SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC (EIN 42-0680407)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202311329349302391
- Schema version
- 2021v4.2
- 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 I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T11:39:38-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420680407 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST IOWA REGIONAL MEDICAL | BusinessNameLine1Txt |
| Business Name Line2 | CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 3197681000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1221 SOUTH GEAR AVENUE | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY ALEXANDER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3197681000 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEREMY | PersonFirstNm |
| Person Last | ALEXANDER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2023-05-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR MICHAEL MCCOY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1221 SOUTH GEAR AVENUE | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $389,638,089 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GREATRIVERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1895 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVING THE REGION'S HEALTH BY PROVIDING HIGH-QUALITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 2310 | TotalEmployeeCnt |
| Total Volunteers | 260 | TotalVolunteersCnt |
| Total Gross UBI | $134,019 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $69,747,787 | PYContributionsGrantsAmt |
| CY Contributions Grants | $52,801,561 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $226,056,254 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $307,954,230 | CYProgramServiceRevenueAmt |
| PY Investment Income | $674,467 | PYInvestmentIncomeAmt |
| CY Investment Income | $874,483 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,109,457 | PYOtherRevenueAmt |
| CY Other Revenue | $9,087,002 | CYOtherRevenueAmt |
| PY Total Revenue | $297,587,965 | PYTotalRevenueAmt |
| CY Total Revenue | $370,717,276 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,849,123 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $168,393,959 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $89,969,945 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $165,178,126 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $22,806 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $130,900,555 | PYOtherExpensesAmt |
| CY Other Expenses | $183,122,071 | CYOtherExpensesAmt |
| PY Total Expenses | $226,719,623 | PYTotalExpensesAmt |
| CY Total Expenses | $516,694,156 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $70,868,342 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$145,976,880 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $412,016,891 | TotalAssetsBOYAmt |
| Total Assets EOY | $268,865,294 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $76,325,438 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $87,497,042 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $335,691,453 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $181,368,252 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SOUTHEAST IOWA REGIONAL MEDICAL CENTER EMPOWERS OUR PEOPLE TO PROVIDE COMPASSIONATE, HIGH QUALITY CARE, WHILE BEING GOOD STEWARDS OF OUR RESOURCES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $505,475,989 | ExpenseAmt |
| Grant | $168,393,959 | GrantAmt |
| Revenue | $307,879,344 | RevenueAmt |
| Desc | SOUTHEAST IOWA REGIONAL MEDICAL CENTER (SIRMC) IS A TWO CAMPUS HOSPITAL. ONE IS LOCATED IN FORT MADISON, IOWA, A 50 BED HOSPTIAL AND THE OTHER IS LOCATED IN WEST BURLINGTON, IOWA, IS A 378-BED REGIONAL MEDICAL CENTER OFFERING ACUTE AND INTERMEDIATE CARE TO RESIDENTS OF SOUTHEAST IOWA, WEST CENTRAL ILLINOIS AND NORTHEAST MISSOURI. THE HOSPITAL OFFERS COMPREHENSIVE MEDICAL, EXTENSIVE SURGICAL, AND EMERGENCY CARE SERVICES. DURING FISCAL YEAR ENDING 6/30/22, SIRMC HAD 7,359 PATIENT ADMISSIONS AND 66,483 PATIENT DAYS OF MEDICAL CARE. SIRMC ALSO HAD 187,801 OUTPATIENT VISITS, 44,384 EMERGENCY ROOM VISITS AND 12,393 HOME HEALTH-CARE VISITS. SIRMC PROVIDES MEDICAL SERVICES REGARDLESS OF ABILITY TO PAY AND ACCEPTS MEDICARE AND MEDICAID.THE HOSPITAL'S 160-BED KLEIN CENTER OFFERS LONG-TERM AND SKILLED CARE ON THE HOSPITAL'S CAMPUS. THE CANCER CENTER, WHICH PROVIDES MEDICAL AND RADIATION THERAPY SERVICES FOR THE TREATMENT OF VARIOUS FORMS OF CANCER AND BLOOD DISEASES, OFFERS THE LATEST THREE-DIMENSIONAL TREATMENT-PLANNING COMPUTER TECHNOLOGY AVAILABLE IN ONLY A FEW HEALTH-CARE CENTERS IN THE STATE. THE WELLNESS PLAZA IS HOME TO ONE OF THE STATE'S PREMIER REHABILITATION AND FITNESS PROGRAMS. | Desc |
| Total Program Service Expenses | $505,475,989 | 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 | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 84 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2310 | 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 |
| Form1098 C Filed | Yes (1) | Form1098CFiledInd |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | 0 | 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 | CHERYL ALBIN | PersonNm |
| Phone | 3197681000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1221 SOUTH GEAR AVENUE | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MATT WENZEL | ||||||||
| PRESIDENT/CEO | 24.00 | 16.00 | Yes (X) | Yes (X) | $0 | $1,109,111 | $58,133 | |
| JEREMY ALEXANDER | ||||||||
| CFO | 40.00 | 3.00 | Yes (X) | $0 | $588,955 | $47,947 | ||
| LOUIS KANZAVELOS | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $583,990 | $0 | $19,582 | Yes (X) | ||
| GEORGI GREKOFF | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $493,442 | $0 | $46,476 | Yes (X) | ||
| RICHARD TO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $416,697 | $0 | $17,854 | Yes (X) | ||
| BRENT WOODBURY | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $408,137 | $0 | $15,277 | Yes (X) | ||
| CHARLES LAHAM | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $375,270 | $0 | $8,044 | Yes (X) | ||
| BILL MALCOM | ||||||||
| CHAIRPERSON | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVE POLAND | ||||||||
| VICE CHAIRMAN | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| VICKI STEPHENSON | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOY ANDERSON | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR STEVE DAVIS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NEAL DODD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON HUTCHESON | ||||||||
| DIRECTOR (THROUGH FEB. 2022) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOANN LAMPE | ||||||||
| DIRECTOR (THROUGH DEC. 2021) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN MARINO | ||||||||
| DIRECTOR (THROUGH JAN. 2022) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,277,536 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,698,066 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $213,313 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 142 | 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 |
|---|---|---|---|---|---|
| MUTUAL CONSULTING & MGMT SVC INC | |||||
| 1221 S GEAR AVENUE | WEST BURLINGTON | IA | 52655 | EXECUTIVE MANAGEMENT | $5,515,394 |
| WAPITI MEDICAL GROUP LC | |||||
| 107 FLYNN DRIVE SUITE 600 | MILBANK | SD | 57252 | STAFFING AGENCY | $3,095,669 |
| AYA HEALTHCARE INC | |||||
| PO BOX 123519 | DALLAS | TX | 75312 | STAFFING AGENCY | $1,837,806 |
| TRUSTED HEALTH INC | |||||
| 201 CALIFORNIA STREET SUITE 950 | SAN FRANCISCO | CA | 94111 | STAFFING AGENCY | $1,642,829 |
| KINDRED REHAB GROUP MANAGEMENT SERVICES | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | REHABILITATION PROGRAM MGMT SERVICES | $1,180,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 89 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $45,662,026 | RelatedOrganizationsAmt |
| Government Grants | $5,615,295 | GovernmentGrantsAmt |
| All Other Contributions | $1,524,240 | AllOtherContributionsAmt |
| Noncash Contributions | $44,500 | NoncashContributionsAmt |
| Total Contributions | $52,801,561 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE INCOME | 621110 | $284,522,683 | $284,522,683 | |
| OTHER OPERATING INCOME | 621300 | $22,938,581 | $22,863,695 | $74,886 |
| SE RENAL DIALYSIS K-1 | 621400 | $492,966 | $492,966 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $307,954,230 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $550,179 | TotalRevenueColumnAmt |
| Exclusion | $550,179 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,064,357 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $622,125 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $442,232 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $442,232 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $59,133 | UnrelatedBusinessRevenueAmt |
| Exclusion | $383,099 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,570,964 | SecuritiesAmt |
| Other | $52,028 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,287,435 | SecuritiesAmt |
| Other | $11,253 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $283,529 | SecuritiesAmt |
| Other | $40,775 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $324,304 | TotalRevenueColumnAmt |
| Exclusion | $324,304 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,644,770 | TotalRevenueColumnAmt |
| Exclusion | $8,644,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,644,770 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $370,717,276 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $307,879,344 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $134,019 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,902,352 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,393,959 | TotalAmt |
| Program Services | $168,393,959 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,814,136 | TotalAmt |
| Management And General | $1,814,136 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,822,517 | TotalAmt |
| Program Services | $137,355,315 | ProgramServicesAmt |
| Management And General | $466,359 | ManagementAndGeneralAmt |
| Fundraising | $843 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,510,992 | TotalAmt |
| Program Services | $4,476,904 | ProgramServicesAmt |
| Management And General | $34,051 | ManagementAndGeneralAmt |
| Fundraising | $37 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,233,065 | TotalAmt |
| Program Services | $11,157,826 | ProgramServicesAmt |
| Management And General | $75,239 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,797,416 | TotalAmt |
| Program Services | $9,773,375 | ProgramServicesAmt |
| Management And General | $23,976 | ManagementAndGeneralAmt |
| Fundraising | $65 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,077,190 | TotalAmt |
| Program Services | $1,077,190 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,748 | TotalAmt |
| Program Services | $98,748 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,441 | TotalAmt |
| Management And General | $31,441 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,028,318 | TotalAmt |
| Program Services | $90,002,530 | ProgramServicesAmt |
| Management And General | $4,004,398 | ManagementAndGeneralAmt |
| Fundraising | $21,390 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,227,937 | TotalAmt |
| Program Services | $1,176,457 | ProgramServicesAmt |
| Management And General | $51,480 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,533,405 | TotalAmt |
| Program Services | $4,531,285 | ProgramServicesAmt |
| Management And General | $2,120 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,306 | TotalAmt |
| Program Services | $230,514 | ProgramServicesAmt |
| Management And General | $321 | ManagementAndGeneralAmt |
| Fundraising | $471 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,167,299 | TotalAmt |
| Program Services | $1,167,299 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,821,104 | TotalAmt |
| Program Services | $13,049,465 | ProgramServicesAmt |
| Management And General | $771,639 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,844,528 | TotalAmt |
| Program Services | $2,796,619 | ProgramServicesAmt |
| Management And General | $2,047,909 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $27,215,591 | $27,213,563 | $2,028 |
| DRUGS | $22,767,555 | $22,767,227 | $328 |
| BAD DEBT | $4,581,840 | $4,581,840 | |
| REPAIRS/MAINTENANCE | $3,043,377 | $3,026,363 | $17,014 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,452,432 | TotalAmt |
| Program Services | $2,599,510 | ProgramServicesAmt |
| Management And General | $1,852,922 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,694,156 | TotalAmt |
| Program Services | $505,475,989 | ProgramServicesAmt |
| Management And General | $11,195,361 | ManagementAndGeneralAmt |
| Fundraising | $22,806 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,805,325 | BOYAmt |
| EOY | $889,137 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,943,887 | BOYAmt |
| EOY | $7,767,411 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,334,169 | BOYAmt |
| EOY | $41,286,511 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,043 | BOYAmt |
| EOY | $2,965,515 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,836,418 | BOYAmt |
| EOY | $3,892,615 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,778,041 | BOYAmt |
| EOY | $2,347,973 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $432,705,670 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $265,752,053 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,850,138 | BOYAmt |
| EOY | $166,953,617 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,097,969 | BOYAmt |
| EOY | $15,396,363 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,793,674 | BOYAmt |
| EOY | $22,577,831 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,346,784 | BOYAmt |
| EOY | $3,349,029 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $524,292 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,027,443 | BOYAmt |
| EOY | $915,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,016,891 | BOYAmt |
| EOY | $268,865,294 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,315,904 | BOYAmt |
| EOY | $27,730,445 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,484,002 | BOYAmt |
| EOY | $119,076 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,786,581 | BOYAmt |
| EOY | $33,259,156 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,738,951 | BOYAmt |
| EOY | $26,388,365 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,325,438 | BOYAmt |
| EOY | $87,497,042 | 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 | $324,382,022 | BOYAmt |
| EOY | $170,307,714 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,309,431 | BOYAmt |
| EOY | $11,060,538 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,691,453 | BOYAmt |
| EOY | $181,368,252 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,016,891 | BOYAmt |
| EOY | $268,865,294 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$145,976,880 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,182,633 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$4,930,951 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$232,737 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $31,441 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $31,441 | 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 | SOUTHEAST IOWA REGIONAL MEDICAL CENTER PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE IOWA HOSPITAL ASSOCIATION. THESE ASSOCIATIONS PARTICIPATE IN LOBBYING ACTIVITIES RELATED TO HEALTHCARE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,229,064 | OtherCostOrOtherBasisAmt |
| Book Value | $15,229,064 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $180,500,249 | OtherCostOrOtherBasisAmt |
| Depreciation | $78,106,967 | DepreciationAmt |
| Book Value | $102,393,282 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,895,612 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,710,302 | DepreciationAmt |
| Book Value | $4,185,310 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $215,450,698 | OtherCostOrOtherBasisAmt |
| Depreciation | $177,934,784 | DepreciationAmt |
| Book Value | $37,515,914 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,630,047 | OtherCostOrOtherBasisAmt |
| Book Value | $7,630,047 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $166,953,617 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $1,635,489 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE COMPANY ANNUITY DEPOSITS | Desc |
| Book Value | $20,942,342 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $22,577,831 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION LIABILITY | $20,306,816 |
| THIRD PARTY PAYABLE | $3,872,500 |
| INTERCORPORATION PAYABLE | $2,209,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,388,365 | 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 ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE COMBINED FINANCIAL STATEMENTS. | 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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $5,153,882 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,153,882 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,340,056 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,580,990 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,759,066 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03470 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $61,493,938 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,580,990 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,912,948 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $123,802 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $123,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,261,773 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,420,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,841,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $76,599 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $76,599 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,462,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,420,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,041,949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,956,112 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $42,001,215 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,954,897 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05260 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,581,840 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $81,219,511 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $98,613,718 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,394,207 | 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 | SOUTHEAST IOWA REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1221 SOUTH GEAR AVENUE | AddressLine1Txt |
| City | WEST BURLINGTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GREATRIVERHEALTH.ORG | WebsiteAddressTxt |
| State License | 290147H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
| Other | TRAUMA CENTER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST IOWA REGIONAL MEDICAL 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 | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | 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 | SEE PART V, SECTION C | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 | SEE PART V, SEC. C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SEC. C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SEC. C | 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 Translated | Yes (X) | FAPTranslatedInd |
| 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 5: SOUTHEAST IOWA REGIONAL MEDICAL CENTER, PART OF GREAT RIVER HEALTH SYSTEM, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO DISTINGUISH THE UNMET MEDICAL AND PUBLIC HEALTH NEEDS IN DES MOINES AND LEE COUNTIES. THE STUDY HAS THREE OBJECTIVES:1. TO CONDUCT AN ASSESSMENT THAT PROVIDES A FOUNDATION FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND ITS PARTNERS TO BUILD A CONSENSUS ABOUT THE AREA'S MOST CRITICAL HEALTH CARE NEEDS.2. TO MEET STATE AND FEDERAL REQUIREMENTS FOR HOSPITALS THAT MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY 3 YEARS.3. TO DEVELOP ACTION PLANS FOR INTERVENTIONS TO ADDRESS CONCERNS HIGHLIGHTED BY THE COMMUNITY AND HEALTH DATA.INFORMATION WAS COLLECTED THROUGH VIRTUAL MEETINGS, PAPER AND ONLINE SURVEYS, KEY INFORMANT QUESTIONNAIRES, AND A REVIEW AND ANALYSIS OF PUBLICLY COLLECTED HEALTH AND DEMOGRAPHIC STATISTICS. THE SURVEY WAS MADE AVAILABLE AT SEVERAL LOCATIONS IN THE STUDY AREA. LOCATIONS WERE CHOSEN BASED ON EASE OF ACCESS AND TRAFFIC BUT WERE RESTRICTED BY COVID-19. THE SURVEY WAS DESIGNED TO ELICIT PUBLIC RESPONSES ABOUT HEALTH NEEDS IN DES MOINES AND LEE COUNTIES. THE SURVEY INCLUDED MULTIPLE CHOICE, OPEN-ENDED AND SCALED QUESTIONS THAT ASKED PEOPLE WHAT THEY PERCEIVED TO BE THE GREATEST AREAS OF COMMUNITY NEED. A TOTAL OF 1,204 SURVEYS WERE RETURNED AND ANALYZED, A DECREASE OF 46 PERCENT FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. DECREASES IN RESPONSES WERE TO BE EXPECTED DUE TO A SHORTENED SURVEY WINDOW AND REDUCED OPPORTUNITIES FOR DISBURSEMENT.INTERVIEWS WERE CONDUCTED WITH LOCAL PROFESSIONALS AND KEY INFORMANTS, INCLUDING PROFESSIONALS IN EDUCATION, LAW ENFORCEMENT, PUBLIC HEALTH AND SOCIAL SERVICES, AND OTHER PROFESSIONALS REPRESENTING UNDERSERVED POPULATIONS IN THE SERVICE AREA. PARTICIPANTS WERE ASKED TO IDENTIFY THE LARGEST HEALTH CONCERNS IN THE COMMUNITY AND TO SUGGEST WAYS TO IMPROVE UNMET HEALTH NEEDS. THE HEALTH AND DEMOGRAPHIC DATA AVAILABLE FOR DES MOINES AND LEE COUNTIES WERE INVESTIGATED BY FOCUSING ON THE PROBLEMS INDICATED FROM THE INTERVIEWS AND COMMUNITY SURVEY. UTILIZING A STATISTICAL RANKING METHOD TO INCORPORATE INFORMATION FROM COLLABORATIVE MEETINGS, SURVEYS, AND THE INTERVIEWS, THE FOLLOWING FOUR UNMET HEALTH NEEDS WERE CHOSEN: MENTAL HEALTH SUBSTANCE MISUSE POVERTY AND EQUITY OBESITY AND OVERWEIGHTTHESE FOUR NEEDS WILL BE THE FOCUS OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND GREAT RIVER HEALTH SYSTEM'S EFFORTS TO IMPROVE THE HEALTH OF DES MOINES AND LEE COUNTIES. |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 6B: SOUTHEAST IOWA REGIONAL MEDICAL CENTER CONTINUALLY WORKS WITH PARTNERS AND STAKEHOLDERS OUTSIDE THE HOSPITAL TO MEET THE HEALTH NEEDS OF THE COMMUNITY. SOUTHEAST IOWA REGIONAL MEDICAL CENTER COLLABORATED WITH DES MOINES COUNTY DEPARTMENT OF PUBLIC HEALTH, COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, BLESSING HEALTH KEOKUK, AND LEE COUNTY HEALTH DEPARTMENT ON A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT. |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 11: SOUTHEAST IOWA REGIONAL MEDICAL CENTER WORKED WITH DES MOINES AND LEE COUNTIES RESPECTIVE PARTNERS TO REVIEW THE DATA AND INFORMATION GATHERED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. AFTER REVIEWING THE DATA FROM THE SURVEY, VIRTUAL TOWN HALL MEETINGS, AND COMMENTS FROM THE KEY INFORMANT QUESTIONNAIRE, THE FOLLOWING HIGH PRIORITY HEALTH CONCERNS WERE SELECTED: MENTAL HEALTH SUBSTANCE MISUSE POVERTY AND EQUITY OBESITY AND OVERWEIGHTLEADERS AT SOUTHEAST IOWA REGIONAL MEDICAL CENTER HIGHLIGHTED THE FOLLOWING IMPLEMENTATION STRATEGIES, POTENTIAL IMPACTS, AND RESOURCES NEEDED FOR EACH FOCUS AREA.MENTAL HEALTH- EXPAND EXISTING PROGRAMS- GERIATRIC INPATIENT UNIT- RECRUITMENTSUBSTANCE MISUSE-OPIOID MANAGEMENT IMPROVEMENTS-PEER RECOVERY GROUP-SUPPORT AND PARTICIPATION IN COMMUNITY BASED INITIATIVES-FITNESS VOUCHER PILOT PROGRAMOBESITY/OVERWEIGHT -POPULATION HEALTH PLATFORM-LIVE HEALTHY LEE COUNTY-HEALTHY LIVING COMMUNITY EDUCATIONPOVERTY AND EQUITY-RURAL PUBLIC HEALTH WORKFORCE TRAINING NETWORK PROGRAM-SOCIAL DETERMINANTS OF HEALTH ASSESSMENT WORKFLOW-GOOD FAITH ESTIMATES-GREAT RIVER HEALTH FOUNDATION PARTNERSHIP WITH SOUTHEASTERN COMMUNITY COLLEGE |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 13H: SIRMC MAY USE PRESUMPTIVE FINANCIAL ASSISTANCE ELIGIBILITY:THERE ARE INSTANCES WHEN A PATIENT/INDIVIDUAL MAY APPEAR TO BE ELIGIBLE FOR CHARITY-CARE DISCOUNTS, BUT THERE IS NO COMPLETED FINANCIAL ASSISTANCE FORM ON FILE BECAUSE OF A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER RESOURCES THAT COULD PROVIDE SUFFICIENT EVIDENCE TO DETERMINE ELIGIBILITY.1. INFORMATION IS PROVIDED WEEKLY TO AN OUTSIDE SOURCE. OUTSIDE SOURCE RETURNS RESULTS TO SOUTHEAST IOWA REGIONAL MEDICAL CENTER ABOUT PATIENT QUALIFICATIONS BASED ON OUR FINANCIAL ASSISTANCE POLICY.2. OUTSIDE SOURCE USES DEMOGRAPHIC AND HOUSEHOLD INFORMATION, AND CREDIT-SCORING TECHNOLOGY TO DETERMINE THE PERCENTAGE OF ASSISTANCE FOR WHICH A PATIENT MAY BE ELIGIBLE.3. SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL ATTEMPT TO CONTACT PATIENTS BASED ON THEIR PRESUMPTIVE ASSISTANCE QUALIFICATION TO ALLOW THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE.4. PATIENTS WILL NOT BE DISQUALIFIED FROM FINANCIAL ASSISTANCE BASED ON PRESUMPTIVE ASSISTANCE RESULTS.5. IF THE ACCOUNT IS PAST DUE AND THERE IS NO COMPLETED FINANCIAL ASSISTANCE APPLICATION OR SUPPORTING DOCUMENTATION, THE PATIENT'S ACCOUNT COULD BE CONSIDERED FOR FINANCIAL ASSISTANCE BASED ON OUTSIDE SOURCE'S RESULTS.6. PRESUMPTIVE ELIGIBILITY ALSO CAN BE DETERMINED BASED ON LIFE CIRCUMSTANCES INCLUDING: -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED -FOOD STAMP ELIGIBILITY -HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC -LOW INCOME/SUBSIDIZED HOUSING PROVIDED AS A VALID ADDRESS -PARTICIPATION IN THE WOMEN INFANTS AND CHILDREN (WIC) PROGRAM -PATIENT IS DECEASED WITH NO KNOWN ESTATE -STATE-FUNDED PRESCRIPTION PROGRAMS -SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY7. IT ALSO IS ACCEPTABLE TO USE PROXY INFORMATION TO DETERMINE ELIGIBILITY WHEN INCOME LEVELS CANNOT BE DIRECTLY DETERMINED. SUCH INFORMATION COULD INCLUDE STATEMENTS LIKE "STAYS WITH FRIENDS OR "OCCASIONALLY WORKS."8. PATIENTS WHO MEET PRESUMPTIVE-CARE GUIDELINES MAY QUALIFY FOR FINANCIAL ASSISTANCE DISCOUNTS. THIS DETERMINATION IS AT THE DISCRETION OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER.9. IN A SITUATION, WHERE PRESUMPTIVE ELIGIBILITY IS GIVEN TO A PATIENT AND A FINANCIAL ASSISTANCE APPLICATION IS OBTAINED LATER, THE UPDATED ELIGIBILITY WILL BE BASED ON THE FINANCIAL ASSISTANCE APPLICATION WITH SUPPORTING DOCUMENTATION. IN THIS CASE, SOUTHEAST IOWA REGIONAL MEDICAL CENTER COULD ADJUST FINANCIAL ASSISTANCE UP TO THREE MONTHS BEFORE THE APPLICATION DATE. |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 20E: SIRMC USES AN OUTSIDE SOURCE TO SCREEN PATIENTS TO SEE IF THEY COULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL GETS NOTIFICATION BACK AS TO HOW MUCH OF A FINANCIAL ASSISTANCE DISCOUNT THEY WOULD BE ELIGIBLE FOR. IF THE PATIENT DOESN'T RESPOND TO PHONE CALLS REGARDING THE FINANCIAL ASSISTANCE APPLICATION OR THEY DON'T COMPLETE THE APPLICATION, THE HOSPITAL MAY STILL DISCOUNT THE PATIENT'S CHARGES UNDER THEIR PRESUMPTIVE CHARITY POLICY. THE HOSPITAL'S PRESUMPTIVE CHARITY PROGRAM GIVES THE HOSPITAL THE OPPORTUNITY TO DISCOUNT PATIENT ACCOUNTS BASED ON INFORMATION IT MAY HAVE REGARDING A PATIENT BEING HOMELESS OR UNEMPLOYED. |
| PART V, SECTION B, LINES 7A AND 10A: | SIRMC'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT: HTTPS://WWW.GREATRIVERHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| PART V, SECTION B, LINE 16: | SIRMC'S FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY, AND APPLICATION ARE AVAILABLE AT:HTTPS://WWW.GREATRIVERHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | SOUTHEAST IOWA REGIONAL MEDICAL CENTER (SIRMC) USES THE FPG TO DETERMINE FREE OR DISCOUNTED CARE. INDIVIDUALS WHO ARE BELOW 200% OF THE FPG QUALIFY FOR FREE CARE. IN MOST INSTANCES, THEY HAVE TO PROVIDE FINANCIAL DOCUMENTATION AND FILL OUT A CHARITY CARE APPLICATION. THE HOSPITAL ALSO USES A PRESUMPTIVE CHARITY CARE PROGRAM THAT ANALYZES PUBLIC AND PRIVATE DATABASES TO HELP DETERMINE ELIGIBILITY FOR CHARITY CARE. THESE INDIVIDUALS DO NOT HAVE ANY OTHER DOCUMENTATION TO PROVIDE. THIS PROGRAM IS USED AFTER COLLECTION ATTEMPTS HAVE BEEN DISCONTINUED. EXTRAORDINARY ASSETS ARE TAKEN INTO CONSIDERATION WHEN DETERMINING CHARITY CARE ELIGIBILITY. MEDICALLY INDIGENT INDIVIDUALS ARE COVERED UNDER THE SAME CHARITY CARE POLICY. INDIVIDUALS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LIMITS ARE GRANTED CHARITY ON A SLIDING SCALE. |
| PART I, LINE 7: | THE AMOUNTS INCLUDED IN PART I, LINES 7A-7D WERE CALCULATED USING COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS SCHEDULE H INSTRUCTIONS. PART I, LINES 7E-7J ARE ACTUAL COSTS. |
| PART I, LINE 7G: | THE SUBSIDIZED HEALTH SERVICES INCLUDED IN PART I, LINE 7G IS MENTAL HEALTH SERVICES PROVIDED BY SIRMC. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSES OF $4,581,840 WERE SUBTRACTED FROM THE TOTAL EXPENSES IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F. |
| PART III, LINE 2: | MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS AND BY CONSIDERING THE PATIENTS' FINANCIAL HISOTRY, CREDIT HISTORY, AND CURRENT ECONOMIC CONDITIONS. |
| PART III, LINE 3: | SOUTHEAST IOWA REGIONAL MEDICAL CENTER CONTRACTS WITH AN EXTERNAL ORGANIZATION. THE ORGANIZATION RECEIVES WEEKLY LISTINGS OF PATIENT RECEIVABLES FROM SIRMC'S PATIENT FINANCIAL SERVICES STAFF. THEY RETURN RESULTS TO SIRMC IDENTIFYING INDIVIDUALS WHO COULD QUALIFY FOR THE FINANCIAL ASSISTANCE PROGRAM. THE DATA IS BASED ON PATIENT INCOME AS WELL AS THEIR CREDIT REPORTING. THE RESULTS ARE APPLIED TO SIRMC'S FINANCIAL ASSISTANCE MATRIX TO IDENTIFY IF AN INDIVIDUAL WOULD QUALIFY AND FOR WHAT PERCENTAGE. SIRMC'S PATIENT FINANCIAL SERVICES STAFF THEN CONTACT THE PATIENT TO ACQUIRE A FINANCIAL ASSISTANCE APPLICATION. |
| PART III, LINE 4: | SEE THE "PATIENTS RECEIVABLES" PARAGRAPH IN NOTE 1 ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT ARE (A) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (B) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; AND (C) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. |
| PART III, LINE 9B: | AN EXCERPT FROM SIRMC'S FINANCIAL ASSISTANCE PROGRAM WRITTEN POLICY, RELATIONSHIP OF FINANCIAL ASSISTANCE PROGRAM TO COLLECTION POLICIES: SOUTHEAST IOWA REGIONAL MEDICAL CENTER MANAGEMENT HAS DEVELOPED POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, WHICH INCLUDES COLLECTION ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE FOLLOWING: A) THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY; B) PATIENT'S GOOD FAITH EFFORT TO APPLY FOR GOVERNMENTAL PROGRAMS; C) PATIENT'S GOOD FAITH EFFORT TO APPLY FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM; D) PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH PAYMENT AGREEMENTS MADE WITH SOUTHEAST IOWA REGIONAL MEDICAL CENTER. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL DO THE FOLLOWING: A) MAY OFFER EXTENDED PAYMENT PLANS; B) WILL NOT SEND UNPAID BALANCES TO OUTSIDE COLLECTION AGENCIES; C) WILL CEASE ALL COLLECTION EFFORTS WITH OUTSIDE COLLECTION AGENCIES. SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND AGENCIES ACTING ON ITS BEHALF WILL NOT IMPOSE EXTRAORDINARY COLLECTION ACTIONS WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. REASONABLE EFFORTS SHALL INCLUDE: A) VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; B) DOCUMENTATION THAT SOUTHEAST IOWA REGIONAL MEDICAL CENTER HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WIHT THE HOSPITAL'S APPLICATION REQUIREMENTS; C) DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL NOT SEND OUTSTANDING BALANCES TO AN OUTSIDE COLLECTION AGENCY UNTIL 120 DAYS FROM THE DATE THE BALANCE BECAME THE PATIENT'S RESPONSIBILITY. AN OUTSIDE AGENCY ACTING ON THE BEHALF OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL NOT TAKE EXTRAORDINARY COLLECTION AGENCY UNTIL AN ADDITIONAL 120 DAYS HAVE BEEN EXHAUSTED. EXTRAORDINARY COLLECTION ACTION INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING: A) SELLING DEBT TO A THIRD PARTY OTHER THAN A COLLECTION AGENCY; B) REPORTING ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY OR CREDIT BUREAU; C) FILING A CLAIM FOR UNPAID DEBT THROUGH THE COURT SYSTEM. |
| PART III, SECTION A, LINE 1: | THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP. |
| PART VI, LINE 2: | SIRMC'S BOARD OF DIRECTORS IS COMMUNITY BASED. REPRESENTATIVES FROM VARIOUS SEGMENTS OF THE COMMUNITY MAKE UP THE BOARD. IN ADDITION, BOARD MEMBERS ARE SELECTED IN OUTLYING COMMUNITIES THAT SIRMC SERVES. THESE BOARD MEMBERS CONSTANTLY PROVIDE INPUT TO THE HEALTHCARE NEEDS OF OUR COMMUNITY THROUGH THE ANNUAL STRATEGIC PLANNING PROCESS. |
| PART VI, LINE 3: | NOTIFICATION ABOUT GOVERNMENT PROGRAM AND/OR FINANCIAL ASSISTANCE FROM SIRMC IS DISSEMINATED BY VARIOUS MEANS AT SIRMC, WHICH INCLUDES - PUBLICATION OF NOTICES IN PATIENT BILLS AND POSTED NOTICES IN THE EMERGENCY ROOMS, ADMISSION FORMS, ADMITTING AND REGISTRATION DEPARTMENT, HOSPITAL BUSINESS OFFICES, AND THE FINANCIAL SERVICES OFFICE ON THE FACILITY CAMPUS. SIRMC ALSO POSTS AT THE LOCAL DEPARTMENT OF HEALTH SERVICES OFFICE. SIRMC ALSO PUBLISHES AND WIDELY PUBLICIZES A SUMMARY OF THE ASSISTANCE OPTIONS ON THE FACILITY WEBSITE AND IN BROCHURES AVAILABLE IN PATIENT ACCESS SITES. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE SIRMC STAFF. ALSO REQUESTS FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. FINANCIAL COUNSELORS MEET WITH PATIENTS TO ASSIST IN COMPLETING A QUESTIONNAIRE THAT HELPS THEM DETERMINE IF THE PATIENT QUALIFIES FOR A GOVERNMENT PROGRAM. |
| PART VI, LINE 4: | A REVIEW WAS CONDUCTED BY SIRMC TO ANALYZE THE ORIGIN OF PATIENTS UTILIZING THE SERVICES PROVIDED BY THE MEDICAL CENTER. THE REVIEW INDICATED THAT DES MOINES COUNTY COMPRISES THE MEDICAL CENTER'S PRIMARY SERVICE AREA AND THAT THE SECONDARY SERVICE AREA OF THE MEDICAL CENTER CONSISTS OF HENRY, LEE, AND LOUISA COUNTIES IN IOWA AND HANCOCK AND HENDERSON COUNTIES IN ILLINOIS. BASED ON THE US CENSUS BUREAU STATISTICAL ESTIMATES FOR 2020, THE PRIMARY SERVICE AREA POPULATION IS ESTIMATED AT 38,910 RESIDENTS. THE SECONDARY SERVICE AREA POPULATIONS ARE ESTIMATED TO TOTAL 68,399 RESIDENTS. OVER AGE 65 GROUP IS CURRENTLY 21.3% OF THE PRIMARY SERVICE AREA POPULATION, AS COMPARED TO 17.7% OF THE STATE OF IOWA POPULATION AND 16.8% OF THE UNITED STATES POPULATION. THE MEDIAN HOUSEHOLD INCOME IN THE PRIMARY SERVICE AREA IS $54,318 COMPARED TO THE STATE AND NATIONAL AVERAGES OF $65,429 AND $69,021, RESPECTIVELY. THE PRIMARY SERVICE AREA POPULATION BELOW POVERTY LEVEL IS 13.2% AS COMPARED TO THE STATE AND NATIONAL AVERAGES OF 11.1% AND 11.6%, RESPECTIVELY.SOUTHEAST IOWA REGIONAL MEDICAL CENTER IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA AND THE LARGEST SERVICE PROVIDER, INCLUDING THE BROADEST SCOPE OF SERVICES, IN THE PRIMARY AND SECONDARY SERVICE AREAS. |
| PART VI, LINE 5: | SOUTHEAST IOWA REGIONAL MEDICAL CENTER FURTHERS ITS EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ENSURING THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY COMPRISES MEMBERS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS OF SUCH.SOUTHEAST IOWA REGIONAL MEDICAL CENTER PROVIDES MEMBERSHIP TO ALL PHYSICIANS WHO MEET MEMBERSHIP AND CLINICAL REQUIREMENTS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER RECRUITS PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, AND OTHER HEALTH PROFESSIONALS TO IMPROVE ACCESS TO HEALTH CARE IN THE HOSPITAL'S SERVICE AREA. IT ALSO PROMOTES HEALTH CAREER EDUCATION BY WORKING CLOSELY WITH SOUTHEASTERN COMMUNITY COLLEGE'S NURSING AND OTHER PROGRAMS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER PARTICIPATES IN COMMUNITY BENEFIT ACTIVITIES SUCH AS PARTNERING WITH LOCAL SCHOOLS, COMMUNITY EDUCATION, COMMUNITY INITIATIVE EVENTS, PRENATAL EDUCATION CLASSES, A PARTICIPATING IN HEALTH FAIRS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY. IT IS OPEN TO ALL, REGARDLESS OF ABILITY TO PAY.SURPLUS FUNDS OF THE HOSPITAL ARE INVESTED IN IMPROVING AND UPDATING CAPITAL EQUIPMENT, AND INCREASING THE SERVICES OFFERED TO ALLOW FOR BETTER CARE OF THE PATIENTS THAT ARE SERVED. |
| PART VI, LINE 6: | SOUTHEAST IOWA REGIONAL MEDICAL CENTER IS PART OF GREAT RIVER HEALTH SYSTEM.GREAT RIVER HEALTH SYSTEM CONSISTS OF TWO HOSPITALS, A HOSPICE HOUSE, HOME HEALTH SERVICES, AMBULANCE SERVICES, THREE PHARMACIES, A DURABLE MEDICAL EQUIPMENT COMPANY, A LONG-TERM CARE NURSING HOME, ABOUT 25 PRIMARY-CARE AND SPECIALTY PHYSICIAN CLINICS, AND IS AFFILIATED WITH AN OUTPATIENT RENAL DIALYSIS CENTER.THE NON-HOSPITAL HEALTH CARE FACILITIES THAT ARE OPERATED BY ORGANIZATIONS RELATED TO THE HOSPITAL ARE: GREAT RIVER HEALTH SYSTEM-ANESTHESIA; GREAT RIVER HEALTH SYSTEM-AUDIOLOGY; GREAT RIVER HEALTH SYSTEM-BUSINESS HEALTH; GREAT RIVER HEALTH SYSTEM-CANCER CENTER; GREAT RIVER HEALTH SYSTEM-CARDIOLOGY; GREAT RIVER HEALTH SYSTEM-DIABETIC FOOT CLINIC; GREAT RIVER HEALTH SYSTEM-EYE SPECIALISTS; GREAT RIVER HEALTH SYSTEM-FAMILY MEDICINE; GREAT RIVER HEALTH SYSTEM-FAMILY MEDICINE, MERCY PLAZA; GREAT RIVER HEALTH SYSTEM-GASTROENTEROLOGY; GREAT RIVER HEALTH SYSTEM-HEALTHY LIVING; GREAT RIVER HEALTH SYSTEM-HERITAGE FAMILY PHARMACY; GREAT RIVER HEALTH SYSTEM-HERITAGE MEDICAL EQUIPMENT AND SUPPLIES; GREAT RIVER HEALTH SYSTEM-HERITAGE PARK PHARMACY; GREAT RIVER HEALTH SYSTEM-HERITAGE PARTNERS PHARMACY; GREAT RIVER HEALTH SYSTEM-KEOKUK; GREAT RIVER HEALTH SYSTEM-MEDIAPOLIS; GREAT RIVER HEALTH SYSTEM-MEDICINE SPECIALISTS; GREAT RIVER HEALTH SYSTEM-MENTAL HEALTH; GREAT RIVER HEALTH SYSTEM-NEPHROLOGY; GREAT RIVER HEALTH SYSTEM-ORTHOPAEDIC SPECIALISTS; GREAT RIVER HEALTH SYSTEM-PULMONOLOGY; GREAT RIVER HEALTH SYSTEM-QUICK CARE; GREAT RIVER HEALTH SYSTEM-SURGEONS; GREAT RIVER HEALTH SYSTEM-UROLOGY; GREAT RIVER HEALTH SYSTEM-WAPELLO; GREAT RIVER HEALTH SYSTEM-WEST POINT; GREAT RIVER HEALTH SYSTEM-WOMEN'S HEALTH; GREAT RIVER HEALTH SYSTEM-WOUND AND HYPERBARIC; SOUTHEASTERN RENAL DIALYSIS. |
| PART VI, LINE 7: | SIRMC DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF IOWA. HOWEVER, COMMUNITY BENEFIT INFORMATION IS PROVIDED TO THE IOWA HOSPITAL ASSOCIATION. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| LEE COUNTY ECONOMIC DEVELOPMENT | ||||||||||
| 2495 280TH ST | MONTROSE | IA | 52639 | 043605260 | 501(C)(3) | $10,000 | $0 | N/A | N/A | SUPPORT COMMUNITY ENHANCEMENT AND WORKFORCE DEVELOPMENT |
| ART GUILD OF BURLINGTON | ||||||||||
| 301 JEFFERSON STREET | BURLINGTON | IA | 52601 | 420932843 | 501(C)(3) | $6,325 | $0 | N/A | N/A | SUPPORT COMMUNITY ENHANCEMENT |
| TRI STATE RODEO | ||||||||||
| PO BOX 80 | FORT MADISON | IA | 52627 | 420658297 | 501(C)(4) | $10,000 | $0 | N/A | N/A | PROMOTE COMMUNITY ACTIVE LIFESTYLE |
| FORT MADISON ECONOMIC DEVELOPMENT | ||||||||||
| 614 7TH STREET PO BOX 277 | FORT MADISON | IA | 52627 | 421300666 | 501(C)(3) | $10,000 | $0 | N/A | N/A | SUPPORT COMMUNITY ENHANCEMENT AND WORKFORCE DEVELOPMENT |
| GREAT RIVER HEALTH SYSTEM INC | ||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 421193185 | 501(C)(3) | $1,550,000 | $0 | N/A | N/A | TRANSFER DUE TO MERGER |
| HENRY COUNTY HEALTH CENTER INC | ||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 862701018 | 501(C)(3) | $2,106,366 | $0 | N/A | N/A | TRANSFER DUE TO MERGER |
| GRHS HOLDINGS INC | ||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 421193186 | 501(C)(3) | $164,598,296 | $0 | N/A | N/A | TRANSFER DUE TO MERGER |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTEES ARE REQUIRED TO PROVIDE FOLLOW-UP INFORMATION WHEN THE PROJECT IS CARRIED OUT OR COMPLETED. IF GRANTEES DON'T COMPLY, SIRMC DOES NOT PROVIDE FURTHER GRANTS TO THEM. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATT WENZEL | ||||||||||||||
| PRESIDENT/CEO | $0 | $856,956 | $0 | $248,615 | $0 | $3,540 | $0 | $14,500 | $0 | $43,633 | $0 | $1,167,244 | $0 | $0 |
| JEREMY ALEXANDER | ||||||||||||||
| CFO | $0 | $492,989 | $0 | $94,670 | $0 | $1,296 | $0 | $14,500 | $0 | $33,447 | $0 | $636,902 | $0 | $0 |
| LOUIS KANZAVELOS | ||||||||||||||
| PHYSICIAN | $581,199 | $0 | $0 | $0 | $2,791 | $0 | $4,750 | $0 | $14,832 | $0 | $603,572 | $0 | $0 | $0 |
| GEORGI GREKOFF | ||||||||||||||
| PHYSICIAN | $462,676 | $0 | $25,000 | $0 | $5,766 | $0 | $14,500 | $0 | $31,976 | $0 | $539,918 | $0 | $0 | $0 |
| RICHARD TO | ||||||||||||||
| PHYSICIAN | $413,708 | $0 | $0 | $0 | $2,989 | $0 | $0 | $0 | $17,854 | $0 | $434,551 | $0 | $0 | $0 |
| BRENT WOODBURY | ||||||||||||||
| PHYSICIAN | $405,470 | $0 | $0 | $0 | $2,667 | $0 | $0 | $0 | $15,277 | $0 | $423,414 | $0 | $0 | $0 |
| CHARLES LAHAM | ||||||||||||||
| PHYSICIAN | $374,470 | $0 | $0 | $0 | $800 | $0 | $0 | $0 | $8,044 | $0 | $383,314 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | MATT WENZEL, HEALTH/SOCIAL CLUB DUES, $5,693. THIS AMOUNT WAS INCLUDED IN TAXABLE COMPENSATION. |
| PART I, LINE 3 | THE COMPENSATION OF THE OFFICERS IS PAID BY RIVERVIEW SYSTEMS LTD., A RELATED ORGANIZATION, BUT DETERMINED BY GREAT RIVER HEALTH SYSTEM. THE FOLLOWING WERE USED BY GREAT RIVER HEALTH SYSTEM IN DETERMINING THE OFFICERS COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. FORM 990 OF OTHER ORGANIZATIONS 4. WRITTEN EMPLOYMENT CONTRACT 5. COMPENSATION SURVEY OR STUDY 6. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| IOWA FINANCE AUTHORITY | ||||||||
| A | 521699886 | 462466BV4 | 2017-05-31 | $25,545,000 | REFUND OF PRIOR ISSUE (7/24/08) | 0 | 0 | 0 |
| DES MOINES COUNTY IOWA | ||||||||
| B | 426004310 | 250087AA1 | 2012-04-04 | $60,000,000 | REFUND PRIOR ISSUE (7/25/01) & CONSTRUCT, RENOVATE, EXPAND & EQUIP FACILITY | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $12,115,000 | $25,545,000 | $284,957 | $25,260,043 | 2000 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $40,666,667 | $60,000,000 | $616,000 | $29,307,242 | 2013 | Yes (1) | 0 | Yes (1) | Yes (1) | $30,076,758 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: IOWA FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/30/2017 ISSUER NAME: DES MOINES COUNTY, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 11/20/2013 |
| SCHEDULE K, PART IV, LINE 2C | NOTE REGARDING THE 11/30/2017 REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. |
| SCHEDULE K, PART IV, LINE 2C | NOTE REGARDING THE 11/20/2013 REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CONCULATIONS ARE NECESSARY. |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehiclesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $44,500 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF CONTRIBUTIONS WAS USED IN PART I. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, AND TWO OR MORE ADDITIONAL BOARD MEMBERS. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE. |
| FORM 990, PART VI, SECTION A, LINE 2 | MATT WENZEL AND JEREMY ALEXANDER HAVE BUSINESS RELATIONSHIPS BY SERVING AS OFFICERS AND/OR BOARD MEMBERS OF FOR-PROFIT ENTITIES RELATED TO SIRMC. |
| FORM 990, PART VI, SECTION A, LINE 3 | ALL EXECUTIVE LEADERSHIP FUNCTIONS FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER ARE PROVIDED BY MUTUAL CONSULTING AND MANAGEMENT SERVICES, INC. MUTUAL CONSULTING AND MANAGEMENT SERVICES IS A SUBSIDIARY OF RIVERVIEW SYSTEMS LTD, WHICH IS A SUBSIDIARY OF GREAT RIVER HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ARTICLES OF INCORPORATION WERE REVISED TO REFLECT MERGER WITH RELATED ORGANIZATION. FORT MADISON COMMUNITY HOSPITAL WITH GREAT RIVER MEDICAL CENTER. THE SURVIVING ORGANIZATION WAS RENAMED SOUTHEAST IOWA REGIONAL MEDICAL CENTER, INC. |
| FORM 990, PART VI, SECTION A, LINE 6 | GREAT RIVER HEALTH SYSTEM INC., IS THE SOLE MEMBER OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, GREAT RIVER HEALTH SYSTEM, INC (GRHS), HAS THE SOLE POWER TO ELECT OR REMOVE ALL BOARD MEMBERS OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER. THE NOMINATING COMMITTEE SHALL PRESENT A RECOMMENDATION FOR THE ELECTION OF DIRECTORS TO THE BOARD, WHICH UPON APPROVAL OF THE BOARD AND THE SUBSEQUENT APPROVAL OF GRHS, SHALL BE ELECTED TO THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE AUTHORIZED ONLY AFTER APPROVAL OF THE SOLE MEMBER: A. MERGER, CONSOLIDATION, OR DISSOLUTION OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER WITH ANY OTHER CORPORATION OR LEGAL ENTITY. B. ANY CHANGE IN SOUTHEAST IOWA REGIONAL MEDICAL CENTER'S ARTICLES OF INCORPORATION OR BYLAWS. C. ELECT OR REMOVE THE BOARD OF DIRECTORS. D. APPROVE STRATEGIC OR OTHER BUSINESS PLANS. E. APPROVE CAPITAL AND OPERATING BUDGETS. F. APPROVE ANY INDEBTEDNESS. G. TRANSFER, SALE OR CLOSURE OF ANY FACILITY , DEPARTMENT OR FUNCTION. H. APPROVE ANY CHARITABLE DISBURSEMENT IN EXCESS OF $100,0000. I. SALE , DISPOSITION OR ANY ENCUMBRANCES OF ANY REAL ESTATE OWNED. J. ADOPT, AMEND OR TERMINATE EMPLOYEE BENEFIT PROGRAMS. K. APPOINT OR TERMINATE CEO. L. APPROVE THE ELECTION OF ANY OFFICER OR CHAIRPERSON. M. TAKE ANY ACTION NECESSARY DEEMED IN THE BEST INTERESTS OF THE HOSPITAL SYSTEM. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 IS REVIEWED IN DETAIL BY THE ACCOUNTANT, DIRECTOR OF FINANCE AND CFO. ANY NECESSARY ADJUSTMENTS ARE MADE PRIOR TO FINALIZING THE FORM. A COPY OF THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. ANY QUESTIONS OF THE BOARD OF DIRECTORS ARE ADDRESSED THROUGH THE ACCOUNTING DEPARTMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOTH CORPORATE AND SUBSIDIARY BOARD MEMBERS ARE PROVIDED EDUCATION REGARDING CONFLICTS OF INTEREST. THIS EDUCATION IS PROVIDED BY THE CHIEF COMPLIANCE OFFICER. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. RELATIONSHIPS NOTED ON THIS FORM MAY BE DISCUSSED WITH THE RESPECTIVE BOARD MEMBER IF THERE ARE QUESTIONS. IF AN INDIVIDUAL HAS A CONFLICT OF INTEREST, THEY MAY NOT PARTICIPATE IN DISCUSSIONS RELATING TO THE TRANSACTION IN QUESTION AND MAY NOT VOTE ON MATTERS RELATED TO THE TRANSACTION. CONFLICT OF INTEREST PROCEEDINGS ARISING FROM CONFLICTS OF INTEREST ARE DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION OF OFFICERS IS PAID BY A RELATED FOR-PROFIT SUBSIDIARY. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS IS DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF GREAT RIVER HEALTH SYSTEM, INC. THE ROLE OF THE COMPENSATION COMMITTEE IS TO ACT ON BEHALF OF THE CORPORATE BOARD OF DIRECTORS IN ADOPTING, REVIEWING AND MAINTAINING AN EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE IS COMPRISED OF THREE BOARD MEMBERS, ALL OF WHOM ARE INDEPENDENT FROM THE CEO AND OTHER OFFICERS. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE CEO AND OTHER OFFICERS ON AN ANNUAL BASIS. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES TAKEN AT THE MEETINGS. GREAT RIVER HEALTH SYSTEM, INC. PARTICIPATES IN AND UTILIZES EXECUTIVE SALARY SURVEYS TO DETERMINE COMPENSATION RANGES. THE COMMITTEE REVIEWS PREVAILING MARKET DATA TO ENSURE CONTINUED MARKET COMPETITIVENESS. THE COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTING GROUP BIANNUALLY TO ASSESS AND VALIDATE THE ENTIRETY OF EXECUTIVE COMPENSATION AND BENEFITS PACKAGES TO ENSURE REGULATORY COMPLIANCE, EXTERNAL COMPETITIVENESS, AND INTERNAL EQUITY. THE MOST RECENT YEAR OF AN INDEPENDENT THIRD PARTY REVIEW WAS 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | SOUTHEAST IOWA REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 90,002,530. MANAGEMENT AND GENERAL EXPENSES 4,004,398. FUNDRAISING EXPENSES 21,390. TOTAL EXPENSES 94,028,318. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN TRUST -232,737. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GREAT RIVER HEALTH SYSTEM INC | |||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 421193185 | HEALTH CARE | IA | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| GREAT RIVER HEALTH FOUNDATION INC | |||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 421446727 | SUPPORT RELATED ORGANIZATIONS | IA | 501(C)(3) | LINE 12B, II | 0 | GREAT RIVER HEALTH SYSTEMS INC | |
| GRHS HOLDINGS INC | |||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 421193186 | SUPPORT RELATED ORGANIZATIONS | IA | 501(C)(3) | LINE 12B, II | 0 | GREAT RIVER HEALTH SYSTEMS INC | |
| HENRY COUNTY HEALTH CENTER INC | |||||||||||
| 1221 SOUTH GEAR AVENUE | WEST BURLINGTON | IA | 52655 | 862701018 | HOSPITAL | IA | 501(C)(3) | LINE 3 | 0 | GREAT RIVER HEALTH SYSTEMS INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| RIVERVIEW SYSTEMS LTD | |||||||||
| 1221 SOUTH GEAR AVE | WEST BURLINGTON | IA | 52655 | 421191960 | MEDICAL SERVICES | IA | N/A | C | 0 |
| GREAT RIVER MEDICAL SERVICES INC | |||||||||
| 1221 SOUTH GEAR AVE | WEST BURLINGTON | IA | 52655 | 421493449 | MEDICAL SERVICES | IA | N/A | C | 0 |
| MUTUAL CONSULTING & MANAGEMENT SERVICES | |||||||||
| 1221 SOUTH GEAR AVE | WEST BURLINGTON | IA | 52655 | 421349668 | MANAGEMENT SERVICES | IA | N/A | C | 0 |
| HERITAGE PARK PHARMACY | |||||||||
| 1221 SOUTH GEAR AVE | WEST BURLINGTON | IA | 52655 | 421191957 | PHARMACY | IA | N/A | C | 0 |
| HERITAGE MEDICAL EQUIPMENT & SUPPLY | |||||||||
| 1221 SOUTH GEAR AVE | WEST BURLINGTON | IA | 52655 | 421191958 | MEDICAL SUPPLY | IA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |