2019-05-14T11:18:02-05:00 2018-06-30 481292483 HENJES CONNER & WILLIAMS PC PO BOX 1937 DAKOTA DUNES SD 57049 990 2017-07-01 383320710 HOSPICE OF SIOUXLAND HOSP 7122334144 4300 HAMILTON BLVD SIOUX CITY IA 51104 CHAD MARKHAM DIRECTOR 7122529418 2019-05-14 1 MELISSA J WILLER P00121904 6052423900 2019-05-13 66.172.193.33 2019-05-14 10:03:29 CD P B150CF43E7E5D7AC6F1B6550679B6FE4051D8571 CC738EC966C998A56CE826455106C2A84F3D9FCE 2017 2019-02-21 02:37:17Z CHAD MARKHAM 230 NEBRASKA ST SIOUX CITY IA 51101 10801733 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. 10 10 106 137 0 0 216167 218186 10806164 10150481 278721 312217 -123135 -74051 11177917 10606833 0 0 0 0 5778757 5377443 0 0 43501 5305895 4943933 11084652 10321376 93265 285457 9690923 9546703 3025537 1814771 6665386 7731932 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 7612542 10056139 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. 7612542 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 37 0 106 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 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 GARRETT SMITH CHAIRPERSON 1.00 X X 0 0 0 MILT AVERY VICE CHAIRPERSON 1.00 X X 0 0 0 BETH HUGHES SECRETARY 1.00 X X 0 0 0 LYNN WOLD TREASURER 1.00 X X 0 0 0 DARIN DABY DIRECTOR 0.50 X 0 0 0 JIM GOBELL DIRECTOR 0.50 X 0 0 0 STEVEN JOYCE DIRECTOR 0.50 X 0 0 0 TRACY LARSON DIRECTOR 0.50 X 0 0 0 CHAD MARKHAM DIRECTOR 0.50 X 0 0 0 CYNTHIA PALS DIRECTOR 0.50 X 0 0 0 KAREN VAN DE STEEG EXECUTIVE DIRECTOR 40.00 X 0 0 0 DAN LAUER CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 ANN MYERS DIRECTOR OF OPERATIONS 40.00 X 97679 0 24962 DALE HOLDIMAN MEDICAL DIRECTOR 40.00 X 237020 0 26584 MICHELLE HUBER PHARMACIST 40.00 X 112389 0 7468 447088 0 59014 2 0 1 0 OPTUM HOSPICE PHARMACY SERVICES 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 PHARMACY AND EDUCATION 453319 NATIONAL HME INC 7451 AIRPORT FREEWAY RICHLAND HILLS TX 76118 EQUIPMENT AND TECHNOLOGY 339587 MERCY MEDICAL CENTER 801 5TH ST SIOUX CITY IA 51101 ADDITIONAL HOSPICAL SERVICES 281215 RVP ENTERPRISES INC 3501 DAKOTA AVE SOUTH SIOUX CITY NE 58776 NURSING HOME CARE FOR PATIENTS 197038 TOUCHSTONE LIVING CENTER 1800 INDIAN HILLS DR SIOUX CITY IA 51104 NURSING HOME CARE FOR PATIENTS 186069 13 218186 218186 PATIENT SERVICE REVENUE 621610 10150481 10150481 10150481 312217 312217 60983 183189 -122206 -122206 -122206 32002 11711 20291 20291 OTHER INCOME 900099 27864 27864 27864 10606833 10056139 0 332508 X 122641 122641 4176241 3030403 1145838 176751 125493 51258 607619 423407 184212 294191 220353 73838 480000 480000 53619 53619 2394312 2271481 122831 43809 43809 326558 262185 44982 19391 231248 183136 48112 30231 260 29971 235038 55066 179972 40911 11903 29008 MEDICAL SUPPLIES 549711 549711 MEDICATIONS 464010 464010 DUES AND SUBSCRIPTIONS 48141 48141 OTHER COSTS 25333 15134 7101 3098 21012 21012 10321376 7612542 2665333 43501 1133641 1192320 1398826 987028 137481 148489 2319979 2222037 301217 97942 5815867 6179160 903891 941764 9690923 9546703 3025537 1814771 3025537 1814771 X 5261109 6303312 904277 928620 500000 500000 6665386 7731932 9690923 9546703 X 285457 105692 675397 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 704611 39154 743765 840612 63999 200000 704611 859871 -19259 840612 852067 7804 859871 755586 96481 852067 0.33000 0.67000 0 0 1684856 1684856 0 603360 537181 66179 31763 31763 97942 BENEFICIAL INTEREST IN TRUSTS 927327 ACCOUNTS RECEIVABLE - OTHER 14437 941764 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. SPECIAL EVENT 32002 32002 11711 32002 32002 11711 11711 20291 X X X X 0 0 0 0 0 0 0 0 0 DALE HOLDIMAN MEDICAL DIRECTOR 237020 0 0 0 0 0 0 0 26584 0 263604 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 2,271,481. MANAGEMENT AND GENERAL EXPENSES 122,831. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,394,312. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT 620,943. CHANGE IN VALUE OF BENEFICIAL INTERESTS IN TRUSTS 54,454. 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 0 1 0 0 0 1 0 0 SIOUXLAND REGIONAL CANCER CENTER J 72612 SIOUXLAND PARAMEDICS M 27620 HEALTH INC M 480000 MERCY MEDICAL CENTER M 315369 UNITY POINT HEALTH Q 74282 UNITY POINT HEALTH M 83657