2019-11-14T14:56:48-06:00 2018-12-31 990 2018-01-01 421477471 UNITYPOINT AT HOME UNIT 5152416161 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 MARGARET VANOOSTEN PRESIDENT & CCO 5155573100 2019-11-11 205.167.2.34 2019-11-11 16:12:14 CS P 7BA72CF2FC23A5EB6E597A73BA6EA537B1AB5705 7BA72CF2FC23A5EB6E597A73BA6EA537B1AB5705 2018 2020-04-17 16:48:07Z X DAVID WILLIAMS MD 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 212065721 0 X WWW.UNITYPOINT.ORG/HOMECARE X 1998 IA IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 13 7 1805 362 683190 204214 1190692 787346 171835981 185524422 1697815 2264916 772778 1167131 175497266 189743815 18627 15975 0 0 94761749 102511673 0 0 120000 75439539 94557012 170219915 197084660 5277351 -7340845 89138085 69229634 33481792 21274450 55656293 47955184 X TO IMPROVE THE HEALTH OF OUR COMMUNITY THROUGH HEALING, CARING AND TEACHING. 0 0 150709485 15975 186715327 HEALTH CARE SERVICESUNITYPOINT AT HOME PROVIDES HOME HEALTH SERVICES FOR PEOPLE IN NEED WITH THE PURPOSE TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. HIGHEST PRIORITY IS GIVEN TO LOW-INCOME INDIVIDUALS BUT SERVICES ARE AVAILABLE TO ALL RESIDENTS. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. HOME HEALTH CARE SERVICES PROVIDED AND PEOPLE SERVED MAY INCLUDE BUT ARE NOT LIMITED TO: CASE MANAGEMENT, CERTIFIED NURSING, PRIVATE DUTY NURSING, PALLIATIVE CARE, HOSPICE, INFUSION SERVICES, HOME MEDICAL EQUIPMENT, MATERNAL HEALTH CLINICS, NURSING CARE, SUPPORT TO HIGH RISK NEW PARENTS AND NEWBORNS, PARENTING SUPPORT, CHILD HEALTH CLINICS, HEALTH MAINTENANCE VISITS AND SCREEENINGS, IMMUNIZATION CLINICS, SENIOR CITIZENS, DISABLED, ILL, HANDICAPPED AND TERMINALLY ILL. SERVICES MAY BE PROVIDED ON A ONE-TIME, INTERMITTENT, PART-TIME OR LONG-TERM BASIS. UNITYPOINT AT HOME MADE 358,980 HOME VISITS IN 2018. 3370512 0 0 COMMUNITY BENEFITSUNITYPOINT AT HOME PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL OF IMPROVING THE COMMUNITY'S HEALTH AND ACCESS TO CARE. THIS INCLUDES PROVIDING HEALTH CARE SERVICES REGARDLESS OF A PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $154,572 IN 2018. OFTENTIMES, UNITYPOINT AT HOME RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN ITS CHARGES FOR SERVICES. UNITYPOINT AT HOME PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. UNITYPOINT AT HOME'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COSTS IS $3,077,970 FOR 2018. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $3,232,542.OTHER BENEFITS: UNITYPOINT AT HOME PROVIDES SEVERAL ADDITIONAL HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS THAT SUPPORT ITS MISSION OF IMPROVING THE HEALTH OF ITS COMMUNITY THROUGH HEALING, CARING AND TEACHING. PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: PREVENTION AND HEALTH SCREENINGS; SUBSIDIZED HEALTH SERVICES; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. UNITYPOINT AT HOME PARTNERS WITH HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND CHILDCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TOTAL OTHER BENEFITS PREPORTED VALUE: $137,970. 154079997 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 1805 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X X MARGARET VANOOSTEN PRESCCO 5155573100 11333 AURORA AVENUE URBANDALE IA 50322 KENNETH ANDERSON MD BOARD CHAIR 1.00 40.00 X X 0 167644 -3577 DAVID BOYER BOARD SEC./TREAS. 1.00 1.00 X X 0 16825 0 KYLE CHRISTIASON MD BOARD MEMBER 1.00 40.00 X 0 389497 25447 STAN DANIELSON MD BOARD VICE CHAIR 1.00 40.00 X X 0 342871 -20589 PAMELA DELAGARDELLE BOARD MEMBER 1.00 40.00 X 0 517861 94602 TATE FEATHERSTONE BOARD MEMBER 1.00 1.00 X 0 0 0 DEBRA JOHNSON BOARD MEMBER 1.00 1.00 X 0 11187 0 PRASAD NADKARNI MD BOARD MEMBER 1.00 40.00 X 0 547828 19735 BRIAN SCOTT BOARD MEMBER 1.00 1.00 X 0 0 0 JAN MILLER STRAUB BOARD MEMBER 1.00 1.00 X 0 0 0 KAREN STUMPE BOARD MEMBER 1.00 1.00 X 0 0 0 ANDREA WHITE BOARD MEMBER 1.00 40.00 X 0 293902 21879 BEVERLY ZENOR BOARD MEMBER 1.00 1.00 X 0 0 0 CRAIG FLANAGAN TO 918 VP/CFO 20.00 20.00 X 442827 0 20973 MARGARET VANOOSTEN PRES & CHIEF CLINICAL OFFICER 40.00 0.00 X 361558 0 44235 DAVID WILLIAMS MD CEO 1.00 40.00 X 0 691230 102140 JANE ARNOLD VP OPERATIONS 1.00 40.00 X 0 187769 28794 LEANNE BURRACK VP HOSPICE 40.00 0.00 X 170411 0 16923 RUTH COADY VP SPECIALTY PHARMACY 40.00 0.00 X 139760 24904 8410 PAULA GEISE DIR OPERATIONAL INITIATIVES 40.00 0.00 X 150038 1855 31162 JESSICA MEISNER VP HUMAN RESOURCES 1.00 40.00 X 0 257810 30744 JENN OFELT VP HOME HEALTH & OPERATIONS 40.00 1.00 X 154564 0 36584 PATRICK REEVES VP HOME MEDICAL EQUIPMENT 40.00 0.00 X 184588 0 25071 TODD RICHARD VP PATIENT ACCESS 40.00 0.00 X 207629 0 18540 DIANNE SCHULTZ DIRECTOR CARE AT HOME SVCS 40.00 0.00 X 202274 0 9487 MARISSA SMITH CHIEF COMPLIANCE OFFICER 40.00 0.00 X 160797 0 27968 DEBORAH COSGROVE HOME CARE CONSULTANT 40.00 0.00 X 138016 0 25235 JENNIFER CRIMMINS EXEC DIRECTOR OPERATIONS 40.00 0.00 X 129991 0 34258 AMY LEISTER EXEC DIRECTION CLINICAL EDUC 40.00 0.00 X 133885 490 23451 MICHAEL WELSCH EXEC DIRECTOR FINANCE 40.00 0.00 X 143298 0 30612 ASHLEY WIRTJES DIRECTOR HUMAN RESOURCES 40.00 0.00 X 147967 0 15044 MELLISSA WOOD TO 1217 CHIEF NURSING EXECUTIVE (QC) 0.00 40.00 X 6108 224002 8156 2873711 3675675 675284 43 1 1 0 BLACKTREE HEALTHCARE CONSULTING 1030 CONTINENTAL DRIVE KING OF PRUSSIA PA 19406 PAYMENT SERVICES 2324272 PUTMAN INC 7050 W 107TH ST OVERLAND PARK KS 66212 STAFFING AGENCY 2082390 OPTUM HOSPICE PHARMACY SERVICE 4525 EXECUTIVE PARK DR STE 100 MONTGOMERY AL 36116 PHARMACY SERVICES 1360067 AT HOME WITH WESTERN HOME 420 EAST 11TH ST CEDAR FALLS IA 50613 STAFFING AGENCY 1009973 AURORA BUSINESS PARK ASSOCIATES 1080 JORDAN CREEK PKWY STE 200 N WEST DES MOINES IA 50266 PROPERTY MANAGEMENT 929481 47 520244 72610 194492 787346 HOME HEALTH CARE SERV 621610 182009934 181361036 648898 MGMT & SUPPORT SVCS 561000 2911504 2911504 SUBS & JOINT VENTURES 900099 604735 570443 34292 MISCELLANEOUS REVENUE 900099 802 802 RENTAL INCOME 531390 -2553 -2553 185524422 419412 23773 395639 24124279 43131 22186894 135012 1937385 -91881 1845504 1845504 MISCELLANEOUS 900099 1259766 1259766 SHARED SAVINGS REVENUE 900099 -92635 -92635 1167131 189743815 186032136 683190 2241143 15975 15975 2430669 2430669 79011994 55319056 23692938 2932481 2053132 879349 12726430 8910218 3816212 5410099 3787799 1622300 9679295 6415183 3264112 237797 125 237672 288095 283168 4927 6277589 3162492 2995097 120000 171219 130135 41084 21610169 20992559 617610 -8095 -8095 5787401 3189979 2597422 2571605 2510793 60812 47399 3540 43859 204606 186264 18342 1658801 1235172 423629 384027 384005 22 MEDICAL SUPPLIES 42762270 42820668 -58398 BAD DEBT EXPENSE 2571687 2579658 -7971 MISCELLANEOUS EXPENSE 206521 67558 138963 INCOME TAXES 106626 40613 66013 197084660 154079997 42884663 120000 1830795 3812393 50970 180815 44747472 33625383 3528633 3198212 6606497 7493868 451766 484490 17966110 10421527 7138703 7544583 23419530 9784549 1345028 3109764 18691 -4423 89138085 69229634 12958369 14921043 170760 170760 20352663 6182647 33481792 21274450 X 54660158 45191049 886405 2559380 109730 204755 55656293 47955184 89138085 69229634 X -7340845 -2427343 2067079 X 0 1 X 1 0 X 1437539 1275742 1095713 1190692 787346 5787032 100556093 119002980 148815932 171288413 184841232 724504650 182278 214275 91715 772778 1167131 2428177 102175910 120492997 150003360 173251883 186795709 732719859 0 0 0 732719859 1836495 906669 485853 493240 419412 4141669 1836495 906669 485853 493240 419412 4141669 299919 393491 436733 152833 204214 1487190 104312324 121793157 150925946 173897956 187419335 738348718 0.99240 0.99040 0.00560 0.00720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 996135 661491 1768001 661492 2764135 1117386 714688 835939 996135 370854 1168611 422079 1117386 357953 414653 401752 370854 348728 612656 603430 357953 0.00000 0.07410 0.92590 0 1 1 160000 160000 5632976 2469434 3163542 12142023 7940554 4201469 31111 11539 19572 7544583 DUE TO AFFILIATES 2858751 SELF-INSURANCE RESERVE 1941366 HEALTH AND WELFARE BENEFITS RESERVE 1222981 LONG-TERM RETENTION INCENTIVES 135876 MISCELLANEOUS LIABILITY 23673 6182647 X 187229000 -2427343 21794 -2405549 189634549 75100 34166 109266 189743815 196861000 0 196861000 75100 148560 223660 197084660 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2015. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 21,794. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN UNRESTRICTED FUND BALANCE 33,424. ROUNDING 742. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN UNRESTRICTED FUND BALANCE 148,093. ROUNDING 467. X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 KENNETH ANDERSON MD BOARD CHAIR 0 146338 0 18582 0 2724 0 -22024 0 18447 0 164067 0 0 KYLE CHRISTIASON MD BOARD MEMBER 0 346167 0 41505 0 1825 0 145 0 25302 0 414944 0 0 STAN DANIELSON MD BOARD VICE CHAIR 0 303349 0 33862 0 5660 0 -30873 0 10284 0 322282 0 0 PAMELA DELAGARDELLE BOARD MEMBER 0 419128 0 52633 0 46100 0 67550 0 27052 0 612463 0 0 PRASAD NADKARNI MD BOARD MEMBER 0 512884 0 28684 0 6260 0 6607 0 13128 0 567563 0 0 ANDREA WHITE BOARD MEMBER 0 256632 0 33959 0 3311 0 13750 0 8129 0 315781 0 0 CRAIG FLANAGAN TO 918 VP/CFO 203686 0 24227 0 214914 0 10993 -6127 16107 0 469927 -6127 129444 0 MARGARET VANOOSTEN PRES & CHIEF CLINICAL OFFICER 311921 0 18359 0 31278 0 35585 0 8650 0 405793 0 0 0 DAVID WILLIAMS MD CEO 0 557832 0 69360 0 64038 0 79011 0 23129 0 793370 0 0 JANE ARNOLD VP OPERATIONS 0 158811 0 13509 0 15449 0 3119 0 25675 0 216563 0 0 LEANNE BURRACK VP HOSPICE 133363 0 14547 0 22501 0 8166 0 8757 0 187334 0 0 0 RUTH COADY VP SPECIALTY PHARMACY 107475 24904 14547 0 17738 0 6514 1217 553 126 146827 26247 0 0 PAULA GEISE DIR OPERATIONAL INITIATIVES 127013 1855 14387 0 8638 0 7567 -68 23387 276 180992 2063 0 0 JESSICA MEISNER VP HUMAN RESOURCES 0 220806 0 23392 0 13612 0 8249 0 22495 0 288554 0 0 JENN OFELT VP HOME HEALTH & OPERATIONS 128569 0 13828 0 12167 0 8028 0 28556 0 191148 0 0 0 PATRICK REEVES VP HOME MEDICAL EQUIPMENT 128024 0 14359 0 42205 0 7744 0 17327 0 209659 0 0 0 TODD RICHARD VP PATIENT ACCESS 175495 0 23179 0 8955 0 9528 0 9012 0 226169 0 0 0 DIANNE SCHULTZ DIRECTOR CARE AT HOME SVCS 170399 0 23117 0 8758 0 8622 0 865 0 211761 0 0 0 MARISSA SMITH CHIEF COMPLIANCE OFFICER 148969 0 11738 0 90 0 7139 0 20829 0 188765 0 0 0 DEBORAH COSGROVE HOME CARE CONSULTANT 123562 0 13692 0 762 0 7181 0 18054 0 163251 0 0 0 JENNIFER CRIMMINS EXEC DIRECTOR OPERATIONS 114482 0 15306 0 203 0 5551 0 28707 0 164249 0 0 0 AMY LEISTER EXEC DIRECTION CLINICAL EDUC 118828 490 14587 0 470 0 6014 23 17345 69 157244 582 0 0 MICHAEL WELSCH EXEC DIRECTOR FINANCE 118265 0 24969 0 64 0 7832 0 22780 0 173910 0 0 0 ASHLEY WIRTJES DIRECTOR HUMAN RESOURCES 134807 0 13106 0 54 0 7498 0 7546 0 163011 0 0 0 MELLISSA WOOD TO 1217 CHIEF NURSING EXECUTIVE (QC) 5779 200314 0 10081 329 13607 174 6330 77 1575 6359 231907 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS. PART I, LINES 4A-B SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: CRAIG FLANAGAN $62,354. NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: KENNETH ANDERSON, MD $-24,544; KYLE CHRISTIASON, MD $-13,605; STAN DANIELSON, MD $-44,623; PAMELA DELAGARDELLE $57,944; CRAIG FLANAGAN $-5,669; MARGARET VANOOSTEN $22,819; AND DAVID WILLIAMS, MD $68,333. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: CRAIG FLANAGAN $129,444. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGERS, AND APPOINT BOARD OF DIRECTORS. AFFILIATE ORGANIZATIONS THAT HAVE TRANSFERRED HOME HEALTH OPERATIONS TO THE ORGANIZATION HAVE THE RIGHT TO NOMINATE AT LEAST ONE BOARD MEMBER, SUBJECT TO APPROVAL BY IOWA HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE PRESIDENT AND CCO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE CEO FORUM GROUP AND SVP POSITIONS FOR THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2018 FOR THE FOLLOWING INDIVIDUALS: PAMELA DELAGARDELLE AND DAVID WILLIAMS, M.D. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST 1,768,001. TRANSFER OF ASSETS FROM TRINITY HEALTH ENTERPRISES, INC. 277,286. MISCELLANEOUS OTHER ADJUSTMENTS 21,792. 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IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 36 HOSPITAL FACILITIES AND OVER 400 OUTPATIENT SITES IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).