2011-11-08T15:06:51-06:00 2010-12-31 990 2010-01-01 421435199 IOWA HEALTH SYSTEM IOWA 5152414237 1200 PLEASANT ST DES MOINES IA 503091453 KEVIN E VERMEER 5152418215 2011-11-01 2010 2016-02-24 21:20:13Z WILLIAM B LEAVER 1200 PLEASANT ST DES MOINES IA 503091453 159070988 0 X WWW.IHS.ORG X 1994 IA TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 19 13 710 13 891838 0 13212720 9605003 77672478 128800508 18550467 20252306 0 0 109435665 158657817 13123399 11508552 0 0 39632576 46146633 0 0 0 107969120 106432733 160725095 164087918 -51289430 -5430101 729964712 708457810 714746700 714562839 15218012 -6105029 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 156466891 11408702 128800508 AFFILIATE SUPPORT SERVICESIHS ADMINISTRATION (CORP) IS ORGANIZED TO SUPPORT THE MISSIONS OF SEVERAL RELATED CHARITABLE, TAX-EXEMPT ORGANIZATIONS INCLUDING SEVEN SENIOR AFFILIATES, IOWA HEALTH DES MOINES (DES MOINES), TRINITY REGIONAL HEALTH SYSTEM (ROCK ISLAND), ST. LUKE'S HEALTHCARE (CEDAR RAPIDS), ALLEN HEALTH SYSTEMS (WATERLOO), TRINITY HEALTH SYSTEMS (FORT DODGE), ST. LUKE'S HEALTH SYSTEM (SIOUX CITY), IOWA HOME HEALTH CARE, AS WELL AS MULTIPLE RURAL AFFILIATES. THE SUPPORT SERVICES PROVIDED TO THESE ORGANIZATIONS ARE TO CONSTRUCT, OWN, LEASE, MANAGE, OPERATE, PROVIDE AND MAINTAIN ANY FACILITIES, PROGRAMS, SERVICES (MANAGEMENT OR OTHERWISE) AND RELATED ACTIVITIES IN FURTHERANCE OF HEALTH-CARE OR HEALTH EDUCATION. FACILITIES INCLUDE HOSPITALS, SELF-CARE FACILITIES, CLINICS, EDUCATIONAL FACILITIES, AND OTHER ESTABLISHMENTS CREATED TO CARRY THROUGH HEALTH-CARE AND EDUCATIONAL PROGRAMS. THE PRIMARY PURPOSE OF THE CORPORATION IS TO ENGAGE IN AND CONDUCT CHARITABLE, EDUCATIONAL, RELIGIOUS AND SCIENTIFIC ACTIVITIES IN ACCORDANCE WITH PREVIOUSLY STATED PURPOSES. 1187432 99850 0 COMMUNITY BENEFITIOWA HEALTH SYSTEM PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. IOWA HEALTH SYSTEM COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. IOWA HEALTH SYSTEM HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $1,187,432. 157654323 1 1 0 1 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 1 180 0 1 710 1 1 1 0 0 0 0 0 0 0 0 0 0 X 19 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X KEVIN E VERMEER EXECUTIVE VPCFO 5152416550 1200 PLEASANT ST DES MOINES IA 503091453 PEG ARMSTRONG-GUSTAFSON 1.00 X 11863 300 0 GENE BLANC 1.00 X X 14938 0 0 PAUL BRANDT 1.00 X 15396 0 0 TERRI CHRISTOFFERSEN 1.00 X 15000 0 0 KATHY ENO 1.00 X 14500 0 0 JOHN GLEESON 1.00 X X 13863 0 0 STEVE HERWIG DO 1.00 X 13163 50 0 JIM HOFFMAN 1.00 X X 26993 0 0 FRANCIS KANE MD 1.00 X 10942 0 0 RON KLOSTERMAN 1.00 X 14533 0 0 LAWRENCE LIEBSCHER MD 1.00 X 13250 71 0 PETER MCLAUGHLIN 1.00 X 13356 0 0 LINDA NEWBORN 1.00 X 11500 0 0 KURT PITTNER 1.00 X 14616 67 0 WILLIAM PROWELL 1.00 X 15000 0 0 DON ROSS 1.00 X 16036 441 0 KEVIN SCHMINKE MD 1.00 X 10863 0 0 BRUCE SHERMAN 1.00 X 15838 225 0 MIKE WILLIAMS 1.00 X 13453 201 0 WILLIAM LEAVER 40.00 X 1280669 0 410066 KEVIN VERMEER 40.00 X 543405 0 198962 VIVIAN BOYD 40.00 X 171636 0 21871 CHERYL BUSTOS 40.00 X 265066 0 41229 DENNIS DRAKE 40.00 X 488664 0 300725 JOY GROSSER 40.00 X 407389 0 65473 ALAN KAPLAN MD 40.00 X 611284 0 103820 KATHERINE MARCHIK 40.00 X 298490 0 40772 THOMAS TIBBITTS 40.00 X 231592 545822 17874 SAL BOGNANNI 40.00 X 206709 0 14789 IGNATIUS BRADY MD 40.00 X 229231 0 34318 DAVID BURLAGE 40.00 X 202463 0 25554 DANIEL MCDOW 40.00 X 246910 0 24563 SABRA ROSENER 40.00 X 293184 0 34908 DUNCAN GALLAGHER X 621676 0 5661 JAMES MORMANN X 232505 0 26284 SARA VOTROUBEK X 278228 0 9595 6884204 547177 1376464 51 1 1 1 IBM PO BOX 643600 PITTSBURGH PA 15264 IT CONSULTING 10546925 MCKESSON PO BOX 98347 CHICAGO IL 606930001 IT CONSULTING 6204710 EPIC PO BOX 88314 MILWAUKEE WI 532880314 IT CONSULTING 4875742 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 606731246 ELECTRONIC HEALTH RECORDS 3424543 FIBER UTILITIES 222 3RD AVE SE SUITE 500 CEDAR RAPIDS IA 52401 IT CONSULTING 2561414 100 9317837 262064 25102 9605003 MGMT & SUPPORT SVCS 561000 128973027 128081189 891838 SUBS & JOINT VENTURES 900099 -172519 -172519 128800508 20268160 20268160 397317 413171 -15854 -15854 -15854 158657817 127908670 891838 20252306 11508552 11508552 5760390 5760390 1173948 1173948 30718934 30718934 568493 568493 5437334 5437334 2487534 2487534 438038 438038 673109 673109 828928 828928 33131 33131 37464865 37274852 190013 188552 182650 5902 11670805 11645612 25193 151145 150733 412 1510172 1492967 17205 1215965 845508 370457 766232 761192 5040 30581107 30581107 20403181 20403181 62064 62064 MISCELLANEOUS EXPENSES 445439 386456 58983 164087918 157654323 6433595 0 500 500 88260507 103361238 710280 509470 536108170 513171511 7817660 10929489 208251366 141746137 68830339 66505229 15603149 4565111 50000 3000 2470034 1244580 5553960 5313722 4560113 2853960 729964712 708457810 24537296 20681865 2591650 2617231 651114358 638293275 1302305 1313281 35201091 51657187 714746700 714562839 X 15176152 -6151799 41860 46770 15218012 -6105029 729964712 708457810 X -5430101 -15892940 X 0 1 1 X 0 X X X 0 0 0 CENTRAL IOWA HOSPITAL CORPORATION 420680452 3 1 1 1 215445 ST LUKE'S METHODIST HOSPITAL 420504780 3 1 1 1 2580746 ALLEN MEMORIAL HOSPITAL CORPORATION 420698265 3 1 1 1 4089772 NORTHWEST IOWA HOSPITAL CORPORATION 421019872 3 1 1 1 0 THE FINLEY HOSPITAL 420680354 3 1 1 1 0 TRINITY REGIONAL MEDICAL CENTER 421009175 3 1 1 1 0 TRINITY MEDICAL CENTER 362739299 3 1 1 1 2281874 7 9167837 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 828928 927928 828928 927928 156825395 1894148872 157654323 1895076800 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 608809 936860 939868 927928 3413465 250000 250000 250000 250000 1000000 1500000 54695 0 0 0 54695 41860 41430 1815 38335 46770 40498 51133 1508 51279 41860 37616 54000 2736 53854 40498 0.00000 0.00000 1.00000 0 0 1855321 1475370 379951 176634682 123784253 52850429 29761363 16486514 13274849 66505229 SELF-INSURANCE RESERVE 1053217 SWAP LIABILITY 46224865 LONG-TERM RETENTION INCENTIVES 4379105 51657187 158657817 164087918 -5430101 -15892940 -15892940 -21323041 130072000 -8598552 708 -8597844 138669844 19987973 19987973 158657817 152987000 0 152987000 11100918 11100918 164087918 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: 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 2007. 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 XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 708. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN UNRESTRICTED FUND BALANCE 19,976,433. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 4,909. IOWA HEALTH SYSTEM CONTRACTING SERVICES REBATES 6,631. PART XIII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN UNRESTRICTED FUND BALANCE 11,094,287. IOWA HEALTH SYSTEM CONTRACTING SERVICES REBATES 6,631. 1 AMERICAN HEART ASSOCIATION 1111 9TH STREET 280 DES MOINES IA 50314 135613797 501C(3) 7500 PROGRAM SUPPORT COMMUNITY FOUNDATION OF GREATER DES MOINES 1915 GRAND AVENUE DES MOINES IA 50309 426060414 501C(3) 25000 PROGRAM SUPPORT DES MOINES BRANCH NAACP PO BOX 5036 DES MOINES IA 50305 426124965 501C(3) 25000 PROGRAM SUPPORT DES MOINES UNIVERSITY 3200 GRAND AVENUE DES MOINES IA 50312 420730347 501C(3) 5000 PROGRAM SUPPORT INSTITUTE FOR CHARACTER DEVELOPMENT 2417 UNIVERSITY AVE DES MOINES IA 50311 391896160 501C(3) 30000 PROGRAM SUPPORT IOWA DEPARTMENT OF PUBLIC HEALTH LUCAS STATE OFFICE BLDG DES MOINES IA 50319 426004523 GOVERNMENT 25000 PROGRAM SUPPORT IOWA HEALTHCARE COLLABORATIVE 100 EAST GRAND SUITE 100 DES MOINES IA 50309 203869767 501C(3) 50000 PROGRAM SUPPORT IOWA HOMELESS YOUTH CENTERS 1219 BUCHANAN STREET DES MOINES IA 50316 421051609 501C(3) 15000 PROGRAM SUPPORT IOWA NURSES FOUNDATION 100 GREAT IOWA NURSES CORALVILLE IA 52241 237198389 501C(3) 5000 PROGRAM SUPPORT IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 8101 BIRCHWOOD CT JOHNSTON IA 50131 421411630 501C(3) 9167837 PROGRAM SUPPORT IOWA PUBLIC RADIO 2111 GRAND AVE SUITE 100 DES MOINES IA 50312 204227123 501C(3) 10000 PROGRAM SUPPORT IOWA SPORTS FOUNDATIONS 1421 S BELL AVE 104 AMES IA 50010 421278326 501C(3) 35950 PROGRAM SUPPORT IOWA STATEWIDE POISON CONTROL 2910 HAMILTON BLVD SIOUX CITY IA 51104 421509042 501C(3) 49613 PROGRAM SUPPORT JUNIOR ACHIEVEMENT OF CENTRAL IOWA 6100 GRAND AVE DES MOINES IA 50312 420759070 501C(3) 7500 PROGRAM SUPPORT PARTNERSHIP FOR A DRUG-FREE IOWA 1112 EAST GRAND AVE DES MOINES IA 50319 421375293 501C(3) 15000 PROGRAM SUPPORT PE4LIFE 127 W 10TH STREET SUITE 101 KANSAS CITY MO 64106 320044523 501C(3) 45000 PROGRAM SUPPORT PRINCIPAL CHARITY CLASSIC 2771 104TH STREET SUITE 1 URBANDALE IA 50322 426139033 501C(3) 15000 PROGRAM SUPPORT ROOSEVELT HIGH SCHOOL FOUNDATION 4419 CENTER STREET DES MOINES IA 50312 421239735 501C(3) 20000 PROGRAM SUPPORT SAFEGUARD IOWA PARTNERSHIP 100 E GRAND AVE SUITE 165 DES MOINES IA 50309 263339967 501C(3) 5000 PROGRAM SUPPORT TRINITY HEALTH SYSTEMS INC 802 KENYON RD FORT DODGE IA 50501 421222877 501C(3) 1926451 PROGRAM SUPPORT UNIVERSITY OF IOWA 2346 MORMAN TREK BLVD IOWA CITY IA 52246 426004813 GOVERNMENT 7045 PROGRAM SUPPORT 21 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: IOWA HEALTH SYSTEM REQUIRES EACH RECIPIENT OF THE GRANTS (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINE A SERIES OF ELIGIBLITY STANDARDS THAT ARE REQUIRED TO BE MET. IOWA HEALTH SYSTEM THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 WILLIAM PROWELL 15000 0 0 0 0 0 0 0 0 0 15000 0 0 0 WILLIAM LEAVER 843095 0 375540 0 62034 0 388573 0 21493 0 1690735 0 0 0 KEVIN VERMEER 410986 0 84714 0 47705 0 182223 0 16739 0 742367 0 0 0 VIVIAN BOYD 136128 0 0 0 35508 0 13190 0 8681 0 193507 0 0 0 CHERYL BUSTOS 186302 0 42094 0 36670 0 37936 0 3293 0 306295 0 0 0 DENNIS DRAKE 338845 0 101608 0 48211 0 278493 0 22232 0 789389 0 0 0 JOY GROSSER 308040 0 60803 0 38546 0 64089 0 1384 0 472862 0 0 0 ALAN KAPLAN MD 483390 0 87679 0 40215 0 84859 0 18961 0 715104 0 0 0 KATHERINE MARCHIK 187239 0 72036 0 39215 0 23278 0 17494 0 339262 0 0 0 THOMAS TIBBITTS 69360 238580 0 86452 162232 220790 0 6125 4172 7577 235764 559524 141799 177248 SAL BOGNANNI 179784 0 18761 0 8164 0 12790 0 1999 0 221498 0 0 0 IGNATIUS BRADY MD 228109 0 1122 0 0 0 11920 0 22398 0 263549 0 0 0 DAVID BURLAGE 176198 0 26044 0 221 0 13921 0 11633 0 228017 0 0 0 DANIEL MCDOW 102661 0 30304 0 113945 0 13927 0 10636 0 271473 0 72227 0 SABRA ROSENER 206757 0 25904 0 60523 0 14638 0 20270 0 328092 0 0 0 DUNCAN GALLAGHER 0 0 0 0 621676 0 5661 0 0 0 627337 0 621676 0 JAMES MORMANN 0 0 0 0 232505 0 12266 0 14018 0 258789 0 235697 0 SARA VOTROUBEK 0 0 0 0 278228 0 645 0 8950 0 287823 0 280134 0 PART I, LINE 1A TRAVEL: CEO AND BOARD MEMBERS USE PRIVATE CHARTER FOR BUSINESS TRAVEL BETWEEN AFFILIATE CITIES AND FOR BOARD OF DIRECTOR MEETINGS. THIS TRAVEL IS FOR BUSINESS PURPOSES ONLY. NO FIRST CLASS COMMERCIAL TRAVEL IS REIMBURSED. TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RETREATS. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING THE YEAR THAT WAS INCLUDED IN THEIR TAXABLE INCOME: DUNCAN GALLAGHER $621,676, DANIEL MCDOW $72,227, JAMES MORMANN $235,697, SARA VOTROUBEK $280,134. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: VIVIAN BOYD $7,125, CHERYL BUSTOS $26,385, DENNIS DRAKE $171,473, JOY GROSSER $54,278, ALAN KAPLAN $72,609, WILLIAM LEAVER $376,323, KATHERINE MARCHIK $11,028, DANIEL MCDOW $6,000, JIM MORMANN $658, SABRA ROSENER $9,738, KEVIN VERMEER $169,973. SUPPLEMENTAL INFORMATION PART III COMPENSATION FROM UNRELATED ORGANIZATION IOWA HEALTH SYSTEM PAYS BOARD FEES TO SHUTTLEWORTH & INGERSOLL, PLC IN THE AMOUNT OF: BASE PAY $15,000. WILLIAM PROWELL, DIRECTOR, IS AN OFFICER OF SHUTTLEWORTH & INGERSOLL, PLC. IOWA FINANCE AUTHORITY 521699886 462466CF8 2009-03-04 244270000 SEE PART V 0 0 0 IOWA FINANCE AUTHORITY 521699886 462466DS9 2009-08-06 402440333 SEE PART V 0 0 0 244271037 201270000 43001037 2011 1 0 1 1 402440333 351270000 1064433 50105900 2010 1 0 0 1 1 1 1 0 1 0.00000 0.00120 0.00120 1 1 1 1 0 1 0.00000 0.00120 0.00120 1 0 1 1 SEE PART V 26.000000000000 1 0 0 0 1 0 0 0 0 0 1 PART I, LINE A(F) - BOND ISSUES DESCRIPTION OF PURPOSE (I) REFUND A PORTION OF THE IOWA FINANCE AUTHORITY'S HOSPITAL FACILITIES REVENUE BONDS, (IOWA HEALTH SYSTEM), SERIES 2005B ISSUED ON 7/27/05; (II) CONSTRUCT AND EQUIP HOSPITAL FACILITIES OF THE ORGANIZATION AND AFFILIATES LOCATED IN CEDAR RAPIDS, DES MOINES, DUBUQUE, FORT DODGE, SIOUX CITY, AND WATERLOO, IOWA. PART I, LINE B(F) - BOND ISSUES DESCRIPTION OF PURPOSE (I) REFUND A PORTION OF THE IOWA FINANCE AUTHORITY'S HOSPITAL FACILITIES REVENUE BONDS, (IOWA HEALTH SYSTEM), SERIES 2005A ISSUED ON 7/27/05; (II) REFUND A PORTION OF THE IOWA FINANCE AUTHORITY'S HOSPITAL FACILITIES REVENUE BONDS (IOWA HEALTH SYSTEM), SERIES 2008A ISSUED ON 5/20/08; (III) CONSTRUCT AND EQUIP HOSPITAL FACILITIES OF THE ORGANIZATION AND AFFILIATES LOCATED IN DES MOINES, DUBUQUE, SIOUX CITY, AND WATERLOO, IOWA. PART II, LINE 3(A) - PROCEEDS TOTAL PROCEEDS AT ISSUE THERE IS A DIFFERENCE BETWEEN THE BOND ISSUE PRICE AND THE TOTAL PROCEEDS OF BOND ISSUE DUE TO INVESTMENT EARNINGS OF $1,037. PART IV - ARBITRAGE NAME OF PROVIDER CITIBANK, N.A.; JPMORGAN CHASE BANK, N.A.; MORGAN STANLEY CAPITAL SERVICES, INC. MEDIMORE INC COMMON BOARD MEMBER/OFFICER 244534 EXPENSE REIMBURSEMENT 0 FORM 990, PART VI, SECTION A, LINE 7A IOWA HEALTH SYSTEM IS A SUPPORTING ORGANIZATION TO AFFILIATED NONPROFIT HOSPITALS. EACH HOSPITAL HAS THE POWER TO APPOINT DIRECTORS TO THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B IOWA HEALTH SYSTEM IS A SUPPORTING ORGANIZATION TO AFFILIATED NONPROFIT HOSPITALS. EACH HOSPITAL HAS THE POWER TO APPOINT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE 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 12C THE 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 15 THE 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, 2010 FOR THE FOLLOWING INDIVIDUALS: VIVIAN BOYD, CHERYL BUSTOS, DENNY DRAKE, JOY GROSSER, ALAN KAPLAN, WILLIAM LEAVER, KATHERINE MARCHIK, SABRA ROSENER, KEVIN VERMEER. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR 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 19 IOWA 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -15,892,940. DISEASE MANAGEMENT STRATEGIES LLC 1200 PLEASANT ST DES MOINES IA 50309 113649153 DISEASE CASE MANAGEMENT SERVICES IA 150297 0 IOWA HEALTH SYSTEM BHC LC 1200 PLEASANT STREET DES MOINES IA 50309 273820391 INFORMATION TECHNOLOGY MGMT. 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CENTRAL IOWA HOSPITAL CORPORATION K 34709008 BASED ON GAAP, CASH, AND/OR FMV. CENTRAL IOWA HOSPITAL CORPORATION M 76151 BASED ON GAAP, CASH, AND/OR FMV. DES MOINES PARKING ASSOCIATES 0 BASED ON GAAP, CASH, AND/OR FMV. DUBUQUE ENDOSCOPY CENTER LC 0 BASED ON GAAP, CASH, AND/OR FMV. FINLEY HEALTH FOUNDATION INC 0 BASED ON GAAP, CASH, AND/OR FMV. FINLEY TRI-STATES HEALTH GROUP INC 0 BASED ON GAAP, CASH, AND/OR FMV. HNC SERVICES P 244776 BASED ON GAAP, CASH, AND/OR FMV. INTRUST A 60607 BASED ON GAAP, CASH, AND/OR FMV. INTRUST J 307222 BASED ON GAAP, CASH, AND/OR FMV. INTRUST K 2150361 BASED ON GAAP, CASH, AND/OR FMV. IOWA HEALTH FOUNDATION 0 BASED ON GAAP, CASH, AND/OR FMV. IOWA HEALTH SYSTEM CONTRACTING SERVICES LC 0 BASED ON GAAP, CASH, AND/OR FMV. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION B 9167837 BASED ON GAAP, CASH, AND/OR FMV. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION J 901960 BASED ON GAAP, CASH, AND/OR FMV. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION K 7826834 BASED ON GAAP, CASH, AND/OR FMV. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION M 15970 BASED ON GAAP, CASH, AND/OR FMV. JONES REGIONAL MEDICAL CENTER FOUNDATION 0 BASED ON GAAP, CASH, AND/OR FMV. MEDIMORE INC 0 BASED ON GAAP, CASH, AND/OR FMV. MEMORIAL FOUNDATION OF ALLEN HOSPITAL 0 BASED ON GAAP, CASH, AND/OR FMV. NELLIE R SHERWOOD TRUST 0 BASED ON GAAP, CASH, AND/OR FMV. NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED 0 BASED ON GAAP, CASH, AND/OR FMV. NORTHWEST IOWA HOSPITAL CORPORATION 0 BASED ON GAAP, CASH, AND/OR FMV. PRECEDENCE INC 0 BASED ON GAAP, CASH, AND/OR FMV. RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S DEVELOPMENT COMPANY 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH CARE FOUNDATION 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH FOUNDATION OF SIOUX CITY IOWA 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH RESOURCES 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH SYSTEM INC A 2341599 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH SYSTEM INC I 1074106 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH SYSTEM INC K 8539434 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTH SYSTEM INC M 18100 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S HEALTHCARE 0 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S METHODIST HOSPITAL A 4162453 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S METHODIST HOSPITAL C 2580746 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S METHODIST HOSPITAL I 1731124 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S METHODIST HOSPITAL K 18067975 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'S METHODIST HOSPITAL M 38386 BASED ON GAAP, CASH, AND/OR FMV. ST LUKE'SJONES REGIONAL MEDICAL CENTER 0 BASED ON GAAP, CASH, AND/OR FMV. STL CARE COMPANY 0 BASED ON GAAP, CASH, AND/OR FMV. STL HEALTH RESOURCES CO 0 BASED ON GAAP, CASH, AND/OR FMV. THE DUBUQUE VISITING NURSE ASSOCIATION 0 BASED ON GAAP, CASH, AND/OR FMV. THE FINLEY HOSPITAL A 598195 BASED ON GAAP, CASH, AND/OR FMV. THE FINLEY HOSPITAL I 555371 BASED ON GAAP, CASH, AND/OR FMV. THE FINLEY HOSPITAL K 5185022 BASED ON GAAP, CASH, AND/OR FMV. THE FINLEY HOSPITAL M 11240 BASED ON GAAP, CASH, AND/OR FMV. THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 0 BASED ON GAAP, CASH, AND/OR FMV. TRIMARK PHYSICIANS GROUP INC 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY BUILDING CORPORATION 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH ENTERPRISES INC 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH FOUNDATION 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH FOUNDATION 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH SYSTEMS INC I 1026988 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH SYSTEMS INC M 19130 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH SYSTEMS INC O 1926451 BASED ON GAAP, CASH, AND/OR FMV. TRINITY HEALTH SYSTEMS INC 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY MEDICAL CENTER K 28170 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HEALTH SYSTEM A 6321082 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HEALTH SYSTEM C 2281874 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HEALTH SYSTEM I 2354564 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HEALTH SYSTEM K 19486976 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HEALTH SYSTEM M 40758 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL HOSPITAL AUXILIARY 0 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL MEDICAL CENTER A 933667 BASED ON GAAP, CASH, AND/OR FMV. TRINITY REGIONAL MEDICAL CENTER K 9012902 BASED ON GAAP, CASH, AND/OR FMV. TRINITY VISITING NURSE & HOMECARE ASSOCIATION 0 BASED ON GAAP, CASH, AND/OR FMV. UNITY HEALTHCARE 0 BASED ON GAAP, CASH, AND/OR FMV. SECTION 512(B)(13) CONTROLLED ENTITY SCHEDULE R, PART II, COLUMN (G) THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, "IOWA HEALTH SYSTEM." FOR ENTITIES THAT ARE PART OF THE CONSOLIDATED HEALTH SYSTEM (WITH COMMON CONTROL) THE ATTRIBUTION RULES OF IRC SECTION 318 APPLY; MEANING THAT ALL ORGANIZATIONS ARE DEEMED TO HAVE CONTROL OF THE ORGANIZATIONS OWNED BY THE CONTROLLING ORGANIZATION. AS SUCH, WE ARE REPORTING ALL RELATED ORGANIZATIONS OF THE HEALTH SYSTEM IN PARTS II, III & IV. FOR PART V REPORTING, THE TRANSACTIONS DISCLOSED ARE THOSE BETWEEN THE DIRECTLY CONTROLLED PARENT-SUBSIDIARY ONLY. IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421435199 X 0 828928 828928 156850395 157679323 1000000 250000 0 0 0 HNC SERVICES 1200 PLEASANT STREET DES MOINES IA 50309 270987243 0 0 0 173820 173820 34764 8691 0 0 0 INTRUST 11333 AURORA AVENUE URBANDALE IA 50322 421477471 0 0 0 47323453 47323453 1000000 250000 0 0 0 CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421189791 0 0 0 2712629 2712629 285631 71408 0 0 0 CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 420680452 0 24000 24000 586314483 586338483 1000000 250000 0 0 0 IOWA HEALTH FOUNDATION 1440 INGERSOLL AVENUE DES MOINES IA 50309 421467682 0 0 0 6126705 6126705 456335 114084 0 0 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA IA 52205 421466284 0 0 0 388395 388395 77679 19420 0 0 0 ST LUKE'S METHODIST HOSPITAL 1026 A AVENUE NE CEDAR RAPIDS IA 52402 420504780 0 0 0 253840526 253840526 1000000 250000 0 0 0 ST LUKE'S HEALTHCARE 1026 A AVENUE NE CEDAR RAPIDS IA 52402 421487968 0 0 0 1434602 1434602 218460 54615 0 0 0 STL CARE COMPANY 1026 A AVENUE NE CEDAR RAPIDS IA 52402 421276632 0 0 0 17131300 17131300 1000000 250000 0 0 0 ST LUKE'SJONES REGIONAL MEDICAL CENTER 104 BROADWAY PLACE ANAMOSA IA 52205 421487967 0 0 0 10518645 10518645 675932 168983 0 0 0 NELLIE SHERWOOD TRUST 1026 A AVENUE NE CEDAR RAPIDS IA 52402 426061621 0 0 0 24414 24414 4883 1221 0 0 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 0 0 0 1307732 1307732 205773 51443 0 0 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 0 0 0 163275025 163275025 1000000 250000 0 0 0 MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO IA 50703 421201138 0 0 0 1346006 1346006 209601 52400 0 0 0 ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 0 0 0 5287361 5287361 414368 103592 0 0 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 0 0 0 104892826 104892826 1000000 250000 0 0 0 ST LUKE'S HEALTH SYSTEM INC 2720 STONE PARK BLVD SIOUX CITY IA 51104 421294091 0 0 0 1663097 1663097 233155 58289 0 0 0 ST LUKE'S HEALTH RESOURCES 2720 STONE PARK BLVD SIOUX CITY IA 51104 421059182 0 0 0 14227861 14227861 861393 215348 0 0 0 FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 421307495 0 0 0 368925 368925 73785 18446 0 0 0 THE FINLEY HOSPITAL 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 420680354 0 0 0 70306065 70306065 1000000 250000 0 0 0 THE DUBUQUE VISITING NURSE ASSOCIATION 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 420680410 0 0 0 2710336 2710336 285517 71379 0 0 0 NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC 720 KENYON ROAD FORT DODGE IA 50501 420937390 0 0 0 1845356 1845356 242268 60567 0 0 0 TRINITY HEALTH SYSTEMS INC 802 KENYON ROAD FORT DODGE IA 50501 421222877 0 0 0 3283868 3283868 314193 78548 0 0 0 TRINITY REGIONAL MEDICAL CENTER 802 KENYON ROAD FORT DODGE IA 50501 421009175 0 0 0 77927524 77927524 1000000 250000 0 0 0 TRINITY REGIONAL HOSPITAL AUXILIARY 802 KENYON ROAD FORT DODGE IA 50501 426081474 0 0 0 349358 349358 69872 17468 0 0 0 TRINITY HEALTH FOUNDATION 802 KENYON ROAD FORT DODGE IA 50501 421222381 0 0 0 1241797 1241797 199180 49795 0 0 0 THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 2701 17TH STREET ROCK ISLAND IL 61201 363678909 0 50000 50000 15959685 16009685 950484 237621 0 0 0 TRINITY HEALTH FOUNDATION 2701 17TH STREET ROCK ISLAND IL 61201 363321751 0 0 0 2449223 2449223 272461 68115 0 0 0 TRINITY MEDICAL CENTER 2701 17TH STREET ROCK ISLAND IL 61201 362739299 0 25000 25000 263124105 263149105 1000000 250000 0 0 0 TRINITY REGIONAL HEALTH SYSTEM 2701 17TH STREET ROCK ISLAND IL 61201 363351952 0 0 0 8403207 8403207 570160 142540 0 0 0 TRINITY VISITING NURSE & HOMEMAKER ASSOCIATION 2701 17TH STREET ROCK ISLAND IL 61201 363052939 0 0 0 24518284 24518284 1000000 250000 0 0 0 UNITY HEALTHCARE 1518 MULBERRY AVENUE MUSCATINE IA 52761 420680337 0 0 0 46846864 46846864 1000000 250000 0 0 0