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HENRY COUNTY HEALTH CENTER INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
HENRY COUNTY HEALTH CENTER INC (EIN 86-2701018)
Tax period
2024-07-01 to 2025-06-30
Filed
2026-05-04
IRS object ID
202641249349301504
Schema version
2024v5.5
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)
Return2026-05-04T11:30:00-05:00ReturnTs
Tax Period End2025-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN862701018EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HENRY COUNTY HEALTH CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHENRBusinessNameControlTxt
Phone3193853141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1407 S WHITE STREETAddressLine1Txt
CityMT PLEASANTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52641ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEREMY ALEXANDERPersonNm
Person TitleCFOPersonTitleTxt
Phone3193853141PhoneNum
Signature2026-05-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNION CPAPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2026-05-01PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GREAT RIVER HENRY COUNTY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTERESA COLGANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1407 S WHITE STREETAddressLine1Txt
CityMT PLEASANTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52641ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$70,038,470GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GREATRIVERHEALTH.ORG/HENRY-COUNTY-HEALTH-CENTWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2021FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionHENRY COUNTY HEALTH CENTER IS COMMITTED TO ENHANCING THE HEALTH OF INDIVIDUALS AND OUR COMMUNITIES THROUGH HIGH QUALITY, EFFECTIVE AND EFFICIENT SERVICES.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers31TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$8,081,950PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$56,954,594PYProgramServiceRevenueAmt
CY Program Service Revenue$69,164,311CYProgramServiceRevenueAmt
PY Investment Income$36,993PYInvestmentIncomeAmt
CY Investment Income$306,938CYInvestmentIncomeAmt
PY Other Revenue$383,298PYOtherRevenueAmt
CY Other Revenue$567,221CYOtherRevenueAmt
PY Total Revenue$65,456,835PYTotalRevenueAmt
CY Total Revenue$70,038,470CYTotalRevenueAmt
PY Grants And Similar Paid$144,358PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,500,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,465,779PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,324,489CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$34,198,583PYOtherExpensesAmt
CY Other Expenses$39,924,512CYOtherExpensesAmt
PY Total Expenses$52,808,720PYTotalExpensesAmt
CY Total Expenses$73,749,001CYTotalExpensesAmt
PY Revenues Less Expenses$12,648,115PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,710,531CYRevenuesLessExpensesAmt
Total Assets BOY$45,143,076TotalAssetsBOYAmt
Total Assets EOY$47,511,032TotalAssetsEOYAmt
Total Liabilities BOY$27,717,225TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,795,712TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,425,851NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,715,320NetAssetsOrFundBalancesEOYAmt
MissionHENRY COUNTY HEALTH CENTER IS COMMITTED TO ENHANCING THE HEALTH OF INDIVIDUALS AND OUR COMMUNITIES THROUGH HIGH QUALITY, EFFECTIVE AND EFFICIENT SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$60,056,467ExpenseAmt
Grant$13,500,000GrantAmt
Revenue$69,164,311RevenueAmt
DescHENRY COUNTY HEALTH CENTER, INC., HAS ENTERED INTO A HOSPITAL LEASE AGREEMENT WHERE IT LEASES ALL OF THE FACILITIES AND OPERATIONS, EXCEPT THE AMBULANCE SERVICE, OF HENRY COUNTY SOLDIERS AND SAILORS MEMORIAL HOSPITAL, A COUNTY HOSPITAL ORGANIZED UNDER IOWA CODE CHAPTER 347. HENRY COUNTY HEALTH CENTER, INC. MANAGES AND OPERATES HEALTH CARE ORGANIZATIONS, INCLUDING OPERATING THE 74-BED CRITICAL ACCESS HOSPITAL THAT FEATURES 25 ACUTE CARE BEDS ALONG WITH A 49-BED LONG-TERM CARE FACILITY, PARK PLACE. HENRY COUNTY HEALTH CENTER, INC. ALSO MANAGES ANDOPERATES A CLINICAL/GROUP PRACTICE LOCATED ON THE GROUNDS OF THE HOSPITAL AND RURAL HEALTH CLINICS IN THE SURROUNDING RURAL COMMUNITIES AND PROVIDES COMMUNITY HEALTH EDUCATION FOR THE COMMUNITY.Desc
Total Program Service Expenses$60,056,467TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document38IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHERYL ALBINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3197681000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11221 SOUTH GEAR AVENUEAddressLine1Txt
CityWEST BURLINGTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52655ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DR MICHAEL MCCOY
PRESIDENT0.5042.50Yes (X)Yes (X)$0$1,089,131$47,792
DAVID FILE
CHAIRPERSON0.500.00Yes (X)Yes (X)$0$0$0
WHITNEY ROGERS
VICE CHAIRMAN0.500.00Yes (X)Yes (X)$0$0$0
SARA BETH SCHURR
SECRETARY/TREASURER0.500.00Yes (X)Yes (X)$0$0$0
CHAD HUDSON
DIRECTOR0.500.00Yes (X)$0$0$0
JENNIFER MOUTRIE
DIRECTOR0.500.00Yes (X)$0$0$0
DR JOE TANSEY
DIRECTOR0.500.00Yes (X)$0$0$0
TERESA COLGAN
CEO40.000.00Yes (X)$0$503,277$49,926
DAVID MUHS
CFO (THROUGH 4/22/2025)40.000.00Yes (X)$179,307$0$45,988
JEREMY ALEXANDER
CFO0.5042.50Yes (X)$0$689,029$60,088
FieldValueIRS element (for citing)
Total Reportable Comp From Org$179,307TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,281,437TotReportableCompRltdOrgAmt
Total Other Compensation$203,794TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PSYCHIATRIC MEDICAL CARE LLC
PO BOX 734606DALLASTX75373CONTRACTED LABOR$902,951
HALLMARK HEALTH CARE SOLUTIONS INC
PO BOX 22937NEW YORKNY10087CONTRACTED LABOR$577,016
ARAMARK SERVICES
27310 NETWORK PLACECHICAGOIL60673NUTRITION SERVICES$399,733
WAPITI MEDICAL STAFFING
107 FLYNN DRIVE SUITE 600MILBANKSD57252EMERGENCY ROOM SERVICES$309,463
MICHAEL NIEHAUS
PO BOX 549WEST BURLINGTONIA52655CONTRACTED LABOR$307,416
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE621400$66,712,476$66,712,476
OTHER OPERATING INCOME621400$2,451,835$2,451,835
FieldValueIRS element (for citing)
Total Program Service Revenue$69,164,311TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$306,938TotalRevenueColumnAmt
Exclusion$306,938ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$399,616RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$399,616RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$399,616TotalRevenueColumnAmt
Exclusion$399,616ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$167,605TotalRevenueColumnAmt
Exclusion$167,605ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$167,605OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,038,470TotalRevenueColumnAmt
Related Or Exempt Func Income$69,164,311RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$874,159ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,500,000TotalAmt
Program Services$13,500,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,710,157TotalAmt
Program Services$13,423,124ProgramServicesAmt
Management And General$2,287,033ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,510,473TotalAmt
Program Services$2,933,735ProgramServicesAmt
Management And General$576,738ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,103,859TotalAmt
Program Services$944,050ProgramServicesAmt
Management And General$159,809ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$101,589TotalAmt
Management And General$101,589ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$193,693TotalAmt
Management And General$193,693ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$22,716,322TotalAmt
Program Services$14,295,343ProgramServicesAmt
Management And General$8,420,979ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$166,052TotalAmt
Program Services$104,481ProgramServicesAmt
Management And General$61,571ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,884,014TotalAmt
Program Services$2,548,738ProgramServicesAmt
Management And General$335,276ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$794,467TotalAmt
Program Services$20ProgramServicesAmt
Management And General$794,447ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$391,129TotalAmt
Program Services$391,129ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$736,450TotalAmt
Program Services$7,944ProgramServicesAmt
Management And General$728,506ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$7,204,605$7,171,712$32,893
BAD DEBT EXPENSE$3,592,125$3,592,125
PROVIDER TAX$1,144,066$1,144,066

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$73,749,001TotalAmt
Program Services$60,056,467ProgramServicesAmt
Management And General$13,692,534ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,293,439BOYAmt
EOY$10,557,056EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,114,588BOYAmt
EOY$11,907,624EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$704,532BOYAmt
EOY$583,883EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,147,312BOYAmt
EOY$1,661,126EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$22,883,205BOYAmt
EOY$22,801,343EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,143,076BOYAmt
EOY$47,511,032EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,480,022BOYAmt
EOY$7,430,367EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,237,203BOYAmt
EOY$26,365,345EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,717,225BOYAmt
EOY$33,795,712EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,425,851BOYAmt
EOY$13,715,320EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,425,851BOYAmt
EOY$13,715,320EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,143,076BOYAmt
EOY$47,511,032EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$3,710,531ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,446OtherActivitiesAmt
Total Lobbying Expenditures$7,446TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationHENRY COUNTY HEALTH CENTER PAYS ASSOCIATION DUES TO THE IOWA HOSPITAL ASSOCIATION (IHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). PORTIONS OF THE ASSOCIATION DUES ARE EXPENDED BY THE ASSOCIATIONS FOR LOBBYING PURPOSES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescRIGHT-OF-USE LEASE ASSETSDesc
Book Value$22,801,343BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$22,801,343TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
RIGHT-OF-USE LEASE LIABILITIES$22,801,343
INTERCOMPANY PAYABLE$3,564,002
FieldValueIRS element (for citing)
Total Liability$26,365,345TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE ORGANIZATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE CONSOLIDATED FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$232,778TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$232,778NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,438,085TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,353,889DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,670,863TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,353,889DirectOffsettingRevenueAmt
Net Community Benefit Expns$232,778NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,121TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,121NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,121TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$39,121NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,709,984TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,353,889DirectOffsettingRevenueAmt
Net Community Benefit Expns$271,899NetCommunityBenefitExpnsAmt
Total Expense0.00390TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,592,125BadDebtExpenseAmt
Bad Debt Expense Attributable$431,055BadDebtExpenseAttributableAmt
Reimbursed By Medicare$17,791,625ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$18,023,478CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$231,853MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HENRY COUNTY HEALTH CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1407 SOUTH WHITE STREETAddressLine1Txt
CityMT PLEASANTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52641ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.GREATRIVERHEALTH.ORG/HENRY-COUNTY-WebsiteAddressTxt
State License440047HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HENRY COUNTY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted23CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt23ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE LINE 16JFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE LINE 16JFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE LINE 16JFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 5: HENRY COUNTY HEALTH CENTER, PART OF GREAT RIVER HEALTH SYSTEM, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO DISTINGUISH THE UNMET MEDICAL AND PUBLIC HEALTH NEEDS IN HENRY COUNTY.THE STUDY HAS THREE OBJECTIVES:1. TO CONDUCT AN ASSESSMENT THAT PROVIDES A FOUNDATION FOR HENRY COUNTY HEALTH CENTER AND ITS PARTNERS TO BUILD A CONSENSUS ABOUT THE AREA'S MOST CRITICAL HEALTH CARE NEEDS2. TO MEET STATE AND FEDERAL REQUIREMENTS FOR HOSPITALS THAT MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY 3 YEARS3. TO DEVELOP ACTION PLANS FOR INTERVENTIONS TO ADDRESS CONCERNS HIGHLIGHTED BY THE COMMUNITY AND HEALTH DATAINFORMATION WAS COLLECTED THROUGH A COMMUNITY SURVEY AND SECONDARY DATA FROM A VARIETY OF SOURCES FROM STATE AND NATIONAL ORGANIZATIONS. THE SURVEY WAS MADE AVAILABLE ONLINE AND AT PUBLIC LOCATIONS ACROSS THE COUNTY. THE SURVEY WAS TRANSLATED INTO SPANISH AND OUTREACH ACTIVITIES TARGETED TYPICALLY UNDERREPRESENTED GROUPS. A TOTAL OF 641 COMPLETED SURVEYS WERE RETURNED, WHICH IS OVER 3% OF THE POPULATION IN HENRY COUNTY.THE ASSESSMENT IDENTIFIED EIGHT PRIORITIES THATE NEED TO BE ADDRESSED IN ORDER TO MAKE HENRY COUNTY A HEALTHIER PLACE TO LIVE AND WORK. SIX OF THE EIGHT WERE CHOOSEN TO BE A PART OF THE IMPROVEMENT PLAN. THE FOLLOWING SIX UNMET HEALTH NEEDS WERE CHOSEN: -MENTAL HEALTH -CANCER -HEALTHLY FOOD ACCESS & AWARENESS -ACTIVE LIVING -OLDER ADULT HEALTH AND AGING ISSUES -ACCESS TO CARETHESE SIX AREAS WILL BE THE FOCUS OF HENRY COUNTY HEALTH CENTER'S EFFORTS TO IMPROVE THE HEALTH OF HENRY COUNTY.
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 6B: HENRY COUNTY HEALTH CENTER CONTINUALLY WORKS WITH PARTNERS AND STAKEHOLDERS OUTSIDE THE HOSPITAL TO MEET THE HEALTH NEEDS OF THE COMMUNITY. HENRY COUNTY HEALTH CENTER COLLABORATED WITH HENRY COUNTY PUBLIC HEALTH, ISU EXTENSION AND OUTREACH, AND HEALTHY HENRY COUNTY COMMUNITIES ON A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT.
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 7D: HCHC'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT:HTTPS://WWW.GREATRIVERHEALTH.ORG/ABOUT-US/COMMUNITY-COMMITMENT/
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 11: HENRY COUNTY HEALTH CENTER WORKED WITH HENRY COUNTY RESPECTIVE PARTNERS TO REVIEW THE DATA AND INFORMATION GATHERED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. AFTER REVIEWING THE DATA FROM THE SURVEY, THE FOLLOWING HIGH PRIORITY HEALTH CONCERNS WERE SELECTED: - MENTAL HEALTH - CANCER - HEALTHY FOOD ACCESS & AWARENESS - ACTIVE LIVING - OLDER ADULT HEALTH AND AGING ISSUES - ACCESS TO CARELEADERS AT HENRY COUNTY HEALTH CENTER HIGHLIGHTED THE FOLLOWING IMPLEMENTATION STRATEGIES, POTENTIAL IMPACTS, AND RESOURCES NEEDED FOR EACH FOCUS AREA.MENTAL HEALTH- EXPAND EXISTING PROGRAMS- RECRUITMENT- EXPAND SENIOR LIFE SOLUTIONS- PROMOTE EXISTING TRANSPORTATION SERVICESCANCER- PROMOTE AND SUPPORT PROGRAMS- CREATE FLYER LISTING SERVICES- EDUCATE ABOUT CANCER SCREENING RECOMMENDATIONSHEALTHY FOOD ACCESS AND AWARENESS - SUPPORT AND PROMOTE FOOD DONATIONS- PROMOTE FOOD ASSISTANCE PROGRAMS- INCREASE EXPOSURE TO AND EDUCATION IN SCHOOLS AND CREATE COMMUNITY EDUCATION CLASSESACTIVE LIVING-HOST AND PROMOTE FREE COMMUNITY ACTIVITIES-PROMOTE OUTDOOR FACILITIES-EXPLORE SHARED USE AGREEMENTS WITH SCHOOL FACILITIESOLDER ADULT HEALTH AND AGING ISSUES- PROMOTE HENRY COUNTY LIFELINE SERVICES- DEVELOP AND PROMOTE A FALL PREVENTION PROGRAM- PROMOTE FINANCIAL ASSISTANCE- TEACH COMMUNITY BLOOD PRESSURE MONITORING ACCESS TO CARE- PROMOTE PUBLIC TRANSPORTATION- PROMOTE SHIIP- PROMOTE DELIVERY SERVICES- DEVELOP CHRONIC CARE MANAGEMENT PROGRAM
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 13H: HCHC MAY USE PRESUMPTIVE FINANCIAL ASSISTANCE ELIGIBILITY:THERE ARE INSTANCES WHEN A PATIENT/INDIVIDUAL MAY APPEAR TO BE ELIGIBLE FOR CHARITY-CARE DISCOUNTS, BUT THERE IS NO COMPLETED FINANCIAL ASSISTANCE FORM ON FILE BECAUSE OF A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER RESOURCES THAT COULD PROVIDE SUFFICIENT EVIDENCE TO DETERMINE ELIGIBILITY.1. INFORMATION IS PROVIDED WEEKLY TO AN OUTSIDE SOURCE. OUTSIDE SOURCE RETURNS RESULTS TO HENRY COUNTY HEALTH CENTER ABOUT PATIENT QUALIFICATIONS BASED ON OUR FINANCIAL ASSISTANCE POLICY.2. OUTSIDE SOURCE USES DEMOGRAPHIC AND HOUSEHOLD INFORMATION, AND CREDIT-SCORING TECHNOLOGY TO DETERMINE THE PERCENTAGE OF ASSISTANCE FOR WHICH A PATIENT MAY BE ELIGIBLE.3. HENRY COUNTY HEALTH CENTER WILL ATTEMPT TO CONTACT PATIENTS BASED ON THEIR PRESUMPTIVE ASSISTANCE QUALIFICATION TO ALLOW THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE.4. PATIENTS WILL NOT BE DISQUALIFIED FROM FINANCIAL ASSISTANCE BASED ON PRESUMPTIVE ASSISTANCE RESULTS.5. IF THE ACCOUNT IS PAST DUE AND THERE IS NO COMPLETED FINANCIAL ASSISTANCE APPLICATION OR SUPPORTING DOCUMENTATION, THE PATIENT'S ACCOUNT COULD BE CONSIDERED FOR FINANCIAL ASSISTANCE BASED ON OUTSIDE SOURCE'S RESULTS.6. PRESUMPTIVE ELIGIBILITY ALSO CAN BE DETERMINED BASED ON LIFE CIRCUMSTANCES INCLUDING: -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED -FOOD STAMP ELIGIBILITY -HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC -LOW INCOME/SUBSIDIZED HOUSING PROVIDED AS A VALID ADDRESS -PARTICIPATION IN THE WOMEN INFANTS AND CHILDREN (WIC) PROGRAM -PATIENT IS DECEASED WITH NO KNOWN ESTATE -STATE-FUNDED PRESCRIPTION PROGRAMS -SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY7. IT ALSO IS ACCEPTABLE TO USE PROXY INFORMATION TO DETERMINE ELIGIBILITY WHEN INCOME LEVELS CANNOT BE DIRECTLY DETERMINED. SUCH INFORMATION COULD INCLUDE STATEMENTS LIKE "STAYS WITH FRIENDS OR "OCCASIONALLY WORKS."8. PATIENTS WHO MEET PRESUMPTIVE-CARE GUIDELINES MAY QUALIFY FOR FINANCIAL ASSISTANCE DISCOUNTS. THIS DETERMINATION IS AT THE DISCRETION OF HENRY COUNTY HEALTH CENTER.9. IN A SITUATION, WHERE PRESUMPTIVE ELIGIBILITY IS GIVEN TO A PATIENT AND A FINANCIAL ASSISTANCE APPLICATION IS OBTAINED LATER, THE UPDATED ELIGIBILITY WILL BE BASED ON THE FINANCIAL ASSISTANCE APPLICATION WITH SUPPORTING DOCUMENTATION. IN THIS CASE, HENRY COUNTY HEALTH CENTER COULD ADJUST FINANCIAL ASSISTANCE UP TO THREE MONTHS BEFORE THE APPLICATION DATE.
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AT WWW.GREATRIVERHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-POLICY-APPLICATION/
HENRY COUNTY HEALTH CENTERPART V, SECTION B, LINE 20E: HCHC USES AN OUTSIDE SOURCE TO SCREEN PATIENTS TO SEE IF THEY COULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL GETS NOTIFICATION BACK AS TO HOW MUCH OF A FINANCIAL ASSISTANCE DISCOUNT THEY WOULD BE ELIGIBLE FOR. IF THE PATIENT DOESN'T RESPOND TO PHONE CALLS REGARDING THE FINANCIAL ASSISTANCE APPLICATION OR THEY DON'T COMPLETE THE APPLICATION, THE HOSPITAL MAY STILL DISCOUNT THE PATIENT'S CHARGES UNDER THEIR PRESUMPTIVE CHARITY POLICY. THE HOSPITAL'S PRESUMPTIVE CHARITY PROGRAM GIVES THE HOSPITAL THE OPPORTUNITY TO DISCOUNT PATIENT ACCOUNTS BASED ON INFORMATION IT MAY HAVE REGARDING A PATIENT BEING HOMELESS OR UNEMPLOYED.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - PARK PLACE ELDER LIVING
401 S VAN BUREN STREETMT PLEASANTIA52641NURSING HOME CARE
2 - HCHC - MT PLEASANT CLINIC
407 S WHITE STREET SUITE 103MT PLEASANTIA52641PROVIDER HEALTH CLINIC
3 - HCHC - WINFIELD CLINIC
110 W PINE STREETWINFIELDIA52659PROVIDER HEALTH CLINIC
4 - HCHC - WAYLAND CLINIC
227 W MAIN STREETWAYLANDIA52654PROVIDER HEALTH CLINIC
5 - HCHC - NEW LONDON CLINIC
111 W WASHINGTON STREETNEW LONDONIA52645PROVIDER HEALTH CLINIC
6 - HCHC - WAPELLO CLINIC
220 MULBERRY STREET SUITE AWAPELLOIA52653PROVIDER HEALTH CLINIC
7 - HCHC - KEOKUK CLINIC
3285 MAIN STREETKEOKUKIA52632PROVIDER HEALTH CLINIC
8 - HCHC - MEDIAPOLIS CLINIC
401 N ORCHARD STREETMEDIAPOLISIA52637PROVIDER HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:HENRY COUNTY HEALTH CENTER (HCHC) USES THE FPG TO DETERMINE FREE OR DISCOUNTED CARE. INDIVIDUALS WHO ARE BELOW 200% OF THE FPG QUALIFY FOR FREE CARE. IN MOST INSTANCES, THEY HAVE TO PROVIDE FINANCIAL DOCUMENTATION AND FILL OUT A CHARITY CARE APPLICATION. THE HOSPITAL ALSO USES A PRESUMPTIVE CHARITY CARE PROGRAM THAT ANALYZES PUBLIC AND PRIVATE DATABASES TO HELP DETERMINE ELIGIBILITY FOR CHARITY CARE. THESE INDIVIDUALS DO NOT HAVE ANY OTHER DOCUMENTATION TO PROVIDE. THIS PROGRAM IS USED AFTER COLLECTION ATTEMPTS HAVE BEEN DISCONTINUED. EXTRAORDINARY ASSETS ARE TAKEN INTO CONSIDERATION WHEN DETERMINING CHARITY CARE ELIGIBILITY. MEDICALLY INDIGENT INDIVIDUALS ARE COVERED UNDER THE SAME CHARITY CARE POLICY. INDIVIDUALS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LIMITS ARE GRANTED CHARITY ON A SLIDING SCALE.
PART I, LINE 7:THE AMOUNTS INCLUDED IN PART I, LINES 7A-7D WERE CALCULATED USING COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS SCHEDULE H INSTRUCTIONS. PART I, LINES 7E-7J ARE ACTUAL COSTS.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,592,125.
PART III, LINE 2:THE HEALTH CENTER DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR GOODS AND SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE HEALTH CENTER'S POLICY, AND OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. THE HEALTH CENTER DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. THE HEALTH CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS.
PART III, LINE 3:THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL. 12% CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE.
PART III, LINE 4:SEE THE "PATIENTS RECEIVABLES" PARAGRAPH IN NOTE 1 ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE.
PART III, LINE 8:THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT ARE (A) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (B) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; AND (C) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B:EACH PATIENT RECEIVES CARE REGARD LESS OF THE ABILITY TO PAY. ANY PATIENT CAN APPLY FOR FINANCIAL ASSISTANCE PRIOR TOO RAFTER RECEIVING A STATEMENT FOR SERVICES. THERE ARE NO COLLECTION EFFORTS WHILE AN INDIVIDUAL IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE. THE HOSPITAL WILL NOT PURSUE EXTRAORDINARY COLLECTION ACTIVITIES ON PATIENTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST STATEMENT AND PROVIDES PATIENTS 240 DAYS TO APPLY FOR ASSISTANCE.
PART VI, LINE 2:HENRY COUNTY HEALTH CENTER, INC., RECEIVED TAX EXEMPT STATUS AS A 501(C)(3) IN MARCH 2021 AND ENTERED INTO A HOSPITAL LEASE AGREEMENT WHERE IT LEASES ALL OF THE FACILITIES AND OPERATIONS, EXCEPT THE AMBULANCE SERVICE, OF HENRY COUNTY SOLDIERS AND SAILORS MEMORIAL HOSPITAL, A COUNTY HOSPITAL ORGANIZED UNDER IOWA CODE CHAPTER 347. HENRY COUNTY HEALTH CENTER, INC. MANAGES AND OPERATES HEALTH CARE ORGANIZATIONS. THIS INCLUDES OPERATING THE 74-BED CRITICAL ACCESS HOSPITAL THAT FEATURES 25 ACUTE CARE BEDS ALONG WITH A 49-BED LONG TERM CARE FACILITY, PARK PLACE. HENRY COUNTY HEALTH CENTER, INC. ALSO MANAGES AND OPERATES A CLINICAL/GROUP PRACTICE LOCATED ON THE GROUNDS OF THE HOSPITAL AND SEVEN RURAL HEALTH CLINICS IN THE SURROUNDING RURAL COMMUNITIES AND PROVIDES COMMUNITY HEALTH EDUCATION FOR THE COMMUNITY.
PART VI, LINE 3:NOTIFICATION ABOUT GOVERNMENT PROGRAM AND/OR FINANCIAL ASSISTANCE FROM HCHC IS DISSEMINATED BY VARIOUS MEANS AT HCHC, WHICH INCLUDES PUBLICATION OF NOTICES IN PATIENT BILLS AND POSTED NOTICES IN THE EMERGENCY ROOMS, ADMISSION FORMS, ADMITTING AND REGISTRATION DEPARTMENT, HOSPITAL BUSINESS OFFICES, AND THE FINANCIAL SERVICES OFFICE ON THE FACILITY CAMPUS. HCHC ALSO POSTS AT THE LOCAL DEPARTMENT OF HEALTH SERVICES OFFICE. HCHC ALSO PUBLISHES AND WIDELY PUBLICIZES A SUMMARY OF THE ASSISTANCE OPTIONS ON THE FACILITY WEBSITE AND IN BROCHURES AVAILABLE IN PATIENT ACCESS SITES. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE SEIRMC STAFF. ALSO REQUESTS FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. FINANCIAL COUNSELORS MEET WITH PATIENTS TO ASSIST IN COMPLETING A QUESTIONNAIRE THAT HELPS THEM DETERMINE IF THE PATIENT QUALIFIES FOR A GOVERNMENT PROGRAM.
PART VI, LINE 4:HENRY COUNTY HEALTH CENTER, INC., ENTERED INTO A HOSPITAL LEASE AGREEMENT WHERE IT LEASES ALL OF THE FACILITIES AND OPERATIONS, EXCEPT THE AMBULANCE SERVICE, OF HENRY COUNTY SOLDIERS AND SAILORS MEMORIAL HOSPITAL, A COUNTY HOSPITAL ORGANIZED UNDER IOWA CODE CHAPTER 347. HENRY COUNTY HEALTH CENTER, INC. MANAGES AND OPERATES HEALTH CARE ORGANIZATIONS. THIS INCLUDES OPERATING THE 74 BED CRITICAL ACCESS HOSPITAL THAT FEATURES 25 ACUTE CARE BEDS. HENRY COUNTY HEALTH CENTER, INC. ALSO MANAGES AND OPERATES A CLINICAL/GROUP PRACTICE LOCATED ON THE GROUNDS OF THE HOSPITAL AND RURAL HEALTH CLINICS IN THE SURROUNDING RURAL COMMUNITIES AND PROVIDE COMMUNITY HEALTH EDUCATION FOR THE COMMUNITY. LOCATED IN SOUTH EAST IOWA, MOUNT PLEASANT IS AT THE CROSSROADS OF U.S. HIGHWAY 218 AND U.S. 34. HENRY COUNTY HAS 11 CITIES AND MORE THAN 20,000 PEOPLE. THE MEDIAN HOUSEHOLD INCOME IN HENRY COUNTY IS $67,436. THIS IS LOWER THAN THE STATE MEDIAN ($75,501) AND NATIONAL MEDIAN ($81,604). 12 PERCENT OF ALL RESIDENTS AND 15.2% OF CHILDREN UNDER THE AGE OF 18 LIVE IN HOUSEHOLDS EARNING LESS THAN THE FEDERAL POVERTY LEVEL. THE STATE POVERTY LEVEL IS 11.3% FOR ALL RESIDENTS AND 13.6% FOR CHILDERN UNDER THE AGE OF 18. THE FEDERAL LEVEL IS 12.1% FOR ALL RESIDENTS AND 15.5% FOR CHILDERN UNDER THE AGE OF 18. 20.2 PERCENT OF THE POPULATION IS 65 YEARS OR OLDER WHICH IS HIGHER THAN IOWA'S OVERALL RATE OF 18.9%. ACCORDING TO THE U.S. CENSUS ESTIMATES, HENRY COUNTY IS 86.1% WHITE, 2.5% BLACK OR AFRICAN AMERICAN, 0.4% AMERICAN INDIAN AND ALASKA NATIVE, 2.2% ASIAN, AND 3.2% TWO OR MORE RACES.
PART VI, LINE 5:THE BOARD MEMBERS LIVE IN THE HOSPITAL SERVICE AREA AND USE THE FACILITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. HENRY COUNTY HEALTH CENTER USES SURPLUS FUNDS TO INVEST IN HOSPITAL EQUIPMENT AND IMPROVEMENTS.
PART VI, LINE 6:HENRY COUNTY HEALTH CENTER IS PART OF GREAT RIVER HEALTH SYSTEM.GREAT RIVER HEALTH SYSTEM CONSISTS OF TWO HOSPITALS, A HOSPICE HOUSE, HOME HEALTH SERVICES, AMBULANCE SERVICES, THREE PHARMACIES, A DURABLE MEDICAL EQUIPMENT COMPANY, A LONG-TERM CARE NURSING HOME, ABOUT 25 PRIMARY-CARE AND SPECIALTY PHYSICIAN CLINICS, AND IS AFFILIATED WITH AN OUTPATIENT RENAL DIALYSIS CENTER.THE NON-HOSPITAL HEALTH CARE FACILITIES THAT ARE OPERATED BY ORGANIZATIONS RELATED TO THE HOSPITAL ARE: GREAT RIVER HEALTH SYSTEM-ANESTHESIA; GREAT RIVER HEALTH SYSTEM-AUDIOLOGY; GREAT RIVER HEALTH SYSTEM-BUSINESS HEALTH; GREAT RIVER HEALTH SYSTEM-CANCER CENTER; GREAT RIVER HEALTH SYSTEM-CARDIOLOGY; GREAT RIVER HEALTH SYSTEM-DIABETIC FOOT CLINIC; GREAT RIVER HEALTH SYSTEM-EYE SPECIALISTS; GREAT RIVER HEALTH SYSTEM-FAMILY MEDICINE; GREAT RIVER HEALTH SYSTEM-FAMILY MEDICINE, MERCY PLAZA; GREAT RIVER HEALTH SYSTEM-GASTROENTEROLOGY; GREAT RIVER HEALTH SYSTEM-HEALTHY LIVING; GREAT RIVER HEALTH SYSTEM-HERITAGE FAMILY PHARMACY; GREAT RIVER HEALTH SYSTEM-HERITAGE MEDICAL EQUIPMENT AND SUPPLIES; GREAT RIVER HEALTH SYSTEM-HERITAGE PARK PHARMACY; GREAT RIVER HEALTH SYSTEM-HERITAGE PARTNERS PHARMACY; GREAT RIVER HEALTH SYSTEM-KEOKUK; GREAT RIVER HEALTH SYSTEM-MEDIAPOLIS; GREAT RIVER HEALTH SYSTEM-MEDICINE SPECIALISTS; GREAT RIVER HEALTH SYSTEM-MENTAL HEALTH; GREAT RIVER HEALTH SYSTEM-NEPHROLOGY; GREAT RIVER HEALTH SYSTEM-ORTHOPAEDIC SPECIALISTS; GREAT RIVER HEALTH SYSTEM-PULMONOLOGY; GREAT RIVER HEALTH SYSTEM-QUICK CARE; GREAT RIVER HEALTH SYSTEM-SURGEONS; GREAT RIVER HEALTH SYSTEM-UROLOGY; GREAT RIVER HEALTH SYSTEM-WAPELLO; GREAT RIVER HEALTH SYSTEM-WEST POINT; GREAT RIVER HEALTH SYSTEM-WOMEN'S HEALTH; GREAT RIVER HEALTH SYSTEM-WOUND AND HYPERBARIC; SOUTHEASTERN RENAL DIALYSIS.
PART VI, LINE 7:HCHC DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF IOWA. HOWEVER, COMMUNITY BENEFIT INFORMATION IS PROVIDED TO THE IOWA HOSPITAL ASSOCIATION.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655420680407501(C)(3)$5,000,000$0N/AN/AOPERATION SUPPORT
GREAT RIVER HEALTH SYSTEM INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421193185501(C)(3)$8,500,000$0N/AN/AOPERATION SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS TO ORGANIZATIONS ARE INTERCOMPANY TRANSFERS. USE OF FUNDS ARE MONITORED BY COMMON BOARD MEMBERS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR MICHAEL MCCOY
PRESIDENT$0$835,743$0$238,910$0$14,478$0$17,250$0$30,542$0$1,136,923$0$0
JEREMY ALEXANDER
CFO$0$582,343$0$105,546$0$1,140$0$17,250$0$42,838$0$749,117$0$0
TERESA COLGAN
CEO$0$382,971$0$81,690$0$38,616$0$17,250$0$32,676$0$553,203$0$0
DAVID MUHS
CFO (THROUGH 4/22/2025)$163,981$0$0$0$15,326$0$2,586$0$43,402$0$225,295$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE COMPENSATION OF DR. MICHAEL MCCOY IS DETERMINED BY GREAT RIVER HEALTH SYSTEM. THE FOLLOWING WERE USED BY GREAT RIVER HEALTH SYSTEM IN DETERMINING HIS COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. FORM 990 OF OTHER ORGANIZATIONS 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4BGREAT RIVER HEALTH SYSTEM MAINTAINS A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN (457(F)). IN CALENDAR YEAR 2024, NO DISTRIBUTIONS WERE MADE OUT OF THE PLAN. IN CALENDAR YEAR 2024, THE FOLLOWING CONTRIBUTIONS WERE MADE THE THE INDIVIDUALS PLAN: DR. MICHALE MCCOY - $175,750 JEREMY ALEXANDER - $67,713 TERESA COLGAN - $50,882
FORM 990, PART VII, SECTION A, LINE 5:DAVID MUHS IS EMPLOYED BY HENRY COUNTY SOLDIERS & SAILORS MEMORIAL HOSPITAL. DR. JOE TANSEY IS EMPLOYED BY HENRY COUNTY SOLDIERS & SAILORS MEMORIAL HOSPITAL. DR. JOE TANSEY RECEIVED $662,800 REPORTABLE COMPENSATION AND $75,537 OTHER COMPENSATION FOR CALENDAR YEAR 2024. THE EMPLOYEES FROM THAT HOSPITAL ARE LEASED TO HENRY COUNTY HEALTH CENTER INC.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2DR. MICHAEL MCCOY, JEREMY ALEXANDER, AND TERESA COLGAN HAVE A BUSINESS RELATIONSHIP. THEY SERVE ON THE FOR-PROFIT ENTITIES RELATED TO HENRY COUNTY HEALTH CENTER.
FORM 990, PART VI, SECTION A, LINE 3EXECUTIVES AND EMPLOYEES OF GREAT RIVER HEALTH SYSTEM INC MANAGE THE ACTIVITIES OF THE HENRY COUNTY HEALTH CENTER INC.
FORM 990, PART VI, SECTION A, LINE 4THE BYLAWS WERE AMENDED IN JUNE 2025 TO REQUIRE THAT AT LEAST FIVE DIRECTORS BE RESIDENTS OF HENRY COUNTY, IOWA.
FORM 990, PART VI, SECTION A, LINE 6GREAT RIVER HEALTH SYSTEM, INC., AN IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HENRY COUNTY HEALTH CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER, GREAT RIVER HEALTH SYSTEM, INC (GRHS), HAS THE SOLE POWER TO ELECT OR REMOVE ALL BOARD MEMBERS OF HENRY COUNTY HEALTH CENTER. THE NOMINATING COMMITTEE SHALL PRESENT A RECOMMENDATION FOR THE ELECTION OF DIRECTORS TO THE BOARD, WHICH UPON APPROVAL OF THE BOARD AND THE SUBSEQUENT APPROVAL OF GRHS, SHALL BE ELECTED TO THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7BTHE GRHS BOARD OF DIRECTORS HAS THE FOLLOWING SPECIFIC POWERS RELATED TO ALL SUBSIDIARY CORPORATIONS AND AFFILIATED ORGANIZATIONS: 1. ELECT OR REMOVE THE BOARD OF DIRECTORS, OR ANY OTHER MEMBER OF THE BOARD OF DIRECTORS; 2. AMEND THE ARTICLES OF INCORPORATION OR THE BYLAWS; 3. DISSOLVE OR APPROVE MERGER WITH ANY OTHER CORPORATE ENTITY; 4. APPROVE STRATEGIC OR OTHER BUSINESS PLANS; 5. APPROVE CAPITAL AND OPERATING BUDGETS; 6. APPROVAL OF ANY INDEBTEDNESS INCURRED; 7. TRANSFER, SELL OR CLOSE ANY FACILITY, DEPARTMENT OR FUNCTION; 8. APPROVE ANY CHARITABLE DISBURSEMENTS, WHETHER INTERNAL OR EXTERNAL, IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000.00) IN THE AGGREGATE DURING ANY FISCAL YEAR; 9. THE SALE, DISPOSITION OR ANY ENCUMBRANCE (OTHER THAN ROUTINE LEASE TRANSACTIONS) OF ANY REAL ESTATE; 10. ADOPT, AMEND, OR TERMINATE EMPLOYEE BENEFIT PROGRAMS OR PLANS; 11. APPOINT OR TERMINATE THE CHIEF EXECUTIVE OFFICER; 12. APPROVE THE ELECTION OF ANY OFFICER OR CHAIRPERSON OF THE BOARD OF DIRECTORS; AND 13. TO TAKE ANY OTHER ACTION NECESSARY DEEMED IN THE BEST INTERESTS OF GRHS.
FORM 990, PART VI, SECTION A, LINE 8BTHERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 WAS REVIEWED IN DETAIL BY THE CORPORATE CONTROLLER AND CFO. ANY NECESSARY ADJUSTMENTS WERE MADE PRIOR TO FINALIZING THE FORM. A COPY OF THE FINAL FORM 990 WAS MADE AVAILABLE TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. ANY QUESTIONS OF THE BOARD MEMBERS WERE ADDRESSED THROUGH THE ACCOUNTING DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 12CBOTH CORPORATE AND SUBSIDIARY BOARD MEMBERS ARE PROVIDED EDUCATION REGARDING CONFLICTS OF INTEREST. THIS EDUCATION IS PROVIDED BY THE CHIEF COMPLIANCE OFFICER. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. RELATIONSHIPS NOTED ON THIS FORM MAY BE DISCUSSED WITH THE RESPECTIVE BOARD MEMBER IF THERE ARE QUESTIONS. IF AN INDIVIDUAL HAS A CONFLICT OF INTEREST, THEY MAY NOT PARTICIPATE IN DISCUSSIONS RELATING TO THE TRANSACTION IN QUESTION AND MAY NOT VOTE ON MATTERS RELATED TO THE TRANSACTION. CONFLICT OF INTEREST PROCEEDINGS ARISING FROM CONFLICTS OF INTEREST ARE DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION OF OFFICERS IS PAID BY GREAT RIVER HEALTH SYSTEM INC. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS IS DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF GREAT RIVER HEALTH SYSTEM, INC. THE ROLE OF THE COMPENSATION COMMITTEE IS TO ACT ON BEHALF OF THE CORPORATE BOARD OF DIRECTORS IN ADOPTING, REVIEWING AND MAINTAINING AN EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE IS COMPRISED OF THREE BOARD MEMBERS, ALL OF WHOM ARE INDEPENDENT FROM THE CEO AND OTHER OFFICERS. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE CEO AND OTHER OFFICERS ON AN ANNUAL BASIS. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES TAKEN AT THE MEETINGS. GREAT RIVER HEALTH SYSTEM, INC. PARTICIPATES IN AND UTILIZES EXECUTIVE SALARY SURVEYS TO DETERMINE COMPENSATION RANGES. THE COMMITTEE REVIEWS PREVAILING MARKET DATA TO ENSURE CONTINUED MARKET COMPETITIVENESS. THE COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTING GROUP BIENNIALLY TO ASSESS AND VALIDATE THE ENTIRETY OF EXECUTIVE COMPENSATION AND BENEFITS PACKAGES TO ENSURE REGULATORY COMPLIANCE, EXTERNAL COMPETITIVENESS, AND INTERNAL EQUITY. THE MOST RECENT YEAR OF AN INDEPENDENT THIRD PARTY REVIEW WAS 2025. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2025.
FORM 990, PART VI, SECTION C, LINE 19HENRY COUNTY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER FEES: PROGRAM SERVICE EXPENSES 14,295,343. MANAGEMENT AND GENERAL EXPENSES 8,420,979. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,716,322.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
GREAT RIVER HEALTH SYSTEM INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421193185HEALTH CAREIA501(C)(3)LINE 12C, III-FIN/A0
SOUTHEAST IOWA REGIONAL MEDICAL CENTER
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655420680407HOSPITALIA501(C)(3)LINE 30GREAT RIVER HEALTH SYSTEM INC
GRHS HOLDINGS INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421193186SUPPORT RELATED ORGANIZATIONSIA501(C)(3)LINE 12B, II0GREAT RIVER HEALTH SYSTEM INC
GREAT RIVER HEALTH FOUNDATION INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421446727SUPPORT RELATED ORGANIZATIONSIA501(C)(3)LINE 12B, II0GREAT RIVER HEALTH SYSTEM INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SOUTHEAST RENAL DIALYSIS LCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH WHITE STREETAddressLine1Txt
CityMOUNT PLEASANTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52641ZIPCd
FieldValueIRS element (for citing)
EIN391878280EIN
Primary ActivitiesMEDICAL SERVICESPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$76,395ShareOfTotalIncomeAmt
Share Of EOY Assets$1,556,735ShareOfEOYAssetsAmt
Disproportionate AllocationsYes (1)DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.25000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
RIVERVIEW SYSTEM LTD
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191960MEDICAL SERVICESIAN/AC0
GREAT RIVER MEDICAL SERVICES INC
1201 WEST AGENCY ROADWEST BURLINGTONIA52655421493449MEDICAL SERVICESIAN/AC0
MUTUAL CONSULTING & MANAGEMENT SERVICES
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421349668MANAGEMENT SERVICESIAN/AC0
HERITAGE PARK PHARMACY
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191957PHARMACYIAN/AC0
HERITAGE MEDICAL EQUIPMENT & SUPPLY
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655421191958MEDICAL SUPPLYIAN/AC0
RIGHTCHOICE INC
1221 SOUTH GEAR AVENUEWEST BURLINGTONIA52655923383523STAFFING AGENCYIAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd