TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) AMMONS CARL E ERIC...................................................................... REGIONAL PRESIDENT, SOUTHEAST MISSOURI	15.00 ................. 40.00	X	X		945,191	114,804
(2) BLAIR RSM CHRISTINE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(3) CARRON RSM SR JUDITH ANN...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(4) CHARLEVILLE TIFFANY...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(5) DIX DENISE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(6) FRANCIS RICHARD BLAKE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(7) GANNON ELAINE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(8) IYER MD KARTHIK...................................................................... PHYSICIAN & BOARD MEMBER	1.00 ................. 49.00	X			601,018	21,192
(9) MCCAFFREY DENA...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(10) MCKENNA WILLIAM...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(11) PEYTON MD JACOB...................................................................... PHYSICIAN & BOARD MEMBER	1.00 ................. 39.00	X			478,171	29,033
(12) REUSS DOUG...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(13) RIORDAN MD TRACY...................................................................... PHYSICIAN & BOARD MEMBER	50.00 ................. 0.00	X			709,207	48,338
(14) ECKENFELS DANIEL...................................................................... VP FINANCE & CAO	30.00 ................. 15.00		X		413,568	29,460
(15) ECKHARDT CHRISTIE...................................................................... VP, CHIEF OPERATIONS COUNSEL & SEC (THRU 10/2023)	1.00 ................. 57.00		X		324,958	17,586
(16) WILKE JAMIE...................................................................... ASSOCIATE COUNSEL & SECRETARY (STARTING 11/2023)	2.00 ................. 58.00		X		223,989	12,297
(17) BEFFA ALISYN...................................................................... CNO & COO	40.00 ................. 0.00			X	356,791	23,131

(A) Name and business address	(B) Description of services	(C) Compensation
ACUITY ANESTHESIOLOGY LLC 1734 CLARKSON RD STE 147 CHESTERFIELD,MO63017	ANESTHESIOLOGY SERVICES	4,313,750
HEALTHTRUST INC - THE HOSPITAL COMPANY 100 SAWGRASS CORP PKWY 6TH FL SUNRISE,FL33323	LABOR MANAGEMENT SVCS	4,112,650
IMAGEFIRST OF ST LOUIS PO BOX 778941 CHICAGO,IL60677	HEALTHCARE LINEN SERVICES	902,782
L PETER ZHANG MD LLC 38 BRENTMOOR PARK CLAYTON,MO63105	PSYCHIATRIC SERVICES	853,827
CRYSTAL OAKS PO BOX 680 CRYSTAL CITY,MO63019	PROFESSIONAL SERVICES (ROOM AND BOARD)	604,459
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 26

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization MERCY HOSPITAL JEFFERSON

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization MERCY HOSPITAL JEFFERSON		Employer identification number 43-0687077

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization MERCY HOSPITAL JEFFERSON			Employer identification number 43-0687077
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

30,125

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

30,125

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
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 MISSOURI HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2024, DUES WERE $29,026, $22,532, AND $61,773, RESPECTIVELY. APPROXIMATELY 32.00% OF AMERICAN HOSPITAL ASSOCIATION DUES, 3.65% OF CATHOLIC HEALTH ASSOCIATION DUES, AND 32.40% OF MISSOURI HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS.

Return Reference

Explanation

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 MISSOURI HOSPITAL ASSOCIATION. FOR THE YEAR ENDED JUNE 30, 2024, DUES WERE $29,026, $22,532, AND $61,773, RESPECTIVELY. APPROXIMATELY 32.00% OF AMERICAN HOSPITAL ASSOCIATION DUES, 3.65% OF CATHOLIC HEALTH ASSOCIATION DUES, AND 32.40% OF MISSOURI HOSPITAL ASSOCIATION DUES WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES PERFORMED BY THESE ASSOCIATIONS.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
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Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	4,238,409		4,238,409
b	Buildings ....	176,192,440	61,708,088	114,484,352
c	Leasehold improvements	23,037	12,929	10,108
d	Equipment ....	73,285,028	58,950,566	14,334,462
e	Other .....	2,284,311	2,149,022	135,289
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				133,202,620

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
OTHER LIABILITIES	404,920








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	404,920
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

FORM 990, SCHEDULE D, PART X, LINE 2

ASC 740 FOOTNOTE PRIMARILY ALL OF THE HEALTH SYSTEM ENTITIES ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) 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. THE HEALTH SYSTEM COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2024 OR 2023.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			4,923,650		4,923,650	2.070 %
b	Medicaid (from Worksheet 3, column a) . . . . .			36,357,225	31,489,185	4,868,040	2.040 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			41,280,875	31,489,185	9,791,690	4.110 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	12	4,799	320,422		320,422	0.130 %
f	Health professions education (from Worksheet 5) . . .	2		344,447		344,447	0.140 %
g	Subsidized health services (from Worksheet 6) . . . .	1		7,468,225	7,022,037	446,188	0.190 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2	985	18,527		18,527	0.010 %
j	Total. Other Benefits . .	17	5,784	8,151,621	7,022,037	1,129,584	0.470 %
k	Total. Add lines 7d and 7j .	17	5,784	49,432,496	38,511,222	10,921,274	4.580 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	1,268	15,647		15,647	0.010 %
7	Community health improvement advocacy
8	Workforce development
9	Other	1	136	13,550		13,550	0.010 %
10	Total	2	1,404	29,197		29,197	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,299,245

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

43,242,458

Enter Medicare allowable costs of care relating to payments on line 5.....

43,189,769

Subtract line 6 from line 5. This is the surplus (or shortfall)........

52,689

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	MERCY HOSPITAL JEFFERSON PO BOX 350 CRYSTAL CITY,MO63019 WWW.MERCY.NET 529-2	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MERCY HOSPITAL JEFFERSON
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MERCY HOSPITAL JEFFERSON
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	MERCY HOSPITAL JEFFERSON
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	MERCY HOSPITAL JEFFERSON
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
MERCY HOSPITAL JEFFERSON	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 JEFFERSON	PART V, SECTION B, LINE 5: WHEN CONDUCTING ITS MOST RECENT CHNA AND DEVELOPING THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), MERCY HOSPITAL JEFFERSON WORKED WITH THE JEFFERSON COUNTY HEALTH DEPARTMENT (JCHD), COMMUNITY TREATMENT, INC. (COMTREA), JEFFERSON COUNTY COMMUNITY PARTNERSHIP (JCCP) AND JEFFERSON FRANKLIN COMMUNITY ACTION CORPORATION (JFCAC) AS A PRIMARY COMMUNITY PARTNERS. METHODS OF COLLECTING AND ANALYZING DATA AND INFORMATION INCLUDED COMMUNITY FOCUS GROUPS, SURVEYS, ORGANIZATION-SPECIFIC DATA AND PUBLISHED DATA. BELOW ARE THE PARTNERING AGENCIES AND THE LEADERS WHO SUPPORTED THE COMBINED EFFORTS OF A JOINT CHNA:- COMTREA- SUE CURFMAN- JCCP- TRACY SMITH- JCHD- KELLEY VOLLMAR- JFCAC- DAVID LEAS- MHJ- ERIC AMMONSIN CONDUCTING ITS COMMUNITY HEALTH NEEDS ASSESSMENT, MERCY JEFFERSON COLLECTED AND ANALYZED A SIGNIFICANT QUANTITY OF PRIMARY AND SECONDARY DATA. PRIMARY DATA WAS COLLECTED, AND COMMUNITY INPUT WAS SOLICITED, BY MEANS OF COMMUNITY FOCUS GROUPS, COMMUNITY SURVEY, STAKEHOLDER SURVEY, INTERNAL AGENCY DATA. COMMUNITY FOCUS GROUPS WERE CONDUCTED TO DIALOGUE DIRECTLY WITH LOCAL COMMUNITY MEMBERS. THERE WAS A TARGETED EFFORT TO CONDUCT FOCUS GROUPS IN A VARIETY OF ZIP CODES AND LOCATIONS SO THAT ALL JEFFERSON COUNTY RESIDENTS HAD THE OPPORTUNITY TO ATTEND. COMMUNITY FOCUS GROUPS WERE CONDUCTED TO DIALOGUE DIRECTLY WITH LOCAL COMMUNITY MEMBERS. THERE WAS A TARGETED EFFORT TO CONDUCT FOCUS GROUPS SO THAT ALL JEFFERSON COUNTY RESIDENTS HAD THE OPPORTUNITY TO ATTEND. COMMUNITY PARTNERS THAT ASSISTED IN DATA COLLECTION FOR 4 VIRTUAL COMMUNITY FOCUS GROUPS AS WELL AS SURVEYING PARTICIPANTS & STAFF AT THE HOMELESS CONNECT EVENT. INPUT FROM PEOPLE REPRESENTING BROAD INTERESTS OF THE COMMUNITY WAS SOLICITED THROUGH A ROBUST SURVEY PROCESS GUIDED BY A MERCY-LED COMMUNITY COALITION. THE GOAL OF THE SURVEY WAS TO GAIN INSIGHT INTO THE PERCEPTIONS OF COUNTY RESIDENTS ON THE MOST PRESSING HEALTH ISSUES, RISK FACTORS, BARRIERS TO CARE, AND HEALTH SERVICES UTILIZATION.
MERCY HOSPITAL JEFFERSON	PART V, SECTION B, LINE 6B: JEFFERSON COUNTY HEALTH DEPARTMENT (JCHD)COMMUNITY TREATMENT, INC. (COMTREA)JEFFERSON COUNTY COMMUNITY PARTNERSHIP (JCCP)JEFFERSON FRANKLIN COMMUNITY ACTION CORPORATION (JFCAC)
MERCY HOSPITAL JEFFERSON	PART V, SECTION B, LINE 11: BASED ON THE FINDINGS OF ITS MOST RECENTLY CONDUCTED CHNA, MERCY HOSPITAL JEFFERSON HAS CHOSEN TO ADDRESS THE FOLLOWING FOUR SIGNIFICANT HEALTH NEEDS IDENTIFIED IN JEFFERSON COUNTY:- ACCESS TO CARE- MENTAL HEALTH- SUBSTANCE USE- FINANCIAL LITERACYTHESE NEEDS ARE BEING ADDRESSED IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH CAN BE ACCESSED HERE: HTTPS://WWW.MERCY.NET/CONTENT/DAM/MERCY/EN/PDF/CHIP/MERCY-JEFFERSON-CHIP-2023.PDF.SOME NOTABLE ACHIEVEMENTS IN THE PAST YEAR INCLUDE: - THE CRISIS NURSERY OUTREACH CENTER CONTINUED TO ASSIST FAMILIES ON-SITE IN ORDER TO HELP THEM NAVIGATE CRISES AND CREATE A STABLE ENVIRONMENT FOR CHILDREN TO THRIVE.- THE COMMUNITY HEALTH WORKER (CHW) PROGRAM, WHICH WAS PILOTED BEGINNING IN 2018, WAS ADOPTED AND EXPANDED ACROSS MERCY HOSPITALS IN 2019. MERCY HOSPITAL JEFFERSON NO HAS TWO FULL-TIME CHWS TO CONNECT UNINSURED AND UNDERINSURED PATIENTS IN THE EMERGENCY DEPARTMENT TO COMMUNITY RESOURCES FOR SOCIAL NEEDS, ADDRESS SOCIAL DETERMINANTS OF HEALTH ISSUES, AND ASSIST PATIENTS WITH APPLYING FOR MEDICAID, MARKETPLACE INSURANCE, DISABILITY OR HOSPITAL CHARITY CARE. CHWS ALSO COLLABORATE CLOSELY WITH THE CARE MANAGEMENT TEAM, SOCIAL WORKERS AND COMMUNITY REFERRAL COORDINATORS TO ENSURE CONTINUITY OF CARE AND IMPROVE QUALITY OF LIFE.-IN FY24, MERCY HOSPITAL JEFFERSON ALSO ADDED A COMMUNITY HEALTH SUPERVISOR AND FULL-TIME HEALTH EQUITY CHW. - IN FY24, MERCY HOSPITAL JEFFERSON'S CHWS SERVED 2,409 PATIENTS THROUGH 5,889 ENCOUNTERS- MERCY CLINIC SOUTH HEALTH LEADS PROGRAM, WHICH SERVES THE SERVICE AREA OF MERCY HOSPITAL JEFFERSON, SCREENED 51,670 PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH NEEDS IN FY24.- 16.08% SCREENED POSITIVE FOR URGENT NEEDS INCLUDING PRESCRIPTION ASSISTANCE, FOOD PANTRIES, MEDICAL TRANSPORTATION AND CHARITY CARE- 547 NEEDS SUCCESSFULLY MET OR EQUIPPED FOR 496CLIENTS- MERCY HOSPITAL JEFFERSON CONTINUED SEVERAL BEHAVIORAL HEALTH PROGRAMS; HOSPITAL COMMUNITY LINKAGES (HCL) PROJECT, THE YOUTH EMERGENCY ROOM ENHANCEMENT PROJECT WHICH MIRRORS THE EMERGENCY ROOM ENHANCEMENT PROJECT FOR ADULTS. THESE PROGRAMS FOCUS ON ENHANCING SUPPORT FOR ADULT AND YOUTH HIGH UTILIZERS OF ER WITH THE PRIMARY GOAL OF REDUCING PREVENTABLE HOSPITAL CONTACTS ACROSS THE REGION BY FOSTERING ENGAGEMENT THROUGH SUPPORT, INTENSIVE OUTREACH AND IMPROVING OUTCOMES THROUGH CONNECTION TO COMMUNITY. MERCY HOSPITAL JEFFERSON ALSO CONTINUED THE ENGAGING PATIENTS IN THE CARE COORDINATION PROGRAM ALSO KNOWN AS EPICC, THIS PROGRAM PROVIDES INTENSIVE REFERRAL AND LINKAGE SERVICES BY RECOVERY COACHES, PEERS WITH LIVED EXPERIENCE, TO IMPACT THOSE WHO HAVE OVERDOSED ON OPIOIDS TO ESTABLISH IMMEDIATE LINKAGES TO SUBSTANCE USE AND EDUCATION ASSISTED TREATMENT SERVICES.ADDITIONAL NEEDS BEING ADDRESSED BY THE HOSPITAL INCLUDE:- COMMUNITY HEALTH IMPROVEMENT SERVICES- HOMELESSNESSMERCY HOSPITAL JEFFERSON IMPLEMENTS AND PARTICIPATES IN THE FOLLOWING PROGRAMS TO WORK TOWARDS COMMUNITY HEALTH IMPROVEMENT- TOBACCO CESSATION- SUPPORT GROUPS FOR BARIATRICS, DIABETES, GRIEF SUPPORT, SUICIDE, PALLIATIVE CARE AND STROKE - HEALTH FAIRS, PRESENTATIONS AND SCREENINGS - PATIENT BENEFIT ADVISOR- HEALTH PROFESSIONS EDUCATIONHEALTH PROFESSIONS STUDENT EDUCATION IS OFFERED AT MERCY HOSPITAL JEFFERSON IN THE AREAS OF PHYSICAL THERAPY, DIETARY, SOCIAL WORK, PHARMACY, NURSING AND OTHER HEALTH PROFESSIONALS. IN FY24, MERCY HOSPITAL JEFFERSON BECAME A REGIONAL CAMPUS FOR LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE (LECOM), THE NATION'S LARGEST MEDICAL COLLEGE, AND WELCOMED IT'S FIRST COHORT OF MEDICAL STUDENTS. THE MEDICAL STUDENTS WILL COMPLETE THEIR CLINICAL ROTATIONS AT MERCY HOSPITAL JEFFERSON. FINANCIAL AND IN-KIND CONTRIBUTIONSMERCY HOSPITAL JEFFERSON CONTINUES TO SUPPORT ORGANIZATIONS THROUGH CASH AND IN-KIND DONATIONS. THOSE INCLUDED BUT NOT LIMITED TO ARE THROUGH BLOOD DRIVES, THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER, LOCAL SCHOOL FOUNDATIONS, A COUNTY GROWTH ASSOCIATION, AND A CHAMBER OF COMMERCE - COMMUNITY BUILDING ACTIVITIES-WORKFORCE & ECONOMIC DEVELOPMENT IN AN EFFORT TO AID IN WORKFORCE AND ECONOMIC DEVELOPMENT, MERCY HOSPITAL JEFFERSON PARTICIPATES IN THE DISABILITY INCLUSION TASK FORCE, THE TWIN CITY CHAMBER OF COMMERCE AND THE FARMINGTON CHAMBER OF COMMERCE.- COMMUNITY BUILDING ACTIVITIES- COALITION BUILDING & BOARD MEMBERSHIPMERCY HOSPITAL JEFFERSON ALSO PARTICIPATES IN LOCAL COALITION BUILDING AND BOARD MEMBERSHIP FOR THE FOLLOWING AGENCIES: JEFFERSON FOUNDATION BOARD, CRYSTAL OAKS BOARD, ECONOMIC DEVELOPMENT CORPORATION, JEFFERSON COUNTY DRUG PREVENTION COALITION, AND JEFFERSON COUNTY UNHOUSED COALITION. THE FOLLOWING NEED IS NOT BEING ADDRESSED BY THE HOSPITAL:- ENVIRONMENTAL: AIR/WATER QUALITYMHJ WILL CONTINUE ITS PARTNERSHIP WITH THE JEFFERSON COUNTY HEALTH DEPARTMENT (JCHD) AND WILL COLLABORATE WITH ANY ENVIRONMENTAL INITIATIVES THEY DEVELOP. WHILE CONTINUED ATTENTION TO THIS ISSUE WAS IMPORTANT, MERCY'S FOCUS REMAINS ON PROVIDING QUALITY HEALTHCARE. THEREFORE, THE ISSUES OF ACCESS, AND THE COMMUNITY'S CRISIS WITH BEHAVIORAL HEALTH AND ADDICTION SHOULD TAKE PRECEDENCE AT THIS TIME.
MERCY HOSPITAL JEFFERSON	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/JEFFERSON-CHNA-2022.PDF
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 10A	HTTPS://WWW.MERCY.NET/CONTENT/DAM/MERCY/EN/PDF/CHIP/MERCY-JEFFERSON-CHIP-2023.PDF
FORM 990, SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C	THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ONLINE AT HTTPS://WWW.MERCY.NET/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	1 - MERCY SERVICES CALVARY CHURCH ROAD 1500 CALVARY CHURCH ROAD FESTUS,MO63028	HOSPITAL BASED OUTPATIENT DEPTS: IMAGING SERVICES
2	2 - MERCY HOME HEALTH AND HOSPICE JEFFERSON 151 INDUSTRIAL DRIVE FESTUS,MO62028	HOSPITAL BASED OUTPATIENT DEPTS: HOSPICE SERVICES, HOME HEALTH SERVICES
3	3 - MERCY CLINIC IMPERIAL 1250 MAIN STREET IMPERIAL,MO63052	HOSPITAL BASED OUTPATIENT DEPTS: THERAPY SERVICES
4	4 - MERCY CANCER CENTER JEFFERSON 1350 US HIGHWAY 61 FESTUS,MO62028	HOSPITAL BASED OUTPATIENT DEPTS: CANCER SERVICES
5	5 - MERCY BEHAVIORAL HEALTH JEFFERSON 1420 US HIGHWAY 61 SOUTH FESTUS,MO62028	HOSPITAL BASED OUTPATIENT DEPTS: BEHAVIORIAL HEALTH SERVICES
6	6 - MERCY SURGERY CENTER (SHU) 1377 US HIGHWAY 61 SOUTH FESTUS,MO62028	HOSPITAL BASED OUTPATIENT DEPTS: SURGERY SERVICES
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization 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.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 6A:	THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050).
PART I, LINE 7:	TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $238,252,605. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $10,620,759. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $227,631,846.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICESTHE PHYSICIAN CLINICS ARE INCLUDED AS A NET AMOUNT (INCOME LESS EXPENSES) ALLOCATED BY THE CLINICAL SERVICE LINE IN THE INDIRECT COST.
PART II, COMMUNITY BUILDING ACTIVITIES:	MERCY HOSPITAL JEFFERSON'S (MHJ) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH, WELLNESS, AND SAFETY OF THE COMMUNITY 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. SOME OF THESE COMMUNITY BUILDING PARTNERSHIPS AND COMMUNITY ENGAGEMENT ACTIVITIES INCLUDE:- JEFFERSON COUNTY HEALTH DEPARTMENT- JEFFERSON COUNTY GROWTH ASSOCIATION- JEFFERSON COLLEGE BOARD- JEFFERSON FOUNDATION BOARD- PARTICIPATION IN THE DESOTO, HILLSBORO, TWIN CITY AREA, AND STE. GENEVIEVE CHAMBERS OF COMMERCE ACTIVITIES- KIWANIS CLUB- COMPASS (FORMERLY COMTREA)- MISSOURI HOSPITAL ASSOCIATION BOARD- EASTERN MISSOURI HOSPITAL ASSOCIATION BOARD- ST. PIUS ALUMNI ASSOCIATION- FESTUS PUBLIC LIBRARY BOARD- DISABILITY RESOURCE COUNCIL- JEFFERSON COUNTY GROWTH ASSOCIATION BOTTLENECK BRIDGE RIDE- GET HEALTHY DESOTO- CRYSTAL OAKS NURSING HOME BOARD CHAIR- BEHAVIORAL HEALTH NETWORK ADULT SERVICES IN ADDITION, MHJ ACTIVELY PARTICIPATES IN SEVERAL COMMUNITY BUILDING COALITIONS THAT ALSO ALIGN WITH THE HOSPITAL'S CHNA TOP HEALTH PRIORITIES, INCLUDING:- JEFFERSON COUNTY DRUG PREVENTION COALITION- ALIVE AND WELL JEFFERSON COUNTY- JEFFERSON COUNTY DRUG EDUCATION CONFERENCE PLANNING COMMITTEE-MERCY JEFFERSON SUICIDE PREVENTION CONFERENCE PLANNING COMMITTEE-JEFFERSON COUNTY UNHOUSED COALITIONEFFORTS WITH THESE COALITIONS WILL CONTINUE AS MHJ DETERMINED THAT ACCESS TO CARE, BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE) TO BE TOP HEALTH PRIORITIES THROUGH THE 2022-2024 CHNA CYCLE.CASH/IN-KIND DONATIONS MERCY PROVIDES CASH AND IN-KIND DONATIONS 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.A FULL DESCRIPTION OF OUR COMMUNITY BUILDING ACTIVITIES CAN BE FOUND AT WWW.MERCY.NET/COMMUNITYBENEFITS.
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:	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 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, SOUTHEAST KANSAS, CAPE GIRARDEU AND STODDARD. 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:	IN 2021, MERCY HOSPITAL JEFFERSON (MHJ) BEGAN PLANNING FOR THE 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA). THE HOSPITAL PRESIDENT LED THE CORRESPONDING COMMUNITY HEALTH COUNCIL IN GUIDING THE NEEDS ASSESSMENT PROCESS. THE COUNCIL CONVENES QUARTERLY AND IS ACCOUNTABLE FOR ENSURING THAT COMMUNITY BENEFIT ACTIVITIES MEET MISSION COMPLIANCE AND IRS GUIDELINES. THE COUNCIL CONSISTS OF MERCY LEADERS FROM VARIOUS DEPARTMENTS, SUCH AS BEHAVIORAL HEALTH, FINANCE, CARE MANAGEMENT, PHILANTHROPY, ETC., AND ONE HOSPITAL BOARD MEMBER. THE COUNCILS DETERMINE WHICH HEALTH INITIATIVES WILL BE PUT FORTH IN THE HOSPITAL'S THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). CO-WORKERS IN MERCY JEFFERSON'S COMMUNITY HEALTH & ACCESS DEPARTMENT SERVE ON THE COUNCIL AND WERE PRIMARY LEADS OF THE 2022 CHNAS. THE VOICES OF THE PEOPLE OF JEFFERSON COUNTY WERE CENTRAL TO THE HEALTH NEEDS ASSESSMENT PROCESS. MHJ GATHERED COMMUNITY INPUT DIRECTLY THROUGH:- SURVEYS ONLINE FOR COMMUNITY MEMBERS AND STAKEHOLDERS- COMMUNITY FOCUS GROUPS- COMMUNITY COALITIONS AND STAKEHOLDER MEETINGSEXTERNAL SOURCES OF PUBLISHED DATA ARE AS FOLLOWS:- COUNTY HEALTH RANKINGS 2021: WWW.COUNTYHEALTHRANKINGS.ORG - US CENSUS BUREAU- SMALL AREA HEALTH ESTIMATES: HTTPS://WWW.CENSUS.GOV/PROGRAMS-SURVEYS/SAHIE.HTML - AMERICAN COMMUNITY SURVEY 2019: HTTPS://WWW.CENSUS.GOV/PROGRAMSSURVEYS/ACS/DATA.HTML- 2020 CENSUS RESULTS: HTTPS://WWW.CENSUS.GOV/- CDC MENTAL HEALTH BASICS, 2021: HTTPS://WWW.CDC.GOV/MENTALHEALTH/LEARN/INDEX.HTM - HEALTHY PEOPLE 2020:HTTPS://WWW.HEALTHYPEOPLE.GOV/2020/LEADING-HEALTH-INDICATORS/2020-LHITOPICS/MENTAL-HEALTH/DETERMINANTSHTTPS://WWW.HEALTHYPEOPLE.GOV/2020/LEADING-HEALTH-INDICATORS/2020-LHITOPICS/MENTAL-HEALTH/DATA- ER OPIOID MISUSE RATE MAP: HTTPS://HEALTH.MO.GOV/DATA/OPIOIDS/ER-OPIOID-MISUSE-RATE.PHP- JEFFERSON COUNTY OPIOIDS FACT SHEET, 2019: HTTPS://HEALTH.MO.GOV/DATA/OPIOIDS/PDF/JEFFERSON-COUNTY-OPIOIDSFACT-SHEET-SPRING-2019.PDF- COMMUNITY PROFILE 2021 JEFFERSON COUNTY: HTTPS://DMH.MO.GOV/MEDIA/PDF/COMMUNITY-PROFILE-2021-JEFFERSON-COUNTY - SPARK MAP 2018-2020: HTTPS://SPARKMAP.ORG/REPORT/ PRIORITIZED SIGNIFICANT COMMUNITY HEALTH NEEDS:THE NOMINAL GROUP TECHNIQUE WAS USED IN THE PRIORITY SETTING PROCESS. THE MERCY HOSPITAL JEFFERSON COUNCIL WAS PRESENTED WITH THE QUANTITATIVE AND QUALITATIVE COMMUNITY HEALTH DATA AND MEMBERS WERE ASKED TO RANK THESEHEALTH ISSUES BY LEVEL OF CONCERN AND ABILITY TO COLLABORATE ON THE ISSUE TO PRODUCE RESULTS. THE STRENGTHS AND SERVICES OF THE HOSPITAL ALONG WITH THEIR STRATEGIC PLANS WERE ALSO CONSIDERED. UPON REVIEW AND DISCUSSION OFTHE PRIMARY AND SECONDARY DATA GATHERED, THE HOSPITAL'S STRATEGIC PLANS, AND THE RESOURCES AVAILABLE AT THE HOSPITALS AND IN THE COMMUNITIES, THE FOLLOWING PRIORITIES WERE SELECTED:MERCY HOSPITAL JEFFERSON: - ACCESS TO CARE- BEHAVIORAL HEALTH/SUBSTANCE ABUSE- SUBSTANCE USE- FINANCIAL LITERACYTHE COMMUNITY HEALTH COUNCIL THEN CREATED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR THE HOSPITAL, IDENTIFYING SPECIFIC INITIATIVES RELATED TO IMPROVING EACH OF THESE HEALTH PRIORITIES. THE CHIP WAS DESIGNED WITHREALISTIC, MEASURABLE, AND ATTAINABLE GOALS THAT ALIGN WITH THE MISSION AND STRATEGY OF THE ORGANIZATIONS. MERCY HOSPITAL JEFFERSON ALSO ASSESSES THE NEEDS OF THE COMMUNITY THROUGH REQUESTS BY LOCAL AGENCIES. ACCORDING TO THE CATHOLIC HEALTH ASSOCIATION, A REQUEST FROM A PUBLIC AGENCY OR COMMUNITY GROUP TO INITIATE OR CONTINUE AN ACTIVITY OR PROGRAM MEETS THE REQUIREMENTS FOR A DOCUMENTED COMMUNITY NEED. MERCY JEFFERSON SERVES ON VARIOUS BOARDS AND HAS PARTNERSHIPS THROUGHOUT THE COMMUNITY THAT CAN BE SEEN IN LINE 5.
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 ACCOUNT IS PLACED FOR REVIEW. IN ADDITION, PATIENTS 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, IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFF'S INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL.
PART VI, LINE 4:	THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL JEFFERSON INCLUDES 30 ZIP CODES ACROSS MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND AHA ANALYTICS. THE AREA'S POPULATION IS 196,101. THE MEDIAN HOUSEHOLD INCOME IS $56,000. 89% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 38. 20.0% OF THE HOUSEHOLDS ARE ON MEDICARE, 21.6% ON MEDICAID, AND 9.2% UNINSURED.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH MERCY 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 ANDFAMILIES 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 JEFFERSON HAS EXCLUSIVE CONTRACTS WITH PHYSICIAN GROUPS FOR THE FOLLOWING SERVICES: RADIOLOGY, PATHOLOGY, ANESTHESIA, AND EMERGENCY MEDICINE. THIS MEANS THAT THE MAJORITY OF THE PHYSICIANS ON STAFF ARE IN CATEGORIES THAT ARE OPEN TO QUALIFIED PHYSICIANS IN THE COMMUNITY. COMMUNITY BOARD FY24 MERCY HEALTH EAST COMMUNITIES FY24 BOARD MEMBERSDON ARNOLD, M.D.JON BAUER, PHDCRAIG BOYD, MDMATUSKCHKA LINDO-BRIGGSAPOLLO CAREYJANICE DENIGANDENNIS GANNONJOHN PORTER, ED. DWINTHROP B. REED, IIICHARLES REHM, M.D.MERCY HOSPITAL JEFFERSON FY24 BOARD MEMBERSERIC AMMONS SR. CHRISTINE BLAIRDOUG RUESSSR. JUDY CARRON, RSMTIFFANY CHARLEVILLEDENISE DIXRICK FRANCISELAINE GANNONDR. KARTHIK IYER, MDDENA MCCAFREYBILL MCKENNAJACOB PEYTON, MDTRACY RIORDAN, MDADDITIONAL COMMUNITY HEALTH INITIATIVES/INFORMATIONCURRENTLY NOT INCLUDED THROUGH THE REPORTING OF COMMUNITY BENEFIT OR COMMUNITY BUILDING ACTIVITIES ARE:IN KEEPING WITH MHJ'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, MHJ CLINICS (NOT UNDER HOSPITAL EIN) PROVIDE:- 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.MANY OF THE PROGRAMS MENTIONED BELOW ARE PART OF OUR CURRENT COMMUNITY HEALTH IMPACT PLAN (CHIP). THESE ARE INDICATED BY ASTERISKS.ACCESS TO CAREHEALTH LEADS*HEALTH LEADS IS A SOCIAL ENTERPRISE THAT ENVISIONS A HEALTHCARE SYSTEM THAT ADDRESSES ALL PATIENTS' BASIC RESOURCE NEEDS AS A STANDARD PART OF QUALITY CARE. IN THE SPRING OF 2016, MERCY HEALTH JOINED THE HEALTH LEADS LEARNING COLLABORATIVE TO BEGIN INTEGRATING THE HEALTH LEADS PROGRAM IN ORDER TO ASSIST PATIENTS WITH HEALTH-RELATED SOCIAL NEEDS THROUGH RESOURCE REFERRAL. THIS PROGRAM IS DESIGNED FOR MERCY CLINIC JEFFERSON PATIENTS AND IS BEING FUNDED THROUGH MERCY CLINICS; THEREFORE, THE TOTAL COMMUNITY BENEFIT OF THIS PROGRAM CANNOT BE REPORTED UNDER THE EIN FOR MERCY HOSPITAL JEFFERSON.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, 2024, MERCY FACILITIES INCLUDED 32 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 7 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 3 ORTHOPEDIC HOSPITALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2024, MERCY HAD MORE THAN 11.9 MILLION CLINIC AND OUTPATIENT VISITS, APPROXIMATELY 2,600 EMPLOYED PHYSICIANS, AND APPROXIMATELY 52,000 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.
FORM 990, SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT: MO

Schedule H (Form 990) 2023

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
MERCY HOSPITAL JEFFERSON

Employer identification number
43-0687077

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) MERCY HEALTH FOUNDATION JEFFERSON PO BOX 350 CRYSTAL CITY,MO63019	46-2797051	501(C)(3)	190,198	0			CHARITABLE SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) CAR/VAN TRANSPORTATION	359	17,931
(2) AMBULANCE TRANSPORTATION	93	46,737
(3) GAS CARDS	180	9,022
(4) SELF HELP MATERIALS	552	2,760
(5) MEMORIALS	4	3,349
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANTS THE ASSISTANCE PROVIDED IS INTENDED TO BE USED FOR THE GENERAL OPERATING PURPOSES OF THE DONEE. THE USE OF GRANT FUNDS IS NOT MONITORED AFTER GRANTS ARE GIVEN. HOWEVER, THE GRANTEE IS PART OF MERCY HEALTH AND THEREFORE A RELATED ORGANIZATION TO MERCY HOSPITAL JEFFERSON. LEADERSHIP OF THE HOSPITAL AND THE GRANTEE COMMUNICATE ON HOW FUNDS ARE USED, ALTHOUGH THERE IS NO FORMAL MONITORING PROCESS. WHEN PATIENT CARE STAFF IDENTIFY PATIENTS NEEDING TRANSPORTATION ASSISTANCE, TAXI RIDES, GAS CARDS, OR AMBULANCE TRANSPORTATION ARE PROVIDED TO THE PATIENT, WITH THE HOSPITAL COVERING THE COSTS. THEREFORE, NO FURTHER MONITORING RELATED TO THE USE OF THE FUNDS IS NEEDED. WHEN PATIENT CARE STAFF IDENTIFY PATIENTS NEEDING VARIOUS OTHER ASSISTANCE, SELF HELP MATERIALS, MEMORIALS, AND VARIOUS OTHER SUPPORT IS PROVIDED TO THE PATIENT WITH THE HOSPITAL COVERING THE COSTS. THEREFORE, NO FURTHER MONITORING RELATED TO THE USE OF THE FUNDS IS NEEDED.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MATEJKA CHERYL L FORMER OFFICER	(i) (ii)	0 ------------- 710,092	0 ------------- 828,245	0 ------------- 54,733	0 ------------- 125,167	0 ------------- 15,200	0 ------------- 1,733,437	0 ------------- 236,192
2JOHNSTON JEFFREY A FORMER OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 1,300,000	0 ------------- 16,754	0 ------------- 10,821	0 ------------- 0	0 ------------- 1,327,575	0 ------------- 0
3AMMONS CARL E ERIC REGIONAL PRESIDENT, SOUTHEAST MISSOU	(i) (ii)	0 ------------- 352,460	0 ------------- 425,134	0 ------------- 167,597	0 ------------- 99,689	0 ------------- 15,115	0 ------------- 1,059,995	0 ------------- 149,016
4GADI BHASKARA PHYSICIAN	(i) (ii)	0 ------------- 864,172	0 ------------- 92,939	0 ------------- 45,810	0 ------------- 8,309	0 ------------- 19,715	0 ------------- 1,030,945	0 ------------- 0
5RIORDAN MD TRACY PHYSICIAN & BOARD MEMBER	(i) (ii)	0 ------------- 584,953	0 ------------- 74,315	0 ------------- 49,939	0 ------------- 28,107	0 ------------- 20,231	0 ------------- 757,545	0 ------------- 0
6BOGACHENCHU SREENIVASULU HOSPITALIST	(i) (ii)	0 ------------- 552,987	0 ------------- 47,583	0 ------------- 54,822	0 ------------- 6,234	0 ------------- 15,932	0 ------------- 677,558	0 ------------- 0
7SIEGEL CRAIG PHYSICIAN	(i) (ii)	0 ------------- 507,487	0 ------------- 44,431	0 ------------- 54,804	0 ------------- 16,009	0 ------------- 9,716	0 ------------- 632,447	0 ------------- 0
8AZAD SALEEM PHYSICIAN	(i) (ii)	0 ------------- 517,711	0 ------------- 77,281	0 ------------- 23,030	0 ------------- 6,320	0 ------------- 6,363	0 ------------- 630,705	0 ------------- 0
9IYER MD KARTHIK PHYSICIAN & BOARD MEMBER	(i) (ii)	0 ------------- 511,405	0 ------------- 44,063	0 ------------- 45,550	0 ------------- 8,597	0 ------------- 12,595	0 ------------- 622,210	0 ------------- 0
10STAHLSCHMIDT MARK PHYSICIAN	(i) (ii)	0 ------------- 454,462	0 ------------- 74,161	0 ------------- 45,486	0 ------------- 6,863	0 ------------- 7,591	0 ------------- 588,563	0 ------------- 0
11PEYTON MD JACOB PHYSICIAN & BOARD MEMBER	(i) (ii)	0 ------------- 412,881	0 ------------- 42,321	0 ------------- 22,969	0 ------------- 9,405	0 ------------- 19,628	0 ------------- 507,204	0 ------------- 0
12ECKENFELS DANIEL VP FINANCE & CAO	(i) (ii)	0 ------------- 320,871	0 ------------- 58,983	0 ------------- 33,714	0 ------------- 9,356	0 ------------- 20,104	0 ------------- 443,028	0 ------------- 0
13MEYER MICHELE VP OPERATIONS	(i) (ii)	0 ------------- 207,558	0 ------------- 51,034	0 ------------- 100,212	0 ------------- 9,656	0 ------------- 14,894	0 ------------- 383,354	0 ------------- 0
14BEFFA ALISYN CNO & COO	(i) (ii)	0 ------------- 279,756	0 ------------- 54,078	0 ------------- 22,957	0 ------------- 3,054	0 ------------- 20,077	0 ------------- 379,922	0 ------------- 0
15ECKHARDT CHRISTIE VP, CHIEF OPERATIONS COUNSEL & SEC (	(i) (ii)	0 ------------- 214,326	0 ------------- 71,422	0 ------------- 39,210	0 ------------- 3,386	0 ------------- 14,200	0 ------------- 342,544	0 ------------- 0
16WILKE JAMIE ASSOCIATE COUNSEL & SECRETARY (START	(i) (ii)	0 ------------- 175,315	0 ------------- 32,753	0 ------------- 15,921	0 ------------- 2,183	0 ------------- 10,114	0 ------------- 236,286	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	MERCY HOSPITAL JEFFERSON 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 SEVERANCE PAY FROM A RELATED ORGANIZATION DURING CALENDAR YEAR 2023: JEFF JOHNSTON - $16,754
FORM 990, SCHEDULE J, PART II	THE AMOUNTS REPORTED FOR CARL E. AMMONS AND CHERYL MATEJKA 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.

Schedule J (Form 990) 2023

Additional Data

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SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

Return Reference	Explanation
FORM 990, PART V, QUESTION 1A	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.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBER OF MERCY HOSPITAL JEFFERSON IS MERCY HEALTH EAST COMMUNITIES, A SUPPORTING ORGANIZATION UNDER SECTION 509(A)(3). THE MEMBER OF MERCY HEALTH EAST COMMUNITIES IS MERCY HEALTH.
FORM 990, PART VI, SECTION A, LINE 7A	MERCY HEALTH, THE MEMBER OF MERCY HEALTH EAST COMMUNITIES, HAS RESERVE POWERS TO APPOINT AND REMOVE ALL DIRECTORS AND OFFICERS FOR MERCY HOSPITAL JEFFERSON.
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): 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 HOSPITAL 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 OR ANY AFFILIATE; 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 PROMORTE 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 PARTIICPATION 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	DSCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY MERCY HEALTH'S TAX DEPARTMENT, 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 CHIEF FINANCIAL OFFICER. THE DRAFT FORM 990 IS ALSO REVIEWED BY MERCY HEALTH'S TAX DEPARTMENT AND AN INDEPENDENT ACCOUNTING FIRM, 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.
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, 2024. THIS PROCESS IS ADMINISTERED AT THE MERCY HEALTH LEVEL BY MERCY'S CORPORATE COMPLIANCE DEPARTMENT. THE CONFLICTS AND THEIR RESPECTIVE RESOLUTIONS ARE SHARED AT THE MERCY LEVEL WITH A TEAM INCLUDING MERCY'S SENIOR VICE PRESIDENT OF FINANCIAL OPERATIONS & PLANNING, CHIEF COMPLIANCE OFFICER AND OTHER MEMBERS OF FINANCE, LEGAL AND HR. THE QUESTIONNAIRES ARE THEN REVIEWED WITH LEADERSHIP AT THE LOCAL LEVEL AND POTENTIAL CONFLICTS DISCUSSED AND RESOLVED. SUMMARY RESULTS ARE REVIEWED WITH MERCY'S STEWARDSHIP COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY EMPLOYEES FOR THE TOP MANAGEMENT OFFICIALS, THOSE CLASSIFIED AS OFFICERS (AND THUS DISQUALIFIED PERSONS) AND KEY EMPLOYEES, THE ORGANIZATION RELIES UPON MERCY HEALTH, WHICH USES THE FOLLOWING TO ESTABLISH THE COMPENSATION: EXTERNAL MARKET SALARY SURVEYS, EXTERNAL MARKET SALARY STUDIES, AND ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT. FOR CERTAIN EXECUTIVES AND PHYSICIANS THE COMPENSATION IS REVIEWED/APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF MERCY HEALTH. FOR ALL OTHER CAREGIVERS COMPENSATION IS REVIEWED/APPROVED BY THE TOTAL REWARDS OVERSIGHT COMMITTEE. COMPENSATION REVIEWS ARE COMPLETED ON AN ANNUAL BASIS AND 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.
FORM 990, PART VII, SECTION A	FORMER EMPLOYEE COMPENSATION IS REPORTED FOR THE CALENDAR YEAR ENDING WITHIN THE ORGANIZATION'S FISCAL YEAR WHILE AVERAGE HOURS ARE BASED ON THE FISCAL YEAR PERIOD FROM JULY 1, 2023 THROUGH JUNE 30, 2024.
FORM 990, PART XI, LINE 9:	TRANSFERS (TO)/FROM AFFILIATES -18,899,696. CHANGE IN RESTRICTED NET ASSETS -1,650. ROUNDING 2.
FORM 990, PART XII, QUESTION 2C	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 2024 (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.
FORM 990, PART XII, QUESTION 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, 2024 BY DECEMBER 13, 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, 2024, IT WILL BE INCLUDED ON THE MERCY HEALTH CONSOLIDATED SEFA, AND THEREFORE, ALSO INCLUDED IN THE POPULATION INCLUDED IN THE AUDIT.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

MERCY HOSPITAL JEFFERSON

Employer identification number

43-0687077

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
(1) JEFFERSON REGIONAL OUTPATIENT FACILITIES LLC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 27-2196402	URGENT CARE AND OUTPATIENT FACILTIES	MO	0	0	MERCY HOSPITAL JEFFERSON
(2) MERCY CLINIC ADULT HOSPITALISTS - JEFFERSON LLC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 46-2913068	MANAGED CARE CONTRACTING	MO	11,352,253	497,519	MERCY HOSPITAL JEFFERSON
(3) MERCY LABS JEFFERSON LLC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 46-3478362	LABORATORY SERVICES	MO	131,340	0	MERCY HOSPITAL JEFFERSON

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?
(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	Yes	No
(1)CASA DE MISERICORDIA 1000 MIER ST LAREDO,TX78040 74-2912461	WOMEN'S DOMESTIC VIOLENCE SHELTER	TX	501(C)(3)	LINE 7	MERCY MINISTRIES OF LAREDO	Yes
(2)MCAULEY PORTFOLIO MANAGEMENT COMPANY 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 26-1708048	PORTFOLIO MANAGEMENT.	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH	Yes
(3)MERCY ACO CLINICAL SERVICES INC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 46-4504901	VIRTUAL CARE CENTER	MO	501(C)(3)	LINE 3	MERCY HEALTH	Yes
(4)MERCY CLINIC EAST COMMUNITIES 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 43-1771217	PHYSICIAN GROUP	MO	501(C)(3)	LINE 10	MERCY HEALTH EAST COMMUNITIES	Yes
(5)MERCY CLINIC FORT SMITH COMMUNITIES 7301 ROGERS AVENUE FORT SMITH,AR72903 26-1318597	PHYSICIAN CLINIC	AR	501(C)(3)	LINE 3	MERCY HEALTH FORT SMITH COMMUNITIES	Yes
(6)MERCY CLINIC OKLAHOMA COMMUNITIES INC 4300 W MEMORIAL ROAD OKLAHOMA CITY,OK73120 27-0473057	PHYSICIAN GROUP	OK	501(C)(3)	LINE 3	MERCY HEALTH OKLAHOMA COMMUNITIES INC	Yes
(7)MERCY CLINIC SPRINGFIELD COMMUNITIES 1965 S FREMONT SUITE 200 SPRINGFIELD,MO65804 43-1560263	PHYSICIAN GROUP	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(8)MERCY FAMILY CENTER 110 VETERANS BLVD METAIRIE,LA70005 72-1069468	FAMILY COUNSELING SERVICE	LA	501(C)(3)	LINE 7	MERCY HEALTH	Yes
(9)MERCY HEALTH 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 43-1423050	CORPORATE OFFICE	MO	501(C)(3)	LINE 1	N/A		No
(10)MERCY HEALTH EAST COMMUNITIES 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 43-1718408	HEALTH SYSTEM	MO	501(C)(3)	LINE 12A, I	MERCY HEALTH	Yes
(11)MERCY HEALTH FORT SMITH COMMUNITIES 7301 ROGERS AVENUE FORT SMITH,AR72917 26-1318515	HOLDING COMPANY	AR	501(C)(3)	LINE 12B, II	MERCY HEALTH	Yes
(12)MERCY HEALTH FOUNDATION 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 20-0901499	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH	Yes
(13)MERCY HEALTH FOUNDATION ADA 430 N MONTE VISTA STREET ADA,OK74820 46-3596274	FOUNDATION	OK	501(C)(3)	LINE 12A, I	MERCY HOSPITAL ADA INC	Yes
(14)MERCY HEALTH FOUNDATION ARDMORE 1011 14TH AVENUE NW ARDMORE,OK73401 71-0962525	FOUNDATION	OK	501(C)(3)	LINE 12A, I	MERCY HOSPITAL ARDMORE INC	Yes
(15)MERCY HEALTH FOUNDATION BERRYVILLE 214 CARTER STREET BERRYVILLE,AR72616 71-0759301	FOUNDATION	AR	501(C)(3)	LINE 12A, I	MERCY HOSPITAL BERRYVILLE	Yes
(16)MERCY HEALTH FOUNDATION FORT SCOTT 401 WOODLAND HILLS BLVD FORT SCOTT,KS66701 48-1077073	FOUNDATION	KS	501(C)(3)	LINE 7	MERCY KANSAS COMMUNITIES INC	Yes
(17)MERCY HEALTH FOUNDATION FORT SMITH 7301 ROGERS AVENUE FORT SMITH,AR72917 23-7330425	FOUNDATION	AR	501(C)(3)	LINE 7	MERCY HEALTH FORT SMITH COMMUNITIES	Yes
(18)MERCY HEALTH FOUNDATION JEFFERSON 1400 US HIGHWAY 61 SOUTH FESTUS,MO63028 46-2797051	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HOSPITAL JEFFERSON	Yes
(19)MERCY HEALTH FOUNDATION JOPLIN 100 MERCY WAY JOPLIN,MO64804 27-0906136	FOUNDATION	MO	501(C)(3)	LINE 7	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(20)MERCY HEALTH FOUNDATION LEBANON 100 HOSPITAL DRIVE LEBANON,MO65536 82-2514567	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HOSPITAL LEBANON	Yes
(21)MERCY HEALTH FOUNDATION LINCOLN 1000 EAST CHERRY STREET TROY,MO63379 81-1477159	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HOSPITALS EAST COMMUNITIES	Yes
(22)MERCY HEALTH FOUNDATION NORTHWEST ARKANSAS 2710 RIFE MEDICAL LANE ROGERS,AR72758 71-0601687	FOUNDATION	AR	501(C)(3)	LINE 7	MERCY HOSPITAL ROGERS	Yes
(23)MERCY HEALTH FOUNDATION OF OKLAHOMA 4300 W MEMORIAL ROAD OKLAHOMA CITY,OK73120 45-4732301	FOUNDATION	OK	501(C)(3)	LINE 12A, I	MERCY HEALTH OKLAHOMA COMMUNITIES INC	Yes
(24)MERCY HEALTH FOUNDATION OKLAHOMA CITY 4300 W MEMORIAL ROAD OKLAHOMA CITY,OK73120 46-3184231	FOUNDATION	OK	501(C)(3)	LINE 12A, I	MERCY HOSPITAL OKLAHOMA CITY INC	Yes
(25)MERCY HEALTH FOUNDATION SPRINGFIELD 1235 E CHEROKEE STREET SPRINGFIELD,MO65804 32-0195818	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(26)MERCY HEALTH FOUNDATION ST FRANCIS 100 W US HIGHWAY 60 MOUNTAIN VIEW,MO65548 43-1873914	FOUNDATION	MO	501(C)(3)	LINE 12A, I	MERCY ST FRANCIS HOSPITAL	Yes
(27)MERCY HEALTH FOUNDATION ST LOUIS 615 SOUTH NEW BALLAS ROAD ST LOUIS,MO63141 56-2410020	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH EAST COMMUNITIES	Yes
(28)MERCY HEALTH FOUNDATION WASHINGTON 901 E FIFTH STREET WASHINGTON,MO63090 56-2410022	FOUNDATION	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH EAST COMMUNITIES	Yes
(29)MERCY HEALTH NORTHWEST ARKANSAS COMMUNITIES 2710 RIFE MEDICAL LANE ROGERS,AR72758 62-1684203	PHYSICIAN GROUP	AR	501(C)(3)	LINE 10	MERCY HEALTH	Yes
(30)MERCY HEALTH OKLAHOMA COMMUNITIES INC 4300 W MEMORIAL ROAD OKLAHOMA CITY,OK73120 73-1453048	HEALTH SYSTEM	OK	501(C)(3)	LINE 12A, I	MERCY HEALTH	Yes
(31)MERCY HEALTH SOUTHWEST MISSOURIKANSAS COMMUNITIES 100 MERCY WAY JOPLIN,MO64804 30-0584463	HEALTH SYSTEM	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH	Yes
(32)MERCY HEALTH SPRINGFIELD COMMUNITIES 1235 E CHEROKEE STREET SPRINGFIELD,MO65804 43-1856028	HEALTH SYSTEM	MO	501(C)(3)	LINE 12B, II	MERCY HEALTH	Yes
(33)MERCY HOSPITAL ADA INC 430 N MONTE VISTA STREET ADA,OK74820 46-2288155	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HEALTH OKLAHOMA COMMUNITIES INC	Yes
(34)MERCY HOSPITAL ARDMORE INC 1011 14TH AVENUE NW ARDMORE,OK73401 73-1500629	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HEALTH OKLAHOMA COMMUNITIES INC	Yes
(35)MERCY HOSPITAL AURORA 500 PORTER AVENUE AURORA,MO65605 43-1936696	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(36)MERCY HOSPITAL BERRYVILLE 214 CARTER STREET BERRYVILLE,AR72616 71-0759299	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HEALTH NW ARK COMMUNITIES	Yes
(37)MERCY HOSPITAL BOONEVILLE 880 WEST MAIN STREET BOONEVILLE,AR72927 46-3851119	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HOSPITAL FORT SMITH	Yes
(38)MERCY HOSPITAL CARTHAGE 3125 DR RUSSELL SMITH WAY CARTHAGE,MO64836 45-3808607	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(39)MERCY HOSPITAL CASSVILLE 94 MAIN STREET CASSVILLE,MO65625 43-1936699	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(40)MERCY HOSPITAL COLUMBUS 220 PENNSYLVANIA AVENUE COLUMBUS,KS66725 27-0842031	HOSPITAL	KS	501(C)(3)	LINE 3	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(41)MERCY HOSPITAL EL RENO INC 2115 PARKVIEW DRIVE EL RENO,OK73036 27-2716065	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL OKLAHOMA CITY INC	Yes
(42)MERCY HOSPITAL FORT SMITH 7301 ROGERS AVENUE FORT SMITH,AR72903 71-0240352	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HEALTH FORT SMITH COMMUNITIES	Yes
(43)MERCY HOSPITAL HEALDTON INC 3462 HOSPITAL RD HEALDTON,OK73438 26-3173902	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL ARDMORE INC	Yes
(44)MERCY HOSPITAL JOPLIN 100 MERCY WAY JOPLIN,MO64804 27-0814858	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(45)MERCY HOSPITAL KINGFISHER INC 1000 KINGFISHER REGIONAL HOSPITAL C KINGFISHER,OK73750 46-3433074	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL OKLAHOMA CITY INC	Yes
(46)MERCY HOSPITAL LEBANON 100 HOSPITAL DRIVE LEBANON,MO65536 43-1767432	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(47)MERCY HOSPITAL LINCOLN 1000 EAST CHERRY STREET TROY,MO63379 47-2219204	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HOSPITALS EAST COMMUNITIES	Yes
(48)MERCY HOSPITAL LOGAN COUNTY INC 200 SOUTH ACADEMY GUTHRIE,OK73044 45-2998842	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL OKLAHOMA CITY INC	Yes
(49)MERCY HOSPITAL OKLAHOMA CITY INC 4300 W MEMORIAL ROAD OKLAHOMA CITY,OK73120 73-0579285	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HEALTH OKLAHOMA COMMUNITIES INC	Yes
(50)MERCY HOSPITAL OZARK 801 W RIVER STREET OZARK,AR72949 71-0689680	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HOSPITAL FORT SMITH	Yes
(51)MERCY HOSPITAL PARIS 500 E ACADEMY PARIS,AR72855 71-0655753	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HOSPITAL FORT SMITH	Yes
(52)MERCY HOSPITAL ROGERS 2710 RIFE MEDICAL LANE ROGERS,AR72758 71-0294390	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HEALTH NW ARK COMMUNITIES	Yes
(53)MERCY HOSPITAL SPRINGFIELD 1235 E CHEROKEE STREET SPRINGFIELD,MO65804 44-0552485	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(54)MERCY HOSPITAL TISHOMINGO INC 1000 SOUTH BYRD TISHOMINGO,OK73460 27-4433830	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL ADA INC	Yes
(55)MERCY HOSPITAL WALDRON 1341 W 6TH STREET WALDRON,AR72958 71-0557895	HOSPITAL	AR	501(C)(3)	LINE 3	MERCY HOSPITAL FORT SMITH	Yes
(56)MERCY HOSPITAL WATONGA INC 500 CLARENCE NASH BLVD WATONGA,OK73772 45-5199762	HOSPITAL	OK	501(C)(3)	LINE 3	MERCY HOSPITAL OKLAHOMA CITY INC	Yes
(57)MERCY HOSPITALS EAST COMMUNITIES 615 S NEW BALLAS ROAD ST LOUIS,MO63141 43-0653493	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH EAST COMMUNITIES	Yes
(58)MERCY KANSAS COMMUNITIES INC 401 WOODLAND HILLS BLVD FT SCOTT,KS66701 48-0956045	HOSPITAL	KS	501(C)(3)	LINE 3	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(59)MERCY MINISTRIES OF LAREDO 2500 ZACATECAS ST LAREDO,TX78046 20-0198462	OUTREACH	TX	501(C)(3)	LINE 7	MERCY HEALTH	Yes
(60)MERCY RESEARCH 524 NORTH BOONEVILLE AVENUE SPRINGFIELD,MO65802 87-0796305	RESEARCH	MO	501(C)(3)	LINE 4	MERCY HEALTH	Yes
(61)MERCY ST FRANCIS HOSPITAL 100 W US HIGHWAY 60 MOUNTAIN VIEW,MO65548 44-0607149	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH SPRINGFIELD COMMUNITIES	Yes
(62)MHM SUPPORT SERVICES 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 20-2553101	CENTRALIZED HEALTH SYSTEM FUNCTIONS	MO	501(C)(3)	LINE 12A, I	MERCY HEALTH	Yes
(63)MISSION CLINICAL SERVICES 216 MCAULEY COURT HOT SPRINGS,AR71913 13-4239691	CHILD ADVOCACY CENTER	AR	501(C)(3)	LINE 3	MERCY HEALTH	Yes
(64)MERCY HEALTH FOUNDATION SOUTH 10010 KENNERLY ROAD ST LOUIS,MO63128 26-1516789	FUNDRAISING	MO	501(C)(3)	LINE 12A, I	MERCY HOSPITAL SOUTH	Yes
(65)MERCY HOSPITAL SOUTH 10010 KENNERLY ROAD ST LOUIS,MO63128 43-0980256	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH EAST COMMUNITIES	Yes
(66)ST ANTHONY'S PHYSICIAN ORGANIZATION 10010 KENNERLY ROAD ST LOUIS,MO63128 43-1784536	HEALTH CARE	MO	501(C)(3)	LINE 3	MERCY HOSPITAL SOUTH	Yes
(67)MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS 1619 W 7TH STREET GALENA,KS66739 84-3730625	HOSPITAL	KS	501(C)(3)	LINE 3	MERCY HEALTH SW MOKS COMMUNITIES	Yes
(68)MERCY HOSPITAL PERRY 434 N WEST STREET PERRYVILLE,MO63775 92-3065473	HOSPITAL	MO	501(C)(3)	LINE 3	MERCY HEALTH EAST COMMUNITIES	Yes
(69)SOUTHEAST HOSPITAL DBA MERCY HOSPITAL SOUTHEAST 1701 LACEY STREET CAPE GIRARDEAU,MO63701 43-0654874	HOSPITAL	MO	501(C)(3)	LINE 3	SOUTHEASTHEALTH SYSTEM	Yes
(70)SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY 1701 LACEY STREET CAPE GIRARDEAU,MO63701 27-3868479	HOSPITAL	MO	501(C)(3)	LINE 3	SOUTHEAST HOSPITAL	Yes
(71)SOUTHEASTHEALTH SYSTEM 1701 LACEY STREET CAPE GIRARDEAU,MO63701 47-4890906	HEALTH SYSTEM	MO	501(C)(3)	LINE 12C, III-FI	MERCY HEALTH	Yes
(72)SOUTHEAST MISSOURI HOSPITAL FOUNDATION 1849 BROADWAY CAPE GIRARDEAU,MO63701 43-1122759	FOUNDATION	MO	501(C)(3)	LINE 7	SOUTHEAST HOSPITAL	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) PLAZA SURGERY SERVICES COMPANY LLC 12700 SOUTHFORK ROAD ST LOUIS,MO63128 20-4709312	INACTIVE	MO	MERCY HOSPITAL SOUTH				No			No
(2) ST EDWARD MERCY MC M-P OFFICE BLDG 7301 ROGERS AVENUE FORT SMITH,AR72903 71-0554050	OFFICE BUILDING	AR	MERCY HOSPITAL FORT SMITH				No			No
(3) PLATINUM CPS HOLDINGS LLC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 84-2493007	HOLDING COMPANY	MO	MERCY MANAGED CARE CORP MERCY HEALTH				No			No

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?
(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	Yes	No
(1) FRONTENAC PROPERTIES INC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 52-1914421	HOLDING COMPANY	DE	MERCY HEALTH	C					No
(2) MERCY HEALTH CENTER CONDOMINIUMS INC 4300 W MEMORIAL RD OKLAHOMA CITY,OK73120 68-0640970	REAL ESTATE	OK	MERCY HOSPITAL OKLAHOMA CITY INC	C					No
(3) MERCY MANAGED CARE CORPORATION 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 73-1441665	HOLDING COMPANY	OK	MERCY HEALTH	C					No
(4) UHL CORP INC 15740 SOUTH OUTER 40 RD CHESTERFIELD,MO63017 74-2499535	HOLDING COMPANY	MO	MERCY HOSPITALS EAST COMMUNITIES	C					No

Schedule R (Form 990) 2023

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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	170,959,846	FMV
(2) MERCY HEALTH EAST COMMUNITIES	Q	118,911,906	FMV
(3) MERCY HEALTH FOUNDATION JEFFERSON	C	430,715	FMV
(4) MERCY HOSPITALS EAST COMMUNITIES	P	369,596	FMV
(5) MERCY HOSPITAL PERRY	Q	243,970	FMV
(6) MERCY HEALTH FOUNDATION JEFFERSON	B	190,198	FMV
(7) MERCY HOSPITAL ARDMORE	P	95,508	FMV

Schedule R (Form 990) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	58
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	290,778	433,006
9	Program service revenue (Part VIII, line 2g) .........	216,608,783	250,465,717
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	95,028	18,807
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,759,675	1,949,737
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	218,754,264	252,867,267
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	197,444	279,997
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	113,611,080	129,245,374
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	84,944,644	108,727,234
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	198,753,168	238,252,605
19	Revenue less expenses. Subtract line 18 from line 12.......	20,001,096	14,614,662
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	228,817,036	229,026,833
21	Total liabilities (Part X, line 26).............	25,370,621	29,867,100
22	Net assets or fund balances. Subtract line 21 from line 20.....	203,446,415	199,159,733

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 27,015,157 including grants of $ ) (Revenue $ 31,968,080 )
	MERCY HOSPITAL JEFFERSON 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 JEFFERSON PROVIDES A WIDE VARIETY OF SERVICES IN THEIR 200 BED FACILITY AND IN FY24, HAD 196,171 TOTAL CASES. MERCY HOSPITAL JEFFERSON 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 JEFFERSON ALSO PROVIDES A FULL COMPLEMENT OF CARDIAC REHABILITATION, THERAPY AND EDUCATION SERVICES. IN FY24, MERCY HOSPITAL JEFFERSON HAD 13,165 CASES AND 6,186 PATIENT DAYS FOR THIS SERVICE LINE.

4b	(Code: ) (Expenses $ 23,151,617 including grants of $ ) (Revenue $ 27,396,204 )
	MERCY HOSPITAL JEFFERSON 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 JEFFERSON'S EMERGENCY DEPARTMENT IS READY 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR WITH FAST, EXPERIENCED AND PROFESSIONAL CARE. IN FY24, MERCY HOSPITAL JEFFERSON HAD 67,450 CASES FOR THIS SERVICE LINE.

4c	(Code: ) (Expenses $ 20,528,321 including grants of $ ) (Revenue $ 24,291,956 )
	MERCY HOSPITAL JEFFERSON HAS A GASTROENTEROLOGY TEAM EXPERIENCED IN DIAGNOSING AND TREATING ALL TYPES OF ILLNESSES AFFECTING THE GASTROINTESTINAL TRACT. MERCY'S TEAM CAN ALLEVIATE YOUR SYMPTOMS AND REDUCE OR ELIMINATE DISCOMFORT NO MATTER WHERE IT MAY APPEAR IN YOUR DIGESTIVE SYSTEM, FROM YOUR ESOPHAGUS AND STOMACH TO YOUR SMALL AND LARGE INTESTINES, AS WELL AS THE LIVER, GALLBLADDER AND PANCREAS. IN FY24, MERCY HOSPITAL JEFFERSON HAD 5,379 CASES AND 4,847 PATIENT DAYS FOR THIS SERVICE LINE.

	(Code: ) (Expenses $ 141,031,030 including grants of $ 279,997 ) (Revenue $ 166,887,468 )
	IN ADDITION TO THE PROGRAM SERVICES DESCRIBED ABOVE, MERCY HOSPITAL JEFFERSON ALSO SERVES PATIENTS IN ADDITIONAL SERVICE LINES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING AREAS: BEHAVIORAL HEALTH; ONCOLOGY; ORTHOPEDICS; PULMONARY; REHABILITATION.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 141,031,030 including grants of $ 279,997 ) (Revenue $ 166,887,468 )
4e	Total program service expenses211,726,125

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) MEYER MICHELE........................................................................ VP OPERATIONS	40.00 .......................0.00	X			0	358,804	24,550
(19) AZAD SALEEM........................................................................ PHYSICIAN	50.00 .......................0.00		X		0	618,022	12,683
(20) BOGACHENCHU SREENIVASULU........................................................................ HOSPITALIST	50.00 .......................0.00		X		0	655,392	22,166
(21) GADI BHASKARA........................................................................ PHYSICIAN	50.00 .......................0.00		X		0	1,002,921	28,024
(22) SIEGEL CRAIG........................................................................ PHYSICIAN	50.00 .......................0.00		X		0	606,722	25,725
(23) STAHLSCHMIDT MARK........................................................................ PHYSICIAN	50.00 .......................0.00		X		0	574,109	14,454
(24) JOHNSTON JEFFREY A........................................................................ FORMER OFFICER	0.00 .......................0.00			X	0	1,316,754	10,821
(25) MATEJKA CHERYL L........................................................................ FORMER OFFICER	0.00 .......................55.00			X	0	1,593,070	140,367

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	10,778,687	574,631

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	430,715
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,291

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		433,006

		Business Code
2a	NET PATIENT SERVICE REVENUE	621110	247,418,739	247,418,739
b	RENTAL INCOME FROM RELATED ORGANI	531120	2,053,806	2,053,806
c	OTHER OPERATING REVENUE	621110	993,172	993,172
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		250,465,717

3 Investment income (including dividends, interest, and othersimilar amounts) ......			18,807			18,807
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	494,347
b	Less: rental expenses	6b	183,593
c	Rental income or (loss)	6c	310,754
d	Net rental income or (loss).......			310,754			310,754
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFE & VENDING		722210	1,560,992			1,560,992
b
c
d	All other revenue ....			77,991	77,991
e	Total. Add lines 11a–11d ......			1,638,983
12	Total revenue. See instructions.....			252,867,267	250,543,708	0	1,890,553

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	200,198	200,198
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	79,799	79,799
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	108,116,970	104,189,874	3,927,096
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,729,998	3,574,469	155,529
9	Other employee benefits .......	10,591,772	10,125,186	466,586
10	Payroll taxes ...........	6,806,634	6,534,459	272,175
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........	30,125		30,125
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	11,030,985	10,430,389	600,596
12	Advertising and promotion ....	25,770		25,770
13	Office expenses .......	4,576,159	3,773,701	802,458
14	Information technology ......	59,296	19,840	39,456
15	Royalties ..
16	Occupancy ...........	5,043,285	4,709,128	334,157
17	Travel ............	290,550	248,036	42,514
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,124		1,124
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	11,433,299	10,805,361	627,938
23	Insurance ...	1,291,062	347,978	943,084
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS & MEDICAL EXPENSE	34,180,974	34,180,974
b	SHARED SERVICE FEES	26,714,091	8,815,650	17,898,441
c	BAD DEBT	10,620,759	10,620,759
d	REPAIRS & MAINTENANCE	2,309,070	2,274,377	34,693
e	All other expenses	1,120,685	795,947	324,738
25	Total functional expenses. Add lines 1 through 24e	238,252,605	211,726,125	26,526,480	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,214,754	1	5,906,388
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			28,126,379	4	31,366,293
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,717,069	8	3,956,245
9	Prepaid expenses and deferred charges ......			178,026	9	202,588
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	256,023,225
b	Less: accumulated depreciation	10b	122,820,605	138,864,959	10c	133,202,620
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			53,636,770	14	53,636,771
15	Other assets. See Part IV, line 11 ...........			79,079	15	755,928
16	Total assets. Add lines 1 through 15 (must equal line 33)...			228,817,036	16	229,026,833

17	Accounts payable and accrued expenses .....	24,849,488	17	29,349,375
18	Grants payable ...	99,383	18	112,805
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	421,750	25	404,920
26	Total liabilities. Add lines 17 through 25..	25,370,621	26	29,867,100

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	203,416,651	27	199,131,619
28	Net assets with donor restrictions ...........	29,764	28	28,114
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	203,446,415	32	199,159,733
33	Total liabilities and net assets/fund balances ........	228,817,036	33	229,026,833