VNA HOSPICE OF SOUTHWEST IOWA: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- VNA HOSPICE OF SOUTHWEST IOWA (EIN 47-0733773)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201441349349301419
- 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 | 2014-05-14T09:00:33-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470757164 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT CREIGHTON HEALTH | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 W DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | 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 | 470733773 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF SOUTHWEST IOWA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 4023434413 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EMMET TINLEY | Name |
| Title | CHAIR | Title |
| Date Signed | 2014-05-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Angela Lea | Name |
| PTIN | P01051055 | PTIN |
| Phone | 4023434413 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMMET TINLEY | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 EAST KANESVILLE BLVD | AddressLine1 |
| City | COUNCIL BLUFFS | City |
| State | IA | State |
| ZIP Code | 51503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1734123 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HOSPICEOFSOUTHWESTIOWA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | A COMMUNITY WHERE ALL INDIVIDUALS AND FAMILIES HAVE ACCESS TO IMPECCABLE END OF LIFE CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 31 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 42812 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 52828 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1584740 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1678936 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 155 | InvestmentIncomePriorYear |
| Investment Income Current Year | 262 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2097 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1627707 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1734123 | 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 | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | 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 | 1480053 | OtherExpensePriorYear |
| Other Expenses Current Year | 1654471 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1480053 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1654471 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 147654 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 79652 | RevenuesLessExpensesCY |
| Total Assets BOY | 1326165 | TotalAssetsBOY |
| Total Assets EOY | 1376410 | TotalAssetsEOY |
| Total Liabilities BOY | 39108 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16302 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1287057 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1360108 | NetAssetsOrFundBalancesEOY |
| Mission Description | CHERISHING LIFE'S JOURNEY THROUGH AN EXTRAORDINARY COMMITMENT TO COMPASSION, COMFORT AND HOLISTIC CARE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1322948 | Expense |
| Grants | 0 | Grants |
| Revenue | 1678936 | Revenue |
| Description | HOSPICE OF SOUTHWEST IOWA IS A MEDICARE CERTIFIED HOSPICE PROGRAM THAT SERVES PATIENTS WHO HAVE BEEN DIAGNOSED WITH A LIFE LIMITING CONDITION. THE PROGRAM SERVES PATIENTS THAT RESIDE IN SEVEN SOUTHWEST IOWA COUNTIES. THE MAIN OFFICE IS LOCATED IN COUNCIL BLUFFS WITH A MULTI-SITE LOCATION IN CORNING, IOWA. HOSPICE OF SOUTHWEST IOWA PLANS TO BUILD AN INPATIENT HOSPICE FACILITY UPON THE COMPLETION OF A COMMUNITY CAPITAL CAMPAIGN. | Description |
| Total Program Service Expense | 1322948 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMMET TINLEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7123521389 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 427 EAST KANESVILLE BLVD | AddressLine1 |
| City | COUNCIL BLUFFS | City |
| State | IA | State |
| ZIP Code | 51503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| EMMET TINLEY | |||||||
| CHAIRMAN | 1.00 | 0 | X | X | 0 | 0 | 0 |
| MARIE KNEDLER | |||||||
| SECRETARY/TREASURER | 1.00 | 0 | X | X | 0 | 0 | 0 |
| HELEN BLEICHER | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| JAMES SUMMERFELT | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| KATHRYNE CUTLER | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| MARIE FERNANDEZ | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| MIKE ADAMS | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| SUSAN TINLEY | |||||||
| DIRECTOR | 1.00 | 0 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT CREIGHTON HEALTH | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | MANAGEMENT SERVICES | DescriptionOfServices |
| Compensation | 1077409 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Government Grants | 22534 | GovernmentGrants |
| All Other Contributions | 30294 | AllOtherContributions |
| Total Contributions | 52828 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICES | 621500 | 1678936 | 1678936 |
| 0 | |||
| 0 | |||
| 0 | |||
| 0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1678936 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 262 | TotalRevenueColumn |
| Exclusion | $262 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISC REVENUE | 900099 | 2097 | $2,097 |
| 0 | |||
| 0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2097 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1734123 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1678936 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,359 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1077409 | Total |
| Program Services | 754186 | ProgramServices |
| Management And General | 323223 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8300 | Total |
| Management And General | 8300 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20050 | Total |
| Program Services | 20050 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5102 | Total |
| Program Services | 5102 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167268 | Total |
| Program Services | 167268 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29936 | Total |
| Program Services | 29936 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38515 | Total |
| Program Services | 38515 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5391 | Total |
| Program Services | 5391 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1659 | Total |
| Program Services | 1659 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27549 | Total |
| Program Services | 27549 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| BAD DEBTS | 2588 | 2588 |
| PURCHASED SERVICES | 257922 | 257922 |
| MEMBERSHIP & DUES | 3809 | 3809 |
| SPECIAL EVENTS | 8121 | 8121 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 852 | Total |
| Program Services | 852 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1654471 | Total |
| Program Services | 1322948 | ProgramServices |
| Management And General | 331523 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97048 | BOY |
| EOY | 152323 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90516 | BOY |
| EOY | 68260 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200025 | BOY |
| EOY | 138076 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 692008 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7787 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 685880 | BOY |
| EOY | 684221 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 150000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 252696 | BOY |
| EOY | 183530 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1326165 | BOY |
| EOY | 1376410 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39108 | BOY |
| EOY | 16302 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39108 | BOY |
| EOY | 16302 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1010995 | BOY |
| EOY | 1088475 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 276062 | BOY |
| EOY | 271633 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1287057 | BOY |
| EOY | 1360108 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1326165 | BOY |
| EOY | 1376410 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 79652 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -6601 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
| Federal Grant Audit Required | false | 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 | 100318 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 135077 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 77831 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 42812 | CurrentTaxYearMinus1Year |
| Current Tax Year | 52828 | CurrentTaxYear |
| Total | 408866 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1205838 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1176118 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1521137 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1584740 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1678936 | CurrentTaxYear |
| Total | 7166769 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1306156 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1311195 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1598968 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1627552 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1731764 | CurrentTaxYear |
| Total | 7575635 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 31000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 31000 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 31000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 31000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 7544635 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5749 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 322 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 653 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 155 | CurrentTaxYearMinus1Year |
| Current Tax Year | 262 | CurrentTaxYear |
| Total | 7141 | Total |
Post1975 UBTI Post1975UBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5749 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 322 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 653 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 155 | CurrentTaxYearMinus1Year |
| Current Tax Year | 262 | CurrentTaxYear |
| Total | 7141 | Total |
Net Income From Other UBI NetIncomeFromOtherUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 216 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2275 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2097 | CurrentTaxYear |
| Total | 4588 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1311905 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1311733 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1601896 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1627707 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1734123 | CurrentTaxYear |
| Total | 7587364 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99440 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99220 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00090 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00390 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART III, LINE 12, OTHER INCOME, DESCRIPTION - OTHER OPERATING INCOME, COLUMN A - , COLUMN B - 216, COLUMN C - 2275, COLUMN D - , COLUMN E - 2097, COLUMN F - 4588; | GeneralExplanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 276062 | BeginningOfYearBalance |
| Contributions | 2172 | Contributions |
| Administrative Expenses | 6601 | AdministrativeExpenses |
| End Of Year Balance | 271633 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 258118 | BeginningOfYearBalance |
| Contributions | 17944 | Contributions |
| End Of Year Balance | 276062 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 667563 | BeginningOfYearBalance |
| Contributions | 33972 | Contributions |
| Other Expenditures | 443417 | OtherExpenditures |
| End Of Year Balance | 258118 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 590336 | BeginningOfYearBalance |
| Contributions | 110765 | Contributions |
| Other Expenditures | 33538 | OtherExpenditures |
| End Of Year Balance | 667563 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 673447 | BeginningOfYearBalance |
| Contributions | 75193 | Contributions |
| Other Expenditures | 158304 | OtherExpenditures |
| End Of Year Balance | 590336 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 206000 | OtherCostOrOtherBasis |
| Book Value | 206000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11096 | OtherCostOrOtherBasis |
| Depreciation | 7787 | Depreciation |
| Book Value | 3309 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 474912 | OtherCostOrOtherBasis |
| Book Value | 474912 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 684221 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM AFFILIATE | Description |
| Book Value | 183530 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 183530 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Intended uses of endowment funds | Identifier |
| Return Reference | Schedule D, Part V, Line 4 | ReturnReference |
| Explanation | ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF HOSPICE OF SOUTHWEST IOWA. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FORM 990, PART V, LINE 1A | FORM 990, PART V, LINE 1A | AS PART OF THE COORDINATION OF SERVICES AGREEMENT WITH ALEGENT CREIGHTON HEALTH, ALEGENT CREIGHTON HEALTH PERFORMS THE ACCOUNTS PAYABLE FUNCTION FOR HOSPICE OF SOUTHWEST IOWA. HOSPICE OF SOUTHWEST IOWA REIMBURSES ALEGENT CREIGHTON HEALTH FOR VENDOR PAYMENTS; THEREFORE, NO FORM 1099'S ARE ISSUED BY HOSPICE OF SOUTHWEST IOWA. ALEGENT CREIGHTON HEALTH ISSUES THE FORM 1099'S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. ANY 1099'S ISSUED BY ALEGENT CREIGHTON HEALTH ON BEHALF OF HOSPICE OF SOUTHWEST IOWA AR REPORTED TO THE IRS. |
| FORM 990, PART I, LINE 5 AND PART V, LINE 2A | FORM 990, PART V, LINE 2A | HOSPICE OF SOUTHWEST IOWA DOES NOT HAVE ANY EMPLOYEES. INDIVIDUALS PROVIDING SERVICES TO PATIENTS OF HOSPICE OF SOUTHWEST IOWA ARE LEASED FROM ALEGENT CREIGHTON HEALTH. |
| Family/business relationships amongst interested persons | Form 990, Part VI, Section A, Line 2 | EMMET TINLEY AND SUSAN TINLEY - FAMILY RELATIONSHIP, KATHRYNE CUTLER, SUSAN TINLEY, JAMES SUMMERFELT AND EMMET TINLEY - BUSINESS RELATIONSHIP |
| Delegation of management duties | Form 990, Part VI, Section A, Line 3 | HOSPICE OF SOUTHWEST IOWA ENTERED INTO A COORDINATION OF SERVICES AGREEMENT WITH ALEGENT CREIGHTON HEALTH FOR ALEGENT CREIGHTON HEALTH TO PERFORM AND MANAGE FINANCIAL SERVICES FOR A MONTHLY FEE. SERVICES INCLUDE BUT ARE NOT LIMITED TO FINANCIAL REPORTING, BUDGETING, BILLING AND COLLECTION, FIXED ASSET MANAGEMENT AND TAX RETURN PREPARATION. IN ADDITION TO FINANCIAL SERVICES, ALEGENT CREIGHTON HEALTH PROVIDES INFORMATION SYSTEMS SUPPORT, SECURITY, RISK MANAGEMENT AND CORPORATE COMPLIANCE, PURCHASING, MAINTENANCE AND VARIOUS OTHER SUPPORT SERVICES. IN ADDITION, HOSPICE OF SOUTHWEST IOWA LEASES ALL EMPLOYEES FROM ALEGENT CREIGHTON HEALTH. ALEGENT CREIGHTON HEALTH IS THE PARENT OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM, ONE OF HOSPICE OF SOUTHWEST IOWA CORPORATE MEMBERS. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE CORPORATE MEMBERS OF HOSPICE OF SOUTHWEST IOWA ARE ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION POTTAWATTAMIE COUNTY, IOWA SHALL APPOINT ONE HALF OF THE VOTING MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF EACH MEMBER'S APPOINTMENTS BY THE OTHER MEMBER. IF A CORPORATE MEMBER DOES NOT RATIFY THE APPOINTMENT OF ONE OR MORE OF THE DIRECTORS APPOINTED BY THE OTHER CORPORATE MEMBER, THEN THE PROCESS SET FORTH ABOVE WILL BE REPEATED UNTIL SUCH TIME AS ALL OF THE DIRECTOR POSITIONS ARE FILLED. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | THE BUSINESS AFFAIRS OF HOSPICE OF SOUTHWEST IOWA SHALL BE MANAGED BY OR UNDER THE DIRECTION OF THE BOARD OF DIRECTORS EXCEPT THAT THE FOLLOWING ACTIONS SHALL BE EFFECTIVE ONLY IF APPROVED BY THE BOARD OF DIRECTORS OF THE CORPORATION AND BY BOTH ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA: 1. ADOPTION OR AMENDMENT OF THE UNIFIED PHILOSOPHY AND MISSION. 2. THE SALE, LEASE, TRANSFER, ENCUMBRANCE OR DISPOSITION OF THE TANGIBLE PROPERTY OR INVESTMENTS OF THE CORPORATION HAVING A FAIR MARKET VALUE IN ANY INDIVIDUAL TRANSACTION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000) OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA. 3. INCURRENCE, ASSUMPTION OR GUARANTY BY THE CORPORATION IN ANY INDIVIDUAL TRANSACTION OF LONG-TERM INDEBTEDNESS, INCLUDING CAPITAL LEASES OUTSTANDING FOR MORE THAN 365 DAYS, IN EXCESS OF THE GREATER OF FIVE HUNDRED THOUSAND DOLLARS ($500,000), OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA. 4. MERGER, DISSOLUTION, CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, EXCEPT FOR A MERGER IN WHICH HOSPICE OF SOUTHWEST IOWA IS THE SURVIVING ENTITY, AND THE TOTAL BOOK VALUE OF THE ASSETS OF THE MERGING ENTITY DOES NOT EXCEED TWENTY-FIVE PERCENT OF THE TOTAL BOOK VALUE OF THE ASSETS OF THE CORPORATION, OR SUCH GREATER VALUE AS MAY BE DETERMINED FROM TIME TO TIME BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | HOSPICE OF SOUTHWEST IOWA AND ALEGENT CREIGHTON HEALTH HAVE A COORDINATION OF SERVICE AGREEMENT IN WHICH ALEGENT PROVIDES THE ACCOUNTING AND FINANCE FUNCTIONS FOR HOSPICE OF SOUTHWEST IOWA FOR A MONTHLY FEE. THE TAX DEPARTMENT OF ALEGENT CREIGHTON HEALTH PREPARES THE FORM 990 FOR HOSPICE OF SOUTHWEST IOWA. FOLLOWING THE PREPARATION OF FORM 990 BY ALEGENT CREIGHTON HEALTH INTERNAL TAX STAFF, THE RETURN IS REVIEWED BY THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND HOSPICE OF SOUTHWEST IOWA'S MANAGEMENT. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED AN ELECTRONIC VERSION OF THE FINAL TAX RETURN AND ALL REQUIRED SCHEDULES. QUESTIONS ARE REFERRED TO THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND THE BOARD IS NOTIFIED OF THE DATE THE TAX RETURN WILL BE FILED. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | WRITTEN CONFLICT OF INTEREST POLICY - HOSPICE OF SOUTHWEST IOWA HAS ADOPTED THE CONFLICT INVESTIGATION PROCESS OF ALEGENT CREIGHTON HEALTH. ANNUAL COMPLETION OF THE DISCLOSURE STATEMENT IS REQUIRED BY THE BOARD OF DIRECTORS. STATED DISCLOSURES ARE INVESTIGATED BY AN APPOINTED DISINTERESTED PERSON OR COMMITTEE THAT IS SELECTED BY THE CHAIRMAN OF THE BOARD. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION. FINALLY, THE BOARD MAKES ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGMENT IN CONFORMITY WITH SUCH DETERMINATION. AT ANY TIME A BOARD MEMBER MAY DECLARE A CONFLICT OF INTEREST AND RECUSE HIM/HERSELF FROM THE DISCUSSION. THE INDIVIDUAL IS ALSO REQUIRED TO DISCLOSE ANY KNOWN OR POSSIBLE CONFLICTS OF INTEREST THAT ARISE DURING THE CALENDAR YEAR. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | HOSPICE OF SOUTHWEST IOWA HAS ADOPTED THE CONFLICT OF INTEREST POLICY OF ALEGENT CREIGHTON HEALTH, WHICH IS AVAILABLE TO THE PUBLIC AT WWW.ALEGENTCREIGHTON.COM. HOSPICE OF SOUTHWEST IOWA DOES NOT MAKE THE GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. HOWEVER, THE ARTICLES OF INCORPORATION ARE AVAILABLE AT WWW.SOS.STATE.NE.US. |
| Other changes in net assets or fund balances | Form 990 , Part XI, Line 9 | NET ASSETS RELEASED FROM RESTRICTIONS - -6601; |
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