2012-05-14T16:13:41-05:00 2011-06-30 ERNST & YOUNG US LLP 190 CARONDELET PLAZA SUITE 1300 CLAYTON MO 63105 990 2010-07-01 261125131 MERCY CLINIC HOT SPRINGS COMMUNITIES f/k/a St Joseph's Mercy Clinic Inc MERC 3146283557 300 Werner PO Box 29001 Hot Springs AR 71913 Andrew D Runge 2012-05-07 3142901000 2010 2016-02-24 21:20:13Z Marc Gunter MD PO Box 29001 Hot Springs AR 71903 58258719 false X www.mercy.net X 2007 AR AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 10 0 657 0 0 0 0 0 41083352 58195070 0 520 0 63129 41083352 58258719 0 0 0 0 31178318 51642719 0 0 0 16376059 21731193 47554377 73373912 -6471025 -15115193 6881147 13429777 17269490 37565895 -10388343 -24136118 AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. false false 68258002 0 58258199 MERCY CLINIC HOT SPRINGS COMMUNITIES PROVIDES QUALITY CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. THE TAXPAYER PROVIDES SERVICES TO 367,029 PATIENTS IN OFFICE VISITS, 6,454 SURGICAL PATIENTS, AND 7,211 HOSPITALS ADMITTED PATIENTS. 68258002 true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true true true false false true X 0 0 657 true false false false false false false false false false false X 10 0 false false false false true true true true true false false false true true true true true true true false AR X SARA BRADLEY VP FINANCE 5016221980 PO Box 29001 Hot Springs AR 71903 Jaime Cardenas MD 60.0 X 466700 10495 32145 Mark Floyd 60.0 X 224393 0 30096 Kyle Roper MD 60.0 X 250116 0 29841 Charles Larrison MD 60.0 X 291374 0 36673 Nizar Suleman MD 60.0 X 654797 0 26100 Patrick A Dolan MD 60.0 X X 358808 0 25197 Marcus E Gunter 60.0 X X 596562 0 124188 Timothy Johnsen 60.0 X X 0 489995 136083 MICHAEL C BODEMANN 60.0 X 119805 0 5774 ROBERT J OLIVE 60.0 X 188877 0 14812 Jonathan Vitiello 60.0 X 0 375238 49437 Amy N Gordon 60.0 X 463760 0 26628 Clinton M Henson MD 60.0 X 464970 0 35570 Thomas Hollis Jr MD 60.0 X 258724 240 31347 Joe Howe 60.0 X 581131 2999 49207 Prabhakara R Kaliki 60.0 X 589761 0 44287 Andrew D Runge 60.0 X 251627 0 25793 John W Webb 60.0 X 440106 0 32321 Robert W Aspell 60.0 X 226475 0 38904 Michael Atta 60.0 X 143675 106701 26506 Thomas Hollis Sr MD 60.0 X 200360 11180 35772 Hosam Kamel 60.0 X 0 301458 25347 Rimantas Kazakevicius 60.0 X 348245 0 30681 Mark Larey 60.0 X 28228 298304 36929 Michael Verser 60.0 X 288874 0 36140 Gregory V Whorton 60.0 X 373931 8747 32377 Greg A St John 60.0 X 501833 0 13555 Robert D Johnson 60.0 X 428308 0 34752 Frederick M Heinemann 60.0 X 428240 0 30122 Manjusha Kota 60.0 X 400457 12500 19741 Stanley S Josef 60.0 X 399291 0 20009 Jerri L Lynne Mitchell 0.0 X 0 400457 23593 9969428 2018314 1159927 74 true true false COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM PHYS SERVICES 874063 NABHOLZ CONSTRUCTION 612 GARLAND ST CONWAY AR 72033 CONTRACTING SERVICES 745043 ADV CARE HOSP 7301 ROGERS AVE FORT SMITH AR 72917 LAB PURCHASED SVCS 230162 GE HEALTHCARE IITS USA CORP 15724 COLLECTIONS CENTER DR CHICAGO IL 60693 SOFTWARE MAINT 156329 GUNTER SMITH PROF CLEANING SERV 1620 S 9TH ST ROGERS AR 72756 CLEANING SERVICES 149004 5 0 HEALTHCARE SERVICES 621110 57734670 57734670 Research Revenue 621110 460400 460400 58195070 520 520 0 0 0 0 0 0 Management Fees 621110 13388 13388 Miscellaneous Revenue 900099 49741 49741 63129 58258719 58258199 520 0 0 0 0 9088120 8502087 586033 0 34390898 31513590 2877308 1424121 1304220 119901 4186921 3784332 402589 2552659 2364798 187861 0 20405 7732 12673 0 0 0 0 2076386 1941766 134620 51829 49838 1991 10144402 9986235 158167 457243 383251 73992 0 4294865 4063396 231469 189651 125748 63903 0 14857 13317 1540 31823 31823 0 797517 755715 41802 536623 536630 -7 Bad Debt 2444513 2436255 8258 Dues 187591 180425 7166 Taxes 250946 249234 1712 MISCELLANEOUS 232542 59433 173109 73373912 68258002 5115910 0 0 12891 3820606 7761677 423176 585665 470555 644598 84797 98698 8516240 4189992 2082013 4326248 6881147 13429777 13859979 5840066 3409511 31725829 17269490 37565895 X -10388343 -24136118 -10388343 -24136118 6881147 13429777 X -15115193 1367418 X X false true true X false X 119690 18753 100937 8396550 4171239 4225311 4326248 0 INTERCOMPANY PAYABLE 7484417 Depository Accounts - BOA 24241412 31725829 ASC 740 FOOTNOTE SUPPLEMENTAL INFORMATION THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH AND SUBSIDIARIES DO NOT INCLUDE A FOOTNOTE TO REPORT THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER ASC 740, AS THEY ARE DEEMED IMMATERIAL FOR DISCLOSURE. X X X X true true true true false false false false false true false Jaime Cardenas MD 407328 2195 37350 0 22022 8300 13630 0 18045 470 498375 10965 0 0 Mark Floyd 185172 0 1605 0 37616 0 16622 0 13474 0 254489 0 0 0 Kyle Roper MD 190034 0 30752 0 29330 0 12413 0 17428 0 279957 0 0 0 Charles Larrison MD 203706 0 37500 0 50168 0 19085 0 17588 0 328047 0 0 0 Nizar Suleman MD 613517 0 20600 0 20680 0 10798 0 15302 0 680897 0 0 0 Patrick A Dolan MD 305663 0 27963 0 25182 0 16591 0 8606 0 384005 0 0 0 Marcus E Gunter 464927 0 110859 0 20776 0 104875 0 19313 0 720750 0 0 0 Timothy Johnsen 0 325407 0 144390 0 20198 0 121272 0 14811 0 626078 0 0 Jonathan Vitiello 0 260553 0 108343 0 6342 0 35784 0 13653 0 424675 0 0 Amy N Gordon 415487 0 42020 0 6253 0 8054 0 18574 0 490388 0 0 0 Clinton M Henson MD 404283 0 39885 0 20802 0 16591 0 18979 0 500540 0 0 0 Thomas Hollis Jr MD 197487 240 24971 0 36266 0 13468 0 17861 18 290053 258 0 0 Joe Howe 511291 -1 20000 0 49840 3000 29865 0 19250 92 630246 3091 0 0 Prabhakara R Kaliki 531763 0 20000 0 37998 0 24708 0 19579 0 634048 0 0 0 Andrew D Runge 182244 0 44611 0 24772 0 12718 0 13075 0 277420 0 0 0 John W Webb 369484 0 50503 0 20119 0 13630 0 18691 0 472427 0 0 0 Robert W Aspell 153163 0 29651 0 43661 0 25632 0 13272 0 265379 0 0 0 Michael Atta 106922 69692 0 0 36753 37009 12204 0 7116 7186 162995 113887 0 0 Thomas Hollis Sr MD 136085 10062 23289 0 40986 1118 24918 0 10854 0 236132 11180 0 0 Hosam Kamel 0 210861 0 53986 0 36611 0 12130 0 13217 0 326805 0 0 Rimantas Kazakevicius 280326 0 41858 0 26061 0 16671 0 14010 0 378926 0 0 0 Mark Larey 26331 247767 0 9642 1897 40895 0 22343 1474 13112 29702 333759 0 0 Michael Verser 221292 0 23971 0 43611 0 17895 0 18245 0 325014 0 0 0 Gregory V Whorton 318445 -381 32750 0 22736 9128 13630 0 18485 262 406046 9009 0 0 Greg A St John 366953 0 100000 0 34880 0 9800 0 3755 0 515388 0 0 0 Robert D Johnson 359667 0 20000 0 48641 0 20445 0 14307 0 463060 0 0 0 Frederick M Heinemann 383360 0 26500 0 18380 0 19600 0 10522 0 458362 0 0 0 Manjusha Kota 363757 0 0 0 36700 12500 8062 0 11679 0 420198 12500 0 0 Stanley S Josef 397411 0 0 0 1880 0 12250 0 7759 0 419300 0 0 0 Jerri L Lynne Mitchell 0 69418 0 79597 0 251442 0 21145 0 2448 0 424050 0 0 ROBERT J OLIVE 152403 0 30000 0 6474 0 11151 0 3661 0 203689 0 0 0 Supplemental Compensation Information FORM 990, SCHEDULE J, PART I, QUESTION 1A CHARTER TRAVEL IS PROVIDED TO ALL EMPLOYEES AS DEEMED NECESSARY FOR BUSINESS TRAVEL AND PURSUANT TO THE APPROVAL BY THE FINANCE DEPARTMENT. 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 UNDER LIMITED CIRCUMSTANCES 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. HOUSING BENEFITS ARE PROVIDED THROUGH A RELOCATION PROGRAM IN ACCORDANCE WITH COMPANY POLICY. SUCH BENEFITS ARE SUBJECT TO TAX TO THE EMPLOYEE. PAYMENT BY THE COMPANY OF COSTS FOR TEMPORARY HOUSING BY EMPLOYEES FOR THE CONVENIENCE OF THE COMPANY IS MADE IN ACCORDANCE WITH THE CO-WORKER TRAVEL AND OTHER EXPENSE POLICY AND PROCEDURES. AS A REIMBURSABLE EXPENSE, THIS TYPE OF LODGING IS NOT TAXABLE TO THE EMPLOYEE. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY CLINIC HOT SPRINGS COMMUNITIES RELIES ON A RELATED ORGANIZATION; REFER TO SCHEDULE O, PART VI, QUESTION 15A AND 15B FOR THE PROCESS THE RELATED ORGANIZATION FOLLOWS. FORM 990, SCHEDULE J, PART I, QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR 2010: JERRI L. MITCHELL, $221,887 FORM 990, SCHEDULE J, PART I, QUESTION 4B MERCY CLINIC HOT SPRINGS COMMUNITIES 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 MARCUS GUNTER, TIMOTHY JOHNSEN, LYNNE MITCHELL AND JON VITIELLO. 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. GUNTER SMITH PROFESS CLEANING SERV BRTHR OF M. GUNTER, PRES 149004 PVDES CLEANING SRVS TO CLINIC false SUPPLEMENTAL INFORMATION FORM 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 VII FOR A LIST OF THE NAME CHANGES. 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. 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 UNTO THE CORPORATE MEMBER: - ADOPT OR AMEND THE MISSION AND PHILOSOPHY OF THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - ADOPT OR AMEND THE STRATEGIC PLANS, GOALS, AND OBJECTIVES OF THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - ADOPT OR AMEND THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND ANY CHANGES IN SUCH BUDGETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER; - REVIEW AND APPROVE ANY CAPITAL EXPENDITURES OR RECOMMENDATIONS NOT PREVIOUSLY APPROVED AS PART OF THE CORPORATION'S BUDGETS; - AUTHORIZE OR APPROVE THE ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION OR INTEREST THEREIN IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER; - AUTHORIZE OR APPROVE THE GRANT OF ANY PLEDGE, LIEN, ENCUMBRANCE, MORTGAGE, DEED OF TRUST OR OTHER SECURITY INTEREST IN ANY OR ALL OF THE ASSETS OF THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - AUTHORIZE OR APPROVE THE INCURRENCE OF DEBT (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION AND THE GRANT OF ANY SECURITY INTERESTS, THE PLACEMENT OF ANY ENCUMBRANCES, THE ENTERING INTO ANY COVENANTS, AND THE EXECUTION OF ANY DOCUMENTS AND THE TAKING OF ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; - MERGE, DISSOLVE OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - AMEND THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION; - APPOINT DIRECTORS PURSUANT TO THE PROCESS SET FORTH IN SECTION 5.2 HEREOF; - ESTABLISH ALL COMPENSATION AND BENEFIT TERMS FOR PHYSICIANS AND OTHER MEDICAL PROFESSIONALS EMPLOYED OR OTHERWISE RETAINED BY THE CORPORATION; - REMOVE DIRECTORS WITH OR WITHOUT CAUSE; - APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION CONTROLLED BY THE CORPORATION; - APPROVE CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS, SUBJECT TO CONSULTATION WITH THE MANAGED CARE CONTRACTING COMMITTEE OF THE MEMBER; - APPROVE THE CLINIC'S MANPOWER PLAN; - THROUGH THE SOLE ACTION OF THE PRESIDENT OF THE MEMBER (WITH THE APPROVAL OF THE PRESIDENT OF MH), APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION; AND - AUTHORIZE AND AMEND THE CHARITY CARE POLICY OF THE CLINIC. 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 VARIOUS REVIEWS 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 THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF MERCY HEALTH HOT SPRINGS COMMUNITIES AND ALL OF ITS SUBSIDIARY CORPORATIONS (COLLECTIVELY REFERRED TO AS "MHHC") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF A CO-WORKER, A MEMBER OF MANAGEMENT OR BOARD MEMBER OF MHHC. THE PRESIDENT OF EACH CORPORATION AND SUB-DIVISION SHALL BE RESPONSIBLE FOR ADMINISTERING THE ANNUAL STATEMENTS OF DISCLOSURE FOR THEIR BOARD MEMBERS AND EXECUTIVE LEADERSHIP TEAM. THE MHSC VICE-PRESIDENT OF HUMAN RESOURCES OR HIS/HER DESIGNEE SHALL BE RESPONSIBLE FOR ADMINISTERING ANNUAL STATEMENTS OF DISCLOSURE FOR SYSTEM SENIOR MANAGEMENT AND ADMINISTRATIVE COUNCIL. TO ENSURE THAT MHHC OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED BY MERCY HEALTH'S LEGAL DEPARTMENT. 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 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, 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 HAVE BEEN 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 TRANSFER OF NET ASSETS FROM MCS - $1,367,418 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 RECEIVE 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'S BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. Advance Care Hospital 300 Werner St 3rd Floor Hot Springs AR 71913 710816634 Hospital AR 501(C)(3) 3 Mercy Health Mercy Hospital Lebanon 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501(C)(3) 3 MHSC Mercy Health Foundation Berryville 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501(C)(3) 11a MH Berryvill Casa de Misericordia 1000 Mier Street Laredo TX 780404653 742912461 Shelter TX 501(C)(3) 7 MM Laredo Mercy Hospital Healdton 918 South Street Healdton OK 73438 263173902 Hospital OK 501(C)(3) 3 MH Ardmore Laredo Medical Group 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764726 Inactive TX 501(C)(3) 9 MHS-TX McAuley Portfolio Management Company 14528 S Outer Forty Ste 100 Chesterfield MO 63017 261708048 Port Mgmt MO 501(C)(3) 11b Mercy Health Mercy Hospital El Reno 2115 Parkview Drive El Reno OK 73036 736617948 Hospital OK 501(C)(3) 3 Mercy Health Mercy Emergency Medical Services Inc 4300 W Memorial Road Oklahoma City OK 73120 810627035 Inactive OK 501(C)(3) 9 MHOC Mercy Foundation for Health Innovation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 501(C)(3) 11b Mercy Health Mercy Health Foundation Fort Scott 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501(C)(3) 11c Mercy KS Com Mercy Health Foundation OK City 4300 W Memorial Road Oklahoma City OK 73120 731593024 Foundation OK 501(C)(3) 11a MHOC Mercy Hospital Oklahoma City 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501(C)(3) 3 MHOC Mercy Hospital Columbus 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 501(C)(3) 3 MHSMKC Mercy Health Foundation Joplin 2727 McClelland Blvd Joplin MO 64804 270906136 Foundation MO 501(C)(3) 11a MHSMKC Mercy Hospital Joplin 2727 McClelland Blvd Joplin MO 64804 270814858 Hospital MO 501(C)(3) 3 MHSMKC Mercy Health SW MOKS Communitites 2727 McClelland Blvd Joplin MO 64804 300584463 Hlth System MO 501(C)(3) 11b Mercy Health Mercy Kansas Communities Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501(C)(3) 3 MHSMKC Mercy Health NW Arkansas Communities 2710 Rife Medical Drive Rogers AR 72758 621684203 Phys Group AR 501(C)(3) 11b Mercy Health Mercy Health System of Texas Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764727 Inactive TX 501(C)(3) 11b Mercy Health Mercy Health Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 731453048 Holding co. OK 501(C)(3) 11b Mercy Health Mercy Health Foundation Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501(C)(3) 11a Mercy KS Com Mercy Hospital of Laredo 14528 S Outer Forty Ste 100 Chesterfield MO 63017 741189682 Inactive TX 501(C)(3) 3 MHS-TX Mercy Clinic East Communites 645 Maryville Centre Dr St 100 St Louis MO 63141 431771217 Phys Group MO 501(C)(3) 9 MHEC Mercy Health Foundation Ardmore 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501(C)(3) 11a MH Ardmore Mercy Hospital Ardmore 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501(C)(3) 3 MHOC Mercy Clinic Oklahoma Communities 4300 W Memorial Road Oklahoma City OK 73120 270473057 Phys Group OK 501(C)(3) 9 MHOC MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 Sup Hlth Sys MO 501(C)(3) 11b Mercy Health Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 nursing home AR 501(C)(3) 9 MHHSC Mercy Hospital Berryville 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501(C)(3) 3 MHSC Mercy Health 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 Sup Hlth Sys MO 501(C)(3) 1 NA Mercy Family Center 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 counseling MO 501(C)(3) 7 Mercy Health Mercy Hospital Ozark 801 W River Street Ozark AR 72949 710689680 Hospital AR 501(C)(3) 3 MHFS Mercy Hospital Paris 500 E Academy Paris AR 72855 710655753 Hospital AR 501(C)(3) 3 MHFS Mercy Hospital Waldron 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501(C)(3) 3 MHFS Mercy Clinic Fort Smith Communitites 7301 Rogers Avenue Fort Smith AR 72917 261318597 Phys Clinic AR 501(C)(3) 9 MHFSC St Edward Mercy Foundation PO Box 17000 Fort Smith AR 72917 237330425 Foundation AR 501(C)(3) 7 MHFS Mercy Health Fort Smith Communities 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Co. AR 501(C)(3) 11b Mercy Health Mercy Hospital Fort Smith 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501(C)(3) 3 MHFSC Mercy St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501(C)(3) 3 MHSC Mercy Hospital Aurora 500 Porter Avenue Aurora MO 65605 431936696 Hospital MO 501(C)(3) 3 MHSC Mercy Hospital Cassville 94 Main Street Cassville MO 65625 431936699 Hospital MO 501(C)(3) 3 MHSC St John's Children's Hospital Inc 1235 E Cherokee Street Springfield MO 65804 431423050 Inactive MO 501(C)(3) 3 MHSC Mercy Clinic Springfield Communities 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 Phys Group MO 501(C)(3) 9 MHSC Mercy Health Foundation Springfield 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501(C)(3) 11b MHSC Mercy Health Springfield Communitites 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Co MO 501(C)(3) 11b Mercy Health Mercy Home Health Berryville 214 Carter Street Berryville AR 72616 870781247 Home Health AR 501(C)(3) 11c MH Sprngfld Mercy Medical Research Institute 1235 E Cherokee Street Springfield MO 65804 870796305 Research MO 501(C)(3) 4 MHSC Mercy Health Foundation St Louis 14528 S Outer Forty Ste 100 Chesterfield MO 63017 562410020 Foundation MO 501(C)(3) 11b MHEC Mercy Health East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431718408 Hlth System MO 501(C)(3) 11b Mercy Health Mercy Hospitals East Communities 14528 S Outer Forty Ste 100 Chesterfield MO 63017 430653493 Hospital MO 501(C)(3) 3 MHEC Mercy Health Foundation Washington 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501(C)(3) 11b MHEC Mercy Support Services 615 S New Ballas Road St Louis MO 63141 431677952 Inactive MO 501(C)(3) 11c MHEC Mercy Hospital Springfield 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501(C)(3) 3 MHSC Mercy Hospital Hot Springs 300 Werner Street Hot Springs AR 71913 710236913 Hospital AR 501(C)(3) 3 MHHSC Mercy Health Foundation Hot Springs 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501(C)(3) 11b MHHS Mercy Health Hot Springs Communities 300 Werner Street Hot Springs AR 71913 261125064 Holding Co AR 501(C)(3) 11b Mercy Health Mercy Hospital Rogers 2710 Rife Medical Lane Rogers AR 72758 710294390 Hospital AR 501(C)(3) 3 MHNWAC Mercy Health Foundation NW Arkansas 2710 Rife Medical Lane Rogers AR 72758 710601687 Foundation AR 501(C)(3) 11c MH Rogers St Mary's Hospital of Enid Oklahoma 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 501(C)(3) 3 MHOC The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501(C)(3) 11a MSFH Unity Ambulatory Care 645 Maryville Centre Dr St 100 St Louis MO 63141 431861745 Inactive MO 501(C)(3) 11c MHEC Mercy Hospital Tishomingo 1000 South Byrd Tishomingo OK 73460 274433830 Hospital OK 501(C)(3) 3 MH Ardmore Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 780466814 200198462 outreach TX 501(C)(3) 7 Mercy Health Merc Ambu Surg CTR 7301 Rogers Av Fort Smith AR 72903 710827721 AMBUL SURG CENTER AR NA RES OPT & INNOV 645 Maryville Centre Dr 200 St Louis MO 63141 460468368 CENTRAL DIST. MO NA SO OK DIAG CTR 1011 14TH Ave NW Ardmore OK 73401 431971232 MRI Services OK NA Fort Smith EMS 1701 S Greenwood Fort Smith AR 72901 710416615 Emergency Med AR NA St Ed Mer Med MOB 7301 Rogers Ave Fort Smith AR 72903 710554050 Office Building AR NA Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 HOLDING COMP DE NA C-Corp Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 IT SERVICES MO NA C-Corp Mercy Community Services Inc 401 Woodland Hills Blvd Fort Smith KS 66701 481078101 CATERING KS NA C-Corp Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 REAL ESTATE OK NA C-Corp Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 HEALTH CARE OK NA C-Corp Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 HEALTH CARE OK NA C-Corp Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 HOLDING COMP OK NA C-Corp MHP Inc 14528 S Outer Forty Suite 300 Chesterfield MO 63017 431697084 HOLDING COMP DE NA C-Corp UH L Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 HOLDING COMP MO NA C-Corp Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 INACTIVE MO NA C-Corp false false false false false false false false false false false false false true true true false false MERCY HOSPITAL HOT SPRINGS N 199484 MHM SUPPORT SERVICES O 4671223 RESOURCE OPTIMIZATION & INNOVATION LLC O 131821 MERCY HOSPITAL HOT SPRINGS O 2086700 MISSION CLINICAL SERVICES O 50585 MERCY HEALTH HOT SPRINGS COMMUNITIES O 1444672 MERCY HEALTH P 1330784 FORM 990, SCHEDULE R, PART II *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 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.