TRINITY REGIONAL MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- TRINITY REGIONAL MEDICAL CENTER (EIN 42-1009175)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201343189349300609
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T06:52:40-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421009175 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRINITY REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TRIN | NameControl |
| Phone | 5155733101 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 KENYON RD | AddressLine1 |
| City | FORT DODGE | City |
| State | IA | State |
| ZIP Code | 50501 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MIKE J DEWERFF | Name |
| Title | CFO | Title |
| Phone | 5155746608 | Phone |
| Date Signed | 2013-11-07 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SUSAN K THOMPSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 KENYON RD | AddressLine1 |
| City | FORT DODGE | City |
| State | IA | State |
| ZIP Code | 50501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 170656622 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UNITYPOINT.ORG/FORTDODGE/DEFAULT.ASPX | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1973 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH OF OUR COMMUNITY AND REGION THROUGH HEALING, CARING AND EDUCATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 914 | TotalNbrEmployees |
| Total Nbr Volunteers | 127 | TotalNbrVolunteers |
| Total Gross UBI | 1298409 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 52652 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1557035 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3331057 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 92507322 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 92928485 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3113714 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5396781 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2595687 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2503346 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 99773758 | TotalRevenuePriorYear |
| Total Revenue Current Year | 104159669 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 20256 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4808 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 49959039 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 46877559 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 50742754 | OtherExpensePriorYear |
| Other Expenses Current Year | 50464883 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 100722049 | TotalExpensesPriorYear |
| Total Expenses Current Year | 97347250 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -948291 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 6812419 | RevenuesLessExpensesCY |
| Total Assets BOY | 138133571 | TotalAssetsBOY |
| Total Assets EOY | 142906433 | TotalAssetsEOY |
| Total Liabilities BOY | 36314723 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 34655325 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 101818848 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 108251108 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO IMPROVE THE HEALTH OF THE CITIZENS OF OUR COMMUNITIES AND REGIONS BY PROVIDING QUALITY HEALTHCARE IN AN EFFICIENT AND COST-EFFECTIVE MANNER. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 73538479 | Expense |
| Revenue | 94658115 | Revenue |
| Description | HEALTH-CARE SERVICESTRINITY REGIONAL MEDICAL CENTER IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE NORTH CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTHCARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. TRINITY REGIONAL MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE, CRITICAL CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, MATERNAL/CHILD CARE, PEDIATRIC CARE, LABORATORY SERVICES, PHARMACEUTICAL DRUGS, RADIOLOGY AND MANY OTHER ROUTINE AND ANCILLARY SERVICES. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2012, TRINITY REGIONAL MEDICAL CENTER ADMITTED 4,689 PATIENTS RESULTING IN A TOTAL OF 15,071 PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 62,700 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 3,149. THERE WERE ALSO 21,692 EMERGENCY ROOM VISITS AND 532 BABIES DELIVERED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8193536 | Expense |
| Grants | 4808 | Grants |
| Revenue | 0 | Revenue |
| Description | COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: TRINITY REGIONAL MEDICAL CENTER PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $2,394,836 IN 2012. OFTENTIMES, TRINITY REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. TRINITY REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. TRINITY REGIONAL MEDICAL CENTER'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $2,143,155 FOR 2012 AND SERVED 11,097 PEOPLE. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $4,537,991.OTHER BENEFITS: TRINITY REGIONAL MEDICAL CENTER 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. TRINITY REGIONAL MEDICAL CENTER COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TRINITY REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 12,107 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE: $3,655,545. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 81732015 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 126 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 914 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IA | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIKE J DEWERFF CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5155746608 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 KENYON ROAD | AddressLine1 |
| City | FORT DODGE | City |
| State | IA | State |
| ZIP Code | 50501 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH ADAMS DO | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | X | 0 | 844996 | 377328 | ||||
| JOHN BIRKETT MD | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | X | 0 | 322576 | 36542 | ||||
| RHONDA CHAMBERS | ||||||||||
| BOARD SECRETARY/TREASURER | 1.00 | 1.00 | X | 0 | 0 | 0 | X | |||
| KAREN KAISER | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | ||||
| JAMES MEYER DO | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | X | 0 | 469349 | 176940 | ||||
| JOHN PERKINS | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 178 | 0 | ||||
| KURT PITTNER | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 16118 | 0 | ||||
| DENNIS PLAUTZ | ||||||||||
| BOARD CHAIR | 1.00 | 1.00 | X | 0 | 1219 | 0 | X | |||
| TOM SCHNURR | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | ||||
| JOHN TAETS | ||||||||||
| BOARD VICE CHAIR | 1.00 | 1.00 | X | 0 | 0 | 0 | X | |||
| SUSAN THOMPSON | ||||||||||
| BOARD MEMBER & PRESIDENT/CEO | 1.00 | 40.00 | X | 0 | 431321 | 27664 | X | |||
| MIKE DEWERFF | ||||||||||
| CFO | 1.00 | 40.00 | 0 | 233372 | 44701 | X | ||||
| TROY MARTENS | ||||||||||
| COO | 40.00 | 1.00 | 0 | 247161 | 45841 | X | ||||
| DEBRA SHRIVER | ||||||||||
| CHIEF NURSING EXECUTIVE | 40.00 | 0.00 | 166124 | 0 | 31903 | X | ||||
| LINDA WHALEY | ||||||||||
| VP CLIN & ANCILLARY SVCS | 40.00 | 0.00 | 156536 | 0 | 16778 | X | ||||
| RICHARD BERGSTROM MD | ||||||||||
| PHYSICIAN-ORTHOPAEDICS | 40.00 | 0.00 | 354319 | 0 | 9129 | X | ||||
| COLIN BROWN | ||||||||||
| CRNA-PROF FEES | 40.00 | 0.00 | 216952 | 0 | 34422 | X | ||||
| SUZANNE CLAPP | ||||||||||
| CRNA-PROF FEES | 40.00 | 0.00 | 226057 | 0 | 30997 | X | ||||
| JEFFREY LUNA MD | ||||||||||
| PHYSICIAN-ORTHOPAEDICS | 40.00 | 0.00 | 634113 | 0 | 27713 | X | ||||
| KEVIN SCHMINKE | ||||||||||
| PHYSICIAN-HOSPITALIST | 40.00 | 0.00 | 246805 | 0 | 30441 | X | ||||
| RALPH HEASLEY TO 1110 | ||||||||||
| FORMER INTERIM CFO | 0.00 | 40.00 | 0 | 182502 | 27943 | X | ||||
| THOMAS TIBBITTS TO 1209 | ||||||||||
| FORMER PRESIDENT/CEO | 0.00 | 40.00 | 0 | 907099 | 25149 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2000906 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3655891 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 943491 | TotalOtherCompensation |
| Number Individuals GT100 K | 30 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WOODRUFF CONSTRUCTION | |||||
| 1890 KOUNTRY LANE | FORT DODGE | IA | 50501 | CONSTRUCTION SERVICES | 2724476 |
| EMERGENCY PRACTICE ASSOCIATES | |||||
| PO BOX 1260 | WATERLOO | IA | 50704 | ER COVERAGE | 2427361 |
| ARAMARK MANAGEMENT SERVICES | |||||
| 24863 NETWORK PLACE | CHICAGO | IL | 606731248 | HSKG,LAUNDRY, DIETARY,PLANT MANAGEMENT | 1550186 |
| ARAMARK CTS | |||||
| 12483 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | BIOMEDICAL SERVICES | 1390587 |
| HEALOGICS WOUND CARE | |||||
| 3087 MOMENTUM PLACE | CHICAGO | IL | 606895330 | WOUND & HYPERBARIC SERVICE | 665248 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 19 | NumberOfContractorsGT100K |
| Related Organizations | 3309592 | RelatedOrganizations |
| Government Grants | 21465 | GovernmentGrants |
| Total Contributions | 3331057 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | 88435171 | 88435171 | ||
| RENTAL INCOME | 531110 | 2613420 | 2613420 | ||
| LABORATORY SERVICES | 621510 | 1024441 | 1024441 | ||
| MGMT & SUPPORT SVCS | 561000 | 332487 | 332487 | ||
| MISCELLANEOUS REVENUE | 900099 | 220361 | $220,361 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 302605 | TotalRevenueColumn |
| Related Or Exempt Function Income | 228772 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 62758 | UnrelatedBusinessRevenue |
| Exclusion | $11,075 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 92928485 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 741663 | TotalRevenueColumn |
| Exclusion | $741,663 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 71094746 | Securities |
| Other | 57325 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 66496953 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4597793 | Securities |
| Other | 57325 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4655118 | TotalRevenueColumn |
| Exclusion | $4,655,118 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | 1983883 | 1931239 | $52,644 | |
| CAFETERIA/FOOD SVCS | 722210 | 721072 | $721,072 | ||
| MGMT & SUPPORT SVCS | 561000 | 211210 | 211210 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -412819 | TotalRevenueColumn |
| Related Or Exempt Function Income | -412819 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2503346 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104159669 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93128270 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1298409 | UnrelatedBusinessRevenue |
| Exclusion | $6,401,933 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4808 | Total |
| Program Services | 4808 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 664343 | Total |
| Management And General | 664343 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37253774 | Total |
| Program Services | 33718831 | ProgramServices |
| Management And General | 3534943 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1437764 | Total |
| Program Services | 1301337 | ProgramServices |
| Management And General | 136427 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5005725 | Total |
| Program Services | 4530741 | ProgramServices |
| Management And General | 474984 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2515953 | Total |
| Program Services | 2277218 | ProgramServices |
| Management And General | 238735 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3389829 | Total |
| Program Services | 137779 | ProgramServices |
| Management And General | 3252050 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 182476 | Total |
| Program Services | 2257 | ProgramServices |
| Management And General | 180219 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132990 | Total |
| Management And General | 132990 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11256638 | Total |
| Program Services | 9587841 | ProgramServices |
| Management And General | 1668797 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293974 | Total |
| Program Services | 60852 | ProgramServices |
| Management And General | 233122 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2530046 | Total |
| Program Services | 2400983 | ProgramServices |
| Management And General | 129063 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9351219 | Total |
| Program Services | 5614948 | ProgramServices |
| Management And General | 3736271 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1365453 | Total |
| Program Services | 1261652 | ProgramServices |
| Management And General | 103801 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213443 | Total |
| Program Services | 152043 | ProgramServices |
| Management And General | 61400 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72063 | Total |
| Program Services | 28287 | ProgramServices |
| Management And General | 43776 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1160816 | Total |
| Management And General | 1160816 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5197183 | Total |
| Program Services | 5005250 | ProgramServices |
| Management And General | 191933 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -386705 | Total |
| Program Services | 12725 | ProgramServices |
| Management And General | -399430 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 15606231 | 15575183 | 31048 |
| MISCELLANEOUS EXPENSE | 98715 | 59280 | 39435 |
| INCOME TAXES | 512 | 512 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97347250 | Total |
| Program Services | 81732015 | ProgramServices |
| Management And General | 15615235 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6491378 | BOY |
| EOY | 2085594 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9684794 | BOY |
| EOY | 449304 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13169506 | BOY |
| EOY | 12897080 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2985662 | BOY |
| EOY | 8308978 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2436152 | BOY |
| EOY | 2581845 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 419990 | BOY |
| EOY | 390915 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 170738943 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 106530035 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56107070 | BOY |
| EOY | 64208908 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29865312 | BOY |
| EOY | 33467984 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16530187 | BOY |
| EOY | 17784759 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 443520 | BOY |
| EOY | 731066 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138133571 | BOY |
| EOY | 142906433 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7226199 | BOY |
| EOY | 8254790 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5000000 | BOY |
| EOY | 240000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 853722 | BOY |
| EOY | 366353 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2028474 | BOY |
| EOY | 1152792 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21206328 | BOY |
| EOY | 24641390 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36314723 | BOY |
| EOY | 34655325 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96072754 | BOY |
| EOY | 101754278 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3866272 | BOY |
| EOY | 4652726 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1879822 | BOY |
| EOY | 1844104 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101818848 | BOY |
| EOY | 108251108 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138133571 | BOY |
| EOY | 142906433 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 6812419 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -1535789 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 1155630 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 33063211 | BeginningOfYearBalance |
| Contributions | 3060682 | Contributions |
| Investment Earnings Or Losses | 5437843 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1506851 | GrantsOrScholarships |
| Administrative Expenses | 70033 | AdministrativeExpenses |
| End Of Year Balance | 39984852 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 29807903 | BeginningOfYearBalance |
| Contributions | 973133 | Contributions |
| Investment Earnings Or Losses | 3392627 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1005240 | GrantsOrScholarships |
| Administrative Expenses | 105212 | AdministrativeExpenses |
| End Of Year Balance | 33063211 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 27332498 | BeginningOfYearBalance |
| Contributions | 1210199 | Contributions |
| Investment Earnings Or Losses | 2606051 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1217174 | GrantsOrScholarships |
| Administrative Expenses | 123671 | AdministrativeExpenses |
| End Of Year Balance | 29807903 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 24531627 | BeginningOfYearBalance |
| Contributions | 277482 | Contributions |
| Investment Earnings Or Losses | 3094721 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 455696 | GrantsOrScholarships |
| Administrative Expenses | 115636 | AdministrativeExpenses |
| End Of Year Balance | 27332498 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 28819843 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -4127098 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 84867 | GrantsOrScholarships |
| Other Expenditures | -270 | OtherExpenditures |
| Administrative Expenses | 76521 | AdministrativeExpenses |
| End Of Year Balance | 24531627 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.83750 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.04610 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.11640 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 331504 | OtherCostOrOtherBasis |
| Book Value | 331504 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 86581759 | OtherCostOrOtherBasis |
| Depreciation | 41339161 | Depreciation |
| Book Value | 45242598 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1866826 | OtherCostOrOtherBasis |
| Depreciation | 677839 | Depreciation |
| Book Value | 1188987 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 76035677 | OtherCostOrOtherBasis |
| Depreciation | 61506284 | Depreciation |
| Book Value | 14529393 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5923177 | OtherCostOrOtherBasis |
| Depreciation | 3006751 | Depreciation |
| Book Value | 2916426 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 64208908 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC | 5000 | C |
| BENEFICIAL INTEREST IN TRINITY HEALTH FOUNDATION | 16982694 | F |
| VARIOUS HEALTH ENTERPRISES OF IOWA PARTNERSHIP INTERESTS | 522702 | C |
| HEALTHNET CONNECT LC | 100 | C |
| TRINITY REGIONAL MEDICAL CENTER AUXILIARY | 274263 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 17784759 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ASBESTOS REMOVAL LIABILITY | $78,357 |
| CONTINGENCY LIABILITY/SELF-INSURANCE RESERVE | $1,587,105 |
| IOWA HEALTH SYSTEM NOTE PAYABLE | $21,300,000 |
| HEALTH AND WELFARE BENEFITS RESERVE | $1,222,957 |
| DUE TO AFFILIATES | $428,991 |
| MISCELLANEOUS LIABILITY | $23,980 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 24641390 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 99330000 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -1535789 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -1535789 | RevenueNotRptdF990 |
| Revenue Subtotal | 100865789 | RevenueSubtotal |
| Investment Expenses Not Included | 70044 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 3223836 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3293880 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 104159669 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 94836000 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 190 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 190 | ExpensesNotRptdF990 |
| Expenses Subtotal | 94835810 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 70044 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 2441396 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 2511440 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 97347250 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | IOWA HEALTH SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE HEALTH SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. THE HEALTH SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME DURING THE CARRYFORWARD PERIOD. NO INCOME TAX BENEFIT HAS BEEN RECOGNIZED FOR THE NET OPERATING LOSS CARRYFORWARDS OR OTHER POTENTIAL DEFERRED TAX ASSETS IN THE CONSOLIDATED FINANCIAL STATEMENTS BECAUSE THE HEALTH SYSTEM BELIEVES REALIZATION OF THESE BENEFITS IS UNLIKELY. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REVENUES IN UNRESTRICTED FUND BALANCE 1,399,554. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 1,553,831. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC REBATES 270,375. ROUNDING 76. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ROUNDING 190. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES IN UNRESTRICTED FUND BALANCE 2,171,021. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC REBATES 270,375. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2394836 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2394836 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02460 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11097 | PersonsServed |
| Total Community Benefit Expense | 9359990 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7216835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2143155 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02200 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11097 | PersonsServed |
| Total Community Benefit Expense | 11754826 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7216835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4537991 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04660 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11520 | PersonsServed |
| Total Community Benefit Expense | 535737 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 62831 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 472906 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 587 | PersonsServed |
| Total Community Benefit Expense | 1666570 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1666570 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 3810101 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2314652 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1495449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01540 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21120 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20620 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 12107 | PersonsServed |
| Total Community Benefit Expense | 6033528 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2377983 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3655545 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03760 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 23204 | PersonsServed |
| Total Community Benefit Expense | 17788354 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9594818 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8193536 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08420 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Building Expense | 9687 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1650 | DirectOffsettingRevenue |
| Net Community Building Expense | 8037 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2961 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2961 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 2 | PersonsServed |
| Total Community Building Expense | 8138 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8138 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 37 | PersonsServed |
| Total Community Building Expense | 382132 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 382132 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 40 | PersonsServed |
| Total Community Building Expense | 402918 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1650 | DirectOffsettingRevenue |
| Net Community Building Expense | 401268 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,813,538 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 30764663 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 36163376 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -5398713 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRINITY REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 KENYON ROAD | AddressLine1 |
| City | FORT DODGE | City |
| State | IA | State |
| ZIP Code | 50501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRINITY REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 6A: TRINITY REGIONAL MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. | ||
| PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. | ||
| PART 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 FREE CLINICS OR AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. TRINITY REGIONAL MEDICAL CENTER (TRMC) 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. TRMC EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, TRMC EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT TRMC HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A VERY WELL COMPREHENSIVE AND INTENTIONAL APPROACH. | ||
| PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR TRINITY REGIONAL MEDICAL CENTER. 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 HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL REPORTED ON LINE 7 ABOVE 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, HAVE LIMITED INCOME 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: TRINITY REGIONAL MEDICAL CENTER (TRMC) CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, TRMC IS A SPONSORING PARTNER OF SEVERAL HEALTH SCREENINGS AND FAIRS WHICH ARE A COMMUNITY COLLABORATIVE CONVENED BY PARTNERS SUCH AS IOWA CENTRAL COMMUNITY COLLEGE AND SURROUNDING NURSING HOMES TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF WEBSTER COUNTY AND SURROUNDING AREAS. A HEALTH AGENDA WAS DEVELOPED BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY THROUGH THESE VARIOUS HEALTH SCREENS.TRMC WORKS CLOSELY WITH OTHER COMMUNITY GROUPS TO ASSESS THE AREA NEED. THEY WORK CLOSELY WITH THE UNITED WAY AND THE CHARACTER COUNTS PROGRAM. TRMC AND THE UNITED WAY ARE SPONSORING PARTNERS, ALONG WITH THE CITY OF FORT DODGE FOR THIS WORTHY PROGRAM. | ||
| PART VI, LINE 3: TRINITY REGIONAL MEDICAL CENTER 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: TRINITY REGIONAL MEDICAL CENTER (TRMC) IS A 200-BED PRIVATE, NON-PROFIT HOSPITAL THAT SERVES FORT DODGE, WHICH IS LOACTED IN WEBSTER COUNTY, AND SURROUNDING COMMUNITIES. TRMC IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.AS A DESIGNATED REGIONAL REFERRAL CENTER, TRMC SERVES AN EIGHT COUNTY AREA WITH A POPULATION OF APPROXIMATELY 100,000. ROUGHLY 25 PERCENT OF TRMC MARKET RESIDENTS LIVE WITHIN THE CITY LIMITS OF FORT DODGE. THE REMAINING MARKET SHARE LIVES IN THE RURAL AREAS OR SMALL TOWNS SURROUNDING FORT DODGE. IN 2012 TRMC ADMITTED 4,689 INPATIENTS AND SAW APPROXIMATELY 21,692 PATIENTS IN THE EMERGENCY ROOMMEDIAN HOUSEHOLD INCOMES FOR TRMC'S PATIENT POPULATION RANGE FROM $33,286 TO $41,155, AND THE AVERAGE POVERTY RATE IS 7 PERCENT. WEBSTER COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 92.3 PERCENT CAUCASIAN, 3.4 PERCENT AFRICAN-AMERICAN AND 3.8 PERCENT HISPANIC. | ||
| PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE. | ||
| PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM. INITIALLY FORMED IN 1995, IOWA HEALTH SYSTEM IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 29 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND 280 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 24,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 4 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2.7 BILLION, IOWA HEALTH SYSTEM IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. IOWA HEALTH SYSTEM AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2012, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED $421 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY IOWA HEALTH SYSTEM AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. | ||
| IA | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH ADAMS DO | ||||||||||||||
| BOARD MEMBER | 0 | 626119 | 0 | 0 | 0 | 218877 | 0 | 359977 | 0 | 17351 | 0 | 1222324 | 0 | 0 |
| JOHN BIRKETT MD | ||||||||||||||
| BOARD MEMBER | 0 | 180723 | 0 | 6716 | 0 | 135137 | 0 | 25000 | 0 | 11542 | 0 | 359118 | 0 | 0 |
| JAMES MEYER DO | ||||||||||||||
| BOARD MEMBER | 0 | 350056 | 0 | 0 | 0 | 119293 | 0 | 159400 | 0 | 17540 | 0 | 646289 | 0 | 0 |
| SUSAN THOMPSON | ||||||||||||||
| BOARD MEMBER & PRESIDENT/CEO | 0 | 316042 | 0 | 58480 | 0 | 56799 | 0 | 9088 | 0 | 18576 | 0 | 458985 | 0 | 0 |
| MIKE DEWERFF | ||||||||||||||
| CFO | 0 | 185439 | 0 | 28623 | 0 | 19310 | 0 | 23785 | 0 | 20916 | 0 | 278073 | 0 | 0 |
| TROY MARTENS | ||||||||||||||
| COO | 0 | 194209 | 0 | 32321 | 0 | 20631 | 0 | 22885 | 0 | 22956 | 0 | 293002 | 0 | 0 |
| DEBRA SHRIVER | ||||||||||||||
| CHIEF NURSING EXECUTIVE | 161679 | 0 | 0 | 0 | 4445 | 0 | 8795 | 0 | 23108 | 0 | 198027 | 0 | 0 | 0 |
| LINDA WHALEY | ||||||||||||||
| VP CLIN & ANCILLARY SVCS | 155643 | 0 | 0 | 0 | 893 | 0 | 7966 | 0 | 8812 | 0 | 173314 | 0 | 0 | 0 |
| RICHARD BERGSTROM MD | ||||||||||||||
| PHYSICIAN-ORTHOPAEDICS | 317308 | 0 | 0 | 0 | 37011 | 0 | 8481 | 0 | 648 | 0 | 363448 | 0 | 0 | 0 |
| COLIN BROWN | ||||||||||||||
| CRNA-PROF FEES | 179727 | 0 | 0 | 0 | 37225 | 0 | 11321 | 0 | 23101 | 0 | 251374 | 0 | 0 | 0 |
| SUZANNE CLAPP | ||||||||||||||
| CRNA-PROF FEES | 190442 | 0 | 0 | 0 | 35615 | 0 | 11598 | 0 | 19399 | 0 | 257054 | 0 | 0 | 0 |
| JEFFREY LUNA MD | ||||||||||||||
| PHYSICIAN-ORTHOPAEDICS | 618488 | 0 | 15000 | 0 | 625 | 0 | 9327 | 0 | 18386 | 0 | 661826 | 0 | 0 | 0 |
| KEVIN SCHMINKE | ||||||||||||||
| PHYSICIAN-HOSPITALIST | 220300 | 0 | 24000 | 0 | 2505 | 0 | 12500 | 0 | 17941 | 0 | 277246 | 0 | 0 | 0 |
| RALPH HEASLEY TO 1110 | ||||||||||||||
| FORMER INTERIM CFO | 0 | 169974 | 0 | 0 | 0 | 12528 | 0 | 8701 | 0 | 19242 | 0 | 210445 | 0 | 0 |
| THOMAS TIBBITTS TO 1209 | ||||||||||||||
| FORMER PRESIDENT/CEO | 0 | 352970 | 0 | 49612 | 0 | 504517 | 0 | 12500 | 0 | 12649 | 0 | 932248 | 0 | 449963 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: MIKE DEWERFF $12,772, TROY MARTENS $11,146 AND SUSAN THOMPSON $-3,412. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521699886 | IssuerEIN |
| CUSIP Number | 46246NHS8 | CUSIPNumber |
| Date Issued | 2008-12-30 | DateIssued |
| Issue Price | 5000000 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF FACILITIES | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 5000095 | TotalProceeds |
| Capital Expenditures | 5000095 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 1 | MngmentCntrctBondFinancdPrprty |
| Engage Bond Counsel Contracts | 1 | EngageBondCounselContracts |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Percentage Of Prvt Business Re UBI | 0.00260 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00260 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 1 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 1 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART II, LINE 3, COLUMN (A) | Identifier |
| Explanation | THERE IS A DIFFERENCE BETWEEN THE BOND ISSUE PRICE AND THE TOTAL PROCEEDS OF BOND ISSUE DUE TO INVESTMENT EARNINGS OF $95. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| CATHERINE LENSCH | |||
| FAMILY MEMBER OF BOARD MEMBER RHONDA CHAMBERS | 67334 | EMPLOYMENT | 0 |
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||
| COMMON BOARD MEMBER/OFFICER | 132022 | PERFORMANCE OF SERVICES | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | TRINITY HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7B | TRINITY HEALTH SYSTEMS, INC., AS SOLE MEMBER, AND IOWA HEALTH SYSTEM, AS SOLE MEMBER OF TRINITY HEALTH SYSTEMS, APPROVE BOARD OF DIRECTORS, BUDGETS, APPOINT PRESIDENT, APPROVE ESTABLISHING SUBSIDIARIES, AFFILIATES AND JOINT VENTURES, APPROVE MERGERS, CONSOLIDATIONS OR DISSOLUTIONS, APPROVE CHANGES IN PURPOSE, AND APPROVE PURCHASE, SALE, LEASE TRANSFER OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY FUNCTIONAL AREA WITH RESPONSIBILITY ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2012 FOR THE FOLLOWING INDIVIDUALS: MIKE DEWERFF, TROY MARTENS, AND SUSAN THOMPSON. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." WE'VE 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 BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES. IN ADDITION, MANY GOVERNANCE POLICIES AND CORPORATE 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 CONFLICT OF INTEREST; GOVERNANCE BEST PRACTICE POLICIES; BOARD MEMBERS AND COMMITTEES; COMPENSATION FOR EACH SENIOR AFFILIATE TOP EXECUTIVE; AND FINANCIAL INFORMATION FOR PAST SEVEN YEARS. | |
| FORM 990, PART IX, LINE 11G | HEALTH-CARE PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 3,727,981. MANAGEMENT AND GENERAL EXPENSES 11,315. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,739,296. PURCHASED HOUSEKEEPING AND LAUNDRY : PROGRAM SERVICE EXPENSES 759,026. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 759,026. MISCELLANEOUS PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 5,100,834. MANAGEMENT AND GENERAL EXPENSES 1,657,482. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,758,316. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST OF TRINITY HEALTH FOUNDATION 1,155,630. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ALLEN COLLEGE | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421351526 | EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS | IA | 501(C)(3) | 170(B)(1) (A)(II) | ALLEN HEALTH SYSTEMS INC | 0 |
| ALLEN HEALTH SYSTEMS INC | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201924 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ALLEN MEMORIAL HOSPITAL CORPORATION | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 420698265 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ALLEN HEALTH SYSTEMS INC | 0 |
| ANAMOSA AREA AMBULANCE SERVICE | ||||||||||
| 101 GRANT WOOD DRIVE | ANAMOSA | IA | 52205 | 421466284 | PROVIDE AMBULANCE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'SJONES REGIONAL MEDICAL CENTER | 0 |
| CENTRAL IOWA HEALTH PROPERTIES CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421233759 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | CENTRAL IOWA HEALTH SYSTEM | 0 | |
| CENTRAL IOWA HEALTH SYSTEM | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421189791 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| CENTRAL IOWA HOSPITAL CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 420680452 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | CENTRAL IOWA HEALTH SYSTEM | 0 |
| FINLEY TRI-STATES HEALTH GROUP INC | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 421307495 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| HNC SERVICES | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 270987243 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 0 |
| INTRUST | ||||||||||
| 11333 AURORA AVENUE | URBANDALE | IA | 50322 | 421477471 | HOME HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 0 |
| IOWA HEALTH FOUNDATION | ||||||||||
| 1415 WOODLAND AVE SUITE E-200 | DES MOINES | IA | 50309 | 421467682 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 509(A)(3), TYPE III | CENTRAL IOWA HEALTH SYSTEM | 0 |
| IOWA HEALTH SYSTEM | ||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421435199 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | 0 | |
| IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION | ||||||||||
| 8101 BIRCHWOOD COURT | JOHNSTON | IA | 50131 | 421411630 | PRIMARY HEALTH CARE SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
| MEMORIAL FOUNDATION OF ALLEN HOSPITAL | ||||||||||
| 1825 LOGAN AVENUE | WATERLOO | IA | 50703 | 421201138 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | ALLEN HEALTH SYSTEMS INC | 0 |
| METHODIST HEALTH SERVICES CORPORATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111135 | HEALTHCARE | IL | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| METHODIST MEDICAL CENTER FOUNDATION | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 510186460 | FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 370661223 | HEALTHCARE | IL | 501(C)(3) | 170(B)(1) (A)(III) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| METHODIST SERVICES INC | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 371111134 | OFFICE RENTAL | IL | 501(C)(3) | 509(A)(2) | METHODIST HEALTH SERVICES CORPORATION | 0 |
| NELLIE R SHERWOOD TRUST | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 426061621 | PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY | IA | 501(C)(3) | 509(A)(3), TYPE I | ST LUKE'S METHODIST HOSPITAL | 0 |
| NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED | ||||||||||
| 720 KENYON DRIVE | FORT DODGE | IA | 50501 | 420937390 | MENTAL HEALTH CARE | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| NORTHWEST IOWA HOSPITAL CORPORATION | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421019872 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | IOWA HEALTH SYSTEM | 0 |
| SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS | ||||||||||
| 221 NORTHEAST GLEN OAK AVENUE | PEORIA | IL | 61636 | 376181831 | FUND SELF-INSURANCE PLAN | IL | 501(C)(3) | 509(A)(3), TYPE I | METHODIST MEDICAL CENER OF ILLINOIS | 0 |
| SIOUXLAND PACE INC | ||||||||||
| 313 COOK STREET | SIOUX CITY | IA | 51103 | 261120134 | ALL-INCLUSIVE CARE FOR THE ELDERLY | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH RESOURCES | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421059182 | OUTPATIENT CLINICS AND HEALTHCARE SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTH SYSTEM INC | 0 |
| ST LUKE'S HEALTH SYSTEM INC | ||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 421294091 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S HEALTHCARE | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421487968 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| ST LUKE'S METHODIST HOSPITAL | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 420504780 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| ST LUKE'SJONES REGIONAL MEDICAL CENTER | ||||||||||
| 1795 HIGHWAY 64 EAST | ANAMOSA | IA | 52205 | 421487967 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | ST LUKE'S HEALTHCARE | 0 |
| STL CARE COMPANY | ||||||||||
| 1026 A AVENUE NE | CEDAR RAPIDS | IA | 52402 | 421276632 | IMPROVE PUBLIC HEALTH SERVICES | IA | 501(C)(3) | 509(A)(2) | ST LUKE'S HEALTHCARE | 0 |
| THE DUBUQUE VISITING NURSE ASSOCIATION | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680410 | PUBLIC HEALTH SERVICES/HOME CARE | IA | 501(C)(3) | 509(A)(2) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE FINLEY HOSPITAL | ||||||||||
| 350 NORTH GRANDVIEW AVENUE | DUBUQUE | IA | 52001 | 420680354 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | FINLEY TRI-STATES HEALTH GROUP INC | 0 |
| THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363678909 | MENTAL HEALTH CARE | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRIMARK PHYSICIANS GROUP | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 453791448 | SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY BUILDING CORPORATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421376187 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | TRINITY HEALTH SYSTEMS INC | 0 | |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222381 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY HEALTH SYSTEMS INC | 0 |
| TRINITY HEALTH FOUNDATION | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363321751 | CHARITABLE FUNDRAISING | IL | 501(C)(3) | 170(B)(1) (A)(VI) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY HEALTH SYSTEMS INC | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421222877 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY MEDICAL CENTER | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 362739299 | HOSPITAL | IL | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HEALTH SYSTEM | ||||||||||
| 2701 17TH STREET | ROCK ISLAND | IL | 61201 | 363351952 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IL | 501(C)(3) | 509(A)(3), TYPE II | IOWA HEALTH SYSTEM | 0 |
| TRINITY REGIONAL HOSPITAL AUXILIARY | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 426081474 | CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES | IA | 501(C)(3) | 509(A)(2) | TRINITY REGIONAL MEDICAL CENTER | 1 |
| TRINITY REGIONAL MEDICAL CENTER | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421009175 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY HEALTH SYSTEMS INC | 0 |
| UNITY HEALTHCARE | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 420680337 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 0 |
| UNITY HEALTHCARE FOUNDATION | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 421525031 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE I | TRINITY REGIONAL HEALTH SYSTEM | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (19 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA | Code VCodeVAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC | |||||||||||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 453237125 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IA | ALLEN MEMORIAL HOSPITAL CORPORATION | RELATED | 126185 | 43766 | 0 | 1 | 0.20000 | ||
| CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC | |||||||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 273625869 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | CENTRAL IOWA HOSPITAL CORPORATION | RELATED | 261340 | 80230 | 0 | 1 | 0.20000 | ||
| CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY | |||||||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 453017991 | ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES | IA | CENTRAL IOWA HOSPITAL CORPORATION | RELATED | 201563 | 101327 | 0 | 1 | 0.20000 | ||
| DES MOINES PARKING ASSOCIATES | |||||||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 382622972 | PARKING DECK OPERATIONS | IA | CENTRAL IOWA HEALTH PROP CORP | RELATED | 1033046 | 0 | 1 | 1.00000 | |||
| DUBUQUE ENDOSCOPY CENTER LC | |||||||||||||||
| 1515 DELHI STREET SUITE 500 | DUBUQUE | IA | 52001 | 201597161 | AMBULATORY SURGERY CENTER | IA | THE FINLEY HOSPITAL | RELATED | 636788 | 274391 | 0 | 0 | 0.51000 | ||
| ENSEVA - HIAWATHA LLC | |||||||||||||||
| 755 METZGER DRIVE | HIAWATHA | IA | 52233 | 453437363 | COLLOCATION FACILITY | IA | IOWA HEALTH SYSTEM | RELATED | -150730 | 2077107 | 0 | 0 | 0.52000 | ||
| FINLEY DEPT OF SURGERY CO-MGMT CO LLC | |||||||||||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 422808785 | SURGERY DEPARTMENT MANAGEMENT SERVICES | IA | THE FINLEY HOSPITAL | RELATED | 110302 | 155255 | 0 | 1 | 0.50000 | ||
| HEALTH CARE AFFILIATES OF THE TRI-STATES LLC | |||||||||||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 421428503 | PROVIDE ACCESS TO LICENSED SOFTWARE | IA | THE FINLEY HOSPITAL | RELATED | 14037 | 0 | 1 | 0.50000 | |||
| HEALTH ENTERPRISES VENTURES LC | |||||||||||||||
| 4250 GLASS ROAD NE | CEDAR RAPIDS | IA | 52402 | 391894290 | INVESTMENT VEHICLE OWNING CLINICAL JVS | IA | UNRELATED | 85147 | 837296 | 0 | 0 | 0.55670 | N/A | $70,249 | |
| HY-VEEIOWA HEALTH LC | |||||||||||||||
| 5820 WESTOWN PARKWAY | WEST DES MOINES | IA | 50266 | 263293530 | PRIMARY CARE CLINIC | IA | CENTRAL IOWA HOSPITAL CORPORATION | RELATED | -186843 | 186116 | 0 | 1 | 0.50000 | ||
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||||||||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421511142 | GROUP PURCHASING | IA | IOWA HEALTH SYSTEM | RELATED | 3278657 | 7072097 | 1 | 1 | 1.00000 | ||
| MEDICAL LABORATORIES OF EASTERN IOWA LC | |||||||||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421359640 | MEDICAL LABORATORY SERVICES | IA | ST LUKE'S METHODIST HOSPITAL | RELATED | 466410 | 1180716 | 0 | 1 | 0.50000 | ||
| MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 221 NE GLEN OAK AVE | PEORIA | IL | 61636 | 461219459 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IL | METHODIST MEDICAL CENTER OF ILLINOIS | RELATED | 32000 | 0 | 1 | 0.20000 | |||
| MR ASSOCIATES LLP | |||||||||||||||
| 1455 SHERMAN ROAD | HIAWATHA | IA | 52233 | 421260463 | OWN AND OPERATE MR UNIT | IA | ST LUKE'S METHODIST HOSPITAL | RELATED | 2526085 | 1348049 | 0 | 1 | 0.33330 | ||
| REHABILITATION THERAPY SERVICES LLC | |||||||||||||||
| 416 ST MARKS CT 110 | PEORIA | IL | 61603 | 810584193 | REHABILATION THERAPY | IL | METHODIST MEDICAL CENTER OF ILLINOIS | RELATED | 323118 | 1122254 | 0 | 0 | 0.60040 | ||
| SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 2720 STONE PARK BLVD | SIOUX CITY | IA | 51104 | 455322324 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | NORTHWEST IOWA HOSPITAL CORPORATION | RELATED | 30396 | 47646 | 0 | 1 | 0.20000 | ||
| THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | |||||||||||||||
| 1075 FIRST AVENUE SE | CEDAR RAPIDS | IA | 52403 | 721550812 | AMBULATORY SURGERY CENTER. | IA | ST LUKE'S METHODIST HOSPITAL | RELATED | 3272140 | 5076873 | 0 | 1 | 0.50000 | ||
| TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 4500 UTICA RIDGE RD | BETTENDORF | IA | 52722 | 272562753 | ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES | IA | TRINITY MEDICAL CENTER | RELATED | 235523 | 149417 | 0 | 1 | 0.50000 | ||
| WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC | |||||||||||||||
| 1660 60TH STREET | WEST DES MOINES | IA | 50266 | 271414600 | ORTHOPEDIC SERVICE LINES MANAGEMENT | IA | CENTRAL IOWA HOSPITAL CORPORATION | RELATED | 245617 | 16245 | 0 | 1 | 0.20000 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| BROADBAND INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 273819741 | INFORMATION TECHNOLOGY MGMT. | IA | N/A | C | 0 |
| DELHI POINT CONDO ASSOCIATION | |||||||||
| 350 N GRANDVIEW | DUBUQUE | IA | 52001 | 421467002 | REAL ESTATE MANAGEMENT | IA | N/A | C | 0 |
| INTEGRATED CARE ORGANIZATION | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 274665007 | INTEGRATED AFFILIATE CARE | IA | N/A | C | 0 |
| IOWA HEALTH SYSTEM 457 DEF COMP PLAN | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421435199 | INVESTMENT | IA | N/A | T | 0 |
| MEDIMORE INC | |||||||||
| 1776 WEST LAKES PKWY 400 | WEST DES MOINES | IA | 50266 | 421414390 | MANAGED CARE | IA | N/A | C | 0 |
| METHODIST HEALTH VENTURES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371140939 | PHARMACY/OFFICE STAFFING | IL | N/A | C | 0 |
| METHODIST PHYSICIAN SERVICES INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 363858550 | MEDICAL SERVICES | IL | N/A | C | 0 |
| PRECEDENCE INC | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 371288604 | MANAGED MENTAL CARE | IA | N/A | C | 0 |
| PROVIDER RESOURCE MANAGEMENT INC | |||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371223550 | RESOURCE MANAGEMENT | IL | N/A | C | 0 |
| RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC | |||||||||
| 700 E UNIVERSITY AVE | DES MOINES | IA | 50316 | 261271143 | SPECIALTY PHYSICIANS MEDICAL CARE | IA | N/A | C | 0 |
| STL HEALTH RESOURCES CO | |||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421193499 | PHYSICIAN OFFICE RENTAL | IA | N/A | C | 0 |
| TRINITY HEALTH ENTERPRISES INC | |||||||||
| 2701 17TH ST | ROCK ISLAND | IL | 61201 | 363320141 | RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY | IL | N/A | C | 0 |
| TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD | |||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 363924720 | MANAGED HEALTH CARE | IA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRINITY BUILDING CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionType |
| Amount Involved | 122214 | AmountInvolved |
| Method Of Amt Determination | BASED ON GAAP, CASH AND/OR FMV | MethodOfAmtDetermination |