NORTHWEST IOWA HOSPITAL CORPORATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST IOWA HOSPITAL CORPORATION (EIN 42-1019872)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349308939
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T15:37:21-06:00 | 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 | 421019872 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST IOWA HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 7122793500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2720 STONE PARK BLVD | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51104 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES L GOBELL | PersonNm |
| Person Title | VP/CFO | PersonTitleTxt |
| Phone | 7122793201 | PhoneNum |
| Signature | 2016-11-10 | 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 | ST LUKE'S REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LYNN WOLD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2720 STONE PARK BLVD | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $167,236,087 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNITYPOINT.ORG/SIOUXCITY | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE PEOPLE OF SIOUXLAND. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1824 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $23,025 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $6,039 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $901,771 | PYContributionsGrantsAmt |
| CY Contributions Grants | $881,081 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $146,320,484 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $157,104,333 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,017,736 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,466,869 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,441,757 | PYOtherRevenueAmt |
| CY Other Revenue | $3,299,148 | CYOtherRevenueAmt |
| PY Total Revenue | $152,681,748 | PYTotalRevenueAmt |
| CY Total Revenue | $163,751,431 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,219,934 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,246,101 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $70,985,130 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $85,116,649 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $75,968,349 | PYOtherExpensesAmt |
| CY Other Expenses | $71,921,119 | CYOtherExpensesAmt |
| PY Total Expenses | $148,173,413 | PYTotalExpensesAmt |
| CY Total Expenses | $158,283,869 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,508,335 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,467,562 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $209,455,800 | TotalAssetsBOYAmt |
| Total Assets EOY | $208,639,254 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $78,779,555 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $73,221,861 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $130,676,245 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $135,417,393 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF NORTHWEST IOWA HOSPITAL CORPORATION, D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER, IS TO IMPROVE THE HEALTH OF THE PEOPLE OF SIOUXLAND. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $122,050,334 | ExpenseAmt |
| Grant | $259,905 | GrantAmt |
| Revenue | $159,188,141 | RevenueAmt |
| Desc | HEALTH-CARE SERVICESNORTHWEST IOWA HOSPITAL CORPORATION D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER IS AN IMPORTANT ELEMENT OF THE HEALTH CARE DELIVERY SYSTEM THAT SIOUXLAND COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. NORTHWEST IOWA HOSPITAL CORPORATION 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, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, 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 ENDING DECEMBER 31, 2015, NORTHWEST IOWA HOSPITAL CORPORATION ADMITTED 10,954 PATIENTS. THE HOSPITAL HAD A TOTAL NUMBER OF 41,741 PATIENT DAYS. OUTPATIENT VISITS TOTALED 70,104 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 2,039. THERE WERE ALSO 29,795 EMERGENCY ROOM VISITS AND 2,059 BABIES DELIVERED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,238,877 | ExpenseAmt |
| Grant | $986,196 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: NORTHWEST IOWA HOSPITAL CORPORATION 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 $2,441,511 IN 2015. OFTENTIMES, NORTHWEST IOWA HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES OR SERVICES. NORTHWEST IOWA HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT SPONSORED HEALTH-CARE PROGRAMS. NORTHWEST IOWA HOSPITAL CORPORATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $7,388,221 FOR 2015. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE WAS $9,829,732. OTHER BENEFITS: NORTHWEST IOWA HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. NORTHWEST IOWA HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. NORTHWEST IOWA HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 8,659 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE WAS $2,409,144. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $134,289,211 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | 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 | 1824 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES L GOBELL VPCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7122793201 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2720 STONE PARK BLVD | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51104 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JAMES JENSEN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $35 | $0 | $0 | |||
| LYNN MILLS | |||||||||
| BOARD TREASURER | 1.00 | 1.00 | Yes (X) | $35 | $0 | $0 | Yes (X) | ||
| JON PEACOCK MD | |||||||||
| BOARD SECRETARY | 1.00 | 1.00 | Yes (X) | $3,647 | $0 | $0 | Yes (X) | ||
| KG SKIP PERLEY | |||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | $35 | $0 | $0 | Yes (X) | ||
| STEVE SHOOK MD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $3,647 | $0 | $0 | |||
| GARRETT SMITH | |||||||||
| BOARD VICE CHAIR | 1.00 | 1.00 | Yes (X) | $35 | $0 | $0 | Yes (X) | ||
| RICH WALLER | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $35 | $0 | $0 | |||
| LEAH GLASGO | |||||||||
| VP/CLINICAL OPERATIONS | 40.00 | 0.00 | $258,736 | $0 | $42,319 | Yes (X) | |||
| JAMES GOBELL | |||||||||
| VP/CFO | 40.00 | 0.00 | $344,949 | $0 | $80,963 | Yes (X) | |||
| RICHARD HILDEBRAND MD | |||||||||
| VP/MEDICAL AFFAIRS | 40.00 | 0.00 | $613,188 | $0 | $15,334 | Yes (X) | |||
| CHAD MARKHAM | |||||||||
| VP/CLINIC & NETWORK DEVELOPMENT | 40.00 | 0.00 | $228,101 | $0 | $48,505 | Yes (X) | |||
| PRISCILLA STOKES | |||||||||
| VP/PATIENT CARE | 40.00 | 0.00 | $201,433 | $0 | $22,125 | Yes (X) | |||
| PETER THOREEN | |||||||||
| PRESIDENT/CEO | 40.00 | 0.00 | $506,110 | $0 | $239,270 | Yes (X) | |||
| SUSAN UNGER | |||||||||
| VP FUNDRAISING DEVELOPMENT | 40.00 | 0.00 | $177,351 | $0 | $15,776 | Yes (X) | |||
| LYNN WOLD VPCOO TO 0515 | |||||||||
| PRESIDENT/CEO (FR 06/15) | 40.00 | 0.00 | $381,162 | $0 | $94,364 | Yes (X) | |||
| ALFRED FLEMING MD | |||||||||
| PHYSICIAN | 40.00 | 1.00 | $573,559 | $0 | $33,136 | Yes (X) | |||
| JITENDRAKUMAR GUPTAMD | |||||||||
| PHYSICIAN | 20.00 | 20.00 | $533,467 | $179,208 | $36,479 | Yes (X) | |||
| FADY JABRE MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $550,561 | $0 | $33,628 | Yes (X) | |||
| LUIS LEBREDO MD | |||||||||
| PHYSICIAN | 20.00 | 20.00 | $502,477 | $197,395 | $39,633 | Yes (X) | |||
| DOUGLAS MARTIN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $548,918 | $0 | $38,232 | Yes (X) | |||
| MARK JOHNSON TO 1211 | |||||||||
| FORMER VP/CFO | 0.00 | 40.00 | $0 | $1,069,029 | $198,116 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,427,481 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,445,632 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $937,880 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 71 | 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 |
|---|---|---|---|---|---|
| CARDIOVASCULAR ASSOC PC | |||||
| PO BOX 3128 | SIOUX CITY | IA | 51102 | CONTRACT PHYSICIAN SERVICES | $4,516,507 |
| ARAMARK MANAGEMENT SERVICES | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | MANAGEMENT SERVICES | $1,708,109 |
| SIOUXLAND HOSPITALISTS PLC | |||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | MEDICAL SERVICES | $1,111,308 |
| WA KLINGER | |||||
| 2015 7TH STREET | SIOUX CITY | IA | 51101 | MEDICAL SERVICES | $1,006,530 |
| CASSLING | |||||
| 13808 F ST | OMAHA | NE | 68137 | MEDICAL SERVICES | $687,868 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 72 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $476,010 | RelatedOrganizationsAmt |
| All Other Contributions | $405,071 | AllOtherContributionsAmt |
| Total Contributions | $881,081 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $150,535,401 | $150,535,401 |
| EDUCATION & RESEARCH | 900099 | $3,176,276 | $3,176,276 |
| SUBS & JOINT VENTURES | 900099 | $2,327,332 | $2,327,332 |
| MISCELLANEOUS REVENUE | 900099 | $573,395 | $573,395 |
| RENTAL INCOME | 531110 | $268,850 | $268,850 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $223,079 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $222,721 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $358 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $157,104,333 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,496,327 | TotalRevenueColumnAmt |
| Exclusion | $1,496,327 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,076,320 | SecuritiesAmt |
| Other | $130,296 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,149,616 | SecuritiesAmt |
| Other | $86,458 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $926,704 | SecuritiesAmt |
| Other | $43,838 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $970,542 | TotalRevenueColumnAmt |
| Exclusion | $970,542 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $322,102 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $248,582 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,520 | TotalRevenueColumnAmt |
| Exclusion | $73,520 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $2,107,191 | $2,084,166 | $23,025 | |
| CAFETERIA/FOOD SVCS | 722210 | $1,118,437 | $1,118,437 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,225,628 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,751,431 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $159,188,141 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $23,025 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,659,184 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,233,750 | TotalAmt |
| Program Services | $1,233,750 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,351 | TotalAmt |
| Program Services | $12,351 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,121,537 | TotalAmt |
| Management And General | $2,121,537 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,675 | TotalAmt |
| Management And General | $186,675 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,822,208 | TotalAmt |
| Program Services | $59,320,078 | ProgramServicesAmt |
| Management And General | $8,502,130 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,496,722 | TotalAmt |
| Program Services | $2,183,662 | ProgramServicesAmt |
| Management And General | $313,060 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,601,582 | TotalAmt |
| Program Services | $7,522,592 | ProgramServicesAmt |
| Management And General | $1,078,990 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,887,925 | TotalAmt |
| Program Services | $3,400,388 | ProgramServicesAmt |
| Management And General | $487,537 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,631,227 | TotalAmt |
| Program Services | $8,314,173 | ProgramServicesAmt |
| Management And General | $6,317,054 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,114 | TotalAmt |
| Management And General | $355,114 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500 | TotalAmt |
| Program Services | $1,500 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $583,742 | TotalAmt |
| Program Services | $336,233 | ProgramServicesAmt |
| Management And General | $247,509 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,926,545 | TotalAmt |
| Program Services | $7,408,584 | ProgramServicesAmt |
| Management And General | $1,517,961 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794,889 | TotalAmt |
| Program Services | $277,813 | ProgramServicesAmt |
| Management And General | $517,076 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,854,968 | TotalAmt |
| Program Services | $3,217,528 | ProgramServicesAmt |
| Management And General | $637,440 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$589,765 | TotalAmt |
| Program Services | -$589,765 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,553,705 | TotalAmt |
| Program Services | $5,871,591 | ProgramServicesAmt |
| Management And General | $682,114 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,707 | TotalAmt |
| Program Services | $206,488 | ProgramServicesAmt |
| Management And General | $168,219 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,823 | TotalAmt |
| Program Services | $126,997 | ProgramServicesAmt |
| Management And General | $26,826 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,339,945 | TotalAmt |
| Program Services | $3,339,945 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,763,182 | TotalAmt |
| Program Services | $7,703,108 | ProgramServicesAmt |
| Management And General | $60,074 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,778 | TotalAmt |
| Program Services | $79,252 | ProgramServicesAmt |
| Management And General | $344,526 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $24,229,994 | $24,080,640 | $149,354 |
| MISCELLANEOUS EXPENSE | $351,943 | $242,223 | $109,720 |
| BAD DEBT EXPENSE | $169,443 | $169,443 | |
| INCOME TAXES | $2,379 | $80 | $2,299 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,283,869 | TotalAmt |
| Program Services | $134,289,211 | ProgramServicesAmt |
| Management And General | $23,994,658 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,020 | BOYAmt |
| EOY | $952,317 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$887,757 | BOYAmt |
| EOY | -$1,035,505 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,710,452 | BOYAmt |
| EOY | $23,046,251 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,541,406 | BOYAmt |
| EOY | $54,716,570 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,582,754 | BOYAmt |
| EOY | $4,147,189 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $499,078 | BOYAmt |
| EOY | $726,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $194,588,881 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $129,226,790 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,377,000 | BOYAmt |
| EOY | $65,362,091 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,574,105 | BOYAmt |
| EOY | $53,050,288 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,558,742 | BOYAmt |
| EOY | $7,673,128 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,455,800 | BOYAmt |
| EOY | $208,639,254 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,826,635 | BOYAmt |
| EOY | $10,911,162 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,307,338 | BOYAmt |
| EOY | $2,268,265 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $745,960 | BOYAmt |
| EOY | $734,656 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,505,337 | BOYAmt |
| EOY | $1,608,359 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,394,285 | BOYAmt |
| EOY | $57,699,419 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,779,555 | BOYAmt |
| EOY | $73,221,861 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,243,544 | BOYAmt |
| EOY | $130,761,518 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,808,864 | BOYAmt |
| EOY | $3,038,522 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,623,837 | BOYAmt |
| EOY | $1,617,353 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,676,245 | BOYAmt |
| EOY | $135,417,393 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,455,800 | BOYAmt |
| EOY | $208,639,254 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,467,562 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$879,559 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $2,098 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $151,047 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $43,726,995 | BeginningYearBalanceAmt |
| Contributions | $117,132 | ContributionsAmt |
| Investment Earnings Or Losses | $319,137 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,603 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $106,580 | AdministrativeExpensesAmt |
| End Year Balance | $44,055,081 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $44,032,288 | BeginningYearBalanceAmt |
| Contributions | $34,312 | ContributionsAmt |
| Investment Earnings Or Losses | $3,238,843 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,505,294 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $73,154 | AdministrativeExpensesAmt |
| End Year Balance | $43,726,995 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $44,271,700 | BeginningYearBalanceAmt |
| Contributions | $3,157,156 | ContributionsAmt |
| Investment Earnings Or Losses | $5,722,694 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,012,351 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1 | OtherExpendituresAmt |
| Administrative Expenses | $106,910 | AdministrativeExpensesAmt |
| End Year Balance | $44,032,288 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $37,872,570 | BeginningYearBalanceAmt |
| Contributions | $2,529,250 | ContributionsAmt |
| Investment Earnings Or Losses | $3,954,660 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,165 | GrantsOrScholarshipsAmt |
| Other Expenditures | $8 | OtherExpendituresAmt |
| Administrative Expenses | $80,606 | AdministrativeExpensesAmt |
| End Year Balance | $44,271,700 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $37,780,619 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $209,844 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,060 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $115,833 | AdministrativeExpensesAmt |
| End Year Balance | $37,872,570 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.89430 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.03670 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.06900 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,533,665 | OtherCostOrOtherBasisAmt |
| Book Value | $5,533,665 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,570,796 | OtherCostOrOtherBasisAmt |
| Depreciation | $70,659,149 | DepreciationAmt |
| Book Value | $43,911,647 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,218,531 | OtherCostOrOtherBasisAmt |
| Depreciation | $663,796 | DepreciationAmt |
| Book Value | $554,735 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $67,594,741 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,925,345 | DepreciationAmt |
| Book Value | $12,669,396 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,671,148 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,978,500 | DepreciationAmt |
| Book Value | $2,692,648 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $65,362,091 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $1,132,281 |
| ASBESTOS REMOVAL LIABILITY | $2,971,470 |
| SELF-INSURANCE RESERVE | $2,269,554 |
| LONG-TERM RETENTION INCENTIVES | $2,036,282 |
| IOWA HEALTH SYSTEM NOTE PAYABLE | $48,457,581 |
| HEALTH AND WELFARE BENEFITS RESERVE | $832,251 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $57,699,419 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $162,225,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$879,559 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $245,948 | OtherRevenueAmt |
| Revenue Not Reported | -$633,611 | RevenueNotReportedAmt |
| Revenue Subtotal | $162,858,611 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $121,800 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $771,020 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $892,820 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $163,751,431 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $157,189,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $245,948 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $245,948 | ExpensesNotReportedAmt |
| Expenses Subtotal | $156,943,052 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $121,800 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $1,219,017 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,340,817 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $158,283,869 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. |
| 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 2D - OTHER ADJUSTMENTS: | GIFT SHOP EXPENSES 245,948. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATE 476,010. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 220,628. REVENUES IN UNRESTRICTED FUND BALANCE 73,730. ROUNDING 652. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | GIFT SHOP EXPENSES 245,948. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATE 476,010. EXPENSES IN TEMPORARILY RESTRICTED FUND BALANCE 1,603. EXPENSES IN UNRESTRICTED FUND BALANCE 741,099. ROUNDING 305. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $2,441,511 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,441,511 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01540 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,081,794 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,693,573 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,388,221 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04670 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,523,305 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,693,573 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,829,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06210 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $827,858 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $827,858 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,330,312 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,925,872 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $404,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $617,942 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $482,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $135,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,080,924 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,039,354 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,041,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,857,036 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,447,892 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,409,144 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01530 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,380,341 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,141,465 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,238,876 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07740 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,062,793 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $38,653,944 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $39,286,787 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$632,843 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 PIERCE STREET SAME DAY SURGERY LC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | AMBULATORY SURGERY CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.05500 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.44500 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | ST LUKE'S REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2720 STONEPARK BLVD | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UNITYPOINT.ORG/SIOUXCITY | WebsiteAddressTxt |
| State License | 970180H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S REGIONAL MEDICAL CENTER | 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.UNITYPOINT.ORG/SIOUXCITY | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.UNITYPOINT.ORG/SIOUXCITY/DISCOUNTS-AND-FINANCIAL-ASSISTANCE.ASP | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.UNITYPOINT.ORG/SIOUXCITY/DISCOUNTS-AND-FINANCIAL-ASSISTANCE.ASP | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| 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 |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. LUKE'S REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 5: IN CONDUCTING UNITYPOINT HEALTH - ST. LUKE'S CHNA, ADDITIONAL INPUT WAS TAKEN FROM PERSONS WHO WITH A RANGE OF KNOWLEDGE ABOUT ISSUES WITHIN THE COMMUNITY. THIS INCLUDED THE SIOUX CITY COMMUNITY SCHOOLS; THE YMCA, LOCATED IN SOUTH SIOUX CITY, NEBRASKA WITH REACH INTO SIOUX CITY, IOWA; SIOUXLAND DISTRICT HEALTH; AND SIOUXLAND MENTAL HEALTH CENTER. INDIVIDUALS THROUGHOUT THE HOSPITAL ALSO SERVE ON NON-PROFIT ORGANIZATIONS THAT SERVE THE SIOUX CITY AND SIOUXLAND COMMUNITY.WORKING TOGETHER THROUGH A SERIES OF MEETINGS, THIS GROUP WAS ABLE TO REVIEW THE DATA AND NOTE DEFINITIONS OR ADDITIONAL CHANGES REQUIRED. |
| ST. LUKE'S REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 6A: MERCY MEDICAL CENTER - SIOUX CITY |
| ST. LUKE'S REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 11: SEVERAL NEEDS OUTLINED IN THE ASSESSMENT HAVE NOT BEEN ADDRESSED IN THIS PLAN. IN INITIAL DISCUSSION AND SUBSEQUENT PRIORITIZATION, ST. LUKE'S CONSIDERED THE LEVEL TO WHICH SOME NEEDS WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUT THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. THE FOLLOWING OUTLINES WHY SOME OF THE NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT ARE NOT ADDRESSED. * TEEN (AGE 15-19) BIRTH RATES NEED ADDRESSED BY: COUNTY HEALTH DEPARTMENTS, LUTHERAN FAMILY SERVICES, PLANNED PARENTHOOD, COMMUNITY HEALTHCARE PROVIDERS * DENTAL NEEDS NEED ADDRESSED BY: SIOUXLAND COMMUNITY HEALTH CENTER, COMMUNITY DENTAL CARE PROVIDERS * NEED FOR PRIMARY CARE PROVIDERS NEED ADDRESSED BY: COMMUNITY HEALTHCARE PROVIDERS * HIGH NUMBER OF UNINSURED ADULTS UNDER AGE 65 NEED ADDRESSED BY: STATE HEALTH DEPARTMENTS, MISSION HEALTH, COMMUNITY HEALTHCARE PROVIDERS * ALCOHOL AND OTHER SUBSTANCE ABUSE NEED ADDRESSED BY: SIOUXLAND CARES, COUNTY HEALTH DEPARTMENTS, TREATMENT CENTERS, HEALTHCARE PROVIDERS * LACK OF RESOURCES FOR PARENTS TO MAKE INFORMED DECISIONS ON NUTRITION AND EXERCISE, CHILDHOOD ILLNESS, PARENTING SKILLS NEED ADDRESSED BY: LOCAL FAMILY RESOURCE CENTERS, LOCAL HEALTHCARE PROVIDERS * SEXUALLY TRANSMITTED DISEASES NEED ADDRESSED BY: COUNTY HEALTH DEPARTMENTS, PLANNED PARENTHOOD, COMMUNITY HEALTHCARE PROVIDERS * ADULT SMOKING NEED ADDRESSED BY: TOBACCO FREE SIOUXLAND, MAYOR'S YOUTH COMMISSION, COUNTY HEALTH DEPARTMENTS, COMMUNITY HEALTHCARE PROVIDERSWHILE NOT ADDRESSED WITHIN ST. LUKE'S PLAN, ST. LUKE'S WILL CONTINUE TO PLAY A LEADING ROLE IN ADDRESSING THE HEALTH NEEDS OF THOSE WITHIN OUR COMMUNITY. |
| ST. LUKE'S REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE U.S. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM, FAMILY INVESTMENT PROGRAM, BARNABAS UPLIFT, MISSION HEALTH, AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - PIERCE STREET SAME DAY SURGERY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2730 PIERCE STREET | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | FREESTANDING OUTPATIENT SURGERY CENTER (JOINT VENTURE) | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | NORTHWEST IOWA HOSPITAL CORPORATION'S D/B/A/ ST. LUKE'S REGIONAL MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 169,443. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS AFFECTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. AS SUCH, NORTHWEST IOWA HOSPITAL CORPORATION D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER (ST. LUKE'S) SUPPORTS AND CONTRIBUTES TO COMMUNITY ORGANIZATIONS, EVENTS, AND PROGRAMS SUCH AS THE LOCAL CHAMBER, SIOUX CITY GROWTH ORGANIZATION, AND OTHER ECONOMIC DEVELOPMENT ACTIVITIES. ST. LUKE'S ALSO CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF SIOUXLAND ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER LOCAL, NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL-BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH. ACCESS TO HEALTHY FOOD IS CRITICAL FOR GOOD HEALTH IS ONE EXAMPLE. ST. LUKE'S WORKS WITH A NONPROFIT ORGANIZATION TO HELP FUND A LOCAL FARMER'S MARKET. THE MARKET OFFERS FARM-FRESH FOOD TO THE COMMUNITY, INCLUDING EBT PARTICIPANTS.WORKING THROUGHOUT THE COMMUNITY IS ALSO IMPORTANT IN DELIVERING COMMUNITY HEALTH. ST. LUKE'S REGIONAL MEDICAL CENTER ALONG WITH OTHER HEALTHCARE AND MENTAL HEALTH AGENCIES MEET TO ASSESS AND PLAN FOR IMPROVED ACCESS AND SERVICES FOR PATIENTS WITH MENTAL ILLNESS; MOST OF WHOM ARE UNDERSERVED. HEALTHY SIOUXLAND INITIATIVE IS ANOTHER COLLABORATIVE GROUP ST. LUKE'S PARTICIPATES IN WITH OTHER HEALTH PROVIDERS AND SOCIAL SERVICE ORGANIZATIONS TO HELP MEET THE COMMUNITY'S HEALTH NEEDS. IN ADDITION, ST. LUKE'S IS ACTIVELY INVOLVED WITH SIOUXLAND COMMUNITY HEALTH CENTER TO RESPOND TO THE UNMET HEALTH CARE NEEDS AMONG THE UNDERSERVED IN THE COMMUNITY. WITH THE GOALS OF INCREASED AWARENESS AND INCREASED NUMBER OF PARTICIPANTS THROUGHOUT THE TRI-STATE AREA, ST. LUKE'S WORKS WITH OTHER HEALTH ORGANIZATIONS TO PROMOTE COLORECTAL CANCER AND MAMMOGRAPHY SCREENINGS.ST. LUKE'S EMPLOYEES, AND IN PARTICULAR ST. LUKE'S LEADERSHIP, ARE ACTIVE IN VOLUNTEERISM FOR NON-PROFIT ORGANIZATIONS, FROM SUPPORT TO LEADERSHIP ROLES. THIS ALLOWS EMPLOYEES TO USE THEIR HEALTHCARE EDUCATION AND EXPERTISE TO IMPACT THE COMMUNITY'S OVERALL HEALTH STATUS. ST. LUKE'S EMPLOYEES ARE PROACTIVE IN EDUCATING THE PEOPLE WE SERVE ABOUT PERTINENT HEALTH INFORMATION THROUGH PUBLIC HEALTH CLASSES, PROFESSIONAL HEALTH EDUCATION PROGRAMS AND PARTICIPATION IN HEALTH FAIRS ACROSS THE TRI-STATE AREA. THE HOSPITAL'S WEBSITE AT WWW.UNITYPOINT.ORG/SIOUXCITY ALSO CONTAINS AN UP-TO-DATE LISTING OF PROGRAMS AND SCREENINGS AS WELL AS PERTINENT HEALTH INFORMATION TO EDUCATE CONSUMERS ABOUT SYMPTOMS, TREATMENT AND HEALTHCARE OPTIONS THEY HAVE IN SIOUXLAND. BY SUPPORTING THE COMMUNITY AND OTHER NON-PROFIT ORGANIZATIONS, ST. LUKE'S IS ABLE TO MOVE ONE STEP CLOSER TO FULFILLING ITS MISSION TO IMPROVE THE HEALTH OF THE PEOPLE OF SIOUXLAND. |
| PART III, LINE 4: | THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR NIHC. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. |
| PART III, LINE 8: | AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE AND REVENUE.THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. |
| PART III, LINE 9B: | AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. |
| LINE 16 A | WWW.UNITYPOINT.ORG/SIOUXCITY/DISCOUNTS-AND-FINANCIAL-ASSISTANCE.ASP |
| PART VI, LINE 2: | NORTHWEST IOWA HOSPITAL CORPORATION D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER (ST. LUKE'S) CONTINUALLY WORKS WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY AND THEN ENGAGES IN PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. SIOUXLAND DISTRICT HEALTH, LOCATED IN SIOUX CITY, ASSESSES THE COMMUNITY'S HEALTHCARE NEEDS AT LEAST ONCE EVERY FIVE YEARS. THROUGH A PLANNED AND ORGANIZED EFFORT, SIOUXLAND DISTRICT HEALTH DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES AND SHARES THAT INFORMATION THROUGH A COMPREHENSIVE REPORT TO THE COMMUNITY. IN COLLABORATION WITH THIS AGENCY, ST. LUKE'S UTILIZES THIS INFORMATION TO MONITOR LOCAL HEALTH, ENSURING THE HOSPITAL'S PROGRAMS, SERVICES AND HEALTH EDUCATION SUPPORTS PRIORITIES IDENTIFIED BY SIOUXLAND DISTRICT HEALTH. ST. LUKE'S ALSO PARTICIPATES IN HEALTHY SIOUXLAND INITIATIVE, A COLLECTION OF PUBLIC HEALTH PARTNERS THAT CONVENES MONTHLY, AND OTHER COMMUNITY HEALTH COLLABORATIONS, DESIGNED TO BUILD PARTNERSHIPS AMONG COMMUNITY HEALTHCARE ORGANIZATIONS TO BUILD A HEALTHY AND SAFE COMMUNITY. UNITED WAY IS ANOTHER PROGRAM ST. LUKE'S PARTICIPATES IN THROUGH THE UNITED WAY COMMUNITY IMPACT TEAMS. THIS GROUP ACTIVELY ADDRESSES NEED AND STRATEGIES ASSOCIATED WITH HEALTH. MORE SPECIFICALLY, THE SOCIAL DETERMINANTS OF HEALTH AND HOW TO IMPACT THEM IN THE EFFORT TO RAISE COMMUNITY HEALTH STATUS IS THE FOCUS OF THIS GROUP. THIS WIDE BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR ST. LUKE'S TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE EFFORTS, ST. LUKE'S CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS ALSO WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATIONS THEY AFFECT. |
| PART VI, LINE 3: | NORTHWEST IOWA HOSPITAL CORPORATION D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER (ST. LUKE'S) CARES FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. TO ACCOMPLISH THIS, ST. LUKE'S PROVIDES EFFECTIVE COMMUNICATIONS FOR PATIENTS REGARDING THEIR HOSPITAL BILLS, MAKES EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS, AND OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS.ST. LUKE'S COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS BY PLACING SIGNAGE AND EDUCATIONAL INFORMATION IN HIGH TRAFFIC AREAS OF THE HOSPITAL AND ITS CAMPUS INCLUDING ADMITTING, EMERGENCY AND OUTPATIENT AREAS AND PROVIDER OFFICES. IN ADDITION, DETAILED INFORMATION ABOUT ST. LUKE'S FINANCIAL ASSISTANCE PROGRAMS INCLUDING CHARITY CARE AND HOW TO OBTAIN MORE INFORMATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT WWW.UNITYPOINT.ORG/SIOUXCITY. ST. LUKE'S ALSO PROVIDES INFORMATION ABOUT FINANCIAL ASSISTANCE AT REGISTRATION, AND AGAIN, ON THE PATIENT'S HEALTHCARE BILLING STATEMENT. STAFF HAS BEEN EDUCATED TO DIRECT INPATIENTS TO APPROPRIATE CONTACTS UPON ADMISSION IF FINANCIAL ASSISTANCE IS NEEDED. DESIGNATED INDIVIDUALS ARE AVAILABLE TO ANSWER QUESTIONS REGARDING ST. LUKE'S CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS. TRANSLATION SERVICES ARE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK TO ENSURE CLARITY OF ASSISTANCE.ST. LUKE'S ALSO WORKS WITH THE MISSION HEALTH PROGRAM, A COLLABORATION BETWEEN THE SIOUXLAND COMMUNITY HEALTH CENTER, MERCY MEDICAL CENTER SIOUX CITY AND ST. LUKE'S. INFORMATION IN THIS PROGRAM IS ALSO AVAILABLE IN SPANISH. THIS COMMUNITY OUTREACH PROGRAM PRE-QUALIFIES PARTICIPANTS FOR FINANCIAL ASSISTANCE AT BOTH LOCAL HOSPITALS, AND PARTICIPANTS ARE INVITED TO SELECT A MEDICAL HOME.EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, FINANCIAL SUPPORT DETERMINATION MAY BE MADE DURING ANY STAGE OF A PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE. |
| PART VI, LINE 4: | ST. LUKE'S REGIONAL MEDICAL CENTER IS AN URBAN, ACUTE-CARE COMMUNITY HOSPITAL LICENSED FOR 346 BEDS AND STAFFED FOR 151 BEDS SERVING THE SIOUXLAND AREA. THE SIOUXLAND AREA IS A TRI-STATE AREA CONSISTING OF NORTHWEST IOWA, NORTHEAST NEBRASKA, AND SOUTHEAST SOUTH DAKOTA. ST. LUKE'S IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE. ST. LUKE'S DISCHARGES APPROXIMATELY 11,000 INPATIENTS AND OVERSEES OVER 75,000 OUTPATIENTS VISITS PER YEAR INCLUDING EMERGENCY PATIENTS. WITHIN THE SIOUXLAND AREA, ST. LUKE'S SERVES A PRIMARY AND SECONDARY MARKET DEFINED BY COUNTIES. THE PRIMARY MARKETS ARE PLYMOUTH AND WOODBURY COUNTIES IN IOWA, DAKOTA COUNTY IN NEBRASKA AND UNION COUNTY IN SOUTH DAKOTA. THE PRIMARY COUNTIES ACCOUNT FOR 85% OF ST. LUKE'S INPATIENT DISCHARGES. WITHIN THE PRIMARY MARKET, TWO COMMUNITY HOSPITALS ARE LOCATED IN WOODBURY COUNTY, IOWA, AND ONE SURGICAL SPECIALTY HOSPITAL THAT IS PHYSICIAN-OWNED IS LOCATED IN UNION COUNTY, SOUTH DAKOTA. WOODBURY COUNTY IS THE LARGEST COUNTY IN THE SIOUXLAND AREA WITH APPROXIMATELY 102,000 RESIDENTS, WITH SIOUX CITY AS THE LARGEST CITY IN THE AREA WITH A 2013 ESTIMATED POPULATION OF 82,700. THE SECONDARY MARKETS ARE CHEROKEE, MONONA AND SIOUX COUNTIES IN IOWA AND THURSTON COUNTY IN NEBRASKA. WITH THE EXCEPTION OF THURSTON, A SEPARATE CRITICAL ACCESS HOSPITAL IS HOUSED IN EACH OF THESE COUNTIES.FOCUSING ON THE PRIMARY MARKET, THE HISPANIC POPULATION HAS THE LARGEST IMPACT IN TWO OF THE FOUR PRIMARY COUNTIES WITH DAKOTA COUNTY'S POPULATION HAVING 36% HISPANIC ETHNICITY AND WOODBURY COUNTY WITH OVER 14%. DAKOTA COUNTY AND WOODBURY COUNTY ALSO HAVE THE HIGHEST PERCENTAGE OF FAMILIES BELOW THE FEDERAL POVERTY LEVEL AT 16.9% AND 15.7% RESPECTIVELY. |
| PART VI, LINE 5: | NORTHWEST IOWA HOSPITAL CORPORATION D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER (ST. LUKE'S) IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. ST. LUKE'S SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. ST. LUKE'S IS THE REGION'S ONLY IOWA LEVEL II REGIONAL OBSTETRICAL TRANSPORT CENTER FOR HIGH-RISK OBSTETRICS AND IOWA LEVEL II NEONATOLOGY CENTER.ST. LUKE'S IS ALSO INVOLVED IN THE NW IOWA'S AMERICAN HEART TASK FORCE, TRI-STATE DISASTER COMMITTEE, IOWA'S DISASTER MEDICAL ASSISTANCE TEAM AND EMERGENCY CONFERENCE COMMITTEE. ST. LUKE'S SUPPORTS THE SIOUXLAND MEDICAL EDUCATION FOUNDATION, A FAMILY PRACTICE RESIDENCY AS WELL AS ST. LUKE'S COLLEGE, WHICH IS THE REGION'S ONLY MEDICAL CENTER BASED HEALTH SCIENCES COLLEGE. THE COLLEGE OFFERS ASSOCIATE OF SCIENCE DEGREES IN NURSING, RADIOLOGY, AND RESPIRATORY CARE AS WELL AS CERTIFICATES IN MEDICAL LABORATORY SCIENCES AND PHLEBOTOMY.THE BOARD OF DIRECTORS OF ST. LUKE'S IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE. |
| PART VI, LINE 6: | THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). INITIALLY FORMED IN 1994, UNITYPOINT HEALTH IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 32 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 280 PHYSICIAN CLINICS, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 30,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 4.5 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $3.9 BILLION, UNITYPOINT HEALTH IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2015, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $507 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| CHILDREN'S MIRACLE NETWORK | |||||||
| 205 W 700 SOUTH | SALT LAKE CITY | UT | 84101 | 870387205 | 501(C)(3) | $15,000 | PROGRAM SUPPORT |
| MARCH OF DIMES FOUNDATION | |||||||
| 1275 MAMARONECK AVE | WHITE PLANS | NY | 10605 | 131046366 | 501(C)(3) | $5,000 | PROGRAM SUPPORT |
| SIOUX CITY SYMPHONY ORCHESTRA | |||||||
| 518 PIERCE STREET | SIOUX CITY | IA | 51101 | 426006580 | 501(C)(3) | $5,000 | PRGRAM SUPPORT |
| SIOUXLAND MEDICAL EDUCATION FOUNDATION | |||||||
| 2501 PIERCE STREET | SIOUX CITY | IA | 51104 | 421036971 | 501(C)(3) | $1,109,951 | PROGRAM SUPPORT |
| UNITED WAY OF SIOUXLAND | |||||||
| 701 STEUBEN STREET | SIOUX CITY | IA | 51101 | 420680395 | 501(C)(3) | $16,300 | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 5 | RecipientCnt |
| Cash Grant | $12,351 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | NORTHWEST IOWA HOSPITAL CORPORATION REQUIRES EACH RECIPIENT OF THE GRANTS MENTIONED IN PART II (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINE A SERIES OF ELIGIBILITY STANDARDS THAT ARE REQUIRED TO BE MET. NORTHWEST IOWA HOSPITAL CORPORATION THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED & ELIGIBILITY, MANAGEMENT MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. NORTHWEST IOWA HOSPITAL CORPORATION MINIMIZES THE THREAT OF DIVERSION FOR INTENDED PURPOSE BY SENDING THE FUNDS DIRECTLY TO THE ORGANIZATION, WHERE POSSIBLE, ETC. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| 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 | 0 | 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LEAH GLASGO | ||||||||||||||
| VP/CLINICAL OPERATIONS | $202,390 | $0 | $38,711 | $0 | $17,635 | $0 | $22,054 | $0 | $20,265 | $0 | $301,055 | $0 | $0 | $0 |
| JAMES GOBELL | ||||||||||||||
| VP/CFO | $200,723 | $0 | $42,674 | $0 | $101,552 | $0 | $60,870 | $0 | $20,093 | $0 | $425,912 | $0 | $90,969 | $0 |
| RICHARD HILDEBRAND MD | ||||||||||||||
| VP/MEDICAL AFFAIRS | $167,358 | $0 | $26,234 | $0 | $419,596 | $0 | $9,169 | $0 | $6,165 | $0 | $628,522 | $0 | $412,768 | $0 |
| CHAD MARKHAM | ||||||||||||||
| VP/CLINIC & NETWORK DEVELOPMENT | $180,246 | $0 | $34,475 | $0 | $13,380 | $0 | $30,795 | $0 | $17,710 | $0 | $276,606 | $0 | $0 | $0 |
| PRISCILLA STOKES | ||||||||||||||
| VP/PATIENT CARE | $152,582 | $0 | $32,287 | $0 | $16,564 | $0 | $9,429 | $0 | $12,696 | $0 | $223,558 | $0 | $0 | $0 |
| PETER THOREEN | ||||||||||||||
| PRESIDENT/CEO | $364,349 | $0 | $97,797 | $0 | $43,964 | $0 | $220,026 | $0 | $19,244 | $0 | $745,380 | $0 | $0 | $0 |
| SUSAN UNGER | ||||||||||||||
| VP FUNDRAISING DEVELOPMENT | $140,105 | $0 | $29,035 | $0 | $8,211 | $0 | $8,578 | $0 | $7,198 | $0 | $193,127 | $0 | $0 | $0 |
| LYNN WOLD VPCOO TO 0515 | ||||||||||||||
| PRESIDENT/CEO (FR 06/15) | $284,826 | $0 | $58,341 | $0 | $37,995 | $0 | $74,271 | $0 | $20,093 | $0 | $475,526 | $0 | $0 | $0 |
| ALFRED FLEMING MD | ||||||||||||||
| PHYSICIAN | $520,269 | $0 | $50,000 | $0 | $3,290 | $0 | $13,250 | $0 | $19,886 | $0 | $606,695 | $0 | $0 | $0 |
| JITENDRAKUMAR GUPTAMD | ||||||||||||||
| PHYSICIAN | $298,906 | $122,730 | $234,035 | $56,079 | $526 | $399 | $13,250 | $573 | $15,642 | $7,014 | $562,359 | $186,795 | $0 | $0 |
| FADY JABRE MD | ||||||||||||||
| PHYSICIAN | $458,754 | $0 | $91,059 | $0 | $748 | $0 | $13,482 | $0 | $20,146 | $0 | $584,189 | $0 | $0 | $0 |
| LUIS LEBREDO MD | ||||||||||||||
| PHYSICIAN | $475,293 | $196,447 | $25,121 | $0 | $2,063 | $948 | $24,902 | $0 | $9,966 | $4,765 | $537,345 | $202,160 | $0 | $0 |
| DOUGLAS MARTIN MD | ||||||||||||||
| PHYSICIAN | $336,701 | $0 | $211,082 | $0 | $1,135 | $0 | $13,250 | $0 | $24,982 | $0 | $587,150 | $0 | $0 | $0 |
| MARK JOHNSON TO 1211 | ||||||||||||||
| FORMER VP/CFO | $0 | $607,066 | $0 | $212,100 | $0 | $249,863 | $0 | $178,022 | $0 | $20,094 | $0 | $1,267,145 | $0 | $202,961 |
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. TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS. |
| PART I, LINE 4B | NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS:LEAH GLASGO $9,420; JAMES GOBELL $46,538; MARK JOHNSON $162,122; CHAD MARKHAM $19,771; PETER THOREEN $205,920; LYNN WOLD $61,368. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: JAMES GOBELL $90,969; RICHARD HILDEBRAND $412,768; MARK JOHNSON $202,961. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (9 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BETH SITZMANN | |||
| FAMILY MEMBER OF OFFICER LYNN WOLD | $58,793 | EMPLOYMENT | 0 |
| CARDIOVASCULAR ASSOCIATES PC | |||
| COMMON BOARD MEMBER/OFFICER | $4,660,507 | INVESTMENT AND PROFESSIONAL MEDICAL SERVICES | 0 |
| IOWA HEALTH SYSTEM CONTRACTING SERVICES | |||
| COMMON BOARD MEMBER/OFFICER | $848,618 | PERFORMANCE OF SERVICES | 0 |
| KASSANDRA SMITH | |||
| FAMILY MEMBER OF BOARD MEMBER GARRETT SMITH | $63,436 | EMPLOYMENT | 0 |
| MARY SHOOK | |||
| FAMILY MEMBER OF BOARD MEMBER STEVEN SHOOK, MD | $49,925 | EMPLOYMENT | 0 |
| PIERCE STREET SAME DAY SURGERY CENTER LC | |||
| COMMON BOARD MEMBER/OFFICER | $3,188,410 | INVESTMENT | 0 |
| RONDA HILDEBRAND | |||
| FAMILY MEMBER OF OFFICER RICHARD HILDEBRAND | $40,329 | EMPLOYMENT | 0 |
| SIOUXLAND CARDIOVASULAR CO-MANAGEMENT COMPANY | |||
| COMMON BOARD MEMBER/OFFICER | $670,000 | INVESTMENT, MANAGEMENT FEES, OTHER | 0 |
| TAFFY ZOELLE | |||
| FAMILY MEMBER OF KEY EMPLOYEE JEFFERY ZOELLE | $126,202 | 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 SYSTEM). 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 4 | - ST. LUKE'S HEALTH SYSTEM, INC., A TAX-EXEMPT, IOWA NOT-FOR-PROFIT CORPORATION, BECAME SOLE MEMBER OF NORTHWEST IOWA HOSPITAL CORPORATION (D/B/A ST. LUKE'S REGIONAL MEDICAL CENTER) EFFECTIVE 8/1/2016. - EXCEPT AS EXPRESSLY SET OUT IN THE BYLAWS, ST. LUKE'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS SHALL RETAIN DISCRETION AND AUTHORITY TO MAKE ALL DECISIONS WITH RESPECT TO THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | ST. LUKE'S HEALTH SYSTEM, INC., A TAX-EXEMPT IOWA NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | ST. LUKE'S HEALTH SYSTEM, INC., AS SOLE MEMBER, APPROVES AMENDMENTS TO ARTICLES AND BYLAWS, APPOINTS AND REMOVES CEO, APPROVES LIQUIDATION OR DISSOLUTION, AND APPROVES INDEBTEDNESS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY FUNCTIONAL AREA WITH RESPONSIBILITY 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: LEAH GLASGO, JAMES GOBELL, MARK JOHNSON, CHAD MARKAHM, AND LYNN WOLD. 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 ST. LUKE'S HEALTH FOUNDATION OF SC, IA 151,047. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | NORTHWEST IOWA HOSPITAL CORPORATION | RELATED | $111,830 | $153,607 | 0 | Yes (1) | 0.20000 | |
| 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 | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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 |