HEALTH INC HOSPICE: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HEALTH INC HOSPICE (EIN 38-3320710)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-10
IRS object ID
202101309349302955
Schema version
2019v5.2
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)
Return2021-05-10T16:44:04-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN481292483PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HENJES CONNER & WILLIAMS PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1937AddressLine1Txt
CityDAKOTA DUNESCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57049ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN383320710EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF SIOUXLANDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt
Phone7122334144PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14300 HAMILTON BLVDAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51104ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKARA WINKERPersonNm
Person TitleDIR OF FINANCEPersonTitleTxt
Phone7122529418PhoneNum
Signature2021-02-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMELISSA J WILLERPreparerPersonNm
PTINP00121904PTIN
Phone6052423900PhoneNum
Preparation2021-02-22PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKARA WINKERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 NEBRASKA STAddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51101ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,280,447GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICEOFSIOUXLAND.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionPROVIDE COMFORT, SUPPORT, AND COMPASSIONATE CARE TO TERMINALLY ILL PEOPLE AND THEIR FAMILIES THAT RESPECTS THE DIGNITY OF EACH INDIVIDUAL, AND TO FOSTER COMMUNITY ACCEPTANCE THAT DYING IS AN INTEGRAL PART OF LIVING.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee114TotalEmployeeCnt
Total Volunteers132TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$199,905PYContributionsGrantsAmt
CY Contributions Grants$312,322CYContributionsGrantsAmt
PY Program Service Revenue$11,177,518PYProgramServiceRevenueAmt
CY Program Service Revenue$11,653,768CYProgramServiceRevenueAmt
PY Investment Income$384,185PYInvestmentIncomeAmt
CY Investment Income$273,587CYInvestmentIncomeAmt
PY Other Revenue-$65,889PYOtherRevenueAmt
CY Other Revenue$13,839CYOtherRevenueAmt
PY Total Revenue$11,695,719PYTotalRevenueAmt
CY Total Revenue$12,253,516CYTotalRevenueAmt
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$5,381,023PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,588,146CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$306,885CYTotalFundraisingExpenseAmt
PY Other Expenses$5,134,587PYOtherExpensesAmt
CY Other Expenses$5,809,625CYOtherExpensesAmt
PY Total Expenses$10,515,610PYTotalExpensesAmt
CY Total Expenses$11,397,771CYTotalExpensesAmt
PY Revenues Less Expenses$1,180,109PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$855,745CYRevenuesLessExpensesAmt
Total Assets BOY$10,624,241TotalAssetsBOYAmt
Total Assets EOY$12,763,286TotalAssetsEOYAmt
Total Liabilities BOY$2,477,777TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,007,924TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,146,464NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,755,362NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE COMFORT, SUPPORT, AND COMPASSIONATE CARE TO TERMINALLY ILL PEOPLE AND THEIR FAMILIES THAT RESPECTS THE DIGNITY OF EACH INDIVIDUAL, AND TO FOSTER COMMUNITY ACCEPTANCE THAT DYING IS AN INTEGRAL PART OF LIVING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,530,257ExpenseAmt
Revenue$11,667,607RevenueAmt
DescHOSPICE OF SIOUXLAND'S MISSION IS TO PROVIDE COMFORT, SUPPORT AND COMPASSIONATE CARE TO PEOPLE WITH LIFE-LIMITING ILLNESSES AND TO THEIR FAMILIES IN A MANNER THAT RESPECTS THE DIGNITY OF EACH INDIVIDUAL AND TO FOSTER COMMUNITY ACCEPTANCE THAT DYING IS AN INTEGRAL PART OF LIVING. ALL PATIENTS WHO MEET ADMISSION CRITERIA ARE ELIGIBLE FOR HOSPICE CARE, NO MATTER WHAT THEIR FINANCIAL CIRCUMSTANCES, OR ABILITY TO PAY.Desc
Total Program Service Expenses$8,530,257TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document29IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee114EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KARA WINKERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7122529418PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 NEBRASKA ST PO BOX 5017AddressLine1Txt
CitySIOUX CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51101ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MILT AVERY
CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
LYNN WOLD
SECRETARY1.00Yes (X)Yes (X)$0$0$0
BETH HUGHES
TREASURER1.00Yes (X)Yes (X)$0$0$0
JIM GOBELL
DIRECTOR1.00Yes (X)$0$0$0
JESSICA HANSON
DIRECTOR1.00Yes (X)$0$0$0
TRACY LARSON
DIRECTOR1.00Yes (X)$0$0$0
CHAD MARKHAM
DIRECTOR1.00Yes (X)$0$0$0
CRAIG BERENSTEIN
VICE CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
KRISTI TURNER
EXECUTIVE DIRECTOR40.00Yes (X)$0$0$0
KARA WINDER
DIRECTOR OF FINANCE40.00Yes (X)$0$0$0
ANN MYERS
DIRECTOR OF OPERATIONS40.00Yes (X)$130,813$0$19,169
DALE HOLDIMAN
MEDICAL DIRECTOR40.00$244,977$0$18,842Yes (X)
MICHELLE HUBER
PHARMACIST40.00$128,620$0$6,438Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$504,410TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$44,449TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REGENCY SQUARE CARE CENTER
3501 DAKOTA AVESOUTH SIOUX CITYNE68776RESIDENTIAL SERVICES$455,327
OPTUM HOSPICE PHARMACY SERVICES
11000 OPTUM CIRCLEEDEN PRAIRIEMN55344PHARMACY AND EDUCATION$425,957
NATIONAL HME INC
7451 AIRPORT FREEWAYRICHLAND HILLSTX56118EQUIPMENT AND TECHNOLOGY$418,244
MID STEP SERVICES INC
4303 STONE AVENUESIOUX CITYIA51106RESIDENTIAL SERVICES$349,465
TOUCHSTONE LIVING CENTER
1800 INDIAN HILLS DRSIOUX CITYIA51104RESIDENTIAL SERVICES$265,785
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
All Other Contributions$312,322AllOtherContributionsAmt
Total Contributions$312,322TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621610BusinessCd
Total Revenue Column$11,653,768TotalRevenueColumnAmt
Related Or Exempt Func Income$11,653,768RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,653,768TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$273,587TotalRevenueColumnAmt
Exclusion$273,587ExclusionAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$26,931RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$26,931RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$26,931TotalRevenueColumnAmt
Related Or Exempt Func Income-$26,931RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$40,770TotalRevenueColumnAmt
Related Or Exempt Func Income$40,770RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$40,770OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,253,516TotalRevenueColumnAmt
Related Or Exempt Func Income$11,667,607RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$273,587ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$149,982TotalAmt
Management And General$149,982ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,456,888TotalAmt
Program Services$2,977,478ProgramServicesAmt
Management And General$1,240,909ManagementAndGeneralAmt
Fundraising$238,501FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$156,755TotalAmt
Program Services$111,296ProgramServicesAmt
Management And General$45,459ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$500,265TotalAmt
Program Services$351,197ProgramServicesAmt
Management And General$138,611ManagementAndGeneralAmt
Fundraising$10,457FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$324,256TotalAmt
Program Services$228,252ProgramServicesAmt
Management And General$90,843ManagementAndGeneralAmt
Fundraising$5,161FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$13,858TotalAmt
Management And General$13,858ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$53,662TotalAmt
Management And General$53,662ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,765,776TotalAmt
Program Services$3,343,559ProgramServicesAmt
Management And General$418,237ManagementAndGeneralAmt
Fundraising$3,980FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,609TotalAmt
Management And General$122ManagementAndGeneralAmt
Fundraising$7,487FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$47,548TotalAmt
Management And General$47,548ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$296,995TotalAmt
Program Services$193,592ProgramServicesAmt
Management And General$89,703ManagementAndGeneralAmt
Fundraising$13,700FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$151,071TotalAmt
Program Services$138,948ProgramServicesAmt
Management And General$10,611ManagementAndGeneralAmt
Fundraising$1,512FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$23,204TotalAmt
Management And General$23,204ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$113,843TotalAmt
Program Services$10,170ProgramServicesAmt
Management And General$103,673ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$56,834TotalAmt
Program Services$21,184ProgramServicesAmt
Management And General$35,650ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$698,608$698,608
MEDICATIONS$409,027$409,027
OTHER COSTS$109,936$46,946$62,170$820
DUES AND SUBSCRIPTIONS$36,387$36,387

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,267TotalAmt
Fundraising$25,267FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,397,771TotalAmt
Program Services$8,530,257ProgramServicesAmt
Management And General$2,560,629ManagementAndGeneralAmt
Fundraising$306,885FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,541,813BOYAmt
EOY$3,733,012EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,118,577BOYAmt
EOY$994,951EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$114,339BOYAmt
EOY$122,049EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,204,927LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,082,142LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,225,207BOYAmt
EOY$1,122,785EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,632,361BOYAmt
EOY$5,830,679EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$991,944BOYAmt
EOY$959,810EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,624,241BOYAmt
EOY$12,763,286EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,477,777BOYAmt
EOY$3,036,524EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$971,400EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,477,777BOYAmt
EOY$4,007,924EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,685,730BOYAmt
EOY$7,320,147EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,460,734BOYAmt
EOY$1,435,215EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,146,464BOYAmt
EOY$8,755,362EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,624,241BOYAmt
EOY$12,763,286EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$855,745ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$17,504NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$229,343OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
MERCY MEDICAL CENTER AND SUBSIDIARIES
3113730803Yes (1)$0$0
NORTHWEST IOWA HOSPITAL CORPORATION
4210198723Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$782,509BeginningYearBalanceAmt
Investment Earnings Or Losses$23,464InvestmentEarningsOrLossesAmt
End Year Balance$805,973EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$743,765BeginningYearBalanceAmt
Investment Earnings Or Losses$38,744InvestmentEarningsOrLossesAmt
End Year Balance$782,509EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$704,611BeginningYearBalanceAmt
Investment Earnings Or Losses$39,154InvestmentEarningsOrLossesAmt
End Year Balance$743,765EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$840,612BeginningYearBalanceAmt
Investment Earnings Or Losses$63,999InvestmentEarningsOrLossesAmt
Other Expenditures$200,000OtherExpendituresAmt
End Year Balance$704,611EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$859,871BeginningYearBalanceAmt
Investment Earnings Or Losses-$19,259InvestmentEarningsOrLossesAmt
End Year Balance$840,612EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.38000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.62000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,582,594OtherCostOrOtherBasisAmt
Depreciation$1,580,649DepreciationAmt
Book Value$1,001,945BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,455OtherCostOrOtherBasisAmt
Depreciation$4,733DepreciationAmt
Book Value$2,722BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$614,878OtherCostOrOtherBasisAmt
Depreciation$496,760DepreciationAmt
Book Value$118,118BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,122,785TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
BENEFICIAL INTEREST IN TRUSTS$929,970
ACCOUNTS RECEIVABLE-OTHER$29,840
FieldValueIRS element (for citing)
Total Book Value Other Assets$959,810TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLOAN PPPDesc
Amt$971,400Amt
FieldValueIRS element (for citing)
Total Liability$971,400TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMANAGEMENT HAS CONCLUDED THAT ANY UNCERTAIN TAX POSITIONS WOULD BE IMMATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR UNCERTAIN TAX POSITIONS, AND NO RELATED INTEREST OR PENALTIES HAVE BEEN RECORDED IN THE STATEMENTS OF ACTIVITIES OR ACCRUED IN THE STATEMENTS OF FINANCIAL POSITION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDALE HOLDIMANPersonNm
TitleMEDICAL DIRECTORTitleTxt
Base Compensation Filing Org$244,977BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$18,842NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$263,819TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2HALF OF THE BOARD WORKS FOR UNITYPOINT HEALTH OR IS ON THE UNITYPOINT HEALTH BOARD AND HALF OF THE BOARD WORKS FOR MERCY MEDICAL CENTER OR IS ON THE MERCY MEDICAL CENTER BOARD.
FORM 990, PART VI, SECTION A, LINE 6HEALTH INC., UNITYPOINT HEALTH AND SUBSIDIARIES, MERCY MEDICAL CENTER AND SUBSIDIARIES
FORM 990, PART VI, SECTION A, LINE 7AHOSPITAL BOARDS HAVE TO APPOINT/ELECT THEIR REPRESENTATIVES.
FORM 990, PART VI, SECTION A, LINE 7BMERCY MEDICAL CENTER AND UNITYPOINT HEALTH HAVE TO APPROVE LARGE CAPITAL PROJECTS
FORM 990, PART VI, SECTION B, LINE 11BORGANIZATION REVIEWED AND SUBMITTED RETURN UPON COMPLETION BY PREPARER
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A FORM DETAILING ANY AND ALL BUSINESS RELATIONSHIPS WITH HEALTH INC AND RELATED ENTITIES. ALL COMPLETED FORMS ARE REVIEWED AND DISCUSSED WITH THE BOARD AS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15TOP MANAGEMENT EMPLOYEES PROVIDE INDEPENDENT DOCUMENTATION FROM TRADE SOURCES TO SUBSTANTIATE PAY LEVELS.
FORM 990, PART VI, SECTION C, LINE 19ORGANIZATION'S DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER: PROGRAM SERVICE EXPENSES 3,343,559. MANAGEMENT AND GENERAL EXPENSES 418,237. FUNDRAISING EXPENSES 3,980. TOTAL EXPENSES 3,765,776.
FORM 990, PART XI, LINE 9:CHANGE IN VALUE OF BENEFICIAL INTERESTS IN TRUSTS -29,857. PENSION ADJUSTMENT -336,988. INTERCOMPANY TRANSFERS 137,502.
FORM 990, PART XI, LINE 2CNO CHANGES

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
HEALTH INC
230 NEBRASKA STREETSIOUX CITYIA51101311712115SERVE AS THE CENTRAL ORGANIZATION FOR OTHER 501(C) (3) ENTITIESIA501(C)(3)PF0
SIOUXLAND REGIONAL CANCER CENTER
PO BOX 5017SIOUX CITYIA51102421411233DEDICATED TO CANCER TREATMENT, RESEARCH AND EDUCATION & SERVICES ALL PATIENTIA501(C)(3)170(B)(1)(A)(I)0
SIOUXLAND PARAMEDICS
1701 TERMINAL DRIVESIOUX CITYIA51105421185707MEDICAL TRANSPORTATION SERVICEIA501(C)(3)509(A)(3) TYPE I0
MERCY MEDICAL CENTER
801 5TH STREETSIOUX CITYIA51102311373080PROVIDES A FULL CONTINUUM OF WELLNESS, PRIMARY, ACUTE AND TERTIARY SERVICESIA501(C)(3)170(B)(1)(A)(III)0
UNITYPOINT HEALTH
2720 STONE PARK BOULEVARDSIOUX CITYIA51104421019872STRIVES TO PROVIDE THE MOST PATIENT-CENTERED CARE IN SIOUXLANDIA501(C)(3)170(B)(1)(A)(III)0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
HEALTH INC
C$137,502
UNITY POINT HEALTH
M$68,827
MERCY MEDICAL CENTER
M$203,116

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