GREAT RIVER HEALTH SYSTEM INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: GREAT RIVER HEALTH SYSTEM INC (EIN 42-1193185)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-07-15
IRS object ID: 202011979349305146
Schema version: 2018v3.2
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
Form 990
Schedule A
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-07-15T14:51:33-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	220 S 6TH STREET SUITE 300	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	421193185	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GREAT RIVER HEALTH SYSTEM INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GREA	BusinessNameControlTxt
Phone	3197681000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEREMY ALEXANDER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	3197681000	PhoneNum
Signature	2020-07-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KOREY BOELTER	PreparerPersonNm
PTIN	P00775161	PTIN
Phone	6123764500	PhoneNum
Preparation	2020-07-15	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	67.137.57.251	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-07-15	IPDt
IP Tm	12:33:42	IPTm
IP Timezone	PD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	9C1DED54EE6A56468881F41BE7A7DD662CF8FCB7	AtSubmissionCreationDeviceId
At Submission Filing Device Id	6F9DF1F17F908910C6C25D31107CE60C7FCD5FB0	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MATT WENZEL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$10,266	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GREATRIVERMEDICAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1983	FormationYr
Legal Domicile State	IA	LegalDomicileStateCd
Activity Or Mission	TO SERVE AS A HOLDING COMPANY OF VARIOUS SUBSIDIARIES PROVIDING HEALTH CARE.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	13	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$22,502	PYInvestmentIncomeAmt
CY Investment Income	$10,266	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$22,502	PYTotalRevenueAmt
CY Total Revenue	$10,266	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,537,276	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,308	PYOtherExpensesAmt
CY Other Expenses	$146,348	CYOtherExpensesAmt
PY Total Expenses	$1,539,584	PYTotalExpensesAmt
CY Total Expenses	$146,348	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,517,082	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$136,082	CYRevenuesLessExpensesAmt
Total Assets BOY	$44,598,539	TotalAssetsBOYAmt
Total Assets EOY	$44,707,180	TotalAssetsEOYAmt
Total Liabilities BOY	$615,731	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$251,344	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$43,982,808	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$44,455,836	NetAssetsOrFundBalancesEOYAmt
Mission	GREAT RIVER HEALTH SYSTEM, INC. (GRHS) IS A NON-STOCK, NOT-FOR-PROFIT CORPORATION ORGANIZED FOR THE PURPOSE OF SERVING AS A HOLDING COMPANY OF VARIOUS SUBSIDIARIES PROVIDING HEALTH CARE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$143,756	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$0	RevenueAmt
Desc	GREAT RIVER HEALTH SYSTEM IS A REGIONAL INTEGRATED HEALTH-SYSTEM THAT INCLUDES GREAT RIVER MEDICAL CENTER, FORT MADISON COMMUNITY HOSPITAL, PHARMACIES, MEDICAL EQUIPMENT AND SUPPLIES PROVIDERS, AND PHYSICIAN CLINICS.	Desc
Total Program Service Expenses	$143,756	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NANCY WHITAKER-KROPP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3197681000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
DOUG MARTIN
CHAIRMAN	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
ROBERT ENGBERG
VICE CHAIRMAN	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
ROBERT FLEMING
SECRETARY/TREASURER	1.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
DEANNA BARR
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
MARK CLEVELAND
DIRECTOR (THROUGH JUNE 2019)	1.00	1.00	Yes (X)		$0	$0	$0
LORRIN DEBLIECK
DIRECTOR (THROUGH DECEMBER 2018)	1.00	1.00	Yes (X)		$0	$0	$0
TERRI DOWELL
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
KENT GAUDIAN
DIRECTOR (THROUGH MAY 2019)	1.00	1.00	Yes (X)		$0	$0	$0
JASON HUTCHESON
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
BILL MALCOM
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
ROBERT MCCULLEY
DIRECTOR (THROUGH SEPTEMBER 2018)	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOHN MCKILLIP
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
KENT SEVERSON
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
DAN WIEDEMEIER
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
PATRICK WILLIAMS MD
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
MATT WENZEL
PRESIDENT/CEO	1.00	42.00	Yes (X)	Yes (X)	$0	$721,153	$27,591
TONY HAYES EXECUTIVE
VICE PRESIDENT (THROUGH APRIL 2019)	1.00	42.00		Yes (X)	$0	$546,239	$39,185
TODD SLADKY
CFO (THROUGH NOVEMBER 2018)	1.00	42.00		Yes (X)	$0	$419,134	$38,264
JEREMY ALEXANDER
CFO	1.00	42.00		Yes (X)	$0	$55,751	$1,036

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,742,277	TotReportableCompRltdOrgAmt
Total Other Compensation	$106,076	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,266	TotalRevenueColumnAmt
Exclusion	$10,266	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,266	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$10,266	ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$2,592	TotalAmt
Management And General	$2,592	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Desc	OTHER SUPPLIES	Desc
Total	$143,756	TotalAmt
Program Services	$143,756	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$146,348	TotalAmt
Program Services	$143,756	ProgramServicesAmt
Management And General	$2,592	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$684,574	BOYAmt
EOY	$489,909	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$420,969	BOYAmt
EOY	$223,679	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$43,090,860	BOYAmt
EOY	$43,993,592	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$402,136	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$44,598,539	BOYAmt
EOY	$44,707,180	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$615,728	BOYAmt
EOY	$251,344	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$615,731	BOYAmt
EOY	$251,344	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$43,982,808	BOYAmt
EOY	$44,455,836	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$43,982,808	BOYAmt
EOY	$44,455,836	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$44,598,539	BOYAmt
EOY	$44,707,180	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$136,082	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$609,110	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type2	Yes (X)	SupportingOrgType2Ind
Supported Organizations	2	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEIN	Organization TypeOrganizationTypeCd	Governing Document ListedGoverningDocumentListedInd	SupportSupportAmt	Other SupportOtherSupportAmt
GREAT RIVER MEDICAL CENTER
420680407	3	Yes (1)	$146,348	$0
FORT MADISON COMMUNITY HOSPITAL
421081055	3	Yes (1)	$0	$0

Field	Value	IRS element (for citing)
Supported Organizations Total	2	SupportedOrganizationsTotalCnt
Support Sum	$146,348	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (1)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	0	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	0	SupportedOrgSectionC456Ind
Supported Org Not Organized US	0	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	Yes (1)	OrganizationChangeSuprtOrgInd
Supported Org Class Designated	Yes (1)	SupportedOrgClassDesignatedInd
Support Non Supported Org	0	SupportNonSupportedOrgInd
Payment Substantial Contribtr	0	PaymentSubstantialContribtrInd
Loan Disqualified Person	0	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	0	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	0	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	0	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	0	ExcessBusinessHoldingsRulesInd
Contribution Controller	0	ContributionControllerInd
Contribution Family	0	ContributionFamilyInd
Contribution35 Controlled	0	Contribution35ControlledInd

Field	Value	IRS element (for citing)
Majority Dir Trst Supported Org	Yes (1)	MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, SEC. A, LINE 2	GRHS SUPPORTS GREAT RIVER MEDICAL CENTER, A 501(C)(3) ORGANIZATION CLASSIFIED AS A PUBLIC CHARITY UNDER IRC SECTION 170(B)(1)(A)(III). GRHS COMPLETED THE CALCULATIONS FOR 509(A)(2) PUBLIC SUPPORT TEST FOR GREAT RIVER MEDICAL CENTER FOR THE PERIOD 7/1/2014-6/30/2019 AND DETERMINED THAT GREAT RIVER MEDICAL CENTER WOULD QUALIFY AS A PUBLICLY SUPPORTED ORGANIZATION UNDER IRC SECTION 509(A)(2).
PART IV, SEC. A, LINE 5A	DURING THE FISCAL YEAR, GREAT RIVER HEALTH SYSTEM ACQUIRED FORT MADISON COMMUNITY HOSPITAL (EIN: 42-1081055), A 501(C)(3) ORGANZATION. UNDER THE DIRECTION OF GREAT RIVER HEALTH SYSTEM'S BOARD OF DIRECTORS, THE ORGANIZATION AMENDED ITS BYLAWS TO IDENTIFY FORT MADISON COMMUNITY HOSPITAL AS A SUPPORT ORGANIZATION.

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$0	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	INVESTMENT IN FOR-PROFIT SUBSIDIARIES	Desc
Book Value	$43,993,592	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$43,993,592	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	INTERCOMPANY PAYABLE	Desc
Amt	$251,344	Amt

Field	Value	IRS element (for citing)
Total Liability	$251,344	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION AND ITS THREE NOT-FOR-PROFIT SUBSIDIARIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE CONSOLIDATED FINANCIAL STATEMENTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MATT WENZEL
PRESIDENT/CEO	$0	$721,153	$0	$0	$0	$0	$0	$0	$0	$27,591	$0	$748,744	$0	$0
TONY HAYES EXECUTIVE
VICE PRESIDENT (THROUGH APRIL 2019)	$0	$317,826	$0	$78,451	$0	$149,962	$0	$0	$0	$39,185	$0	$585,424	$0	$0
TODD SLADKY
CFO (THROUGH NOVEMBER 2018)	$0	$419,134	$0	$0	$0	$0	$0	$0	$0	$38,264	$0	$457,398	$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD, THE PRESIDENT AND CEO AND TWO OR MORE ADDITIONAL DIRECTORS. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE.
FORM 990, PART VI, SECTION A, LINE 2	MATT WENZEL, TONEY HAYES, JEREMY ALEXANDER AND TODD SLADKY HAVE BUSINESS RELATIONSHIPS BY SERVING AS OFFICERS AND/OR BOARD MEMBERS OF FOR-PROFIT ENTITIES RELATED TO GRMC. KENT GAUDIAN, DOUGLAS MARTIN AND ROBERT MCCULLEY HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3	ALL EXECUTIVE LEADERSHIP FUNCTIONS FOR GREAT RIVER HEALTH SYSTEM INC., AND ITS SUBSIDIARIES ARE PROVIDED BY MUTUAL CONSULTING AND MANAGEMENT SERVICES, INC. MUTUAL CONSULTING AND MANAGEMENT SERVICES IS A SUBSIDIARY OF RIVERVIEW SYSTEMS LTD, WHICH IS A SUBSIDIARY OF GREAT RIVER HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 4	THE ORGANIZATION'S BYLAWS WERE AMENDED IN JULY 2018 TO REFLECT THE ACQUISITION OF FORT MADISON COMMUNITY HOSPITAL, A TAX-EXEMPT ORGANIZATION. ONE OF THE GREAT RIVER HEALTH SYSTEM'S BOARD MEMBERS IS APPOINTED BY THE BOARD OF DIRECTORS OF FORT MADISON COMMUNITY HOSPITAL, SUBJECT TO APPROVAL BY GREAT RIVER HEALTH SYSTEM'S BOARD OF DIRECTORS
FORM 990, PART VI, SECTION A, LINE 7A	GREAT RIVER HEALTH SYSTEM'S MEDICAL STAFF ELECT THE CHIEF OF STAFF, WHO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 IS REVIEWED IN DETAIL BY A MEMBER OF THE ACCOUNTING DEPARTMENT, DIRECTOR OF FINANCE AND CFO. ANY NECESSARY ADJUSTMENTS ARE MADE PRIOR TO FINALIZING THE FORM.
FORM 990, PART VI, SECTION B, LINE 12C	EVERY YEAR, THE DIRECTOR OF FINANCE IN THE ACCOUNTING DEPARTMENT PROVIDES THE BOARD OF DIRECTORS THE MEANING OF THE CONFLICT OF INTEREST STATEMENT, HOW IT APPLIES, HOW IT IMPACTS THE BOARD, AND WHAT THEIR RESPONSIBILITIES ARE. ALL BOARD MEMBERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST FORM AND THE FORM IS THEN REVIEWED BY THE DIRECTOR OF FINANCE. RELATIONSHIPS NOTED ON THE FORM MAY BE DISCUSSED WITH THE BOARD MEMBER IF THERE ARE QUESTIONS. IF AN INDIVIDUAL HAS A CONFLICT OF INTEREST, THEY MAY NOT PARTICIPATE IN DISCUSSIONS OF THE TRANSACTION AND MAY NOT VOTE ON MATTERS RELATED TO THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION OF THE OFFICERS OF GREAT RIVER HEALTH SYSTEM IS PAID BY A RELATED FOR-PROFIT SUBSIDIARY. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS IS DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF GREAT RIVER HEALTH SYSTEM. THE ROLE OF THE COMPENSATION COMMITTEE IS TO ACT ON BEHALF OF THE BOARD IN ADOPTING, REVIEWING AND MAINTAINING AN EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE IS COMPRISED OF FIVE BOARD MEMBERS, ALL OF WHOM ARE INDEPENDENT FROM THE CEO AND OTHER OFFICERS. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE CEO AND OTHER OFFICERS ON AN ANNUAL BASIS. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES TAKEN AT THE MEETINGS. GREAT RIVER HEALTH SYSTEM PARTICIPATES AND UTILIZES THREE EXECUTIVE SALARY SURVEYS TO DETERMINE COMPENSATION RANGES. THE COMMITTEE REVIEWS PREVAILING MARKET DATA TO ENSURE CONTINUED MARKET COMPETITIVENESS. THE COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTING GROUP BIENNIALLY TO ASSESS AND VALIDATE THE ENTIRETY OF THE EXECUTIVE COMPENSATION AND BENEFITS PACKAGES TO ENSURE REGULATORY COMPLIANCE, EXTERNAL COMPETITIVENESS, AND INTERNAL EQUITY. THE MOST RECENT YEAR OF AN INDEPENDENT THIRD PARTY REVIEW WAS 2018.
FORM 990, PART VI, SECTION C, LINE 19	GREAT RIVER HEALTH SYSTEM MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	TRANSFER FROM RELATED ORGANIZATIONS 23,600,000. LOSS ON INVESTMENT IN SUBSIDIARIES -22,990,890.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	GREAT RIVER HEALTH ALLIANCE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 S GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Field	Value	IRS element (for citing)
EIN	830728216	EIN
Primary Activities	ACCOUNTABLE CARE ORGANZIATION	PrimaryActivitiesTxt
Legal Domicile State	IA	LegalDomicileStateCd
Total Income	$0	TotalIncomeAmt
End Of Year Assets	$0	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	GRHS	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
GREAT RIVER MEDICAL CENTER
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	420680407	HOSPITAL	IA	501(C)(3)	3	GRHS	Yes (1)
GRMC FOUNDATION CORP
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421193186	SUPPORT RELATED ORGANIZATIONS	IA	501(C)(3)	12 - TYPE II	GRHS	Yes (1)
GREAT RIVER FOUNDATION INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421469162	SUPPORT RELATED ORGANIZATIONS	IA	501(C)(3)	12 - TYPE II	GRHS	Yes (1)
FORT MADISON COMMUNITY HOSPITAL
5445 AVENUE O	FORT MADISON	IA	52627	421081055	HOSPITAL	IA	501(C)(3)	3	GRHS	Yes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
RIVERVIEW SYSTEMS LTD
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421191960	MEDICAL SERVICES	IA	GRHS	C	$21,069	$153,816,805	1.00000	Yes (1)
GREAT RIVER MEDICAL SERVICES INC
1201 WEST AGENCY ROAD	WEST BURLINGTON	IA	52655	421493449	MEDICAL SERVICES	IA	GRHS	C			1.00000	Yes (1)
MUTUAL CONSULTING & MANAGEMENT SERVICES
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421349668	MANAGEMENT SERVICES	IA	RIVERVIEW SYSTEMS LTD	C	$5,587,042	$4,578,593	1.00000	Yes (1)
HEALTH CARE REALTY
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421193532	REAL ESTATE	IA	RIVERVIEW SYSTEMS LTD	C	$2,597,726	$34,216,581	1.00000	Yes (1)
HERITAGE PARK PHARMACY
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421191957	PHARMACY	IA	RIVERVIEW SYSTEMS LTD	C	$2,616,549	$3,893,520	1.00000	Yes (1)
HERITAGE MEDICAL EQUIPMENT & SUPPLY
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421191958	MEDICAL SUPPLY	IA	RIVERVIEW SYSTEMS LTD	C	$1,875,229	$1,958,987	1.00000	Yes (1)
SOUTHEASTERN IOWA MEDICAL SERVICES
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421307141	PHYSICIAN CLINICS	IA	RIVERVIEW SYSTEMS LTD	C	$58,359,182	$9,607,204	1.00000	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
GREAT RIVER FOUNDATION
S	$18,800,000	CASH
GREAT RIVER MEDICAL CENTER
S	$4,800,000	CASH
FORT MADISON COMMUNITY HOSPITAL
S	$12,000,000	CASH

GREAT RIVER HEALTH SYSTEM INC: Form 990, tax year 2018

Return header ReturnHeader

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Preparer US Address PreparerUSAddress

Filer Filer

Business Name BusinessName

US Address USAddress

Business Officer BusinessOfficerGrp

Preparer Person PreparerPersonGrp

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Form 990 IRS990

US Address USAddress

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

US Address USAddress

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

Investment Income InvestmentIncomeGrp

Total Revenue TotalRevenueGrp

Fees For Services Management FeesForServicesManagementGrp

Other Expenses OtherExpensesGrp

Total Functional Expenses TotalFunctionalExpensesGrp

Cash Non Interest Bearing CashNonInterestBearingGrp

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Investments Other Securities InvestmentsOtherSecuritiesGrp

Other Assets Total OtherAssetsTotalGrp

Total Assets TotalAssetsGrp

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Other Liabilities OtherLiabilitiesGrp

Total Liabilities TotalLiabilitiesGrp

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FS Audited Basis FSAuditedBasisGrp

Schedule A IRS990ScheduleA

Supported Org Information SupportedOrgInformationGrp (2 entries)

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Schedule D IRS990ScheduleD

Other Securities OtherSecuritiesGrp

Other Liabilities Org OtherLiabilitiesOrgGrp

Supplemental Information Detail SupplementalInformationDetail

Schedule J IRS990ScheduleJ

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

US Address USAddress

Direct Controlling Entity Name DirectControllingEntityName

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Comments