MERCY HOSPITAL WALDRON: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MERCY HOSPITAL WALDRON (EIN 71-0557895)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201211369349300316
Schema version
2010v3.7
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)
Timestamp2012-05-15T06:55:56-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

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 Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN710557895EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mercy Hospital WaldronBusinessNameLine1
Business Name Line2f/k/a St Edward Health Fac of Scott CountyBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone3146283557Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11341 West 6TH STAddressLine1
CityWALDRONCity
StateARState
ZIP Code72958ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGRETA WILCHERName
TitleVP FINANCETitle
Date Signed2012-05-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGRETA WILCHER VP FINANCENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11341 West 6TH STAddressLine1
CityWALDRONCity
StateARState
ZIP Code72958ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8866485GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.mercy.netWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
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 Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees78TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8000ContributionsGrantsPriorYear
Contributions Grants Current Year31092ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9263559ProgramServiceRevenuePriorYear
Program Service Revenue CY8834934ProgramServiceRevenueCY
Investment Income Prior Year800InvestmentIncomePriorYear
Investment Income Current Year459InvestmentIncomeCurrentYear
Other Revenue Prior Year36760OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year9309119TotalRevenuePriorYear
Total Revenue Current Year8866485TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year715GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY837GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4493316SalariesEtcPriorYear
Salaries Etc Current Year4584616SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5663178OtherExpensePriorYear
Other Expenses Current Year6514295OtherExpensesCurrentYear
Total Expenses Prior Year10157209TotalExpensesPriorYear
Total Expenses Current Year11099748TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-848090RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2233263RevenuesLessExpensesCY
Total Assets BOY2440104TotalAssetsBOY
Total Assets EOY2625421TotalAssetsEOY
Total Liabilities BOY8809718TotalLiabilitiesBOY
Total Liabilities EOY11228298TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-6369614NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8602877NetAssetsOrFundBalancesEOY
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
Expense1091624Expense
Grants0Grants
Revenue1161595Revenue
DescriptionCRITICAL ACCESS HOSPITAL EMERGENCY SERVICE - ACCESS TO EMERGENCY CARE IN RURAL COMMUNITIES IS ESSENTIAL TO THE HEALTH OF THE COMMUNITY. THE HOSPITAL FURNISHES 24-HOUR EMERGENCY CARE SERVICES USING EITHER ON-SITE OR ON-CALL PHYSICIAN STAFF. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATELY 5,169 ER VISITS TO MERCY HOSPITAL WALDRON.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense723579Expense
Grants0Grants
Revenue2638034Revenue
DescriptionCRITICAL ACCESS HOSPITAL ACUTE CARE SERVICE - ACCESS TO SHORT-STAY INPATIENT CARE IN RURAL COMMUNITIES IS ESSENTIAL TO THE HEALTH OF THE COMMUNITY. THE HOSPITAL FURNISHES SHORT-TERM INPATIENT ACUTE CARE THROUGH LOCAL PRIVATE PHYSICIAN ADMISSIONS. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATELY 458 ADMISSIONS TO MERCY HOSPITAL WALDRON.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense35947Expense
Grants0Grants
Revenue131057Revenue
DescriptionCRITICAL ACCESS HOSPITAL SWING BED SERVICE - ACCESS TO SWING-BED INPATIENT CARE IN RURAL COMMUNITIES IS ESSENTIAL TO THE HEALTH OF THE COMMUNITY. THE HOSPITAL FURNISHES SWING-BED INPATIENT CARE THROUGH LOCAL PRIVATE PHYSICIAN ADMISSIONS. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATELY 70 ADMISSIONS TO MERCY HOSPITAL WALDRON.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp8647730TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt837TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev4904248TotalOfOtherProgramServiceRev
Total Program Service Expense10498880TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
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 OrganizationsfalseGrantsToOrganizations
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 EntityfalseDisregardedEntity
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 With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees78NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
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 Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
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 BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGRETA WILCHER VP OF FINANCENamePerson
Telephone Number4793146104TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17301 ROGERS AVENUEAddressLine1
CityFORT SMITHCity
StateARState
ZIP Code72903ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KATHERINE SCHLUTERMAN
BOARD MEMBER40.0X0171760
BILL MURRAY
BOARD MEMBER1.0X000
CYNTHIA KUYKENDALL
BOARD MEMBER1.0X000
GARY CLEPPER
BOARD MEMBER1.0X000
JAMES FLOYD
BOARD MEMBER1.0X000
JASON RICHEY MD
BOARD MEMBER1.0X000
LARRY GOSS
BOARD MEMBER1.0X000
MIKE KOEHLER
BOARD MEMBER1.0X000
SR DOROTHY CALHOUN RSM
BOARD MEMBER1.0X000
SR JUDITH MARIE KEITH RSM
BOARD MEMBER1.0X000
SR REBECCA HENDRICKS RSM
BOARD MEMBER1.0X000
JEFFREY A JOHNSTON
CHIEF EXECUTIVE OFFICER60.0X0513656154704X
JONATHAN R VITIELLO
CHIEF FINANCIAL OFFICER60.0037523849437X
GRETA WILCHER
VP-FINANCE60.0025956338491X
APRIL REVIS
ADVANCE PRACTICE NURSE40.0103318018520X
FieldValueIRS element (for citing)
Total Reportable Comp From Org103318TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1165633TotalReportableCompFrmRltdOrgs
Total Other Compensation261152TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
F AND S PHYSICAL THERAPY
4008 COLTON DRIVEFORT SMITHAR72903PHYSICAL THERAPY211819
CPP WOUND CARE
3017 N CAUSEWAY BLVDMETAIRIELA70002WOUND CARE SERVICES199840
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations31092RelatedOrganizations
Total Contributions31092TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient revenue62211087962238796223
Other program service revenue6221103871138711
FieldValueIRS element (for citing)
Total Program Service Revenue8834934TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column459TotalRevenueColumn
Exclusion$459ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8866485TotalRevenueColumn
Related Or Exempt Function Income8834934RelatedOrExemptFunctionIncome
Exclusion$459ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total837Total
Program Services837ProgramServices

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3724071Total
Program Services3654834ProgramServices
Management And General69237ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total128361Total
Program Services125975ProgramServices
Management And General2386ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total528319Total
Program Services518497ProgramServices
Management And General9822ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total203865Total
Program Services200074ProgramServices
Management And General3791ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total701Total
Program Services701ProgramServices

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)
Total4629Total
Program Services331ProgramServices
Management And General4298ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total7998Total
Program Services7356ProgramServices
Management And General642ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4023376Total
Program Services3656062ProgramServices
Management And General367314ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total191937Total
Program Services191937ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total168114Total
Program Services168114ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total25655Total
Program Services24230ProgramServices
Management And General1425ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6592Total
Program Services6418ProgramServices
Management And General174ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total159408Total
Program Services104536ProgramServices
Management And General54872ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total86866Total
Management And General86866ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Provision for Bad Debt18305951830595
ALL OTHER EXPENSES8424838341

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11099748Total
Program Services10498880ProgramServices
Management And General600868ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1340BOY
EOY1340EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY52955BOY
EOY7593EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1218454BOY
EOY1059451EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4990BOY
EOY34532EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6119973LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5214572LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1019309BOY
EOY905402EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY143056BOY
EOY617103EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2440104BOY
EOY2625421EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY339484BOY
EOY330275EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY11452EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8470234BOY
EOY10886571EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8809718BOY
EOY11228298EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-6369614BOY
EOY-8602877EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-6369614BOY
EOY-8602877EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2440104BOY
EOY2625421EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-2233263ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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$701OtherActivitiesAmount
Total Lobbying Expenditures IIB701TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL LOBBYING INFORMATIONIdentifier
Return ReferenceSCHEDULE C, PART IVReturnReference
ExplanationTHE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: AMERICAN HOSPITAL ASSOCIATION, ARKANSAS HOSPITAL ASSOCIATION, AND CATHOLIC HEALTH ASSOCIATION. DUES FOR THE YEAR ENDED JUNE 30, 2011 WERE $3,226, $616, AND $1,503 RESPECTIVELY. APPROXIMATELY 16.30% OF AMERICAN HOSPITAL ASSOCIATION DUES, 17% OF ARKANSAS HOSPITAL ASSOCIATION DUES, AND 4.68% OF CATHOLIC HEALTH 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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis261782OtherCostOrOtherBasis
Book Value261782BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1692687OtherCostOrOtherBasis
Depreciation1434558Depreciation
Book Value258129BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis342253OtherCostOrOtherBasis
Depreciation301680Depreciation
Book Value40573BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3823251OtherCostOrOtherBasis
Depreciation3478333Depreciation
Book Value344918BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings905402TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
PATIENT REFUNDS10555
THIRD PARTY SETTLEMENTS606548
FieldValueIRS element (for citing)
Total Book Value Other Assets617103TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to AffiliatesDescription
Amount$10,886,571Amount
FieldValueIRS element (for citing)
Total Of Amounts10886571TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationTHE 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 (ASC 740), AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense290958TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense290958NetCommunityBenefitExpense
Percent Of Total Expense0.03140PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1121848TotalCommunityBenefitExpense
Direct Offsetting Revenue1024028DirectOffsettingRevenue
Net Community Benefit Expense97820NetCommunityBenefitExpense
Percent Of Total Expense0.01060PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1412806TotalCommunityBenefitExpense
Direct Offsetting Revenue1024028DirectOffsettingRevenue
Net Community Benefit Expense388778NetCommunityBenefitExpense
Percent Of Total Expense0.04200PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1412806TotalCommunityBenefitExpense
Direct Offsetting Revenue1024028DirectOffsettingRevenue
Net Community Benefit Expense388778NetCommunityBenefitExpense
Percent Of Total Expense0.04200PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$854,522BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare3362564AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare3513514CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-150950MedicareSurplusOrShortfall

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 WALDRONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1HIGHWAY 71 BYPASS HIGHWAY 80AddressLine1
CityWALDRONCity
StateARState
ZIP Code72958ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY HOSPITAL WALDRONBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (2 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H, SUPPLEMENTAL INFORMATIONPART I, LINE 3C: N/A PART I, LINE 6A: THERE IS AN ANNUAL COMMUNITY BENEFIT REPORT PREPARED AND MADE AVAILABLE FOR PUBLIC VIEWING. PART I, LINE 7, COLUMN F: OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25 COLUMN (A) WAS $11,099,748. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $1,830,595. THIS LEFT A TOTAL EXPENSE OF $9,269,153 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7: PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACES WITH COLLECTION AGENCIES, ARE INITIALLY CHARGES 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. PART II: N/A 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 COLLECTIONS POLICIES OF THE HEALTH SYSTEMS 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 ASSESS 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." TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNTING, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY (REFER TO DISCLOSURE FOR PART III, #9B) TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE. PART III, LINE 8: IT IS THE POSITION OF MERCY HOSPITAL WALDRON THAT 100% OF ANY SHORT FALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96). PART III, LINE 9B: MERCY HOSPITAL WALDRON'S ("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 HAVE MET THE MERCY HOSPITAL 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 HOSPITAL 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 $10,000. 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. NEEDS ASSESSMENT: PART VI, LINE 2: MERCY HOSPITAL WALDRON'S OBJECTIVES OF COMMUNITY NEEDS ASSESSMENT ARE TO IDENTIFY HEALTH NEEDS IN FORT SMITH AND SURROUNDING COMMUNITIES, AND INVOLVE THE COMMUNITY IN THE HEALTH PLANNING EFFORTS. THE INFORMATION GATHERED IS USED TO PLAN STRATEGICALLY, AND BETTER MEET THE HEATH AND HUMAN SERVICE NEEDS OF THESE COMMUNITIES. MERCY HOSPITAL WALDRON 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, SPECIFIC FOCUS GROUPS, OPINION SURVEYS, AND COMMUNITY ROUND TABLE DISCUSSIONS. STAKEHOLER PARTICIPANTS INCLUDE BOARD MEMBERS, COMMUNITY/CIVIC LEADERS, LOCAL EMPLOYERS, OTHER HEALTH CARE PROVIDERS, FORMER PATIENTS, AND CO-WORKERS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PART VI, LINE 3: THE FILING ORGANIZATION 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, THE FILING ORGANIZATION IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR FINANCIAL SITUATION. WE OFFER PAYMENT ASSISTANCE FOR THOSE WHO DO NOT HAVE INSURANCE OR WHO ARE IN FINANCIAL NEED. UNINSURED PATIENT DISCOUNTS A DISCOUNT FROM THE HOSPITAL'S REGULAR BILLED CHARGES WILL BE PROVIDED TO PATIENTS WHO DO NOT HAVE INSURANCE. THIS INCLUDES PATIENTS WHOSE FINANCIAL SITUATION NORMALLY WOULD NOT OTHERWISE QUALIFY THEM FOR CHARITY CARE DISCOUNTS. PATIENTS WITHOUT INSURANCE WHOSE FINANCIAL SITUATION QUALIFIES THEM FOR CHARITY CARE DISCOUNTS (SEE ELIGIBILITY GUIDELINES BELOW) 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 CHA
STATE FILING OF COMMUNITY BENEFIT REPORTAR, KS, MO,OK,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 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
JEFFREY A JOHNSTON
032556101667340213610138924015780066836000
JONATHAN R VITIELLO
0260553010834306342035784013653042467500
GRETA WILCHER
01898100668250292803236006131029805400

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
ExplanationFORM 990, SCHEDULE J, PART I, QUESTION 3 FOR THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS), THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT, AND REVIEW/APPROVAL OF COMPENSATION BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, MERCY HEALTH 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, SCHEDULE J, PART I, QUESTION 4B MERCY HOSPITAL WALDRON 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 JEFFREY JOHNSTON, JONATHAN VITIELLO AND GRETA WILCHER. 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 2011 (JULY 1, 2010 - JUNE 30, 2011) 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 AND ARE THEN TAKEN INTO ACCOUNT WHEN ANALYZING EXECUTIVE COMPENSATION FOR REASONABLENESS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationFORM 990, HEADING, BOX B DURING THE TAX YEAR ENDED JUNE 30, 2012, SISTERS OF MERCY HEALTH SYSTEM ("MERCY HEALTH") BEGAN A SYSTEM-WIDE REBRANDING INITIATIVE TO HELP PATIENTS, PHYSICIANS, CO-WORKERS, AND THE PUBLIC BETTER UNDERSTAND THE FULL SCOPE AND LOCATIONS OF MERCY HEALTH'S SERVICES. SEVERAL OF THE MERCY HEALTH AFFILIATES HAVE CHANGED OR ARE IN THE PROCESS OF CHANGING LEGAL NAMES. PRIOR TO FILING THE 2010 FORMS 990 (DUE MAY 15, 2012), MERCY HEALTH NOTIFIED THE IRS OF THESE NAME CHANGES, THEREFORE BOX B "NAME CHANGE" HAS NOT BEEN CHECKED ON THIS FORM 990. REFER TO SCHEDULE R, PART VI FOR A LIST OF THE NAME CHANGES. DESCRIPTION OF OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D OTHER HEALTH CARE PROGRAMS. EXPENSES: $8,647,730 INCLUDING GRANTS OF: $837 AND REVENUE: $4,904,248. THE CRITICAL ACCESS HOSPITAL IS ESSENTIAL TO THE HEALTH OF THE COMMUNITY. THE HOSPITAL OFFERS A WIDE VARIETY OF SERVICES, INCLUDING EMERGENCY SERVICES, ACUTE CARE, SHORT-TERM INPATIENT CARE, AS WELL AS MANY OTHERS THAT CONTRIBUTE TO GOOD HEALTH. THE COMMUNITY NEED IS REPRESENTED BY THE APPROXIMATELY 147,000 VISITS TO MERCY HOSPITAL WALDRON. FORM 1099/1096 FILING FORM 990, PART V, QUESTION 1A VENDORS FOR THE FILING ORGANIZATION ARE PAID BY MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE MERCY HEALTH (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINES 6, 7A, 7B THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HOSPITAL FORT SMITH. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES ARE RESERVED SOLELY FOR THE SOLE CORPORATE MEMBER: - ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION OPERATES; - APPOINT THE BOARD OF TRUSTEES OF THE CORPORATION; - AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION; - APPROVE THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION; AND, - APPROVE THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION. ONLY MERCY HEALTH SHALL HAVE THE RIGHT AND DUTY TO: - LEASE, SELL, OR ENCUMBER CORPORATE REAL ESTATE IN EXCESS OF ONE MILLION DOLLARS ($1,000,000), AND, IN ADDITION, TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION, AND, IN CONNECTION THEREWITH, GRANT ALL SECURITY INTERESTS, PLACE ALL ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ALL DOCUMENTS AND TAKE ALL ACTIONS NECESSARY IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; AND, - MERGE, DISSOLVE, OR ABANDON THE CORPORATION. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, USING INFORMATION PROVIDED BY THE FILING ORGANIZATION. A DRAFT FORM 990 IS REVIEWED BY THE FILING ORGANIZATION'S FINANCE TEAM, INCLUDING THE MANAGER OF ACCOUNTING AND THE VICE-PRESIDENT OF FINANCE. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE COMPLIANCE POLICY COVERAGE INCLUDES: CO-WORKERS, LEADERS, PROVIDERS, BOARD MEMBERS, AND ADMINISTRATORS. THE DETERMINATION OF A CONFLICT OF INTEREST IS MADE AND REVIEWED AT ALL LEVELS. A CORPORATE COMPLIANCE COMMITTEE MEETS TO REVIEW ANY CONFLICTS AND PROVIDE A REASONABLE ALTERNATIVE TO RESOLVE THE CONFLICT OF INTEREST, WHICH MAY INCLUDE SUPERVISORY PROCEDURES OR TRANSFER A DECISION-MAKING ROLE. BOARD MEMBERS INVOLVED IN THE CONFLICT ARE EXCLUDED FROM THE DELIBERATIONS AND DECISION MAKING PROCESS. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS HAVE BEEN MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY. AVERAGE HOURS PER WEEK FORM 990, PART VII, SECTION A, COLUMN B SEVERAL INDIVIDUALS LISTED IN PART VII ARE DISCLOSED AS TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ON MULTIPLE FORM 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. AUDIT OF FINANCIAL STATEMENTS FORM 990, PART XII, QUESTION 2B 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 2011(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 MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (64 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Advance Care Hospital
300 Werner St 3rd FloorHot SpringsAR71913710816634HospitalAR501(C)(3)3Mercy Health
Mercy Hospital Lebanon
100 Hospital DriveLebanonMO65536431767432HospitalMO501(C)(3)3MHSC
Mercy Health Foundation Berryville
214 Carter StreetBerryvilleAR72616710759301FoundationAR501(C)(3)11aMH Berryvill
Casa de Misericordia
1000 Mier StreetLaredoTX780404653742912461ShelterTX501(C)(3)7MM Laredo
Mercy Hospital Healdton
918 South StreetHealdtonOK73438263173902HospitalOK501(C)(3)3MH Ardmore
Laredo Medical Group
14528 S Outer Forty Ste 100ChesterfieldMO63017742764726InactiveTX501(C)(3)9MHS-TX
McAuley Portfolio Management Company
14528 S Outer Forty Ste 100ChesterfieldMO63017261708048Port MgmtMO501(C)(3)11bMercy Health
Mercy Hospital El Reno
2115 Parkview DriveEl RenoOK73036736617948HospitalOK501(C)(3)3Mercy Health
Mercy Emergency Medical Services Inc
4300 W Memorial RoadOklahoma CityOK73120810627035InactiveOK501(C)(3)9MHOC
Mercy Foundation for Health Innovation
14528 S Outer Forty Ste 100ChesterfieldMO63017200901499FoundationMO501(C)(3)11bMercy Health
Mercy Health Foundation Fort Scott
401 Woodland Hills BlvdFort ScottKS66701481077073FoundationKS501(C)(3)11cMercy KS Com
Mercy Health Foundation OK City
4300 W Memorial RoadOklahoma CityOK73120731593024FoundationOK501(C)(3)11aMHOC
Mercy Hospital Oklahoma City
4300 W Memorial RoadOklahoma CityOK73120730579285HospitalOK501(C)(3)3MHOC
Mercy Hospital Columbus
220 Pennsylvania AvenueColumbusKS66725270842031HospitalMO501(C)(3)3MHSMKC
Mercy Health Foundation Joplin
2727 McClelland BlvdJoplinMO64804270906136FoundationMO501(C)(3)11aMHSMKC
Mercy Hospital Joplin
2727 McClelland BlvdJoplinMO64804270814858HospitalMO501(C)(3)3MHSMKC
Mercy Health SW MOKS Communitites
2727 McClelland BlvdJoplinMO64804300584463Hlth SystemMO501(C)(3)11bMercy Health
Mercy Kansas Communities Inc
401 Woodland Hills BlvdFt ScottKS66701480956045HospitalKS501(C)(3)3MHSMKC
Mercy Health NW Arkansas Communities
2710 Rife Medical DriveRogersAR72758621684203Phys GroupAR501(C)(3)11bMercy Health
Mercy Health System of Texas Inc
14528 S Outer Forty Ste 100ChesterfieldMO63017742764727InactiveTX501(C)(3)11bMercy Health
Mercy Health Oklahoma Communities
4300 W Memorial RoadOklahoma CityOK73120731453048Holding co.OK501(C)(3)11bMercy Health
Mercy Health Foundation Independence
800 W MyrtleIndependenceKS67301481079981FoundationKS501(C)(3)11aMercy KS Com
Mercy Hospital of Laredo
14528 S Outer Forty Ste 100ChesterfieldMO63017741189682InactiveTX501(C)(3)3MHS-TX
Mercy Clinic East Communites
645 Maryville Centre Dr St 100St LouisMO63141431771217Phys GroupMO501(C)(3)9MHEC
Mercy Health Foundation Ardmore
1011 14th Avenue NWArdmoreOK73401710962525FoundationOK501(C)(3)11aMH Ardmore
Mercy Hospital Ardmore
1011 14th Avenue NWArdmoreOK73401731500629HospitalOK501(C)(3)3MHOC
Mercy Clinic Oklahoma Communities
4300 W Memorial RoadOklahoma CityOK73120270473057Phys GroupOK501(C)(3)9MHOC
MHM Support Services
14528 S Outer Forty Ste 100ChesterfieldMO63017202553101Sup Hlth SysMO501(C)(3)11bMercy Health
Mission Clinical Services
300 Werner StreetHot SpringsAR71913134239691nursing homeAR501(C)(3)9MHHSC
Mercy Hospital Berryville
214 Carter StreetBerryvilleAR72616710759299HospitalAR501(C)(3)3MHSC
Mercy Health
14528 S Outer Forty Ste 100ChesterfieldMO63017431423050Sup Hlth SysMO501(C)(3)1NA
Mercy Family Center
14528 S Outer Forty Ste 100ChesterfieldMO63017721069468counselingMO501(C)(3)7Mercy Health
Mercy Hospital Ozark
801 W River StreetOzarkAR72949710689680HospitalAR501(C)(3)3MHFS
Mercy Hospital Paris
500 E AcademyParisAR72855710655753HospitalAR501(C)(3)3MHFS
Mercy Clinic Fort Smith Communitites
7301 Rogers AvenueFort SmithAR72917261318597Phys ClinicAR501(C)(3)9MHFSC
St Edward Mercy Foundation
PO Box 17000Fort SmithAR72917237330425FoundationAR501(C)(3)7MHFS
Mercy Health Fort Smith Communities
7301 Rogers AvenueFort SmithAR72917261318515Holding Co.AR501(C)(3)11bMercy Health
Mercy Hospital Fort Smith
7301 Rogers AvenueFort SmithAR72917710240352HospitalAR501(C)(3)3MHFSC
Mercy St Francis Hospital
100 W Highway 60Mountain ViewMO65548440607149HospitalMO501(C)(3)3MHSC
Mercy Hospital Aurora
500 Porter AvenueAuroraMO65605431936696HospitalMO501(C)(3)3MHSC
Mercy Hospital Cassville
94 Main StreetCassvilleMO65625431936699HospitalMO501(C)(3)3MHSC
St John's Children's Hospital Inc
1235 E Cherokee StreetSpringfieldMO65804InactiveMO501(C)(3)3MHSC
Mercy Clinic Springfield Communities
1965 Fremont Street Ste 2950SpringfieldMO65804431560263Phys GroupMO501(C)(3)9MHSC
Mercy Health Foundation Springfield
1235 E Cherokee StreetSpringfieldMO65804320195818FoundationMO501(C)(3)11bMHSC
Mercy Health Springfield Communitites
1235 E Cherokee StreetSpringfieldMO65804431856028Holding CoMO501(C)(3)11bMercy Health
Mercy Home Health Berryville
214 Carter StreetBerryvilleAR72616870781247Home HealthAR501(C)(3)11cMH Sprngfld
Mercy Medical Research Institute
1235 E Cherokee StreetSpringfieldMO65804870796305ResearchMO501(C)(3)4MHSC
Mercy Health Foundation St Louis
14528 S Outer Forty Ste 100ChesterfieldMO63017562410020FoundationMO501(C)(3)11bMHEC
Mercy Health East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017431718408Hlth SystemMO501(C)(3)11bMercy Health
Mercy Hospitals East Communities
14528 S Outer Forty Ste 100ChesterfieldMO63017430653493HospitalMO501(C)(3)3MHEC
Mercy Health Foundation Washington
901 E Fifth StreetWashingtonMO63090562410022FoundationMO501(C)(3)11bMHEC
Mercy Support Services
615 S New Ballas RoadSt LouisMO63141431677952InactiveMO501(C)(3)11cMHEC
Mercy Hospital Springfield
1235 E Cherokee StreetSpringfieldMO65804440552485HospitalMO501(C)(3)3MHSC
Mercy Clinic Hot Springs Communitites
1 Mercy LaneHot SpringsAR71913261125131Phys ClinicAR501(C)(3)9MHHSC
Mercy Hospital Hot Springs
300 Werner StreetHot SpringsAR71913710236913HospitalAR501(C)(3)3MHHSC
Mercy Health Foundation Hot Springs
300 Werner StreetHot SpringsAR71913710804718FoundationAR501(C)(3)11bMHHS
Mercy Health Hot Springs Communities
300 Werner StreetHot SpringsAR71913261125064Holding CoAR501(C)(3)11bMercy Health
Mercy Hospital Rogers
2710 Rife Medical LaneRogersAR72758710294390HospitalAR501(C)(3)3MHNWAC
Mercy Health Foundation NW Arkansas
2710 Rife Medical LaneRogersAR72758710601687FoundationAR501(C)(3)11cMH Rogers
St Mary's Hospital of Enid Oklahoma
14528 S Outer Forty Ste 100ChesterfieldMO63017730614655InactiveOK501(C)(3)3MHOC
The Sister M Cornelia Blasko Foundation
100 W Highway 60Mountain ViewMO65548431873914FoundationMO501(C)(3)11aMSFH
Unity Ambulatory Care
645 Maryville Centre Dr St 100St LouisMO63141431861745InactiveMO501(C)(3)11cMHEC
Mercy Hospital Tishomingo
1000 South ByrdTishomingoOK73460274433830HospitalOK501(C)(3)3MH Ardmore
Mercy Ministries of Laredo
2500 ZacatecasLaredoTX780466814200198462outreachTX501(C)(3)7Mercy Health

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 (10 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 SmithKS66701481078101CATERINGKSNAC-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
MHP Inc
14528 S Outer Forty Suite 300ChesterfieldMO63017431697084HOLDING COMPDENAC-Corp
UH L Corp Inc
645 Maryville Centre Drive Suite 1St LouisMO63141742499535HOLDING COMPMONAC-Corp
Unity Support Services Inc
645 Maryville Centre Drive Suite 1St LouisMO63141431797042INACTIVEMONAC-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 EmployeesfalseSharingOfPaidEmployees
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 (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MHM SUPPORT SERVICES
o1079170
Resource Optimization & Innovation LLC
o215368
MERCY CLINIC FORT SMITH COMMUNITIES
P1487889

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE R, PART IIIdentifier
Explanation*MERCY MEDICAL GROUP IS NOW MERCY CLINIC EAST COMMUNITIES *ST. EDWARD MERCY CLINIC, INC. IS NOW MERCY CLINIC FORT SMITH COMMUNITIES *ST. JOSEPH'S MERCY CLINIC, INC. IS NOW MERCY CLINIC HOT SPRINGS COMMUNITIES *MERCY PHYSICIANS OF OKLAHOMA, INC. IS NOW MERCY CLINIC OKLAHOMA COMMUNITIES *ST. JOHN'S CLINIC, INC. IS NOW MERCY CLINIC SPRINGFIELD COMMUNITIES *SISTERS OF MERCY HEALTH SYSTEM IS NOW MERCY HEALTH *ST. JOHN'S MERCY HEALTH CARE IS NOW MERCY HEALTH EAST COMMUNITIES *ST. EDWARD MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH FORT SMITH COMMUNITIES *MERCY MEMORIAL HEALTH CENTER FOUNDATION IS NOW MERCY HEALTH FOUNDATION ARDMORE *CARROLL HEALTH FOUNDATION IS NOW MERCY HEALTH FOUNDATION BERRYVILLE *MERCY HEALTH CENTER FOUNDATION IS NOW MERCY HEALTH FOUNDATION FORT SCOTT *ST. JOSEPH'S MERCY HEALTH FOUNDATION IS NOW MERCY HEALTH FOUNDATION HOT SPRINGS *MERCY HOSPITAL FOUNDATION OF INDEPENDENCE, INC. IS NOW MERCY HEALTH FOUNDATION INDEPENDENCE *MERCY HEALTH OF JOPLIN FOUNDATION IS NOW MERCY HEALTH FOUNDATION JOPLIN *ST. MARY'S HOSPITAL FOUNDATION IS NOW MERCY HEALTH FOUNDATION NORTHWEST ARKANSAS *MERCY HEALTH CENTER FOUNDATION, INC. IS NOW MERCY HEALTH FOUNDATION OKLAHOMA CITY *ST. JOHN'S FOUNDATION FOR COMMUNITY HEALTH INC. IS NOW MERCY HEALTH FOUNDATION SPRINGFIELD *ST. JOHN'S MERCY FOUNDATION IS NOW MERCY HEALTH FOUNDATION ST. LOUIS *ST. JOHN'S MERCY HOSPITAL FOUNDATION IS NOW MERCY HEALTH FOUNDATION WASHINGTON *ST. JOSEPH'S MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH HOT SPRINGS COMMUNITIES *MERCY HEALTH SYSTEM OF NORTHWEST ARKANSAS, INC. IS NOW MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES *MERCY HEALTH SYSTEM, INC. IS NOW MERCY HEALTH OKLAHOMA COMMUNITIES *MERCY HEALTH SYSTEM-JOPLIN, INC. IS NOW MERCY HEALTH SOUTHWEST MISSOURI/KANSAS COMMUNITIES *ST. JOHN'S HEALTH SYSTEM, INC. IS NOW MERCY HEALTH SPRINGFIELD COMMUNITIES *ST. JOHN'S HOME CARE OF BERRYVILLE, INC. IS NOW MERCY HOME HEALTH BERRYVILLE *MERCY MEMORIAL HEALTH CENTER, INC. IS NOW MERCY HOSPITAL ARDMORE *ST. JOHN'S AURORA, INC. IS NOW MERCY HOSPITAL AURORA *OZARKS REGIONS HEALTH SYSTEM, INC. IS NOW MERCY HOSPITAL BERRYVILLE *ST. JOHN'S CASSVILLE, INC. IS NOW MERCY HOSPITAL CASSVILLE *MERCY HEALTH MHMCH, INC. IS NOW MERCY HOSPITAL COLUMBUS *MERCY EL RENO HOSPITAL CORPORATION IS NOW MERCY HOSPITAL EL RENO *ST. EDWARD MERCY MEDICAL CENTER IS NOW MERCY HOSPITAL FORT SMITH *HEALDTON MERCY HOSPITAL CORPORATION IS NOW MERCY HOSPITAL HEALDTON *ST. JOSEPH'S MERCY HEALTH CENTER IS NOW MERCY HOSPITAL HOT SPRINGS *MERCY HEALTH OF JOPLIN, INC. IS NOW MERCY HOSPITAL JOPLIN *BREECH REGIONAL MEDICAL CENTER IS NOW MERCY HOSPITAL LEBANON *MERCY HEALTH CENTER, INC. IS NOW MERCY HOSPITAL OKLAHOMA CITY *ST. EDWARD HEALTH FACILITIES OF FRANKLIN COUNTY IS NOW MERCY HOSPITAL OZARK *ST. EDWARD HEALTH FACILITIES OF LOGAN COUNTY IS NOW MERCY HOSPITAL PARIS *ST. EDWARD HEALTH FACILITIES OF SCOTT COUNTY IS NOW MERCY HOSPITAL WALDRON *ST. MARY-ROGERS MEMORIAL HOSPITAL, INC. IS NOW MERCY HOSPITAL ROGERS *ST. JOHN'S REGIONAL HEALTH CENTER IS NOW MERCY HOSPITAL SPRINGFIELD *MERCY TISHOMINGO HOSPITAL CORPORATION IS NOW MERCY HOSPITAL TISHOMINGO *ST. JOHN'S MERCY HEALTH SYSTEM IS NOW MERCY HOSPITALS EAST COMMUNITIES *ST. JOHN'S MERCY MEDICAL CENTER IS NOW MERCY HOSPITAL ST LOUIS *ST. JOHN'S MERCY HOSPITAL IS NOW MERCY HOSPITAL SPRINGFIELD *MERCY HEALTH SYSTEM OF KANSAS, INC. IS NOW MERCY KANSAS COMMUNITIES *MERCY HEALTH CENTER, INC. IS NOW MERCY HOSPITAL FORT SCOTT *MERCY HOSPITAL IS NOW MERCY HOSPITAL INDEPENDENCE *ST. JOHN'S MEDICAL RESEARCH INSTITUTE, INC. IS NOW MERCY MEDICAL RESEARCH INSTITUTE *ST. FRANCIS HOSPITAL, MOUNTAIN VIEW, MISSOURI IS NOW MERCY ST. FRANCIS HOSPITAL *ST. JOHN'S MERCY SUPPORT SERVICES IS NOW MERCY SUPPORT SERVICES FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY HEALTH SYSTEM, INC. 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.Explanation

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.