services N 62180 MHM Support Services O 147304395 Resource Optimization & Innovation LLC O 34739777 Mercy Health Foundation St Louis B 30000 Mercy Health Foundation St Louis C 2791513 Mercy Health Foundation Washington C 682388