FURP.ORG / PUBLIC DATA EXPLORER

OTTUMWA REGIONAL LEGACY FOUNDATION INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
OTTUMWA REGIONAL LEGACY FOUNDATION INC (EIN 42-0681060)
Tax period
2009-04-01 to 2010-03-31
Filed
2011-02-15
IRS object ID
201110469349301426
Schema version
2009v1.7
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)
Timestamp2011-02-15T17:32:44-06:00Timestamp
Tax Period End Date2010-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SEIM JOHNSON SESTAK & QUIST LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18807 INDIAN HILLS DRIVE SUITE 300AddressLine1
CityOMAHACity
StateNEState
ZIP Code681144123ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN420681060EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OTTUMWA REGIONAL HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOTTUNameControl
Phone6416842315Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVENUEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTOM LAZIOName
TitleVICE CHAIRMANTitle
Phone6416842315Phone
Date Signed2011-02-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJulie M GerkenName
Phone4023302660Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTOM LAZIONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVENUEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts95565948GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.orhc.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1892YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionPROVIDE GENERAL ACUTE CARE AND OTHER HEALTH SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees962TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI39169TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year702577ContributionsGrantsPriorYear
Contributions Grants Current Year308536ContributionsGrantsCurrentYear
Program Service Revenue Prior Year78622064ProgramServiceRevenuePriorYear
Program Service Revenue CY81063066ProgramServiceRevenueCY
Investment Income Prior Year108797InvestmentIncomePriorYear
Investment Income Current Year-100405InvestmentIncomeCurrentYear
Other Revenue Prior Year2880566OtherRevenuePriorYear
Other Revenue Current Year2534256OtherRevenueCurrentYear
Total Revenue Prior Year82314004TotalRevenuePriorYear
Total Revenue Current Year83805453TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year541810GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY180742GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year41672064SalariesEtcPriorYear
Salaries Etc Current Year40551876SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year38701095OtherExpensePriorYear
Other Expenses Current Year40898924OtherExpensesCurrentYear
Total Expenses Prior Year80914969TotalExpensesPriorYear
Total Expenses Current Year81631542TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1399035RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2173911RevenuesLessExpensesCY
Total Assets BOY94337792TotalAssetsBOY
Total Assets EOY99337601TotalAssetsEOY
Total Liabilities BOY51645276TotalLiabilitiesBOY
Total Liabilities EOY49826734TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY42692516NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY49510867NetAssetsOrFundBalancesEOY
Mission DescriptionIN THE PURSUIT OF EXCELLENCE, WE DEDICATE OURSELVES TO PROVIDING QUALITY HEALTH SERVICES IN A CARING MANNER.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense7997491Expense
Revenue34043138Revenue
DescriptionTHE SURGICAL SERVICES UNIT INCLUDES PRE-ADMISSION TESTING AND CONSULTATION, ONE DAY (AMBULATORY) SURGERY, OPERATING ROOM, POST-ANESTHESIA CARE, ENDOSCOPY, MINOR SURGERY AND PAIN MANAGEMENT. THE OPERATING ROOM PROVIDES 24-HOUR SURGICAL AND ANESTHESIA CARE TO ALL PATIENTS REQUIRING ELECTIVE OR EMERGENT SURGICAL INTERVENTION. IN THE FISCAL YEAR ENDING MARCH 31, 2010, THERE WERE 1,034 INPATIENT SURGICAL PROCEDURES PERFORMED AND 8,301 OUTPATIENT PROCEDURES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6175292Expense
Revenue21946560Revenue
DescriptionTHE EMERGENCY MEDICAL SERVICES DEPARTMENT OPERATES AS A LEVEL III TRAUMA CENTER. IT PROVIDES 24-HOUR PHYSICIAN COVERED ACUTE AND URGENT CARE TO REGIONAL RESIDENTS. A MINIMUM OF TWO AMBULANCES ARE STAFFED AT ALL TIMES THROUGH ON-DUTY AND ON-CALL PARAMEDIC STAFFING. IN THE FISCAL YEAR ENDING MARCH 31, 2010, THERE WERE 26,518 VISITS TO THE EMERGENCY ROOM AND 4,056 AMBULANCE RUNS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4293368Expense
Revenue20420042Revenue
DescriptionTHE DEPARTMENT OF RADIOLOGY IS A CONSULTATIVE SERVICE THAT EMPHASIZES AN INTEGRATED APPROACH TO MEDICAL IMAGING AT THE LOWEST POSSIBLE RADIATION EXPOSURE TO THE PATIENT. ALONG WITH CONVENTIONAL X-RAY EXAMINATIONS, THE DEPARTMENT'S CAPABILITIES INCLUDE SPIRAL 3D COMPUTER TOMOGRAPHY, ULTRASONOGRAPHY, A FULL RANGE OF NUCLEAR MEDICINE STUDIES, MAGNETIC RESONANCE IMAGING, MAMMOGRAPHY, AND SPECIAL PROCEDURES. MOBILE SERVICES FOR STEREOTACTIC BREAST BIOPSY ARE AVAILABLE ON A SCHEDULED BASIS. RADIOLOGISTS ARE AVAILABLE ON A 24-HOUR BASIS FOR CONSULTATION REGARDING INTERPRETATION AND PARTICULAR DIAGNOSTIC PROBLEMS. IN THE FISCAL YEAR ENDING MARCH 31, 2010, THERE WERE 44,407 PROCEDURES PERFORMED IN THE RADIOLOGY DEPARTMENT.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense52345752Expense
Revenue5459274Revenue
DescriptionOTHER PROGRAM SERVICES INCLUDE NUMEROUS HEALTH-RELATED SERVICES TO PATIENTS AND NON-PATIENTS IN THE COMMUNITY.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp52345752TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev5459274TotalOfOtherProgramServiceRev
Total Program Service Expense70811903TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109694NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees962NumberOfEmployees
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
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 FiledIAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MADONNA FISHERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6416842315TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVENUEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DR TED Haas
CHAIRMAN1.00XX000
TOM LAzio
VICE CHairman1.00XX000
DR STEVE ELLISON
SECRETARY/TREASURER1.00XX000
DR MARC HINES
MEDICAL STAFF PRESIDENT1.00X000
ELDON HUNSICKER
DIRECTOR1.00X000
DOUG MATHIAS
DIRECTOR1.00X000
DR DAVID WITTE
DIRECTOR1.00X000
PAM WARD
DIRECTOR1.00X000
CHERYLL A JONES PT NUR
DIRECTOR5.00X136501046
TOM SIEMERS
PRESIDENT/CEO40.00XX320728029467
madonna fisher
ASSISTANT TREASURER40.00X123561018959
beth davis
ASSISTANT SECRETARY40.00X58800018147
CAROL NORTHUP
INTERIM CNO40.00X107194025471
DAN PORTER
CFO40.00X225954029086
SHERYL TILUS
CNO THROUGH 9/200940.00128085026505X
EDWARD B ORTELL MD
Physician40.00794595031708X
GLENDA S ROEFER MD
PHYSICIAN40.00367411023419X
MARK S O'BRIEN MD
PHYSICIAN40.00409665015526X
LONNIE L LANFERMAN MD
PHYSICIAN40.00349620034117X
RAMESH REDDY MD
Physician40.00348956014646X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3107849TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation241592TotalOtherCompensation
Number Individuals GT100 K33NumberIndividualsGT100K
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
Collaborative Laboratory Services LLP
1005 PENNSYLVANIA AVEOTTUMWAIA52501Lab Services3524116
KAUFMAN HALL & ASSOCIATES
5502 OLD ORCHARD ROADSKOKIEIL60077CONSULTING SERVICES609625
REHAB CARE GROUP INC
PO BOX 502096ST LOUISMO631502096MANAGEMENT SERVICES - REHAB592172
ADVANTAGE COMPANIES
1035 33RD AVE SWCEDAR RAPIDSIA52404SCANNING SERVICES475488
FIRST ADMINISTRATORS
PO BOX 9900SIOUX CITYIA51102TPA SERVICES-HEALTH INSURANCE439517
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
Related Organizations75029RelatedOrganizations
Government Grants218583GovernmentGrants
All Other Contributions14924AllOtherContributions
Total Contributions308536TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYM6219904428373144283731
NET PATIENT SERVICE RE6219903677933536779335
FieldValueIRS element (for citing)
Total Program Service Revenue81063066TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column816657TotalRevenueColumn
Exclusion$816,657ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real271665Real
Personal280594Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real271665Real
Personal280594Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column552259TotalRevenueColumn
Related Or Exempt Function Income280594RelatedOrExemptFunctionIncome
Exclusion$271,665ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10842596Securities
Other837Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10840917Securities
Other919578Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1679Securities
Other-918741Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-917062TotalRevenueColumn
Related Or Exempt Function Income-918741RelatedOrExemptFunctionIncome
Exclusion$1,679ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
SERVICES & SUPPLIES621990907730907730
CAFETERIA & DIETARY722210457219$457,219
MANAGEMENT OF AFFILIAT561000262000262000

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column355048TotalRevenueColumn
Related Or Exempt Function Income274365RelatedOrExemptFunctionIncome
Unrelated Business Revenue39169UnrelatedBusinessRevenue
Exclusion$41,514ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1981997TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column83805453TotalRevenueColumn
Related Or Exempt Function Income81869014RelatedOrExemptFunctionIncome
Unrelated Business Revenue39169UnrelatedBusinessRevenue
Exclusion$1,588,734ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total180742Total
Program Services180742ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1024041Total
Management And General1024041ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31989159Total
Program Services29341213ProgramServices
Management And General2647946ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total705669Total
Program Services634912ProgramServices
Management And General70757ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4593367Total
Program Services4203431ProgramServices
Management And General389936ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2239640Total
Program Services1996315ProgramServices
Management And General243325ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1026247Total
Management And General1026247ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total925537Total
Management And General925537ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total101915Total
Program Services18571ProgramServices
Management And General83344ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total20268Total
Management And General20268ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10565377Total
Program Services7914596ProgramServices
Management And General2650781ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total121340Total
Management And General121340ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11223966Total
Program Services10576755ProgramServices
Management And General647211ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1894587Total
Program Services1830776ProgramServices
Management And General63811ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total343462Total
Program Services271917ProgramServices
Management And General71545ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total304330Total
Program Services245584ProgramServices
Management And General58746ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1754416Total
Program Services1754416ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4824566Total
Program Services4227855ProgramServices
Management And General596711ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total584458Total
Program Services584458ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debt expense64823066482306
OTHER EXPENSES48285243319749655
DUES AND SUBSCRIPTIONS21639088542127848
LICENSES2690726317590

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total81631542Total
Program Services70811903ProgramServices
Management And General10819639ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6502478BOY
EOY7553751EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY16821002BOY
EOY7474423EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9336887BOY
EOY8279772EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY899996BOY
EOY476364EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1881758BOY
EOY1972243EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY347635BOY
EOY361975EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis77584938LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec49112100LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY32285868BOY
EOY28472838EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY7901630BOY
EOY26148952EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY287216BOY
EOY14357EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY18073322BOY
EOY18582926EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY94337792BOY
EOY99337601EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8108554BOY
EOY8792899EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY35805000BOY
EOY35805000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2896505BOY
EOY1693552EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4835217BOY
EOY3535283EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY51645276BOY
EOY49826734EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY37189120BOY
EOY43316521EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2283930BOY
EOY2173689EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3219466BOY
EOY4020657EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42692516BOY
EOY49510867EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY94337792BOY
EOY99337601EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals20992FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals20992FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals81631542FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals81652534FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus317164CurrentYearMinus3
Current Year Minus220670CurrentYearMinus2
Current Year Minus120142CurrentYearMinus1
Current Year20992CurrentYear
Total78968Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4172386BeginningOfYearBalance
Contributions93971Contributions
Investment Earnings Or Losses819934InvestmentEarningsOrLosses
Other Expenditures81224OtherExpenditures
Administrative Expenses1490AdministrativeExpenses
End Of Year Balance5003577EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3983318BeginningOfYearBalance
Contributions323821Contributions
Investment Earnings Or Losses-47403InvestmentEarningsOrLosses
Other Expenditures85450OtherExpenditures
Administrative Expenses1900AdministrativeExpenses
End Of Year Balance4172386EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis406858OtherCostOrOtherBasis
Book Value406858BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27322235OtherCostOrOtherBasis
Depreciation14280544Depreciation
Book Value13041691BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis224212OtherCostOrOtherBasis
Depreciation104953Depreciation
Book Value119259BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis46205114OtherCostOrOtherBasis
Depreciation32483300Depreciation
Book Value13721814BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3426519OtherCostOrOtherBasis
Depreciation2243303Depreciation
Book Value1183216BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings28472838TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM REGIONAL RETIREMENT LIVING5502262
INVESTMENTS IN JOINT VENTURES4601352
AUXILLIARY ASSETS375964
INTEREST IN OTTUMWA REGIONAL HEALTH FOUNDATION4119801
BOND ISSUANCE COSTS1402247
GOODWILL AND COVENANT NOT TO COMPETE1825805
RELATED PARTY RECEIVABLES575366
DEFERRED COMPENSATION180129
FieldValueIRS element (for citing)
Total Book Value Other Assets18582926TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
3RD PARTY SETTLEMENT PAYABLE$1,426,240
457B PLAN LIABILITY$180,129
SWAP AGREEMENTS$1,469,969
Capitalized Lease Obligations$458,945
FieldValueIRS element (for citing)
Total Of Amounts3535283TotalOfAmounts
Total Revenue83805453TotalRevenue
Total Expenses81631542TotalExpenses
Excess Or Deficit For Year2173911ExcessOrDeficitForYear
Other$4,644,440OtherAmount
Total Adjustments4644440TotalAdjustments
Excess Or Deficit Per FS6818351ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:ENDOWMENT FUNDS ARE HELD BY THE HOSPITAL AND THE FOUNDATION, A SUPPORTING ORGANIZATION OF THE HOSPITAL. THE ENDOWMENTS ARE HELD FOR CAPITAL IMPROVEMENTS, EQUIPMENT ACQUISITIONS, THE EXPENSES OF INDIGENT CARE, AUXILIARY OPERATIONS, PASTORAL OPERATIONS, CANCER CENTER IMPROVEMENTS, REGIONAL RETIREMENT LIVING OPERATIONS AND IMPROVEMENTS, AND TO SUSTAIN FOUNDATION OPERATIONS.
Part X:Description of Uncertain Tax Positions Under FIN 48:The Organization and its affiliates are a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code. The Organization has received a determination letter that it is exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code, except for Regional Enterprises, Inc. which is a for-profit taxable entity. The Internal Revenue Service has established standards to be met to maintain tax-exempt status. In general, such standards require the Organization to meet a community benefit standard and comply with various laws and regulations. The Organization accounts for uncertainties in accounting for income tax assets and liabilities using the guidance included in FASB ASC Topic 740, Income Taxes. The Organization recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. At March 31, 2010, the Organization had no uncertain tax positions accrued.
Part XI, Line 8 - Other Adjustments:CHANGE IN VALUE OF SWAP AGREEMENTS: 1573235. CHANGE IN INTEREST IN FOUNDATION - TEMPORARILY RESTRICTED: -110241. Change in AUXILIARY ASSETS: 50920. CHANGE IN INTEREST IN FOUNDATION - PERMANENTLY RESTRICTED: 356232. CHANGE IN UNREALIZED GAIN - PERMANENTLY RESTRICTED: 402364. EQUITY INTEREST IN JOINT VENTURE: 852188. CHANGE IN UNREALIZED GAIN - UNRESTRICTED : 917824. NONCONTROLLING INTEREST IN SUBSIDIARY: 801918. NET ASSET TRANSFER TO REGIONAL ENTERPRISES: -200000.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense597493TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense597493NetCommunityBenefitExpense
Percent Of Total Expense0.00800PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11779153TotalCommunityBenefitExpense
Direct Offsetting Revenue9990799DirectOffsettingRevenue
Net Community Benefit Expense1788354NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense12376646TotalCommunityBenefitExpense
Direct Offsetting Revenue9990799DirectOffsettingRevenue
Net Community Benefit Expense2385847NetCommunityBenefitExpense
Percent Of Total Expense0.03180PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12376646TotalCommunityBenefitExpense
Direct Offsetting Revenue9990799DirectOffsettingRevenue
Net Community Benefit Expense2385847NetCommunityBenefitExpense
Percent Of Total Expense0.03180PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,007,790BadDebtExpenseAmount
Amount Attributable To751950AmountAttributableTo
Amount Reimbursed By Medicare21413532AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22922829CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1509297MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
SOUTHEAST IOWA RADIATION ONCOLOGY LLC
RADIATION THERAPY0.500000.000000.50000
COLLABORATIVE LABORATORY SERVICES LLC
LAB SERVICES0.800000.000000.20000

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1OTTUMWA REGIONAL HEALTH CENTER INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVENUEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.IncomeBasedCriteria
Annual Community Benefit ExplnPart I, Line 6a: OTTUMWA REGIONAL HEALTH CENTER, INC.'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION.AnnualCommunityBenefitExpln
Bad Debt FootnotePart III, Line 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TITLED "PATIENT RECEIVABLES, NET":Net patient receivables consist of uncollateralized patient and third party obligations reduced by a valuation allowance for doubtful accounts and contractual adjustments from third party payors. The allowances reflect managements estimate of amounts that will not be collected in the future and are based on reviews of patient balances by aging category. Percentages are applied to each aging category based on contractual agreements and historical collection and recovery information to determine the net realizable value of the patient receivables.Payment for services is expected within thirty days of receipt of the billing on insurance accounts and within twenty days of billing on self-pay accounts. Accounts considered past due are sent to collection agencies when internal collection efforts have been unsuccessful. Any amounts deemed uncollectible are written off on a monthly basis. The Organization also maintains a charity care policy.THE OVERALL COST-TO-CHARGE RATIO WAS USED TO ESTIMATE BAD DEBT AT COST.PART III, SECTION A, LINE 2 WAS CALCULATED AS FOLLOWS:[(OPERATING EXPENSES - BAD DEBT) / (GROSS PATIENT SERVICE REVENUE + OTHER REVENUE)] X BAD DEBT.[(81,430,532 - 6,482,306) / 158,484,516 + 2,906,704] X 6,482,306 = 3,007,790.ALL INFORMATION IS FROM THE AUDITED FINANCIAL STATEMENTS.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: THE SHORTFALL REPRESENTS ACTUAL UNREIMBURSED COSTS INCURRED BY OTTUMWA REGIONAL HEALTH CENTER, INC. IN PROVIDING SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICARE. THE COMMUNITY BENEFITS BECAUSE THE HOSPITAL APPLIES OTHER REVENUES TO COVER THE COSTS OF CARING FOR MEDICARE PATIENTS."MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT, D, E, H AND M WORKSHEETS, OR PS&R.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: EACH ENCOUNTER IS REVIEWED AND PATIENTS WHO HAVE HAD FINANCIAL ASSISTANCE WITHIN THE PAST SIX MONTHS DO NOT HAVE TO REAPPLY.DebtCollectionPolicy
Number Of Facility Type ExplnPart V: ALL FACILITY INFORMATION IS ADEQUATELY ADDRESSED IN PART V.NumberOfFacilityTypeExpln
Needs AssessmentPart VI, Line 2: A COMMUNITY NEEDS ASSESSMENT IS PERFORMED EVERY 2 YEARS. AN EXTERNAL CONSULTANT IS HIRED TO PERFORM THIS FUNCTION. THEY OBTAIN THE RESULTS THROUGH A SERIES OF INTERVIEWS AND FOCUS GROUPS WITH KEY INVIDUALS IN THE COMMUNITY.NeedsAssessment
Patient Education AssistancePart VI, Line 3: OTTUMWA REGIONAL HEALTH CENTER, INC. EMPLOYS A FINANCIAL ASSISTANCE COUNSELOR TO ASSIST PATIENTS WITH ELIGIBILITY FOR VARIOUS PROGRAMS, AND TO HELP DETERMINE IF A PATIENT IS ELIGIBLE UNDER THE CHARITY CARE POLICY.PATIENTS ARE MADE AWARE THROUGH A PATIENT ACCOUNT BROCHURE, USUALLY OBTAINED AT ADMISSION.PatientEducationAssistance
Community InformationPart VI, Line 4: WAPELLO COUNTY AND SEVEN SURROUNDING COUNTIES.CommunityInformation
Community Building ActivitiesPart VI, Line 5: N/ACommunityBuildingActivities
Other InformationPart VI, Line 6: N/AOtherInformation
Affiliated Health Care SystemPart VI, Line 7: THE AFFILIATED HEALTH CARE SYSTEM INCLUDES THESE ORGANIZATIONS:OTTUMWA REGIONAL HEALTH CENTER, INC. - OWNS AND OPERATE A HOSPITAL.OTTUMWA REGIONAL HEALTH CARE FOUNDATION, INC. - SUPPORTS THE HOSPITAL BY FUND RAISING.REGIONAL RETIREMENT LIVING, INC. - OPERATES A RESIDENTIAL FACILITY FOR THE ELDERLY.COLLABORATIVE LABORATORY SERVICES, LLC - OPERATES THE ONLY LABORATORY IN THE GEOGRAPHIC AREA.AffiliatedHealthCareSystem
Reports Filed With StatesIAReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1OTTUMWA REGIONAL HEALTH FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVENUEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient421271720EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant180742AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantTO SUPPORT FUNDRAISING OPERATIONS.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: GRANTS OR CONTRIBUTIONS ARE ONLY MADE TO OTHER 501(C)(3) ORGANIZATIONS. OTTUMWA REGIONAL HEALTH CENTER VERIFIES THE STATUS OF THE DONEE ORGANIZATION PRIOR TO MAKING A GIFT. THE FUNDS ARE RESTRICTED TO BEING USED TO SUPPORT THE DONEE ORGANIZATION'S TAX EXEMPT OPERATIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (7 entries)

Base 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
TOM SIEMERS
3207280000085750208920350195000
DAN PORTER
2259540000080260210600255040000
EDWARD B ORTELL MD
7945950000085750231330826303000
GLENDA S ROEFER MD
3674110000000234190390830000
MARK S O'BRIEN MD
4096650000000155260425191000
LONNIE L LANFERMAN MD
3496200000085750255420383737000
RAMESH REDDY MD
3489560000000146460363602000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
WAPELLO COUNTY VARIABLE RATE REVENUE BONDS SERIES 2004
426295832933805AA12007-11-3021400000SEE SCH. K, SUPPLEMENTAL INFORMATION, ABOVE.00
WAPELLO COUNTY VARIABLE RATE DEMAND REFUND REVENUE BONDS SERIES 2006
426295832933805AB92006-12-0717005000REFUND 2001 BOND ISSUE00

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount DefeasedAmountDefeased
704097824535851295364329202920061011
167171601278147104278727632007010114393463

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000001
000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2Term Of HedgeTermOfHedgeGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
GOLDMAN SACHS
011CAPITAL MARKETS LP13.100000000000011
GOLDMAN SACHS
011CAPITAL MARKETS LP5.000000000000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part III, line 3Changes in Program ServicesCLOSED THE ALLERGY CLINIC AND FAMILY MEDICAL CLINIC IN ELDON, IA.
Form 990, Part VI, Section B, line 11THE FORMs 990 AND 990T ALONG WITH THE RELATED SCHEDULES ARE REVIEWED AND APPROVED BY each member of the board of directors OF OTTUMWA REGIONAL LEGACY FOUNDATION, INC (ORLF) FORMERLY KNOWN AS OTTUMWA REGIONAL HEALTH CENTER, INC BEFORE THE FORMS ARE FILED. FURTHERMORE, THE FORMS 990 AND 990T ALONG WITH THE RELATED SCHEDULES ARE PRESENTED TO THE ORLF BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING AFTER THE FORMS ARE FILED.
Form 990, Part VI, Section B, line 12cEACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF ANY COMMITTEE WITH BOARD-DESIGNATED POWERS SHALL SIGN AN ANNUAL STATEMENT THAT THE PERSON HAS (A) RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) AGREES TO COMPLY WITH THE POLICY; (D) UNDERSTANDS THAT THE POLICY APPLIES TO COMMITTEES AND SUBCOMMITTEES; AND (E) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION THAT MUST ENGAGE PRIMARILY IN EXEMPT ACTIVITIES. THE CONFLICT OF INTEREST POLICY ALSO HAS PROVISIONS FOR DETERMINING WHETHER A CONFLICT EXISTS, ADDRESSING A CONFLICT OF INTEREST, AND ADDRESSING A PERCEIVED VIOLATION.
Form 990, Part VI, Section B, line 15THE HEALTH CENTER UTILIZES PEER GROUP INFORMATION FROM OUTSIDE ORGANIZATIONS SUCH AS HAY GROUP, INTEGRATED HEALTHCARE STRATEGIES AND THE IOWA HOSPITAL ASSOCIATION. DATA FOR ESTABLISHING BASE PAY LEVELS ARE BASED ON THE 50TH PERCENTILE. BASE SALARIES FOR THE CEO AND OTHER KEY EMPLOYEES OF THE ORGANIZATION ARE EVALUATED ANNUALLY. ANY ADJUSTMENTS ARE APPROVED THROUGH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Section C, line 19OTTUMWA REGIONAL HEALTH CENTER, INC. MAKEs ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST PRESENTED AT ORHC'S OFFICES.
FORM 990, PART XI, LINE 2CTHE ROLES OF THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS INCLUDE SELECTING THE INDEPENDENT PUBLIC ACCOUNTANTS AND OVERSEEING THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS. THIS PROCEDURE IS THE SAME AS IN THE FISCAL YEAR ENDED MARCH 31, 2009.
Schedule K Supplental InformationPART I, COLUMN (F), LINE A - INITIALLY ISSUED AUGUST 19, 2004 AND USED FOR CAPITAL IMPROVEMENTS, REFUNDING OF PRIOR ISSUES (11/4/1993 & 8/13/1998), AND REFINANCING TAXABLE DEBT. ON NOVEMBER 30, 2007, THE PERIODIC AUCTION RATE SECURITIES CONVERTED TO BEAR INTEREST IN THE WEEKLY RATE PERIOD AND AN IRS FORM 8038 WAS FILED. PART II, COLUMN (A), LINE 5 - ISSUANCE COSTS $382,300, CREDIT ENHANCEMENT FEE $913,064 PART II, COLUMN (B), LINE 5 - ISSUANCE COSTS $340,100, CREDIT ENHANCEMENT FEE $702,687

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
OTTUMWA REGIONAL HEALTH FOUNDATION
1001 PENNSYLVANIA AVENUEOTTUMWAIA52501421271720FOUNDATIONIA501(c)(3)Line 11a, IN/A
REGIONAL RETIREMENT LIVING INC
1001 PENNSYLVANIA AVENUEOTTUMWAIA52501421326693RETIREMENT COMMUNITYIA501(c)(3)Line 9N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1REGIONAL ENTERPRISES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11001 PENNSYLVANIA AVEAddressLine1
CityOTTUMWACity
StateIAState
ZIP Code52501ZIPCode
FieldValueIRS element (for citing)
EIN421269387EIN
Primary ActivityCHEMICAL DEPENDENCY UNITPrimaryActivity
Legal Domicile StateIALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income1015608ShareOfTotalIncome
Share Of EOY Assets258470ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
OTTUMWA REGIONAL HEALTH FOUNDATION INC
B180742
OTTUMWA REGIONAL HEALTH FOUNDATION INC
C75029
REGIONAL RETIREMENT LIVING INC
A251226
REGIONAL ENTERPRISES INC
K222000
REGIONAL ENTERPRISES INC
Q200000