2011-11-15T09:44:30-06:00 2010-12-31 Gronewold Bell Kyhnn & CoPC 1910 East 7th Street Atlantic IA 50022 990 2010-01-01 420933383 GRINNELL REGIONAL MEDICAL CENTER GRIN 6412367511 210 FOURTH AVENUE GRINNELL IA 50112 Todd Linden 6412367511 2011-11-14 1 Christopher J Nelson 7122431800 2010 2016-02-24 21:20:13Z TODD LINDEN 210 FOURTH AVENUE GRINNELL IA 50112 39922799 0 X http://www.grmc.us/index.html X 1967 IA FOR TREATMENT, HEALING, AND CARE OF THE SICK AND DISABLED. 15 14 469 258 2791 -4949 1845308 1624043 38133939 36004865 81788 -9175 1374500 2295531 41435535 39915264 0 0 0 0 23539683 23015699 0 0 129776 17960501 17845639 41500184 40861338 -64649 -946074 39470665 34624485 13217906 12683993 26252759 21940492 FOR TREATMENT, HEALING, AND CARE OF THE SICK AND DISABLED. 0 0 39385195 387855 38298170 THE ORGANIZATION IS A PROSPECTIVE PAYMENT SYSTEM HOSPITAL WITH 49 ACUTE BEDS. THE ORGANIZATION PROVIDES ACUTE AND ANCILLARY SERVICES TO INDIVIDUALS IN AN INPATIENT AND OUTPATIENT SETTING. IN ADDITION, THE ORGANIZATION OPERATES SEVERAL PHYSICIANS' CLINICS. DURING 2010, THE ORGANIZATION PROVIDED 4,209 DAYS OF ACUTE CARE, 414 DAYS OF SKILLED NURSING CARE, 459 NURSERY DAYS AND 47,904 OUTPATIENT OCCASIONS OF SERVICE. 39385195 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 41 0 1 469 0 1 1 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IA X X JACK FRITTS 6412367511 210 FOURTH AVENUE GRINNELL IA 50112 SUSAN WITT 1.00 X X 0 0 0 DEBBY POHLSON 1.00 X X 0 0 0 ED HATCHER 1.00 X X 0 0 0 FRANK BROWNELL 1.00 X X 0 0 0 STANLEY GREENWALD MD 1.00 X X 0 0 0 LAURA M FERGUSON MD 1.00 X 0 0 0 JOANN MANATT 1.00 X 0 0 0 BILL MENNER 1.00 X 0 0 0 LAURA VAN CLEVE DO 1.00 X 0 0 0 KARLA ERICKSON 1.00 X 0 0 0 MICHELLE S REBELSKY MD 1.00 X 0 0 0 TODD REDING 1.00 X 0 0 0 WALLY WALKER 1.00 X 0 0 0 JOANNE YUSKA 1.00 X 0 0 0 TODD LINDEN 40.00 X X 332984 0 50174 JACK FRITTS 40.00 X 154897 0 9977 SUZANNE COONER 40.00 X 182265 0 9977 DAVID NESS 40.00 X 168509 0 9977 CHRISTINE LINDGREN 40.00 X 251086 0 369 JOHN BAMBARA 40.00 X 281210 0 10174 KENNETH WHIPPLE 40.00 X 305881 0 28827 KEVIN EMGE 40.00 X 316193 0 12330 PATRICK COGLEY 40.00 X 211411 0 23030 2204436 0 154835 15 0 1 0 MERCY CLINICAL LAB PO BOX 4867 DES MOINES IA 50305 CLINICAL LAB SERVICES 499367 PHILIPS MEDICAL SYSTEMS PO BOX 847182 DALLAS TX 75284 RADIOLOGY MAINTENANCE 193155 G & K SERVICES 1325 METRO EAST DR PLEASANT HILL IA 50327 LAUNDRY PROVIDER 191229 MEDASSETS 16482 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 COLLECTION SERVICES 182132 GENE GESSNER MD DBA PAIN CLINIC LLC 2180 NORCOR AVE B CORALVILLE IA 52241 ANESTHESIA PROVIDER 174971 12 387855 1236188 1624043 NET PATIENT SERVICE RE 621110 36004865 36004865 36004865 -9740 -9740 8100 7535 565 565 565 OTHER REVENUE 900099 1854654 1854654 HOME HEALTH AGENCY GRA 621300 438086 438086 OUTSIDE LAUNDRY 812300 2791 2791 2295531 39915264 38298170 2791 -9740 838655 154897 683758 16992417 16834827 75379 82211 141393 134721 6020 652 3841647 3660380 163554 17713 1201587 1144891 51156 5540 20393 20393 11628741 11357317 247764 23660 115122 115122 569619 569619 2718408 2718408 PROVISION FOR BAD DEBTS 1910055 1910055 PROFESSIONAL FEES 599481 501138 98343 INSURANCE 237425 237425 POSTAGE 46395 46395 40861338 39385195 1346367 129776 4233665 4399822 10353125 6269593 80000 20000 90426 180568 1268740 1320753 597191 985432 51226087 32778617 20065978 18447470 1542084 1681027 1239456 1319820 39470665 34624485 3478762 3841278 9306734 8455510 432410 387205 13217906 12683993 X 25490103 20788405 666153 1057174 96503 94913 26252759 21940492 39470665 34624485 X -946074 -3366193 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 5042 0 0 5042 0 493179 493179 25583525 13675040 11908485 23237266 17544881 5692385 1912117 1558696 353421 18447470 DUE TO GRMC FOUNDATION 387205 387205 39915264 40861338 -946074 -3366193 -3366193 -4312267 40258583 343319 343319 39915264 0 39915264 40916512 55174 55174 40861338 0 40861338 Part XI, Line 8 - Other Adjustments: CHANGE IN FV OF INTEREST RATE SWAP CONTRACTS CHANGE IN ACCOUNTING ESTIMATE Part XII, Line 2d - Other Adjustments: CHANGE IN FV OF SWAP CONTRACT GRMC FOUNDATION REVENUES HEALTH ADVANTAGE PLUS REVENUES LOSS ON DEER CREEK CLINIC OPERATIONS Part XIII, Line 2d - Other Adjustments: GRMC FOUNDATION MGMT FEES HEALTH ADVANTAGE PLUS EXPENSES 1 1 0 1 X 0 1 1 0 1 1 232774 232774 0.00570 2774312 1995418 778894 0.01910 3007086 1995418 1011668 0.02480 5 7444 614079 87322 526757 0.01290 1 4 2300 2300 0.00010 9 11100 7893700 5714100 2179600 0.05330 5 12832 12832 0.00030 20 18548 8522911 5801422 2721489 0.06660 20 18548 11529997 7796840 3733157 0.09140 1 1110814 8879629 12452666 -3573037 X 1 1 1 1 GRINNELL REGIONAL MEDICAL CENTER

210 4TH AVENUE GRINNELL IA 50112

X X X GRINNELL REGIONAL MEDICAL CENTER 1 1 0 1 1 X 1 1 X X X X 1 X X 1 X X X X X 1 0 1 8 GRINNELL REGIONAL COMMUNITY CARE CLINIC

306 4TH AVENUE GRINNELL IA 50112

CLINIC GRINNELL REGIONAL PAIN CLINIC

210 4TH AVENUE GRINNELL IA 50112

CLINIC GRINNELL HEALTH ALLIANCE

210 4TH AVENUE GRINNELL IA 50112

CLINIC LYNNVILLE CLINIC

30 EAST STREET LYNNVILLE IA 50153

RURAL HEALTH CLINIC NEW SHARON MEMORIAL CLINIC

302 SOUTH PARK NEW SHARON IA 50207

RURAL HEALTH CLINIC DEER CREEK HEALTH CENTER

401 FIRST AVENUE TOLEDO IA 52342

CLINIC POSTELS COMMUNITY HEALTH PARK

807 BROAD STREET GRINNELL IA 50112

CLINIC VICTOR CLINIC

709 2ND STREET VICTOR IA 52347

RURAL HEALTH CLINIC Part III, Line 9b: IF PATIENTS DON'T APPLY FOR ASSISTANCE PRIOR TO SERVICE AND LATER INDICATE THEY ARE HAVING DIFFICULTY PAYING, OUR STAFF WORKS WITH THEM TO FIND THE APPROPRIATE FORM OF ASSISTANCE. GRINNELL REGIONAL MEDICAL CENTER Part V, Section B, Line 21: HOSPITAL DID NOT IMPLEMENT ITS' DISCOUNT FOR UNINSURED PATIENTS UNTIL JANUARY 1, 2011. Part VI, Line 2: POWESHIEK COUNTY RESIDENTS RECENTLY PARTICIPATED IN AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS SURVEY PROVIDED DIRECTION FOR GRINNELL REGIONAL MEDICAL CENTER (GRMC) AND GRINNELL REGIONAL PUBLIC HEALTH OVER THE NEXT FIVE YEARS TO DEVELOP A HEALTH IMPROVEMENT PLAN AND DETERMINE WHAT IS IMPORTANT FOR THE HEALTH OF THE COUNTY. GRMC HAS RECENTLY SURVEYED IT'S COMMUNITY HEALTHCARE PROVIDERS TO IDENTIFY WHAT THEY FEEL ARE THE MOST URGENT NEEDS. WE ALSO REVIEW STATEWIDE DATABASES (I.E. TEEN PREGNANCY, CANCER RATES) TO IDENTIFY AREAS TO CONCENTRATE OUR EFFORTS. Part VI, Line 3: WE HAVE A BROCHURE AVAILABLE THAT IDENTIFIES THE PATIENT ACCOUNTING PHONE NUMBER PATIENTS CAN CALL FOR INFORMATION ABOUT ANY TYPE OF ASSISTANCE. IF PATIENTS DON'T APPLY FOR ASSISTANCE PRIOR TO SERVICE AND LATER INDICATE THEY ARE HAVING DIFFICULTY PAYING, OUR STAFF WORKS WITH THEM TO FIND THE APPROPRIATE FORM OF ASSISTANCE. WE ALSO PLAN TO INCLUDE MORE DETAILED INFORMATION ON OUR WEBSITE. Part VI, Line 4: GRINNELL REGIONAL MEDICAL CENTER(GRMC) IS A PRIVATE, NON-PROFIT AND NON-TAX SUPPORTED MEDICAL CENTER, SERVING MORE THAN 47,000 RESIDENTS IN A SIX-COUNTY RURAL AREA OF EAST CENTRAL IOWA. GRMC IS A PROGRESSIVE, RURAL HOSPITAL LOCATED IN GRINNELL, IOWA. GRINNELL IS 50 MILES EAST OF DES MOINES AND 60 MILES WEST OF IOWA CITY. DES MOINES AND IOWA CITY ARE THE CLOSEST CITIES WITH TERTIARY HOSPITALS FOR OUR SERVICE AREA. MEDIAN HOUSEHOLD INCOME FOR THE AREA IS ESTIMATED AT $46,650, BELOW THE STATE AVERAGE OF $48,065BASED ON STATEWIDE AVERAGES: - 17 PERCENT OF THE PEOPLE IN THIS SERVICE ARE 65 AND OLDER AND USE MEDICARE - 9.5 PERCENT ARE UNINSURED - 27.7 PERCENT USE SOME FORM OF PUBLIC INSURANCE, SUCH AS MEDICAID - 14.1 PERCENT ARE COVERED INDIVIDUALLY - 62.2 PERCENT CARRY EMPLOYER-SPONSORED INSURANCE - SPECIFICALLY, GRMC REPORTS THAT APPROXIMATELY 51 PERCENT OF ITS PATIENTS RELY ON MEDICARE FOR THEIR HEALTH INSURANCE. Reports Filed With States Part VI, Line 7 IA X X 0 1 0 0 0 0 0 0 0 TODD LINDEN 332784 0 200 0 0 0 40000 0 10174 0 383158 0 0 0 JACK FRITTS 154897 0 0 0 0 0 0 0 9977 0 164874 0 0 0 SUZANNE COONER 182065 0 200 0 0 0 0 0 9977 0 192242 0 0 0 DAVID NESS 168309 0 200 0 0 0 0 0 9977 0 178486 0 0 0 CHRISTINE LINDGREN 251086 0 0 0 0 0 369 0 0 0 251455 0 0 0 JOHN BAMBARA 279161 0 2049 0 0 0 0 0 10174 0 291384 0 0 0 KENNETH WHIPPLE 305681 0 200 0 0 0 16497 0 12330 0 334708 0 0 0 KEVIN EMGE 316193 0 0 0 0 0 0 0 12330 0 328523 0 0 0 PATRICK COGLEY 205111 0 6300 0 0 0 10700 0 12330 0 234441 0 0 0 DR LINDGREN X 30000 20000 0 0 1 20000 Form 990, Part VI, Section B, line 11 DISTRIBUTED TO THE FULL BOARD PRIOR TO FILING AND REVIEWED IN DETAIL AT THE NEXT MEETING OF THE BOARD FOLLOWING DISTRIBUTION. Form 990, Part VI, Section B, line 12c REQUIRED TO DISCLOSE CONFLICTS OF INTEREST. Form 990, Part VI, Section B, line 15 COMPENSATION IS DETERMINED BY BOARD OF DIRECTORS WITH THE USE OF INDEPENDENT CONSULTANTS. Form 990, Part VI, Section C, line 19 AVAILABLE UPON WRITTEN REQUEST. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: CHANGE IN FV OF INTEREST RATE SWAP CONTRACTS 198352. CHANGE IN ACCOUNTING ESTIMATE -3564545. Total to Form 990, Part XI, Line 5: -3366193. BOARD SELECTS AUDITORS AND AUDITORS PRESENT FINANCIAL STATEMENTS TO THE BOARD OF DIRECTORS. GRINNELL REGIONAL MEDICAL CENTER FOUNDATION 210 FOURTH AVE GRINNELL IA 50112 421454737 SUPPORT FOR GRMC IA 501(c)(3) 11 0 HEALTH ADVANTAGE PLUS INC 1020 MAIN STREET GRINNELL IA 50112 421436490 PHYSICIAN BILLING SERVICES IA N/A C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 HEALTH ADVANTAGE PLUS Q 138943 CASH