2020-05-15T14:53:07-05:00 2019-06-30 481292483 HENJES CONNER & WILLIAMS PC PO BOX 1937 DAKOTA DUNES SD 57049 990 2018-07-01 383320710 HOSPICE OF SIOUXLAND HOSP 7122334144 4300 HAMILTON BLVD SIOUX CITY IA 51104 CHAD MARKHAM DIRECTOR 7122529418 2020-05-14 1 MELISSA J WILLER P00121904 6052423900 2020-05-12 66.172.193.33 2020-05-14 13:38:43 CD P E6CC7DE3821211A2CF8AFC51DA2EDD8A239254B8 CC738EC966C998A56CE826455106C2A84F3D9FCE 2018 2020-11-06 18:47:13Z CHAD MARKHAM 230 NEBRASKA ST SIOUX CITY IA 51101 11817208 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. 9 9 112 199 0 0 218186 199905 10150481 11177518 312217 384185 -74051 -65889 10606833 11695719 0 0 0 0 5377443 5381023 0 0 290046 4943933 5134587 10321376 10515610 285457 1180109 9546703 10624241 1814771 2477777 7731932 8146464 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 7929340 11474515 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. 7929340 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 112 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 X TIMM FUNK 7122529418 230 NEBRASKA ST PO BOX 5017 SIOUX CITY IA 51101 MILT AVERY CHAIRPERSON 1.00 X X 0 0 0 DARIN DABY VICE CHAIRPERSON 1.00 X X 0 0 0 LYNN WOLD SECRETARY 1.00 X X 0 0 0 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 CHAD MARKHAM DIRECTOR 1.00 X 0 0 0 DR CYNTHIA PALS DIRECTOR 1.00 X 0 0 0 DALE HOLDIMAN MEDICAL DIRECTOR 40.00 X 242726 0 19565 MICHELLE HUBER PHARMACIST 40.00 X 114111 0 6502 ANN MYERS DIRECTOR OF OPERATIONS 40.00 X 125275 0 22364 KRISTA MCCULLOUGH EXECUTIVE DIRECTOR 40.00 X 0 0 0 DAN LAUER CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 482112 0 48431 3 0 1 0 WILTGEN CONSTRUCTION CO INC 426 2ND AVENUE SE LE MARS IA 51031 CONSTRUCTION 987633 OPTUM HOSPICE PHARMACY SERVICES 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 PHARMACY AND EDUCATION 416683 NATIONAL HME INC 7451 AIRPORT FREEWAY RICHLAND HILLS TX 56118 EQUIPMENT AND TECHNOLOGY 373731 MID STEP SERVICES INC 4303 STONE AVENUE SIOUX CITY IA 51106 RESIDENTIAL SERVICES 175059 LEGACY GARDEN REHAB & LIVING 200 VALLEY VIEW DR PENDER NE 68047 MEDICAL EQUIPMENT SUPPLIER 173578 17 199905 199905 PATIENT SERVICE REVENUE 621610 11177518 11177518 11177518 384185 384185 12500 111975 -99475 -99475 -99475 30813 9514 21299 21299 OTHER INCOME 900099 12287 12287 12287 11695719 11474515 0 21299 X 147639 147639 4256832 3020234 1018132 218466 163701 119502 44199 505992 371911 134081 306859 225170 77195 4494 345000 345000 51695 51695 2800393 2641012 159381 3944 20 3924 44315 44315 362665 251058 77760 33847 212382 183691 28089 602 32527 32527 113790 59824 53966 54686 20666 34020 MEDICAL SUPPLIES 595754 595754 MEDICATIONS 426994 426994 DUES AND SUBSCRIPTIONS 37596 37596 OTHER COSTS 30189 13523 10610 6056 22657 22657 10515610 7929340 2296225 290046 1192320 1541813 987028 1118577 148489 114339 3193506 1968299 97942 1225207 6179160 5632361 941764 991944 9546703 10624241 1814771 2477777 1814771 2477777 X 6303312 6685730 928620 960734 500000 500000 7731932 8146464 9546703 10624241 X 1180109 -26630 -738947 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 743765 38744 782509 704611 39154 743765 840612 63999 200000 704611 859871 -19259 840612 852067 7804 859871 0.36100 0.63900 0 0 2573249 1526831 1046418 7455 4038 3417 612802 437430 175372 1225207 BENEFICIAL INTEREST IN TRUSTS 959828 ACCOUNTS RECEIVABLE-OTHER 32116 991944 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. DUELING PIANOS 30813 30813 9514 30813 30813 9514 9514 21299 X X X X 0 0 0 0 0 0 0 0 0 DALE HOLDIMAN MEDICAL DIRECTOR 242726 0 0 0 0 0 0 0 19565 0 262291 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 2,641,012. MANAGEMENT AND GENERAL EXPENSES 159,381. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,800,393. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTERESTS IN TRUSTS 36,371. PENSION ADJUSTMENT -775,318. 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 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 SIOUXLAND REGIONAL CANCER CENTER J 25364 SIOUXLAND PARAMEDICS M 12 HEALTH INC M 345000 UNITY POINT HEALTH L 102353 UNITY POINT HEALTH M 109286 MERCY MEDICAL CENTER L 251470 MERCY MEDICAL CENTER M 251470