CENTRAL IOWA HEALTHCARE: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL IOWA HEALTHCARE (EIN 42-0948420)
- Tax period
- 2014-11-01 to 2015-10-31
- Filed
- 2016-09-15
- IRS object ID
- 201612599349301181
- Schema version
- 2014v6.0
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-09-15T15:43:16-05:00 | ReturnTs |
| Tax Period End | 2015-10-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N HARRISON STREET SUITE 300 | AddressLine1Txt |
| City | DAVENPORT | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 528011999 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420948420 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 6417545126 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAROL HIBBS | PersonNm |
| Person Title | CHAIR, BOARD OF TRUSTEES | PersonTitleTxt |
| Phone | 6417545126 | PhoneNum |
| Signature | 2016-09-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN J ROMANO | PreparerPersonNm |
| PTIN | P00227323 | PTIN |
| Phone | 5638884000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CAROL HIBBS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $62,772,484 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRALIOWAHEALTHCARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO CREATE AND CONTINUALLY IMPROVE SERVICES THAT RESPOND TO HEALTHCARE NEEDS IN OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 704 | TotalEmployeeCnt |
| Total Volunteers | 250 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $61,646 | PYContributionsGrantsAmt |
| CY Contributions Grants | $61,942 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $67,966,624 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $57,707,153 | CYProgramServiceRevenueAmt |
| PY Investment Income | $61,618 | PYInvestmentIncomeAmt |
| CY Investment Income | $92,434 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,312,419 | PYOtherRevenueAmt |
| CY Other Revenue | $3,309,318 | CYOtherRevenueAmt |
| PY Total Revenue | $70,402,307 | PYTotalRevenueAmt |
| CY Total Revenue | $61,170,847 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $24,647 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,375,001 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $35,831,927 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,790,295 | PYOtherExpensesAmt |
| CY Other Expenses | $44,106,586 | CYOtherExpensesAmt |
| PY Total Expenses | $72,165,296 | PYTotalExpensesAmt |
| CY Total Expenses | $79,963,160 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,762,989 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$18,792,313 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $71,123,105 | TotalAssetsBOYAmt |
| Total Assets EOY | $102,694,171 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,212,072 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $65,572,738 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $55,911,033 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,121,433 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO CREATE AND CONTINUALLY IMPROVE SERVICES THAT RESPOND TO HEALTHCARE NEEDS IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $57,040,558 | ExpenseAmt |
| Grant | $24,647 | GrantAmt |
| Revenue | $58,414,389 | RevenueAmt |
| Desc | TO PROVIDE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO MEMBERS OF THE COMMUNITY AND SURROUNDING COMMUNITIES REGARDLESS OF ABILITY TO PAY. CARE INCLUDES PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND OTHER SERVICES. CENTRAL IOWA HEALTHCARE EXPERIENCED APPROXIMATELY 196,102 OUTPATIENT VISITS; 2,717 ADMISSIONS; 480 BIRTHS; 8,388 PATIENT DAYS; 4,131 SURGICAL PROCEDURES AND 20,671 EMERGENCY ROOM VISITS. | Desc |
| Total Program Service Expenses | $57,040,558 | 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 | 0 | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 119 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 704 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY K PFANTZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6417545126 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| TL BRIGGS | |||||||||
| FORMER TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JACQUE GOODMAN | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SHARON GREER | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CAROL HIBBS | |||||||||
| VICE CHAIRPERSON | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| POLLY HINEMAN MD | |||||||||
| FORMER TRUSTEE/PHYSICIAN | 40.00 | Yes (X) | $170,047 | $0 | $9,774 | ||||
| JOHN C HUGHES | |||||||||
| PRESIDENT & CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $276,507 | $0 | $32,445 | Yes (X) | |||
| JIM LOWRANCE | |||||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| SUE MARTIN | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MIKE MASON | |||||||||
| CHAIRPERSON | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| MIKE MCCARTY | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOSEPH POLLPETER | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KIMBERLE SCHRYVER | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN SWARTZ | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHEN VAN BUREN | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| BRUCE WIRIN | |||||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| TODD BURCH | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $0 | $0 | $0 | Yes (X) | ||||
| HILARY DOLBEE | |||||||||
| FORMER V.P. OF FINANCE | 40.00 | $152,991 | $0 | $15,169 | Yes (X) | ||||
| LIZ ZUERCHER | |||||||||
| FORMER V.P. OF ADMINISTRATION | 40.00 | $155,386 | $0 | $27,144 | Yes (X) | ||||
| SADIA ASHRAF-BENSON DO | |||||||||
| PHYSICIAN | 40.00 | $259,705 | $0 | $14,659 | Yes (X) | ||||
| BONTE GBEMUDU MD | |||||||||
| PHYSICIAN | 40.00 | $219,148 | $0 | $27,180 | Yes (X) | ||||
| JOHN MCCUNE MD | |||||||||
| PHYSICIAN | 40.00 | $324,249 | $0 | $37,889 | Yes (X) | ||||
| RONALD TERRILL MD | |||||||||
| PHYSICIAN | 40.00 | $234,284 | $0 | $27,752 | Yes (X) | ||||
| YARED VAZQUEZ MD | |||||||||
| PHYSICIAN | 40.00 | $204,878 | $0 | $31,474 | Yes (X) | ||||
| ROBERT L DOWNEY | |||||||||
| FORMER CHIEF FINANCIAL OFF | 40.00 | $201,246 | $0 | $12,501 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,198,441 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $235,987 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MACFARLAND CLINIC PC | |||||
| 1215 DUFF AVE | AMES | IA | 50010 | PHYSICIAN SERVICES | $2,307,757 |
| SQUARE WAVEFORM ANESTHESIOLOGY | |||||
| PO BOX 1192 | MARSHALLTOWN | IA | 50158 | ANESTHESIA SERVICES | $1,933,500 |
| ICE TECHNOLOGIES | |||||
| 411 SE 9TH ST | PELLA | IA | 50219 | IT SERVICES | $1,438,473 |
| ARAMARK CORPORATION | |||||
| 1225 E 60TH ST | CHICAGO | IL | 60673 | CLIN ENG/FACILITIES | $1,428,524 |
| IOWA ORTHO | |||||
| 1601 NW 114TH ST | CLIVE | IA | 50325 | PHYSICIAN SERVICES | $1,320,144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $13,550 | MembershipDuesAmt |
| All Other Contributions | $48,392 | AllOtherContributionsAmt |
| Total Contributions | $61,942 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $57,707,153 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,707,153 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $57,707,153 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,482 | TotalRevenueColumnAmt |
| Exclusion | $14,482 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,907,026 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,042,759 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $864,267 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $864,267 | TotalRevenueColumnAmt |
| Exclusion | $864,267 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $575,660 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $497,708 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $77,952 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,952 | TotalRevenueColumnAmt |
| Exclusion | $77,952 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $119,969 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $61,170 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,799 | TotalRevenueColumnAmt |
| Exclusion | $58,799 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| JOINT VENTURE INCOME | 900099 | $707,236 | $707,236 | |
| CAFETERIA INCOME | 722514 | $487,528 | $487,528 | |
| ELECTRONIC HEALTH RECORD REVENUE | 900099 | $227,158 | $227,158 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $964,330 | TotalRevenueColumnAmt |
| Exclusion | $964,330 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,386,252 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,170,847 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,414,389 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,694,516 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,647 | TotalAmt |
| Program Services | $24,647 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,818 | TotalAmt |
| Management And General | $995,818 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,495,841 | TotalAmt |
| Program Services | $22,103,044 | ProgramServicesAmt |
| Management And General | $5,392,797 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,102,681 | TotalAmt |
| Program Services | $879,826 | ProgramServicesAmt |
| Management And General | $222,855 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,240,868 | TotalAmt |
| Program Services | $3,383,776 | ProgramServicesAmt |
| Management And General | $857,092 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,996,719 | TotalAmt |
| Program Services | $1,593,176 | ProgramServicesAmt |
| Management And General | $403,543 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,968,090 | TotalAmt |
| Management And General | $3,968,090 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,834 | TotalAmt |
| Program Services | $19,195 | ProgramServicesAmt |
| Management And General | $447,639 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,573 | TotalAmt |
| Management And General | $58,573 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,902 | TotalAmt |
| Management And General | $13,902 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,296,776 | TotalAmt |
| Program Services | $15,034,999 | ProgramServicesAmt |
| Management And General | $1,261,777 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,881 | TotalAmt |
| Management And General | $268,881 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $496,665 | TotalAmt |
| Program Services | $355,396 | ProgramServicesAmt |
| Management And General | $141,269 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,739,067 | TotalAmt |
| Management And General | $1,739,067 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $954,851 | TotalAmt |
| Program Services | $565,615 | ProgramServicesAmt |
| Management And General | $389,236 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,062 | TotalAmt |
| Program Services | $78,952 | ProgramServicesAmt |
| Management And General | $48,110 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,606 | TotalAmt |
| Program Services | $50,348 | ProgramServicesAmt |
| Management And General | $27,258 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,243,997 | TotalAmt |
| Management And General | $1,243,997 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,131,888 | TotalAmt |
| Program Services | $1,570,004 | ProgramServicesAmt |
| Management And General | $2,561,884 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,942 | TotalAmt |
| Program Services | $76,223 | ProgramServicesAmt |
| Management And General | $448,719 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $8,150,940 | $8,150,940 | |
| ANCILLARY EXPENSES | $2,351,478 | $2,351,478 | |
| ADMINISTRATIVE EXPENSES | $1,210,760 | $1,210,760 | |
| NURSING EXPENSES | $611,792 | $611,792 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,412,482 | TotalAmt |
| Program Services | $191,147 | ProgramServicesAmt |
| Management And General | $1,221,335 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,963,160 | TotalAmt |
| Program Services | $57,040,558 | ProgramServicesAmt |
| Management And General | $22,922,602 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,121 | BOYAmt |
| EOY | $33,545 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,807,597 | BOYAmt |
| EOY | $2,180,843 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,540 | BOYAmt |
| EOY | $38,243 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,621,933 | BOYAmt |
| EOY | $9,531,074 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,874 | BOYAmt |
| EOY | $166,774 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,034,951 | BOYAmt |
| EOY | $2,370,281 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $773,462 | BOYAmt |
| EOY | $866,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $141,838,368 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $64,492,878 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,288,768 | BOYAmt |
| EOY | $77,345,490 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,119 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,500,000 | BOYAmt |
| EOY | $3,695,768 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,249,849 | BOYAmt |
| EOY | $2,003,395 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,561,891 | BOYAmt |
| EOY | $4,462,453 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,123,105 | BOYAmt |
| EOY | $102,694,171 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,312,736 | BOYAmt |
| EOY | $16,042,262 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,899,336 | BOYAmt |
| EOY | $49,530,476 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,212,072 | BOYAmt |
| EOY | $65,572,738 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,422,234 | BOYAmt |
| EOY | $35,579,968 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,488,799 | BOYAmt |
| EOY | $1,541,465 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,911,033 | BOYAmt |
| EOY | $37,121,433 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,123,105 | BOYAmt |
| EOY | $102,694,171 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$18,792,313 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $5,328 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,615 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,902 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,902 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 22.8% OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, OR $4,995, AND 21% OF MEMBERSHIP DUES PAID TO THE IOWA HOSPITAL ASSOCIATION, OR $8,907. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $640,301 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $5,002,147 | OtherCostOrOtherBasisAmt |
| Book Value | $5,642,448 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $19,328,772 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $69,471,591 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,018,390 | DepreciationAmt |
| Book Value | $50,781,973 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $16,261 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $44,884,745 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,253,432 | DepreciationAmt |
| Book Value | $19,647,574 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $357,295 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,137,256 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,221,056 | DepreciationAmt |
| Book Value | $1,273,495 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $77,345,490 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $60,434,807 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $60,434,807 | RevenueSubtotalAmt |
| Other Revenues Not Included | $736,040 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $736,040 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $61,170,847 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $79,227,120 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$736,040 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$736,040 | ExpensesNotReportedAmt |
| Expenses Subtotal | $79,963,160 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $79,963,160 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NONPROFIT 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. THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO ORGANIZATIONS SUCH AS THIS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE NATURE, THE CHARACTERIZATION AND THE TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. HOWEVER, AS OF OCTOBER 31, 2015 AND 2014, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AS MANAGEMENT DOES NOT BELIEVE THE HOSPITAL HAS TAKEN ANY TAX POSITIONS THAT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES. FORMS 990 AND 990T FILED BY THE HOSPITAL ARE GENERALLY SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. THE HOSPITAL'S IRS FORMS 990 AND 990T ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR ENDED OCTOBER 31, 2012 AND PRIOR. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | COST OF GOODS SOLD -61,170. GAIN ON SALE OF FIXED ASSETS 77,952. JOINT VENTURE INCOME 707,236. RESTRICTED INCOME 12,022. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | COST OF GOODS SOLD 61,170. GAIN ON SALE OF FIXED ASSETS -77,952. JOINT VENTURE INCOME -707,236. RESTRICTED EXPENSES -12,022. |
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 |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | $24,647 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,647 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,659,661 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,553,967 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,105,694 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03880 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,684,308 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,553,967 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,130,341 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03910 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $436,754 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $33,143 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $403,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,567,378 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,889,126 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $678,252 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00850 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,674 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,674 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,026,806 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,922,269 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,104,537 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,711,114 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,476,236 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,234,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05290 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,025 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,025 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $20,096,333 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $21,042,030 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,661,227 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,619,197 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (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 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3 SOUTH 4TH AVE | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CENTRALIOWAHEALTHCARE.COM | WebsiteAddressTxt |
| State License | 640007H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL IOWA HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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.CENTRALIOWAHEALTHCARE.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CENTRALIOWAHEALTHCARE.COM | 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 | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CENTRAL IOWA HEALTHCARE | PART V, SECTION B, LINE 5: CENTRAL IOWA HEALTHCARE UTILIZED MANY METHODS IN ORDER TO ENSURE THAT INPUT WAS RECEIVED FROM THE ENTIRE COMMUNITY, INCLUDING REPRESENTATIVES OF THE COMMUNITY WITH PUBLIC HEALTH KNOWLEDGE, THOSE WITH SPECIALIZED HEALTH KNOWLEDGE, AS WELL AS THOSE SERVED BY THE HOSPITAL. THIS WAS DONE BY HOSTING THREE COMMUNITY MEETINGS, CONDUCTING A DIRECT MAIL SURVEY OF HOUSEHOLDS IN THE SERVICE AREA, AND FORMING FOCUS GROUPS ATTENDED BY BUSINESS LEADERS, CITY AND COUNTY LEADERS, HEALTH CARE PROFESSIONALS, RELIGIOUS LEADERS, NOT-FOR-PROFIT ORGANIZATIONS AND CONSUMERS. |
| CENTRAL IOWA HEALTHCARE | PART V, SECTION B, LINE 6B: THE MARSHALL COUNTY BOARD OF HEALTH AND THE PIONEERING HEALTHIER COMMUNITY COALITION |
| CENTRAL IOWA HEALTHCARE | PART V, SECTION B, LINE 11: CENTRAL IOWA HEALTHCARE WILL FOCUS ON PROVIDING MORE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN THE CENTRAL IOWA HEALTHCARE SERVICE AREA AND WILL WORK TOWARDS GREATER UTILIZATION OF THESE SPECIALTY SERVICES THAT ARE PREVIOUSLY EXISTING IN THE COMMUNITY. CENTRAL IOWA HEALTHCARE HAS MADE A NUMBER OF ADVANCEMENTS TOWARDS THE MENTAL HEALTH GOAL. IN FISCAL YEAR 2015, WE HIRED AN EXECUTIVE DIRECTOR OF BEHAVIOR HEALTH, WITH A FOCUS ON THE MOST CRITICAL AREA - BEHAVIORAL HEALTH PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT. IN ADDITION TO BRINGING THIS RESOURCE ON BOARD, WE REMODELED AN ED PATIENT ROOM FOR THE SAFETY OF THESE PATIENTS THAT INCLUDED REMOVING ITEMS THAT COULD BE USED TO SELF HARM OR HARM CAREGIVERS, ADDED VIDEO MONITORING TO ENSURE THAT THE PATIENT IN THE ROOM IS SAFE, GROWN AN ONSITE EMPLOYED SECURITY TEAM, PARTNERED MORE CLOSELY WITH THE COUNTY SHERIFF'S DEPARTMENT TO ENSURE THE SAFETY OF INDIVIDUALS UNDER THEIR CARE, AND MODIFIED POLICIES TO ENSURE ADEQUATE CARE IS PROVIDED. WE ALSO CONTRACTED WITH OTHER ORGANIZATIONS TO PROVIDE REMOTE EVALUATIONS WHEN THE PHYSICIANS REQUEST THE SERVICE.THERE WERE NEEDS IDENTIFIED THAT CENTRAL IOWA HEALTHCARE DOES NOT HAVE THE RESOURCES TO ADDRESS AT THIS TIME. THESE NEEDS WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY WERE NOT CHOSEN BASED ON THE ORGANIZATION'S PRIORITIZATION PROCESS, AVAILABLE STAFF RESOURCES AND OTHER PRIORITY PROJECTS. THIS PROCESS INCLUDED THE FOLLOWING QUESTIONS: 1) THE SEVERITY OF THE PROBLEM 2) THE HEALTH SYSTEM'S ABILITY TO IMPACT AND 3) THE EXTENT TO WHICH OTHER ORGANIZATIONS WERE MEETING THE NEED AS WELL AS 4) THE HEALTH SYSTEM'S CAPACITY AT THIS TIME. |
| CENTRAL IOWA HEALTHCARE | PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY USES THE RATES PAID BY COMMERCIAL INSURANCE PAYORS TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO INDIVIDUALS ELIGIBLE UNDER THE HOSPITALS FINANCIAL ASSISTANCE POLICY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| CIH CLINIC - STATE CENTER | ||||
| 503 3RD AVENUE SW | STATE CENTER | IA | 50247 | PHYSICIAN CLINIC |
| CIH CLINIC - TAMATOLEDO | ||||
| 1307 SOUTH BROADWAY | TOLEDO | IA | 52342 | PHYSICIAN CLINIC |
| CIH CLINIC - CONRAD | ||||
| 105 NORTH CHURCH ST | CONRAD | IA | 50621 | PHYSICIAN CLINIC |
| CIH CLINIC - MARSHALLTOWN | ||||
| 405 EAST MAIN ST | MARSHALLTOWN | IA | 50158 | PHYSICIAN CLINIC |
| CIH - URGENT CARE | ||||
| 55 CENTRAL IOWA DRIVE SUITE 5 | MARSHALLTOWN | IA | 50158 | URGENT CARE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NOT APPLICABLE |
| PART I, LINE 6A: | A COMMUNITY BENEFIT REPORT IS PREPARED ANNUALLY IN A COLLABORATIVE EFFORT WITH THE IOWA HOSPITAL ASSOCIATION. THIS INFORMATION IS SHARED IN TOTAL FOR THE ENTIRE STATE THROUGH PRESS RELEASES AND FOR OUR INDIVIDUAL HOSPITAL BY INCLUDING THIS INFORMATION IN OUR ANNUAL CORPORATE REPORT, ON OUR WEBSITE AND A LOCAL PRESS RELEASE. |
| PART I, LINE 7: | AMOUNTS REPORTED IN THIS TABLE WERE CALCULATED BASED ON IRS WORKSHEETS 1-8, USING ENTITY SPECIFIC COST TO CHARGE RATIOS. |
| PART I, LINE 7G: | THE AMOUNT REPORTED ON THIS LINE INCLUDES SUBSIDIZED HEALTH SERVICES AT TWO PHYSICIAN CLINICS LOCATED IN RURAL COMMUNITIES IN OUR GEOGRAPHIC SERVICE AREA. THE PHYSICIAN CLINICS ARE PROVIDED IN THE RURAL AND MEDICALLY UNDERSERVED COMMUNITIES OF TAMA/TOLEDO, IOWA AND MARSHALLTOWN, IOWA TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY REDUCING GEOGRAPHIC AND FINANCIAL BARRIERS. COSTS OF $1,229,205 FOR TAMA/TOLEDO AND $2,338,173 WERE INCLUDED IN COMMUNITY BENEFIT EXPENSE, AS THESE COMMUNITIES WOULD BE MEDICALLY UNDERSERVED IF THESE SERVICES WERE NOT PROVIDED. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE COMMUNITY BUILDING ACTIVITIES EXPENSE INCURRED BY CENTRAL IOWA HEALTHCARE ARE EXPENSES INCURRED TO RECRUIT PHYSICIANS WHO WOULD NOT OTHERWISE COME TO THIS MEDICALLY UNDERSERVED AREA AND TO RETAIN PHYSICIANS IN THIS MEDICALLY UNDERSERVED AREA. |
| PART III, LINE 2: | THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) IS DETERMINED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BY AN ALLOWANCE FOR AN ESTIMATE MADE FOR CONTRACTUAL ADJUSTMENTS OR DISCOUNTS PROVIDED TO THIRD-PARTY PAYORS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | COSTS WERE DERIVED USING THE MEDICARE COST REPORT. THE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: 1) MANY MEDICARE RECIPIENTS ARE LOW-INCOME INDIVIDUALS AND IF NOT FOR MEDICARE, WOULD QUALIFY FOR CHARITY CARE OR OTHER MEANS TESTED GOVERNMENT PROGRAMS 2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS 3) IRS REV RULING 69-545 ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR HOSPITALS, WHICH INDICATES THAT IF A HOSPITAL SERVES PATIENTS COVERED BY GOVERNMENTAL HEALTH BENEFITS (INCLUDING MEDICARE), THEN THIS INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| PART III, LINE 9B: | AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN-OFF. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. |
| PART VI, LINE 2: | CENTRAL IOWA HEALTHCARE AND THE MARSHALL COUNTY BOARD OF HEALTH AND THE PIONEERING HEALTHIER COMMUNITY COALITION PARTNERED TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN CALENDAR YEAR 2013. THROUGH THESE EFFORTS, PRIORITIES AND STRATEGIES HAVE BEEN DEVELOPED. REPRESENTATIVES OF CENTRAL IOWA HEALTHCARE ARE INVOLVED IN THE ABOVE MENTIONED GROUPS AND THE LARGER COALITION. THE HEALTH NEEDS OF THE COMMUNITY ARE ASSESSED THROUGH A COMMUNITY NEEDS ASSESSMENT PROCESS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY, AND TO ASSIST OUR COMMUNITY PARTNERS IN FOCUSING ON OUR COMMUNITIES FUTURE HEALTH NEEDS. THIS ASSESSMENT SERVES AS THE BASIS FOR MARSHALL COUNTY PUBLIC HEALTH, PIONEERING HEALTHIER COMMUNITIES, AND OUR OVERALL HEALTHCARE COMMUNITY TO DEVELOP ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES. THIS NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO - GAIN INSIGHT INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY - ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS - PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNING. CENTRAL IOWA HEALTHCARE ACTIVELY CONTRIBUTES TO THE COMMUNITY NEEDS ASSESSMENT AND ENGAGES IN THE PRIORITIES THAT MATCH ITS VISION AND MISSION. MEASUREMENT AND EVALUATION TOOLS ARE COLLECTED AND MONITORED BY THE LARGER COMMUNITY COALITION ENGAGED IN THE VARIOUS EFFORTS. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, CENTRAL IOWA HEALTHCARE MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND RESOURCES AVAILABLE. INDIVIDUAL DEPARTMENTS ALSO WORK TO IDENTIFY COMMUNITY NEEDS AS RELATED TO THEIR SERVICES AND THE POPULATION SERVED. |
| PART VI, LINE 3: | SIGNS STATING THAT FINANCIAL ASSISTANCE AND FREE CARE ARE AVAILABLE AND ARE POSTED IN THE HOSPITAL REGISTRATION AND CASHIER AREAS. REGISTRATION STAFF HAVE EDUCATIONAL MATERIAL AND APPLICATION FORMS THAT ARE MADE AVAILABLE TO PATIENTS WANTING INFORMATION OR AN APPLICATION FOR OUR COMMUNITY ASSISTANCE PROGRAM. PATIENT FINANCIAL SERVICE REPS CONSULT AND ADVISE SELF PAY PATIENTS ON THEIR OPTIONS FOR GOVERNMENT SPONSORED FINANCIAL ASSITANCE AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, AN OUTSIDE VENDOR CONTACTS ADMITTED SELF PAY PATIENTS AND DISCUSSES OPTIONS FOR GOVERNMENT SPONSORED FINANCIAL ASSISTANCE AND PROVIDES ASSISTANCE TO PATIENTS APPLYING FOR A SPECIFIC PROGRAM. OUR OUTSIDE VENDOR DIRECTS PATIENTS THAT DO NOT QUALITY FOR A GOVERNMENT SPONOSORED PROGRAM TO A HOSPITAL FINANCIAL SERVICE REPRESENTATIVE TO FOLLOW UP WITH AN APPLICATION FOR COMMUNITY ASSISTANCE. WE FURTHER USE AN "EARLY OUT" SELF PAY VENDOR THAT PROVIDES INFORMATION ON GOVERNMENT PROGRAMS AND THE HOSPITAL'S COMMUNITY ASSISTANCE PROGRAM. OUR SELF PAY VENDOR PROVIDES COMMUNITY ASSISTANCE APPLICATIONS TO PATIENTS WHEN AN APPLICATION IS REQUESTED AND MAKES REFERRALS FOR POSSIBLE APPLICATION TO GOVERNMENT SPONOSORED ASSISTANCE PROGRAMS. ALSO, A STATEMENT IS INCLUDED IN THE FIRST BILLING TO PATIENTS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | MARSHALL COUNTY, POPULATION 40,746, IS COMPRISED OF 13 INCORPORATED COMMUNITIES AND THEIR SURROUNDING AREAS. THE POPULATION IS SOMEWHAT CONCENTRATED IN THE CENTRAL CITY OF MARSHALLTOWN WHERE ABOUT 66% OF COUNTY RESIDENTS LIVE. THE COUNTY'S POPULATION HAS REMAINED STABLE OVER THE PAST 50 YEARS, HOWEVER, THE DEMOGRAPHICS OF THE POPULATION HAVE SHIFTED DRAMATICALLY IN THE PAST 15 YEARS. NEW IMMGRANTS RECRUITED TO THE COMMUNITY BY THE MEAT PACKING INDUSTRY HAVE DRIVEN THESE CHANGES. LARGE NUMBERS OF HISPANIC IMMIGRANTS HAVE LEFT THE SUB-MINIMUM WAGE EXISTENCE IN CENTRAL MEXICO TO TRAVEL TO THE AMERICAN MIDWEST FOR JOBS IN MEAT PACKING. THIS INDUSTRY IS THE LARGEST PRIVATE EMPLOYER IN MARSHALL COUNTY WITH PAY RANGING FROM $9 - $13 PER HOUR. THESE CHANGES HAVE RESULTED IN AN INCREASE IN THE NUMBER OF PEOPLE LIVING IN POVERTY AND AN UPSURGE IN THE NUMBER OF UNINSURED OR UNDERINSURED RESIDENTS. MARSHALL COUNTY IS DESIGNATED AS A HEALTH PROVIDER SHORTAGE AREA (HPSA). FURTHER, THE COUNTY HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED COMMUNITY (MUC) AND THE IMMIGRANT POPULATION HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION (MUP) DUE TO LANGUAGE AND CULTURAL BARRIERS IN ACCESSSING HEALTH CARE SERVICES. ACCORDING TO THE 2015 US CENSUS DATA, 20.7% OF THE MARSHALL COUNTY'S POPULATION IS OF HISPANIC OR LATINO ORIGIN COMPARED TO 5.7% IN THE STATE OF IOWA; 18.8% OF MARSHALL COUNTY'S POLUATION (AGE 5+) SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME COMPARED TO 7.4% IN THE STATE OF IOWA; 84.7% OF MARSHALL COUNTY RESDIENTS ARE HIGH SCHOOL GRADUATES COMAPRED TO 91.3% IN IOWA; 20.1% OF MARSHALL COUNTY POPULATION HAD A BACHELOR'S DEGREE OR HIGHER COMPARED TO 26.4% IN IOWA (2000); THE MEDIAN HOUSEHOLD INCOME IN 2010-2014 IN MARSHALL COUNTY WAS 52,354 COMPARED TO 52,716 IN IOWA; PERSONS LIVING BELOW POVERTY IN MARSHALL COUNTY WAS 13% COMPARED TO 12.2% IN IOWA. |
| PART VI, LINE 5: | CENTRAL IOWA HEALTHCARE IS A SOLE COMMUNITY HOSPITAL AND A RURAL REFERRAL CENTER BY CMS'S DEFINITIONS. THE HOSPITAL IS LOCATED IN A RURAL, MEDICALLY UNDERSERVED AREA AND IS THE ONLY HOSPITAL WITHIN A 30 MILE RADIUS. THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES AND CONTINUALLY IMPROVING SERVICES TO RESPOND TO HEALTH CARE NEEDS. THE HOSPITAL PROVIDES A 24 HOUR EMERGENCY DEPARTMENT, INCLUDING AMBULANCE COVERAGE, AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES, NOR CONTRACTORS, NOR FAMILY MEMBERS THEREOF AND ARE A BROAD CROSS SECTION OF COMMUNITY LEADERS. THE ORGANIZATION PROVIDES AN OPEN MEDICAL STAFF TO ALL QUALIFIED PHYSICIANS, SUBJECT TO THE NORMAL, EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, EMERGENCY DEPARTMENT, AND HEART CATHETERIZATION LAB. THE EXCLUSIVE CONTRACTS ARE NECESSARY TO ASSURE THAT THESE MUCH NEEDED SERVICES ARE PROVIDED IN THIS RURAL MEDICALLY UNDERSERVED COMMUNITY. ALL SURPLUS FUNDS ARE USED TO MEET AND TO RESPOND TO THE HEALTHCARE NEEDS OF THE COMMUNITIES THIS ORGANIZATION SERVES. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL COUNTY EMERGENCY MEDICAL SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 E MAIN STREET | AddressLine1Txt |
| City | MARSHALLTOWN | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50158 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 426004936 | RecipientEIN |
| IRC Section | MARSHALL COUNTY | IRCSectionDesc |
| Cash Grant | $5,609 | CashGrantAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION ISSUES FUNDS DIRECTLY TO THE RECIPIENT ORGANIZATION FOR USE AT ITS DISCRETION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| POLLY HINEMAN MD | ||||||||||||||
| FORMER TRUSTEE/PHYSICIAN | $168,997 | $0 | $0 | $0 | $1,050 | $0 | $8,450 | $0 | $1,324 | $0 | $179,821 | $0 | $0 | $0 |
| JOHN C HUGHES | ||||||||||||||
| PRESIDENT & CHIEF EXECUTIVE OFFICER | $267,823 | $0 | $0 | $0 | $8,684 | $0 | $13,601 | $0 | $18,844 | $0 | $308,952 | $0 | $0 | $0 |
| HILARY DOLBEE | ||||||||||||||
| FORMER V.P. OF FINANCE | $152,796 | $0 | $0 | $0 | $195 | $0 | $7,681 | $0 | $7,488 | $0 | $168,160 | $0 | $0 | $0 |
| LIZ ZUERCHER | ||||||||||||||
| FORMER V.P. OF ADMINISTRATION | $154,900 | $0 | $0 | $0 | $486 | $0 | $7,944 | $0 | $19,200 | $0 | $182,530 | $0 | $0 | $0 |
| SADIA ASHRAF-BENSON DO | ||||||||||||||
| PHYSICIAN | $234,342 | $0 | $0 | $0 | $25,363 | $0 | $12,967 | $0 | $1,692 | $0 | $274,364 | $0 | $0 | $0 |
| BONTE GBEMUDU MD | ||||||||||||||
| PHYSICIAN | $218,908 | $0 | $0 | $0 | $240 | $0 | $11,185 | $0 | $15,995 | $0 | $246,328 | $0 | $0 | $0 |
| JOHN MCCUNE MD | ||||||||||||||
| PHYSICIAN | $309,589 | $0 | $11,314 | $0 | $3,346 | $0 | $16,316 | $0 | $21,573 | $0 | $362,138 | $0 | $0 | $0 |
| RONALD TERRILL MD | ||||||||||||||
| PHYSICIAN | $229,560 | $0 | $0 | $0 | $4,724 | $0 | $11,718 | $0 | $16,034 | $0 | $262,036 | $0 | $0 | $0 |
| YARED VAZQUEZ MD | ||||||||||||||
| PHYSICIAN | $204,592 | $0 | $0 | $0 | $286 | $0 | $10,501 | $0 | $20,973 | $0 | $236,352 | $0 | $0 | $0 |
| ROBERT L DOWNEY | ||||||||||||||
| FORMER CHIEF FINANCIAL OFF | $0 | $0 | $0 | $0 | $201,246 | $0 | $0 | $0 | $12,501 | $0 | $213,747 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT OR CHANGE OF CONTROL PAYMENT IN TAX YEAR 2014: ROBERT L. DOWNEY - $197,431. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS IN THIS ENTITY SHALL BE BONA FIDE CITIZENS OF THE AREA SERVED BY THIS HOSPITAL WHO ARE AT LEAST 18 YEARS OF AGE AND WHO HAVE PAID THEIR ANNUAL DUES. |
| FORM 990, PART VI, SECTION A, LINE 7A | AN ANNUAL MEETING IS HELD IN WHICH THE AGENDA INCLUDES ELECTION OF TRUSTEES. PROXY VOTES MAY BE CAST BY ELIGIBLE MEMBERS WHO ARE UNABLE TO ATTEND THE MEETING. THE BOARD MEMBERSHIP SHALL INCLUDE MEMBERS FROM THE COMMUNITIES THAT ARE SERVED BY CENTRAL IOWA HEALTHCARE. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 AND ALL RELATED SCHEDULES AND SUPPLEMENTAL INFORMATION ARE EMAILED TO THE BOARD FOR A REVIEW PERIOD AND ALL QUESTIONS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY REQUIRES ANNUAL CERTIFICATION THAT EACH TRUSTEE HAS THE CONFLICT OF INTEREST POLICY, THAT THEY HAVE A COPY OF THE SECTION OF THE ORGANIZATIONAL BY-LAWS THAT DISCUSSES CONFLICTS OF INTEREST, AND THAT THEY AGREE TO COMPLY WITH THE POLICY. THE EXECUTIVE ASSISTANT TO THE PRESIDENT IS ASSIGNED TO ENSURE THAT ALL RECIPIENTS ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. THE DIRECTOR OF ACCOUNTING/FINANCE REVIEWS THE CONFLICT OF INTEREST QUESTIONNAIRES TO DETERMINE IF A CONFLICT DOES EXIST. IF A POTENTIAL CONFLICT IS DISCLOSED, THE INDIVIDUAL IS ALLOWED TO MAKE A PRESENTATION CONCERNING THE PROPOSED TRANSACTION BUT IS THEN ASKED TO LEAVE THE ROOM WHILE FURTHER DISCUSSION TAKES PLACE AND THE REST OF THE BOARD DETERMINES WHETHER OR NOT TO ENTER THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS WHO MEET MULTIPLE TIMES PER YEAR TO REVIEW THE IOWA HOSPITAL ASSOCIATION'S WAGE SURVEY DATA. THE COMMITTEE RECOMMENDS CHANGES BASED ON SURVEY COMPARISONS AND ANNUAL PERFORMANCE EVALUATIONS. THE RECOMMENDATIONS ARE PRESENTED TO THE FULL BOARD. NO INCREASES WERE GIVEN IN THE CURRENT YEAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | ER FEES: PROGRAM SERVICE EXPENSES 2,141,316. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,141,316. ANESTHESIA FEES: PROGRAM SERVICE EXPENSES 2,280,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,280,000. CARDIOLOGY FEES: PROGRAM SERVICE EXPENSES 220,620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 220,620. HOSPITALIST FEES: PROGRAM SERVICE EXPENSES 1,561,696. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,561,696. ENT FEES: PROGRAM SERVICE EXPENSES 75,568. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,568. ORTHO FEES: PROGRAM SERVICE EXPENSES 1,125,241. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,125,241. PEDIATRIC CALL FEES: PROGRAM SERVICE EXPENSES 175,200. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,200. SURGICAL CALL FEES: PROGRAM SERVICE EXPENSES 194,025. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 194,025. ORTHO CALL FEES: PROGRAM SERVICE EXPENSES 225,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 225,000. PATHOLOGY FEES: PROGRAM SERVICE EXPENSES 150,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 150,000. OTHER PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 154,225. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,225. CLINICAL ENGINEERING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 240,561. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,561. UTILIZATION REVIEW SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 189,967. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,967. PURCHASED SERVICE FEES: PROGRAM SERVICE EXPENSES 1,092,962. MANAGEMENT AND GENERAL EXPENSES 147,255. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,240,217. DIAG IMAGING SERVICE FEES: PROGRAM SERVICE EXPENSES 909,899. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 909,899. CATH LAB SERVICE FEES: PROGRAM SERVICE EXPENSES 80,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,841. LAB SERVICE FEES: PROGRAM SERVICE EXPENSES 88,249. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,249. BILLING SERVICE AND COLLECTION FEES: PROGRAM SERVICE EXPENSES 311,704. MANAGEMENT AND GENERAL EXPENSES 632,841. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 944,545. STAFFING SERVICE FEES: PROGRAM SERVICE EXPENSES 4,248,453. MANAGEMENT AND GENERAL EXPENSES 51,153. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,299,606. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NET ASSETS OF CENTRAL IOWA HEALTHCARE FOUNDATION -2,615. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. |
| FORM 990, PART VI, SECTION B, LINE 16B | WHILE CENTRAL IOWA HEALTHCARE DID NOT HAVE A WRITTEN POLICY OR PROCEDURE IN PLACE TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS IN THE FISCAL YEAR-ENDED OCTOBER 31, 2015, THE ORGANIZATION IS CURRENTLY DEVELOPING SUCH POLICIES AND PROCEDURES AND PLANS TO HAVE THEM IN PLACE PRIOR TO THE YEAR-ENDING OCTOBER 31, 2016. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL IOWA PHYSIO LLC | |||||||||||||
| 4714 GETTYSBURG ROAD | MECHANICSBURG | PA | 17055 | 364799633 | PHYSICAL THERAPY REHABILITATION | IA | CENTRAL IOWA HEALTHCARE | RELATED | $58,136 | $583,136 | 0 | 0 | 0.50000 |
| MARSHALLTOWN MOB 1 MANAGING MEMBER LLC | |||||||||||||
| 4706 BROADWAY SUITE 240 | KANSAS CITY | MO | 64112 | 464821701 | REAL ESTATE | DE | CENTRAL IOWA HEALTHCARE | RELATED | $195,768 | $3,695,768 | 0 | 0 | 0.63390 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CENTRAL IOWA PHYSIO LLC | ||
| B | $525,000 | FAIR MARKET VALUE |
| CENTRAL IOWA PHYSIO LLC | ||
| S | $400,000 | FAIR MARKET VALUE |