2013-05-15T13:23:20-05:00 2012-06-30 990 2011-07-01 421478417 MERCY HEALTH NETWORK INC MERC 5156435300 1111 6TH AVENUE DES MOINES IA 50314 DAVID VELLINGA 5156435300 2013-05-14 2011 2016-02-24 21:20:13Z DAVID VELLINGA 1111 6TH AVENUE DES MOINES IA 50314 2299268 0 X MERCYHEALTHNETWORK.COM X 1998 DE HEALTHCARE MANAGEMENT 3 0 0 0 0 0 0 0 1521126 2080065 426356 219203 0 0 1947482 2299268 155000 71500 0 0 0 0 0 0 0 3919001 2058261 4074001 2129761 -2126519 169507 14670741 12080508 4427839 1996714 10242902 10083794 X HEALTHCARE MANAGEMENT 0 0 2111756 71500 2080065 MERCY HEALTH NETWORK, INC. (MHN) PROVIDES SIGNIFICANT ADMINISTRATIVE, MANAGEMENT, GOVERNANCE AND OVERSIGHT RESPONSIBILITIES FOR THE OVERALL ACTIVITIES AND OPERATIONS OF SIX ACUTE CARE HOSPITALS PRESENTLY OWNED AND OPERATED BY TRINITY HEALTH - MICHIGAN (TH) OR MERCY HEALTH SERVICES - IOWA, CORP. (MHS-IOWA) AND TWO ACUTE CARE HOSPITALS PRESENTLY OWNED AND OPERATED BY CATHOLIC HEALTH INITIATIVES (CHI) OR CATHOLIC HEALTH INITIATIVES - IOWA, CORP. (CHI-IOWA). MHN ALSO INTEGRATES AND MANAGES THE ACTIVITIES AND OPERATIONS OF VARIOUS AMBULATORY CARE FACILITIES, HOME CARE AND HOSPICE PROGRAMS CURRENTLY OWNED BY TH, MHS-IOWA, CHI, OR CHI-IOWA.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 TH ARE UNIFIED AND THE ABILITY TO EFFECTIVELY AND EFFICIENTLY MEET THE HEALTH CARE NEEDS OF THE COMMUNITY SERVED BY THE MHN SYSTEM ARE ENHANCED. 2111756 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 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 0 1 1 1 0 0 1 11 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 0 0 0 0 0 0 X KIMBERLY SAXTON DIR OF ACCOUNTING 7343430844 20555 VICTOR PARKWAY LIVONIA MI 481527018 X DAVID VELLINGA 2.00 X X 0 852592 100487 J RICHARD O'CONNELL 2.00 X X 0 943237 118221 MICHAEL ROWAN 2.00 X X 0 1440629 195279 0 3236458 413987 0 0 1 0 CIC ASSOCIATES INC 1601 NW 114TH ST STE 347 DES MOINES IA 50325 PHYSICIAN SERVICES 1110792 PHILLIPS HEALTHCARE 3000 MINUTEMAN ROAD MSD400 ANDOVER MA 01810 HEALTH CARE SERVICES 210090 ACCENTURE LLP 161 N CLARK STREET CHICAGO IL 60601 CONSULTANT SERVICES 101691 3 MANAGEMENT REVENUE 541610 2080065 2080065 2080065 96397 96397 111057 11749 0 0 111057 11749 122806 122806 2299268 2080065 0 219203 71500 71500 211 211 148071 148071 24934 7140 17794 110362 110362 32115 32115 8907 8907 32549 32549 45122 45122 20098 20098 CONTRACT LABOR 1619567 1619567 SUBSCRIPTIONS AND DUES 16325 16325 2129761 2111756 18005 0 213 213 2221840 1413898 105709 1621587 1600155 73674 21432 4243354 2875136 4981328 4691011 3044623 3078818 14670741 12080508 1548171 539791 657828 43025 2221840 1413898 4427839 1996714 X 10242902 10083794 10242902 10083794 14670741 12080508 X 169507 -328615 X 0 0 0 X X X 0 0 0 TRINITY HEALTH - MICHIGAN 382113393 3 1 1 1 0 CATHOLIC HEALTH INITIATIVES - IOWA CORP 420680448 3 1 1 1 0 CATHOLIC HEALTH INITIATIVES 470617373 3 1 1 1 0 MERCY HEALTH SERVICES - IOWA CORP 311373080 3 1 1 1 0 4 0 152050 136845 15205 1469537 1463310 6227 21432 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 2648151 F EQUITY METHOD INVESTMENTS 2042860 C 4691011 OTHER RECEIVABLES 3078818 3078818 1 IOWA HEALTHCARE COLLABORATIVE 100 EAST GRAND AVE STE 100 DES MOINES IA 50309 203869767 501(C)(3) 50000 COMMUNITY WELFARE UNIVERSITY OF IOWA FOUNDATION PO BOX 4550 IOWA CITY IA 52244 420796760 501(C)(3) 10000 COMMUNITY WELFARE IOWA NURSES FOUNDATION 2400 86TH STREET STE 32 URBANDALE IA 50322 237198389 501(C)(3) 5000 COMMUNITY WELFARE 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY MERCY HEALTH NETWORK, INC. 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. 0 1 0 0 0 0 0 0 0 DAVID VELLINGA 0 630107 0 195541 0 26944 0 87357 0 13130 0 953079 0 0 J RICHARD O'CONNELL 0 571942 0 230946 0 140349 0 85919 0 32302 0 1061458 0 0 MICHAEL ROWAN 0 967569 0 444803 0 28257 0 175879 0 19400 0 1635908 0 0 PART I, LINE 4B DURING THE 2011 CALENDAR YEAR, CHI MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR VICE PRESIDENTS AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE AND ACCRUALS FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: DAVID VELLINGA - $54,879 MICHAEL ROWAN - $153,201 PART I, LINE 4B:THE FOLLOWING IS A PARTICIPANT IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011). THE FOLLOWING ACCRUAL FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: J. RICHARD O'CONNELL - $ 66,279 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF MERCY HEALTH NETWORK, INC. ARE TRINITY HEALTH - MICHIGAN (TH-MI) AND CATHOLIC HEALTH INITIATIVES (CHI). SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER OF MERCY HEALTH NETWORK, INC. HAS THE RIGHT TO APPOINT ONE-HALF OF THE BOARD OF DIRECTORS OF MERCY HEALTH NETWORK, INC. 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, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 MERCY HEALTH NETWORK, INC.'S FORM 990 WAS REVIEWED BY MANAGEMENT. THE MEMBERS OF THE BOARD OF TRUSTEES RECEIVE A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 MERCY HEALTH NETWORK, INC. DOES NOT CURRENTLY MAKE ITS DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, COLUMN B: THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: DAVID VELLINGA - 58 HOURS MICHAEL ROWAN - 58 HOURS J. RICHARD O'CONNELL - 53 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -328,615. TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA MI 48152 382113393 HEALTHCARE SERVICES MI 501(C)(3) 3 TRINITY HEALTH CORPORATION 0 CATHOLIC HEALTH INITIATIVES 1999 BROADWAY STE 4000 DENVER CO 80202 470617373 SPONSOR AND SUPPORT HEALTHCARE PROVIDERS CO 501(C)(3) 9 N/A 0 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES IA 50314 420680448 HEALTHCARE SERVICES IA 501(C)(3) 3 CATHOLIC HEALTH INITIATIVES 0 MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY IA 50401 311373080 HEALTHCARE SERVICES DE 501(C)(3) 3 TRINITY HEALTH - MICHIGAN 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 MERCY HEALTH SERVICES - IOWA CORP K 395280 PER BOOKS