GREAT RIVER HEALTH SYSTEM INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
GREAT RIVER HEALTH SYSTEM INC (EIN 42-1193185)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201521359349302322
Schema version
2013v4.0
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)
Return2015-05-15T09:13:44-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421193185EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREAT RIVER HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlGREABusinessNameControlTxt
Phone3197681000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11221 SOUTH GEAR AVENUEAddressLine1
CityWEST BURLINGTONCity
StateIAState
ZIP Code52655ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTODD SLADKYPersonNm
Person TitleCFOPersonTitleTxt
Phone3197681000PhoneNum
Signature2015-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKACIE MCEWENPreparerPersonNm
PTINP01599614PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK RICHARDSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11221 SOUTH GEAR AVENUEAddressLine1
CityWEST BURLINGTONCity
StateIAState
ZIP Code52655ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$1,132GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GREATRIVERMEDICAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO SERVE AS A HOLDING COMPANY OF VARIOUS SUBSIDIARIES PROVIDING HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,654PYInvestmentIncomeAmt
CY Investment Income$1,132CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,654PYTotalRevenueAmt
CY Total Revenue$1,132CYTotalRevenueAmt
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$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$45,676PYOtherExpensesAmt
CY Other Expenses$17,180CYOtherExpensesAmt
PY Total Expenses$45,676PYTotalExpensesAmt
CY Total Expenses$17,180CYTotalExpensesAmt
PY Revenues Less Expenses-$43,022PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$16,048CYRevenuesLessExpensesAmt
Total Assets BOY$41,045,120TotalAssetsBOYAmt
Total Assets EOY$42,230,440TotalAssetsEOYAmt
Total Liabilities BOY$115,193TotalLiabilitiesBOYAmt
Total Liabilities EOY$161,358TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$40,929,927NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$42,069,082NetAssetsOrFundBalancesEOYAmt
MissionGREAT RIVER HEALTH SYSTEMS, INC. (GRHS) IS A NON-STOCK, NOT-FOR-PROFIT CORPORATION ORGANIZED FOR THE PURPOSE OF SERVING AS A HOLDING COMPANY OF VARIOUS SUBSIDIARIES PROVIDING HEALTH CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescGREAT RIVER HEALTH SYSTEMS IS A REGIONAL INTEGRATED HEALTH-SYSTEM THAT INCLUDES GREAT RIVER MEDICAL CENTER, PHARMACIES, MEDICAL EQUIPMENT AND SUPPLIES PROVIDERS, AND PHYSICIAN CLINICS.Desc
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 SecYes (1)ReportInvestmentsOtherSecInd
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
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 EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
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
Excess Business Holdings0ExcessBusinessHoldingsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHRISTINE DES JARDINSBusinessNameLine1
FieldValueIRS element (for citing)
Phone3197681000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11221 SOUTH GEAR AVENUEAddressLine1
CityWEST BURLINGTONCity
StateIAState
ZIP Code52655ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KENT GUADIAN
CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
DAN WIEDEMEIER
VICE CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
ROBERT MCCULLEY
SECRETARY / TREASURER1.001.00Yes (X)Yes (X)$0$0$0
MICHAEL MCCOY MD
DIRECTOR1.001.00Yes (X)$0$321,928$27,608
LORRIN DEBLIECK
DIRECTOR1.001.00Yes (X)$0$0$0
KENNETH ASPELMEIER
DIRECTOR1.003.00Yes (X)$0$0$0
DENNIS HINKLE
DIRECTOR1.001.00Yes (X)$0$0$0
JAN TOWNE
DIRECTOR1.001.00Yes (X)$0$0$0
JO ELLEN HOTH MD
DIRECTOR1.001.00Yes (X)$0$0$0
ROBERT FLEMING
DIRECTOR1.003.00Yes (X)$0$0$0
DON SCHMIDGALL
DIRECTOR1.001.00Yes (X)$0$0$0
WILLIAM DAWS
DIRECTOR1.001.00Yes (X)$0$0$0
MARK RICHARDSON
PRESIDENT/CEO0.4040.60Yes (X)Yes (X)$0$702,284$47,184
TONY HAYES
COO0.4040.60Yes (X)$0$442,286$42,193
TODD SLADKY
CFO0.4040.60Yes (X)$0$402,570$43,998
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,869,068TotReportableCompRltdOrgAmt
Total Other Compensation$160,983TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,132TotalRevenueColumnAmt
Exclusion$1,132ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,132TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,132ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$8,490TotalAmt
Management And General$8,490ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,450TotalAmt
Management And General$8,450ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$240TotalAmt
Management And General$240ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,180TotalAmt
Program Services$0ProgramServicesAmt
Management And General$17,180ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$346,335BOYAmt
EOY$393,531EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$104BOYAmt
EOY$3,096EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$21,795BOYAmt
EOY$1,725EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$24,141BOYAmt
EOY$24,140EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$40,652,745BOYAmt
EOY$41,807,948EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$41,045,120BOYAmt
EOY$42,230,440EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$115,193BOYAmt
EOY$161,358EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$115,193BOYAmt
EOY$161,358EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$40,929,927BOYAmt
EOY$42,069,082EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,929,927BOYAmt
EOY$42,069,082EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$41,045,120BOYAmt
EOY$42,230,440EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$16,048ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,155,203OtherChangesInNetAssetsAmt
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 A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
CertificationYes (X)CertificationInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GREAT RIVER MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN420680407EIN
Organization Type3OrganizationTypeDesc
Governing Document ListedYes (1)GoverningDocumentListedInd
Supported Org NotifiedYes (1)SupportedOrgNotifiedInd
US OrganizedYes (1)USOrganizedInd
Support$17,180SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$17,180SupportSumAmt

Schedule D IRS990ScheduleD

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

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN FOR-PROFIT SUBSIDIARIESDesc
Book Value$41,807,948BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$41,807,948TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescINTERCOMPANY PAYABLEDesc
Amt$161,358Amt
FieldValueIRS element (for citing)
Total Liability$161,358TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationDESCRIPTION FROM CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. THE TAX RETURNS FOR THE YEARS 2009 THROUGH 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 (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
MICHAEL MCCOY MD
DIRECTOR$0$321,928$0$0$0$0$0$10,200$0$17,408$0$349,536$0$0
MARK RICHARDSON
PRESIDENT/CEO$0$536,948$0$45,000$0$120,336$0$10,200$0$36,984$0$749,468$0$0
TONY HAYES
COO$0$345,374$0$0$0$96,912$0$10,200$0$31,993$0$484,479$0$0
TODD SLADKY
CFO$0$320,738$0$0$0$81,832$0$10,200$0$33,798$0$446,568$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD, THE PRESIDENT AND CEO AND TWO OR MORE ADDITIONAL DIRECTORS. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE.
FORM 990, PART VI, SECTION A, LINE 2KENT GAUDIAN AND ROBERT MCCULLEY HAVE A BUSINESS RELATIONSHIP. ROBERT FLEMING, KENT GAUDIAN, KENNETH ASPELMEIER, MARK RICHARDSON AND TODD SLADKY HAVE BUSINESS RELATIONSHIPS BY SERVING ON FOR-PROFIT SUBSIDIARIES OF GREAT RIVER HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 3ALL EXECUTIVE LEADERSHIP FUNCTIONS FOR GREAT RIVER HEALTH SYSTEMS INC., AND ITS SUBSIDIARIES ARE PROVIDED BY MUTUAL CONSULTING AND MANAGEMENT SERVICES, INC. MUTUAL CONSULTING AND MANAGEMENT SERVICES IS A SUBSIDIARY OF RIVERVIEW SYSTEMS LTD, WHICH IS A SUBSIDIARY OF GREAT RIVER HEALTH SYSTEMS.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 IS REVIEWED IN DETAIL BY THE ACCOUNTANT, ACCOUNTING MANAGER AND CFO. ANY NECESSARY ADJUSTMENTS ARE MADE PRIOR TO FINALIZING THE FORM. A COPY OF THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. ANY QUESTIONS OF THE BOARD MEMBERS ARE ADDRESSED THROUGH THE ACCOUNTING DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 12CEVERY YEAR, THE ACCOUNTING MANAGER IN THE ACCOUNTING DEPARTMENT PROVIDES THE BOARD OF DIRECTORS THE MEANING OF THE CONFLICT OF INTEREST STATEMENT, HOW IT APPLIES, HOW IT IMPACTS THE BOARD, AND WHAT THEIR RESPONSIBILITIES ARE. ALL BOARD MEMBERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST FORM AND THE FORM IS THEN REVIEWED BY THE ACCOUNTING MANAGER. RELATIONSHIPS NOTED ON THE FORM MAY BE DISCUSSED WITH THE BOARD MEMBER IF THERE ARE QUESTIONS. IF AN INDIVIDUAL HAS A CONFLICT OF INTEREST, THEY MAY NOT PARTICIPATE IN DISCUSSIONS OF THE TRANSACTION AND MAY NOT VOTE ON MATTERS RELATED TO THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION OF THE OFFICERS OF GREAT RIVER HEALTH SYSTEMS IS PAID BY A RELATED FOR-PROFIT SUBSIDIARY. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS IS DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF GREAT RIVER HEALTH SYSTEMS. THE ROLE OF THE COMPENSATION COMMITTEE IS TO ACT ON BEHALF OF THE BOARD IN ADOPTING, REVIEWING AND MAINTAINING AN EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE IS COMPRISED OF FIVE BOARD MEMBERS, ALL OF WHOM ARE INDEPENDENT FROM THE CEO AND OTHER OFFICERS. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE CEO AND OTHER OFFICERS ON AN ANNUAL BASIS. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES TAKEN AT THE MEETINGS. GREAT RIVER HEALTH SYTEMS PARTICIPATES AND UTILIZES FOUR EXECUTIVE SALARY SURVEYS TO DETERMINE COMPENSATION RANGES. THE COMMITTEE REVIEWS PREVAILING MARKET DATA TO ENSURE CONTINUED MARKET COMPETITIVENESS. THE COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTING GROUP TO ASSESS AND VALIDATE THE ENTIRETY OF THE EXECUTIVE COMPENSATION AND BENEFITS PACKAGES TO ENSURE REGULATORY COMPLIANCE, EXTERNAL COMPETITIVENESS, AND INTERNAL EQUITY. THE MOST RECENT YEAR OF AN INDEPENDENT THIRD PARTY REVIEW WAS 2012.
FORM 990, PART VI, SECTION C, LINE 19GREAT RIVER HEALTH SYSTEMS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:TRANSFER FROM RELATED ORGANIZATIONS 15,350,000. LOSS IN INVESTMENT IN SUBSIDIARIES -14,194,797.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
GREAT RIVER MEDICAL CENTER
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655420680407HOSPITALIA501(C)(3)3GRHSYes (1)
GRMC FOUNDATION CORP
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421193186SUPPORT RELATED ORGANIZATIONSIA501(C)(3)11 - TYPE IIGRHSYes (1)
GREAT RIVER FOUNDATION INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421469162SUPPORT RELATED ORGANIZATIONSIA501(C)(3)11 - TYPE IIGRHSYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
RIVERVIEW SYSTEMS LTD
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191960MEDICAL SERVICESIAGRHSC$50,407,086$48,357,9871.00000Yes (1)
GREAT RIVER MEDICAL SERVICES INC
1201 WEST AGENCY ROADWEST BURLINGTONIA52655421493449MEDICAL SERVICESIAGRHSC$6,864,393$2,707,8831.00000Yes (1)
MUTUAL CONSULTING & MANAGEMENT SERVICES
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421349668MANAGEMENT SERVICESIACYes (1)N/A
HEALTH CARE REALTY
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421193532REAL ESTATEIACYes (1)N/A
HERITAGE PARK PHARMACY
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191957PHARMACYIACYes (1)N/A
HERITAGE MEDICAL EQUIPMENT & SUPPLY
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191958MEDICAL SUPPLYIACYes (1)N/A
SOUTHEASTERN IOWA MEDICAL SERVICES
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421307141PHYSICIAN CLINICSIACYes (1)N/A
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
GREAT RIVER FOUNDATION
S$12,650,000CASH
GRMC FOUNDATION
S$2,700,000CASH

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