2021-12-17T11:42:17-06:00 2021-06-30 481292483 HENJES CONNER & WILLIAMS PC PO BOX 1937 DAKOTA DUNES SD 57049 990 2020-07-01 383320710 HOSPICE OF SIOUXLAND HOSP 7122334144 PO BOX 5017 SIOUX CITY IA 51102 KARA WINKER DIR OF FINANCE 7122529418 2021-12-16 1 KARA WINKER 999009999 MELISSA J WILLER P00121904 6052423900 2021-12-14 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X KARA WINKER 230 NEBRASKA ST SIOUX CITY IA 51101 9501030 0 X WWW.HOSPICEOFSIOUXLAND.ORG X 1982 IA PROVIDE 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. 8 8 106 0 0 0 312322 327322 11653768 7824267 273587 468124 13839 866541 12253516 9486254 0 0 0 0 5588146 4452801 0 0 213637 5809625 4044857 11397771 8497658 855745 988596 12763286 12817698 4007924 1165141 8755362 11652557 PROVIDE 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. 0 0 5883660 8690808 HOSPICE 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. 5883660 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 53 0 1 106 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 X KARA WINKER 7122529418 230 NEBRASKA ST PO BOX 5017 SIOUX CITY IA 51101 X BETH HUGHES TREASURER 1.00 X X 0 0 0 JIM GOBELL DIRECTOR 1.00 X 0 0 0 JESICA HANSON DIRECTOR 1.00 X 0 0 0 TRACY LARSON DIRECTOR 1.00 X 0 0 0 CRAIG BERENSTEIN CHAIRPERSON 1.00 X X 0 0 0 WENDY LINDLEY DIRECTOR 1.00 X 0 0 0 LEAH GLASGO SECRETARY 1.00 X X 0 0 0 DOUG SKINNER VICE CHAIRPERSON 1.00 X X 0 0 0 KRISTI TURNER EXECUTIVE DIRECTOR 40.00 X 0 0 0 KARA WINKER DIRECTOR OF FINANCE 40.00 X 0 0 0 DALE HOLDIMAN MEDICAL DIRECTOR 40.00 X 244977 0 16446 MICHELLE HUBER PHARMACIST 40.00 X 131664 0 6467 STEFANI MOSER - WIGTON RN 40.00 X 108683 0 13481 ALBERTA CARDENAS WR 40.00 X 108883 0 7783 SHERRI MOREY RN 40.00 X 109199 0 4995 703406 0 49172 5 0 1 0 SUNRISE MANOR INC 5501 GORDON DR SIOUX CITY IA 51106 ROOM & BOARD 316234 NATIONAL HME INC 7451 AIRPORT FREEWAY RICHLAND HILLS TX 56118 MEDICAL SUPPLIES 300818 OPTUM HOSPICE PHARMACY SERVICES 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 PHARMACY AND EDUCATION 273509 SIMIONE HEALTHCARE CONSULTANTS 4130 WHITNEY AVE HAMDEN CT 06518 INTERIM DIRECTOR 262752 LEGACY GARDEN 200 VALLEY VIEW DRIVE PENDER NE 68047 MEDICAL SUPPLIES 206224 11 327322 327322 PATIENT SERVICE REVENU 621610 7824267 7824267 7824267 468124 468124 14776 -14776 -14776 -14776 PROVIDER RELIEF FUNDS 900099 846335 846335 OTHER INCOME 900099 34982 34982 881317 9486254 8690808 0 468124 X 3759995 2477080 1218484 64431 126693 126672 21 300361 166737 126672 6952 265752 182586 78840 4326 13788 13788 60470 60470 2500156 1801926 654141 44089 29912 187 29725 244453 145893 89232 9328 150925 141600 9317 8 5389 5312 77 4884 4884 113378 9732 103646 46586 9856 36730 MEDICAL SUPPLIES 498725 469351 29374 MEDICATIONS 289672 289672 DUES AND SUBSCRIPTIONS 39754 39470 284 OTHER COSTS 36744 62555 -70207 44396 10021 10021 8497658 5883660 2400361 213637 3733012 2617069 994951 492736 122049 102538 3217848 2195520 1122785 1022328 5830679 7100805 959810 1482222 12763286 12817698 3036524 1165141 971400 0 4007924 1165141 X 7320147 10022891 1435215 1629666 8755362 11652557 12763286 12817698 X 988596 868629 1039970 X X 0 1 X 1 0 X X 2 MERCY MEDICAL CENTER AND SUBSIDIARIES 311373080 3 1 0 0 NORTHWEST IOWA HOSPITAL CORPORATION 421019872 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 805973 167578 973551 782509 23464 805973 743765 38744 782509 704611 39154 743765 840612 63999 200000 704611 0.49000 0.51000 0 0 2582594 1634935 947659 7455 5428 2027 614878 555157 59721 12921 12921 1022328 BENEFICIAL INTEREST IN TRUSTS 1126962 ACCOUNTS RECEIVABLE-OTHER 24861 DUE FROM JENCC 330399 1482222 X PART X, LINE 2: MANAGEMENT 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. X X X X 0 0 0 0 0 0 0 0 0 DALE HOLDIMAN MEDICAL DIRECTOR 244977 0 0 0 0 0 0 0 16446 0 261423 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 HALF 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 6 HEALTH INC., UNITYPOINT HEALTH AND SUBSIDIARIES, MERCY MEDICAL CENTER AND SUBSIDIARIES FORM 990, PART VI, SECTION A, LINE 7A HOSPITAL BOARDS HAVE TO APPOINT/ELECT THEIR REPRESENTATIVES. FORM 990, PART VI, SECTION A, LINE 7B MERCY MEDICAL CENTER AND UNITYPOINT HEALTH HAVE TO APPROVE LARGE CAPITAL PROJECTS FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION REVIEWED AND SUBMITTED RETURN UPON COMPLETION BY PREPARER FORM 990, PART VI, SECTION B, LINE 12C ALL 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 15 TOP MANAGEMENT EMPLOYEES PROVIDE INDEPENDENT DOCUMENTATION FROM TRADE SOURCES TO SUBSTANTIATE PAY LEVELS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 1,801,926. MANAGEMENT AND GENERAL EXPENSES 654,141. FUNDRAISING EXPENSES 44,089. TOTAL EXPENSES 2,500,156. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTERESTS IN TRUSTS 196,992. PENSION ADJUSTMENT 879,552. INTERCOMPANY TRANSFERS -36,574. FORM 990, PART XI, LINE 2C NO CHANGES HEALTH INC 230 NEBRASKA STREET SIOUX CITY IA 51101 311712115 SERVE AS THE CENTRAL ORGANIZATION FOR OTHER 501(C) (3) ENTITIES IA 501(C)(3) PF 0 SIOUXLAND REGIONAL CANCER CENTER PO BOX 5017 SIOUX CITY IA 51102 421411233 DEDICATED TO CANCER TREATMENT, RESEARCH AND EDUCATION & SERVICES ALL PATIENT IA 501(C)(3) 170(B)(1)(A)(I) 0 SIOUXLAND PARAMEDICS 1701 TERMINAL DRIVE SIOUX CITY IA 51105 421185707 MEDICAL TRANSPORTATION SERVICE IA 501(C)(3) 509(A)(3) TYPE I 0 MERCY MEDICAL CENTER 801 5TH STREET SIOUX CITY IA 51102 311373080 PROVIDES A FULL CONTINUUM OF WELLNESS, PRIMARY, ACUTE AND TERTIARY SERVICES IA 501(C)(3) 170(B)(1)(A)(III) 0 UNITYPOINT HEALTH 2720 STONE PARK BOULEVARD SIOUX CITY IA 51104 421019872 STRIVES TO PROVIDE THE MOST PATIENT-CENTERED CARE IN SIOUXLAND IA 501(C)(3) 170(B)(1)(A)(III) 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 HEALTH INC C UNITY POINT HEALTH M 57522 MERCY MEDICAL CENTER M 79556