2024-05-10T11:27:42-05:00 2023-06-30 264532849 PURK & ASSOCIATES PC 1034 SOUTH BRENTWOOD BLVD STE 2000 SAINT LOUIS MO 63117 990 2022-07-01 472219204 MERCY HOSPITAL LINCOLN MERC 6365288551 1000 EAST CHERRY STREET TROY MO 63379 MARK THORN EXEC DIRECTOR FINANCE 6365283329 2024-05-10 1 MARK THORN 999009999 0 DOUGLAS G PLEUS CPA P00013488 3148844000 2024-05-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALAN SMITH 1000 EAST CHERRY STREET TROY MO 63379 52057993 0 0928 X WWW.MERCY.NET X 1953 MO AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 8 7 0 21 0 0 22920 266314 56470226 51637529 17928 0 124746 153674 56635820 52057517 32992 24301 0 0 25198119 29234541 0 0 0 22241382 16046324 47472493 45305166 9163327 6752351 10839592 11213852 803145 6152622 10036447 5061230 X AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE. 0 0 24150002 29298209 MERCY HOSPITAL LINCOLN PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY BY OFFERING ESSENTIAL HEALTH SERVICES TO ITS COMMUNITY. IN ACTIVE PURSUIT OF THIS MISSION, MERCY HOSPITAL LINCOLN PROVIDES A WIDE VARIETY OF SERVICES IN THEIR 16 BED FACILITY AND IN FY23, HAD 54,656 TOTAL CASES. MERCY HOSPITAL LINCOLN HAS A TEAM OF EXPERT DOCTORS, NURSES AND TECHNICIANS THAT BLEND COMPASSIONATE CARE WITH THE LATEST, MOST ADVANCED DIAGNOSTIC AND TREATMENT RESOURCES IN PROVIDING EMERGENCY CARE. MERCY HOSPITAL LINCOLN'S EMERGENCY DEPARTMENT IS READY 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR WITH FAST, EXPERIENCED AND PROFESSIONAL CARE. IN FY23, MERCY HOSPITAL LINCOLN HAD 13,373 CASES FOR THIS SERVICE LINE. 13415195 16274997 MERCY HOSPITAL LINCOLN'S RADIOLOGISTS USE THE LATEST TECHNOLOGIES TO PRODUCE PRECISE IMAGES AND EXACTING TEST RESULTS. MERCY OFFERS A FULL RANGE OF DIAGNOSTIC IMAGING SERVICES FOR ADULTS AND CHILDREN. MERCY RADIOLOGISTS GIVE MORE INSIGHT INTO YOUR CONDITION, SO YOU RECEIVE AN ACCURATE DIAGNOSIS AND THE MOST EFFECTIVE TREATMENT. IN FY23, MERCY HOSPITAL LINCOLN HAD 7,727 CASES FOR THIS SERVICE LINE. 3098332 3758823 MERCY HOSPITAL LINCOLN OFFERS COMPREHENSIVE HEART AND VASCULAR SERVICES, A WIDE VARIETY OF TREATMENT OPTIONS AND ADVANCED TECHNOLOGIES TO DIAGNOSE AND TREAT A FULL RANGE OF CONDITIONS. MERCY HOSPITAL LINCOLN ALSO PROVIDES A FULL COMPLEMENT OF CARDIAC REHABILITATION, THERAPY AND EDUCATION SERVICES. IN FY23, MERCY HOSPITAL LINCOLN HAD 2,332 CASES FOR THIS SERVICE LINE. 1914148 24301 2322199 IN ADDITION TO THE PROGRAM SERVICES DESCRIBED ABOVE, MERCY HOSPITAL LINCOLN ALSO SERVES PATIENTS IN ADDITIONAL SERVICE LINES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING AREAS: LAB; MEDICAL SURGERY; ONCOLOGY; PEDIATRICS; WOMEN & INFANTS. 1914148 24301 2322199 42577677 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARK THORN 6365283329 1000 EAST CHERRY STREET TROY MO 63379 X BURKEMPER SARAH BOARD MEMBER 1.00 1.00 X 0 0 0 KELLY JOHN BOARD MEMBER 1.00 1.00 X 0 0 0 MASSEY BRADLEY PHYSICIAN & BOARD MEMBER 1.00 49.00 X 0 594016 35409 PENNY MARK BOARD MEMBER 1.00 0.00 X 0 0 0 RELLER TIM BOARD MEMBER 1.00 0.00 X 0 0 0 RHOADS HARVEY BOARD MEMBER 1.00 0.00 X 0 0 0 WARD RSM SR CLAUDIA BOARD MEMBER 1.00 1.00 X 0 0 0 MEYER ANETTE BOARD MEMBER 1.00 0.00 X 0 0 0 ECKHARDT CHRISTIE VP, CHIEF OPERATIONS COUNSEL & SECRETARY 1.00 57.00 X 0 307029 26241 ROTHERMICH ANTHONY VP, OPERATIONS 10.00 40.00 X 0 293330 53252 SMITH ALAN ADMINISTRATOR 40.00 0.00 X 0 284708 23189 THORN MARK A EXEC DIRECTOR, FINANCE 25.00 25.00 X 0 181231 17544 GRAY JACQUELINE REGISTERED NURSE 40.00 0.00 X 0 173802 14739 HILL NICHOLAS NURSE ANESTHETIST 40.00 0.00 X 0 175383 7022 KLIETHERHMES JACOB EXEC DIRECTOR, NURSING 40.00 0.00 X 0 173319 20076 LOUZADER WILLIAM REGISTERED NURSE 40.00 0.00 X 0 191528 30828 NEILL DAVID A NURSE ANESTHETIST 40.00 0.00 X 0 243294 19047 MACKIN STEPHEN L FORMER OFFICER 0.00 60.00 X 0 3215797 434541 MATEJKA CHERYL L FORMER OFFICER 0.00 55.00 X 0 1197639 127825 JOHNSTON JEFFREY A FORMER KEY EMPLOYEE 0.00 0.00 X 0 2171276 23699 0 9202352 833412 0 1 1 0 HEALTHTRUST INC - THE HOSPITAL COMPANY 100 SAWGRASS CORP PKWY 6TH FL SUNRISE FL 33323 LABOR MANAGEMENT SVCS 521937 MCCARTHY BUILDING CO 12851 MANCHESTER RD ST LOUIS MO 63131 CONSTRUCTION SVCS; BUILDING REPAIRS/MAIN 312107 PATRICK ORUWARI MD 1 LYNNBROOK RD FRONTENAC MO 63131 PSYCHIATRIC SERVICES 177365 MANAGEMENT HEALTH SYSTEMS DBA MEDPRO HEA 1580 SAWGRASS CORP PKWY STE 200 SUNRISE FL 33323 LABOR MANAGEMENT SVCS 104371 4 22159 244155 266314 NET PATIENT SERVICE REVENU 621110 50077799 50077799 OTHER OPERATING REVENUE 621110 1528080 1528080 RENTAL INCOME FROM RELATED OREGAN 531120 31650 31650 51637529 2833 476 2357 2357 2357 CAFE AND VENDING 722210 134618 134618 16699 16699 151317 52057517 51654228 0 136975 20691 20691 3610 3610 62263 59326 2937 24590389 23455159 1135230 818880 766185 52695 2401643 2267644 133999 1361366 1272080 89286 14266 14266 1249875 1194833 55042 7429 7429 790144 580300 209844 2415 2415 886988 749308 137680 16096 11075 5021 875785 819995 55790 506510 506510 DRUGS & MEDICAL EXPENSE 5471162 5471162 BAD DEBT EXPENSE 5141076 5141076 REPAIRS AND MAINTENANCE 632516 608859 23657 SHARED SERVICE FEES 330117 125444 204673 121945 28515 93430 45305166 42577677 2727489 0 400 200 232743 7257318 5957161 155554 81201 28298 28447 9671795 4757695 3154314 4914100 243708 0 10839592 11213852 781624 6116797 21521 31274 0 4551 803145 6152622 X 10036447 5061230 10036447 5061230 10839592 11213852 X 6752351 -11727568 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 14266 0 0 0 14266 0 PART II-B, LINE 1: THE FILING ORGANIZATION IS A MEMBER OF AND PAYS DUES TO THE FOLLOWING HOSPITAL ASSOCIATIONS: AMERICAN HOSPITAL ASSOCIATION, CATHOLIC HEALTH ASSOCIATION, AND THE MISSOURI HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2023, DUES WERE $5,108, $5,281, AND $35,202, RESPECTIVELY. APPROXIMATELY 27.29% OF THE AMERICAN HOSPITAL ASSOCIATION DUES, 3.78% OF THE CATHOLIC HEALTH ASSOCIATION, AND 36.00% OF MISSOURI HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THIS ASSOCIATION. 2349812 881709 1468103 367060 191240 175820 6919135 3666751 3252384 35788 17995 17793 4914100 OTHER LIABILITIES 4551 4551 PART X, LINE 2 FEDERAL INCOME TAX PRIMARILY ALL OF THE MERCY HEALTH ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS CHARITABLE ORGANIZATIONS QUALIFYING UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), BY VIRTUE OF IRS DETERMINATION LETTERS OR INCLUSION IN THE OFFICIAL CATHOLIC DIRECTORY. MERCY COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2023 OR 2022. 1 1 X 1 X 1 X 1 1 0 1 1 1300838 1300838 0.03240 7514721 3576582 3938139 0.09810 8815559 3576582 5238977 0.13050 3 34 28771 28771 0.00070 3 34 28771 28771 0.00070 3 34 8844330 3576582 5267748 0.13120 1 79 7920 0 7920 0.00020 1 79 7920 7920 0.00020 1 1320010 0 5946834 6085587 -138753 X 1 1 1 1 MERCY HOSPITAL LINCOLN 1000 EAST CHERRY STREET TROY MO 63379 WWW.MERCY.NET 539-1 X X X X MERCY HOSPITAL LINCOLN 1 0 0 1 X X X X X X X X X X 21 1 0 1 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X 1 X HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X X 1 X 0 0 MERCY HOSPITAL LINCOLN PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN ITS MOST RECENT CHNA REPORT.THE CHNA HAS ALL THE SECTIONS REFERENCED ABOVE AND INCLUDES AN EXECUTIVE SUMMARY, POTENTIALLY AVAILABLE RESOURCES, EVALUATION OF IMPACT, REFERENCES, AND APPENDICES. MERCY HOSPITAL LINCOLN PART V, SECTION B, LINE 5: THE VOICES OF THE PEOPLE OF LINCOLN COUNTY WERE CENTRAL TO THE HEALTH NEEDS ASSESSMENT PROCESS. MERCY HOSPITAL LINCOLN (MHL) EMPLOYED THE FOLLOWING COMMUNICATION MODES TO GATHER THOUGHTS AND CONCERNS ABOUT HEALTH CARE IN THE COMMUNITY:1. MERCY COMMUNITY HEALTH NEEDS SURVEYS2. COMMUNITY STAKEHOLDERS FOCUS GROUP3. COMMUNITY COALITION MEMBERSHIPS AND ENGAGEMENTMERCY COMMUNITY HEALTH NEEDS SURVEYS A TOTAL OF 106 INDIVIDUALS WHO STATED THEY RECEIVE THEIR HEALTH CARE IN LINCOLN COUNTY COMPLETED THE SURVEY OVER A 3-MONTH TIMEFRAME (FEBRUARY 2022 APRIL 2022). MOST PARTICIPANTS (67%) WERE RESIDENTS OF LINCOLN, WITH 22% RESIDING IN ST. CHARLES COUNTY, AND 11% FROM WARREN COUNTY.COMMUNITY STAKEHOLDERS FOCUS GROUP MERCY HOSPITAL LINCOLN INVITED COMMUNITY STAKEHOLDERS FROM THE AREA DISCUSSIONS AND HAD MULTIPLE COMMUNITY LEADERS AND MEMBERS PARTICIPATE IN THESE DISCUSSIONS. ATTENDEES INCLUDED LINCOLN COUNTY HEALTH DEPARTMENT WORKERS, REPRESENTATIVES FROM OTHER HEALTH CARE SERVICES IN THE AREA, BANKERS, CHURCH LEADERS, FARMERS, AND OTHER COMMUNITY MEMBERS. COMMUNITY COALITION MEMBERSHIPS AND ENGAGEMENT MERCY COMMUNITY HEALTH LEADER FACILITATED THE COMMUNITY HEALTH COUNCIL WHICH ENGAGED VARIOUS SOCIAL SERVICE LEADERS. IN ADDITION, COUNTY-WIDE COALITIONS WERE USED TO FOR DISSEMINATING THE IMPORTANT INFORMATION OF CHNA DEVELOPMENT. SECONDARY DATA RESEARCH UTILIZATION OF EXTERNAL SOURCES OF PUBLISHED DATA FROM REPUTABLE SOURCES INCLUDING U.S. CENSUS BUREAU AND ROBERT WOOD JOHNSON FOUNDATION THAT HIGHLIGHT DISEASE STATUS, AVAILABLE SERVICES AND OTHER IMPORTANT INFORMATION. MERCY HOSPITAL LINCOLN FOCUSES ON IDENTIFYING UNMET NEEDS AND GAPS IN HEALTH CARE, DEVELOPING PARTNERSHIPS WITH HEALTH AND SOCIAL SERVICE AGENCIES, INCREASING KNOWLEDGE OF AVAILABLE RESOURCES, MAKING CONNECTIONS AND REFERRALS, AND ADVOCATING FOR THOSE MOST VULNERABLE IN THE COMMUNITY. PARTNERING AGENCIES AND TASK FORCES IN WHICH THE CHNA WAS DEVELOPED INCLUDE:- LINCOLN COUNTY HEALTH DEPARTMENT (LCHD) JENNIFER HARRIS, DIRECTOR OF PROGRAMS- LINCOLN COUNTY HEALTHY COMMUNITIES COALITION GLENDA KEETEMAN, COMMUNITY HEALTH WORKER- LINCOLN COUNTY RESOURCE BOARD CHERI WINCHESTER, DIRECTOR, LINCOLN COUNTY KIDS- LINCOLN COUNTY COUNCIL ON AGING KELLY HARDCASTLE, EXECUTIVE DIRECTOR- LINCOLN COUNTY AND PIKE COUNTY SCHOOL DISTRICTSTHROUGH CONTINUOUS DAILY NETWORKING AND COLLABORATION, MERCY REMAINS CLOSELY ENGAGED WITH COMMUNITY PARTNERS AND INFORMED ON THE NEEDS OF THE COMMUNITIES IT SERVES. MERCY HOSPITAL LINCOLN PART V, SECTION B, LINE 11: IN CONJUNCTION WITH THE CHNA, MERCY HOSPITAL LINCOLN'S BOARD ADOPTED AN IMPLEMENTATION STRATEGY IN FY23 RELATED TO THE 2021 CHNA. MERCY HOSPITAL LINCOLN BEGAN ADDRESSING THE FOLLOWING COMMUNITY HEALTH NEEDS BEGINNING IN FY23:- BEHAVIORAL HEALTH- HOUSING INSTABILITY- TRANSPORTATION ACCESSTHESE NEEDS ARE BEING ADDRESSED IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH CAN BE ACCESSED HERE: HTTPS://WWW.MERCY.NET/FORMS/COMMUNITY-BENEFITS/. ACTIVITIES AND PROGRAMS WILL BE WELL DOCUMENTED IN ORDER TO PRODUCE MEASURABLE OUTCOMES. SOME NOTABLE ACHIEVEMENTS DURING 2022 INCLUDE:- 2022 PATIENTS SEEN IN THE MHL EMERGENCY DEPARTMENT AND URGENT CARE CENTER WHO HAD NOT SEEN A PRIMARY CARE PROVIDER IN RECENT YEARS OR WERE UNINSURED WERE REFERRED TO THE COMMUNITY HEALTH WORKER PROGRAM (CHW), A PARTNERSHIP WITH THE LINCOLN COUNTY HEALTH DEPARTMENT. THE CHW HELPED THE PATIENTS ESTABLISH A "MEDICAL HOME AND/OR ADDRESSED SOCIAL DETERMINANT OF HEALTH ISSUES AND WERE SCREENED AND ASSISTED WITH APPLYING FOR MEDICAID, MARKET PLACE INSURANCE, DISABILITY OR HOSPITAL CHARITY CARE.- 2022 VIRTUAL BEHAVIORAL HEALTH PROGRAM DEVELOPED FOR URGENT ACUTE NEEDS AND ASSESSMENTS WITHIN BOTH THE EMERGENCY DEPARTMENT AND INPATIENT AREAS. THIS HELPS IN PROVIDING REAL-TIME BEHAVIORAL HEALTH SERVICES TO PATIENTS IN-NEED AND AT-RISK OF CRISIS.- 2022 MERCY COLLABORATED WITH SAINT LOUIS CRISIS NURSERY TO HOUSE THE LINCOLN COUNTY FAMILY EMPOWERMENT CENTER WHICH LOOKS TO PREVENT CHILD NEGLECT/ABUSE AND IMPROVE FAMILY WELLBEING.- 2022 MERCY PARTICIPATED IN THE EMERGENCY ROOM ENHANCEMENT PROJECTS (ERE) IN PARTNERSHIP WITH AREA MENTAL HEALTH PROVIDERS AND BEHAVIOR HEALTH NETWORK TO ADDRESS MENTAL HEALTH PATIENTS WHO ARE HIGH UTILIZERS OF EMERGENCY ROOMS. ERE STREAMLINES THE PROCESS FOR PATIENTS IN OBTAINING THE APPROPRIATE LEVEL OF BEHAVIORAL HEALTH CARE SERVICES NEEDED AND REDUCES PREVENTABLE HOSPITAL READMISSIONS FOR MENTAL HEALTH SERVICES. - 2022 MERCY HAS COLLABORATED IN THE DEVELOPMENT OF A NEW HOUSING RESOURCE CENTER IN THE REGION NAMED BRIDGE OF HOPE LINCOLN COUNTY. THIS WILL BE THE FIRST-OF-ITS-KIND ORGANIZATION OF THE COUNTY TO SERVE UNHOUSED INDIVIDUALS TO PROVIDE WRAP-AROUND CASE MANAGEMENT FOR PRODUCTIVE FUTURE LIFE IMPROVEMENT. MERCY HOSPITAL LINCOLN PART V, SECTION B, LINE 20E: OTHER AREAS FROM A NOTICE PERSPECTIVE: FAP IS POSTED IN ALL REGISTRATION AREAS, FULL POLICY AND PLAIN LANGUAGE DOCUMENT POSTED ON WEBSITE, PLAIN LANGUAGE DOCUMENT IS AVAILABLE WHEN REQUESTED, THERE IS A NOTICE ON STATEMENT, AND ALL PATIENTS GET THREE STATEMENTS BEFORE THEY CAN GO TO A COLLECTION AGENCY. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7A HTTPS://WWW.MERCY.NET/CONTENT/DAM/MERCY/EN/PDF/CHNA/LINCOLN-CHNA-2022.PDF FORM 990, SCHEDULE H, PART V, SECTION B, LINE 10A HTTPS://WWW.MERCY.NET/CONTENT/DAM/MERCY/EN/PDF/CHIP/MERCY-LINCOLN-CHIP-2023.PDF FORM 990, SCHEDULE H, PART V, SECTION B, LINE 22 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 200% OR BELOW, THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 300% OF THE FEDERAL POVERTY GUIDELINES FOR MOST COMMUNITIES, MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS. 5 1 - MERCY HOSPITAL LINCOLN FAMILY MEDICINE 1003 EAST CHERRY STREET TROY MO 63379 HOSPITAL BASED OUTPATIENT DEPTS: FAMILY PRACTICE 2 - MERCY HOSPITAL LINCOLN FAMILY MED & PS 900 EAST CHERRY STREET TROY MO 63379 HOSPITAL BASED OUTPATIENT DEPTS: FAMILY PRACTICE & PSYCH SERVICES 3 - MERCY HOSPITAL LINCOLN FAMILY PRAC 1165 EAST CHERRY STREET TROY MO 63379 HOSPITAL BASED OUTPATIENT DEPTS: FAMILY PRACTICE 4 - MERCY HOSPITAL LINCOLN FAM MED ELSBERRY 106 BROADWAY STREET SUITE 3C ELSBERRY MO 63343 HOSPITAL BASED OUTPATIENT DEPTS: FAMILY PRACTICE 5 - MERCY HOSPITAL LINCOLN FAM MED WINFIELD 35 WINFIELD PLAZA WINFIELD MO 63389 HOSPITAL BASED OUTPATIENT DEPTS: FAMILY PRACTICE PART I, LN 7 COL(F): TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $45,305,166. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $5,141,076. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $40,164,090. PART I, LINE 6A COMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050). PART II, COMMUNITY BUILDING ACTIVITIES: MERCY HOSPITAL LINCOLN (MHL) WAS ACQUIRED FROM LINCOLN COUNTY MEDICAL CENTER IN MARCH 2015 AS A CRITICAL ACCESS HOSPITAL. OUR COMMUNITY BUILDING ACTIVITIES HAVE CONTINUED TO PROMOTE THE HEALTH, WELLNESS AND SAFETY OF THE COMMUNITY IN WHICH IT SERVES. THROUGH ACTIVE PARTICIPATION ON COMMUNITY BOARDS, NEIGHBORHOOD/COMMUNITY COALITIONS AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MERCY BUILDS PARTNERSHIPS TO DEVELOP COLLABORATIVE SOLUTIONS TO ADDRESS COMMUNITY NEEDS. MERCY HOSPITAL LINCOLN PARTNERS WITH ORGANIZATIONS, CHURCHES, SCHOOLS AND AREA BUSINESSES TO CONTINUALLY STRIVE TO IMPROVE THE OVERALL HEALTH AND STRENGTH OF THE COMMUNITIES THEY SERVE WITH SPECIAL FOCUS ON THOSE WHO ARE POOR. SOME OF THESE COMMUNITY BUILDING PARTNERSHIPS AND COMMUNITY ENGAGEMENT ACTIVITIES INCLUDE:- LINCOLN COUNTY HEALTH DEPARTMENT- LINCOLN COUNTY RESOURCE BOARD- LINCOLN COUNTY COUNCIL ON AGING/SENIOR TASK FORCE- STS. JOACHIM & ANN CARE SERVICE- TROY AREA CHAMBER OF COMMERCEIN ADDITION, MHL ACTIVELY PARTICIPATES IN COALITIONS THAT ALIGN WITH THE HOSPITAL'S CHNA TOP HEALTH PRIORITIES OF ACCESS TO CARE AND SUBSTANCE USE, SUCH AS:- LINCOLN COUNTY HEALTHY COMMUNITIES- D.A.R.T. DRUG ALCOHOL REDUCTION TEAM TASK FORCE- ST. CHARLES, WARREN & LINCOLN COUNTY CONTINUUM OF CARE FOR ENDING HOMELESSNESSCASH/IN-KIND DONATIONSMERCY PROVIDES CASH AND IN-KIND DONATIONS ALL YEAR LONG THROUGH THE SUPPORT OF CO-WORKER ENGAGEMENT AND COMMUNITY SERVICE ACTIVITIES. THESE COMMUNITY BUILDING ACTIVITIES ALLOW MERCY CO-WORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE TO BETTER UNDERSTAND AND ADDRESS THE NEEDS OF THE COMMUNITY. DURING 2022, CASH DONATIONS WERE GIVEN TO ORGANIZATIONS THROUGHOUT THE COMMUNITY THAT INCLUDED:- TROY R-III SCHOOL DISTRICT- DRUG ALCOHOL REDUCTION TEAM- LINCOLN COUNTY COUNCIL ON AGING A FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND ATWWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS. PART III, LINE 2: TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNT, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED. PART III, LINE 3: THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY 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 4: THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE FOLLOWS:IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE 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 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 PATIENT BALANCES WITH COLLECTION AGENCIES. PART III, LINE 8: IT IS THE POSITION OF MERCY HOSPITALS EAST COMMUNITIES THAT 100% OF ANY SHORTFALL 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'S COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE COMMUNICATION AND/OR REVIEW OF PATIENT ACCOUNTS AS IT RELATES TO ANY SERVICE PROVIDED AT OUR FACILITIES BEFORE TURNING THE ACCOUNT TO BAD DEBT FOR NONPAYMENT. MERCY ACTIVELY SCRUBS ACCOUNTS FOR PAYOR PLAN COVERAGE, INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR PATIENT IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS. MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY FOR ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE AND SOUTHEAST KANSAS. THIS PRESUMPTIVE SCREENING PROCESS DETAILS EVALUATIONS THAT TAKE PLACE PRIOR TO PATIENT BILLING AND ADDITIONALLY PRIOR TO BAD DEBT PLACEMENT. THE PRESUMPTIVE SCREENING WAS PER ENCOUNTER AND DID NOT PROMOTE ANY LOOK-BACK ADJUSTMENTS.MERCY WILL GRANT CHARITY IN SITUATIONS WHERE THERE HAS BEEN AN INABILITY TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION WHEN A PATIENT HAS SUBMITTED AN APPLICATION. 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 PLACEMENT WITH A COLLECTION AGENCY CONSISTENT WITH MERCY MISSION AND VALUES. THIS OCCURS AFTER 3 MONTHLY STATEMENTS HAVE BEEN SENT WITH THE FINAL STATEMENT INCLUDING NOTIFICATION OF PLACEMENT WITH A COLLECTION AGENCY. WHILE MERCY USES THE COLLECTION FOLLOW-UP SERVICES OF COLLECTION AGENCIES, MERCY WILL NOT UTILIZE ANY TYPE OF EXTRAORDINARY COLLECTION ACTIVITY. THE DEFINITION OF EXTRAORDINARY COLLECTION ACTIVITY IS TAKEN FROM THE 501(R) DESCRIPTION. PART VI, LINE 2: COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSIN MARCH OF 2022, MERCY HOSPITAL LINCOLN (MHL) BEGAN PLANNING FOR ITS 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).A COMMUNITY HEALTH COUNCIL (CHC), LED BY THE ADMINISTRATOR OF MERCY HOSPITAL LINCOLN, WAS FORMED AND GUIDED THE NEEDS ASSESSMENT PROCESS. THE COUNCIL CONVENES QUARTERLY AND IS ACCOUNTABLE FOR ENSURING THAT COMMUNITY BENEFIT ACTIVITIES MEET MISSION COMPLIANCE AND IRS GUIDELINES. IT CONSISTS OF MERCY LEADERS FROM VARIOUS DEPARTMENTS, SUCH AS BEHAVIORAL HEALTH, FINANCE, CARE MANAGEMENT, PHILANTHROPY, ETC., IN ADDITION TO A HOSPITAL BOARD MEMBER. THE COUNCIL DETERMINES WHICH HEALTH INITIATIVES WILL BE PUT FORTH IN THE HOSPITAL'S THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).CO-WORKERS IN MERCY'S COMMUNITY HEALTH & ACCESS DEPARTMENT SERVED ON THE COUNCIL AND WERE THE PRIMARY LEADS OF THE 2022 CHNA. LINCOLN COUNTY HEALTH DEPARTMENT PROVIDED SUPPORT BY COLLECTING AND REVIEWING DATA FROM VARIOUS SOURCES. THESE INCLUDED SURVEYS, FOCUS GROUPS, PUBLISHED DATA, AND HOSPITAL-SPECIFIC DATA.THE VOICES OF THE PEOPLE OF LINCOLN COUNTY WERE CENTRAL TO THE HEALTH NEEDS ASSESSMENT PROCESS. MHL GATHERED COMMUNITY INPUT THROUGH:- SURVEYS - ONLINE AND PRINTED (FOR THOSE WITH NO COMPUTER ACCESS)- COMMUNITY FOCUS GROUP- SECONDARY DATA RESEARCHEXTERNAL SOURCES OF PUBLISHED DATA AREA AS FOLLOWS:1. COUNTY HEALTH RANKINGS 2020WWW.COUNTYHEALTHRANKINGS.ORGTHIS RESOURCE PROVIDES COUNTY-LEVEL DATA ON IMPORTANT HEALTH INDICATORS UPDATED ANNUALLY BY THE UNIVERSITY OF WISCONSIN-POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION.2. CDC COMMUNITY HEALTH STATUS INDICATOR REPORTHTTP://WWWN.CDC.GOV/COMMUNITYHEALTH/PROFILE/CURRENTPROFILE/MO/LINCOLN/COMMUNITY HEALTH STATUS INDICATORS (CHSI) 2020 IS AN ONLINE WEB APPLICATION THAT PRODUCES HEALTH STATUS PROFILES FOR EACH OF THE 3,143 COUNTIES IN THE UNITED STATES AND THE DISTRICT OF COLUMBIA. SUMMARY COMPARISON REPORTS PROVIDE AN "AT A GLANCE" SUMMARY OF HOW THE SELECTED COUNTY COMPARES WITH PEER COUNTIES ON THE FULL SET OF PRIMARY INDICATORS. (APPENDIX D)3. MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES BUREAU OF HEALTH INFORMATION AND MICA (MISSOURI INFORMATION FOR COMMUNITY ASSESSMENT)HTTP://HEALTH.MO.GOV/DATA/COMMUNITYDATAPROFILES/INDEX.HTMLTHIS RESOURCE PROVIDES COMMUNITY HEALTH ASSESSMENT PLANNING TOOLS AND COMMUNITY DATA PROFILES ON THIRTY HEALTH INDICATORS ON ALL 115 OF MISSOURI'S COUNTIES.4. COMMUNITY COMMONSHTTP://WWW.COMMUNITYCOMMONS.ORG/THIS RESOURCE IS DESIGNED TO ASSIST HOSPITALS AND OTHER ORGANIZATIONS SEEKING TO BETTER UNDERSTAND THE NEEDS AND ASSETS OF THEIR COMMUNITIES, AND TO ENCOURAGE COLLABORATION TO MAKE MEASURABLE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING.PRIORITIZED SIGNIFICANT COMMUNITY HEALTH NEEDS THE NOMINAL GROUP TECHNIQUE WAS USED IN THE PRIORITY SETTING PROCESS. THE MERCY HOSPITAL LINCOLN COMMUNITY HEALTH COUNCIL WAS PRESENTED WITH THE QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA AND MEMBERS WERE ASKED TO RANK THESE HEALTH ISSUES BY LEVEL OF CONCERN AND ABILITY TO COLLABORATE ON THE ISSUE TO PRODUCE RESULTS. THE STRENGTHS AND SERVICES OF THE HOSPITALS ALONG WITH THEIR STRATEGIC PLANS WERE ALSO CONSIDERED. UPON REVIEW AND DISCUSSION OF THE PRIMARY AND SECONDARY DATA GATHERED, THE HOSPITAL'S STRATEGIC PLANS, AND THE RESOURCES AVAILABLE AT THE HOSPITAL AND IN THE COMMUNITY, THE FOLLOWING PRIORITIES WERE SELECTED: - HOUSING INSTABILITY- SUBSTANCE USE / MENTAL HEALTH- OBESITYTHE COMMUNITY HEALTH COUNCILS THEN CREATED COMMUNITY HEALTH IMPROVEMENT PLANS (CHIP) FOR THEIR HOSPITAL, IDENTIFYING SPECIFIC INITIATIVES RELATED TO IMPROVING EACH OF THESE HEALTH PRIORITIES. THE CHIPS WERE DESIGNED WITH REALISTIC, MEASURABLE, AND ATTAINABLE GOALS THAT ALIGN WITH THE MISSION AND STRATEGY OF THE ORGANIZATIONS. PART VI, LINE 3: MERCY INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNTS IS PLACED FOR REVIEW. IN ADDITION, PATIENT HAVE SIGNAGE ABOUT THE POLICY AT THE ACCESS POINTS, AND ALL STAFF WORKING WITH THE PATIENT AT POINT OF SERVICE, SCHEDULING, CUSTOMER SERVICE, AND EVEN THROUGH THE MEDICAID ELIGIBILITY SCREENING, HAVE THE MEANS TO SEND THE ACCOUNT FOR REVIEW. THERE IS THE PLAIN LANGUAGE SUMMARY THAT IS BEING PROVIDED TO ALL WHOM EXPRESS HARDSHIP WHEN PRESENTING IN THE FACILITIES. IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS (BILLING) INCLUDES MESSAGING TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL LINCOLN INCLUDES 14 ZIP CODES ACROSS MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND MO/HIDI ANALYTICS 2022-2023. THE AREA'S POPULATION IS 69,966. THE MEDIAN HOUSEHOLD INCOME IS $57,000. 40.1% OF THE POPULATION IS 45 AND OLDER. 89% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 37. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHMERCY PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. MERCY IS A CATHOLIC HEALTH CARE CORPORATION THAT, PURSUANT TO THE ORGANIZATIONAL CORE BELIEF, THAT HEALTH CARE SERVICES ARE A VITAL AND INTEGRAL PART OF THE CHURCH'S HEALING MISSION, ENGAGES IN A MINISTRY WHICH PROVIDES GENERAL ACUTE CARE, AMBULATORY, LONG-TERM AND HOME CARE HEALTH SERVICES TO INDIVIDUALS AND FAMILIES IN ITS COMMUNITIES. MERCY OFFERS SERVICES AND PROGRAMS WHICH FURTHER HEALTH PROMOTION, MAINTENANCE AND CARE TO THE COMMUNITY. PROGRAMS PROVIDED TO MEET THE COMMUNITY INCLUDE SUPPORT GROUPS, OUTREACH EVENTS, BLOOD DRIVES, AND CO-WORKER WORKDAYS. MERCY IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS FROM A VARIETY OF SECTORS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARE SERVED. SURPLUS FUND AND UNRESTRICTED ASSETS HELD ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES.OPEN MEDICAL STAFFMEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR NEARLY ALL OF OUR DEPARTMENTS. MERCY HOSPITAL LINCOLN HAS EXCLUSIVE CONTRACTS WITH PHYSICIAN GROUPS FOR THE FOLLOWING SERVICES: RADIOLOGY AND PATHOLOGY. THIS MEANS THAT GREATER THAN 90% OF THE PHYSICIANS ON STAFF ARE IN CATEGORIES THAT ARE OPEN TO QUALIFIED PHYSICIANS IN THE COMMUNITY.COMMUNITY BOARDS - FY23 MERCY HEALTH EAST COMMUNITIES FY23 BOARD MEMBERSDON ARNOLD, M.D.KELLY BAIN, M.D.JON BAUER, PHDCRAIG BOYD, MDMATUSKCHKA LINDO-BRIGGSAPOLLO CAREYJANICE DENIGANDENNIS GANNONSR. MICHAEL MARY GUTOWSKI, RSMSR. MIRIAM NOLAN, RSMJOHN PORTERWINTHROP B. REED, IIICHARLES REHM, M.D.KEVIN SHORT MERCY HOSPITAL LINCOLN FY23 BOARD MEMBERSSARAH BURKEMPERJOHN KELLYBRADLEY MASSEY, DOANNETTE MEYERDR. MARK PENNYDR. TIM RELLERHARVEY RHOADSSR. CLAUDIA WARD RSM USE OF SURPLUS FUNDSSURPLUS FUNDS AND UNRESTRICTED ASSETS HELD BY MERCY HOSPITAL LINCOLN ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES. EXAMPLES INCLUDE THE FOLLOWING:- MERCY HOSPITAL AND MERCY CLINICS IN LINCOLN CONTINUED OPERATIONS ON EPIC, OUR ELECTRONIC HEALTH RECORD SYSTEM. BESIDES CONNECTING THE LINCOLN HOSPITAL WITH MERCY HOSPITALS AND 300 OUTPATIENT FACILITIES ACROSS ARKANSAS, KANSAS, MISSOURI AND OKLAHOMA, THE ELECTRONIC HEALTH RECORD ALSO SERVES AS A CENTRAL STORAGE POINT FOR MEDICAL INFORMATION. THIS "ONE PATIENT, ONE RECORD" CONCEPT MAKES HEALTH CARE EASIER, SAFER AND MORE EFFECTIVE.- OPENED A NEW ORTHOPEDIC OFFICE ON SITE THAT SEES PATIENTS FROM THE LOCAL PRIMARY CARE OFFICES AS WELL AS THE URGENT CARE AND EMERGENCY DEPARTMENT. OFTEN TIMES THEY CAN BE SEEN THE SAME DAY. - CONTINUED EXPANSION OF PRIMARY CARE AND SPECIALTY CARE PHYSICIANS TO THE MERCY HOSPITAL LINCOLN SERVICE AREA WITH A FOCUS TO REACH THE UNDERSERVED POPULATIONS CLOSER TO THEIR HOMES- CONTINUED PARTNERING WITH AREA EDUCATION PROGRAMS TO HELP PROMOTE THE TRAINING OF CRITICALLY NEEDED SERVICES FOR THE COMMUNITY INCLUDING SCHOOLS OF NURSING, RADIOLOGY AND PHARMACY- CONTINUED PARTNERING WITH THE LINCOLN COUNTY RESOURCE BOARD TO ADDRESS THE BEHAVIORAL HEALTH NEEDS OF THE COUNTYADDITIONAL COMMUNITY HEALTH INITIATIVE/INFORMATIONCURRENTLY NOT INCLUDED THROUGH THE REPORTING OF COMMUNITY BENEFIT OR COMMUNITY BUILDING ACTIVITIES ARE:IN KEEPING WITH MHL'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, MHL PROVIDES:- FREE CARE AND/OR SUBSIDIZED CARE- CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST- HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY- HEALTH EDUCATION PROGRAMS, AND- A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.NUMEROUS COLLECTION DRIVES BY CO-WORKERS ARE HELD THROUGHOUT THE YEAR AND THE ITEMS, SUCH AS FOOD, CLOTHING, PERSONAL CARE ITEMS, GAS CARDS, SCHOOL SUPPLIES AND OTHER CRITICAL ITEMS ARE DONATED TO NON-PROFIT AGENCIES TO DISTRIBUTE TO THEIR CLIENTS. MERCY NEIGHBORHOOD MINISTRY (MNM)MERCY NEIGHBORHOOD MINISTRY IS A DEPARTMENT THAT SUPPORTS THE SERVICE AREAS OF MERCY HOSPITALS LINCOLN, ST. LOUIS, WASHINGTON, JEFFERSON AND THE SURROUNDING COUNTIES. IT FOCUSES ON CONNECTING THE ECONOMICALLY UNDERSERVED WITH APPROPRIATE HEALTH AND SOCIAL SERVICES AS WELL AS OVERALL COMMUNITY HEALTH AND ACCESS THROUGH PROMOTION AND EDUCATION OF AVAILABLE PROGRAMS. MNM PARTNERS WITH OVER 100 COMMUNITY HEALTH AND SOCIAL SERVICE AGENCIES, CLINICS, CHURCHES AND SCHOOLS. NEARLY HALF OF ITS ANNUAL EXPENSES ARE OFFSET THROUGH MERCY FOUNDATION. MANY OF THE PROGRAMS MENTIONED BELOW ARE PART OF OUR CURRENT COMMUNITY HEALTH IMPACT PLAN (CHIP). THESE ARE INDICATED BY ASTERISKS.ACCESS TO CAREMERCY ELIGIBILITY PROGRAM*SINCE THE BEGINNING OF OPEN ENROLLMENT THROUGH THE AFFORDABLE CARE ACT IN AUGUST 2013, MERCY HAS HELPED THOSE IN NEED OF AFFORDABLE HEALTH INSURANCE TO ENROLL IN PLANS AND/OR EDUCATE THEM ABOUT THEIR OPTIONS. ENROLLMENTS TO-DATE TOTAL OVER 1,000 COVERED LIVES AND ATTENDED EVENTS RESULTING IN EDUCATIONAL OPPORTUNITIES IN UNDERSTANDING THE TERMINOLOGY AND USAGE OF HEALTH INSURANCE.BEHAVIORAL HEALTH SUBSTANCE USEPDMP*AS MISSOURI IS THE ONLY STATE IN THE UNION WITHOUT A PRESCRIPTION DRUG MONITORING PROGRAM, ADVOCACY EFFORTS CONTINUE TO APPEAL TO THE STATE. PROVIDER EDUCATION CONTINUES TO PROMOTE USING THE ST. LOUIS COUNTY/MULTI-COUNTY SYSTEM IN PLACE. NARCAN TRAINING*MERCY HOSPITAL WASHINGTON ENTERED INTO PARTNERSHIP TO TRAIN FIRST RESPONDERS IN SEVERAL COUNTIES ON THE USE OF NARCAN (NALOXONE) WHICH REVERSES THE EFFECTS OF AN OPIOID OVERDOSE AND STORE THE NALOXONE AT MERCY. LINCOLN COUNTY AND MERCY HOSPITAL LINCOLN WERE PART OF THE PARTNERSHIP.MERCY ROAD TO FREEDOMTHIS PROGRAM WAS OFFERED TO THE COMMUNITY AND MERCY CO-WORKERS AS A TELEPHONIC, ONE-ON-ONE SUPPORT SYSTEM WITH A SPECIALTY TRAINED COUNSELOR TO STOP USING TOBACCO PRODUCTS. SINCE 2013, OVER 100 PEOPLE HAVE KICKED THE HABIT.PHYSICIANSMERCY HEALTH SYSTEM HAS A LARGE NUMBER OF CLINICS, PHYSICIAN OFFICES AND OTHER HEALTHCARE FACILITIES LOCATED IN THE EAST COMMUNITY THAT ARE NOT ASSOCIATED WITH A HOSPITAL EIN. THESE CLINICS AND FACILITIES PROVIDE FINANCIAL ASSISTANCE, PARTICIPATE IN HEALTH PROFESSIONS EDUCATION (I.E. STUDENT SHADOWING) AND PROVIDE IN-KIND CONTRIBUTIONS TO THEIR COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE FILING ORGANIZATION IS PART OF MERCY HEALTH ("MERCY"). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS ("MINISTRY OFFICE") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN ARKANSAS, LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS "AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE." AS OF JUNE 30, 2023, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 6 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2023, MERCY HAD MORE THAN 10.9 MILLION CLINIC AND OUTPATIENT VISITS, APPROXIMATELY 2,400 EMPLOYED PHYSICIANS, AND APPROXIMATELY 45,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES. 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: FINANCE (INCLUDING TREASURY, FINANCIAL ACCOUNTING AND REPORTING, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTS PAYABLE AND PAYROLL OPERATIONS, ANALYTICS AND DECISION SUPPORT); ENVIRONMENTAL SERVICES SUPPORT; CLINICAL INTEGRATION; CARE MANAGEMENT; CLINICAL PERFORMANCE ACCELERATION; CLINICAL ENGINEERING; CLINICAL QUALITY MANAGEMENT; COMPLIANCE; GRANTS AND RESEARCH SERVICES; LEGAL AND COMPLIANCE COUNSEL; MARKETING AND COMMUNICATIONS; PLANNING, DESIGN AND CONSTRUCTION; PRODUCT DEVELOPMENT INFORMATICS; REAL ESTATE; SUPPLY CHAIN MANAGEMENT; MANAGED CARE STRATEGY SUPPORT; HUMAN RESOURCES (INCLUDING COMPENSATION, BENEFITS AND RECRUITING); MISSION SERVICES AND ETHICS; PHILANTHROPY SUPPORT; INFORMATION TECHNOLOGY; AND, COMMUNITY RELATIONS. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS. PART VI, LINE 7, REPORTS FILED WITH STATES MO COVID-19 PLEASE SEE SCHEDULE O FOR INFORMATION RELATED TO COVID-19. 1 MERCY HEALTH FOUNDATION LINCOLN 1000 EAST CHERRY STREET TROY MO 63379 811477159 501C3 6511 0 CHARITABLE SUPPORT 1 0 CAR/VAN SERVICE 9 1610 STUDENT SCHOLARSHIPS 2 2000 PART I, LINE 2: THE ORGANIZATION USES AN APPROVAL PROCESS TO DETERMINE WHICH ORGANIZATIONS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE DEPARTMENT, AS THEY ARE EARNED. GRANTS ARE OFTEN MADE TO RELATED ORGANIZATIONS. THE ORGANIZATION USES AN APPROVAL PROCESS, WHEN APPLICABLE, TO DETERMINE WHICH INDIVIDUALS WILL RECEIVE GRANTS DURING THE FISCAL YEAR. THE FUNDS ARE THEN GIVEN DIRECTLY TO THE INDIVIDUALS. 1 0 0 0 0 0 0 0 0 MACKIN STEPHEN L FORMER OFFICER 0 1379837 0 1777017 0 58943 0 415147 0 19394 0 3650338 0 487532 JOHNSTON JEFFREY A FORMER KEY EMPLOYEE 0 -10246 0 1300000 0 881522 0 23649 0 50 0 2194975 0 0 MATEJKA CHERYL L FORMER OFFICER 0 671340 0 387006 0 139293 0 113518 0 14307 0 1325464 0 0 MASSEY BRADLEY PHYSICIAN & BOARD MEMBER 0 556384 0 9107 0 28525 0 19225 0 16184 0 629425 0 0 ROTHERMICH ANTHONY VP, OPERATIONS 0 230088 0 30346 0 32896 0 33787 0 19465 0 346582 0 0 ECKHARDT CHRISTIE VP, CHIEF OPERATIONS COUNSEL & SECRE 0 244381 0 30223 0 32425 0 10189 0 16052 0 333270 0 0 SMITH ALAN ADMINISTRATOR 0 208021 0 25831 0 50856 0 12097 0 11092 0 307897 0 0 NEILL DAVID A NURSE ANESTHETIST 0 208404 0 0 0 34890 0 8074 0 10973 0 262341 0 0 LOUZADER WILLIAM REGISTERED NURSE 0 160819 0 3750 0 26959 0 12357 0 18471 0 222356 0 0 THORN MARK A EXEC DIRECTOR, FINANCE 0 141602 0 12477 0 27152 0 10161 0 7383 0 198775 0 0 KLIETHERHMES JACOB EXEC DIRECTOR, NURSING 0 137592 0 12360 0 23367 0 12646 0 7430 0 193395 0 0 GRAY JACQUELINE REGISTERED NURSE 0 163361 0 5000 0 5441 0 7582 0 7157 0 188541 0 0 HILL NICHOLAS NURSE ANESTHETIST 0 148575 0 0 0 26808 0 4399 0 2623 0 182405 0 0 PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAY: JEFFREY JOHNSTON $854,474 MERCY HEALTH, THE ULTIMATE PARENT COMPANY, OFFERS A SUPPLEMENTAL RETIREMENT PLAN TO CERTAIN EXECUTIVES WHICH PROVIDE BENEFITS UPON VESTING DATE BASED ON COMPENSATION, AGE AT THE TIME OF BENEFIT COMMENCEMENT, LENGTH OF SERVICE WITH THE COMPANY AND/OR ITS AFFILIATES, AND LENGTH OF TENURE IN THE PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN: N/A THE AMOUNT OF ALL ACCRUED BENEFITS IS INCLUDED IN COMPENSATION AMOUNTS PROVIDED IN SCHEDULE J, PART II, COLUMN (C). THE AMOUNTS REPORTED FOR STEVE MACKIN IN COLUMN (F) ARE EITHER INCLUDED IN B(I) BASE COMPENSATION, B(II) AS BONUS AND INCENTIVE COMPENSATION, OR B(III) AS OTHER REPORTABLE COMPENSATION. THESE AMOUNTS ARE A PAYOUT OF THE EXECUTIVE RETENTION PLAN AND WERE INCLUDED IN COLUMN (C) OF PREVIOUSLY FILED FORMS 990. FORM 990, SCHEDULE J, PART I, QUESTION 3 MERCY HEALTH (ULTIMATE PARENT COMPANY) IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THE FOLLOWING METHODS WERE USED BY MERCY HEALTH TO ESTABLISH COMPENSATION: -INDEPENDENT COMPENSATION CONSULTANT -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PATRICIA RHOADS FAMILY MEMBER OF BOARD MEMBER (HARVEY RHOADS) 61747 EMPLOYMENT ARRANGEMENT, MERCY HOSPITAL LINCOLN 0 FORM 990, PART VI, SECTION A, LINE 6 THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, MERCY HOSPITALS EAST COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 7A MERCY HEALTH, THE ULTIMATE PARENT COMPANY AND THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, HAS RESERVE POWERS TO APPOINT AND REMOVE ALL DIRECTORS AND OFFICERS FOR MERCY HEALTH EAST COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO THE CORPORATE MEMBER (AND WITH REGARD TO CERTAIN POWERS AND RESPONSIBILITIES, TO MERCY HEALTH EAST COMMUNITIES AS THE CORPORATE MEMBER OF THE CORPORATE MEMBER OR TO MERCY HEALTH): A. APPROVAL OF REVISIONS TO THE MISSION, VISION AND OPERATING VALUES PURSUANT TO WHICH THE CORPORATION OPERATES; B. APPROVAL OF ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THESE BYLAWS AND ANY AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE OF THE CORPORATION; C. APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD; D. APPROVAL OF THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION SUBJECT TO THE CONSENT OF MERCY HEALTH EAST COMMUNITIES; E. ADOPTION OF THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION; F. ADOPTION OF THE OPERATING, CAPITAL AND ALL OTHER BUDGETS FOR THE CORPORATION; G. APPROVAL OF THE ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000) IN ANY ONE OR SERIES OF RELATED TRANSACTIONS OCCURRING WITHIN ANY TWELVE (12) MONTH PERIOD; H. AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; I. APPROVAL OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; J. APPROVAL OF THE LEASE, MANAGEMENT OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HOSPITAL SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION; AND, K. TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION. L. OVERSEE, APPROVE AND MONITOR HUMAN RESOURCE PROGRAMS, WHICH SHALL PROMOTE AN ORGANIZATIONAL ENVIRONMENT THAT: 1. PROVIDES FOR THE RECRUITMENT AND RENTION OF CO-WORKERS WHO ARE SERVICE ORIENTED, COMPASSIONATE, ENGAGED, AND WHO FIND MEANING AND PURPOSE IN WORKING IN A FAITH-BASED ORGANIZATION; 2. ENABLES PEOPLE TO RELATE TO ONE ANOTHER WITH RESPECT AND ACCEPTANCE IN A SPIRIT OF COMMUNITY; 3. PROMOTES CO-WORKER PARTICIPATION AND VOICE IN THEIR WORK LIVES; 4. GIVES CO-WORKERS A FAIR OPPORTUNITY TO DEVLEOP THEIR SKILLS AND TALENTS, AND A MEANS BY WHICH THEIR CONTRIBUTIONS ARE RECOGNIZED; 5. PROVIDES CO-WORKERS WITH THE MATERIALS AND EQUIPMENT TO PROPERLY DO THEIR WORK; AND, 6. ENSURES CO-WORKER SAFETY AND WELL-BEING. FORM 990, PART VI, SECTION B, LINE 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 LEADERSHIP. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'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, SECTION B, LINE 12C OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY AND DID SO IN THE NORMAL COURSE FOR THE YEAR ENDED JUNE 30, 2023. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S CORPORATE COMPLIANCE DEPARTMENT. THE QUESTIONNAIRES ARE REVIEWED WITH LEADERSHIP AT THE LOCAL LEVEL AND POTENTIAL CONFLICTS DISCUSSED AND RESOLVED. THE CONFLICTS AND THEIR RESPECTIVE RESOLUTIONS ARE SHARED AT THE MERCY LEVEL WITH A TEAM INCLUDING MERCY'S CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER AND OTHER MEMBERS OF FINANCE, LEGAL AND HR. SUMMARY RESULTS ARE REVIEWED WITH MERCY'S STEWARDSHIP COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 FOR THE TOP MANAGEMENT OFFICIALS, THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS) AND KEY EMPLOYEES, THE ORGANIZATION RELIES UPON MERCY HEALTH (ULTIMATE PARENT COMPANY), 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 COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS AND A REVIEW WAS COMPLETED DURING THE REPORTING YEAR. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BUT ARE NOT PUBLISHED PUBLICLY; WE ARE NOT REQUIRED TO MAKE THESE DOCUMENTS AVAILABLE TO THE PUBLIC. FINANCIAL RESULTS ARE AVAILABLE VIA REQUEST OF COPY OF FORM 990. FORM 990, PART VII, SECTION A, COLUMN B AVERAGE HOURS PER WEEK THE HOURS PER WEEK DISCLOSED IN PART VII IS THE AVERAGE HOURS THE LISTED PERSON WORKED OR DEVOTED PER WEEK WHILE EMPLOYED OR ASSOCIATED WITH THE FILING ORGANIZATION AND RELATED ORGANIZATIONS (IF APPLICABLE). FORM 990, PART XI, LINE 9: NET TRANSFERS TO/FROM AFFILIATES -11,727,565. ROUNDING -3. PART XII, LINE 2 AUDIT OF FINANCIAL STATEMENTS 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 2023 (THE TAX YEAR CURRENTLY BEING REPORTED). HOWEVER, NO SEPARATE AUDIT OPINION WAS ISSUED ON THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION. THE ULTIMATE RESPONSIBILITY FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE EXTERNAL AUDITOR LIES WITH THE STEWARDSHIP COMMITTEE OF THE MERCY HEALTH BOARD OF DIRECTORS. AUDIT RESULTS ARE COMMUNICATED TO THIS COMMITTEE. PART XII, LINE 3A AND 3B SINGLE AUDIT ACT AND 2 CFR 200 AUDIT MERCY HEALTH UNDERGOES A CONSOLIDATED 2 CFR 200 AUDIT EVERY YEAR AND THIS AUDIT WAS COMPLETED FOR THE FISCAL YEAR ENDING JUNE 30, 2023 BY MARCH 31, 2024. EACH ENTITY THAT RECEIVES FEDERAL FUNDS DURING THE YEAR IS INCLUDED ON THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) AND IS ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. IF THE FILING ENTITY RECEIVED FEDERAL FUNDS DURING THE YEAR ENDED JUNE 30, 2023, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT. FORM 990, SCHEDULE R, PART V SYSTEM LIMITATIONS MERCY HEALTH (MERCY) HAS A COMPLEX LEGAL STRUCTURE WITH OVER 60 LEGAL ENTITIES. LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY MERCY AND THE MAJORITY OF THE INTERCOMPANY/RELATED ORGANIZATION TRANSACTIONS ARE PROCESSED THROUGH LAWSON. WITH THE CURRENT DESIGN OF THE ERP SYSTEM, THERE ARE VARIOUS LIMITATIONS ON EXTRACTING THE INTERCOMPANY/RELATED ORGANIZATION INFORMATION 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 P AND Q. FORM 990, PART V, LINE 2A W-3 FILING SALARIES AND WAGES WITH LIMITED EXCEPTIONS, THE SALARIES AND WAGES REPORTED ON FORM 990, PART IX, LINE 7 REPRESENT AN ALLOCATION OF SALARIES AND WAGES FROM A RELATED ORGANIZATION. MOST EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT. AS SUCH, ALL REQUIRED PAYROLL FILING FOR THESE EMPLOYEES (INCLUDING W-2 AND W-3'S) IS REPORTED UNDER THE RELATED ORGANIZATION, MHM SUPPORT SERVICES,EIN 20-2553101. FORM 990, PART V, QUESTION 1A INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS FOR THE FILING ORGANIZATION ARE PAID BY THE MERCY HEALTH (EIN 43-1423050). AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE HEALTH SYSTEM (WITH LIMITED EXCEPTIONS) UNDER THE MERCY HEALTH EIN. FORM 990, SCHEDULE R, PART II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITALS EAST COMMUNITIES ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITALS EAST COMMUNITIES WASHINGTON, EIN 43-1066883. COVID-19 EARLY IN 2020, THE MERCY HEALTH SYSTEM WAS CALLED TO SERVE AS THE COVID-19 PANDEMIC SWEPT ACROSS THE WORLD. DURING FY 2023, THE IMPACT OF COVID-19 AND INFLATION HAS BEEN AND STILL IS SIGNIFICANT TO OUR COMMUNITIES WITH CHANGES IN PATIENT CARE REVENUES DUE TO SURGES, INCREASING THE COSTS OF SALARIES AND AGENCY LABOR, AND SUPPLY CHAIN IMPACTS. ALL MERCY FACILITIES ADJUSTED OPERATIONS FOR THE IMPACTS OF THE PANDEMIC. IN ADDITION, MERCY FOUNDATIONS AND OUTREACH MINISTRIES EXPERIENCED LIMITATIONS IN FUNDRAISING FOR PROGRAM AND CAPITAL SUPPORT EFFORTS THAT ASSIST THE UNDERSERVED IN OUR COMMUNITIES. MERCY DID RECEIVE FUNDING FROM THE CORONAVIRUS AID RELIEF AND ECONOMIC SECURITY ACT ("CARES ACT"). MERCY RECEIVED CARES ACT FUNDING FOR THE PAST FOUR FISCAL YEARS ACROSS VARIOUS ENTITIES AND RECOGNIZED A PORTION OF THIS FUNDING IN OTHER OPERATING REVENUE. THESE FUNDS HELPED TO OFFSET REVENUE LOSSES AND ADDITIONAL EXPENSES INCURRED DUE TO THE PANDEMIC; HOWEVER, THESE FUNDS FELL SHORT OF THE SYSTEM LOSSES EXPERIENCED SINCE THE START OF THE PANDEMIC. MERCY CONTINUES TO MONITOR THE IMPACTS OF THE PANDEMIC BOTH TO THE HEALTH SYSTEM AND THE COMMUNITIES SERVED AS WE CONTINUE TO PROVIDE ASSISTANCE AND MAINTAIN ACCESS TO CARE WITHIN OUR COMMUNITIES. 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