2025-05-15T17:26:52-05:00 2024-06-30 390859910 BAKER TILLY ADVISORY GROUP LP 500 MIDLAND COURT PO BOX 8130 JANESVILLE WI 535478130 990 2023-07-01 391035110 MERCY ASSISTED CARE INC MERC 6087542201 PO BOX 5003 - 901 MINERAL POINT A JANESVILLE WI 535485003 JAVON BEA PRESIDENT/CEO 6087542201 2025-05-15 1 1 TROY MARINE CPA P00187863 6087525835 2025-05-15 2023 2025-03-06 01:10:19Z MERCYHEALTH AT HOME JAVON BEA PO BOX 5003 - 901 MINERAL POINT AVE JANESVILLE WI 535485003 19925849 0 X HTTPS://MERCYASSISTEDCARE.ORG/ X 1985 WI TO IMPROVE AND PROTECT THE HEALTH AND WELFARE OF THE COMMUNITY IN ACCORDANCE WITH OUR MISSION, THE MISSION OF MAC IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER." THE FOUNDATION OF THIS MISSION IS BASED ON A VISION OF QUALITY: EXCELLENCE IN PATIENT CARE; SERVICE: EXCEPTIONAL PATIENT AND CUSTOMER CARE; PARTNERING: BEST PLACE TO WORK; AND COST: COST-EFFECTIVE CARE, ALONG WITH A COMMITMENT TO THE VALUES OF HEALING IN THE BROADEST SENSE, PATIENTS COME FIRST, TREAT EACH OTHER LIKE FAMILY AND ALWAYS SEEK EXCELLENCE. 8 6 143 6 1185570 328697 226181 0 11260860 5608948 -13371 6639 3482810 9547826 14956480 15163413 0 0 0 0 9745883 10192978 0 0 0 3112217 3214790 12858100 13407768 2098380 1755645 14233277 19219577 2784179 6014834 11449098 13204743 X THE MISSION OF MERCY ASSISTED CARE, INC. (MAC) IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER." THE FOUNDATION OF THIS MISSION IS BASED ON A VISION OF QUALITY: EXCELLENCE IN PATIENT CARE; SERVICE: EXCEPTIONAL PATIENT AND CUSTOMER CARE; PARTNERING: BEST PLACE TO WORK; AND COST: COST-EFFECTIVE CARE, ALONG WITH A COMMITMENT TO THE VALUES OF HEALING IN THE BROADEST SENSE, PATIENTS COME FIRST, TREAT EACH OTHER LIKE FAMILY AND ALWAYS SEEK EXCELLENCE. 0 0 9639731 13863218 HOME HEALTH IS A CORE SERVICE AND HAS BECOME CRITICALLY IMPORTANT WITH HELPING TO KEEP PEOPLE IN THEIR HOMES AND OUT OF INSTITUTIONS WHERE COSTS ARE SIGNIFICANTLY GREATER. THE HOME HEALTH CARE STAFF PROVIDED 832 PATIENTS WITH OVER 17,900 VISITS BY NURSES, THERAPISTS AND NURSE AIDES. HOSPICE HOMECARE PROVIDED 8,795 VISITS.HOSPITAL COMMUNITY BENEFIT REPORT IRS FORM 990, SUPPLEMENT PART IIITHE COMMUNITY BENEFIT CONTRIBUTION OF MAC INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES.1. MERCY ASSISTED CARE INC.'S COMMITMENT TO PROVIDING COMMUNITY BENEFIT:A. THE MISSION OF MERCY ASSISTED CARE INC. IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER." MERCY ASSISTED CARE PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MERCY ASSISTED CARE, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY OF JANESVILLE AND SOUTHERN WISCONSIN WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING ITS MISSION, MERCY ASSISTED CARE ROUTINELY PROVIDES: 1.) FREE CARE AND/OR SUBSIDIZED CARE, 2.) CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT ARE REIMBURSED BELOW COST, AND 3.) HEALTH ACTIVITIES AND EDUCATIONAL AND SUPPORT PROGRAMS TO THE COMMUNITIES IT SERVES IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. MANY OF THE SERVICES OF MERCY ASSISTED CARE ARE FOCUSED ON KEEPING THE ELDERLY AND MEDICALLY FRAIL IN THE TYPE OF INDEPENDENT SETTING MOST APPROPRIATE TO THEIR MEDICAL CONDITION. B. MERCY ASSISTED CARE CONSIDERS ITS TARGET POPULATIONS TO BE RESIDENTS OF ROCK AND WALWORTH COUNTIES IN WISCONSIN, AS WELL AS PARTS OF MCHENRY COUNTY IN ILLINOIS. THE SYSTEM USES MULTIPLE STRATEGIES TO IDENTIFY NEEDS IN THESE COMMUNITIES. THESE STRATEGIES INCLUDE ONE-ON-ONE MEETINGS WITH LOCAL COMMUNITY LEADERS, FORMAL SURVEYS, PARTICIPATION ON COMMUNITY TASK FORCES, SUGGESTIONS FROM PATIENTS, AND DIRECT INPUT FROM ITS EMPLOYEES. MERCY ASSISTED CARE HAS WORKED WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP MEET THESE NEEDS:1) MERCY ASSISTED CARE SUBSIDIZES ITS HOSPICE PROGRAM (THROUGH FUNDRAISING/DONATIONS FROM MERCYHEALTH DEVELOPMENT FOUNDATION)- SO THAT THIS PROGRAM IS AVAILABLE TO THOSE IN NEED WITHIN THE COMMUNITY.2) IT PROVIDES HEALTH SCREENINGS AND HEALTH EDUCATION SEMINARS AT PUBLIC EVENTS AND AT ITS OWN SITES THROUGHOUT THE TARGET AREA.3), MERCY ASSISTED CARE PROVIDES TRAINING OPPORTUNITIES FOR NURSES, PHYSICIANS, AND OTHER HEALTH PROFESSIONALS. C. FINANCIAL ASSISTANCE IS PROVIDED BY MERCY ASSISTED CARE TO CUSTOMERS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR CHARGES AND WHO MEET ELIGIBILITY REQUIREMENTS. ELIGIBILITY IS BASED ON THE FOLLOWING: INDIVIDUAL OR FAMILY INCOME, INDIVIDUAL OR FAMILY ASSETS, FAMILY SIZE, AND OTHER SOURCES OF PAYMENT FOR SERVICES. ELIGIBILITY FOR ALL OTHER CATEGORICAL AIDS IS A PREREQUISITE BEFORE QUALIFYING FOR FINANCIAL ASSISTANCE. PATIENTS THAT QUALIFY WILL RECEIVE A REDUCTION IN THE BALANCE OWED AND EXTENDED PAYMENT TERMS. THE AMOUNT OF THE FINANCIAL ASSISTANCE BENEFIT IS BASED ON THAT PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE. INFORMATION IS MADE AVAILABLE AT THE TIME OF REGISTRATION, THROUGH PATIENT FINANCIAL COUNSELORS, AND AT THE CUSTOMER SERVICE PATIENT ACCOUNTS AREAS. TRAINING IS PROVIDED TO PERSONNEL AS TO HOW TO COMMUNICATE THIS PROGRAM'S AVAILABILITY TO PATIENTS AND HOW TO DIRECT PATIENT'S INQUIRIES. TRANSLATION SERVICES ARE AVAILABLE AS NEEDED.2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION- MERCY ASSISTED CARE, INC. HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY.- MERCY ASSISTED CARE, INC. PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS.3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMSMERCY ASSISTED CARE OFFERS MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH MERCY ASSISTED CARE, INC. BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THE PROGRAMS INCLUDE:- PARTICIPATION IN HEALTH FAIRS- PARTICIPATION IN HOSPICE SUPPORT GROUPS 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION MERCY HEALTH SYSTEM'S WEB PAGE: WWW.MERCYHEALTHSYSTEM.ORGSECTION 2 - QUANTIFIABLE COMMUNITY BENEFITFISCAL YEAR ENDED JUNE 30, 2024:1) CHARITY CARE - AT COST = $18,2082) MEDICAID SHORTFALL - NET EXPENSE = $149,747 TOTAL QUANTIFIABLE COMMUNITY BENEFIT = $167,955 9639731 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 20 0 143 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 WI IL X JOE MALAS 8159716738 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 TODD ANDERSON VP/CFO (TERM 01/2025) 1.00 62.00 X 0 890535 87531 MARK L GOELZER MD DIRECTOR/PHYSICIAN 1.00 62.00 X 0 481051 33521 KIMBERLY SCACCIA VP - REVENUE CYCLE 1.00 62.00 X 0 545085 60588 KAYLIE FUHRMAN RN HOME HEALTH HOSPICE 5 54.00 0.00 X 158243 0 30197 TRACI HEINTZELMAN RN HOME HEALTH HOSPICE 1 55.00 0.00 X 166881 0 16429 SHELLEY HERBST-NGUYEN HOME HEALTH THERAPY SUPERVISOR 40.00 0.00 X 144621 0 31631 BRANDON COOLEY DIRECTOR OF HOME HEALTH 40.00 0.00 X 176331 0 11076 KATHLEEN GARWICK RESPIRATORY THERAPIST HME CV SUPERVISOR 42.00 0.00 X 138004 0 25952 JAVON R BEA PRESIDENT/CEO (SEE PAGES 26-31) 1.00 67.00 X X 0 16001686 6756093 ROWLAND J MCCLELLAN CHAIR & DIRECTOR 1.00 7.00 X X 0 23157 0 THOMAS D BUDD SECRETARY & TREASURER 1.00 7.00 X X 0 13500 0 WESLEY M JOST DIRECTOR 1.00 7.00 X 0 13858 0 KATHERINE A SCHACK DIRECTOR 1.00 7.00 X 0 13663 0 THOMAS R POOL VICE CHAIR & DIRECTOR 1.00 7.00 X X 0 13500 0 DAVE L SYVERSON DIRECTOR 1.00 7.00 X 0 12932 0 784080 18008967 7053018 15 0 1 0 0 PATIENT SERVICE REVENU 621610 5504914 5504914 RENT FROM AFFILIATED O 531190 104034 104034 5608948 6639 6639 14306310 4762436 9543874 8358304 1185570 MISCELLANEOUS 900099 3952 3952 3952 15163413 13863218 1185570 114625 9635726 6647240 2988486 557252 436855 120397 5013 13 5000 406455 222873 183582 2517 1218 1299 37064 36529 535 191443 99577 91866 267197 263146 4051 1753 281 1472 851938 550406 301532 30155 30155 EQUIPMENT REPAIRS & MAI 427503 381681 45822 BAD DEBT 403145 403145 DRUGS & MEDICAL SUPPLIE 333816 317660 16156 UNREL. BUS. INC. TAX 225651 224356 1295 31140 24596 6544 13407768 9639731 3768037 0 850 737 5106788 9267253 2422673 3017934 1238013 1330220 4668 28585 14812195 10883975 3720460 3928220 1739825 1646628 14233277 19219577 2336636 2806561 447543 3208273 2784179 6014834 X 11449098 13204743 11449098 13204743 14233277 19219577 1755645 0 X 0 1 X 1 1 1 X 12288 81563 226181 0 320032 14568210 14770583 14875608 16816887 18625654 79656942 14568210 14782871 14957171 17043068 18625654 79976974 0 0 0 79976974 1515 554 165 2120 6639 10993 104689 140916 231965 743533 328697 1549800 106204 141470 232130 745653 335336 1560793 804 4095 8116 8414 3952 25381 14675218 14928436 15197417 17797135 18964942 81563148 0.98060 0.97990 0.01910 0.01980 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2019 AMOUNT: $ 804. 2020 AMOUNT: $ 4,095. 2021 AMOUNT: $ 8,116. 2022 AMOUNT: $ 8,414. 2023 AMOUNT: $ 3,952. 8062916 6299650 1763266 224958 212759 12199 6524321 4371566 2152755 3928220 DUE FROM MERCY CRYSTAL LAKE HOSPITAL 187363 DUE FROM MERCY HARVARD HOSPITAL 636367 DUE FROM MERCY HEALTH CORP 17808 DUE FROM MERCY HEALTH DEVELOPMENT FOUNDATION 2769 DUE FROM MERCY HEALTH VISITING NURSES ASSOCIATION 799991 FORWARD ACCRUAL 2330 1646628 2806561 360662 DUE TO JAVON BEA HOSPITAL 474867 DUE TO MERCY HEALTH SYSTEM CORPORATION 2321027 DUE TO ROCKFORD HEALTH PHYSICIANS 6713 OTHER PAYABLES 45004 3208273 0 1 0 0 0 0 0 0 0 TODD ANDERSON VP/CFO (TERM 01/2025) 0 583582 0 298099 0 8854 0 49833 0 37698 0 978066 0 0 MARK L GOELZER MD DIRECTOR/PHYSICIAN 0 246712 0 227923 0 6416 0 15657 0 17864 0 514572 0 0 KIMBERLY SCACCIA VP - REVENUE CYCLE 0 364549 0 174918 0 5618 0 28911 0 31677 0 605673 0 0 KAYLIE FUHRMAN RN HOME HEALTH HOSPICE 5 151661 0 0 0 6582 0 455 0 29742 0 188440 0 0 0 TRACI HEINTZELMAN RN HOME HEALTH HOSPICE 1 154396 0 0 0 12485 0 8831 0 7598 0 183310 0 0 0 SHELLEY HERBST-NGUYEN HOME HEALTH THERAPY SUPERVISOR 138779 0 0 0 5842 0 4638 0 26993 0 176252 0 0 0 BRANDON COOLEY DIRECTOR OF HOME HEALTH 148206 0 5625 0 22500 0 10042 0 1034 0 187407 0 0 0 KATHLEEN GARWICK RESPIRATORY THERAPIST HME CV SUPERVI 124908 0 2250 0 10846 0 7541 0 18411 0 163956 0 0 0 JAVON R BEA PRESIDENT/CEO (SEE PAGES 26-31) 0 1816003 0 0 0 14185683 0 6738431 0 17662 0 22757779 0 12669012 PART I, LINE 3 THE CEO IS PAID FROM A RELATED ORGANIZATION, MERCY HEALTH SYSTEM CORPORATION (MHSC). MHSC USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATION, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE MHSC COMPENSATION COMMITTEE IS COMPRISED OF THE BOARD CHAIRPERSON, VICE CHAIR, AND SECRETARY/TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED BY INDEPENDENT LEGAL COUNSEL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNSEL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE FULL BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2023. PART I, LINE 4B INCENTIVE PLAN DISTRIBUTION: JAVON R. BEA - $8,510,830 PART II, LINE 1: JAVON R. BEA DEFERRED COMPENSATION PAYMENT MR. BEA HAS BEEN EMPLOYED BY MHSC AS PRESIDENT AND CEO OVER THE PAST 36 YEARS. DURING THIS TIME, MR. BEA HAS LED AN INCREDIBLE TRANSFORMATION TAKING A SMALL, SINGLE, STAND-ALONE COMMUNITY HOSPITAL AND CREATING A VERTICALLY INTEGRATED HEALTH SYSTEM WITH 89 FACILITIES IN 50 COMMUNITIES THROUGHOUT SOUTHERN WISCONSIN AND NORTHERN ILLINOIS, INCREASING GROSS REVENUE FROM $33 MILLION TO OVER $4.1 BILLION IN FY2024. THIS HAS ALLOWED THE HEALTH SYSTEM TO GO FROM SERVING 89,000 PATIENTS IN 1989 TO OVER 1.9 MILLION PATIENTS TODAY WORKING TOGETHER WITH OVER 7,500+ PARTNERS IN HEALTH CARE AND OVER 800 EMPLOYED PHYSICIANS. TODAY, MHSC HAS BECOME THE LARGEST EMPLOYER IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. THIS GROWTH CAN BE ATTRIBUTED TO MR. BEA'S VISIONARY LEADERSHIP. LEADERSHIP THAT OVER THE YEARS HAS LED TO MHSC RECEIVING NUMEROUS NATIONAL RECOGNIZED AWARDS INCLUDING BEING NAMED THE FIRST FULLY INTEGRATED HEALTH SYSTEM TO RECEIVE THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD FROM THE PRESIDENT OF THE UNITED STATES IN THE OVAL OFFICE, THE MAGNET RECOGNITION AWARD, BEING RANKED #1 AND #2 ON AARP'S TOP 100 BEST PLACES TO WORK FOR WORKERS OVER 50, AND BEING RANKED IN THE TOP 25 ON THE TOP 100 INTEGRATED HEALTHCARE NETWORKS LIST BY MODERN HEALTHCARE. THE TURNAROUND OF MHSC IMPLEMENTED BY MR. BEA IS UNPARALLELED. BY PIONEERING A "PARTNERSHIP MODEL" OF COMPENSATION AND DESIGNING A CUSTOM CULTURE OF EXCELLENCE, MR. BEA IS VITAL TO THE DECADES-LONG AND CONTINUING GROWTH AT MHSC. THIS SUCCESS HAS MADE MR. BEA A HIGHLY SOUGHT AFTER SPEAKER AND CONSULTANT AS HE IS NOW WELL-RENOWNED FOR HIS INNOVATIONS IN THE AREAS OF INTEGRATED HEALTHCARE AND PHYSICIAN PARTNERSHIP MODELS. THE TREMENDOUS SUCCESS OF MHSC UNDER THE LEADERSHIP OF MR. BEA HAS ALLOWED HIM TO RECEIVE PAYOUTS FROM A DEFERRED COMPENSATION PACKAGE WHICH MHSC HAS BEEN PAYING INTO OVER MANY YEARS. THESE PAYMENTS ONLY BECAME PAYABLE IF MHSC ATTAINED CERTAIN DEFINED FINANCIAL AND STRATEGIC GOALS AND THE AMOUNTS ARE AT RISK EVERY SINGLE YEAR. AS INDICATED ABOVE, MANY OF THESE GOALS WERE ACHIEVED WITHIN THE PAST FEW YEARS RESULTING IN A RELEASE OF THESE DEFERRED PAYMENTS WHICH IMPACTED MR. BEA'S COMPENSATION REPORTING. THE SETTING OF THESE GOALS WERE LAID OUT BY THE BOARD OF DIRECTORS IN COOPERATION WITH NATIONALLY RECOGNIZED COMPENSATION ATTORNEYS AND CONSULTANTS TO MAKE SURE ALL FACTORS WERE TAKEN INTO CONSIDERATION. MR. BEA'S COMPENSATION HAS ALSO BEEN SCRUTINIZED BY NUMEROUS OUTSIDE ORGANIZATIONS AND MOST IMPORTANTLY, THE INTERNAL REVENUE SERVICE; AND HAS PASSED INSPECTION IN EACH CASE. TOTAL COMPENSATION IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS OF MHSC. FORM 990, PART VI, SECTION A, LINE 1A THE VOTING MEMBERS OF THE EXECUTIVE COMMITTEE CONSISTS OF EIGHT INDIVIDUALS, EACH OF WHOM SHALL HAVE A VOTE, INCLUDING THE CEO, THE CHAIRMAN, VICE-CHAIRMAN, IMMEDIATE PAST CHAIRMAN, TREASURER, AND TWO ADDITIONAL DIRECTORS OF THE BOARD. AT LEAST ONE MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE A PHYSICIAN. THE EXECUTIVE COMMITTEE SHALL IN ALL INSTANCES BE COMPRISED OF AT LEAST 51% COMMUNITY MEMBERS. IN THE EVENT THAT ONE OR MORE OF THE AFOREMENTIONED VOTING MEMBERS OF THE EXECUTIVE COMMITTEE IS UNABLE TO SERVE IN SUCH CAPACITY, THEN THE CHAIRMAN OF THE CORPORATION SHALL DESIGNATE A REPLACEMENT FROM AMONG THE BOARD MEMBERS. THE EXECUTIVE COMMITTEE SHALL MEET AS NEEDED. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS, DUTIES, RESPONSIBILITIES AND AUTHORITY OF THE BOARD, EXCEPT AS PROHIBITED BY LAW. FORM 990, PART VI, SECTION A, LINE 6 MERCY HEALTH CORPORATION (MHC) IS THE SOLE CORPORATE MEMBER OF MERCY ASSISTED CARE, INC. (MAC). THE SOLE MEMBER SHALL HAVE THE POWERS AND VOTING RIGHTS TO DO THE FOLLOWING: (A) APPOINT ALL THE DIRECTORS OF THE CORPORATION (B) NOMINATE TO THE CORPORATION'S BOARD OF DIRECTORS ALL CANDIDATES FOR SELECTION AS THE CORPORATION PRESIDENT (C) APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS (D) APPROVE ANNUAL BUDGETS, AND STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS OF THE CORPORATION (E) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AUTHORIZING THE PLEDGE OR TRANSFER OF ASSETS TO MHC OR AS DIRECTED BY MHC, OR THE EXECUTION OF CONTRACTS) WHICH WOULD IMPROVE THE CREDIT WORTHINESS OR OTHERWISE RESULT IN FINANCIAL BENEFIT TO MHC AND ITS TAX-EXEMPT AFFILIATED CORPORATIONS (PROVIDED THAT UNDER NO CIRCUMSTANCES MAY MHC REQUIRE TRANSFER OF ASSETS IN VIOLATION OF LAW OR THE TERMS OF ANY CHARITABLE TRUST OR DONATION) (F) APPROVE ALL CONTRACTS OF INDEBTEDNESS EFFECTIVE FOR LONGER THAN EIGHTEEN MONTHS (G) APPROVE ALL PLANS OF MERGER OR CONSOLIDATION (H) APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION (I) APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION (J) APPROVE MATERIAL AMENDMENTS TO THE CORPORATION'S STANDARD FORM OF PHYSICIAN EMPLOYMENT AGREEMENT, PROVIDED THE CORPORATION SHALL HAVE THE AUTHORITY TO NEGOTIATE THE TERMS AND CONDITIONS OF INDIVIDUAL PHYSICIAN EMPLOYMENT AGREEMENTS SO LONG AS THE NEGOTIATED TERMS AND CONDITIONS ARE CONSISTENT WITH THE REQUIREMENTS OF APPLICABLE LAW AND THE STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS APPROVED BY MHC (K) APPROVE MATERIAL AMENDMENTS TO THE STANDARD COMPENSATION SYSTEM USED BY THE CORPORATION TO ESTABLISH INDIVIDUAL PHYSICIAN COMPENSATION (L) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AMENDING THE ARTICLES OF INCORPORATION OR BYLAWS), OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, IF MHC DETERMINES THAT FAILURE TO TAKE THE ACTION, OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, MAY RESULT IN THE CORPORATIONS FAILURE TO OBTAIN OR MAINTAIN ITS EXEMPTION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION A, LINE 7A SEE NARRATIVE FOR PART VI, LINE 6 FORM 990, PART VI, SECTION A, LINE 7B SEE NARRATIVE FOR PART VI, LINE 6 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE FORM 990 BEFORE FILING AND IT IS AVAILABLE TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C BY WRITTEN POLICY, MHC SENDS OUT, ON AN ANNUAL BASIS, THE CORPORATE CONFLICT AND DUALITY OF INTEREST POLICY TO ALL BOARD MEMBERS, CORPORATE OFFICERS AND OTHER KEY INDIVIDUALS (THOSE HAVING RESPONSIBILITY AND AUTHORITY TO MAKE FINAL DECISIONS REGARDING THE ACQUISITION OF PRODUCTS OR SERVICES). EACH RECIPIENT IS REQUIRED TO COMPLETE A FINANCIAL INTEREST DISCLOSURE STATEMENT, WHICH IS SUBMITTED TO THE MHC COMPLIANCE DEPARTMENT FOR REVIEW. WITH RESPECT TO PHYSICIANS AND MANAGERS WHO ARE KEY INDIVIDUALS, ANY POTENTIAL CONFLICT OF INTEREST IS REVIEWED WITH THE APPROPRIATE EXECUTIVE STAFF MEMBER FOR FOLLOW UP WITH THE DISCLOSING PARTY IN ORDER TO REVIEW THE MATTER IN MORE DETAIL. THIS INCLUDES EMPHASIZING THAT THE DISCLOSING PARTY IS NOT PERMITTED TO PARTICIPATE IN ANY NEGOTIATIONS FOR THE PURCHASE OF ANY PRODUCTS OR SERVICES WHERE THE CONFLICT IS DEEMED MATERIAL OR AUTHORIZE THE SUBSEQUENT PURCHASE OF RELATED GOODS AND SERVICES. THE DISCLOSING PARTY IS ALSO REQUIRED TO IDENTIFY EACH AND EVERY INSTANCE OF A POTENTIAL CONFLICT AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. A SIMILAR PROCESS IS FOLLOWED FOR THE BOARD OF DIRECTORS, EXCEPT THAT ANY POTENTIAL CONFLICT IS REVIEWED BY THE BOARD'S GOVERNANCE COMMITTEE. BOARD MEMBERS MAY COMMENT ON TRANSACTIONS WHERE THERE IS A POTENTIAL CONFLICT BUT CANNOT VOTE ON THE RELATED MATTER AND MAY BE REQUIRED TO LEAVE ANY MEETING WHERE THE POTENTIAL CONFLICT IS REVIEWED BY THE BOARD OR WHERE THE BOARD TAKES ACTION TO EITHER APPROVE OR NOT APPROVE THE PROPOSED TRANSACTION. A BOARD MEMBER ALSO HAS A CONTINUING DUTY TO REPORT ANY CONFLICTS AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. IN THE EVENT THAT A POTENTIAL CONFLICT OF INTEREST IS REPORTED OR DISCOVERED OUTSIDE THE ESTABLISHED PROCESS, APPROPRIATE REVIEW AND ACTION WOULD BE TAKEN. THIS PROCESS WAS LAST COMPLETED IN 2024, WHEN THE QUESTIONNAIRES WERE SENT TO ADDRESS ANY 2023 CONFLICTS IDENTIFIED. MHC AND MAC HAVE THE SAME BOARD, AND THEREFORE THE MHC QUESTIONNAIRE IS USED TO ALSO ADDRESS POTENTIAL AND ACTUAL CONFLICTS FOR THE FILING ORGANIZATION. THE MHC CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS 1000 MINERAL POINT AVE JANESVILLE WI 53548 390912682 SUPPORT OF HEALTHCARE WI 501(C)(3) LINE 12C, III-FI MERCY HEALTH SYSTEM CORPORATION 0 MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT AVE JANESVILLE WI 53548 390816848 HEALTHCARE WI 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY HARVARD HOSPITAL INC 901 GRANT STREET HARVARD IL 60033 311551871 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 875 S ROUTE 31 CRYSTAL LAKE IL 60014 201673011 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY HEALTH CORPORATION 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 472158680 SUPPORT OF HEALTHCARE IL 501(C)(3) LINE 12A, I N/A 0 JAVON BEA HOSPITAL 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 362167847 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCYHEALTH DEVELOPMENT FOUNDATION 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 363197918 SUPPORT OF HEALTHCARE IL 501(C)(3) LINE 12A, I MERCY HEALTH CORPORATION 0 MERCYHEALTH VISITING NURSES ASSOCIATION 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 362167945 HEALTHCARE IL 501(C)(3) LINE 10 MERCY HEALTH CORPORATION 0 ROCKFORD HEALTH PHYSICIANS 8201 E RIVERSIDE BLVD ROCKFORD IL 61114 363907436 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 JANESVILLE MEDICAL CENTER INC 1000 MINERAL POINT JANESVILLE WI 53548 391520130 MANAGEMENT OF UNION EMPLOYEES WI N/A C 0 MERCYCARE INSURANCE COMPANY 580 N WASHINGTON ST JANESVILLE WI 53546 391768192 INSURANCE WI N/A C 0 MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO 580 N WASHINGTON ST JANESVILLE WI 53546 201482553 INSURANCE WI N/A C 0 ROCKFORD HEALTH INSURANCE LTD WELLESLY HOUSE SO 2ND FL PEMBROKE HM BD INSURANCE BD N/A C 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0