2012-03-02T08:56:33-06:00 2011-06-30 HENJES CONNER & WILLIAMS PC 800 FRANCES BLDG SIOUX CITY IA 51101 990 2010-07-01 421411233 SIOUXLAND REGIONAL CANCER CENTER SIOU 7122529418 PO BOX 5017 SIOUX CITY IA 51102 DANIEL K LAUER 7122529418 2012-03-02 1 MELISSA J WILLER 7122773931 2012-03-02 2010 2016-02-24 21:20:13Z DANIEL K LAUER 230 NEBRASKA ST SIOUX CITY IA 51101 11646328 0 X WWW.NYLENCANCERCENER.COM X 1995 IA PROVIDES THE HIGHEST QUALITY, COMPASSIONATE CANCER CARE THROUGH PREVENTION, TREATMENT, AND RESEARCH FOR THE PEOPLE OF SIOUXLAND. 10 10 22 30 0 0 340588 372101 8196967 8924064 76132 116919 484125 870764 9097812 10283848 0 0 0 0 2341991 2450154 0 0 146502 5962418 6161973 8304409 8612127 793403 1671721 16073257 16757470 10753262 9174134 5319995 7583336 PROVIDES THE HIGHEST QUALITY, COMPASSIONATE CANCER CARE THROUGH PREVENTION, TREATMENT, AND RESEARCH FOR THE PEOPLE OF SIOUXLAND. 0 0 5484371 9492860 PROVIDE DIAGNOSIS, TREATMENT, EDUCATION AND CARE FOR CANCER PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 5484371 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 38 0 22 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 X DAN LAUER 7122529418 230 NEBRASKA STREET PO BOX 5017 SIOUX CITY IA 51101 CHIC WOLFE 0.50 X X 0 0 0 MILT AVERY 1.00 X X 0 0 0 BOB PEEBLES 1.00 X X 0 0 0 PETER THOREEN 1.00 X X 0 0 0 CHARESE YANNEY 1.00 X 0 0 0 MARI KAPTAIN-DAHLEN 0.50 X 0 0 0 LYNN WOLD 0.50 X 0 0 0 STEVE EAVENSON 0.50 X 0 0 0 MARK JOHNSON 0.50 X 0 0 0 RON PETERSON 0.50 X 0 0 0 KAREN VAN DE STEEG 40.00 X 194771 0 20385 DAN LAUER 40.00 X 126442 0 18465 MIKE SHEA 40.00 X 113830 0 24084 435043 0 62934 3 0 1 0 TRI STATE RADIATION ONCOLOGY 230 NEBRASKA STREET SIOUX CITY IA 51101 RADIATION ONCOLOGY PROFESSIONAL SERVICES 1432492 CASSLING 13808 F STREET OMAHA NE 68137 EQUIPMENT MAINTENANCE SERVICES 591867 PYRAMID TECHNOLOGIES 125 6TH ST SIOUX CITY IA 51103 CONTRACT COMPUTER SERVICES, SUPLIES AND 517589 VARIAN MEDICAL SYSTEMS 3100 HANSEN WAY PALO ALTO CA 94304 RADIATION ONCOLOGY SUPPLIES AND EQUIPMEN 239583 ACCELETRONICS INC 602 GORDON DRIVE EXTON PA 19341 EQUIPMENT MAINTENANCE SERVICES 224593 5 372101 6600 372101 PATIENT SERVICE REVENU 621300 8924064 8924064 8924064 87897 87897 361566 170999 190567 190567 190567 1184263 1155241 29022 29022 29022 147641 36240 111401 111401 OTHER REVENUE 900099 545715 545715 OTHER INVESTMENT INCOM 900099 23081 23081 568796 10283848 9492860 0 418887 360063 360063 1546090 975363 501640 69087 131541 64613 62161 4767 282133 138583 133324 10226 130327 67541 57661 5125 38866 38866 2155858 1828307 327551 136550 136270 280 343114 283459 57947 1708 265257 265257 996302 731895 264407 24832 7738 15844 1250 230337 230337 1326414 958077 348749 19588 PATIENT PROGRAM EXPENSE 241044 241044 BAD DEBTS 178206 178206 MISCELLANEOUS 163943 9545 119927 34471 REAL ESTATE TAXES 61250 61250 8612127 5484371 2981254 146502 2291515 1804533 166796 96226 1678653 1593438 263860 274639 17026464 9126577 8814173 7899887 2745171 5017168 113089 71579 16073257 16757470 1938262 1729134 4415000 3045000 4400000 4400000 10753262 9174134 X 5033139 7248168 286856 335168 5319995 7583336 16073257 16757470 X 1671721 591620 X X 0 1 1 X 0 X 1175013 450552 254199 340588 372101 2592453 7381224 8089971 8207718 8196967 8924064 40799944 8556237 8540523 8461917 8537555 9296165 43392397 15000 125000 110000 100000 100000 450000 0 15000 125000 110000 100000 100000 450000 42942397 169132 142632 101382 73818 87898 574862 169132 142632 101382 73818 87898 574862 335311 49636 371474 383128 545715 1685264 9060680 8732791 8934773 8994501 9929778 45652523 0.94060 0.94980 0.01260 0.01550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5780319 3696440 2083879 256330 235578 20752 10973294 5194559 5778735 16521 16521 7899887 MUTUAL FUNDS 814418 F US GOVERNMENT SECURITIES 288253 F CORPORATE SECURITIES/EQUITIES 3830935 F CASH AND EQUIVALENTS 83562 F 5017168 10283848 8612127 1671721 458180 133440 591620 2263341 10874161 458180 170999 629179 10244982 38866 38866 10283848 8744260 170999 170999 8573261 38866 38866 8612127 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: HEALTH, INC. AND ITS SUBSIDIARIES ARE NON-PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, INCOME EARNED IN THE PERFORMANCE OF ITS EXEMPT PURPOSE IS NOT SUBJECT TO INCOME TAX AND ACCORDINGLY, THE FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. MANAGEMENT HAS CONCLUDED THAT ANY UNCERTAIN TAX POSITIONS WOULD BE IMMATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR UNCERTAIN TAX POSITIONS, AND NO RELATED INTEREST OR PENALTIES HAVE BEEN RECORDED IN THE OPERATING STATEMENT OR ACCRUED IN THE BALANCE SHEET. TAX RETURNS OF THE ENTITY ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE DATE THE RETURNS ARE FILED. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION ADJUSTMENT 133,440. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 170,999. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENT EXPENSES 170,999. WINTER BENEFIT 95666 95666 12067 400 5971 RACE FOR HOPE 51975 51975 1800 16002 147641 147641 1800 12067 400 21973 36240 111401 X 1 1 X X X X 0 0 0 0 0 0 0 0 0 KAREN VAN DE STEEG 155706 0 39065 0 0 0 0 0 20385 0 215156 0 0 0 WOODBURY COUNTY IA 426004221 2005-12-30 5300000 PURCHASE OF CANCER TREATMENT EQUIPMENT 0 0 0 2255000 5300000 5300000 2009 0 0 1 1 FORM 990, PART VI, SECTION A, LINE 2 HALF OF THE BOARD WORKS FOR NORTHWEST IOWA HOSPITAL CORPORATION OR IS ON THE NORTHWEST IOWA HOSPITAL CORPORATION BOARD AND HALF OF THE BOARD WORKS FOR MERCY HEALTH SERVICES OR IS ON THE MERCY HEALTH SERVICES BOARD. FORM 990, PART VI, SECTION A, LINE 6 HEALTH INC., NORTHWEST IOWA HOSPITAL CORPORATION AND SUBSIDIARIES, MERCY HEALTH SERVICES AND SUBSIDIARIES FORM 990, PART VI, SECTION A, LINE 7A HOSPITAL BOARDS HAVE TO APPOINT/ELECT THEIR REPRESENTATIVES. FORM 990, PART VI, SECTION A, LINE 7B TRINITY HEALTH AND IOWA HEALTH SYSTEMS HAVE TO APPROVE LARGE CAPITAL PROJECTS FORM 990, PART VI, SECTION B, LINE 11 ORGANIZATION REVIEWED AND SUBMITTED RETURN UPON COMPLETION BY PREPARER FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A FORM DETAILING ANY AND ALL BUSINESS RELATIONSHIPS WITH HEALTH INC AND RELATED ENTITIES. ALL COMPLETED FORMS ARE REVIEWED AND DISCUSSED WITH THE BOARD AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 TOP MANAGEMENT EMPLOYEES PROVIDE INDEPENDENT DOCUMENTATION FROM TRADE SOURCES TO SUBSTANTIATE PAY LEVELS. FORM 990, PART VI, SECTION C, LINE 19 ALL ITEMS ARE AVAILABLE UPON REQUEST CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 458,180. PENSION ADJUSTMENT 133,440. TOTAL TO FORM 990, PART XI, LINE 5: 591,620. FORM 990, PART XI, LINE 2C NO CHANGES HEALTH INC 230 NEBRASKA STREET SIOUX CITY IA 51101 311712115 SERVE AS THE CENTRAL ORGANIZATION FOR OTHER 501(C) (3) ENTITIES IA 501(C)(3) PF 0 SIOUXLAND PACE 313 COOK STREET SIOUX CITY IA 51103 261120134 PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY IA 501(C)(3) 170(B)(1)(A)(III) 0 SIOUXLAND PARAMEDICS 1701 TERMINAL DRIVE SIOUX CITY IA 51105 421185707 MEDICAL TRANSPORTATION SERVICE IA 501(C)(3) 509(A)(3) TYPE I 0 MERCY HEALTH SERVICES 801 FIFTH STREET SIOUX CITY IA 51102 311019872 PROVIDES A FULL CONTINUUM OF WELLNESS, PRIMARY, ACUTE AND TERTIARY SERVICES IA 501(C)(3) 509(A)(3) TYPE III 0 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51101 383320710 PROVIDE COMFORT, SUPPORT, AND COMPASSIONATE CARE TO TERMINALLY ILL PEOPLE AN IA 501(C)(3) 509(A)(3) TYPE I 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 STRIVES TO PROVIDE THE MOST PATIENT-CENTERED CARE IN SIOUXLAND IA 501(C)(3) 509(A)(3) TYPE III 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 HOSPICE OF SIOUXLAND P 105342 SIOUXLAND PACE N 162300 HOSPICE OF SIOUXLAND N 102600 SIOUXLAND PACE P 9766 SIOUXLAND PARAMEDICS N 147300 SIOUXLAND PARAMEDICS O 85100 MERCY HEALTH SERVICES E 3100000 NORTHWEST IOWA HOSPITAL CORPORATION E 3100000 MERCY HEALTH SERVICES O 56626 MERCY HEALTH SERVICES P 119840 NORTHWEST IOWA HOSPITAL CORPORATION O 30287 NORTHWEST IOWA HOSPITAL CORPORATION P 64178