ALLEN MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ALLEN MEMORIAL HOSPITAL CORPORATION (EIN 42-0698265)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-12
- IRS object ID
- 201503169349303520
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-12T13:46:53-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420698265 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEN MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALLE | BusinessNameControlTxt |
| Phone | 3192353995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1825 LOGAN AVE | AddressLine1Txt |
| City | WATERLOO | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 507031916 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAN CARPENTER | PersonNm |
| Person Title | INTERIM VP FIN/CFO | PersonTitleTxt |
| Phone | 3192353995 | PhoneNum |
| Signature | 2015-11-11 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAMELA DELAGARDELLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1825 LOGAN AVE | AddressLine1Txt |
| City | WATERLOO | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 507031916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $239,045,404 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNITYPOINT.ORG/WATERLOO | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1938 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 2268 | TotalEmployeeCnt |
| Total Volunteers | 359 | TotalVolunteersCnt |
| Total Gross UBI | $65,859 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,044,530 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,721,631 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $215,708,649 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $227,400,102 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,188,691 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,206,186 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,698,963 | PYOtherRevenueAmt |
| CY Other Revenue | $1,608,242 | CYOtherRevenueAmt |
| PY Total Revenue | $226,640,833 | PYTotalRevenueAmt |
| CY Total Revenue | $237,936,161 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,654,054 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,023,349 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $91,831,982 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $97,694,570 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $116,254,822 | PYOtherExpensesAmt |
| CY Other Expenses | $115,955,852 | CYOtherExpensesAmt |
| PY Total Expenses | $211,740,858 | PYTotalExpensesAmt |
| CY Total Expenses | $219,673,771 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $14,899,975 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $18,262,390 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $269,716,807 | TotalAssetsBOYAmt |
| Total Assets EOY | $285,662,209 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $100,482,004 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $99,391,462 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $169,234,803 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $186,270,747 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF ALLEN MEMORIAL HOSPITAL CORPORATION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $182,543,217 | ExpenseAmt |
| Grant | $3,283,759 | GrantAmt |
| Revenue | $227,950,772 | RevenueAmt |
| Desc | HEALTH-CARE SERVICES:ALLEN MEMORIAL HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE GREATER CEDAR VALLEY COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH-CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. ALLEN MEMORIAL HOSPTIAL 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, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PHARMACEUTICAL DRUGS, WOUND CARE, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2014, ALLEN MEMORIAL HOSPITAL CORPORATION ADMITTED 10,084 PATIENTS WITHOUT NEWBORNS AND NICU AND 11,057 PATIENTS WITH NEWBORNS AND NICU; RESULTING IN A TOTAL OF 39,083 PATIENT DAYS WITHOUT NEWBORNS AND NICU, AND 40,953 PATIENT DAYS WITH NEWBORNS AND NICU. OUTPATIENT VISITS TOTALED 273,109 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 3,766. THERE WERE ALSO 35,141 EMERGENCY ROOM VISITS AND 1,048 BABIES DELIVERED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,413,064 | ExpenseAmt |
| Grant | $2,739,590 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: ALLEN MEMORIAL 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 TO PEOPLE AT A VALUE OF $1,362,572 IN 2014. OFTEN TIMES, ALLEN MEMORIAL HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ALLEN MEMORIAL HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. ALLEN MEMORIAL HOSPITAL CORPORATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $4,194,423 FOR 2014. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $5,556,996.OTHER BENEFITS: ALLEN MEMORIAL 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; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. ALLEN MEMORIAL HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. ALLEN MEMORIAL HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 9,554 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE: $4,856,068. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $192,956,281 | 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 | Yes (1) | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 188 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2268 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 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 | DAN CARPENTER INTERIM VP FINCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3192353995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1825 LOGAN AVE | AddressLine1Txt |
| City | WATERLOO | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50703 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (34 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| STACEY BENTLEY FR 214 | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $838 | $0 | $0 | ||||
| BOB BUCKLEY | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | ||||
| KYLE CHRISTIASON MD | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $401 | $304,595 | $90,729 | ||||
| MICHAEL CHRISTIASON | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $401 | $0 | $0 | ||||
| DARREL COLSON | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | ||||
| PAMELA DELAGARDELLE | ||||||||||
| BOARD MEMBER/PRESIDENT/CEO | 1.00 | 40.00 | Yes (X) | $460,866 | $0 | $101,600 | Yes (X) | |||
| DANIEL GLASCOCK MD | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $54 | $301,811 | $41,826 | ||||
| BETH HANSEN | ||||||||||
| BOARD SECRETARY | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | Yes (X) | |||
| DAVE HAPPEL | ||||||||||
| BOARD TREASURER | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | Yes (X) | |||
| JOAN HEADINGTON | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | ||||
| VINAY KANTAMNENI MD | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $866 | $0 | $0 | ||||
| KATHY MCCOY | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $670 | $0 | $0 | ||||
| BEV SMITH | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $417 | $0 | $0 | ||||
| KALYANA SUNDARAM MD | ||||||||||
| BOARD VICE CHAIR | 1.00 | 1.00 | Yes (X) | $1,256 | $0 | $0 | Yes (X) | |||
| SAILU TIMBO FR 214 | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $946 | $0 | $0 | ||||
| JEAN TRAINOR | ||||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | $146 | $10,000 | $0 | Yes (X) | |||
| BISHOP STEVE ULLESTAD | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $54 | $0 | $0 | ||||
| MIKE WILLIAMS | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $54 | $11,977 | $0 | ||||
| RENEE RASMUSSEN | ||||||||||
| SR VP FIN/CFO/CO | 40.00 | 1.00 | $306,013 | $0 | $109,089 | Yes (X) | ||||
| CHRISTOPHER CLAYTON | ||||||||||
| DIRECTOR - PHARMACY | 40.00 | 0.00 | $166,175 | $0 | $36,361 | Yes (X) | ||||
| JENNIFER FRIEDLY | ||||||||||
| VP/CHIEF OPERATING OFFICER | 40.00 | 0.00 | $271,770 | $0 | $51,610 | Yes (X) | ||||
| MARY HAGEN | ||||||||||
| VP CHIEF NURSE EXECUTIVE | 40.00 | 0.00 | $220,343 | $0 | $37,293 | Yes (X) | ||||
| TIM HORRIGAN MD | ||||||||||
| CMO | 40.00 | 1.00 | $0 | $307,828 | $34,980 | Yes (X) | ||||
| STEVEN SESTERHENN | ||||||||||
| VP HUMAN RESOURCES | 40.00 | 0.00 | $167,863 | $0 | $29,139 | Yes (X) | ||||
| JAMES WATERBURY | ||||||||||
| VP INSTITUTIONAL DEVELOP | 40.00 | 1.00 | $228,892 | $0 | $30,013 | Yes (X) | ||||
| AMEER ALMULLAHASSANI MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $617,310 | $0 | $23,274 | Yes (X) | ||||
| BILAL KAAKI MD | ||||||||||
| MED DIRECTOR-OB/GYN | 40.00 | 0.00 | $634,315 | $23,126 | $51,370 | Yes (X) | ||||
| PAUL MCCAUGHEY MD | ||||||||||
| PHYSICIAN-ER | 40.00 | 0.00 | $519,850 | $0 | $30,506 | Yes (X) | ||||
| NIK NIKOUEIHA MD | ||||||||||
| PHYSICIAN-ER | 40.00 | 0.00 | $473,064 | $0 | $36,728 | Yes (X) | ||||
| PUBLIO ORTIZ MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $401,960 | $0 | $30,554 | Yes (X) | ||||
| RICHARD SEIDLER TO 610 | ||||||||||
| FORMER PRESIDENT/CEO | 0.00 | 40.00 | $0 | $722,168 | $272,810 | Yes (X) | ||||
| TOM TIBBITTS TO 1212 | ||||||||||
| FORMER INTERIM PRESIDENT/CEO | 0.00 | 40.00 | $0 | $604,359 | $32,950 | Yes (X) | ||||
| RUSSELL ADAMS MD TO 1212 | ||||||||||
| FORMER HOSPITALIST MEDICAL DIRECTOR | 0.00 | 40.00 | $0 | $386,012 | $37,733 | Yes (X) | ||||
| JAY WILLSHER TO 910 | ||||||||||
| FORMER VP REGIONAL OPERATIONS | 0.00 | 40.00 | $0 | $417,735 | $131,354 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,474,794 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,089,611 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,209,919 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 83 | 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 |
|---|---|---|---|---|---|
| CEDAR VALLEY MEDICAL SPECIALISTS | |||||
| PO BOX 2758 | WATERLOO | IA | 50704 | MEDICAL SERVICES | $3,714,031 |
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | MEDICAL SERVICES | $1,305,397 |
| ARAMARK MANAGEMENT SERVICES LP | |||||
| 24863 NETWORK PLACE | CHICAGO | IL | 60673 | STAFFING | $912,222 |
| STAFF CARE INC | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | STAFFING | $869,109 |
| REHABCARE GROUP EAST INC | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | MANAGEMENT SERVICES | $616,537 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 29 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $4,030 | MembershipDuesAmt |
| Related Organizations | $1,664,897 | RelatedOrganizationsAmt |
| Government Grants | $1,032,494 | GovernmentGrantsAmt |
| All Other Contributions | $20,210 | AllOtherContributionsAmt |
| Total Contributions | $2,721,631 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $157,071,270 | $157,071,270 | ||
| PHARMACY REVENUE | 446110 | $62,407,876 | $31,596,836 | $37,794 | $30,773,246 |
| MANAGEMENT, IT AND SUPPORT SVCS | 561000 | $4,298,617 | $3,742,647 | $19,500 | $536,470 |
| RENTAL INCOME | 531100 | $1,855,273 | $1,855,073 | $200 | |
| MISCELLANEOUS REVENUE | 900099 | $1,742,980 | $1,742,980 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,086 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,721 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,365 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $227,400,102 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,268,513 | TotalRevenueColumnAmt |
| Exclusion | $6,268,513 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $826,076 | SecuritiesAmt |
| Other | $4,150 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $811,536 | SecuritiesAmt |
| Other | $81,017 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,540 | SecuritiesAmt |
| Other | -$76,867 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$62,327 | TotalRevenueColumnAmt |
| Exclusion | -$62,327 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $84,601 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $99,697 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$15,096 | TotalRevenueColumnAmt |
| Exclusion | -$15,096 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $178,746 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $116,993 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,753 | TotalRevenueColumnAmt |
| Exclusion | $61,753 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA/FOOD SVCS | 722210 | $958,332 | $958,332 | |
| MISCELLANEOUS REVENUE | 900099 | $550,671 | $550,671 | |
| PHARMACY REVENUE | 446110 | $52,582 | $52,582 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,561,585 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $237,936,161 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $196,575,198 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $65,859 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,573,473 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,007,849 | TotalAmt |
| Program Services | $6,007,849 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,500 | TotalAmt |
| Program Services | $15,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,566,203 | TotalAmt |
| Management And General | $2,566,203 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,389,127 | TotalAmt |
| Management And General | $1,389,127 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,965,852 | TotalAmt |
| Program Services | $66,656,698 | ProgramServicesAmt |
| Management And General | $7,309,154 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,346,000 | TotalAmt |
| Program Services | $3,916,537 | ProgramServicesAmt |
| Management And General | $429,463 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,198,688 | TotalAmt |
| Program Services | $9,190,875 | ProgramServicesAmt |
| Management And General | $1,007,813 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,228,700 | TotalAmt |
| Program Services | $4,712,010 | ProgramServicesAmt |
| Management And General | $516,690 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,316,485 | TotalAmt |
| Program Services | $1,147,114 | ProgramServicesAmt |
| Management And General | $6,169,371 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,230 | TotalAmt |
| Management And General | $600,230 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824,600 | TotalAmt |
| Program Services | $537,744 | ProgramServicesAmt |
| Management And General | $286,856 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,681,321 | TotalAmt |
| Program Services | $17,135,280 | ProgramServicesAmt |
| Management And General | $4,546,041 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $547,833 | TotalAmt |
| Program Services | $242,151 | ProgramServicesAmt |
| Management And General | $305,682 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,784,600 | TotalAmt |
| Program Services | $4,300,320 | ProgramServicesAmt |
| Management And General | $484,280 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,551,753 | TotalAmt |
| Program Services | $11,404,991 | ProgramServicesAmt |
| Management And General | $146,762 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,258,289 | TotalAmt |
| Program Services | $3,746,393 | ProgramServicesAmt |
| Management And General | $511,896 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,933 | TotalAmt |
| Program Services | $250,300 | ProgramServicesAmt |
| Management And General | $46,633 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,313 | TotalAmt |
| Program Services | $138,153 | ProgramServicesAmt |
| Management And General | $17,160 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,742,725 | TotalAmt |
| Program Services | $3,742,725 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,586,939 | TotalAmt |
| Program Services | $14,396,222 | ProgramServicesAmt |
| Management And General | $190,717 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$193,218 | TotalAmt |
| Program Services | -$193,218 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $45,569,256 | $45,529,737 | $39,519 |
| MISCELLANEOUS EXPENSE | $249,362 | $78,900 | $170,462 |
| INCOME TAXES | -$16,569 | -$16,569 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,673,771 | TotalAmt |
| Program Services | $192,956,281 | ProgramServicesAmt |
| Management And General | $26,717,490 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,640 | BOYAmt |
| EOY | $5,846,958 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,609 | BOYAmt |
| EOY | $2,692,220 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,361,881 | BOYAmt |
| EOY | $2,440,019 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,361,683 | BOYAmt |
| EOY | $29,611,303 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,499,161 | BOYAmt |
| EOY | $9,438,670 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,859,157 | BOYAmt |
| EOY | $6,240,206 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $666,347 | BOYAmt |
| EOY | $553,066 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $243,470,880 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $135,743,678 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,670,034 | BOYAmt |
| EOY | $107,727,202 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,260,593 | BOYAmt |
| EOY | $116,719,825 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,639 | BOYAmt |
| EOY | $4,639 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,653,697 | BOYAmt |
| EOY | $1,364,742 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,426,371 | BOYAmt |
| EOY | $2,230,611 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $555,995 | BOYAmt |
| EOY | $792,748 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,716,807 | BOYAmt |
| EOY | $285,662,209 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,350,706 | BOYAmt |
| EOY | $20,852,203 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,103 | BOYAmt |
| EOY | $15,869 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,200 | BOYAmt |
| EOY | $9,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,421,733 | BOYAmt |
| EOY | $4,779,230 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,669,262 | BOYAmt |
| EOY | $73,735,160 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,482,004 | BOYAmt |
| EOY | $99,391,462 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,314,114 | BOYAmt |
| EOY | $182,293,207 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,606,468 | BOYAmt |
| EOY | $1,507,521 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,314,221 | BOYAmt |
| EOY | $2,470,019 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,234,803 | BOYAmt |
| EOY | $186,270,747 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,716,807 | BOYAmt |
| EOY | $285,662,209 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $18,262,390 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,408,051 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,634,497 | 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 | $111,695,899 | BeginningYearBalanceAmt |
| Contributions | $34 | ContributionsAmt |
| Investment Earnings Or Losses | $7,737,320 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $167,027 | AdministrativeExpensesAmt |
| End Year Balance | $119,266,226 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $98,883,337 | BeginningYearBalanceAmt |
| Contributions | $653,744 | ContributionsAmt |
| Investment Earnings Or Losses | $13,006,912 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $598,208 | OtherExpendituresAmt |
| Administrative Expenses | $249,886 | AdministrativeExpensesAmt |
| End Year Balance | $111,695,899 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $84,637,772 | BeginningYearBalanceAmt |
| Contributions | $6,969,458 | ContributionsAmt |
| Investment Earnings Or Losses | $10,300,929 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,841,422 | OtherExpendituresAmt |
| Administrative Expenses | $183,400 | AdministrativeExpensesAmt |
| End Year Balance | $98,883,337 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $75,776,848 | BeginningYearBalanceAmt |
| Contributions | $12,020,271 | ContributionsAmt |
| Investment Earnings Or Losses | -$907,542 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,013,448 | OtherExpendituresAmt |
| Administrative Expenses | $238,357 | AdministrativeExpensesAmt |
| End Year Balance | $84,637,772 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $62,282,606 | BeginningYearBalanceAmt |
| Contributions | $6,212,189 | ContributionsAmt |
| Investment Earnings Or Losses | $8,740,976 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,180,548 | OtherExpendituresAmt |
| Administrative Expenses | $278,375 | AdministrativeExpensesAmt |
| End Year Balance | $75,776,848 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.96670 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.02070 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.01260 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $985,647 | OtherCostOrOtherBasisAmt |
| Book Value | $985,647 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $138,636,298 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,345,481 | DepreciationAmt |
| Book Value | $69,290,817 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,189,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,900,270 | DepreciationAmt |
| Book Value | $289,562 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,394,728 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,927,333 | DepreciationAmt |
| Book Value | $34,467,395 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,264,375 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,570,594 | DepreciationAmt |
| Book Value | $2,693,781 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $107,727,202 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| ASBESTOS REMOVAL LIABILITY | $5,198,600 |
| DUE TO AFFILIATES | $7,469,669 |
| LONG-TERM RETENTION INCENTIVES | $1,329,177 |
| IOWA HEALTH SYSTEM NOTE PAYABLE | $54,973,580 |
| SELF-INSURANCE RESERVE | $2,717,706 |
| HEALTH AND WELFARE BENEFITS RESERVE | $1,004,450 |
| DEFINED BENEFIT RETIREMENT PLAN LIABILITY | $1,041,978 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $73,735,160 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $237,681,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,282,252 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $117,203 | OtherRevenueAmt |
| Revenue Not Reported | $1,399,455 | RevenueNotReportedAmt |
| Revenue Subtotal | $236,281,545 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $167,027 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $1,487,589 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,654,616 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $237,936,161 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $211,188,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $118,562 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $118,562 | ExpensesNotReportedAmt |
| Expenses Subtotal | $211,069,438 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $167,027 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $8,437,306 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $8,604,333 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $219,673,771 | 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 2011. 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: | COST OF GOODS SOLD 116,993. ROUNDING 210. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REVENUES IN UNRESTRICTED FUND BALANCE 735,697. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 1,894. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 749,998. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | COST OF GOODS SOLD 116,993. ROUNDING 1,569. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES IN UNRESTRICTED FUND BALANCE 7,687,308. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 749,998. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SCRUB SALES | Event1Nm |
| Gross Receipts Event1 | $39,286 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $39,286 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $57,191 | OtherDirectExpensesEvent1Amt |
| Event2 | BOOK SALES | Event2Nm |
| Gross Receipts Event2 | $12,850 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $12,850 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $15,551 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 6 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $32,465 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $32,465 | GrossRevenueOtherEventsAmt |
| Entertainment Other Events | $1,332 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $25,623 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $84,601 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $84,601 | GrossRevenueTotalEventsAmt |
| Entertainment Total Events | $1,332 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $98,365 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $99,697 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$15,096 | NetIncomeSummaryAmt |
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 | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,362,573 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,362,573 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,631,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,437,175 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,194,423 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01910 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,994,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,437,175 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,556,996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02530 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,624,926 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $736,499 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $888,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $451,669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $451,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $776,382 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $776,382 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,192,494 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,452,904 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,739,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01250 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,045,471 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,189,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,856,068 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02210 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $39,039,642 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,626,578 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,413,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04740 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,594 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,594 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,826 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $668,195 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $458,306 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $209,889 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,163 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $710,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $458,306 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $252,472 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,734,645 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $77,441,791 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $73,263,016 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $4,178,775 | 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 ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MANAGE ORTHOPEDIC SERVICE LINE | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.20000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.80000 | 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 | ALLEN MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1825 LOGAN AVENUE | AddressLine1Txt |
| City | WATERLOO | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50703 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UNITYPOINT.ORG/WATERLOO | WebsiteAddressTxt |
| State License | 070034H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEN MEMORIAL HOSPITAL CORPORATION | 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 | HTTP://WWW.UNITYPOINT.ORG/WATERLOO/FINANCES | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.UNITYPOINT.ORG/WATERLOO/FINANCES | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 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 App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ALLEN MEMORIAL HOSPITAL CORPORATION | PART V, SECTION B, LINE 5: THE PROJECT TEAM WORKED THROUGH FIVE PHASES IN THE CREATION OF THE CHNA - ORIENTATION, DESIGN, DATA COLLECTION, ANALYSIS AND PRIORITIZATION. WORK BEGAN WITH THE COMMUNITY ADVISORY BOARD. THE BOARD BEGAN MEETING MONTHLY IN OCTOBER 2011, LEARNING ABOUT VARIOUS SERVICES OFFERED BY ALLEN HOSPITAL AND PROVIDING FEEDBACK TO ALLEN ADMINISTRATION ON HEATLH ISSUES SEEN IN THE COMMUNITY.THE COMMUNITY ADVISORY BOARD BEGAN DEVELOPING LISTS OF COMMUNITY MEMBERS, BUSINESS LEADERS, INDIVIDUALS WITH INFORMATION REGARDING A VARIETY OF DEMOGRAPHIC INSTEREST AND HEALTHCARE LEADERS. AFTER WORKING TOGETHER FOR SEVERAL WEEKS TO ENSURE WE HAD A BALANCED, REPRESENTATIVE LIST, WORK MOVED TO THE STEERING COMMITTEE.THE CHNA STEERING COMMITTEE FORMED IN LATE 2011 TO COLLABORATE ON THE CHNA PROJECT. THE STEERING COMMITTEE INCLUDED ADMINISTRATORS AND STAFF FROM OTHER AREA HOSPITALS WHOSE SERVICE AREAS OVERLAP THE ALLEN HOSPITAL SERVICE AREA. ALL PARTICIPATING HOSPITALS WORKED TOGETHER TO IDENTIFY COMMON DATA, RESOURCES AND NEEDS IN ORDER TO PREPARE INDIVIDUAL COMMUNITY HEALTH NEEDS ASSESSMENTS. THE COMMITTEE CONVENED TO DEVELOP AN ACTION PLAN, DIVIDE TASKS, SHARE DISCOVERED INFORMATION AND COMBINE RESOURCES TO WRITE INDIVIDUAL REPORTS. THE GROUP DEVELOPED A DETAILED INTERVIEW TEMPLATE THAT WILL SERVE AS THE FRAMEWORK FOR SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENTS. IT ALSO ESTABLISHED A SHARED ONLINE DOCUMENT-SHARING PROTOCOL THAT WILL ALLOW MEMBERS TO SHARE DATA AND IDEAS FOR THE CURRENT AND FUTURE PROJECTS. |
| ALLEN MEMORIAL HOSPITAL CORPORATION | PART V, SECTION B, LINE 6A: WHEATON FRANCISCAN HEALTHCARE, WAVERLY HEALTH CENTER, GRUNDY COUNTY MEMORIAL HOSPITAL, AND COMMUNITY MEMORIAL HOSPITAL IN SUMNER. |
| ALLEN MEMORIAL HOSPITAL CORPORATION | PART V, SECTION B, LINE 11: MENTAL HEALTH- FORMALLY AFFILIATED WITH BLACK HAWK-GRUNDY MENTAL HEALTH CENTER IN JANUARY 2015, OFFERING PRIMARY CARE AND BEHAVIORAL HEALTH CARE COORDINATION TO 6,000 MENTAL HEALTH PATIENTS - BROUGHT 13 ADDITIONAL MENTAL HEALTH PROVIDERS INTO UNITYPOINT CLINIC FROM WATERLOO PSYCH ASSOCIATES OF NORTHEAST IOWA- INTEGRATING PRIMARY CARE BEHAVIORAL HEALTH INTO PATIENT CENTERED MEDICAL HOME 2.0 AT ONE PRIMARY CARE SITE BY END OF 2015 AND REST OF PRIMARY CARE SITES IN 2016- NEWLY-OPENED OCCUPATIONAL THERAPY DEGREE TRACK AT ALLEN COLLEGE ADDRESSES MENTAL HEALTH ISSUES.ACCESS TO HEALTHCARE- OPENED NEW PRIMARY CARE CLINIC AT ALLEN HOSPITAL IN JANUARY 2014- BROKE GROUND FOR PRAIRIE PARKWAY, NEW PRIMARY CARE CENTER IN CEDAR FALLS- BROKE GROUND FOR NEW OCCUPATIONAL HEALTH CENTER IN CEDAR FALLS- ADDED NEW PRIMARY CARE CLINIC IN ELDORA; PLANNING CLINIC IN JESUP; ADDING MORE CONVENIENT LOCATION IN DENVER, PLANNING FOR NEIGHBORHOOD CLINIC IN EAST WATERLOO- EXTENDED HOURS IN SIX UNITYPOINT CLINIC-WATERLOO SITES- ADDED VIRTUAL CARE (MDLIVE)- PROVIDED MYCHART ONLINE ACCESS TO INDIVIDUAL CHARTSCHRONIC DISEASE MANAGEMENT- PATIENT-CENTERED MEDICAL HOME (PCMH) HAS BEEN DEPLOYED IN ALL UPC PRIMARY CARE SITES WITH THE EXCEPTION OF GREENHILL THAT WILL DEPLOY WHEN THEY MOVE TO THE NEW BUILDING FOR MODERATE RISK CHRONIC CARE MANAGEMENT- ADVANCED CARE BY UNITYPOINT AT HOME IS DEVELOPING FOR HIGH- RISK CHRONIC CARE MANAGEMENT- ALL UNITYPOINT CLINIC SITES AS WELL AS MANY OF OUR INDEPENDENT ALIGNED PARTNERS ARE PROVIDING TRANSITIONAL CARE MANAGEMENT SERVICES- ADDED LOW BACK PAIN CARE PATHWAY - DEVELOPING IMPACT (INTEGRATED CARE PATIENT CARE MANAGEMENT) PROGRAM IN EARLY STAGES FOR OUR POST-ACUTE AND LONG TERM CARE PATIENTS AS PART OF T.H.E. CARE MODEL FOR 2016 INTRODUCTION- ADDED EDCCP PROGRAM TO EMERGENCY DEPARTMENT IN 2013- ADDED SOCIAL WORKER TO EMERGENCY DEPARTMENT IN 2014- ADDED TWO EMERGENCY DEPARTMENT CASE MANAGERS IN 2015- ADDED A CHRONIC DISEASE NAVIGATOR IN 2015 TO MAKE FOLLOW-UP CONTACTS WITH COPD AND HEART-FAILURE PATIENTS FOR AT LEAST SIX WEEKS FOLLOWING HOSPITALIZATION- NEW PUBLIC HEALTH DEGREE PROGRAM AT ALLEN COLLEGE ADDRESSES CHRONIC DISEASE- PLANNED PHYSICAL THERAPY DEGREE TRACK AT ALLEN COLLEGE ADDRESSES CHRONIC HEALTH ISSUES.NUTRITION, OBESITY, WELLNESS AND PREVENTION- DIETICIAN DEPLOYED AT DIABETES AND ENDOCRINOLOGY CLINIC FOR DIABETIC AND WEIGHT MANAGEMENT CARE- NEW FOCUS ON OUTPATIENT THERAPY SERVICES- DIETICIANS ARE A PART OF PATIENT-CENTERED MEDICAL HOME 2.0 AND WILL BE DEPLOYED IN ONE PRIMARY CARE SITE BY THE END OF 2015 WITH THE REST SLATED FOR 2016- UNITYPOINT AT WORK NOW PROVIDES ACTIVE OUTREACH INTO LOCAL EMPLOYERS TO OFFER WELLNESS SCREENING AND COACHING SERVICES AS WELL. - NEW PUBLIC HEALTH DEGREE PROGRAM AT ALLEN COLLEGE ADDRESSES WELLNESS- PRAIRIE PARKWAY, NEW PRIMARY CARE CENTER UNDER CONSTRUCTION IN CEDAR FALLS, WILL EMPHASIZE PREVENTION AND EARLY INTERVENTION IN DISEASE, NUTRITION AND WELLNESS WITH SPECIAL EMPHASIS ON PEDIATRIC SERVICES |
| ALLEN MEMORIAL HOSPITAL CORPORATION | 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. |
| PART V, SECTION B, LINE 16B | HTTPS://WWW.UNITYPOINT.ORG/WATERLOO/FINANCES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| ALLEN DIGESTIVE DISEASE CENTER-TWR PARK | ||||
| 125 EAST TOWER PARK DRIVE | WATERLOO | IA | 50701 | OUTPATIENT ONLY - DIGESTIVE DISEASE CENTER |
| ALLEN WOMEN'S HEALTH CENTER | ||||
| 233 VOLD STREET | WATERLOO | IA | 50703 | OUTPATIENT ONLY - WOMEN'S HEALTH CENTER |
| ALLEN OB-GYN | ||||
| 1015 S HACKETT ROAD SUITE 200 | WATERLOO | IA | 50701 | OUTPATIENT ONLY - WOMEN'S OB-GYN |
| PMP OCCUPATIONAL HEALTH | ||||
| 4612 PRAIRIE PARKWAY SUITE 102 | CEDAR FALLS | IA | 50613 | OUTPATIENT ONLY - OCCUPATIONAL HEALTH |
| ALLEN WOMEN'S HEALTH CENTER | ||||
| 1600 1ST STREET E | INDEPENDENCE | IA | 50644 | OUTPATIENT ONLY - WOMEN'S HEALTH CENTER |
| BREAST BIOPSY SERVICES LC | ||||
| 4250 GLASS ROAD NE | CEDAR RAPIDS | IA | 52402 | PROVIDE BREAST BIOPSY SERVICES |
| CEDAR VALLEY COMMUNITY HEALTHCARE LLC | ||||
| 999 HOME PLAZA SUITE 210B | WATERLOO | IA | 50701 | REGIONAL HEALTH INSURANCE POOL |
| DIGITAL MAMOGRAPHY IMAGING SERVICES LLC | ||||
| 4250 GLASS ROAD NE SUITE 200 | CEDAR RAPIDS | IA | 52402 | DIGITAL MAMOGRAPHY IMAGING |
| HEALTH ENTERPRISES OF IOWA | ||||
| 4250 GLASS ROAD NE SUITE 200 | CEDAR RAPIDS | IA | 52402 | MANAGEMENT COMPANY |
| HEALTH ENTERPRISES VENTURES LC | ||||
| 4250 GLASS ROAD NE | CEDAR RAPIDS | IA | 52402 | INVESTMENT VEHICLE OWNING PARTS OF EACH OF THE CLINICAL JOINT VENTURES |
| MRIOWA LC | ||||
| 4250 GLASS ROAD NE | CEDAR RAPIDS | IA | 52402 | PROVIDE MOBILE MRI SERVICES |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | ALLEN MEMORIAL HOSPITAL'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 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 IMPACTING 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. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE HOSPITAL CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. |
| 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 ALLEN MEMORIAL HOSPITAL. 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. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $12,740,020. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE OF $2,436,698 AND REVENUE OF $2,242,532. AFTER TAKING THESE ITEMS INTO ACCOUNT WE CALCULATE AN ACTUAL MEDICARE SHORTFALL OF $12,934,186.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. |
| PART VI, LINE 2: | ALLEN MEMORIAL HOSPITAL CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN WATERLOO, IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, ALLEN MEMORIAL HOSPITAL IS A SPONSORING PARTNER OF THE COMMUNITY HEALTH ADVISORY BOARD, WHICH IS A COMMUNITY COLLABORATIVE CONVENED BY ALLEN HOSPITAL TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF BLACK HAWK COUNTY. THROUGH A PLANNED AND ORGANIZED EFFORT, THE COMMUNITY HEALTH ADVISORY BOARD DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. THE COMMUNITY HEALTH ADVISORY BOARD WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. ALLEN MEMORIAL HOSPITAL, AS A SPONSORING AGENCY, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. THE COMMUNITY HEALTH ADVISORY BOARD CONVENES EIGHT MEETINGS ANNUALLY TO SEEK PUBLIC INPUT ON HEALTH INITIATIVES. ALLEN HOSPITAL IS ALSO A SPONSORING PARTNER IN TOGETHER FOR YOUTH. THIS COLLABORATIVE ALSO COMPLETES A COMMUNITY HEALTH ASSESSMENT. FROM THIS, PRIORITIES AND STRATEGIES HAVE BEEN IDENTIFIED. ALLEN HOSPITAL HAS ACTIVELY ENGAGED IN ADDRESSING AND MONITORING HEALTH ISSUES AND NEEDS AS A RESULT OF THIS PROCESS. ALLEN HOSPITAL ALSO PARTICIPATES AS PART OF THE UNITED WAY OF THE CEDAR VALLEY. THIS GROUP ACTIVELY ADDRESSES NEED AND STRATEGIES ASSOCIATED WITH HEALTH. MORE SPECIFICALLY, THIS GROUP OFTEN FOCUSES ON THE SOCIAL DETERMINANTS OF HEALTH AND HOW TO IMPACT THEM IN THE EFFORT TO RAISE THE COMMUNITY HEALTH STATUS. THIS WIDE BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR ALLEN HOSPITAL 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 ORGANIZED COMMUNITY EFFORTS, ALLEN HOSPITAL CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS OFTEN WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT. |
| PART VI, LINE 3: | ALLEN MEMORIAL HOSPITAL PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS: 1) PLACES SIGNAGE, INFORMATION, AND/OR BROCHURES IN APPROPRIATE AREAS OF THE PROVIDER (E.G., THE EMERGENCY DEPARTMENT, AND REGISTRATION AND CHECK-OUT/CASHIER AREAS) STATING THE PROVIDER/PHYSICIAN PRACTICE OFFERS CHARITY CARE AND DESCRIBES HOW TO OBTAIN MORE INFORMATION ABOUT FINANCIAL ASSISTANCE, 2) PLACES A NOTE ON THE HEALTH-CARE BILL AND STATEMENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE, 3) DESIGNATES INDIVIDUALS WHO CAN EXPLAIN THE PROVIDER'S CHARITY CARE POLICY, AND 4) INSTRUCTS STAFF WHO INTERACT WITH PATIENTS TO DIRECT QUESTIONS REGARDING THE CHARITY CARE POLICY TO THE PROPER PROVIDER REPRESENTATIVE AND, 5) POSTS CHARITY CARE AND PATIENT-DISCOUNT INFORMATION ON THE HOSPITAL WEB SITE'S HOME PAGE AT WWW.UNITYPOINT.ORG/WATERLOO UNDER FINANCES. |
| PART VI, LINE 4: | ALLEN MEMORIAL HOSPITAL IS A 201-BED COMMUNITY HOSPITAL SERVING THE CEDAR VALLEY OF IOWA. ALLEN MEMORIAL HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF ALLEN MEMORIAL HOSPITAL'S MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF BLACK HAWK, BREMER, BUCHANAN, FAYETTE, TAMA AND BUTLER. ALLEN MEMORIAL HOSPITAL ADMITS APPROXIMATELY 11,057 INPATIENTS AND CARES FOR 35,100 EMERGENCY PATIENTS PER YEAR. ALLEN MEMORIAL HOSPITAL CARES FOR MORE INPATIENTS, OUTPATIENTS, EMERGENCY PATIENTS AND CARDIAC PATIENTS THAN ANY OTHER HOSPITAL IN THE CEDAR VALLEY OF IOWA. THERE ARE 5 OTHER HOSPITALS WITHIN THE 6-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $45,542 TO $61,216 AND THE AVERAGE POVERTY RATE IS 11.2%. 68.6% OF ALLEN MEMORIAL HOSPITAL INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. BLACK HAWK COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 84% CAUCASIAN AMERICAN AND BOSNIAN, 9% AFRICAN-AMERICAN, 4% HISPANIC AND 1% ALL OTHER MINORITY POPULATIONS. |
| PART VI, LINE 5: | THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL 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 $3.7 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 2014, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $443 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 (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| ALLEN COLLEGE | |||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421351526 | 501(C)(3) | $30,578 | PROGRAM SUPPORT |
| ALLEN HEALTH SYSTEMS INC | |||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201924 | 501(C)(3) | $34,773 | PROGRAM SUPPORT |
| AMERICAN HEART ASSOCIATION | |||||||
| 460 N LINDBERGH BLVD | ST LOUIS | MO | 63141 | 135613797 | 501(C)(3) | $30,000 | PROGRAM SUPPORT |
| GALLEGHER BLUEDORN UNI | |||||||
| UNIVERSITY OF NORTHERN IA | CEDAR FALLS | IA | 50613 | 426004333 | STATE OF IOWA | $15,000 | PROGRAM SUPPORT |
| GREATER CEDAR VALLEY ALLIANCE | |||||||
| WEST FOURTH STREET-STE 310 | WATERLOO | IA | 50701 | 421241941 | 501(C)(6) | $21,326 | PROGRAM SUPPORT |
| IOWA HEALTH SYSTEM | |||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421435199 | 501(C)(3) | $5,482,262 | PROGRAM SUPPORT |
| MEMORIAL FOUNDATION OF ALLEN HOSPITAL | |||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201138 | 501(C)(3) | $383,105 | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 57 | RecipientCnt |
| Cash Grant | $15,500 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALLEN MEMORIAL HOSPITAL CORPORATION MONITORS THE USE OF GRANT FUNDS ACCORDING TO THE STANDARD FINANCIAL POLICIES OF THE ORGANIZATION AND AS REQUIRED BY THE GRANT OR GRANTOR. THE POLICIES AND PROTOCOLS OF THE FUNDING SOURCE ARE ENFORCED AND MONITORED BY THE ORGANIZATION AND REPORTED AS REQUIRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| 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 (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KYLE CHRISTIASON MD | ||||||||||||||
| BOARD MEMBER | $401 | $280,408 | $0 | $21,413 | $0 | $2,774 | $0 | $65,516 | $0 | $25,213 | $401 | $395,324 | $0 | $0 |
| PAMELA DELAGARDELLE | ||||||||||||||
| BOARD MEMBER/PRESIDENT/CEO | $344,057 | $0 | $74,617 | $0 | $42,192 | $0 | $82,362 | $0 | $19,238 | $0 | $562,466 | $0 | $0 | $0 |
| DANIEL GLASCOCK MD | ||||||||||||||
| BOARD MEMBER | $54 | $263,657 | $0 | $36,743 | $0 | $1,411 | $0 | $18,233 | $0 | $23,593 | $54 | $343,637 | $0 | $0 |
| RENEE RASMUSSEN | ||||||||||||||
| SR VP FIN/CFO/CO | $226,316 | $0 | $51,087 | $0 | $28,610 | $0 | $86,141 | $0 | $22,948 | $0 | $415,102 | $0 | $0 | $0 |
| CHRISTOPHER CLAYTON | ||||||||||||||
| DIRECTOR - PHARMACY | $148,319 | $0 | $9,503 | $0 | $8,353 | $0 | $9,009 | $0 | $27,352 | $0 | $202,536 | $0 | $0 | $0 |
| JENNIFER FRIEDLY | ||||||||||||||
| VP/CHIEF OPERATING OFFICER | $212,317 | $0 | $44,074 | $0 | $15,379 | $0 | $39,606 | $0 | $12,004 | $0 | $323,380 | $0 | $0 | $0 |
| MARY HAGEN | ||||||||||||||
| VP CHIEF NURSE EXECUTIVE | $184,939 | $0 | $19,474 | $0 | $15,930 | $0 | $30,990 | $0 | $6,303 | $0 | $257,636 | $0 | $0 | $0 |
| TIM HORRIGAN MD | ||||||||||||||
| CMO | $0 | $249,271 | $0 | $56,083 | $0 | $2,474 | $0 | $11,750 | $0 | $23,230 | $0 | $342,808 | $0 | $0 |
| STEVEN SESTERHENN | ||||||||||||||
| VP HUMAN RESOURCES | $136,736 | $0 | $30,631 | $0 | $496 | $0 | $8,737 | $0 | $20,402 | $0 | $197,002 | $0 | $0 | $0 |
| JAMES WATERBURY | ||||||||||||||
| VP INSTITUTIONAL DEVELOP | $168,627 | $0 | $36,620 | $0 | $23,645 | $0 | $15,855 | $0 | $14,158 | $0 | $258,905 | $0 | $0 | $0 |
| AMEER ALMULLAHASSANI MD | ||||||||||||||
| PHYSICIAN | $467,637 | $0 | $0 | $0 | $149,673 | $0 | $5,200 | $0 | $18,074 | $0 | $640,584 | $0 | $0 | $0 |
| BILAL KAAKI MD | ||||||||||||||
| MED DIRECTOR-OB/GYN | $622,912 | $23,126 | $0 | $0 | $11,403 | $0 | $13,000 | $18,866 | $19,504 | $0 | $666,819 | $41,992 | $0 | $0 |
| PAUL MCCAUGHEY MD | ||||||||||||||
| PHYSICIAN-ER | $516,686 | $0 | $1,000 | $0 | $2,164 | $0 | $10,452 | $0 | $20,054 | $0 | $550,356 | $0 | $0 | $0 |
| NIK NIKOUEIHA MD | ||||||||||||||
| PHYSICIAN-ER | $446,401 | $0 | $10,823 | $0 | $15,840 | $0 | $13,754 | $0 | $22,974 | $0 | $509,792 | $0 | $0 | $0 |
| PUBLIO ORTIZ MD | ||||||||||||||
| PHYSICIAN | $400,856 | $0 | $0 | $0 | $1,104 | $0 | $13,000 | $0 | $17,554 | $0 | $432,514 | $0 | $0 | $0 |
| RICHARD SEIDLER TO 610 | ||||||||||||||
| FORMER PRESIDENT/CEO | $0 | $521,953 | $0 | $140,259 | $0 | $59,956 | $0 | $256,706 | $0 | $16,104 | $0 | $994,978 | $0 | $0 |
| TOM TIBBITTS TO 1212 | ||||||||||||||
| FORMER INTERIM PRESIDENT/CEO | $0 | $0 | $0 | $0 | $0 | $604,359 | $0 | $32,950 | $0 | $0 | $0 | $637,309 | $0 | $604,359 |
| RUSSELL ADAMS MD TO 1212 | ||||||||||||||
| FORMER HOSPITALIST MEDICAL DIRECTOR | $0 | $352,745 | $0 | $32,666 | $0 | $601 | $0 | $25,225 | $0 | $12,508 | $0 | $423,745 | $0 | $0 |
| JAY WILLSHER TO 910 | ||||||||||||||
| FORMER VP REGIONAL OPERATIONS | $0 | $311,808 | $0 | $80,160 | $0 | $25,767 | $0 | $107,607 | $0 | $23,747 | $0 | $549,089 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD IMPUTED AMOUNTS TO PAYCHECK IN ORDER TO TAX APPROPRIATELY. |
| PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: PAMELA DELAGARDELLE $69,362, JENNIFER FRIEDLY $26,639, MARY HAGEN $21,382, RENEE RASMUSSEN $57,532, RICHARD SEIDLER $234,580, AND TOM TIBBITTS $32,950. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: TOM TIBBITTS $604,359. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||
| COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE | $412,000 | INVESTMENT, MANAGEMENT FEES, FINANCIAL SERVICES | 0 |
| CEDAR VALLEY COMMUNITY HEALTHCARE LLC | |||
| COMMON BOARD MEMBER/OFFICER | $5,000 | INVESTMENT | 0 |
| CEDAR VALLEY MEDICAL SPECIALISTS PC | |||
| COMMON BOARD MEMBER/SHAREHOLDER | $5,223,000 | RENT, CONTRACT PHYSICIANS, PHONE, CATERING, ETC. | 0 |
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||
| COMMON BOARD MEMBER/KEY EMPLOYEE | $749,735 | PERFORMANCE OF SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | STACEY BENTLEY; ROBERT BUCKLEY; BUSINESS RELATIONSHIP KYLE CHRISTIASON, MD; MICHAEL CHRISTIASON; FAMILY RELATIONSHIP |
| FORM 990, PART VI, SECTION A, LINE 6 | ALLEN HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGER, AND APPOINT BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE WILL BE THE SAME AS ALLEN HEALTH SYSTEMS, INC. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2014 FOR THE FOLLOWING INDIVIDUALS: PAMELA DELAGARDELLE, JENNIFER FRIEDLY, MARY HAGEN, RENEE RASMUSSEN, RICHARD SEIDLER, JAMES WATERBURY, AND JAY WILLSHER. 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: | CHANGES IN PENSION LIABILITY -2,563,656. CHANGE IN BENEFICIAL INTEREST OF MEMORIAL FOUNDATION OF ALLEN HOSPITAL -70,841. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (52 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 |
| 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 |
| 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) | IOWA HEALTH SYSTEM | 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 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 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 | UBI Code VUBICodeVAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | ALLEN MEMORIAL HOSPITAL CORPORATION | RELATED | $100,861 | $55,632 | 0 | Yes (1) | 0.20000 | ||
| 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 | ||||||||
| HEALTH ENTERPRISES VENTURES LC | |||||||||||||||
| 4250 GLASS ROAD NE | CEDAR RAPIDS | IA | 52402 | 391894290 | INVESTMENT VEHICLE OWNING CLINICAL JVS | IA | N/A | UNRELATED | $352 | 0 | 0 | $37,446 | |||
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||||||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421511142 | GROUP PURCHASING | IA | N/A | ||||||||
| MEDICAL LABORATORIES OF EASTERN IOWA LC | |||||||||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421359640 | MEDICAL LABORATORY SERVICES | 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 | ||||||||
| REGIONAL HEALTH PARTNERS LLC | |||||||||||||||
| 1258 W SOUTH ST | KEWANEE | IL | 61443 | 800899158 | AMBULATORY HEALTH CLINICS | IL | N/A | ||||||||
| REHABILITATION THERAPY SERVICES LLC | |||||||||||||||
| 416 ST MARKS CT 110 | PEORIA | IL | 61603 | 810584193 | REHABILATION THERAPY | IL | N/A | ||||||||
| SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 455322324 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A | ||||||||
| THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | |||||||||||||||
| 1075 FIRST AVENUE SE | CEDAR RAPIDS | IA | 52403 | 721550812 | AMBULATORY SURGERY CENTER. | IA | N/A | ||||||||
| TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 4500 UTICA RIDGE RD | BETTENDORF | IA | 52722 | 272562753 | ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES | IA | N/A | ||||||||
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 | Yes (1) | 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 | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 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 SEVENTEEN 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 |