MHIC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MHIC (EIN 42-0680391)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-06
- IRS object ID
- 201331269349300763
- Schema version
- 2011v1.5
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-06T11:05:43-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Ste 2800 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554021538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420680391 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Hospital Iowa City Iowa | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 3193390300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael G Heinrich | Name |
| Title | Executive VP of Finance & CFO | Title |
| Phone | 3193390300 | Phone |
| Date Signed | 2013-04-29 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kristina Rasmussen | Name |
| PTIN | P00143920 | PTIN |
| Phone | 6123974000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Michael G Heinrich | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 187795124 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mercyiowacity.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1873 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | To heal and comfort the sick and improve the health of the community in the spirit of Jesus Christ. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1326 | TotalNbrEmployees |
| Total Nbr Volunteers | 449 | TotalNbrVolunteers |
| Total Gross UBI | 3648646 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -584174 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 628872 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 577231 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 139782498 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 148788946 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7219828 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4442057 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2053325 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2136634 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 149684523 | TotalRevenuePriorYear |
| Total Revenue Current Year | 155944868 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 161366 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 158938 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 74776974 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 75245058 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 65664439 | OtherExpensePriorYear |
| Other Expenses Current Year | 69585066 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 140602779 | TotalExpensesPriorYear |
| Total Expenses Current Year | 144989062 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9081744 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 10955806 | RevenuesLessExpensesCY |
| Total Assets BOY | 269627417 | TotalAssetsBOY |
| Total Assets EOY | 286076441 | TotalAssetsEOY |
| Total Liabilities BOY | 122320945 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 163143135 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 147306472 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 122933306 | NetAssetsOrFundBalancesEOY |
| Mission Description | Mercy Iowa City ("Mercy") heals and comforts the sick and works to improve the health of the community in the spirit of Jesus Christ and the Catholic tradition of the Sisters of Mercy. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 101451572 | Expense |
| Revenue | 148922011 | Revenue |
| Description | Hospital Services. In keeping with our mission of healing and comforting the sick, providing hospital medical services is at the heart of what we do. These services are provided in inpatient and outpatient settings in situations that may be emergent, acute, or chronic. Services include a 24-hour emergency unit, intensive care, cardiovascular care and the services of a cardiac cath lab, maternity unit and newborn nursery, surgical services, cancer care, orthopedic care, telemetry monitored care, medical care, stroke care, behavioral health care, and skilled nursing. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 858728 | Expense |
| Revenue | 195679 | Revenue |
| Description | Education. The ongoing education of Mercy staff members is critical in the fast-changing field of health care and is necessary in many cases to meet regulation and certification. In addition to the efforts designed for staff members, Mercy provides a setting for many students who are considering or pursuing health care careers. For high school students, a health careers class is offered to give students insight into possible careers and options; it also prepares students for the certified nursing assistant exam. Mercy also works with students from Kirkwood Community College, and other local colleges, offering such options as a paid summer nursing internship program, a lab student rotation opportunity, and job shadow opportunity in anesthesiology. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2855782 | Expense |
| Grants | 158938 | Grants |
| Description | Community Benefit. Mercy's community benefits take many forms, beginning with traditional charity care of $.8 million, and the unpaid cost of Medicaid ($2 million). Other examples are varied; they include cash donations to community non-for-profits such as the Free Medical Clinic, free meeting space to valued community organizations, leadership time and skills that further the work of community non-for-profits, first aid booths provided at public events. These efforts are detailed in Mercy's community benefit report, prepared annually. As a trusted, longtime member of the community, Mercy plays an important role not only in furthering community health but the general community good. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 105166082 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 67 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1326 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jean Berge | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3193393238 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Robert Beckman MD Oct 11-June 12 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Mark Danielson Oct 11-June 12 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Geraldine Felton | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Scott Fisher | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Nyle Kauffman MD July 11-Oct 11 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| SR Sharon Kerrigan | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Tim Krumm | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Chuck McComas Oct 11-June 12 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Tom McLaughlin | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| SR Patricia Murphy | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Dick Oberman July 11-Oct 11 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Mark Phillips | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Cyndie Schmeiser | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Mary Westabrook July 11-Oct 11 | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| SR Margaret Wright | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Ronald R Reed | |||||||
| President & CEO | 40.00 | X | 551156 | 0 | 68149 | X | |
| Jean M Berge | |||||||
| Director, Fiscal Mgmt | 40.00 | 151685 | 0 | 43965 | X | ||
| Michael G Heinrich | |||||||
| Executive VP & CFO | 40.00 | 306601 | 0 | 56000 | X | ||
| Cindy Penney | |||||||
| VP Nursing | 40.00 | 173651 | 0 | 45160 | X | ||
| Andrew R Ashby MD | |||||||
| Physician | 40.00 | 504149 | 0 | 38674 | X | ||
| RJoe Ewing MD | |||||||
| Physician | 40.00 | 654066 | 0 | 40791 | X | ||
| Brian O'Meara MD | |||||||
| Physician | 40.00 | 654925 | 0 | 24439 | X | ||
| Thomas Shreves MD | |||||||
| Physician | 40.00 | 647346 | 0 | 45412 | X | ||
| Joseph Truszkowski MD | |||||||
| Physician | 40.00 | 509799 | 0 | 44009 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4153378 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 406599 | TotalOtherCompensation |
| Number Individuals GT100 K | 67 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Rohrbach Associates PC | |||||
| 325 E Washington | Iowa City | IA | 52244 | Engineering/Architecture | 1015935 |
| Cross Medical Laboratories | |||||
| 2406 Towncrest Drive | Iowa City | IA | 52244 | Laboratory Services | 368557 |
| Deloitte & Touche LLP | |||||
| 50 South 6th Street Suite 2800 | Minneapolis | MN | 55402 | Auditing Services | 159678 |
| Phelan Tucker Mullen Walker Tucker & Gel | |||||
| Box 2150 | Iowa City | IA | 52244 | Legal Services | 120848 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 568333 | RelatedOrganizations |
| Government Grants | 8898 | GovernmentGrants |
| Total Contributions | 577231 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Patient Serv. Revenue | 621400 | 87155647 | 87155647 | |
| Medicare/Medicaid | 621400 | 53208909 | 53208909 | |
| Lab Outreach | 621511 | 3648646 | 3648646 | |
| ASC Income | 900099 | 3108017 | 3108017 | |
| Program Relat. Revenue | 621400 | 833666 | 833666 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 834061 | TotalRevenueColumn |
| Related Or Exempt Function Income | 834061 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 148788946 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2245408 | TotalRevenueColumn |
| Exclusion | $2,245,408 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2172424 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1132042 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1040382 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1040382 | TotalRevenueColumn |
| Exclusion | $1,040,382 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 32792062 | Securities |
| Other | 122801 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 30688329 | Securities |
| Other | 29885 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2103733 | Securities |
| Other | 92916 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2196649 | TotalRevenueColumn |
| Exclusion | $2,196,649 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| Cafeteria Income | 722210 | 753841 | $753,841 | |
| Access | 621400 | 94343 | 94343 | |
| Miscellaneous revenue | 900099 | 39226 | 39226 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 208842 | TotalRevenueColumn |
| Related Or Exempt Function Income | 195175 | RelatedOrExemptFunctionIncome |
| Exclusion | $13,667 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1096252 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 155944868 | TotalRevenueColumn |
| Related Or Exempt Function Income | 145469044 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3648646 | UnrelatedBusinessRevenue |
| Exclusion | $6,249,947 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141270 | Total |
| Program Services | 141270 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17668 | Total |
| Program Services | 17668 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1277542 | Total |
| Program Services | 561677 | ProgramServices |
| Management And General | 715865 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56917160 | Total |
| Program Services | 43205337 | ProgramServices |
| Management And General | 13711823 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4809715 | Total |
| Program Services | 3566404 | ProgramServices |
| Management And General | 1243311 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8164868 | Total |
| Program Services | 6018664 | ProgramServices |
| Management And General | 2146204 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4075773 | Total |
| Program Services | 3057771 | ProgramServices |
| Management And General | 1018002 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188844 | Total |
| Management And General | 188844 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153336 | Total |
| Management And General | 153336 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30604 | Total |
| Management And General | 30604 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4640825 | Total |
| Program Services | 3551496 | ProgramServices |
| Management And General | 1089329 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 769910 | Total |
| Program Services | 6800 | ProgramServices |
| Management And General | 763110 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9678904 | Total |
| Program Services | 5017936 | ProgramServices |
| Management And General | 4660968 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3228331 | Total |
| Program Services | 443085 | ProgramServices |
| Management And General | 2785246 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2065644 | Total |
| Program Services | 56357 | ProgramServices |
| Management And General | 2009287 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 334499 | Total |
| Program Services | 217441 | ProgramServices |
| Management And General | 117058 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2756874 | Total |
| Program Services | 1874766 | ProgramServices |
| Management And General | 882108 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10946895 | Total |
| Program Services | 9453326 | ProgramServices |
| Management And General | 1493569 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3761822 | Total |
| Management And General | 3761822 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 15032887 | 15031370 | 1517 | 0 |
| Bad Debt Expense | 6870033 | 6870033 | 0 | 0 |
| Pharmacy Supplies | 3015690 | 3015690 | 0 | 0 |
| Food Expense | 1043297 | 1043297 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5066671 | Total |
| Program Services | 2015694 | ProgramServices |
| Management And General | 3050977 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144989062 | Total |
| Program Services | 105166082 | ProgramServices |
| Management And General | 39822980 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2831957 | BOY |
| EOY | 8409921 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2379090 | BOY |
| EOY | 1597588 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20402245 | BOY |
| EOY | 21282928 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54373 | BOY |
| EOY | 60992 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3969188 | BOY |
| EOY | 4062526 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1968027 | BOY |
| EOY | 2201942 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 232227222 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 148181315 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75209532 | BOY |
| EOY | 84045907 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139357794 | BOY |
| EOY | 134034675 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5800378 | BOY |
| EOY | 3446694 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17654833 | BOY |
| EOY | 26933268 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 269627417 | BOY |
| EOY | 286076441 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15358510 | BOY |
| EOY | 15383318 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62073856 | BOY |
| EOY | 81955827 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 304211 | BOY |
| EOY | 734523 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44584368 | BOY |
| EOY | 65069467 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122320945 | BOY |
| EOY | 163143135 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147306472 | BOY |
| EOY | 122933306 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147306472 | BOY |
| EOY | 122933306 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 269627417 | BOY |
| EOY | 286076441 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 10955806 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -35328972 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Belongs To Affiliated Group | X | OrgBelongsToAffiliatedGroup |
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 1 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $30,604 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 30604 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Mercy Hospital, Iowa City, Iowa is a member of the Iowa Hospital Association (IHA). A percentage of membership dues paid to IHA relate to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 12951892 | BeginningOfYearBalance |
| Contributions | 165736 | Contributions |
| Investment Earnings Or Losses | -117757 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 455752 | GrantsOrScholarships |
| End Of Year Balance | 12544119 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 10653690 | BeginningOfYearBalance |
| Contributions | 451005 | Contributions |
| Investment Earnings Or Losses | 2031685 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 184488 | GrantsOrScholarships |
| End Of Year Balance | 12951892 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9665745 | BeginningOfYearBalance |
| Contributions | 140749 | Contributions |
| Investment Earnings Or Losses | 1003105 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 155909 | GrantsOrScholarships |
| End Of Year Balance | 10653690 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 12302591 | BeginningOfYearBalance |
| Contributions | 36954 | Contributions |
| Investment Earnings Or Losses | -2231983 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 441817 | GrantsOrScholarships |
| End Of Year Balance | 9665745 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.81000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.19000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6379393 | OtherCostOrOtherBasis |
| Book Value | 6379393 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 118872579 | OtherCostOrOtherBasis |
| Depreciation | 74484017 | Depreciation |
| Book Value | 44388562 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 614410 | OtherCostOrOtherBasis |
| Depreciation | 561109 | Depreciation |
| Book Value | 53301 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 68048011 | OtherCostOrOtherBasis |
| Depreciation | 51930936 | Depreciation |
| Book Value | 16117075 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 38312829 | OtherCostOrOtherBasis |
| Depreciation | 21205253 | Depreciation |
| Book Value | 17107576 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 84045907 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Beneficial Interest-Foundation | 12960163 |
| Due From Affiliates | 2155895 |
| Cash Value Life Insurance | 368089 |
| Deferred Financing Cost Other Assets | 506432 |
| Non-Compete Agreement Value | 1190000 |
| 2011 Bond Fund | 9752689 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 26933268 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Pension Benefit Liability | $62,279,484 |
| Fair Value of Interst Rate SWAP | $2,789,983 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 65069467 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | All Restricted Endowed Funds are used for the benefit of Mercy Hospital Iowa City - capital equipment, employee grants, scholarships, etc. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | Mercy adopted the provisions of FIN No. 48 in fiscal 2008. As a result of the implementation of FIN No. 48, and as of June 30, 2012, Mercy recorded no liabilities for unrecognized tax benefits. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 806548 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 806548 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5741857 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3702475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2039382 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01480 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22283 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12431 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9852 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6570688 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3714906 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2855782 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02070 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 866413 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9047 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 857366 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00620 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 77787 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 20901 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 56886 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2008338 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1408201 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 600137 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 574426 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 574426 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00420 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3526964 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1438149 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2088815 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01510 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10097652 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5153055 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4944597 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03580 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 40737 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 40737 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 37032 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 37032 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 77769 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 77769 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,304,896 | BadDebtExpenseAmount |
| Amount Attributable To | 68642 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 38992202 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 55938516 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -16946314 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 Iowa City Ambulatory Surgery Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Outpatient Surgery Center | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.57500 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.42500 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Skilled Nursing and Lab Outreach | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Hospital Iowa City Iowa | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Home Health Care | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | Home Health & Private Duty Nursing | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: Amounts in the table were derived using a cost accounting system that addresses all patient segments. A cost to charge ratio derived from completing IRS worksheet 2 was used to determine the amounts in Part I, Line 7a, 7b, 7c, and 7g. | ||
| Part I, L7 Col(f): Bad debt expense of $6,870,033 was subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f). | ||
| Part II: Economic development:Mercy works with such groups as the Iowa City Area Chamber of Commerce and Iowa City Area Development Group to support the business community, welcome innovation to the area, and develop the workforce. Mercy's own growth benefits the community as well, particularly when Mercy's recruiting efforts attract new professionals to the area.Community support:Mercy has provided extensive support for many years to United Way of Johnson County. Mercy holds its own campaign for employees each autumn (typically raising more than $120,000) and provides much staff time and support to the local United Way organization. Environmental improvements:Mercy has been a good neighbor for its closest neighbors by maintaining its buildings and landscaping at a high level. Mercy also pursues extensive recycling (including newspapers, magazines, office paper, plastics, batteries, cooking oil, construction materials, and more) and programs that reduce energy consumption. Mercy regularly holds silent auctions open to employees to sell equipment that is no longer needed, rather than sending it into the trash stream. Mercy recently created a Sustainability Committee to further and standardize these efforts.Leadership development and training for community members:Mercy lends support to the Iowa City Area Chamber of Commerce annual Community Leadership Program. In this nine-month program, 24 members of the civic community receive an in-depth look at the workings of local government, public works, education system, health care, arts community, and more. This program gives participants a better understanding and appreciation of the entire community and develops fellowship among members from diverse backgrounds and settings.Coalition building:Mercy is involved in many ways with local citizens and groups that are working to afford all members of our community a good quality of life and to improve the overall quality of life. Mercy is a cosponsor of and provides leadership for the 20-year-old Johnson County Safe Kids Coalition, a grass-roots effort to reduce unintentional injuries to children from birth to age 14. Since its inception, the coalition has been active in promoting bike helmet use, bike safety, and safety education events. The coalition is particularly active in providing free car seat check clinics to parents.Community health improvement advocacy:Healthy Kids Community Care is a school-based clinic that provides health care to children who have no other access to it. Mercy made large cash donations over a period of five years to help launch this initiative and provided key leadership as the program developed. Mercy has also provided financial support to the Free Medical Clinic, which saw almost 2,300 unique patients in FY2012. Those who seek care of the Free Medical Clinic typically have no other access to health care services. Workforce development:Kirkwood Foundation, Workplace Learning Connection | ||
| Part III, Line 4: We do not currently have a footnote to our financial statements that describes bad debt expense. The amount on line 2 was derived from taking actual bad debt write-offs and applying the cost to charge ratio of .3355 to that amount. Mercy Hospital does not include bad debt amounts as part of community benefit.An estimate of bad debt attributable to patients eligible for charity care has been estimated to be $68,642. This estimate was derived by using the outstanding patient balance of accounts recommended for presumptive charity at cost that were reviewed and denied. The presumptive charity program was implemented on October 1, 2010. | ||
| Part III, Line 8: Mercy Hospital does not include Medicare shortfalls as part of it's community benefit. Total revenue was determined using charges per the CMS Provider Statistical Reimbursement System reports for Fee Reimbursed Services for the fiscal year ended 6/30/12. Costs calculated using the Cost to Charge Ratio for the appropriate services from the submitted Medicare Cost Report form 2552-96 for the fiscal year ended 6/30/12. | ||
| Part III, Line 9b: Mercy Hospital has two policies related to debt collection. The Financial Assistance Policy provides guidelines for forgiving all or part of a patient's financial responsibility for healthcare services received at Mercy Hospital. Patients may be given a financial assistance application at the time of service, be offered financial assistance during the normal collection process or learn of the option on the Hospital website. All patients with no insurance are offered financial assistance via billing statements & follow up telephone calls. Any patient that is known to qualify for financial assistance is provided assistance. The payment plan policy enables those who qualify for partial financial assistance to establish payment plans of the remaining balance of their bill. | ||
| Part V, Section B, Line 13g: A copy of the Financial Assistance Policy Application is available on the Mercy Hospital website. The Financial Assistance Policy is available upon request. If a patient does not have insurance, the invoice states that financial assistance is available. | Mercy Hospital, Iowa City, Iowa | |
| Part V, Section B, Line 19d: Mercy Hospital determines on an individual basis based on the patient's ability to pay for the maximum amounts that can be charged to FAP-Eligible individuals for emergency and other medically necessary care. Patients, who fall under the 200% Federal Poverty Guidelines, are eligible for free care. Mercy Hospital uses the following factors to determine the amount to charge FAP-eligible patients for individuals who earn more than 200% of the FPG: Income level, Asset level, medical indigency, insurance status, uninsured discount, Medicaid/Medicare. In addition to the financial assistance policy, all uninsured patients are eligible for discounts ranging from 30-10% based on timeliness of payment. | Mercy Hospital, Iowa City, Iowa | |
| Part VI, Line 2: Historically, community health needs assessment is conducted every 5-7 years. The most recent assessment was conducted in Fall 2012. The organization engaged Professional Research Consultants to conduct the assessment. The community health survey is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in the communities the organization serves. The survey instrument used for the assessment is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to national health promotion and disease prevention objectives and other recognized health issues. The results of the survey will be used to improve health status, elevate overall quality of life, reduce health disparities, and increase accessibility to services for community residents. | ||
| Part VI, Line 3: Evaluation for Medicaid, disability, and other types of coverage is provided for uninsured patients for inpatient stays as well as high dollar outpatient services. The evaluation is conducted during the patient stay or by a phone call to the patient's home.- Financial assistance is available for patients who meet Mercy assistance guidelines. Assistance may be available for uninsured, under-insured and catastrophic circumstances. Assistance may take the form of forgiving all or part of a bill and/or providing an extended payment option.- Meeting financial assistance guidelines involves evaluating family income and assets, using other sources of funds such as insurance or government programs, and other family or social support networks.- Financial assistance applications are available at the points of registration. Information and applications are also available at Mercy-affiliated clinics.- The first statement sent to patients who do not have insurance explains that financial assistance is available and provides information about further inquiry. Subsequent statements also contain information about who to contact for financial assistance. Financial assistance is offered to all patients with no insurance on the first telephone contact.- During the collection process for insured patients, if the patient expresses concern about payment, he/she is offered financial assistance and/or payment plan options. Full or partial assistance is available. If partial assistance is received, the balance may be set up on a payment plan if needed.- The State of Iowa offers a statewide health insurance plan for uninsured children called hawk-i. Information about hawk-i is provided at registration points. | ||
| Part VI, Line 4: Mercy Hospital is located in the community of Iowa City, Iowa, in Johnson County in the east central part of the state. The county's population in 2011 was approximately 133,000. From 2000 to 2008 Johnson County experienced strong population growth of 15.4 percent, compared to 2.6 percent for the entire state. Johnson County's population is projected to increase by another 9.5 percent by the year 2014.Mercy Hospital serves 10 counties in southeast Iowa, with the primary service area being Johnson County. The secondary service area includes Cedar, Iowa, Muscatine and Washington counties. The tertiary service area includes Henry, Jefferson, Keokuk, Lee and Louisa counties. The population of the service area is approximately 325,168.Iowa City is home to the University of Iowa, which has an enrollment of 31,498 for the 2012-2013 academic year. Johnson County is well-educated; of individuals 25 and older, 95.3 percent are high school graduates and 50.6 percent hold a bachelor's degree or higher.The University of Iowa also provides the foundation for an economy that has particular strengths in education, health care, services, technology, agribusiness, and manufacturing.According to the U.S. Census Bureau, 17.8 percent of the Johnson County population lived below the poverty line between 2007 and 2011, compared to 11.9 percent for the entire state. | ||
| Part VI, Line 5: Mercy Iowa City is a faith-based institution that provides services based on the ethical and religious directives of the Catholic Church. An important part of Mercy's mission is to improve the health of the community. Mercy does so by: Ensuring that the medical staff is open to all qualified physicians; ensuring that the hospital is accredited and in good standing with The Joint Commission; ensuring that the board of directors is comprised of diverse, independent individuals, not employees of the hospital, representing the community and also providing necessary expertise; establishing and carrying out a conflict of interest policy; providing a site for clinical experience for a variety of health care professionals; providing charity care and financial assistance with medical bills as needed to community members; participating in such programs as Medicare, Medicaid, and hawk-i, an insurance program for needy Iowa children; absorbing unreimbursed costs for such government programs; ensuring that account collections are carried out in compliance with state and federal guidelines; providing emergency room services and working with local and state officials in community prepardness issues; treating emergency patients according to EMTALA guidelines and serving all patients regardless of their ability to pay; investing surplus funds in services, technology, and personnel that will further the benefit of the community. | ||
| IA | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Community Foundation of Johnson County | |||||||
| 325 East Washington Street | Iowa City | IA | 52240 | 421508117 | 501(c)(3) | 100000 | Healthy Kids Fund |
| Iowa City Free Medical Clinic | |||||||
| 2440 Towncrest Drive | Iowa City | IA | 503402902 | 420960955 | 501(c)(3) | 15500 | General Support |
| American Heart Association-Midwest Affiliate | |||||||
| PO Box 4002902 | Des Moines | IA | 503402902 | 135613797 | 501(c)(3) | 12000 | Iowa City Events Sponsor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Temporary Assistance Program | TypeOfGrant |
| Number Of Recipients | 29 | NumberOfRecipients |
| Amount Of Cash Grant | 17668 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: All organizations Mercy provides assistance to are local organizations. Therefore, Mercy is in frequent contact with the organizations and is generally aware of their use of Mercy's assistance. However, there is no formal mechanism in place to track specific uses of the assistance. Mercy Hospital offers a Temporary Assistance Program (TAP) for emergency financial needs that employees may have. This confidential program offers crisis assistance and health benefit assistance. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ronald R Reed | |||||||||||||
| 411388 | 0 | 0 | 0 | 139768 | 0 | 29220 | 0 | 38929 | 0 | 619305 | 0 | 116855 | 0 |
| Jean M Berge | |||||||||||||
| 147005 | 0 | 0 | 0 | 4680 | 0 | 23989 | 0 | 19976 | 0 | 195650 | 0 | 0 | 0 |
| Michael G Heinrich | |||||||||||||
| 274159 | 0 | 0 | 0 | 32442 | 0 | 14342 | 0 | 41658 | 0 | 362601 | 0 | 31302 | 0 |
| Cindy Penney | |||||||||||||
| 163618 | 0 | 0 | 0 | 10033 | 0 | 11802 | 0 | 33358 | 0 | 218811 | 0 | 7888 | 0 |
| Andrew R Ashby MD | |||||||||||||
| 359688 | 0 | 144096 | 0 | 365 | 0 | 0 | 0 | 38674 | 0 | 542823 | 0 | 0 | 0 |
| RJoe Ewing MD | |||||||||||||
| 646825 | 0 | 6344 | 0 | 897 | 0 | 0 | 0 | 40791 | 0 | 694857 | 0 | 0 | 0 |
| Brian O'Meara MD | |||||||||||||
| 648153 | 0 | 6242 | 0 | 530 | 0 | 0 | 0 | 24439 | 0 | 679364 | 0 | 0 | 0 |
| Thomas Shreves MD | |||||||||||||
| 640399 | 0 | 6050 | 0 | 897 | 0 | 0 | 0 | 45412 | 0 | 692758 | 0 | 0 | 0 |
| Joseph Truszkowski MD | |||||||||||||
| 503585 | 0 | 5786 | 0 | 428 | 0 | 0 | 0 | 44009 | 0 | 553808 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Health club membership dues were paid for Mercy's CEO, Ronald Reed in the amount of $898.80 and were included as taxable income on his W-2. |
| Part I, Line 4b | Mercy established an IRC Section 457(f) plan as a way of retaining executives, officers and select groups of highly compensated employees with supplemental retirement benefits. The following individuals participated in and received payments from the plan. - Michael Heinrich - $31,302 - Ronald Reed - $116,855 - Cindy Penney - $7,888 |
| Part I, Line 7 | Non-fixed payments were provided to physicians who met stated criteria that included meeting certain RVU (Relative Value Unit) productivity levels, specified CMS/JCAHO performance core indicators and certain patient satisfaction and/or nursing satisfaction survey scores. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| City of Hills Iowa | |||||||
| 420920947 | 431669AA8 | 2008-04-29 | 39235000 | Refund Bonds issued 10/19/2005 | 0 | 0 | 0 |
| City of Hills Iowa | |||||||
| 420920947 | 431669AW0 | 2011-11-30 | 44742571 | Build and Equip Facility; Refund Bonds issued 7/16/1998 | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Other Spent ProceedsOtherSpentProceeds | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|
| 1660000 | 39235000 | 278380 | 96759 | 38859861 | 1 | 0 | 1 | 1 | ||
| 44743448 | 589874 | 24151438 | 1 | 0 | 0 | 1 | 10249535 | 9752601 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs | Engage Bond Counsel ContractsEngageBondCounselContracts |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 | |
| 0 | 0 | 1 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 1 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Schedule K, Part II, Line 3: | Differences between the issue price (Part I) and total proceeds (Part II, line 3) are due to investment earnings. |
| Schedule K, Part II, Line 4: | The amounts shown here consists solely of debt service fund deposits. |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| Michael G Heinrich | ||||||
| Split Dollar Life Insurance Policy | X | $18,524 | 18524 | 0 | 0 | 0 |
| Ronald R Reed | ||||||
| Split Dollar Life Insurance Policy | X | $42,468 | 42468 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 60992 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Sister Sharon Kerrigan, board member; Sister Patricia Murphy, board member; and Sister Margaret Wright, board member are all members of the Sisters of Mercy of the Americas West Midwest Community. | |
| Form 990, Part VI, Section A, line 6 | Mercy's sole member is the Sisters of Mercy of the Americas West Midwest Community, Inc. | |
| Form 990, Part VI, Section A, line 7b | Mercy's sole member, Sisters of Mercy of the Americas West Midwest Community, Inc., maintains a number of "reserved powers" including but not limited to approval of annual budgets, approval of amendments to the articles of incorporation and bylaws, approval of real property transactions and approval of long term borrowing. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared and reviewed by Mercy Hospital management and is also reviewed by Deloitte Tax LLP. In addition, a board resolution was established that provides that each board member be (i) provided a copy of the Form 990 as it is intended to be filed, and (ii) given a reasonable opportunity before filing to provide to the Audit Committee any comments, corrections, concerns or other input on the proposed Form. The Audit Committee's review process shall be intended to reasonably verify that the Form 990 has been fully and accurately completed, including but not limited to, all inquiries therein relating to corporate governance. After completing its review, the Audit Committee, on the Board's behalf, shall have the authority to authorize the filing of the annual Form 990. | |
| Form 990, Part VI, Section B, line 12c | A conflict of interest statement is signed at the beginning of Board members term and on an annual basis there after. Any abstention from a vote is recorded in Board minutes. After the fiscal year end a "look back" questionnaire is distributed to all Board members to disclose any conflicts of interest that may have taken place in the previous year. Form 990, Part VI, Section B, Line 13: Per IRS guidance, because the board had not formally adopted the whistleblower policy as of 6/30/12, the organization has answered "No" to this question. Mercy has an Administrative team "A Team" which is made up of Vice Presidents and the CEO that has been delegated by the board of directors to manage and approve policies. The A Team has approved the whistleblowers policy. | |
| Form 990, Part VI, Section B, line 15 | Compensation for all executives and other key employees is determined based on national or regional market data for comparable positions at comparatively sized hospitals. The Executive Committee of the Board of Directors uses this market-based information to set the President and CEO's compensation. In turn, the CEO uses the same information to set compensation for officers and key employees, which is also approved by the board. | |
| Form 990, Part VI, Section C, line 19 | An annual statement of "Financial Highlights" is published in Mercy's annual report. It provides annual Funds Available and Funds Applied in the form of percentages of Mercy's total budget. The annual report is produced in print form and appears on Mercy's Website, www.mercyiowacity.org, as a PDF. Mercy's governing documents and conflict of interest policy are not available to the public. | |
| Form 990, Part VII: | The following individuals held positions at both Mercy Hospital and the Mercy Hospital, Iowa City, Iowa Self Insurance Plan and Trust. The hours listed on Part VII are the average hours per week these individuals devoted to the Hospital during the year. In addition, these individuals also devoted the following average hours per week to the Trust. - Ronald R. Reed - 1.0 hour - Michael Heinrich - 1.0 hour - Mark Phillips - 1.0 hour - Tim Krumm - 1.0 hour The following individuals held positions at both Mercy Hospital and Mercy Foundation. The hours listed on Part VII are the average hours per week these individuals devoted to the Hospital during the year. In addition, these individuals also devoted the following average hours per week to Mercy Foundation. - Ronald R. Reed - 2.0 hours - Michael Heinrich - 2.0 hours - Jean Berge - 1.0 hour - Scott Fisher - 1.0 hour - Robert Beckman - 1.0 hour - Mark Danielson - 1.0 hour | |
| Form 990, Part XI, line 5: | Net unrealized losses on investments: -3,460,572. Change in Unrecognized Pension Actuarial Loss -22,294,780. Change in Beneficial Interest in Foundation -394,677. Transfer to Mercy Hospital Self Insurance Plan & Trust -3,500,000. Change in Beneficial Interest in Services -4,741,795. Loss on Extinguishment of Debt -1,002,866. Other adjustment 65,718. Total to Form 990, Part XI, Line 5: -35,328,972. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mercy Foundation | |||||||||||
| 500 East Market Street | Iowa City | IA | 52245 | 237040506 | Foundation/Fundraising | IA | 501(c)(3) | 11-I | Mercy Hospital | 1 | |
| Mercy Hospital Iowa City Iowa Self Insurance Plan & Trust | |||||||||||
| 500 East Market Street | Iowa City | IA | 52245 | 426591803 | Self Insurance | IA | 501(c)(3) | 11-I | Mercy Hospital | 1 | |
| Sisters of Mercy of the Americas West Midwest Community Inc | |||||||||||
| 7262 Mercy Road | Omaha | NE | 68124 | 262400800 | Religious Order | NE | 501(c)(3) | 0 | N/A | ||
| Mercy Hospital Guild | |||||||||||
| 500 East Market Street | Iowa City | IA | 52245 | 426099912 | Fundraising | IA | 501(c)(3) | 11-III-FI | 0 | N/A | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cancer Care of Iowa City LLC | |||||||||||||
| 613 East Bloomington Suite 100 | Iowa City | IA | 52245 | 421460774 | Oncology Services | IA | Mercy Hospital | Related | 160243 | 960752 | 0 | 0 | 0.58950 |
| Iowa City Ambulatory Surgical Center LLC | |||||||||||||
| 2963 Northgate Drive | Iowa City | IA | 52245 | 208503424 | Outpatient Surgery | IA | Mercy Hospital | Related | 3619133 | 6201371 | 0 | 1 | 0.57500 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Services Iowa City Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 East Market Street | AddressLine1 |
| City | Iowa City | City |
| State | IA | State |
| ZIP Code | 52245 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421241044 | EIN |
| Primary Activity | Medical Clinic Services | PrimaryActivity |
| Legal Domicile State | IA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -4707223 | ShareOfTotalIncome |
| Share Of EOY Assets | 7966521 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Mercy Services Iowa City | ||
| A | 955191 | Cost |
| Cancer Care of Iowa City | ||
| A | 124472 | Cost |
| Mercy Foundation | ||
| C | 568333 | Cost |
| Mercy Hospital Self Insurance Plan & Trust | ||
| B | 3500000 | Cost |
| Mercy Services Iowa City | ||
| P | 4290106 | Cost |
| Cancer Care of Iowa City | ||
| P | 1334544 | Cost |
| Mercy Foundation | ||
| P | 229799 | Cost |
| Mercy Services Iowa City | ||
| B | 4000000 | Cost |