MERCY HEALTH NETWORK INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH NETWORK INC (EIN 42-1478417)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-10
- IRS object ID
- 202341309349302969
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-10T12:27:12-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421478417 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH NETWORK INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 5153589200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1449 NW 128TH STREET BLDG 5 200 | AddressLine1Txt |
| City | CLIVE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50325 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT RITZ | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5153589200 | PhoneNum |
| Signature | 2023-05-10 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ROBERT | PersonFirstNm |
| Person Last | RITZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCYONE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT RITZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1449 NW 128TH STREET BLDG 5 200 | AddressLine1Txt |
| City | CLIVE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50325 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,987,227 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYONE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | DE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,165,394 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,908,876 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,268,898 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,078,351 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $25,434,292 | PYTotalRevenueAmt |
| CY Total Revenue | $38,987,227 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $112,250 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $29,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,601,658 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,949,801 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,458,677 | PYOtherExpensesAmt |
| CY Other Expenses | $32,241,874 | CYOtherExpensesAmt |
| PY Total Expenses | $27,172,585 | PYTotalExpensesAmt |
| CY Total Expenses | $36,220,675 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,738,293 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,766,552 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,567,569 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,982,290 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,777,470 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,142,718 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,790,099 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,839,572 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MERCYONE SERVES WITH FIDELITY TO THE GOSPEL AS A COMPASSIONATE, HEALING MINISTRY OF JESUS CHRIST TO TRANSFORM THE HEALTH OF OUR COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,058,555 | ExpenseAmt |
| Grant | $29,000 | GrantAmt |
| Revenue | $37,908,876 | RevenueAmt |
| Desc | MERCY HEALTH NETWORK (MERCYONE) IS AN INTEGRATED SYSTEM OF MEMBER HOSPITALS AND OTHER HEALTH AND PATIENT CARE FACILITIES-UNITED INTO ONE OPERATING ORGANIZATION TO IMPROVE THE DELIVERY OF HEALTH CARE SERVICES TO THE PEOPLE OF IOWA AND SURROUNDING COMMUNITIES. MERCYONE IS SPONSORED BY COMMONSPIRIT HEALTH AND TRINITY HEALTH CORPORATION. MERCYONE PROVIDES SIGNIFICANT ADMINISTRATIVE, MANAGEMENT, GOVERNANCE AND OVERSIGHT RESPONSIBILITIES FOR THE OVERALL ACTIVITIES AND OPERATIONS OF MANY ACUTE CARE HOSPITALS, AMBULATORY CARE FACILITIES, HOME CARE AND HOSPICE PROGRAMS PRESENTLY OWNED AND OPERATED BY COMMONSPIRIT HEALTH OR TRINITY HEALTH.THE MERCYONE SYSTEM FUNCTIONS AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM (IN THE BROAD SENSE) BY ESTABLISHING A SINGLE SYSTEM THAT PROVIDES A CONTINUUM OF HEALTH CARE SERVICES PREVIOUSLY PROVIDED THROUGH SEPARATE PROVIDERS. THROUGH THIS SINGLE SYSTEM, THE RESPECTIVE MISSIONS OF COMMONSPIRIT HEALTH AND TRINITY HEALTH ARE UNIFIED AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY MEET THE HEALTH CARE NEEDS OF THE COMMUNITY SERVED BY THE MERCYONE SYSTEM ARE ENHANCED.PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: WWW.MERCYONE.ORG | Desc |
| Total Program Service Expenses | $31,058,555 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JODIE ROETTGER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5153589267 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1449 NW 128TH ST BLDG 5 SUITE 200 | AddressLine1Txt |
| City | CLIVE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50325 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT RITZ | ||||||||||
| PRESIDENT AND CEO | 54.00 | 1.00 | Yes (X) | $1,997,684 | $0 | $45,071 | ||||
| MICHAEL WEGNER | ||||||||||
| EVP, REG CFO THR 2/22; INT REG COO | 49.00 | 1.00 | $0 | $1,286,950 | $39,835 | Yes (X) | ||||
| KENT CARR MD | ||||||||||
| FORMER HIGHEST COMPENSATED EMPLOYEE | 0.00 | 0.00 | $0 | $1,043,933 | $10,299 | Yes (X) | ||||
| HIJINIO CARREON DO | ||||||||||
| EVP, CHIEF MEDICAL EXECUTIVE | 50.00 | 0.00 | $0 | $724,671 | $49,305 | Yes (X) | ||||
| LINDA GOODWIN | ||||||||||
| VP CLIN & OPS INTEG THROUGH 3/22 | 50.00 | 0.00 | $0 | $655,742 | $36,627 | Yes (X) | ||||
| HEATHER CAMPBELL | ||||||||||
| SECRETARY; CHIEF LEGAL OFFICER | 49.00 | 1.00 | Yes (X) | $0 | $529,015 | $51,246 | ||||
| ROBERT HEEN | ||||||||||
| PRESIDENT, MEDICAL GROUP | 50.00 | 0.00 | $0 | $496,997 | $43,492 | Yes (X) | ||||
| MICHAEL TRACHTA | ||||||||||
| SVP, NETWORK AFFILIATES | 25.00 | 25.00 | $0 | $495,647 | $42,058 | Yes (X) | ||||
| JANELL PITTMAN | ||||||||||
| CHIEF MKTG & DIGITAL STRATEGY OFFCR | 50.00 | 0.00 | $0 | $396,993 | $18,471 | Yes (X) | ||||
| JODIE ROETTGER | ||||||||||
| INTERIM CFO AS OF 2/22; VP FINANCE | 49.00 | 1.00 | $0 | $361,084 | $33,180 | Yes (X) | ||||
| LINDA ROSS | ||||||||||
| DIRECTOR; CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DAVID BITTNER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| MATTHEW BROWN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| LOUIS FIERENS II | ||||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| MITCH MELFI | ||||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| JON TIMMIS | ||||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,997,684 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,991,032 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $369,584 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRESS GANEY ASSOCIATES | |||||
| PO BOX 88335 | MILWAUKEE | WI | 53288 | ENGAGEMENT SURVEY SERVICES | $301,685 |
| MERCURY HEALTHCARE INC | |||||
| 1801 CALIFORNIA STREET | DENVER | CO | 80202 | WEB IMPLEMENTATION SERVICES | $165,943 |
| INCREDIBLE HEALTH INC | |||||
| 1655 MISSION STREET UNIT 646 | SAN FRANCISCO | CA | 94103 | RECRUITING SERVICES | $137,500 |
| SULLIVANCOTTER INC | |||||
| 62272 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | CONSULTING SERVICES | $134,761 |
| POLSINELLI SHUGHART | |||||
| 700 W 47TH STREET SUITE 1000 | KANSAS CITY | MO | 64112 | LEGAL SERVICES | $128,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MANAGEMENT REVENUE | Desc |
| Business | 541610 | BusinessCd |
| Total Revenue Column | $37,908,876 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,908,876 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,908,876 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $705,560 | TotalRevenueColumnAmt |
| Exclusion | $705,560 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $372,791 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $372,791 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $372,791 | TotalRevenueColumnAmt |
| Exclusion | $372,791 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,987,227 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,908,876 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,078,351 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,000 | TotalAmt |
| Program Services | $29,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,949,801 | TotalAmt |
| Management And General | $3,949,801 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991,904 | TotalAmt |
| Management And General | $991,904 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,250 | TotalAmt |
| Management And General | $120,250 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,040,949 | TotalAmt |
| Program Services | $30,040,949 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,975 | TotalAmt |
| Program Services | $96,975 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,554 | TotalAmt |
| Program Services | $33,389 | ProgramServicesAmt |
| Management And General | $100,165 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,742 | TotalAmt |
| Program Services | $137,742 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,820 | TotalAmt |
| Program Services | $33,820 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,854 | TotalAmt |
| Program Services | $38,854 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,794 | TotalAmt |
| Program Services | $258,794 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,322 | TotalAmt |
| Program Services | $30,322 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUBSCRIPTIONS AND DUES | $312,880 | $312,880 |
| OTHER PROGRAM EXPENSES | $45,830 | $45,830 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,220,675 | TotalAmt |
| Program Services | $31,058,555 | ProgramServicesAmt |
| Management And General | $5,162,120 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $328,600 | BOYAmt |
| EOY | $95,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,333,037 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,174,794 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,417,037 | BOYAmt |
| EOY | $1,158,243 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,544,568 | BOYAmt |
| EOY | $14,045,064 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,293,229 | BOYAmt |
| EOY | $9,363,376 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,984,135 | BOYAmt |
| EOY | $5,320,607 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,567,569 | BOYAmt |
| EOY | $29,982,290 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,268,200 | BOYAmt |
| EOY | $3,072,303 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,509,270 | BOYAmt |
| EOY | $12,070,415 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,777,470 | BOYAmt |
| EOY | $15,142,718 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,790,099 | BOYAmt |
| EOY | $14,839,572 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,790,099 | BOYAmt |
| EOY | $14,839,572 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,567,569 | BOYAmt |
| EOY | $29,982,290 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,766,552 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,766,552 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $49,473 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| MERCY HEALTH SERVICES - IOWA | ||||
| 311373080 | 3 | Yes (1) | $0 | $0 |
| CATHOLIC HEALTH INITIATIVES - IOWA | ||||
| 420680448 | 3 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | Yes (1) | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART 1, LINE 12G: | MERCY HEALTH NETWORK (MERCYONE) PROVIDES HEALTH CARE DELIVERY SYSTEM SERVICES TO ITS SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION A, LINE 2: | CATHOLIC HEALTH INITIATIVES - IOWA DOES NOT HAVE AN IRS DETERMINATION OF STATUS UNDER SECTION 509(A)(1); IT HAS BEEN RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) UNDER GROUP EXEMPTION NO. 0928 AND IS LISTED IN THE OFFICIAL CATHOLIC DIRECTORY AS A HOSPITAL. CATHOLIC HEALTH INITIATIVES - IOWA IS A PUBLIC CHARITY AS DESCRIBED IN SECTION 509(A)(1) BECAUSE IT IS A HOSPITAL AS DESCRIBED UNDER SECTION 170(B)(1)(A)(III). |
| PART IV, SECTION A, LINE 6: | MERCYONE PROVIDED MANAGEMENT AND OTHER SERVICES TO RELATED ORGANIZATIONS WHO SHARE THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATIONS. MERCYONE ALSO PROVIDED GRANTS TO UNRELATED CHARITIES THAT CARRY OUT THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION D, LINE 3: | CERTAIN BOARD MEMBERS OF EACH SUPPORTED ORGANIZATION SERVE AS BOARD MEMBERS OR OFFICERS OF MERCYONE. AS REQUIRED BY THE GOVERNING DOCUMENTS, THE CEO OF EACH SUPPORTED ORGANIZATION IS ON THE MANAGEMENT TEAM OF MERCYONE. THE PRESIDENT AND CEO OF A SUPPORTED ORGANIZATION IS THE PRESIDENT AND CEO OF MERCYONE, AND CERTAIN OTHER OFFICERS EQUALLY SERVE BOTH THE MERCYONE AND A SUPPORTED ORGANIZATION. THIS COMBINATION OF OVERLAPPING CONTROL AND MANAGEMENT ALLOWS THE SUPPORTED ORGANIZATIONS TO HAVE A SIGNIFICANT VOICE IN THE INVESTMENT POLICIES AND DIRECTING THE USE OF THE INCOME AND ASSETS OF MERCYONE. |
| PART IV, SECTION E, LINE 2A: | THE EXEMPT PURPOSES OF THE SUPPORTED ORGANIZATIONS OF MERCYONE ARE TO PROVIDE HEALTH CARE SERVICES TO COMMUNITIES THROUGHOUT THE STATE OF IOWA AND SURROUNDING STATES THROUGH THE OPERATION OF TAX-EXEMPT HEALTH CARE AND HOSPITAL SYSTEMS. SUBSTANTIALLY ALL OF MERCYONE'S ACTIVITIES ARE IN DIRECT FURTHERANCE OF THE EXEMPT PURPOSES OF ITS SUPPORTING ORGANIZATIONS BY IMPROVING THE DELIVERY OF HEALTH CARE SERVICES IN THEIR COMMUNITIES THROUGH THE PROVISION OF SIGNIFICANT ADMINISTRATIVE, MANAGEMENT, GOVERNANCE, AND OVERSIGHT SERVICES FOR THE OVERALL ACTIVITIES AND OPERATIONS OF HEALTH CARE AND HOSPITAL SYSTEMS IN THESE COMMUNITIES. |
| PART IV, SECTION E, LINE 2B: | EACH SUPPORTED ORGANIZATION OF MERCYONE IS A HEALTH CARE AND HOSPITAL SYSTEM. MERCYONE PROVIDES INTEGRATED HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT SERVICES TO ITS SUPPORTED ORGANIZATIONS. THESE ACTIVITIES INCLUDE PAYER STRATEGY/CONTRACTING, QUALITY/SAFETY MANAGEMENT, FINANCIAL SERVICES, MARKETING/COMMUNICATIONS STAFF, CORPORATE RESPONSIBILITY/COMPLIANCE OPERATIONS, STRATEGIC PLANNING, HUMAN RESOURCES, AND OTHER MANAGEMENT AND SUPPORT FUNCTIONS NECESSARY FOR THE OPERATION OF HEALTH CARE SYSTEMS. BUT FOR THE PROVISION OF THESE SERVICES BY MERCYONE, EACH SUPPORTED ORGANIZATION WOULD HAVE HAD TO ENGAGE IN THESE ACTIVITIES FOR ITSELF. |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $120,250 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $84,389 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $204,639 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | MERCY HEALTH NETWORK (MERCYONE) HAS ENGAGED ONE OR MORE LOBBYING FIRMS TO PROVIDE GOVERNMENTAL RELATIONS FOR MERCYONE FOR STATE LEGISLATIVE AND REGULATORY ISSUES. MERCYONE BACKS PUBLIC POLICIES THAT PROMOTE BETTER HEALTH, BETTER CARE AND LOWER COSTS. MERCYONE WANTS TO ENSURE AFFORDABLE, HIGH-QUALITY CARE FOR ALL. AT THE STATE CAPITAL IN DES MOINES, MERCYONE WORKS WITH MEMBERS OF THE LEGISLATURE, THE GOVERNOR'S OFFICE, AND THE STATE AGENCIES. AT THE FEDERAL LEVEL, MERCYONE MEETS WITH THE IOWA CONGRESSIONAL DELEGATION AND THEIR STAFF SEVERAL TIMES EACH YEAR. IN THOSE MEETINGS, MERCYONE SPEAKS ON BEHALF OF OUR PATIENTS, PROVIDERS AND MEDICAL CENTERS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,826,384 | OtherCostOrOtherBasisAmt |
| Depreciation | $748,672 | DepreciationAmt |
| Book Value | $1,077,712 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $506,653 | OtherCostOrOtherBasisAmt |
| Depreciation | $426,122 | DepreciationAmt |
| Book Value | $80,531 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,158,243 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES | $2,340,844 | F |
| EQUITY METHOD INVESTMENTS | $5,852,110 | C |
| HEDGE FUNDS | $1,170,422 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $9,363,376 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| MISCELLANEOUS RECEIVABLES | $1,512,608 |
| INVESTMENT IN UNCONSOL. AFFILIATES | $3,112,725 |
| OPERATING LEASE RIGHT-OF-USE ASSETS | $695,274 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,320,607 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| RELATED PARTY PAYABLES | $1,251,917 |
| OTHER CURRENT LIABILITIES | $9,665,597 |
| OPERATING LEASE LIABILITIES | $1,152,901 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,070,415 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT RITZ | ||||||||||||||
| PRESIDENT AND CEO | $1,235,353 | $0 | $542,654 | $0 | $219,677 | $0 | $16,733 | $0 | $28,338 | $0 | $2,042,755 | $0 | $0 | $0 |
| MICHAEL WEGNER | ||||||||||||||
| EVP, REG CFO THR 2/22; INT REG COO | $0 | $776,342 | $0 | $487,996 | $0 | $22,612 | $0 | $17,275 | $0 | $22,560 | $0 | $1,326,785 | $0 | $0 |
| KENT CARR MD | ||||||||||||||
| FORMER HIGHEST COMPENSATED EMPLOYEE | $0 | $12,089 | $0 | $75,436 | $0 | $956,408 | $0 | $9,322 | $0 | $977 | $0 | $1,054,232 | $0 | $0 |
| HIJINIO CARREON DO | ||||||||||||||
| EVP, CHIEF MEDICAL EXECUTIVE | $0 | $582,630 | $0 | $118,377 | $0 | $23,664 | $0 | $17,351 | $0 | $31,954 | $0 | $773,976 | $0 | $0 |
| LINDA GOODWIN | ||||||||||||||
| VP CLIN & OPS INTEG THROUGH 3/22 | $0 | $510,193 | $0 | $115,881 | $0 | $29,668 | $0 | $19,038 | $0 | $17,589 | $0 | $692,369 | $0 | $0 |
| HEATHER CAMPBELL | ||||||||||||||
| SECRETARY; CHIEF LEGAL OFFICER | $0 | $404,643 | $0 | $103,621 | $0 | $20,751 | $0 | $19,712 | $0 | $31,534 | $0 | $580,261 | $0 | $0 |
| ROBERT HEEN | ||||||||||||||
| PRESIDENT, MEDICAL GROUP | $0 | $376,995 | $0 | $118,070 | $0 | $1,932 | $0 | $10,150 | $0 | $33,342 | $0 | $540,489 | $0 | $0 |
| MICHAEL TRACHTA | ||||||||||||||
| SVP, NETWORK AFFILIATES | $0 | $384,190 | $0 | $95,525 | $0 | $15,932 | $0 | $17,100 | $0 | $24,958 | $0 | $537,705 | $0 | $0 |
| JANELL PITTMAN | ||||||||||||||
| CHIEF MKTG & DIGITAL STRATEGY OFFCR | $0 | $300,811 | $0 | $75,730 | $0 | $20,452 | $0 | $16,444 | $0 | $2,027 | $0 | $415,464 | $0 | $0 |
| JODIE ROETTGER | ||||||||||||||
| INTERIM CFO AS OF 2/22; VP FINANCE | $0 | $270,769 | $0 | $69,900 | $0 | $20,415 | $0 | $13,355 | $0 | $19,825 | $0 | $394,264 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | MERCY HEALTH NETWORK'S (MERCYONE) CEO IS PAID DIRECTLY BY COMMONSPIRIT HEALTH, AN UNRELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION FOR MERCYONE'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINES 4A-B | CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF NINE MONTHS TO TWO YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING THE 2021 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): KENT CARR, $956,062 LINE 4B: DURING THE 2021 CALENDAR YEAR, COMMONSPIRIT HEALTH, AN UNRELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT HEALTH EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. NO REPORTABLE INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE COMMONSPIRIT HEALTH DEFERRED COMPENSATION PLAN DURING 2021. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRT HEALTH'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN FIVE YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2021 CONTRIBUTIONS IN CASH. DURING 2021, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: ROBERT RITZ, $202,733 COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). PART VII, LINE 5: ROBERT RITZ, CEO, IS PAID DIRECTLY BY COMMONSPIRIT HEALTH, AN UNRELATED ORGANIZATION. MERCYONE REIMBURSED COMMONSPIRIT HEALTH FOR ROBERT RITZ'S COMPENSATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF MERCY HEALTH NETWORK (MERCYONE) ARE TRINITY HEALTH CORPORATION AND COMMONSPIRIT HEALTH. SEE LINE 7 FOR ADDITIONAL INFORMATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER OF MERCYONE HAS THE RIGHT TO APPOINT ONE-HALF OF THE BOARD OF DIRECTORS OF MERCYONE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE TWO MEMBERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. BOTH MEMBERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, THE FORM 990 FOR MERCYONE IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | MERCYONE HAS ADOPTED A CONFLICT OF INTEREST POLICY, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCYONE, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCYONE AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MERCYONE (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCYONE OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCYONE (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MERCYONE. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | MERCYONE DOES NOT CURRENTLY MAKE ITS DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONSULTING FEES: PROGRAM SERVICE EXPENSES 515,938. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 515,938. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 12,032,913. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,032,913. SHARED SERVICES: PROGRAM SERVICE EXPENSES 17,492,098. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,492,098. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFERS FROM AFFILIATE 49,473. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY COMMUNITY HOSPITAL GROUP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1449 NW 128TH ST BLDG 5 SUITE 200 | AddressLine1Txt |
| City | CLIVE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50325 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352473948 | EIN |
| Primary Activities | ACCOUNTABLE CARE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH NETWORK INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MERCY HEALTH SERVICES - IOWA CORP | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 311373080 | HEALTH CARE AND HOSPITAL SERVICES | DE | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | Yes (1) |
| WHEATON FRANCISCAN HEALTHCARE - IOWA INC | ||||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421177001 | HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT | IA | 501(C)(3) | LINE 12C, III-FI | MERCY HEALTH NETWORK INC | Yes (1) |
| NORTHEAST IOWA REAL ESTATE INVESTMENTS LTD | ||||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421207432 | TITLE HOLDING COMPANY | IA | 501(C)(2) | WHEATON FRANCISCAN HEALTHCARE-IOWA | Yes (1) | |
| SARTORI MEMORIAL HOSPITAL INC | ||||||||||
| 515 COLLEGE STREET | CEDAR FALLS | IA | 50613 | 420758901 | HEALTH CARE AND HOSPITAL SERVICES | IA | 501(C)(3) | LINE 3 | WHEATON FRANCISCAN HEALTHCARE-IOWA | Yes (1) |
| SARTORI HEALTH CARE FOUNDATION INC | ||||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421240996 | FOUNDATION | IA | 501(C)(3) | LINE 12A, I | SARTORI MEMORIAL HOSPITAL INC | Yes (1) |
| MERCY HOSPITAL OF FRANCISCAN SISTERS INC | ||||||||||
| 201 8TH AVENUE SE | OELWEIN | IA | 50662 | 421178403 | HEALTH CARE AND HOSPITAL SERVICES | IA | 501(C)(3) | LINE 3 | WHEATON FRANCISCAN HEALTHCARE-IOWA | Yes (1) |
| COVENANT MEDICAL CENTER INC | ||||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421264647 | HEALTH CARE AND HOSPITAL SERVICES | IA | 501(C)(3) | LINE 3 | WHEATON FRANCISCAN HEALTHCARE-IOWA | Yes (1) |
| COVENANT FOUNDATION INC | ||||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421295784 | FOUNDATION | IA | 501(C)(3) | LINE 10 | COVENANT MEDICAL CENTER INC | Yes (1) |
| CENTRAL COMMUNITY HOSPITAL | ||||||||||
| 901 DAVIDSON ST NW | ELKADER | IA | 52043 | 420818642 | HEALTH CARE AND HOSPITAL SERVICES | IA | 501(C)(3) | LINE 3 | MERCY COMMUNITY HOSPITAL GROUP LLC | Yes (1) |
| CATHOLIC HEALTH INITIATIVES - IOWA CORP | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 420680448 | HEALTH CARE AND HOSPITAL SERVICES | IA | 501(C)(3) | LINE 3 | CATHOLIC HEALTH INITIATIVES | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MERCY HEALTH SERVICES - IOWA CORP | ||
| Q | $10,857,269 | PER BOOKS |
| CATHOLIC HEALTH INITIATIVES - IOWA CORP | ||
| Q | $12,175,975 | PER BOOKS |
| WHEATON FRANCISCAN HEALTHCARE - IOWA INC | ||
| Q | $4,537,544 | PER BOOKS |