KEOKUK AREA HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- KEOKUK AREA HOSPITAL (EIN 42-0710268)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-14
- IRS object ID
- 201742269349302244
- Schema version
- 2015v3.0
- 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 J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-14T14:48:26-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420710268 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KEOK | BusinessNameControlTxt |
| Phone | 3195247150 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WALT STEPHENS | PersonNm |
| Person Title | BOARD CHAIR | PersonTitleTxt |
| Phone | 3195247150 | PhoneNum |
| Signature | 2017-08-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WALT STEPHENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,461,216 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | KEOKUKHEALTHSYSTEMS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVING COMMUNITY HEALTH & ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 329 | TotalEmployeeCnt |
| Total Volunteers | 209 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $110,116 | PYContributionsGrantsAmt |
| CY Contributions Grants | $142,906 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,197,178 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,085,213 | CYProgramServiceRevenueAmt |
| PY Investment Income | $731 | PYInvestmentIncomeAmt |
| CY Investment Income | $44,625 | CYInvestmentIncomeAmt |
| PY Other Revenue | $279,066 | PYOtherRevenueAmt |
| CY Other Revenue | $147,097 | CYOtherRevenueAmt |
| PY Total Revenue | $19,587,091 | PYTotalRevenueAmt |
| CY Total Revenue | $19,419,841 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,103,574 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,474,708 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,279,573 | PYOtherExpensesAmt |
| CY Other Expenses | $10,644,791 | CYOtherExpensesAmt |
| PY Total Expenses | $20,383,147 | PYTotalExpensesAmt |
| CY Total Expenses | $21,119,499 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$796,056 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,699,658 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,707,741 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,055,919 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,717,872 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,765,708 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$10,131 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,709,789 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IMPROVING COMMUNITY HEALTH AND ENSURING ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,073,685 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $19,232,310 | RevenueAmt |
| Desc | KEOKUK AREA HOSPITAL (KAH) IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL FULLY ACCREDITED BY THE JOINT COMMISSION. ANNUALLY, KAH SERVICES APPROXIMATELY 1,000 ADMISSIONS, 230,000 OUTPATIENT PROCEDURES AND 12,000 EMERGENCY ROOM VISITS TO THE RESIDENTS OF KEOKUK, IOWA AND SURROUNDING AREAS. KAH ALSO HAS A HOME HEALTH AGENCY THAT SERVICES OVER 7,200 PATIENTS PER YEAR FROM LEE COUNTY, IA AND HANCOCK COUNTY, IL. THE HOSPITAL HAS APPROXIMATELY 120 CREDENTIALED PHYSICIANS ON THE MEDICAL STAFF AND IS GOVERNED BY THE KEOKUK HEALTH SYSTEMS BOARD OF DIRECTORS WHICH IS MADE UP OF LOCAL COMMUNITY MEMBERS. | Desc |
| Total Program Service Expenses | $20,073,685 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 329 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA HOSPITAL ATTNACCOUNTING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3195247150 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| NEVILLE CRENSHAW DO | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KIRAN KHANOLKAR MD | ||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $1,350 | $112,605 | $8,867 | ||
| MIKE MAHER | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM MARION | ||||||||
| BOARD MEMBER (TO 12/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KENT NIXON | ||||||||
| BOARD VICE CHAIR/TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TOM RICHARDSON | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RON SCOTT | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK SMITH | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WALT STEPHENS | ||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WENDY SWANK | ||||||||
| BOARD SECRETARY | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ELIZABETH DAVIS | ||||||||
| PHARMACY DIRECTOR | 40.00 | 0.00 | $117,412 | $0 | $18,453 | Yes (X) | ||
| JAGADAMBA KANTANMENI | ||||||||
| ANESTHESIOLOGIST | 40.00 | 0.00 | $307,027 | $0 | $1,349 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $425,789 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $112,605 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $28,669 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FITCH HEALTHCARE | |||||
| 123 W FRONT STREET | WHEATON | IL | 60187 | MANAGEMENT SERVICES | $810,316 |
| SHARED MEDICAL SERVICES | |||||
| 209 LIMESTONE | COTTAGE GROVE | WI | 53527 | MRI SERVICES | $198,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $80,460 | RelatedOrganizationsAmt |
| Government Grants | $11,334 | GovernmentGrantsAmt |
| All Other Contributions | $51,112 | AllOtherContributionsAmt |
| Total Contributions | $142,906 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $18,086,564 | $18,086,564 |
| MISCELLANEOUS REVENUE | 900099 | $927,281 | $927,281 |
| RENTAL REVENUE | 532000 | $53,353 | $53,353 |
| LABORATORY SERVICES | 621500 | $18,015 | $18,015 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,085,213 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $502 | TotalRevenueColumnAmt |
| Exclusion | $502 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $85,498 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $41,375 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $44,123 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,123 | TotalRevenueColumnAmt |
| Exclusion | $44,123 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA/LAUNDRY/MISC | 900099 | $80,924 | $80,924 |
| OTHER HEALTHCARE SERVICES | 900099 | $43,327 | $43,327 |
| MISCELLANEOUS REVENUE | 900099 | $22,846 | $22,846 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $147,097 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,419,841 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,232,310 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $44,625 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,350 | TotalAmt |
| Program Services | $1,350 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,490,692 | TotalAmt |
| Program Services | $8,490,692 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,385,767 | TotalAmt |
| Program Services | $1,385,767 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $596,899 | TotalAmt |
| Program Services | $596,899 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $820,903 | TotalAmt |
| Management And General | $820,903 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,771 | TotalAmt |
| Management And General | $29,771 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,480 | TotalAmt |
| Management And General | $22,480 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,000 | TotalAmt |
| Management And General | $60,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Management And General | $2,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,070,595 | TotalAmt |
| Program Services | $1,960,435 | ProgramServicesAmt |
| Management And General | $110,160 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,918 | TotalAmt |
| Program Services | $48,918 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,546 | TotalAmt |
| Program Services | $224,546 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $534,124 | TotalAmt |
| Program Services | $534,124 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,417 | TotalAmt |
| Program Services | $33,417 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $491,351 | TotalAmt |
| Program Services | $491,351 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,049,907 | TotalAmt |
| Program Services | $1,049,907 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,582 | TotalAmt |
| Program Services | $107,582 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $3,664,528 | $3,664,528 |
| MISCELLANEOUS EXPENSE | $1,251,403 | $1,251,403 |
| MEDICAID PROVIDER ASSES | $228,428 | $228,428 |
| INCOME TAXES | $4,338 | $4,338 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,119,499 | TotalAmt |
| Program Services | $20,073,685 | ProgramServicesAmt |
| Management And General | $1,045,814 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,300,895 | BOYAmt |
| EOY | $587,419 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,310,407 | BOYAmt |
| EOY | $1,157,768 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,695,764 | BOYAmt |
| EOY | $2,717,521 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $120,069 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,039,037 | BOYAmt |
| EOY | $955,897 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,326 | BOYAmt |
| EOY | $138,476 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $29,255,823 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,986,827 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,154,421 | BOYAmt |
| EOY | $4,268,996 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,891 | BOYAmt |
| EOY | $109,773 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,707,741 | BOYAmt |
| EOY | $10,055,919 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,182,960 | BOYAmt |
| EOY | $3,994,449 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,646,461 | BOYAmt |
| EOY | $2,417,366 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,989,085 | BOYAmt |
| EOY | $5,153,893 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $899,366 | BOYAmt |
| EOY | $200,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,717,872 | BOYAmt |
| EOY | $11,765,708 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$885,166 | BOYAmt |
| EOY | -$2,376,826 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $875,035 | BOYAmt |
| EOY | $667,037 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$10,131 | BOYAmt |
| EOY | -$1,709,789 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,707,741 | BOYAmt |
| EOY | $10,055,919 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,699,658 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $60,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $60,000 | 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 | KEOKUK AREA HOSPITAL CONTRACTED WITH FIRM PRIMARILY TO PROVIDE LOBBYING ACTIVITIES IN SUPPORT OF THE RURAL EMERGENCY ACUTE CARE HOSPITAL ACT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $438,675 | OtherCostOrOtherBasisAmt |
| Book Value | $438,675 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,143,849 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,720,774 | DepreciationAmt |
| Book Value | $2,423,075 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,068,730 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,786,563 | DepreciationAmt |
| Book Value | $1,282,167 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $604,569 | OtherCostOrOtherBasisAmt |
| Depreciation | $479,490 | DepreciationAmt |
| Book Value | $125,079 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,268,996 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS LIABILITY | Desc |
| Amt | $200,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $200,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $19,504,876 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $207,998 | OtherRevenueAmt |
| Revenue Not Reported | $207,998 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,296,878 | RevenueSubtotalAmt |
| Other Revenues Not Included | $122,963 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $122,963 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,419,841 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,345,039 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,345,039 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $774,460 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $774,460 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,119,499 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KEOKUK AREA HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. FORMS 990 FILED BY KEOKUK AREA HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS") UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 FILED BY KEOKUK AREA HOSPITAL ARE GENERALLY NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND PRIOR. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 207,998. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REVENUES IN UNRESTRICTED FUND BALANCE 76,927. EXPENSES NETTED IN REVENUES 46,036. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES IN UNRESTRICTED FUND BALANCE 728,424. EXPENSES NETTED IN REVENUES 46,036. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $280,057 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $280,057 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $267,966 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $267,966 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,262 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,262 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $580,285 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $580,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02750 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,360 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $191,955 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $191,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00910 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $846,642 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $846,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,648 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,648 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,087,605 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,087,605 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,667,890 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,667,890 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07900 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,060 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,060 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,980 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,980 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,580 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,643 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,643 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,263 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,263 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,064,834 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $472,985 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,960,255 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,114,524 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $845,731 | 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 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.KEOKUKHEALTHSYSTEMS.ORG | WebsiteAddressTxt |
| State License | 560054H | 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 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.KEOKUKHEALTHSYSTEMS.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | LEECOUNTYHD.ORG | OtherWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.KEOKUKHEALTHSYSTEMS.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | 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 |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.KEOKUKHEALTHSYSTEM.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.KEOKUKHEALTHSYSTEM.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.KEOKUKHEALTHSYSTEM.ORG | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 5: KEOKUK AREA HOSPITAL, FORT MADISON COMMUNITY HOSPITAL AND THE LEE COUNTY HEALTH DEPARTMENT ALL COME TOGETHER TO HOST A COMMUNITY STAKEHOLDER'S MEETING WHICH CONSISTS OF MEMBERS OF EACH ORGANIZATION AS WELL AS INTERESTED COMMUNITY MEMBERS. DURING THIS MEETING, ALL MEMBERS ARE DIVIDED INTO SMALL GROUPS AND PROVIDED WITH A LEE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT DATA PROFILE. EACH GROUP IS ASKED TO REVIEW THE DATA AND COME UP WITH A LIST OF TOP HEALTH NEEDS TO LEE COUNTY. EACH GROUP PRESENTS THEIR FINDINGS AND THEN AS AN ENTIRE GROUP, VOTE ON THE TOP 3-5 HEALTH NEEDS TO FOCUS ON OVER THE NEXT 3-5 YEARS. TASKFORCES ARE THEN DEVELOPED FOR EACH HEALTH NEED AND MEETINGS OF THOSE TASKFORCES ARE HELD EVERY FEW MONTHS. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 6A: KEOKUK AREA HOSPITAL'S CHNA WAS PERFORMED WITH FORT MADISON COMMUNITY HOSPITAL. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 6B: KEOKUK AREA HOSPITAL'S CHNA WAS PERFORMED WITH THE LEE COUNTY HEALTH DEPARTMENT. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 7D: A COPY OF THE CHNA IS AVAILABLE UPON REQUEST. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 11: SOME OF THE HEALTH NEEDS IDENTIFIED THROUGH THE ASSESSMENT WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA BY THE LEE COUNTY HEALTH DEPARTMENT AND FORT MADISON COMMUNITY HOSPITAL. ADDITIONALLY, SOME COMMUNITY HEALTH NEEDS SUCH AS INCREASED NUTRITION & FITNESS, IMPROVED BICYCLE/WALKING TRAILS AND IMPROVED HEALTH DEPARTMENT FACILITIES WERE BEYOND ON THE SCOPE, EXPERTISE AND RESOURCES AVAILABLE AT KEOKUK AREA HOSPITAL. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 18D: PATIENTS FOLLOW THE HOSPITAL'S COLLECTIONS POLICY UNLESS THEY APPLY AND QUALIFY FOR FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY REQUIRES PATIENTS TO AGREE AND ADHERE TO A PAYMENT PLAN ONCE APPROVED FOR DISCOUNTED CARE. |
| KEOKUK AREA HOSPITAL | PART V, SECTION B, LINE 22D: THE HOSPITAL USES ITS CHARGE MASTER RATES LESS A 40% DISCOUNT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - TRI-STATE MEDICAL GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | PRIMARY CARE CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | KEOKUK AREA HOSPITAL PREPARES AND SUBMITS A COMMUNITY BENEFITS REPORT TO THE IOWA HOSPITAL ASSOCIATION EACH TAX YEAR. |
| PART I, LINE 7: | THE COST REPORT METHODOLOGY WAS USED TO CALCULATE 7A THROUGH 7D. THE COMMUNITY BENEFITS REPORT WAS USED TO CALCULATE 7E THROUGH 7I. |
| PART I, LINE 7G: | REPRESENTS THE SUBSIDY TO TRI-STATE MEDICAL GROUP, INC. TO COVER UNCOMPENSATED HEALTHCARE COSTS. |
| PART I, LN 7 COL(F): | BAD DEBT WAS NOT INCLUDED IN FORM 990 PART IX LINE 25 BUT RECORDED AS AN OFFSET TO GROSS REVENUE. IT WAS ALSO NOT INCLUDED IN THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | KEOKUK AREA HOSPITAL'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY THROUGH INCREASED EDUCATION AND TRAINING OF HEALTHCARE RELATED ISSUES AS WELL AS PROMOTING CAREER DEVELOPMENT IN THE HEALTHCARE FIELD. |
| PART III, LINE 4: | PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT WHEN DEEMED UNCOLLECTABLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 8: | MEDICARE PAYS KEOKUK AREA HOSPITAL SUBSTANIALLY LESS THAN REASONABLE COST WHICH REPRESENTS UNCOMPENSATED CARE JUST LIKE PROVIDED TO INDIGENT PATIENTS WHO CANNOT PAY FOR THEIR SERVICES. THE COST OF THIS CARE IS CALCULATED PER MEDICARE COST REPORT METHODOLOGY. |
| PART III, LINE 9B: | IF INFORMATION IS AVAILABLE TO CONFIRM ELIGIBILITY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS NOT PURSUED. |
| PART VI, LINE 2: | KEOKUK AREA HOSPITAL PARTICIPATES WITH MANY HEALTH RELATED ORGANIZATIONS TO ASSESS HEALTHCARE NEEDS IN LEE COUNTY, IOWA AND SHARES THE RESULTS IN A WRITTEN COMMUNITY HEALTH NEEDS ASSESSMENT WHICH IS AVAILABLE ON THE WEBSITE OR BY REQUEST. |
| PART VI, LINE 3: | PATIENT STATEMENTS INCLUDE A WRITTEN NOTICE TO PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND ENCOURAGES THEM TO EITHER CALL OR VISIT THE BUSINESS OFFICE FOR FURTHER INFORMATION. FINANCIAL ASSISTANCE IS ALSO DISCUSSED WITH ALL PRIVATE PAY PATIENTS DURING REGISTRATION AND SIGNS ARE POSTED BY THE BUSINESS OFFICE AND OUTPATIENT REGISTRATION AREAS. |
| PART VI, LINE 4: | KEOKUK AREA HOSPITAL MAINLY SERVES THE COMMUNITIES OF SOUTHERN LEE COUNTY IN IOWA, WESTERN HANCOCK COUNTY IN ILLINOIS, AND NORTHERN CLARK COUNTY IN MISSOURI. |
| PART VI, LINE 5: | KEOKUK AREA HOSPITAL HAS AN ALL VOLUNTEER BOARD OF DIRECTORS MADE UP OF LOCAL COMMUNITY MEMBERS WHO SERVE WITHOUT COMPENSATION. THE MEDICAL STAFF IS OPEN TO ALL INTERESTED PROVIDERS WHO ARE APPROPRIATELY CREDENTIALED. ALL FUNDS GENERATED BY THE HOSPITAL ARE UTILIZED FOR PATIENT RELATED SERVICES AND TO ENSURE THAT ALL PATIENTS IN THE MARKET HAVE ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. |
| PART VI, LINE 6: | KEOKUK AREA HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES. TRI-STATE MEDICAL GROUP PROVIDES PRIMARY CARE, PROMPT CARE, OCCUPATIONAL HEALTH AND SPECIALTY CARE SERVICES. KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY SELLS AND DELIVERS DURABLE MEDICAL EQUIPMENT WITHIN A 75 MILE RADIUS. ALL ENTITIES ARE IN CLOSE PROXIMITY TO ONE ANOTHER AND WORK TOGETHER TO REDUCE LENGTH OF STAY IN THE HOSPITAL AND ENSURE CONTINUITY OF CARE FROM ONE LEVEL TO ANOTHER. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAGADAMBA KANTANMENI | PersonNm |
| Title | ANESTHESIOLOGIST | TitleTxt |
| Base Compensation Filing Org | $307,027 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $1,349 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $308,376 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CEO/EXECUTIVE SALARY IS APPROVED BY THE BOARD OF DIRECTORS AFTER REVIEW BY EXECUTIVE COMMITTEE USING VARIOUS BENCHMARK DATA, INCLUDING 990 DATA OF SIMILAR HOSPITALS, IOWA HOSPITAL ASSOCIATION SALARY SURVEYS AND EXPERIENCE LEVEL OF CANDIDATE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO FITCH HEALTHCARE. |
| FORM 990, PART VI, SECTION A, LINE 6 | KEOKUK HEALTH SYSTEMS INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | KEOKUK HEALTH SYSTEMS INC.'S BOARD OF DIRECTORS, KEOKUK AREA HOSPITAL FOUNDATION'S CURRENT PRESIDENT AND KEOKUK AREA HOSPITAL'S CURRENT CHIEF OF STAFF HAVE SEATS ON THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | KEOKUK HEALTH SYSTEMS INC. IS THE PARENT COMPANY OF KEOKUK AREA HOSPITAL AND SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE 990 IS REVIEWED BY TOP MANAGEMENT AND DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS AND EMPLOYEES ATTEST IN WRITING ANNUALLY THAT THEY HAVE DISCLOSED ANY POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS ALL COMPENSATION ARRANGEMENTS WITH HIGHLY PAID EMPLOYEES UTILIZING BENCHMARK DATA FROM VARIOUS SOURCES INCLUDING THE IOWA HOSPITAL ASSOCIATION WAGE AND SALARY SURVEYS AND PHYSICIAN COMPENSATION SURVEYS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATIONAL DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE 990 IS PUBLISHED ON WWW.GUIDESTAR.COM |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| KEOKUK AREA HOSPITAL FOUNDATION | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421202608 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 509(A)(3), 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 | 0 | |
| TRI-STATE MEDICAL GROUP INC | ||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421435525 | MEDICAL OFFICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | KEOKUK HEALTH SYSTEMS INC | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421237312 | EIN |
| Primary Activities | DME SALES AND RENTALS | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| KEOKUK AREA MEDICAL EQUIPMENT INC | ||
| S | $4,400 | BASED ON GAAP, CASH AND/OR FMV. |
| TRI-STATE MEDICAL GROUP INC | ||
| R | $772,424 | BASED ON GAAP, CASH AND/OR FMV. |