FURP.ORG / PUBLIC DATA EXPLORER

MERCY MEDICAL CENTER-NEWTON: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MERCY MEDICAL CENTER-NEWTON (EIN 42-1470935)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201141329349303744
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-12T17:44:01-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1
CityENGLEWOODCity
StateCOState
ZIP Code80112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN421470935EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY PROFESSIONAL PRACTICE ASSOCIATES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone5156437302Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 6TH AVENUEAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code50314ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSteven KuklaName
TitleSenior Vice President/CFOTitle
Date Signed2011-05-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone7208741500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJACKIE FROST-KUNNENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11111 6TH AVENUEAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code50314ZIPCode
FieldValueIRS element (for citing)
Gross Receipts45611310GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE A CATHOLIC-SPONSORED NOT-FOR-PROFIT MULTI-SPECIALTY PHYSICIAN PRACTICE WHOSE MISSION IS TO PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY ON A NON-DISCRIMINATORY BASIS.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees117TotalNbrEmployees
Total Nbr Volunteers3TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year11000000ContributionsGrantsPriorYear
Contributions Grants Current Year18004613ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22544392ProgramServiceRevenuePriorYear
Program Service Revenue CY27562197ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year9100OtherRevenuePriorYear
Other Revenue Current Year44500OtherRevenueCurrentYear
Total Revenue Prior Year33553492TotalRevenuePriorYear
Total Revenue Current Year45611310TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year26260442SalariesEtcPriorYear
Salaries Etc Current Year31934791SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8158836OtherExpensePriorYear
Other Expenses Current Year8958002OtherExpensesCurrentYear
Total Expenses Prior Year34419278TotalExpensesPriorYear
Total Expenses Current Year40892793TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-865786RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4718517RevenuesLessExpensesCY
Total Assets BOY6540066TotalAssetsBOY
Total Assets EOY8469067TotalAssetsEOY
Total Liabilities BOY4855613TotalLiabilitiesBOY
Total Liabilities EOY2066099TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1684453NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6402968NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense39213866Expense
Grants0Grants
Revenue27562197Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense39213866TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees117NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRandall L RubinNamePerson
Telephone Number5156437860TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11111 6th AvenueAddressLine1
CityDes MoinesCity
StateIAState
ZIP Code50314ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationReportable Comp From OrganizationReportableCompFromOrganizationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
CHRIS CHRISTENSEN
director1.0X21497340762
DANIEL DIMEO
Director/Physician40.0X33249256073
WAEL HAIDAR
Director/Physician40.0X27943259925
JACQUELINE FROST-KUNNEN
President/CEO/Board Chair1.0X45735232217X
LENARD KERR
Director/Physician40.0X37299277626
STEVE KUKLA
Director1.0X45408642510
MIRZA BAIG
PHYSICIAN40.024274432459X
GARY HEMANN
PHYSICIAN40.040821403561X
CASS FRANKLIN
PHYSICIAN40.027943457048X
KYRIACOS PANAYIDES
PHYSICIAN40.041178457634X
BALA NAPA
PHYSICIAN40.044967402158X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2946484TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1126411TotalReportableCompFrmRltdOrgs
Total Other Compensation393163TotalOtherCompensation
Number Individuals GT100 K78NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MRAS Inc
7231 Plum DrUrbandaleIA50322Transcription100612
RI Transcription Solutions
26040 Wild Rose LaneExcelsiorMN553317935Transcription108123
Mary Hlavin MD
5100 Woodland AveDes MoinesIA50312Medical Professional560000
LABCORP
PO BOX 8111BURLINGTONNC272168111LABORATORY195940
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Related Organizations18004613RelatedOrganizations
Total Contributions18004613TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient ServicesDescription
Business Code900099BusinessCode
Total Revenue Column27562197TotalRevenueColumn
Related Or Exempt Function Income27562197RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue27562197TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionTuitionDescription
Business Code611600BusinessCode
Total Revenue Column44500TotalRevenueColumn
Exclusion$44,500ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue44500TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column45611310TotalRevenueColumn
Related Or Exempt Function Income27562197RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$44,500ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total998325Total
Program Services998325ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total26635388Total
Program Services25253702ProgramServices
Management And General1381686ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1244335Total
Program Services1182118ProgramServices
Management And General62217ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1810420Total
Program Services1719899ProgramServices
Management And General90521ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1246323Total
Program Services1184007ProgramServices
Management And General62316ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total952767Total
Program Services952767ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total721099Total
Program Services685044ProgramServices
Management And General36055ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total677557Total
Program Services643679ProgramServices
Management And General33878ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total77376Total
Program Services73507ProgramServices
Management And General3869ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total878Total
Program Services878ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total341435Total
Program Services341435ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total966620Total
Program Services966620ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debts31741723174172
Repairs and maintenance385046385046
Education9428594285
Dues & subscriptions1677061593218385
Recruitment and relocation255255

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1398807Total
Program Services1398806ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total40892793Total
Program Services39213866ProgramServices
Management And General1678927ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY228BOY
EOY228EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5539810BOY
EOY4617422EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY490659BOY
EOY527370EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4023405LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec966440LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY242287BOY
EOY3056965EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY267082BOY
EOY267082EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6540066BOY
EOY8469067EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2652312BOY
EOY1471934EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2203301BOY
EOY594165EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4855613BOY
EOY2066099EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1684453BOY
EOY6402968EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1684453BOY
EOY6402968EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6540066BOY
EOY8469067EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5000000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6300000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6000000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11000000CurrentTaxYearMinus1Year
Current Tax Year18004613CurrentTaxYear
Total46304613Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years16202145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16550625CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18095812CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22544392CurrentTaxYearMinus1Year
Current Tax Year27562197CurrentTaxYear
Total100955171Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21202145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22850625CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years24095812CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year33544392CurrentTaxYearMinus1Year
Current Tax Year45566810CurrentTaxYear
Total147259784Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total509147259784PublicSupportTotal509

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year9100CurrentTaxYearMinus1Year
Current Tax Year44500CurrentTaxYear
Total53600Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21202145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22850625CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years24095812CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year33553492CurrentTaxYearMinus1Year
Current Tax Year45611310CurrentTaxYear
Total147313384Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99964PublicSupportPercentage509
Prior Year Support Percentage0.99056PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00000PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$1,169GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Total Lobbying Expenditures IIB1169TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSCH. C, PART II-B, LINE 1FReturnReference
ExplanationOf the $10,625 dues paid to Polk County Medical Society, $1,169 was reported to be lobbying expenses and is included on line 1f of Schedule C, Part II-B.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2127700OtherCostOrOtherBasis
Depreciation267251Depreciation
Book Value1860448BookValue
FieldValueIRS element (for citing)
EquipmentEquipment

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1895705OtherCostOrOtherBasis
Depreciation699189Depreciation
Book Value1196517BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3056965TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED EXPENSES$516,338
INTERCOMPANY PAYABLE$77,827
FieldValueIRS element (for citing)
Total Of Amounts594165TotalOfAmounts
Total Revenue45611310TotalRevenue
Total Expenses40892793TotalExpenses
Excess Or Deficit For Year4718517ExcessOrDeficitForYear
Excess Or Deficit Per FS4718517ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierREPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740Identifier
Return ReferenceSCHEDULE D, PART XReturnReference
ExplanationMERCY PROFESSIONAL PRACTICE ASSOCIATES, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI's FIN 48 footnote for the year ended June 30, 2010 reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements."Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrg
CHRIS CHRISTENSEN
169463162642924640762255735
MIRZA BAIG
426946551324274456733
DANIEL DIMEO
254185188933249289322
WAEL HAIDAR
2506311944279432878687350
GARY HEMANN
263599133840821444382138624
JACQUELINE FROST-KUNNEN
356984562594410932217489569
CASS FRANKLIN
451471557727943484991
LENARD KERR
22448321153729931492551027
STEVE KUKLA
353779548054550142510496596
KYRIACOS PANAYIDES
456039159541178498812
BALA NAPA
398854330444967447125

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Executive compensationSCHEDULE J, PART I, Q. 3COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CHI-IOWA CORP, A RELATED ORGANIZATION. THE FOLLOWING METHODS WERE USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
POST-TERMINATION PAYMENTSSCHEDULE J, PART I, Q. 4APOST-TERMINATION PAYMENTS ARE ADDRESSED IN THE EXECUTIVE EMPLOYMENT AGREEMENTS. 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2009 CALENDAR YEAR.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, Q. 4AINTRODUCTION: I.Organization's Mission, Vision, and Tax-Exempt Purpose Mercy Professional Practice Associates is a multi-specialty physician practice located in Des Moines, IA. The mission of the group is to provide healthcare services to the community on a non-discriminatory basis. These services include managing the emergency room that is open to all persons regardless of ability to pay, for Mercy Medical Center-Des Moines, a tax-exempt hospital. In addition, the group provides specialty services in pediatric medicine, endocrinology, psychiatry, breast health and sedation to the community based on need. Mercy Professional Practice Associates is guided by the values of Reverence, Integrity, Compassion, and Excellence and we hold ourselves to a high standard of giving to the poor and broader community. Mercy Professional Practice Associates is included in the Official Catholic Directory as a tax-exempt organization. The group participates in government-sponsored health care programs like Medicaid and Medicare. II. Community Benefit Approach Mercy Professional Practice Associates has a tradition of providing excellent health care to all people. We are equally committed to improving the quality of life in the communities we serve by partnering with individuals, organizations and elected officials to anticipate, identify and meet the changing health needs of central Iowans. Mercy Professional Practice Associates has financial assistance policies and programs for low-income persons like the Uninsured/Underinsured Patient Discount Policy and the Self-Pay and Third-Party Discounts Policy. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: COMMUNITY BENEFIT COST Community Benefit Provided to the Poor: Cost of charity care provided 321,856 Unpaid cost of public programs, Medicaid, and other indigent care programs 1,400,518 Cost of community benefit provided to the Poor 1,722,374 Total Cost of Community Benefit 1,722,374 Unpaid Costs of Medicare* 5,962,374 Total Cost of Community Benefit and the Unpaid Cost of Medicare 7,684,748 * The unpaid cost of Medicare is not included in total community benefit.
MEMBERS OR STOCKHOLDERSFORM 990, PART VI, Q.6THE ENTITY'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES - IOWA, CORP. D/B/A MERCY MEDICAL CENTER - DES MOINES, AN IOWA NONPROFIT CORPORATION.
MEMBER ELECT ONE OR MORE MEMBERS OF GOVERNING BOARDFORM 990, PART VI, Q. 7ATHE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
GOVERNING POWERSFORM 990, PART VI, Q. 7BTHE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES - IOWA, CORP., D/B/A MERCY MEDICAL CENTER - DES MOINES, AN IOWA NONPROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S BYLAWS, MERCY MEDICAL CENTER HAS THE RIGHT TO: - INITIATE AND APPROVE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION - INITIATE AND APPROVE SUBSTANTIAL CHANGES TO THE MISSION AND PHILOSOPHICAL DIRECTION OF THE ORGANIZATION - INITIATE AND APPROVE JOINT VENTURES IN WHICH THE ORGANIZATION PROPOSES TO PARTICIPATE, PURSUANT TO GUIDELINES ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER - APPROVE AND REMOVE WITH OR WITHOUT CAUSE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION - APPROVE THE INCURRENCE OF ANY DEBT BY THE ORGANIZATION THAT IS IN EXCESS OF A THRESHOLD ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER - RECOMMEND TO THE SOLE CORPORATE MEMBER OF THE CORPORATE MEMBER THE ALIENATION OF PROPERTY, WITHIN THE MEANING OF THE CANON LAW, OF THIS ORGANIZATION, AS REQUIRED, AND - APPOINT AND TERMINATE WITH OR WITHOUT CAUSE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION.
PROCESS, IF ANY, THE ORGANIZATION USES TO REVIEW FORM 990FORM 990, PART VI, Q.11The CFO reviews the return and any necessary revisions are included in the final version which is approved for filing with the IRS. Subsequent to review by the chief financial officer, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Subsequent to e-filing, the final e-filed form 990 is presented to the board at a regularly scheduled board meeting.
PROCEDURES FOR MONITORING AND ENFORCING THE COI POLICYFORM 990, PART VI, Q. 12CALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. IN ADDITION, ANY BOARD MEMBER WITH A CONFLICT IS REQUIRED TO DECLARE THE CONFLICT BEFORE THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING. THE ENTIRE BOARD OR COMMITTEE DETERMINES WHETHER THE AFFECTED BOARD MEMBER SHOULD BE EXCLUDED FROM THE MEETING DUE TO THE DISCLOSED CONFLICT.
PROCESS FOR DETERMINING EXECUTIVE COMPENSATIONFORM 990, PART VI, Q. 15ATHE ORGANIZATION'S PRESIDENT IS COMPENSATED BY CHI-IOWA CORP, A RELATED ORGANIZATION, WHO USED A THIRD-PARTY CONSULTANT TO SURVEY COMPENSATION TRENDS ANNUALLY AND RECOMMEND COMPENSATION RANGES FOR THE TOP MANAGEMENT OFFICIAL. THESE RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. THE SALARIES ARE COMPARED TO INDUSTRY STANDARDS AND GUIDELINES FOR APPROPRIATENESS.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, Q. 15BThe organization referenced industry compensation comparability studies and surveys when setting top management compensation amounts which were reviewed by an independent compensation consultant, approved by a compensation committee, and paid in accordance with a written employment contract. The organization's board of directors oversees the compensation setting process to ensure reasonableness and compliance with Mercy Professional Practice Associates, Inc.'s compensation philosophy.
ORGANIZATION'S GOVERNING DOCUMENTSFORM 990, PART VI, Q.19MERCY PROFESSIONAL PRACTICE ASSOCIATES' FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. The organization's conflict of interest policy IS NOT PUBLICLY AVAILABLE. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE IOWA SECRETARY OF STATE'S WEBSITE.
ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIICOMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 40 HOUR-PER-WEEK EMPLOYEES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (132 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
St Joseph Community Health Services
300 Central SW Suite 300AlbuquerqueNM87102710897107CommunityNM501(c)(3)11aCHI
St Joseph Community Health Foundation
300 Central SW Suite 300AlbuquerqueNM87102850253087FoundationNM501(c)(3)7SJCHS
St Francis of Baker City
3325 Pocahontas RoadBaker CityOR97814930412495HospitalOR501(c)(3)3CHI
St Elizabeth Health Care Foundation
3325 Pocahontas RoadBaker CityOR97814943164869FoundationOR501(c)(3)7SEHS
Flaget Memorial Hospital Foundation Inc
4305 New Shepherdsville RoadBardstownKY40004562351341FundraisingKY501(c)(3)11aFH
Flaget Healthcare DBA Flaget Memorial
4305 New Shepherdsville RoadBardstownKY40004611345363HospitalKY501(c)(3)3CHI
Lakewood Health Center
600 Main Avenue SouthBaudetteMN56623410758434LTerm CareMN501(c)(3)3CHI
Appletree Court
601 Oak StreetBreckenridgeMN56520411850500Senior HomesMN501(c)(3)9SFH
Healthcare and Wellness Foundation
2400 St Francis DriveBreckenridgeMN56520760761782FoundationMN501(c)(3)11aSFMC
St Francis Home
2400 St Francis DriveBreckenridgeMN56520410729978LTerm CareMN501(c)(3)9CHI
St Francis Medical Center
2400 St Francis DriveBreckenridgeMN56520410695598HealthcareMN501(c)(3)3CHI
Carrington Health Center
800 North 4th StreetCarringtonND58421450227311HealthcareND501(c)(3)3CHI
Saint Clare's Community Care
66 Ford RoadDenvilleNJ07834222876836HealthcareNJ501(c)(3)11bSCHS
Saint Clare's Foundation Inc
66 Ford RoadDenvilleNJ07834222502997FundraisingNJ501(c)(3)7SCHS
Good Samaritan College of Nursing & Heal
375 Dixmyth AveCincinnatiOH45220311778403EducationKY501(c)(3)2GHS
Total Healthcare
PO Box 7021Colorado SpringsCO80933840927232HealthcareCO501(c)(3)3CHI Colorado
Memorial Health Care System Inc
2525 De Sales AvenueChattanoogaTN37404620532345HospitalTN501(c)(3)3CHI
Memorial Health Care System Foundation
2525 De Sales AvenueChattanoogaTN37404621839548FoundationTN501(c)(3)7MHCS
Memorial Health Partners Foundation Inc
6028 Shallowford RoadChattanoogaTN37421030417049HealthcareTN501(c)(3)9MHCS
The Community Limited Care Dialysis Cent
619 Oak Street Accounting-3 WestCincinnatiOH45206237419853DialysisOH501(c)(2)noneGSH
Good Samaritan Foundation of Cincinnati
619 Oak Street Accounting-3 WestCincinnatiOH45206311206047FoundationOH501(c)(3)11aGSH
The Good Samaritan Hospital of Cincinnat
619 Oak Street Accounting-3 WestCincinnatiOH45206310537486HospitalOH501(c)(3)3TRI-HEALTH
Saint Clare's Hospital
66 Ford RoadDenvilleNJ07834223319886HospitalNJ501(c)(3)3CHI
St Francis Life Care Corporation
19 Pocono RoadDenvilleNJ07834222536017Elderly CareNJ501(c)(3)9SCHS
TriHealth Physician Institute
619 Oak Street Accounting-3 WestCincinnatiOH45206311074519PhysiciansOH501(c)(3)11aGSH
Catholic Health Initiatives Colorado Fou
961 East Colorado AvenueColorado SpringsCO80903840902211FoundationCO501(c)(3)7CHI Colorado
SET of Colorado Springs Inc
825 E Pikes Peak Avenue Bldg 29Colorado SpringsCO80903841183335LTerm CareCO501(c)(3)7CHI Colorado
Catholic Health Initiatives
1999 Broadway Suite 4000DenverCO80202470617373HealthcareCO501(c)(3)9CHI
Catholic Health Care Federation
1999 Broadway Suite 4000DenverCO80202208473567Jurdic PersonCO501(c)(3)11aCHI
Global Health Initiatives
1999 Broadway Suite 4000DenverCO80202201536108MinistriesCO501(c)(3)11aCHI
Health SET
4200 West Conejos Place 436DenverCO80204841102943Low Inc.CareCO501(c)(3)7CHI Colorado
Bishop Drumm Retirement Center
1111 6th AvenueDes MoinesIA50314420725196LTerm CareIA501(c)(3)9CHI-IA Corp
Mercy Medical Center - Des Moines AKA
1111 6th AvenueDes MoinesIA50314420680448HospitalIA501(c)(3)3CHI-IA Corp
House of Mercy
1111 6th AvenueDes MoinesIA50314421323808ShelterIA501(c)(3)7CHI-IA Corp
Mercy Auxiliary of Central Iowa
1111 6th AvenueDes MoinesIA50314426076069AuxiliaryIA501(c)(3)11aCHI-IA Corp
Mercy Clinics Inc
1111 6th AvenueDes MoinesIA50314421193699PhysicianIA501(c)(3)9CHI-IA Corp
Mercy College of Health Sciences
1111 6th AvenueDes MoinesIA50314421511682EducationIA501(c)(3)2CHI-IA Corp
Mercy Foundation of Des Moines IA
1111 6th AvenueDes MoinesIA50314237358794FoundationIA501(c)(3)7CHI-IA Corp
Mercy Medical Center - Centerville FKA
1 St Josephs DriveCentervilleIA52544420680308HospitalIA501(c)(3)3CHI-IA Corp
Mercy Professional Practice Associates
1111 6th AvenueDes MoinesIA50314421470935PhysicianIA501(c)(3)9CHI-IA Corp
Mercy Hospital of Devils Lake
1031 East Seventh StreetDevils LakeND58301450227012HealthcareND501(c)(3)3CHI
Saint Joseph's Hospital Foundation
30 West 7th StreetDickinsonND58601363418207FoundationND501(c)(3)11aSJHHC
St Joseph's Hospital and Health Center
30 West 7th StreetDickinsonND58601450226429HealthcareND501(c)(3)3CHI
Mercy Regional Medical Center of Durango
1010 Three Springs BlvdDurangoCO81301840405515HospitalCO501(c)(3)3CHI
CHI Kentucky Inc
3900 Olympic Blvd Suite 400ErlangerKY41018202741651HealthcareKY501(c)(3)11aCHI
Villa Nazareth Inc
801 Page DriveFargoND58103450226714LT CareND501(c)(3)9CHI
St Catherine Hospital
401 East Spruce StreetGarden CityKS67846480543721HospitalKS501(c)(3)3CHI
St Catherine Hospital Development Found
401 East Spruce StreetGarden CityKS67846200598702FoundationKS501(c)(3)11aSCH
Saint Francis Medical Center Foundation
PO Box 9804Grand IslandNE68802470630267FoundationNE501(c)(3)7SFMC
Saint Francis Medical Center
PO Box 9804Grand IslandNE68802470376601HealthCareNE501(c)(3)3CHI Nebraska
Central Kansas Medical Center
3515 BroadwayGreat BendKS67530480543724HospitalKS501(c)(3)3CHI
St Joseph Memorial Hospital
923 Carroll AveLarnedKS67550481253246HospitalKS501(c)(3)3CKMC
MNMCH Inc
220 North PennsylvaniaColumbusKS66725481216238HospitalKS501(c)(3)3SJRMC
Mercy Lifecare Systems
2727 McClelland BlvdJoplinMO64804431305163Property MgmtMO501(c)(3)11aSJRMC
St John's Medical Group
2727 McClelland BlvdJoplinMO64804431882377Phys PracticeMO501(c)(3)9SJRMC
St John's Mercy Regional Foundation
2727 McClelland BlvdJoplinMO64804431308084FoundationMO501(c)(3)7SJRMC
St John's Regional Medical Center
2727 McClelland BlvdJoplinMO64804440545809HospitalMO501(c)(3)3CHI
Good Samaritan Hospital
PO Box 1990KearneyNE68848470379755HealthCareNE501(c)(3)3CHI Nebraska
Good Samaritan Hospital Foundation
PO Box 1810KearneyNE68848470659443FoundationNE501(c)(3)7GSH
St Joseph Health Ministries
1929 Lincoln Hwy E Ste 150LancasterPA17602232342997HealthPA501(c)(3)11aCHI
St Joseph Health Ministries Foundation
1929 Lincoln Hwy E Ste 150LancasterPA17602232605579FundraisingPA501(c)(3)11aSJHM
St Joseph Health Services Inc
1929 Lincoln Hwy E Ste 150LancasterPA17602201425375Dental carePA501(c)(3)11aSJHM
Continuing Care Hospital
150 North Eagle Creek DriveLexingtonKY40509611400619LTACHKY501(c)(3)3SJHS
Saint Joseph Berea Hospital Foundation
305 Estill StreetBereaKY40403260152877FoundationKY501(c)(3)7SJHS
Saint Joseph Health System Inc
150 N Eagle Creek DrLexingtonKY40509611334601HospitalKY501(c)(3)3CHI
St Joseph Hospital Foundation Inc
One St Joseph DriveLexingtonKY40504611159649FoundationKY501(c)(3)11aSJHS
Saint Joseph Medical Foundation Inc
One St Joseph DriveLexingtonKY40504311539059Phy PracticesKY501(c)(3)3SJHS
Visiting Nurse Association of Saint Clar
191 Woodport RoadSpartaNJ07871221768334Home HealthNJ501(c)(3)9SCHS
Saint Elizabeth Foundation
555 South 70th StreetLincolnNE68510470625523FoundationNE501(c)(3)7SERMC
Saint Elizabeth Health Services
555 South 70th StreetLincolnNE68510363233120HealthcareNE501(c)(3)3SERMC
CHI Nebraska
555 South 70th StreetLincolnNE68510363233121HealthcareNE501(c)(3)11aCHI
Saint Elizabeth Regional Medical Center
555 South 70th StreetLincolnNE68510470379836HealthcareNE501(c)(3)3CHI Nebraska
The Physician Network
8055 O Street Suite 300LincolnNE68510470780857HealthcareNE501(c)(3)11aCHI Nebraska
Lisbon Area Health Services
905 Main StreetLisbonND58054820558836HealthcareND501(c)(3)3CHI
Alverna Apartments
300 SE 8th AvenueLittle FallsMN56345411351177Lterm CareMN501(c)(3)9CHI
Unity Family Healthcare
815 2nd Street SELittle FallsMN56345410721642HealthcareMN501(c)(3)3CHI
St Anthony's Hospital Association
4 Hospital DriveMorriltonAR72110710245507HealthcareAR501(c)(3)3SVIMC
St Vincent Infirmary Medical Center
2 St Vincent CircleLittle RockAR72205710236917HealthcareAR501(c)(3)3CHI
St Vincent Medical Group
2 St Vincent CircleLittle RockAR72205710830696HealthcareAR501(c)(3)9SVIMC
Maria-Joseph Center
4830 Salem AvenueDaytonOH45416310935118HealthcareOH501(c)(3)9SHP
Saint Joseph London Foundation Inc
310 East Ninth StreetLondonKY40741260438748FoundationKY501(c)(3)11aSJHS
Samaritan Behavioral Health
601 S Edwin C Moses BlvdDaytonOH45408020633634HospitalOH501(c)(3)3SHP
Mercy Medical Center
1512 12th Avenue RoadNampaID83686820200896HospitalID501(c)(3)3CHI
Mercy Medical Center Foundation
1512 12th Avenue RoadNampaID83686261737256FoundationID501(c)(3)11aMercy Med Ct
Mercy Physician Group Inc
1512 12th Avenue RoadNampaID83686208192593Phys GroupID501(c)(3)9Mercy Med Ct
St Mary's Hospital
1314 3rd AvenueNebraska CityNE68410470443636HospitalNE501(c)(3)3CHI Nebraska
St Mary's Hospital Foundation
1314 3rd AvenueNebraska CityNE68410470707604FoundationNE501(c)(3)7SMH
Oakes Community Hospital
314 South 8th StreetOakesND58474450231675HospitalND501(c)(3)3CHI
Oakes Community Hospital Foundation
314 South 8th StreetOakesND58474710966606FoundationND501(c)(3)11aOCH
St Dominic at Ontario
351 SW 9th StreetOntarioOR97914930433692HospitalOR501(c)(3)3CHI
Holy Rosary Medical Center Foundation
351 SW 9th StreetOntarioOR97914202683560FoundationOR501(c)(3)11aHRMC
St Joseph's Area Health Services
600 Pleasant AvenuePark RapidsMN56470410695603HospitalMN501(c)(3)3CHI
St Anthony Hospital
1601 SE Court AvenuePendletonOR97801930391614HospitalOR501(c)(3)3CHI
St Anthony Hospital Foundation
1601 SE Court AvenuePendletonOR97801930992727FoundationOR501(c)(3)11aSA Hospital
Gettysburg Medical Center
606 East Garfield AvenueGettysburgSD57442460234354HospitalSD501(c)(3)3SMHC
St Mary's Healthcare Center
801 East Sioux AvenuePierreSD57501460230199HealthcareSD501(c)(3)3CHI
Mt St Joseph Inc
3060 SE Stark StreetPortlandOR97214930386870Nursing CareOR501(c)(3)9CHI
Pueblo Stepup
1925 East Orman Avenue Suite G52PuebloCO81004841234295CommunityCO501(c)(3)7CHI
Bornemann Healthcare Corporation
2500 Bernville Road PO Box 316ReadingPA19603232187242HealthcarePA501(c)(3)11aCHI
St Joseph Medical Center Foundation
2500 Bernville Road PO Box 316ReadingPA19603232649362FoundationPA501(c)(3)11aSJRHN
St Joseph Medical Group
2500 Bernville Road PO Box 316ReadingPA19603208544021HealthcarePA501(c)(3)9BHC
St Joseph Regional Health Network
2500 Bernville Road PO Box 316ReadingPA19603231352211HealthcarePA501(c)(3)3CHI
Linus Oakes Inc
2700 Stewart ParkwayRoseburgOR97470930821381Senior LivingOR501(c)(3)9MMC
Mercy Foundation Inc
2700 Stewart ParkwayRoseburgOR97470936088946FoundationOR501(c)(3)7MMC
Mercy Medical Center
2700 Stewart ParkwayRoseburgOR97470930386868HospitalOR501(c)(3)3CHI
Franciscan Villa of South Milwaukee Inc
3601 South Chicago AvenueSouth MilwaukeeWI53172391093829HealthcareWI501(c)(3)9CHI
Enumclaw Community Hospital
1450 Battersby AvenueEnumclawWA98022910715805HospitalWA501(c)(3)3FHS
Franciscan Foundation
1717 South J StreetTacomaWA98405911145592FundraisingWA501(c)(3)9FHS
Franciscan Health System FKA Franciscan
1717 South J StreetTacomaWA98405910564491HealthcareWA501(c)(3)3CHI
Franciscan Medical Group
1708 South Yakima AvenueTacomaWA98405911939739HealthcareWA501(c)(3)9FHS
St Joseph Medical Center Foundation In
7601 Osler DriveTowsonMD21204521681044FundraisingMD501(c)(3)7SJMC
St Joseph Medical Center Inc
7601 Osler DriveTowsonMD21204520591461HospitalMD501(c)(3)3CHI
St Joseph Physician Enterprises
7601 Osler DriveTowsonMD21204521311775PhysiciansMD501(c)(3)11aCHI
Samaritan Health Foundation
2222 Philadelphia DriveDaytonOH45406237296923FoundationOH501(c)(3)7SHP
Mercy Hospital of Valley City
570 Chautauqua BoulevardValley CityND58072450226553HospitalND501(c)(3)3CHI
Mercy Medical Center
1301 15th Avenue WestWillistonND58801450231183HealthcareND501(c)(3)3CHI
Mercy Medical Foundation
1301 15th Avenue WestWillistonND58801450381803FoundationND501(c)(3)11aMMC
Samaritan Health Partners
2222 Philadelphia DriveDaytonOH45406311107411HealthcareOH501(c)(3)11aCHI
St Vincent Foundation
Two St Vincent CircleLittle RockAR72205510169537FundraisingAR501(c)(3)11aSVIMC
Auxiliary of Holy Rosary Hospital Inc
351 SW 9th StreetOntarioOR97914943059469HospitalOR501(c)(3)9HRMC
The Mercy Hospital of Devils Lake Fdn
1031 East Seventh StreetDevils LakeND58301352367360FoundationND501(c)(3)11aMHDL
Alegent Health - Bergan Mercy Health Sys
7500 Mercy RoadOmahaNE68124470484764HospitalNE501(c)(3)3CHI
Alegent Health - Mercy Hospital Corning
PO Box 368CorningIA50841420782518HospitalIA501(c)(3)3AHBMHS
Mercy Health Care Foundation
PO Box 368CorningIA50841421461064FoundationNE501(c)(3)11aAHMH
Mercy Hospital Foundation Council Bluff
800 Mercy DriveCouncil BluffsIA51503421178204FoundationIA501(c)(3)11aAHBMHS
CHI Institute For Research and Innovatio
198 Inverness Drive WestEnglewoodCO80112271050565HealthcareCO501(c)(3)11aCHI
CHI Colorado
188 Inverness Drive WestEnglewoodCO80112840405257HealthcareCO501(c)(3)3CHI
Saint Joseph Mount Sterling Foundation
50 Sterling AvenueMount SterlingKY40353272884584FoundationKY501(c)(3)7SJHS
Centennial Medical Group Inc
2700 Stewart ParkwayRoseburgOR97470900433062PhysiciansOR501(c)(3)9MMC
CHI National Foundation
198 Inverness Drive WestEnglewoodCO80112270930004FoundationCO501(c)(3)11aCHI
Saint Clare's Health Services Inc
25 Pocono RoadDenvilleNJ07834223639733ManagementNJ501(c)(3)7CHI
Good Samaritan Hospital
2222 Philadelphia DriveDaytonOH45406310536981HospitalOH501(c)(3)3SHP

Form990 Schedule R Part III Form990ScheduleRPartIII (17 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
Superior Medical Imaging LLC
5000 North 26th StreetLincolnNE68521262884555OP DiagnosticsNESERMCRelated-155495993429false$272false
Central Nebraska Rehab Services
3004 W Faidley AveGrand IslandNE68802810653461Physical TherapyNECHIRelated18169792933623false$5,050false
Mercy West Endoscopy LLC
1601 NW 114th St Suite 244CliveIA50325900129077Ambulatory SurgIACHI-IA CorpRelated19177161695121falsefalse
Audubon Land Company LLC
5390 N Academy Blvd Suite 300Colorado SpringsCO80918841513085Real EstateCOTHCRelated675779001605falsefalse
Breckenridge Medical Clinic LLC
555 South Park Avenue Plaza 11BreckenridgeCO80424651295958Medical ClinicCOTHCRelatedfalsefalse
Penrad Imaging
1390 Kelly Johnson BlvdColorado SpringsCO80920841072619Medical ImagingCOTHCRelated19224418248492falsefalse
St Anthony Regional Mtn Cancer Center
4231 W 16th AvenueDenverCO80112371568013Cancer CenterCOTHCRelated60513318803falsefalse
St Francis Land Company
5390 N Academy Blvd Suite 300Colorado SpringsCO80918263134100Real EstateCOTHCRelated-18097914886022falsefalse
OrthoColorado LLC
11650 West 2nd PlaceLakewoodCO80255371577105Ortho HospitalCOTHCRelated-537516515265510falsefalse
Mercy Outpatient Surgery Center LLC
1512 12th Avenue RoadNampaID83686841380439Surgery CenterIDMMCRelated-812036949357false$4,620true
Peninsula Radiation Oncology
314 Martin Luther King Jr Way 11TacomaWA98405870808610Healthcare SrvcWAFHSRelated-5160763860362falsefalse
Healthcare Support Services LLC
PO Box 9804Grand IslandNE68802721546196LaundryNECHIRelated1999683913481false$58,436false
Bluegrass Regional Imaging Center
1218 South Broadway Suite 310LexingtonKY40504611386736DiagnosticKYSJ HospitalLexRelated2424563773725falsefalse
North River Surgery Center LLC
2209 Wildwood AvenueSherwoodAR72120710799771Ambul Surg CtrARSVIMCRelated2139891696001falsefalse
CHI Operating Investment Program LP
198 Inverness Drive WestEnglewoodCO80112470727942InvestmentsCOCHIInvestment580224069968false$14,031true
Ruxton Surgicenter LLC
8322 Bellona Avenue Suite 201BaltimoreMD21204522095835Surgery CenterMDSJMCRelated-757163421084falsetrue
Central Nebraska Home Care Services
PO Box 1146-4510 Second AvenueKearneyNE68848470692112Healthcare SrvcNEHSEINCRelated-1029821021500falsetrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipLegal Domicile Foreign CountryLegalDomicileForeignCountry
Mercy Health Services Corporation
2727 McClelland BlvdJoplinMO64804431457881DMEMOSt John's RMCC Corp-103383220936831.00000
Mountain Management Services Inc
6028D Shallowford RoadChattanoogaTN37422621570739mgmt svc orgTNMHCSC Corp34864245308451.00000
MedQuest
1301 15th Avenue WestWillistonND58801450392137Sale of DMENDMHof WillistonC Corp-167949114941.00000
St Anthony Development Company
1415 SouthgatePendletonOR97801931216943Athletic ClubORSt Anthony HC Corp4186130479381.00000
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990KEARNEYNE68848470659440MEDICAL CLINICNECHI NebraskaC Corp-24916238402321.00000
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990KEARNEYNE68848470664558MANAGEMENTNEGSHC Corp1095715597471.00000
Mercy Park Apartments Ltd
1111 6th AvenueDes MoinesIA50314421202422HousingIACHI-IA CorpC Corp22724418061991.00000
Des Moines Medical Center Inc
1111 6th AvenueDes MoinesIA50314420837382Real EstateIACHI-IA CorpC Corp11231730.92980
Comcare Services
4231 W 16th AvenueDenverCO80204840904813InactiveCOCHICC Corp1.00000
Mednow Inc
1512 12th Avenue RoadNampaID83686820389927Outpat PharmacyIDMercy Med CtrC Corp-67295453484761.00000
Saint Clare's Primary Care Inc
66 Ford RoadDenvilleNJ07834222441202Billing ServicesNJSCCCC Corp-35063025904871.00000
Healthcare Mgmt Services Org Inc
1149 Market StTacomaWA98402911865474Health Org.WAFHSC Corp1.00000
Physician Health System Network
1149 Market StTacomaWA98402911746721Health Org.WAFHSC Corp1.00000
Mercy Services Corp
2700 Stewart ParkwayRoseburgOR97470930824308Retail SalesORMercy MedicalC Corp-49940914030011.00000
Caduceus Medical Associates Inc
6028 Shallowford Road Suite DChattanoogaTN37422621570736HealthcareTNMHCSC Corp10081.00000
CENTRAL KANSAS HEALTH SERVICES ASSOCIATI
3515 BroadwayGreat BendKS67530481042853MEDICAL EQUIPMENTKSCKMCC Corp1101251.00000
St Vincent Community Health Services In
Two St Vincent CircleLittle RockAR72205710710785HealthcareARSVIMCC Corp2404944101950001.00000
Alternative Insurance Management Service
3900 Olympic Boulevard Suite 400ErlangerKY41018841112049Management ServicCOCHIC Corp32721761.00000
Nazareth Assurance Company
76 St Paul Street Suite 500BurlingtonVT05401030304831InsuranceVTCHIC Corp1.00000
Franciscan Services Inc
198 Inverness Drive WestEnglewoodCO80112232487967HealthcareCOCHIC Corp194756125982581.00000
SJH Services Corporation
198 Inverness Drive WestEnglewoodCO80112232307408HealthcareCOFSIC Corp31434634230121.00000
St Joseph Development Company Inc
1717 South J StreetTacomaWA98405911480569RentalWAFSIC Corp1677122119847251.00000
Towson Management Inc
7601 Osler DriveTowsonMD21204521710750Management ServicMDFSIC Corp993154983831.00000
Captive Management Initiatives
980663022Captive ManagemenCHIC Corp1.00000CJ
First Initiatives Insurance Ltd
980203038InsuranceCHIC Corp1.00000CJ
Center for Translational Research
198 Inverness Drive WestEnglewoodCO80112272269511HealthcareCOCHIC Corp-84094917462011.00000
Samaritan Family Care Inc
40 W Fourth St 1700DaytonOH45402311299450HealthcareOHSHPLLC-119983648943971.00000
SJL Physician Management Services Inc
424 Lewis Hargett Cr 160LexingtonKY40503999999999ManagementKYSJHSC Corp1.00000
CGH Realty Company Inc
215 N 12th StReadingPA19603232326801Real EstatePASJHMC Corp1007424151.00000
St Joseph Office Park Association
1401 HarrodsBurg Road Bldg B70LexingtonKY40504611079899ManagementKYSJHSC Corp102175728430.85000
FieldValueIRS element (for citing)
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CHI IOWA CORP
C18000000
CHI IOWA CORP
J107669
MERCY CLINICS
O1224290