IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION (EIN 42-1411630)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349302704
- Schema version
- 2015v2.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T09:32:39-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421411630 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA PHYSICIANS CLINIC MEDICAL | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IOWA | BusinessNameControlTxt |
| Phone | 5154719200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8101 BIRCHWOOD COURT NO N | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH G SEASHORE | PersonNm |
| Person Title | EXECUTIVE VP/CFO | PersonTitleTxt |
| Phone | 5154719305 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITYPOINT CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID WILLIAMS MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8101 BIRCHWOOD COURT NO N | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $414,772,318 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNITYPOINT.ORG/CLINICS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 3734 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $1,050,331 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $81,220 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $63,556,827 | PYContributionsGrantsAmt |
| CY Contributions Grants | $80,081,798 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $301,350,776 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $320,682,749 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,812,974 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,142,437 | CYInvestmentIncomeAmt |
| PY Other Revenue | $9,583,336 | PYOtherRevenueAmt |
| CY Other Revenue | $8,425,062 | CYOtherRevenueAmt |
| PY Total Revenue | $376,303,913 | PYTotalRevenueAmt |
| CY Total Revenue | $411,332,046 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $22,005 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $17,821 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $266,149,767 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $304,334,688 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $116,356,031 | PYOtherExpensesAmt |
| CY Other Expenses | $115,555,269 | CYOtherExpensesAmt |
| PY Total Expenses | $382,527,803 | PYTotalExpensesAmt |
| CY Total Expenses | $419,907,778 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,223,890 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,575,732 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $136,214,503 | TotalAssetsBOYAmt |
| Total Assets EOY | $151,952,559 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $88,774,146 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $115,122,470 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $47,440,357 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $36,830,089 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $350,234,552 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $328,908,545 | RevenueAmt |
| Desc | HEALTH-CARE SERVICESIOWA PHYSICIANS CLINIC MEDICAL FOUNDATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE IOWA AND WESTERN ILLINOIS COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, REHABILITATION, SKILLED NURSING, MATERNAL/CHILD CARE, LABORATORY, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2015, IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION HAD 1,962,119 PATIENT ENCOUNTERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $28,431,416 | ExpenseAmt |
| Grant | $17,821 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $1,104,926 IN 2015. OFTENTIMES, IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $25,240,029 FOR 2015. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $26,344,955OTHER BENEFITS: IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONAL'S EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION COLLABORATES WITH OTHER HEALTH-CARE PROVIDERS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TOTAL OTHER BENEFITS REPORTED VALUE: $2,086,461 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $378,665,968 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3734 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEITH G SEASHORE EXEC VPCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5154719305 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8101 BIRCHWOOD COURT N | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH ANDERSON MD | ||||||||||
| BOARD SECRETARY | 40.00 | 1.00 | Yes (X) | Yes (X) | $335,307 | $0 | $29,799 | |||
| ANDRIA BARR DO | ||||||||||
| BOARD MEMBER | 40.00 | 1.00 | Yes (X) | $428,846 | $0 | $37,111 | ||||
| DAVID BOYER | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $15,921 | $0 | ||||
| KYLE CHRISTIASON MD | ||||||||||
| BOARD CHAIR | 40.00 | 1.00 | Yes (X) | Yes (X) | $316,447 | $5,000 | $37,771 | |||
| STAN DANIELSON MD | ||||||||||
| BOARD TREASURER | 40.00 | 1.00 | Yes (X) | Yes (X) | $433,046 | $0 | $63,919 | |||
| PAMELA DELAGARDELLE | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $530,644 | $105,628 | ||||
| RANDY EASTON | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $15,427 | $0 | ||||
| VENESSA MACRO | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KURT PITTNER | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $12,705 | $0 | ||||
| KAREN STUMPE | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICH WELLMAN | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEITH SEASHORE | ||||||||||
| EXEC VP & CFO | 40.00 | 0.00 | Yes (X) | $375,548 | $0 | $67,977 | ||||
| ALAN KAPLAN MD | ||||||||||
| CEO | 1.00 | 40.00 | Yes (X) | $0 | $899,181 | $186,036 | ||||
| RUSSELL ADAMS MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $385,208 | $0 | $24,161 | Yes (X) | ||||
| DANIEL ALLEN MD | ||||||||||
| REGIONAL VP MEDICAL DIRECTOR - CI | 40.00 | 0.00 | $362,941 | $0 | $32,873 | Yes (X) | ||||
| ENRIQUE BEDIA MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $659,665 | $0 | $38,200 | Yes (X) | ||||
| MICHAEL BERSTLER MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $290,901 | $0 | $26,713 | Yes (X) | ||||
| JASON COGDILL MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $383,511 | $0 | $43,196 | Yes (X) | ||||
| DOUGLAS DAWSON MD | ||||||||||
| PHYSICIAN | 40.00 | 1.00 | $461,119 | $0 | $16,128 | Yes (X) | ||||
| AMY FRANTA MD | ||||||||||
| PHYSICIAN | 1.00 | 40.00 | $0 | $620,488 | $38,093 | Yes (X) | ||||
| DANIEL GLASCOCK MD | ||||||||||
| REGIONAL VP MEDICAL DIRECTOR - WL | 40.00 | 1.00 | $333,166 | $0 | $37,522 | Yes (X) | ||||
| RICHARD HODGE MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $789,615 | $0 | $31,616 | Yes (X) | ||||
| AMR KAMHAWY MD | ||||||||||
| CHIEF MEDICAL INFORMATION OFFICER | 40.00 | 0.00 | $530,594 | $0 | $33,941 | Yes (X) | ||||
| KISHORE KARAMCHANDANI MD | ||||||||||
| PHYSICIAN | 1.00 | 40.00 | $0 | $746,448 | $14,024 | Yes (X) | ||||
| ERICK LAINE | ||||||||||
| EXEC VP/COO | 40.00 | 0.00 | $581,137 | $0 | $74,138 | Yes (X) | ||||
| TODD LANGAGER MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $473,076 | $0 | $41,501 | Yes (X) | ||||
| THERESA LEWIS | ||||||||||
| VP PRACTICE OPERATIONS | 40.00 | 0.00 | $293,649 | $0 | $34,353 | Yes (X) | ||||
| TIMOTHY MAYFIELD MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $468,756 | $0 | $41,963 | Yes (X) | ||||
| MICHELLE NIERMANN | ||||||||||
| SVP/COO VP CLINIC OPERATIONS | 1.00 | 40.00 | $0 | $442,406 | $79,114 | Yes (X) | ||||
| MARK REINERTSON MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $330,213 | $0 | $27,879 | Yes (X) | ||||
| MATTHEW ROMANIN | ||||||||||
| REGIONAL VP PRACTICE OPERATIONS - CI | 40.00 | 0.00 | $297,382 | $0 | $34,239 | Yes (X) | ||||
| JOHN ROOF MD | ||||||||||
| REGIONAL VP MEDICAL DIRECTOR - CR | 40.00 | 0.00 | $384,698 | $0 | $27,262 | Yes (X) | ||||
| LYNN STRUCK MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $472,287 | $0 | $28,322 | Yes (X) | ||||
| NATHAN FIERCE MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,207,794 | $0 | $34,874 | Yes (X) | ||||
| MARY HLAVIN MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $931,855 | $0 | $28,558 | Yes (X) | ||||
| TAUSEEF KHAN MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $906,549 | $0 | $34,385 | Yes (X) | ||||
| CRAIG STARK MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $758,453 | $0 | $35,369 | Yes (X) | ||||
| WARANGKHANA WONGBA MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $762,455 | $0 | $22,264 | Yes (X) | ||||
| MARK BARNHILL DO TO 1211 | ||||||||||
| FORMER CHIEF MEDICAL OFFICER | 0.00 | 40.00 | $0 | $300,808 | $16,917 | Yes (X) | ||||
| KIRK PETERSON MD TO 1214 | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $403,801 | $0 | $42,971 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,358,019 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,589,028 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,468,817 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 605 | 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 |
|---|---|---|---|---|---|
| EDGE COMMERCIAL LLC | |||||
| 2910 WESTOWN PKWY | WEST DES MOINES | IA | 50266 | PROPERTY MANAGEMENT | $1,840,677 |
| LAKEVIEW MEDICAL OFFICE BUILDING | |||||
| 5900 WESTOWN PKWY | WEST DES MOINES | IA | 50266 | PROPERTY MANAGEMENT | $1,227,471 |
| NUANCE COMMUNICATIONS INC | |||||
| P O BOX 2561 | CAROL STREAM | IL | 601322561 | TRANSCRIPTION | $952,988 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PHYSICIAN SERVICES | $686,336 |
| MDLIVE INC | |||||
| 13630 NW 8TH STREET SUITE 205 | SUNRISE | FL | 33325 | TELEMEDICINE | $663,733 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 75 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $80,026,935 | RelatedOrganizationsAmt |
| All Other Contributions | $54,863 | AllOtherContributionsAmt |
| Total Contributions | $80,081,798 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $289,352,101 | $289,352,101 | |
| MANAGEMENT, IT AND SUPPORT SERVIC | 561000 | $28,346,306 | $28,081,790 | $264,516 |
| MISCELLANEOUS REVENUE | 900099 | $1,820,771 | $1,820,771 | |
| RENTAL REVENUE | 531100 | $1,015,642 | $1,015,642 | |
| SUBS & JOINT VENTURES | 900099 | $147,929 | $147,929 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $320,682,749 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,121,267 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,675 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,119,592 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,452,495 | SecuritiesAmt |
| Other | $8,947 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,440,272 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,012,223 | SecuritiesAmt |
| Other | $8,947 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,021,170 | TotalRevenueColumnAmt |
| Exclusion | $1,021,170 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $4,214,902 | $3,758,265 | $255,696 | $200,941 |
| OTHER HEALTHCARE SVCS | 900099 | $4,210,160 | $3,680,041 | $530,119 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,425,062 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $411,332,046 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $327,858,214 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,050,331 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,341,703 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,821 | TotalAmt |
| Program Services | $17,821 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,217,694 | TotalAmt |
| Management And General | $10,217,694 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $831,434 | TotalAmt |
| Management And General | $831,434 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,236,357 | TotalAmt |
| Program Services | $238,641,453 | ProgramServicesAmt |
| Management And General | $10,594,904 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,058,814 | TotalAmt |
| Program Services | $8,673,729 | ProgramServicesAmt |
| Management And General | $385,085 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,084,091 | TotalAmt |
| Program Services | $21,145,308 | ProgramServicesAmt |
| Management And General | $938,783 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,906,298 | TotalAmt |
| Program Services | $12,357,658 | ProgramServicesAmt |
| Management And General | $548,640 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,884,910 | TotalAmt |
| Program Services | $16,774,206 | ProgramServicesAmt |
| Management And General | $7,110,704 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,036 | TotalAmt |
| Program Services | $262,778 | ProgramServicesAmt |
| Management And General | $81,258 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,260 | TotalAmt |
| Program Services | $6,636 | ProgramServicesAmt |
| Management And General | $665,624 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,283,707 | TotalAmt |
| Program Services | $10,226,505 | ProgramServicesAmt |
| Management And General | $4,057,202 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $595,656 | TotalAmt |
| Program Services | $133,356 | ProgramServicesAmt |
| Management And General | $462,300 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,538,682 | TotalAmt |
| Program Services | $2,817,629 | ProgramServicesAmt |
| Management And General | $721,053 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,760,488 | TotalAmt |
| Program Services | $1,760,488 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,317,210 | TotalAmt |
| Program Services | $25,061,502 | ProgramServicesAmt |
| Management And General | $1,255,708 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,384,708 | TotalAmt |
| Program Services | $740,146 | ProgramServicesAmt |
| Management And General | $644,562 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,227 | TotalAmt |
| Program Services | $299,459 | ProgramServicesAmt |
| Management And General | $66,768 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,525 | TotalAmt |
| Program Services | $435,525 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,369,350 | TotalAmt |
| Program Services | $6,007,241 | ProgramServicesAmt |
| Management And General | $362,109 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,618,847 | TotalAmt |
| Program Services | $4,548,187 | ProgramServicesAmt |
| Management And General | $70,660 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $30,243,225 | $30,245,435 | -$2,210 |
| MISCELLANEOUS EXPENSE | $644,192 | -$1,489,094 | $2,133,286 |
| INCOME TAXES | $96,246 | $96,246 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,907,778 | TotalAmt |
| Program Services | $378,665,968 | ProgramServicesAmt |
| Management And General | $41,241,810 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,943 | BOYAmt |
| EOY | $1,818,123 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $734,319 | BOYAmt |
| EOY | $681,710 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,772,968 | BOYAmt |
| EOY | $36,847,644 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,071,053 | BOYAmt |
| EOY | $7,816,149 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,677,258 | BOYAmt |
| EOY | $4,488,114 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,480 | BOYAmt |
| EOY | $2,626,354 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $69,444,439 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,528,347 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,855,121 | BOYAmt |
| EOY | $30,916,092 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,964,597 | BOYAmt |
| EOY | $50,363,862 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,002 | BOYAmt |
| EOY | $63,686 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,762 | BOYAmt |
| EOY | $30,937 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $16,299,888 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,214,503 | BOYAmt |
| EOY | $151,952,559 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,273,703 | BOYAmt |
| EOY | $36,067,737 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,946,705 | BOYAmt |
| EOY | $8,425,593 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,553,738 | BOYAmt |
| EOY | $70,629,140 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,774,146 | BOYAmt |
| EOY | $115,122,470 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,440,357 | BOYAmt |
| EOY | $36,818,982 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $11,107 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,440,357 | BOYAmt |
| EOY | $36,830,089 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,214,503 | BOYAmt |
| EOY | $151,952,559 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,575,732 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,045,643 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $11,107 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,623,345 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,317,530 | DepreciationAmt |
| Book Value | $18,305,815 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,440,080 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,210,817 | DepreciationAmt |
| Book Value | $9,229,263 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,381,014 | OtherCostOrOtherBasisAmt |
| Book Value | $3,381,014 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,916,092 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LONG-TERM DUE FROM AFFILIATE - PHYSICIAN RETENTION | Desc |
| Book Value | $16,299,888 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $16,299,888 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF INSURANCE RESERVE | $15,752,786 |
| LONG-TERM RETENTION INCENTIVES | $23,388,079 |
| DUE TO AFFILIATES | $29,808,413 |
| HEALTH AND WELFARE BENEFITS RESERVE | $1,612,924 |
| INCOME TAXES PAYABLE | $66,938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $70,629,140 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $329,199,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,045,643 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$2,045,643 | RevenueNotReportedAmt |
| Revenue Subtotal | $331,244,643 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $80,200 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $80,007,203 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $80,087,403 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $411,332,046 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $418,020,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $418,020,000 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $80,200 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $1,807,578 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,887,778 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $419,907,778 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2012. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REVENUES IN UNRESTRICTED FUND BALANCE 80,006,762. ROUNDING 441. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES IN UNRESTRICTED FUND BALANCE 1,807,469. ROUNDING 109. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (34 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH ANDERSON MD | ||||||||||||||
| BOARD SECRETARY | $307,202 | $0 | $18,405 | $0 | $9,700 | $0 | $12,924 | $0 | $16,875 | $0 | $365,106 | $0 | $0 | $0 |
| ANDRIA BARR DO | ||||||||||||||
| BOARD MEMBER | $407,702 | $0 | $20,000 | $0 | $1,144 | $0 | $13,769 | $0 | $23,342 | $0 | $465,957 | $0 | $0 | $0 |
| KYLE CHRISTIASON MD | ||||||||||||||
| BOARD CHAIR | $288,906 | $5,000 | $25,129 | $0 | $2,412 | $0 | $12,891 | $0 | $24,880 | $0 | $354,218 | $5,000 | $0 | $0 |
| STAN DANIELSON MD | ||||||||||||||
| BOARD TREASURER | $400,761 | $0 | $24,406 | $0 | $7,879 | $0 | $54,895 | $0 | $9,024 | $0 | $496,965 | $0 | $0 | $0 |
| PAMELA DELAGARDELLE | ||||||||||||||
| BOARD MEMBER | $0 | $383,807 | $0 | $101,028 | $0 | $45,809 | $0 | $87,277 | $0 | $18,351 | $0 | $636,272 | $0 | $0 |
| KEITH SEASHORE | ||||||||||||||
| EXEC VP & CFO | $273,959 | $0 | $68,400 | $0 | $33,189 | $0 | $44,735 | $0 | $23,242 | $0 | $443,525 | $0 | $0 | $0 |
| ALAN KAPLAN MD | ||||||||||||||
| CEO | $0 | $632,225 | $0 | $212,240 | $0 | $54,716 | $0 | $162,744 | $0 | $23,292 | $0 | $1,085,217 | $0 | $0 |
| RUSSELL ADAMS MD | ||||||||||||||
| PHYSICIAN | $360,808 | $0 | $23,750 | $0 | $650 | $0 | $11,794 | $0 | $12,367 | $0 | $409,369 | $0 | $0 | $0 |
| DANIEL ALLEN MD | ||||||||||||||
| REGIONAL VP MEDICAL DIRECTOR - CI | $321,560 | $0 | $39,246 | $0 | $2,135 | $0 | $12,711 | $0 | $20,162 | $0 | $395,814 | $0 | $0 | $0 |
| ENRIQUE BEDIA MD | ||||||||||||||
| PHYSICIAN | $637,918 | $0 | $20,000 | $0 | $1,747 | $0 | $9,504 | $0 | $28,696 | $0 | $697,865 | $0 | $0 | $0 |
| MICHAEL BERSTLER MD | ||||||||||||||
| PHYSICIAN | $273,796 | $0 | $11,835 | $0 | $5,270 | $0 | $12,344 | $0 | $14,369 | $0 | $317,614 | $0 | $0 | $0 |
| JASON COGDILL MD | ||||||||||||||
| PHYSICIAN | $342,679 | $0 | $39,805 | $0 | $1,027 | $0 | $12,181 | $0 | $31,015 | $0 | $426,707 | $0 | $0 | $0 |
| DOUGLAS DAWSON MD | ||||||||||||||
| PHYSICIAN | $429,288 | $0 | $25,838 | $0 | $5,993 | $0 | $13,350 | $0 | $2,778 | $0 | $477,247 | $0 | $0 | $0 |
| AMY FRANTA MD | ||||||||||||||
| PHYSICIAN | $0 | $543,896 | $0 | $2,000 | $0 | $74,592 | $0 | $10,600 | $0 | $27,493 | $0 | $658,581 | $0 | $0 |
| DANIEL GLASCOCK MD | ||||||||||||||
| REGIONAL VP MEDICAL DIRECTOR - WL | $300,292 | $0 | $31,571 | $0 | $1,303 | $0 | $13,181 | $0 | $24,341 | $0 | $370,688 | $0 | $0 | $0 |
| RICHARD HODGE MD | ||||||||||||||
| PHYSICIAN | $750,188 | $0 | $35,237 | $0 | $4,190 | $0 | $13,561 | $0 | $18,055 | $0 | $821,231 | $0 | $0 | $0 |
| AMR KAMHAWY MD | ||||||||||||||
| CHIEF MEDICAL INFORMATION OFFICER | $469,776 | $0 | $58,451 | $0 | $2,367 | $0 | $12,634 | $0 | $21,307 | $0 | $564,535 | $0 | $0 | $0 |
| KISHORE KARAMCHANDANI MD | ||||||||||||||
| PHYSICIAN | $0 | $734,601 | $0 | $0 | $0 | $11,847 | $0 | $6,500 | $0 | $7,524 | $0 | $760,472 | $0 | $0 |
| ERICK LAINE | ||||||||||||||
| EXEC VP/COO | $367,441 | $0 | $88,334 | $0 | $125,362 | $0 | $56,305 | $0 | $17,833 | $0 | $655,275 | $0 | $88,455 | $0 |
| TODD LANGAGER MD | ||||||||||||||
| PHYSICIAN | $469,328 | $0 | $0 | $0 | $3,748 | $0 | $13,250 | $0 | $28,251 | $0 | $514,577 | $0 | $0 | $0 |
| THERESA LEWIS | ||||||||||||||
| VP PRACTICE OPERATIONS | $251,489 | $0 | $33,392 | $0 | $8,768 | $0 | $13,211 | $0 | $21,142 | $0 | $328,002 | $0 | $0 | $0 |
| TIMOTHY MAYFIELD MD | ||||||||||||||
| PHYSICIAN | $452,539 | $0 | $15,169 | $0 | $1,048 | $0 | $13,109 | $0 | $28,854 | $0 | $510,719 | $0 | $0 | $0 |
| MICHELLE NIERMANN | ||||||||||||||
| SVP/COO VP CLINIC OPERATIONS | $0 | $326,829 | $0 | $82,408 | $0 | $33,169 | $0 | $60,280 | $0 | $18,834 | $0 | $521,520 | $0 | $0 |
| MARK REINERTSON MD | ||||||||||||||
| PHYSICIAN | $305,654 | $0 | $17,849 | $0 | $6,710 | $0 | $11,982 | $0 | $15,897 | $0 | $358,092 | $0 | $0 | $0 |
| MATTHEW ROMANIN | ||||||||||||||
| REGIONAL VP PRACTICE OPERATIONS - CI | $237,324 | $0 | $46,857 | $0 | $13,201 | $0 | $13,241 | $0 | $20,998 | $0 | $331,621 | $0 | $0 | $0 |
| JOHN ROOF MD | ||||||||||||||
| REGIONAL VP MEDICAL DIRECTOR - CR | $341,835 | $0 | $40,423 | $0 | $2,440 | $0 | $12,745 | $0 | $14,517 | $0 | $411,960 | $0 | $0 | $0 |
| LYNN STRUCK MD | ||||||||||||||
| PHYSICIAN | $457,559 | $0 | $12,013 | $0 | $2,715 | $0 | $12,915 | $0 | $15,407 | $0 | $500,609 | $0 | $0 | $0 |
| NATHAN FIERCE MD | ||||||||||||||
| PHYSICIAN | $1,175,985 | $0 | $30,760 | $0 | $1,049 | $0 | $13,250 | $0 | $21,624 | $0 | $1,242,668 | $0 | $0 | $0 |
| MARY HLAVIN MD | ||||||||||||||
| PHYSICIAN | $809,898 | $0 | $120,160 | $0 | $1,797 | $0 | $10,437 | $0 | $18,121 | $0 | $960,413 | $0 | $0 | $0 |
| TAUSEEF KHAN MD | ||||||||||||||
| PHYSICIAN | $905,450 | $0 | $0 | $0 | $1,099 | $0 | $13,250 | $0 | $21,135 | $0 | $940,934 | $0 | $0 | $0 |
| CRAIG STARK MD | ||||||||||||||
| PHYSICIAN | $634,739 | $0 | $0 | $0 | $123,714 | $0 | $13,250 | $0 | $22,119 | $0 | $793,822 | $0 | $0 | $0 |
| WARANGKHANA WONGBA MD | ||||||||||||||
| PHYSICIAN | $708,874 | $0 | $52,536 | $0 | $1,045 | $0 | $13,250 | $0 | $9,014 | $0 | $784,719 | $0 | $0 | $0 |
| MARK BARNHILL DO TO 1211 | ||||||||||||||
| FORMER CHIEF MEDICAL OFFICER | $0 | $27,815 | $0 | $34,763 | $0 | $238,230 | $0 | $4,553 | $0 | $12,364 | $0 | $317,725 | $0 | $0 |
| KIRK PETERSON MD TO 1214 | ||||||||||||||
| PHYSICIAN | $369,576 | $0 | $32,877 | $0 | $1,348 | $0 | $22,175 | $0 | $20,796 | $0 | $446,772 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | FIRST-CLASS OR CHARTER TRAVEL: CEO AND BOARD MEMBERS USE PRIVATE CHARTER FOR BUSINESS TRAVEL BETWEEN AFFILIATE CITIES AND FOR BOARD OF DIRECTOR MEETINGS. THIS TRAVEL IS FOR BUSINESS PURPOSES ONLY. NO FIRST CLASS COMMERCIAL TRAVEL IS REIMBURSED. |
| PART I, LINES 4A-B | SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: MARK BARNHILL $209,470. NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: RUSSELL ADAMS, MD ($1,006); DANIEL ALLEN, MD ($537); KENNETH ANDERSON, MD ($1,296); ENRIQUE BEDIA, MD ($616); MICHAEL BERSTLER, MD ($906); KYLE CHRISTIASON, MD ($359); STAN DANIELSON, MD $11,756; PAMELA DELAGARDELLE $74,027; DANIEL GLASCOCK, MD ($69); RICHARD HODGE, MD ($1,296); AMR KAMHAWY, MD ($616); ALAN KAPLAN, MD $149,494; ERICK LAINE $44,505; MICHELLE NIERMANN $47,030; KIRK PERTERSON, MD $8,925; MARK REINERTSON, MD ($1,268); JOHN ROOF, MD ($505); AND KEITH SEASHORE $33,454 AND LYNN STRUCK, MD ($616). NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: ERICK LAINE $88,455. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KAREN REINERTSON | |||
| FAMILY MEMBER OF KEY EMPLOYEE MARK REINERTSON, MD | $23,831 | EMPLOYMENT | 0 |
| MARGARET LEWIS | |||
| FAMILY MEMBER OF KEY EMPLOYEE THERESA LEWIS | $20,823 | EMPLOYMENT | 0 |
| SAMANTHA DANIELSON | |||
| FAMILY MEMBER OF BOARD MEMBER STAN DANIELSON, MD | $20,821 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINES 1A & 1B | CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. |
| FORM 990, PART VI, SECTION A, LINE 6 | IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER, IOWA HEALTH SYSTEM, HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, STRATEGIC PLANNING, BUSINESS PLANS, OPERATING AND/OR CAPITAL BUDGETS, SELECTION AND REMOVAL OF THE CEO, INCURRING INDEBTEDNESS, MANAGED CARE STRATEGY, TRANSFER OF ASSETS, TRANSFER, SALE OR CLOSURE OF ANY FACILITY OR DEPARTMENT, AND DIRECT THE TRANSFER OR SALE OF ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2015 FOR THE FOLLOWING INDIVIDUALS: PAMELA DELAGARDELLE; ALAN KAPLAN, MD; ERICK LAINE; MICHELLE NIERMANN; AND KEITH SEASHORE. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST OF IOWA HEALTH FOUNDATION 11,107. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (55 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| ALLEN COLLEGE | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421351526 | EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS | IA | 501(C)(3) | 170(B)(1) (A)(II) | ALLEN HEALTH SYSTEMS INC | 0 |
| ALLEN HEALTH SYSTEMS INC | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201924 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ALLEN MEMORIAL HOSPITAL CORPORATION | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 420698265 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ALLEN HEALTH SYSTEMS INC | 0 |
| ANAMOSA AREA AMBULANCE SERVICE | ||||||||||
| 101 GRANT WOOD DRIVE | ANAMOSA | IA | 52205 | 421466284 | PROVIDE AMBULANCE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'SJONES REGIONAL MEDICAL CENTER | 0 |
| BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC | ||||||||||
| 3251 WEST NINTH STREET | WATERLOO | IA | 50702 | 420733463 | MENTAL HEALTH CARE | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| CENTRAL IOWA HEALTH PROPERTIES CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421233759 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | CENTRAL IOWA HEALTH SYSTEM | 0 | |
| CENTRAL IOWA HEALTH SYSTEM | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421189791 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| CENTRAL IOWA HOSPITAL CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 420680452 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | CENTRAL IOWA HEALTH SYSTEM | 0 |
| DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC | ||||||||||
| 1415 WOODLAND AVE SUITE 130 | DES MOINES | IA | 50309 | 421412497 | COORDINATION OF MEDICAL EDUCATION PROGRAMS | IA | 501(C)(3) | 509(A)(3), TYPE III | 0 | |
| FINLEY TRI-STATES HEALTH GROUP INC | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 421307495 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER | ||||||||||
| 3820 HILLSIDE DRIVE | CEDAR FALLS | IA | 50613 | 421372380 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| HULT CENTER FOR HEALTHY LIVING INC | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 363510390 | HEALTH EDUCATION TO THE COMMUNITY | IL | 501(C)(3) | 170(B)(1) (A)(VI) | PROCTOR HOSPITAL | 0 |
| IOWA HEALTH FOUNDATION | ||||||||||
| 1415 WOODLAND AVE SUITE E-200 | DES MOINES | IA | 50309 | 421467682 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | CENTRAL IOWA HEALTH SYSTEM | 0 |
| IOWA HEALTH SYSTEM | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421435199 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | 0 | |
| IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION | ||||||||||
| 8101 BIRCHWOOD COURT | JOHNSTON | IA | 50131 | 421411630 | PRIMARY HEALTH CARE SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
| MEMORIAL FOUNDATION OF ALLEN HOSPITAL | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201138 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| MERITER FOUNDATION INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 237098688 | CHARITABLE FUNDRAISING | WI | 501(C)(3) | 170(B)(1) (A)(VI) | MERITER HEALTH SERVICES INC | 0 |
| MERITER HEALTH SERVICES INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391412318 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | WI | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| MERITER HOSPITAL INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 390806367 | HOSPITAL | WI | 501(C)(3) | 170(B)(1) (A)(III) | MERITER HEALTH SERVICES INC | 0 |
| MERITER MEDICAL GROUP INC | ||||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 050545222 | SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES | WI | 501(C)(3) | 509(A)(3), TYPE II | MERITER HOSPITAL INC | 0 |
| METHODIST HEALTH SERVICES CORPORATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111135 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| METHODIST MEDICAL CENTER FOUNDATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 510186460 | CHARITABLE FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 370661223 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST SERVICES INC | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111134 | OFFICE RENTAL | IL | 501(C)(3) | 509(A)(2) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| NELLIE R SHERWOOD TRUST | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 426061621 | PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY | IA | 501(C)(3) | 509(A)(3), TYPE I | ST LUKE'S METHODIST HOSPITAL | 0 |
| NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED | ||||||||||
| 720 KENYON DRIVE | FORT DODGE | IA | 50501 | 420937390 | MENTAL HEALTH CARE | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| NORTHWEST IOWA HOSPITAL CORPORATION | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421019872 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| PROCTOR HEALTH CARE INCORPORATED | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371133412 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 170(B)(1) (A)(III) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| PROCTOR HEALTH SYSTEMS | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 364147437 | PRIMARY HEALTH CARE SERVICES | IL | 501(C)(3) | 170(B)(1) (A)(III) | PROCTOR HEALTH CARE INCORPORATED | 0 |
| PROCTOR HOSPITAL | ||||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 370681540 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | PROCTOR HEALTH CARE INCORPORATED | 0 |
| SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 376181831 | FUND SELF-INSURANCE PLAN | IL | 501(C)(3) | 509(A)(3), TYPE I | METHODIST MEDICAL CENER OF ILLINOIS | 0 |
| SHARED MAGNETIC RESONANCE IMAGING FACILITY INC | ||||||||||
| 1104 JOHN NOLEN DRIVE | MADISON | WI | 53713 | 391534744 | MEDICAL TECHNOLOGY | WI | 501(C)(3) | 509(A)(3), TYPE I | 0 | |
| SIOUXLAND PACE INC | ||||||||||
| 313 COOK STREET | SIOUX CITY | IA | 51103 | 261120134 | ALL-INCLUSIVE CARE FOR THE ELDERLY | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH RESOURCES | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421059182 | OUTPATIENT CLINICS AND HEALTHCARE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH SYSTEM INC | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421294091 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S HEALTHCARE | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421487968 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S METHODIST HOSPITAL | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 420504780 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| ST LUKE'SJONES REGIONAL MEDICAL CENTER | ||||||||||
| 1795 HIGHWAY 64 EAST | ANAMOSA | IA | 52205 | 421487967 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| STL CARE COMPANY | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421276632 | IMPROVE PUBLIC HEALTH SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTHCARE | 0 |
| THE DUBUQUE VISITING NURSE ASSOCIATION | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680410 | PUBLIC HEALTH SERVICES/HOME CARE | IA | 501(C)(3) | 509(A)(2) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE FINLEY HOSPITAL | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680354 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363678909 | MENTAL HEALTH CARE | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRIMARK PHYSICIANS GROUP | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 453791448 | SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY BUILDING CORPORATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421376187 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | TRINITY HEALTH SYSTEMS INC | 0 | |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222381 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363321751 | CHARITABLE FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY HEALTH SYSTEMS INC | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222877 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY MEDICAL CENTER | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 362739299 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HEALTH SYSTEM | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363351952 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HOSPITAL AUXILIARY | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 426081474 | CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES | IA | 501(C)(3) | 509(A)(2) | TRINITY REGIONAL MEDICAL CENTER | 0 |
| TRINITY REGIONAL MEDICAL CENTER | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421009175 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| UNITY HEALTHCARE | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 420680337 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| UNITY HEALTHCARE FOUNDATION | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 421525031 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE I | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| UNITYPOINT AT HOME | ||||||||||
| 11333 AURORA AVENUE | URBANDALE | IA | 50322 | 421477471 | HOME HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 0 |
| UNITYPOINT HEALTH AT WORK | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 810872241 | EMPLOYER ONSITE MEDICAL SERVICES AND OCCUPATIONAL MEDICINE | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| ADVANCED IMAGING CENTER LLC | |||||||
| 615 VALLEY VIEW DRIVE | MOLINE | IL | 61265 | 364356301 | DIAGNOSTIC RADIOLOGY CENTER | IA | N/A |
| ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC | |||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 453237125 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC | |||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 273625869 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 453017991 | ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC | |||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 471608704 | SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| DUBUQUE ENDOSCOPY CENTER LC | |||||||
| 1515 DELHI STREET SUITE 500 | DUBUQUE | IA | 52001 | 201597161 | AMBULATORY SURGERY CENTER | IA | N/A |
| ENSEVA - HIAWATHA LLC | |||||||
| 755 METZGER DRIVE | HIAWATHA | IA | 52233 | 453437363 | COLLOCATION FACILITY | IA | N/A |
| FINLEY DEPT OF SURGERY CO-MGMT CO LLC | |||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 422808785 | SURGERY DEPARTMENT MANAGEMENT SERVICES | IA | N/A |
| HEALTH CARE AFFILIATES OF THE TRI-STATES LLC | |||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 421428503 | PROVIDE ACCESS TO LICENSED SOFTWARE | IA | N/A |
| IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 030482623 | OUTPATIENT DIAGNOSTIC IMAGING | IA | N/A |
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421511142 | GROUP PURCHASING | IA | N/A |
| LAKEVIEW SURGERY CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421516120 | SURGERY CENTER | IA | N/A |
| MERITER UW PHYSICIANS CONTRACTING COMPANY LLC | |||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391998819 | HEALTH SERVICES | WI | N/A |
| MISSISSIPPI VALLEY SLEEP DISORDER CENTER LC | |||||||
| 3400 DEXTER COURT | DAVENPORT | IA | 52807 | 421489697 | MEDICAL LABORATORY SERVICES | IA | N/A |
| MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||
| 221 NE GLEN OAK AVE | PEORIA | IL | 61636 | 461219459 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IL | N/A |
| MMCI SURGERY CO-MANAGEMENT COMPANY LLC | |||||||
| 221 NE GLEN OAK AVE | PEORIA | IL | 61636 | 471323385 | SURGERY MANAGEMENT & ADMINISTRATIVE SERVICES | IL | N/A |
| MR ASSOCIATES LLP | |||||||
| 1956 1ST AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421260463 | OWN AND OPERATE MR UNIT | IA | N/A |
| ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC | |||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421508092 | AMBULATORY SURGERY CENTER | IA | N/A |
| REGIONAL HEALTH PARTNERS LLC | |||||||
| 1258 W SOUTH ST | KEWANEE | IL | 61443 | 800899158 | AMBULATORY HEALTH CLINICS | IL | N/A |
| REHABILITATION THERAPY SERVICES LLC | |||||||
| 416 ST MARKS CT 110 | PEORIA | IL | 61603 | 810584193 | REHABILATION THERAPY | IL | N/A |
| SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC | |||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 455322324 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A |
| THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | |||||||
| 1075 FIRST AVENUE SE | CEDAR RAPIDS | IA | 52403 | 721550812 | AMBULATORY SURGERY CENTER. | IA | N/A |
| TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||
| 4500 UTICA RIDGE RD | BETTENDORF | IA | 52722 | 272562753 | ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES | IA | N/A |
| TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY LLC | |||||||
| 500 JOHN DEERE ROAD | MOLINE | IL | 61265 | 900953327 | ONCOLOGY MANAGEMENT SERVICES | IL | N/A |
| UNITYPOINT AT WORK LC | |||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 472181113 | OCCUPATIONAL MEDICINE | IA | N/A |
| UPHT-SCA HOLDINGS LLC | |||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 473564984 | AMBULATORY SURGERY CENTER INVESTMENT | DE | N/A |
| WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||
| 1660 60TH STREET | WEST DES MOINES | IA | 50266 | 271414600 | ORTHOPEDIC SERVICE LINES MANAGEMENT | IA | N/A |
| WEST LAKES SLEEP CENTER LLC | |||||||
| 5950 UNIVERSITY AVENUE SUITE 2 | WEST DES MOINES | IA | 50266 | 263193923 | SLEEP DISORDER DIAGNOSTIC TESTING FACILITY | IA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BELCREST SERVICES LTD | |||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371196307 | MEDICAL SERVICES | IL | N/A | C | 0 |
| BROADBAND INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 273819741 | INFORMATION TECHNOLOGY MGMT. | IA | N/A | C | 0 |
| DELHI POINT CONDO ASSOCIATION | |||||||||
| 350 N GRANDVIEW | DUBUQUE | IA | 52001 | 421467002 | REAL ESTATE MANAGEMENT | IA | N/A | C | 0 |
| HCP CORPORATION | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391177562 | REAL ESTATE RENTAL | WI | N/A | C | 0 |
| HEALTH PLUS INC | |||||||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | 371295532 | MANAGED CARE ADMINISTRATION | IL | N/A | C | 0 |
| HNC SERVICES | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 270987243 | FIBER OPTIC NETWORK SERVICES | IA | N/A | C | 0 |
| MEDIMORE INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421414390 | MANAGED CARE | IA | N/A | C | 0 |
| MERITER HEALTH ENTERPRISES INC | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391293620 | MANAGEMENT SERVICES | WI | N/A | C | 0 |
| MERITER MANAGEMENT SERVICES INC | |||||||||
| 202 SOUTH PARK STREET | MADISON | WI | 53715 | 391458235 | ADMINISTRATIVE SERVICES | WI | N/A | C | 0 |
| METHODIST HEALTH VENTURES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371140939 | PHARMACY/OFFICE STAFFING | IL | N/A | C | 0 |
| METHODIST PHYSICIAN SERVICES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 363858550 | MEDICAL SERVICES | IL | N/A | C | 0 |
| PRECEDENCE INC | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 371288604 | MANAGED MENTAL CARE | IA | N/A | C | 0 |
| PROVIDER RESOURCE MANAGEMENT INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371223550 | RESOURCE MANAGEMENT | IL | N/A | C | 0 |
| PHYSICIANS PLUS INSURANCE CORPORATION | |||||||||
| 2650 NOVATION PARKWAY SUITE 400 | MADISON | WI | 53713 | 391565691 | FEDERALLY QUALIFIED HMO | WI | N/A | C | 0 |
| RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC | |||||||||
| 700 E UNIVERSITY AVE | DES MOINES | IA | 50316 | 261271143 | SPECIALTY PHYSICIANS MEDICAL CARE | IA | N/A | C | 0 |
| STL HEALTH RESOURCES CO | |||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421193499 | PHYSICIAN OFFICE RENTAL | IA | N/A | C | 0 |
| TRINITY HEALTH ENTERPRISES INC | |||||||||
| 2701 17TH ST | ROCK ISLAND | IL | 61201 | 363320141 | RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY | IL | N/A | C | 0 |
| TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 363924720 | MANAGED HEALTH CARE | IA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | 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 |
|---|---|---|
| TRINITY BUILDING CORPORATION | ||
| J | $758,931 | BASED ON GAAP, CASH, AND/OR FMV. |
| CENTRAL IOWA HEALTH PROPERTIES CORPORATION | ||
| J | $1,144,401 | BASED ON GAAP, CASH, AND/OR FMV. |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PARTS I - IV: | FormAndLineReferenceDesc |
| Explanation | IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 32 HOSPITAL FACILITIES AND VARIOUS AMBULATORY SERVICE AND CLINIC LOCATIONS IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A). | ExplanationTxt |