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IOWA CITY VA MEDICAL RESEARCH FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
IOWA CITY VA MEDICAL RESEARCH FOUNDATION (EIN 39-1886437)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-06-14
IRS object ID
201741659349300209
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)
Return2017-06-14T08:25:36-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1600 3RD AVE SE STE 300AddressLine1Txt
CityCEDAR RAPIDSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52401ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391886437EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1IOWA CITY VA MEDICAL RESEARCH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlIOWABusinessNameControlTxt
Phone3196883542PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 HIGHWAY 6 WEST 151AddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52246ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJULIE SLINGERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3196883542PhoneNum
Signature2017-06-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCONNIE M LIRAPreparerPersonNm
PTINP00481097PTIN
Phone3193632697PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-06-09IPDt
IP Tm14:05:23IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id81FF5BF34CBA6F4D9B1398674A1DA3B48C71A947AtSubmissionCreationDeviceId
At Submission Filing Device Id1BAC06048B1AC44E7C7DE62F9C14DAF727EFD790AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJULIE SLINGERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 HIGHWAY 6 WEST 151AddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52246ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$642,920GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ICVAFOUNDATION.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO MOBILIZE RESOURCES TO IMPROVE THE HEALTH AND WELL BEING OF THE VETERAN COMMUNITYActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee4TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$17,214PYContributionsGrantsAmt
CY Contributions Grants$7,796CYContributionsGrantsAmt
PY Program Service Revenue$550,581PYProgramServiceRevenueAmt
CY Program Service Revenue$632,251CYProgramServiceRevenueAmt
PY Investment Income$3,694PYInvestmentIncomeAmt
CY Investment Income$2,873CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$571,489PYTotalRevenueAmt
CY Total Revenue$642,920CYTotalRevenueAmt
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$111,249PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$75,303CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$499,937PYOtherExpensesAmt
CY Other Expenses$558,800CYOtherExpensesAmt
PY Total Expenses$611,186PYTotalExpensesAmt
CY Total Expenses$634,103CYTotalExpensesAmt
PY Revenues Less Expenses-$39,697PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$8,817CYRevenuesLessExpensesAmt
Total Assets BOY$1,213,446TotalAssetsBOYAmt
Total Assets EOY$1,119,931TotalAssetsEOYAmt
Total Liabilities BOY$921,405TotalLiabilitiesBOYAmt
Total Liabilities EOY$819,073TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$292,041NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$300,858NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE IOWA CITY VA MEDICAL RESEARCH FOUNDATION'S (ICVARF) MISSION IS TO MOBILIZE RESOURCES TO IMPROVE THE HEALTH AND WELL BEING OF THE VETERAN COMMUNITY. EFFORTS ARE FOCUSED TO ACHIEVE OUR VISION: TO DISCOVER KNOWLEDGE AND CREATE INNOVATIONS THAT HELP ADVANCE THE HEALTH AND CARE OF OUR NATION'S HEROES, VETERANS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$528,462ExpenseAmt
Revenue$632,251RevenueAmt
DescICVARF MOBILIZES RESOURCES THAT HELP TARGET, CURE, AND IMPROVE VETERANS' HEALTH PROBLEMS. BASED IN IOWA CITY, A HUB OF RESEARCH AND HEALTH CARE IN THE MIDWEST, WE SERVE VETERANS IN IOWA AND EASTERN ILLINOIS. ICVARF HELPS THE IOWA CITY VA HEALTH CARE SYSTEM ADVANCE ITS HEALTHCARE GOALS. ICVARF SUPPORTS MEDICAL RESEARCH PROJECTS LED BY VA STAFF IN ORDER TO ASSIST AND IMPROVE THE HEALTHCARE PROVIDED TO THE VETERAN COMMUNITY.FOR THE YEAR ENDED DECEMBER 31, 2016 THE FOUNDATION CONTINUED TO MANAGE TWO DEPARTMENT OF DEFENSE (DOD) GRANTS AND SEVERAL INDUSTRY SPONSORED GRANTS. ONE DOD GRANT SUPPORTS RESEARCH FOR VETERANS WITH SEVERE HEARING LOSS THROUGH COCHLEAR IMPLANT TECHNOLOGY AND THE SECOND DOD GRANT FOCUSES ON TRAUMATIC BRAIN INJURY AS A RESULT OF MULTIPLE IMPACTS OR BLASTS. THE TWO NEW INDUSTRY SPONSORED GRANTS BOTH SUPPORT MEDICAL RESEARCH RELATED TO CHRONIC HEPATITIS C. THE FOUNDATION HAS APPROXIMATELY 20 MEDICAL RESEARCH ACCOUNTS IN VARIOUS STAGES OF ACTIVITY AND EXPENDED APPROXIMATELY $438,925 TO SUPPORT MEDICAL RESEARCH ACTIVITIES.HOSPITALS, PHYSICIANS, AND OTHER HEALTH CARE PROVIDERS OFTEN FALL SHORT OF USING THE FINDINGS FROM RESEARCH STUDIES TO IMPROVE HEALTH CARE SERVICES FOR VETERANS. WHILE RESEARCH STUDIES SHOW THAT THE VA DOES A BETTER JOB OF USING RESEARCH INFORMATION THAN PROVIDERS IN THE PRIVATE SECTOR, MORE CAN STILL BE DONE TO IMPROVE THE TRANSFER OF INFORMATION IS REFERRED TO AS "IMPLEMENTATION". THE CENTER FOR RESEARCH IN THE IMPLEMENTATION OF INNOVATIVE STRATEGIES IN PRACTICE (CRIISP) WAS ESTABLISHED IN JUNE 2004 AS A NEW VA HEALTH SERVICES RESEARCH AND DEVELOPMENT (HSR&D) CENTER OF EXCELLENCE FOCUSING ON IMPLEMENTATION OR TRANSFER OF INFORMATION.CRIISP'S GOAL IS TO CREATE WAYS TO CHANNEL RESEARCH INFORMATION TO CLINICIANS IN A MORE DIRECT FASHION IN ORDER TO IMPROVE VETERAN'S WELLBEING. SPECIFICALLY THE AIMS TO:1. IDENTIFY EXISTING PROCESSES THAT ASSIST OR HINDER THE TRANSFER OF RESEARCH INFORMATION.2. DEVELOP, TEST, AND DISTRIBUTE NEW PROCESSES THAT IMPROVE THE QUALITY AND COSTS OF MEDICAL SERVICES.Desc
Total Program Service Expenses$528,462TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
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
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
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
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee4EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
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 Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNJStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJULIE SLINGERPersonNm
Phone3196883542PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 HIGHWAY 6 WEST 151AddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52246ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerInd
JUDITH JOHNSON-MEKOTA
DIRECTOR1.00Yes (X)$0$0$0
STANLEY PARKER
DIRECTOR1.00Yes (X)$0$0$0
RANDY KARDON
DIRECTOR1.00Yes (X)$0$495,534$58,24540.00
KARI STEINKAMP
DIRECTOR1.00Yes (X)$0$109,339$25,99240.00
PHILLIP SCHMID JR
DIRECTOR1.00Yes (X)$0$0$0
PETER VANDERHOEF
DIRECTOR1.00Yes (X)$0$0$0
JOHN MIKELSON
SECRETARY/TREASURER2.00Yes (X)$0$0$0Yes (X)
MARK YOREK
CHAIR2.00Yes (X)$0$114,647$21,66840.00Yes (X)
ELI PERENCEVICH
DIRECTOR - LEFT IN 20161.00Yes (X)$0$355,206$54,97740.00
RICHARD CHARLAT
DIRECTOR - LEFT IN 20161.00Yes (X)$0$170,278$48,95540.00
SARAH ELSE
EXECUTIVE DIRECTOR - LEFT JULY 201625.00$25,619$0$2,562Yes (X)
JULIE SLINGER
EXECUTIVE DIRECTOR25.00$36,791$0$3,679Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$62,410TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,245,004TotReportableCompRltdOrgAmt
Total Other Compensation$216,078TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY OF IOWABusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 CALVIN HALLAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd
FieldValueIRS element (for citing)
ServicesRESEARCH SERVICESServicesDesc
Compensation$265,497CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$7,796AllOtherContributionsAmt
Total Contributions$7,796TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROGRAM SERVICE FEES541700$625,297$625,297
CRIISP MANAGEMENT FEES561000$6,954$6,954
FieldValueIRS element (for citing)
Total Program Service Revenue$632,251TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,873TotalRevenueColumnAmt
Exclusion$2,873ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$642,920TotalRevenueColumnAmt
Related Or Exempt Func Income$632,251RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,873ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$66,067TotalAmt
Program Services$2,470ProgramServicesAmt
Management And General$63,597ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,102TotalAmt
Program Services$2,102ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,566TotalAmt
Program Services$378ProgramServicesAmt
Management And General$1,188ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,568TotalAmt
Program Services$269ProgramServicesAmt
Management And General$5,299ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,538TotalAmt
Management And General$19,538ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$697TotalAmt
Management And General$697ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$750TotalAmt
Management And General$750ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,019TotalAmt
Program Services$169ProgramServicesAmt
Management And General$3,850ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$21,692TotalAmt
Program Services$19,704ProgramServicesAmt
Management And General$1,988ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,635TotalAmt
Program Services$8,603ProgramServicesAmt
Management And General$2,032ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,834TotalAmt
Program Services$4,558ProgramServicesAmt
Management And General$1,276ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,816TotalAmt
Program Services$77ProgramServicesAmt
Management And General$1,739ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
RESEARCH SUPPORT/SUPPLI$438,925$438,925
NURSE SUPPORT/SUPPLIES$26,616$26,616
INTERNAL REVIEW$23,340$23,340
DUES/MEMBERSHIPS$4,606$1,251$3,355

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$332TotalAmt
Management And General$332ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$634,103TotalAmt
Program Services$528,462ProgramServicesAmt
Management And General$105,641ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,188,344BOYAmt
EOY$1,105,158EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$23,771BOYAmt
EOY$12,327EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,331BOYAmt
EOY$2,446EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,213,446BOYAmt
EOY$1,119,931EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$262,808BOYAmt
EOY$175,266EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$255,711BOYAmt
EOY$347,225EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$402,886BOYAmt
EOY$296,582EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$921,405BOYAmt
EOY$819,073EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$292,041BOYAmt
EOY$300,858EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$292,041BOYAmt
EOY$300,858EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,213,446BOYAmt
EOY$1,119,931EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$8,817ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Medical Research OrganizationYes (X)MedicalResearchOrganizationInd

Hospital Name And Address HospitalNameAndAddressGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1IOWA CITY VA MEDICAL HEALTH CARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$642,920TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$642,920RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$642,920TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$634,103TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$634,103ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$634,103TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR SECTION OF THE IOWA INCOME TAX LAW, WHICH PROVIDES INCOME TAX EXEMPTION FOR CORPORATIONS ORGANIZED AND OPERATED EXCLUSIVELY FOR RELIGIOUS, CHARITABLE, OR EDUCATIONAL PURPOSES. THE INTERNAL REVENUE SERVICE HAS NOT CLASSIFIED THE FOUNDATION AS A PRIVATE FOUNDATION. THE FOUNDATION FILES INFORMATION RETURNS IN THE U.S. FEDERAL JURISDICTION. THE FOUNDATION FOLLOWS THE STANDARD FOR EVALUATING UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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
RANDY KARDON
DIRECTOR$0$488,534$0$7,000$0$0$0$58,245$0$0$0$553,779$0$0
ELI PERENCEVICH
DIRECTOR - LEFT IN 2016$0$340,206$0$15,000$0$0$0$41,874$0$13,103$0$410,183$0$0
RICHARD CHARLAT
DIRECTOR - LEFT IN 2016$0$170,278$0$0$0$0$0$40,356$0$8,599$0$219,233$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE FULL BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF THE EXECUTIVE DIRECTOR. COMPENSATION IS BASED ON COMPARABLE COMPENSATION WITHIN THE VETERANS ADMINISTRATION SYSTEM AND BY A NATION-WIDE COMPENSATION SURVEY COMPLETED BY THE NATIONAL ASSOCIATION OF VETERANS RESEARCH AND EDUCATION FOUNDATION. THIS PROCESS LAST TOOK PLACE IN 2016. COMPENSATION OF THE EXECUTIVE DIRECTOR DOES NOT RISE TO THE LEVEL WHERE DISCLOSURE IS REQUIRED ON SCHEDULE J, PART II, THEREFORE BOXES ON SCHEDULE J, PART I, LINE 3 HAVE BEEN LEFT BLANK.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS SHALL INCLUDE THREE STATUTORY MEMBERS, DEFINED AS THOSE INDIVIDUALS WHO HOLD THE FOLLOWING POSITIONS AT THE IOWA CITY VA HEALTH CARE SYSTEM: 1. MEDICAL CENTER DIRECTOR 2. CHIEF OF STAFF 3. ASSOCIATE CHIEF OF STAFF FOR RESEARCH AND DEVELOPMENT THE BOARD OF DIRECTORS, INITIAL OR OTHERWISE, IS SUBJECT TO REMOVAL BY THE SECRETARY OF VETERANS AFFAIRS OR THE SECRETARY'S DESIGNEE.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS TAKEN BY THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE MEDICAL CENTER DIRECTOR AT THE IOWA CITY VA HEALTH CARE SYSTEM: 1. FILLING VACANCIES IN NON-STATUTORY BOARD POSITIONS 2. APPOINTMENT OF THE EXECUTIVE DIRECTOR
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, WHO PROVIDES A DRAFT TO THE EXECUTIVE DIRECTOR FOR REVIEW AND INITIAL APPROVAL. IT IS THEN DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW. THE FINAL FORM 990 IS APPROVED BY THE BOARD PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CEACH MEMBER OF THE BOARD OF DIRECTORS, OFFICERS, AND EMPLOYEES OF THE ORGANIZATION SHALL ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE AS WELL AS SIGN A STATEMENT CERTIFYING THAT THEY ARE AWARE OF AND HAVE COMPLIED WITH ALL FEDERAL LAWS AND REGULATIONS WITH RESPECT TO CONFLICTS OF INTEREST IN THE PERFORMANCE OF ANY AND ALL OFFICIAL FUNCTIONS. THE BOARD OF DIRECTORS WHO ARE NOT IN CONFLICT ARE RESPONSIBLE FOR DETERMINING WHETHER A POTENTIAL CONFLICT IS AN ACTUAL CONFLICT. IF AN ACTUAL CONFLICT OF INTEREST WERE TO ARISE THE CONFLICTED PARTY WOULD RECUSE THEMSELVES FROM DISCUSSION AND VOTE ON THE MATTER IN CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15ATHE FULL BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF THE EXECUTIVE DIRECTOR. COMPENSATION IS BASED ON COMPARABLE COMPENSATION WITHIN THE VETERANS ADMINISTRATION SYSTEM AND BY A NATION-WIDE COMPENSATION SURVEY COMPLETED BY THE NATIONAL ASSOCIATION OF VETERANS RESEARCH AND EDUCATION FOUNDATION. OTHER EMPLOYEE COMPENSATION IS REVIEWED BY THE EXECUTIVE DIRECTOR USING COMPARABLE DATA AND BASED ON COMPARABLE POSITIONS WITHIN THE VETERANS ADMINISTRATIVE SYSTEM. BOARD MEMBERS ARE NOT COMPENSATED. THIS PROCESS LAST TOOK PLACE IN 2016. FORM 990, PART VI, SECTION B, LINE 15B: NO OTHER COMPENSATED INDIVIDUAL MEETS THE IRS DEFINITION OF OFFICER OR KEY EMPLOYEE.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST MADE TO THE EXECUTIVE DIRECTOR OR VOTING BOARD MEMBER.
FORM 990, PART XII, LINE 2C:NO CHANGE FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1IOWA CITY VA MEDICAL HEALTH CARE SYSTEMBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 HIGHWAY 6 WESTAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd
FieldValueIRS element (for citing)
EIN470376487EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
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 Org0RentalOfFcltsFromOthOrgInd
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 Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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