CHI ST VINCENT HOSPITAL HOT SPRINGS: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CHI ST VINCENT HOSPITAL HOT SPRINGS (EIN 71-0236913)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-14
IRS object ID
201331349349306023
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-14T15:28:51-04:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1190 CARONDELET PLAZA SUITE 1300AddressLine1
CityCLAYTONCity
StateMOState
ZIP Code63105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN710236913EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL HOT SPRINGSBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% Sara Bradley VP of FinanceInCareOfName
Name ControlMERCNameControl
Phone3145796100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 Werner PO Box 29001AddressLine1
CityHot SpringsCity
StateARState
ZIP Code71913ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSara B BradleyName
TitleVP Finance/TreasurerTitle
Date Signed2013-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTimothy JohnsenNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1300 WernerAddressLine1
CityHot SpringsCity
StateARState
ZIP Code71913ZIPCode
FieldValueIRS element (for citing)
Gross Receipts192386699GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.mercy.netWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileARStateLegalDomicile
Activity Or Mission DescriptionAS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees1893TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI2145185TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1758500ContributionsGrantsPriorYear
Contributions Grants Current Year1458826ContributionsGrantsCurrentYear
Program Service Revenue Prior Year189884079ProgramServiceRevenuePriorYear
Program Service Revenue CY189523910ProgramServiceRevenueCY
Investment Income Prior Year427566InvestmentIncomePriorYear
Investment Income Current Year34501InvestmentIncomeCurrentYear
Other Revenue Prior Year932029OtherRevenuePriorYear
Other Revenue Current Year1369462OtherRevenueCurrentYear
Total Revenue Prior Year193002174TotalRevenuePriorYear
Total Revenue Current Year192386699TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year78202GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY164431GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year84019025SalariesEtcPriorYear
Salaries Etc Current Year82457941SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year-35486TotalFundrsngExpCurrentYear
Other Expense Prior Year104557065OtherExpensePriorYear
Other Expenses Current Year106891216OtherExpensesCurrentYear
Total Expenses Prior Year188654292TotalExpensesPriorYear
Total Expenses Current Year189513588TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4347882RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2873111RevenuesLessExpensesCY
Total Assets BOY126148486TotalAssetsBOY
Total Assets EOY129009106TotalAssetsEOY
Total Liabilities BOY10917422TotalLiabilitiesBOY
Total Liabilities EOY11006501TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY115231064NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY118002605NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense129842903Expense
Grants164431Grants
Revenue189523910Revenue
DescriptionMercy Hospital Hot Springs, as part of Mercy Health, has a long history and tradition of working to improve community health, both in the narrow sense of treating illness and the broader sense of other community services. Since 1888 we have responded to the health care needs of individuals in Hot Springs and the surrounding communities, as well as working with others to achieve community health. Mercy is committed to enhancing access to healthcare services so that all in need are served in a timely and just manner. Our efforts include working collaboratively with other healthcare providers and community organizations to identify and implement solutions, developing internal policies and practices to promote just treatment, addressing the need of greater community outreach in order to provide services at the appropriate level of care and supporting policy initiatives that make health care more accessible.Description
Total Program Service Expense129842903TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1893NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledARStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSara Bradley VP of FinanceNamePerson
Telephone Number5016221921TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 29001AddressLine1
CityHot SpringsCity
StateARState
ZIP Code71903ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Robert W Aspell MD
Board Member-through 4/30/1260.0X022959431420
Bruce Burton MD
Board Member-through 4/30/121.0X000
Forrest L Spicher II
Board Member1.0X000
Gregory M Asbell
Board Member-through 4/30/121.0X000
Monda Barlow
Board Member1.0X000
Sr Ann Hardcastle RSM
Board Member1.0X000
Timothy Johnsen
Chief Executive Officer60.0X0455225288835X
Michael Ferguson
Board member-through 4/30/121.0X000
Sara Bradley
VP-Finance60.015252707183X
Jonathan R Vitiello
Chief Financial Officer60.0043976761898X
Brenda Chase
Chief Operating Officer60.0025102450413X
Michele Diedrich
Chief Nursing Officer60.0161024035494X
Patrick McCruden
VP-Mission60.0170204041465X
Douglas Ross
Medical Director60.0524124024910X
Jed Liuzza
VP-Human Resources60.0171494015049X
Bradley Kim Day
President-Central Comm60.00833159436266X
Michael Merrigan
Regional VP-General Counsel60.0032092365228X
Jaime Cardenas
Medical Director60.01914150750929497X
William Hennessey III
Regional VP-Marketing/Comm60.0028054447347X
Robert Kleinhenz MD
Physician40.029966023852220440X
Jonathan Townley
Physician40.0308843023422X
Wade C Wernecke
Physician40.0396516023183X
Tim Bumpas
Physician40.032962032408X
Eric Vogel
Physician40.0296559031594X
Jerri L Mitchell
Former CFO0.001067570X
Mark Larey DO
Former Key Employee60.016390919796433998X
Kathy Taylor
Former Key Employee40.0144518010378X
James Tutton
Former Key Employee40.0290418030303X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3428557TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3860988TotalReportableCompFrmRltdOrgs
Total Other Compensation1340731TotalOtherCompensation
Number Individuals GT100 K48NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
QUEST DIAGNOSTICS
PO BOX 740709ATLANTAGA30374LAB SERVICES755356
MIDSTATE MEDICAL SERV
3810 CENTRAL AVE SUITE HHOT SPRINGSAR71913anesthesia COVERAGE668000
FAYETTEVILLE LITHOTRIPTERS ARI
PO Box 847324DALLASTX75284LITHOTRIPSY SERVICES645319
ROCHE DIAGNOSTICS CORP
Mail Code 5021 PO Box 660367DALLASTX75266LAB SERVICES584368
ARKANSAS NEPHROLOGY SERVICES
1900 Malvern Ave Suite 304HOT SPRINGSAR71901Dialysis services511200
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
Related Organizations794557RelatedOrganizations
All Other Contributions664269AllOtherContributions
Total Contributions1458826TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REVENUE622110185706844185706844
NON-PATIENT LABORATORY62150021417262141726
RENTAL INCOME FROM RELATED ORGS531120328263328263
FOOD CATERER72232034593459
OTHER OPERATING REVENUE90009913436181343618
FieldValueIRS element (for citing)
Total Program Service Revenue189523910TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-26735TotalRevenueColumn
Exclusion-$26,735ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real394587Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real394587Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column394587TotalRevenueColumn
Exclusion$394,587ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities51121Securities
Other10115Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities51121Securities
Other10115Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column61236TotalRevenueColumn
Exclusion$61,236ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFTERIA & VENDINGDescription
Business Code900099BusinessCode
Total Revenue Column974875TotalRevenueColumn
Exclusion$974,875ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue974875TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column192386699TotalRevenueColumn
Related Or Exempt Function Income187378725RelatedOrExemptFunctionIncome
Unrelated Business Revenue2145185UnrelatedBusinessRevenue
Exclusion$1,403,963ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total164431Total
Program Services164431ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1366581Total
Program Services1224872ProgramServices
Management And General141709ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total63604551Total
Program Services56676354ProgramServices
Management And General6928197ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2951415Total
Management And General2951415ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9976541Total
Program Services36113ProgramServices
Management And General9940428ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4558853Total
Program Services42ProgramServices
Management And General4558811ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9523Total
Management And General9523ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total36929Total
Management And General36929ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5899076Total
Program Services4817438ProgramServices
Management And General1073972ManagementAndGeneral
Fundraising7666Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total90248Total
Program Services4308ProgramServices
Management And General85596ManagementAndGeneral
Fundraising344Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3617906Total
Program Services3411401ProgramServices
Management And General205997ManagementAndGeneral
Fundraising508Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total55514Total
Program Services20450ProgramServices
Management And General35064ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2744028Total
Program Services1168645ProgramServices
Management And General1575383ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total336386Total
Program Services285087ProgramServices
Management And General51299ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6757Total
Program Services597ProgramServices
Management And General6160ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9545617Total
Program Services4974264ProgramServices
Management And General4571353ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1474775Total
Management And General1474775ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SHARED SERVICE FEES32627569718866325485570-46664
BAD DEBT EXPENSE1302675513026755
REPAIRS & MAINTENANCE693761287953405808
MEDICAL SUPPLIES3632263036322630

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total403742Total
Program Services232900ProgramServices
Management And General168182ManagementAndGeneral
Fundraising2660Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total189513588Total
Program Services129842903ProgramServices
Management And General59706171ManagementAndGeneral
Fundraising-35486Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7993873BOY
EOY15556060EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20889753BOY
EOY25077662EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY25085836BOY
EOY454336EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3980703BOY
EOY4182703EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY219669BOY
EOY235246EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis236876104LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec176884249LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY62757599BOY
EOY59991855EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY4847549BOY
EOY4828394EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY373504BOY
EOY18682850EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY126148486BOY
EOY129009106EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10917422BOY
EOY10366447EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY640054EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10917422BOY
EOY11006501EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY115206064BOY
EOY117977605EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY25000BOY
EOY25000EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY115231064BOY
EOY118002605EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY126148486BOY
EOY129009106EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2873111ReconcilationRevenueExpenses
Reconcilation Other Changes-101570ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$16,495OtherActivitiesAmount
Total Lobbying Expenditures IIB16495TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE C, PART II-B, LINE 1(I)Identifier
Return ReferenceSUPPLEMENTAL LOBBYING INFORMATIONReturnReference
ExplanationTHE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: ARKANSAS HOSPITAL ASSOCIATION, CATHOLIC HEALTH ASSOCIATION, AND AMERICAN HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2012, DUES WERE $59,736, $36,840 AND $18,060, RESPECTIVELY. APPROXIMATELY 17% OF ARKANSAS HOSPITAL ASSOCIATON DUES, 5.15% OF CATHOLIC HEALTH ASSOCIATION DUES AND 24.6% OF AMERICAN HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance25000BeginningOfYearBalance
End Of Year Balance25000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance25000BeginningOfYearBalance
End Of Year Balance25000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance25000BeginningOfYearBalance
End Of Year Balance25000EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance25000BeginningOfYearBalance
End Of Year Balance25000EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3026557OtherCostOrOtherBasis
Book Value3026557BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis76467679OtherCostOrOtherBasis
Depreciation45440453Depreciation
Book Value31027226BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1680893OtherCostOrOtherBasis
Depreciation631935Depreciation
Book Value1048958BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis148316043OtherCostOrOtherBasis
Depreciation125438638Depreciation
Book Value22877405BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7384932OtherCostOrOtherBasis
Depreciation5373223Depreciation
Book Value2011709BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings59991855TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY RECEIVABLES18674889
OTHER RECEIVABLES7961
FieldValueIRS element (for citing)
Total Book Value Other Assets18682850TotalBookValueOtherAssets

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, SCHEDULE D, PART V, LINE 4INTENDED USE OF THE ORGANIZATIONS ENDOWMENT FUNDSTEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED TO FUND NURSING SCHOOL SCHOLARSHIPS.
FORM 990, SCHEDULE D, PART X, LINE 2ASC 740 FOOTNOTETHE 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 ASC 740, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense12357884TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense12357884NetCommunityBenefitExpense
Percent Of Total Expense0.07000PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21856998TotalCommunityBenefitExpense
Direct Offsetting Revenue9644796DirectOffsettingRevenue
Net Community Benefit Expense12212202NetCommunityBenefitExpense
Percent Of Total Expense0.06910PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense34214882TotalCommunityBenefitExpense
Direct Offsetting Revenue9644796DirectOffsettingRevenue
Net Community Benefit Expense24570086NetCommunityBenefitExpense
Percent Of Total Expense0.13910PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense536424TotalCommunityBenefitExpense
Net Community Benefit Expense536424NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense320142TotalCommunityBenefitExpense
Net Community Benefit Expense320142NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense182229TotalCommunityBenefitExpense
Net Community Benefit Expense182229NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense286864TotalCommunityBenefitExpense
Net Community Benefit Expense286864NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1325659TotalCommunityBenefitExpense
Net Community Benefit Expense1325659NetCommunityBenefitExpense
Percent Of Total Expense0.00740PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense35540541TotalCommunityBenefitExpense
Direct Offsetting Revenue9644796DirectOffsettingRevenue
Net Community Benefit Expense25895745NetCommunityBenefitExpense
Percent Of Total Expense0.14650PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense50000TotalCommunityBuildingExpense
Net Community Building Expense50000NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense75848TotalCommunityBuildingExpense
Net Community Building Expense75848NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense125848TotalCommunityBuildingExpense
Net Community Building Expense125848NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,556,304BadDebtExpenseAmount
Amount Reimbursed By Medicare85165234AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare77768566CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall7396668MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL HOT SPRINGSBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1300 WERNERAddressLine1
CityHOT SPRINGSCity
StateARState
ZIP Code71913ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL HOT SPRINGSBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities22NumberOfOtherFacilities

Other Facilities OtherFacilities (22 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Mercy Glenwood
234 BroadwayGlenwoodAR71943Primary Care Small
Mercy Medical Office Building
One Mercy LaneHot SpringsAR71913Physician Clinic/Practice
Mercy Women's Center
118 Womens Center LaneHot SpringsAR71913Primary Care Medium
Mercy Cancer Center
1455 Higdon Ferry RoadHot SpringsAR71913Physician Clinic/Practice
Mercy McGowan Court
100 McGowan CourtHot SpringsAR71913Physician Clinic/Practice
Mercy 70 West
1707 Airport RoadHot SpringsAR71913Primary Care Medium
Mercy Hollywood Avenue
104 Hollywood AvenueHot SpringsAR71901Primary Care Small
Mercy 270 West
2825 Albert PikeHot SpringsAR71913Primary Care Medium
Mercy McAuley Court
225 McAuley CourtHot SpringsAR71913Primary Care Medium
Mercy Central Avenue
3604 Central AvenueHot SpringsAR71913Rehab & Urgent Care
Mercy Wound Care
221 McAuley CourtHot SpringsAR71913Physician Clinic/Practice
Mercy Outpatient Surgery Center
1636 Higdon Ferry RoadHot SpringsAR71913Hospital
Mercy South Campus
1662 Higdon Ferry RoadHot SpringsAR71913Physician Clinic/Practice
Mercy McAuley Court
220 McAuley CourtHot SpringsAR71913Physician Clinic/Practice
Mercy Hot Springs Village
4419 N Highway 7Hot SpringsAR71909Physician Clinic/Practice
Mercy Heart and Vascular Center
200 Heart Center LaneHot SpringsAR71913Physician Clinic/Practice
Mercy Home Health
174 Cornerstone CtHot SpringsAR71913Home Care
McAuley Senior Community Center
5010 Highway 7 NorthHot Springs VillageAR71909Urgent Care
Mercy DeSoto Boulevard
903 DeSoto BoulevardHot Springs VillageAR71909Primary Care Small
Mercy Malvern
1424 Tanner StreetMalvernAR72104Primary Care Small
Mercy Mount Ida
320 LuzerneMount IdaAR71913Primary Care Small
Mercy Murfreesboro
319 E13th StreetMurfreesboroAR71958Primary Care Small

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE H, PART I, LINE 6AIdentifier
ExplanationTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS PARENT ENTITY, MERCY HEALTH HOT SPRINGS COMMUNITIES. FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $189,513,588. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $13,026,755. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $176,486,833. FORM 990, SCHEDULE H, PART II EXPLANATION MERCY HOSPITAL HOT SPRINGS' COMMUNITY BUILDING AND COALITION BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE THROUGH THEIR PARTICIPATION IN COMMUNITY-BASED EVENTS, MEETINGS AND BY SERVING ON COMMUNITY BOARDS. COALITION BUILDING WITH THE MEETINGS WITH PUBLIC SCHOOL DISTRICTS TO DISCUSS AND DEVELOP THE HEALTHTEACHER HEALTH AND WELLNESS INITIATIVE OFFERED AT NO CHARGE TO THESE SCHOOLS. FORM 990, SCHEDULE H, PART III, LINE 2 TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNTING, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. FORM 990, SCHEDULE H, PART III, LINE 3 THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY (REFER TO DISCLOSURE FOR PART III, #9B) TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE. FORM 990, SCHEDULE H, PART III, LINE 4 THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: "PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES AS OF THE REPORTING DATE WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE BALANCES WITH COLLECTION AGENCIES." FORM 990, SCHEDULE H, PART III, LINE 8 IT IS THE POSITION OF MERCY HOSPITAL HOT SPRINGS THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS THE COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE ARE CALCULATED BY TAKING 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). FORM 990, SCHEDULE H, PART III, LINE 9B MERCY HOSPITAL HOT SPRINGS' ("MERCY'S") DEBT COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT BEFORE TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH MERCY'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO HAVE MET THE MERCY COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY FOR APPROPRIATE FOLLOW-UP. MERCY REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. MERCY UTILIZES THE "SEARCH AMERICA" TOOL TO ENHANCE THE ABILITY TO DETERMINE CHARITY QUALIFICATION. PRESUMPTIVE CHARITY WILL BE GRANTED IN SITUATIONS WHERE MERCY HAS BEEN UNABLE TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION. MERCY UTILIZES PRESUMPTIVE CHARITY PRIOR TO BAD DEBT PLACEMENT FOR CHARITY ADJUSTMENTS IN EXCESS OF $6,500. IN THESE CASES, MERCY UTILIZES THE SEARCH AMERICA REPORT STATUS OF "PROBABLE CHARITY" AS THE BASIS FOR ASSIGNING THE CHARITY LEVEL. MERCY WILL PURSUE APPROPRIATE MEANS IN THE COLLECTION OF DELINQUENT ACCOUNTS FROM PATIENTS WITH AN ESTABLISHED ABILITY TO PAY OR AN UNWILLINGNESS TO COOPERATE IN VALIDATING ELIGIBILITY FOR FINANCIAL ASSISTANCE. THESE APPROPRIATE MEANS MAY INCLUDE LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES. ADDITIONALLY THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENT, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENFORCE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEWS COMPLIANCE WITH ALL POLICIES. FORM 990, SCHEDULE H, PART V, 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%. FORM 990, SCHEDULE H, PART VI, LINE 2 NEEDS ASSESMENT MERCY HOSPITAL HOT SPRINGS' OBJECTIVES OF COMMUNITY NEEDS ASSESSMENT ARE TO IDENTIFY HEALTH NEEDS IN HOT SPRINGS, ARKANSAS AND THE SURROUNDING COMMUNITIES, AND TO INVOLVE THE COMMUNITY IN THE HEALTH PLANNING EFFORTS. THE INFORMATION GATHERED IS USED TO PLAN STRATEGICALLY, AND BETTER MEET THE HEALTH AND HUMAN SERVICE NEEDS OF THESE COMMUNITIES. MERCY HOSPITAL HOT SPRINGS LOOKS AT COMMUNITY NEEDS ASSESSMENT AS AN OPPORTUNITY TO BUILD RELATIONSHIPS, EDUCATE THE COMMUNITY AND IDENTIFY RESOURCES THAT ARE AVAILABLE TO MEET IDENTIFIED NEEDS. BASIC DISCUSSION FORUMS HAVE BEEN UTILIZED TO FOSTER CONVERSATION WITH KEY STAKEHOLDERS. EXAMPLES OF FORUMS INCLUDE AN ADVISORY BOARD, FOCUS GROUPS, OPINION SURVEYS, AND COMMUNITY ROUND TABLE DISCUSSIONS. STAKEHOLDER PARTICIPANTS INCLUDE BOARD MEMBERS, COMMUNITY/CIVIC LEADERS, LOCAL EMPLOYERS, OTHER HEALTH CARE PROVIDERS, FORMER PATIENTS, AND CO-WORKERS. FORM 990, SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE MERCY HOSPITAL HOT SPRINGS HAS PRINTED MATERIAL AVAILABLE AT EACH POINT OF REGISTRATION IN OUR FACILITY, IN ADDITION TO ELECTRONIC AVAILABILITY AT OUR WEB SITE. SPECIFIC INFORMATION PROVIDED: FINANCIAL ASSISTANCE INFORMATION AS A PART OF OUR HEALING MINISTRY, MERCY HOSPITAL HOT SPRINGS IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR FINANCIAL SITUATION. WE OFFER PAYMENT ASSISTANCE FOR THOSE WHO DO NOT HAVE INSURANCE OR WHO ARE IN FINANCIAL NEED. UNINSURED PATIENT DISCOUNTS A DISCOUNT FROM THE HOSPITAL'S REGULAR BILLED CHARGES WILL BE PROVIDED TO PATIENTS WHO DO NOT HAVE INSURANCE. THIS INCLUDES PATIENTS WHOSE FINANCIAL SITUATION NORMALLY WOULD NOT OTHERWISE QUALIFY THEM FOR CHARITY CARE DISCOUNTS. PATIENTS WITHOUT INSURANCE WHOSE FINANCIAL SITUATION QUALIFIES THEM FOR CHARITY CARE DISCOUNTS (SEE ELIGIBILITY GUIDELINES BELOW) 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 RATEExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
St John's Catholic School
583 W Grand AveHot SpringsAR71901710539026501(C)(3)30000Scholarships
Mid-America Science Museum
500 Mid American BlvdHot SpringsAR71913202129318501(C)(3)25000Donations
American Heart Association
7272 Greenville AvenueDallasTX75231135613797501(c)(3)12500Sponsorship Heart Ball
Garland County Habitat for Humanity
P O Box 171Hot SpringsAR71902710776139501(C)(3)50000Habitat House
Arkansas Hospital Education & Research
419 Natural ResourcesLittle RockAR72205710392458501(C)(3)17292Community Assistance Program Contribution
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule I, Part I, Line 2Identifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationTHE ASSISTANCE PROVIDED IS INTENDED TO BE USED FOR THE GENERAL OPERATING PURPOSES OF THE DONEE. THE USE OF GRANT FUNDS IS NOT MONITORED AFTER GRANTS ARE GIVEN.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (22 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Robert W Aspell MD
015406402000005553001697401444602610140
Timothy Johnsen
03396190947480208580272538016297074406000
Jerri L Mitchell
000001067570000010675700
Sara Bradley
1373620140260113901433057500159710000
Jonathan R Vitiello
0278936069300091531046475015423050166500
Brenda Chase
018265104059102778204372006693030143700
Michele Diedrich
1322650150970136620207340147600196518000
Patrick McCruden
1255280161450285310268790145860211669000
Douglas Ross
437262032774054088093440155660549034000
Robert Kleinhenz MD
16284922187424687011212416648465237036901518431121324740900
Jonathan Townley
246997017230044616080700153520332265000
Wade C Wernecke
323524021981051011071250160580419699000
Jed Liuzza
14013701565101570605510095390186543000
Bradley Kim Day
0598570020388703070204228390134270126942500
Michael Merrigan
0214349066366040208049457015771038615100
Jaime Cardenas
18541456662020000600308473378947852193612033053581700
Tim Bumpas
230705133548556119905125033620280
Eric Vogel
2285900169580510110155360160580328153000
Mark Larey DO
128694170147934802586727817017231732094471712292246420
Kathy Taylor
11766801339401345604278061000154896000
James Tutton
2201580164990537610178000125030320721000
William Hennessey III
0132990095312052242032357014990032789100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule J, Part I, Question 1Identifier
ExplanationCharter 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 Hospital Hot Springs 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 2011: Jerri (Lynne) Mitchell, $106,757. 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: Timothy Johnsen, Jonathan Vitiello, Bradley Day, Michael Merrigan, Brenda Chase, Michele Diedrich, Patrick McCruden, and William Hennessey. 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 provides a non-fixed bonus plan for which certain tiers of its employees are eligible. For fiscal year 2012 (July 1, 2011 - June 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 is reviewed by the Executive Compensation Committee of Mercy Health and is then taken into account when analyzing executive compensation for reasonableness.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierFORM 990, PART V, QUESTION 1AIdentifier
ExplanationVENDORS 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 Systen (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, PART VI, QUESTION 6, 7A, & 7B DESCR OF CLSES OF MMBRS OR STCKHDS, DEC REQ APPR & TYPE OF VOTING RGTS THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH HOT SPRINGS COMMUNITIES. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY TO THE CORPORATE MEMBER: - TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION, AND ALL ORGANIZATIONS CONTROLLED BY THE CORPORATION, SHALL OPERATE; - TO ADOPT OR AMEND THE ARTICLES OF INCORPORATION AND BYLAWS, AND TO AMEND THE ORGANIZATIONAL AND GOVERNANCE DOCUMENTS OF EACH ORGANIZATION CONTROLLED BY THE CORPORATION; - TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD; - THROUGH THE SOLE ACTION OF THE PRESIDENT OF THE CORPORATE MEMBER, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER OF THE SSU WHO SHALL SERVE AS THE PRESIDENT OF THE CORPORATION; - TO APPROVE OR AMEND THE STRATEGIC, LONG RANGE, AND HEALTH MANPOWER DEVELOPMENT PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - TO APPROVE OR AMEND THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, AND CHANGES IN THE BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; - TO ASSIGN, TRANSFER, LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION 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 ORGANIZATION CONTROLLED BY THE CORPORATION; - TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS 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 ORGANIZATION CONTROLLED BY THE CORPORATION; AND - TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION. FORM 990, PART VI, QUESTION 11B DESCRIBE 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 MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990. AFTER QUESTIONS ARISING FROM THE REVIEW ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM. 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, 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, QUESTION 15A & 15B OFFICES & 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 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 GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS 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 SEVERAL INDIVIDUALS LISTED IN PART VII ARE DISCLOSED AS TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ON MULTIPLE FORMS 990 OF ENTITIES INCLUDED WITHIN MERCY HEALTH. THE AVERAGE HOURS PER WEEK DISCLOSED IN PART VII IS AN ESTIMATE OF THE HOURS PER WEEK THAT THE LISTED INDIVIDUAL SPENDS ON BOTH THE FILING ORGANIZATION AND ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 5 RECONCILIATION OF NET ASSETS Prior Period Adjustment = ($101,570) TOTAL OTHER CHANGES IN NET ASSETS = ($101,570) FORM 990, PART XII, QUESTION 2C THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN MERCY HEALTH AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. MERCY HEALTH AND SUBSIDIARIES RECEIVED AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2012 (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 FINANCE, AUDIT, AND COMPLIANCE COMMITTEE OF MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1St Joseph's PET Center LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 Werner StreetAddressLine1
CityHot SpringsCity
StateARState
ZIP Code72901ZIPCode
FieldValueIRS element (for citing)
EIN470886845EIN
Primary ActivitiesPET/MRI CTRPrimaryActivities
Legal Domicile StateARLegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MHHSBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (67 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Advance Care Hospital
300 Werner StreetHot SpringsAR71913710816634HospitalAR501(C)(3)3Mercy Healthtrue
Casa de Misericordia
1602 McClelland StreetLaredoTX78044742912461ShelterTX501(C)(3)7MM Laredotrue
Laredo Medical Group
14528 S Outer Forty Ste 100ChesterfieldMO63017742764726InactiveTX501(C)(3)9MHS-TXtrue
McAuley Portfolio Management Company
14528 S Outer Forty Ste 100ChesterfieldMO63017261708048Port MgmtMO501(C)(3)11bMercy Healthtrue
Mercy Clinic East Communites
14528 S Outer Forty Ste 100ChesterfieldMO63017431771217Phys GroupMO501(C)(3)9MHECtrue
Mercy Clinic Fort Smith Communitites
7301 Rogers AvenueFort SmithAR72917261318597Phys ClinicAR501(C)(3)9MHFSCtrue
Mercy Clinic Hot Springs Communitites
1 Mercy LaneHot SpringsAR71913261125131Phys ClinicAR501(C)(3)9MHHSCtrue
Mercy Clinic Oklahoma Communities
4300 W Memorial RoadOklahoma CityOK73120270473057Phys GroupOK501(C)(3)9MHOCtrue
Mercy Clinic Springfield Communities
1965 Fremont Street Ste 2950SpringfieldMO65804431560263Phys GroupMO501(C)(3)9MHSCtrue
Mercy Family Center
14528 S Outer Forty Ste 100ChesterfieldMO63017721069468counselingMO501(C)(3)7Mercy Healthtrue
Mercy Foundation for Health Innovation
14528 S Outer Forty Ste 100ChesterfieldMO63017200901499FoundationMO501(C)(3)11bMercy Healthtrue
Mercy Health
14528 S Outer Forty Ste 100ChesterfieldMO63017431423050Sup Hlth SysMO501(C)(3)1NAfalse
Mercy Health East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017431718408Hlth SystemMO501(C)(3)11bMercy Healthtrue
Mercy Health Fort Smith Communities
7301 Rogers AvenueFort SmithAR72917261318515Holding CoAR501(C)(3)11bMercy Healthtrue
Mercy Health Foundation Ardmore
1011 14th Avenue NWArdmoreOK73401710962525FoundationOK501(C)(3)11aMH Ardmoretrue
Mercy Health Foundation Berryville
214 Carter StreetBerryvilleAR72616710759301FoundationAR501(C)(3)11aMH Berryvilltrue
Mercy Health Foundation Fort Scott
401 Woodland Hills BlvdFort ScottKS66701481077073FoundationKS501(C)(3)11cMercy KS Comtrue
Mercy Health Foundation Hot Springs
300 Werner StreetHot SpringsAR71913710804718FoundationAR501(C)(3)11bMHHStrue
Mercy Health Foundation Independence
800 W MyrtleIndependenceKS67301481079981FoundationKS501(C)(3)11aMercy KS Comtrue
Mercy Health Foundation Joplin
2817 St Johns BlvdJoplinMO64804270906136FoundationMO501(C)(3)11aMHSMKCtrue
Mercy Health Foundation NW Arkansas
2710 Rife Medical LaneRogersAR72758710601687FoundationAR501(C)(3)11cMH Rogerstrue
Mercy Health Foundation OF Oklahoma
4300 W Memorial RoadOklahoma CityOK73120454732301FoundationOK501(C)(3)11aMHOCtrue
Mercy Health Foundation OK City
4300 W Memorial RoadOklahoma CityOK73120731593024FoundationOK501(C)(3)11aMHOCtrue
Mercy Health Foundation Springfield
1235 E Cherokee StreetSpringfieldMO65804320195818FoundationMO501(C)(3)11bMHSCtrue
Mercy Health Foundation St Louis
14528 S Outer Forty Ste 100ChesterfieldMO63017562410020FoundationMO501(C)(3)11bMHECtrue
Mercy Health Foundation Washington
901 E Fifth StreetWashingtonMO63090562410022FoundationMO501(C)(3)11bMHECtrue
Mercy Health Hot Springs Communities
300 Werner StreetHot SpringsAR71913261125064Holding CoAR501(C)(3)11bMercy Healthfalse
Mercy Health NW Arkansas Communities
2710 Rife Medical DriveRogersAR72758621684203Phys GroupAR501(C)(3)11bMercy Healthtrue
Mercy Health Oklahoma Communities
4300 W Memorial RoadOklahoma CityOK73120731453048Holding coOK501(C)(3)11bMercy Healthtrue
Mercy Health Springfield Communitites
1235 E Cherokee StreetSpringfieldMO65804431856028Holding CoMO501(C)(3)11bMercy Healthtrue
Mercy Health SW MOKS Communitites
2817 St Johns BlvdJoplinMO64804300584463Hlth SystemMO501(C)(3)11bMercy Healthtrue
Mercy Health System of Texas Inc
14528 S Outer Forty Ste 100ChesterfieldMO63017742764727InactiveTX501(C)(3)11bMercy Healthtrue
Mercy Home Health Berryville
804 W Freeman Suite 4BerryvilleAR72616870781247Home HealthAR501(C)(3)11cMH Sprngfldtrue
Mercy Hospital Ardmore
1011 14th Avenue NWArdmoreOK73401731500629HospitalOK501(C)(3)3MHOCtrue
Mercy Hospital Aurora
500 Porter AvenueAuroraMO65605431936696HospitalMO501(C)(3)3MHSCtrue
Mercy Hospital Berryville
214 Carter StreetBerryvilleAR72616710759299HospitalAR501(C)(3)3MHSCtrue
Mercy Hospital Carthage
3125 Dr Russell Smith WayCarthageMO64836453808607HospitalMO501(C)(3)3MHSMKCtrue
Mercy Hospital Cassville
94 Main StreetCassvilleMO65625431936699HospitalMO501(C)(3)3MHSCtrue
Mercy Hospital Columbus
220 Pennsylvania AvenueColumbusKS66725270842031HospitalMO501(C)(3)3MHSMKCtrue
Mercy Hospital El Reno
2115 Parkview DriveEl RenoOK73036272716065HospitalOK501(C)(3)3MHOCtrue
Mercy Hospital Fort Smith
7301 Rogers AvenueFort SmithAR72917710240352HospitalAR501(C)(3)3MHFSCtrue
Mercy Hospital Healdton
918 South 8th StreetHealdtonOK73438263173902HospitalOK501(C)(3)3MH Ardmoretrue
Mercy Hospital Joplin
2817 St Johns BlvdJoplinMO64804270814858HospitalMO501(C)(3)3MHSMKCtrue
Mercy Hospital Lebanon
100 Hospital DriveLebanonMO65536431767432HospitalMO501(C)(3)3MHSCtrue
Mercy Hospital Logan County Inc
200 South AcademyGuthrieOK73044452998842HospitalOK501(C)(3)3MHOCtrue
Mercy Hospital of Laredo
14528 S Outer Forty Ste 100ChesterfieldMO63017741189682InactiveTX501(C)(3)3MHS-TXtrue
Mercy Hospital Oklahoma City
4300 W Memorial RoadOklahoma CityOK73120730579285HospitalOK501(C)(3)3MHOCtrue
Mercy Hospital Ozark
801 W River StreetOzarkAR72949710689680HospitalAR501(C)(3)3MHFStrue
Mercy Hospital Paris
500 E AcademyParisAR72855710655753HospitalAR501(C)(3)3MHFStrue
Mercy Hospital Rogers
2710 Rife Medical LaneRogersAR72758710294390HospitalAR501(C)(3)3MHNWACtrue
Mercy Hospital Springfield
1235 E Cherokee StreetSpringfieldMO65804440552485HospitalMO501(C)(3)3MHSCtrue
Mercy Hospital Tishomingo
1000 South ByrdTishomingoOK73460274433830HospitalOK501(C)(3)3MH Ardmoretrue
Mercy Hospital Waldron
1341 W 6th StreetWaldronAR72958710557895HospitalAR501(C)(3)3MHFStrue
Mercy Hospital Watonga Inc
500 Clarence Nash BlvdWatongaOK73772455199762HospitalOK501(C)(3)3MHOCtrue
Mercy Hospitals East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017430653493HospitalMO501(C)(3)3MHECtrue
Mercy Kansas Communities Inc
401 Woodland Hills BlvdFt ScottKS66701480956045HospitalKS501(C)(3)3MHSMKCtrue
Mercy Medical Research Institute
1235 E Cherokee StreetSpringfieldMO65804870796305ResearchMO501(C)(3)4MHSCtrue
Mercy Ministries of Laredo
2500 ZacatecasLaredoTX78046200198462outreachTX501(C)(3)7Mercy Healthtrue
Mercy St Francis Hospital
100 W Highway 60Mountain ViewMO65548440607149HospitalMO501(C)(3)3MHSCtrue
Mercy Support Services
14528 S OUTER FORTY STE 100CHESTERFIELDMO63017431677952InactiveMO501(C)(3)11cMHECtrue
MHM SUPPORT SERVICES
14528 S OUTER FORTY STE 100CHESTERFIELDMO63017202553101Hlth SystemMO501(C)(3)11BMERCY HEALTHtrue
Mission Clinical Services
300 Werner StreetHot SpringsAR71913134239691nursing homeAR501(C)(3)9MHHSCtrue
St Edward Mercy Foundation
PO Box 17000Fort SmithAR72917237330425FoundationAR501(C)(3)7MHFStrue
St John's Children's Hospital Inc
1235 E Cherokee StreetSpringfieldMO65804InactiveMO501(C)(3)3MHSCtrue
St Mary's Hospital of Enid Oklahoma
14528 S Outer Forty Ste 100ChesterfieldMO63017730614655InactiveOK501(C)(3)3MHOCtrue
The Sister M Cornelia Blasko Foundation
100 W Highway 60Mountain ViewMO65548431873914FoundationMO501(C)(3)11aMSFHtrue
Unity Ambulatory Care
14528 S OUTER FORTY STE 100CHESTERFIELDMO63017431861745InactiveMO501(C)(3)11cMHECtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Merc Ambu Surg CTR
7301 Rogers AvFort SmithAR72903710827721AMBUL SURG CENTERARNA
RES OPT & INNOV
645 Maryville Centre Dr 200St LouisMO63141460468368CENTRAL DIST.MONA
SO OK DIAG CTR
1011 14TH Ave NWArdmoreOK73401431971232MRI ServicesOKNA
Fort Smith EMS
1701 S GreenwoodFort SmithAR72901710416615Emergency MedARNA
St Ed Mer Med MOB
7301 Rogers AveFort SmithAR72903710554050Office BuildingARNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Frontenac Properties Inc
14528 S Outer Forty Suite 100ChesterfieldMO63017521914421HOLDING COMPDENAC-Corp
Inveno Health Inc
1235 E Cherokee StreetSpringfieldMO65804264509571IT SERVICESMONAC-Corp
Mercy Community Services Inc
401 Woodland Hills BlvdFort ScottKS66701481078101RETAIL PHARMACYKSNAC-Corp
Mercy Health Center Condominium Inc
4300 W Memorial RdOklahoma CityOK73120680640970REAL ESTATEOKNAC-Corp
Mercy Health Network of the Southern Reg
1011 14th Avenue NWArdmoreOK73401731580607HEALTH CAREOKNAC-Corp
Mercy Health Network Inc
4300 W Memorial RoadOklahoma CityOK73120731381689HEALTH CAREOKNAC-Corp
Mercy Managed Care Corporation
4300 W Memorial RoadOklahoma CityOK73120731441665HOLDING COMPOKNAC-Corp
UH L Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535HOLDING COMPMONAC-Corp
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042PRACTICE MGTMONAC-Corp
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Mercy Clinic Hot Springs Communities
N276952FMV
Mercy Clinic Hot Springs Communities
O968215FMV
Mercy Clinic Hot Springs Communities
P442384FMV
Mercy Hospital Fort Smith
O56080FMV
Mercy Hospitals East Communities
O583908FMV
MHM Support Services
P5510728FMV
Resource Optimization & Innovation LLC
O6375606FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE R, PART VIdentifier
ExplanationLAWSON 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. 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.Explanation

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