Northeast Iowa Medical Education: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
Northeast Iowa Medical Education (EIN 42-1058745)
Tax period
2021-07-01 to 2021-09-30
Filed
2022-06-29
IRS object ID
202221809349300807
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-06-29T09:18:31-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421058745EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Northeast Iowa Medical EducationBusinessNameLine1Txt
Business Name Line2Foundation IncBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone3192722525PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12055 Kimball Avenue 101AddressLine1Txt
CityWaterlooCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50702ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAnthony A Day MDPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone3192722525PhoneNum
Signature2022-06-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAnthonyPersonFirstNm
Person LastDay MDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2022-06-28PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Final ReturnYes (X)FinalReturnInd
Principal OfficerAnthony A Day MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12055 Kimball Avenue 101AddressLine1Txt
CityWaterlooCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50702ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$0GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.familypracticeresidency.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionDevelop excellent Family Medicine physicians.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
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Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,592,643PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,931,460PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income-$8,035PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,516,068PYTotalRevenueAmt
CY Total Revenue$0CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,737,797PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,418CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,494,834PYOtherExpensesAmt
CY Other Expenses$871,980CYOtherExpensesAmt
PY Total Expenses$7,232,631PYTotalExpensesAmt
CY Total Expenses$885,398CYTotalExpensesAmt
PY Revenues Less Expenses$1,283,437PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$885,398CYRevenuesLessExpensesAmt
Total Assets BOY$3,029,033TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$247,636TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,781,397NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionDeveloping excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$821,339ExpenseAmt
DescThe Northeast Iowa Medical Education Foundation was founded in 1975 to develop a Family Medicine training program. The Organization administratively dissolved on September 7, 2021.Desc
Total Program Service Expenses$821,339TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
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Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
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School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
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More Than5000 K To Org0MoreThan5000KToOrgInd
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Professional Fundraising0ProfessionalFundraisingInd
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Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
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Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate OperationsYes (1)TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
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Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
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Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

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FieldValueIRS element (for citing)
Business Name Line1Julie SmithBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3192722112PhoneNum

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Address Line12055 Kimball Avenue Ste 101AddressLine1Txt
CityWaterlooCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50702ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Anthony A Day MD
Executive Director5.00Yes (X)Yes (X)$0$0$0
Russel Adams MD
President0.10Yes (X)Yes (X)$0$0$0
Matthew Sojka MD
Vice President0.10Yes (X)Yes (X)$0$0$0
Jack Dusenbery
Secretary0.10Yes (X)Yes (X)$0$0$0
Pamela Delagardelle
Treasurer0.10Yes (X)Yes (X)$0$0$0
Eric Neverman DO
Director0.10Yes (X)$0$0$0
Vinko Bogdanic MD
Director0.10Yes (X)$0$0$0
Adriane Argenio MD
Director0.10Yes (X)$0$0$0
Julie Sandell DO
Director0.10Yes (X)$0$0$0
Greg Nelson
Director0.10Yes (X)$0$0$0
Attiq-UR Rehman MD
Director0.10Yes (X)$0$0$0
Dan Glascock MD
Director0.10Yes (X)$0$0$0
Julie Smith
Clinical Operations Manager10.00Yes (X)$0$0$0
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Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

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FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

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Total$2,351TotalAmt
Program Services$2,351ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

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Total$8,507TotalAmt
Program Services$8,507ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

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Total$2,560TotalAmt
Program Services$2,560ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

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Total$1,927TotalAmt
Management And General$1,927ManagementAndGeneralAmt

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Total$25,381TotalAmt
Management And General$25,381ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

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Total$172,667TotalAmt
Program Services$172,667ProgramServicesAmt

Office Expenses OfficeExpensesGrp

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Total$96,037TotalAmt
Program Services$96,037ProgramServicesAmt

Information Technology InformationTechnologyGrp

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Total$36,751TotalAmt
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Occupancy OccupancyGrp

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Total$52,030TotalAmt
Program Services$52,030ProgramServicesAmt

Insurance InsuranceGrp

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Total$478,221TotalAmt
Program Services$478,221ProgramServicesAmt

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DescPatient refundsDesc
Total$8,966TotalAmt
Program Services$8,966ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

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Program Services$821,339ProgramServicesAmt
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BOY$308,555BOYAmt
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EOY$0EOYAmt

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EOY$0EOYAmt

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Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

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BOY$455,808BOYAmt
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EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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Other Assets Total OtherAssetsTotalGrp

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BOY$1,395,253BOYAmt
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Total Assets TotalAssetsGrp

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BOY$3,029,033BOYAmt
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Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

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BOY$174,523BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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BOY$73,113BOYAmt

Total Liabilities TotalLiabilitiesGrp

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BOY$247,636BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

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BOY$2,781,397BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

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BOY$2,781,397BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

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BOY$3,029,033BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$885,398ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1,895,999OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,745,630CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,464,023CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,582,952CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,592,643CurrentTaxYearMinus1YearAmt
Total$15,385,248TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,787,265CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,117,044CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,952,616CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,931,460CurrentTaxYearMinus1YearAmt
Total$15,788,385TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,532,895CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,581,067CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,535,568CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,524,103CurrentTaxYearMinus1YearAmt
Total$31,173,633TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

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Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$31,173,633PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,389CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,241CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,242CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,478CurrentTaxYearMinus1YearAmt
Total$17,350TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$4,241CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,242CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,478CurrentTaxYearMinus1YearAmt
Total$17,350TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$7,585,308CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,539,810CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,529,581CurrentTaxYearMinus1YearAmt
Total$31,190,983TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99940PublicSupportCY509Pct
Public Support PY5090.99940PublicSupportPY509Pct
Investment Income CY0.00060InvestmentIncomeCYPct
Investment Income PY0.00060InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Section A, column (e):FormAndLineReferenceDesc
ExplanationNo revenue is shown as the Organization is preparing a short year, final Form 990 and did not have any activity that generated revenue.ExplanationTxt

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail (5 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
UnityPoint Health - Allen Hospital
Cash2021-07-01$800,000Book value4206982651825 Logan AveWaterlooIA50703501(c)(3)
Covenant Medical Center - MercyOne Waterloo Medical Center
Cash2021-07-01$580,000Book value4212646473421 W 9th StWaterlooIA50702501(c)(3)
Covenant Medical Center - MercyOne Waterloo Medical Center
Leasehold Improvement2021-07-01$328,530Book value4212646473421 W 9th StWaterlooIA50702501(c)(3)
Covenant Medical Center - MercyOne Waterloo Medical Center
Grant and research contracts2021-07-01$63,327Book value4212646473421 W 9th StWaterlooIA50702501(c)(3)
Covenant Medical Center - MercyOne Waterloo Medical Center
Cash2022-03-31$124,142Book value4212646473421 W 9th StWaterlooIA50702501(c)(3)
FieldValueIRS element (for citing)
Director Of SuccessorYes (1)DirectorOfSuccessorInd
Employee Of SuccessorYes (1)EmployeeOfSuccessorInd
Owner Of Successor0OwnerOfSuccessorInd
Receive Compensation0ReceiveCompensationInd
Assets DistributedYes (1)AssetsDistributedInd
Required To Notify AGYes (1)RequiredToNotifyAGInd
Attorney General NotifiedYes (1)AttorneyGeneralNotifiedInd
Liabilities PaidYes (1)LiabilitiesPaidInd
Bonds Outstanding0BondsOutstandingInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2e:FormAndLineReferenceDesc
ExplanationExplanation of Involvement: Russell Adams, MD, board President, is CMO of UnityPoint Health Allen Hospital.Matthew Sojka, MD, board Vice President, is VP of Medical Affairs and Trustee Director of Covenant Medical Center MercyOne Waterloo Medical Center.Jack Dusenbery, board Secretary, is President and CEO Covenant Medical Center MercyOne Waterloo Medical Center.Pamela Delagardell, board Treasurer, is CEO of UnityPoint Health Allen Hospital.Dan Glascock, MD, board Director, is Physician Director of UnityPoint Health Allen Hospital.Vinko Bogdanic, MD, board Director, is Physician Director of UnityPoint Health Allen Hospital.Julie Sandell, DO, board Director, is Physician Director of Covenant Medical Center MercyOne Waterloo Medical Center.Adriane Argenio, MD, board Director, is Physician Director of Covenant Medical Center MercyOne Waterloo Medical Center.Eric Neverman, DO, board Director, is Physician Director of UnityPoint Health Allen Hospital.Attiq-UR Rehman, MD, board Director, is Physician Director of Covenant Medical Center MercyOne Waterloo Medical Center.The individuals held the positions with the transferee organizations before and after the dissolution.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 3Northeast Iowa Medical Education Foundation administratively dissolved effective September 7, 2021.
Form 990, Part VI, Section A, line 1aThe Executive Committee is composed of the officers elected by the Board of Directors. The Executive Committee has authority to transact all regular business of the organization during the period between the meetings of the Board of Directors subject to any prior limitation imposed by the Board of Directors.
Form 990, Part VI, Section A, line 4MercyOne and Allen were the members of Northeast Iowa Medical Education Foundation, Inc., an Iowa nonprofit corporation. The Members effectively dissolved the corporation on July 1, 2021. The Organization administratively dissolved with the State of Iowa effective September 7, 2021.
Form 990, Part VI, Section A, line 6The members of Northeast Iowa Medical Education Foundation are Unity Point Health - Allen and MercyOne Waterloo Medical Center. New members may be admitted only with the unanimous consent of the present members.
Form 990, Part VI, Section A, line 7aThe two members, Unity Point Health - Allen and MercyOne Waterloo Medical Center, appoint the Board of Directors of Northeast Iowa Medical Education Foundation Inc. The President/Chief Executive Officer of each of the Members are automatically, by virtue of their office, Directors of this corporation. The Executive Director of the Northeast Iowa Medical Education Foundation, Inc. serves on the Board. A representative of the University of Iowa College of Medicine serves on the Board as appointed by the Dean of the College. Each Member appoints to the Board of Directors two persons who are members of the medical staff of the appointing Member, and two persons who are also directors of the appointing Member, or an affiliated organization of such appointing Member.
Form 990, Part VI, Section B, line 11bThe Form 990 is provided to the governing body. The Executive Director and Administrator review the 990 before it is filed.
Form 990, Part VI, Section B, line 12cBoard members and officers are required to sign a conflict of interest statement annually. The statements are reviewed by the Administrator of the organization. Any potential conflict is brought to the Board's attention for discussion. In the event of a potential conflict, the Member will disclose the potential conflict and either abstain from involvement or discussion of the issue leading to the conflict or resign.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request.
Form 990, Part IX, line 11gPurchased services: Program service expenses 172,667. Management and general expenses 0. Fundraising expenses 0. Total expenses 172,667.
Form 990, Part XI, line 9:Asset transfers due to dissolution -1,895,999.

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