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CENTRAL IOWA HOSPITAL CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CENTRAL IOWA HOSPITAL CORPORATION (EIN 42-0680452)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201333189349304268
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T13:34:23-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN420680452EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL IOWA HOSPITAL CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone5152416212Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 PLEASANT STAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code503091453ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOSEPH F CORFITSName
TitleSENIOR VP FINANCE/CFOTitle
Phone5152416396Phone
Date Signed2013-11-11DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonERIC T CROWELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11200 PLEASANT STAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code503091453ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1516666933GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UNITYPOINT.ORG/DES-MOINES.ASPXWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1933YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionIMPROVING THE HEALTH OF THE COMMUNITY THROUGH HEALING, CARING AND TEACHING.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees6497TotalNbrEmployees
Total Nbr Volunteers9174TotalNbrVolunteers
Total Gross UBI14796582TotalGrossUBI
Net Unrelated Business Txbl Income3144073NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9455763ContributionsGrantsPriorYear
Contributions Grants Current Year7404440ContributionsGrantsCurrentYear
Program Service Revenue Prior Year668022800ProgramServiceRevenuePriorYear
Program Service Revenue CY641617707ProgramServiceRevenueCY
Investment Income Prior Year20742840InvestmentIncomePriorYear
Investment Income Current Year62506054InvestmentIncomeCurrentYear
Other Revenue Prior Year7101192OtherRevenuePriorYear
Other Revenue Current Year8586039OtherRevenueCurrentYear
Total Revenue Prior Year705322595TotalRevenuePriorYear
Total Revenue Current Year720114240TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4127361GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY18619833GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year361594672SalariesEtcPriorYear
Salaries Etc Current Year323266688SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year300283479OtherExpensePriorYear
Other Expenses Current Year302949469OtherExpensesCurrentYear
Total Expenses Prior Year666005512TotalExpensesPriorYear
Total Expenses Current Year644835990TotalExpensesCurrentYear
Revenues Less Expenses Prior Year39317083RevenuesLessExpensesPriorYear
Revenues Less Expenses CY75278250RevenuesLessExpensesCY
Total Assets BOY816650125TotalAssetsBOY
Total Assets EOY845832765TotalAssetsEOY
Total Liabilities BOY306304651TotalLiabilitiesBOY
Total Liabilities EOY276320904TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY510345474NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY569511861NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIMPROVING THE HEALTH OF THE COMMUNITY THROUGH HEALING, CARING AND TEACHING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense513223798Expense
Grants17359542Grants
Revenue644756878Revenue
DescriptionHEALTH-CARE SERVICESCENTRAL IOWA HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. CENTRAL IOWA HOSPITAL CORPORATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2012, CENTRAL IOWA HOSPITAL CORPORATION ADMITTED 35,566 PATIENTS RESULTING IN A TOTAL OF 175,541 PATIENT DAYS. OUTPATIENT VISITS TOTALED 324,889 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 22,674. THERE WERE ALSO 83,753 EMERGENCY ROOM VISITS AND 4,302 BABIES DELIVERED.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense44599665Expense
Grants1260291Grants
Revenue0Revenue
DescriptionCHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE TO 3,811 PEOPLE AT A VALUE OF $9,416,104 IN 2012. OFTENTIMES, CENTRAL IOWA HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. CENTRAL IOWA HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA METHODIST MEDICAL CENTER, IOWA LUTHERAN HOSPITAL AND BLANK CHILDREN'S HOSPITALS' NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $21,891,217 FOR 2012. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $31,307,321.OTHER BENEFITS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS 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. CENTRAL IOWA HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. CENTRAL IOWA HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 16,163 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL NET OTHER BENEFITS REPORTED VALUE: $13,292,344.Description
FieldValueIRS element (for citing)
Total Program Service Expense557823463TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096291NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees6497NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledIAStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOSEPH F CORFITS SENIOR VPCFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5152416470TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 PLEASANT STAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code50309ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (43 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
BRAD ARCHER MD FROM 0212
BOARD MEMBER1.001.00X62200
LARRY BAKER DO
BOARD MEMBER40.001.00X442843034140
BRAD BRODY
BOARD VICE CHAIR1.001.00X46000X
BISHOP MICHAEL BURK
BOARD SECRETARY1.001.00X46100X
MARY CHAPMAN
BOARD MEMBER1.001.00X46000
ERIC CROWELL
BOARD MEMBER/CEO40.001.00X7849360354442X
STEVE GOLDSTEIN
BOARD MEMBER1.0040.00X048803132628
DIANA GORSCHE
BOARD MEMBER1.001.00X46100
KENT HENNING
BOARD MEMBER1.001.00X461118580
STEVE HERWIG
BOARD MEMBER1.001.00X461117980
JAMES HUBBELL III TO 0612
BOARD MEMBER1.001.00X19600
BURTON TOBY JOSEPH
BOARD CHAIR1.001.00X46111420X
RICHARD MCCONNELL
BOARD MEMBER1.001.00X461146440
PAT MCGOLDRICK
BOARD MEMBER1.001.00X53100
JANETTE MILLER-STRAUB
BOARD MEMBER1.001.00X46100
MARY O'KEEFE
BOARD MEMBER1.001.00X46100
JAMES PATTEN MD
BOARD MEMBER1.001.00X46100
RICK PERTZBORN
BOARD MEMBER1.001.00X000
BRUCE SHERMAN
BOARD MEMBER1.001.00X494158760
LYLE SIMPSON FROM 0612
BOARD MEMBER1.001.00X46100
BISHOP JULIUS TRIMBLE
BOARD MEMBER1.001.00X46100
RICHARD WILLIS
BOARD TREASURER1.001.00X46100X
MARTHA WILLITS FROM 0612
BOARD MEMBER1.001.00X000
JOSEPH CORFITS
SENIOR VP FINANCE/CFO40.001.00457563059364X
AMY BETHEL
EXEC DIR SURGERY40.000.00162758037650X
CHRISTINE BLAIR
CHIEF ADMINISTRATIVE OFFICER-W40.000.00212314043701X
DOUGLAS DORNER
VP MEDICAL EDUCATION40.000.00665325041500X
CECELIA KIRVIN
EXEC DIR/CCO BCH40.000.00166295030207X
TODD KRANPITZ
EXEC DIR DIAGNOSTIC SVCS40.000.00168253025005X
ERIC LOTHE
VP OPERATIONS/CAO-ILH40.000.00401575047843X
JOYCE MCDANEL
VP HUMAN RESOURCES40.000.00272698065938X
DEBRA MOYER
CHIEF NURSING EXEC40.000.00347195044349X
MARK PURTLE
VP MEDICAL AFFAIRS40.000.005161100198681X
SIDNEY RAMSEY
VP STRATEGIC BUSINESS DEV-CIHS40.000.00354399044806X
DAVID STARK
PRESIDENT/COO BCH & EVP IHDM40.000.00465445054919X
STEPHEN STEPHENSON
EXEC VP/COO-IHDM40.000.005528370195329X
ROBERT GOEBEL
PHYSICIAN-RADATION ONCOLOGIST40.000.00949686031382X
MICHAEL IRISH
PHYSICIAN-BLANK SURGERY40.000.00569316038919X
ROBERT ISAAK
PHYSICIAN-RADATION ONCOLOGIST40.000.00896474043669X
JOHN TRIANTAFYLLOS
PHYSICIAN-RADATION ONCOLOGIST40.000.00901421036941X
ONYEBUCHI UKABIALA
PHYSICIAN-BLANK SURGERY40.000.00569439049441X
LESLIE SMIAROWSKI
EXEC DIR-FAC SVCS FORMER KEY EMPL.40.000.00151284026895X
JEAN SHELTON
ADMIN-PHYS PRACTICE FORMER KEY EMPL.0.0040.005147427966144925X
FieldValueIRS element (for citing)
Total Reportable Comp From Org10067935TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs823010TotalReportableCompFrmRltdOrgs
Total Other Compensation1582674TotalOtherCompensation
Number Individuals GT100 K237NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ARAMARK FACILITIES S
22506 NETWORK PLACECHICAGOIL60673LAUNDRY, CLEANING AND FOOD SERVICES7470267
FLYNN WRIGHT INC
501 SW 7TH STREETDES MOINESIA50309ADVERTISING AND PROMOTIONAL1115386
AJ ALLEN COMPANY
PO BOX 931DES MOINESIA503040931REPAIR AND MAINTENANCE1086712
WEITZ COMPANY INC
5901 THORNTON AVEDES MOINESIA50321CONSTRUCTION913840
RALPH N SMITH INC
714 SE 15TH STREETDES MOINESIA50317CONSTRUCTION611496
FieldValueIRS element (for citing)
Number Of Contractors GT100 K34NumberOfContractorsGT100K
Related Organizations6056469RelatedOrganizations
Government Grants1037025GovernmentGrants
All Other Contributions310946AllOtherContributions
Total Contributions7404440TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT REVENUE900099606198978605506531692447
LABORATORY SERVICES6215001103063011030630
MGMT & SUPPORT SVCS56100072446973118354358912$3,767,431
SUBS & JOINT VENTURES90009968279076827907
RENTAL INCOME5313906040553602422516328

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column4274942TotalRevenueColumn
Related Or Exempt Function Income3768349RelatedOrExemptFunctionIncome
Unrelated Business Revenue268345UnrelatedBusinessRevenue
Exclusion$238,248ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue641617707TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7624569TotalRevenueColumn
Exclusion$7,624,569ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities851259029Securities
Other172306Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities796207589Securities
Other342261Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities55051440Securities
Other-169955Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column54881485TotalRevenueColumn
Exclusion$54,881,485ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory4056GrossSalesOfInventory
Cost Of Goods Sold2843CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1213TotalRevenueColumn
Exclusion$1,213ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
CAFETERIA/FOOD SVCS7222104423763169362160317$4,094,084
SUBS & JOINT VENTURES90009922696032269603
CHILDCARE SERVICES6244101351571$1,351,571

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column539889TotalRevenueColumn
Related Or Exempt Function Income539889RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue8584826TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column720114240TotalRevenueColumn
Related Or Exempt Function Income625954617RelatedOrExemptFunctionIncome
Unrelated Business Revenue14796582UnrelatedBusinessRevenue
Exclusion$71,958,601ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total18619833Total
Program Services18619833ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total7257178Total
Management And General7257178ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total623716Total
Management And General623716ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total250825129Total
Program Services219345886ProgramServices
Management And General31479243ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total12314044Total
Program Services10768598ProgramServices
Management And General1545446ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total34556355Total
Program Services30219438ProgramServices
Management And General4336917ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total17690266Total
Program Services15470089ProgramServices
Management And General2220177ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total10353374Total
Program Services10348374ProgramServices
Management And General5000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2779579Total
Program Services18662ProgramServices
Management And General2760917ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total24000Total
Management And General24000ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1138324Total
Program Services34457ProgramServices
Management And General1103867ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total58038883Total
Program Services41270009ProgramServices
Management And General16768874ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1817083Total
Program Services49367ProgramServices
Management And General1767716ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total17854879Total
Program Services16613691ProgramServices
Management And General1241188ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total41747309Total
Program Services41672080ProgramServices
Management And General75229ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11730409Total
Program Services11145262ProgramServices
Management And General585147ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1334334Total
Program Services1087258ProgramServices
Management And General247076ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total441629Total
Program Services336917ProgramServices
Management And General104712ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total7465134Total
Management And General7465134ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total31959697Total
Program Services31383907ProgramServices
Management And General575790ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4662887Total
Program Services23731ProgramServices
Management And General4639156ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES109483897108800996682901
MISCELLANEOUS EXPENSES1513671530283983388
INCOME TAXES519755519755
PATIENT BAD DEBT8462584625

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total644835990Total
Program Services557823463ProgramServices
Management And General87012527ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY31220BOY
EOY28673900EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8476448BOY
EOY20012252EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY88474989BOY
EOY94160223EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY266291BOY
EOY21741EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY19996950BOY
EOY14098269EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY10811158BOY
EOY11159072EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2285534BOY
EOY2414136EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis720971175LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec486416682LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY253876690BOY
EOY234554493EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY402563279BOY
EOY411242071EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY29474958BOY
EOY29125707EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY392608BOY
EOY370901EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY816650125BOY
EOY845832765EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY65953827BOY
EOY56395350EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1205866BOY
EOY1361519EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY23000000BOY
EOY23000000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY11491566BOY
EOY3744277EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY204653392BOY
EOY191819758EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY306304651BOY
EOY276320904EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY486999833BOY
EOY545998952EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8946204BOY
EOY7318555EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY14399437BOY
EOY16194354EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY510345474BOY
EOY569511861EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY816650125BOY
EOY845832765EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses75278250ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-16333059ReconciliationUnrealizedInvest
Reconcilation Other Changes221196ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$24,000OtherActivitiesAmount
Total Lobbying Expenditures IIB24000TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPAID TO CONSULTING FIRM FOR LOBBYING ACTIVITIES ON BEHALF OF HEALTH CARE.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance402694127BeginningOfYearBalance
Contributions10820990Contributions
Investment Earnings Or Losses44751469InvestmentEarningsOrLosses
Grants Or Scholarships48054272GrantsOrScholarships
Administrative Expenses825844AdministrativeExpenses
End Of Year Balance409386470EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance393764418BeginningOfYearBalance
Contributions14837391Contributions
Investment Earnings Or Losses-4633215InvestmentEarningsOrLosses
Administrative Expenses1274466AdministrativeExpenses
End Of Year Balance402694128EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance345461149BeginningOfYearBalance
Contributions7133406Contributions
Investment Earnings Or Losses46487853InvestmentEarningsOrLosses
Grants Or Scholarships3862243GrantsOrScholarships
Administrative Expenses1455747AdministrativeExpenses
End Of Year Balance393764418EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance247692356BeginningOfYearBalance
Contributions25092385Contributions
Investment Earnings Or Losses77357269InvestmentEarningsOrLosses
Grants Or Scholarships3399333GrantsOrScholarships
Administrative Expenses1281528AdministrativeExpenses
End Of Year Balance345461149EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance310035426BeginningOfYearBalance
Contributions5000000Contributions
Investment Earnings Or Losses-52884188InvestmentEarningsOrLosses
Grants Or Scholarships13612295GrantsOrScholarships
Administrative Expenses846587AdministrativeExpenses
End Of Year Balance247692356EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.94340BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.03960PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01700TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis11282819OtherCostOrOtherBasis
Book Value11282819BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis237937516OtherCostOrOtherBasis
Depreciation153058762Depreciation
Book Value84878754BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis9117265OtherCostOrOtherBasis
Depreciation6621117Depreciation
Book Value2496148BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis445941498OtherCostOrOtherBasis
Depreciation318502980Depreciation
Book Value127438518BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16692077OtherCostOrOtherBasis
Depreciation8233823Depreciation
Book Value8458254BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings234554493TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
ASBESTOS REMOVAL LIABILITY$2,522,789
DUE TO AFFILIATES$16,509,911
SELF-INSURANCE RESERVE$16,536,970
LONG-TERM RETENTION INCENTIVES$11,266,826
IOWA HEALTH SYSTEM NOTE PAYABLE$135,316,000
HEALTH AND WELFARE BENEFITS RESERVE$3,292,971
MISCELLANEOUS LIABILITY$2,437,879
DEFINED BENEFIT RETIREMENT PLAN LIABILITY$3,936,412
FieldValueIRS element (for citing)
Total Of Amounts191819758TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt698857000TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-16538059NetUnrealizedGainsInvestments
Other Revenues2843OtherRevenues
Revenue Not Rptd F990-16535216RevenueNotRptdF990
Revenue Subtotal715392216RevenueSubtotal
Investment Expenses Not Included729013InvestmentExpensesNotIncluded
Other Revenues Not Included3993011OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt4722024RevenueNotRptdOnFinStmt
Total Revenue Per Form990720114240TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt615825000TotExpensesEtcAuditedFinclStmt
Other Expenses Included2843OtherExpensesIncluded
Expenses Not Rptd F9902843ExpensesNotRptdF990
Expenses Subtotal615822157ExpensesSubtotal
Investment Expenses Not Included2729013InvestmentExpensesNotIncluded2
Other Expenses Not Included28284820OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt29013833ExpensesNotRptdOnFinStmt
Total Expenses Per Form990644835990TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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:SALES OF INVENTORY 2,843.
PART XI, LINE 4B - OTHER ADJUSTMENTS:IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 1,782,852. REVENUES IN UNRESTRICTED FUND BALANCE 2,199,103. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 10,784. ROUNDING 272.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SALES OF INVENTORY 2,843.
PART XII, LINE 4B - OTHER ADJUSTMENTS:IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 1,782,852. EXPENSES IN UNRESTRICTED FUND BALANCE 26,489,519. EXPENSES IN TEMPORARILY RESTRICTED FUND BALANCE 12,000. ROUNDING 449.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense9416104TotalCommunityBenefitExpense
Net Community Benefit Expense9416104NetCommunityBenefitExpense
Percent Of Total Expense0.01460PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense81428280TotalCommunityBenefitExpense
Direct Offsetting Revenue59537063DirectOffsettingRevenue
Net Community Benefit Expense21891217NetCommunityBenefitExpense
Percent Of Total Expense0.03390PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense90844384TotalCommunityBenefitExpense
Direct Offsetting Revenue59537063DirectOffsettingRevenue
Net Community Benefit Expense31307321NetCommunityBenefitExpense
Percent Of Total Expense0.04850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served14028PersonsServed
Total Community Benefit Expense2175522TotalCommunityBenefitExpense
Direct Offsetting Revenue65691DirectOffsettingRevenue
Net Community Benefit Expense2109831NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served2135PersonsServed
Total Community Benefit Expense11985943TotalCommunityBenefitExpense
Direct Offsetting Revenue6465218DirectOffsettingRevenue
Net Community Benefit Expense5520725NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense18746317TotalCommunityBenefitExpense
Direct Offsetting Revenue14635916DirectOffsettingRevenue
Net Community Benefit Expense4110401NetCommunityBenefitExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense188809TotalCommunityBenefitExpense
Net Community Benefit Expense188809NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1362578TotalCommunityBenefitExpense
Net Community Benefit Expense1362578NetCommunityBenefitExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served16163PersonsServed
Total Community Benefit Expense34459169TotalCommunityBenefitExpense
Direct Offsetting Revenue21166825DirectOffsettingRevenue
Net Community Benefit Expense13292344NetCommunityBenefitExpense
Percent Of Total Expense0.02070PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served16163PersonsServed
Total Community Benefit Expense125303553TotalCommunityBenefitExpense
Direct Offsetting Revenue80703888DirectOffsettingRevenue
Net Community Benefit Expense44599665NetCommunityBenefitExpense
Percent Of Total Expense0.06920PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense190533TotalCommunityBuildingExpense
Net Community Building Expense190533NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense190533TotalCommunityBuildingExpense
Net Community Building Expense190533NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$9,848,342BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare144049807AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare143491168CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall558639MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (7 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT COMPANY
MANAGEMENT OF CARDIAC SERVICE LINE0.200000.24350
2 CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY
MANAGEMENT OF ONCOLOGY SERVICE LINE0.200000.13330
3 IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
OUTPATIENT DIAGNOSTIC IMAGING0.500000.50000
4 LAKEVIEW SURGERY CENTER LC
SURGERY CENTER0.500000.50000
5 ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
AMBULATORY SURGERY CENTER0.500000.50000
6 WEST HOSPITAL ORTHOPAEDIC CO-MANAGEMENT COMPANY
MANAGEMENT OF METHODIST WEST ORTHO SERVICE LINE0.200000.80000
7 WEST LAKES SLEEP CENTER LLC
TREATMENT OF CHRONIC SLEEP DISORDERS0.500000.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalChildrens HospitalChildrensHospitalTeaching HospitalTeachingHospitalCritical Access HospitalCriticalAccessHospitalResearch FacilityResearchFacilityEr24 HoursEr24Hours
IOWA METHODIST MEDICAL CENTER
11200 PLEASANT STREETDES MOINESIA50309XXXXXXX
IOWA LUTHERAN HOSPITAL
2700 EAST UNIVERSITY AVENUEDES MOINESIA50316XXX
METHODIST WEST HOSPITAL
31660 60TH STREETWEST DES MOINESIA50266XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNotify Upon AdmissionNotifyUponAdmissionNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyAverage Negotiated RatesAverageNegotiatedRatesAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
IOWA METHODIST MEDICAL CENTER
111200.0000000000001400.0000000000001XXXXX11XXX10XXXX1X00
IOWA LUTHERAN HOSPITAL
211200.0000000000001400.0000000000001XXXXX11XXX10XXXX1X00
METHODIST WEST HOSPITAL
311200.0000000000001400.0000000000001XXXXX11XXX10XXXX1X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities18NumberOfOtherFacilities

Other Facilities OtherFacilities (18 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
1776 WESTLAKES PARKWAY LC
1776 WESTLAKES PARKWAYWEST DES MOINESIA50266OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BLDGS
CARDIO THORACIC
1200 PLEASANT STDES MOINESIA50309PHYSICIAN CLINIC
CENTRAL IOWA CARDIOVASCULAR CO-MGMT
1200 PLEASANT STDES MOINESIA50309MANAGEMENT OF CARDIAC SERVICE LINE
CHILDREN'S HEALTH CENTER
MOB I STE 300DES MOINESIA50309PHYSICIAN CLINIC
COUNSELING CENTER
6000 UNIVERSITY AVE SUITE 200WEST DES MOINESIA50266PHYSICIAN CLINIC
HY-VEEIOWA HEALTH LC
1200 PLEASANT STDES MOINESIA50309PHYSICIAN CLINIC
IOWA DIAGNOSTIC IMAGING & PROCEDURE CTR
6000 UNIVERSITY AVE SUITE 150WEST DES MOINESIA50266OUTPATIENT DIAGNOSTIC IMAGING
IOWA KIDNEY STONE CENTER (INACTIVE)
818 5TH AVENUEDES MOINESIA50309REMOVAL OF KIDNEY STONES
JOHN STODDARD CANCER CENTER - RADIATION
1221 PLEASANT STREETDES MOINESIA50309PHYSICIAN CLINIC
LAKEVIEW SURGERY CENTER LC
1750 60TH STWEST DES MOINESIA50266SURGERY CENTER
MIDWIVES
1440 PLEASANT ST STE1DES MOINESIA50309PHYSICIAN CLINIC
OCC MED
6000 UNIVERSITY AVE SUITE 124WEST DES MOINESIA50266OCCUPATIONAL MEDICINE
ORTHOPAEDIC OUTPATIENT SURGERY CENTER
1600 60TH STWEST DES MOINESIA50266AMBULATORY SURGERY CENTER
PERINATAL
MOB II STE 116DES MOINESIA50309PHYSICIAN CLINIC
TRANSPLANT CTR & CENTER FOR LIVER DISEAS
1215 PLEASANT STREET SUITE 506DES MOINESIA50309PHYSICIAN CLINIC
WEST HOSPITAL ORTHOPAEDIC CO-MANAGEMENT
1660 60TH STWEST DES MOINESIA50266MANAGEMENT OF METHODIST WEST ORTHO SERVICE LINE
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVEWEST DES MOINESIA50266TREATMENT OF CHRONIC SLEEP DISORDERS
CENTRAL IOWA ONCOLOGY CO-MGMT
1200 PLEASANT STDES MOINESIA50309MANAGEMENT OF ONCOLOGY SERVICE LINE

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 6A: CENTRAL IOWA HOSPITAL CORPORATION'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES.
PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO.
PART II: COMMUNITY BUILDING ACTIVITIES 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. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES 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. OTHER DONATIONS SUCH AS FOOD OR OTHER DURABLE GOODS PROVIDE AREA SHELTERS AND OTHER ORGANIZATIONS IN THE AREA. THIS ALLOWS THESE ORGANIZATIONS TO MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH. 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' 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 CENTRAL IOWA HOSPITAL CORPORATION. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2.
PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $39,220,238. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE OF $8,598,178 AND REVENUE OF $4,268,527. AFTER TAKING THESE ITEMS INTO ACCOUNT WE CALCULATE AN ACTUAL MEDICARE SHORTFALL OF $43,548,889.THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.
PART VI, LINE 2: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A SPONSORING PARTNER OF HEALTHY POLK WHICH IS A COMMUNITY COLLABORATIVE CONVENED BY POLK COUNTY HEALTH DEPARTMENT TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF POLK COUNTY. THROUGH A PLANNED AND ORGANIZED EFFORT, HEALTHY POLK DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. HEALTHY POLK WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES, AS A SPONSORING AGENCY, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. EFFORTS ARE MONITORED IN PART BY OTHER PARTNER AGENCIES SUCH AS THE FAMILY AND CHILD POLICY CENTER WHICH MONITORS AND REPORTS SPECIFIC INDICATORS TO ASSESS EFFECTIVENESS AND AID IN THE DEVELOPMENT OF NEW PLANS OR REFINING EXISTING ONES. FURTHER, HEALTHY POLK 2020 HAS DEVELOPED A MEASUREMENT PROCESS TO EVALUATE EFFECTIVENESS AS WELL AS NEED. HEALTHY POLK CONVENES TWO TOWN HALL MEETINGS ANNUALLY TO SEEK PUBLIC INPUT ON HEALTH INITIATIVES. CENTRAL IOWA HOSPITAL CORPORATIONS D/B/A IOWA HEALTH DES MOINES IS ALSO A SPONSORING PARTNER IN DALLAS COUNTY PARTNERSHIP FOR HEALTH. THIS COLLABORATIVE ALSO COMPLETES A COMMUNITY HEALTH ASSESSMENT. FROM THIS, PRIORITIES AND STRATEGIES HAVE BEEN IDENTIFIED. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES HAS ACTIVELY ENGAGED IN ADDRESSING AND MONITORING HEALTH ISSUES AND NEEDS AS A RESULT OF THIS PROCESS. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ALSO PARTICIPATES AS PART OF THE UNITED WAY COMMUNITY IMPACT COMMITTEE. 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 CENTRAL IOWA HOSPTIAL CORPORATION D/B/A IOWA HEALTH DES MOINES 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, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES 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: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES 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.
PART VI, LINE 4: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A 779-BED COMMUNITY HOSPITAL SYSTEM SERVING CENTAL IOWA. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF DALLAS, GUTHRIE, JASPER, MADISON, MARION, POLK, STORY, AND WARREN. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ADMITS 36,566 INPATIENTS AND CARES FOR 83,753 EMERGENCY PATIENTS PER YEAR. THERE ARE 34 OTHER HOSPITALS WITHIN THE 30-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $48,881.00 TO $71,691.00 AND THE AVERAGE POVERTY RATE IS 10.88%. FIFTY TWO PERCENT OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES PATIENTS ARE ELIGIBLE FOR MEDICARE (41%) OR MEDICAID (11%). DALLAS, POLK AND STORY COUNTIES ARE THE ONLY COUNTIES IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATIONS. DALLAS COUNTY IS 6 PERCENT HISPANIC, POLK COUNTY IS 6 PERCENT AFRICAN AMERICAN, POLK COUNTY IS 7 PERCENT HISPANIC, AND STORY COUNTY IS 6 PERCENT ASIAN.
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.
IAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (26 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
1111 NINTH STREET SUITE 280DES MOINESIA50314135613797501(C)347500EVENT SPONSOR
BLANK PARK ZOO
7401 SW 9TH STREETDES MOINESIA50315421171821501(C)311334CAPITAL BUILDING CAMPAIGN
BRAVO GREATER DES MOINES
1915 GRAND AVEDES MOINESIA50309203598346501(C)310000EVENT SPONSOR
CASTING FOR RECOVERY
PO BOX 1123MANCHESTERVT05254030354382501(C)315000EVENT SPONSOR
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421189791501(C)377997PROGRAM SUPPORT
CITY OF DES MOINES
400 ROBERT D RAY DRIVEDES MOINESIA50309426004514GOVERNMENT174037OTHER
DES MOINES AREA COMMUNITY COLLEGE FOUNDATION
2006 S ANKNEY BLVDANKENYIA500233993237229486501(C)35000EVENT SPONSOR
DES MOINES SYMPHONY
221 WALNUT STREETDES MOINESIA50309426058830501(C)315000EVENT SPONSOR
DES MOINES UNIVERSITY
3200 GRAND AVEDES MOINESIA50312420730347501(C)36500CAPITAL BUILDING CAMPAIGN
EFR EMPLOYEE AND FAMILY RESOURCES
505 5TH AVE SUITE 600DES MOINESIA503092319420923932501(C)35000EVENT SPONSOR
GIRL SCOUTS OF GREATER IOWA PAT GROTE
10715 HICKMAN RDURBANDALEIA50322420698218501(C)38000EVENT SPONSOR
GRANDVIEW UNIVERSITY
1200 GRANDVIEW AVEDES MOINESIA50316420681049501(C)320000PROGRAM SUPPORT
GREATER DES MOINES COMMUNITY FOUNDATION
1915 GRAND AVEDES MOINESIA50309426139033501(C)315750OTHER
GREATER DSM CONVENTION & VISITORS BUREAU
400 LOCUST ST STE 265DES MOINESIA503092350421221738501(C)65000OTHER
IOWA CAREGIVERS
1211 VINE ST STE 1000WEST DES MOINESIA502654478421457592501(C)310000PROGRAM SUPPORT
IOWA CLINIC HEALTHCARE FOUNDATION
1215 PLEASANT ST SUITE 618DES MOINESIA50309810599749501(C)315000EVENT SPONSOR
IOWA HEALTH SYSTEM
1776 WEST LAKES PKWY SUITE 400WEST DES MOINESIA50266421435199501(C)317697292PROGRAM SUPPORT
JUVENILE DIABETES RESEARCH FOUNDATION
5444 NW 96TH ST SUITE AJOHNSTONIA50131421907729501(C)345500EVENT SPONSOR
KIVANIS CLUB OF DES MOINES FOUNDATION
505 5TH AVE SUITE 302DES MOINESIA50309421376704501(C)315000EVENT SPONSOR
MARCH OF DIMES
111 9TH STE 270DES MOINESIA50314131846366501(C)37000EVENT SPONSOR
MID-IOWA COUNCIL BOY SCOUTS OF AMERICA
1659 E EUCLID AVEDES MOINESIA50316420981715501(C)335000EVENT SPONSOR
OPERATION DOWNTOWN
700 LOCUST STREET SUITE 100DES MOINESIA50309861058466501(C)625000PROGRAM SUPPORT
POLK COUNTY MEDICAL SOCIETY
1520 HIGH STREETDES MOINESIA50309420472780501(C)68250EVENT SPONSOR
PRINCIPAL CHARITY CLASSIC
2771 104TH ST STE 1URBANDALEIA50322426139033501(C)385000EVENT SPONSOR
THE ALS ASSOCIATION IOWA CHAPTER
6165 NW 86TH STREETJOHNSTONIA501312270300051272501(C)35000EVENT SPONSOR
THE GREATER DES MOINES PARTNERSHIP
700 LOCUST STREET SUITE 100DES MOINESIA50309421489668501(C)6185000CAPITAL BUILDING CAMPAIGN
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants21TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations5TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: CENTRAL IOWA HOSPITAL CORPORATION REQUIRES EACH RECIPIENT OF THE GRANTS (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINE A SERIES OF ELIGIBLITY STANDARDS THAT ARE REQUIRED TO BE MET. ORGANIZATION THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LARRY BAKER DO
BOARD MEMBER353496000893470151970189430476983000
ERIC CROWELL
BOARD MEMBER/CEO5446070174400065929033222402221801139378000
STEVE GOLDSTEIN
BOARD MEMBER046125502500001776012623020005052065900
JOSEPH CORFITS
SENIOR VP FINANCE/CFO3252330829450493850390660202980516927000
AMY BETHEL
EXEC DIR SURGERY138683020754033210199250177250200408000
CHRISTINE BLAIR
CHIEF ADMINISTRATIVE OFFICER-W1512480455120155540242150194860256015000
DOUGLAS DORNER
VP MEDICAL EDUCATION36907801073980188849028409013091070682501560890
CECELIA KIRVIN
EXEC DIR/CCO BCH141900019701046940191480110590196502000
TODD KRANPITZ
EXEC DIR DIAGNOSTIC SVCS14377002125303230084360165690193258000
ERIC LOTHE
VP OPERATIONS/CAO-ILH2809920820820385010311560166870449418000
JOYCE MCDANEL
VP HUMAN RESOURCES1969180543500214300466620192760338636000
DEBRA MOYER
CHIEF NURSING EXEC236529066393044273039201051480391544000
MARK PURTLE
VP MEDICAL AFFAIRS342201010223607167301804630182180714791000
SIDNEY RAMSEY
VP STRATEGIC BUSINESS DEV-CIHS241046066277047076039667051390399205000
DAVID STARK
PRESIDENT/COO BCH & EVP IHDM3175480941010537960317500231690520364000
STEPHEN STEPHENSON
EXEC VP/COO-IHDM385849010887205811601666370286920748166000
ROBERT GOEBEL
PHYSICIAN-RADATION ONCOLOGIST5628390381284055630125000188820981068000
MICHAEL IRISH
PHYSICIAN-BLANK SURGERY56797900013370125000264190608235000
ROBERT ISAAK
PHYSICIAN-RADATION ONCOLOGIST507343038869304380125000311690940143000
JOHN TRIANTAFYLLOS
PHYSICIAN-RADATION ONCOLOGIST510662039010206570125000244410938362000
ONYEBUCHI UKABIALA
PHYSICIAN-BLANK SURGERY56654800028910250000244410618880000
LESLIE SMIAROWSKI
EXEC DIR-FAC SVCS FORMER KEY EMPL.12865501954103088078170190780178179000
JEAN SHELTON
ADMIN-PHYS PRACTICE FORMER KEY EMPL.5385258850455121845557723564072219740188795554632051400

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATRAVEL 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. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD AS "NONCASH COMP" (IMPUTED MISCELLANEOUS) TO PAYCHECK IN ORDER TO TAX APPROPRIATELY.
PART I, LINE 1BTAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD AS "NONCASH COMP" (IMPUTED MISCELLANEOUS) TO PAYCHECK IN ORDER TO TAX APPROPRIATELY.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: JOSEPH CORFITS $54, ERIC CROWELL $305,816, ERIC LOTHE $18,656, JOYCE MCDANEL $31,259, DEBRA MOYER $26,701, MARK PURTLE $167,963, SIDNEY RAMSEY $10,917, DAVID STARK $19,250, STEPHEN STEPHENSON $133,980. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: DOUGLAS DORNER $156,089.

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonDAVID STARKNamePerson
Relationship With OrganizationKEY EMPLOYEERelationshipWithOrganization
Purpose Of LoanRECRUITMENT INDUCEMENTPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$60,000OriginalPrincipalAmount
Balance Due21741BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due21741TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (18 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
1776 WESTLAKES PARKWAY LC
COMMON BOARD MEMBER/OFFICER1695945INVESTMENT0
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
COMMON BOARD MEMBER/OFFICER1407000INVESTMENT, MANAGEMENT FEE AND FINANCIAL SERVICES0
CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY LLC
COMMON BOARD MEMBER/OFFICER1072000INVESTMENT0
DES MOINES AREA COMMUNITY COLLEGE
COMMON BOARD MEMBER/OFFICER672362TUITION0
DRAKE UNIVERSITY
COMMON BOARD MEMBER/OFFICER281000STUDENT HEALTH AGREEMENT AND TUITION0
HUBBELL REALTY COMPANY
COMMON BOARD MEMBER/OFFICER254000RENT0
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
COMMON BOARD MEMBER/OFFICER1757000INVESTMENT AND LAUNDRY0
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
COMMON BOARD MEMBER/KEY EMPLOYEE721061PERFORMANCE OF SERVICES0
IOWA KIDNEY STONE CENTER
COMMON BOARD MEMBER/OFFICER32000INVESTMENT0
JENNIFER WILLIS
FAMILY MEMBER OF BOARD MEMBER RICHARD WILLIS11121DAUGHTER OF RICHARD WILLIS WHO IS A BOARD MEMBER0
LAKEVIEW SURGERY CENTER LC
COMMON BOARD MEMBER/OFFICER947000INVESTMENT, SUPPLIES, OTHER0
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
COMMON BOARD MEMBER/OFFICER1121000INVESTMENT, MAINTENANCE, TRANSCRIPTION, PHARMACY, MAINTENANCE, BIO-TECH0
PRINCIPAL FINANCIAL GROUP
COMMON BOARD MEMBER/OFFICER137859SPONSORSHIP BENEFITS0
(no name)
1691770
TRACY EKHARDT MD
FAMILY MEMBER OF KEY EMPLOYEE STEPHEN STEPHENSON, MD296283DAUGHTER OF KEY EMPLOYEE0
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
COMMON BOARD MEMBER/OFFICER1260000INVESTMENT, MANAGEMENT FEE AND FINANCIAL SERVICES0
WEST LAKES SLEEP CENTER LLC
COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE131000INVESTMENT0
WINIFRED HALL
FAMILY MEMBER OF KEY EMPLOYEE WINIFRED HALL35284MENTAL HLTH THRPST MSW-PCDC0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2BISHOP MICHAEL BURK; ERIC CROWELL; KENT HENNING; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 2ERIC LOTHE; SIDNEY RAMSEY; JEANETTE SHELTON; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6CENTRAL IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ACENTRAL IOWA HEALTH SYSTEM ELECTS BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BCENTRAL IOWA HEALTH SYSTEM ELECTS AND CAN REMOVE BOARD OF DIRECTORS, AND APPROVE DISSOLUTIONS OR MERGER. IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION CAN AMEND THE ARTICLES AND BYLAWS AFTER CONSULTATION WITH CENTRAL IOWA HEALTH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CTHE 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 15THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2012 FOR THE FOLLOWING INDIVIDUALS: JOSEPH CORFITS, ERIC CROWELL, DOUGLAS DORNER, ERIC LOTHE, JOYCE MCDANEL, DEBORA MOYER, MARK PURTLE, SIDNEY RAMSEY, DAVID STARK, STEPHEN STEPHENSON. 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, STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS AND WRITTEN EMPLOYMENT CONTRACT. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19IOWA 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.UNITYPOINT.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 XI, LINE 9:CHANGE IN BENEFICIAL INTEREST OF IOWA HEALTH FOUNDATION 167,066. CHANGES IN PENSION LIABILITY 3,293,178. NET ASSET TRANSFER TO IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION -3,240,415. MISCELLANEOUS OTHER ADJUSTMENTS 1,367.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1DMPA NO 2 LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 PLEASANT STREETAddressLine1
CityDES MOINESCity
StateIAState
ZIP Code50309ZIPCode
FieldValueIRS element (for citing)
EIN272514210EIN
Primary ActivitiesPROPERTY MANAGEMENTPrimaryActivities
Legal Domicile StateIALegalDomicileState
Total Income129125TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL IOWA HOSPITAL CORPORATIONBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ALLEN COLLEGE
1825 LOGAN AVENUEWATERLOOIA50703421351526EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALSIA501(C)(3)170(B)(1) (A)(II)ALLEN HEALTH SYSTEMS INC0
ALLEN HEALTH SYSTEMS INC
1825 LOGAN AVENUEWATERLOOIA50703421201924SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
ALLEN MEMORIAL HOSPITAL CORPORATION
1825 LOGAN AVENUEWATERLOOIA50703420698265HOSPITALIA501(C)(3)170(B)(1) (A)(III)ALLEN HEALTH SYSTEMS INC0
ANAMOSA AREA AMBULANCE SERVICE
101 GRANT WOOD DRIVEANAMOSAIA52205421466284PROVIDE AMBULANCE SERVICESIA501(C)(3)509(A)(2)ST LUKE'SJONES REGIONAL MEDICAL CENTER0
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREETDES MOINESIA50309421233759PROPERTY HOLDING COMPANYIA501(C)(2)CENTRAL IOWA HEALTH SYSTEM0
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421189791SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
CENTRAL IOWA HOSPITAL CORPORATION
1200 PLEASANT STREETDES MOINESIA50309420680452HOSPITALIA501(C)(3)170(B)(1) (A)(III)CENTRAL IOWA HEALTH SYSTEM0
FINLEY TRI-STATES HEALTH GROUP INC
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001421307495SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
HNC SERVICES
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266270987243SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM0
INTRUST
11333 AURORA AVENUEURBANDALEIA50322421477471HOME HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM0
IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200DES MOINESIA50309421467682CHARITABLE FUNDRAISINGIA501(C)(3)509(A)(3), TYPE IIICENTRAL IOWA HEALTH SYSTEM0
IOWA HEALTH SYSTEM
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421435199SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE III0
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
8101 BIRCHWOOD COURTJOHNSTONIA50131421411630PRIMARY HEALTH CARE SERVICESIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUEWATERLOOIA50703421201138CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC0
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111135HEALTHCAREIL501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636510186460FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)METHODIST HEALTH SERVICES CORPORATION0
METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636370661223HEALTHCAREIL501(C)(3)170(B)(1) (A)(III)METHODIST HEALTH SERVICES CORPORATION0
METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111134OFFICE RENTALIL501(C)(3)509(A)(2)METHODIST HEALTH SERVICES CORPORATION0
NELLIE R SHERWOOD TRUST
1026 A AVENUE NECEDAR RAPIDSIA52402426061621PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAYIA501(C)(3)509(A)(3), TYPE IST LUKE'S METHODIST HOSPITAL0
NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED
720 KENYON DRIVEFORT DODGEIA50501420937390MENTAL HEALTH CAREIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVDSIOUX CITYIA51104421019872HOSPITALIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM0
SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636376181831FUND SELF-INSURANCE PLANIL501(C)(3)509(A)(3), TYPE IMETHODIST MEDICAL CENER OF ILLINOIS0
SIOUXLAND PACE INC
313 COOK STREETSIOUX CITYIA51103261120134ALL-INCLUSIVE CARE FOR THE ELDERLYIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH RESOURCES
2720 STONE PARK BLVDSIOUX CITYIA51104421059182OUTPATIENT CLINICS AND HEALTHCARE SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTH SYSTEM INC0
ST LUKE'S HEALTH SYSTEM INC
2720 STONE PARK BLVDSIOUX CITYIA51104421294091SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM0
ST LUKE'S HEALTHCARE
1026 A AVENUE NECEDAR RAPIDSIA52402421487968SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
ST LUKE'S METHODIST HOSPITAL
1026 A AVENUE NECEDAR RAPIDSIA52402420504780HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE0
ST LUKE'SJONES REGIONAL MEDICAL CENTER
1795 HIGHWAY 64 EASTANAMOSAIA52205421487967HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE0
STL CARE COMPANY
1026 A AVENUE NECEDAR RAPIDSIA52402421276632IMPROVE PUBLIC HEALTH SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTHCARE0
THE DUBUQUE VISITING NURSE ASSOCIATION
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680410PUBLIC HEALTH SERVICES/HOME CAREIA501(C)(3)509(A)(2)FINLEY TRI-STATES HEALTH GROUP INC0
THE FINLEY HOSPITAL
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680354HOSPITALIA501(C)(3)170(B)(1) (A)(III)FINLEY TRI-STATES HEALTH GROUP INC0
THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
2701 17TH STREETROCK ISLANDIL61201363678909MENTAL HEALTH CAREIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRIMARK PHYSICIANS GROUP
802 KENYON ROADFORT DODGEIA50501453791448SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICESIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
TRINITY BUILDING CORPORATION
802 KENYON ROADFORT DODGEIA50501421376187PROPERTY HOLDING COMPANYIA501(C)(2)TRINITY HEALTH SYSTEMS INC0
TRINITY HEALTH FOUNDATION
802 KENYON ROADFORT DODGEIA50501421222381CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)TRINITY HEALTH SYSTEMS INC0
TRINITY HEALTH FOUNDATION
2701 17TH STREETROCK ISLANDIL61201363321751CHARITABLE FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY HEALTH SYSTEMS INC
802 KENYON ROADFORT DODGEIA50501421222877SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY MEDICAL CENTER
2701 17TH STREETROCK ISLANDIL61201362739299HOSPITALIL501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
TRINITY REGIONAL HEALTH SYSTEM
2701 17TH STREETROCK ISLANDIL61201363351952SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM0
TRINITY REGIONAL HOSPITAL AUXILIARY
802 KENYON ROADFORT DODGEIA50501426081474CHARITABLE FUNDRAISING AND VOLUNTEER SERVICESIA501(C)(3)509(A)(2)TRINITY REGIONAL MEDICAL CENTER0
TRINITY REGIONAL MEDICAL CENTER
802 KENYON ROADFORT DODGEIA50501421009175HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC0
UNITY HEALTHCARE
1518 MULBERRY AVENUEMUSCATINEIA52761420680337HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM0
UNITY HEALTHCARE FOUNDATION
1518 MULBERRY AVENUEMUSCATINEIA52761421525031SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE ITRINITY REGIONAL HEALTH SYSTEM0

Form990 Schedule R Part III Form990ScheduleRPartIII (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNACode VCodeVAmount
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC
1825 LOGAN AVEWATERLOOIA50703453237125ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESIAALLEN MEMORIAL HOSPITAL CORPORATIONRELATED12618543766010.20000
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT STDES MOINESIA50309273625869CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIACENTRAL IOWA HOSPITAL CORPORATIONRELATED26134080230010.20000
CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY
1200 PLEASANT STREETDES MOINESIA50309453017991ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICESIACENTRAL IOWA HOSPITAL CORPORATIONRELATED201563101327010.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT STDES MOINESIA50309382622972PARKING DECK OPERATIONSIACENTRAL IOWA HEALTH PROP CORPRELATED1033046011.00000
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500DUBUQUEIA52001201597161AMBULATORY SURGERY CENTERIATHE FINLEY HOSPITALRELATED636788274391000.51000
ENSEVA - HIAWATHA LLC
755 METZGER DRIVEHIAWATHAIA52233453437363COLLOCATION FACILITYIAIOWA HEALTH SYSTEMRELATED-1507302077107000.52000
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVEDUBUQUEIA52001422808785SURGERY DEPARTMENT MANAGEMENT SERVICESIATHE FINLEY HOSPITALRELATED110302155255010.50000
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVEDUBUQUEIA52001421428503PROVIDE ACCESS TO LICENSED SOFTWAREIATHE FINLEY HOSPITALRELATED14037010.50000
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NECEDAR RAPIDSIA52402391894290INVESTMENT VEHICLE OWNING CLINICAL JVSIAUNRELATED85147837296000.55670N/A$70,249
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAYWEST DES MOINESIA50266263293530PRIMARY CARE CLINICIACENTRAL IOWA HOSPITAL CORPORATIONRELATED-186843186116010.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421511142GROUP PURCHASINGIAIOWA HEALTH SYSTEMRELATED32786577072097111.00000
MEDICAL LABORATORIES OF EASTERN IOWA LC
1026 A AVE NECEDAR RAPIDSIA52402421359640MEDICAL LABORATORY SERVICESIAST LUKE'S METHODIST HOSPITALRELATED4664101180716010.50000
MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
221 NE GLEN OAK AVEPEORIAIL61636461219459ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESILMETHODIST MEDICAL CENTER OF ILLINOISRELATED32000010.20000
MR ASSOCIATES LLP
1455 SHERMAN ROADHIAWATHAIA52233421260463OWN AND OPERATE MR UNITIAST LUKE'S METHODIST HOSPITALRELATED25260851348049010.33330
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110PEORIAIL61603810584193REHABILATION THERAPYILMETHODIST MEDICAL CENTER OF ILLINOISRELATED3231181122254000.60040
SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC
2720 STONE PARK BLVDSIOUX CITYIA51104455322324CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIANORTHWEST IOWA HOSPITAL CORPORATIONRELATED3039647646010.20000
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SECEDAR RAPIDSIA52403721550812AMBULATORY SURGERY CENTER.IAST LUKE'S METHODIST HOSPITALRELATED32721405076873010.50000
TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
4500 UTICA RIDGE RDBETTENDORFIA52722272562753ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICESIATRINITY MEDICAL CENTERRELATED235523149417010.50000
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREETWEST DES MOINESIA50266271414600ORTHOPEDIC SERVICE LINES MANAGEMENTIACENTRAL IOWA HOSPITAL CORPORATIONRELATED24561716245010.20000

Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
BROADBAND INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266273819741INFORMATION TECHNOLOGY MGMT.IAN/AC0
DELHI POINT CONDO ASSOCIATION
350 N GRANDVIEWDUBUQUEIA52001421467002REAL ESTATE MANAGEMENTIAN/AC0
INTEGRATED CARE ORGANIZATION
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266274665007INTEGRATED AFFILIATE CAREIAN/AC0
IOWA HEALTH SYSTEM 457 DEF COMP PLAN
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421435199INVESTMENTIAN/AT0
MEDIMORE INC
1776 WEST LAKES PKWY 400WEST DES MOINESIA50266421414390MANAGED CAREIAN/AC0
METHODIST HEALTH VENTURES INC
PO BOX 87PEORIAIL61650371140939PHARMACY/OFFICE STAFFINGILN/AC0
METHODIST PHYSICIAN SERVICES INC
PO BOX 87PEORIAIL61650363858550MEDICAL SERVICESILN/AC0
PRECEDENCE INC
4622 PROGRESS DRIVE STE ADAVENPORTIA52807371288604MANAGED MENTAL CAREIAN/AC0
PROVIDER RESOURCE MANAGEMENT INC
PO BOX 87PEORIAIL61650371223550RESOURCE MANAGEMENTILN/AC0
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVEDES MOINESIA50316261271143SPECIALTY PHYSICIANS MEDICAL CAREIAC1CIHC4909762738140.57000
STL HEALTH RESOURCES CO
1026 A AVE NECEDAR RAPIDSIA52402421193499PHYSICIAN OFFICE RENTALIAN/AC0
TRINITY HEALTH ENTERPRISES INC
2701 17TH STROCK ISLANDIL61201363320141RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACYILN/AC0
TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD
4622 PROGRESS DRIVE STE ADAVENPORTIA52807363924720MANAGED HEALTH CAREIAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
K1659433BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
Q253851BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
D177014BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
I1342840BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
S240000BASED ON GAAP, CASH, AND/OR FMV.