Mercy Hospital Carthage

“Classes of members or stockholders the filing organization has a sole corporate member, mercy health southwest missouri/kansas communities. The following corporate powers and responsibilities shall be reserved solely to the corporate member: -to approve the mission and establish the philosophy according to which the corporation, and all organizations controlled by the corporation, shall operate; -to adopt or amend the articles of incorporation and bylaws; -to appoint and remove, with or without cause, members of the board; -through the sole action of the president of mh, to appoint and remove, with or without cause, the chief executive officer who shall serve as president of the corporation; -to approve or amend the strategic, long range, and health manpower development plans, goals, and objectives of the corporation; -to approve or amend the operating, capital, and construction budgets for the corporation; -to assign, transfer, lease or sell any of the assets of the corporation; -to encumber any or all of the assets of the corporation; -to authorize and approve the incurrence of debt by the corporation; -to merge, dissolve, or abandon the corporation; and, -to approve the creation, ownership or acquisition of, or affiliation with, any other organization controlled by the corporation.”

“Dscr the 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 director of accounting and the vice-president of finance. The draft form 990 is also reviewed by mercy health's tax department, to ensure accuracy and consistency with other related organizations' forms 990. After questions arising from the various reviews are addressed and incorporated into the form 990, a revised draft is provided to the filing organization's leadership team, including the cfo and ceo, for review. Once reviewed and approved by the filing organization's leadership team, the form 990 is provided to the board of directors for review; it is then signed and filed with the irs.”

“Description of process to monitor transactions for conflicts of interest 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, 2014. This process is administered at the mercy health level by mercy's business risk (internal audit) department. The questionnaires are reviewed with leadership at the local level and potential conflicts discussed and resolved. The conflicts and their respective resolutions are shared at the mercy level with a team including mercy's chief financial officer, chief compliance officer and other members of finance, legal and hr. Summary results are reviewed with mercy's stewardship committee (formerly finance, audit and compliance committee) of the board of directors.”

“Officers & 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 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.”

“Avail of gov docs, conflict of interest policy, & fin stmt to gen public governing documents, conflict of interest policy, and financial statements are made available upon request but are not published publicly.”

“Average hours per week the hours per week disclosed in part vii are 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 1099/1096 filing 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 system (with limited exceptions) under the mercy health ein.”

“Other fees physician/medical services = $2,913,003 consulting fees = $1,786,915 miscellaneous fees for services = $1,897,380 total = $6,597,298”

“Other changes in net assets release of net assets for equipment (capitalized): $(95,061)”

“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 2014 (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 (formerly finance, audit, and compliance committee) of the mercy health board of directors. Audit results are communicated to this committee.”