Mercy Annual 2011-12

One2011 Annual Report

To do something extraordinary, one must step away from the ordinary. That’s what Catherine McAuley did when she asked the Sisters of Mercy to venture into communities to tend to the sick and marginalized. At a time when many religious orders remained cloistered, it was a revolutionary idea. Her vision quickly came to life well beyond Dublin, Ireland, as thousands of Sisters shared in her ardent desire to help people.

Our 38,000 co-workers share a common spirit of service today. We see how our diverse skills and ideas work together to dramatically change how we care for people. What was once “pioneering” is now becoming our new standard of care. And we’re determined to reach even further, so the many people we serve in seven states can also imagine a better future for themselves and their children.

Mercy HospitalsMercy operates acute care, specialty care and critical access hospitals in 31 communities across four states:

Arkansas Berryville Fort Smith Hot Springs Nashville Ozark Paris Rogers Waldron

Mercy ClinicAcross these four states, a team of more than Mercy 1,600 primary and specialty care physicians, 600 advanced practitioners and supporting staff deliver health care services through more than 360 offices.

Outreach MinistriesMercy serves a variety of special needs, particularly for low-come patients, in Louisiana, Mississippi and Texas.

Vision Through Many EyesOne

MissouriAuroraCarthageCassvilleChesterfieldJoplinLebanonMountain ViewSpringfieldSt. LouisWashington

OklahomaArdmoreEl RenoGuthrieHealdtonKingfisherMariettaOklahoma CitySulphurTishomingoWatonga

KansasColumbusFort ScottIndependence

“As the Sisters

of Mercy

before us, we

bring to life

the healing

ministry of

Jesus

through our

compassionate

care and

exceptional

service.”

Unlike any other story in our recent history, people want to hear about Joplin. Mercy leaders have spoken to countless groups since the May 2011 tornado. They recount tales of loss and recovery … unimaginable damage and rebuilding. The real story, however, is not about a twisted shell of a hospital or of construction cranes setting new steel. It’s about the potential in each of us to overcome challenges. Rebuilding in Joplin has required the focus and talents of thousands of people, each willing and able to do the right things. In less than a year, we progressively provided better facilities for families there. We partnered with the Joplin community to make sure we were providing the most needed services. We imagined how we could make things even better than they were. It took lots of hands working together, and the job isn’t done yet. This same exciting work is taking place everywhere in Mercy today. As we unite under one name and symbol, we’re shaping the future of health care around you to be more effective, convenient, personal. Just one co-worker can bring Mercy to a patient or family member. When we’re all working with that same goal, great things happen. You’ll see some examples in this report.

Our new name is a tribute to our heritage. Its accompanying symbol not only celebrates the unique gifts each of us

lends to our work, but our shared vision to improve people’s health and lives. If you haven’t already, you’ll soon see

our new logo and signs on Mercy buildings in your area. Thank you for your interest and support of Mercy. Blessings and best wishes to all in 2012.

How One Person Makes A Difference, Thousands Of Times Each Day

Lynn Britton Ron AshworthMercy President/CEO Mercy Health Ministry Board Chair

Nightmare Comes to LifeOn May 22, 2011, the unthinkable happened. Within minutes, an ordinary springtime Sunday turned deadly as an F5 tornado ripped through Joplin. It destroyed nearly everything along a path a mile wide and 22 miles long – including Mercy Hospital.

This was one of the deadliest tornadoes in U.S. history. More than 180 patients and 117 Mercy co-workers were in the hospital, and one surgery was in progress, when the tornado hit. While caregivers moved patients into interior hallways or shielded those who couldn’t be moved with their own bodies, windows and walls were blown out, portions of the roof pulled

In only 45 seconds, a deadly tornado destroyed Mercy’s hospital in Joplin, Mo., but it didn’t break our spirit or commitment Joplin. In fact, it’s stronger than ever.

off, and everything large or small became a potentially deadly projectile in the voracious winds.

Miraculously, the staff, along with visiting friends and families, safely evacuated the patients – through darkness, ankle-deep water, broken glass and fallen beams. Sadly, five patients on life support died, as did one visitor. While the basic hospital structure withstood the storm, most everything else was destroyed.

Emerging from the RubbleMercy co-workers worked closely together, and quickly, to establish a triage center outside the crippled emergency department. Co-workers who weren’t scheduled to work that day came by the hundreds to assist in the evacuation and to provide medical care.

Thanks to our electronic health record system, installed in Joplin just a few weeks prior, medical records for all 183 patients were readily available. Within a few hours, a substitute hospital was set up in downtown Joplin. Many co-workers walked miles across the rubble to carry materials salvaged from the hospital.

devastating storm, thousands of helping hands

2011 20132012 2014 2015

Mercy promises Joplin it will have a hospital back up in one week. By the following Sunday, a 60-bed mobile hospital was functioning.

An arrangement with the nearby McCune-Brooks Regional Hospital in Carthage helped open additional beds and surgical space.

In August, a temporary hard-sided hospital replaced the tent hospital

Within less than a year, Mercy opened a component hospital with 120 beds and increased services.

By 2015, a new permanent Mercy Hospital will open with 424 beds.

One

Mercy breaks ground on new Mercy Hospital in Joplin.

“Our ministry has never been confined to a building. Our people and our spirit are at the core of who we are and what we do. We are already rising from the rubble stronger than ever before.”

~ Lynn Britton, Mercy President and CEO

The only thing unscathed at the hospital was a statue of the Mercy cross being elevated by two strong hands. It quickly became an inspirational icon to all who came to view the destruction and those involved in the clean-up and rebuilding.

Beginning to RebuildMercy immediately pledged to remain in the community, keep Joplin co-workers on the payroll and give them recovery assistance. A mobile, 60-bed tent hospital was erected near the destroyed hospital on a cleared parking lot.

By the end of June, planning for a new hospital was on a fast track. An arrangement with the nearby McCune-Brooks Regional Hospital in Carthage helped open additional beds and surgical space, and put nearly 800 co-workers back to work. Another 1,800 found work at other Mercy facilities.

In August, a temporary hard-sided hospital replaced the tent hospital and a location for the permanent replacement hospital, roughly three miles from the devastated campus, was selected. The facility should be ready in spring 2015.

To meet the immediate needs of the community, Mercy opened a component hospital in April. This 150,000 square-foot facility was constructed from 224 modules in less than six months. Expanded services include surgery, an ICU, obstetrics and pediatrics, and more beds.

Keeping the Earth in MindMercy has developed plans to assure the new hospital is built in ways that preserve southwest Missouri’s beauty. • 400nativesaplingswerehand-dugandtransportedfrom

the new hospital site to a nearby nursery. These saplings will beautify the grounds of the new hospital.

• LargetreeswereharvestedintolumbertohelprebuildJoplin.

• Fixturesfromhomesbeingclearedfromthesitewillbeused by Joplin’s Habitat for Humanity.

• Steel,aluminum,copper,concreteandasphaltarebeingsalvaged and recycled.

• Once the destroyed hospital buildings have been removed, Mercy will restore the land. We have already donated 12 acres to the Joplin school district for a new elementary school that will replace two schools destroyed in the tornado.

“God Loves a Cheerful Giver”

– Catherine McAuley, Sisters of Mercy founder

In the months since the tragedy, more than $1.3 million has been given by co-workers, community members and businesses for Joplin tornado relief. The donors are too numerous to name individually, but we would especially like to thank: • TheBankofAmericaCharitableFoundation,Inc.• BransonCares• CoventryHealthCareInc.• CrosslandConstructionCompany,Inc.• MHACenterforEducation• MissouriFoundationforHealth• UnitedWayofSouthwestMissouriandSoutheastKansas

Our gratitude goes to countless others who gave of their time, talent and generosity to help us continue our ministry in Joplin.

Want to read more? Mercy published a series of books on the events that changed the lives of so many in the community and how the health ministry has responded. Click here to be taken to the books onlilne.

In 2011, we launched Mercy Clinic, bringing together more than 1,600 primary and specialty carephysicians and 600 advanced practitioners.

Your Mercy TeamPatients and families are learning the benefits of having a care team that’s truly working together to keep them well. Ask a new mom who quickly needs her child’s immunization records or a newly diagnosed diabetic senior living alone. These patients and many others have found Mercy Clinic. The team continues to grow, ensuring patients receive care that is:

• Complete. Family medicine doctors, internists, pediatricians and OB-GYNs easily work together with cardiologists, surgeons, pediatric ENTs and other specialists.

• Coordinated. With our industry-leading electronic health record, information is complete, up to date and readily available to all team members, wherever a patient is seen.

• Connected. We’re using today’s online and mobile communications technology, such as MyMercy, our online patient tool, to stay connected with our patients and their families.

• Convenient. Our goal is to create greater access, reduce barriers and ease the path our customers take to receive the health care they and their families need.

Adding More ProvidersCommunity leaders and residents in many Mercy communities spoke. And we listened. We recently announced plans to add:• 500newprimarycarephysiciansinthenextfiveyears.• 300specialtycareproviders.• Morenursepractitioners,physicianassistantsandcare

managers.

A Place to Call HomeThe days of simply treating sick patients when they arrive at the office are over. Health care costs are rising, America is aging and more people are expected to have at least one chronic illness later in life. A medical home approach can be the answer. Mercy physicians and their staffs in five Mercy Clinic offices have transformed their practices into certified medical homes over the past year. And we plan to add another 20-25 medical homes during the upcoming year.

The staffs of our medical homes focus on building relationships with patients that go beyond office visits. With additional team members, greater use of technology and new approaches, a medical home takes responsibility for meeting each patient’s physical and mental health care needs, including prevention, wellness and acute and chronic care. This includes coordinating specialty and hospital care, home health and community services and support.

In addition, our medical homes strive to be more available, with shorter waiting times for urgent needs, walk-in and after- hours services, plus around-the-clock telephone or MyMercy electronic access to members of our care team.

2,200 Providers: Mercy ClinicOne

64-year-old Steve Ward still remembers the day he bent down to put on his shoes and couldn’t get them on because his feet were so swollen. He was wise to seek help quickly because his condition required hospitalization. After more than a week, he went home with a new defibrillator in his chest and a diagnosis of congestive heart failure.

Today, Steve’s care team at Mercy Clinic Primary Care in Bella Vista, Ark., monitors the readings that come in from a device in his home. Dr. Mark Lee will step in if Steve starts gaining weight or his blood pressure is out of a safe range. “The monitoring equipment allows us to be proactive about our patient’s health,” says Dr. Lee. “It also means they have a whole team of health care professionals looking out for them.”

One of Many . . . Medical Homes Make a Difference

Kids Are Number

includes our children’s hospitals in St. Louis and Springfield, Mo., and our 700 primary care providers and 125 pediatric specialists located across our four-state service area.

Telemedicine is another important part of the strategy, making hard-to-find specialties available to families in rural communities. Our specialized children’s programs include:

• Sleepdisorders• Pediatricdiabetes• Specializedcancercare• Urology• Criticalcare• Reconstructivesurgery

Mercy’s work on building children’s services in the upcoming year includes:• Renovation and redesign. Mercy Children’s Hospital in

Springfield will expand to include new services and more convenience.

• Research. Mercy in Oklahoma City is conducting first-time research with a “vein viewer” to start IV’s more eaily in tiny newborns and save them from the discomfort of multiple needle sticks.

• Telemedicine. Parents can now get the right specialist for their child, a pediatric neurologist for example, even if that physician is hundreds of miles away.

Kids are our future. The communities we serve have told us that keeping them healthy is a top priority.We agree.

One Teaching Healthy Habits“Help us keep our kids healthy.” That was a loud-and-clear message we heard from our community roundtable meetings. “Our future success and prosperity is built on healthy, well-cared-for children.”

In response, Mercy quickly partnered with HealthTeacher to make health education available to nearly 737,000 students in 1,695schoolsacrossMercy’sserviceareasinArkansas,Kansas,Missouri and Oklahoma. Mercy has committed $5 million over five years to underwrite the program.

HealthTeacher is a worldwide provider of online health lesson plans and resources focused on improving health from kindergarten through 12th grade. For more than a decade, HealthTeacher has been used with great success in some of the nation’s largest school districts.

Expert Kids CareMercy’s focus on kids is as old as our ministry. The challenge today is to bring children the care they need, especially in locations where access to pediatric specialists is difficult. Mercy Children’s Hospital Services does just that. It brings physicians and other Mercy leaders together as their own operating division to further build services and programs for kids. Mercy Children’s

Learning is vital to protecting kids’ health for the future. Our partnership with HealthTeacher provides educators with lesson plans and resources focused on early health education. Over 737,000 students in 1,695 schools now have access to these resources. Mercy has committed $5 million over five years to underwrite the program.

• Neurosurgery• Orthopedics• Cardiology• Cancer• Autism• Behavioralhealth

Grayson Langan was three years old when doctors at Mercy Clinic in Washington suspected he had salmonella poisoning. Grayson was sent to Mercy Children’s Hospital in St. Louis for a few days for treatment.

All Mercy patients have a single medical record that is available to their care team in any location. This makes care more personal and coordinated – great for parents who are already concerned about their kids. “Everything they had in the computer in Washington was already there in St. Louis,” his mom Stacy said.

After Grayson returned home, the local health department required more testing before he could go back to daycare. Since MyMercy also allows parents to access information about their children, Stacy could see Grayson’s results right away. “They sent me an email and I could log on to see the results. It was fast and the worry was over,” she said.

One of Many . . . Making Kids Care Easy and Complete

Technology allows Mercy to reach patients in new ways, especially those living in small communities that lack specialty and emergency care. Telemedicine is providing expert attention that saves and improves their lives.

First Virtual Care TeamPatients value a personal connection with their doctor. It’s a chance to understand more about their health issues, ask questions and share concerns. Now telemedicine uses two-way video technology for a face-to-face, coordinated experience …even when doctors and patients are miles apart.

Mercy’s Virtual Care Center is a $90 million investment in connecting people to the care they need. The center will be staffed by hundreds of doctors and nurses linked electronically to Mercy hospitals, clinics and even patient homes using

telemedicine technology. Office visits won’t be a thing of the past, but the center will instead offer specialized services that are hard to find in some communities: • Radiology and pathology – Virtual teams interpret digital

images and other testing information 24/7, for faster diagnosis and treatment.

• Specialty physicians – People in rural areas can have faster, more efficient access to care via telemedicine.

• Nurse On Call – With a simple telephone call, patients can get help deciding the most appropriate level of care.

• Remote disease management – Patients are “connected” to the center via in-home technologies to monitor weight, blood pressure, blood glucose and more.

When Minutes Matter“The moment you have a stroke, the sand in the hourglass starts running out, and if you don’t get care quickly, many people die or have to live with severe disabilities,” says Chris Veremakis, MD, medical director of Mercy’s Center for Innovative Care. Expanded stroke care was a logical first step in Mercy’s telemedicine strategy because of its great potential to help people, especially in remote locations.

Using two-way video and other technology, Mercy neurology/ stroke experts work with a patient’s local care team to diagnose and treat stroke in the ER. The neurologist can interact and talk with the patient to make a full assessment. For some patients, a clot-busting drug called t-PA may help restore blood flow and prevent damage to the brain.

Stroke care is paving the way for other specialty care that may be offered through telemedicine in the future. Imagine, for example, parents in a small town consulting with a pediatric urologist without a long drive or overnight stay.

Telemedicine: Virtual -to-One CareOne

One of Many . . . Stroke Expertise is Always Available

Buddy Bilyeu lives in Spokane, MO. His Sunday took an unexpected turn as he was getting ready for church. “I couldn’t pick up the toothbrush,” he recalls. “In fact, my right side wasn’t responding at all.” Buddy’s wife Judy, a retired RN, recognized the signs of stroke and immediately called 911. He was transported to Mercy Hospital Springfield.

Thanks to Mercy’s telestroke program, the local stroke team always has quick access to a neurology specialist. Sometimes a simple phone call is all that’s needed. Neurologists may also use Mercy’s two-way video system to evaluate patients when needed. In Buddy’s case, the stroke team quickly administered a clot-busting drug and performed other life-saving procedures.

“I don’t remember much about what happened when I reached the hospital,” Buddy admits, “but I felt peaceful and was released in 48 hours with no restrictions. I call that a miracle.”

Mercy is a leader in the use of electronic health records that make sure a patient’s medical information is complete and readily available to caregivers and patients alike.

One Patient, One RecordThere was a time when a patient’s medical information (doctor notes, lab results, and more) could be kept in many different places. Not anymore. Mercy’s electronic health record stores everything in one place, so doctors, registration staff and other care team members can instantly share the same information. There’s no need for patients to repeatedly write down health history, medications and past treatments when they visit different locations. And the benefits go much deeper.

With the EHR available at most Mercy locations (and more hospital locations added in 2011), care teams use information to reduce medication errors and unnecessary tests, improve patient safety, and even make decisions based on the best-known treatment recommendations.

Helping Patients Take ChargeOur electronic health record powers MyMercy, our online patient tool. Over 220,000 patients now can have secure, online access to their own health information. If they choose a Mercy Clinic physician, they can also message their doctor with questions or updates, request appointments online and request prescription renewals. In a growing mobile world, patients like the ability to access their information from anywhere they have a computer or Internet-enabled device.

Lots of Medical Information, All In Place

““I feel like I finally have ownership of my medical care. I feel like I’m now in partnership with my doctor. I’m not alone. We’re a team.”

–Taresa Copeland, 62, patient

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Caryn Adams was diagnosed with lupus in her mid-20s. MyMercy not only helps her manage her own health, but also keeps track of three kids and her husband, Tim. The Oklahoma City couple also helps Tim’s ailing 80-year-old father who suffers from dementia and other chronic conditions.

“If at the end of the day, I need to get my daughter in the next day to our doctor, all I have to do is go on to MyMercy,” said Caryn. “It only takes a second. I can pull up MyMercy wherever we are and see what I need to see. How cool is that?”

Caryn’s husband Tim serves as medical power of attorney for his father. “Before MyMercy, tracking my dad’s health was chaotic because we did it by calling and talking,” Tim shared. “Now, we have one electronic record that we can refer to 24/7.”

One of Many . . . MyMercy is a Family Affair

This past year, our facilities began adopting a common Mercy name and logo. What has always been our only mission is now our only name: Mercy.

Bringing Us TogetherWe recognize that we continue the work of the Sisters of

Mercy. A common Mercy identity helps us connect our co-workers and facilities, and better serve our patients. We want people to instantly associate our name and visual identity with an exceptional health care experience, knowing they now have access to a large team of skilled people and services that extends well beyond what is physically located in their local communities. The most visual part of this transition – announcing new names and placing new signs – will be

complete by the end of 2012. Honoring the SistersOur connection to the Sisters of Mercy and the principles that guide our ministry remain rock solid. In fact, taking on the Mercy name has been warmly supported by the Sisters and is seen as a way to honor and preserve the Sisters of Mercy legacy. In addition, Mercy’s new logo is a contemporary version of the original cross which Catherine McAuley, founder of the Sisters of Mercy, adopted for her ministry. The outer extensions of the cross represent a ministry that is diverse but aligned around a common purpose. The inner cross is a reminder that we should dedicate ourselves to the work God has given us, take up our own cross and serve with a deep respect for others.

Hundreds of locations: NameOne

Awards and Recognition• Modern Healthcare inducted Sister Mary Roch Rocklage,

RSM, into its Healthcare Hall of Fame. For her lifetime of service to health care, she joins the likes of Clara Barton, TedKennedyandBenFranklin.

• TheNationalBusinessGrouponHealthhonoredMercyforour “Healthification” wellness efforts with a Gold Award in its annual Best Employers for Healthy Lifestyles program.

• MercyHospitalinHotSprings,Ark.,earnedan Innovator Award from the Arkansas Foundation for Medical Care’s annual Quality Awards program.

• MercyinSpringfield,Mo.,wasrankedamongthebest-performing health systems in the nation, according Thomson Reuters’ third annual study.

• MercyinSpringfield,Mo.,wasnamedthenumberonemost integrated health care network in the nation by IMS Health. Mercy in St. Louis is ranked ninth.

• Hospitals & Health Networks named Mercy as one of the nation’s “Most Wired” health care organizations.

• MercyinFortSmith,Ark.,andSpringfield,Mo.,bothwerehonored with Consumer Choice Awards by the National Research Corporation.

• GartnerResearchrankedROi,Mercy’ssupplychaindivision,number two on its Healthcare Supply Chain Top 25.

• MercyHospitalinRogers,Ark.,wasoneofonly25hospitals in the nation to earn the U.S. Environmental Protection Agency’s prestigious Energy Star efficiency award.

• Mercyreceiveda$496,000 grant to improve health care access and reduce medical costs in rural southwest Missouri and northwest Arkansas from The U.S. Department of Agriculture. Mercy also secured a $500,000 Distance Learning and Telemedicine Grant for 12 rural communities.

Building Projects Our plans call for Mercy to expand and renew many of our facilities, and extend our presence into 50 new communities, with over 100 new facilities. In 2011:

• Mercybrokegroundonan$88millionmedical complex in Edmond, Okla. Designed with community input, the facility includes a walk-in clinic, wellness and women centers, childcare for patients, sports rehab, outpatient surgery and offices for 30 specialized physicians.

• Mercybeganconstructionofa$105million,48-bed orthopedic hospital in Springfield, Mo.

• MercyinRogers,Ark.,beganconstructionofanexpanded$5.5 million heart and vascular center.

• InpartnershipwiththeArdmore(Okla.)ChamberofCommerce Foundation, Mercy Hospital opened a new cancer treatment center.

• MercyandCenterreHealthcareCorporationbrokeground on a rehabilitation hospital in Oklahoma City. The 50-bed facility will help patients recover from injuries and surgeries in a home-like setting where patients and families can practice daily tasks.

• MercyHospitalinWashington,Mo.,openedanewlyrenovated and expanded emergency department – the only ED within a 30-mile radius.

• Anewlyopened12-bedburn center at Mercy Hospital St. Louis is the only facility providing comprehensive acute and reconstructive burn care for adults and children in eastern Missouri and southern Illinois.

Accomplishments:Being of the BestOne

$114 millionCharity care – free or unreimbursed health care we offer to people who are poor and who lack insurance or the financial means to pay for their care. Charity care doesn’t include bad debt, which is health care provided to people with the means to pay for some or all of their care, but who don’t.

$103 millionShortfalls from Medicaid reimbursement – financial losses we incur providing health care to people who are poor but for whom we receive some reimbursement through the government’s Medicaid program.

$55 millionCommunity services offered for free or at a financial loss – programs such as community health education, community-based clinical services such as health screenings for people who are poor or uninsured, community health initiatives addressing specific health needs among the poor and vulnerable, health care support groups and pastoral outreach programs.

Community Benefits: More Way We ServeTaking care of everyone who lives in the areas we serve is important to us. Mercy provided community and financial benefits valued at $272 million to communities in our areas of service.

One

Region 2011 FY 11 Net Community Regional Patient Revenue Benefit % Community of Net Patient Benefit Revenue

Fort Smith, Ark. $23,561,843 $263,513,000 8.9%

Hot Springs, Ark. $14,775,889 $246,642,000 6.0%

Rogers, Ark. $7,403,586 $205,317,000 3.6%

Joplin, Mo. $255,64,913 $203,965,000 12.5%

Independence/FortScott,Kan. $6,372,396 $68,122,000 9.4%

St. Louis, Mo. $6,650,1948 $1,053,346,000 6.3%

Springfield, Mo. $85,923,857 $1,282,006,000 6.7%

Oklahoma City/Ardmore, Okla. $32,012,256 $557,099,000 5.7%

Mercy Ministries of Laredo $3,557,835 $272,000 350.6%

TOTAL $272,105,487 $3,789,573,000 6.2%

Statistical and Service HighlightsService AreaMercyhasco-workers,physiciansandfacilitiesinArkansas,Kansas,MissouriandOklahoma.

HospitalsAcute Care Hospitals 31Heart Hospitals 3Children’s Hospitals 2Rehabilitation Hospital 1

Outpatient FacilitiesPhysician Clinic Locations 220Urgent Care Centers 28Outpatient Surgery Centers 6Retail Clinics 5

PeopleCo-workers 38,000Mercy Physicians 1,614Mercy Advanced Practitioners 603Medical Staff Members: 5,199

Sponsored MinistriesLouisianaMississippiTexas

Utilization FY 2011 FY 2010Acute Licensed Beds 3,822 4,387Acute Discharges 145,359 145,582Acute Length Of Stay (Days) 5.0 5.0Non-Acute Licensed Beds 704 694Non-Acute Discharges 15,023 13,653Outpatient Visits 6,566,057 6,236,474Emergency Visits 574,666 535,479Inpatient Surgeries 46,008 48,838Outpatient Surgeries 90,844 87,080

Mercy ended the fiscal year 2011 with $85 million in net operating income, 95% of our budgeted results of $89.5 million.1

Compared to fiscal year 2010, our operating results increased by approximately $13 million, or 18%. We experienced soft volumes, both in our hospitals as well as our physician clinics, with flat, and in some cases, lower volumes compared to the previous year. We were significantly impacted by several substantial winter storms in numerous Mercy communities. Additionally, we launched our electronic health record in four communities, which further influenced volumes and increased expenses.

During fiscal year 2011, we experienced an increase in charity care and bad debt. On the other hand, our operating results benefited significantly from improved revenue management, which included generating additional funds for the services we provide, utilizing automation and reducing the cost associated with our revenue cycle. Through these efforts, we realized approximately $70 million in increased revenue and lower costs. Mercy leaders are pursuing revenue and expense initiatives to ensure we achieve our fiscal year 2012 operating budget of $97.2 million, a 14% increase over fiscal year 2011.

Mercy’s Financial PerformanceFiscal Year 2011

Financial Highlights For Fiscal Years Ended June 30, 2011, and June 30, 2010 ($ in thousands) June 30, 2011 June 30, 2010

Cash and cash equivalents $195,419 $128,837Accounts receivable, net 459,733 453,760 Other current assets 225,147 285,611Assets limited as to use or restricted, current and long-term 1,377,091 1,225,948Property and equipment, net 2,080,125 2,061,065Other assets 293,493 252,310Total assets $4,631,008 $4,407,531

Long-term debt, including current maturities $815,940 $825,021Other liabilities 1,210,597 1,259,169Total liabilities 2,026,537 2,084,190Total net assets 2,604,471 2,323,341Total Liabilities and Net Assets $4,631,008 $4,407,531

Operating Revenues Net patient service revenues $3,789,573 $3,562,164 Other operating revenues 491,610 395,721 Total operating revenues 4,281,183 3,957,885

Operating Expenses Salaries and benefits 2,240,168 2,071,450 Supplies and other 1,431,818 1,301,865 Interest 6,183 6,032 Provision for doubtful accounts 264,888 269,614Operating Expenses Before Depreciation and Amortization 3,943,057 3,648,961

Operating Income before Depreciation and Amortization 338,126 308,924 Depreciation & amortization 255,332 237,783

Operating Income $82,794 $71,141

1 Excluding Joplin results, actual and budget for May and June

Mercy Health MinistryBoard of Directors Ronald Ashworth, Chair MercySt. Louis, MO

Sister Helen Amos, RSMExecutive Chair, Mercy Health ServicesBaltimore, MD

Carrol Aulbaugh Katy,TX

Lynn Britton President/Chief Executive Officer, MercySt. Louis, MO

Sister Mary Padraic Hallaron, RSMMcAuley PlaceMetairie, LA

Eric Jackson President, Oaklawn Jockey ClubHot Springs, AR

Reginald MebaneDirector, Office of Diversity Management and EEO, U.S. Dept of Health & Human Services Centers for Disease Control and PreventionAtlanta, GA

Timothy Morgenthaler, MD Division of Pulmonary & Critical Care MedicineMayo ClinicRochester, MN

Sister Miriam Nolan, RSMSisters of MercySt. Louis, MO

Ronald Paulus, MDPresident/CEO, Mission Health SystemAsheville, NC

David PrattRex Realty Co.St. Louis, MO

Sister Mary Roch Rocklage, RSMHealth Ministry Liaison, MercySt. Louis, MO

Most Rev. Joseph M. Sullivan Former Auxiliary Bishop – Diocese of BrooklynBrooklyn, NY

Charles ThoeleSt. Louis, MO

Sister Rose Weidenbenner, RSMGalilee Housing Initiative and CommunityDevelopment CorporationNew Orleans, LA

Ellen Zane President/Chief Executive OfficerTufts Medical CenterBoston, MA

Executive and Community Leadership – Mercy Health Lynn BrittonPresident/Chief Executive Officer

Judy AkinsSenior Vice President, Marketing and Communications

Eric Ammons President, Mercy Independence

Patty ArnoldVice President, Philanthropy

Reta Baker President, Mercy Fort Scott

Mindy Burdick President, Mercy Ardmore

Randy CombsSenior Vice President/Chief Financial Officer

Kim DayRegional President, Central Communities

Fred FordSenior Vice President, Ambulatory Care

Ryan GehrigPresident, Mercy Fort Smith

Marie GlancyMercy Chief Advocacy Officer

Jolene GoedkenSenior Vice President/Chief Nursing Officer

Cole Goodman, MDPresident, Mercy Clinic Fort Smith

Steve Goss, MDPresident Mercy Clinic, Northwest Arkansas

Marc Gunter, MDPresident, Mercy Clinic Hot Springs

Thomas Hale, MDMedical Director Center for Innovative Care

John Hubert, MDPresident, Mercy Clinic East Communities

Timothy JohnsenPresident, Mercy Hot Springs

Jeff JohnstonPresident, Mercy St. Louis

Mercy Health LeadershipTerri McLainPresident, Mercy Washington

Michael McCurryExecutive Vice President/Mercy Chief Operating Officer

Fred McQueary, MDPresident, Mercy Clinic Springfield Communities

Rex MenascoExecutive Director,Mercy Family Center New Orleans

Cynthia MercerSenior Vice President, Human Resources

Roy MitchellDirector, Mississippi Health Advocacy Program

Vance MooreSenior Vice President, Operations

Brian O’Toole, PhDSenior Vice President, Mission and Ethics

Gary PulsipherPresident, Mercy Joplin

Charles Rehm, MDRegional Chief Administrative Officer

William ShowalterVice President/Chief Information Officer

Diana Smalley, FACHERegional President, West Communities

Shannon SockExecutive Vice President, Organization Effectiveness

Donn SorensenRegional President, East Communities

Robert Steele, MDMercy Clinic Springfield

Scott StreetPresident, Mercy Northwest Arkansas

Sean Smith, MDDivision President, Mercy Clinic Joplin

Jon SwopePresident, Mercy Springfield Communities

Cullen Thomas, MDPresident, Mercy Clinic West Communities

Sr. Maria Luisa Vera, RSMPresident, Mercy Ministries of Laredo

Philip Wheeler, JDSenior Vice President/General Counsel

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