SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
MERCY HOSPITAL FORT SMITH
 
Employer identification number

71-0240352
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)Casa de Misericordia
1000 Mier St

Laredo,TX78040
74-2912461
SHELTER TX 501c3 7 MM LAREDO
 
Yes
 
(2)McAuley Portfolio Management Company
14528 S Outer Forty Suite 100

Chesterfield,MO63017
26-1708048
PORT MGMT MO 501c3 12b Mercy Health
 
Yes
 
(3)Mercy ACO Clinical Services Inc
14528 S Outer Forty Suite 100

Chesterfield,MO63017
46-4504901
VIRTUAL CARE MO 501c3 3 Mercy Health
 
Yes
 
(4)Mercy Clinic East Communities
645 MARYVILLE CTR STE 100

St Louis,MO63141
43-1771217
PHYS GROUP MO 501c3 10 MH EAST COMM
 
Yes
 
(5)Mercy Clinic Fort Smith Communities
7301 Rogers Avenue

Fort Smith,AR72903
26-1318597
PHYS CLINIC AR 501c3 3 MH FS COMM
 
Yes
 
(6)Mercy Clinic Oklahoma Communities Inc
4300 W Memorial Road

Oklahoma City,OK73120
27-0473057
PHYS GROUP OK 501c3 3 MH OK COMM
 
Yes
 
(7)Mercy Clinic Springfield Communities
1965 Fremont St Suite 2950

Springfield,MO65804
43-1560263
PHYS GROUP MO 501c3 3 MH SF COMM
 
Yes
 
(8)Mercy Family Center
14528 S Outer Forty Suite 100

Chesterfield,LA63017
72-1069468
COUNSELING LA 501c3 7 Mercy Health
 
Yes
 
(9)Mercy Health
14528 S Outer Forty Suite 100

Chesterfield,MO63017
43-1423050
CORP OFFICE MO 501c3 1 NA
 
 
No
(10)Mercy Health East Communities
14528 S Outer Forty Suite 100

Chesterfield,MO63017
43-1718408
HLTH SYSTEM MO 501c3 12a Mercy Health
 
Yes
 
(11)Mercy Health Fort Smith Communities
7301 Rogers Avenue

Fort Smith,AR72917
26-1318515
HOLDING CO AR 501c3 12b Mercy Health
 
Yes
 
(12)Mercy Health Foundation
14528 S Outer Forty Suite 100

Chesterfield,MO63017
20-0901499
Foundation MO 501c3 12b Mercy Health
 
Yes
 
(13)Mercy Health Foundation Ada
430 N Monte Vista Street

Ada,OK74820
46-3596274
Foundation OK 501c3 12a MH ADA INC
 
Yes
 
(14)Mercy Health Foundation Ardmore
1011 14th Avenue NW

Ardmore,OK73401
71-0962525
Foundation OK 501c3 12a MH ARDMORE
 
Yes
 
(15)Mercy Health Foundation Berryville
214 Carter Street

Berryville,AR72616
71-0759301
Foundation AR 501c3 12a MH BERRYVILL
 
Yes
 
(16)Mercy Health Foundation Fort Scott
401 Woodland Hills Blvd

Fort Scott,KS66701
48-1077073
Foundation KS 501c3 7 M KS COMM
 
Yes
 
(17)Mercy Health Foundation Fort Smith
7301 Rogers Avenue

Fort Smith,AR72917
23-7330425
Foundation AR 501c3 7 MH FS COMM
 
Yes
 
(18)Mercy Health Foundation Jefferson
1400 US Highway 61 South

Festus,MO63028
46-2797051
Foundation MO 501c3 12b MH JEFFERSON
 
Yes
 
(19)Mercy Health Foundation Joplin
100 Mercy Way

Joplin,MO64804
27-0906136
Foundation MO 501c3 7 MH SW MOKS
 
Yes
 
(20)Mercy Health Foundation Lebanon
100 Hospital Drive

Lebanon,MO65536
82-2514567
Foundation MO 501c3 12b MH LEBANON
 
Yes
 
(21)Mercy Health Foundation Lincoln
1000 East Cherry Street

Troy,MO63379
81-1477159
Foundation MO 501c3 12b MH EAST COMM
 
Yes
 
(22)Mercy Health Foundation NW Arkansas
2710 Rife Medical Lane

Rogers,AR72758
71-0601687
Foundation AR 501c3 7 MH ROGERS
 
Yes
 
(23)Mercy Health Foundation of Oklahoma
4300 W Memorial Road

Oklahoma City,OK73120
45-4732301
Foundation OK 501c3 12a MH OK COMM
 
Yes
 
(24)Mercy Health Foundation Oklahoma City
4300 W Memorial Road

Oklahoma City,OK73120
46-3184231
Foundation OK 501c3 12a MH OK CITY
 
Yes
 
(25)Mercy Health Foundation Springfield
1235 E Cherokee Street

Springfield,MO65804
32-0195818
Foundation MO 501c3 12b MH SF COMM
 
Yes
 
(26)Mercy Health Foundation St Francis
100 W Highway 60

Mountain View,MO65548
43-1873914
Foundation MO 501c3 12a M ST FRANCIS
 
Yes
 
(27)Mercy Health Foundation St Louis
14528 S Outer Forty Suite 100

Chesterfield,MO63017
56-2410020
Foundation MO 501c3 12b MH EAST COMM
 
Yes
 
(28)Mercy Health Foundation Washington
901 E Fifth Street

Washington,MO63090
56-2410022
Foundation MO 501c3 12b MH EAST COMM
 
Yes
 
(29)Mercy Health NW Arkansas Communities
2710 Rife Medical Lane

Rogers,AR72758
62-1684203
PHYS GROUP AR 501c3 10 Mercy Health
 
Yes
 
(30)Mercy Health Oklahoma Communities Inc
4300 W Memorial Road

Oklahoma City,OK73120
73-1453048
HLTH SYSTEM OK 501c3 12a Mercy Health
 
Yes
 
(31)Mercy Health Plans of Missouri Inc
3265 S National Avenue

Springfield,MO65807
32-0481419
HMO MO 501c4 N/A Mercy Health
 
Yes
 
(32)Mercy Health Plans Inc
3265 S National Avenue

Springfield,MO65807
32-0486150
PPO MO 501c4 N/A MH PLANS MO
 
Yes
 
(33)MERCY HEALTH SW MOKS COMMUNITIES
100 Mercy Way

Joplin,MO64804
30-0584463
HLTH SYSTEM MO 501c3 12b Mercy Health
 
Yes
 
(34)Mercy Health Springfield Communities
1235 E Cherokee Street

Springfield,MO65804
43-1856028
HLTH SYSTEM MO 501c3 12b Mercy Health
 
Yes
 
(35)Mercy Hospital Ada Inc
430 N Monte Vista Street

Ada,OK74820
46-2288155
Hospital OK 501c3 3 MH OK COMM
 
Yes
 
(36)Mercy Hospital Ardmore Inc
1011 14th Avenue NW

Ardmore,OK73401
73-1500629
Hospital OK 501c3 3 MH OK COMM
 
Yes
 
(37)Mercy Hospital Aurora
500 Porter Avenue

Aurora,MO65605
43-1936696
Hospital MO 501c3 3 MH SF COMM
 
Yes
 
(38)Mercy Hospital Berryville
214 Carter Street

Berryville,AR72616
71-0759299
Hospital AR 501c3 3 MH NW AK COM
 
Yes
 
(39)Mercy Hospital Booneville
880 West Main Street

Booneville,AR72927
46-3851119
Hospital AR 501c3 3 MH FT SMITH
 
Yes
 
(40)Mercy Hospital Carthage
3125 Dr Russell Smith Way

Carthage,MO64836
45-3808607
Hospital MO 501c3 3 MH SW MOKS
 
Yes
 
(41)Mercy Hospital Cassville
94 Main Street

Cassville,MO65625
43-1936699
Hospital MO 501c3 3 MH SF COMM
 
Yes
 
(42)Mercy Hospital Columbus
220 Pennsylvania Avenue

Columbus,KS66725
27-0842031
Hospital KS 501c3 3 MH SW MOKS
 
Yes
 
(43)Mercy Hospital El Reno Inc
2115 Parkview Drive

El Reno,OK73036
27-2716065
Hospital OK 501c3 3 MH OK CITY
 
Yes
 
(44)Mercy Hospital Healdton Inc
3462 Hospital Rd

Healdton,OK73438
26-3173902
Hospital OK 501c3 3 MH ARDMORE
 
Yes
 
(45)Mercy Hospital Jefferson
1400 Highway 61 South

Festus,MO63028
43-0687077
Hospital MO 501c3 3 MH EAST COMM
 
Yes
 
(46)Mercy Hospital Joplin
100 Mercy Way

Joplin,MO64804
27-0814858
Hospital MO 501c3 3 MH SW MOKS
 
Yes
 
(47)Mercy Hospital Kingfisher Inc
1000 KINGFISHER REG HOSP

Kingfisher,OK73750
46-3433074
Hospital OK 501c3 3 MH OK CITY
 
Yes
 
(48)Mercy Hospital Lebanon
100 Hospital Drive

Lebanon,MO65536
43-1767432
Hospital MO 501c3 3 MH FS COMM
 
Yes
 
(49)Mercy Hospital Lincoln
1000 East Cherry Street

Troy,MO63379
47-2219204
Hospital MO 501c3 3 MH EAST COMM
 
Yes
 
(50)Mercy Hospital Logan County Inc
200 South Academy

Guthrie,OK73044
45-2998842
Hospital OK 501c3 3 MH OK CITY
 
Yes
 
(51)Mercy Hospital Oklahoma City Inc
4300 W Memorial Road

Oklahoma City,OK73120
73-0579285
Hospital OK 501c3 3 MH OK COMM
 
Yes
 
(52)Mercy Hospital Ozark
801 W River Street

Ozark,AR72949
71-0689680
Hospital AR 501c3 3 MH FT SMITH
 
Yes
 
(53)Mercy Hospital Paris
500 E Academy

Paris,AR72855
71-0655753
Hospital AR 501c3 3 MH FT SMITH
 
Yes
 
(54)Mercy Hospital Rogers
2710 Rife Medical Lane

Rogers,AR72758
71-0294390
Hospital AR 501c3 3 MH NW AK COM
 
Yes
 
(55)Mercy Hospital Springfield
1235 E Cherokee Street

Springfield,MO65804
44-0552485
Hospital MO 501c3 3 MH SF COMM
 
Yes
 
(56)Mercy Hospital Tishomingo Inc
1000 South Byrd

Tishomingo,OK73460
27-4433830
Hospital OK 501c3 3 MH ADA INC
 
Yes
 
(57)Mercy Hospital Waldron
1341 W 6th Street

Waldron,AR72958
71-0557895
Hospital AR 501c3 3 MH FT SMITH
 
Yes
 
(58)Mercy Hospital Watonga Inc
500 Clarence Nash Blvd

Watonga,OK73772
45-5199762
Hospital OK 501c3 3 MH OK CITY
 
Yes
 
(59)MERCY HOSPITALS EAST COMMUNITIES
615 S New Ballas Road

St Louis,MO63141
43-0653493
Hospital MO 501c3 3 MH EAST COMM
 
Yes
 
(60)MERCY KANSAS COMMUNITIES INC
401 Woodland Hills Blvd

Ft Scott,KS66701
48-0956045
Hospital KS 501c3 3 MH SW MOKS
 
Yes
 
(61)Mercy Ministries of Laredo
2500 Zacatecas

Laredo,TX78046
20-0198462
Outreach TX 501c3 7 Mercy Health
 
Yes
 
(62)Mercy Research
524 North Booneville Avenue

Springfield,MO65802
87-0796305
Research MO 501c3 4 Mercy Health
 
Yes
 
(63)Mercy St Francis Hospital
100 W Highway 60

Mountain View,MO65548
44-0607149
Hospital MO 501c3 3 MH FS COMM
 
Yes
 
(64)MHM Support Services
14528 S Outer Forty Suite 100

Chesterfield,MO63017
20-2553101
CTRL SYS FUNC MO 501c3 12a Mercy Health
 
Yes
 
(65)Mission Clinical Services
300 Werner Street

Hot Springs,AR71913
13-4239691
CHILD ADVOC AR 501c3 3 Mercy Health
 
Yes
 
(66)Mercy Health Foundation South
10010 Kennerly Road

St Louis,MO63128
26-1516789
Fundraising MO 501c3 12a MH SOUTH
 
Yes
 
(67)Mercy Hospital South
10010 Kennerly Road

St Louis,MO63128
43-0980256
Hospital MO 501c3 3 MH EAST COMM
 
Yes
 
(68)St Anthony's Physician Organization
10010 Kennerly Road

St Louis,MO63128
43-1784536
Health care MO 501c3 3 MH SOUTH
 
Yes
 
(69)St Mary's Hospital of Enid Oklahoma Inc
14528 S Outer Forty Suite 100

Chesterfield,MO63017
73-0614655
Inactive OK 501c3 3 MH OK COMM
 
Yes
 
(70)Unity Ambulatory Care
14528 S Outer Forty Suite 100

Chesterfield,MO63017
43-1861745
Inactive MO 501c3 12c MH EAST COMM
 
Yes
 
(71)MERCY SPECIALTY HOSPITAL SE KS
14528 S OUTER FORTY SUITE 100

CHESTERFIELD,MO63017
84-3730625
Hospital KS 501c3 3 MH SW MOKS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) FORT SMITH EMS

1701 S Greenwood
FT SMITH,AR72901
71-0416615
EMERGENCY MEDICAL AR MERCY HOSP FS
 
Related 0 1,228   No     No 50.000 %
(2) PLAZA SURG SVCS CO

12700 SOUTHFORK RD
St Louis,MO63128
20-4709312
Inactive MO NA
 
                 
(3) ST ED MER MED MOB

7301 ROGERS
FT SMITH,AR72903
71-0554050
Office Building AR MERCY HOSP FS
 
Related 0 15   No   Yes   85.960 %
(4) MERCY AMBU SURG CTR

7301 ROGERS
FT SMITH,AR72903
71-0827721
Ambul Surg Ct AR MERCY HOSP FS
 
                 
(5) PLATINUM CPS HLDNGS

14528 S OUTER 40
Chesterfield,MO63017
84-2493007
Holding Company MO NA
 
                 




Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Frontenac Properties Inc

14528 S Outer Forty Suite 100
Chesterfield,MO63017
52-1914421
HOLDING CO DE NA
 
C-CORP          
(2) Inveno Health Inc

1235 E Cherokee Street
Springfield,MO65804
26-4509571
Product Commerce MO NA
 
C-CORP          
(3) Mercy Commercial Services Inc

14528 South Outer Forty Suite 100
Chesterfield,MO63017
46-4953543
PARENT OF VCC MO NA
 
C-CORP          
(4) Mercy Health Center Condominium Inc

4300 W Memorial Rd
Oklahoma City,OK73120
68-0640970
Real estate OK NA
 
C-CORP          
(5) Mercy Managed Care Corporation

14528 S Outer Forty Suite 100
Chesterfield,MO63017
73-1441665
Holding co OK NA
 
C-CORP          
(6) UHL Corp Inc

645 Maryville Centre Drive Suite 1
St Louis,MO63141
74-2499535
Holding co MO NA
 
C-CORP          
(7) Unity Support Services Inc

645 Maryville Centre Drive Suite 1
St Louis,MO63141
43-1797042
Inactive MO NA
 
C-CORP          
(8) ST ANTHONY'S PHYSICIAN ORG OF ILLINOIS

10010 Kennerly Road
St Louis,MO63128
32-0457168
Health Care MO NA
 
C-CORP          
(9) McAuley Insurance Company Ltd

Aon House 30 Woodbourne Avenue
PEMBROKE   HM 08
BD
000000000
Inactive BD NA
 
C-CORP          
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) MHM Support Services

Q 157,613,609 FMV
(2) Mercy ACO Clinical Services

Q 2,623,297 FMV
(3) Mercy Health Springfield Communities

Q 1,314,859 FMV
(4) Mercy Hospital Booneville

P 564,487 FMV
(5) Mercy Clinic Fort Smith Communities

P 401,833 FMV
(6) Mercy Hospital Ozark

P 278,322 FMV
(7) Mercy Hospital Paris

P 265,731 FMV
(8) Mercy Health Fort Smith Communities

P 169,906 FMV
(9) Mercy Hospital Waldron

P 148,546 FMV
(10) Mercy Health Foundation Fort Smith

Q 95,867 FMV
(11) Mercy Hospital Springfield

P 89,291 FMV
(12) Mercy Hospital Oklahoma City

P 57,120 FMV
(13) Mercy Hospital Joplin

P 50,285 FMV
(14) MERCY HEALTH FOUNDATION FORT SMITH

C 1,111,084 FMV
(15) MERCY HEALTH FOUNDATION FORT SMITH

B 291,601 FMV
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
FORM 990, SCHEDULE R, PART II MERCY HOSPITALS EAST COMMUNITIES MERCY HOSPITALS EAST COMMUNITIES CONSISTS OF MERCY HOSPITAL ST. LOUIS, EIN 43-0653493, AND MERCY HOSPITAL WASHINGTON, EIN 43-1066883.
FORM 990, SCHEDULE R, PART V LAWSON ERP SOFTWARE IS THE PRIMARY ACCOUNTING SOFTWARE USED BY 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 P AND Q.
Schedule R (Form 990) 2020

Additional Data


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