Mercy is a nonprofit Catholic healthcare system located in the Midwestern United States headquartered in St. Louis, Missouri. Serving millions annually, Mercy is the fifth largest Catholic healthcare system in the United States. Mercy retained Dini Spheris to assist the healthcare system in preparation for a $1 billion comprehensive campaign. This engagement involved both strategy and hands-on work within every aspect of the philanthropy program. The work began with an inclusive process to identify priority programs and needs for philanthropy across the system, which is comprised of 32 hospitals and 13 foundations. Dini Spheris designed and implemented a volunteer leadership structure addressing both centralized and regional approaches to fundraising. At the same time, an intensive staffing assessment identified opportunities and strategies to shape system, regional and local infrastructures that would support a $1 billion fundraising initiative. In six of the healthcare locations, Dini Spheris conducted planning studies to right-size the community campaigns. Four of the local hospital communities (Oklahoma City, OK; Joplin, MO; Springfield, MO; Rogers, AR) have implemented their campaign plan recommendations and completed successful campaigns.