4A (Expenses $ 68399733 including grants of $ 0) (Revenue $ 81789141)
MERCY HOSPITAL ADA 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 ADA PROVIDES A WIDE VARIETY OF SERVICES IN THEIR 156 BED FACILITY AND IN FY22, HAD 53,518 TOTAL CASES. AT MERCY HOSPITAL ADA, CANCER CARE IS ABOUT MORE THAN PROVIDING CLINICAL TREATMENTS. MERCY HOSPITAL ADA ALSO OFFERS SUPPORT SERVICES TO HELP YOU MAINTAIN YOUR PHYSICAL, MENTAL AND EMOTIONAL HEALTH. MERCY'S CANCER SPECIALISTS CARE FOR ALMOST EVERY TYPE OF CANCER AND PARTICIPATE IN CLINICAL RESEARCH TO BRING YOU THE MOST ADVANCED CANCER TREATMENT AVAILABLE. IN FY22, MERCY HOSPITAL ADA HAD 4,266 CASES AND 175 PATIENT DAYS FOR THIS SERVICE LINE.

4B (Expenses $ 18313431 including grants of $ 0) (Revenue $ 21898328)
MERCY HOSPITAL ADA'S RADIOLOGISTS USE THE LATEST TECHNOLOGIES TO PRODUCE PRECISE IMAGES AND EXACTING TEST RESULTS. MERCY OFFERS A FULL RANGE OF DIAGNOSTIC IMAGING SERVICES FOR ADULTS AND CHILDREN. MERCY RADIOLOGISTS GIVE MORE INSIGHT INTO YOUR CONDITION, SO YOU RECEIVE AN ACCURATE DIAGNOSIS AND THE MOST EFFECTIVE TREATMENT. IN FY22, MERCY HOSPITAL ADA HAD 11,222 CASES FOR THIS SERVICE LINE.

4C (Expenses $ 2068142 including grants of $ 0) (Revenue $ 2472986)
MERCY HOSPITAL ADA 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 FY22, MERCY HOSPITAL ADA HAD 1,635 CASES AND 1,425 PATIENT DAYS FOR THIS SERVICE LINE.

4D (Expenses $ 749825 including grants of $ 286979) (Revenue $ 896604)
IN ADDITION TO THE PROGRAM SERVICES DESCRIBED ABOVE, MERCY HOSPITAL ADA ALSO SERVES PATIENTS IN ADDITIONAL SERVICE LINES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING AREAS: ORTHOPEDICS; PEDIATRICS.

MERCY HOSPITAL ADA, INC.
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 ADA, INC.
PART V, SECTION B, LINE 5: WHEN CONDUCTING THE CHNA, MERCY HOSPITAL, ADA WORKED CLOSELY WITH THE FOLLOWING:- ADA HOMELESS SERVICES- ADA PUBLIC SCHOOLS- ADA REGIONAL UNITED WAY- CHICKASAW NATION MEMBERS- COMPASSION OUTREACH CENTER (MEDICAL CARE FOR THE UNINSURED.)- EAST CENTRAL UNIVERSITY - PONTOTOC COUNTY HEALTH DEPARTMENT- PONTOTOC TECHNOLOGY CENTER REPRESENTATIVES- MERCY ADA COMMUNITY PARAMEDIC- VALLEY VIEW HEALTH AND WELLNESS FOUNDATION- MEMBERS OF AREA FAITH BASED COMMUNITIES- MERCY HOSPITAL, ADA LEADERSHIP

MERCY HOSPITAL ADA, INC.
PART V, SECTION B, LINE 6B: SEE PART V, SECTION B, LINE 5 RESPONSE

MERCY HOSPITAL ADA, INC.
PART V, SECTION B, LINE 11: IN CONJUNCTION WITH THE CHNA, MERCY HOSPITAL ADA'S BOARD ADOPTED AN IMPLEMENTATION STRATEGY IN FY23 RELATED TO THE 2021 CHNA. MERCY HOSPITAL ADA WILL ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS BEGINNING IN FY23:OK HEART HOSPITAL COLLABORATION: OUR PLANS TO EXPAND CARDIAC CARE AT MERCY ADA HOSPITAL IN PARTNERSHIP WITH OKLAHOMA HEART HOSPITAL WAS SEVERELY IMPACTED BY OUR INABILITY TO HIRE A KEY RESOURCE. EVEN WITH THE STAFFING STRUGGLES, MERCY ADA WAS ABLE TO ENSURE 133 PATIENTS RECEIVED KEY CARDIAC PROCEDURES THAT ARE NOT AVAILABLE IN THE LOCAL RURAL COMMUNITY THROUGH OTHER MERCY ACUTE CARE FACILITIES. CANCER SCREENING AND EDUCATION IS A PROGRAM TO SCREEN AND PROVIDE PREVENTION EDUCATION RESOURCES TO COMMUNITY MEMBERS FOR VARIOUS FORMS OF CANCER. WITHIN THE EARLY MONTHS OF THE PROGRAM, WE SERVED 115 PATIENTS BUT OUR ATTEMPTS TO MAINTAIN OUR REGULAR CANCER SCREENINGS WERE SEVERELY CURTAILED DUE TO COVID REALITIES. DIABETES SUPPORT GROUP WORKED CLOSELY WITH COMMUNITY PARTNER, COMPASSION OUTREACH IN ADA, OK TO ESTABLISH SCHEDULED OUTREACH UTILIZING MERCY RESOURCES TRAINED IN THE EDUCATION, PREVENTION AND TREATMENT OF DIABETES. THE PROGRAM GOT OFF TO A GOOD START WITH 259 PATIENTS RECEIVING THE SERVICES. HOWEVER, FURTHER EDUCATION, TESTING AND TREATMENT WAS SEVERELY CONSTRAINED BY THE ONSET OF COVID-19. BEHAVIORAL HEALTHTHROUGH PARTNERSHIPS WITH LOCAL COMMUNITY PARTNERS, MERCY HOSPITAL ADA REFERS PATIENTS BOTH WITHIN THE HOSPITAL AND IN THE CLINICS TO SEVERAL BEHAVIORAL HEALTH PROGRAMS:- BEHAVIORAL HEALTH COUNSELING FOCUSES ON ENHANCING SUPPORT FOR OUR ADULT PATIENTS UTILIZING THE ER UNNECESSARILY 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.- SUBSTANCE USE SUPPORT GROUPS FOCUSES ON INTENSIVE INTERNAL AND EXTERNAL REFERRAL TO BEHAVIORAL HEALTH SPECIALISTS, TO IMPACT THOSE WHO HAVE OVERDOSED ON OPIOIDS TO ESTABLISH IMMEDIATE LINKAGES TO SUBSTANCE USE AND MEDICATION ASSISTED TREATMENT SERVICES. - BEREAVEMENT SUPPORT GROUPS ASSIST FAMILIES THAT HAVE ENCOUNTERED DEATH IN THE FAMILY IMMEDIATE AND ONGOING SUPPORT TO DECOMPRESS THROUGH THE DIFFICULT TIME IN THEIR LIVES. FIRST BAPTIST CHURCH OF ADA AND MERCY WORK TO ENSURE SUPPORT FOR THESE COMMUNITY MEMBERS.ADDITIONAL INITIATIVES:- $40,000 SUPPLIED ANNUALLY BY THE MERCY HOSPITAL FOUNDATION ADA FOR UNDER/UNINSURED PATIENTS WITH LIMITED RESOURCES FOR TRANSPORTATION, DISCHARGE MEDICATIONS AND MEDICAL EQUIPMENT. - THE DIABETES SUPPORT GROUP IS A JOINT COLLABORATION BETWEEN MERCY HOSPITAL ADA AND THE STAFF OF THE DIABETES CENTER OF THE CHICKASAW NATION MEDICAL CENTER. MONTHLY MEETINGS OFFER EDUCATION AND SUPPORT FOR ALL DIABETICS AND THEIR FAMILY MEMBERS IN A GROUP SETTING. 194 PATIENTS HAVE PARTICIPATED.- MHA COORDINATES THE MEALS ON WHEELS PROGRAM WHICH PROVIDES MEALS TO SENIORS AND DISABLED MEMBERS OF THE COMMUNITY. WHEN THERE ARE NOT ENOUGH DRIVERS, CO-WORKERS FROM MERCY HOSPITAL ADA VOLUNTEER TO DELIVER TRAYS.- NINE MONTHS TO COUNTDOWN IS A 1 HOUR CLASS OFFERED AT NO CHARGE FOR ALL MOTHERS-TO-BE IN THE FIRST TRIMESTER OF PREGNANCY, PROVIDING EDUCATION ON NUTRITION, EXERCISE AND PERSONAL CARE DURING THE PREGNANCY. - TOURS ARE HELD TO PREPARE FAMILY MEMBERS FOR A NEW ADDITION TO THE FAMILY. SIBLING TOURS ARE HELD UPON REQUEST. - CANCER-RELATED EDUCATIONAL PROGRAMS ARE HELD ANNUALLY FOR THE COMMUNITY.- ON EACH TUESDAY, WEDNESDAY AND THURSDAY, MERCY HOSPITAL ADA TRANSPORTS OUR WOUND CARE PATIENTS WHO LIVE OUT OF TOWN OR HAVE NO ACCESS TO TRANSPORTATION TO THE HOSPITAL. - VOLUNTARY CONTRIBUTIONS TO THE UNITED WAY- A SENIOR LEADER IS SERVING ON THE ADA CHAMBER OF COMMERCE. - PARTICIPATION IN OBI BLOOD DRIVE- MERCY CO-WORKERS HELP AT THE COMPASSION OUTREACH CENTER, A FREE HEALTHCARE CLINIC FOR THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY.- MERCY CO-WORKERS HELP AT ABBA'S TABLE, A COMMUNITY FOOD-KITCHEN.- MERCY EMS PROVIDES AN AMBULANCE ON STAND-BY AT HIGH-RISK COMMUNITY EVENTS INCLUDING, BUT NOT LIMITED TO, JUNIOR HIGH, HIGH SCHOOL AND COLLEGE FOOTBALL GAMES, MARATHON EVENTS, RODEOS AND BULL-RIDING COMPETITIONS.A SIGNIFICANT NEED NOT BEING ADDRESSED IS SUBSTANCE ABUSE PREVENTION WHICH IS BEING ADDRESSED THROUGH THE PONTOTOC COUNTY DRUG FREE COALITION. MHA IS A MEMBER OF THE COALITION AND WILL CONTINUE TO PROVIDE SUPPORT AND COMMITMENT BUT NOT DIRECT REHABILITATION. THESE NEEDS ARE BEING ADDRESSED IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH CAN BE ACCESSED HERE: HTTPS://WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS/

MERCY HOSPITAL ADA, INC.
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/ADA-CHNA-2022.PDF

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 10A
HTTPS://WWW.MERCY.NET/CONTENT/DAM/MERCY/EN/PDF/CHIP/MERCY-ADA-CHIP-2023.PDF

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 22
ELIGIBILITY GUIDELINES FOR CHARITY CARE DISCOUNTS THE FEDERAL POVERTY GUIDELINES FOR INCOME ARE THE BASIS FOR DETERMINING ELIGIBILITY FOR CHARITY CARE DISCOUNTS. FOR EXAMPLE, INDIVIDUALS WITH INCOMES 200% OR BELOW, THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR FREE CARE. INDIVIDUALS WITH INCOMES GREATER THAN 200% OF THE FEDERAL POVERTY GUIDELINES FOR MOST COMMUNITIES, MAY BE ELIGIBLE FOR CARE AT DISCOUNTED RATES DEPENDING ON THEIR INCOME LEVEL AND/OR THE AMOUNT DUE TO THE HOSPITAL. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL FACILITY USES AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. THE HOSPITAL USES A LOOK BACK METHOD THAT CONSIDERS DISCOUNTS ALLOWED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS.

PART I, LN 7 COL(F):
TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $113,862,196. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $6,835,470. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $107,026,726.

PART I, LINE 6A
COMMUNITY BENEFIT REPORTTHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050).

PART II, COMMUNITY BUILDING ACTIVITIES:
MERCY HOSPITAL ADA (MHA) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IN WHICH THEY SERVE. THROUGH PARTICIPATION IN NEIGHBORHOOD/COMMUNITY MEETINGS, COMMUNITY BOARDS, AND INVOLVEMENT IN COMMUNITY-BASED EVENTS, MHA DEMONSTRATES ITS ONGOING COMMITMENT TO THE COMMUNITY. COMMUNITY BUILDING ACTIVITIES SERVE AS A LINK TO ENGAGE MERCY COWORKERS TO LOOK BEYOND THE WALLS OF THE FACILITIES IN WHICH THEY SERVE. SOME OF THE COMMUNITY BUILDING ACTIVITIES IN WHICH MHA ADDRESSES THE PRIORITIZED HEALTH NEEDS OF INCREASED CARDIAC CARE, INCREASE RATE OF CANCER SURVIVAL THROUGH EARLY DETECTION, EQUIP NON-MEDICAL CITIZENS TO PROVIDE EMERGENCY RELIEF, INCREASE AWARENESS OF AND PROVIDE DIABETES SUPPORT FOR UNINSURED AND AT-RISK PERSONS, INCREASE THE NUMBER OF MEDICAL CARE PROVIDERS FOR THE ADA, IMPLEMENT AN INTEGRATED CARE MODEL APPROACH TO BEHAVIORAL HEALTH IN THE PRIMARY CARE SETTING AREA. A FULL DESCRIPTION OF THE COMMUNITY'S BUILDING ACTIVITIES CAN BE FOUND AT: HTTPS://WWW.MERCY.NET/ABOUT/COMMUNITY-BENEFITS/

PART III, LINE 2:
TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNT, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED.

PART III, LINE 3:
THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE.

PART III, LINE 4:
THE TEXT OF THE FOOTNOTE THAT IS INCLUDED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.

PART III, LINE 8:
IT IS THE POSITION OF MERCY HOSPITAL ADA 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 VI, LINE 4:
THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL ADA INCLUDES 39 ZIP CODES ACROSS OKLAHOMA. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND THE OK DEPARTMENT OF HEALTH 2021-2022 ANALYTICS. THE AREA'S POPULATION IS 120,223. THE MEDIAN HOUSEHOLD INCOME IS $50,000. 41.9% OF THE POPULATION IS 45 AND OLDER. 87% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 38. 20.4% OF THE HOUSEHOLDS ARE ON MEDICARE, 24.5% ON MEDICAID, AND 16.3% UNINSURED.

PART VI, LINE 7, REPORTS FILED WITH STATES
OK

COVID-19
PLEASE SEE SCHEDULE O FOR INFORMATION RELATED TO COVID-19.

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 OR TAKING LEGAL ACTION 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 IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS. MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY FOR ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE AND SOUTHEAST KANSAS. THIS PRESUMPTIVE SCREENING PROCESS DETAILS EVALUATIONS THAT TAKE PLACE PRIOR TO PATIENT BILLING AND ADDITIOANLLY PRIOT 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 LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES AFTER SENDING 3 MONTHLY STATEMENTS WITH THE FINAL INCLUDING NOTIFICATION; IF NO RESOLUTION THEY WILL BE TURNED TO COLLECTIONS. ADDITIONALLY, THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENTS, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENSURE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEW COMPLIANCE WITH POLICIES BUT ENSURE 120 DAYS OF BILLING AND COLLECTIONS OCCUR PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED.

PART VI, LINE 2:
ON JANUARY 30, 2018, MHA HELD ITS FIRST MEETING OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT TASK FORCE. THE TASK FORCE MET MONTHLY WELL INTO FALL 2018. THE TASK FORCE WHICH CONSISTED OF A BROAD REPRESENTATION OF THE ADA AND BEYOND COMMUNITY DID THE FOLLOWING: FORMULATED A HEALTH NEEDS SURVEY AND THEN ADMINISTERED IT TO SOME 685 PARTICIPANTS; PLANNED AND CONDUCTED FOUR FOCUS GROUPS WHICH TOOK PLACE AT CHICKASAW COMMUNITY CENTER, HOLDENVILLE COMMUNITY CENTER, WITH FRIENDS AND FAMILIES OF ADDICTION AND ST. JOSEPH'S CHURCH WHICH WAS CONDUCTED IN SPANISH. AFTER COLLECTING THE DATA, THE MHA CHNA TASK FORCE ANALYZED THE DATA AND THEN COMPARED IT WITH BOTH INTERNAL AND EXTERNAL DEMOGRAPHICS, UTILIZATION, CHRONIC CONDITIONS AND HEALTH STATUS. LATER, DATA WAS SUPPLIED BY THE MERCY MARKETING AND COMMUNICATION DEPARTMENT. THE NEEDS ASSESSMENT PROCESS INVOLVED REVIEW OF BOTH QUANTITATIVE AND QUALITATIVE INFORMATION TO ATTAIN THE FULL SCOPE OF THE COMMUNITY'S NEEDS. PLEASE REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CAN BE FOUND AT: WWW/MERCY.NET/COMMUNITY-BENEFITS

PART VI, LINE 3:
MERCY INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNTS IS PLACED FOR REVIEW. IN ADDITION, PATIENT HAVE SIGNAGE ABOUT THE POLICY AT THE ACCESS POINTS, AND ALL STAFF WORKING WITH THE PATIENT AT POINT OF SERVICE, SCHEDULING, CUSTOMER SERVICE, AND EVEN THROUGH THE MEDICAID ELIGIBILITY SCREENING, HAVE THE MEANS TO SEND THE ACCOUNT FOR REVIEW. THERE IS THE PLAIN LANGUAGE SUMMARY THAT IS BEING PROVIDED TO ALL WHOM EXPRESS HARDSHIP WHEN PRESENTING IN THE FACILITIES. IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS (BILLING) MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL.

PART VI, LINE 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 AND FAMILIES IN ITS COMMUNITIES. MERCY OFFERS SERVICES AND PROGRAMS WHICH FURTHER HEALTH PROMOTION, MAINTENANCE AND CARE TO THE COMMUNITY. PROGRAMS PROVIDED TO MEET THE COMMUNITY INCLUDE SUPPORT GROUPS, OUTREACH EVENTS, BLOOD DRIVES, AND CO-WORKER WORKDAYS. MERCY IS GOVERNED BY A BOARD OF DIRECTORS WHICH INCLUDES REPRESENTATION FROM COMMUNITY LEADERS FROM A VARIETY OF SECTORS. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY. ANY POTENTIAL CONFLICTS OF INTEREST DISCLOSED ARE REVIEWED AND RESOLVED. THIS PROCESS ENSURES THAT PUBLIC, RATHER THAN PRIVATE INTERESTS ARE SERVED. SURPLUS FUND AND UNRESTRICTED ASSETS HELD ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH INITIATIVES WHICH SUPPORT THE ORGANIZATION'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH CARE SERVICES TO THE COMMUNITIES IT SERVES.

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, 2022, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 5 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPTIALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2022, MERCY HAD MORE THAN 10.4 MILLION OUTPATIENT AND PHYSICIAN OFFICE VISITS, APPROXIMATELY 2,300 EMPLOYED PHYSICIANS, AND APPROXIMATELY 42,000 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."