2022-11-14T11:31:12-06:00 2021-12-31 990 2021-01-01 421477471 UNITYPOINT AT HOME UNIT 5152416161 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 JENN OFELT INTERIM PRES/CHIEF CLINIC OFFICER 5155573253 2022-11-09 JENN OFELT 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JENN OFELT 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 356916210 0 X WWW.UNITYPOINT.ORG/HOMECARE X 1998 IA IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 12 6 1699 270 850777 303190 4325088 654604 215692287 236148271 527138 1458966 1611053 1228168 222155566 239490009 3183125 135265 0 0 100923881 105751723 0 0 0 110851502 130029189 214958508 235916177 7197058 3573832 111756123 105258341 46466947 36214315 65289176 69044026 X TO IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH HEALING, CARING AND TEACHING. 0 0 190546671 135265 237390023 HEALTH CARE SERVICESUNITYPOINT AT HOME PROVIDES HOME HEALTH SERVICES FOR PEOPLE IN NEED WITH THE PURPOSE TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. HIGHEST PRIORITY IS GIVEN TO LOW-INCOME INDIVIDUALS BUT SERVICES ARE AVAILABLE TO ALL RESIDENTS. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. HOME HEALTH CARE SERVICES PROVIDED AND PEOPLE SERVED MAY INCLUDE BUT ARE NOT LIMITED TO: CASE MANAGEMENT, CERTIFIED NURSING, PRIVATE DUTY NURSING, PALLIATIVE CARE, HOSPICE, INFUSION SERVICES, HOME MEDICAL EQUIPMENT, MATERNAL HEALTH CLINICS, NURSING CARE, SUPPORT TO HIGH RISK NEW PARENTS AND NEWBORNS, PARENTING SUPPORT, CHILD HEALTH CLINICS, HEALTH MAINTENANCE VISITS AND SCREEENINGS, IMMUNIZATION CLINICS, SENIOR CITIZENS, DISABLED, ILL, HANDICAPPED AND TERMINALLY ILL. SERVICES MAY BE PROVIDED ON A ONE-TIME, INTERMITTENT, PART-TIME OR LONG-TERM BASIS. UNITYPOINT AT HOME MADE 322,381 HOME VISITS IN 2021. 190546671 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 1699 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X X MICHAEL WELSCH VP FINANCE 5155573176 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 HOLLEY BERMEL DO BOARD VICE CHAIR 1.00 40.00 X X 0 264125 17576 MICHELLE BLACKMER BOARD MEMBER 1.00 1.00 X 0 0 0 PAMELA DELAGARDELLE BOARD MEMBER 1.00 40.00 X 0 664220 146478 DIANA EDWARDS MD BOARD MEMBER 1.00 40.00 X 0 388254 41831 DEBRA JOHNSON BOARD MEMBER 1.00 1.00 X 0 0 0 BRADLEY MANNING MD BOARD MEMBER 1.00 1.00 X 0 11750 0 ERIC NEVERMAN DO BOARD MEMBER 1.00 40.00 X 0 405995 25172 BRIAN SCOTT BOARD TREASURER 1.00 1.00 X X 0 0 0 KAREN STUMPE BOARD MEMBER 1.00 1.00 X 0 0 0 TODD WENCK MD BOARD MEMBER 1.00 40.00 X 0 485518 41915 ANDREA WHITE MD BOARD CHAIR 1.00 40.00 X X 0 307124 23022 BEVERLY ZENOR BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET VANOOSTEN PRES & CHIEF CLINICAL OFFICER 40.00 0.00 X 543552 0 88800 MICHAEL WELSCH VP FINANCE 40.00 0.00 X 223427 0 30086 LEANNE BURRACK VP HOSPICE 40.00 0.00 X 184860 0 16411 RUTH COADY VP SPECIALTY PHARMACY & INFUSION 40.00 0.00 X 183552 0 8944 PHILLIP DEHNER VP HOME HEALTH & OPERATIONS 40.00 0.00 X 171266 0 22930 JESSICA MEISNER VP HUMAN RESOURCES 1.00 40.00 X 0 382462 37555 JENN OFELT CHIEF OPERATING OFFICER 40.00 0.00 X 305956 0 30415 PATRICK REEVES VP HOME MEDICAL EQUIPMENT 40.00 0.00 X 176888 0 25667 TODD RICHARD VP PATIENT ACCESS 40.00 0.00 X 225220 0 25356 MARISSA SMITH CHIEF COMPLIANCE OFFICER 40.00 0.00 X 208508 0 31517 LOIS GLANZ EXEC DIRECTOR CLINICAL OPS 40.00 0.00 X 143077 0 17453 AMY LEISTER DIRECTOR CLINICAL EDUCATION 40.00 0.00 X 153008 539 18087 TERESA MARTIN POPULATION HEALTH CARE COORDINATOR 40.00 0.00 X 144289 1076 20047 DIANNE SCHULTZ DIRECTOR CARE AT HOME SVCS 40.00 0.00 X 196692 0 10678 VICKI WILDMAN DIRECTOR OF CLINICAL SERVICES 40.00 0.00 X 138470 0 25389 DAVID WILLIAMS MD-CEO TO 0420 SVP CHIEF CLINIC OFF-UPH (FR 4/20) 1.00 40.00 X 0 865703 190774 MELLISSA WOOD TO 1217 CHIEF NURSING EXECUTIVE (QC) 0.00 40.00 X 0 347914 7575 JANE ARNOLD TO 1218 FORMER VP OPERATIONS 0.00 40.00 X 0 265027 61074 2998765 4389707 964752 50 1 1 0 BLACKTREE HEALTHCARE CONSULTING 1030 CONTINENTAL DRIVE KING OF PRUSSIA PA 19406 CONSULTING SERVICES 3130596 MEDEFIS INC PO BOX 5068 NEW YORK NY 10087 STAFFING AGENCY 1739762 PUTMAN INC PO BOX 310729 DES MOINES IA 50331 STAFFING AGENCY 1508371 OPTUM HOSPICE PHARMACY SERVICE 4525 EXECUTIVE PARK DR STE 100 MONTGOMERY AL 36116 PHARMACY SERVICES 1143458 EDGE COMMERCIAL LLC 3155 SE MIEHE DR STE 2 GRIMES IA 50111 CONSTRUCTION SERVICES 535094 28 439845 214759 654604 HOME HEALTH CARE SERV 621610 231726433 230996383 730050 MGMT & SUPPORT SVCS 561000 3798524 3798524 SUBS & JOINT VENTURES 900099 615514 494787 120727 RENTAL INCOME 531390 7800 7800 236148271 814712 13584 801128 118030938 39517 117413398 12803 617540 26714 644254 644254 MISCELLANEOUS 900099 1350460 1350460 SHARED SAVINGS REVENUE 900099 -122292 -122292 1228168 239490009 236539246 850777 1445382 135265 135265 2503355 2503355 82487705 55018253 27469452 2684144 1790290 893854 12696718 8468550 4228168 5379801 3588259 1791542 10758205 10758205 -63714 -98688 34974 513814 229873 283941 9226966 4595728 4631238 75029 1123 73906 30155178 29709419 445759 163103 163103 4816065 2453781 2362284 2388398 2249217 139181 31863 5375 26488 929741 607471 322270 1092369 1092369 MEDICAL SUPPLIES 69683190 69667217 15973 MISCELLANEOUS EXPENSE 177394 116003 61391 INCOME TAXES 81588 -4142 85730 235916177 190546671 45369506 0 20057918 14475798 5513072 6689882 31168135 27793721 3039714 2494554 8950121 9409508 310536 420775 18703386 12935500 5869229 5767886 26243285 28371466 3911665 3801060 6692448 6033691 111756123 105258341 14359237 16007323 12628421 5587425 543072 -164318 18936217 14783885 46466947 36214315 X 62121353 65793322 3167823 3250704 65289176 69044026 111756123 105258341 X 3573832 98137 82881 X 0 1 X 1 0 X 1190692 787346 827775 4325088 654604 7785505 171288413 184841232 206085097 214857806 235028597 1012101145 772778 1167131 1398861 1611053 1228168 6177991 173251883 186795709 208311733 220793947 236911369 1026064641 0 0 0 1026064641 493240 419412 590015 260115 814712 2577494 493240 419412 590015 260115 814712 2577494 152833 204214 299537 309015 303190 1268789 173897956 187419335 209201285 221363077 238029271 1029910924 0.99630 0.99610 0.00250 0.00240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3167823 654604 82881 654604 3250704 2912682 527050 255142 527051 3167823 2764135 827301 148547 827301 2912682 996135 661491 1768001 661492 2764135 1117386 714688 835939 996135 0.00000 0.06794 0.93205 0 1 1 160000 160000 5164872 3023624 2141248 11884841 9882439 2002402 1493673 29437 1464236 5767886 OPERATING LEASE ASSETS 6033691 6033691 DUE TO AFFILIATES 4637363 SELF-INSURANCE RESERVE 2453394 HEALTH AND WELFARE BENEFITS RESERVE 994186 LONG-TERM RETENTION INCENTIVES 469089 OPERATING LEASE LIABILITY 6208720 INCOME TAXES PAYABLE 21133 14783885 X 239533000 98137 29 98166 239434834 55175 55175 239490009 235578000 101 101 235577899 55175 283103 338278 235916177 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2018. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 29. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 101. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN NET ASSETS WITHOUT RESTRICTION 283,103. 1 IOWA HEALTH FOUNDATION 1415 WOODLAND AVE DES MOINES IA 50309 421467682 501(C)(3) 0 120000 PROGRAM SUPPORT 1 0 PART I, LINE 2: UNITYPOINT AT HOME REQUIRES EACH RECIPIENT OF THE GRANTS MENTIONED IN PARTS II & III (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINES A SERIES OF ELIGIBILITY STANDARDS THAT ARE REQUIRED TO BE MET. UNITYPOINT AT HOME THEN REVIEWS THESE APPLICATIONS AND, BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. 1 X X X X X 0 1 0 0 0 0 0 0 0 DAVID WILLIAMS MD-CEO TO 0420 SVP CHIEF CLINIC OFF-UPH (FR 4/20) 0 611964 0 232920 0 20819 0 168386 0 22388 0 1056477 0 0 PAMELA DELAGARDELLE BOARD MEMBER 0 475846 0 169501 0 18873 0 131888 0 14590 0 810698 0 0 MARGARET VANOOSTEN PRES & CHIEF CLINICAL OFFICER 410209 0 122514 0 10829 0 68626 0 20174 0 632352 0 0 0 TODD WENCK MD BOARD MEMBER 0 475534 0 9019 0 965 0 14500 0 27415 0 527433 0 0 ERIC NEVERMAN DO BOARD MEMBER 0 397049 0 8444 0 502 0 14500 0 10672 0 431167 0 0 DIANA EDWARDS MD BOARD MEMBER 0 343893 0 43976 0 385 0 14500 0 27331 0 430085 0 0 JESSICA MEISNER VP HUMAN RESOURCES 0 278492 0 98203 0 5767 0 14500 0 23055 0 420017 0 0 MELLISSA WOOD TO 1217 CHIEF NURSING EXECUTIVE (QC) 0 282209 0 64524 0 1181 0 5800 0 1775 0 355489 0 0 JENN OFELT CHIEF OPERATING OFFICER 233812 0 68890 0 3254 0 12452 0 17963 0 336371 0 0 0 ANDREA WHITE MD BOARD CHAIR 0 292461 0 13641 0 1022 0 14500 0 8522 0 330146 0 0 JANE ARNOLD TO 1218 FORMER VP OPERATIONS 0 204778 0 56036 0 4213 0 38334 0 22740 0 326101 0 0 HOLLEY BERMEL DO BOARD VICE CHAIR 0 255492 0 8236 0 397 0 13296 0 4280 0 281701 0 0 MICHAEL WELSCH VP FINANCE 172926 0 50441 0 60 0 10691 0 19395 0 253513 0 0 0 TODD RICHARD VP PATIENT ACCESS 172136 0 52946 0 138 0 11500 0 13856 0 250576 0 0 0 MARISSA SMITH CHIEF COMPLIANCE OFFICER 158954 0 49216 0 338 0 10781 0 20736 0 240025 0 0 0 DIANNE SCHULTZ DIRECTOR CARE AT HOME SVCS 164644 0 25533 0 6515 0 9822 0 856 0 207370 0 0 0 PATRICK REEVES VP HOME MEDICAL EQUIPMENT 134232 0 42566 0 90 0 8521 0 17146 0 202555 0 0 0 LEANNE BURRACK VP HOSPICE 141039 0 42959 0 862 0 7012 0 9399 0 201271 0 0 0 PHILLIP DEHNER VP HOME HEALTH & OPERATIONS 146694 0 24176 0 396 0 7531 0 15399 0 194196 0 0 0 RUTH COADY VP SPECIALTY PHARMACY & INFUSION 140911 0 42245 0 396 0 8196 0 748 0 192496 0 0 0 AMY LEISTER DIRECTOR CLINICAL EDUCATION 132182 539 20688 0 138 0 7204 28 10809 46 171021 613 0 0 TERESA MARTIN POPULATION HEALTH CARE COORDINATOR 140645 1076 3516 0 128 0 7363 55 12539 90 164191 1221 0 0 VICKI WILDMAN DIRECTOR OF CLINICAL SERVICES 115319 0 18385 0 4766 0 5782 0 19607 0 163859 0 0 0 LOIS GLANZ EXEC DIRECTOR CLINICAL OPS 119039 0 18915 0 5123 0 7373 0 10080 0 160530 0 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: KYLE CHRISTIASON, MD $16,080; STAN DANIELSON, MD $33,554; PAMELA DELAGARDELLE $117,726; MARGARET VANOOSTEN $53,500; ANDREA WHITE $11,576; AND DAVID WILLIAMS, MD $233,691. ABBY SNOBERGER FAMILY MEMBER OF KEY EMPLOYEE LEANNE BURRACK 127130 EMPLOYMENT 0 FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 2 MARGARET VANOOSTEN; PHILLIP DEHNER; FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGERS, AND APPOINT BOARD OF DIRECTORS. AFFILIATE ORGANIZATIONS THAT HAVE TRANSFERRED HOME HEALTH OPERATIONS TO THE ORGANIZATION HAVE THE RIGHT TO NOMINATE AT LEAST ONE BOARD MEMBER, SUBJECT TO APPROVAL BY IOWA HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE PRESIDENT AND CCO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2021 FOR THE FOLLOWING INDIVIDUALS: JANE ARNOLD, LEANNE BURRACK, RUTH COADY, PHILIP DEHNER, PAMELA DELAGARDELLE, JESSICA MEISNER, JENNIFER OFELT, PATRICK REEVES, TODD RICHARD, MARISSA SMITH, MARGARET VANOOSTEN, AND MICHAEL WELSCH, DAVID WILLIAMS, MD, AND MELISSA WOOD. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST 82,881. ABBE CENTER FOR COMMUNITY MENTAL HEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421045257 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 ABBEHEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421373123 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'S HEALTHCARE 0 AGING SERVICES INC 740 N 15TH AVE NO A HIAWATHA IA 52233 237085316 SENIOR SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) ABBEHEALTH INC 0 ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS IA 501(C)(3) 170(B)(1) (A)(II) ALLEN HEALTH SYSTEMS INC 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ALLEN HEALTH SYSTEMS INC 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA IA 52205 421466284 PROVIDE AMBULANCE SERVICES IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'SJONES REGIONAL MEDICAL CENTER 0 BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC 3251 WEST NINTH STREET WATERLOO IA 50702 420733463 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 CENTER FOR ALCOHOL AND DRUG SERVICES INC 4869 FOREST GROVE DRIVE BETTENDORF IA 52722 421134273 SUBSTANCE ABUSE SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 0 CENTRAL IOWA HEALTH PROPERTIES CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 421233759 PROPERTY HOLDING COMPANY IA 501(C)(2) CENTRAL IOWA HEALTH SYSTEM 0 CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421189791 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 420680452 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 CHATHAM OAKS 740 N 15TH AVE NO A HIAWATHA IA 52233 421302928 MENTAL HEALTH AND/OR DISABILITY RESIDENTIAL TREATMENT SERVICES IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC 1415 WOODLAND AVE SUITE 130 DES MOINES IA 50309 421412497 COORDINATION OF MEDICAL EDUCATION PROGRAMS IA 501(C)(3) 509(A)(3), TYPE III 0 EYERLY-BALL COMMUNITY MENTAL HEALTH SERVICES 945 19TH STREET DES MOINES IA 50314 420942273 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) CENTRAL IOWA HEALTH SYSTEM 0 FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 421307495 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER 3820 HILLSIDE DRIVE CEDAR FALLS IA 50613 421372380 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 420933383 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 GRINNELL REGIONAL MEDICAL CENTER AUXILIARY 210 FOURTH AVENUE GRINNELL IA 50112 237075505 CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES IA 501(C)(3) 509(A)(3), TYPE I GRINNELL REGIONAL MEDICAL CENTER 0 GRINNELL REGIONAL MEDICAL CENTER FOUNDATION 210 FOURTH AVENUE GRINNELL IA 50112 421454737 CHARITABLE FUNDRAISING IA 501(C)(3) 509(A)(3), TYPE I GRINNELL REGIONAL MEDICAL CENTER 0 HULT CENTER FOR HEALTHY LIVING INC 5409 N KNOXVILLE AVE PEORIA IL 61614 363510390 HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1) (A)(VI) PROCTOR HOSPITAL 0 HUMAN SERVICE CENTER 600 FAYETTE PO BOX 1346 PEORIA IL 61654 371004882 MENTAL HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(VI) UNITYPOINT HEALTH - 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IA N/A 0 1 UNITED MEDICAL PARK ASC LLC DBA THE SURGERY CENTER AT UNITED MEDICAL PARK 1825 LOGAN AVE WATERLOO IA 50703 420698265 AMBULATORY SURGERY CENTER IA N/A 0 1 UPHT-SCA HOLDINGS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 473564984 AMBULATORY SURGERY CENTER INVESTMENT DE N/A 0 0 WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC 1660 60TH STREET WEST DES MOINES IA 50266 271414600 ORTHOPEDIC SERVICE LINES MANAGEMENT IA N/A 0 1 WEST LAKES SLEEP CENTER LLC 5950 UNIVERSITY AVENUE SUITE 2 WEST DES MOINES IA 50266 263193923 SLEEP DISORDER DIAGNOSTIC TESTING FACILITY IA N/A 0 1 ABBE MANAGEMENT CORPORATION 740 N 15TH AVE NO A HIAWATHA IA 52233 421361755 MANAGEMENT SERVICES IA N/A C 0 BELCREST SERVICES LTD 5409 N KNOXVILLE AVE PEORIA IL 61614 371196307 MEDICAL SERVICES IL N/A C 0 BROADBAND INC 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 273819741 INFORMATION TECHNOLOGY MGMT. 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AS THE NATION'S 13TH LARGEST NONPROFIT HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES PROGRESSIVE AND HIGH QUALITY SERVICES ACROSS ITS 9 REGIONS WHICH SPAN IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN. THIS REGIONAL CARE MODEL HAS BEEN SUCCESSFUL IN ACHIEVING STANDARDIZED LEVELS OF PERFORMANCE AND KEEPING CARE LOCAL. WITH $4.9B IN TOTAL OPERATING REVENUE, UNITYPOINT HEALTH EMPLOYS APPROXIMATELY 33,000 TEAM MEMBERS AND OPERATES 20 REGIONAL HOSPITALS, 19 COMMUNITY NETWORK HOSPITALS AND OVER 435 CLINICS. AS A KEY COMPONENT OF UNITYPOINT HEALTH, UNITYPOINT CLINIC IS A 1,180 PROVIDER MULTISPECIALTY GROUP THAT IS BUILT ON THE FOUNDATION OF CARE DELIVERY, INNOVATION AND EXPERIENCE. REPRESENTED BY OVER 40 SPECIALTIES, UPC IS A FORWARD-THINKING DELIVERY PROVIDER AND IS ON THE LEADING EDGE OF CARE DELIVERY WITH ITS TELEHEALTH, AMBULATORY AND URGENT CARE PROGRAMS. THE DIVERSIFIED HEALTH SYSTEM ALSO INCLUDES UNITYPOINT ACCOUNTABLE CARE, UNITYPOINT HEALTH COLLEGES, UNITYPOINT AT HOME AND EXTENDS HEALTH COVERAGE THROUGH THE HEALTHPARTNERS UNITYPOINT INSURANCE PLAN.