TRINITY BUILDING CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
TRINITY BUILDING CORPORATION (EIN 42-1376187)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201713199349302141
Schema version
2016v3.0
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)
Return2017-11-15T08:19:47-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421376187EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TRINITY BUILDING CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTRINBusinessNameControlTxt
Phone5155733101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1802 KENYON RDAddressLine1Txt
CityFORT DODGECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50501ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRENT FEICKERTPersonNm
Person TitleCFOPersonTitleTxt
Phone5155746608PhoneNum
Signature2017-11-15SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address205.167.2.34IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-15IPDt
IP Tm08:19:32IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id5E6E106DF48B9972D6C92B0B0C0F16768180E897AtSubmissionCreationDeviceId
At Submission Filing Device Id2CDFA0C539A59EBEECABA2BB3574D231EAAE060CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMIKE J DEWERFFPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1802 KENYON RDAddressLine1Txt
CityFORT DODGECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,249,918GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN / AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionHOLD TITLE TO PROPERTY AND TURN ALL INCOME THEREFROM OVER TO TRINITY HEALTH SYSTEMS, INC.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$2,291,351PYProgramServiceRevenueAmt
CY Program Service Revenue$2,247,596CYProgramServiceRevenueAmt
PY Investment Income$194PYInvestmentIncomeAmt
CY Investment Income$2,322CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,291,545PYTotalRevenueAmt
CY Total Revenue$2,249,918CYTotalRevenueAmt
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$157,321PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$193,455CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,925,159PYOtherExpensesAmt
CY Other Expenses$1,995,390CYOtherExpensesAmt
PY Total Expenses$2,082,480PYTotalExpensesAmt
CY Total Expenses$2,188,845CYTotalExpensesAmt
PY Revenues Less Expenses$209,065PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$61,073CYRevenuesLessExpensesAmt
Total Assets BOY$13,173,424TotalAssetsBOYAmt
Total Assets EOY$13,158,040TotalAssetsEOYAmt
Total Liabilities BOY$559,032TotalLiabilitiesBOYAmt
Total Liabilities EOY$482,575TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,614,392NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,675,465NetAssetsOrFundBalancesEOYAmt
MissionHOLD TITLE TO PROPERTY, COLLECT THE INCOME THEREFROM, AND TURN ALL OF SAID INCOME, LESS EXPENSES, OVER TO TRINITY HEALTH SYSTEMS, INC., AN IOWA NON-PROFIT CORPORATION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescAFFILIATE SUPPORT SERVICESTRINITY BUILDING CORPORATION IS A CORPORATION CREATED TO HOLD TITLES TO AND MANAGE REAL ESTATE BY COLLECTING INCOME AND PAYING EXPENSES RELATING TO THE USAGE OF THE PROPERTY. ALL OF THE INCOME FROM THE REAL ESTATE IS CONTRIBUTED TO TRINITY HEALTH SYSTEMS, INC., A 501(C)(3) CORPORATION, AND ITS SUBSIDIARIES IN FURTHERANCE OF THEIR MISSIONS.Desc
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
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
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
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 PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRENT FEICKERT CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5155746608PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1802 KENYON RDAddressLine1Txt
CityFORT DODGECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50501ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BRENT FEICKERT FROM 816
BOARD CHAIR & CFO1.0040.00Yes (X)Yes (X)$0$234,204$37,670
CHUCK KELCH TO 816
BOARD CHAIR & CFO1.0040.00Yes (X)Yes (X)$0$199,065$24,041
TOM SCHNURR
BOARD SECRETARY/TREASURER1.001.00Yes (X)Yes (X)$0$158$0
JOHN TAETS
BOARD VICE CHAIR1.001.00Yes (X)Yes (X)$0$0$0
MIKE DEWERFF
PRESIDENT/CEO1.0040.00Yes (X)$0$497,827$114,767
SUSAN THOMPSON TO 0215
FORMER PRESIDENT/CEO0.0040.00$0$558,852$231,648Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,490,106TotReportableCompRltdOrgAmt
Total Other Compensation$408,126TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
KOLACIA CONSTRUCTION
1206 S 32ND STFORT DODGEIA50501CONSTRUCTION SERVICES$267,174
ABM ONSITE SERVICES-MIDWEST
1509 MICHIGAN STREETDES MOINESIA50314JANITORIAL SERVICES$217,963
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRENTAL INCOMEDesc
Business531100BusinessCd
Total Revenue Column$2,247,596TotalRevenueColumnAmt
Related Or Exempt Func Income$2,247,596RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,247,596TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,322TotalRevenueColumnAmt
Exclusion$2,322ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,249,918TotalRevenueColumnAmt
Related Or Exempt Func Income$2,247,596RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,322ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$145,736TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,183TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$39,251TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,285TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$49,968TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,890TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$331,850TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,211TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$762,189TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$814,155TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$8,915TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmt
BAD DEBT EXPENSE$11,709
MISCELLANEOUS EXPENSE$4,503

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,188,845TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$323,142BOYAmt
EOY$1,561,998EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$134,603BOYAmt
EOY$1,901EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$863,099BOYAmt
EOY$265,382EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$25,323,966LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,998,937LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,852,580BOYAmt
EOY$11,325,029EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$3,730EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,173,424BOYAmt
EOY$13,158,040EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$358,992BOYAmt
EOY$416,176EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$33,367BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$166,673BOYAmt
EOY$66,399EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$559,032BOYAmt
EOY$482,575EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,614,392BOYAmt
EOY$12,675,465EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,614,392BOYAmt
EOY$12,675,465EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,173,424BOYAmt
EOY$13,158,040EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$61,073ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$389,435OtherCostOrOtherBasisAmt
Book Value$389,435BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,588,739OtherCostOrOtherBasisAmt
Depreciation$13,420,751DepreciationAmt
Book Value$9,167,988BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$235,287OtherCostOrOtherBasisAmt
Depreciation$197,841DepreciationAmt
Book Value$37,446BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,110,505OtherCostOrOtherBasisAmt
Depreciation$380,345DepreciationAmt
Book Value$1,730,160BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,325,029TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$66,399Amt
FieldValueIRS element (for citing)
Total Liability$66,399TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,250,000TotalRevEtcAuditedFinclStmtAmt
Other Revenue$82OtherRevenueAmt
Revenue Not Reported$82RevenueNotReportedAmt
Revenue Subtotal$2,249,918RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,249,918TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,189,000TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$155OtherExpensesIncludedAmt
Expenses Not Reported$155ExpensesNotReportedAmt
Expenses Subtotal$2,188,845ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,188,845TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2013. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL.
PART XI, LINE 2D - OTHER ADJUSTMENTS:ROUNDING 82.
PART XII, LINE 2D - OTHER ADJUSTMENTS:ROUNDING 155.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRENT FEICKERT FROM 816
BOARD CHAIR & CFO$0$203,711$0$21,779$0$8,714$0$17,405$0$20,265$0$271,874$0$0
CHUCK KELCH TO 816
BOARD CHAIR & CFO$0$135,506$0$37,411$0$26,148$0$10,114$0$13,927$0$223,106$0$0
MIKE DEWERFF
PRESIDENT/CEO$0$366,364$0$81,686$0$49,777$0$91,304$0$23,463$0$612,594$0$0
SUSAN THOMPSON TO 0215
FORMER PRESIDENT/CEO$0$414,812$0$94,114$0$49,926$0$225,055$0$6,593$0$790,500$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationNONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: MICHAEL DEWERFF $74,846, BRENT FEICKERT $6,246, TROY MARTENS $46,093, AND SUSAN THOMPSON $211,848.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINES 1A & 1BCASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH SYSTEM). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS.
FORM 990, PART VI, SECTION A, LINE 6TRINITY HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BTRINITY HEALTH SYSTEMS, INC., AS SOLE MEMBER, APPROVES BOARD OF DIRECTORS, BUDGETS, APPOINTS PRESIDENT, APPROVES ESTABLISHING SUBSIDIARIES, AFFILIATES AND JOINT VENTURES, APPROVES MERGERS, CONSOLIDATIONS OR DISSOLUTIONS, APPROVES CHANGES IN PURPOSE, APPROVES PURCHASE SALE, LEASE TRANSFER OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2016 FOR THE FOLLOWING INDIVIDUALS: MIKE DEWERFF AND SUSAN THOMPSON. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG.
FORM 990, PART IX, LINE 11GPURCHASED HOUSEKEEPING AND LAUNDRY 88,958. MISCELLANEOUS PURCHASED SERVICES 242,892.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (56 entries)

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ALLEN COLLEGE
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ALLEN HEALTH SYSTEMS INC
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ALLEN MEMORIAL HOSPITAL CORPORATION
1825 LOGAN AVENUEWATERLOOIA50703420698265HOSPITALIA501(C)(3)170(B)(1) (A)(III)ALLEN HEALTH SYSTEMS INC0
ANAMOSA AREA AMBULANCE SERVICE
101 GRANT WOOD DRIVEANAMOSAIA52205421466284PROVIDE AMBULANCE SERVICESIA501(C)(3)509(A)(2)ST LUKE'SJONES REGIONAL MEDICAL CENTER0
BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC
3251 WEST NINTH STREETWATERLOOIA50702420733463MENTAL HEALTH CAREIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC0
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREETDES MOINESIA50309421233759PROPERTY HOLDING COMPANYIA501(C)(2)CENTRAL IOWA HEALTH SYSTEM0
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421189791SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
CENTRAL IOWA HOSPITAL CORPORATION
1200 PLEASANT STREETDES MOINESIA50309420680452HOSPITALIA501(C)(3)170(B)(1) (A)(III)CENTRAL IOWA HEALTH SYSTEM0
DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC
1415 WOODLAND AVE SUITE 130DES MOINESIA50309421412497COORDINATION OF MEDICAL EDUCATION PROGRAMSIA501(C)(3)509(A)(3), TYPE III0
FINLEY TRI-STATES HEALTH GROUP INC
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001421307495SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER
3820 HILLSIDE DRIVECEDAR FALLSIA50613421372380CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC0
HULT CENTER FOR HEALTHY LIVING INC
5409 N KNOXVILLE AVEPEORIAIL61614363510390HEALTH EDUCATION TO THE COMMUNITYIL501(C)(3)170(B)(1) (A)(VI)PROCTOR HOSPITAL0
IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200DES MOINESIA50309421467682CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)CENTRAL IOWA HEALTH SYSTEM0
IOWA HEALTH SYSTEM
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421435199SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE III0
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
8101 BIRCHWOOD COURTJOHNSTONIA50131421411630PRIMARY HEALTH CARE SERVICESIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUEWATERLOOIA50703421201138CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC0
MERITER FOUNDATION INC
202 SOUTH PARK STREETMADISONWI53715237098688CHARITABLE FUNDRAISINGWI501(C)(3)170(B)(1) (A)(VI)MERITER HEALTH SERVICES INC0
MERITER HEALTH SERVICES INC
202 SOUTH PARK STREETMADISONWI53715391412318SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREWI501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
MERITER HOSPITAL INC
202 SOUTH PARK STREETMADISONWI53715390806367HOSPITALWI501(C)(3)170(B)(1) (A)(III)MERITER HEALTH SERVICES INC0
MERITER MEDICAL GROUP INC
202 SOUTH PARK STREETMADISONWI53715050545222SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICESWI501(C)(3)509(A)(3), TYPE IIMERITER HOSPITAL INC0
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111135SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636510186460CHARITABLE FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)METHODIST HEALTH SERVICES CORPORATION0
METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636370661223HOSPITALIL501(C)(3)170(B)(1) (A)(III)METHODIST HEALTH SERVICES CORPORATION0
METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111134OFFICE RENTALIL501(C)(3)509(A)(2)METHODIST HEALTH SERVICES CORPORATION0
NELLIE R SHERWOOD TRUST
1026 A AVENUE NECEDAR RAPIDSIA52402426061621PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAYIA501(C)(3)509(A)(3), TYPE IST LUKE'S METHODIST HOSPITAL0
NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED
720 KENYON DRIVEFORT DODGEIA50501420937390MENTAL HEALTH CAREIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVDSIOUX CITYIA51104421019872HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTH SYSTEM INC0
PROCTOR HEALTH CARE INCORPORATED
5409 N KNOXVILLE AVEPEORIAIL61614371133412SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)170(B)(1) (A)(III)METHODIST HEALTH SERVICES CORPORATION0
PROCTOR HEALTH SYSTEMS
5409 N KNOXVILLE AVEPEORIAIL61614364147437PRIMARY HEALTH CARE SERVICESIL501(C)(3)170(B)(1) (A)(III)PROCTOR HEALTH CARE INCORPORATED0
PROCTOR HOSPITAL
5409 N KNOXVILLE AVEPEORIAIL61614370681540HOSPITALIL501(C)(3)170(B)(1) (A)(III)PROCTOR HEALTH CARE INCORPORATED0
SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636376181831FUND SELF-INSURANCE PLANIL501(C)(3)509(A)(3), TYPE IMETHODIST MEDICAL CENER OF ILLINOIS0
SHARED MAGNETIC RESONANCE IMAGING FACILITY INC
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SIOUXLAND PACE INC
313 COOK STREETSIOUX CITYIA51103261120134ALL-INCLUSIVE CARE FOR THE ELDERLYIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH RESOURCES
2720 STONE PARK BLVDSIOUX CITYIA51104421059182OUTPATIENT CLINICS AND HEALTHCARE SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH SYSTEM INC
2720 STONE PARK BLVDSIOUX CITYIA51104421294091SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
ST LUKE'S HEALTHCARE
1026 A AVENUE NECEDAR RAPIDSIA52402421487968SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
ST LUKE'S METHODIST HOSPITAL
1026 A AVENUE NECEDAR RAPIDSIA52402420504780HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE0
ST LUKE'SJONES REGIONAL MEDICAL CENTER
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STL CARE COMPANY
1026 A AVENUE NECEDAR RAPIDSIA52402421276632IMPROVE PUBLIC HEALTH SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTHCARE0
THE DUBUQUE VISITING NURSE ASSOCIATION
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THE FINLEY HOSPITAL
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680354HOSPITALIA501(C)(3)170(B)(1) (A)(III)FINLEY TRI-STATES HEALTH GROUP INC0
THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
2701 17TH STREETROCK ISLANDIL61201363678909MENTAL HEALTH CAREIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRIMARK PHYSICIANS GROUP
802 KENYON ROADFORT DODGEIA50501453791448SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICESIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
TRINITY BUILDING CORPORATION
802 KENYON ROADFORT DODGEIA50501421376187PROPERTY HOLDING COMPANYIA501(C)(2)TRINITY HEALTH SYSTEMS INC0
TRINITY COLLEGE OF NURSING & HEALTH SCIENCES
2122 25TH AVEROCK ISLANDIL61201810994377EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALSIL501(C)(3)170(B)(1) (A)(II)TRINITY MEDICAL CENTER0
TRINITY HEALTH FOUNDATION
802 KENYON ROADFORT DODGEIA50501421222381CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)TRINITY HEALTH SYSTEMS INC0
TRINITY HEALTH FOUNDATION
2701 17TH STREETROCK ISLANDIL61201363321751CHARITABLE FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY HEALTH SYSTEMS INC
802 KENYON ROADFORT DODGEIA50501421222877SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY MEDICAL CENTER
2701 17TH STREETROCK ISLANDIL61201362739299HOSPITALIL501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY REGIONAL HEALTH SYSTEM
2701 17TH STREETROCK ISLANDIL61201363351952SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY REGIONAL HOSPITAL AUXILIARY
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TRINITY REGIONAL MEDICAL CENTER
802 KENYON ROADFORT DODGEIA50501421009175HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
UNITY HEALTHCARE
1518 MULBERRY AVENUEMUSCATINEIA52761420680337HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
UNITY HEALTHCARE FOUNDATION
1518 MULBERRY AVENUEMUSCATINEIA52761421525031SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE ITRINITY REGIONAL HEALTH SYSTEM0
UNITYPOINT AT HOME
11333 AURORA AVENUEURBANDALEIA50322421477471HOME HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM0
UNITYPOINT HEALTH AT WORK
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266810872241EMPLOYER ONSITE MEDICAL SERVICES AND OCCUPATIONAL MEDICINEIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (28 entries)

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ADVANCED IMAGING CENTER LLC
615 VALLEY VIEW DRIVEMOLINEIL61265364356301DIAGNOSTIC RADIOLOGY CENTERIAN/A
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC
1825 LOGAN AVEWATERLOOIA50703453237125ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESIAN/A
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT STDES MOINESIA50309273625869CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIAN/A
CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY
1200 PLEASANT STREETDES MOINESIA50309453017991ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICESIAN/A
CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC
1200 PLEASANT STDES MOINESIA50309471608704SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICESIAN/A
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500DUBUQUEIA52001201597161AMBULATORY SURGERY CENTERIAN/A
ENSEVA - HIAWATHA LLC
755 METZGER DRIVEHIAWATHAIA52233453437363COLLOCATION FACILITYIAN/A
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVEDUBUQUEIA52001422808785SURGERY DEPARTMENT MANAGEMENT SERVICESIAN/A
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVEDUBUQUEIA52001421428503PROVIDE ACCESS TO LICENSED SOFTWAREIAN/A
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
1200 PLEASANT STREETDES MOINESIA50309030482623OUTPATIENT DIAGNOSTIC IMAGINGIAN/A
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421511142GROUP PURCHASINGIAN/A
LAKEVIEW SURGERY CENTER LC
1200 PLEASANT STREETDES MOINESIA50309421516120SURGERY CENTERIAN/A
MERITER UW PHYSICIANS CONTRACTING COMPANY LLC
202 SOUTH PARK STREETMADISONWI53715391998819HEALTH SERVICESWIN/A
MISSISSIPPI VALLEY SLEEP DISORDER CENTER LC
3400 DEXTER COURTDAVENPORTIA52807421489697MEDICAL LABORATORY SERVICESIAN/A
MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
221 NE GLEN OAK AVEPEORIAIL61636461219459ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESILN/A
MMCI SURGERY CO-MANAGEMENT COMPANY LLC
221 NE GLEN OAK AVEPEORIAIL61636471323385SURGERY MANAGEMENT & ADMINISTRATIVE SERVICESILN/A
MR ASSOCIATES LLP
1956 1ST AVENUE NECEDAR RAPIDSIA52402421260463OWN AND OPERATE MR UNITIAN/A
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
1200 PLEASANT STREETDES MOINESIA50309421508092AMBULATORY SURGERY CENTERIAN/A
REGIONAL HEALTH PARTNERS LLC
1258 W SOUTH STKEWANEEIL61443800899158AMBULATORY HEALTH CLINICSILN/A
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110PEORIAIL61603810584193REHABILATION THERAPYILN/A
SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC
2720 STONE PARK BLVDSIOUX CITYIA51104455322324CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIAN/A
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SECEDAR RAPIDSIA52403721550812AMBULATORY SURGERY CENTER.IAN/A
TRINITY ANESTHESIOLOGY SERVICES CO-MANAGEMENT COMPANY LLC
2701 17TH STREETROCK ISLANDIL61201300932074ANESTHESIOLOGY SERVICE LINES ADMINISTRATIVE SERVICESILN/A
TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY LLC
500 JOHN DEERE ROADMOLINEIL61265900953327ONCOLOGY MANAGEMENT SERVICESILN/A
UNITYPOINT AT WORK LC
1825 LOGAN AVEWATERLOOIA50703472181113OCCUPATIONAL MEDICINEIAN/A
UPHT-SCA HOLDINGS LLC
569 BROOKWOOD VILLAGE SUITE 901BIRMINGHAMAL35209473564984AMBULATORY SURGERY CENTER INVESTMENTDEN/A
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREETWEST DES MOINESIA50266271414600ORTHOPEDIC SERVICE LINES MANAGEMENTIAN/A
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVENUE SUITE 2WEST DES MOINESIA50266263193923SLEEP DISORDER DIAGNOSTIC TESTING FACILITYIAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BELCREST SERVICES LTD
5409 N KNOXVILLE AVEPEORIAIL61614371196307MEDICAL SERVICESILN/AC0
BROADBAND INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266273819741INFORMATION TECHNOLOGY MGMT.IAN/AC0
DELHI POINT CONDO ASSOCIATION
350 N GRANDVIEWDUBUQUEIA52001421467002REAL ESTATE MANAGEMENTIAN/AC0
HCP CORPORATION
202 SOUTH PARK STREETMADISONWI53715391177562REAL ESTATE RENTALWIN/AC0
HEALTH PLUS INC
5409 N KNOXVILLE AVEPEORIAIL61614371295532MANAGED CARE ADMINISTRATIONILN/AC0
HNC SERVICES
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266270987243FIBER OPTIC NETWORK SERVICESIAN/AC0
HOME HEALTH PLUS SERVICES INC
PO BOX 87PEORIAIL61650364053068HOME HEALTH SERVICESILN/AC0
MEDIMORE INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421414390MANAGED CAREIAN/AC0
MERITER HEALTH ENTERPRISES INC
202 SOUTH PARK STREETMADISONWI53715391293620MANAGEMENT SERVICESWIN/AC0
MERITER MANAGEMENT SERVICES INC
202 SOUTH PARK STREETMADISONWI53715391458235ADMINISTRATIVE SERVICESWIN/AC0
METHODIST HEALTH VENTURES INC
PO BOX 87PEORIAIL61650371140939PHARMACY/OFFICE STAFFINGILN/AC0
METHODIST PHYSICIAN SERVICES INC
PO BOX 87PEORIAIL61650363858550MEDICAL SERVICESILN/AC0
PRECEDENCE INC
4622 PROGRESS DRIVE STE ADAVENPORTIA52807371288604MANAGED MENTAL CAREIAN/AC0
PROVIDER RESOURCE MANAGEMENT INC
PO BOX 87PEORIAIL61650371223550RESOURCE MANAGEMENTILN/AC0
PHYSICIANS PLUS INSURANCE CORPORATION
2650 NOVATION PARKWAY SUITE 400MADISONWI53713391565691FEDERALLY QUALIFIED HMOWIN/AC0
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVEDES MOINESIA50316261271143SPECIALTY PHYSICIANS MEDICAL CAREIAN/AC0
STL HEALTH RESOURCES CO
1026 A AVE NECEDAR RAPIDSIA52402421193499PHYSICIAN OFFICE RENTALIAN/AC0
TRINITY HEALTH ENTERPRISES INC
2701 17TH STROCK ISLANDIL61201363320141RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACYILN/AC0
TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD
4622 PROGRESS DRIVE STE ADAVENPORTIA52807363924720MANAGED HEALTH CAREIAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
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 OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PARTS I - IV:FormAndLineReferenceDesc
ExplanationIOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 33 HOSPITAL FACILITIES AND OVER 400 OUTPATIENT SITES IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).ExplanationTxt

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