2023-11-14T09:06:40-06:00 2022-12-31 411431613 BERGANKDV LTD PO BOX 2100 WATERLOO IA 507042100 990 2022-01-01 421154098 IOWA CITY HOSPICE INC IOWA 3193515665 1526 SYCAMORE STREET IOWA CITY IA 52240 SARA KRIEGER CHAIR 3196884212 2023-11-14 1 SARA KRIEGER 999009999 0 BRIAN ARONSON CPA P01425251 3192346885 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SARA KRIEGER 1526 SYCAMORE STREET IOWA CITY IA 52240 7871663 0 X WWW.IOWACITYHOSPICE.COM X 1980 IA PROVIDE INNOVATIVE CARE FOR PEOPLE WITH SERIOUS ADVANCED ILLNESSES AND END OF LIFE CONDITIONS. 4 1 122 50 0 0 1938196 2166229 5763934 4832018 20973 225598 -3383 -4482 7719720 7219363 0 0 0 0 4064337 2812140 0 0 115571 2516277 1892313 6580614 4704453 1139106 2514910 6148159 7684204 797307 212245 5350852 7471959 X TO PROVIDE COMPASSIONATE CARE FOR ANYONE IN OUR COMMUNITY AFFECTED BY SERIOUS ADVANCED ILLNESS AND END OF LIFE CONDITIONS. 0 0 4006849 4832018 THE ORGANIZATION PROVIDES SERVICES TO THOSE FACING A LIFE LIMITING ILLNESS. IN 2022 520 NEW PATIENTS WERE SERVED IN OUR SEVEN COUNTY SERVICE AREA (CEDAR, IOWA, JOHNSON, LINN, LOUISA, MUSCATINE AND WASHINGTON COUNTIES) FOR A TOTAL OF 26,660 DAYS OF CARE.IN ADDITION TO OUR PROFESSIONAL STAFF, IOWA CITY HOSPICE VOLUNTEERS PROVIDE SERVICES THAT ARE AS VARIED AS THE PATIENTS, FAMILIES AND COMMUNITIES WE SERVE. PATIENT CARE VOLUNTEERS PROVIDE COMPANIONSHIP AND SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR LOVED ONES. VOLUNTEERS PROVIDE MANY FORMS OF ASSISTANVE, AT ALL LEVELS OF SKILL. OUR 70 PATIENT CARE VOLUNTEERS PROVIDED 1131 HOURS OF SUPPORTIVE SERVICES TO THOSE WE SERVED IN 2022. FOLLOWING A PATIENT'S DEATH, IOWA CITY HOSPICE BEREAVEMENT STAFF IS AVAILABLE TO SUPPORT FAMILY MEMBERS AND FRIENDS THROUGHOUT THE GRIEVING PROCESS. OUR SERVICES ARE ALSO AVAILABLE TO ANYONE WHO IS GRIEVING THE LOSS OF A LOVED ONE, REGARDLESS OF WHETHER THE PERSON WAS IN HOSPICE CARE WITH IOWA CITY HOSPICE. IOWA CITY HOSPICE OFFERED 43 SESSIONS A OF GRIEF SUPPORT SERVICES INCLUDING SUPPORT GROUPS, GRIEF EDUCATION, AND SPECIAL EVENTS. IOWA CITY HOSPICE STAFF SERVED 102 PARTICIPANTS IN GROUPS, BEREAVEMENT LUNCHEONS AND OTHER EVENTS. 4006849 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 3 0 1 122 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KAREN DEGROOT 3196884212 1526 SYCAMORE STREET IOWA CITY IA 52240 SARA KRIEGER CEO 40.00 X X 0 97937 8216 KARLA KAMAL FORMER CEO 40.00 X X 0 63304 19951 KARA THOMA FORMER PSYCHOSOCIAL SERVICES MANA 40.00 X X 0 60855 27889 LYNN MORRIS DIRECTOR 40.00 X 0 59662 2741 RANDY MCDONOUGH DIRECTOR 0.50 X 0 0 0 0 281758 58797 0 0 0 0 0 2304 52692 405098 1706135 2166229 PATIENT CARE FEES 623990 4832018 4832018 4832018 14066 14066 855190 643658 211532 211532 211532 4160 52692 8642 -4482 -4482 7219363 4832018 0 221116 2313050 1767887 478234 66929 64464 49192 13407 1865 254307 194059 52890 7358 180319 137599 37502 5218 1941 1941 1803 1803 169333 169333 15400 15400 23738 16682 7056 113022 113022 5698 5698 98540 98540 19628 19628 24167 24167 112455 112455 1774 1774 MEDICAL SUPPLIES & DRUG 614936 614936 PATIENT EXPENSES 597498 597498 DUES AND SUBSCRIPTIONS 49181 27533 21648 BAD DEBT 29016 29016 14183 8686 5497 4704453 4006849 582033 115571 1001076 3122673 761746 403488 585076 575535 32901 15587 0 935745 2831615 3566921 6148159 7684204 446581 350726 212245 797307 212245 X 3863214 5985556 1487638 1486403 5350852 7471959 6148159 7684204 X 2514910 22994 -416797 X 0 1 X 1 0 X 505009 551703 1200117 1176450 1762741 5196020 505009 551703 1200117 1176450 1762741 5196020 1342875 3853145 57458 6821 21634 2849 14066 102828 4060 3745 4160 11965 5310813 29148505 0.72550 0.96070 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING INCOME - 2018 AMOUNT: $ 4,060. 2019 AMOUNT: $ 3,745. 2022 AMOUNT: $ 4,160. SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: DESCRIPTION: BEQUEST DATE: 06/06/19 AMOUNT: 235760. DESCRIPTION: ERC DATE: 12/31/21 AMOUNT: 761746. DESCRIPTION: ERC DATE: 12/31/22 AMOUNT: 403488. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2443491 3660 -469450 1977701 2145317 10175 287999 2443491 1890030 5313 249974 2145317 1578173 6870 304987 1890030 2102063 7895 -81785 450000 1578173 0.11000 0.89000 1 0 0 BENEFICIAL INTEREST IN ASSETS HELD 1754259 DUE FROM RELATED PARTY 1812662 3566921 CAPITAL LEASE OBLIGATIONS 212245 212245 PART V, LINE 4: THE ENDOWMENT FUND REPRESENTS AMOUNTS HELD BY A COMMUNITY FOUNDATION FOR THE ORGANIZATION. THE FUNDS CAN BE USED FOR OPERATING PURPOSES. PART 1, LINE 5 IOWA CARE COMMUNITY, INC. IS THE SOLE MEMBER OF IOWA CITY HOSPICE, INC AND VISITING NURSE ASSOCIATION OF JOHNSON COUNTY. AS THE SOLE MEMBER, IOWA CARE COMMUNITY, INC. ACTS AS THE COMMON PAYROLL PROVIDER FOR ALL THREE ENTITIES WITH TOTAL EMPLOYEE/W2 COUNT IN 2022 OF 122. THE SALARIES, OTHER COMPENSATION AND EMPLOYEE BENEFITS FOR IOWA CITY HOSPICE, INC AND VISITING NURSE ASSOCIATION OF JOHNSON COUNTY ARE REFLECTED ON THEIR RESPECTIVE 990 FILINGS. FORM 990, PART VI, SECTION A, LINE 7A IOWA CARE COMMUNITY, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE CEO EMAILS THE FINAL COPY OF THE FORM 990 TO THE IOWA CARE COMMUNITY, INC. BOARD OF DIRECTORS TO REVIEW AND APPROVE BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO DECLARE ALL CONFLICTS OF INTEREST AT LEAST ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S HUMAN RESOURCE SPECIALIST EVALUATES THE PAY RANGE OF THE CEO ANNUALLY BY USING COMPARATIVE DATA. PAY RANGES FOR THE ORGANIZATION ARE APPROVED CEO BY IOWA CARE COMMUNITY INC.'S BOARD OF DIRECTORS. THIS INFORMATION IS TAKEN INTO ACCOUNT WHEN THE EXECUTIVE DIRECTOR IS EVALUATED ANNUALLY BY THE ENTIRE BOARD OF DIRECTORS. ANY CHANGES TO THE COMPENSATION ARE APPROVED THROUGH THE BUDGETING PROCESS; REVIEWED AND APPROVED BY FIRST THE FINANCE COMMITTEE AND THEN THE BOARD OF DIRECTORS. COMMITTEE WORK HAPPENS THE SECOND HALF OF THE YEAR FOR IMPLEMENTATION IN THE SUBSEQUENT JANUARY. THE APPROVED PAY RATE IS THEN DOCUMENTED AND PLACED IN THE CEO'S PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST -416,797. VISTING NURSE ASSOCIATION OF JOHNSON COUNTY 1526 SYCAMORE STREET IOWA CITY IA 52240 420703760 NURSE ASSOCIATION IA 501(C)(3) LINE 7 IOWA CARE COMMUNITY INC 1 IOWA CARE COMMUNITY INC 1526 SYCAMORE STREET IOWA CITY IA 52240 863945811 SUPPORTING ORGANIZATION IA 501(C)(3) LINE 12C, III-FI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0