Baum-Harmon Mercy Hospital

“The sole member of baum harmon mercy hospital (baum harmon) is mercy health services - iowa (mhs-ia). See line 7 for additional information.”

“Mhs-ia is the sole member of baum harmon. Mhs-ia has the right to appoint all persons to the board of directors of baum harmon.”

“As sole member, mhs-ia must approve certain decisions of the governing body, including the strategic plan, annual capital plan, and annual operating budget. Mhs-ia must also approve significant changes such as a merger, dissolution, sale of assets in excess of certain limits and modifications to governing documents.”

“Prior to filing, the form 990 for baum harmon 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.”

“Baum harmon 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 baum harmon, which includes directors, principal officers, key employees, and members of committees with board-delegated powers. Interested persons are expected to discharge their duties in a manner the person reasonably believes to be in the best interests of baum harmon and to avoid situations involving a conflict of interest. On an annual basis, interested persons are required to complete a conflict of interest disclosure statement and to affirm their receipt of the conflict of interest policy, compliance with its requirements, and agree to notify the organization of changes impacting their annual disclosure in accordance with the policy. The annual disclosures are provided to internal legal counsel and the integrity and compliance officer, from which legal counsel prepares a report for the board chair and ceo. A summary of potential conflicts is reviewed with the board of directors of baum harmon (or a delegated committee of the board) on a yearly basis. Interested persons are required to make full disclosure to baum harmon of any financial or business interests that might result in or have the appearance of a conflict of interest. The board of directors of baum harmon (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 baum harmon. 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.”

“Question 15a is answered "no" because the compensation for certain officers and key management officials of baum harmon is established by mercy medical center - sioux city, a related organization. Question 15b is answered "no" because the compensation for certain officers of baum harmon is established by trinity health, a related organization. In establishing certain officers' compensation, trinity health follows a process and policy that is intended to mirror the irc section 4958 guidelines for obtaining a "rebuttable presumption of reasonableness" with regard to compensation and benefits. As part of that process, the compensation and benefits of certain officers and directors of baum harmon are reviewed at least annually by the trinity health board or the trinity health human resources and compensation committee (hrcc) of the board, authorized to act on behalf of the board with respect to certain compensation matters. As part of its review process, the hrcc retains an independent firm experienced in compensation and benefit matters for not-for-profit health care organizations to advise it in the determinations it makes on the reasonableness of proposed compensation and benefits arrangements.”

“Baum harmon 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, baum harmon includes a copy of its most recently filed schedule h on trinity health's website: (www.trinity-health.org/mercy-medical-center-sioux-city-ia) baum harmon's governing documents and conflict of interest policy are available upon request.”

“Hartley mercy medical clinic paullina mercy medical clinic primghar mercy medical clinic sutherland mercy medical clinic”

“Medical services: program service expenses 549,911. Management and general expenses 0. Fundraising expenses 0. Total expenses 549,911. Contract labor: program service expenses 176,352. Management and general expenses 13,655. Fundraising expenses 0. Total expenses 190,007. Medical specialist fees: program service expenses 135,982. Management and general expenses 0. Fundraising expenses 0. Total expenses 135,982. Misc. Purchased services: program service expenses 72,441. Management and general expenses 5,609. Fundraising expenses 0. Total expenses 78,050. Laundry/linen services: program service expenses 8,288. Management and general expenses 642. Fundraising expenses 0. Total expenses 8,930. Consulting services: program service expenses 6,539. Management and general expenses 506. Fundraising expenses 0. Total expenses 7,045. Billing services: program service expenses 2,055. Management and general expenses 159. Fundraising expenses 0. Total expenses 2,214. Recruiting services: program service expenses 810. Management and general expenses 63. Fundraising expenses 0. Total expenses 873.”

“Equity transfers to/from affiliates 574,963.”

“Baum harmon's financial statements were included in the fy17 consolidated financial statements of trinity health, which were audited by an independent public accounting firm.”