2016-05-13T14:25:03-05:00 2015-06-30 420714325 RSM US LLP 201 N HARRISON STREET SUITE 300 DAVENPORT IA 528011999 990 2014-07-01 420698295 MERCY MEDICAL CENTER MERC 3193986107 701 10TH STREET SE CEDAR RAPIDS IA 52403 NATHAN VAN GENDEREN EXECUTIVE VP/CFO 3193986107 2016-05-09 1 JOHN J ROMANO P00227323 5638884000 2014 2016-08-17 19:52:53Z NATHAN VAN GENDEREN 701 10TH STREET SE CEDAR RAPIDS IA 52403 326455677 0 0928 X WWW.MERCYCARE.ORG X 1900 IA TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 31 25 2777 903 679305 0 5924084 5595344 266783691 299414067 3505571 3382518 -973157 1764947 275240189 310156876 5021357 5087776 0 0 127511930 129188189 0 0 0 143299110 152787273 275832397 287063238 -592208 23093638 543266322 559469597 205979268 228530377 337287054 330939220 X TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 0 0 220441208 5087776 300697432 THE MEDICAL CENTER PROVIDES MEDICAL HEALTH CARE, INCLUDING 24 HOURS A DAY, SEVEN DAYS A WEEK TRAUMA CENTER SERVICE, TO ALL PATIENTS ACCESSING THE SYSTEM, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO OR NOMINAL PAYMENT IS ANTICIPATED. ADDITIONALLY, EACH HOSPITAL DEPARTMENT ACCEPTS ALL PATIENTS WHO ARE COVERED BY GOVERNMENTAL INDIGENT PROGRAMS. SUCH INDIGENT PROGRAMS TYPICALLY REMIT AMOUNTS SUBSTANTIALLY LESS THAN CHARGES. THE FOLLOWING SUMMARIZES THE HOSPITAL'S CARE OF THE UNINSURED AND UNDERINSURED (DOLLARS IN THOUSANDS):COSTS IN EXCESS OF MEDICARE REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICARE) - $22,820,000; OTHER COMMUNITY BENEFITS (INCLUDES SUBSIDIZED HEALTH SERVICES, FINANCIAL CONTRIBUTIONS) - $4,730,000; FREE SERVICE (TO PATIENTS WHO MEET MERCY'S FREE-SERVICE GUIDELINES) - $2,214,000; COSTS IN EXCESS OF MEDICAID REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICAID) - $3,840,000 PHYSICIAN EDUCATION - $954,000.IN ADDITION, CHARITY CARE AND COMMUNITY SERVICE ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR. THESE PROGRAMS PROVIDE A BONA FIDE COMMUNITY HEALTH NEED, INCLUDING: A. A HEALTH NEWS PUBLICATION, THE MERCY TOUCH, DISTRIBUTED TO 71,000 HOUSEHOLDS IN 2015 AT A TOTAL COST OF OVER $55,000. B. PUBLIC AND PROFESSIONAL EDUCATIONAL SEMINARS OFFERED ON TOPICS INCLUDING CHRONIC BACK AND NECK PAIN, PRENATAL EDUCATION, BREAST FEEDING, DIABETES, EATING DISORDERS, OSTEOPOROSIS, CROHNS/COLITIS, CARDIOVASCULAR DISEASE AND WELLNESS, SPECIALIZED CANCER SEMINARS FOR SOCIAL WORKERS, DENTAL HYGIENISTS, NURSES, DENTISTS, AND PHYSICIANS ARE ALSO FREQUENTLY OFFERED. C. HOSPITAL MEETING FACILITIES ARE FREQUENTLY USED WITHOUT CHARGE BY SUCH GROUPS AS THE AMERICAN HEART ASSOCIATION, IOWA BREAST CANCER FOUNDATION, HEALTHY LINN NETWORK ADVISORY COMMITTEE, OVEREATERS ANONYMOUS, CATHOLIC LAYMEN, UNITED WAY, CATHERINE MCAULEY CENTER FOR WOMEN, THE AMERICAN CANCER SOCIETY, M.S. SUPPORT GROUP, AND ARC OF EAST CENTRAL IOWA. D. CONTRIBUTIONS OF 143,000 HOURS TOWARD THE COMMON PURPOSE OF SERVING THE HEALTH CARE OF THE COMMUNITY. THE VALUE OF THESE CONTRIBUTIONS WAS APPROXIMATELY $1,721,000 AND WAS GIVEN BACK THE COMMUNITY THROUGH LOWER COSTS. 220441208 1 1 0 1 0 0 0 0 0 1 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 1 205 0 1 2777 1 1 1 0 0 0 0 0 0 0 0 0 X 31 25 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X KAY CRIST 3193986107 701 10TH STREET SE CEDAR RAPIDS IA 52403 MATT ANDERSON MD MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 GORDON BAUSTIAN MD FORMER MEMBER BOARD OF TRUSTEESS 1.00 X 0 0 0 JOHN-PAUL BESONG MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 LYDIA BROWN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MICHELE BUSSE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TIMOTHY L CHARLES PRESIDENT & CEO 40.00 X X 475132 0 59770 JACK COSGROVE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHRIS DEWOLF MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARRIE ERNST MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TONY GOLOBIC MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER LUANN HANNASCH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 NANCY KASPAREK MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JAN KAZIMOUR MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARB KNAPP MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER TERRY MALTBY MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BRUCE MCGRATH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHERYLE MITVALSKY MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 DARREL MORF MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 RUE PATEL MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 FRED PILCHER MD MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MARY QUASS CHAIRMAN 1.00 X X 0 0 0 TOM REED MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN RIFE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHARLIE ROHDE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 AL RUFFALO MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 EMMETT SCHERRMAN TREASURER 1.00 X X 0 0 0 KYLE SKOGMAN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN SMITH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER MAURITA SOUKUP MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER SHARI SUTHERLAND SECRETARY 1.00 X X 0 0 0 BOB VERHILLE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER MARGARET WEIGEL MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TIMOTHY QUINN MD CHIEF OF CLINICAL OPERATIO 40.00 X 430553 0 63563 NATHAN VANGENDEREN EXECUTIVE VP/CFO 40.00 X 204881 0 25698 MARY BROBST CHIEF NURSING OFFICER 40.00 X 214831 0 30251 JEFFREY CASH CHIEF INFORMATION OFFICER 40.00 X 223821 0 44648 DOUG JONTZ VP - HUMAN RESOURCES 40.00 X 194339 0 39062 DR MARK VALLIERE CHIEF MEDICAL OFFICER 40.00 X 357262 0 62550 SURAJ BOPANNA PHYSICIAN 40.00 X 379288 0 30863 CAM CAMPBELL PHYSICIAN 40.00 X 727925 0 29537 DAVID GLASSMAN PHYSICIAN 40.00 X 624013 0 29215 NICHOLAS HODGMAN PHYSICIAN 40.00 X 788663 0 32514 SUSAN SCHIMA PHYSICIAN 40.00 X 527512 0 28354 PHILIP PETERSON FORMER CHIEF FINANCIAL OFFICER 40.00 X 326904 0 9826 MICHAEL TRACTA FORMER CHIEF OPERATING OFFICIER 40.00 X 200479 0 5574 5675603 0 491425 43 1 1 0 HMP OF LINN COUNTY PLC PO BOX 645037 CINCINNATI OH 45264 HEALTHCARE PROFESSIONAL SERVICES 3887926 ONCOLOGY ASSOCIATES OF CEDAR RAPIDS 701 10TH STREET CEDAR RAPIDS IA 52403 HEALTHCARE PROFESSIONAL SERVICES 2590008 WELAND CLINICAL LABORATORY 1911 1ST AVE SE CEDAR RAPIDS IA 52406 HEALTHCARE PROFESSIONAL SERVICES 484801 PRECYSE SOLUTIONS LLC PO BOX 11407 BIRMINGHAM AL 35246 HEALTHCARE PROFESSIONAL SERVICES 275156 RSM US LLP 5155 PAYSPHERE CIRCLE CHICAGO IL 60674 ACCOUNTING SERVICES 237526 21 5424922 170422 1290 5595344 PATIENT REVENUES 900099 229495266 229495266 LABORATORY REVENUE 621500 78373497 77770174 603323 FAMILY COUNSELING REVENUE 624100 263839 263839 LESS: PROVISION FOR BAD DEBT 900099 -8718535 -8718535 299414067 5022488 5022488 2059696 1921672 138024 138024 138024 9919980 400 11413324 147026 -1493344 -146626 -1639970 -1639970 2640224 2816779 -176555 -176555 INVESTMENT PARTNERSHIP INCOME(LOS 561000 2873169 2797187 75982 MRI MR ASSOCIATES 621110 2148861 2148861 MISCELLANEOUS REVENUE 900099 631847 631847 -3850399 -3850399 1803478 310156876 300538240 679305 3343987 5087776 5087776 1813701 1385180 428521 100575757 76812819 23762938 6025732 4602038 1423694 14304425 10924732 3379693 6468574 4940250 1528324 435 332 103 264127 201722 62405 181051 138274 42777 33942 25923 8019 39027 29806 9221 11066219 8451614 2614605 1940171 1481769 458402 68613051 52401911 16211140 13010697 9936672 3074025 9900 7561 2339 3301976 2521821 780155 338885 258817 80068 67045 51204 15841 4043681 3088284 955397 24058658 18374342 5684316 2270083 1733733 536350 CONTRACTED SERVICES 8827268 6741658 2085610 REPAIRS 6551850 5003851 1547999 EQUIPMENT RENTAL & MAIN 2858672 2183256 675416 RESIDENCY EXPENSE 1598795 1221049 377746 3711740 2834814 876926 287063238 220441208 66622030 0 6575209 5893594 12510928 36664784 36756061 38713580 1407991 992636 5909990 6424912 3675872 3076532 431009632 242060822 201409266 188948810 86573183 82385937 121366149 125915840 67081673 70452972 543266322 559469597 29734675 34932362 119112363 117905661 57132230 75692354 205979268 228530377 X 298517762 287195799 13692779 18301549 25076513 25441872 337287054 330939220 543266322 559469597 X 23093638 -6986129 -22455343 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 33942 33942 0 PART II-B, LINE 1: 21% OR $32,471 OF MEMBERSHIP DUES TO THE IOWA HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES AND 2.98% OR $1,471 OF MEMBERSHIP DUES TO THE CATHOLIC HEALTH ASSOCIATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 34987320 298033 285414 397399 35173368 32934062 53555 2557545 557842 34987320 31300732 514737 1667102 548509 32934062 29795537 1481261 723609 135675 564000 31300732 27886845 151882 4618232 2317922 543500 29795537 0.16180 0.72330 0.11490 0 1 1 19866795 19866795 267920311 152346406 115573905 140378176 87436751 52941425 2844350 2277665 566685 188948810 MONEY MARKET FUNDS 5281 F COMMERCIAL PAPER & CASH 31995828 F MUTUAL FUNDS, INVESTED IN CORP BONDS, LLPS, & REAL ESTATE 93914731 F 125915840 INVESTMENT IN MERCY MEDICAL CENTER FOUNDATION 66248760 C DEFERRED FINANCING COSTS 896710 C INVESTMENT IN CEDAR RAPIDS PHO 886000 C SLEEP LAB JOINT VENTURE 1218000 C INVESTMENT IN MR ASSOCIATES 499000 C INVESTMENT IN MEDICAL MALL 704502 C 70452972 INTEREST RATE SWAP AGREEMENTS 10432034 PENSION LIABILITY 54634479 SELF INSURANCE RESERVES 8028508 THIRD PARTY SETTLEMENTS 764000 PAYABLE TO MERCY CARE MGMT, INC. 1833333 75692354 X 279465531 -6986129 -17348200 -24334329 303799860 6357016 6357016 310156876 285809923 2028060 2028060 283781863 3281375 3281375 287063238 PART V, LINE 4: MERCY HOSPITAL, CEDAR RAPIDS, IA ENDOWMENT FOUNDATION, INC., A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE FOUNDATION'S ENDOWMENT FUNDS ARE USED FOR THE HALL-PERRINE CANCER CENTER & CANCER PROGRAMS, HALL RADIATION CENTER, NEUROSCIENCES, HOSPICE OF MERCY, HOSPICE PROGRAM, FAMILY CAREGIVERS CENTER AT MERCY, HALL-PERRINE FAMILY RESOURCE CENTER, HALLMAR, WATTS LIBRARY, MERCY MEDICAL CENTER CAPITAL PROJECTS, AND GENERAL ENDOWMENT FUNDS TO BE USED AT THE BOARD OF DIRECTOR'S DISCRETION. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX EXEMPT STATUS OF BONDS ISSUED BY THE OBLIGATED GROUP, THE NATURE, THE CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2015 AND 2014, THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990 AND 990T FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -606,693. CHANGE IN UNRECOGNIZED FUNDED STATUS OF RETIREMENT PLAN -17,558,163. CHANGE IN INTEREST IN NET ASSETS OF MERCY MEDICAL CENTER FOUNDATION 3,316,656. GRANT TO MERCYCARE SERVICE CORPORATION INCLUDED WITH REVENUES -2,500,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES -1,881,434. LOSS ON SALE OF ASSETS -146,626. AUXILIARY AND GIFT SHOP REVENUE NOT INCLUDED IN AUDIT REPORT 36,629. BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) 2,640,970. EXPENSES INCLUDED WITH REVENUES IN REPORT 378,991. PURCHASE OF BUILDING FROM AFFILIATE (MERCYCARE MANAGEMENT, INC.) 4,877,313. CONTRIBUTION REVENUE NOT REPORTED FOR BOOKS 339,179. ADDITIONAL CONTRIBUTION REVENUE NOT INCLUDED FOR BOOKS 110,445. AUDIT REPORT ROUNDING/GROUPING ADJUSTMENT 1,549. PART XII, LINE 2D - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES 1,881,434. LOSS ON SALE OF FIXED ASSETS 146,626. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO MERCYCARE SERVICE CORPORATION INCLUDED WITH REVENUES 2,500,000. EXPENSES INCLUDED WITH REVENUES IN REPORT 378,991. ADDITIONAL CONTRIBUTION EXPENSE NOT INCLUDED FOR BOOKS 339,179. CONTRIBUTION REVENUE INCLUDED WITH EXPENSES 58,215. AUDIT REPORT ROUNDING/GROUPING ADJUSTMENT 4,990. 1 1 1 X 1 X 100.000000000000 1 1 1 0 1 1 4371735 0 4371735 0.01520 36613488 30860761 5752727 0.02000 40985223 30860761 10124462 0.03520 712746 0 712746 0.00250 1816982 862728 954254 0.00330 10117177 7528797 2588380 0.00900 0 0 179358 0 179358 0.00060 12826263 8391525 4434738 0.01540 53811486 39252286 14559200 0.05060 1091 0 1091 0.00000 1200 0 1200 0.00000 2062 0 2062 0.00000 1300 0 1300 0.00000 334408 0 334408 0.00120 473271 0 473271 0.00160 1622 0 1622 0.00000 814954 814954 0.00280 1 8718535 0 99342864 122159219 -22816355 X 1 1 1 MR ASSOCIATES LLP MRI SERVICES 0.33000 0.00000 0.33000 2 EASTERN IOWA SLEEP CENTER LLC SLEEP STUDIES 0.33000 0.00000 0.33000 3 PARAMOUNT HEALTH OPTIONS PAYOR CONTRACTING 0.40000 0.00000 0.60000 4 PCI REGIONAL MED MALL LLC MEDICAL SERVICES 0.10000 0.00000 0.80000 5 PCI LENDER LLC FINANCIAL SERVICES 0.07500 0.00000 0.85000 1 1 MERCY MEDICAL CENTER 701 10TH STREET SE CEDAR RAPIDS IA 52403 WWW.MERCYCARE.ORG 570036H X X X X MERCY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 12 1 1 1 1 X WWW.MERCYCARE.ORG X 1 13 1 WWW.MERCYCARE.ORG/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 0 1 X 200.000000000000 100.000000000000 X X X X X 1 1 X X X 1 X X X X 0 0 X X X 1 X 0 0 MERCY MEDICAL CENTER PART V, SECTION B, LINE 5: LINN COUNTY PUBLIC HEALTH FACILITATED THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS THROUGH THE USE OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). THIS PROCESS INCLUDED THE FOLLOWING: A COMMUNITY HEALTH STATUS ASSESSMENT (COLLECTION OF STATISTICAL DATA FROM MAJOR LEADING HEALTH INDICATORS); COMMUNITY THEMES AND STRENGTHS ASSESSMENT (FACILITATED DIALOGUES/FOCUS GROUPS THAT ARE CONDUCTED AMONG DIVERSE POPULATIONS); A LOCAL PUBLIC HEALTH SYSTEMS ASSESSMENT (AN EVENT THAT BRINGS TOGETHER COMMUNITY MEMBERS, AGENCIES, AND LEADERS TO IDENTIFY THE PUBLIC HEALTH SYSTEM'S STRENGTHS AND WEAKNESSES); AND A FORCE OF CHANGE ASSESSMENT (AN IMPORTANT BRAINSTORMING ACTIVITY THAT IDENTIFIED FORCES THAT HAVE THE POTENTIAL TO AFFECT HEALTH OUTCOMES). SPECIFICALLY, LINN COUNTY PUBLIC HEALTH CONDUCTED A TOTAL OF 12 COMMUNITY DIALOGUES WITH VARIOUS GROUPS, INCLUDING: MENTAL HEALTH SERVICES PLANNING COMMITTEE, WOMEN'S HEALTH NETWORK, FAMILY VIOLENCE PREVENTION COALITION, PARTNERSHIP FOR A DRUG FREE COMMUNITY, LAW ENFORCEMENT INTELLIGENCE NETWORK (HOUSED IN BENTON COUNTY), RESIDENTS IN TREATMENT AT THE HEART OF IOWA, SAFE KIDS COALITION, HEALTH LIVING COALITION/BLUE ZONES PROJECT SUBCOMMITTEES, SEXUAL HEALTH ALLIANCE OF LINN AND JOHNSON COUNTIES, PROVIDERS WITH THE LINN COUNTY MEDICAL SOCIETY AND ENVIRONMENTAL PUBLIC HEALTH WORK GROUP. BENTON COUNTY PUBLIC HEALTH CONDUCTED TWO ADDITIONAL COMMUNITY DIALOGUES WITHIN BENTON COUNTY. IN ADDITION, THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE INCLUDED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: BENTON COUNTY PUBLIC HEALTH/VIRGINIA GAY HOSPITAL, CEDAR COUNTY, COMMUNITY HEALTH FREE CLINIC, HACAP, HIS HANDS FREE MEDICAL CLINIC, JOHNSON COUNTY PUBLIC HEALTH, JONES REGIONAL MEDICAL CENTER, LINN COMMUNITY CARE, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL AND UNITED WAY OF EAST CENTRAL IOWA. MERCY MEDICAL CENTER VALIDATED THE IDENTIFIED NEEDS WITH MERCY'S PRIMARY CARE NETWORK OF PHYSICIANS AND THE HOSPITAL'S QUALITY STEERING COMMITTEE. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6A: LINN COUNTY PUBLIC HEALTH FACILITATED A CHNA FOR UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL AND MERCY MEDICAL CENTER. BOTH HOSPITALS ARE LOCATED IN CEDAR RAPIDS, IA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6B: IN ADDITION TO LINN COUNTY PUBLIC HEALTH AND UNITY POINT HEALTH - ST. LUKES HOSPITAL, OTHER ORGANIZATIONS PARTICIPATING IN THE CHNA INCLUDED: BENTON PUBLIC HEALTH/VIRGINIA GAY HOSPITAL, CEDAR COUNTY, COMMUNITY HEALTH FEE CLINIC, HACAP, HIS HANDS FREE MEDICAL CLINIC, JOHNSON COUNTY PUBLIC HEALTH, UNITY POINT HEALTH - JONES REGIONAL MEDICAL CENTER, LINN COMMUNITY CARE (NOW EASTERN IOWA HEALTH CENTER) AND UNITED WAY OF EAST CENTRAL IOWA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 11: MERCY MEDICAL CENTER IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA IN A VARIETY OF WAYS. THESE INCLUDE HEALTH PROMOTION PROGRAMS AND ACTIVITIES SUCH AS THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, COLLABORATION WITH COMMUNITY PARTNERS AT GENEVA TOWER TO IMPROVE THE HEALTH AND WELL-BEING OF RESIDENTS, PROVIDING COMMUNITY EDUCATION, PARTICIPATING IN THE COMMUNITY'S BLUE ZONES INITIATIVES, SUPPORTING COMMUNITY EVENTS BOTH WITH FINANCIAL AND IN-KIND CONTRIBUTIONS THAT ADDRESS AND SUPPORTS ENHANCING HEALTH INITIATIVES, FACILITATING SUPPORT GROUPS FOR A VARIETY OF DISEASE CONDITIONS THAT ARE OPEN TO AND FOR COMMUNITY MEMBERS, OFFERING A VARIETY OF SCREENINGS (I.E. SKIN CANCER, HEAD AND NECK CANCER, BLOOD PRESSURE), PROVIDING SMOKING CESSATION CLASSES, PARTICIPATING IN COMMUNITY WIDE COALITIONS TO ADDRESS A VARIETY OF HEALTH ISSUES, PROVIDING IN-KIND LAB AND RADIOLOGY SERVICES TO BOTH FREE CLINICS IN OUR COMMUNITY, UTILIZING OUR MOBILE MAMMOGRAPHY UNIT TO SERVE RURAL AND UNDERSERVED AREAS IN OUR AREA WITH MAMMOGRAM SCREENINGS, SUPPORTING THE ESPECIALLY FOR YOU FUND FOR UNINSURED AND UNDERINSURED PERSONS TO RECEIVE ACCESS TO HEALTH CARE SERVICES RELATING TO BREAST HEALTH, INCREASING THE NUMBER OF PRIMARY CARE PROVIDERS IN OUR AREA, IMPLEMENTING PROGRAMS TO PROVIDE ADDITIONAL CASE MANAGEMENT, COMPREHENSIVE AND COORDINATED CARE TO THOSE PATIENTS WHO HAVE MULTIPLE, COMPLEX PROBLEMS.SEXUAL HEALTH WAS IDENTIFIED AS A HIGH PRIORITY FOR LINN AND JOHNSON COUNTIES. TO ADDRESS THIS NEED, MERCY MEDICAL CENTER HAS SEXUAL ASSAULT NURSE EXAMINERS LOCATED IN THE ED AND THEY PARTICIPATE ON THE LINN COUNTY SEXUAL ASSAULT RESPONSE TEAM. MERCY WILL NOT BE FURTHER ADDRESSING THIS NEED BECAUSE THE LINN COUNTY PUBLIC HEALTH DEPARTMENT CURRENTLY OFFERS EXTENSIVE SERVICES IN THIS AREA. THESE SERVICES INCLUDE: COORDINATING THE SEXUAL HEALTH ALLIANCE OF LINN AND JOHNSON COUNTIES COALITION (A MERCY PHYSICIAN SERVES ON THIS COALITION); OFFERING HIV TESTS AND FREE STD EXAMINATIONS AND TREATMENT; CONDUCTING STD PARTNER TRACKING FOLLOW-UP SERVICES; OFFERING FREE CONDOMS, DENTAL DAMS AND LUBRICANT; PROVIDING OFFSITE STD/HIV TESTING TO HIGH-RISK COMMUNITY AGENCIES AND EVENTS WITH HIGH-RISK POPULATIONS; AND MONITORING POPULATION HEALTH CHANGES THROUGH PUBLIC HEALTH SURVEILLANCE. VIOLENCE, INJURY PREVENTION, ENVIRONMENTAL HEALTH AND PRENATAL/EARLY CHILDHOOD HEALTH WERE OTHER KEY HEALTH PRIORITIES ANALYZED IN THE CHNA. HOWEVER, THEY WERE NOT IDENTIFIED AS HIGH PRIORITY AREAS DUE TO LIMITED DATA AND/OR THE LOWER INCIDENCE OR PREVALENCE RATES WHEN COMPARED TO STATE AND NATIONAL RATES. FOR THIS REASON, MERCY WILL NOT BE ADDRESSING THESE NEEDS BEYOND CURRENT PROGRAMMING. PART I, LINE 6A: NOT APPLICABLE PART I, LINE 7: MERCY MEDICAL CENTER UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO, AND THIS RATIO WAS USED IN COMPUTING THE INFORMATION REPORTED IN PART I, LINE 7. PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES. PART I, LN 7 COL(F): BAD DEBT EXPENSE WAS NOT INCLUDED IN THE DENOMINATOR BECAUSE IT WAS REPORTED ON LINE 2E OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 18.75%. THIS PERCENTAGE INCREASES TO 61.30% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN THE TOTAL COMMUNTY BENEFIT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: MERCY MEDICAL CENTER (MERCY) PARTICIPATED IN A NUMBER OF COMMUNITY BUILDING ACTIVITIES THAT PROMOTED THE HEALTH OF THE COMMUNITIES IT SERVES. THIS WAS DONE THROUGH MERCY REPRESENTATION ON A NUMBER OF COALITIONS, COMMITTEES AND BOARDS. MERCY MADE FINANCIAL CONTRIBUTIONS TO NON-PROFIT ORGANIZATIONS THAT SUPPORT COMMUNITY-BUILDING EFFORTS, INCLUDING PHYSICAL IMPROVEMENTS AND COMMUNITY SUPPORT. MERCY PROVIDES REPRESENTATION ON THE FOLLOWING COMMUNITY-BUILDING COALITIONS, BOARDS, AND COMMITTEES: - AGING SERVICES BOARD - BIG BROTHERS BIG SISTERS - CATHERINE MCAULEY CENTER BOARD - CEDAR RAPIDS CHAMBER OF COMMERECE - COMMUNITY EMERGENCY RESPONSE TEAM - DAYBREAK ROTARY - DIVERSITY FOCUS BOARD - HACAP BOARD - MARION CHAMBER OF COMMERCE - MEET ME AT THE MARKET COMMITTE - SAFE KIDS LINN COUNTY COALITION - UNITED WAY TEAMS AND BOARD - WILLIS DADY EMERGENCY SHELTER - WOMEN'S LEADERSHIP INITIATIVE - YOUNG PARENTS NETWORK BOARD PART III, LINE 2: BAD DEBT RECORDED IS THE UNPAID AMOUNT OF THE PATIENT'S ACCOUNT; IT DOES NOT REFLECT GROSS ESTABLISHMENT CHARGES. FOR PATIENTS WITH INSURANCE COVERAGE, THIS IS THE RESULTING PATIENT LIABILITY AFTER INSURANCE PAYMENTS AND CONTRACTUAL ALLOWANCES HAVE BEEN APPLIED TO THE ACCOUNT. FOR PATIENTS WITHOUT INSURANCE COVERAGE, A DISCOUNT PERCENTAGE BASED ON THE ORGANIZATION'S CURRENT POLICY IS APPLIED TO GROSS ESTABLISHED CHARGES BEFORE THE PATIENT IS BILLED. IF THEY DO NOT PAY THIS REMAINING AMOUNT AND DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THIS AMOUNT WOULD BE APPLIED TO BAD DEBT. PAYMENTS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT ARE CREDITED TO A BAD DEBT RECOVERY ACCOUNT. DISCOUNTS FROM INSURANCE OR SELF-PAY ACCOUNTS ARE WRITTEN OFF TO CONTRACTUAL ALLOWANCE ACCOUNTS. PART III, LINE 3: NOT APPLICABLE PART III, LINE 4: SEE PAGES 7 AND 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE. PART III, LINE 8: THE COSTS SHOWN FOR THE MEDICARE SHORTFALL ARE BASED ON TOTAL CHARGES OF ALL MEDICARE AND MEDICARE REPLACEMENT (PART C) PATIENTS. THE SHORTFALL IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES BY THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2, LESS PAYMENTS WE RECEIVED FOR THESE SERVICES.THE MEDICARE COST REPORT IS NOT AN APPROPRIATE SOURCE TO DETERMINE THE COSTS FOR THESE PATIENTS. MANY ITEMS, INCLUDING ALL OUTPATIENT SERVICES FOR PATIENTS WHO ARE COVERED BY A MEDICARE REPLACEMENT PLAN (PART C) AND MANY SERVICES SUCH AS LABORATORY, PHYSICAL AND OCCUPATIONAL THERAPY, AND OTHERS PAID ON A FEE FOR SERVICE BASIS, ARE NOT INCLUDED ON THE MEDICARE COST REPORT. IN ADDITION, HOSPICE, HOME HEALTH, AND DIALYSIS SERVICES, ALTHOUGH INCLUDED IN MEDICARE COST REPORT, DO NOT SHOW THE COSTS AND PAYMENTS ASSOCIATED WITH THESE SERVICES FOR MEDICARE BENEFICIARIES. FOR MERCY MEDICAL CENTER, 50% OF OUR GROSS CHARGES ARE GENERATED BY PATIENTS WITH MEDICARE AND MEDICARE REPLACEMENT (PART C) COVERAGE. ANOTHER 8% OF OUR GROSS CHARGES ARE GENERATED BY PATIENTS WITH MEDICAID COVERAGE. NEITHER GOVERNMENT PROGRAM HAS HISTORICALLY REIMBURSED ENOUGH TO COVER THE COSTS OF THE SERVICES PROVIDED TO THESE PATIENTS. IF WE DID NOT SERVE THESE PATIENT POPULATIONS, ANOTHER FACILITY WOULD HAVE TO PROVIDE THE SERVICE. OF THE 76,735 MEDICARE PATIENTS DISCHARGED IN THE 2015 FISCAL YEAR, 16.9% OF THEM HAD MEDICAID SECONDARY COVERAGE. THIS DOES NOT REFLECT ANY OF THE PATIENTS WHOSE PRIMARY COVERAGE IS MEDICARE REPLACEMENT (PART C) POLICY. BASED ON INFORMATION FROM THE AMERICAN HOSPITAL ASSOCIATION, APPROXIMATELY 20% OF MEDICARE BENEFICIARIES ARE DUALLY-ELIGIBLE AND ACCOUNT FOR APPROXIMATELY 59% OF A HOSPITAL'S MEDICARE BAD DEBT. PART III, LINE 9B: MERCY MEDICAL CENTER UNDERSTANDS PATIENTS MAY NOT HAVE THE ABILITY TO PAY FOR SERVICES NOR RECOGNIZE THE OPPORTUNITY THEY MAY HAVE TO RECEIVE FINANCIAL ASSISTANCE. TO AID IN THIS PROCESS, MERCY MEDICAL CENTER HAS IMPLEMENTED A PRESUMPTIVE CHARITY ELIGIBILITY PROGRAM (PCEP). PATIENTS WHO QUALIFY FOR THIS PROGRAM DO NOT COMPLETE PAPERWORK. MERCY MEDICAL CENTER UTILIZES AN OUTSIDE VENDOR TO ASSIST IN DETERMINING A PATIENT'S FINANCIAL RISK. MERCY MEDICAL CENTER USES BILLING AND COLLECTION RECOMMENDATIONS FROM THE IOWA HOSPITAL ASSOCIATION. THESE RECOMMENDATIONS INCLUDE: - MERCY MEDICAL CENTER WILL PROVIDE THE SAME INFORMATION CONCERNING SERVICES AND CHARGES TO ALL PATIENTS. - MERCY MEDICAL CENTER WILL NOT KNOWINGLY SEND A PATIENT'S BILL TO A COLLECTION AGENCY BEFORE INITIAL FINANCIAL ELIGIBILITY ASSISTANCE DETERMINATION HAS BEEN MADE. - MERCY MEDICAL CENTER WILL REVIEW THE PATIENT'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS APPROPRIATE BEFORE ANY COLLECTION AGENCY ASSIGNMENT. PART VI, LINE 2: MERCY MEDICAL CENTER UNDERSTANDS THE NEED FOR ONGOING ASSESSMENT AND USES DATA AND INFORMATION OBTAINED FROM HOSPITAL CHARITY CARE CASES, COMMUNITY FREE CLINICS, UNITED WAY AND COUNTY HEALTH RANKING REPORTS TO MODIFY CURRENT ACTIVITIES AND CREATE NEW PROGRAMS TO ADDRESS HEALTH NEEDS. ADDITIONALLY, MERCY MEDICAL CENTER RECEIVES REQUESTS FROM LOCAL NON-PROFIT ORGANIZATIONS FOR FINANCIAL AND IN-KIND SUPPORT TO ADDRESS COMMUNITY NEEDS FOR WHICH THEY PROVIDE PROGRAMS AND SERVICES. MERCY MEDICAL CENTER UTILIZES ALL OF THIS INFORMATION, IN ADDITION TO THE CHNA TO COMPLETE A COMMUNITY BENEFIT PLAN FOR THE HOSPITAL EACH YEAR. PART VI, LINE 3: MERCY MEDICAL CENTER IS COMMITTED TO PROVIDING ACCESS TO QUALITY HEALTHCARE WITH COMPASSION, DIGNITY AND RESPECT FOR ALL THOSE WE SERVE, PARTICULARLY THE POOR AND UNDERSERVED; CARING FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES; ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE AND COMMUNICATING INFORMATION ABOUT FINANCIAL ASSISTANCE IN A CLEAR AND CONSISTENT MANNER.MERCY MEDICAL CENTER INFORMS PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE IN THE FOLLOWING WAYS. MERCY MEDICAL CENTER'S BILLING AND COLLECTION POLICIES ALONG WITH THE LIST OF ALL FINANCIAL RESOURCES ARE PROVIDED IN BROCHURES, ARE INCLUDED IN PATIENT REGISTRATION PACKETS, INCLUDED IN HOSPITAL BILLING STATEMENTS AND POSTED IN KEY PUBLIC AREAS.PATIENTS ARE EDUCATED ABOUT THEIR RESPONSIBILITIES, THE POTENTIAL FINANCIAL OBLIGATION THEY MAY INCUR, THEIR OBLIGATIONS FOR COMPLETING ELIGIBILITY DOCUMENTATIONS AND THE HOSPITAL'S BILLING AND COLLECTION POLICIES. PATIENTS ARE REFERRED TO AND/OR PROVIDED WITH ASSISTANCE TO COMPLETE MEDICAID, STATE INSURANCE EXCHANGE PRODUCTS OR OTHER LOCAL FUNDING APPLICATIONS. MERCY MEDICAL CENTER PROVIDES THESE SERVICES UTILIZING INTERPRETER SERVICES IF NECESSARY. PART VI, LINE 4: MERCY MEDICAL CENTER SERVES A PRIMARY SERVICE AREA (PSA) OF LINN COUNTY AND A SECONDARY SERVICE AREA (SSA) OF EIGHT CONTIGUOUS COUNTIES (BENTON, BUCHANAN, CEDAR, DELAWARE, IOWA, JOHNSON, JONES AND TAMA). 17.8% OF MERCY'S INPATIENT DISCHARGES AND OUTPATIENT VISITS COME FROM THE SECONDARY SERVICE AREA.THE TOTAL POPULATION OF LINN COUNTY IN 2012 IS 215,295. THE TOTAL POPULATION OF BOTH PRIMARY AND SECONDARY SERVICE AREAS IS 488,735. THE PROJECTED 10-YEAR POPULATION GROWTH FOR THE PSA IS 1% AND THE SSA, 1%, ANNUALLY. - 13.4% OF PERSONS LIVING IN MERCY'S COMBINED SERVICE AREA ARE AGE 65 OR OLDER. - 93.3% ARE HIGH SCHOOL GRADUATES, WHILE 32.3% HOLD A BACHELOR'S DEGREE OR HIGHER. - THE MEDIAN HOUSEHOLD INCOME IS $53,722. - THE PERCENTAGE OF PEOPLE LIVING BELOW POVERTY LEVEL IS 11.7%, AS COMPARED TO 11.9% FOR ALL OF IOWA. - THE IOWAN UNINSURED RATE WAS 11% BEFORE THE EXPANDED ACA COVERAGE BECOME AVAILABLE. THE UNINSURED RATE IN LINN COUNTY WAS 9%. THE EIGHT CONTIGUOUS UNINSURED RATES RANGED FROM 8 TO 14%. WHILE PRIVATE AGENCIES HAVE RELEASED ESTIMATES BASED ON SURVEYS, CONCRETE NUMBERS REFLECTING THE IMPACT OF THE ACA ARE NOT CURRENTLY AVAILABLE. - THE AVERAGE PERSONS PER HOUSEHOLD ARE 2.42.DEMOGRAPHICS FOR THE COMBINED SERVICE AREA ARE AS FOLLOWS: - 49.7% MALE, 50.3% FEMALE - 91.5% CAUCASIAN - 3.5% AFRICAN AMERICAN - 0.5% NATIVE AMERICAN - 2.6% ASIAN/PACIFIC - 1.9% TWO OR MORE RACES - 3.3% HISPANICAS OF AUGUST 2015, THE UNEMPLOYMENT RATE FOR LINN COUNTY IS 4.9%. THE EIGHT CONTIGUOUS UNEMPLOYMENT RATES RANGE FROM 3.8 TO 5.2%. LINN COUNTY FEATURES A DIVERSE EMPLOYER BASE, INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE.UNITY POINT HEALTH - ST. LUKE'S HOSPITAL IS LOCATED IN LINN COUNTY AND SERVES THE SAME GEOGRAPHIC SERVICE AREA AS MERCY MEDICAL CENTER. ADDITIONALLY, THE UNIVERSITY OF IOWA AND MERCY HOSPITAL ARE LOCATED IN JOHNSON COUNTY AND VIRGINA GAY HOSPITAL IS LOCATED IN BENTON COUNTY. PART VI, LINE 5: MERCY MEDICAL CENTER CONTRIBUTES TO THE HEALTH OF THE COMMUNITIES IT SERVES IN A NUMBER OF WAYS. MERCY PROVIDES REPRESENTATION ON SEVERAL COMMUNITY BOARDS, COALITIONS AND COMMITTEES ADDRESSING HEALTH NEEDS. EXAMPLES INCLUDE: - THE ARC OF EAST CENTRAL IOWA BOARD - ALZHEIMER'S ASSOCIATION BOARD - BLUE ZONES PROJECT COMMITTEES - COMMUNITY HEALTH FREE CLINIC BOARD - GEMS OF HOPE BOARD - PARTNERSHIP FOR A DRUG-FREE COMMUNITY COALITIION - SEXUAL ASSAULT RESPONSE TEAM OF LINN COUNTYMERCY HONORED THE LIFETIME ACCOMPLISHMENTS OF SR. MARY LAWRENCE HALLAGAN WITH A NON-PROFIT COMMUNITY CENTER THAT OPENED SEPT. 6, 2011 TO PROVIDE SPACE AND DIRECT CLIENT SERVICES TO NONPROFIT ORGANIZATIONS AT 420 6TH STREET, CEDAR RAPIDS. TENANTS INCLUDE: GEMS OF HOPE; KIDS FIRST LAW CENTER; YOUNG PARENTS NETWORK AND BOYS & GIRLS CLUB; CATHOLIC CHARITIES; AND METRO CATHOLIC OUTREACH. THESE AGENCIES SHARE MERCY'S VISION TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. TOGETHER, WE MAKE A DIFFERENCE IN THE LIVES OF MANY. MERCY LEASES THE SPACE FOR $1 PER YEAR, PLUS THE COST OF MONTHLY UTILITIES.MERCY SUPPORTS THE CEDAR RAPIDS MEDICAL SELF-SUPPORTED MUNICIPAL IMPROVEMENT DISTRICT - THE MEDICAL QUARTER REGIONAL MEDICAL DISTRICT (MEDQUARTER) - TO ENHANCE OUR COMMUNITY'S NATIONALLY RECOGNIZED REPUTATION FOR HIGH-QUALITY, LOW-COST CARE WITH A CONCENTRATED AREA OF MEDICAL SERVICES THAT ARE EASILY ACCESSIBLE.MERCY MEDICAL CENTER PARTNERS WITH UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL TO SUPPORT A FAMILY PRACTICE RESIDENCY PROGRAM. A COMMUNITY-BASED PROGRAM UNDERSCORES A COMMITMENT TO THE CONCEPT OF THE PATIENT-CENTERED MEDICAL HOME. THE MEDICAL HOME IS A COMMUNITY HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER, ONE WHICH ALLOWS RESIDENTS TO CARE FOR THE NEEDS OF BOTH RURAL AND URBAN UNDERSERVED POPULATIONS. MERCY MEDICAL CENTER HAS COMMITTED A FULL-TIME EQUIVALENT TO THE ROLE OF MANAGER, COMMUNITY BENEFIT AND MISSION OUTREACH MINISTRIES. IN ADDITION, MERCY ADMINISTRATION BUDGETS 2 HOURS PER FULL-TIME EQUIVALENT THAT IS USED TO SUPPORT COMMUNITY BENEFIT VOLUNTEER ACTIVITIES AND PRECEPTING. IN THE PAST YEAR, MERCY MEDICAL CENTER EMPLOYEES ACCRUED 20,986 COMMUNITY BENEFIT HOURS, OR 7.62 HOURS PER FULL-TIME EMPLOYEE. THE HOSPITAL ALSO HAS A SUPPORTIVE COMMITTEE STRUCTURE THAT WORKS WITH THE MANAGER OF COMMUNITY BENEFIT AND MISSION OUTREACH MINISTRIES IN DEVELOPING THE COMMUNITY BENEFIT PLAN AND EVALUATING THE IMPACT OF PROGRAMS AND ACTIVITIES ESTABLISHED TO MEET GAPS IN CARE WITHIN THE PRIMARY AND SECONDARY SERVICE AREAS. THE COMMITTEES REFERENCED ABOVE ARE THE HOSPITAL COMMUNITY BENEFIT COMMITTEE, CONSISTING OF SEVERAL HOSPITAL AND CLINIC REPRESENTATIVES, AND THE HOSPITAL BOARD COMMITTEE FOR COMMUNITY BENEFIT. THE MANAGER OF COMMUNITY BENEFIT AND MISSION OUTREACH MINISTRIES REPORTS TO THE VICE PRESIDENT OF MISSION INTEGRATION, WHO REPORTS TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER (CEO).MERCY MEDICAL CENTER MAINTAINS AN OPEN MEDICAL STAFF, AS PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS.MERCY MEDICAL CENTER'S BOARD OF TRUSTEES IS MADE UP OF VOLUNTEERS, THE MAJORITY OF WHOM ARE RESIDENTS WITHIN THE PSA. THE BOARD CONSISTS OF 30 MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE GOVERNANCE STRUCTURE ENSURES THAT COMMUNITY INTERESTS ARE REPRESENTED IN DECISION-MAKING FOR THE ORGANIZATION. IN ADDITION, FIVE SEATS ARE ALLOCATED TO WOMEN RELIGIOUS WHO ENSURE THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION.MERCY MEDICAL CENTER UTILIZES OPERATING INCOME SURPLUSES TO FUND CAPITAL EXPENDITURES. THE PROPOSED CAPITAL ITEMS ARE REVIEWED BY STAFF, MEDICAL STAFF AND ADMINISTRATION TO ENSURE ITEMS WILL PROVIDE ONGOING HIGH QUALITY, LOW COST CARE TO PATIENTS AND ALIGN WITH THE STRATEGIC INITIATIVES OF THE FACILITY. ANY ECESS OPERATING FUNDS ARE RETAINED BY THE ORGANIZATION FOR FUTURE CAPITAL IMPROVEMENTS OR OPERATING FUNDS AS NEEDED. PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 MERCYCARE SERVICE CORPORATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 501(C)(3) 2500000 FOR USE IN CONTINUING OPERATIONS MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 510233180 501(C)(3) 851332 FOR USE IN CONTINUING OPERATIONS AMERICAN CANCER SOCIETY INC 4080 1ST AVENUE NE SUITE 101 CEDAR RAPIDS IA 52402 131788491 501(C)(3) 40000 GENERAL SUPPORT CEDAR RAPIDS SYMPHONY ORCHESTRA ASSOCIATION INC 119 3RD AVENUE SE CEDAR RAPIDS IA 52401 420772544 501(C)(3) 10000 GENERAL SUPPORT UNITED WAY OF EAST CENTRAL IOWA 317 7TH AVENUE SE STE 401 CEDAR RAPIDS IA 52401 420861239 501(C)(3) 14270 GENERAL SUPPORT AMERICAN DIABETES ASSOCIATION INC 317 7TH AVENUE SE SUITE 202B CEDAR RAPIDS IA 52401 131623888 501(C)(3) 10000 GENERAL SUPPORT DIVERSITY FOCUS 222 SECOND STREET SE CEDAR RAPIDS IA 52401 203420207 501(C)(3) 10000 GENERAL SUPPORT JUNIOR ACHIEVEMENT OF EASTERN IOWA 324 3RD STREET SE STE 200 CEDAR RAPIDS IA 52401 420919209 501(C)(3) 14000 GENERAL SUPPORT GEMS OF HOPE INC 420 6TH STREET SE CEDAR RAPIDS IA 52401 203155610 501(C)(3) 10000 GENERAL SUPPORT ALZHEIMER'S DISEASE & RELATED DISORDERS ASSOCIATION 317 7TH AVENUE SE STE 402 CEDAR RAPIDS IA 52401 133039601 501(C)(3) 7500 GENERAL SUPPORT AMERICAN HEART ASSOCIATION INC 1035 N CENTER POINT RD SUITE B HIAWATHA IA 52233 135613797 501(C)(3) 6500 GENERAL SUPPORT ZACH JOHNSON FOUNDATION PO BOX 2336 CEDAR RAPIDS IA 52406 272683100 501(C)(3) 6750 GENERAL SUPPORT FOUR OAKS FAMILY AND CHILDREN SERVICES 5400 KIRKWOOD BLVD SW CEDAR RAPIDS IA 52404 420998726 501(C)(3) 25000 GENERAL SUPPORT AFFORDABLE HOUSING NETWORK 3000 J STREET SW CEDAR RAPIDS IA 52404 208640691 501(C)(3) 25000 GENERAL SUPPORT GREATER CEDAR RAPIDS COMMUNITY 324 3RD STREET SE CEDAR RAPIDS IA 52401 426053860 501(C)(3) 10000 CONTRIBUTION TO THE ARC OF EAST CENTRAL IOWA ENDOWMENT FUND CATHERINE MCAULEY CENTER 866 4TH AVENUE SE CEDAR RAPIDS IA 52403 421342872 501(C)(3) 5000 GENERAL SUPPORT ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 501(C)(3) 20000 GENERAL SUPPORT IOWA HEALTHCARE COLLABORATIVE 100 EAST GRAND SUITE 360 DES MOINES IA 50309 203869767 501(C)(3) 20000 GENERAL SUPPORT IOWA WOMENS LEADERSHIP CONFERENCE 200 FIRST STREET SE SUITE 2100 CEDAR RAPIDS IA 52401 452932668 501(C)(3) 5000 GENERAL SUPPORT JUVENILE DIABETES FOUNDATION (JDRF) 1026 A AVENUE NE SUITE 113 PO BOX 3026 CEDAR RAPIDS IA 52402 231907729 501(C)(3) 10600 GENERAL SUPPORT LEUKEMIA & LYMPHOMA SOCIETY 2700 WESTOWN PKWY SUITE 260 DES MOINES IA 50266 135644916 501(C)(3) 5000 GENERAL SUPPORT MARCH OF DIMES (WALK AMERICA) 425 2ND STREET SE SUITE 605 CEDAR RAPIDS IA 52401 131846366 501(C)(3) 5000 GENERAL SUPPORT MIA-USA FUNDRAISING INC 2039 NORTH GEYER ROAD ST LOUIS MO 63131 461959457 501(C)(3) 5000 GENERAL SUPPORT NEWBO CITY MARKET 1100 3RD STREET SE CEDAR RAPIDS IA 52401 270600597 501(C)(3) 10000 GENERAL SUPPORT STATE UNIVERSITY OF IOWA FOUNDATION ONE WEST PARK RD PO BOX 4550 IOWA CITY IA 52244 420796760 501(C)(3) 6080 GENERAL SUPPORT WAYPOINT SERVICES FOR WOMEN CHILDREN AND FAMILIES 318 5TH STREET SE CEDAR RAPIDS IA 52401 420680307 501(C)(3) 5000 GENERAL SUPPORT 26 0 PART I, LINE 2: ALL CHECKS ARE ISSUED DIRECTLY TO THE ORGANIZATION TO BE USED AT THEIR DISCRETION. X 1 1 X X X X 1 1 0 0 0 0 0 0 0 TIMOTHY L CHARLES PRESIDENT & CEO 428136 0 0 0 46996 0 44410 0 15360 0 534902 0 0 0 TIMOTHY QUINN MD CHIEF OF CLINICAL OPERATIO 427362 0 0 0 3191 0 44370 0 19193 0 494116 0 0 0 NATHAN VANGENDEREN EXECUTIVE VP/CFO 195404 0 0 0 9477 0 13831 0 11867 0 230579 0 0 0 MARY BROBST CHIEF NURSING OFFICER 206588 0 0 0 8243 0 14646 0 15605 0 245082 0 0 0 JEFFREY CASH CHIEF INFORMATION OFFICER 207931 0 0 0 15890 0 27416 0 17232 0 268469 0 0 0 DOUG JONTZ VP - HUMAN RESOURCES 185120 0 0 0 9219 0 23936 0 15126 0 233401 0 0 0 DR MARK VALLIERE CHIEF MEDICAL OFFICER 343333 0 0 0 13929 0 38432 0 24118 0 419812 0 0 0 SURAJ BOPANNA PHYSICIAN 363551 0 0 0 15737 0 14300 0 16563 0 410151 0 0 0 CAM CAMPBELL PHYSICIAN 511646 0 136442 0 79837 0 14300 0 15237 0 757462 0 0 0 DAVID GLASSMAN PHYSICIAN 515017 0 96142 0 12854 0 14300 0 14915 0 653228 0 0 0 NICHOLAS HODGMAN PHYSICIAN 532940 0 185942 0 69781 0 14300 0 18214 0 821177 0 0 0 SUSAN SCHIMA PHYSICIAN 448718 0 61265 0 17529 0 14300 0 14054 0 555866 0 0 0 PHILIP PETERSON FORMER CHIEF FINANCIAL OFFICER 271348 0 0 0 55556 0 0 0 9826 0 336730 0 20253 0 MICHAEL TRACTA FORMER CHIEF OPERATING OFFICIER 0 0 0 0 200479 0 0 0 5574 0 206053 0 42641 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: LIMITED TRAVEL FOR COMPANIONS IS PAID BY THE ORGANIZATION ON BEHALF OF TOP MANAGEMENT. IN TAX YEAR 2014, TIMOTHY L. CHARLES (AN OFFICER AND TRUSTEE), TIMOTHY QUINN (OFFICER), AND NATHAN VANGENDEREN (OFFICER) REPORTED IN PART VII, RECEIVED THIS BENEFIT. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION AS REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II. PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE OR CHANGE OF CONTROL PAYMENT FROM THE ORGANIZATION IN 2014: MICHAEL TRACHTA - $157,422. THE DOLLAR AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2014: MARY BROBST - $14,646, JEFFREY CASH - $14,787, TIMOTHY L. CHARLES - $30,110, DOUG JONTZ - $13,089, DR. MARK VALLIERE - $24,132, AND NATHAN VANGENDEREN - $13,831. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY THE ORGANIZATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2014. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2014: PHILIP PETERSON - $20,253, AND MICHAEL TRACHTA - $42,641. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR DISTRIBUTION FROM THE PLAN IN 2014. A CITY OF CEDAR RAPIDS IOWA 426004336 150543AA4 2003-04-10 30000000 REIMBURSE HOSPITAL FOR COSTS OF ACQUIRING AND CONSTRUCTING FACILITIES 0 0 0 B CITY OF CEDAR RAPIDS IOWA 426004336 150543AB2 2005-11-17 58405000 ADVANCE REFUND OF 1999 BONDS 0 0 0 C IOWA FINANCE AUTHORITY 521699886 4624466EQ 2012-12-13 45604359 REIMBURSE HOSPITAL FOR CAPITAL 0 0 0 A 4100000 30000000 1288620 28711380 2003 0 0 1 1 B 13020000 58405000 1552500 56852500 2005 0 1 1 1 C 1435000 41195000 604359 40590641 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 UBS AG 29.000000000000 0 0 0 0 1 B 0 0 0 1 1 1 UBS AG 24.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 10/01/2008 ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2009 MERCY CARE MANAGEMENT INC SEE BELOW IN PART V 880060 MERCY CARE MANAGEMENT, INC. PAID MERCY MEDICAL CENTER RENT. 0 MERCY CARE MANAGEMENT INC SEE BELOW IN PART V 10000000 MERCY MEDICAL CENTER PURCHASED LAND AND BUILDINGS FROM MERCY CARE MANAGEMENT, INC. 0 FORM 990, SCHEDULE L, PART IV, COLUMN B EMMETT SCHERRMAN AND TIMOTHY L. CHARLES ARE OFFICERS AND JAN KAZIMOUR, BRUCE MCGRATH, BOB VERHILLE AND KYLE SKOGMAN ARE MEMBERS OF THE BOARD OF TRUSTEES OF MERCY MEDICAL CENTER AND ARE REPORTED ON THE FORM 990, PART VII. DURING THE TAX YEAR, ALL THE AFOREMENTIONED INDIVIDUALS WERE OFFICERS OR MEMBERS OF THE BOARD OF DIRECTORS OF MERCY CARE MANAGEMENT, INC. X 1 400 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY MEDICAL CENTER IS MERCYCARE SERVICE CORPORATION, AN IOWA NONPROFIT CORPORATION. THE SOLE MEMBER HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE POWER TO APPROVE THE FOLLOWING ACTIONS: 1. AMEND, REPEAL, OR RESTATE THE ARTICLES OF INCORPORATION; 2. ANY MATTER DIRECTLY RELATED TO THE RELIGIOUS PRINCIPLES AND MORAL PHILOSOPHY OF THE SISTERS OF MERCY; 3. ADOPT OR CHANGE THE PHILOSOPHY AND MISSION OF THE CORPORATION; 4. SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, AND MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER ENTITY; 5. DISSOLUTION OF THE CORPORATION; 6. ADOPTION OR AMENDMENT TO LONG-TERM STRATEGIC PLANS; 7. ADOPTION OR AMENDMENT TO ANNUAL CAPITAL OR OPERATING BUDGETS; AND 8. APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED WITH THE EXECUTIVE COMMITTEE (SUBCOMMITTEE OF THE BOARD OF TRUSTEES) PRIOR TO FILING THE FORM. THE COMMITTEE IS PROVIDED WITH GENERAL BACKGROUND INFORMATION REGARDING THE FORM 990, AND THE FORM ITSELF (INCLUDING ATTACHMENTS) IS REVIEWED. UPON REQUEST, THE TAX RETURN WILL BE AVAILABLE FOR REVIEW BY THE BOARD OF TRUSTEES. MEMBERS OF THE EXECUTIVE COMMITTEE AND MANAGEMENT ARE AVAILABLE TO ANSWER QUESTIONS FROM THE TRUSTEES ON THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES, AS WELL AS EACH EMPLOYEE TO DISCLOSE ANY INTEREST IN, OBLIGATION OR DUTY TO, OR ACTIVITY FOR ANY CONCERN IN WHICH A DIRECTOR, OFFICER, KEY EMPLOYEE, OR EMPLOYEE OR THEIR FAMILY MEMBER MAY BE INVOLVED THAT: MIGHT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR MIGHT HAVE THE APPEARANCE OF ADVERSELY AFFECTING THE DIRECTOR'S, OFFICER'S, KEY EMPLOYEE'S, OR EMPLOYEE'S JUDGMENT OR ACTIONS IN PERFORMING HIS/HER DUTIES TOWARDS MERCY. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES SHALL FILE AN INITIAL CONFLICT OF INTEREST REPORT UPON HIRE AND SHALL BE REQUIRED TO FILE AN UPDATED REPORT IMMEDIATELY IF ANY CHANGES OCCUR WHICH RESULT IN A CONFLICT OF INTEREST OR FINANCIAL INTEREST. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES (SUPERVISOR AND ABOVE), PHYSICIANS, AND ANY EMPLOYEE IN A POSITION TO INFLUENCE A PURCHASE DECISION SHALL RE-SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WITH ANY NECESSARY CHANGES, EACH YEAR AND IMMEDIATELY IF ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. ALL BOARD MEMBERS SHALL SUBMIT IN WRITING A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. THE STATEMENT SHALL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR AND AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT IS SET BY THE COMPENSATION COMMITTEE. THE COMMITTEE USES MERCER (US) INC. FOR THE REVIEW OF SALARIES AND COMPARES THEM TO COMPARABLE ENTITIES IN THE REGION. THIS PROCESS WAS LAST COMPLETED ON APRIL 15, 2015. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN ADDITIONAL MINIMUM LIABILITY FOR RETIREMENT BENEFITS -17,558,163. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 3,316,656. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -606,693. BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) -2,640,970. BUILDING FROM MERCY CARE MANAGEMENT -4,877,313. CONTRIBUTION NOT RECORDED FOR BOOK PURPOSES -52,230. CHANGE IN INTEREST IN NET ASSETS OF AUXILIARY AND GIFT SHOP -36,630. FORM 990, PART XI, LINE 2C THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION INC 701 10TH STREET SE CEDAR RAPIDS IA 52403 510233180 FUNDRAISING FOR MERCY MEDICAL CENTER IA 501(C)(3) LINE 11B, II MERCY MEDICAL CENTER 1 MERCYCARE SERVICE CORPORATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 HEALTHCARE OVERSIGHT IA 501(C)(3) LINE 11B, II N/A 0 MR ASSOCIATES LLP 1455 SHERMAN ROAD HIAWATHA IA 52233 421260463 MEDICAL IMAGING IA MERCY MEDICAL CENTER RELATED 2149168 778865 0 1 0.33330 UNIVERSITY OF IOWA AFFILIATED HEALTH PROVIDERS LC 200 HAWKINS DRIVE IOWA CITY IA 52242 421432272 ACCOUNTABLE CARE ORGANIZATION IA N/A EASTERN IOWA SLEEP CENTER 600 7TH STREET CEDAR RAPIDS IA 52401 260310416 SLEEP STUDIES IA RELATED 350735 1218237 0 1 0.33330 MERCY CARE MANAGEMENT INC PO BOX 786 CEDAR RAPIDS IA 52406 421198970 MEDICAL CLINICS IA N/A C 0 MERCY PHYSICIANS ASSOCIATES (SUB OF MERCY CARE MANAGEMENTINC) PO BOX 786 CEDAR RAPIDS IA 52406 421442443 MEDICAL SERVICES IA N/A C 0 MERCY PHYSICIAN SERVICES (SUB OF MERCY CARE MANAGEMENTINC) PO BOX 786 CEDAR RAPIDS IA 52406 421442442 SUPPORT SERVICES IA N/A C 0 1 1 1 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 MERCY CARE MANAGEMENT INC A 880060 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION A 1 FAIR MARKET VALUE MERCYCARE SERVICE CORPORATION B 2500000 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION B 851332 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION C 3348074 FAIR MARKET VALUE MERCYCARE SERVICE CORPORATION C 2076848 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION Q 577672 FAIR MARKET VALUE MERCY CARE MANAGEMENT INC H 10000000 FAIR MARKET VALUE MERCY CARE MANAGEMENT INC O 1755766 FAIR MARKET VALUE