2014-11-20T09:24:40-06:00 2014-06-30 450250958 EIDE BAILLY LLP 1545 ASSOCIATES DR STE 101 DUBUQUE IA 52002 990 2013-07-01 421058745 Northeast Iowa Medical Education Foundation Inc NORT 3192722525 2055 Kimball Avenue No 101 Waterloo IA 50702 Anthony A Day Executive Director 3192722525 2014-11-19 1 Carmen Krantz P00031958 5635561790 2014-11-18 2013 2015-11-30 17:44:51Z Anthony A Day 2055 Kimball Avenue No 101 Waterloo IA 50702 7610579 0 X www.familypracticeresidency.org X 1975 IA Developing family medicine physicians through modeling and teaching 12 11 95 78 0 0 3463031 3476368 3873685 4114627 8583 16389 2640 3195 7347939 7610579 0 0 0 0 5140330 5150653 0 0 0 2221090 2459738 7361420 7610391 -13481 188 3620424 3656890 1109775 1146053 2510649 2510837 X Developing excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality. 0 0 6361132 4114627 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 2013-14, five 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, 2014, 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 36 medical students, 14 pharmacy students, two pharmacy residents, two IPPE students, one podiatry student, two podiatry residents, seven athletic training students, two NRP students, and one MD observership. 6361132 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 17 0 1 95 1 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Holly Wolff 3192722538 2055 Kimball Avenue Ste 101 Waterloo IA 50702 Mark Feldkamp DO President 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 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 Jim Lehman MD Director 1.00 X 0 0 0 Anthony A Day MD Executive Director 55.00 X X 263335 0 28613 Greg Nelson Administrator until 5/28/14 45.00 X 131612 0 3984 Robert Friedman MD Undergrad Educ Dir 45.00 X 242166 0 24431 James Poock MD Assistant Program Dir 45.00 X 206141 0 28515 Suzanne Munns MD Assistant Program Director 45.00 X 173538 0 28445 Adam Roise MD Assistant Program Director 45.00 X 199406 0 5750 John Sutherland MD Former highest compensated employee 30.00 X 105391 0 12020 1321589 0 131758 7 1 1 0 Computer Sense Inc 421 Olive Street Cedar Falls IA 50613 Computer services 151950 1 287123 3189245 3476368 Clinic revenue 621110 3604898 3604898 Pharmacy research and 900099 256833 256833 Supporting revenue 900099 149825 149825 Pharmacy residency rei 900099 57948 57948 Quality performance in 900099 45123 45123 4114627 1512 1512 3195 0 3195 3195 3195 14877 0 14877 14877 14877 7610579 4114627 0 19584 454096 454096 3995742 3894347 101395 136508 133031 3477 306520 286561 19959 257787 227946 29841 44 44 13840 13840 358862 321547 37315 86776 86776 431781 314116 117665 215164 42541 172623 320535 320535 82605 9800 72805 12233 12233 221806 221806 127190 127190 Medical supplies 287900 287900 Provision for bad debts 187282 187282 Refund of educ support 56860 56860 Success sharing incenti 56860 56860 7610391 6361132 1249259 0 879945 1087450 684532 454379 377599 420896 30833 20833 88973 99705 3732196 2817055 943776 915141 328402 372055 6364 6431 280000 280000 3620424 3656890 622898 623523 206877 242530 280000 280000 1109775 1146053 X 1906705 2148470 603944 362367 2510649 2510837 3620424 3656890 188 0 X 0 1 X 1 0 X 3444556 3228811 3462921 3463031 3476368 17075687 3467330 3714337 3777963 3873685 4114627 18947942 6911886 6943148 7240884 7336716 7590995 36023629 0 0 0 36023629 1622 4180 3861 3346 4707 17716 1622 4180 3861 3346 4707 17716 6913508 6947328 7244745 7340062 7595702 36041345 0.99950 0.99960 0.00050 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 34252 5309 1389 479 37693 33821 3617 2683 503 34252 35395 155 1246 483 33821 31385 5752 1255 487 35395 1.00000 1 0 2250538 1826648 423890 1481658 990407 491251 915141 Estimated insurance recoveries receivable 280000 280000 Estimated claims liability 280000 280000 X 7423297 -187282 -187282 7610579 0 7610579 7309389 0 7309389 301002 301002 7610391 Part V, Line 4: An endowment fund known as the Charles A. Waterbury, Jr., M.D. Endowment Fund has 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. 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 -187,282. Part XII, Line 4b - Other Adjustments: Success sharing payout included in expenses for Form 990 56,860. Refund of education support included in expenses for Form 990 56,860. Provision for bad debts included in expenses for Form 990 187,282. X X X X 0 0 0 0 0 1 0 0 0 Anthony A Day MD Executive Director 261766 0 1569 0 0 0 11738 0 16875 0 291948 0 0 0 Robert Friedman MD Undergrad Educ Dir 240442 0 1724 0 0 0 11707 0 12723 0 266596 0 0 0 James Poock MD Assistant Program Dir 204872 0 1269 0 0 0 11567 0 16198 0 233906 0 0 0 Suzanne Munns MD Assistant Program Director 172437 0 1101 0 0 0 11622 0 16823 0 201983 0 0 0 Adam Roise MD Assistant Program Director 198347 0 1059 0 0 0 0 0 5750 0 205156 0 0 0 John Sutherland MD Former highest compensated employee 105174 0 217 0 0 0 7807 0 4213 0 117411 0 0 0 Part I, Line 6 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. Dr Adam Roise Student loan advance as part of a recruitment agreement X 50000 20833 0 1 1 20833 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 Pam Delagardelle, Russell Adams, MD, Tim Horrigan, MD, Raja Akbar, MD, and JoAn Headington have a business relationship. Mark Feldkamp, DO, Jack Dusenbery, Angela Townsend, MD, Jim Lehman, MD, and Kim Neumann, 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 2014. 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.