ALLEN MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: ALLEN MEMORIAL HOSPITAL CORPORATION (EIN 42-0698265)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201303189349300015
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-14T06:51:42-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	420698265	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ALLE	NameControl
Phone	3192353995	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	507031916	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RENEE A RASMUSSEN	Name
Title	SR VP FINANCE/CFO	Title
Phone	3192353544	Phone
Date Signed	2013-11-01	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PAMELA DELAGARDELLE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	507031916	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	416460033	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.ALLENHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1938	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	2293	TotalNbrEmployees
Total Nbr Volunteers	365	TotalNbrVolunteers
Total Gross UBI	228651	TotalGrossUBI
Net Unrelated Business Txbl Income	-169527	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	4076680	ContributionsGrantsPriorYear
Contributions Grants Current Year	7130777	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	204453091	ProgramServiceRevenuePriorYear
Program Service Revenue CY	209306744	ProgramServiceRevenueCY
Investment Income Prior Year	3713202	InvestmentIncomePriorYear
Investment Income Current Year	14601713	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1601374	OtherRevenuePriorYear
Other Revenue Current Year	1666894	OtherRevenueCurrentYear
Total Revenue Prior Year	213844347	TotalRevenuePriorYear
Total Revenue Current Year	232706128	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	5824903	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	7919184	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	89039701	SalariesEtcPriorYear
Salaries Etc Current Year	92528832	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	107263108	OtherExpensePriorYear
Other Expenses Current Year	111127893	OtherExpensesCurrentYear
Total Expenses Prior Year	202127712	TotalExpensesPriorYear
Total Expenses Current Year	211575909	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	11716635	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	21130219	RevenuesLessExpensesCY
Total Assets BOY	240687848	TotalAssetsBOY
Total Assets EOY	254744643	TotalAssetsEOY
Total Liabilities BOY	109217221	TotalLiabilitiesBOY
Total Liabilities EOY	111201627	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	131470627	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	143543016	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE MISSION OF ALLEN MEMORIAL HOSPITAL CORPORATION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	168987279	Expense
Grants	7131001	Grants
Revenue	210889674	Revenue
Description	HEALTH-CARE SERVICESALLEN 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, HOME HEALTH, 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, 2012, ALLEN MEMORIAL HOSPITAL CORPORATION ADMITTED 10,516 PATIENTS WITHOUT NEWBORNS AND NICU AND 11,508 PATIENTS WITH NEWBORNS AND NICU, RESULTING IN A TOTAL OF 39,716 PATIENT DAYS WITHOUT NEWBORNS AND NICU, AND 42,355 PATIENT DAYS WITH NEWBORNS AND NICU. OUTPATIENT VISITS TOTALED 269,721 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 9631. THERE WERE ALSO 34,560 EMERGENCY ROOM VISITS AND 956 BABIES DELIVERED.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	14676363	Expense
Grants	788183	Grants
Description	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 OVER 2,000 PEOPLE AT A VALUE OF $4,892,422 IN 2012. 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 $4,997,847 FOR 2012. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $9,890,269.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 10,368 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE: $4,188,174.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	183663642	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	192	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2293	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	IA	StatesWhereCopyOfReturnIsFiled
Own Website	X	OwnWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RENEE RASMUSSEN SR VP FINANCECFO	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3192353995	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	50703	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
MARK BALDWIN
BOARD CHAIR	1.00	1.00	X	X	194	3574	0
BOB BUCKLEY
BOARD MEMBER	1.00	1.00	X		50	0	0
MICHAEL CHRISTIASON
BOARD MEMBER	1.00	1.00	X		313	177	0
DAVE HAPPEL
BOARD MEMBER	1.00	1.00	X		50	0	0
BETH HANSEN
BOARD MEMBER	1.00	1.00	X		50	0	0
BILAL KAAKI
BOARD MEMBER	40.00	1.00	X		720902	0	38773
LAWRENCE LIEBSCHER MD
BOARD MEMBER	1.00	1.00	X		50	11500	0
KATHY MCCOY
BOARD MEMBER	1.00	1.00	X		50	0	0
BEV SMITH
BOARD MEMBER	1.00	1.00	X		785	177	0
ROBERT SMITH
BOARD MEMBER	1.00	1.00	X		50	0	0
BETTY STEEGE
BOARD MEMBER	1.00	1.00	X		50	0	0
KALYANA SUNDARAM MD
BOARD MEMBER	1.00	1.00	X		649	0	0
KEVIN SWALLEY
BOARD VICE CHAIR	1.00	1.00	X	X	818	0	0
TOM TIBBITTS
BOARD MEMBER/INTERIM PRESIDENT/CEO	40.00	1.00	X	X	0	907099	25149
JEAN TRAINOR
BOARD TREASURER	1.00	1.00	X	X	70	0	0
BISHOP STEVE ULLESTAD
BOARD MEMBER	1.00	1.00	X		445	0	0
MIKE WILLIAMS
BOARD MEMBER	1.00	1.00	X		418	14838	0
RENEE RASMUSSEN
SR VP FINANCE/CFO	40.00	1.00		X	301810	0	67808
RUSSELL ADAMS
HOSPITALIST MEDICAL DIRECTOR	40.00	0.00			0	346139	39656	X
JENNIFER FRIEDLY
DIRECTOR-OR	40.00	0.00			161172	0	21884	X
TIM HORRIGAN MD
CMO	40.00	0.00			0	304393	37919	X
JUDITH RENAAS
CNE	40.00	0.00			280797	0	69957	X
STEVE SLESSOR
VP OF OPERATIONS	40.00	0.00			176620	0	23288	X
JAMES WATERBURY
VP INSTITUTIONAL DEVELOP	40.00	1.00			227736	0	33675	X
CHRISTOPHER HILL
PHYSICIAN	40.00	0.00			470738	0	21360		X
PAUL MCCAUGHEY
PHYSICIAN	40.00	0.00			517851	0	32810		X
HIND MOUSSA
PHYSICIAN	40.00	0.00			426572	0	14939		X
PUBLIO ORTIZ
PHYSICIAN	40.00	0.00			427010	0	28868		X
ISLAM TAFISH
PHYSICIAN	40.00	0.00			401013	0	21539		X
JOHN KNOX TO 1111
FORMER PRESIDENT/CEO	0.00	0.00			578376	0	26789			X
RICHARD SEIDLER TO 610
FORMER PRESIDENT/CEO	0.00	0.00			0	628499	258250			X
JEFFREY CRANDALL MD TO 511
FORMER CMO	0.00	0.00			0	212670	23435			X
JAY WILLSHER TO 910
FORMER VP REGIONAL OPERATIONS	0.00	0.00			0	323467	113701			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4694639	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2752533	TotalReportableCompFrmRltdOrgs
Total Other Compensation	899800	TotalOtherCompensation
Number Individuals GT100 K	80	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
KNUTSON CONSTRUCTION SERVICES
2351 S SCOTT BLVD	IOWA CITY	IA	52240	CONSTRUCTION SERVICES	6323590
ARAMARK MANAGEMENT SERVICES LP
22506 NETWORK PLACE	CHICAGO	IL	60673	PERSONNEL	3777304
CEDAR VALLEY MEDICAL SPECIALISTS
PO BOX 2758	WATERLOO	IA	50704	MEDICAL SERVICES	3297665
LARSON CONSTRUCTION CO INC
PO BOX 112	INDEPENDENCE	IA	50644	CONSTRUCTION SERVICES	2089127
WEATHERBY LOCUMS INC
PO BOX 972633	DALLAS	TX	75397	LOCUMS	1272281

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	20	NumberOfContractorsGT100K
Membership Dues	3129	MembershipDues
Related Organizations	5987694	RelatedOrganizations
Government Grants	1112553	GovernmentGrants
All Other Contributions	27401	AllOtherContributions
Total Contributions	7130777	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
NET PATIENT REVENUE	900099	156534798	156534798
PHARMACY REVENUE	446110	49414300	49205263	208867	$170
RENTAL INCOME	531100	1694797	1694697	100
MANAGEMENT, IT AND SUPPORT SVCS	561000	1644939	1576515		$68,424
SUBS & JOINT VENTURES	900099	87905	68616	19289

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-69995	TotalRevenueColumn
Related Or Exempt Function Income	-69995	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	209306744	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1948709	TotalRevenueColumn
Exclusion	$1,948,709	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	11603	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1528	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	10075	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	10075	TotalRevenueColumn
Exclusion	$10,075	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	196181590	Securities
Other	7926	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	183494262	Securities
Other	42250	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	12687328	Securities
Other	-34324	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	12653004	TotalRevenueColumn
Exclusion	$12,653,004	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	86372	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	66701	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	19671	TotalRevenueColumn
Exclusion	$19,671	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	203382	GrossSalesOfInventory
Cost Of Goods Sold	149164	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	54218	TotalRevenueColumn
Exclusion	$54,218	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA/FOOD SVCS	722210	1008521	1008521
MISCELLANEOUS REVENUE	900099	532704	532704
PHARMACY REVENUE	446110	41705	41310	395

Field	Value	IRS element (for citing)
Total Other Revenue	1582930	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	232706128	TotalRevenueColumn
Related Or Exempt Function Income	210592429	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	228651	UnrelatedBusinessRevenue
Exclusion	$14,754,271	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	7903309	Total
Program Services	7903309	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	15875	Total
Program Services	15875	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2856574	Total
Management And General	2856574	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	858602	Total
Management And General	858602	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	70404157	Total
Program Services	64955601	ProgramServices
Management And General	5448556	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2925455	Total
Program Services	2699055	ProgramServices
Management And General	226400	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	10442558	Total
Program Services	9634412	ProgramServices
Management And General	808146	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	5041486	Total
Program Services	4651327	ProgramServices
Management And General	390159	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	3731102	Total
Program Services	21870	ProgramServices
Management And General	3709232	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	935078	Total
Management And General	935078	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	407445	Total
Program Services	145355	ProgramServices
Management And General	262090	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	21623139	Total
Program Services	16325421	ProgramServices
Management And General	5297718	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	399604	Total
Program Services	13149	ProgramServices
Management And General	386455	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5860870	Total
Program Services	5271066	ProgramServices
Management And General	589804	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	14143189	Total
Program Services	12246025	ProgramServices
Management And General	1897164	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	4136940	Total
Program Services	3289904	ProgramServices
Management And General	847036	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	271897	Total
Program Services	222655	ProgramServices
Management And General	49242	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	99575	Total
Program Services	64020	ProgramServices
Management And General	35555	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	3034265	Total
Management And General	3034265	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	12690128	Total
Program Services	12452313	ProgramServices
Management And General	237815	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	64038	Total
Program Services	64038	ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	43554403	43540456	13947
MISCELLANEOUS EXPENSE	174987	146558	28429
BAD DEBT EXPENSE	1233	1233

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	211575909	Total
Program Services	183663642	ProgramServices
Management And General	27912267	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3431635	BOY
EOY	6145478	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	11946275	BOY
EOY	4381261	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	1823270	BOY
EOY	1962915	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	23135969	BOY
EOY	25841528	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	5017238	BOY
EOY	3206197	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	6011290	BOY
EOY	5675057	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	765761	BOY
EOY	999110	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	225353437	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	120361640	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	100497693	BOY
EOY	104991797	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	80081908	BOY
EOY	96096467	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	102355	BOY
EOY	32349	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	4199562	BOY
EOY	1861853	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	3664892	BOY
EOY	3545631	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	10000	BOY
EOY	5000	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	240687848	BOY
EOY	254744643	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	19060424	BOY
EOY	20830901	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	28894	BOY
EOY	31805	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	91554	BOY
EOY	50049	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	5894584	BOY
EOY	6214230	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	84141765	BOY
EOY	84074642	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	109217221	BOY
EOY	111201627	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	125520236	BOY
EOY	139789258	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4164387	BOY
EOY	1798280	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1786004	BOY
EOY	1955478	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	131470627	BOY
EOY	143543016	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	240687848	BOY
EOY	254744643	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	21130219	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-4692422	ReconciliationUnrealizedInvest
Reconcilation Other Changes	-4365408	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	84637772	BeginningOfYearBalance
Contributions	6969458	Contributions
Investment Earnings Or Losses	10300929	InvestmentEarningsOrLosses
Other Expenditures	2841422	OtherExpenditures
Administrative Expenses	183400	AdministrativeExpenses
End Of Year Balance	98883337	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	75776848	BeginningOfYearBalance
Contributions	12020271	Contributions
Investment Earnings Or Losses	-907542	InvestmentEarningsOrLosses
Other Expenditures	2013448	OtherExpenditures
Administrative Expenses	238357	AdministrativeExpenses
End Of Year Balance	84637772	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	62282606	BeginningOfYearBalance
Contributions	6212189	Contributions
Investment Earnings Or Losses	8740976	InvestmentEarningsOrLosses
Other Expenditures	1180548	OtherExpenditures
Administrative Expenses	278375	AdministrativeExpenses
End Of Year Balance	75776848	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	42620642	BeginningOfYearBalance
Contributions	10459126	Contributions
Investment Earnings Or Losses	10425170	InvestmentEarningsOrLosses
Other Expenditures	1016429	OtherExpenditures
Administrative Expenses	205903	AdministrativeExpenses
End Of Year Balance	62282606	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	59647961	BeginningOfYearBalance
Contributions	2042078	Contributions
Investment Earnings Or Losses	-12929473	InvestmentEarningsOrLosses
Grants Or Scholarships	6014219	GrantsOrScholarships
Administrative Expenses	125705	AdministrativeExpenses
End Of Year Balance	42620642	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.96200	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.01980	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.01820	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1284668	OtherCostOrOtherBasis
Book Value	1284668	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	120210515	OtherCostOrOtherBasis
Depreciation	60533369	Depreciation
Book Value	59677146	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3212026	OtherCostOrOtherBasis
Depreciation	2677554	Depreciation
Book Value	534472	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	90080647	OtherCostOrOtherBasis
Depreciation	52746452	Depreciation
Book Value	37334195	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	10565581	OtherCostOrOtherBasis
Depreciation	4404265	Depreciation
Book Value	6161316	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	104991797	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescription	AmountAmount
ASBESTOS REMOVAL LIABILITY	$4,682,439
DUE TO AFFILIATES	$6,814,101
LONG-TERM RETENTION INCENTIVES	$1,124,650
MISCELLANEOUS LIABILITY	$810,000
IOWA HEALTH SYSTEM NOTE PAYABLE	$59,557,683
SELF-INSURANCE RESERVE	$4,500,512
DEFINED BENEFIT RETIREMENT PLAN LIABILITY	$5,681,431
HEALTH AND WELFARE BENEFITS RESERVE	$903,826

Field	Value	IRS element (for citing)
Total Of Amounts	84074642	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	221984000	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-4861896	NetUnrealizedGainsInvestments
Other Revenues	2516837	OtherRevenues
Revenue Not Rptd F990	-2345059	RevenueNotRptdF990
Revenue Subtotal	224329059	RevenueSubtotal
Investment Expenses Not Included	183400	InvestmentExpensesNotIncluded
Other Revenues Not Included	8193669	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	8377069	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	232706128	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	200125000	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	150692	OtherExpensesIncluded
Expenses Not Rptd F990	150692	ExpensesNotRptdF990
Expenses Subtotal	199974308	ExpensesSubtotal
Investment Expenses Not Included2	183400	InvestmentExpensesNotIncluded2
Other Expenses Not Included	11418201	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	11601601	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	211575909	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	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.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	IOWA HEALTH SYSTEM 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 HEALTH 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 2009. THE HEALTH 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 DURING THE CARRYFORWARD PERIOD. NO INCOME TAX BENEFIT HAS BEEN RECOGNIZED FOR THE NET OPERATING LOSS CARRYFORWARDS OR OTHER POTENTIAL DEFERRED TAX ASSETS IN THE CONSOLIDATED FINANCIAL STATEMENTS BECAUSE THE HEALTH SYSTEM BELIEVES REALIZATION OF THESE BENEFITS IS UNLIKELY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:		REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 2,366,107. COST OF GOODS SOLD 149,164. RENTAL EXPENSES REPORTED AS OFFSET TO RENTAL INCOME 1,528. ROUNDING 38.
PART XI, LINE 4B - OTHER ADJUSTMENTS:		REVENUES IN UNRESTRICTED FUND BALANCE 7,566,449. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 627,220.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		COST OF GOODS SOLD 149,164. RENTAL EXPENSES REPORTED AS OFFSET TO RENTAL INCOME 1,528.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		EXPENSES IN UNRESTRICTED FUND BALANCE 10,790,952. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 627,220. ROUNDING 29.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SCRUB SALES	NameOfEvent1
Gross Receipts Event1	53441	GrossReceiptsEvent1
Gross Revenue Event1	53441	GrossRevenueEvent1
Other Direct Expenses Event1	43401	OtherDirectExpensesEvent1
Name Of Event2	BOOK SALES	NameOfEvent2
Gross Receipts Event2	15073	GrossReceiptsEvent2
Gross Revenue Event2	15073	GrossRevenueEvent2
Other Direct Expenses Event2	12996	OtherDirectExpensesEvent2
Total Number Of Other Events	7	TotalNumberOfOtherEvents
Gross Receipts Other Events	17858	GrossReceiptsOtherEvents
Gross Revenue Other Events	17858	GrossRevenueOtherEvents
Other Direct Expenses Other Events	10304	OtherDirectExpensesOtherEvents
Gross Receipts Total	86372	GrossReceiptsTotal
Gross Revenue Total Events	86372	GrossRevenueTotalEvents
Other Direct Expenses Total Events	66701	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	66701	DirectExpenseSummaryEvents
Net Income Summary	19671	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4760651	TotalCommunityBenefitExpense
Net Community Benefit Expense	4760651	NetCommunityBenefitExpense
Percent Of Total Expense	0.02250	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	8953	PersonsServed
Total Community Benefit Expense	20672848	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15675001	DirectOffsettingRevenue
Net Community Benefit Expense	4997847	NetCommunityBenefitExpense
Percent Of Total Expense	0.02360	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	8953	PersonsServed
Total Community Benefit Expense	25433499	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15675001	DirectOffsettingRevenue
Net Community Benefit Expense	9758498	NetCommunityBenefitExpense
Percent Of Total Expense	0.04610	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Persons Served	10004	PersonsServed
Total Community Benefit Expense	1427238	TotalCommunityBenefitExpense
Direct Offsetting Revenue	142771	DirectOffsettingRevenue
Net Community Benefit Expense	1284467	NetCommunityBenefitExpense
Percent Of Total Expense	0.00610	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Persons Served	364	PersonsServed
Total Community Benefit Expense	91682	TotalCommunityBenefitExpense
Net Community Benefit Expense	91682	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1077284	TotalCommunityBenefitExpense
Net Community Benefit Expense	1077284	NetCommunityBenefitExpense
Percent Of Total Expense	0.00510	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	29	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	3888199	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1423767	DirectOffsettingRevenue
Net Community Benefit Expense	2464432	NetCommunityBenefitExpense
Percent Of Total Expense	0.01160	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	29	NumberOfActivitiesOrPrograms
Persons Served	10368	PersonsServed
Total Community Benefit Expense	6484403	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1566538	DirectOffsettingRevenue
Net Community Benefit Expense	4917865	NetCommunityBenefitExpense
Percent Of Total Expense	0.02320	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	29	NumberOfActivitiesOrPrograms
Persons Served	19321	PersonsServed
Total Community Benefit Expense	31917902	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17241539	DirectOffsettingRevenue
Net Community Benefit Expense	14676363	NetCommunityBenefitExpense
Percent Of Total Expense	0.06930	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Persons Served	25	PersonsServed
Total Community Building Expense	15496	TotalCommunityBuildingExpense
Net Community Building Expense	15496	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	1212	PersonsServed
Total Community Building Expense	16540	TotalCommunityBuildingExpense
Net Community Building Expense	16540	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	30	PersonsServed
Total Community Building Expense	807542	TotalCommunityBuildingExpense
Net Community Building Expense	807542	NetCommunityBuildingExpense
Percent Of Total Expense	0.00380	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20	PersonsServed
Total Community Building Expense	516	TotalCommunityBuildingExpense
Net Community Building Expense	516	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	11	NumberOfActivitiesOrPrograms
Persons Served	1287	PersonsServed
Total Community Building Expense	840094	TotalCommunityBuildingExpense
Net Community Building Expense	840094	NetCommunityBuildingExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$3,005,909	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	73784025	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	71306056	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	2477969	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	MANAGE ORTHOPEDIC SERVICE LINE	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.20000	OrganizationProfitOrOwnership
Physicans Profit Or Ownership	0.80000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVENUE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	50703	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	11	NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
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
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 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 SERVICE
HEALTH ENTERPRISES OF IOWA
4250 GLASS ROAD NE SUITE 200	CEDAR RAPIDS	IA	52402	MANAGEMENT COMPANY
ALLEN OB-GYN
1015 S HACKETT ROAD SUITE 200	WATERLOO	IA	50701	OUTPATIENT ONLY - WOMEN'S OB-GYN

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
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 I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1233.
PART II: 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.
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.ALLENHOSPITAL.ORG UNDER FINANCE.
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 11,600 INPATIENTS AND CARES FOR 34,500 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 $42,108 TO $58,372 AND THE AVERAGE POVERTY RATE IS 11.5%.MORE THAN 50% 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 87% CAUCASIAN AMERICAN AND BOSNIAN, 8% 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. INITIALLY FORMED IN 1995, IOWA HEALTH SYSTEM IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 29 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND 280 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 24,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 4 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2.7 BILLION, IOWA HEALTH SYSTEM 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. IOWA HEALTH SYSTEM 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 2012, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED $421 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY IOWA HEALTH SYSTEM AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES.
IA	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
460 N LINDBERGH BLVD	ST LOUIS	MO	63141	135613797	501(C)(3)	45320	PROGRAM SUPPORT
GALLEGHER BLUEDORN UNI
UNIVERSITY OF NORTHERN IA	CEDAR FALLS	IA	50613	426004333	501(C)(3)	48750	PROGRAM SUPPORT
IOWA HEALTH PHYSICIANS
8101 BIRCHWOOD COURT SUITE N	JOHNSTON	IA	50131	421411630	501(C)(3)	4696841	PROGRAM SUPPORT
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUE	WATERLOO	IA	50703	421201138	501(C)(3)	3088604	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	4	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	40	NumberOfRecipients
Amount Of Cash Grant	15875	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	X	TravelForCompanions
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BILAL KAAKI
BOARD MEMBER	709549	0	0	0	11353	0	20245	0	18528	0	759675	0	0	0
TOM TIBBITTS
BOARD MEMBER/INTERIM PRESIDENT/CEO	0	352970	0	49612	0	504517	0	12500	0	12649	0	932248	0	449963
RENEE RASMUSSEN
SR VP FINANCE/CFO	211425	0	67109	0	23276	0	44232	0	23576	0	369618	0	0	0
RUSSELL ADAMS
HOSPITALIST MEDICAL DIRECTOR	0	343217	0	0	0	2922	0	27329	0	12327	0	385795	0	0
JENNIFER FRIEDLY
DIRECTOR-OR	142611	0	18561	0	0	0	4970	0	16914	0	183056	0	0	0
TIM HORRIGAN MD
CMO	0	252625	0	47748	0	4020	0	16412	0	21507	0	342312	0	0
JUDITH RENAAS
CNE	196168	0	60115	0	24514	0	69841	0	116	0	350754	0	0	0
STEVE SLESSOR
VP OF OPERATIONS	144192	0	32428	0	0	0	8977	0	14311	0	199908	0	0	0
JAMES WATERBURY
VP INSTITUTIONAL DEVELOP	155032	0	48548	0	24156	0	11881	0	21794	0	261411	0	0	0
CHRISTOPHER HILL
PHYSICIAN	434841	0	22847	0	13050	0	12500	0	8860	0	492098	0	0	0
PAUL MCCAUGHEY
PHYSICIAN	473086	0	28499	0	16266	0	10271	0	22539	0	550661	0	0	0
HIND MOUSSA
PHYSICIAN	423117	0	0	0	3455	0	9266	0	5673	0	441511	0	0	0
PUBLIO ORTIZ
PHYSICIAN	426320	0	0	0	690	0	12500	0	16368	0	455878	0	0	0
ISLAM TAFISH
PHYSICIAN	344095	0	0	0	56918	0	5000	0	16539	0	422552	0	0	0
JOHN KNOX TO 1111
FORMER PRESIDENT/CEO	0	0	114414	0	463962	0	16549	0	10240	0	605165	0	298980	0
RICHARD SEIDLER TO 610
FORMER PRESIDENT/CEO	0	480524	0	87666	0	60309	0	245587	0	12663	0	886749	0	0
JEFFREY CRANDALL MD TO 511
FORMER CMO	0	194821	0	16549	0	1300	0	9421	0	14014	0	236105	0	0
JAY WILLSHER TO 910
FORMER VP REGIONAL OPERATIONS	0	252108	0	39372	0	31987	0	88838	0	24863	0	437168	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	TRAVEL FOR COMPANIONS SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS.
PART I, LINES 4A-B	SEVERANCE PAYMENT: THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE YEAR THAT WAS INCLUDED IN THEIR TAXABLE INCOME: JOHN KNOX $164,981. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: RENEE RASMUSSEN $18,697, JUDITH RENAAS $44,841, AND RICHARD SEIDLER $223,629.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
COMMON BOARD MEMBER/OFFICER	29000	INVESTMENT	0
CEDAR VALLEY COMMUNITY HEALTHCARE LLC
COMMON BOARD MEMBER/OFFICER	44000	INVESTMENT	0
CEDAR VALLEY MEDICAL SPECIALISTS PC
COMMON BOARD MEMBER/SHAREHOLDER	4338000	RENT, MEDICAL SERVICES, LAUNDRY, PHONE, ETC.	0
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
COMMON BOARD MEMBER/OFFICER	751081	PERFORMANCE OF SERVICES	0
KAREN KNOX
FAMILY MEMBER OF OFFICER JOHN KNOX	24387	EMPLOYMENT	0
KIRK GROSS COMPANY
COMMON BOARD MEMBER/OFFICER	640307	FURNITURE AND DESIGN SERVICES	0
NINA THOMAS
FAMILY MEMBER OF BOARD MEMBER BEV SMITH	47906	EMPLOYMENT	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	ROBERT BUCKLEY; KATHY MCCOY; ROBERT SMITH; BUSINESS 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 NOVEMBER 2012 FOR THE FOLLOWING INDIVIDUALS: RENEE RASMUSSEN, JUDITH RENAAS, RICHARD SEIDLER, AND JAMES WATERBURY. 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	IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS.
FORM 990, PART IX, LINE 11G	HEALTH-CARE PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 7,864,270. MANAGEMENT AND GENERAL EXPENSES 3,426,342. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,290,612. PURCHASED HOUSEKEEPING AND LAUNDRY : PROGRAM SERVICE EXPENSES 1,292,879. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,292,879. MISCELLANEOUS PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 7,168,272. MANAGEMENT AND GENERAL EXPENSES 1,871,376. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,039,648.	OTHER FEES
FORM 990, PART XI, LINE 9:	CHANGES IN PENSION LIABILITY -4,365,408.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (42 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
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
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
HNC SERVICES
1776 WEST LAKES PKWY 400	WEST DES MOINES	IA	50266	270987243	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	0
INTRUST
11333 AURORA AVENUE	URBANDALE	IA	50322	421477471	HOME HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	0
IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200	DES MOINES	IA	50309	421467682	CHARITABLE FUNDRAISING	IA	501(C)(3)	509(A)(3), TYPE III	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
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	371111135	HEALTHCARE	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	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	HEALTHCARE	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
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
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

Form990 Schedule R Part III Form990ScheduleRPartIII (19 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Direct Controlling Entity NADirectControllingEntityNA	Code VCodeVAmount
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	126185	43766	0	1	0.20000
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT ST	DES MOINES	IA	50309	273625869	CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES	IA	CENTRAL IOWA HOSPITAL CORPORATION	RELATED	261340	80230	0	1	0.20000
CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY
1200 PLEASANT STREET	DES MOINES	IA	50309	453017991	ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES	IA	CENTRAL IOWA HOSPITAL CORPORATION	RELATED	201563	101327	0	1	0.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT ST	DES MOINES	IA	50309	382622972	PARKING DECK OPERATIONS	IA	CENTRAL IOWA HEALTH PROP CORP	RELATED	1033046		0	1	1.00000
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500	DUBUQUE	IA	52001	201597161	AMBULATORY SURGERY CENTER	IA	THE FINLEY HOSPITAL	RELATED	636788	274391	0	0	0.51000
ENSEVA - HIAWATHA LLC
755 METZGER DRIVE	HIAWATHA	IA	52233	453437363	COLLOCATION FACILITY	IA	IOWA HEALTH SYSTEM	RELATED	-150730	2077107	0	0	0.52000
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVE	DUBUQUE	IA	52001	422808785	SURGERY DEPARTMENT MANAGEMENT SERVICES	IA	THE FINLEY HOSPITAL	RELATED	110302	155255	0	1	0.50000
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVE	DUBUQUE	IA	52001	421428503	PROVIDE ACCESS TO LICENSED SOFTWARE	IA	THE FINLEY HOSPITAL	RELATED		14037	0	1	0.50000
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NE	CEDAR RAPIDS	IA	52402	391894290	INVESTMENT VEHICLE OWNING CLINICAL JVS	IA		UNRELATED	85147	837296	0	0	0.55670	N/A	$70,249
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAY	WEST DES MOINES	IA	50266	263293530	PRIMARY CARE CLINIC	IA	CENTRAL IOWA HOSPITAL CORPORATION	RELATED	-186843	186116	0	1	0.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1776 WEST LAKES PKWY 400	WEST DES MOINES	IA	50266	421511142	GROUP PURCHASING	IA	IOWA HEALTH SYSTEM	RELATED	3278657	7072097	1	1	1.00000
MEDICAL LABORATORIES OF EASTERN IOWA LC
1026 A AVE NE	CEDAR RAPIDS	IA	52402	421359640	MEDICAL LABORATORY SERVICES	IA	ST LUKE'S METHODIST HOSPITAL	RELATED	466410	1180716	0	1	0.50000
MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
221 NE GLEN OAK AVE	PEORIA	IL	61636	461219459	ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES	IL	METHODIST MEDICAL CENTER OF ILLINOIS	RELATED		32000	0	1	0.20000
MR ASSOCIATES LLP
1455 SHERMAN ROAD	HIAWATHA	IA	52233	421260463	OWN AND OPERATE MR UNIT	IA	ST LUKE'S METHODIST HOSPITAL	RELATED	2526085	1348049	0	1	0.33330
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110	PEORIA	IL	61603	810584193	REHABILATION THERAPY	IL	METHODIST MEDICAL CENTER OF ILLINOIS	RELATED	323118	1122254	0	0	0.60040
SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC
2720 STONE PARK BLVD	SIOUX CITY	IA	51104	455322324	CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES	IA	NORTHWEST IOWA HOSPITAL CORPORATION	RELATED	30396	47646	0	1	0.20000
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SE	CEDAR RAPIDS	IA	52403	721550812	AMBULATORY SURGERY CENTER.	IA	ST LUKE'S METHODIST HOSPITAL	RELATED	3272140	5076873	0	1	0.50000
TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
4500 UTICA RIDGE RD	BETTENDORF	IA	52722	272562753	ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES	IA	TRINITY MEDICAL CENTER	RELATED	235523	149417	0	1	0.50000
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREET	WEST DES MOINES	IA	50266	271414600	ORTHOPEDIC SERVICE LINES MANAGEMENT	IA	CENTRAL IOWA HOSPITAL CORPORATION	RELATED	245617	16245	0	1	0.20000

Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg
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
INTEGRATED CARE ORGANIZATION
1776 WEST LAKES PKWY 400	WEST DES MOINES	IA	50266	274665007	INTEGRATED AFFILIATE CARE	IA	N/A	C	0
IOWA HEALTH SYSTEM 457 DEF COMP PLAN
1776 WEST LAKES PKWY 400	WEST DES MOINES	IA	50266	421435199	INVESTMENT	IA	N/A	T	0
MEDIMORE INC
1776 WEST LAKES PKWY 400	WEST DES MOINES	IA	50266	421414390	MANAGED CARE	IA	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
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 Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg