2019-05-10T11:52:07-05:00 2018-06-30 990 2017-07-01 421478417 MERCY HEALTH NETWORK INC MERC 5153589200 1449 NW 128TH STREET BLDG 5 NO 200 CLIVE IA 50325 ROBERT RITZ CEO 5153589200 2019-05-10 170.232.227.252 2019-05-10 11:52:02 ED P 6410079965079D3074AAD5C60F569B728853E432 E9C924457B5D275461852EC86B70A375E5271692 2017 2019-02-21 02:37:17Z X MERCYONE ROBERT RITZ 1449 NW 128TH STREET BLDG 5 NO 200 CLIVE IA 50325 25435719 0 X WWW.MERCYONE.ORG X 1998 DE TO PROVIDE HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT 6 0 0 0 0 0 0 0 18422351 25295039 93230 140680 0 0 18515581 25435719 170300 87849 0 0 2890712 5370123 0 0 0 15847123 20144772 18908135 25602744 -392554 -167025 10415445 13638384 1911598 5134538 8503847 8503846 X MERCYONE SERVES WITH FIDELITY TO THE GOSPEL AS A COMPASSIONATE, HEALING MINISTRY OF JESUS CHRIST TO TRANSFORM THE HEALTH OF OUR COMMUNITIES. 0 0 21856397 87849 25295039 MERCY HEALTH NETWORK (MHN) IS AN INTEGRATED SYSTEM OF MEMBER HOSPITALS AND OTHER HEALTH AND PATIENT CARE FACILITIES-UNITED INTO ONE OPERATING ORGANIZATION TO IMPROVE THE DELIVERY OF HEALTH CARE SERVICES TO THE PEOPLE OF IOWA AND SURROUNDING COMMUNITIES. MHN IS SPONSORED BY CATHOLIC HEALTH INITIATIVES (CHI) AND TRINITY HEALTH CORPORATION (THC). MHN PROVIDES SIGNIFICANT ADMINISTRATIVE, MANAGEMENT, GOVERNANCE AND OVERSIGHT RESPONSIBILITIES FOR THE OVERALL ACTIVITIES AND OPERATIONS OF MANY ACUTE CARE HOSPITALS, AMBULATORY CARE FACILITIES, HOME CARE AND HOSPICE PROGRAMS PRESENTLY OWNED AND OPERATED BY CHI OR THC.THE MHN SYSTEM FUNCTIONS AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM (IN THE BROAD SENSE) BY ESTABLISHING A SINGLE SYSTEM THAT PROVIDES A CONTINUUM OF HEALTH CARE SERVICES PREVIOUSLY PROVIDED THROUGH SEPARATE PROVIDERS. THROUGH THIS SINGLE SYSTEM, THE RESPECTIVE MISSIONS OF CHI AND THC ARE UNIFIED AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY MEET THE HEALTH CARE NEEDS OF THE COMMUNITY SERVED BY THE MHN SYSTEM ARE ENHANCED.PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: WWW.MERCYONE.ORG 21856397 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 20 0 1 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 1 1 X KIMBERLY SAXTON DIR FINANCE & PAYROLL 7343430844 20555 VICTOR PARKWAY LIVONIA MI 481527018 DEAN SWINDLE DIR; CHAIR AS OF 3/18; CHI PRES/CFO 1.00 59.00 X X 0 3938227 42763 SALLY JEFFCOAT DIR;CHAIR THR 3/18; TRINITY HLTH EVP 1.00 54.00 X X 0 1517657 43445 CYNTHIA CLEMENCE DIRECTOR; TRINITY HEALTH SVP 1.00 54.00 X 0 913132 48428 MITCH MELFI DIRECTOR; CHI EVP 1.00 54.00 X 0 1717244 42107 LINDA ROSS DIRECTOR; TRINITY HEALTH SVP 1.00 49.00 X 0 690128 157871 PATRICIA WEBB DIR; CATHOLIC HEALTH INITIATIVES EVP 1.00 54.00 X 0 1852355 34081 ROBERT RITZ PRESIDENT AND CEO 58.00 2.00 X 0 1147213 134316 MARCIA SMITH SECRETARY; ASSOCIATE COUNSEL 48.00 2.00 X 0 365778 40617 MICHAEL WEGNER SVP OPS/CFO AT 1/18; CHI-IA SVP 55.00 0.00 X 0 620188 36549 STEVEN KUKLA INTERIM CFO THROUGH 2/18 55.00 0.00 X 0 545530 30861 KENT CARR MD PRESIDENT, PHYSICIAN ENTERPRISE 50.00 0.00 X 0 606876 35290 BARBARA GESSEL CHRO THROUGH 4/18 50.00 0.00 X 0 434110 32165 JOSEPH LEVALLEY VP PLANNING; CHI SVP 50.00 0.00 X 0 427144 39388 MIKE TRACHTA VP, NETWORK AFFILIATES 50.00 0.00 X 0 391796 36522 KEVIN ELSBERRY INTERIM HR OFCR AT 10/17; CHI-IA VP 25.00 25.00 X 0 341371 34189 DAVID VELLINGA FORMER OFFICER; HOSPITAL LIAISON 45.00 0.00 X 0 2432337 16734 MICHAEL ROWAN FORMER OFFICER 0.00 0.00 X 0 1388245 8780 RICHARD O'CONNELL FORMER OFFICER 0.00 0.00 X 0 880863 16625 0 20210194 830731 0 1 1 0 HURON CONSULTING SERVICES LLC 3005 MOMENTUM PLACE CHICAGO IL 60689 CONSULTING SERVICES 851884 WITT KIEFFER INC 2015 SPRING ROAD STE 510 OAK BROOK IL 60523 RECRUITING SERVICES 353420 INSIGHT HEALTH PARTNERS LLC 830 WEST ROUTE 22 STE 224 LAKE ZURICH IL 60047 CONSULTING SERVICES 330995 MONIGLE ASSOCIATES INC 150 ADAMS ST DENVER CO 80206 ADVERTISING SERVICES 229603 HEALTH MARKET SOLUTIONS 1932 VINSETTA BOULEVARD ROYAL OAK MI 48073 CONSULTING SERVICES 225006 9 MANAGEMENT REVENUE 541610 25295039 25295039 25295039 27326 27326 113354 0 113354 113354 113354 25435719 25295039 0 140680 X 87849 87849 2921052 2921052 2449071 2449071 664167 664167 109000 109000 3209883 3209883 52253 125 52128 64948 64948 92418 92418 178857 178857 26552 26552 11467 11467 SHARED SERVICES EXPENSE 9938296 9938296 CONTRACT LABOR 5769144 5769144 SUBSCRIPTIONS AND DUES 27787 27787 25602744 21856397 3746347 0 2314464 4925881 25000 2361314 26552 0 2334762 2293137 436826 2203210 387374 3579634 5553541 10415445 13638384 545155 3039969 1366443 2094569 1911598 5134538 X 8503847 8503846 8503847 8503846 10415445 13638384 -167025 167024 0 X 0 0 0 X X 2 MERCY HEALTH SERVICES - IOWA 311373080 3 1 0 0 CATHOLIC HEALTH INITIATIVES - IOWA 420680448 3 1 0 0 2 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 PART 1, LINE 12G: MERCY HEALTH NETWORK PROVIDES HEALTH CARE DELIVERY SYSTEM SERVICES TO ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION A, LINE 2: CATHOLIC HEALTH INITIATIVES - IOWA DOES NOT HAVE AN IRS DETERMINATION OF STATUS UNDER SECTION 509(A)(1); IT HAS BEEN RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) UNDER GROUP EXEMPTION NO. 0928 AND IS LISTED IN THE OFFICIAL CATHOLIC DIRECTORY AS A HOSPITAL. CATHOLIC HEALTH INITIATIVES - IOWA IS A PUBLIC CHARITY AS DESCRIBED IN SECTION 509(A)(1) BECAUSE IT IS A HOSPITAL AS DESCRIBED UNDER SECTION 170(B)(1)(A)(III). PART IV, SECTION A, LINE 6: MERCY HEALTH NETWORK PROVIDED MANAGEMENT AND OTHER SERVICES TO RELATED ORGANIZATIONS WHO SHARE THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATIONS. MERCY HEALTH NETWORK ALSO PROVIDED GRANTS TO UNRELATED CHARITIES THAT CARRY OUT THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION C, LINE 1: THE BOARD OF MERCY HEALTH NETWORK IS APPOINTED BY THE SAME BODIES THAT APPOINT THE BOARDS OF MERCY HEALTH NETWORK'S SUPPORTED ORGANIZATIONS. MERCY HEALTH SERVICES - IOWA IS CONTROLLED BY TRINITY HEALTH CORPORATION AND CATHOLIC HEALTH INITIATIVES - IOWA IS CONTROLLED BY CATHOLIC HEALTH INITIATIVES. TRINITY HEALTH CORPORATION AND CATHOLIC HEALTH INITIATIVES EACH HAVE THE RIGHT TO APPOINT ONE-HALF OF THE BOARD OF DIRECTORS OF MERCY HEALTH NETWORK. TRINITY HEALTH CORPORATION AND CATHOLIC HEALTH INITIATIVES HAVE THE POWER TO APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, SUCH AS A MERGER, DISSOLUTION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. 0 0 0 0 0 0 1 109000 0 1 111981 220981 0 PART II-B, LINE 1: MERCY HEALTH NETWORK HAS ENGAGED ONE OR MORE LOBBYING FIRMS TO PROVIDE GOVERNMENTAL RELATIONS FOR MERCY HEALTH NETWORK FOR STATE LEGISLATIVE AND REGULATORY ISSUES. MERCY HEALTH NETWORK ALSO EMPLOYS A FULL TIME ADVOCACY DIRECTOR WHO WORKS WITH THE IOWA LEGISLATURE AND THE IOWA CONGRESSIONAL DELEGATION ON PUBLIC POLICY ISSUES THAT IMPACT MERCY HEALTH NETWORK AND THEIR AFFILIATES. 1163810 14548 1149262 441000 12004 428996 756504 756504 2334762 MISCELLANEOUS RECEIVABLES 1580123 INVESTMENT IN UNCONSOL. AFFILIATES 2500000 RELATED PARTY RECEIVABLES 1473418 5553541 RELATED PARTY PAYABLES 2094569 2094569 1 IOWA ACADEMY OF FAMILY PHYSICIANS FOUNDATION 100 EAST GRAND AVE STE 170 DES MOINES IA 50309 421300642 501(C)(3) 70000 RURAL PRIMARY CARE LOAN REPAYMENT UNIVERSITY OF IOWA FOUNDATION PO BOX 4550 IOWA CITY IA 52244 420796760 501(C)(3) 7500 100 GREAT IOWA NURSES PROGRAM 2 0 PART I, LINE 2: DONATIONS MADE BY MERCY HEALTH NETWORK TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS. 1 1 0 0 0 0 0 0 0 DEAN SWINDLE DIR; CHAIR AS OF 3/18; CHI PRES/CFO 0 1210550 0 2110703 0 616974 0 16950 0 25813 0 3980990 0 288009 SALLY JEFFCOAT DIR;CHAIR THR 3/18; TRINITY HLTH EVP 0 898754 0 388608 0 230295 0 12150 0 31295 0 1561102 0 0 CYNTHIA CLEMENCE DIRECTOR; TRINITY HEALTH SVP 0 626427 0 173136 0 113569 0 20250 0 28178 0 961560 0 0 MITCH MELFI DIRECTOR; CHI EVP 0 679789 0 875160 0 162295 0 16075 0 26032 0 1759351 0 0 LINDA ROSS DIRECTOR; TRINITY HEALTH SVP 0 497557 0 172715 0 19856 0 131625 0 26246 0 847999 0 0 PATRICIA WEBB DIR; CATHOLIC HEALTH INITIATIVES EVP 0 687908 0 872792 0 291655 0 16075 0 18006 0 1886436 0 128263 ROBERT RITZ PRESIDENT AND CEO 0 741171 0 323926 0 82116 0 113111 0 21205 0 1281529 0 57150 MARCIA SMITH SECRETARY; ASSOCIATE COUNSEL 0 294618 0 69041 0 2119 0 12150 0 28467 0 406395 0 0 MICHAEL WEGNER SVP OPS/CFO AT 1/18; CHI-IA SVP 0 534049 0 65182 0 20957 0 16075 0 20474 0 656737 0 0 STEVEN KUKLA INTERIM CFO THROUGH 2/18 0 467842 0 48660 0 29028 0 16075 0 14786 0 576391 0 0 KENT CARR MD PRESIDENT, PHYSICIAN ENTERPRISE 0 511925 0 50000 0 44951 0 9450 0 25840 0 642166 0 0 BARBARA GESSEL CHRO THROUGH 4/18 0 287139 0 44001 0 102970 0 18954 0 13211 0 466275 0 0 JOSEPH LEVALLEY VP PLANNING; CHI SVP 0 349374 0 48702 0 29068 0 16075 0 23313 0 466532 0 0 MIKE TRACHTA VP, NETWORK AFFILIATES 0 360253 0 16435 0 15108 0 15221 0 21301 0 428318 0 0 KEVIN ELSBERRY INTERIM HR OFCR AT 10/17; CHI-IA VP 0 295754 0 28876 0 16741 0 13350 0 20839 0 375560 0 0 DAVID VELLINGA FORMER OFFICER; HOSPITAL LIAISON 0 650306 0 959783 0 822248 0 4040 0 12694 0 2449071 0 353247 MICHAEL ROWAN FORMER OFFICER 0 67219 0 0 0 1321026 0 8780 0 0 0 1397025 0 0 RICHARD O'CONNELL FORMER OFFICER 0 31633 0 193351 0 655879 0 7059 0 9566 0 897488 0 0 PART I, LINE 3 MERCY HEALTH NETWORK'S CEO IS PAID DIRECTLY BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION FOR MERCY HEALTH NETWORK'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS FROM TRINITY HEALTH (A RELATED ORGANIZATION) IN CALENDAR 2017. THIS AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: RICHARD O'CONNELL - $448,968 THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CHI (A RELATED ORGANIZATION) IN CALENDAR 2017. THESE AMOUNTS WERE INCLUDED IN COLUMN B (III) OF SCHEDULE J, PART II: KENT CARR, MD - $30,093 MICHAEL ROWAN - $1,303,356 POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CHI AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2017. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2017, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2017. THE FOLLOWING PAYOUTS FOR 2017 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CYNTHIA CLEMENCE - $97,577 SALLY JEFFCOAT - $199,865 RICHARD O'CONNELL - $202,294 THE FOLLOWING ACCRUAL FOR 2017 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: LINDA ROSS - $119,475 THE FOLLOWING IS A PARTICIPANT IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($270,000 FOR 2017). THE FOLLOWING PAYOUT FOR 2017 FOR THIS PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: MARCIA SMITH - $798 DURING THE 2017 CALENDAR YEAR CHI MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CEOS/PRESIDENTS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: MITCH MELFI ROBERT RITZ MICHAEL ROWAN DEAN SWINDLE DAVID VELLINGA PATRICIA WEBB DURING 2017 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: ROBERT RITZ - $58,350 DEAN SWINDLE - $288,050 DAVID VELLINGA - $718,619 PATRICIA WEBB - $128,281 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAD MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION WERE ELIGIBLE TO RECEIVE THEIR 2017 CONTRIBUTIONS IN CASH DURING THE CALENDAR YEAR. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2017, THE FOLLOWING CONTRIBUTIONS AND ASSOCIATED GAINS OR LOSSES THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: MITCH MELFI - $135,426 DEAN SWINDLE - $303,912 DAVID VELLINGA - $89,462 PATRICIA WEBB - $136,430 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF MERCY HEALTH NETWORK ARE TRINITY HEALTH CORPORATION AND CATHOLIC HEALTH INITIATIVES. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER OF MERCY HEALTH NETWORK HAS THE RIGHT TO APPOINT ONE-HALF OF THE BOARD OF DIRECTORS OF MERCY HEALTH NETWORK. FORM 990, PART VI, SECTION A, LINE 7B THE TWO MEMBERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. BOTH MEMBERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MERCY HEALTH NETWORK IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MERCY HEALTH NETWORK HAS ADOPTED A CONFLICT OF INTEREST POLICY, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCY HEALTH NETWORK, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCY HEALTH NETWORK AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MERCY HEALTH NETWORK (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCY HEALTH NETWORK OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCY HEALTH NETWORK (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MERCY HEALTH NETWORK. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 MERCY HEALTH NETWORK DOES NOT CURRENTLY MAKE ITS DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 3,053,188. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,053,188. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 156,695. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 156,695. MERCY COMMUNITY HOSPITAL GROUP LLC 1449 NW 128TH ST BLDG 5 SUITE 200 CLIVE IA 50325 352473948 ACCOUNTABLE CARE ORGANIZATION IA 0 0 MERCY HEALTH NETWORK INC CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 SPONSOR AND SUPPORT HEALTH CARE PROVIDERS CO 501(C)(3) LINE 12A, I N/A 1 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES IA 50314 420680448 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 CATHOLIC HEALTH INITIATIVES 1 MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY IA 50401 311373080 HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 TRINITY HEALTH CORPORATION 20555 VICTOR PARKWAY LIVONIA MI 48152 351443425 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IN 501(C)(3) LINE 12B, II CATHOLIC HEALTH MINISTRIES 1 WHEATON FRANCISCAN HEALTHCARE - IOWA INC 3421 WEST NINTH STREET WATERLOO IA 50702 421177001 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IA 501(C)(3) LINE 12C, III-FI MERCY HEALTH NETWORK 1 NORTHEAST IOWA REAL ESTATE INVESTMENTS LTD 3421 WEST NINTH STREET WATERLOO IA 50702 421207432 TITLE HOLDING COMPANY IA 501(C)(2) WHEATON FRANCISCAN HEALTHCARE-IOWA 1 SARTORI MEMORIAL HOSPITAL INC 515 COLLEGE STREET CEDAR FALLS IA 50613 420758901 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 WHEATON FRANCISCAN HEALTHCARE-IOWA 1 SARTORI HEALTH CARE FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421240996 FOUNDATION IA 501(C)(3) LINE 12A, I SARTORI MEMORIAL HOSPITAL INC 1 MERCY HOSPITAL OF FRANCISCAN SISTERS INC 3421 WEST NINTH STREET WATERLOO IA 50702 421178403 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 WHEATON FRANCISCAN HEALTHCARE-IOWA 1 COVENANT MEDICAL CENTER INC 3421 WEST NINTH STREET WATERLOO IA 50702 421264647 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 WHEATON FRANCISCAN HEALTHCARE-IOWA 1 COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421295784 FOUNDATION IA 501(C)(3) LINE 10 COVENANT MEDICAL CENTER INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 MERCY HEALTH SERVICES - IOWA CORP Q 6670264 PER BOOKS WHEATON FRANCISCAN HEALTHCARE - IOWA INC Q 1964477 PER BOOKS CATHOLIC HEALTH INITIATIVES - IOWA CORP Q 626202 PER BOOKS