2011-05-13T09:56:24-05:00 2010-06-30 ERNST & YOUNG US LLP 190 CARONDELET PLAZA SUITE 1300 CLAYTON MO 63105 990 2009-07-01 710294390 St Mary-Rogers Memorial Hospital STMA 4793382903 2710 Rife Medical Lane Rogers AR 72758 Benny Sotver 2011-05-05 3142901000 2009 2016-02-24 21:20:13Z Mercy Medical Center Benny J Stover CPA 2710 Rife Medical Lane Rogers AR 72758 138289343 false 0928 X WWW.mercy4u.com X 1995 AR AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 6 3 993 130 0 0 0 0 334339755 137030486 8042003 48098 936367 1210759 343318125 138289343 8030000 32500 0 0 43208043 43919127 0 0 0 287465390 85834295 338703433 129785922 4614692 8503421 177550552 184343315 111582364 108948969 65968188 75394346 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 35256976 55500157 INPATIENT HEALTHCARE: The Hospital is a full service medical facility that provides quality inpatient healthcare to all patients regardless of their ability to pay. The inpatient hospital is licensed for 147 acute beds, and 18 newborn beds, for a total of 165 beds. During the fiscal year ended June 30, 2010, acute discharges were 8,680, and acute patient days were 29,161. Newborn acute discharges were 1,509 and newborn patient days were 2,490. 15450530 22581550 SURGICAL SERVICES: The Hospital provides a broad scope of surgical services, on both and inpatient and outpatient basis. During the fiscal year ended June 30, 2010, the hospital performed 2,834 inpatient surgeries and 5,736 outpatient surgeries. 4340280 8428019 EMERGENCY SERVICES: The hospital provides 24 hour emergency services, and provides such services regardless of ability to pay. During the fiscal year ended June 30, 2010, the hospital provided 39,611 emergency visits. Of this amount, 33,683 were treated and sent home, while 5,928 became inpatient admissions. 32071298 32500 51317443 87119084 true false false true false false false false false true false true false false false false false false false false true true false true false false false false false false false false false false false false false true true false false true 0 0 true 993 true false false false false false false false false false 6 3 false false false false true true true true true false false true true true true true true true true false X BENNY J STOVER CPA 4793382903 2710 RIFE MEDICAL LANE ROGERS AR 72758 Paul Bergant 1.0 X 0 0 0 Sister Annrene Brau RSM 1.0 X 0 0 0 Wayne Callahan 1.0 X 0 0 0 Donna Johnson 1.0 X 3395 345437 30189 Dr James Byrum 1.0 X 0 220177 32143 George Flynn 40.0 X X 0 517731 143317 Scott Street 40.0 X X 0 0 0 Jon Vitiello 40.0 X 0 316771 38423 Benny J Stover 40.0 X 0 166709 12535 Michele Stewart 40.0 X 0 244988 69376 James L Johnson 40.0 X 150389 0 31016 Charlotte Rankin 40.0 X 141596 0 10652 Robert Donnell 40.0 X 235443 0 45263 Harry Lazarte 40.0 X 290472 0 17674 James Merritt 40.0 X 249119 0 18392 Ralph Ritz 40.0 X 235671 0 22879 Cynthia Wilson 40.0 X 284906 0 26740 Susan Barrett 0.0 X 0 590410 101948 1590991 2402223 600547 37 true true false Pinnacle Radiology 4500 S Garnett STE 919 TULSA OK 74146 Patient SRVC MNGMNT 656475 3M Company PO Box 844127 DALLAS TX 75284 Prof Srvc (Prgm Imp) 255100 Cornerstone Healthcare 222 S First Street ROGERS AR 72756 Prof Srvc (Staffing) 486621 Linen King 14780 S Memorial BIXBY OK 74008 Linen PRCHSD SRCVS 308425 Wound Care Centers PO Box 850001 ORLANDO FL 32885 Patient SRVC MNGMNT 302419 14 0 PATIENT SERVICES 624100 50520760 50520760 SURGICAL SERVICES 624100 22581550 22581550 INPATIENT HEALTHCARE 624100 55500157 55500157 EMERGENCY SERVICES 624100 8428019 8428019 137030486 35586 35586 0 0 414076 414076 414076 414076 12512 12512 12512 12512 0 0 0 Misc Revenue 624100 338455 338455 Cafeteria and Vending 624100 458228 458228 796683 138289343 137368941 920402 32500 32500 0 0 0 320802 320802 0 34543036 30418248 4124788 1569001 1345828 223173 4880997 4301064 579933 2605291 2296564 308727 343467 341367 2100 0 0 0 0 0 5488301 4351468 1136833 6178 3502 2676 39780355 25537350 14243005 5959567 297 5959270 2600 2600 2258878 513243 1745635 230752 174168 56584 0 52974 12605 40369 5860030 5860030 0 10375032 2842526 7532506 106368 20550 85818 PROVISION FOR BAD DEBT 14392680 14392680 REPAIRS AND MAINTENANCE 761856 156442 605414 All Other Expenses 215257 57880 157377 129785922 87119084 42666838 0 1 8263590 9930490 54512 15399312 16512220 2338148 2078354 1928277 1969864 446590 66205 183277626 52807744 138054450 130469882 9453284 24928688 177550552 184343315 111047582 9258589 534782 398242 99292138 111582364 108948969 X 65968188 75394346 65968188 75394346 177550552 184343315 X false true true X true true X false false false false false false false false true 11404 11404 false Lobbying Portion of Dues Part II-B, Line 1(i) The filing organization is a member of and pays dues to the following hospital associations: American Hospital Association, Arkansas Hospital Association, and Catholic Health Association. For the year ended June 30, 2010, dues were $12,847, $39,293, and $27,642, respectively. Approximately 25% of American Hospital Association dues, 17% of Arkansas Hospital Association dues, and 5.46% of Catholic Health Association dues were attributable to lobbying activities performed by these associations. 5694080 5694080 133940885 22478968 111461917 1477392 335494 1141898 40806158 29993282 10812876 1359111 1359111 130469882 DUE FROM AFFILIATE 23463530 INVESTMENT IN SUBSIDIARY 91707 3RD PARTY SETTLEMENTS 1373451 24928688 Supplemental Information FIN 48 Footnote The consolidated audited financial statements of the Sisters of Mercy Health System, Inc. and Subsidiaries do not include a footnote to report the organization's liability for uncertain tax provisions under FIN 48, as they are deemed immaterial for disclosure. true true X true X true X true true true false true true 4075778 4075778 0.03200 16485898 15028043 1457855 0.01150 20561676 15028043 5533633 0.04350 5 1777 23689 23689 0.00020 2 93 214493 214493 0.00170 2 3712 113683 113683 0.00090 9 5582 351865 351865 0.00280 9 5582 20913541 15028043 5885498 0.04630 1 232 232 0.00000 1 232 232 0.00000 true 4528873 0 32908618 34651170 -1742552 X true true St Marys-Rogers Memorial Hospital

2710 Rife Medical Lane Rogers AR 72758

X X X X X St. Mary's Mercy Medical Center Eligibility Guidelines for Charity Care Discounts - The Federal Poverty Guidelines for income are the basis for determining eligibility for charity care discounts. For example, individuals with incomes below 100% of the Federal Poverty Guidelines will be eligible for free care. Individuals with incomes greater than 100% of the Federal Poverty Guidelines may be eligible for care at discounted rates depending on their income level and/or the amount due to the hospital. Charity/Medical Indigence Parameters: Charity/Medical Indigence parameters are based on Federal Income Poverty (FPL) Guidelines which are updated annually. Generally, no patient's financial responsibility shall be greater than 20% of the household adjusted gross income, subject to an asset test. This determination shall be made per episode of care where income exceeds 300% of the FPL, and, when warranted, in aggregate for multiple episodes. The parameters will be reviewed annually with the FPL updates. The review will include assessment of the sliding scale ranges, maximum out of pockets, and overall impact to the facilities and system. Revisions will be completed as warranted. N/A N/A N/A Our total expense from Form 990, Part IX, Line 25, Column (A) was $129,785,922. The bad debt expense included in this amount was $14,392,680. This left a total expense of $115,393,242 for purposes of calculating Line 7, Column (F). The text of the footnote that is included in the Sisters of Mercy Health System, Inc. and Subsidiaries audited financial statements that describes bad debt expense follows: "Patient accounts that are uncollected, including those placed with collection agencies, are initially charged against the allowance for uncollectible accounts in accordance with collections 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 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. Description of the Costing Methodology - Accounts active in accounts receivable and active with collection agencies are adjusted to charity when patients or guarantors met the guidelines outlined in our policy. Accounts previously written off to bad debt as uncollectible and later returned are not adjusted to charity, unless additional information has been collected by the collection agency. Subsequent events and additional information that would lead to consideration of charity vs. bad debt include bankruptcy filing, or death notice with no surviving spouse or estate. Credit reporting agencies will be notified for any changes to account balances that have been previously listed on the patient guarantor credit reports. The Medicare shortfall was computed using the annual prepared Medicare Cost Report; CMS Form 2552-96. It is the position of St Mary's that 100% of the short fall should be treated as community benefit. This amount represents cost of providing services that remain uncompensated to the provider. Presumptive Charity - Mercy will utilize the Search America tool to enhance our ability to determine charity qualification. Presumptive charity will be granted in situations where we have been unable to obtain information from our patients or the information provided is not complete enough to make a charity determination. Mercy will utilize presumptive charity prior to bad debt placement for charity adjustments in excess of $6,500. In these cases, Mercy will utilize the Search America report status of "probable charity" as the basis for the 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, including legal action consistent with Mercy mission and values, which 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 lien. Mercy has policies and procedures established to address the initiation of legal action. Mercy annually reviews collection agency compliance with all policies. N/A St Mary's objectives regarding community needs assessment are to identify health needs in Benton County and Washington County, along with surrounding communities, and involve the community in the health planning efforts. The information gathered is used to plan strategically, and better meet the health and human service needs of these communities. St Mary's 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. Stakeholder participants include board members, community/civic leaders, local employers, other health care providers, former patients, and co-workers. As part of our commitment to improving the health of the communities we serve, Mercy conducted a needs assessment on May 11, 2010 in Rogers Arkansas. Three sessions with representatives from Northwest Arkansas were held with members of the local administrative team to gather input and feedback on these local communities. Independent consultants were used to gather demographic data pertaining to Northwest Arkansas including current and future population figures, health status indicators, and other community centric data. The filing organization has printed material available at each point of registration in our facility, in addition to electronically availability at our web site. Specific information provided: Financial Assistance Information As a part of our healing ministry, 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 charity care discounts. For example, individuals with incomes below 100% of the Federal Poverty Guidelines will be eligible for free care. Individuals with incomes greater than 100% of the Federal Poverty Guidelines may be eligible for care at discounted rates depending on their income level and/or the amount due to the hospital. Additional Financial Assistance After appropriate discounts have been applied, arrangements may be made for an interest-free monthly payment plan. Generally, no patient's financial responsibility will be greater than 10% of annual household income, adjusted to consider availability of other assets that could be used toward making payments. The service area is made up of Benton and Washington County and small communities outside of those counties. The total population serviced is 425,505 based on 2009 Census figures. Key demographic indicators for the population; 9.9% are individuals in excess of 65 years of age, 89.7% white, 3.6% black, and 14.1% Hispanic. The unemployment rate as of March 2010, based on US department of Labor was 6.1%. St Mary's continued its collaboration with the Jones Trust in the conversion of the old St. Mary's Hospital into the Center for Non Profits at St. Mary's. St Mary's invested in several renovations of the Center and engaged in renting significant square footage for our Home Health and Wound Care centers. St Mary's also formed The Max, a thrift shop focused on providing educational opportunities for the Women's Shelter at the Center for Non-Profits. Local organizations such as The American Heart Association benefited from activities including staff time in support of specific health related activities, including but not limited to board membership, grant writing, administrative support, physician recruitment, and work force development. St. Mary's co-workers are service oriented and responsive community members. In addition to our traditional acute care service role, St Mary's co-workers provided more than 3,000 volunteer hours, supporting various community events. Events such as health screening, community education seminars, food and clothing collection for Women's Crisis Center and donations of time and funds to community benevolent agencies. The filing organization is part of the Sisters of Mercy Health System ("Mercy"). Mercy is a Missouri non-profit corporation with its headquarters ("ministry office") in St. Louis, Missouri. Mercy provides health care services in four states - Arkansas, Kansas, Missouri, and Oklahoma - and has outreach ministries located in Louisiana, Mississippi, and Texas. Mercy's mission is "As the Sisters of Mercy before us, we bring life to the healing ministry of Jesus through our compassionate care and exceptional service." As of June 30, 2010, Mercy facilities included 28 hospitals with 3,718 acute licensed beds (3,300 acute available beds). Mercy facilities offer a wide range of health care services across the system, including inpatient and outpatient care, rehabilitation services, cancer care, trauma care, burn care, skilled nursing, home health and hospice, sports medicine, and neonatal and pediatric intensive care. For the fiscal year ended June 30, 2010, Mercy had more than 6.3 million outpatient visits, more than 1,200 employed physicians, and approximately 28,000 employees, making Mercy the eighth largest Catholic health system in the United States based on net patient service revenue. Mercy is sponsored by Mercy Health Ministry, which is governed by members that include Sisters of Mercy. Many services that are essential to fulfilling Mercy's mission are centralized at the Ministry Office. Such centralized services include Treasury, Information Technology, Clinical Quality Management, Legal and Compliance Counsel, Compensation and Benefits, Consulting, Performance Management, Revenue Management, Capital Management, Clinical Engineering, and Clinical Safety. The centralization of such support services enables Mercy to ensure that each of its communities, whether large or small, has the services it needs. AR KS LA MS MO OK TX false Northwest Arkansas Community Foundation 800 Founders Park Drive East Springdale AR 72762 311682365 501(c)(3) 32500 To help start and provide for an Inpatient Psychiatric Service Hospital in NWA 1 0 true true false false false false false true false Donna Johnson 2987 283193 0 23558 408 38686 0 15913 112 14164 3507 375514 0 0 Dr James Byrum 0 206861 0 502 0 12814 0 19242 0 12901 0 252320 0 0 George Flynn 0 383453 0 112888 0 21390 0 133347 0 9970 0 661048 0 0 Jon Vitiello 0 241732 0 50149 0 24890 0 29343 0 9080 0 355194 0 0 Benny J Stover 0 130275 0 25006 0 11428 0 4698 0 7837 0 179244 0 0 Michele Stewart 0 196136 0 43781 0 5071 0 60654 0 8722 0 314364 0 0 James L Johnson 107732 0 10427 0 32230 0 23554 0 7462 0 181405 0 0 0 Charlotte Rankin 119066 0 9726 0 12804 0 7297 0 3355 0 152248 0 0 0 Robert Donnell 199183 0 10000 0 26260 0 33844 0 11419 0 280706 0 0 0 Harry Lazarte 217192 0 10000 0 63280 0 5055 0 12619 0 308146 0 0 0 James Merritt 218076 0 10000 0 21043 0 5142 0 13250 0 267511 0 0 0 Ralph Ritz 175688 0 10000 0 49983 0 9571 0 13308 0 258550 0 0 0 Cynthia Wilson 260035 0 10000 0 14871 0 13051 0 13689 0 311646 0 0 0 Susan Barrett 0 285574 0 0 0 304836 0 96928 0 5020 0 692358 0 0 Supplemental Compensation Information Part I, Line 3: The filing organization relies on a related organization; refer to Schedule O, Part VI, Question 15A and 15B for the process the related organization follows. Part I, Line 4A: The following individual received a serverance payment during calendar 2009: Susan Barrett - $240,398 Part I, line 4b: Sisters of Mercy Health System 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 Susan Barrett, George Flynn, Stephen Goss, Jon Vitiello, and Michele Stewart. No payments were made under the Plans during the tax year. The amount of all accrued benefits is included in compensation amounts provided in Schedule J, Part II, Column (C). Part I, Line 7: Non Fixed Bonus Plan The filing organization provides a non-fixed bonus plan for which certain tiers of its employees are eligible. For fiscal year 2009 (July 1, 2008 - June 30, 2009) payment of all or part of the bonus is contingent upon percentage attainment of (I) personal goals and (II) certain financial targets. For fiscal year 2010 (July 1, 2009 - June 30, 2010), payment of all or part of the bonus is 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 the goal achievement (applicable for fiscal year 2009). Bonus opportunities are tiered percentages and are dependent upon the leadership level and attainment percentage. Mercy's attainment of financial goals are validated by an external consulting firm and are then taken into account by the executive compensation committee of Mercy when analyzing executive compensation for reasonableness. SUPPLEMENTAL INFORMATION FORM 990, PART III, LINE 4D DESCRIPTION OF OTHER PROGRAM SERVICES ST. MARY'S -ROGERS MEMORIAL HOSPITAL (SMRH) AND ITS MEMBER HEALTH CARE FACILITIES PROVIDE QUALITY CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SMRH PROVIDED 31,651 INPATIENT SERVICE DAYS OF ACUTE OR SUB-ACUTE CARE. SMRH PERFORMED APPROX. 1,520 DELIVERIES, RESPONDED TO APPROX. 39,611 EMERGENCY ROOM ENCOUNTERS, MADE APPROX. 22,541 HOME HEALTH CARE VISITS AND COMPLETED 68,183 OUTPATIENT VISITS. COMMUNITY OUTREACH/BENEFIT PROGRAMS INCLUDE SUPPORT GROUPS FOR CURRENT AND PAST PATIENTS (DIABETIC, CARDIAC, ETC), EXPECTING/NEW PARENTS (CHILD BIRTH CLASSES, VARIOUS SUPPORT GROUPS, ETC), EMPLOYEES (EDUCATIONAL ASSISTANCE PROGRAMS, ETC), AND LOCAL/SURROUNDING COMMUNITY (HEALTH AND WELLNESS PROGRAMS, HEALTH FAIRS, HOME HEALTH PROGRAMS, ETC). RELIEF FROM THE FINANCIAL BURDEN OF HEALTH CARE SERVICES TO THE INDIGENT CONSISTS OF CHARGES OF $12,792,362 FOR CHARITY CARE PROVIDED WITH A COST OF RELATED SERVICES. FORM 990, PART V, QUESTION 1A VENDORS FOR THE FILING ORGANIZATION ARE PAID BY THE SISTERS OF MERCY HEALTH SYSTEM (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE SMHS EIN. FORM 990, PART VI, QUESTION 6, 7A, & 7B THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HEALTH SYSTEM OF NORTHWEST ARKANSAS, INC. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED SOLELY UNTO THE CORPORATE MEMBER: A. TO APPROVE THE MISSION AND ESTABLISH THE PHILOSOPHY ACCORDING TO WHICH THE CORPORATION AND ANY ORGANIZATION CONTROLLED BY THE CORPORATION SHALL OPERATE; B. TO AMEND THE ARTICLES OF INCORPORATION AND BYLAWS; C. TO APPOINT AND REMOVE MEMBERS OF THE BOARD; D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; E. TO APPROVE OR AMEND THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; F. TO APPROVE OR AMEND THE OPERATING, CAPITAL, AND CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; G. TO LEASE OR SELL ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000); H. TO ENCUMBER ANY OR ALL OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; I. TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; J. TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION; AND, K. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. FORM 990, PART VI, QUESTION 11A 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 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 THE SISTERS OF MERCY HEALTH SYSTEM'S TAX DEPARTMENT, TO ENSURE ACCURACY AND CONSISTENCY WITH OTHER RELATED ORGANIZATIONS' FORM 990S. AFTER QUESTIONS ARISING FROM THE VARIOUS REVIEWS ARE ADDRESSED AND INCORPORATED INTO THE FORM 990, A REVISED DRAFT IS PROVIDED TO THE FILING ORGANIZATION'S LEADERSHIP TEAM, INCLUDING THE CFO AND CEO, FOR REVIEW. ONCE REVIEWED AND APPROVED BY THE FILING ORGANIZATION'S LEADERSHIP TEAM, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW; IT IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, QUESTION 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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 PROVIDES A REASONABLE ALTERNATIVE TO RESOLVE THE CONFLICT OF INTEREST, WHICH MAY INCLUDE SUPERVISORY PROCEDURES OR TRANSFER A DECISION MAKING ROLE. FOR BOARD MEMBERS, THEY ARE EXCLUDED FROM THE DELIBERATIONS AND DECISION MAKING PROCESS. FORM 990, PART VI, QUESTION 15A AND 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 SISTERS OF MERCY HEALTH SYSTEM, 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 THE SISTERS OF MERCY HEALTH SYSTEM. FOR THOSE CLASSIFIED AS KEY EMPLOYEES, THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND REVIEW/APPROVAL OF EXECUTIVE MANAGEMENT. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS, AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, PART VI, QUESTION 19 AVAIL GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS HAVE BEEN MADE AVAILABLE FROM TIME TO TIME BUT ARE NOT PUBLISHED PUBLICLY. FORM 990, PART VII, SECTION A SCOTT STREET WAS NAMED PRESIDENT AND CEO OF ST. MARY-ROGERS MEMORIAL HOSPITAL EFFECTIVE MARCH 8, 2010; THEREFORE, HE HAS NO REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION OR RELATED ORGANIZATIONS FOR CALENDAR 2009. 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 FORM 990S OF ENTITIES INCLUDED WITHIN THE SISTERS OF MERCY HEALTH SYSTEM. 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, QUESTION 2B THE FILING ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE SISTERS OF MERCY HEALTH SYSTEM, INC. AND SUBSIDIARIES ANNUAL FINANCIAL STATEMENT AUDIT. THE SISTERS OF MERCY HEALTH SYSTEM, INC. AND SUBSIDIARIES RECEIVE AN UNQUALIFIED OPINION FROM THE EXTERNAL AUDITORS FOR FISCAL 2010 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION IS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE FINANCE, AUDIT, AND COMPLIANCE COMMITTEE OF THE SISTERS OF MERCY HEALTH SYSTEM BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY SISTERS OF 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. Advance Care Hospital 300 Werner St 3rd Floor Hot Springs AR 71913 710816634 Hospital AR 501(C)(3) 3 SMHS Breech Regional Medical Center 100 Hospital Drive Lebanon MO 65536 431767432 Hospital MO 501(C)(3) 3 St Johns HS Carroll Health Foundation 214 Carter Street Berryville AR 72616 710759301 Foundation AR 501(C)(3) 11a Ozark RG HS Casa de Misericordia 1602 McClelland Street Laredo TX 78044 742912461 Shelter TX 501(C)(3) 7 MM Laredo Healdton Mercy Hospital Corporation 918 South Street Healdton OK 73438 263173902 Hospital OK 501(C)(3) 3 MMHC 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 Invst Mgmt MO 501(C)(3) 11b SMHS Mercy El Reno Hospital Corporation 2115 Parkview Drive El Reno OK 73036 736617948 LEASED HOSPT OK 501(C)(3) 3 MHS Mercy Emergency Medical Services Inc 4300 W Memorial Road Oklahoma City OK 73120 810627035 Inactive OK 501(C)(3) 9 MHC Mercy Foundation for Health Innovation 14528 S Outer Forty Ste 100 Chesterfield MO 63017 200901499 Foundation MO 501(C)(3) 11b SMHS Mercy Health Center Foundation 401 Woodland Hills Blvd Fort Scott KS 66701 481077073 Foundation KS 501(C)(3) 11c MHS-KS Mercy Health Center Foundation Inc 4300 W Memorial Road Oklahoma City OK 73120 731593024 Foundation OK 501(C)(3) 11a MHC Mercy Health Center Inc 4300 W Memorial Road Oklahoma City OK 73120 730579285 Hospital OK 501(C)(3) 3 MHS Mercy Health MHMCH Inc 220 Pennsylvania Avenue Columbus KS 66725 270842031 Hospital MO 501(C)(3) 9 MHS-Joplin Mercy Health of Joplin Foundation 2727 McClelland Blvd Joplin MO 64804 270906136 Foundation MO 501(C)(3) 11a MHS-Joplin Mercy Health of Joplin Inc 2727 McClelland Blvd Joplin MO 64804 270814858 Hospital MO 501(C)(3) 9 MHS-Joplin Mercy Health Services Inc 4300 W Memorial Road Oklahoma City OK 73120 141838609 DISV 6/30/10 OK 501(C)(3) 9 MHC Mercy Health System-Joplin Inc 2727 McClelland Blvd Joplin MO 64804 300584463 Hlth System MO 501(C)(3) 11b SMHS Mercy Health System of Kansas Inc 401 Woodland Hills Blvd Ft Scott KS 66701 480956045 Hospital KS 501(C)(3) 3 MHS-JOPLIN Mercy Health System Northwest Arkansas 2710 Rife Medical Drive Rogers AR 72758 621684203 Phys Group AR 501(C)(3) 11b SMHS Mercy Health System of Texas Inc 14528 S Outer Forty Ste 100 Chesterfield MO 63017 742764727 Inactive TX 501(C)(3) 11b SMHS Mercy Health System Inc 4300 W Memorial Road Oklahoma City OK 73120 731453048 Holding co. OK 501(C)(3) 11b SMHS Mercy Hosp Foundation of Independence 800 W Myrtle Independence KS 67301 481079981 Foundation KS 501(C)(3) 11a MHS-KS Mercy Hospital of Laredo 14528 S Outer Forty Ste 100 Chesterfield MO 63017 741189682 Inactive TX 501(C)(3) 3 MHS-TX Mercy Medical Group 645 Maryville Centre Dr St 100 St Louis MO 63141 431771217 Phys Group MO 501(C)(3) 9 ST JOHN MHC Mercy Memorial Health Center Foundation 1011 14th Avenue NW Ardmore OK 73401 710962525 Foundation OK 501(C)(3) 11a MMHC Mercy Memorial Health Center Inc 1011 14th Avenue NW Ardmore OK 73401 731500629 Hospital OK 501(C)(3) 3 MHS Mercy Ministries of Laredo 2500 Zacatecas Laredo TX 78043 200198462 Outreach TX 501(C)(3) 7 SMHS Mercy Physicians of Oklahoma Inc 4300 W Memorial Road Oklahoma City OK 73120 270473057 Phys Group OK 501(C)(3) 9 MHS MHM Support Services 14528 S Outer Forty Ste 100 Chesterfield MO 63017 202553101 Sup Hlth Sys MO 501(C)(3) 11b SMHS Mission Clinical Services 300 Werner Street Hot Springs AR 71913 134239691 Phys Group AR 501(C)(3) 9 ST JOS MHS Ozarks Regions Health Systems Inc 214 Carter Street Berryville AR 72616 710759299 Hospital AR 501(C)(3) 3 ST JOHNS HS Sisters of Mercy Health System 14528 S Outer Forty Ste 100 Chesterfield MO 63017 431423050 Sup Hlth Sys MO 501(C)(3) 1 NA Sisters of Mercy Ministries 14528 S Outer Forty Ste 100 Chesterfield MO 63017 721069468 Outreach MO 501(C)(3) 7 SMHS St Edward Hlth Fac-Franklin Co 801 W River Street Ozark AR 72949 710689680 Hospital AR 501(C)(3) 3 SEMMC St Edward Hlth Fac-Logan Co 500 E Academy Paris AR 72855 710655753 Hospital AR 501(C)(3) 3 SEMMC St Edward Hlth Fac-Scott Co 1341 W 6th Street Waldron AR 72958 710557895 Hospital AR 501(C)(3) 3 SEMMC St Edward Mercy Clinic Inc 7301 Rogers Avenue Fort Smith AR 72917 261318597 Phys Clinic AR 501(C)(3) 9 SEMHS St Edward Mercy Foundation PO Box 17000 Fort Smith AR 72917 237330425 Foundation AR 501(C)(3) 7 SEMMC St Edward Mercy Health System Inc 7301 Rogers Avenue Fort Smith AR 72917 261318515 Holding Co. AR 501(C)(3) 11b SMHS St Edward Mercy Medical Center 7301 Rogers Avenue Fort Smith AR 72917 710240352 Hospital AR 501(C)(3) 3 SEMHS St Francis Hospital 100 W Highway 60 Mountain View MO 65548 440607149 Hospital MO 501(C)(3) 3 ST JOHNS HS St John's Aurora Inc 500 Porter Avenue Aurora MO 65605 431936696 Lease Hosp MO 501(C)(3) 3 St Johns HS St John's Cassville Inc 94 Main Street Cassville MO 65625 431936699 Lease Hosp MO 501(C)(3) 3 St Johns HS St John's Children's Hospital Inc 1235 E Cherokee Street Springfield MO 65804 Inactive MO 501(C)(3) 3 St Johns HS St John's Clinic Inc 1965 Fremont Street Ste 2950 Springfield MO 65804 431560263 Phys Group MO 501(C)(3) 9 St Johns HS St John's Foundation for Community Hlth 1235 E Cherokee Street Springfield MO 65804 320195818 Foundation MO 501(C)(3) 11b St Johns HS St John's Health System Inc 1235 E Cherokee Street Springfield MO 65804 431856028 Holding Co MO 501(C)(3) 11b SMHS St John's Home Care of Berryville Inc 214 Carter Street Berryville AR 72616 870781247 Home Health AR 501(C)(3) 11c ST JOHN RHC St John's Medical Research Institute 1235 E Cherokee Street Springfield MO 65804 870796305 Research MO 501(C)(3) 4 ST JOHNS HS St John's Mercy Foundation 645 Maryville Centre Dr St 100 St Louis MO 63141 562410020 Foundation MO 501(C)(3) 11b ST JOHN MHC St John's Mercy Health Care 645 Maryville Centre Dr St 100 St Louis MO 63141 431718408 Hlth System MO 501(C)(3) 11b SMHS St John's Mercy Health System 645 Maryville Centre Dr St 100 St Louis MO 63141 430653493 Hospital MO 501(C)(3) 3 ST JOHN MHC St John's Mercy Hospital Foundation 901 E Fifth Street Washington MO 63090 562410022 Foundation MO 501(C)(3) 11b ST JOHN MHC St John's Mercy Support Services 615 S New Ballas Road St Louis MO 63141 431677952 Inactive MO 501(C)(3) 11c ST JOHN MHS St John's Regional Health Center 1235 E Cherokee Street Springfield MO 65804 440552485 Hospital MO 501(C)(3) 3 St Johns HS St Joseph's Mercy Clinic Inc 1 Mercy Lane Hot Springs AR 71913 261125131 Phys Clinic AR 501(C)(3) 9 ST JOS MHS St Joseph's Mercy Health Center 300 Werner Street Hot Springs AR 71913 710236913 Hospital AR 501(C)(3) 3 ST JOS MHS St Joseph's Mercy Health Foundation 300 Werner Street Hot Springs AR 71913 710804718 Foundation AR 501(C)(3) 11b ST JOS MHC St Joseph's Mercy Health System Inc 300 Werner Street Hot Springs AR 71913 261125064 Holding Co AR 501(C)(3) 11b SMHS St Mary's Hospital Foundation 2710 Rife Medical Lane Rogers AR 72858 710601687 Foundation AR 501(C)(3) 11c ST MARY RMC St Mary's Hospital of Enid Oklahoma I 14528 S Outer Forty Ste 100 Chesterfield MO 63017 730614655 Inactive OK 501(C)(3) 3 MHS The Sister M Cornelia Blasko Foundation 100 W Highway 60 Mountain View MO 65548 431873914 Foundation MO 501(C)(3) 11a ST FRAN HOS Unity Ambulatory Care 645 Maryville Centre Dr St 100 St Louis MO 63141 431861745 Inactive MO 501(C)(3) 11c ST JOHN MHC HOT SPRINGS EQUIP 300 Werner Street Hot Springs AR 71913 204340915 DISSOLVED 9/30/09 AR NA Hot Springs MRI 100 Ridgeway Place Hot Springs AR 72901 710675196 DISSOLVED 8/5/09 AR NA Merc Ambu Surg CTR 7301 Rogers Avenue Fort Smith AR 72903 710827721 AMBULATORY S. CTR AR NA RES OPT & INNOV 645 Maryville Centre Drive Suite St Louis MO 63141 460468368 CENTRAL DIST. CTR MO NA SO OK DIAG CTR 1011 Fourteeth Avenue NW Ardmore OK 73401 431971232 MRI Services OK NA Fort Smith Emergency Medical Services 1701 South Greenwood Fort Smith AR 72901 710416615 Emergency Med SEV AR NA Southern Oklahoma PHO LLC 1011 Fourteeth Avenue NW Ardmore OK 73401 731462104 DISSLV 12/31/09 OK NA HORIZONTAL PROPERTY 7301 Rogers Avenue Fort Smith AR 72903 710554050 Office Building AR NA Consolidated Logistics Inc 2710 Rife Medical Lane Rogers AR 72758 710474406 DISSOLVED 8/4/09 AR N/A C-Corp Frontenac Properties Inc 14528 S Outer Forty Suite 100 Chesterfield MO 63017 521914421 HOLDING COMP DE N/A C-Corp Inveno Health Inc 1235 E Cherokee Street Springfield MO 65804 264509571 IT SERVICES MO N/A C-Corp Mercy Community Services Inc 401 Woodland Hills Blvd Fort SCOTT KS 66701 481078101 CATERING KS N/A C-Corp Mercy Health Center Condominium Inc 4300 W Memorial Rd Oklahoma City OK 73120 680640970 REAL ESTATE OK N/A C-Corp Mercy Health Network of the Southern Reg 1011 14th Avenue NW Ardmore OK 73401 731580607 HEALTH CARE OK N/A C-Corp Mercy Health Network Inc 4300 W Memorial Road Oklahoma City OK 73120 731381689 HEALTH CARE OK N/A C-Corp Mercy Managed Care Corporation 4300 W Memorial Road Oklahoma City OK 73120 731441665 HOLDING COMP OK N/A C-Corp Mercy Medical Services Inc 14528 S Outer Forty Suite 300 Chesterfield MO 63017 710641246 DISSOLVED 7/1/09 MO N/A C-Corp MHP Inc 14528 S Outer Forty Suite 300 Chesterfield MO 63017 431697084 HOLDING COMP DE N/A C-Corp St Edward Medical Services Inc 7301 Rogers Avenue Fort Smith AR 72903 202965518 DISSOLVED 5/5/10 AR N/A C-Corp UH L Corp Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 742499535 HOLDING COMP MO N/A C-Corp Unity Support Services Inc 645 Maryville Centre Drive Suite 1 St Louis MO 63141 431797042 MANAGEMENT MO N/A C-Corp false false false false false false false false false false false false false true true true false false MERCY HEALTH SYSTEM OF NW ARKANSAS INC P 168132 MERCY HEALTH SYSTEM OF NW ARKANSAS INC N 140389 MERCY HEALTH SYSTEM OF NW ARKANSAS INC O 2395428 MHM SUPPORT SERVICES O 16328978 MHP INC O 1536405 MHP INC P 282704 RESOURCE OPTIMIZATION & INNOVATION LLC O 6262081 SISTERS OF MERCY HEALTH SYSTEM O 9749544 ST JOHN'S MERCY HEALTH SYSTEM O 228092 ST MARY'S HOSPITAL FOUNDATION P 81362