CENTRAL IOWA HEALTHCARE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL IOWA HEALTHCARE (EIN 42-0948420)
- Tax period
- 2017-11-01 to 2018-03-31
- Filed
- 2019-01-10
- IRS object ID
- 201900109349301865
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-01-10T13:18:00-06:00 | ReturnTs |
| Tax Period End | 2018-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 824526527 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARG & HENSON CPAS PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 S UNIVERSITY DR STE 312 | AddressLine1Txt |
| City | FORT WORTH | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 761078099 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420948420 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 6109091675 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 WILLIAMS ROAD | AddressLine1Txt |
| City | WYNNEWOOD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19096 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NEIL GILMOUR III | PersonNm |
| Person Title | LIQUIDATION TRUSTEE | PersonTitleTxt |
| Phone | 6109091675 | PhoneNum |
| Signature | 2018-12-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DONALD R BARG | PreparerPersonNm |
| PTIN | P00196715 | PTIN |
| Phone | 8178701057 | PhoneNum |
| Preparation | 2019-01-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.16.49 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-01-10 | IPDt |
| IP Tm | 13:18:00 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 977CFCB9C685DC8DED6EB91A22541EBE6B77B20C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EAEF60479818725E5025E18C1E66B65AF0C8A52B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIL GILMOUR III | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 WILLIAMS ROAD | AddressLine1Txt |
| City | WYNNEWOOD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19096 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $0 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRALIOWAHEALTHCARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO CREATE AND CONTINUALLY IMPROVE SERVICES THAT RESPOND TO THE HEALTHCARE NEEDS IN OUR COMMUNITY | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 512 | TotalEmployeeCnt |
| Total Volunteers | 225 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $150,836 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,658,276 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$30,940,530 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$426,712 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | -$1,558,130 | PYTotalRevenueAmt |
| CY Total Revenue | $0 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,446,824 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,370,944 | PYOtherExpensesAmt |
| CY Other Expenses | $1,020,935 | CYOtherExpensesAmt |
| PY Total Expenses | $24,817,768 | PYTotalExpensesAmt |
| CY Total Expenses | $1,020,935 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$26,375,898 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,020,935 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,487,737 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,720,407 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,253,605 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$9,232,670 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$10,253,605 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO CREATE AND CONTINUALLY IMPROVE SERVICES THAT RESPOND TO THE HEALTHCARE NEEDS IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Desc | TO PROVIDE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO MEMBERS OF THE COMMUNITY AND SURROUNDING COMMUNITIES REGARDLESS OF ABILITY TO PAY. CARE INCLUDES PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND OTHER SERVICES. CENTRAL IOWA HEALTHCARE EXPERIENCED THOUSANDS OF OUTPATIENT VISITS, ADMISSIONS, BIRTHS, SURGICAL PROCEDURES, AND EMERGENCY ROOM VISITS. | Desc |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | Yes (true) | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 56 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 512 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITYPOINT HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6417545126 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVENUE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|
| NEIL GILMOUR III | |||||
| LIQUIDATION | Yes (X) | $0 | $0 | $0 | |
| JOHN C HUGHES | |||||
| PRESIDENT & | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DAWNETT WILLIS | |||||
| COO/ACTING C | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TODD BURCH | |||||
| FORMER CFO | $0 | $0 | $0 | Yes (X) | |
| LORI KRENOS | |||||
| CHIEF NURSIN | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTH ENTERPRISES | |||||
| 5825 DRY CREEK LANE NE | CEDAR RAPIDS | IA | 52402 | HEALTHCARE SVC | $1,339,789 |
| SUGAR FELSENTHAL GRAIS & HAMMER LLP | |||||
| 30 N LA SALLE ST STE 3000 | CHICAGO | IL | 60602 | LEGAL | $1,035,902 |
| BARTON ASSOCIATES INC | |||||
| PO BOX 417844 | BOSTON | MA | 022417844 | STAFFING | $737,756 |
| NURSE ANESTHESIA OF NC PLLC | |||||
| 6225 N STATE HWY 161 SUITE 200 | IRVING | TX | 75038 | ANESTHESIA | $647,094 |
| ALVAREZ & MARSAL NORTH AMERICA LLC | |||||
| 600 MADISON AVENUE 8TH FLOOR | NEW YORK | NY | 10022 | RESTRUCTURING | $633,433 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESTRUCTURING COSTS | Desc |
| Total | $1,020,935 | TotalAmt |
| Management And General | $1,020,935 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,020,935 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,020,935 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,372,800 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,985,360 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,577 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,487,737 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,720,407 | BOYAmt |
| EOY | $10,253,605 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,720,407 | BOYAmt |
| EOY | $10,253,605 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,232,670 | BOYAmt |
| EOY | -$10,253,605 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,232,670 | BOYAmt |
| EOY | -$10,253,605 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,487,737 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,020,935 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVENUE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CENTRALIOWAHEALTHCARE.COM | WebsiteAddressTxt |
| State License | 640007H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CENTRALIOWAHEALTHCARE.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CENTRALIOWAHEALTHCARE.COM | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| 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 |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Engaged Selling Debt | Yes (X) | EngagedSellingDebtInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CENTRAL IOWA HEALTHCARE - PART V, LINE 3E | CENTRAL IOWA HEALTHCARE IDENTIFIED EIGHTEEN POTENTIAL AREAS OF FOCUS AND AS A RESULT OF A PRIORITIZATION PROCESS THE NEEDS IDENTIFIED FOR FOCUSE WERE OVERWEIGHT AND OBESITY (WHICH UNDERLIES MANY CHRONIC DISEASES) AND BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH ND SUBSTANCE ABUSE. CENTRAL IOWA HEALTHCARE'S BOARD OF TRUSTEES APPROVED THE IMPLEMENTATION STRATEGY ON OCTOBER 20, 2016. |
| FACILITY 1, CENTRAL IOWA HEALTHCARE - PART V, LINE 5 | CENTRAL IOWA HEALTHCARE UTILIZED MANY METHODS IN ORDER TO ENSURE THAT INPUT WAS RECEIVED FROM THE ENTIRE COMMUNITY, INCLUDING REPRESENTATIVES OF THE COMMUNITY WITH PUBLIC HEALTH KNOWLEDGE, THOSE WITH SPECIALIZED HEALTH KNOWLEDGE, AND THOSE SERVED BY THE HOSPITAL. THE PROCESS INVOLVED ACTIVELY REACHING OUT TO KEY INFORMANTS IN THE SERVICE AREA, COMMUNITY-WIDE SURVEYS (ON-LINE AND IN PAPAR IN ENGLISH AND SPANISH), A COMMUNITY IMPUT MEETING AND GATHERING OF LOCAL, REGIONAL AND NATIONALLY AVAILABLE DATA SOURCES. |
| FACILITY 1, CENTRAL IOWA HEALTHCARE - PART V, LINE 11 | CENTRAL IOWA HEALTHCARE IDENTIFIED EIGHTEEN POTENTIAL AREAS OF FOCUS AND AS A RESULT OF A PRIORITIZATION PROCESS THE NEEDS INDENTIFIED FOR FOCUS WERE OVERWEIGHT AND OBESITY (WHICH UNDERLIES MANY CHRONIC DISEASES) AND BEHAVIOR HEALTH, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE. CENTRAL IOWA HEALTHCARE'S BOARD OF TRUSTEES APPROVED THE IMPLEMENTATION STATEGY ON OCTOBER 20, 2016 AND AT PRIOR FISCAL YEAR END WAS JUST BEGINNING TO WORK ON ADDRESSING THESE TWO FOCUS AREAS. THERE WERE NEEDS IDENTIFIED THAT CENTRAL IOWA HEALTHCARE DOES NOT HAVE THE RESOURCES TO ADDRESS AT THE TIME. THESE NEEDS, WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY, WERE NOT CHOSEN BASED ON THE ORGANIZATION'S PRIORITIZATION PROCESS, BASED ON THE URGENCY OF THE NEED, THE ESSENTIAL NATURE OF THESE NEEDS TO THE OVERALL HEALTH OF THE COMMUNITY; AND THAT BY ADDRESSING THESE ISSUES, CENTRAL IOWA HEALTHCARE MIGHT POSITIVELY IMPACT RELATED NEEDS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MMSC CLINIC - STATE CENTER | ||||
| 503 3RD AVENUE SW | STATE CENTER | IA | 50247 | PHYSICIAN CLINIC |
| MMSC CLINIC - TAMATOLEDO | ||||
| 1307 SOUTH BROADWAY | TOLEDO | IA | 52342 | PHYSICIAN CLINIC |
| MMSC CLINIC - CONRAD | ||||
| 105 NORTH CHURCH ST | CONRAD | IA | 50621 | PHYSICIAN CLINIC |
| MMSC CLINIC - MARSHALLTOWN | ||||
| 405 EAST MAIN ST | MARSHALLTOWN | IA | 50158 | PHYSICIAN CLINIC |
| CIH - URGENT CARE | ||||
| 55 CENTRAL IOWA DRIVE SUITE 5 | MARSHALLTOWN | IA | 50158 | URGENT CARE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | NOT APPLICABLE |
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | A COMMUNITY BENEFIT REPORT IS PREPARED ANNUALLY (EXCEPT FOR THIS YEAR DUE TO BANKRUPTCY) IN A COLLABORATIVE EFFORT WITH THE IOWA HOSPITAL ASSOCIATION. THIS INFORMATION IS SHARED IN TOTAL FOR THE ENTIRE STATE THROUGH PRESS RELEASES AND FOR OUR INDIVIDUAL HOSPITAL BY INCLUDING THIS INFORMATION IN OUR ANNUAL CORPORATE REPORT, ON OUR WEBSITE AND A LOCAL PRESS RELEASE. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE ORGANIZATIONS BAD DEBT EXPENSE (AT COST) IS DETERMINED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BY AN ALLOWANCE FOR AN ESTIMATE MADE FOR CONTRACTUAL ADJUSTMENTS OR DISCOUNTS PROVIDED TO THIRD-PARTY PAYORS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNT DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL). THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEN THE STANDARD RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN-OFF. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | CENTRAL IOWA HEALTHCARE AND THE MARSHALL COUNTY BOARD OF HEALTH PARTNERED TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN TAX YEAR 2015. THROUGH THESE EFFORTS, PRIORITIES AND STRATEGIES HAVE BEEN DEVELOPED. REPRESENTATIVES OF CENTRAL IOWA HEALTHCARE ARE INVOLVED IN THE ABOVE MENTIONED GROUPS AND THE LARGER COALITION. THE HEALTH NEEDS OF THE COMMUNITY ARE ASSESSED THROUGH A COMMUNITY NEEDS ASSESSMENT PROCESS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY AND TO ASSIST OUR COMMUNITY PARTNERS IN FOCUSING ON OUR COMMUNITIES FUTURE HEALTH NEEDS. THIS ASSESSMENT SERVES AS THE BASIS FOR MARSHALL COUNTY PUBLIC HEALTH AND OUR OVERALL HEALTHCARE COMMUNITY TO DEVELOP ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES. THIS NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO - GAIN INSIGHT INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY - ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS - TO PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNING. CENTRAL IOWA HEALTHCARE ACTIVELY CONTRIBUTES TO THE COMMUNITY NEEDS ASSESSMENT AND ENGAGES IN THE PRIORITIES THAT MATCH ITS VISION AND MISSION. MEASUREMENT AND EVALUATION TOOLS ARE COLLECTED AND MONITORED BY THE LARGER COMMUNITY COALITION ENGAGED IN THE VARIOUS EFFORTS. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, CENTRAL IOWA HEALTHCARE MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND RESOURCES AVAILABLE. INDIVIDUAL DEPARTMENTS ALSO WORK TO IDENTIFY COMMUNITY NEEDS AS RELATED TO THEIR SERVICES AND THE POPULATION SERVED. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SIGN STATING THAT FINANCIAL ASSISTANCE AND FREE CARE ARE AVAILABLE AND ARE POSTED IN THE HOSPITAL REGISTRATION AND CASHIER AREAS. REGISTRATION STAFF HAVE EDUCATIONAL MATERIAL AND APPLICATION FORMS THAT ARE MADE AVAILABLE TO PATIENTS WANTING INFORMATION OR AN APPLICATION FOR OUR COMMUNITY ASSISTANCE PROGRAM. PATIENT FINANCIAL SERVICE REPRESENTATIVES CONSULT AND ADVISE SELF PAY PATIENTS ON THEIR OPTIONS FOR GOVERNMENT SPONSORED FINANCIAL ASSISTANCE AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, AN OUTSIDE VENDOR CONTACTS ADMITTED SELF PAY PATIENTS AND DISCUSSES OPTION FOR GOVERNMENT SPONSORED FINANCIAL ASSISTANCE AND PROVIDES ASSISTANCE TO PATIENTS APPLYING FOR A SPECIFIC PROGRAM. OUR OUTSIDE VENDOR DIRECTS PATIENTS THAT DO NOT QUALIFY FOR A GOVERNMENT SPONSORED PROGRAM TO A HOSPITAL FINANCIAL SERVICE REPRESENTATIVE TO FOLLOW UP WITH AN APPLICATION FOR COMMUNITY ASSISTANCE. WE FURTHER USE AN "EARLY OUT" SELF PAY VENDOR THAT PROVIDES INFORMATION ON GOVERNMENT PROGRAMS AND THE HOSPITAL'S COMMUNITY ASSISTANCE PROGRAM. OUR SELF PAY VENDOR PROVIDES COMMUNITY ASSISTANCT APPLICATIONS TO PATIENTS WHEN AN APPLICATION IS REQUESTED AND MAKES REFERRALS FOR POSSIBLE APPLICATION TO GOVERNMENT SPONSORED ASSISTANCE PROGRAMS. ALSO, A STATEMENT IS INCLUDED IN THE FIRST BILLING TO PATIENTS REGARDING THE AVAILABLILITY OF FINANCIAL ASSISTANCE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | MASHALL COUNTY, POPULATION OF 40,312, IS COMPRISED OF 13 INCORPORATED COMMUNITIES AND THEIR SURROUNDING AREAS. THE POPULATION IS SOMEWHAT CONCENTRATED IN THE CENTRAL CITY OF MARSHALLTOWN WHERE ABOUT 66% OF COUNTY RESIDENTS LIVE. THE COUNTY'S POPULATION HAS REMAINED STABLE OVER THE PAST 50 YEARS, HOWEVER, THE DEMOGRAPHICS OF THE POPULATION HAVE SHIFTED DRAMATICALLY IN THE PAST 15 YEARS. NEW IMMIGRANTS RECRUITED TO THE COMMUNITY BY THE MEAT PACKING INDUSTRY HAVE DRIVEN THESE CHANGES. LARGE NUMBERS OF HISPANIC IMMIGRANTS HAVE LEFT THE SUB-MINIMUM WAGE EXISTENCE IN CENTRAL MEXICO TO TRAVEL TO THE AMERICAN MIDWEST FOR JOBS IN THE MEAT PACKING INDUSTRY. THIS INDUSTRY IS THE LARGEST PRIVATE EMPLOYER IN MARSHALL COUNTY WITH PAY RANGING FROM 9 TO 13 PER HOUR. THESE CHANGES HAVE RESULTED IN AN INCREASE IN THE NUMBER OF PEOPLE LIVING IN POVERTY AND AN UPSURGE IN THE NUMBER OF UNINSURED OR UNDERINSURED RESIDENTS. MARSHALL COUNTY IS DESIGNATED AS A HEALTH PROVIDER SHORTAGE AREA (HPSA). FURTHER, THE COUNTY HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED COMMUNITY (MUC) AND THE IMMIGRANT POPULATION HAS BEEN DESIGNATED AS A MEDICALLY UNERSERVED POPULATION (MUP) DUE TO LANGUAGE AND CULTURAL BARRIERS IN ACCESSING HEALTH CARE SERVICES. ACCORDING THE THE 2016 US CENSUS DATA, 21.1% OF THE MARSHALL COUNTY'S POPULATION IS OF HISPANIC OR LATINO ORIGIN COMPARED TO 5.8% IN THE STATE OF IOWA; 83.5% OF MARSHALL COUNTY RESIDENTS ARE HIGH SCHOOL GRADUATES COMPARED TO 91.5% IN IOWA; 19.7% OF MARSHALL COUNTY POPULATION HAD A BACHELOR'S DEGREE OR HIGHER COMPARED TO 26.7% IN IOWA (2000); THE MEDIAN HOUSEHOLD INCOME IN 2011-2015 IN MARSHALL COUNTY WAS 53,351 COMPARED TO 53,183 IN IOWA; PERSONS LIVING BELOW POVERTY IN MARSHALL COUNTY WAS 11.3% COMPARED TO 12.2% IN IOWA. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | CENTRAL IOWA HEALTHCARE IS A SOLE COMMUNITY HOSPITAL AND A RURAL REFERRAL CENTER BY CMS'S DEFINITIONS. THE HOSPITAL IS LOCATED IN A RURAL, MEDICALLY UNDERSERVED AREA AND IS THE ONLY HOSPITAL WITHIN A 30 MILE RADIUS. THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES AND CONTINUALLY IMPROVING SERVICES TO RESPOND TO HEALTH CARE NEEDS. THE HOSPITAL PROVIDES A 24 HOUR EMERGENCY DEPARTMENT, INCLUDING AMBULANCE COVERAGE; AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES, NOR CONTRACTORS, NOR FAMILY MEMBERS THEREOF AND ARE A BROAD CROSS SECTION OF COMMUNITY LEADERS. THE ORGANIZATION PROVIDES AN OPEN MEDICAL STAFF TO ALL QUALIFIED PHYSICIANS, SUBJECT TO THE NORMAL, EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, EMERGENCY DEPARTMENT, AND HEART CATHETERIZATION LAB. THE EXCLUSIVE CONTRACTS ARE NECESSARY TO ASSURE THAT THESE MUCH NEEDED SERVICES ARE PROVIDED IN THIS RURAL MEDICALLY UNDERSERVED COMMUNITY. ALL SURPLUS FUNDS ARE USED TO MEET AND TO RESPOND TO THE HEALTHCARE NEEDS OF THE COMMUNITIES THIS ORGANIZATION SERVES. |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (3 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| CENTRAL IOWA HEALTHCARE LIQUID TR | |||||||||
| CASH | 2018-03-02 | $4,647,896 | N/A | 826927492 | 500 WILLIAMS ROAD | WYNNEWOOD | PA | 19096 | 671 |
| CENTRAL IOWA HEALTHCARE LIQUID TR | |||||||||
| CAUSES OF ACTION | 2018-03-02 | 826927492 | 500 WILLIAMS ROAD | WYNNEWOOD | PA | 19096 | 671 | ||
| CENTRAL IOWA HEALTHCARE LIQUID TR | |||||||||
| CONTRACT RIGHTS | 2018-03-02 | 826927492 | 500 WILLIAMS ROAD | WYNNEWOOD | PA | 19096 | 671 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (true) | DirectorOfSuccessorInd |
| Employee Of Successor | false | EmployeeOfSuccessorInd |
| Owner Of Successor | false | OwnerOfSuccessorInd |
| Receive Compensation | false | ReceiveCompensationInd |
| Assets Distributed | false | AssetsDistributedInd |
| Required To Notify AG | false | RequiredToNotifyAGInd |
| Liabilities Paid | false | LiabilitiesPaidInd |
| Bonds Outstanding | false | BondsOutstandingInd |
| Director Of Successor2 | Yes (true) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | false | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE N, PAGE 1, PART I, LINE 2E | PURSUANT TO A COURT APPROVED PLAN OF LIQUIDATION A LIQUIDATING TRUST WAS ESTABLISHED FOR THE PURPOSE OF LIQUIDATING THE REMAINING ASSETS, WHICH CONSISTS OF CASH, CAUSES OF ACTION, AND CONTRACT RIGHTS. GILMOUR CONSULTING LLC WAS APPOINTED LIQUIDATION TRUSTEE. THE LIQUIDATION TRUSTEE IS CONSIDERED A "REPRESENTATIVE OF THE ESTATE" UNDER SECTION 1123(B)(3)(B) OF THE BANKRUPTCY CODE. |
| SCHEDULE N | SUBSANTIALLY ALL ASSETS OF THE TAXPAYER WERE SOLD MAY 1, 2017. ALL REMAINING ASSETS, CONSISTING OF CASH, CAUSES OF ACTION, AND CONTRACT RIGHTS, WERE TRANSFERRED TO THE CENTRAL IOWA HEALTHCARE LIQUIDATING TRUST (TRUST)PURSUANT TO A PLAN OF LIQUIDATION APPROVED BY THE BANKRUPTCY COURT. THE TRUST IS A GRANTOR TRUST PURSUANT TO INTERNAL REVENUE CODE SECTION 671 AND IS CONSIDERED A LIQUIDATING TRUST PURSUANT TO TREASURY REGULATION 301.7701-4(D). THE TRUST IS FOR THE BENEFIT OF CREDITORS WITH ALLOWED CLAIMS. THE TAXPAYER DOES NOT RETAIN ANY BENEFICIARY INTEREST IN THE TRUST. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 3 | ON DECEMBER 20, 2016 CENTRAL IOWA HEALTHCARE (DEBTOR) FILED FOR RELIEF UNDER CHAPTER 11 OF THE U.S. BANKRUPTCY CODE IN THE SOUTHERN DISTRICT OF IOWA, DES MOINES DIVISION (CASE NO. 16-02438-ALS-11). THE DEBTOR SOLD SUBSTANTIALLY ALL ASSETS ON MAY 1, 2017. BY ORDER OF THE BANKRUPTCY COURT, THE SALE IS CONSISTENT WITH THE MISSION OF THE DEBTOR AS A NON-PROFIT HEALTCARE ORGANIZATION. POST-SALE THE DEBTOR NO LONGER CONTINUES AS A GOING CONCERN, INSTEAD FOCUSING ON THE LIQUIDATION OF ITS REMAINING ASSETS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | YES |
| FORM 990, PAGE 6, PART VI, LINE 7A | YES |
| FORM 990, PAGE 6, PART VI, LINE 9 | DAWNETT WILLIS 3 SOUTH 4TH AVE MARSHALLTOWN, IA 50158 TODD BURCH 3 SOUTH 4TH AVE MARSHALLTOWN, IA 50158 |
| FORM 990, PAGE 6, PART VI, LINE 11B | ON DECEMBER 20, 2016 CENTRAL IOWA HEALTHCARE (DEBTOR) FILED FOR RELIEF UNDER CHAPTER 11 OF THE U.S. BANKRUPTCY CODE IN THE SOUTHERN DISTRICT OF IOWA, DES MOINES DIVISION (CASE NO. 16-02438-ALS-11). THE DEBTOR SOLD SUBSTANTIALLY ALL ASSETS ON MAY 1, 2017. A PLAN OF LIQUIDATION WAS CONFIRMED ON FEBRUARY 9, 2018. THE PLAN TRANSFERS ALL REMAINING ASSETS, PRIMARILY CASH AND CAUSES OF ACTION, TO A LIQUIDATING TRUST. THE LIQUIDATION TRUSTEE IS RESPONSIBLE FOR FILING THE DEBTORS TAX RETURNS. THE TAX RETURN WAS REVIEWED BY THE LIQUIDATION TRUSTEE AND ACCOUNTING FIRM PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICTS OF INTEREST POLIY REQUIRES ANNUAL CERTIFICATION THAT EACH TRUSTEE HAS THE CONFLICT OF INTEREST POLICY; THAT THEY HAVE A COPY OF THE SECTION OF THE ORGANIZATION BY-LAWS THAT DISCUSSES CONFLICTS OF INTEREST; AND THAT THEY AGREE TO COMPLY WITH THE POLICY. THE EXECUTIVE ASSISTANT TO THE PRESIDENT IS ASSIGNED TO ENSURE THAT ALL RECIPIENTS ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. THE DIRECTOR OF ACCOUNTING/FINANCE REVIEWS THE CONFLICT OF INTEREST QUESTIONNAIRES TO DETERMINE IF A CONFLICT DOES EXIST. IF A POTENTIAL CONFLICT IS DISCLOSED THE INDIVIDUAL IS ALLOWED TO MAKE A PRESENTATION CONCERNING THE PROPOSED TRANSACTION BUT IS THEN ASKED TO LEAVE THE ROOM WHILE FURTHER DISCUSSION TAKES PLACE AND THE REST OF THE BOARD DETERMINES WHETHER OR NOT TO ENTER THE TRANSACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS WHO MEET MULTIPLE TIMES PER YEAR TO REVIEW THE IOWA HOSPITAL ASSOCIATIONS WAGE SURVEY DATA. THE COMMITTEE RECOMMENDS CHANGES BASED ON THE SURVEY COMPARISONS AND ANNUAL PERFORMANCE EVALUATIONS. THE RECOMMENDATIONS ARE PRESENTED TO THE FULL BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |