Northeast Iowa Medical Education: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- Northeast Iowa Medical Education (EIN 42-1058745)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-01-30
- IRS object ID
- 201440309349300259
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-01-30T07:49:47-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3999 PENNSYLVANIA AVE SUITE 100 | AddressLine1 |
| City | DUBUQUE | City |
| State | IA | State |
| ZIP Code | 52002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421058745 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northeast Iowa Medical Education Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 3192722525 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 50702 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Anthony A Day | Name |
| Title | Executive Director | Title |
| Phone | 3192722525 | Phone |
| Date Signed | 2014-01-17 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carmen Krantz | Name |
| PTIN | P00031958 | PTIN |
| Phone | 5635561790 | Phone |
| Date Prepared | 2014-01-17 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Anthony A Day | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 50702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7347939 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.familypracticeresidency.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1975 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | Developing family medicine physicians through modeling and teaching | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 93 | TotalNbrEmployees |
| Total Nbr Volunteers | 156 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3462921 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3463031 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3777963 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3873685 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9098 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8583 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2640 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2640 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7252622 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7347939 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5098629 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5140330 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2347113 | OtherExpensePriorYear |
| Other Expenses Current Year | 2221090 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7445742 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7361420 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -193120 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -13481 | RevenuesLessExpensesCY |
| Total Assets BOY | 4736155 | TotalAssetsBOY |
| Total Assets EOY | 3620424 | TotalAssetsEOY |
| Total Liabilities BOY | 2212025 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1109775 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2524130 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2510649 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Developing excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6107064 | Expense |
| Revenue | 3873685 | Revenue |
| Description | The Northeast Iowa Medical Education Foundation was founded in 1975 to develop a Family Medicine training program. The Family Medicine Residency Program is the branch of the Foundation which provides physicians with three years of additional training in the specialty of family medicine. During their training, resident physicians provide comprehensive health care under the supervision of board certified family medicine physicians. Upon graduation, these physicians provide a potential source of family physicians settling to practice in the community.Resident training takes place in the hospital setting, in private physician offices and in the Northeast Iowa Family Practice Center. During their three-year training program, the physicians receive training in internal medicine, obstetrics/gynecology, surgery, pediatrics, emergency medicine, family medicine, community medicine, psychiatry and behavioral science, orthopedics, otorhinolaryngology, ophthalmology and dermatology. In addition, they may use elective time to concentrate on specialties and sub-specialties of their choice. Resident physicians provide comprehensive medical care to a group of up to 250 patient families at the Northeast Iowa Family Practice Center. Residents may consult with faculty physicians during patient visits. Patients requiring care in the hospital are seen by both resident and faculty physicians.Area physicians are committed to the Northeast Iowa Family Medicine Residency Program. Nearly all private physicians in the area volunteer to teach the skills and procedures resident physicians will need in private practice. Physicians selected to be residents in the Northeast Iowa Family Medicine Residency Program are all graduates of accredited medical schools. The Waterloo Program recruits medical school graduates of the highest caliber, taking into consideration personal characteristics, aptitude and academic achievements.Graduates of the Northeast Iowa Family Medicine Residency Program are eligible to sit for the certification examination in the specialty of family medicine. This examination is administered by the American Board of Family Medicine, which is the specialty board that certifies family physicians. During the academic year 2012-13, six residents graduated and will take the examination for certification.The Residency Program is accredited by the Accreditation Council of Graduate Medical Education (ACGME), which is composed of representatives of five national associations interested in medical education. These associations are the American Board of Medical Specialties, American Hospital Association, American Medical Association, Association of American Medical Colleges and the Council of Medical Specialty Societies. The ACGME accredits residency programs through their Residency Review Committees with each specialty having its own committee.Educational activities of the Foundation include the Family Medicine Residency Program, undergraduate medical education, continuing medical education, and medical research. The Foundation is sponsored by Allen Memorial Hospital and Covenant Medical Center.During fiscal year ended June 30, 2013, Northeast Iowa Medical Education Foundation trained 18 resident physicians in the specialty of family medicine and one pharmacy resident in traditional and clinical pharmacy services. Clinical experience in family medicine was also provided for 35 medical students, 16 pharmacy students, three pharmacy residents, two podiatry students, one podiatry resident, four athletic training students, two NRP students, one social worker, and one MD observership. | Description |
| Total Program Service Expense | 6107064 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 65 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 93 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Greg Nelson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3192722525 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 50702 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Mark Feldkamp DO | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Paul Franke | |||||||
| President until Dec. 2012 | 1.00 | X | X | 0 | 0 | 0 | |
| Tim Horrigan MD | |||||||
| Vice President | 1.00 | X | X | 0 | 0 | 0 | |
| Jack Duesenbery | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Pam Delagardelle | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Tom Tibbitts | |||||||
| Treasurer until Nov. 2012 | 1.00 | X | 0 | 0 | 0 | ||
| Russell Adams MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Raja Akbar MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| JoAn Headington | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Kim Neumann MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Angela Townsend MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Roger Tracy | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Anthony A Day MD | |||||||
| Executive Director | 55.00 | X | X | 269730 | 0 | 28021 | |
| Greg Nelson | |||||||
| Administrator | 45.00 | X | 135047 | 0 | 750 | ||
| Robert Friedman MD | |||||||
| Undergrad Educ Dir | 45.00 | 275899 | 0 | 26946 | X | ||
| James Poock MD | |||||||
| Assistant Program Dir | 45.00 | 227948 | 0 | 27743 | X | ||
| John Sutherland MD | |||||||
| Executive Program Director | 30.00 | 177652 | 0 | 21876 | X | ||
| Suzanne Munns MD | |||||||
| Assistant Program Director | 45.00 | 185029 | 0 | 19946 | X | ||
| Adam Roise MD | |||||||
| Assistant Program Director | 45.00 | 196996 | 0 | 6259 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1468301 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 131541 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Computer Sense Inc | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 Olive Street | AddressLine1 |
| City | Cedar Falls | City |
| State | IA | State |
| ZIP Code | 50613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Computer services | DescriptionOfServices |
| Compensation | 209337 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Government Grants | 274123 | GovernmentGrants |
| All Other Contributions | 3188908 | AllOtherContributions |
| Total Contributions | 3463031 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Clinic revenue | 621110 | 3409274 | 3409274 |
| Supporting revenue | 900099 | 227658 | 227658 |
| Pharmacy research and | 900099 | 127910 | 127910 |
| Pharmacy residency rei | 900099 | 56169 | 56169 |
| Quality performance in | 900099 | 52674 | 52674 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3873685 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 706 | TotalRevenueColumn |
| Exclusion | $706 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2640 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2640 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2640 | TotalRevenueColumn |
| Exclusion | $2,640 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7877 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7877 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7877 | TotalRevenueColumn |
| Exclusion | $7,877 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7347939 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3873685 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $11,223 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431040 | Total |
| Management And General | 431040 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3992801 | Total |
| Program Services | 3818218 | ProgramServices |
| Management And General | 174583 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124727 | Total |
| Program Services | 118762 | ProgramServices |
| Management And General | 5965 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 327104 | Total |
| Program Services | 298560 | ProgramServices |
| Management And General | 28544 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264658 | Total |
| Program Services | 230735 | ProgramServices |
| Management And General | 33923 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 397 | Total |
| Management And General | 397 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13440 | Total |
| Management And General | 13440 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331045 | Total |
| Program Services | 293603 | ProgramServices |
| Management And General | 37442 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80279 | Total |
| Management And General | 80279 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309276 | Total |
| Program Services | 188339 | ProgramServices |
| Management And General | 120937 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 183932 | Total |
| Program Services | 44923 | ProgramServices |
| Management And General | 139009 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316770 | Total |
| Program Services | 316770 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65145 | Total |
| Program Services | 9800 | ProgramServices |
| Management And General | 55345 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12028 | Total |
| Management And General | 12028 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 217285 | Total |
| Program Services | 217285 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121424 | Total |
| Management And General | 121424 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Medical supplies | 272950 | 272950 |
| Provision for bad debts | 246269 | 246269 |
| Refund of educ support | 27120 | 27120 |
| Success sharing incenti | 23730 | 23730 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7361420 | Total |
| Program Services | 6107064 | ProgramServices |
| Management And General | 1254356 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 696711 | BOY |
| EOY | 879945 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 944062 | BOY |
| EOY | 684532 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 428854 | BOY |
| EOY | 377599 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6898 | BOY |
| EOY | 30833 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88648 | BOY |
| EOY | 88973 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3574854 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2631078 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 971879 | BOY |
| EOY | 943776 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1271159 | BOY |
| EOY | 328402 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6095 | BOY |
| EOY | 6364 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41849 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 280000 | BOY |
| EOY | 280000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4736155 | BOY |
| EOY | 3620424 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 788725 | BOY |
| EOY | 622898 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 251276 | BOY |
| EOY | 206877 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1172024 | BOY |
| EOY | 280000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2212025 | BOY |
| EOY | 1109775 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1678608 | BOY |
| EOY | 1906705 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 845522 | BOY |
| EOY | 603944 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2524130 | BOY |
| EOY | 2510649 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4736155 | BOY |
| EOY | 3620424 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -13481 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3409270 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3444556 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3228811 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3462921 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3463031 | CurrentTaxYear |
| Total | 17008589 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3350536 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3467330 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3714337 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3777963 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3873685 | CurrentTaxYear |
| Total | 18183851 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6759806 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6911886 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6943148 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7240884 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7336716 | CurrentTaxYear |
| Total | 35192440 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 35192440 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1929 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1622 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4180 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3861 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3346 | CurrentTaxYear |
| Total | 14938 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1929 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1622 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4180 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3861 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3346 | CurrentTaxYear |
| Total | 14938 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6761735 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6913508 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6947328 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7244745 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7340062 | CurrentTaxYear |
| Total | 35207378 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99960 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99950 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00040 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00050 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 33821 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 3617 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2683 | GrantsOrScholarships |
| Administrative Expenses | 503 | AdministrativeExpenses |
| End Of Year Balance | 34252 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 35395 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 155 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1246 | GrantsOrScholarships |
| Administrative Expenses | 483 | AdministrativeExpenses |
| End Of Year Balance | 33821 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 31385 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 5752 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1255 | GrantsOrScholarships |
| Administrative Expenses | 487 | AdministrativeExpenses |
| End Of Year Balance | 35395 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2138186 | OtherCostOrOtherBasis |
| Depreciation | 1714216 | Depreciation |
| Book Value | 423970 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1436668 | OtherCostOrOtherBasis |
| Depreciation | 916862 | Depreciation |
| Book Value | 519806 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 943776 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated insurance recoveries receivable | Description |
| Book Value | 280000 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 280000 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated claims liability | Description |
| Amount | $280,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 280000 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 7093793 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -246269 | OtherRevenues |
| Revenue Not Rptd F990 | -246269 | RevenueNotRptdF990 |
| Revenue Subtotal | 7340062 | RevenueSubtotal |
| Other Revenues Not Included | 7877 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 7877 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7347939 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7056424 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -7877 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -7877 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7064301 | ExpensesSubtotal |
| Other Expenses Not Included | 297119 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 297119 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7361420 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | An endowment fund known as the Charles A. Waterbury, Jr., M.D. Endowment Fund has also been established at the community foundation. The community foundation manages the fund with the long-term objectives of safeguarding principal, increasing the principal's growth sufficiently to offset any decrease in purchasing power due to inflation, and generating income for distribution to the Foundation. The community foundation has variance power, which allows them to modify the donor's stipulations under certain circumstances as they monitor the changing needs of the community. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X, Line 2: | The Foundation is organized as an Iowa non-profit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Foundation is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Foundation is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Foundation has determined that it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Foundation believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Foundation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 2d - Other Adjustments: | Provision for bad debts included in expenses for Form 990 -246,269. | |
| Part XI, Line 4b - Other Adjustments: | Deferred gain on former building included in revenue for Form 990 7,877. | |
| Part XII, Line 2d - Other Adjustments: | Deferred gain on former building included in expenses for financial stmts -7,877. | |
| Part XII, Line 4b - Other Adjustments: | Success sharing payout included in expenses for Form 990 23,730. Refund of education support included in expenses for Form 990 27,120. Provision for bad debts included in expenses for Form 990 246,269. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Anthony A Day MD | ||||||||||||||
| Executive Director | 260523 | 0 | 9207 | 0 | 0 | 0 | 11802 | 0 | 16219 | 0 | 297751 | 0 | 0 | 0 |
| Robert Friedman MD | ||||||||||||||
| Undergrad Educ Dir | 267372 | 0 | 8527 | 0 | 0 | 0 | 10884 | 0 | 16062 | 0 | 302845 | 0 | 0 | 0 |
| James Poock MD | ||||||||||||||
| Assistant Program Dir | 220499 | 0 | 7449 | 0 | 0 | 0 | 11884 | 0 | 15859 | 0 | 255691 | 0 | 0 | 0 |
| John Sutherland MD | ||||||||||||||
| Executive Program Director | 171268 | 0 | 6384 | 0 | 0 | 0 | 11772 | 0 | 10104 | 0 | 199528 | 0 | 0 | 0 |
| Suzanne Munns MD | ||||||||||||||
| Assistant Program Director | 178568 | 0 | 6461 | 0 | 0 | 0 | 4656 | 0 | 15290 | 0 | 204975 | 0 | 0 | 0 |
| Adam Roise MD | ||||||||||||||
| Assistant Program Director | 191839 | 0 | 5157 | 0 | 0 | 0 | 0 | 0 | 6259 | 0 | 203255 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 6 | ReturnReference |
| Explanation | A Success Sharing Policy has been approved by the Board of Directors which allows all employees, including those listed in Part VII, to be eligible for additional financial compensation based upon the financial success (net earnings) of the Organization and other quality measures. | Explanation |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dr Adam Roise | NamePerson |
| Purpose Of Loan | Student loan advance as part of a recruitment agreement | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $50,000 | OriginalPrincipalAmount |
| Balance Due | 30833 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 30833 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 1 | The Executive Committee is composed of the officers elected by the Board of Directors. The Executive Committee has authority to transact all regular business of the organization during the period between the meetings of the Board of Directors subject to any prior limitation imposed by the Board of Directors. |
| Form 990, Part VI, Section A, line 2 | Dave Happel, Russell Adams, MD, John Knox, Kyle Christiason, MD, and Raja Akbar, MD have a business relationship. Mark Feldkamp, DO, Paul Franke, Jack Dusenbery, and Angela Townsend, MD have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The members of Northeast Iowa Medical Education Foundation are Allen Memorial Hospital Corporation and Covenant Health System. New members may be admitted only with the unanimous consent of the present members. |
| Form 990, Part VI, Section A, line 7a | The two members, Allen Memorial Hospital Corporation and Covenant Health System, appoint the Board of Directors of Northeast Iowa Medical Education Foundation Inc. The President/Chief Executive Officer of each of the Members are automatically, by virtue of their office, Directors of this corporation. The Executive Director of the Northeast Iowa Medical Education Foundation, Inc. serves on the Board. A representative of the University of Iowa College of Medicine serves on the Board as appointed by the Dean of the College. Each Member appoints to the Board of Directors two persons who are members of the medical staff of the appointing Member, and two persons who are also directors of the appointing Member, or an affiliated organization of such appointing Member. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is made available to the governing body. The Executive Director and Administrator review the 990 before it is filed. |
| Form 990, Part VI, Section B, line 12c | Board members and officers are required to sign a conflict of interest statement annually. The statements are reviewed by the Administrator of the organization. Any potential conflict is brought to the Board's attention for discussion. In the event of a potential conflict, the Member will disclose the potential conflict and either abstain from involvement or discussion of the issue leading to the conflict or resign. |
| Form 990, Part VI, Section B, line 15a | The Executive Director's compensation is determined by the Executive Committee of the Board with salary adjustment recommendations based on an annual individual performance evaluation and review of Medical Group compensation surveys published by MGMA, AMGA, and University of Iowa compensation survey of Iowa medical residency programs including size of groups, ownership, productivity, and geographic area. The Executive Director determines the Administrator's compensation based on the above process. The Organization documents and provides substantiation for their compensation process. The process for determining compensation for the Executive Director and Administrator was completed in fiscal year 2013. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request. |
Comments