BURGESS HEALTH CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- BURGESS HEALTH CENTER (EIN 42-0859940)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-14
- IRS object ID
- 202501349349306720
- Schema version
- 2023v6.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-14T12:50:09-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420859940 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BURG | BusinessNameControlTxt |
| Phone | 7124232311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 DIAMOND STREET | AddressLine1Txt |
| City | ONAWA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51040 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN WOLD | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 7124232311 | PhoneNum |
| Signature | 2025-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL CPA | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2025-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LYNN WOLD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 DIAMOND STREET | AddressLine1Txt |
| City | ONAWA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $73,741,611 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BURGESSHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 335 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $2,199,677 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,976,616 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,426,773 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,801,308 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,995,382 | CYProgramServiceRevenueAmt |
| PY Investment Income | $878,770 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,273,566 | CYInvestmentIncomeAmt |
| PY Other Revenue | $255,371 | PYOtherRevenueAmt |
| CY Other Revenue | $370,638 | CYOtherRevenueAmt |
| PY Total Revenue | $33,912,065 | PYTotalRevenueAmt |
| CY Total Revenue | $43,066,359 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,177,252 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,749,454 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,481,513 | PYOtherExpensesAmt |
| CY Other Expenses | $16,556,959 | CYOtherExpensesAmt |
| PY Total Expenses | $35,658,765 | PYTotalExpensesAmt |
| CY Total Expenses | $36,306,413 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,746,700 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,759,946 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,607,419 | TotalAssetsBOYAmt |
| Total Assets EOY | $66,207,546 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,627,480 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,037,952 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $38,979,939 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $43,169,594 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BURGESS HEALTH CENTER IS COMMITTED TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES IT SERVES BY PROVIDING EXCELLENT HEALTHCARE AND EXCEPTIONAL PATIENT EXPERIENCES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,295,226 | ExpenseAmt |
| Revenue | $31,146,014 | RevenueAmt |
| Desc | BURGESS HEALTH CENTER INCLUDES A NOT-FOR-PROFIT ACUTE CARE HOSPITAL. OUR PHYSICIANS AND STAFF ARE COMMITTED TO PROVIDING PATIENTS WITH COMPASSIONATE, KNOWLEDGEABLE AND TRUSTWORTHY CARE. WE PROVIDE THE FOLLOWING SERVICES: CANCER CARE AND INFUSION, CARDIAC REHABILITATION, DIABETES CENTER, EMERGENCY SERVICES, HOME HEALTH, HOSPICE, PRIVATE DUTY AND LIFE ASSIST CARE, ON-SITE LABORATORY, MENTAL HEALTH, SURGERY, FAMILY BEGINNINGS, ORTHOPEDICS, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, PULMONARY REHAB, RADIOLOGY, SCREENINGS, AND VARIOUS OUTPATIENT SPECIALTY CLINICS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,505,568 | ExpenseAmt |
| Revenue | $2,758,007 | RevenueAmt |
| Desc | BURGESS HEALTH CENTER INCLUDES TWO RURAL HEALTH CLINICS IN A FOUR COUNTY SERVICE AREA. CLINICS ARE LOCATED IN SLOAN AND MAPLETON, IOWA; WHICH ARE STAFFED BY DEDICATED PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS TO PROVIDE A COMPLETE SPECTRUM OF HEALTHCARE SERVICES FOR THE WHOLE FAMILY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,000,983 | ExpenseAmt |
| Revenue | $1,101,834 | RevenueAmt |
| Desc | BURGESS HEALTH CENTER INCLUDES HOME HEALTH SERVICES. STAFF ARE DEDICATED TO ADD COMFORT TO PATIENTS' RECOVERY, EASE THE IMPACT ON FRIENDS AND FAMILY, AND HELP PATIENTS' TRANSITION TO LIFESTYLE ADJUSTMENTS NECESSARY FOR THE ILLNESS. SERVICES INCLUDE I.V. MEDICATIONS, NOURISHMENT, WOUND CARE, HYGIENE AND DAILY LIVING ASSISTANCE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES, SUPPORT THROUGH SOCIAL WORKERS, SKILLED NURSING VISITS, AND HOMEMAKER SERVICES.BURGESS HOSPICE STAFF PROVIDE PROFESSIONAL GRIEF COUNSELORS AND SKILLED VOLUNTEERS TO PATIENTS (TYPICALLY WITH A LIFE-LIMITING ILLNESS WITH A SHORT-TERM SURVIVAL ESTIMATE). ENSURING THE PATIENT IS AS COMFORTABLE AND PAIN-FREE AS POSSIBLE. THEY, ALSO, HELP FAMILY MEMBERS COPE WITH END OF LIFE ISSUES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $31,801,777 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 335 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN WOLD | PersonNm |
| Phone | 7124239206 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 DIAMOND STREET | AddressLine1Txt |
| City | ONAWA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51040 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOHN GARRED JR MD | |||||||||
| BOARD MEMBER THRU 05/2024 | 40.00 | Yes (X) | $264,315 | $0 | $39,829 | ||||
| PAUL DUDLEY MD | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $24,140 | $0 | $0 | ||||
| KEITH SCHRUNK OD | |||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| MARI MILLER | |||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| AMY MAULE | |||||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| SHEILA DUARTE DDS | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| TERRY MURRELL | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MATTHEW MINNIHAN | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ANDY TIREVOLD | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| BEAU HUPKE | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEFFREY PRATT | |||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARY BLACK | |||||||||
| BOARD MEMBER THRU 11/2024 | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| CARL BEHNE | |||||||||
| CEO THRU 3/2024 | 39.00 | $143,613 | $0 | $15,540 | Yes (X) | 1.00 | |||
| JOHN WILKER | |||||||||
| VICE PRESIDENT OF FINANCE THRU 09/2023 | 39.00 | $156,821 | $0 | $631 | Yes (X) | 1.00 | |||
| LYNN WOLD | |||||||||
| CEO | 39.00 | $74,512 | $0 | $16,859 | Yes (X) | 1.00 | |||
| JAMES GOBELL | |||||||||
| VICE PRESIDENT OF FINANCE | 39.00 | $32,181 | $0 | $1,271 | Yes (X) | 1.00 | |||
| TERESA BUTLER | |||||||||
| VP OF CLINICAL SERVICES/IN | 40.00 | $174,167 | $0 | $17,924 | Yes (X) | ||||
| WASEEM ALOUNK MD | |||||||||
| PHYSICIAN | 40.00 | $478,079 | $0 | $55,649 | Yes (X) | ||||
| RACHEL KNUDSON DO | |||||||||
| GENERAL SURGERY SPECIALIST | 40.00 | $441,204 | $0 | $48,871 | Yes (X) | ||||
| PETER DAHER MD | |||||||||
| PHYSICIAN | 40.00 | $381,646 | $0 | $46,610 | Yes (X) | ||||
| MONTY MCKINVEN | |||||||||
| CRNA | 40.00 | $266,827 | $0 | $46,594 | Yes (X) | ||||
| LYNN CHARRLIN MD | |||||||||
| PHYSICIAN | 40.00 | $252,925 | $0 | $27,797 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,690,430 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $317,575 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GRAHAM CONSTRUCTION CO | |||||
| 421 GRAND AVENUE | DES MOINES | IA | 50309 | CONTRACTOR FOR BUILDING | $564,763 |
| GRAPETREE MEDICAL STAFFING INC | |||||
| 2501 BOJI BEND DRIVE | MILFORD | IA | 51351 | STAFFING | $467,870 |
| FAMILY MEDICINE CLINIC PC | |||||
| 1614 DIAMOND STREET PLACE | ONAWA | IA | 51040 | ER PHYSICIAN COVERAGE | $415,407 |
| CNOS PC | |||||
| 575 SIOUX POINT RD | DAKOTA DUNES | SD | 57049 | PHYSICIAN SERVICES | $287,990 |
| RODNEY J DEAN MD PC | |||||
| 3549 SOUTHERN HILLS DRIVE | SIOUX CITY | IA | 51102 | PHYSICIAN SERVICES | $141,980 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $558,604 | RelatedOrganizationsAmt |
| Government Grants | $696,388 | GovernmentGrantsAmt |
| All Other Contributions | $171,781 | AllOtherContributionsAmt |
| Total Contributions | $1,426,773 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $34,656,740 | $34,656,740 | |
| RETAIL PHARMACY | 456110 | $2,199,677 | $2,199,677 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $138,965 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $138,965 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,995,382 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,015,626 | TotalRevenueColumnAmt |
| Exclusion | $1,015,626 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $283,117 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $65,091 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $218,026 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $218,026 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $143,635 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $74,391 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $33,856,101 | SecuritiesAmt |
| Other | $12,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $30,610,161 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,245,940 | SecuritiesAmt |
| Other | $12,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,257,940 | TotalRevenueColumnAmt |
| Exclusion | $3,257,940 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA / DIETARY | 722514 | $86,097 | $86,097 | |
| REBATES / DISCOUNTS | 900099 | $66,515 | $66,515 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $152,612 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,066,359 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,005,855 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,199,677 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,434,054 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $961,804 | TotalAmt |
| Program Services | $222,315 | ProgramServicesAmt |
| Management And General | $739,489 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,446 | TotalAmt |
| Program Services | $149,446 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,077,871 | TotalAmt |
| Program Services | $13,856,334 | ProgramServicesAmt |
| Management And General | $1,221,537 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,340 | TotalAmt |
| Program Services | $271,397 | ProgramServicesAmt |
| Management And General | $39,943 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,231,613 | TotalAmt |
| Program Services | $2,036,410 | ProgramServicesAmt |
| Management And General | $195,203 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017,380 | TotalAmt |
| Program Services | $897,390 | ProgramServicesAmt |
| Management And General | $119,990 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,867 | TotalAmt |
| Management And General | $93,867 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,901 | TotalAmt |
| Management And General | $107,901 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,492,176 | TotalAmt |
| Program Services | $2,093,315 | ProgramServicesAmt |
| Management And General | $1,398,861 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,050 | TotalAmt |
| Program Services | $410 | ProgramServicesAmt |
| Management And General | $51,640 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,102,793 | TotalAmt |
| Program Services | $1,882,881 | ProgramServicesAmt |
| Management And General | $219,912 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,535 | TotalAmt |
| Program Services | $9,535 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,512 | TotalAmt |
| Program Services | $402,608 | ProgramServicesAmt |
| Management And General | $33,904 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,433 | TotalAmt |
| Program Services | $86,740 | ProgramServicesAmt |
| Management And General | $17,693 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $845,296 | TotalAmt |
| Program Services | $805,130 | ProgramServicesAmt |
| Management And General | $40,166 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,093,145 | TotalAmt |
| Program Services | $1,996,198 | ProgramServicesAmt |
| Management And General | $96,947 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,908 | TotalAmt |
| Program Services | $253,412 | ProgramServicesAmt |
| Management And General | $12,496 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,191,244 | $4,191,244 | |
| RETAIL PHARMACY EXPENSE | $2,389,121 | $2,389,121 | |
| FOOD | $152,210 | $152,210 | |
| LICENSES & TAXES | $106,195 | $43,723 | $62,472 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,573 | TotalAmt |
| Program Services | $61,958 | ProgramServicesAmt |
| Management And General | $52,615 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,306,413 | TotalAmt |
| Program Services | $31,801,777 | ProgramServicesAmt |
| Management And General | $4,504,636 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,454 | BOYAmt |
| EOY | $3,454,225 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,050,493 | BOYAmt |
| EOY | $20,415,500 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,525,420 | BOYAmt |
| EOY | $6,139,440 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,656 | BOYAmt |
| EOY | $141,577 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,234,398 | BOYAmt |
| EOY | $952,097 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $551,592 | BOYAmt |
| EOY | $499,730 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,635,363 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,354,928 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,536,329 | BOYAmt |
| EOY | $28,280,435 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,264,283 | BOYAmt |
| EOY | $4,160,705 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,098,794 | BOYAmt |
| EOY | $2,163,837 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,607,419 | BOYAmt |
| EOY | $66,207,546 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,736,593 | BOYAmt |
| EOY | $2,813,836 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $661,492 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,349,542 | BOYAmt |
| EOY | $19,321,818 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $879,853 | BOYAmt |
| EOY | $902,298 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,627,480 | BOYAmt |
| EOY | $23,037,952 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,979,939 | BOYAmt |
| EOY | $43,169,594 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,979,939 | BOYAmt |
| EOY | $43,169,594 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,607,419 | BOYAmt |
| EOY | $66,207,546 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,759,946 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,570,291 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,340 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,340 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | BURGESS HEALTH CENTER PAYS ASSOCIATION DUES TO THE IOWA HOSPITAL ASSOCIATION (IHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). PORTIONS OF THE ASSOCIATION DUES ARE EXPENDED BY THE ASSOCIATIONS FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $85,000 | OtherCostOrOtherBasisAmt |
| Book Value | $85,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,391,731 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,170,675 | DepreciationAmt |
| Book Value | $4,221,056 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,719,222 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,555,248 | DepreciationAmt |
| Book Value | $2,163,974 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,439,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $629,005 | DepreciationAmt |
| Book Value | $21,810,405 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $28,280,435 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $277,215 |
| RIGHT OF USE LEASE LIABILITY | $107,582 |
| RELATED PARTY PAYABLE | $517,501 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $902,298 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HEALTH CENTER AND FOUNDATION ACCOUNT FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HEALTH CENTER AND FOUNDATION RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2024 AND 2023, THE HEALTH CENTER AND FOUNDATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $161,125 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $161,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,895,489 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,895,489 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,056,614 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,895,489 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $161,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $92,828 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $92,828 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,325,236 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,844,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $480,429 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,418,064 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,844,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $573,257 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,474,678 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,740,296 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $734,382 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $884,961 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $265,488 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,961,518 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,170,491 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$208,973 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 DIAMOND STREET | AddressLine1Txt |
| City | ONAWA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 61040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BURGESSHC.ORG | WebsiteAddressTxt |
| State License | 670082H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.BURGESSHC.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BURGESSHC.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BURGESSHC.ORG/CURRENT-PATIENTS/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BURGESSHC.ORG/CURRENT-PATIENTS/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.BURGESSHC.ORG/CURRENT-PATIENTS/FINANCIAL-ASSISTANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BURGESS HEALTH CENTER | PART V, SECTION B, LINE 5: COMMUNITY STAKEHOLDERS WERE ASKED TO DETERMINE KEY AREAS THEY SEE AS A CONCERN. STAKEHOLDERS WERE CHOSEN TO SHOWCASE A UNIQUE PERSPECTIVE OF COUNTY BARRIERS BASED ON THEIR PROFESSIONS, CHILDREN, HEALTHCARE SERVICES, COUNTY AND SURROUNDING COUNTY SERVICES AND INDIVIDUAL TOWN NEEDS. STAKEHOLDERS INCLUDED:- SCHOOL ADMINISTRATORS - BURGESS HEALTH CENTER DIRECTORS- MONONA COUNTY WELLNESS COALITION - ONAWA CHAMBER OF COMMERCE- MONONA COUNTY CHILD ABUSE PREVENTION COUNCIL - MONONA COUNTY BOARD OF HEALTH- MONONA COUNTY COMMUNITY MAYORSTHE INFORMATION COLLECTED WAS ANALYZED AND A COMMUNITY SURVEY WAS CREATED TO DETERMINE WHAT RESIDENTS OF MONONA COUNTY FELT WERE AREAS OF GREATEST CONCERN. THE SURVEY INCLUDED DEMOGRAPHICS AND FOUR QUESTIONS TO HELP NARROW THE BARRIERS FACED BY MONONA COUNTY RESIDENTS. THE SURVEY WAS MADE AVAILABLE ONLINE AND IN PRINT. IT WAS ADVERTISED ON SOCIAL MEDIA, IN NEWSPAPERS AND FLYERS WERE PLACED IN LOCAL ESTABLISHMENTS. A TOTAL OF 104 RESIDENT RESPONDED TO THE SURVEY, ACCOUNTING FOR 1.2% OF THE POPULATION. |
| BURGESS HEALTH CENTER | PART V, SECTION B, LINE 11: NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA INCLUDE: MENTAL HEALTH AND MENTAL HEALTH DISORDERS, OVERWEIGHT AND OBESITY RATES, OLDER HEALTH/AGING ISSUES, AND RATE OF CANCER. TO ADDRESS, EDUCATE AND PREVENT THE PRIMARY CONCERNS OF THE CHNA, BURGESS HEALTH CENTER HAS DEVELOPED THE FOLLOWING GOALS AND PROGRAMS TO ADDRESS THE NEEDS IDENTIFIED IN OUR SERVICE AREA:1) MENTAL HEALTH AND MENTAL HEALTH DISORDERS - PARTNERED WITH VA TO BRING "ASK THE QUESTION" CAMPAIGN TO BURGESS CLINICS, AND WORKED WITH NAMI SOUTHWEST IOWA TO BRING SUPPORT GROUPS TO MONONA COUNTY. STARTED PROGRAMS CALLED UNLICKING BRAIN FITNESS FOR DEMENTIA PREVENTIA. PROMOTED THE 988 MENTAL HEALTH NUMBER THROUGH SOCIAL MEDIA AND COMMUNITY PARTNERS. PROMOTED MENTAL HEALTH WALK-IN CLINIC FOR THOSE THAT ARE WAITING TO BE SEEN BY A THERAPIST. WORKED WITH FUNERAL DIRECTORS TO ACCESS MORE INFORMATION ON SUICIDE AND HELPING FAMILIES COPE WHEN LOSING SOMEONE TO SUICIDE.2) OVERWEIGHT AND OBESITY RATES - PROMOTED HEALTHY LIFESTYLES AND ROUTINE CHECK-UPS WITH PHYSICIANS VIA SOCIAL MEDIA. STARTED 5 2 1 0 PROGRAM IN WEST MONONA SCHOOL, AS WELL AS THE "DIABETES PREVENTION" PROGRAM THAT IS FREE FOR ALL PARTCIPANTS. WORKED WITH THE CITY OF ONAWA ON CREATING A WALKING TRAIL.3) OLDER HEALTH/AGING ISSUES - PROMOTED HEALTH MONTH AND WELLNESS CHECKUPS, AS WELL AS ROUTINE WELLNESS VISITS AND MEN'S HEALTH MONTH FOR SCREENINGS. STARTED DEMENTIA PREVENTION CLASS IN ONAWA CALLED UNLOCKING THE KEYS TO DEMENTIA PREVENTION. PROMOTED SPECIALTY SERVICES SUCH AS COLONOSCOPIES, DIABETES PREVENTION, ORTHOPEDIC SERVICES, ETC.4) RATES OF CANCER - PROMOTED COLORECTAL CANCER SCREENING THROUGH COMPUTER SOFTWARE, AS WELL AS MEN'S HEALTH MONTH AND ROUTINE VISITS FOR EARLY CANCER DETECTION. PROMOTED ANNUAL WELLNESS VISITS AND CHRONIC CARE MANAGEMENT FOR MEDICARE PATIENTS.THERE WERE NO SIGNIFICANT NEEDS IDENTIFIED THAT ARE NOT CURRENTLY BEING ADDRESSED. OTHER NEEDS THAT WERE IDENTIFIED, BUT NOT ADDRESSED INCLUDE DIABETES, RADON TESTING AND PREVENTION, IMMUNIZATIONS, CANCER SCREENINGS, LOW BIRTH WEIGHT, DEPRESSION, ACCIDENTS AND EMERGENCY PREPAREDNESS. THESE NEEDS WERE NOT ADDRESSED BECAUSE OTHER EXISTING PROGRAMS ARE ALREADY ADDRESSING THE NEED OR THERE IS A LACK OF HUMAN AND FINANCIAL RESOURCES TO DEDICATE TO THE ISSUE. |
| BURGESS HEALTH CENTER | PART V, SECTION B, LINE 13B: BURGESS HEALTH CENTER USES HUD GUIDELINES FOR IOWA WHICH ARE LESS RESTRICTIVE FOR THE PATIENTS. THESE GUIDELINES CAN BE FOUND AT HUDUSER.GOV. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - BURGESS FAMILY CLINIC - MAPLE VALLEY | ||||
| 513 SOUTH MUCKEY STREET | MAPLETON | IA | 51304 | FAMILY MEDICAL CLINIC |
| 2 - BURGESS FAMILY CLINIC - SLOAN | ||||
| 409 EVANS | SLOAN | IA | 51055 | FAMILY MEDICAL CLINIC |
| 3 - BURGESS CLINIC WHITING | ||||
| 153 BLAIR STREET | WHITING | IA | 51063 | FAMILY MEDICAL CLINIC |
| 4 - BURGESS HOME CARE & HOSPICE | ||||
| 1600 DIAMOND ST | ONAWA | IA | 51040 | HOSPICE AND HOME HEALTH CARE |
| 5 - BURGESS COMMUNITY MENTAL HEALTH CENTER | ||||
| 1600 DIAMOND ST | ONAWA | IA | 51040 | OUTPATIENT ADULT BEHAVIORAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | BURGESS HEALTH CENTER USES HUD GUIDELINES WHICH ARE LESS RESTRICTIVE FOR OUR PATIENTS. THE HOSPITAL DOES NOT USE ASSET TESTING OR OTHER FACTORS REGARDLESS OF INCOME AS A FACTOR TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. OTHER FACTORS USED INCLUDE MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, AND SUBSIDIZED HEALTH SERVICES, LINE 7G, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. |
| PART I, LINE 7G: | ALL COSTS REPORTED ON PART I, LINE 7G ARE ATTRIBUTABLE TO THE PHYSICIAN CLINICS. |
| PART III, LINE 2: | THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE HEALTH CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. THE AMOUNT REPORTED AS IMPLICIT PRICE CONCESSIONS DURING THE YEAR IS $884,961. |
| PART III, LINE 3: | THE IMPLICIT PRICE CONCESSIONS RECOGNIZED OF $884,961, IS 2.55% OF NET PATIENT SERVICE REVENUE FOR THE FISCAL YEAR. BURGESS HEALTH CENTER ESTIMATES THAT 30% OF IMPLICIT PRICE CONCESSIONS IS FOR PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE IF THEY WOULD APPLY. ALL OF THIS AMOUNT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 10 AND 11 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | IF ALL RESPONSIBLE PERSONS APPLY FOR FINANCIAL ASSISTANCE UNDER THE POLICY, AND THE BUSINESS OFFICE DETERMINES DEFINITIVELY THAT THE RESPONSIBLE INDIVIDUALS ARE INELIGIBLE FOR ANY FINANCIAL ASSISTANCE UNDER THE POLICY (INCLUDING BECAUSE THE PATIENT WAS NOT UNINSURED), BHC MAY INITIATE ECAS.IF ANY RESPONSIBLE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE POLICY PRIOR TO THE APPLICATION DEADLINE, THEN ECAS MAY NOT BE INITIATED UNTIL AFTER EACH OF THE FOLLOWING STEPS HAS BEEN COMPLETED.A. BUSINESS OFFICE PROVIDES THE RESPONSIBLE INDIVIDUAL WITH A WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION OR DOCUMENTATION REQUIRED UNDER THE POLICY IN ORDER TO COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE, WHICH NOTICE WILL INCLUDE A COPY OF THE ALL-HOSPITAL PLAIN LANGUAGE SUMMARY.B. BUSINESS OFFICE PROVIDES THE RESPONSIBLE INDIVIDUAL WITH AT LEAST 30 DAYS' PRIOR WRITTEN NOTICE OF THE ECAS THAT BHC MAY INITIATE AGAINST THE RESPONSIBLE INDIVIDUAL IF THE POLICY APPLICATION IS NOT COMPLETED OR PAYMENT IS NOT MADE; PROVIDED, HOWEVER, THAT THE DEADLINE FOR COMPLETION OR PAYMENT MAY NOT BE SET PRIOR TO THE APPLICATION DEADLINE.C. IF THE RESPONSIBLE INDIVIDUAL WHO HAS SUBMITTED THE INCOMPLETE APPLICATION COMPLETES THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE BUSINESS OFFICE DETERMINES DEFINITIVELY THAT THE RESPONSIBLE INDIVIDUAL IS INELIGIBLE FOR ANY FINANCIAL ASSISTANCE UNDER THE POLICY, BHC MAY INITIATE ECAS.D. IF THE RESPONSIBLE INDIVIDUAL WHO HAS SUBMITTED THE INCOMPLETE APPLICATION FAILS TO COMPLETE THE APPLICATION BY THE DEADLINE SET IN THE NOTICE, THEN ECAS MAY BE INITIATED.E. IF AN APPLICATION, COMPLETE OR INCOMPLETE, FOR FINANCIAL ASSISTANCE UNDER THE POLICY IS SUBMITTED BY A RESPONSIBLE PERSON, AT ANY TIME PRIOR TO THE APPLICATION DEADLINE BHC WILL SUSPEND ECAS WHILE SUCH FINANCIAL ASSISTANCE APPLICATION IS PENDING. |
| PART VI, LINE 2: | BURGESS HEALTH CENTER REVIEWS DATA FROM THE IOWA DEPARTMENT OF PUBLIC HEALTH. BURGESS HEALTH CENTER FOCUSES ON TOP ADMISSIONS TO THE HOSPITAL AND REVIEWS THE AGGREGATE DATA FROM WELLNESS SCREENS. |
| PART VI, LINE 3: | PATIENTS' BILLS CONTAIN INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND GIVES CONTACT INFORMATION FOR OBTAINING THIS ASSISTANCE. IF A PATIENT HAS NOT RESPONDED TO THE BILL, THE FINANCIAL COUNSELOR WILL CONTACT THE PATIENT TO MAKE ARRANGEMENTS TO HELP THE PATIENT APPLY FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | BURGESS HEALTH CENTER IS SITUATED IN MONONA COUNTY, IA. THE SERVICE AREA IS CONSIDERED A RURAL SETTING WITH A POPULATION OF APPROXIMATELY 9,000. OF THIS POPULATION, 24.7% OF MONONA COUNTY IS OVER AGE 65. THE SERVICE AREA RANKS LOW REGARDING THE MEDIAN HOUSEHOLD INCOME. THE IOWA AVERAGE HOUSEHOLD INCOME IS $62,000 WITH MONONA COUNTY HAVING AN AVERAGE HOUSEHOLD INCOME OF $53,000, $9,000 LOWER. THE UNEMPLOYMENT RATE IN MONONA COUNTY IS 3%, HIGHER THAN THE STATE AVERAGE OF 2.7%. |
| PART VI, LINE 5: | PROMOTING THE HEALTH OF THE COMMUNITIES BURGESS HEALTH CENTER SERVES IS IMPORTANT TO BURGESS HEALTH CENTER. FURTHERMORE, IT IS PART OF THE MISSION STATEMENT OF BURGESS HEALTH CENTER. - "BURGESS HEALTH CENTER IS COMMITTED TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES WE SERVE BY PROVIDING EXCELLENT HEALTHCARE AND EXCEPTIONAL PATIENT EXPERIENCES." TO HELP SUPPORT THAT MISSION BURGESS HEALTH CENTER HAS OPENED UP MEDICALLY ORIENTED GYMS (MOGS) IN 2 COMMUNITIES OF OUR SERVICE AREA, MAPLETON AND ONAWA. THROUGH FITNESS, WELLNESS AND GUIDANCE, THE MOGS ARE SPECIFICALLY DESIGNED TO IMPROVE THE LIFE AND HEALTH OF OUR COMMUNITY MEMBERS. THE PROFESSIONAL STAFF DEVELOP CUSTOMIZED FITNESS PROGRAMS TO HELP PEOPLE OF ALL AGES OBTAIN A HEALTHY LIFESTYLE.BURGESS HEALTH CENTER ALSO PARTNERS WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO IMPROVE COMMUNITY HEALTH AND WELL BEING. BURGESS HEALTH CENTER PARTICIPATES IN MEDICARE, MEDICAID CHAMPUS AND TRICARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WASEEM ALOUNK MD | ||||||||||||||
| PHYSICIAN | $478,079 | $0 | $0 | $0 | $0 | $0 | $30,000 | $0 | $25,649 | $0 | $533,728 | $0 | $0 | $0 |
| RACHEL KNUDSON DO | ||||||||||||||
| GENERAL SURGERY SPECIALIST | $441,204 | $0 | $0 | $0 | $0 | $0 | $22,500 | $0 | $26,371 | $0 | $490,075 | $0 | $0 | $0 |
| PETER DAHER MD | ||||||||||||||
| PHYSICIAN | $381,646 | $0 | $0 | $0 | $0 | $0 | $30,000 | $0 | $16,610 | $0 | $428,256 | $0 | $0 | $0 |
| MONTY MCKINVEN | ||||||||||||||
| CRNA | $266,827 | $0 | $0 | $0 | $0 | $0 | $29,984 | $0 | $16,610 | $0 | $313,421 | $0 | $0 | $0 |
| JOHN GARRED JR MD | ||||||||||||||
| BOARD MEMBER THRU 05/2024 | $264,315 | $0 | $0 | $0 | $0 | $0 | $37,039 | $0 | $2,790 | $0 | $304,144 | $0 | $0 | $0 |
| LYNN CHARRLIN MD | ||||||||||||||
| PHYSICIAN | $252,925 | $0 | $0 | $0 | $0 | $0 | $20,563 | $0 | $7,234 | $0 | $280,722 | $0 | $0 | $0 |
| TERESA BUTLER | ||||||||||||||
| VP OF CLINICAL SERVICES/IN | $174,167 | $0 | $0 | $0 | $0 | $0 | $10,690 | $0 | $7,234 | $0 | $192,091 | $0 | $0 | $0 |
| CARL BEHNE | ||||||||||||||
| CEO THRU 3/2024 | $143,613 | $0 | $0 | $0 | $0 | $0 | $5,987 | $0 | $9,553 | $0 | $159,153 | $0 | $0 | $0 |
| JOHN WILKER | ||||||||||||||
| VICE PRESIDENT OF FINANCE THRU 09/20 | $156,821 | $0 | $0 | $0 | $0 | $0 | $631 | $0 | $0 | $0 | $157,452 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KATHRYN GARRED | |||
| EMPLOYEE OF ORGANIZATION AND SPOUSE OF JOHN GARRED JR., MD, BOARD MEMBER | $40,099 | EMPLOYEES W-2 WAGES | 0 |
| FAMILY MEDICINE CLINIC | |||
| DR. PAUL DUDLEY OWNS 100% OF THE CLINIC AND IS A CURRENT BOARD MEMBER | $415,407 | CONTRACTED SERVICES PROVIDED FOR ER COVERAGE | 0 |
| MATTHEW GARRED | |||
| EMPLOYEE OF ORGANIZATION AND SON OF JOHN GARRED JR., MD, BOARD MEMBER | $109,347 | EMPLOYEES W-2 WAGES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 6 | BURGESS HEALTH CENTER HAS MEMBERS. A PERSON MAY BECOME A MEMBER IF HE OR SHE (1) IS AT THAT TIME A RESIDENT OF THE GEOGRAPHIC AREA SERVED BY THE CORPORATION; (2) COMPLETES A MEMBERSHIP REGISTRATION FORM, AND (3) PAYS A LIFE MEMBERSHIP FEE OF $10. |
| FORM 990, PART VI, SECTION A, LINE 7B | THERE IS AN ANNUAL MEETING OF THE MEMBERS. AT THE MEETING, THE MEMBERS RECEIVE AN ANNUAL REPORT ON THE AFFAIRS OF THE CORPORATION AND HAVE THE OPPORTUNITY TO OFFER THEIR INPUT ON ANY MATTER AFFECTING THE CORPORATION. THE MEMBERS SHALL ALSO CARRY OUT ANY DUTIES RESERVED TO MEMBERS UNDER THE IOWA NONPROFIT CORPORATION ACT. EACH MEMBER HAS ONE VOTE. THE ACT OF A MAJORITY OF MEMBERS PRESENT AND VOTING SHALL BE THE ACT OF THE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS E-MAILED TO THE ENTIRE BOARD; ALL QUESTIONS AND COMMENTS ARE ADDRESSED PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON A ANNUAL BASIS, ALL BOARD MEMBERS ALONG WITH THE MANAGEMENT STAFF (MANAGERS, DIRECTORS, OFFICERS) COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THE RESULTS ARE REVIEWED AT ONE OF THE BOARD MEETINGS. IF THERE IS A CONFLICT, THE BOARD MEMBER REFRAINS FROM VOTING ON THAT ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO SALARY IS DETERMINED BASED ON GRADE, NUMBER OF YEARS IN THE POSITION AND COMPARED TO IOWA HOSPITAL ASSOCIATION DATA SHOWING MARKET RATES FOR THE BURGESS CUSTOM GROUP. THIS INFORMATION IS PASSED ON TO THE EXECUTIVE COMMITTEE OF THE BOARD WHO MAKES A RECOMMENDATION TO THE COMPLETE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE FINAL DECISION. OFFICER'S COMPENSATION OTHER THAN THE CEO IS DETERMINED BY THE IHA SALARY SURVEY, CAH GROUP AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | BURGESS HEALTH CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 DIAMOND STREET | AddressLine1Txt |
| City | ONAWA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421188964 | EIN |
| Primary Activities | RAISING FUNDS FOR BURGESS HEALTH CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURGESS FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $558,604 | InvolvedAmt |
Comments