SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC (EIN 42-0680407)
Tax period: 2022-07-01 to 2023-06-30
Filed: 2024-05-11
IRS object ID: 202431329349300128
Schema version: 2022v5.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-05-11T09:13:43-05:00	ReturnTs
Tax Period End	2023-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	10700 NORTHUP WAY SUITE 200	AddressLine1Txt
City	BELLEVUE	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98004	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	420680407	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHEAST IOWA REGIONAL MEDICAL	BusinessNameLine1Txt
Business Name Line2	CENTER INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	SOUT	BusinessNameControlTxt
Phone	3197681000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEREMY ALEXANDER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	3197681000	PhoneNum
Signature	2024-05-08	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	JEREMY	PersonFirstNm
Person Last	ALEXANDER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KURT BENNION CPA	PreparerPersonNm
PTIN	P01469618	PTIN
Phone	4252506100	PhoneNum
Preparation	2024-05-08	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DR MICHAEL MCCOY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$362,323,486	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GREATRIVERHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1895	FormationYr
Legal Domicile State	IA	LegalDomicileStateCd
Activity Or Mission	IMPROVING THE REGION'S HEALTH BY PROVIDING HIGH-QUALITY HEALTH CARE.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	2316	TotalEmployeeCnt
Total Volunteers	176	TotalVolunteersCnt
Total Gross UBI	$152,494	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$52,801,561	PYContributionsGrantsAmt
CY Contributions Grants	$34,495,455	CYContributionsGrantsAmt
PY Program Service Revenue	$307,954,230	PYProgramServiceRevenueAmt
CY Program Service Revenue	$325,802,142	CYProgramServiceRevenueAmt
PY Investment Income	$874,483	PYInvestmentIncomeAmt
CY Investment Income	$411,876	CYInvestmentIncomeAmt
PY Other Revenue	$9,087,002	PYOtherRevenueAmt
CY Other Revenue	$945,464	CYOtherRevenueAmt
PY Total Revenue	$370,717,276	PYTotalRevenueAmt
CY Total Revenue	$361,654,937	CYTotalRevenueAmt
PY Grants And Similar Paid	$168,393,959	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$11,733,292	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$165,178,126	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$166,082,098	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$14,297	CYTotalFundraisingExpenseAmt
PY Other Expenses	$183,122,071	PYOtherExpensesAmt
CY Other Expenses	$202,604,921	CYOtherExpensesAmt
PY Total Expenses	$516,694,156	PYTotalExpensesAmt
CY Total Expenses	$380,420,311	CYTotalExpensesAmt
PY Revenues Less Expenses	-$145,976,880	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$18,765,374	CYRevenuesLessExpensesAmt
Total Assets BOY	$268,865,294	TotalAssetsBOYAmt
Total Assets EOY	$252,815,297	TotalAssetsEOYAmt
Total Liabilities BOY	$87,497,042	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$91,046,703	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$181,368,252	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$161,768,594	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SOUTHEAST IOWA REGIONAL MEDICAL CENTER EMPOWERS OUR PEOPLE TO PROVIDE COMPASSIONATE, HIGH QUALITY CARE, WHILE BEING GOOD STEWARDS OF OUR RESOURCES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$367,299,824	ExpenseAmt
Grant	$11,733,292	GrantAmt
Revenue	$325,738,436	RevenueAmt
Desc	SOUTHEAST IOWA REGIONAL MEDICAL CENTER (SIRMC) IS A TWO CAMPUS HOSPITAL. ONE IS A 50 BED HOSPITAL LOCATED IN FORT MADISON, IOWA. THE OTHER IS A 378-BED REGIONAL MEDICAL CENTER LOCATED IN WEST BURLINGTON, IOWA OFFERING ACUTE AND INTERMEDIATE CARE TO RESIDENTS OF SOUTHEAST IOWA, WEST CENTRAL ILLINOIS AND NORTHEAST MISSOURI. THE HOSPITAL OFFERS COMPREHENSIVE MEDICAL, EXTENSIVE SURGICAL, AND EMERGENCY CARE SERVICES. DURING FISCAL YEAR ENDING 6/30/23, SIRMC HAD 10,537 PATIENT ADMISSIONS AND 60,559 PATIENT DAYS OF MEDICAL CARE. SIRMC ALSO HAD 354,366 OUTPATIENT VISITS, 44,073 EMERGENCY ROOM VISITS AND 36,750 HOME HEALTH-CARE VISITS. SIRMC PROVIDES MEDICAL SERVICES REGARDLESS OF ABILITY TO PAY AND ACCEPTS MEDICARE AND MEDICAID.THE HOSPITAL'S 160-BED KLEIN CENTER OFFERS LONG-TERM AND SKILLED CARE ON THE HOSPITAL'S CAMPUS. THE CANCER CENTER, WHICH PROVIDES MEDICAL AND RADIATION THERAPY SERVICES FOR THE TREATMENT OF VARIOUS FORMS OF CANCER AND BLOOD DISEASES, OFFERS THE LATEST THREE-DIMENSIONAL TREATMENT-PLANNING COMPUTER TECHNOLOGY AVAILABLE IN ONLY A FEW HEALTH-CARE CENTERS IN THE STATE. THE WELLNESS PLAZA IS HOME TO ONE OF THE STATE'S PREMIER REHABILITATION AND FITNESS PROGRAMS.	Desc
Total Program Service Expenses	$367,299,824	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	115	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	2316	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CHERYL ALBIN	PersonNm
Phone	3197681000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd
LOUIS KANZAVELOS
PHYSICIAN	40.00	0.00	Yes (X)	$1,235,319	$0	$42,510
MATT WENZEL
PRESIDENT/CEO (THROUGH 10/12/22)	24.00	19.00		$0	$1,122,540	$53,171	Yes (X)	Yes (X)
BRENT WOODBURY
PHYSICIAN	40.00	0.00	Yes (X)	$872,640	$0	$36,895
TIMOTHY STAUDTE
PHYSICIAN	40.00	0.00	Yes (X)	$764,140	$0	$50,270
JEREMY ALEXANDER
CFO	40.00	3.00		$0	$671,653	$51,571		Yes (X)
MEGHAN WOOSTER
PHYSICIAN	40.00	0.00	Yes (X)	$693,849	$0	$15,636
DR MICHAEL MCCOY
PRESIDENT/CEO	24.00	19.00		$0	$624,684	$51,091	Yes (X)	Yes (X)
CHARLES FRANK
PHYSICIAN	40.00	0.00	Yes (X)	$360,261	$0	$14,147
DAVE POLAND
CHAIRPERSON	1.00	0.00		$0	$0	$0	Yes (X)	Yes (X)
VICKI STEPHENSON
VICE CHAIRMAN	1.00	0.00		$0	$0	$0	Yes (X)	Yes (X)
JOY ANDERSON
SECRETARY	1.00	0.00		$0	$0	$0	Yes (X)	Yes (X)
DR STEVE DAVIS
DIRECTOR	1.00	0.00		$0	$0	$0	Yes (X)
NEAL DODD
DIRECTOR	1.00	0.00		$0	$0	$0	Yes (X)
BOB HUFFMAN
DIRECTOR	1.00	1.00		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,926,209	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,418,877	TotReportableCompRltdOrgAmt
Total Other Compensation	$315,291	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	234	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MEDEFIS INC
2121 NORTH 117TH AVENUE SUITE 200	OMAHA	NE	68164	STAFFING AGENCY	$6,000,237
MUTUAL CONSULTING & MGMT SVC INC
1221 S GEAR AVENUE	WEST BURLINGTON	IA	52655	EXECUTIVE MANAGEMENT	$4,637,581
WAPITI MEDICAL GROUP
107 FLYNN DRIVE SUITE 600	MILBANK	SD	57252	STAFFING AGENCY	$3,244,067
MYERS CONSTRUCTION
651 MAIN STREET PO BOX 118	MEDIAPOLIS	IA	52637	CONSTRUCTION	$1,908,431
MIKE NELSON CONCRETE PAVING COMPANY
6430 115TH AVENUE	BURLINGTON	IA	52601	CONSTRUCTION	$1,717,449

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	94	CntrctRcvdGreaterThan100KCnt
Related Organizations	$31,006,603	RelatedOrganizationsAmt
All Other Contributions	$3,488,852	AllOtherContributionsAmt
Total Contributions	$34,495,455	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE INCOME	621110	$301,990,641	$301,990,641
OTHER OPERATING INCOME	621300	$22,805,630	$22,741,924	$63,706
PARTNERSHIP INCOME	621400	$1,005,871	$1,005,871

Field	Value	IRS element (for citing)
Total Program Service Revenue	$325,802,142	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$385,726	TotalRevenueColumnAmt
Exclusion	$385,726	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,265,841	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$630,299	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$635,542	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$635,542	TotalRevenueColumnAmt
Unrelated Business Revenue	$88,788	UnrelatedBusinessRevenueAmt
Exclusion	$546,754	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$64,400	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$38,250	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$26,150	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$26,150	TotalRevenueColumnAmt
Exclusion	$26,150	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$309,922	TotalRevenueColumnAmt
Exclusion	$309,922	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$309,922	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$361,654,937	TotalRevenueColumnAmt
Related Or Exempt Func Income	$325,738,436	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$152,494	UnrelatedBusinessRevenueAmt
Exclusion	$1,268,552	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$11,733,292	TotalAmt
Program Services	$11,733,292	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,710,626	TotalAmt
Management And General	$2,710,626	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$137,305,561	TotalAmt
Program Services	$136,955,382	ProgramServicesAmt
Management And General	$350,179	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,061,575	TotalAmt
Program Services	$4,645,820	ProgramServicesAmt
Management And General	$415,755	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$14,245,510	TotalAmt
Program Services	$13,829,221	ProgramServicesAmt
Management And General	$416,289	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$6,758,826	TotalAmt
Program Services	$6,732,410	ProgramServicesAmt
Management And General	$26,416	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$766,737	TotalAmt
Program Services	$766,737	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$470,530	TotalAmt
Program Services	$470,530	ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$87,308	TotalAmt
Management And General	$87,308	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$3,266	TotalAmt
Management And General	$3,266	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$100,269,642	TotalAmt
Program Services	$95,889,173	ProgramServicesAmt
Management And General	$4,366,523	ManagementAndGeneralAmt
Fundraising	$13,946	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,289,189	TotalAmt
Program Services	$1,494,074	ProgramServicesAmt
Management And General	-$205,236	ManagementAndGeneralAmt
Fundraising	$351	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,192,500	TotalAmt
Program Services	$4,191,332	ProgramServicesAmt
Management And General	$1,168	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$312,267	TotalAmt
Program Services	$309,679	ProgramServicesAmt
Management And General	$2,588	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$891,185	TotalAmt
Program Services	$891,185	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$14,476,818	TotalAmt
Program Services	$13,754,875	ProgramServicesAmt
Management And General	$721,943	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$6,001,805	TotalAmt
Program Services	$3,735,582	ProgramServicesAmt
Management And General	$2,266,223	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$27,113,622	$27,113,622
DRUGS	$24,523,657	$24,523,618	$39
BAD DEBT	$11,645,250	$11,645,250
REPAIRS/MAINTENANCE	$4,241,810	$4,239,738	$2,072

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,319,335	TotalAmt
Program Services	$4,378,304	ProgramServicesAmt
Management And General	$1,941,031	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$380,420,311	TotalAmt
Program Services	$367,299,824	ProgramServicesAmt
Management And General	$13,106,190	ManagementAndGeneralAmt
Fundraising	$14,297	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$889,137	BOYAmt
EOY	$1,968,822	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,767,411	BOYAmt
EOY	$15,879,957	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$41,286,511	BOYAmt
EOY	$36,199,908	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$2,965,515	BOYAmt
EOY	$4,016,575	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,892,615	BOYAmt
EOY	$2,350,197	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,347,973	BOYAmt
EOY	$2,278,579	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$441,313,097	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$279,121,808	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$166,953,617	BOYAmt
EOY	$162,191,289	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$15,396,363	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$22,577,831	BOYAmt
EOY	$22,944,537	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$3,349,029	BOYAmt
EOY	$3,284,900	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$524,292	BOYAmt
EOY	$224,712	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$915,000	BOYAmt
EOY	$1,475,821	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$268,865,294	BOYAmt
EOY	$252,815,297	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$27,730,445	BOYAmt
EOY	$28,895,504	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$119,076	BOYAmt
EOY	$135,211	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,259,156	BOYAmt
EOY	$26,665,551	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,388,365	BOYAmt
EOY	$35,350,437	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$87,497,042	BOYAmt
EOY	$91,046,703	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$170,307,714	BOYAmt
EOY	$151,262,966	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,060,538	BOYAmt
EOY	$10,505,628	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$181,368,252	BOYAmt
EOY	$161,768,594	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$268,865,294	BOYAmt
EOY	$252,815,297	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$18,765,374	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$626,790	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$207,494	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$45,000	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$42,308	OtherActivitiesAmt
Total Lobbying Expenditures	$87,308	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	SOUTHEAST IOWA REGIONAL MEDICAL CENTER PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE IOWA HOSPITAL ASSOCIATION. THESE ASSOCIATIONS PARTICIPATE IN LOBBYING ACTIVITIES RELATED TO HEALTHCARE. CAPITOL CONSULTANTS OF IOWA PROVIDES LOBBYING SERVICES RELATED TO STATE-LEVEL HEALTHCARE ISSUES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,160,986	OtherCostOrOtherBasisAmt
Book Value	$14,160,986	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$182,802,285	OtherCostOrOtherBasisAmt
Depreciation	$83,271,085	DepreciationAmt
Book Value	$99,531,200	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,919,721	OtherCostOrOtherBasisAmt
Depreciation	$10,150,158	DepreciationAmt
Book Value	$5,769,563	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$226,122,773	OtherCostOrOtherBasisAmt
Depreciation	$185,700,565	DepreciationAmt
Book Value	$40,422,208	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,307,332	OtherCostOrOtherBasisAmt
Book Value	$2,307,332	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$162,191,289	TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

Field	Value	IRS element (for citing)
Book Value	$1,665,071	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	INSURANCE COMPANY ANNUITY DEPOSITS	Desc
Book Value	$21,279,466	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$22,944,537	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION LIABILITY	$24,745,724
THIRD PARTY PAYABLE	$3,031,022
DUE TO RELATED ORGANIZATIONS	$7,006,119
RIGHT-OF-USE LEASE LIABILITIES	$567,572

Field	Value	IRS element (for citing)
Total Liability	$35,350,437	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE 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 COMBINED FINANCIAL STATEMENTS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,581,205	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,581,205	NetCommunityBenefitExpnsAmt
Total Expense	0.01240	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,174,959	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$40,080,955	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$21,094,004	NetCommunityBenefitExpnsAmt
Total Expense	0.05720	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$65,756,164	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$40,080,955	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,675,209	NetCommunityBenefitExpnsAmt
Total Expense	0.06960	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$195,919	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$195,919	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,160,139	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,565,245	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,594,894	NetCommunityBenefitExpnsAmt
Total Expense	0.01250	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$71,030	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$71,030	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,427,088	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,565,245	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,861,843	NetCommunityBenefitExpnsAmt
Total Expense	0.01320	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$72,183,252	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$41,646,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$30,537,052	NetCommunityBenefitExpnsAmt
Total Expense	0.08280	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$11,645,250	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$79,851,716	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$101,981,200	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$22,129,484	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHEAST IOWA REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1221 SOUTH GEAR AVENUE	AddressLine1Txt
City	WEST BURLINGTON	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52655	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.GREATRIVERHEALTH.ORG	WebsiteAddressTxt
State License	290147H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Emergency Room Other	Yes (X)	EmergencyRoomOtherInd
Other	TRAUMA CENTER	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHEAST IOWA REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE LINE 7D	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE LINE 7D	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE LINE 16J	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE LINE 16J	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE LINE 16J	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: SOUTHEAST IOWA REGIONAL MEDICAL CENTER, PART OF GREAT RIVER HEALTH SYSTEM, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO DISTINGUISH THE UNMET MEDICAL AND PUBLIC HEALTH NEEDS IN DES MOINES AND LEE COUNTIES. THE STUDY HAS THREE OBJECTIVES:1. TO CONDUCT AN ASSESSMENT THAT PROVIDES A FOUNDATION FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND ITS PARTNERS TO BUILD A CONSENSUS ABOUT THE AREA'S MOST CRITICAL HEALTH CARE NEEDS.2. TO MEET STATE AND FEDERAL REQUIREMENTS FOR HOSPITALS THAT MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY 3 YEARS.3. TO DEVELOP ACTION PLANS FOR INTERVENTIONS TO ADDRESS CONCERNS HIGHLIGHTED BY THE COMMUNITY AND HEALTH DATA.INFORMATION WAS COLLECTED THROUGH VIRTUAL MEETINGS, PAPER AND ONLINE SURVEYS, KEY INFORMANT QUESTIONNAIRES, AND A REVIEW AND ANALYSIS OF PUBLICLY COLLECTED HEALTH AND DEMOGRAPHIC STATISTICS. THE SURVEY WAS MADE AVAILABLE AT SEVERAL LOCATIONS IN THE STUDY AREA. LOCATIONS WERE CHOSEN BASED ON EASE OF ACCESS AND TRAFFIC BUT WERE RESTRICTED BY COVID-19. THE SURVEY WAS DESIGNED TO ELICIT PUBLIC RESPONSES ABOUT HEALTH NEEDS IN DES MOINES AND LEE COUNTIES. THE SURVEY INCLUDED MULTIPLE CHOICE, OPEN-ENDED AND SCALED QUESTIONS THAT ASKED PEOPLE WHAT THEY PERCEIVED TO BE THE GREATEST AREAS OF COMMUNITY NEED. A TOTAL OF 1,204 SURVEYS WERE RETURNED AND ANALYZED, A DECREASE OF 46 PERCENT FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. DECREASES IN RESPONSES WERE TO BE EXPECTED DUE TO A SHORTENED SURVEY WINDOW AND REDUCED OPPORTUNITIES FOR DISBURSEMENT.INTERVIEWS WERE CONDUCTED WITH LOCAL PROFESSIONALS AND KEY INFORMANTS, INCLUDING PROFESSIONALS IN EDUCATION, LAW ENFORCEMENT, PUBLIC HEALTH AND SOCIAL SERVICES, AND OTHER PROFESSIONALS REPRESENTING UNDERSERVED POPULATIONS IN THE SERVICE AREA. PARTICIPANTS WERE ASKED TO IDENTIFY THE LARGEST HEALTH CONCERNS IN THE COMMUNITY AND TO SUGGEST WAYS TO IMPROVE UNMET HEALTH NEEDS. THE HEALTH AND DEMOGRAPHIC DATA AVAILABLE FOR DES MOINES AND LEE COUNTIES WERE INVESTIGATED BY FOCUSING ON THE PROBLEMS INDICATED FROM THE INTERVIEWS AND COMMUNITY SURVEY. UTILIZING A STATISTICAL RANKING METHOD TO INCORPORATE INFORMATION FROM COLLABORATIVE MEETINGS, SURVEYS, AND THE INTERVIEWS, THE FOLLOWING FOUR UNMET HEALTH NEEDS WERE CHOSEN: MENTAL HEALTH SUBSTANCE MISUSE POVERTY AND EQUITY OBESITY AND OVERWEIGHTTHESE FOUR NEEDS WILL BE THE FOCUS OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND GREAT RIVER HEALTH SYSTEM'S EFFORTS TO IMPROVE THE HEALTH OF DES MOINES AND LEE COUNTIES.
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6B: SOUTHEAST IOWA REGIONAL MEDICAL CENTER CONTINUALLY WORKS WITH PARTNERS AND STAKEHOLDERS OUTSIDE THE HOSPITAL TO MEET THE HEALTH NEEDS OF THE COMMUNITY. SOUTHEAST IOWA REGIONAL MEDICAL CENTER COLLABORATED WITH DES MOINES COUNTY DEPARTMENT OF PUBLIC HEALTH, COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, BLESSING HEALTH KEOKUK, AND LEE COUNTY HEALTH DEPARTMENT ON A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT.
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 7D: SIRMC'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT: HTTPS://WWW.GREATRIVERHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: SOUTHEAST IOWA REGIONAL MEDICAL CENTER WORKED WITH DES MOINES AND LEE COUNTIES RESPECTIVE PARTNERS TO REVIEW THE DATA AND INFORMATION GATHERED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. AFTER REVIEWING THE DATA FROM THE SURVEY, VIRTUAL TOWN HALL MEETINGS, AND COMMENTS FROM THE KEY INFORMANT QUESTIONNAIRE, THE FOLLOWING HIGH PRIORITY HEALTH CONCERNS WERE SELECTED: MENTAL HEALTH SUBSTANCE MISUSE POVERTY AND EQUITY OBESITY AND OVERWEIGHTLEADERS AT SOUTHEAST IOWA REGIONAL MEDICAL CENTER HIGHLIGHTED THE FOLLOWING IMPLEMENTATION STRATEGIES, POTENTIAL IMPACTS, AND RESOURCES NEEDED FOR EACH FOCUS AREA.MENTAL HEALTH- EXPAND EXISTING PROGRAMS- GERIATRIC INPATIENT UNIT- RECRUITMENTSUBSTANCE MISUSE-OPIOID MANAGEMENT IMPROVEMENTS-PEER RECOVERY GROUP-SUPPORT AND PARTICIPATION IN COMMUNITY BASED INITIATIVES-FITNESS VOUCHER PILOT PROGRAMOBESITY/OVERWEIGHT -POPULATION HEALTH PLATFORM-LIVE HEALTHY LEE COUNTY-HEALTHY LIVING COMMUNITY EDUCATIONPOVERTY AND EQUITY-RURAL PUBLIC HEALTH WORKFORCE TRAINING NETWORK PROGRAM-SOCIAL DETERMINANTS OF HEALTH ASSESSMENT WORKFLOW-GOOD FAITH ESTIMATES-GREAT RIVER HEALTH FOUNDATION PARTNERSHIP WITH SOUTHEASTERN COMMUNITY COLLEGE
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 13H: SIRMC 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 SOUTHEAST IOWA REGIONAL MEDICAL 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. SOUTHEAST IOWA REGIONAL MEDICAL 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 SOUTHEAST IOWA REGIONAL MEDICAL 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, SOUTHEAST IOWA REGIONAL MEDICAL CENTER COULD ADJUST FINANCIAL ASSISTANCE UP TO THREE MONTHS BEFORE THE APPLICATION DATE.
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART 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/.
SOUTHEAST IOWA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 20E: SIRMC 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.

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - KEOKUK CLINIC
3285 MAIN STREET	KEOKUK	IA	52632	PROVIDER HEALTH CLINIC
2 - MEDIAPOLIS CLINIC
401 N ORCHARD STREET	MEDIAPOLIS	IA	52637	PROVIDER HEALTH CLINIC
3 - WAPELLO CLINIC
220 MULBERRY STREET SUITE A	WAPELLO	IA	52653	PROVIDER HEALTH CLINIC
4 - URGENT CARE CLINIC
1321 S GEAR AVENUE	WEST BURLINGTON	IA	52655	URGENT CARE CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	SOUTHEAST IOWA REGIONAL MEDICAL CENTER (SIRMC) 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 7G:	THE SUBSIDIZED HEALTH SERVICES INCLUDED IN PART I, LINE 7G IS MENTAL HEALTH SERVICES PROVIDED BY SIRMC.
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 $ 11,645,250.
PART III, LINE 2:	MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS AND BY CONSIDERING THE PATIENTS' FINANCIAL HISOTRY, CREDIT HISTORY, AND CURRENT ECONOMIC CONDITIONS.
PART III, LINE 3:	SOUTHEAST IOWA REGIONAL MEDICAL CENTER CONTRACTS WITH AN EXTERNAL ORGANIZATION. THE ORGANIZATION RECEIVES WEEKLY LISTINGS OF PATIENT RECEIVABLES FROM SIRMC'S PATIENT FINANCIAL SERVICES STAFF. THEY RETURN RESULTS TO SIRMC IDENTIFYING INDIVIDUALS WHO COULD QUALIFY FOR THE FINANCIAL ASSISTANCE PROGRAM. THE DATA IS BASED ON PATIENT INCOME AS WELL AS THEIR CREDIT REPORTING. THE RESULTS ARE APPLIED TO SIRMC'S FINANCIAL ASSISTANCE MATRIX TO IDENTIFY IF AN INDIVIDUAL WOULD QUALIFY AND FOR WHAT PERCENTAGE. SIRMC'S PATIENT FINANCIAL SERVICES STAFF THEN CONTACT THE PATIENT TO ACQUIRE A FINANCIAL ASSISTANCE APPLICATION.
PART III, LINE 4:	SEE THE "PATIENTS RECEIVABLES" PARAGRAPH IN NOTE 1 ON PAGE 10 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:	AN EXCERPT FROM SIRMC'S FINANCIAL ASSISTANCE PROGRAM WRITTEN POLICY, RELATIONSHIP OF FINANCIAL ASSISTANCE PROGRAM TO COLLECTION POLICIES: SOUTHEAST IOWA REGIONAL MEDICAL CENTER MANAGEMENT HAS DEVELOPED POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, WHICH INCLUDES COLLECTION ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE FOLLOWING: A) THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY; B) PATIENT'S GOOD FAITH EFFORT TO APPLY FOR GOVERNMENTAL PROGRAMS; C) PATIENT'S GOOD FAITH EFFORT TO APPLY FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM; D) PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH PAYMENT AGREEMENTS MADE WITH SOUTHEAST IOWA REGIONAL MEDICAL CENTER. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL DO THE FOLLOWING: A) MAY OFFER EXTENDED PAYMENT PLANS; B) WILL NOT SEND UNPAID BALANCES TO OUTSIDE COLLECTION AGENCIES; C) WILL CEASE ALL COLLECTION EFFORTS WITH OUTSIDE COLLECTION AGENCIES. SOUTHEAST IOWA REGIONAL MEDICAL CENTER AND AGENCIES ACTING ON ITS BEHALF WILL NOT IMPOSE EXTRAORDINARY COLLECTION ACTIONS WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. REASONABLE EFFORTS SHALL INCLUDE: A) VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; B) DOCUMENTATION THAT SOUTHEAST IOWA REGIONAL MEDICAL CENTER HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WIHT THE HOSPITAL'S APPLICATION REQUIREMENTS; C) DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL NOT SEND OUTSTANDING BALANCES TO AN OUTSIDE COLLECTION AGENCY UNTIL 120 DAYS FROM THE DATE THE BALANCE BECAME THE PATIENT'S RESPONSIBILITY. AN OUTSIDE AGENCY ACTING ON THE BEHALF OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER WILL NOT TAKE EXTRAORDINARY COLLECTION AGENCY UNTIL AN ADDITIONAL 120 DAYS HAVE BEEN EXHAUSTED. EXTRAORDINARY COLLECTION ACTION INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING: A) SELLING DEBT TO A THIRD PARTY OTHER THAN A COLLECTION AGENCY; B) REPORTING ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY OR CREDIT BUREAU; C) FILING A CLAIM FOR UNPAID DEBT THROUGH THE COURT SYSTEM. REFER TO SOUTHEAST IOWA REGIONAL MEDICAL CENTER BILLING AND COLLECTION POLICY INCLUDED IN EXHIBIT C FOR ADDITIONAL INFORMATION.
PART III, SECTION A, LINE 1:	THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.
PART VI, LINE 2:	SIRMC'S BOARD OF DIRECTORS IS COMMUNITY BASED. REPRESENTATIVES FROM VARIOUS SEGMENTS OF THE COMMUNITY MAKE UP THE BOARD. IN ADDITION, BOARD MEMBERS ARE SELECTED IN OUTLYING COMMUNITIES THAT SIRMC SERVES. THESE BOARD MEMBERS CONSTANTLY PROVIDE INPUT TO THE HEALTHCARE NEEDS OF OUR COMMUNITY THROUGH THE ANNUAL STRATEGIC PLANNING PROCESS.
PART VI, LINE 3:	NOTIFICATION ABOUT GOVERNMENT PROGRAM AND/OR FINANCIAL ASSISTANCE FROM SIRMC IS DISSEMINATED BY VARIOUS MEANS AT SIRMC, 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. SIRMC ALSO POSTS AT THE LOCAL DEPARTMENT OF HEALTH SERVICES OFFICE. SIRMC 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 SIRMC 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:	A REVIEW WAS CONDUCTED BY SIRMC TO ANALYZE THE ORIGIN OF PATIENTS UTILIZING THE SERVICES PROVIDED BY THE MEDICAL CENTER. THE REVIEW INDICATED THAT DES MOINES COUNTY COMPRISES THE MEDICAL CENTER'S PRIMARY SERVICE AREA AND THAT THE SECONDARY SERVICE AREA OF THE MEDICAL CENTER CONSISTS OF HENRY, LEE, AND LOUISA COUNTIES IN IOWA AND HANCOCK AND HENDERSON COUNTIES IN ILLINOIS. BASED ON THE US CENSUS BUREAU STATISTICAL ESTIMATES FOR 2021, THE PRIMARY SERVICE AREA POPULATION IS ESTIMATED AT 38,242 RESIDENTS. THE SECONDARY SERVICE AREA POPULATIONS ARE ESTIMATED TO TOTAL 87,121 RESIDENTS. OVER AGE 65 GROUP IS CURRENTLY 21.6% OF THE PRIMARY SERVICE AREA POPULATION, AS COMPARED TO 18.3% OF THE STATE OF IOWA POPULATION AND 17.3% OF THE UNITED STATES POPULATION. THE MEDIAN HOUSEHOLD INCOME IN THE PRIMARY SERVICE AREA IS $58,084 COMPARED TO THE STATE AND NATIONAL AVERAGES OF $70,571 AND $75,149, RESPECTIVELY. THE PRIMARY SERVICE AREA POPULATION BELOW POVERTY LEVEL IS 14.8% AS COMPARED TO THE STATE AND NATIONAL AVERAGES OF 11.0% AND 11.5%, RESPECTIVELY.SOUTHEAST IOWA REGIONAL MEDICAL CENTER IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA AND THE LARGEST SERVICE PROVIDER, INCLUDING THE BROADEST SCOPE OF SERVICES, IN THE PRIMARY AND SECONDARY SERVICE AREAS.
PART VI, LINE 5:	SOUTHEAST IOWA REGIONAL MEDICAL CENTER FURTHERS ITS EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ENSURING THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY COMPRISES MEMBERS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS OF SUCH.SOUTHEAST IOWA REGIONAL MEDICAL CENTER PROVIDES MEMBERSHIP TO ALL PHYSICIANS WHO MEET MEMBERSHIP AND CLINICAL REQUIREMENTS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER RECRUITS PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, AND OTHER HEALTH PROFESSIONALS TO IMPROVE ACCESS TO HEALTH CARE IN THE HOSPITAL'S SERVICE AREA. IT ALSO PROMOTES HEALTH CAREER EDUCATION BY WORKING CLOSELY WITH SOUTHEASTERN COMMUNITY COLLEGE'S NURSING AND OTHER PROGRAMS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER PARTICIPATES IN COMMUNITY BENEFIT ACTIVITIES SUCH AS PARTNERING WITH LOCAL SCHOOLS, COMMUNITY EDUCATION, COMMUNITY INITIATIVE EVENTS, PRENATAL EDUCATION CLASSES, A PARTICIPATING IN HEALTH FAIRS.SOUTHEAST IOWA REGIONAL MEDICAL CENTER MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY. IT IS OPEN TO ALL, REGARDLESS OF ABILITY TO PAY.SURPLUS FUNDS OF THE HOSPITAL ARE INVESTED IN IMPROVING AND UPDATING CAPITAL EQUIPMENT, AND INCREASING THE SERVICES OFFERED TO ALLOW FOR BETTER CARE OF THE PATIENTS THAT ARE SERVED.
PART VI, LINE 6:	SOUTHEAST IOWA REGIONAL MEDICAL 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:	SIRMC 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

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
GREAT RIVER HEALTH SYSTEM INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421193185	501(C)(3)	$6,000,000	$0	N/A	N/A	TRANSFER DUE TO MERGER
IOWA POISON CONTROL CENTER
401 DOUGLAS STREET SUITE 501	SIOUX CITY	IA	51101	421509042	501(C)(3)	$12,000	$0	N/A	N/A	GENERAL SUPPORT
SOUTHEASTERN COMMUNITY COLLEGE
1500 WEST AGENCY ROAD	WEST BURLINGTON	IA	52655	420926823	501(C)(3)	$5,654,982	$0	N/A	N/A	NURSING PROGRAM

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	GRANTEES ARE REQUIRED TO PROVIDE FOLLOW-UP INFORMATION WHEN THE PROJECT IS CARRIED OUT OR COMPLETED. IF GRANTEES DON'T COMPLY, SIRMC DOES NOT PROVIDE FURTHER GRANTS TO THEM.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LOUIS KANZAVELOS
PHYSICIAN	$1,228,565	$0	$0	$0	$6,754	$0	$15,250	$0	$27,260	$0	$1,277,829	$0	$0	$0
MATT WENZEL
PRESIDENT/CEO (THROUGH 10/12/22)	$0	$740,784	$0	$213,774	$0	$167,982	$0	$15,250	$0	$37,921	$0	$1,175,711	$0	$0
BRENT WOODBURY
PHYSICIAN	$866,148	$0	$0	$0	$6,492	$0	$10,355	$0	$26,540	$0	$909,535	$0	$0	$0
TIMOTHY STAUDTE
PHYSICIAN	$755,974	$0	$0	$0	$8,166	$0	$15,250	$0	$35,020	$0	$814,410	$0	$0	$0
JEREMY ALEXANDER
CFO	$0	$552,461	$0	$117,896	$0	$1,296	$0	$15,250	$0	$36,321	$0	$723,224	$0	$0
MEGHAN WOOSTER
PHYSICIAN	$692,727	$0	$0	$0	$1,122	$0	$0	$0	$15,636	$0	$709,485	$0	$0	$0
DR MICHAEL MCCOY
PRESIDENT/CEO	$0	$532,528	$0	$80,672	$0	$11,484	$0	$15,250	$0	$35,841	$0	$675,775	$0	$0
CHARLES FRANK
PHYSICIAN	$358,133	$0	$0	$0	$2,128	$0	$0	$0	$14,147	$0	$374,408	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	MATT WENZEL, HEALTH/SOCIAL CLUB DUES, $4,463. THIS AMOUNT WAS INCLUDED IN TAXABLE COMPENSATION.
PART I, LINE 3	THE COMPENSATION OF THE OFFICERS IS PAID BY RIVERVIEW SYSTEMS LTD., A RELATED ORGANIZATION, BUT DETERMINED BY GREAT RIVER HEALTH SYSTEM. THE FOLLOWING WERE USED BY GREAT RIVER HEALTH SYSTEM IN DETERMINING THE OFFICERS' COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. FORM 990 OF OTHER ORGANIZATIONS 4. WRITTEN EMPLOYMENT CONTRACT 5. COMPENSATION SURVEY OR STUDY 6. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4A	MATT WENZEL RECEIVED A SEVERANCE PAYMENT OF $164,442. THIS AMOUNT WAS INCLUDED IN W-2 WAGES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
IOWA FINANCE AUTHORITY
A	521699886	2017-05-31	$25,545,000	REFUND OF PRIOR ISSUE (7/24/08)	0	0	0
DES MOINES COUNTY IOWA
B	426004310	2012-04-04	$60,000,000	SEE PART VI	0	0	0	250087AA1

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capital ExpendituresCapitalExpendituresAmt
A	$14,695,000	$25,545,000	$284,957	$25,260,043	2000	Yes (1)	0	Yes (1)	Yes (1)
B	$44,736,842	$60,000,000	$616,000	$29,307,242	2013	Yes (1)	0	Yes (1)	Yes (1)	$30,076,758

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	0	Yes (1)	Yes (1)	0	0	0	0	Yes (1)
B	0	0	Yes (1)	Yes (1)	0	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: IOWA FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/30/2017 ISSUER NAME: DES MOINES COUNTY, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 11/20/2013
PART I, COLUMN F, ROW B:	REFUND PRIOR ISSUE (07/25/2001) AND CONSTRUCT, RENOVATE, EXPAND AND EQUIP FACILITIES
SCHEDULE K, PART IV, LINE 2C:	NOTE REGARDING THE 11/30/2017 REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.
SCHEDULE K, PART IV, LINE 2C:	NOTE REGARDING THE 11/20/2013 REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CONCULATIONS ARE NECESSARY.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1A	THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, AND TWO OR MORE ADDITIONAL TRUSTEES. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE.
FORM 990, PART VI, SECTION A, LINE 2	DR. MICHAEL MCCOY, MATT WENZEL AND JEREMY ALEXANDER HAVE BUSINESS RELATIONSHIPS BY SERVING AS OFFICERS AND/OR BOARD MEMBERS OF FOR-PROFIT SUBSIDIARIES OF GREAT RIVER HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 3	ALL EXECUTIVE LEADERSHIP FUNCTIONS FOR SOUTHEAST IOWA REGIONAL MEDICAL CENTER ARE PROVIDED BY MUTUAL CONSULTING AND MANAGEMENT SERVICES, INC. MUTUAL CONSULTING AND MANAGEMENT SERVICES IS A SUBSIDIARY OF RIVERVIEW SYSTEMS LTD, WHICH IS A SUBSIDIARY OF GREAT RIVER HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 6	GREAT RIVER HEALTH SYSTEM INC., IS THE SOLE MEMBER OF SOUTHEAST IOWA REGIONAL MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER, GREAT RIVER HEALTH SYSTEM, INC (GRHS), HAS THE SOLE POWER TO ELECT OR REMOVE ALL BOARD MEMBERS OF SOUTHEAST IOWA REGIONAL MEDICAL 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 7B	THE 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 B, LINE 11B	THE FORM 990 WAS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 WAS REVIEWED IN DETAIL BY A MEMBER OF THE ACCOUNTING DEPARTMENT, DIRECTOR OF FINANCE 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 12C	BOTH 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 15	COMPENSATION OF OFFICERS IS PAID BY A RELATED FOR-PROFIT SUBSIDIARY. 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 BIANNUALLY 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 2023.
FORM 990, PART VI, SECTION C, LINE 19	SOUTHEAST IOWA REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 95,889,173. MANAGEMENT AND GENERAL EXPENSES 4,366,523. FUNDRAISING EXPENSES 13,946. TOTAL EXPENSES 100,269,642.
FORM 990, PART XI, LINE 9:	CHANGE IN BENEFICIAL INTEREST IN TRUSTS -207,494.
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/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
GREAT RIVER HEALTH SYSTEM INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421193185	HEALTH CARE	IA	501(C)(3)	LINE 12C, III-FI	N/A	0
GRHS HOLDINGS INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421193186	SUPPORT RELATED ORGANIZATIONS	IA	501(C)(3)	LINE 12B, II		0	GREAT RIVER HEALTH SYSTEMS INC
HENRY COUNTY HEALTH CENTER INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	862701018	HOSPITAL	IA	501(C)(3)	LINE 3		0	GREAT RIVER HEALTH SYSTEMS INC
GREAT RIVER HEALTH FOUNDATION INC
1221 SOUTH GEAR AVENUE	WEST BURLINGTON	IA	52655	421446727	SUPPORT RELATED ORGANIZATIONS	IA	501(C)(3)	LINE 12B, II		0	GREAT RIVER HEALTH SYSTEMS INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHEAST RENAL DIALYSIS LC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	507 SOUTH WHITE STREET	AddressLine1Txt
City	MOUNT PLEASANT	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52641	ZIPCd

Field	Value	IRS element (for citing)
EIN	391878280	EIN
Primary Activities	MEDICAL SERVICES	PrimaryActivitiesTxt
Legal Domicile State	IA	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	$696,213	ShareOfTotalIncomeAmt
Share Of EOY Assets	$3,271,898	ShareOfEOYAssetsAmt
Disproportionate Allocations	Yes (1)	DisproportionateAllocationsInd
General Or Managing Partner	0	GeneralOrManagingPartnerInd
Ownership	0.50000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
RIVERVIEW SYSTEM LTD
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	421191960	MEDICAL SERVICES	IA	N/A	C	0
GREAT RIVER MEDICAL SERVICES INC
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	421493449	MEDICAL SERVICES	IA	N/A	C	0
MUTUAL CONSULTING & MANAGEMENT SERVICES
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	421349668	MANAGEMENT SERVICES	IA	N/A	C	0
HERITAGE PARK PHARMACY
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	421191957	PHARMACY	IA	N/A	C	0
HERITAGE MEDICAL EQUIPMENT & SUPPLY
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	421191958	MEDICAL SUPPLY	IA	N/A	C	0
RIGHTCHOICE INC
1221 SOUTH GEAR AVE	WEST BURLINGTON	IA	52655	923383523	STAFFING AGENCY	IA	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd