PEKIN MEMORIAL HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PEKIN MEMORIAL HOSPITAL (EIN 37-0692351)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-14
- IRS object ID
- 201803189349310360
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-14T15:50:51-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370692351 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEKIN MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEKI | BusinessNameControlTxt |
| Phone | 3093530700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 SOUTH 13TH STREET | AddressLine1Txt |
| City | PEKIN | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61554 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT A QUIN | PersonNm |
| Person Title | VP FINANCE/CFO | PersonTitleTxt |
| Phone | 3096724893 | PhoneNum |
| Signature | 2018-11-13 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 205.167.2.34 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-13 | IPDt |
| IP Tm | 08:52:19 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DD9323F46DB11854D78E7A2C9F8A94245B159947 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 8902F0315789D87F117F8AA9CDCEB0C04F949551 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITYPOINT HEALTH-PEKIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT A QUIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 SOUTH 13TH STREET | AddressLine1Txt |
| City | PEKIN | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61554 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,608,582 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1913 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE HEALTH AND WELL-BEING OF COMMUNITY WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 729 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $203,115 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,474,480 | PYContributionsGrantsAmt |
| CY Contributions Grants | $205,233 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,087,672 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $60,498,800 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,879,331 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,066,518 | CYInvestmentIncomeAmt |
| PY Other Revenue | $592,625 | PYOtherRevenueAmt |
| CY Other Revenue | $714,836 | CYOtherRevenueAmt |
| PY Total Revenue | $48,034,108 | PYTotalRevenueAmt |
| CY Total Revenue | $62,485,387 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $629,769 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,576,597 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,842,834 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,917,974 | PYOtherExpensesAmt |
| CY Other Expenses | $28,770,372 | CYOtherExpensesAmt |
| PY Total Expenses | $48,494,571 | PYTotalExpensesAmt |
| CY Total Expenses | $64,242,975 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$460,463 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,757,588 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,011,539 | TotalAssetsBOYAmt |
| Total Assets EOY | $48,434,799 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,922,676 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,782,407 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,088,863 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,652,392 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY AND TO DO SO WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $45,516,010 | ExpenseAmt |
| Grant | $361,014 | GrantAmt |
| Revenue | $61,302,378 | RevenueAmt |
| Desc | HEALTH-CARE SERVICESPEKIN MEMORIAL HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE PEKIN, ILLINOIS AND SURROUNDING COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. PEKIN MEMORIAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE AND EMERGENCY SERVICES. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2017, PEKIN MEMORIAL HOSPITAL ADMITTED 2,745 PATIENTS RESULTING IN A TOTAL OF 10,093 PATIENT DAYS. OUTPATIENT VISITS TOTALED 97,802 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 3,997. THERE WERE ALSO 25,111 EMERGENCY ROOM VISITS AND 377 BABIES DELIVERED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,021,746 | ExpenseAmt |
| Grant | $268,755 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: [ABC HOSPITAL] PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE 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 $197,046 IN 2017. OFTENTIMES, PEKIN MEMORIAL HOSPITAL RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. PEKIN MEMORIAL HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. PEKIN MEMORIAL HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $4,555,945 FOR 2017. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $4,752,991.OTHER BENEFITS: PEKIN MEMORIAL HOSPITAL PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. PEKIN MEMORIAL HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. PEKIN MEMORIAL HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $268,755. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $50,537,756 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | 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 | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 91 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 729 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| 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-PEKIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3093530989 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 SOUTH 13TH STREET | AddressLine1Txt |
| City | PEKIN | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61554 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| GORDON CROSS MD | |||||||||
| BOARD MEMBER (TO 5/17) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RUSTY DUNN | |||||||||
| BOARD SECRETARY/TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DELORES EAGLESON | |||||||||
| BOARD VICE CHAIR (TO 7/17) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CURTIS EETEN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROSS GOULD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL HONAN MD | |||||||||
| BOARD MEMBER (FR 6/17) | 1.00 | 1.00 | Yes (X) | $0 | $417,171 | $45,948 | |||
| MARIA HORNSTEIN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RONALD MILLER | |||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| F NANI MOAZZAM MD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $385,377 | $19,877 | |||
| JASON PROEHL | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DIRK ROECKER | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEBBIE SIMON | |||||||||
| PRES & CEO MHSC/BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $811,527 | $73,073 | Yes (X) | ||
| JAIMIE STEVENSON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $13,099 | $0 | |||
| KAREN STUMPE | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BOB HALEY | |||||||||
| CEO (TO 12/17) | 1.00 | 40.00 | $0 | $279,641 | $28,186 | Yes (X) | |||
| STEVE HALL | |||||||||
| CFO (TO 8/17) | 1.00 | 40.00 | $0 | $281,570 | $33,880 | Yes (X) | |||
| ROBERT QUIN | |||||||||
| VP FINANCE/CFO, MHSC | 1.00 | 40.00 | $0 | $454,953 | $86,882 | Yes (X) | |||
| JEANINE SPAIN | |||||||||
| VP, REGIONAL CNO/COO-PEKIN | 20.00 | 20.00 | $0 | $396,720 | $93,660 | Yes (X) | |||
| ANGELIA DREHER | |||||||||
| PHARMACY MANAGER | 40.00 | 0.00 | $140,301 | $0 | $39,537 | Yes (X) | |||
| CRYSTAL ELLIOTT | |||||||||
| VP OF HR | 40.00 | 0.00 | $103,621 | $0 | $9,111 | Yes (X) | |||
| ASHOKKUMAR PATEL | |||||||||
| PHARMACIST | 40.00 | 0.00 | $113,455 | $0 | $28,749 | Yes (X) | |||
| FRANCES VANDYKE | |||||||||
| LAB DIRECTOR | 40.00 | 0.00 | $110,138 | $0 | $16,161 | Yes (X) | |||
| APRIL WILLOBY | |||||||||
| PHARMACIST | 40.00 | 0.00 | $109,508 | $0 | $21,934 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $577,023 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,040,058 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $496,998 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | 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 |
|---|---|---|---|---|---|
| EPSS LLC | |||||
| 12528 SR 78 | HAVANA | IL | 62644 | ER PHYSICIANS | $4,510,857 |
| MIDWEST ANESTHESIA CONSULTANTS SC | |||||
| 4128 W STONEWATER DR | PEORIA | IL | 61615 | ANESTHESIA SERVICES | $1,335,613 |
| PROFESSIONAL THERAPY SERVICES | |||||
| 2810 FRANK SCOTT PARKWAY WEST | BELLEVILLE | IL | 62223 | REHAB SERVICES | $1,303,677 |
| MIDWEST ORTHOPAEDIC CTR | |||||
| 6000 N ALLEN ROAD | PEORIA | IL | 61614 | ORTHOPEDIC SERVICES | $342,500 |
| DRINKER BIDDLE & REATH LLP | |||||
| ONE LOGAN SQUARE STE 2000 | PHILADELPHIA | PA | 19103 | LEGAL SERVICES | $267,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $205,233 | GovernmentGrantsAmt |
| Total Contributions | $205,233 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $60,279,228 | $60,279,228 | |
| LABORATORY SERVICES | 621500 | $203,115 | $203,115 | |
| RENTAL INCOME | 531390 | $13,848 | $13,848 | |
| PUBLIC HEALTH PROGRAMS | 900099 | $2,609 | $2,609 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $60,498,800 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $185,720 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $88,742 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $96,978 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,003,993 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,114,995 | SecuritiesAmt |
| Other | $8,200 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $888,998 | SecuritiesAmt |
| Other | -$8,200 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $880,798 | TotalRevenueColumnAmt |
| Exclusion | $880,798 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA/FOOD SVCS | 722210 | $470,567 | $470,567 |
| MISCELLANEOUS | 900099 | $244,269 | $244,269 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $714,836 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,485,387 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,099,263 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $203,115 | UnrelatedBusinessRevenueAmt |
| Exclusion | $977,776 | 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 | $629,769 | TotalAmt |
| Program Services | $629,769 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,450 | TotalAmt |
| Management And General | $315,450 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,460,471 | TotalAmt |
| Program Services | $23,027,727 | ProgramServicesAmt |
| Management And General | $5,432,744 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,212 | TotalAmt |
| Program Services | $195,168 | ProgramServicesAmt |
| Management And General | $46,044 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,120,979 | TotalAmt |
| Program Services | $3,353,783 | ProgramServicesAmt |
| Management And General | $767,196 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,704,722 | TotalAmt |
| Program Services | $1,379,312 | ProgramServicesAmt |
| Management And General | $325,410 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,109 | TotalAmt |
| Management And General | $22,109 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,385 | TotalAmt |
| Management And General | $90,385 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,035 | TotalAmt |
| Management And General | $24,035 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,901,421 | TotalAmt |
| Program Services | $8,039,291 | ProgramServicesAmt |
| Management And General | $4,862,130 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,306 | TotalAmt |
| Program Services | $1,008 | ProgramServicesAmt |
| Management And General | $162,298 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,450,399 | TotalAmt |
| Program Services | $1,225,618 | ProgramServicesAmt |
| Management And General | $224,781 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,337,407 | TotalAmt |
| Program Services | $1,333,233 | ProgramServicesAmt |
| Management And General | $4,174 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,465 | TotalAmt |
| Program Services | $11,415 | ProgramServicesAmt |
| Management And General | $18,050 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,308 | TotalAmt |
| Program Services | $15,425 | ProgramServicesAmt |
| Management And General | $22,883 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,189 | TotalAmt |
| Management And General | $331,189 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,350,591 | TotalAmt |
| Program Services | $3,350,591 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $984,881 | TotalAmt |
| Management And General | $984,881 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $8,033,500 | $7,962,874 | $70,626 |
| MISCELLANEOUS EXPENSE | $12,738 | $11,904 | $834 |
| INCOME TAXES | $638 | $638 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,242,975 | TotalAmt |
| Program Services | $50,537,756 | ProgramServicesAmt |
| Management And General | $13,705,219 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$641,365 | BOYAmt |
| EOY | $2,011,025 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,831,737 | BOYAmt |
| EOY | $328,561 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,495,892 | BOYAmt |
| EOY | $12,040,130 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,432,217 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,208,531 | BOYAmt |
| EOY | $1,313,032 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,084,391 | BOYAmt |
| EOY | $1,851,067 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $91,320,488 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $69,310,809 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,593,601 | BOYAmt |
| EOY | $22,009,679 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,033,622 | BOYAmt |
| EOY | $2,449,088 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,405,130 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,011,539 | BOYAmt |
| EOY | $48,434,799 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,117,152 | BOYAmt |
| EOY | $5,465,201 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,604,886 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,825,455 | BOYAmt |
| EOY | $857,242 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,704,008 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,375,183 | BOYAmt |
| EOY | $26,755,956 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,922,676 | BOYAmt |
| EOY | $35,782,407 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,851,178 | BOYAmt |
| EOY | $12,652,392 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $237,685 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,088,863 | BOYAmt |
| EOY | $12,652,392 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,011,539 | BOYAmt |
| EOY | $48,434,799 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,757,588 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$479,156 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,199,727 | OtherChangesInNetAssetsAmt |
| 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
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 | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $24,035 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $24,035 | 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 | LOBBYING EXPENSES ARE ONLY INCURRED THROUGH ASSOCIATIONS WITH NATIONAL ORGANIZATIONS OF WHICH THE ORGANIZATION IS A MEMBER. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,250,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,250,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,082,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,732,294 | DepreciationAmt |
| Book Value | $6,349,886 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,960,534 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,822,468 | DepreciationAmt |
| Book Value | $138,066 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,671,844 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,756,047 | DepreciationAmt |
| Book Value | $9,915,797 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,355,930 | OtherCostOrOtherBasisAmt |
| Book Value | $3,355,930 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,009,679 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| MINIMUM PENSION LIABILITY | $6,404,449 |
| ESTIMATED SELF-INSURANCE COSTS | $322,432 |
| DUE TO AFFILIATES | $11,620,301 |
| SELF-INSURANCE RESERVE | $8,408,774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,755,956 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $80,024,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$479,156 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $18,018,058 | OtherRevenueAmt |
| Revenue Not Reported | $17,538,902 | RevenueNotReportedAmt |
| Revenue Subtotal | $62,485,098 | RevenueSubtotalAmt |
| Other Revenues Not Included | $289 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $289 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $62,485,387 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $63,703,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $313 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $313 | ExpensesNotReportedAmt |
| Expenses Subtotal | $63,702,687 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $540,288 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $540,288 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $64,242,975 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2014. 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. H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT (THE ACT), WAS SIGNED INTO LAW ON DECEMBER 22, 2017. THE ACT CONTAINS VARIOUS PROVISIONS AFFECTING BOTH TAXABLE AND TAX-EXEMPT ENTITIES. TAX EXEMPT ENTITIES ARE IMPACTED IN PART BY THE INCLUSION OF A NEW EXCISE TAX ON EXCESS COMPENSATION FOR COVERED EMPLOYEES, CHANGES TO UNRELATED BUSINESS INCOME, CHANGES TO TAX RATES, AS WELL AS THEIR ABILITY TO ADVANCE REFUND BONDS. IN ADDITION, TAX-EXEMPT ENTITIES MAY BE IMPACTED THROUGH CERTAIN FOR-PROFIT SUBSIDIARIES AND/OR JOINT VENTURES BASED ON THE ACT'S PROVISIONS FOR TAX RATES, ELIMINATION OF THE CORPORATE ALTERNATIVE MINIMUM TAX, CHANGES TO NET OPERATING LOSS UTILIZATION AND CARRYOVER/CARRYBACK PERIOD, AND MEASUREMENT OF DEFERRED TAXES AS WELL AS OTHER LIMITATIONS ON DEDUCTIONS. THE ACT'S PROVISIONS MAY ALSO IMPACT DONOR TAX INCENTIVES FOR CHARITABLE GIVING. THE SYSTEM IS CURRENTLY ASSESSING THE OVERALL IMPACT OF THE ACT AND ITS IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PURCHASE ACCOUNTING VALUATION ADJUSTMENT 18,018,058. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | ROUNDING 289. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ROUNDING 313. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES IN UNRESTRICTED FUND BALANCE 540,288. |
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 |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $197,046 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $197,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,267,611 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,711,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,555,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,464,657 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,711,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,752,991 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07400 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $268,755 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $268,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $268,755 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $268,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,733,412 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,711,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,021,746 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07820 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,507,467 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,980,942 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,913,644 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,932,702 | 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 | PEKIN MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 SOUTH 13TH STREET | AddressLine1Txt |
| City | PEKIN | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61554 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | WebsiteAddressTxt |
| State License | 001834 | 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 | PEKIN MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | 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 | 600.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | UNITYPOINT.ORG/PEORIA/DEFAULT.ASPX | 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 |
| 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 |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PEKIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A COLLABORATIVE UNDERTAKING BY ORGANIZATIONS THAT REPRESENT THE INTERESTS OF THE POPULATION SERVED BY THE HOSPITAL. IN ADDITION TO HOSPITAL MEMBERS, THE COLLABORATIVE INCLUDED THE PEORIA CITY/COUNTY HEALTH DEPARTMENT, TAZEWELL COUNTY HEALTH DEPARTMENT, WOODFORD COUNTY HEALTH DEPARTMENT, HEART OF ILLINOIS UNITED WAY AND HEARTLAND COMMUNITY HEALTH CLINIC (A FEDERALLY QUALIFIED HEALTH CARE CENTER). EACH OF THESE ORGANIZATIONS SERVE/REPRESENT BOTH THE GENERAL AND AT-RISK POPULATION OF THE PRIMARY SERVICE AREA.IN ADDITION TO BROAD BASED REPRESENTATION ON THE COLLABORATIVE, THE CHNA INCLUDES A DETAILED ANALYSIS OF PRIMARY DATA COLLECTED FOR THE GENERAL POPULATION AND THE AT-RISK OR ECONOMICALLY DISADVANTAGED POPULATION. AREAS OF INVESTIGATION INCLUDED PERCEPTIONS OF THE COMMUNITY HEALTH ISSUES, UNHEALTHY BEHAVIORS, ISSUES WITH QUALITY OF LIFE, HEALTH BEHAVIORS AND ACCESS TO MEDICAL CARE, DENTAL CARE, PRESCRIPTION MEDICATIONS AND MENTAL HEALTH COUNSELING. ADDITIONALLY, DEMOGRAPHIC CHARACTERISTICS OF RESPONDENTS WERE UTILIZED TO PROVIDE INSIGHTS INTO WHY CERTAIN SEGMENTS OF THE POPULATION BEHAVED DIFFERENTLY. |
| PEKIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: PEKIN MEMORIAL HOSPITAL CHNA WAS A COLLABORATIVE UNDERTAKING BY PROCTOR HOSPITAL, METHODIST MEDICAL CENTER OF ILLINOIS, KINDRED HOSPITAL, ADVOCATE EUREKA HOSPITAL, HOPEDALE MEDICAL CENTER, PEKIN HOSPITAL AND OSF SAINT FRANCIS MEDICAL CENTER TO HIGHLIGHT THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN PEORIA, TAZEWELL, AND WOODFORD COUNTIES. |
| PEKIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: PEORIA CITY/COUNTY HEALTH DEPARTMENT, TAZEWELL COUNTY HEALTH DEPARTMENT, WOODFORD COUNTY HEALTH DEPARTMENT, HEART OF ILLINOIS UNITED WAY, HEARTLAND COMMUNITY HEALTH CLINIC AND BRADLEY UNIVERSITY. |
| PEKIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: FOR THE HEALTH NEEDS PRIORITIZATION PROCESS, THE HOSPITAL ENGAGED A HOSPITAL LEADERSHIP TEAM TO REVIEW THE MOST SIGNIFICANT HEALTH NEEDS REPORTED IN THE CHNA, USING THE FOLLOWING CRITERIA: CURRENT AREA OF HOSPITAL FOCUS, ESTABLISHED RELATIONSHIPS WITH COMMUNITY PARTNERS TO ADDRESS THE HEALTH NEED AND ORGANIZATIONAL CAPACITY AND EXISTING INFRASTRUCTURE TO ADDRESS THE HEALTH NEED. HEALTH NEEDS RATED WITH A TOTAL SCORE OF 15 OR ABOVE WERE PRIORITIZED TAKING INTO ACCOUNT THEIR RANKING ON FACTORS 1 THROUGH 5 (PERCEIVED IMPORTANCE OF THE NEED) AND THEIR RANKING REGARDING EXISTING HOSPITAL PROGRAMS TO ADDRESS THE NEED. EACH NEED WAS ALSO ASSIGNED A RATING BETWEEN 1 AND 14 REGARDING THE HEALTH NEEDS' IMPACT ON OVERALL HEALTH. BASED ON THE CRITERIA OUTLINED ABOVE, THE LEADERSHIP TEAM RANKED EACH OF THE HEALTH NEEDS. AS A RESULT OF THE PRIORITY SETTING PROCESS, THE IDENTIFIED PRIORITY AREAS THAT ARE ADDRESSED THROUGH PEKIN HOSPITAL'S IMPLEMENTATION STRATEGY WILL BE: UNINSURED/LIMITED INSURANCE, LACK OF PRIMARY CARE PHYSICIANS AND HEALTHY BEHAVIORS AND LIFESTYLE CHOICES. ADDITIONALLY, THE PRIORITY RANKING OF AREA HEALTH NEEDS WERE USED TO ORGANIZE THE SEARCH FOR LOCALLY AVAILABLE RESOURCES.PEKIN HOSPITAL HAS CATEGORIZED THE FOLLOWING NEEDS AS EITHER LOW PRIORITY OR LOW RESPONSIBILITY: POOR NUTRITION, GOOD EMPLOYMENT PRACTICES, HEART DISEASE, LACK OF STATE FUNDING FOR PROGRAMS, ADULT SMOKING/TOBACCO USE, LACK OF MENTAL HEALTH, CANCER, LACK OF DENTAL HEALTH, EXCESSIVE DRINKING, DIABETES, AFFORDABLE HOUSING, TRANSPORTATION, LUNG DISEASE, STROKE, SEXUALLY TRANSMITTED INFECTIONS, TEEN BIRTH RATE, VIOLENT CRIME RATE. THE HOSPITAL WILL MONITOR BUT GENERALLY WILL NOT ADDRESS THESE NEEDS AS ACTIONS REQUIRED ARE BEYOND THE MISSION OF PEKIN HOSPITAL; PEKIN HOSPITAL CAN BE MORE EFFECTIVE APPLYING ITS RESOURCES TO HIGHER PRIORITY NEEDS; PEKIN HOSPITAL DOES NOT POSSESS THE EXPERTISE NECESSARY FOR SUBSTANTIVE POSITIVE IMPROVEMENT; ACTIONS CONTEMPLATED FOR IMPLEMENTATION FALL MORE APPROPRIATELY TO THE RESPONSIBILITY OF OTHERS; OTHER THAN PROVIDING ENCOURAGEMENT, IMPLEMENTATION EFFORTS FOR SOME NEEDS REQUIRE APPROPRIATE ACTIONS BY INDIVIDUALS MODIFYING PERSONAL HABITS RATHER THAN A RESPONSE BY AN ORGANIZATION OR THE HEALTH SYSTEM; AND BEST USE OF PEKIN HOSPITAL RESOURCES IS TO FOCUS ON RESOLVING OR IMPROVING HIGHER PRIORITY NEEDS RATHER THAN ATTEMPTING TO RESPOND TO EVERYTHING WITH SMALL, PERHAPS INEFFECTIVE, EFFORTS. |
| PEKIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE U.S. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - PEKIN HOSPITAL MRI BUILDING | ||||
| 1300 PARK AVENUE | PEKIN | IL | 61554 | DIAGNOSTIC CENTER |
| 2 - PEKIN HOSPITAL PAIN MANAGEMENT LLC | ||||
| 600 SOUTH 13TH STREET | PEKIN | IL | 61554 | PAIN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | PEKIN MEMORIAL HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE UNITYPOINT HEALTH COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. |
| PART I, LN 7 COL(F): | NO BAD DEBT EXPENSE WAS INCLUDED IN PART IX, LINE 25. |
| PART III, LINE 4: | THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT' LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR CENTRAL IOWA HOSPITAL CORPORATION. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. |
| PART III, LINE 8: | AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.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 MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. |
| PART III, LINE 9B: | AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. |
| PART VI, LINE 2: | PEKIN HOSPITAL CONTRACTED WITH BKD, TO ASSIST WITH THE CREATION OF ITS STRATEGIC PLAN. THE COMMUNITY ASSESSMENT WAS PERFORMED THROUGH A SERIES OF FOCUS GROUPS, COMMUNITY SURVEYS, INTERNAL STATISTICAL DATA, AND COUNTY AND SERVICE AREA DEMOGRAPHICS. |
| PART VI, LINE 3: | THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIER'S OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. |
| PART VI, LINE 4: | PEKIN HOSPITAL PRIMARILY SERVES TAZEWELL, MASON AND PEORIA COUNTIES IN THE STATE OF ILLINOIS. IT IS ONE OF THE LARGEST EMPLOYERS IN THE CITY OF PEKIN AND IN TAZEWELL COUNTY. THE SERVICE AREA SITS TO THE SOUTH AND EAST OF THE GREATER PEORIA AREA, WHERE CATERPILLAR IS A MAJOR INDUSTRIAL EMPLOYER. ITS PRIMARY SERVICE AREA HAS A POPULATION OF 59,000 WITH A SECONDARY SERVICE AREA OF APPROXIMATELY 14,000. THE MEDIAN AGE OF ITS SERVICE AREA IS 41 YEARS, WHILE THE MEDIAN HOUSEHOLD INCOME IS $55,000. |
| PART VI, LINE 5: | PEKIN HOSPITAL PROVIDES MANY FREE HEALTH SCREENINGS THROUGHOUT THE YEAR TO PROMOTE EARLY DETECTION AND PREVENTION. THIS INCLUDES BUT IS NOT LIMITED TO MAMMOGRAPHY, BONE DENSITY, BLOOD PRESSURE, COLON, OBESITY AND SPIROMETRY. PEKIN HOSPITAL HAS ENGAGED ITS PHYSICIANS TO SPEAK AT DIFFERENT COMMUNITY ORGANIZATIONS, TO SHARE INFORMATION ON HEALTH AND WELL-BEING. IT HAS ALSO SENT REPRESENTATIVES OUT TO DISCUSS HEALTHCARE REFORM. |
| PART VI, LINE 6: | THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THROUGH RELATIONSHIPS WITH 36 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 400 OUTPATIENT SITES, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 30,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 6.2 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $4.2 BILLION, UNITYPOINT HEALTH IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2017, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $524 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| UNITYPOINT HEALTH | |||||||
| 1776 WEST LAKES PARKWAY SUITE 400 | WEST DES MOINES | IA | 50266 | 421435199 | 501(C)(3) | $540,287 | PROGRAM SUPPORT |
| PEKIN MEMORIAL HOSPITAL FOUNDATION | |||||||
| 600 S 13TH STREET | PEKIN | IL | 61554 | 371200267 | 501(C)(3) | $89,482 | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | 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 | THE ORGANIZATION REQUIRES EACH RECIPIENT OF THE GRANTS MENTIONED IN PART II & III (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINES A SERIES OF ELIGIBLITY STANDARDS THAT ARE REQUIRED TO BE MET. THE ORGANIZATION THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL HONAN MD | ||||||||||||||
| BOARD MEMBER (FR 6/17) | $0 | $416,913 | $0 | $0 | $0 | $258 | $0 | $24,000 | $0 | $21,948 | $0 | $463,119 | $0 | $0 |
| F NANI MOAZZAM MD | ||||||||||||||
| BOARD MEMBER | $0 | $368,777 | $0 | $0 | $0 | $16,600 | $0 | $18,000 | $0 | $1,877 | $0 | $405,254 | $0 | $0 |
| DEBBIE SIMON | ||||||||||||||
| PRES & CEO MHSC/BOARD MEMBER | $0 | $534,926 | $0 | $125,875 | $0 | $150,726 | $0 | $55,944 | $0 | $17,129 | $0 | $884,600 | $0 | $0 |
| BOB HALEY | ||||||||||||||
| CEO (TO 12/17) | $0 | $267,116 | $0 | $0 | $0 | $12,525 | $0 | $12,502 | $0 | $15,684 | $0 | $307,827 | $0 | $0 |
| STEVE HALL | ||||||||||||||
| CFO (TO 8/17) | $0 | $202,962 | $0 | $0 | $0 | $78,608 | $0 | $21,200 | $0 | $12,680 | $0 | $315,450 | $0 | $0 |
| ROBERT QUIN | ||||||||||||||
| VP FINANCE/CFO, MHSC | $0 | $319,282 | $0 | $71,411 | $0 | $64,260 | $0 | $72,578 | $0 | $14,304 | $0 | $541,835 | $0 | $61,661 |
| JEANINE SPAIN | ||||||||||||||
| VP, REGIONAL CNO/COO-PEKIN | $0 | $286,024 | $0 | $59,436 | $0 | $51,260 | $0 | $74,913 | $0 | $18,747 | $0 | $490,380 | $0 | $0 |
| ANGELIA DREHER | ||||||||||||||
| PHARMACY MANAGER | $129,145 | $0 | $0 | $0 | $11,156 | $0 | $11,590 | $0 | $27,947 | $0 | $179,838 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINES 4A-B | FormAndLineReferenceDesc |
| Explanation | SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: BOB HALEY $10,769; STEVE HALL $74,552, FRANCES VANDYKE $23,784. NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: ROBERT QUIN $55,103, DEBBIE SIMON $101,650, JEANINE SPAIN $46,838. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JACOB MILLER | |||
| FAMILY MEMBER OF BOARD MEMBER RONALD MILLER | $21,130 | EMPLOYMENT | 0 |
| MEGAN GOULD | |||
| FAMILY MEMBER OF BOARD MEMBER ROSS GOULD | $20,771 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | PROGRESSIVE HEALTH SYSTEMS IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, PROGRESSIVE HEALTH SYSTEMS, HAS THE POWER TO ELECT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER, PROGRESSIVE HEALTH SYSTEMS, HAS THE RIGHT TO APPROVE THE FOLLOWING DECISIONS BY THE GOVERNING BODY: A) ESTABLISHMENT OR MODIFICATION OF COMPENSATION AND BENEFIT POLICIES; AND B) DEVELOPMENT OR MODIFICATION OF CORPORATE COMPLIANCE PROGRAMS, INCLUDING PROGRAMS DESIGNED TO DETECT OR PREVENT HEALTH CARE FRAUD OR IMPROPER THIRD PARTY BILLING, ACTIVITIES REGARDING LEGAL AND REGULATORY COMPLIANCE RELATING TO THE CODE, ENVIRONMENTAL ISSUES, OCCUPATIONAL SAFETY AND HEALTH, ANTITRUST, FEDERAL ELECTION LAWS, AND ALL OTHER LAWS APPLICABLE TO THE CORPORATION. VARIOUS OTHER POWERS ARE RESERVED EXCLUSIVELY TO THE SOLE MEMBER, AS OUTLINED IN THE BYLAWS OF THE ORGANIZATION. |
| 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 CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE 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 TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2017 FOR THE FOLLOWING INDIVIDUALS: ROBERT QUIN; DEBBIE SIMON; JEANINE SPAIN. 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 IX, LINE 11G | HEALTHCARE PROFESSIONALS : PROGRAM SERVICE EXPENSES 1,936,415. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,936,415. PURCHASED HOUSEKEEPING AND LAUNDRY : PROGRAM SERVICE EXPENSES 13,494. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,494. MISC PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 6,089,382. MANAGEMENT AND GENERAL EXPENSES 4,862,130. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,951,512. |
| FORM 990, PART XI, LINE 9: | CHANGES IN PENSION LIABILITY 1,732,694. FUND BALANCE TRANSFERS -4,861,616. PRIOR FUND BALANCE AND PURCHASE ACCOUNTING ADJUSTMENT 1,929,195. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (70 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ABBE CENTER FOR COMMUNITY MENTAL HEALTH INC | ||||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 421045257 | MENTAL HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | ABBEHEALTH INC | 0 |
| ABBEHEALTH INC | ||||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 421373123 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTHCARE | 0 |
| AGING SERVICES INC | ||||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 237085316 | SENIOR SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ABBEHEALTH INC | 0 |
| ALLEN COLLEGE | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421351526 | EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS | IA | 501(C)(3) | 170(B)(1) (A)(II) | ALLEN HEALTH SYSTEMS INC | 0 |
| ALLEN HEALTH SYSTEMS INC | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201924 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ALLEN MEMORIAL HOSPITAL CORPORATION | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 420698265 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ALLEN HEALTH SYSTEMS INC | 0 |
| ANAMOSA AREA AMBULANCE SERVICE | ||||||||||
| 101 GRANT WOOD DRIVE | ANAMOSA | IA | 52205 | 421466284 | PROVIDE AMBULANCE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'SJONES REGIONAL MEDICAL CENTER | 0 |
| BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC | ||||||||||
| 3251 WEST NINTH STREET | WATERLOO | IA | 50702 | 420733463 | MENTAL HEALTH CARE | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| CENTER FOR ALCOHOL AND DRUG SERVICES INC | ||||||||||
| 4869 FOREST GROVE DRIVE | BETTENDORF | IA | 52722 | 421134273 | SUBSTANCE ABUSE SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(VI) | THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH | 0 |
| CENTRAL IOWA HEALTH PROPERTIES CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421233759 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | CENTRAL IOWA HEALTH SYSTEM | 0 | |
| CENTRAL IOWA HEALTH SYSTEM | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421189791 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| CENTRAL IOWA HOSPITAL CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 420680452 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | CENTRAL IOWA HEALTH SYSTEM | 0 |
| CHATHAM OAKS | ||||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 421302928 | MENTAL HEALTH AND/OR DISABILITY RESIDENTIAL TREATMENT SERVICES | IA | 501(C)(3) | 509(A)(2) | ABBEHEALTH INC | 0 |
| DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC | ||||||||||
| 1415 WOODLAND AVE SUITE 130 | DES MOINES | IA | 50309 | 421412497 | COORDINATION OF MEDICAL EDUCATION PROGRAMS | IA | 501(C)(3) | 509(A)(3), TYPE III | 0 | |
| FINLEY TRI-STATES HEALTH GROUP INC | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 421307495 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER | ||||||||||
| 3820 HILLSIDE DRIVE | CEDAR FALLS | IA | 50613 | 421372380 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| HULT CENTER FOR HEALTHY LIVING INC | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 363510390 | HEALTH EDUCATION TO THE COMMUNITY | IL | 501(C)(3) | 170(B)(1) (A)(VI) | PROCTOR HOSPITAL | 0 |
| IOWA HEALTH FOUNDATION | ||||||||||
| 1415 WOODLAND AVE SUITE E-200 | DES MOINES | IA | 50309 | 421467682 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | CENTRAL IOWA HEALTH SYSTEM | 0 |
| IOWA HEALTH SYSTEM | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421435199 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | 0 | |
| IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION | ||||||||||
| 8101 BIRCHWOOD COURT | JOHNSTON | IA | 50131 | 421411630 | PRIMARY HEALTH CARE SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
| KEOKUK AREA HOSPITAL | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 420710268 | HOSPITAL | IA | 501(C)(3) | 170(B)(1)(A)(III) | KEOKUK HEALTH SYSTEMS INC | 0 |
| KEOKUK AREA HOSPITAL FOUNDATION | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421202608 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 509(A)(2) TYPE II | KEOKUK HEALTH SYSTEMS INC | 0 |
| KEOKUK HEALTH SYSTEMS INC | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421237361 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| MEMORIAL FOUNDATION OF ALLEN HOSPITAL | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201138 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| MERITER FOUNDATION INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 237098688 | CHARITABLE FUNDRAISING | WI | 501(C)(3) | 170(B)(1) (A)(VI) | MERITER HEALTH SERVICES INC | 0 |
| MERITER HEALTH SERVICES INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391412318 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | WI | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| MERITER HOSPITAL INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 390806367 | HOSPITAL | WI | 501(C)(3) | 170(B)(1) (A)(III) | MERITER HEALTH SERVICES INC | 0 |
| MERITER MEDICAL GROUP INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 050545222 | SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES | WI | 501(C)(3) | 509(A)(3), TYPE II | MERITER HOSPITAL INC | 0 |
| METHODIST HEALTH SERVICES CORPORATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111135 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| METHODIST MEDICAL CENTER FOUNDATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 510186460 | CHARITABLE FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 370661223 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST SERVICES INC | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111134 | OFFICE RENTAL | IL | 501(C)(3) | 509(A)(2) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| NELLIE R SHERWOOD TRUST | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 426061621 | PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY | IA | 501(C)(3) | 509(A)(3), TYPE I | ST LUKE'S METHODIST HOSPITAL | 0 |
| NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED | ||||||||||
| 720 KENYON DRIVE | FORT DODGE | IA | 50501 | 420937390 | MENTAL HEALTH CARE | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| NORTHWEST IOWA HOSPITAL CORPORATION | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421019872 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| PARK COURT LIMITED | ||||||||||
| 600 SOUTH 13TH STREET | PEKIN | IL | 61554 | 371178386 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | PROGRESSIVE HEALTH SYSTEMS | 0 |
| PENN CENTER INC | ||||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 421421803 | RESIDENTIAL TREATMENT SERVICES FOR INDEPENDENT LIVING | IA | 501(C)(3) | 509(A)(2) | ABBEHEALTH INC | 0 |
| PROCTOR HEALTH CARE INCORPORATED | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371133412 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | METHODIST HEALTH SERVICES CORPORATION | 0 |
| PROCTOR HEALTH SYSTEMS | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 364147437 | PRIMARY HEALTH CARE SERVICES | IL | 501(C)(3) | 170(B)(1) (A)(III) | PROCTOR HEALTH CARE INCORPORATED | 0 |
| PROCTOR HOSPITAL | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 370681540 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | PROCTOR HEALTH CARE INCORPORATED | 0 |
| PROGRESSIVE HEALTH SYSTEMS | ||||||||||
| 600 SOUTH 13TH STREET | PEKIN | IL | 61554 | 371200263 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 376181831 | FUND SELF-INSURANCE PLAN | IL | 501(C)(3) | 509(A)(3), TYPE I | METHODIST MEDICAL CENER OF ILLINOIS | 0 |
| SHARED MAGNETIC RESONANCE IMAGING FACILITY INC | ||||||||||
| 1104 JOHN NOLEN DRIVE | MADISON | WI | 53713 | 391534744 | MEDICAL TECHNOLOGY | WI | 501(C)(3) | 509(A)(3), TYPE I | 0 | |
| SIOUXLAND PACE INC | ||||||||||
| 313 COOK STREET | SIOUX CITY | IA | 51103 | 261120134 | ALL-INCLUSIVE CARE FOR THE ELDERLY | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH RESOURCES | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421059182 | OUTPATIENT CLINICS AND HEALTHCARE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH SYSTEM INC | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421294091 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S HEALTHCARE | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421487968 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S METHODIST HOSPITAL | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 420504780 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| ST LUKE'SJONES REGIONAL MEDICAL CENTER | ||||||||||
| 1795 HIGHWAY 64 EAST | ANAMOSA | IA | 52205 | 421487967 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| STL CARE COMPANY | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421276632 | IMPROVE PUBLIC HEALTH SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTHCARE | 0 |
| THE DUBUQUE VISITING NURSE ASSOCIATION | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680410 | PUBLIC HEALTH SERVICES/HOME CARE | IA | 501(C)(3) | 509(A)(2) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE FINLEY HOSPITAL | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680354 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363678909 | MENTAL HEALTH CARE | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRIMARK PHYSICIANS GROUP | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 453791448 | SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY BUILDING CORPORATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421376187 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | TRINITY HEALTH SYSTEMS INC | 0 | |
| TRINITY COLLEGE OF NURSING & HEALTH SCIENCES | ||||||||||
| 2122 25TH AVE | ROCK ISLAND | IL | 61201 | 810994377 | EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS | IL | 501(C)(3) | 170(B)(1) (A)(II) | TRINITY MEDICAL CENTER | 0 |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222381 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363321751 | CHARITABLE FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY HEALTH SYSTEMS INC | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222877 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY MEDICAL CENTER | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 362739299 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HEALTH SYSTEM | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363351952 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HOSPITAL AUXILIARY | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 426081474 | CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES | IA | 501(C)(3) | 509(A)(2) | TRINITY REGIONAL MEDICAL CENTER | 0 |
| TRINITY REGIONAL MEDICAL CENTER | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421009175 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRI-STATE MEDICAL GROUP INC | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421435525 | PRIMARY HEALTH CARE SERVICES | IA | 501(C)(3) | 170(B)(1)(A)(III) | KEOKUK HEALTH SYSTEMS INC | 0 |
| UNITY HEALTHCARE | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 420680337 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| UNITY HEALTHCARE FOUNDATION | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 421525031 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE I | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| UNITYPOINT HEALTH - MARSHALLTOWN | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 815034179 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ALLEN HEALTH SYSTEMS INC | 0 |
| UNITYPOINT AT HOME | ||||||||||
| 11333 AURORA AVENUE | URBANDALE | IA | 50322 | 421477471 | HOME HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 0 |
| UNITYPOINT HEALTH AT WORK | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 810872241 | EMPLOYER ONSITE MEDICAL SERVICES AND OCCUPATIONAL MEDICINE | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
| WISCONSIN DIALYSIS INC | ||||||||||
| 3034 FISH HATCHERY ROAD | MADISON | WI | 53713 | 300072647 | OUTPATIENT KIDNEY DIALYSIS | WI | 501(C)(3) | 509(A)(3), TYPE III | MERITER HOSPITAL INC 45 | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| ADVANCED IMAGING CENTER LLC | |||||||
| 615 VALLEY VIEW DRIVE | MOLINE | IL | 61265 | 364356301 | DIAGNOSTIC RADIOLOGY CENTER | IA | N/A |
| ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC | |||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 453237125 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC | |||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 273625869 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 453017991 | ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA PHYSIO LLC | |||||||
| 4714 GETTYSBURG ROAD | MECHANICSBURG | PA | 17055 | 364799633 | PHYSICAL THERAPY SERVICES | IA | N/A |
| CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC | |||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 471608704 | SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| DUBUQUE ENDOSCOPY CENTER LC | |||||||
| 1515 DELHI STREET SUITE 500 | DUBUQUE | IA | 52001 | 201597161 | AMBULATORY SURGERY CENTER | IA | N/A |
| FINLEY DEPT OF SURGERY CO-MGMT CO LLC | |||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 422808785 | SURGERY DEPARTMENT MANAGEMENT SERVICES | IA | N/A |
| HEALTH CARE AFFILIATES OF THE TRI-STATES LLC | |||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 421428503 | PROVIDE ACCESS TO LICENSED SOFTWARE | IA | N/A |
| IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 030482623 | OUTPATIENT DIAGNOSTIC IMAGING | IA | N/A |
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421511142 | GROUP PURCHASING | IA | N/A |
| LAKEVIEW SURGERY CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421516120 | SURGERY CENTER | IA | N/A |
| MERITER UW PHYSICIANS CONTRACTING COMPANY LLC | |||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391998819 | HEALTH SERVICES | WI | N/A |
| MISSISSIPPI VALLEY SLEEP DISORDER CENTER LC | |||||||
| 3400 DEXTER COURT | DAVENPORT | IA | 52807 | 421489697 | MEDICAL LABORATORY SERVICES | IA | N/A |
| MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||
| 221 NE GLEN OAK AVE | PEORIA | IL | 61636 | 461219459 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IL | N/A |
| MR ASSOCIATES LLP | |||||||
| 1956 1ST AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421260463 | OWN AND OPERATE MR UNIT | IA | N/A |
| ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421508092 | AMBULATORY SURGERY CENTER | IA | N/A |
| REHABILITATION THERAPY SERVICES LLC | |||||||
| 416 ST MARKS CT 110 | PEORIA | IL | 61603 | 810584193 | REHABILATION THERAPY | IL | N/A |
| THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | |||||||
| 1075 FIRST AVENUE SE | CEDAR RAPIDS | IA | 52403 | 721550812 | AMBULATORY SURGERY CENTER. | IA | N/A |
| UPHT-SCA HOLDINGS LLC | |||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 473564984 | AMBULATORY SURGERY CENTER INVESTMENT | DE | N/A |
| WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||
| 1660 60TH STREET | WEST DES MOINES | IA | 50266 | 271414600 | ORTHOPEDIC SERVICE LINES MANAGEMENT | IA | N/A |
| WEST LAKES SLEEP CENTER LLC | |||||||
| 5950 UNIVERSITY AVENUE SUITE 2 | WEST DES MOINES | IA | 50266 | 263193923 | SLEEP DISORDER DIAGNOSTIC TESTING FACILITY | IA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ABBE MANAGEMENT CORPORATION | |||||||||
| 740 N 15TH AVE NO A | HIAWATHA | IA | 52233 | 421361755 | MANAGEMENT SERVICES | IA | N/A | C | 0 |
| BELCREST SERVICES LTD | |||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371196307 | MEDICAL SERVICES | IL | N/A | C | 0 |
| BROADBAND INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 273819741 | INFORMATION TECHNOLOGY MGMT. | IA | N/A | C | 0 |
| DELHI POINT CONDO ASSOCIATION | |||||||||
| 350 N GRANDVIEW | DUBUQUE | IA | 52001 | 421467002 | REAL ESTATE MANAGEMENT | IA | N/A | C | 0 |
| HCP CORPORATION | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391177562 | REAL ESTATE RENTAL | WI | N/A | C | 0 |
| HEALTH PLUS INC | |||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371295532 | MANAGED CARE ADMINISTRATION | IL | N/A | C | 0 |
| HNC SERVICES | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 270987243 | FIBER OPTIC NETWORK SERVICES | IA | N/A | C | 0 |
| HOME HEALTH PLUS SERVICES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 364053068 | HOME HEALTH SERVICES | IL | N/A | C | 0 |
| KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY INC | |||||||||
| 420 NORTH 17TH STREET | KEOKUK | IA | 52632 | 421237312 | RETAIL DURABLE MEDICAL EQUIPMENT | IA | N/A | C | 0 |
| MARIGOLD CITY LAND TRUST NO ONE | |||||||||
| 2956 COURT STREET | PEKIN | IL | 61554 | 272750273 | PROPERTY MANAGEMENT | IL | N/A | T | 0 |
| MEDIMORE INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421414390 | MANAGED CARE | IA | N/A | C | 0 |
| MERITER HEALTH ENTERPRISES INC | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391293620 | MANAGEMENT SERVICES | WI | N/A | C | 0 |
| MERITER MANAGEMENT SERVICES INC | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391458235 | ADMINISTRATIVE SERVICES | WI | N/A | C | 0 |
| METHODIST HEALTH VENTURES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371140939 | PHARMACY/OFFICE STAFFING | IL | N/A | C | 0 |
| METHODIST PHYSICIAN SERVICES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 363858550 | MEDICAL SERVICES | IL | N/A | C | 0 |
| OPTIMUM HEALTH SOLUTIONS INC | |||||||||
| 221 NORTHEAST GLEN OAK AVE | PEORIA | IL | 61636 | 205430137 | HEALTH & WELLNESS CONSULTING | IA | N/A | C | 0 |
| PEKIN PROHEALTH INC | |||||||||
| 600 SOUTH 13TH STREET | PEKIN | IL | 61554 | 371117052 | CLINIC | IL | N/A | C | 0 |
| PRECEDENCE INC | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 371288604 | MANAGED MENTAL CARE | IA | N/A | C | 0 |
| PROVIDER RESOURCE MANAGEMENT INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371223550 | RESOURCE MANAGEMENT | IL | N/A | C | 0 |
| RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC | |||||||||
| 700 E UNIVERSITY AVE | DES MOINES | IA | 50316 | 261271143 | SPECIALTY PHYSICIANS MEDICAL CARE | IA | N/A | C | 0 |
| STL HEALTH RESOURCES CO | |||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421193499 | PHYSICIAN OFFICE RENTAL | IA | N/A | C | 0 |
| TRINITY HEALTH ENTERPRISES INC | |||||||||
| 2701 17TH ST | ROCK ISLAND | IL | 61201 | 363320141 | RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY | IL | N/A | C | 0 |
| TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 363924720 | MANAGED HEALTH CARE | 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 | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PEKIN PAIN MANAGEMENT LLC | ||
| J | $58,806 | BASED ON GAAP, CASH, AND/OR FMV. |
| PEKIN PAIN MANAGEMENT LLC | ||
| L | $46,066 | BASED ON GAAP, CASH, AND/OR FMV. |
| PEKIN PAIN MANAGEMENT LLC | ||
| O | $89,329 | BASED ON GAAP, CASH, AND/OR FMV. |
| PEKIN PAIN MANAGEMENT LLC | ||
| S | $273,450 | BASED ON GAAP, CASH, AND/OR FMV. |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) | FormAndLineReferenceDesc |
| Explanation | IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. 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). | ExplanationTxt |