UNITYPOINT AT HOME: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
UNITYPOINT AT HOME (EIN 42-1477471)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201343189349300114
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

FieldValueIRS element (for citing)
Timestamp2013-11-14T06:51:42-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN421477471EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INTRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlINTRNameControl
Phone5155573100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line111333 AURORA AVENUEAddressLine1
CityURBANDALECity
StateIAState
ZIP Code50322ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCRAIG R FLANAGANName
TitleVP/CFOTitle
Phone5155573100Phone
Date Signed2013-11-07DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1IOWA HEALTH HOME CAREBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonPHYLLIS STADTLANDERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line111333 AURORA AVENUEAddressLine1
CityURBANDALECity
StateIAState
ZIP Code50322ZIPCode
FieldValueIRS element (for citing)
Gross Receipts131813395GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UNITYPOINT.ORG/HOMECARE/DEFAULT.ASPXWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH HEALING, CARING AND TEACHING.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees1415TotalNbrEmployees
Total Nbr Volunteers4TotalNbrVolunteers
Total Gross UBI223603TotalGrossUBI
Net Unrelated Business Txbl Income23926NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1683428ContributionsGrantsPriorYear
Contributions Grants Current Year1582335ContributionsGrantsCurrentYear
Program Service Revenue Prior Year87480501ProgramServiceRevenuePriorYear
Program Service Revenue CY94449881ProgramServiceRevenueCY
Investment Income Prior Year669710InvestmentIncomePriorYear
Investment Income Current Year2691756InvestmentIncomeCurrentYear
Other Revenue Prior Year30197OtherRevenuePriorYear
Other Revenue Current Year51553OtherRevenueCurrentYear
Total Revenue Prior Year89863836TotalRevenuePriorYear
Total Revenue Current Year98775525TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year8104GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY6395GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year60525210SalariesEtcPriorYear
Salaries Etc Current Year61474943SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year32048TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY25764TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year145978TotalFundrsngExpCurrentYear
Other Expense Prior Year27821518OtherExpensePriorYear
Other Expenses Current Year30247216OtherExpensesCurrentYear
Total Expenses Prior Year88386880TotalExpensesPriorYear
Total Expenses Current Year91754318TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1476956RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7021207RevenuesLessExpensesCY
Total Assets BOY43905187TotalAssetsBOY
Total Assets EOY52234377TotalAssetsEOY
Total Liabilities BOY11832790TotalLiabilitiesBOY
Total Liabilities EOY13845776TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32072397NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY38388601NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH HEALING, CARING AND TEACHING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense67620692Expense
Grants6395Grants
Revenue94515384Revenue
DescriptionHEALTH CARE SERVICESINTRUST PROVIDES HOME HEALTH SERVICES FOR PEOPLE IN NEED WITH THE PURPOSE TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. HIGHEST PRIORITY IS GIVEN TO LOW-INCOME INDIVIDUALS BUT SERVICES ARE AVAILABLE TO ALL RESIDENTS. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. HOME HEALTH CARE SERVICES PROVIDED AND PEOPLE SERVED MAY INCLUDE BUT ARE NOT LIMITED TO: CASE MANAGEMENT, CERTIFIED NURSING, PRIVATE DUTY NURSING, PALLIATIVE CARE, HOSPICE, INFUSION SERVICES, HOME MEDICAL EQUIPMENT, LIFELINE, MATERNAL HEALTH CLINICS, NURSING CARE, SUPPORT TO HIGH RISK NEW PARENTS AND NEWBORNS, PARENTING SUPPORT, CHILD HEALTH CLINICS, HEALTH MAINTENANCE VISITS AND SCREEENINGS, IMMUNIZATION CLINICS, SENIOR CITIZENS, DISABLED, ILL, HANDICAPPED AND TERMINALLY ILL. SERVICES MAY BE PROVIDED ON A ONE-TIME, INTERMITTENT, PART-TIME OR LONG-TERM BASIS. INTRUST MADE 206,946 HOME VISITS IN 2012.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7131062Expense
Grants0Grants
Revenue0Revenue
DescriptionCOMMUNITY BENEFITSINTRUST PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL OF IMPROVING THE COMMUNITY'S HEALTH AND ACCESS TO CARE. THIS INCLUDES PROVIDING HEALTH CARE SERVICES REGARDLESS OF A PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE TO 231 PATIENTS AT A VALUE OF $222,392 IN 2012. OFTENTIMES, INTRUST RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN ITS CHARGES FOR SERVICES. INTRUST PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. INTRUST'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COSTS IS $6,426,134 FOR 2012. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $6,648,526.OTHER BENEFITS: INTRUST PROVIDES SEVERAL ADDITIONAL HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS THAT SUPPORT ITS MISSION OF IMPROVING THE HEALTH OF ITS COMMUNITY THROUGH HEALING, CARING AND TEACHING. PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: PREVENTION AND HEALTH SCREENINGS; SUBSIDIZED HEALTH SERVICES; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. INTRUST PARTNERS WITH HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND CHILDCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. APPROXIMATELY 22,971 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS PREPORTED VALUE: $482,536.Description
FieldValueIRS element (for citing)
Total Program Service Expense74751754TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096229NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1415NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CRAIG R FLANAGAN VPCFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5155573100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line111333 AURORA AVENUEAddressLine1
CityURBANDALECity
StateIAState
ZIP Code50322ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
PASTOR STACIE FIDLAR
BOARD MEMBER1.000.00X000
PHIL GUNDERSON
BOARD SECRETARY1.000.00X000X
NORMA HAGENOW
BOARD VICE CHAIR1.000.00X000X
BERGEN PETERSON
BOARD MEMBER1.0040.00X014139215460
MARIA ISABEL PINEIRO VAN DORN
BOARD MEMBER1.000.00X000
MARK PURTLE MD
BOARD CHAIR1.0040.00X0516110198681X
RICH WELLMAN
BOARD MEMBER1.000.00X000
GARY BARGSTADT
VP/COO40.000.00176355015019X
SANDRA DIELEMAN
VP/CFO/CAO40.000.00189817029975X
PHYLLIS STADTLANDER
PRESIDENT/CEO40.000.00242439028446X
ALAN KAPLAN
CHIEF MEDICAL OFFICER1.0040.000799880202490X
MONIQUE REESE
VP/CHIEF CLINICAL OFFICER40.000.0023190408522X
TIMOTHY HACKBART
EXEC DIR SIOUX CITY40.000.00110072024585X
TODD RICHARD
EXEC DIR TVNHA40.000.00120479028319X
MARISSA SMITH
CHIEF COMPLIANCE OFFICER40.000.00106986034247X
TAMMY STAPP
VP OPERATIONS40.000.00136720026831X
PATRICK WALTER
PHARMACIST40.000.00110428027473X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1425200TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1457382TotalReportableCompFrmRltdOrgs
Total Other Compensation640048TotalOtherCompensation
Number Individuals GT100 K14NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
TRUECARE LLC
PO BOX 7585URBANDALEIA50323STAFFING AGENCY1554813
LIFELINE SYSTEMS INC
PO BOX 846071BOSTONMA022846071MONITORING SERVICE664469
A-1 CAREERS INC
PO BOX 25830SHAWNEE MISSIONKS66225STAFFING AGENCY530034
VERIZON WIRELESS
151 COLLINS RD NECEDAR RAPIDSIA52402PHONE SERVICE452771
MAXIM HEALTHCARE SERVICES
12558 COLLECTIONS CENTER DRCHICAGOIL60693STAFFING AGENCY364776
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Related Organizations831765RelatedOrganizations
Government Grants489706GovernmentGrants
All Other Contributions260864AllOtherContributions
Total Contributions1582335TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
HOME HEALTH CARE SVCS6216109259858892383462215126
MGMT & SUPPORT SVCS56100017517001751700
SUBS & JOINT VENTURES90009999593911168477
FieldValueIRS element (for citing)
Total Program Service Revenue94449881TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column505849TotalRevenueColumn
Related Or Exempt Function Income13950RelatedOrExemptFunctionIncome
Exclusion$491,899ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities35223777Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities32945808Securities
Other92062Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2277969Securities
Other-92062Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2185907TotalRevenueColumn
Exclusion$2,185,907ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column51553TotalRevenueColumn
Related Or Exempt Function Income51553RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue51553TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column98775525TotalRevenueColumn
Related Or Exempt Function Income94291781RelatedOrExemptFunctionIncome
Unrelated Business Revenue223603UnrelatedBusinessRevenue
Exclusion$2,677,806ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total6395Total
Program Services6395ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total922476Total
Management And General922476ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total49047150Total
Program Services40622007ProgramServices
Management And General8346468ManagementAndGeneral
Fundraising78675Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1756059Total
Program Services1438615ProgramServices
Management And General313577ManagementAndGeneral
Fundraising3867Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6398963Total
Program Services5299165ProgramServices
Management And General1088801ManagementAndGeneral
Fundraising10997Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3350295Total
Program Services2774625ProgramServices
Management And General570092ManagementAndGeneral
Fundraising5578Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total873957Total
Program Services12534ProgramServices
Management And General861423ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3855Total
Management And General3855ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total25764Total
Fundraising25764Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total126740Total
Management And General126740ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4185139Total
Program Services3734148ProgramServices
Management And General441314ManagementAndGeneral
Fundraising9677Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total83256Total
Program Services21926ProgramServices
Management And General61330ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1787887Total
Program Services1456782ProgramServices
Management And General331073ManagementAndGeneral
Fundraising32Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3291222Total
Program Services2127580ProgramServices
Management And General1163642ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1587615Total
Program Services234093ProgramServices
Management And General1353522ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1591094Total
Program Services1351421ProgramServices
Management And General239237ManagementAndGeneral
Fundraising436Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total40515Total
Program Services8189ProgramServices
Management And General32326ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total43922Total
Management And General43922ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2025567Total
Program Services1561810ProgramServices
Management And General463757ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total329634Total
Program Services2554ProgramServices
Management And General327080ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES13268724132620856639
BAD DEBT EXPENSE678481678481
MISCELLANEOUS EXPENSE30160815934413131210952
INCOME TAXES2800028000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total91754318Total
Program Services74751754ProgramServices
Management And General16856586ManagementAndGeneral
Fundraising145978Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY297386BOY
EOY3296843EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2081916BOY
EOY2523353EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15573009BOY
EOY17669962EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1836364BOY
EOY2248335EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1031231BOY
EOY1255178EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY38658BOY
EOY101223EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18426308LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11906767LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6307266BOY
EOY6519541EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16183091BOY
EOY18102500EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY556266BOY
EOY517442EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY43905187BOY
EOY52234377EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7993949BOY
EOY9518738EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
EOY551502EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY751840BOY
EOY695861EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3087001BOY
EOY3079675EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11832790BOY
EOY13845776EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY31720571BOY
EOY38056276EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY351826BOY
EOY332325EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32072397BOY
EOY38388601EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY43905187BOY
EOY52234377EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses7021207ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-705003ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5212CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1050737CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years466442CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1683428CurrentTaxYearMinus1Year
Current Tax Year1582335CurrentTaxYear
Total4788154Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45754426CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years50880911CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years56665265CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year87480501CurrentTaxYearMinus1Year
Current Tax Year93771400CurrentTaxYear
Total334552503Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years28399CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years130210CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years132918CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year30197CurrentTaxYearMinus1Year
Current Tax Year51553CurrentTaxYear
Total373277Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years45788037CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years52061858CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years57264625CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year89194126CurrentTaxYearMinus1Year
Current Tax Year95405288CurrentTaxYear
Total339713934Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509339713934PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years345228CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years472417CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years505399CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year372215CurrentTaxYearMinus1Year
Current Tax Year505849CurrentTaxYear
Total2201108Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years345228CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years472417CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years505399CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year372215CurrentTaxYearMinus1Year
Current Tax Year505849CurrentTaxYear
Total2201108Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years96793CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years126127CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years247834CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year262044CurrentTaxYearMinus1Year
Current Tax Year223603CurrentTaxYear
Total956401Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years46230058CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years52660402CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years58017858CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year89828385CurrentTaxYearMinus1Year
Current Tax Year96134740CurrentTaxYear
Total342871443Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99080PublicSupportPercentage509
Prior Year Support Percentage0.99010PriorYearSupportPercentage
Investment Income Percentage0.00640InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00700PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance351826BeginningOfYearBalance
Contributions783065Contributions
Other Expenditures802566OtherExpenditures
End Of Year Balance332325EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance60422BeginningOfYearBalance
Contributions875890Contributions
Other Expenditures584486OtherExpenditures
End Of Year Balance351826EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance71425BeginningOfYearBalance
Contributions245006Contributions
Other Expenditures256009OtherExpenditures
End Of Year Balance60422EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2007900BeginningOfYearBalance
Contributions199654Contributions
Grants Or Scholarships1965738GrantsOrScholarships
Other Expenditures169379OtherExpenditures
Administrative Expenses1012AdministrativeExpenses
End Of Year Balance71425EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance67543BeginningOfYearBalance
Contributions2298975Contributions
Investment Earnings Or Losses-133563InvestmentEarningsOrLosses
Other Expenditures224220OtherExpenditures
Administrative Expenses835AdministrativeExpenses
End Of Year Balance2007900EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis160000OtherCostOrOtherBasis
Book Value160000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3642913OtherCostOrOtherBasis
Depreciation2035974Depreciation
Book Value1606939BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis14623395OtherCostOrOtherBasis
Depreciation9870793Depreciation
Book Value4752602BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6519541TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$791,633
SELF-INSURANCE RESERVE$1,440,050
HEALTH AND WELFARE BENEFITS RESERVE$532,992
IOWA HEALTH SYSTEM NOTE PAYABLE$315,000
FieldValueIRS element (for citing)
Total Of Amounts3079675TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt98033000TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-705003NetUnrealizedGainsInvestments
Other Revenues20111OtherRevenues
Revenue Not Rptd F990-684892RevenueNotRptdF990
Revenue Subtotal98717892RevenueSubtotal
Investment Expenses Not Included37697InvestmentExpensesNotIncluded
Other Revenues Not Included19936OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt57633RevenueNotRptdOnFinStmt
Total Revenue Per Form99098775525TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt91949000TotExpensesEtcAuditedFinclStmt
Other Expenses Included232379OtherExpensesIncluded
Expenses Not Rptd F990232379ExpensesNotRptdF990
Expenses Subtotal91716621ExpensesSubtotal
Investment Expenses Not Included237697InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt37697ExpensesNotRptdOnFinStmt
Total Expenses Per Form99091754318TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:IOWA HEALTH SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE HEALTH SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. THE HEALTH SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME DURING THE CARRYFORWARD PERIOD. NO INCOME TAX BENEFIT HAS BEEN RECOGNIZED FOR THE NET OPERATING LOSS CARRYFORWARDS OR OTHER POTENTIAL DEFERRED TAX ASSETS IN THE CONSOLIDATED FINANCIAL STATEMENTS BECAUSE THE HEALTH SYSTEM BELIEVES REALIZATION OF THESE BENEFITS IS UNLIKELY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 19,501. ROUNDING 610.
PART XI, LINE 4B - OTHER ADJUSTMENTS:REVENUES IN UNRESTRICTED FUND BALANCE 19,936.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES IN UNRESTRICTED FUND BALANCE 232,290. ROUNDING 89.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeActivityActivityFundraiser Control Of FundsFundraiserControlOfFundsGross ReceiptsGrossReceiptsAmount Retained By ContractorAmountRetainedByContractorNet To OrganizationNetToOrganization
TRINITY HEALTH FOUNDATION
802 KENYON RDFORT DODGEIA50501RECEIPTING OF MEMORIALS/MAILINGS14103239264401059
IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200DES MOINESIA50309RECEIPTING OF MEMORIALS/MAILINGS137274216500356242
FieldValueIRS element (for citing)
Total Gross Receipts783065TotalGrossReceipts
Total Retained By Contractors25764TotalRetainedByContractors
Total Net To Organization757301TotalNetToOrganization
Licensed StatesIALicensedStates
Licensed StatesILLicensedStates

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF FUNDRAISING PAYMENTSIdentifier
Return ReferenceSCHEDULE G, PART I, LINE 2B, COLUMN (V)ReturnReference
ExplanationWE WORK COLLABORATIVELY WITH FUNDRAISERS ON PROJECTS AND METHODS TO RAISE FUNDS. WE HAVE THE ULTIMATE DECISION AS TO METHODS, PROJECTS AND EVENTS THAT ARE DONE. ALL RECEIPTING AND IRS RELATED ISSUES ARE HANDLED BY FOUNDATION STAFF.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BERGEN PETERSON
BOARD MEMBER0108667024174085510683508625015685200
MARK PURTLE MD
BOARD CHAIR034220101022360716730180463018218071479100
GARY BARGSTADT
VP/COO1464950213600850007331076880191374000
SANDRA DIELEMAN
VP/CFO/CAO153189023116013512093190206560219792000
PHYLLIS STADTLANDER
PRESIDENT/CEO2004260270130150000116660167800270885000
ALAN KAPLAN
CHIEF MEDICAL OFFICER0536285020400005959501772380252520100237000
MONIQUE REESE
VP/CHIEF CLINICAL OFFICER17025903814502350006270022520240426000
TAMMY STAPP
VP OPERATIONS11774401897600070910197400163551000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: ALAN KAPLAN $164,738 AND MARK PURTLE $167,963Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (10 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WEST LAKES MEDICAL EQUIPMENT LLC
COMMON BOARD MEMBER/OFFICER488000INVESTMENT AND MANAGEMENT FEES0
(no name)
0
(no name)
0
(no name)
0
(no name)
0
(no name)
0
(no name)
0
(no name)
0
(no name)
0
(no name)
0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 6IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGERS, AND APPOINT BOARD OF DIRECTORS. AFFILIATE ORGANIZATIONS THAT HAVE TRANSFERRED HOME HEALTH OPERATIONS TO THE ORGANIZATION HAVE THE RIGHT TO NOMINATE AT LEAST ONE BOARD MEMBER, SUBJECT TO APPROVAL BY IHS.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2012 FOR THE FOLLOWING INDIVIDUALS: ALAN KAPLAN AND MARK PURTLE, MD. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY A COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ALLEN COLLEGE
1825 LOGAN AVENUEWATERLOOIA50703421351526EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALSIA501(C)(3)170(B)(1) (A)(II)ALLEN HEALTH SYSTEMS INC0
ALLEN HEALTH SYSTEMS INC
1825 LOGAN AVENUEWATERLOOIA50703421201924SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
ALLEN MEMORIAL HOSPITAL CORPORATION
1825 LOGAN AVENUEWATERLOOIA50703420698265HOSPITALIA501(C)(3)170(B)(1) (A)(III)ALLEN HEALTH SYSTEMS INC0
ANAMOSA AREA AMBULANCE SERVICE
101 GRANT WOOD DRIVEANAMOSAIA52205421466284PROVIDE AMBULANCE SERVICESIA501(C)(3)509(A)(2)ST LUKE'SJONES REGIONAL MEDICAL CENTER0
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREETDES MOINESIA50309421233759PROPERTY HOLDING COMPANYIA501(C)(2)CENTRAL IOWA HEALTH SYSTEM0
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421189791SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
CENTRAL IOWA HOSPITAL CORPORATION
1200 PLEASANT STREETDES MOINESIA50309420680452HOSPITALIA501(C)(3)170(B)(1) (A)(III)CENTRAL IOWA HEALTH SYSTEM0
FINLEY TRI-STATES HEALTH GROUP INC
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001421307495SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
HNC SERVICES
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266270987243SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM0
INTRUST
11333 AURORA AVENUEURBANDALEIA50322421477471HOME HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM0
IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200DES MOINESIA50309421467682CHARITABLE FUNDRAISINGIA501(C)(3)509(A)(3), TYPE IIICENTRAL IOWA HEALTH SYSTEM0
IOWA HEALTH SYSTEM
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421435199SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE III0
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
8101 BIRCHWOOD COURTJOHNSTONIA50131421411630PRIMARY HEALTH CARE SERVICESIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUEWATERLOOIA50703421201138CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC0
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111135HEALTHCAREIL501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636510186460FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)METHODIST HEALTH SERVICES CORPORATION0
METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636370661223HEALTHCAREIL501(C)(3)170(B)(1) (A)(III)METHODIST HEALTH SERVICES CORPORATION0
METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111134OFFICE RENTALIL501(C)(3)509(A)(2)METHODIST HEALTH SERVICES CORPORATION0
NELLIE R SHERWOOD TRUST
1026 A AVENUE NECEDAR RAPIDSIA52402426061621PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAYIA501(C)(3)509(A)(3), TYPE IST LUKE'S METHODIST HOSPITAL0
NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED
720 KENYON DRIVEFORT DODGEIA50501420937390MENTAL HEALTH CAREIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVDSIOUX CITYIA51104421019872HOSPITALIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0
SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636376181831FUND SELF-INSURANCE PLANIL501(C)(3)509(A)(3), TYPE IMETHODIST MEDICAL CENER OF ILLINOIS0
SIOUXLAND PACE INC
313 COOK STREETSIOUX CITYIA51103261120134ALL-INCLUSIVE CARE FOR THE ELDERLYIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH RESOURCES
2720 STONE PARK BLVDSIOUX CITYIA51104421059182OUTPATIENT CLINICS AND HEALTHCARE SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH SYSTEM INC
2720 STONE PARK BLVDSIOUX CITYIA51104421294091SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
ST LUKE'S HEALTHCARE
1026 A AVENUE NECEDAR RAPIDSIA52402421487968SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
ST LUKE'S METHODIST HOSPITAL
1026 A AVENUE NECEDAR RAPIDSIA52402420504780HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE0
ST LUKE'SJONES REGIONAL MEDICAL CENTER
1795 HIGHWAY 64 EASTANAMOSAIA52205421487967HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE0
STL CARE COMPANY
1026 A AVENUE NECEDAR RAPIDSIA52402421276632IMPROVE PUBLIC HEALTH SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTHCARE0
THE DUBUQUE VISITING NURSE ASSOCIATION
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680410PUBLIC HEALTH SERVICES/HOME CAREIA501(C)(3)509(A)(2)FINLEY TRI-STATES HEALTH GROUP INC0
THE FINLEY HOSPITAL
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680354HOSPITALIA501(C)(3)170(B)(1) (A)(III)FINLEY TRI-STATES HEALTH GROUP INC0
THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
2701 17TH STREETROCK ISLANDIL61201363678909MENTAL HEALTH CAREIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRIMARK PHYSICIANS GROUP
802 KENYON ROADFORT DODGEIA50501453791448SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICESIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
TRINITY BUILDING CORPORATION
802 KENYON ROADFORT DODGEIA50501421376187PROPERTY HOLDING COMPANYIA501(C)(2)TRINITY HEALTH SYSTEMS INC0
TRINITY HEALTH FOUNDATION
802 KENYON ROADFORT DODGEIA50501421222381CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)TRINITY HEALTH SYSTEMS INC0
TRINITY HEALTH FOUNDATION
2701 17TH STREETROCK ISLANDIL61201363321751CHARITABLE FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY HEALTH SYSTEMS INC
802 KENYON ROADFORT DODGEIA50501421222877SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY MEDICAL CENTER
2701 17TH STREETROCK ISLANDIL61201362739299HOSPITALIL501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY REGIONAL HEALTH SYSTEM
2701 17TH STREETROCK ISLANDIL61201363351952SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY REGIONAL HOSPITAL AUXILIARY
802 KENYON ROADFORT DODGEIA50501426081474CHARITABLE FUNDRAISING AND VOLUNTEER SERVICESIA501(C)(3)509(A)(2)TRINITY REGIONAL MEDICAL CENTER0
TRINITY REGIONAL MEDICAL CENTER
802 KENYON ROADFORT DODGEIA50501421009175HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
UNITY HEALTHCARE
1518 MULBERRY AVENUEMUSCATINEIA52761420680337HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
UNITY HEALTHCARE FOUNDATION
1518 MULBERRY AVENUEMUSCATINEIA52761421525031SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE ITRINITY REGIONAL HEALTH SYSTEM0

Form990 Schedule R Part III Form990ScheduleRPartIII (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNACode VCodeVAmount
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC
1825 LOGAN AVEWATERLOOIA50703453237125ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESIAALLEN MEMORIAL HOSPITAL CORPORATIONRELATED12618543766010.20000
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT STDES MOINESIA50309273625869CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIACENTRAL IOWA HOSPITAL CORPORATIONRELATED26134080230010.20000
CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY
1200 PLEASANT STREETDES MOINESIA50309453017991ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICESIACENTRAL IOWA HOSPITAL CORPORATIONRELATED201563101327010.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT STDES MOINESIA50309382622972PARKING DECK OPERATIONSIACENTRAL IOWA HEALTH PROP CORPRELATED1033046011.00000
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500DUBUQUEIA52001201597161AMBULATORY SURGERY CENTERIATHE FINLEY HOSPITALRELATED636788274391000.51000
ENSEVA - HIAWATHA LLC
755 METZGER DRIVEHIAWATHAIA52233453437363COLLOCATION FACILITYIAIOWA HEALTH SYSTEMRELATED-1507302077107000.52000
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVEDUBUQUEIA52001422808785SURGERY DEPARTMENT MANAGEMENT SERVICESIATHE FINLEY HOSPITALRELATED110302155255010.50000
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVEDUBUQUEIA52001421428503PROVIDE ACCESS TO LICENSED SOFTWAREIATHE FINLEY HOSPITALRELATED14037010.50000
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NECEDAR RAPIDSIA52402391894290INVESTMENT VEHICLE OWNING CLINICAL JVSIAUNRELATED85147837296000.55670N/A$70,249
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAYWEST DES MOINESIA50266263293530PRIMARY CARE CLINICIACENTRAL IOWA HOSPITAL CORPORATIONRELATED-186843186116010.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421511142GROUP PURCHASINGIAIOWA HEALTH SYSTEMRELATED32786577072097111.00000
MEDICAL LABORATORIES OF EASTERN IOWA LC
1026 A AVE NECEDAR RAPIDSIA52402421359640MEDICAL LABORATORY SERVICESIAST LUKE'S METHODIST HOSPITALRELATED4664101180716010.50000
MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
221 NE GLEN OAK AVEPEORIAIL61636461219459ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESILMETHODIST MEDICAL CENTER OF ILLINOISRELATED32000010.20000
MR ASSOCIATES LLP
1455 SHERMAN ROADHIAWATHAIA52233421260463OWN AND OPERATE MR UNITIAST LUKE'S METHODIST HOSPITALRELATED25260851348049010.33330
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110PEORIAIL61603810584193REHABILATION THERAPYILMETHODIST MEDICAL CENTER OF ILLINOISRELATED3231181122254000.60040
SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC
2720 STONE PARK BLVDSIOUX CITYIA51104455322324CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIANORTHWEST IOWA HOSPITAL CORPORATIONRELATED3039647646010.20000
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SECEDAR RAPIDSIA52403721550812AMBULATORY SURGERY CENTER.IAST LUKE'S METHODIST HOSPITALRELATED32721405076873010.50000
TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
4500 UTICA RIDGE RDBETTENDORFIA52722272562753ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICESIATRINITY MEDICAL CENTERRELATED235523149417010.50000
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREETWEST DES MOINESIA50266271414600ORTHOPEDIC SERVICE LINES MANAGEMENTIACENTRAL IOWA HOSPITAL CORPORATIONRELATED24561716245010.20000

Form990 Schedule R Part IV Form990ScheduleRPartIV (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
BROADBAND INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266273819741INFORMATION TECHNOLOGY MGMT.IAN/AC0
CHARITABLE REMAINDER UNITRUST #1
INVESTMENTIAN/AT0
CHARITABLE REMAINDER UNITRUST #2
INVESTMENTIAN/AT0
CHARITABLE REMAINDER UNITRUST #3
INVESTMENTIAN/AT0
DELHI POINT CONDO ASSOCIATION
350 N GRANDVIEWDUBUQUEIA52001421467002REAL ESTATE MANAGEMENTIAN/AC0
INTEGRATED CARE ORGANIZATION
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266274665007INTEGRATED AFFILIATE CAREIAN/AC0
IOWA HEALTH SYSTEM 457 DEF COMP PLAN
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421435199INVESTMENTIAN/AT0
MEDIMORE INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421414390MANAGED CAREIAN/AC0
METHODIST HEALTH VENTURES INC
PO BOX 87PEORIAIL61650371140939PHARMACY/OFFICE STAFFINGILN/AC0
METHODIST PHYSICIAN SERVICES INC
PO BOX 87PEORIAIL61650363858550MEDICAL SERVICESILN/AC0
PRECEDENCE INC
4622 PROGRESS DRIVE STE ADAVENPORTIA52807371288604MANAGED MENTAL CAREIAN/AC0
PROVIDER RESOURCE MANAGEMENT INC
PO BOX 87PEORIAIL61650371223550RESOURCE MANAGEMENTILN/AC0
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVEDES MOINESIA50316261271143SPECIALTY PHYSICIANS MEDICAL CAREIAN/AC0
STL HEALTH RESOURCES CO
1026 A AVE NECEDAR RAPIDSIA52402421193499PHYSICIAN OFFICE RENTALIAN/AC0
TRINITY HEALTH ENTERPRISES INC
2701 17TH STROCK ISLANDIL61201363320141RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACYILN/AC0
TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD
4622 PROGRESS DRIVE STE ADAVENPORTIA52807363924720MANAGED HEALTH CAREIAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.