Mercy Hospital Booneville

“Classes of members or stockholders the filing organization has a sole corporate member, mercy hospital fort smith. The following corporate powers and responsibilities are reserved solely for the corporate member: -approval of revisions to the mission, vision and operating values pursuant to which the corporation operates; -approval of any amendments to the articles of incorporation and the bylaws and any amendments to the organizational documents of any affiliate of the corporation; -appointment and removal of members of the board, as provided in sections 5.2 and 5.10 of the bylaws; -approval of the appointment and removal of the president of the corporation as provided in sections 7.2.1 and 7.3 of the bylaws; -adoption of the strategic plan, goals and objectives of the corporation; -adoption of the operating, capital, and all other budgets for the corporation; -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; -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; -approval of a plan of merger, consolidation or dissolution of the corporation; -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, -approval of 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 finance 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, 2017. 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.”

“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.”

“Other program services the critical access hospital is essential to the health of the community. The hospital offers a wide variety of services, including emergency services, acute care, short-term inpatient care, as well as many others that contribute to good health. The community need is represented by the approximately 31,900 visits to mercy hospital booneville.”

“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. Form 990, part v, question 2a w-3 filing most employees are paid by a related organization under a common paymaster arrangement. As such, required payroll filing (including w-2 and w-3's) is reported under the related organization, mhm support services, ein 20-2553101.”

“Other changes in net assets net transfers to/from affiliates = $2,593,495”

“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 2017 (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.”

“Single audit act and omb circular a-133 mercy health undergoes a consolidated a-133 audit every year and did so for the fiscal year ending june 30, 2017. 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 available for audit. The filing entity received federal funds during the year ended june 30, 2017, was included on the mercy health consolidated sefa, and therefore, was also included in the population available for audit.”