2024-05-13T13:39:44-05:00 2023-06-30 990 2022-07-01 420680448 CATHOLIC HEALTH INITIATIVES - IOWA CORP CATH 5152473121 1111 6TH AVENUE DES MOINES IA 50314 TERRI DONOVAN INTERIM VP OF FINANCE 5152473121 2024-05-13 TERRI DONOVAN 999009999 1 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O FOR LIST KURT ANDERSEN MD 1111 6TH AVENUE DES MOINES IA 50314 896595007 0 0928 X WWW.MERCYONE.ORG/DESMOINES/ X 1965 IA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 18 12 5719 462 8748457 0 21441454 8004730 751622774 842325598 19636596 4661928 106550529 41602751 899251353 896595007 69069547 17309377 0 0 345907251 64983831 0 0 0 549954592 879778838 964931390 962072046 -65680037 -65477039 935566495 695250879 288508986 626801736 647057509 68449143 X WE, CATHOLIC HEALTH INITIATIVES - IOWA, CORP. AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. CATHOLIC HEALTH INITIATIVES - IOWA, CORP. IS A MEMBER OF TRINITY HEALTH. 0 0 849174898 17309377 870007755 CATHOLIC HEALTH INITIATIVES - IOWA, CORP. (MERCYONE DES MOINES) IS THE LONGEST CONTINUALLY OPERATING HOSPITAL IN DES MOINES AND IOWA'S LARGEST MEDICAL CENTER, WITH 802 BEDS AVAILABLE. THE HOSPITAL IS ONE OF THE MIDWEST'S LARGEST REFERRAL CENTERS.MERCYONE DES MOINES HAS RECEIVED MANY ACCOLADES FOR QUALITY CARE AND EXCELLENCE, BOTH LOCALLY AND ON A NATIONAL LEVEL. TOGETHER WITH COMMUNITY PARTNERS, MERCYONE DES MOINES IS FOCUSING ITS EFFORTS TO IMPROVE THE HEALTH OF THOSE MOST IN NEED.PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES AND SPECIALTIES:WWW.MERCYONE.ORG/LOCATION/MERCYONE-DES-MOINES-MEDICAL-CENTER 849174898 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 X 0 0 5719 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 18 12 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X TERRI DONOVAN 5156432588 1111 6TH AVENUE DES MOINES IA 50314 ROBERT RITZ DIRECTOR; CEO MERCY HEALTH NETWORK 1.00 54.00 X 0 1923691 64471 MICHAEL WEGNER DIRECTOR; PRES MERCYONE CENTRAL IA 50.00 5.00 X X 734589 553015 41869 KARL KEELER FORMER OFFICER 0.00 0.00 X 1166358 0 26358 DAVID HOCKMUTH MD CARDIOTHORACIC SURGEON 50.00 0.00 X 733754 389032 45754 MARK TANNENBAUM MD CARDIOLOGIST 50.00 0.00 X 641243 369278 50694 HIJINIO CARREON COO, MERCYONE CENTRAL IA 25.00 25.00 X 548147 380363 50450 AARON FROM MD CARDIOLOGIST 50.00 0.00 X 593815 323844 43747 BART JENSON MD CARDIOTHORACIC SURGEON 50.00 0.00 X 540075 301707 43747 ATUL CHAWLA MD CARDIOLOGIST 50.00 0.00 X 480755 359280 42739 MICHAEL FRAIZER MD DIRECTOR; CARDIOLOGIST 49.00 1.00 X 447404 268407 46716 NEIL HORNING MD DIRECTOR;PULMONOLOGIST CRITICAL CARE 1.00 49.00 X 0 713268 43388 RANDALL RUBIN SVP, CFO MERCYONE CENTRAL IA 44.00 6.00 X 319558 262266 44235 ERIN NETTELAND-SANDVIG MD DIRECTOR; PHYSICIAN FAMILY MEDICINE 1.00 49.00 X 0 531056 44733 JORDAN HARROP FORMER KEY EMPLOYEE 0.00 0.00 X 335175 0 25507 LINDA GOODWIN FORMER KEY EMPLOYEE 0.00 0.00 X 124748 0 33002 STEPHEN NOWAK DO DIRECTOR; PHYSICIAN FAMILY MEDICINE 1.00 19.00 X 0 51510 0 MONICA FRIEDMAN DIRECTOR; CHAIR 1.00 1.00 X X 0 0 0 THERESA MCCONEGHEY DIRECTOR; VICE CHAIR 1.00 1.00 X X 0 0 0 GLEN HALL DIRECTOR; SECRETARY 1.00 1.00 X X 0 0 0 TERRY LILLIS DIRECTOR; TREASURER 1.00 1.00 X X 0 0 0 EMILY ABBAS DIRECTOR 1.00 1.00 X 0 0 0 BRENDA CUSHING DIRECTOR 1.00 1.00 X 0 0 0 ERIN DRINNIN DIRECTOR 1.00 1.00 X 0 0 0 BRIAN JOHNSON DIRECTOR 1.00 1.00 X 0 0 0 PATRICIA MCDERMOTT DIRECTOR 1.00 1.00 X 0 0 0 TIMOTHY MILLER DIRECTOR 1.00 1.00 X 0 0 0 CHRIS NELSON DIRECTOR 1.00 1.00 X 0 0 0 MAURITA SOUKUP RSM DIRECTOR 1.00 3.00 X 0 0 0 6665621 6426717 647410 148 1 1 0 AMN HEALTHCARE 12400 HIGH BLUFF DR SAN DIEGO CA 92130 MEDICAL SERVICES 9743697 MEDICAL STAFFING SOLUTION 1085 KERN AVE RICE LAKE WI 54868 STAFFING SERVICES 8483648 GIFTED NURSES LLC 3330 W ESPLANADE AVE STE 505 METAIRIE LA 70002 STAFFING SERVICES 6523271 NISC NATL INFO SOLUTIONS COOP 3201 NYGREN DRIVE MANDAN ND 58554 IT SERVICES 5907863 GRAHAM CONSTRUCTION CO 56 16TH AVE SW CEDAR RAPIDS IA 52404 CONTRUCTION SERVICES 5360330 114 1872258 2232695 3899777 8004730 NET PATIENT SERVICE REVENUE 622110 790064594 790064594 PHARMACY REVENUE 456110 30389861 30389861 LABORATORY REVENUE 621500 21871143 13122686 8748457 842325598 2799472 2799472 2069754 0 2069754 2069754 2069754 1862456 0 1862456 1862456 1862456 OTHER OPERATING REVENUE 622110 36430614 36430614 CAFETERIA REVENUE 722514 3102383 3102383 39532997 896595007 870007755 8748457 9834065 X 17309377 17309377 3697019 762527 2934492 1711148 157750 1553398 49006630 42118335 6888295 2096290 1725507 370783 5291857 4269120 1022737 3180887 2449283 731604 45000 45000 318084 318084 451185639 372002536 79183103 2300320 648980 1651340 11272975 7461599 3811376 28199620 24358931 3840689 1010907 865329 145578 580668 535898 44770 15436504 15436504 17235883 16864221 371662 11403202 11402748 454 MEDICAL SUPPLIES EXP 196291478 196291478 I/C PURCHASED SERVICES 49298100 44685645 4612455 BAD DEBT EXPENSE 46583087 46583087 EQUIPMENT MAINTENANCE 18102294 16286309 1815985 30515077 26959734 3555343 962072046 849174898 112897148 0 5006 5008 23763595 33424342 130059691 141524357 25000 65000 26146315 21650717 2056570 26587460 279457239 15653355 311000190 263803884 10871899 329773300 8438756 11163891 112736828 177715565 935566495 695250879 97322559 91410144 645215 865682 190541212 534525910 288508986 626801736 X 647057509 68449143 647057509 68449143 935566495 695250879 X -65477039 8119632 -521250959 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 44262 0 0 0 44262 0 PART II-B, LINE 1: CATHOLIC HEALTH INITIATIVES - IOWA (MERCYONE DES MOINES) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCYONE DES MOINES WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 33335858 33335858 157484368 6077148 151407220 8182287 1296310 6885977 50307565 8279897 42027668 30147161 30147161 263803884 INTERCOMPANY RECEIVABLES 78076236 INVESTMENT IN UNCONSOLIDATED AFFILIATES 58988213 OPERATING LEASE RIGHT-OF-USE ASSETS 28213817 MISCELLANEOUS RECEIVABLES 12437299 177715565 INTERCOMPANY ACCOUNTS PAYABLE 39998449 INTERCOMPANY NOTES PAYABLE 436907160 OPERATING LEASE LIABILITIES 29670586 OTHER CURRENT LIABILITIES 27103279 ASSET RETIREMENT OBLIGATION 846436 534525910 PART V, LINE 4: ENDOWMENTS HELD BY MERCY FOUNDATION OF DES MOINES, IA (MERCY FOUNDATION) FOR THE BENEFIT OF MERCYONE DES MOINES ARE REPORTED ON THE FORM 990 OF MERCY FOUNDATION. MERCY FOUNDATION USES THE ENDOWMENT FUNDS AS DIRECTED BY THE ENDOWMENT DOCUMENTS. THE ENDOWMENTS FUND EQUIPMENT PURCHASES FOR TAX-EXEMPT HEALTH CARE NEEDS AND FUND HOSPITAL TAX-EXEMPT OPERATIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 5153504 5153504 0.00560 131753472 97079524 34673948 0.03790 136906976 97079524 39827452 0.04350 7 4548 509606 509606 0.00060 4 187 12418402 7225709 5192693 0.00570 1 10083 10083 0.00000 7 3113347 80915 3032432 0.00330 19 4735 16051438 7306624 8744814 0.00960 19 4735 152958414 104386148 48572266 0.05310 1 131250 131250 0.00010 1 7621 31257 31257 0.00000 2 7621 162507 162507 0.00010 1 46583087 0 159482480 180115307 -20632827 X 1 1 1 MERCY TERRACE HILL SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.50000 0.50000 2 RCG MERCY DES MOINES LLC PHYSICIAN SERVICES 0.20000 0.80000 3 WEST LAKES SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.51080 0.48920 3 1 MERCYONE DES MOINES MEDICAL CENTER 1111 6TH AVENUE DES MOINES IA 50314 WWW.MERCYONE.ORG/DESMOINES/ 770158H X X X A 2 MERCY REHABILITATION HOSPITAL LLC 1401 CAMPUS DR CLIVE IA 50325 WWW.MERCYREHABDESMOINES.COM 770123H X REHABILITATION SERVICES A 3 CLIVE BEHAVIORAL HEALTH HOSPITAL 1450 NW 114TH ST CLIVE IA 50325 WWW.CLIVEBEHAVIORAL.COM 770124H X BEHAVIORAL HEALTH SERVICES A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 21 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: MERCYONE DES MOINES MEDICAL CENTER, - FACILITY 2: MERCY REHABILITATION HOSPITAL, LLC, - FACILITY 3: CLIVE BEHAVIORAL HEALTH HOSPITAL GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 3J: N/ALINE 3E:CATHOLIC HEALTH INITIATIVES - IOWA (MERCYONE DES MOINES), MERCY REHABILITATION HOSPITAL (MERCYONE CLIVE REHAB), AND CLIVE BEHAVIORAL HEALTH INCLUDED IN THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. MENTAL HEALTH2. RESPIRATORY DISEASE (COVID-19)3. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT4. SUBSTANCE ABUSE5. HEART DISEASE AND STROKE6. ACCESS TO HEALTH CARE SERVICES7. INFANT HEALTH AND FAMILY PLANNING8. INJURY AND VIOLENCE9. DISABILITY AND CHRONIC PAIN10. SEXUAL HEALTH11. CANCER GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 5: INPUT WAS COLLECTED FROM JUNE TO AUGUST OF 2021 FROM PERSONS WHO REPRESENT THE COMMUNITY THROUGH SURVEYS CONDUCTED VIA TELEPHONE (LANDLINE AND CELL PHONE), AS WELL AS THROUGH ONLINE QUESTIONNAIRES. IN ALL, 537 AREA ADULTS COMPLETED THE COMMUNITY HEALTH SURVEY. TO SOLICIT INPUT FROM INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THIS PROCESS. IN ALL, 66 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. PARTICIPANTS INCLUDED 2 PHYSICIANS, 6 PUBLIC HEALTH REPRESENTATIVES (INCLUDING DALLAS COUNTY HEALTH DEPARTMENT, POLK COUNTY HEALTH DEPARTMENT, AND WARREN COUNTY PUBLIC HEALTH), 4 SOCIAL SERVICES PROVIDERS, 48 COMMUNITY LEADERS, AND 6 OTHER HEALTH PROVIDERS. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCYONE DES MOINES, MERCYONE CLIVE REHAB, AND CLIVE BEHAVIORAL HEALTH COLLABORATED WITH BROADLAWNS MEDICAL CENTER AND UNITYPOINT HEALTH-DES MOINES TO CONDUCT THE JOINT CHNA. GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: POLK COUNTY HEALTH DEPARTMENT, DALLAS COUNTY HEALTH DEPARTMENT, WARREN COUNTY HEALTH SERVICES, UNITED WAY OF CENTRAL IOWA, EVERYSTEP, AND MID-IOWA HEALTH FOUNDATION. GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 11: MERCYONE DES MOINES ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23: ACCESS TO HEALTH CARE SERVICES:- AWARDED A GRANT TO PRIMARY HEALTH CARE, A FEDERALLY QUALIFIED HEALTH CENTER, TO FUND THE OTHERWISE UNCOMPENSATED COST OF CARE PROVIDED AT THE FAMILY MEDICINE RESIDENCY CENTER;- CONTINUED TO HAVE A COMMUNITY HEALTH WORKER EMBEDDED IN THE EMERGENCY DEPARTMENT AND EXPANDED THE PROGRAM TO THE WEST LAKES CAMPUS TO ASSIST PATIENTS IN NAVIGATING COMMUNITY RESOURCES AND PUBLIC ASSISTANCE PROGRAMS;- PROVIDED ENROLLMENT ASSISTANCE IN GOVERNMENTAL INSURANCE PLANS; - UPON DISCHARGE OF PATIENTS, PROVIDED CAB VOUCHERS TO THOSE WHO COULD NOT AFFORD TRANSPORTATION AND PRESCRIPTION ASSISTANCE TO PATIENTS UNABLE TO PAY FOR NEEDED MEDICATION; AND - STARTED A REMOTE PATIENT MONITORING PILOT FOR PATIENTS WITH DIABETES, HYPERTENSION, CHRONIC KIDNEY DISEASE (CKD), AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). SUBSTANCE ABUSE: COLLABORATED WITH HOUSE OF MERCY (HOM) TO EXPAND SUBSTANCE USE DISORDER TREATMENT SERVICES AND TRAIN ADDITIONAL STAFF IN EVIDENCE-BASED COUNSELING AND THERAPEUTIC TECHNIQUES. TWO HOM COUNSELORS WERE DEDICATED TO PROVIDING SCREENING BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) AT MERCYONE DES MOINES WORKING DIRECTLY WITH NURSES, DOCTORS, AND SOCIAL WORKERS. THIS CONNECTION INCREASED COLLABORATION WITH HOM'S SUBSTANCE USE DISORDER SERVICES AND ALLOWED FOR A MORE SEAMLESS APPROACH FOR INDIVIDUALS TO ENTER TREATMENT. INFANT HEALTH AND FAMILY PLANNING: - EXPANDED COMMUNITY HEALTH WORKER COVERAGE TO THE OBSTETRIC EMERGENCY DEPARTMENT IN FY23 TO ASSIST PATIENTS IN NAVIGATING COMMUNITY RESOURCES, APPLYING FOR PUBLIC ASSISTANCE PROGRAMS, AND IDENTIFYING A MEDICAL HOME THAT MEETS THEIR PRE-NATAL CARE NEEDS AND PREFERENCES; - CONTRIBUTED TO AND PARTNERED WITH HEALTHY BIRTH DAY ON SEVERAL COMMUNITY EVENTS TO EDUCATE AND PROVIDE RESOURCES. HEALTHY BIRTH DAY'S MISSION IS TO IMPROVE BIRTH OUTCOMES THROUGH PROGRAMMING, ADVOCACY, AND SUPPORT; AND - SERVED ON UNITED WAY'S EARLY CHILDHOOD SUCCESS CABINET, WHICH IS FOCUSED ON INVESTING FUNDS TOWARD STRATEGIES TO ADDRESS INFANT MORTALITY, DEVELOPMENTAL SCREENINGS, QUALITY CHILDCARE, AND KINDERGARTEN READINESS. HEART DISEASE AND STROKE: - CONTRIBUTED TO THE AMERICAN HEART ASSOCIATION TO FURTHER RESEARCH, COMMUNITY OUTREACH, AND EDUCATION ON HEART DISEASE AND STROKE;- IN PARTNERSHIP WITH THE IOWA HEART CENTER, CONTINUED TO TREAT A VARIETY OF CARDIAC AND RELATED CONDITIONS USING THE LATEST MEDICAL TREATMENTS AND PROCEDURES, AS WELL AS EDUCATE PEOPLE ABOUT CARDIOVASCULAR HEALTH AND PREVENTIVE MEDICINE. MERCYONE DES MOINES DID NOT DIRECTLY ADDRESS ALL NEEDS IDENTIFIED IN THIS CYCLE, AS IT WAS DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THIS REASON, MERCYONE DES MOINES DID NOT DIRECTLY ADDRESS THE FOLLOWING NEEDS: MENTAL HEALTH; RESPIRATORY DISEASE (COVID-19); NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT; INJURY AND VIOLENCE; DISABILITY AND CHRONIC PAIN; SEXUAL HEALTH; AND CANCER. HOWEVER, MERCY DES MOINES CONTINUED TO COLLABORATE WITH OTHER AGENCIES TO ADDRESS THESE NEEDS. GROUP A-FACILITY 1 -- MERCYONE DES MOINES MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, AND PATIENTS WHO ARE ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (SUCH AS FOOD STAMPS OR LOW-INCOME/SUBSIDIZED HOUSING).FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. GROUP A-FACILITY 2 -- MERCY REHABILITATION HOSPITAL, LLC PART V, SECTION B, LINE 3J: LINE 3E: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 2 -- MERCY REHABILITATION HOSPITAL, LLC PART V, SECTION B, LINE 5: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 2 -- MERCY REHABILITATION HOSPITAL, LLC PART V, SECTION B, LINE 6A: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 2 -- MERCY REHABILITATION HOSPITAL, LLC PART V, SECTION B, LINE 6B: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 2 -- MERCY REHABILITATION HOSPITAL, LLC PART V, SECTION B, LINE 11: MERCYONE CLIVE REHAB ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23: MENTAL HEALTH: CLIVE BEHAVIORAL HEALTH AND MERCYONE CLIVE REHAB PARTNERED TO TRIAGE REHABILITATION PATIENTS WITH BEHAVIORAL HEALTH CONCERNS TO THE APPROPRIATE LEVEL OF CARE. CLIVE BEHAVIORAL HEALTH PROVIDED EDUCATION TO MERCYONE CLIVE REHAB STAFF ON AVAILABLE BEHAVIORAL HEALTH SERVICES. HEART DISEASE AND STROKE: MERCYONE CLIVE REHAB COMPLETED A GAP ANALYSIS IN FY23 TO IDENTIFY POPULATIONS WHO MAY BENEFIT FROM PHYSICAL MEDICINE AND REHABILITATION PROGRAMS BUT ARE NOT CURRENTLY ABLE TO BE CARED FOR AT THE HOSPITAL. FROM THIS ANALYSIS, THE HOSPITAL WILL BE FOCUSING ON STROKE PATIENTS IN FY24. THE HOSPITAL CONTINUED TO WORK TOWARDS A STROKE CERTIFICATION THROUGH THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES.MERCYONE CLIVE REHAB DID NOT DIRECTLY ADDRESS ALL NEEDS IDENTIFIED IN THIS CYCLE, AS IT WAS DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THIS REASON, MERCYONE CLIVE REHAB DID NOT DIRECTLY ADDRESS THE FOLLOWING NEEDS: RESPIRATORY DISEASE (COVID-19); NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT; SUBSTANCE ABUSE; ACCESS TO HEALTH CARE SERVICES; INFANT HEALTH AND FAMILY PLANNING; INJURY AND VIOLENCE; DISABILITY AND CHRONIC PAIN; SEXUAL HEALTH; AND CANCER. GROUP A-FACILITY 3 -- CLIVE BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 3J: LINE 3E: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 3 -- CLIVE BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 5: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 3 -- CLIVE BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 6A: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 3 -- CLIVE BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 6B: SEE FACILITY 1 EXPLANATION. GROUP A-FACILITY 3 -- CLIVE BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 11: CLIVE BEHAVIORAL HEALTH ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23: MENTAL HEALTH: CLIVE BEHAVIORAL HEALTH CONTINUED TO INCREASE CAPACITY FOR THEIR INPATIENT AND OUTPATIENT PROGRAMS. CLIVE BEHAVIORAL HEALTH LAUNCHED AN ADULT PARTIAL HOSPITALIZATION PROGRAM AND ADDED A SECOND COUNSELOR TO THE ADOLESCENT INTENSIVE OUTPATIENT PROGRAM. CLIVE BEHAVIORAL HEALTH AND MERCYONE CLIVE REHAB PARTNERED TO TRIAGE REHAB PATIENTS WITH BEHAVIORAL HEALTH CONCERNS TO THE APPROPRIATE LEVEL OF CARE. CLIVE BEHAVIORAL HEALTH PROVIDED EDUCATION TO MERCYONE CLIVE REHAB STAFF ON AVAILABLE BEHAVIORAL HEALTH SERVICES. SUBSTANCE ABUSE: CLIVE BEHAVIORAL HEALTH OPENED THE FIRST STEP RECOVERY CENTER, WHICH PROVIDES TREATMENT FOR ADULTS WITH CHEMICAL DEPENDENCY AND EMOTIONAL ISSUES OR RECURRING DISORDERS.CLIVE BEHAVIORAL HEALTH DID NOT DIRECTLY ADDRESS ALL NEEDS IDENTIFIED IN THIS CYCLE, AS IT WAS DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THIS REASON, CLIVE BEHAVIORAL HEALTH DID NOT DIRECTLY ADDRESS THE FOLLOWING NEEDS: RESPIRATORY DISEASE (COVID-19); NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT; HEART DISEASE AND STROKE; ACCESS TO HEALTH CARE SERVICES; INFANT HEALTH AND FAMILY PLANNING; INJURY AND VIOLENCE; DISABILITY AND CHRONIC PAIN; SEXUAL HEALTH; AND CANCER. PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 16A-C: FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY: WWW.MERCYONE.ORG/DESMOINES/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE 18 1 - MERCY OUTPATIENT CARDIAC TESTING 5880 UNIVERSITY SUITE 211 WEST DES MOINES IA 50266 AMBULATORY HEALTH CARE 2 - MERCY AMBULATORY SURGERY CENTER 411 LAUREL STREET DES MOINES IA 50314 AMBULATORY HEALTH CARE 3 - MERCY FRANKLIN CENTER 1818 48TH STREET DES MOINES IA 50314 BEHAVIORAL HEALTH 4 - RCG MERCY DES MOINES LLC 920 WINTER STREET WALTHAM MA 02451 PHYSICIAN SERVICES 5 - RIVER HILLS SURGERY CENTER 1111 6TH AVENUE DES MOINES IA 50314 SURGERY CENTER 6 - CENTRAL IOWA CYBERKNIFE 411 LAUREL STREET DES MOINES IA 50314 PHYSICIAN OFFICE 7 - MERCY WEIGHT LOSS & NUTRITION CENTER 12493 UNIVERSITY AVENUE SUITE 110 WEST DES MOINES IA 50235 AMBULATORY HEALTH CARE 8 - MERCY WEST ENDOSCOPY 1601 NW 114TH STREET SUITE 244 CLIVE IA 50325 AMBULATORY HEALTH CARE 9 - MERCY OUTPATIENT CARDIAC TESTING 411 LAUREL STREET DES MOINES IA 50314 AMBULATORY HEALTH CARE 10 - MERCY WEST RADIOLOGY 1601 NW 114TH STREET SUITE 149 CLIVE IA 50325 MEDICAL IMAGING 11 - MERCY CANCER CENTER 411 LAUREL STREET DES MOINES IA 50314 PHYSICIAN SERVICES 12 - WEST LAKES SURGERY CENTER LLC 12499 UNIVERSITY AVENUE SUITE 100 CLIVE IA 50325 SURGERY CENTER 13 - RADIOLOGY CENTER 12495 UNIVERSITY AVENUE CLIVE IA 50325 MEDICAL IMAGING 14 - MERCY SLEEP CENTER 1449 NW 128TH STREET SUITE 100 CLIVE IA 50325 AMBULATORY HEALTH CARE 15 - MERCY RIVERSIDE REHABILITATION CENTER 730 EAST 2ND STREET DES MOINES IA 50309 REHABILITATION CENTER 16 - MERCY CARDIAC & PULMONARY REHABILITATION 411 LAUREL STREET DES MOINES IA 50314 AMBULATORY HEALTH CARE 17 - MERCY ATRIUM IMAGING 411 LAUREL STREET DES MOINES IA 50314 MEDICAL IMAGING 18 - MERCY FAMILY MEDICINE RESIDENCY CENTER 250 LAUREL STREET DES MOINES IA 50314 PHYSICIAN OFFICE PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: CATHOLIC HEALTH INITIATIVES - IOWA, CORP. (MERCYONE DES MOINES) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.MERCYONE DES MOINES ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $46,583,087, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: WORKFORCE DEVELOPMENT: TO ADDRESS WORKFORCE SHORTAGES IN THE HEALTH CARE FIELD, MERCYONE DES MOINES PROVIDED AWARENESS AND EXPLORATION ACTIVITIES PROVIDING EXPOSURE TO A VARIETY OF HEALTH CARE CAREERS. MERCYONE DES MOINES ATTENDED OR HOSTED 20 EVENTS SERVING HIGH SCHOOL STUDENTS IN THE 2022-2023 SCHOOL YEAR. EVENTS INCLUDED SPEAKING TO STUDENTS ABOUT CAREERS IN HEALTH CARE, BRINGING STUDENTS TO THE HOSPITAL TO TOUR AND EXPLORE SPECIFIC CLINICAL PATHWAYS, CAREER FAIRS SHOWCASING DIFFERENT HEALTH CARE OPPORTUNITIES, AND ADDITIONAL CAREER EXPLORATION THROUGH GAMES AND HANDS-ON ACTIVITIES DURING ONSITE EVENTS. ECONOMIC DEVELOPMENT: MERCYONE DES MOINES FINANCIALLY CONTRIBUTED TO THE GREATER DES MOINES PARTNERSHIP TO HELP SPUR ECONOMIC DEVELOPMENT, ATTRACT, RETAIN, AND DEVELOP TALENT, AND SUPPORT SMALL BUSINESSES. EXAMPLES OF INITIATIVES INCLUDED: MINORITY BUSINESS INCUBATOR AND MINORITY BUSINESS ACCELERATOR, WHICH HELP SUPPORT STARTUP BUSINESSES AND PROVIDE EDUCATION TO SUSTAIN GROWTH; AND THE DOWNTOWN FUTURE FORWARD VISION PLAN TO HELP POSITION DOWNTOWN DES MOINES FOR SHORT-TERM ECONOMIC RECOVERY AND LONG-TERM ECONOMIC VITALITY AND VIBRANCY, PART OF WHICH INCLUDES ADDRESSING HOUSING INSECURITY BY PRESERVING AND ENHANCING AFFORDABLE HOUSING UNITS. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MERCYONE DES MOINES USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MERCYONE DES MOINES IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCYONE DES MOINES IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MERCYONE DES MOINES IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED." PART III, LINE 8: MERCYONE DES MOINES DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT -MERCYONE DES MOINES, MERCYONE CLIVE REHAB, AND CLIVE BEHAVIORAL HEALTH ASSESS THE HEALTH STATUS OF THEIR COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITALS USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCYONE DES MOINES COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. MERCYONE DES MOINES OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. NOTIFICATION ABOUT FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. INFORMATION REGARDING FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES.IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION -THE PRIMARY SERVICE AREA FOR MERCYONE DES MOINES, MERCYONE CLIVE REHAB, AND CLIVE BEHAVIORAL HEALTH INCLUDES POLK, WARREN, AND DALLAS COUNTIES IN IOWA. POLK, WARREN, AND DALLAS COUNTIES TOGETHER ENCOMPASS 1,730 SQUARE MILES AND HOUSE A TOTAL POPULATION OF 616,787 RESIDENTS, ACCORDING TO THE LATEST CENSUS ESTIMATES. IN THE SERVICE AREA, 25.4% OF THE POPULATION ARE CHILDREN FROM AGE 0 TO 17; ANOTHER 61.7% ARE INDIVIDUALS FROM AGE 18 TO 64, WHILE 12.9% ARE AGE 65 AND OLDER. IN LOOKING AT RACE INDEPENDENT OF ETHNICITY (HISPANIC OR LATINO ORIGIN), 85.9% OF RESIDENTS ARE WHITE AND 5.6% ARE BLACK. A TOTAL OF 7.6% OF RESIDENTS ARE HISPANIC OR LATINO. TWO IN THREE TOTAL SERVICE AREA ADULTS AGES 18 TO 64 (66.3%) REPORT HAVING HEALTH CARE COVERAGE THROUGH PRIVATE INSURANCE. ANOTHER 28.9% REPORT COVERAGE THROUGH A GOVERNMENT-SPONSORED PROGRAM (E.G., MEDICAID, MEDICARE, MILITARY BENEFITS). AMONG ADULTS AGES 18 TO 64, 4.8% REPORT HAVING NO INSURANCE COVERAGE FOR HEALTH CARE EXPENSES. THE LATEST CENSUS ESTIMATE SHOWS 9.5% OF THE SERVICE AREA POPULATION LIVE BELOW THE FEDERAL POVERTY LEVEL. AMONG THE SERVICE AREA POPULATION AGES 25 AND OLDER, AN ESTIMATED 7.6% DO NOT HAVE A HIGH SCHOOL EDUCATION, WHICH IS WELL BELOW THE NATIONAL PERCENTAGE. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH -MERCYONE DES MOINES OPERATES TWO MEDICAL CENTERS IN DES MOINES AND WEST DES MOINES AND TWO SPECIALTY HOSPITALS - MERCYONE CHILDREN'S HOSPITAL IN DES MOINES AND MERCYONE REHABILITATION HOSPITAL IN CLIVE - ALONG WITH MORE THAN 20 ADDITIONAL FACILITIES THAT HOUSE MORE THAN 60 PRIMARY CARE, PEDIATRIC, INTERNAL MEDICINE AND SPECIALTY CLINICS. ADDITIONALLY, MERCYONE DES MOINES PARTNERS WITH CLIVE BEHAVIORAL HEALTH TO PROVIDE INPATIENT CARE FOR PEOPLE WITH BEHAVIORAL HEALTH DISORDERS OR CO-OCCURRING DISORDERS. THE ORGANIZATION'S HOSPITAL FACILITIES HAVE AN OPEN MEDICAL STAFF. THE BOARD OF DIRECTORS REPRESENTS DIVERSE PROFESSIONAL EXPERTISE AND LIFE EXPERIENCE IN THE COMMUNITY. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT.MERCYONE DES MOINES COLLABORATES WITH HEALTH EDUCATION PROGRAMS IN THE AREA INCLUDING MERCY COLLEGE, DES MOINES UNIVERSITY, DRAKE UNIVERSITY, UNIVERSITY OF IOWA, SIMPSON COLLEGE, IOWA STATE UNIVERSITY, AND DES MOINES AREA COMMUNITY COLLEGE. MERCYONE DES MOINES ALSO OFFERS RESIDENCY PROGRAMS IN FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, PHARMACY, AND PSYCHIATRY, AS WELL AS A CARDIOLOGY FELLOWSHIP. MERCYONE DES MOINES OPERATES AN INSTITUTIONAL REVIEW BOARD THAT REVIEWS THE VARIOUS RESEARCH STUDIES CONDUCTED AT MERCYONE FACILITIES.MERCYONE DES MOINES CONTINUES TO SUPPORT THE COMMUNITY BY HAVING LEADERS ACTIVELY PARTICIPATE IN LOCAL COMMUNITY BOARDS. MERCYONE DES MOINES PARTICIPATES IN REGULAR BLOOD DRIVES THROUGHOUT THE YEAR AND HOSTS A FREE MAMMOGRAM EVENT TO PROVIDE UNINSURED OR UNDER-INSURED QUALIFYING PATIENTS WITH A SCREENING MAMMOGRAM. MERCYONE DES MOINES CONTINUES TO PARTNER WITH POLK COUNTY'S SEXUAL ASSAULT RESPONSE TEAM PROGRAM TO PROVIDE QUALITY, COMPASSIONATE AND CONSISTENT CARE TO VICTIMS OF SEXUAL ASSAULT. MERCYONE DES MOINES PROVIDES COMMUNITY EDUCATION COURSES SUCH AS STOP THE BLEED, WHICH PROVIDES TRAINING ON HOW TO STOP A LIFE-THREATENING HEMORRHAGE, AND MATTER OF BALANCE, A FALL PREVENTION PROGRAM. MERCYONE DES MOINES PROVIDES EDUCATIONAL COURSES TO COMMUNITY EMS, PARAMEDICS, NURSES, AND PROVIDERS ON VARIOUS TOPICS, INCLUDING AIRWAY MANAGEMENT, ADVANCED TRAUMA LIFE SUPPORT, AND RURAL TRAUMA TEAM DEVELOPMENT. PART VI, LINE 6: MERCYONE DES MOINES IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE - EMPHASIZING THE NECESSITY TO INTEGRATE SOCIAL AND CLINICAL CARE. WE DO THIS BY: 1. ADDRESSING PATIENT SOCIAL NEEDS, 2. INVESTING IN OUR COMMUNITIES, AND 3. STRENGTHENING THE IMPACT OF OUR COMMUNITY BENEFIT. TRINITY HEALTH CHWB TEAMS LEAD THE DEVELOPMENT AND IMPLEMENTATION OF TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES AND FOCUS INTENTIONALLY ON ENGAGING COMMUNITIES AND RESIDENTS EXPERIENCING POVERTY AND OTHER VULNERABILITIES. WE BELIEVE THAT COMMUNITY MEMBERS AND COMMUNITIES THAT ARE THE MOST IMPACTED BY RACISM AND OTHER FORMS OF DISCRIMINATION EXPERIENCE THE GREATEST DISPARITIES AND INEQUITIES IN HEALTH OUTCOMES AND SHOULD BE INCLUSIVELY ENGAGED IN ALL COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT EFFORTS. THROUGHOUT OUR WORK, WE DISMANTLE OPPRESSIVE SYSTEMS, AND BUILD COMMUNITY CAPACITY AND PARTNERSHIPS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2023 (FY23), TRINITY HEALTH CONTRIBUTED $1.47 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. IN ADDITION TO ANNUAL COMMUNITY BENEFIT SPENDING, TRINITY HEALTH IMPLEMENTS A SOCIALLY RESPONSIBLE INVESTING PROGRAM. AS OF THE END OF FY23, $62.7 MILLION (INCLUDING $7.0 MILLION IN NEW LENDING) WAS ALLOCATED IN THE FOLLOWING AREAS:- HOUSING: BUILDING AFFORDABLE HOUSING; IMPROVING ACCESS TO SENIOR HOUSING; AND COMBATTING HOMELESSNESS ($35.5 MILLION)- EDUCATION: SUPPORTING STUDENTS ENTERING THE HEALTH PROFESSIONS ($10.1 MILLION)- FACILITIES: BUILDING COMMUNITY FACILITIES FOR NONPROFITS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS ($9.7 MILLION)- ECONOMIC DEVELOPMENT: ENCOURAGING SMALL BUSINESS DEVELOPMENT, CREATING LOCAL JOBS AND SUPPORTING ACCESS TO HEALTHY FOODS; QUALITY CHILDCARE; AND OTHER COMMUNITY SERVICES ($7.4 MILLION)ACROSS THE SYSTEM, NEARLY 700,000 OF PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. FOR ABOUT 30% OF THOSE PATIENTS, AT LEAST ONE SOCIAL NEED WAS IDENTIFIED. TOGETHERCARE - TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, POWERED BY EPIC - HAS MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (COMMUNITYRESOURCES.TRINITY-HEALTH.ORG). COMMUNITY HEALTH WORKERS (CHW'S) SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES. TRINITY HEALTH CHW'S PARTNERED WITH POPULATION HEALTH NURSES AND SOCIAL WORK CARE MANAGERS TO SERVE MEDICARE PATIENTS AT RISK FOR PREVENTABLE HOSPITALIZATIONS, RESULTING IN A DECREASE IN PREVENTABLE HOSPITALIZATIONS FOR THE MEDICARE POPULATION OVERALL, AND ALSO FOR LOW-INCOME PATIENTS DUALLY ENROLLED IN MEDICARE AND MEDICAID. CHW'S ADVANCE SOCIAL AND CLINICAL CARE INTEGRATION BY ASSESSING AND ADDRESSING A PATIENT'S SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECTING THE PATIENT (AND THEIR FAMILY) TO SERVICES WITHIN THE COMMUNITY. TRINITY HEALTH PROVIDES A 40+ HOUR FOUNDATIONAL CHW AND CHRONIC DISEASE-SPECIFIC TRAINING TO TRINITY HEALTH-EMPLOYED CHW'S AND ALSO TO COMMUNITY PARTNERS THAT EMPLOY CHW'S. IN 2017, TRINITY HEALTH RECEIVED A SIX-YEAR, $8.5 MILLION GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO INCREASE THE NUMBER OF NATIONAL DIABETES PREVENTION PROGRAM (DPP) DELIVERY SITES, INCREASE PROGRAM ENROLLMENT, MAINTAIN PARTICIPATION RATES, AND INCREASE BENEFIT COVERAGE. IN ADDITION, THE GRANT WAS USED TO STANDARDIZE CLINICAL SCREENING AND DETECTION OF DIABETES. DURING THE GRANT PERIOD, TRINITY HEALTH BUILT THE NATIONAL DPP INTO ITS ELECTRONIC HEALTH RECORD SYSTEM TO MAKE IDENTIFYING PATIENTS AND ENROLLING THEM IN THE PROGRAM EASIER. SINCE SEPTEMBER 2017, OVER 6,000 PARTICIPANTS HAVE ENROLLED IN A TRINITY HEALTH NATIONAL DPP AND HAVE COLLECTIVELY LOST A TOTAL OF OVER 51,000 POUNDS.LASTLY, TRINITY HEALTH'S FY23 SHAREHOLDER ADVOCACY PRIORITIES FOCUSED ON IMPROVING CORPORATE POLICIES AND PRACTICES THAT IMPACT COMMUNITIES, WITH THE AIM OF REDUCING STRUCTURAL RACISM AND HEALTH INEQUITIES. TRINITY HEALTH, IN COLLABORATION WITH ITS PARTNERS THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY AND THE INVESTOR ENVIRONMENTAL HEALTH NETWORK, FILED SHAREHOLDER PROPOSALS AT 20 COMPANIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 1 GREATER DES MOINES COMMITTEE 700 LOCUST ST STE 100 DES MOINES IA 50309 420283250 501(C)(6) 125000 0 COMMUNITY SUPPORT GOLF CHARITABLE FOUNDATION 655 9TH ST DES MOINES IA 50393 812651226 501(C)(3) 300000 0 COMMUNITY SUPPORT DIOCESE OF DES MOINES 601 GRAND AVE DES MOINES IA 50309 420680255 501(C)(3) 34546 0 COMMUNITY SUPPORT HEALTHY BIRTH DAY 501 SW 7TH ST STE G DES MOINES IA 50309 263998964 501(C)(3) 32500 0 COMMUNITY SUPPORT CATHOLIC CHARITIES OF IOWA 601 GRAND AVE DES MOINES IA 50309 420680464 501(C)(3) 25000 0 COMMUNITY SUPPORT ABOVE & BEYOND CANCER 1915 GRAND AVE DES MOINES IA 50309 453951308 501(C)(3) 25000 0 COMMUNITY SUPPORT RONALD MCDONALD HOUSE CENTRAL IOWA 1441 PLEASANT ST DES MOINES IA 50314 421117423 501(C)(3) 22500 0 COMMUNITY SUPPORT INNERVISIONS HEALTHCARE 1355 50TH ST STE 400 WEST DES MOINES IA 50266 453790483 501(C)(3) 17500 0 COMMUNITY SUPPORT IOWA CATHOLIC RADIO 1355 50TH ST STE 500 WEST DES MOINES IA 50266 201935653 501(C)(3) 16916 0 COMMUNITY SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 15000 0 COMMUNITY SUPPORT MAKE A WISH FOUNDATION OF IOWA 3009 100TH ST URBANDALE IA 50322 421310530 501(C)(3) 15000 0 COMMUNITY SUPPORT OPERATION DOWNTOWN 700 LOCUST ST STE 100 DES MOINES IA 50309 861058466 501(C)(6) 15000 0 COMMUNITY SUPPORT CHILDSERVE FOUNDATION 5406 MERLE HAY RD JOHNSTON IA 50131 421157665 501(C)(3) 13500 0 COMMUNITY SUPPORT BRAVO GREATER DES MOINES 1915 GRAND AVE DES MOINES IA 50309 203598346 501(C)(3) 10000 0 COMMUNITY SUPPORT NATIONAL MULTIPLE SCLEROSIS SOCIETY 733 THIRD AVE 3RD FLOOR NEW YORK NY 10017 135661935 501(C)(3) 10000 0 COMMUNITY SUPPORT PRIMARY HEALTH CARE 3506 E 29TH ST DES MOINES IA 50317 421350092 501(C)(3) 1580020 0 COMMUNITY SUPPORT MERCY CLINICS INC 1111 6TH AVENUE DES MOINES IA 50314 421193699 501(C)(3) 14400400 0 PROGRAM SUPPORT MERCY MEDICAL CENTER - CENTERVILLE 1 ST JOSEPHS DRIVE CENTERVILLE IA 52544 420680308 501(C)(3) 602779 0 PROGRAM SUPPORT 16 2 PART I, LINE 2: DONATIONS MADE BY CATHOLIC HEALTH INITIATIVES - IOWA (MERCYONE DES MOINES) TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. X X X X X 1 1 0 0 0 0 0 0 0 ROBERT RITZ DIRECTOR; CEO MERCY HEALTH NETWORK 0 1340299 0 433955 0 149437 0 27617 0 36854 0 1988162 0 0 MICHAEL WEGNER DIRECTOR; PRES MERCYONE CENTRAL IA 603418 337641 122925 200793 8246 14581 17925 0 20243 3701 772757 556716 0 0 KARL KEELER FORMER OFFICER 166582 0 88530 0 911246 0 16978 0 9380 0 1192716 0 0 0 DAVID HOCKMUTH MD CARDIOTHORACIC SURGEON 726764 385324 0 0 6990 3708 17488 0 24392 3874 775634 392906 0 0 MARK TANNENBAUM MD CARDIOLOGIST 548531 288100 85722 77470 6990 3708 17750 0 28117 4827 687110 374105 0 0 HIJINIO CARREON COO, MERCYONE CENTRAL IA 465140 260359 76284 111253 6723 8751 17837 0 28098 4515 594082 384878 0 0 AARON FROM MD CARDIOLOGIST 507254 245923 85722 77470 839 451 17750 0 22908 3089 634473 326933 0 0 BART JENSON MD CARDIOTHORACIC SURGEON 450713 232296 85722 67477 3640 1934 17750 0 22908 3089 580733 304796 0 0 ATUL CHAWLA MD CARDIOLOGIST 392656 280095 85722 77470 2377 1715 16473 0 23084 3182 520312 362462 0 0 MICHAEL FRAIZER MD DIRECTOR; CARDIOLOGIST 360404 190253 85722 77470 1278 684 17750 0 24849 4117 490003 272524 0 0 NEIL HORNING MD DIRECTOR;PULMONOLOGIST CRITICAL CARE 0 709641 0 0 0 3627 0 17122 0 26266 0 756656 0 0 RANDALL RUBIN SVP, CFO MERCYONE CENTRAL IA 311196 179311 0 68574 8362 14381 17925 0 23128 3182 360611 265448 0 0 ERIN NETTELAND-SANDVIG MD DIRECTOR; PHYSICIAN FAMILY MEDICINE 0 529766 0 0 0 1290 0 16606 0 28127 0 575789 0 0 JORDAN HARROP FORMER KEY EMPLOYEE 102780 0 0 0 232395 0 17025 0 8482 0 360682 0 0 0 LINDA GOODWIN FORMER KEY EMPLOYEE 120209 0 0 0 4539 0 17193 0 15809 0 157750 0 0 0 PART I, LINES 4A-B CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2022. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JORDAN HARROP - $229,331 KARL KEELER - $907,882 PART I, LINE 4B: DURING THE 2022 CALENDAR YEAR, ROBERT RITZ WAS A PARTICIPANT IN THE COMMONSPIRIT HEALTH SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES. DUE TO THE "SUPER" VESTING RULES UNDER THIS PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS, SUCH AS AGE, OR AGE AND YEARS OF SERVICE, ARE ELIGIBLE TO RECEIVE THEIR 2022 CONTRIBUTIONS IN CASH. DURING 2022, THE FOLLOWING PAYMENT WAS MADE PURSUANT TO THE SUPER VESTING RULES AND IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: ROBERT RITZ - $127,049 PART V, LINE 1C: UNTIL SEPTEMBER 1, 2022, MERCYONE DES MOINES WAS A SUBSIDIARY IN THE COMMONSPIRIT HEALTH SYSTEM. PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 WERE ISSUED BY MERCYONE DES MOINES. COMMONSPIRIT HEALTH FILED THE 2022 FORMS 1099 AND COMPLIED WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. THE FORMS 1099 ISSUED ON BEHALF OF MERCYONE DES MOINES ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 2 BRENDA CUSHING, BOARD MEMBER, AND EMILY ABBAS, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION AND BYLAWS OF MERCYONE DES MOINES WERE AMENDED AND RESTATED TO CHANGE THE SOLE MEMBER OF THE CORPORATION. EFFECTIVE SEPTEMBER 1, 2022 THE SOLE MEMBER IS MERCY HEALTH NETWORK. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCYONE DES MOINES IS MERCY HEALTH NETWORK. AS OF SEPTEMBER 1, 2022, MERCY HEALTH NETWORK BECAME A WHOLLY-OWNED SUBSIDIARY OF TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A MERCY HEALTH NETWORK IS THE SOLE MEMBER OF MERCYONE DES MOINES. MERCY HEALTH NETWORK HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MERCYONE DES MOINES. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, MERCY HEALTH NETWORK MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH NETWORK MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. AS THE PARENT OF THE NATIONAL TRINITY HEALTH SYSTEM, CERTAIN POWERS ARE RESERVED TO TRINITY HEALTH CORPORATION. THESE INCLUDE THE AUTHORITY TO ADOPT OR MODIFY THE ORGANIZATION'S GOVERNING DOCUMENTS, TO APPROVE MAJOR CHANGES SUCH AS A MERGER OR DISSOLUTION, AND TO APPROVE SIGNIFICANT FINANCE MATTERS IN EXCESS OF CERTAIN LIMITS ESTABLISHED BY TRINITY HEALTH CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MERCYONE DES MOINES 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 MERCYONE DES MOINES HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCYONE DES MOINES, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DESIGNATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCYONE DES MOINES 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 THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, 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 MERCYONE DES MOINES (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCYONE DES MOINES OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCYONE DES MOINES (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 MERCYONE DES MOINES. 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 B, LINE 15 LINE 15A: THE ORGANIZATION USES A THIRD-PARTY CONSULTANT TO SURVEY COMPENSATION TRENDS ANNUALLY AND TO RECOMMEND COMPENSATION RANGES FOR THE PRESIDENT. THESE RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. THE SALARIES ARE COMPARED TO INDUSTRY STANDARDS AND GUIDELINES FOR APPROPRIATENESS. LINE 15B: FOR THE OFFICERS AND KEY EMPLOYEES, THE ORGANIZATION USES A THIRD-PARTY CONSULTANT TO ANNUALLY SURVEY COMPENSATION TRENDS AND RECOMMEND COMPENSATION RANGES. THESE RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 MERCYONE DES MOINES IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MERCYONE DES MOINES INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MERCYONE DES MOINES' GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 34,675,255. MANAGEMENT AND GENERAL EXPENSES 147,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,823,041. MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 21,605,141. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,605,141. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 5,619,952. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,619,952. LAUNDRY AND LINEN SERVICES: PROGRAM SERVICE EXPENSES 82,887. MANAGEMENT AND GENERAL EXPENSES 50,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,131. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 83,669,956. MANAGEMENT AND GENERAL EXPENSES 8,805,349. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,475,305. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 32,420. MANAGEMENT AND GENERAL EXPENSES 188,037. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 220,457. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 1,299,989. MANAGEMENT AND GENERAL EXPENSES 961,419. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,261,408. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 2,009. MANAGEMENT AND GENERAL EXPENSES 63,394. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,403. OUTSOURCED LABOR - COMMONSPIRIT: PROGRAM SERVICE EXPENSES 225,014,927. MANAGEMENT AND GENERAL EXPENSES 68,966,874. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 293,981,801. FORM 990, PART XI, LINE 9: OTHER TRANSACTIONS -524,730. EQUITY TRANSFERS FROM AFFLIATES 108,353,287. EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 6,415,912. PURCHASE ACCOUNTING ADJUSTMENT DUE TO ACCQUISITION BY TRINITY HEALTH SYSTEM ON SEPT 1, 2022 -635,495,428. FORM 990, PART XII, LINE 2: MERCYONE DES MOINES' FINANCIAL STATEMENTS WERE INCLUDED IN THE FY23 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: ADOLESCENT SEXUAL OFFENDER PROGRAM HEALTHY LIVING CENTER HEART CHECK INTENSIVE PSYCHOTHERAPY PROGRAM IOWA DIABETES AND ENDOCRINOLOGY CENTER IOWA HEART CENTER IOWA INTERNATIONAL HEART INSTITUTE OF MERCY HOSPITAL MERCY - CAPITOL MERCY HERITAGE CLUB THE MERCY LASER CENTER MERCY MEDICAL CENTER - DES MOINES MERCY MEDICAL CENTER - WEST LAKES MERCY NETWORK OF HEALTH SERVICES MERCY TELECARE MERCYONE DES MOINES MEDICAL CENTER MERCYONE HEALTH & FITNESS CENTER MERCYONE WEST DES MOINES MEDICAL CENTER MERCY HEALTH NETWORK ACO LLC 1111 6TH AVE DES MOINES IA 50314 812764963 ACCOUNTABLE CARE ORGANIZATION IA 0 0 CATHOLIC HEALTH INITIATIVES - IOWA CORP MERCY ACO LLC 1111 6TH AVE DES MOINES IA 50314 454498644 ACCOUNTABLE CARE ORGANIZATION IA 46521374 15412841 CATHOLIC HEALTH INITIATIVES - IOWA CORP ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL HEALTH FOUNDATION-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 521025476 FOUNDATION NJ 501(C)(3) LINE 7 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH LIFE INC 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH MEDICAL GROUP-EAST TRENTON PA 601 HAMILTON AVENUE TRENTON NJ 08629 832199054 HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 223431049 HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI MI 48197 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 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 MERCY HEALTH NETWORK INC 0 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 420818642 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY COMMUNITY HOSPITAL GROUP LLC 1 COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421295784 FOUNDATION IA 501(C)(3) LINE 7 COVENANT MEDICAL CENTER INC 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 INC 1 DILEY RIDGE MEDICAL CENTER 3100 EASTON SQUARE PL STE 300 COLUMBUS OH 43219 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC PO BOX 9184 FARMINGTON HILLS MI 48333 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 TRINITY CONTINUING CARE SERVICES 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL INC 1 GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME STREET DAVENPORT IA 52803 421421670 FOUNDATION IA 501(C)(3) LINE 7 GENESIS HEALTH SYSTEM 1 GENESIS HEALTH SYSTEM 1227 E RUSHOLME STREET DAVENPORT IA 52803 421418847 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM (IL) 801 ILLINI DRIVE SILVIS IL 61282 363616314 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST 1227 E RUSHOLME STREET DAVENPORT IA 52803 391905171 EMPLOYEE BENEFIT TRUST IA 501(C)(3) LINE 12A, I GENESIS HEALTH SYSTEM 1 GENESIS MEDICAL CENTER ALEDO 409 NW 9TH AVENUE ALEDO IL 61231 454475683 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 GENESIS HEALTH SYSTEM (IL) 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 TRINITY HEALTH GEORGIA INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 12D, III-O N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HEARTWOOD LODGE TRINITY HEALTH (FKA NORTH OTTAWA CARE CENTER) 18525 WOODLAND RIDGE SPRING LAKE MI 49456 382602971 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 520738041 HEALTH CARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791028 HEALTH CARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 465421068 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 812531495 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOLY CROSS SENIOR SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 832256461 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY NY 12180 141514867 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 50401 421173708 HOSPICE SERVICES IA 501(C)(3) LINE 10 MERCY HEALTH SERVICES-IOWA CORP 1 HOSPICE OF NORTH OTTAWA COMMUNITY INC 1027 SOUTH BEACON BLVD GRAND HAVEN MI 49417 382370192 HOSPICE 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