2025-11-13T15:14:45-06:00 2024-12-31 990 2024-01-01 421411630 IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION IOWA 5154719200 1776 WEST LAKES PKWY STE 400 WEST DES MOINES IA 50266 KEITH SEASHORE CFO 5154719200 2025-11-03 0 2024 2025-03-06 01:10:19Z UNITYPOINT CLINIC PATRICIA NEWLAND MD 1776 WEST LAKES PKWY STE 400 WEST DES MOINES IA 50266 615671876 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1993 IA TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 13 7 4911 7 2124079 0 152598391 151926832 435822764 463432199 736122 1166306 23004946 -1463297 612162223 615062040 37535 15330 0 0 448145032 456875606 0 0 0 167880938 170949771 616063505 627840707 -3901282 -12778667 274653856 291806440 256432738 286151221 18221118 5655219 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 539560559 0 461969200 HEALTH-CARE SERVICESIOWA PHYSICIANS CLINIC MEDICAL FOUNDATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE IOWA AND WESTERN ILLINOIS COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 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, MENTAL HEALTH CARE, REHABILITATION, SKILLED NURSING, MATERNAL/CHILD CARE, LABORATORY, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2024, IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION HAD 3,055,194 PATIENT ENCOUNTERS. 59211787 15330 0 COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 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 $3,010,663 IN 2024. OFTENTIMES, IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $50,811,313 FOR 2024. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $53,821,976.OTHER BENEFITS:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONAL'S EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION COLLABORATES WITH OTHER HEALTH-CARE PROVIDERS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TOTAL OTHER BENEFITS REPORTED VALUE: $5,389,811. 598772346 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 4911 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X X KEITH SEASHORE CFO 5154405109 1776 WEST LAKES PKWY SUITE 400 WEST DES MOINES IA 50266 JANE ARNOLD BOARD VICE CHAIR 40.00 1.00 X X 385211 0 73645 LEANNE BURRACK BOARD MEMBER 1.00 1.00 X 0 0 0 DIANNA EDWARDS MD BOARD CHAIR 40.00 1.00 X X 370926 0 47489 KEN FELZ MD BOARD MEMBER 1.00 40.00 X 7904 0 1495 DEBBIE FREIBURG BOARD MEMBER 1.00 1.00 X 0 0 0 LANCE HORBACH BOARD MEMBER 1.00 1.00 X 0 0 0 DEBRA JOHNSON BOARD MEMBER 1.00 1.00 X X 0 0 0 ERIC NEVERMAN DO BOARD MEMBER 40.00 1.00 X 507200 0 29857 BRIAN SCOTT BOARD TREASURER/SECRETARY 1.00 1.00 X X 0 0 0 DEBRA SHRIVER BOARD MEMBER 1.00 1.00 X 0 0 0 ANDREA WHITE MD BOARD MEMBER 40.00 1.00 X 350956 0 27005 PATRICIA NEWLAND MD - BOARD MEMBER PRESIDENT - UNITYPOINT CLINIC 40.00 0.00 X X 793456 0 103744 TODD WENCK MD BOARD MEMBER 40.00 1.00 X 715779 0 46721 WENDY MORTIMORE CHIEF MEDICAL INFORMATION OFFICER 5.00 30.00 X 42793 476662 30674 STEVE PALMERSHEIM CFO 40.00 0.00 X 0 464024 85286 MATTHEW ROMANIN TO 0324 EXEC VP & COO 40.00 0.00 X 235098 497660 112236 KEITH SEASHORE CFO 40.00 0.00 X 363856 0 48768 ALECIA ALLEN MD PHYSICIAN 40.00 0.00 X 550690 0 37027 VINKO BOGDANIC MD PHYSICIAN 40.00 0.00 X 592628 0 46665 STEVEN BROOMHEAD PHYSICIAN 40.00 0.00 X 854254 0 53405 STEVEN CAHALAN MD PHYSICIAN 40.00 0.00 X 368855 0 47708 DEREK CLEVIDENCE MD REGIONAL VP MEDICAL DIRECTOR - MERITER 40.00 0.00 X 510371 0 39921 EVAN DIEHL MD REGIONAL VP MEDICAL DIRECTOR - CR 40.00 0.00 X 495901 0 51660 DANIEL GLASCOCK MD REGIONAL VP MEDICAL DIRECTOR - WL 40.00 1.00 X 520542 0 46941 MELINDA HANSEN MD PHYSICIAN 40.00 0.00 X 696539 0 45521 JASON HUISENGA DO PHYSICIAN 40.00 0.00 X 627684 0 53420 SHAWN KEEVEN MD REGIONAL VP MEDICAL DIRECTOR - QC 40.00 0.00 X 576614 0 46678 ANGIE KNOBLAUCH PHYSICIAN 40.00 0.00 X 440777 0 29659 MICHAEL LEE MD REGIONAL VP MEDICAL DIRECTOR - FD 40.00 0.00 X 375801 0 33258 KATHERINE MEYERS DO PHYSICIAN 40.00 0.00 X 472944 0 53420 MICHAEL NAMANNY REGIONAL VP CLINIC OPERATIONS - DSM 40.00 0.00 X 416352 0 40247 ANDREW NORDINE MD PHYSICIAN 40.00 0.00 X 543673 0 48060 STEPHEN PALLONE MD REGIONAL VP MEDICAL DIRECTOR - SC 40.00 0.00 X 408098 0 43117 STEPHEN PEDRON MD PHYSICIAN 40.00 0.00 X 599542 0 56620 JOSHUA REHMANN DO CHIEF MEDICAL OFFICER - CLINIC 40.00 0.00 X 610837 0 45479 CHAD STADSVOLD DO PHYSICIAN 40.00 0.00 X 569853 0 53362 ANDREW STEFANI MD PHYSICIAN - HOSPITALIST 40.00 0.00 X 401549 0 38576 RAJEEV FERNANDO MD PHYSICIAN 40.00 0.00 X 1936756 0 26517 TAUSEEF KHAN MD PHYSICIAN 40.00 0.00 X 1790656 0 44449 BHAVIK PATEL MD PHYSICIAN 40.00 0.00 X 2108494 0 46721 HIMANSHU TANDON MD PHYSICIAN 40.00 0.00 X 2283440 0 19662 GARRY WEIDE DO PHYSICIAN 40.00 0.00 X 1503391 0 39499 DAVID WILLIAMS MD CEO TO 0420 FMR SVP CHIEF CLINICAL OFFICER-UPH 0.00 40.00 X 0 860742 7935 RUSSELL ADAMS MD TO 1220 PHYSICIAN 40.00 0.00 X 446051 70095 34195 HIMABINDU ALLA MD TO 1219 PHYSICIAN 40.00 0.00 X 438266 0 53556 DANIEL ALLEN MD TO 1222 FORMER EXEC VP & CMO 0.00 0.00 X 389096 0 0 STACEY BARRETT REGIONAL VP CLINIC OPERATIONS - CR 40.00 0.00 X 295994 0 48977 MATTHEW BEHRENS TO 1219 REGIONAL VP CLINIC OPERATIONS - QC 40.00 0.00 X 316644 0 13058 TODD BUTLER MD TO 1221 PHYSICIAN 40.00 0.00 X 571981 0 42778 DAVID CHILDERS REGIONAL VP CLINIC OPERATIONS - MERITER 40.00 0.00 X 295557 0 44197 MARCEL DEVETTEN MD TO 1219 REGIONAL VP MEDICAL DIRECTOR - DSM 0.00 40.00 X 0 648431 28464 LAUREN HARDISON EXEC DIR STRATEGY & BUSINESS DEVELOPMENT 40.00 0.00 X 164817 169196 41558 AMR KAMHAWY MD TO 1222 PHYSICIAN 40.00 0.00 X 579761 0 54640 JESSICA MEISNER TO 1222 FMR VP HUMAN RESOURCES & EDUCATION 0.00 40.00 X 0 699181 125092 JOHN ROOF MD REGIONAL VP MEDICAL DIRECTOR - CR 40.00 0.00 X 140536 0 30130 KATHERINE SCHMITT MD TO 1220 PHYSICIAN 40.00 0.00 X 453174 0 54514 SHAWN SPOONER MD TO 1220 PHYSICIAN 40.00 0.00 X 372581 0 42459 LINCOLN WALLACE MD TO 1221 REGIONAL VP MEDICAL DIRECTOR - FD 40.00 0.00 X 310856 0 55146 28804734 3885991 2371211 1239 1 1 0 FAILOR HURLEY CONSTRUCTION 3337 MARNIE AVE WATERLOO IA 50701 CONSTRUCTION SERVICES 4362016 CNOS PC 575 SIOUX POINT RD DAKOTA DUNES SD 57049 STAFFING SERVICES 1985374 EDGE COMMERCIAL LLC 3155 SE MIEHE DR STE 2 GRIMES IA 50111 CONSTRUCTION SERVICES 1792013 AMN HEALTHCARE INC PO BOX 910738 DALLAS TX 75391 HEALTHCARE STAFFING 548331 KNAPP WINDSOR LLC 5000 WESTOWN PKWY STE 400 WEST DES MOINES IA 50266 REAL ESTATE SERVICES 500044 39 150788810 950698 187324 151926832 NET PATIENT REVENUE 900099 440467545 440467545 MGMT & SUPPORT SVCS 561000 20900647 20900647 RENTAL INCOME 531390 2022560 2022560 PHARMACY REVENUE 900099 40047 40047 PUBLIC HEALTH PROGRAMS 900099 1400 1400 463432199 689212 298 688914 1086930 601381 8455 485549 -8455 477094 477094 OTHER HEALTHCARE SVCS 900099 2124079 2124079 SHARED SAVINGS REVENUE 900099 -3587376 -3587376 -1463297 615062040 459845121 2124079 1166008 15330 15330 15713125 15713125 5260535 5260535 362243513 358740533 3502980 11630341 11517873 112468 41922885 41517481 405404 20105207 19910785 194422 48447663 48447663 1104268 358590 745678 844614 754075 90539 17535041 16603274 931767 92683 71779 20904 1495978 1338846 157132 697701 697701 38496372 37127134 1369238 839128 615563 223565 192240 182868 9372 142888 142888 5311997 4773055 538942 8070625 8070711 -86 MEDICAL SUPPLIES 47447731 47446432 1299 MISCELLANEOUS EXPENSE 116670 385706 -269036 INCOME TAXES 60497 384 60113 BAD DEBT EXPENSE 53675 53675 627840707 598772346 29068361 0 0 48313543 50747316 25987060 32314714 5796359 5940004 3268778 2900103 105907012 70022725 38966260 35884287 65005147 75614548 370299 424886 86946410 87980582 274653856 291806440 49855288 55907918 330217 471954 3279169 2227305 21731 3259485 202946333 224284559 256432738 286151221 X 17862152 5241665 358966 413554 18221118 5655219 274653856 291806440 X -12778667 158181 54587 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 60082690 38959882 21122808 44930016 31062843 13867173 894306 894306 35884287 LONG-TERM DUE FROM AFFILIATE - PHYSICIAN RETENTION 15097896 OPERATING LEASE ASSETS 72882686 87980582 SELF INSURANCE RESERVE 47079849 LONG-TERM RETENTION INCENTIVES 69883888 DUE TO AFFILIATES 27441643 HEALTH AND WELFARE BENEFITS RESERVE 3652405 OPERATING LEASE LIABILITY 75889274 MISCELLANEOUS LIABILITY 337500 224284559 X 464321000 158181 428 158609 464162391 20084 150879565 150899649 615062040 627123000 78 78 627122922 20084 697701 717785 627840707 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 2021. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 428. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN FUND BALANCE WITHOUT RESTRICTIONS 150,879,565. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 78. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN FUND BALANCE WITHOUT RESTRICTIONS 697,701. 1 1 0 0 0 0 0 0 0 HIMANSHU TANDON MD PHYSICIAN 1394765 0 887955 0 720 0 17250 0 2412 0 2303102 0 0 0 BHAVIK PATEL MD PHYSICIAN 2107405 0 0 0 1089 0 17250 0 29471 0 2155215 0 0 0 RAJEEV FERNANDO MD PHYSICIAN 1935545 0 500 0 711 0 17250 0 9267 0 1963273 0 0 0 TAUSEEF KHAN MD PHYSICIAN 1789552 0 0 0 1104 0 16336 0 28113 0 1835105 0 0 0 GARRY WEIDE DO PHYSICIAN 1360824 0 141856 0 711 0 17250 0 22249 0 1542890 0 0 0 STEVEN BROOMHEAD PHYSICIAN 844675 0 8250 0 1329 0 17250 0 36155 0 907659 0 0 0 PATRICIA NEWLAND MD - BOARD MEMBER PRESIDENT - UNITYPOINT CLINIC 593994 0 182506 0 16956 0 77458 0 26286 0 897200 0 0 0 DAVID WILLIAMS MD CEO TO 0420 FMR SVP CHIEF CLINICAL OFFICER-UPH 0 0 0 207269 0 653473 0 0 0 7935 0 868677 0 179828 MATTHEW ROMANIN TO 0324 EXEC VP & COO 109439 441719 124083 50000 1576 5941 7529 77221 7497 19989 250124 594870 0 0 JESSICA MEISNER TO 1222 FMR VP HUMAN RESOURCES & EDUCATION 0 580151 0 111344 0 7686 0 105000 0 20092 0 824273 0 0 TODD WENCK MD BOARD MEMBER 706330 0 8120 0 1329 0 17250 0 29471 0 762500 0 0 0 MELINDA HANSEN MD PHYSICIAN 690915 0 4520 0 1104 0 17250 0 28271 0 742060 0 0 0 JASON HUISENGA DO PHYSICIAN 626964 0 0 0 720 0 17250 0 36170 0 681104 0 0 0 MARCEL DEVETTEN MD TO 1219 REGIONAL VP MEDICAL DIRECTOR - DSM 0 247758 0 109761 0 290912 0 13889 0 14575 0 676895 0 0 JOSHUA REHMANN DO CHIEF MEDICAL OFFICER - CLINIC 490734 0 116184 0 3919 0 17245 0 28234 0 656316 0 0 0 STEPHEN PEDRON MD PHYSICIAN 593446 0 0 0 6096 0 17250 0 39370 0 656162 0 0 0 VINKO BOGDANIC MD PHYSICIAN 590564 0 0 0 2064 0 17250 0 29415 0 639293 0 0 0 AMR KAMHAWY MD TO 1222 PHYSICIAN 565209 0 11384 0 3168 0 17250 0 37390 0 634401 0 0 0 SHAWN KEEVEN MD REGIONAL VP MEDICAL DIRECTOR - QC 534491 0 41163 0 960 0 17250 0 29428 0 623292 0 0 0 CHAD STADSVOLD DO PHYSICIAN 569142 0 0 0 711 0 17250 0 36112 0 623215 0 0 0 TODD BUTLER MD TO 1221 PHYSICIAN 565711 0 4206 0 2064 0 17250 0 25528 0 614759 0 0 0 ANDREW NORDINE MD PHYSICIAN 542569 0 0 0 1104 0 17250 0 30810 0 591733 0 0 0 ALECIA ALLEN MD PHYSICIAN 526202 0 23768 0 720 0 17250 0 19777 0 587717 0 0 0 DANIEL GLASCOCK MD REGIONAL VP MEDICAL DIRECTOR - WL 453193 0 65085 0 2264 0 17250 0 29691 0 567483 0 0 0 RUSSELL ADAMS MD TO 1220 PHYSICIAN 349996 70095 69633 0 26422 0 7534 2003 20704 3954 474289 76052 0 0 DEREK CLEVIDENCE MD REGIONAL VP MEDICAL DIRECTOR - MERIT 462754 0 45553 0 2064 0 17250 0 22671 0 550292 0 0 0 WENDY MORTIMORE CHIEF MEDICAL INFORMATION OFFICER 42793 391641 0 84883 0 138 872 16378 1080 12344 44745 505384 0 0 STEVE PALMERSHEIM CFO 0 360665 0 99691 0 3668 0 54750 0 30536 0 549310 0 0 EVAN DIEHL MD REGIONAL VP MEDICAL DIRECTOR - CR 416833 0 78495 0 573 0 14819 0 36841 0 547561 0 0 0 ERIC NEVERMAN DO BOARD MEMBER 496265 0 10483 0 452 0 17250 0 12607 0 537057 0 0 0 KATHERINE MEYERS DO PHYSICIAN 462777 0 9735 0 432 0 17250 0 36170 0 526364 0 0 0 KATHERINE SCHMITT MD TO 1220 PHYSICIAN 432510 0 19953 0 711 0 17250 0 37264 0 507688 0 0 0 HIMABINDU ALLA MD TO 1219 PHYSICIAN 428523 0 8414 0 1329 0 17250 0 36306 0 491822 0 0 0 ANGIE KNOBLAUCH PHYSICIAN 439588 0 0 0 1189 0 17250 0 12409 0 470436 0 0 0 JANE ARNOLD BOARD VICE CHAIR 319694 0 59472 0 6045 0 46581 0 27064 0 458856 0 0 0 MICHAEL NAMANNY REGIONAL VP CLINIC OPERATIONS - DSM 315433 0 93253 0 7666 0 17250 0 22997 0 456599 0 0 0 STEPHEN PALLONE MD REGIONAL VP MEDICAL DIRECTOR - SC 369323 0 38064 0 711 0 17250 0 25867 0 451215 0 0 0 ANDREW STEFANI MD PHYSICIAN - HOSPITALIST 368071 0 32918 0 560 0 10979 0 27597 0 440125 0 0 0 DIANNA EDWARDS MD BOARD CHAIR 339879 0 30660 0 387 0 17250 0 30239 0 418415 0 0 0 STEVEN CAHALAN MD PHYSICIAN 362772 0 0 0 6083 0 17250 0 30458 0 416563 0 0 0 SHAWN SPOONER MD TO 1220 PHYSICIAN 371861 0 0 0 720 0 17250 0 25209 0 415040 0 0 0 KEITH SEASHORE CFO 355390 0 0 0 8466 0 17213 0 31555 0 412624 0 0 0 MICHAEL LEE MD REGIONAL VP MEDICAL DIRECTOR - FD 349989 0 20000 0 5812 0 6900 0 26358 0 409059 0 0 0 DANIEL ALLEN MD TO 1222 FORMER EXEC VP & CMO 0 0 389096 0 0 0 0 0 0 0 389096 0 337581 0 ANDREA WHITE MD BOARD MEMBER 341404 0 8448 0 1104 0 17118 0 9887 0 377961 0 0 0 LAUREN HARDISON EXEC DIR STRATEGY & BUSINESS DEVELOP 93348 167798 70465 0 1004 1398 6042 8562 11487 15467 182346 193225 0 0 LINCOLN WALLACE MD TO 1221 REGIONAL VP MEDICAL DIRECTOR - FD 308808 0 0 0 2048 0 15978 0 39168 0 366002 0 0 0 STACEY BARRETT REGIONAL VP CLINIC OPERATIONS - CR 224056 0 71680 0 258 0 15160 0 33817 0 344971 0 0 0 DAVID CHILDERS REGIONAL VP CLINIC OPERATIONS - MERI 219575 0 75844 0 138 0 15431 0 28766 0 339754 0 0 0 MATTHEW BEHRENS TO 1219 REGIONAL VP CLINIC OPERATIONS - QC 238218 0 77898 0 528 0 12491 0 567 0 329702 0 0 0 JOHN ROOF MD REGIONAL VP MEDICAL DIRECTOR - CR 118891 0 19435 0 2210 0 7524 0 22606 0 170666 0 0 0 PART I, LINES 4A-B SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: MARCEL DEVETTEN $280,664 AND DAVID WILLIAMS, MD $653,473. NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: JANE ARNOLD $32,969; JESSICA MEISNER $87,750; PATRICIA NEWLAND $60,208; STEVEN PALMERSHEIM $37,500; AND MATTHEW ROMANIN $67,500. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: DANIEL ALLEN $389,096 AND DAVID WILLIAMS, MD $207,269. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. SCHEDULE J, PART I, LINE 3 - ESTABLISHING COMPENSATION 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. NANDITA ALLA MD FAMILY MEMBER OF FORMER KEY EMPLOYEE HIMABINDU ALLA, MD 33546 EMPLOYMENT 0 KELLI WALLACE MD FAMILY MEMBER OF FORMER KEY EMPLOYEE LINCOLN WALLACE, MD 14376 EMPLOYMENT 0 FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, STRATEGIC PLANNING, BUSINESS PLANS, OPERATING AND/OR CAPITAL BUDGETS, SELECTION AND REMOVAL OF THE CEO, INCURRING INDEBTEDNESS, MANAGED CARE STRATEGY, TRANSFER OF ASSETS, TRANSFER, SALE OR CLOSURE OF ANY FACILITY OR DEPARTMENT, AND DIRECT THE TRANSFER OR SALE OF ASSETS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY UNITYPOINT HEALTH'S CORPORATE SERVICES TAX DEPARTMENT AND GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE DEPARTMENT WITH ULTIMATE APPROVAL BY THE DIRECTOR OF TAX SERVICES. THE DIRECTOR OF TAX SERVICES MEETS WITH THE FINANCE EXECUTIVE AND REVIEWS KEY PARTS OF THE FORM 990 UTILIZING A PRESENTATION SUMMARY. A COPY OF THE FORM 990 IS GIVEN TO EACH MEMBER OF THE BOARD VIA THE BOARD PORTAL ALONG WITH A REVIEW GUIDE. 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 2023 FOR THE FOLLOWING INDIVIDUALS: STACEY L. BARRETT, MATTHEW BEHRENS, DAVID CHILDERS, DEREK CLEVIDENCE, MD, PAMELA K. DELAGARDELLE, MARCEL P. DEVETTEN, MD, EVAN J. DIEHL, MD, DANIEL G. GLASCOCK, MD, LAUREN R. HARDISON, L.J. SHAWN KEEVEN, MD, MICHAEL NAMANNY, PATRICIA K. NEWLAND, MD, STEPHEN R. PALLONE, MD, STEVEN R. PALMERSHEIM, JOSHUA J. REHMANN, MD, AND MATTHEW T. ROMANIN. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN IOWA HEALTH FOUNDATION 59,868. CHANGE IN BENEFICIAL INTEREST IN ST. LUKE'S HEALTH CARE FOUNDATION -5,281. 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $5.3B IN OPERATING REVENUE AND 29,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 400 CLINICS; 17 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.