2011-05-13T11:20:35-05:00 2010-06-30 990 2009-07-01 421497221 Covenant-Mercycare Inc COVE 3192728000 3421 West Ninth Street Waterloo IA 507025499 MICHELE M PANICUCCI 3192727300 2011-05-15 2009 2016-02-24 21:20:13Z X Jack Dusenbery 3421 West Ninth Street Waterloo IA 507025499 416167 false X www.wheatoniowa.org X 1999 IA COVENANT MERCYCARE, INC. WAS ESTABLISHED TO PROVIDE AND ENHANCE THE PROVISION OF HEALTH CARE SERVICES TO PERSONS RESIDING IN THE COMMUNITIES OF EASTERN IOWA. X 4 2 0 0 0 0 0 1191812 414926 1257 1241 0 0 1193069 416167 0 529413 0 0 0 0 0 0 0 1046799 372644 1046799 902057 146270 -485890 555164 0 69274 0 485890 0 COVENANT-MERCYCARE STRIVES TO LIVE OUT THE HEALING MINISTRY OF THE JUDEO-CHRISTIAN TRADITION WHILE PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTE THE DIGNITY AND WELL BEING OF THE PATIENTS AND COMMUNITIES WE SERVE. OUR VISION IS TO BE RECOGNIZED FOR SUPERIOR HEALTHCARE SERVICE, CLINICAL EXCELLENCE, AS THE HEALTHCARE EMPLOYER OF CHOICE, AND THE PREFERRED PARTNER OF PHYSICIANS. false true 886081 529413 414926 Covenant-Mercycare, Inc. is an Iowa nonprofit corporation which was created to consolidate and coordinate the provision and availability of dialysis services to patients in the combined service area. The services are for renal dialysis patients residing in and around the cities of Independence and Vinton which benefits and improves the access to and quality of care for residents of those communities. 886081 true false false false false false false false false false false false false false false false false false false false false true false true false false false false false false false false false false true false false false false false false true 2 0 true 0 false false false false false false false false false 4 2 true false false false true true true true true false false true true true true true true true true false X TIMOTHY HUBER 3192727607 3421 WEST NINTH STREET WATERLOO IA 507025499 X Phil Peterson 1.0 X X 0 0 0 Tim Charles 1.0 X X 0 0 0 Jack Dusenbery 1.0 X X 4812 622 Michele Panicucci 1.0 X X 3301 586 8113 0 1208 0 false false true 0 0 NET PATIENT SERVICE REVENUE 621400 414926 414926 414926 1241 1241 0 0 0 0 0 0 0 416167 414926 1241 529413 529413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226094 210402 15692 0 0 0 0 0 0 0 0 284 284 146266 146266 0 0 902057 886081 15976 0 431584 0 123580 0 555164 0 69274 0 69274 0 X 485890 485890 0 555164 0 X false false false X true Covenant Medical Center Inc 3421 West 9th St Waterloo IA 507025499 421264647 501(c)(3) 529413 Book Voluntary distribution 1 0 Schedule I Disclosures Part I Line 2 The organization maintains files and records to manage the decision-making and award process for organizations that it provides community sponsorship dollars to. The organization sponsors other organizations that have missions that align with the mission, vision and values of Wheaton Franciscan Healthcare. The organization also looks for certain other criteria when deciding which organizations will receive contributions, including but not limited to supporting healthcare related activities within Iowa, supporting programming that works to further diversity and cultural competency, and aligning with other WFH business relationships or service lines. false false false false false false false false false Phil Peterson 0 0 0 0 0 0 0 0 0 0 0 0 Tim Charles 0 0 0 0 0 0 0 0 0 0 0 0 Jack Dusenbery 3663 1047 102 386 236 5434 Michele Panicucci 2374 784 143 400 186 3887 Schedule J Disclosure Schedule J Part II Jack Dusenbery and Michele Panicucci, directors and officers of the organization, are employed by Wheaton Franciscan Services, Inc., an unrelated organization. It is estimated that 1% of their compensation from this unrelated organization is attributable to services provided to Covenant-Mercycare, Inc. All assets including cash and AR 2010-06-30 9632 Book Value 421264647 Covenant Medical Center Inc 3421 West Ninth Street Waterloo IA 50702 501(c)(3) false false false false true false true true true false Schedule O Disclosures Various - See the following references IRS Form 990 Part VI Section A Line 2 Board members Tim Charles and Phil Peterson are both employed officers for Mercy Service Corp. IRS Form 990 Part VI Section A Lines 6-7 Covenant-Mercycare, Inc. had two members which held several reserved powers over Covenant-Mercycare, Inc. Those reserved powers included, but were not limited to, the election of members of the governing body and election of officers, and approval of certain financial expenditures. IRS Form 990 Part VI Section B Line 11 Covenant-Mercycare, Inc. has a multiple-level review process on all information and tax returns to ensure accurate and timely filing. Under the direction of the Tax Manager, the Accounting Department prepares Form 990. When complete, the return is first reviewed by the Accounting Director, who focuses on the income statement and balance sheet items, and all schedules where transactions of this type might be reported. If discrepancies are found, the item will be corrected prior to the next step in the review process. Once cleared through Accounting, the return is provided to the Tax Department, where the Tax Manager and Vice President of Treasury and Risk Management focus their review on consistency of reporting, accuracy of tax related information, and explanation and understanding of any outliers. Again, any problems or questions are investigated and corrected. Depending on the level of complexity of the year in question, as well as the individual issues specific to that filing, the return may be selected for outside review by a public accounting firm. This decision will vary from year to year based on many factors, and sometimes outside review is not utilized at all. The Tax Department, upon completion of all levels of review, will schedule an appointment with the Senior Vice President and CFO, who will perform a review prior to signing the return. Once signed, the return is cleared to provide to members of the Board of Directors. Prior to efiling, the full board is provided access to the 990 via an online portal. IRS Form 990 Part VI Section B Line 12 As part of the annual process, conflict of interest questionnaires are sent out to all Officers, Directors, and other individuals in key positions in order to capture information on potential conflicts, as well as information on business and family relationships for purposes of answering certain questions on IRS Form 990. Responses to these questionnaires are reviewed weekly by the Vice President of Compliance, the Manager of Tax Compliance, and the Manager of Legal Services. Responses to questions are documented in a spreadsheet for follow up at a later time. After an approximate 6 week time frame, names of all non responders are compiled, and these individuals receive either an email or letter with a duplicate questionnaire, asking them once again to complete the information. Responses to questionnaires continue to be reviewed and documented throughout this time period. Approximately 1 month prior to the filing deadline of IRS Form 990, responses to date are compiled. Any response requiring disclosure is entered into the information return. Also at this date, the remaining non responder names are determined, and a letter, along with the actual Conflict of Interest Policy, is sent to the Chairperson of each board. The letter outlines the current non responders, as well as any Officer or Board member that has disclosed a financial interest that might pose a potential conflict of interest. Depending upon the nature of the financial interest and work done by the board, several actions may be considered - the board member with a financial interest would need to voluntarily excuse him or herself from the deliberations or voting on such a matter; or, if necessary, the board would determine that the subject's financial interest was an actual conflict of interest, in which case the board member would be informed by the board Chairperson that he or she would not be allowed to vote in any such matters due to this real or perceived conflict of interest. Minutes of the board meeting would document this decision process, and reflect whatever action(s) are ultimately taken. The board chairperson is also required to discuss with non responders the repercussions of not responding after two attempts, and require the board member to complete the annual conflict of interest disclosure questionnaire before being allowed to continue in any board matters. If the board member refuses, the Chairperson has the authority to determine the appropriate action, including, but not limited to prohibiting them from participating in deliberations, preventing them from voting, and/or removing them as a board member. IRS Form 990 Part VI Section B Line 15 The compensation of officers and key emplyees of the filing organization who are employed by Wheaton Franciscan Services, Inc.(WFSI), an unrelated organization, is reviewed and approved on an annual basis by the Executive Committee of the WFSI Board of Directors, an independent board, acting in a manner consistent with its conflicts of interest policy. The board's decision is informed by an opinion on market comparable compensation data provided to the board by an independent compensation expert. The organization maintains contemporaneous documentation of the substantiation of the deliberation and decision by the board. IRS Form 990 Part VI Section C Line 19 Covenant-Mercycare, Inc. provides upon request certain documents including financial statements, conflict of interest policy, and governing documents that support it's tax exempt status, including, but not limited to, articles of incorporation and bylaws. Requests for information are considered on a case-by-case basis, and this process is outlined in the Wheaton Franciscan Healthcare Public Disclosure Policy, adopted for use by Covenant-Mercycare, Inc.