IOWA CITY VA MEDICAL RESEARCH FOUNDATION: Form 990, tax year 2015
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- Organization
- IOWA CITY VA MEDICAL RESEARCH FOUNDATION (EIN 39-1886437)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-06-17
- IRS object ID
- 201621699349300707
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-06-17T09:03:23-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 600 3RD AVE SE STE 300 | AddressLine1Txt |
| City | CEDAR RAPIDS | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391886437 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA CITY VA MEDICAL RESEARCH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IOWA | BusinessNameControlTxt |
| Phone | 3196883542 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 HIGHWAY 6 WEST 151 | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52246 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARAH ELSE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3196883542 | PhoneNum |
| Signature | 2016-06-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LITTLE | PreparerPersonNm |
| PTIN | P01480921 | PTIN |
| Phone | 3193632697 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SARAH ELSE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 HIGHWAY 6 WEST 151 | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $571,489 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ICVAFOUNDATION.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO MOBILIZE RESOURCES TO IMPROVE THE HEALTH AND WELL BEING OF THE VETERAN COMMUNITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 7 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $519 | PYContributionsGrantsAmt |
| CY Contributions Grants | $17,214 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $391,547 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $550,581 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,613 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,694 | CYInvestmentIncomeAmt |
| PY Other Revenue | $22,215 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $418,894 | PYTotalRevenueAmt |
| CY Total Revenue | $571,489 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $91,077 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $111,249 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $345,147 | PYOtherExpensesAmt |
| CY Other Expenses | $499,937 | CYOtherExpensesAmt |
| PY Total Expenses | $436,224 | PYTotalExpensesAmt |
| CY Total Expenses | $611,186 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$17,330 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$39,697 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,246,469 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,213,446 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $914,731 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $921,405 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $331,738 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $292,041 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $475,585 | ExpenseAmt |
| Revenue | $550,581 | RevenueAmt |
| Desc | ICVARF 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, 2015 THE FOUNDATION CONTINUED TO MANAGE TWO DEPARTMENT OF DEFENSE (DOD) GRANTS AND RECEIVED TWO NEW 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 $488,000 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 FROM RESEARCHERS TO CLINICIANS. THIS 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 VETERANS' WELL BEING. SPECIFICALLY, THE CENTER AIMS TO:1. IDENTIFY EXISTING PROCESSES THAT ASSIST OR HINDER THE TRANSFER OF RESEARCH INFORMATION2. DEVELOP, TEST, AND DISTRIBUTE NEW PROCESSES THAT IMPROVE THE QUALITY AND COSTS OF MEDICAL SERVICES | Desc |
| Total Program Service Expenses | $475,585 | 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 | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 7 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NJ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARAH ELSE | PersonNm |
| Phone | 3196883542 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 HIGHWAY 6 WEST 151 | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52246 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| RICHARD CHARLAT | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $285,842 | $61,666 | |
| ANN DAVIDSHOFERR | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $87,433 | $14,331 | |
| JUDITH JOHNSON-MEKOTA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RANDY KARDON | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $309,905 | $55,490 | |
| ELI PERENCEVICH | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $238,950 | $53,790 | |
| PHILLIP SCHMID JR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PETER VANDERHOEF | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN MIKELSON | |||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARK YOREK | |||||||
| CHAIR | 2.00 | 40.00 | Yes (X) | $0 | $117,459 | $21,379 | Yes (X) |
| TAMMY RICHARDSON | |||||||
| SECRETARY/TREASURER - LEFT MAY 2015 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DAWN OXLEY | |||||||
| DIRECTOR - LEFT JAN 2015 | 1.00 | Yes (X) | $0 | $180,246 | $24,304 | ||
| SARAH ELSE | |||||||
| EXECUTIVE DIRECTOR | 25.00 | $56,641 | $0 | $5,664 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $56,641 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,219,835 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $236,624 | 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 |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY OF IOWA | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 CALVIN HALL | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | RESEARCH SERVICES | ServicesDesc |
| Compensation | $345,113 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $17,214 | AllOtherContributionsAmt |
| Total Contributions | $17,214 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROGRAM SERVICE FEES | 541700 | $544,988 | $544,988 |
| CRIISP MANAGEMENT FEES | 561000 | $5,593 | $5,593 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $550,581 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,694 | TotalRevenueColumnAmt |
| Exclusion | $3,694 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $571,489 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $550,581 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,694 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,305 | TotalAmt |
| Management And General | $62,305 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,540 | TotalAmt |
| Program Services | $8,742 | ProgramServicesAmt |
| Management And General | $29,798 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,542 | TotalAmt |
| Program Services | $466 | ProgramServicesAmt |
| Management And General | $3,076 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,862 | TotalAmt |
| Program Services | $347 | ProgramServicesAmt |
| Management And General | $6,515 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430 | TotalAmt |
| Program Services | $430 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,575 | TotalAmt |
| Management And General | $19,575 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017 | TotalAmt |
| Management And General | $1,017 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750 | TotalAmt |
| Program Services | $750 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,871 | TotalAmt |
| Program Services | $5,600 | ProgramServicesAmt |
| Management And General | $1,271 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,629 | TotalAmt |
| Program Services | $3,629 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,423 | TotalAmt |
| Management And General | $6,423 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,325 | TotalAmt |
| Program Services | $9,325 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,404 | TotalAmt |
| Program Services | $5,799 | ProgramServicesAmt |
| Management And General | $1,605 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,511 | TotalAmt |
| Program Services | $2,046 | ProgramServicesAmt |
| Management And General | $465 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RESEARCH SUPPORT/SUPPLI | $403,146 | $403,146 | |
| NURSE SUPPORT/SUPPLIES | $34,035 | $34,035 | |
| DUES/MEMBERSHIPS | $4,630 | $1,195 | $3,435 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191 | TotalAmt |
| Program Services | $75 | ProgramServicesAmt |
| Management And General | $116 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611,186 | TotalAmt |
| Program Services | $475,585 | ProgramServicesAmt |
| Management And General | $135,601 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,209,739 | BOYAmt |
| EOY | $1,188,344 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,833 | BOYAmt |
| EOY | $23,771 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,897 | BOYAmt |
| EOY | $1,331 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,246,469 | BOYAmt |
| EOY | $1,213,446 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,489 | BOYAmt |
| EOY | $262,808 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,963 | BOYAmt |
| EOY | $255,711 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,279 | BOYAmt |
| EOY | $402,886 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,731 | BOYAmt |
| EOY | $921,405 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,738 | BOYAmt |
| EOY | $292,041 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,738 | BOYAmt |
| EOY | $292,041 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,246,469 | BOYAmt |
| EOY | $1,213,446 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$39,697 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Medical Research Organization | Yes (X) | MedicalResearchOrganizationInd |
Hospital Name And Address HospitalNameAndAddressGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA CITY VA MEDICAL HEALTH CARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $402,886 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $402,886 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $571,489 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $571,489 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $571,489 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $611,186 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $611,186 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $611,186 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD CHARLAT | ||||||||||||||
| DIRECTOR | $0 | $268,388 | $0 | $13,500 | $0 | $3,954 | $0 | $49,146 | $0 | $12,520 | $0 | $347,508 | $0 | $0 |
| RANDY KARDON | ||||||||||||||
| DIRECTOR | $0 | $302,905 | $0 | $7,000 | $0 | $0 | $0 | $55,490 | $0 | $0 | $0 | $365,395 | $0 | $0 |
| ELI PERENCEVICH | ||||||||||||||
| DIRECTOR | $0 | $225,280 | $0 | $13,670 | $0 | $0 | $0 | $41,256 | $0 | $12,534 | $0 | $292,740 | $0 | $0 |
| DAWN OXLEY | ||||||||||||||
| DIRECTOR - LEFT JAN 2015 | $0 | $158,922 | $0 | $0 | $0 | $21,324 | $0 | $12,215 | $0 | $12,089 | $0 | $204,550 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE 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 2013. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE 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 7B | THE 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 11 | THE 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 12C | EACH 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 15 | THE 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 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA CITY VA MEDICAL HEALTH CARE SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 HIGHWAY 6 WEST | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470376487 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA CITY VA MEDICAL HEALTH CARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $87,393 | InvolvedAmt |
| Method Of Amount Determination | FAIR MARKET VALUE | MethodOfAmountDeterminationTxt |
Comments