2018-04-26T13:42:05-05:00 2017-06-30 450250958 EIDE BAILLY LLP 1545 ASSOCIATES DR STE 101 DUBUQUE IA 52002 990 2016-07-01 421058745 Northeast Iowa Medical Education Foundation Inc NORT 3192722525 2055 Kimball Avenue No 101 Waterloo IA 50702 Bonnie Hough Administrator 3192722525 2018-04-26 1 Carmen Krantz P00031958 5635561790 2018-04-24 38.134.125.87 2018-04-26 08:41:42 CD P 330E77A2EC15986A2DC713C7FDB26B906589BB96 29BBA8D890E806DD5B901A3069759B359A9455D8 2016 2021-01-29 14:40:06Z Anthony A Day 2055 Kimball Avenue No 101 Waterloo IA 50702 7479475 0 X www.familypracticeresidency.org X 1975 IA Developing excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality. 11 10 92 86 0 0 3670263 3739069 3819303 3732714 3507 -8537 4302 4302 7497375 7467548 0 0 0 0 5310651 5394639 0 0 0 2189240 2304009 7499891 7698648 -2516 -231100 2674975 2565576 681176 802877 1993799 1762699 X Developing excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality. 0 0 6623895 3732714 The Northeast Iowa Medical Education Foundation was founded in 1975 to develop a Family Medicine training program. The Family Medicine Residency Program is the branch of the Foundation which provides physicians with three years of additional training in the specialty of family medicine. During their training, resident physicians provide comprehensive health care under the supervision of board certified family medicine physicians. Upon graduation, these physicians provide a potential source of family physicians settling to practice in the community.Resident training takes place in the hospital setting, in private physician offices and in the Northeast Iowa Family Practice Center. During their three-year training program, the physicians receive training in internal medicine, obstetrics/gynecology, surgery, pediatrics, emergency medicine, family medicine, community medicine, psychiatry and behavioral science, orthopedics, otorhinolaryngology, ophthalmology and dermatology. In addition, they may use elective time to concentrate on specialties and sub-specialties of their choice. Resident physicians provide comprehensive medical care to a group of up to 250 patient families at the Northeast Iowa Family Practice Center. Residents may consult with faculty physicians during patient visits. Patients requiring care in the hospital are seen by both resident and faculty physicians.Area physicians are committed to the Northeast Iowa Family Medicine Residency Program. Nearly all private physicians in the area volunteer to teach the skills and procedures resident physicians will need in private practice. Physicians selected to be residents in the Northeast Iowa Family Medicine Residency Program are all graduates of accredited medical schools. The Waterloo Program recruits medical school graduates of the highest caliber, taking into consideration personal characteristics, aptitude and academic achievements.Graduates of the Northeast Iowa Family Medicine Residency Program are eligible to sit for the certification examination in the specialty of family medicine. This examination is administered by the American Board of Family Medicine, which is the specialty board that certifies family physicians. During the academic year 2016-17, seven residents graduated and will take the examination for certification.The Residency Program is accredited by the Accreditation Council of Graduate Medical Education (ACGME), which is composed of representatives of five national associations interested in medical education. These associations are the American Board of Medical Specialties, American Hospital Association, American Medical Association, Association of American Medical Colleges and the Council of Medical Specialty Societies. The ACGME accredits residency programs through their Residency Review Committees with each specialty having its own committee.Educational activities of the Foundation include the Family Medicine Residency Program, undergraduate medical education, continuing medical education, and medical research. The Foundation is sponsored by Allen Memorial Hospital and Covenant Medical Center.During fiscal year ended June 30, 2017, Northeast Iowa Medical Education Foundation trained 19 resident physicians in the specialty of family medicine and one pharmacy resident in traditional and clinical pharmacy services. Clinical experience in family medicine was also provided for 55 medical students, 13 pharmacy students, four athletic training students, 11 radiology students, 1 NRP-S student, and two research interns. 6623895 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 0 1 92 1 0 0 0 0 0 0 0 0 0 0 X 11 10 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Anthony Day MD 3192722525 2055 Kimball Avenue Ste 101 Waterloo IA 50702 Tim Horrigan MD President 1.00 X X 0 0 0 Jim Lehman MD Vice President 1.00 X X 0 0 0 Jack Duesenbery Secretary 1.00 X X 0 0 0 Pamela Delagardelle Treasurer 1.00 X X 0 0 0 Nicholas Goetsch DO Director 1.00 X 0 0 0 JoAn Headington Director 1.00 X 0 0 0 Manju Mahajan MD Director 1.00 X 0 0 0 Angela Townsend MD Director 1.00 X 0 0 0 Greg Nelson Director 1.00 X 0 0 0 Julie Sandell DO Director 1.00 X 0 0 0 Anthony A Day MD Executive Director 55.00 X X 285834 0 40593 Bonnie Hough Administrator beginning 2/13/17 45.00 X 0 0 0 Robert Friedman MD Undergrad Educ Director 45.00 X 260040 0 31572 James Poock MD Assistant Program Director 45.00 X 226656 0 36164 Suzanne Munns MD Assistant Program Director 45.00 X 193914 0 33494 Adam Roise MD Assistant Program Director 45.00 X 208679 0 22170 Robert Welshons PAC Physician's Assistant 45.00 X 101782 0 9792 1276905 0 173785 6 0 1 0 ICE Technologies 411 SE 9th St Pella IA 50219 Computer consulting 121047 1 286398 3452671 3739069 Clinic revenue 621110 3373204 3373204 Research/faculty devel 900099 235216 235216 Pharmacy residency rei 900099 61047 61047 63247 63247 3732714 3390 3390 4302 0 4302 4302 4302 11927 -11927 -11927 -11927 7467548 3732714 0 -4235 356894 356894 4236034 4133676 102358 154840 151099 3741 381376 367664 13712 265495 240824 24671 1481 1481 24440 24440 320454 305427 15027 99098 99098 381989 268705 113284 196030 55240 140790 383244 383244 47377 20038 27339 11876 11876 186820 186820 140042 140042 Medical supplies 333827 333827 Repairs and maintenance 131222 131222 Provision for bad debts 46109 46109 7698648 6623895 1074753 0 1025 1025 710541 530693 52348 263497 332953 833 124665 122612 2955511 2175444 846081 780067 441720 452020 6384 6360 280229 287498 2674975 2565576 380928 420719 300248 310478 71680 681176 802877 X 1993799 1762699 1993799 1762699 2674975 2565576 -231100 0 X X 0 1 X 1 0 X 3463031 3476368 3081916 3670263 3739069 17430647 3873685 4114627 4048292 3819303 3732714 19588621 7336716 7590995 7130208 7489566 7471783 37019268 0 0 0 37019268 3346 4707 6743 8521 7692 31009 3346 4707 6743 8521 7692 31009 7340062 7595702 7136951 7498087 7479475 37050277 0.99920 0.99930 0.00080 0.00070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6384 52 76 6360 6411 50 77 6384 6431 134 154 6411 6364 78 11 6431 6095 300 31 6364 0.00000 1.00000 0.00000 1 0 1533392 1154965 378427 1422119 1020479 401640 780067 Educational support 261965 Other receivables 25533 287498 X 7433366 -46109 -46109 7479475 -11927 -11927 7467548 7664466 11927 11927 7652539 46109 46109 7698648 Part V, Line 4: An endowment fund known as the Charles A. Waterbury, Jr., M.D. Endowment Fund has been established at the community foundation. The community foundation manages the fund with the long-term objectives of safeguarding principal, increasing the principal's growth sufficiently to offset any decrease in purchasing power due to inflation, and generating income for distribution to the Foundation. The community foundation has variance power, which allows them to modify the donor's stipulations under certain circumstances as they monitor the changing needs of the community. Part X, Line 2: The Foundation is organized as an Iowa non-profit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Foundation is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Foundation is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Foundation has determined that it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Foundation believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Foundation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for bad debts included in expenses for Form 990 -46,109. Part XI, Line 4b - Other Adjustments: Disposal of assets included in revenue for Form 990 -11,927. Part XII, Line 2d - Other Adjustments: Disposal of assets included in revenue for Form 990 11,927. Part XII, Line 4b - Other Adjustments: Provision for bad debts included in expenses for Form 990 46,109. X X X 0 0 0 0 0 1 0 0 0 Anthony A Day MD Executive Director 285495 0 65 0 274 0 20240 0 22542 0 328616 0 0 0 Robert Friedman MD Undergrad Educ Director 259741 0 25 0 274 0 19990 0 13579 0 293609 0 0 0 James Poock MD Assistant Program Director 226357 0 25 0 274 0 17688 0 20249 0 264593 0 0 0 Suzanne Munns MD Assistant Program Director 193615 0 25 0 274 0 14727 0 20311 0 228952 0 0 0 Adam Roise MD Assistant Program Director 208360 0 45 0 274 0 15935 0 7778 0 232392 0 0 0 Part I, Line 6 A Success Sharing Policy has been approved by the Board of Directors which allows all employees, including those listed in Part VII, to be eligible for additional financial compensation based upon the financial success (net earnings) of the Organization and other quality measures. Form 990, Part VI, Section A, line 1 The Executive Committee is composed of the officers elected by the Board of Directors. The Executive Committee has authority to transact all regular business of the organization during the period between the meetings of the Board of Directors subject to any prior limitation imposed by the Board of Directors. Form 990, Part VI, Section A, line 2 Pam Delagardelle, Nicholas Goetsch, DO, Tim Horrigan, MD, and JoAn Headington have a business relationship. Jack Dusenbery, Angela Townsend, MD, Jim Lehman, MD, Julie Sandell, DO and Manju Mahajan, MD have a business relationship. Form 990, Part VI, Section A, line 6 The members of Northeast Iowa Medical Education Foundation are Allen Memorial Hospital Corporation and Covenant Health System. New members may be admitted only with the unanimous consent of the present members. Form 990, Part VI, Section A, line 7a The two members, Allen Memorial Hospital Corporation and Covenant Health System, appoint the Board of Directors of Northeast Iowa Medical Education Foundation Inc. The President/Chief Executive Officer of each of the Members are automatically, by virtue of their office, Directors of this corporation. The Executive Director of the Northeast Iowa Medical Education Foundation, Inc. serves on the Board. A representative of the University of Iowa College of Medicine serves on the Board as appointed by the Dean of the College. Each Member appoints to the Board of Directors two persons who are members of the medical staff of the appointing Member, and two persons who are also directors of the appointing Member, or an affiliated organization of such appointing Member. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body. The Executive Director and Administrator review the 990 before it is filed. Form 990, Part VI, Section B, line 12c Board members and officers are required to sign a conflict of interest statement annually. The statements are reviewed by the Administrator of the organization. Any potential conflict is brought to the Board's attention for discussion. In the event of a potential conflict, the Member will disclose the potential conflict and either abstain from involvement or discussion of the issue leading to the conflict or resign. Form 990, Part VI, Section B, line 15a The Executive Director's compensation is determined by the Executive Committee of the Board with salary adjustment recommendations based on an annual individual performance evaluation and review of Medical Group compensation surveys published by MGMA, AMGA, and University of Iowa compensation survey of Iowa medical residency programs including size of groups, ownership, productivity, and geographic area. The Executive Director determines the Administrator's compensation annually based on the above process. The Organization documents and provides substantiation for their compensation process. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request. Form 990, Part XII, Line 2c: The process did not change from the prior year.