ST LUKES-JONES REGIONAL MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST LUKES-JONES REGIONAL MEDICAL CENTER (EIN 42-1487967)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201233199349301593
- Schema version
- 2011v1.2
- 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 O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T09:20:17-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421487967 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'SJONES REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STLU | NameControl |
| Phone | 3194626131 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1795 HIGHWAY 64 EAST | AddressLine1 |
| City | ANAMOSA | City |
| State | IA | State |
| ZIP Code | 52205 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ERIC BRIESEMEISTER | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 3194626131 | Phone |
| Date Signed | 2012-11-08 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JONES REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | THEODORE E TOWNSEND JR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1795 HIGHWAY 64 EAST | AddressLine1 |
| City | ANAMOSA | City |
| State | IA | State |
| ZIP Code | 52205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 25684419 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.JONESREGIONAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY SERVICES AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 184 | TotalNbrEmployees |
| Total Nbr Volunteers | 39 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 44886 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 147630 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16736391 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 19678786 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 296635 | InvestmentIncomePriorYear |
| Investment Income Current Year | 343494 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 48374 | OtherRevenuePriorYear |
| Other Revenue Current Year | 76857 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17126286 | TotalRevenuePriorYear |
| Total Revenue Current Year | 20246767 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 6200 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1525 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7115660 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7817828 | 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 | 7288460 | OtherExpensePriorYear |
| Other Expenses Current Year | 7530067 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14410320 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15349420 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2715966 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4897347 | RevenuesLessExpensesCY |
| Total Assets BOY | 27373014 | TotalAssetsBOY |
| Total Assets EOY | 31032719 | TotalAssetsEOY |
| Total Liabilities BOY | 10558076 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9712000 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 16814938 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 21320719 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE QUALITY SERVICES IN AN EFFICIENT, COST-EFFECTIVE MANNER AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 11406129 | Expense |
| Revenue | 19885015 | Revenue |
| Description | HEALTH-CARE SERVICESST. LUKE'S/JONES 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, MENTAL HEALTH CARE, REHABILITATION, SKILLED NURSING, LABORATORY, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2011, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER DISCHARGED 612 PATIENTS RESULTING IN A TOTAL OF 3,005 PATIENT DAYS. OUTPATIENT VISITS TOTALED 55,536 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 703. THERE WERE ALSO 8,016 EMERGENCY ROOM VISITS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 869920 | Expense |
| Grants | 1525 | Grants |
| Description | COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: ST. LUKE'S/JONES 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 $437,474 IN 2011. OFTENTIMES, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $627,292. OTHER BENEFITS: ST. LUKE'S/JONES 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. ST. LUKE'S/JONES 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. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $242,628. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 12276049 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 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 | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | 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 | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 40 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 184 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | 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 | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| 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 | RACHEL VONBEHREN FISCAL SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3194816302 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1795 HIGHWAY 64 EAST | AddressLine1 |
| City | ANAMOSA | City |
| State | IA | State |
| ZIP Code | 52205 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MILTON AUNAN II | ||||||||
| BOARD MEMBER/VP FIN/CFO | 1.00 | X | X | 0 | 366174 | 53717 | ||
| ERIC BRIESEMEISTER | ||||||||
| BOARD MEMBER/PRESIDENT/CEO | 40.00 | X | X | 0 | 102695 | 23547 | ||
| VICTOR HAMRE | ||||||||
| BOARD VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| JOHN HARMS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MICHELLE NIERMANN | ||||||||
| BOARD SECRETARY/VP OPERATIONS | 40.00 | X | X | 0 | 275318 | 47902 | ||
| DOROTHY POSTEL TO 1211 | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOHN SHEEHAN | ||||||||
| BOARD MEMBER/EXEC VP/COO | 1.00 | X | 0 | 459290 | 81146 | |||
| THEODORE TOWNSEND JR | ||||||||
| BOARD CHAIR/PRES/CEO | 1.00 | X | X | 0 | 607173 | 135676 | ||
| JAY WILLEMS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| VICTOR SALAS MD | ||||||||
| ER DOCTOR/DIRECTOR | 40.00 | 302306 | 0 | 27906 | X | |||
| CHARLES SCHAUBERGER MD | ||||||||
| VP MEDICAL AFFAIRS | 40.00 | 0 | 343571 | 16653 | X | |||
| THOMAS SERBOUSEK MD | ||||||||
| ER DOCTOR/CO-DIRECTOR | 40.00 | 272313 | 0 | 25094 | X | |||
| JENNY BUTLER MD | ||||||||
| PHYSICIAN | 40.00 | 222274 | 0 | 14820 | X | |||
| THOMAS DEVANEY | ||||||||
| PHARMACIST | 40.00 | 127893 | 0 | 16596 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 924786 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2154221 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 443057 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EAST CENTRAL IA ACUTE CARE LLP | |||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | ER DOCTOR SERVICES | 629727 |
| GRAPETREE MEDICAL STAFFING | |||||
| 703 16TH ST | SPIRIT LAKE | IA | 51360 | TRAVELING NURSES | 192022 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| PO BOX 96485 | CHICAGO | IL | 60693 | MRI SERVICES | 188300 |
| PHILIPS MEDICAL CAPITAL | |||||
| PO BOX 92449 | CLEVELAND | OH | 44193 | IMAGING EQUIPMENT LEASE | 114859 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 20182 | GovernmentGrants |
| All Other Contributions | 127448 | AllOtherContributions |
| Total Contributions | 147630 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | 17072895 | 17072895 | |
| PHARMACY REVENUE | 446110 | 2388151 | 2388151 | |
| MISCELLANEOUS REVENUE | 900099 | 127000 | 127000 | |
| MGMT & SUPPORT SVCS | 561000 | 70815 | $70,815 | |
| RENTAL REVENUE | 531100 | 19925 | 19925 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 19678786 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 153676 | TotalRevenueColumn |
| Exclusion | $153,676 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5623564 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5433746 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 189818 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 189818 | TotalRevenueColumn |
| Related Or Exempt Function Income | 189818 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 9855 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 3906 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5949 | TotalRevenueColumn |
| Exclusion | $5,949 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA/FOOD SVCS | 722210 | 54497 | $54,497 | |
| SUBS & JOINT VENTURES | 900099 | 13590 | 13590 | |
| MISCELLANEOUS REVENUE | 900099 | 2821 | 2821 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 70908 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20246767 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19814200 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $284,937 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1525 | Total |
| Program Services | 1525 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 753861 | Total |
| Management And General | 753861 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5586050 | Total |
| Program Services | 5549024 | ProgramServices |
| Management And General | 37026 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113692 | Total |
| Program Services | 112938 | ProgramServices |
| Management And General | 754 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 945344 | Total |
| Program Services | 939078 | ProgramServices |
| Management And General | 6266 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418881 | Total |
| Program Services | 416105 | ProgramServices |
| Management And General | 2776 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10 | Total |
| Management And General | 10 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18561 | Total |
| Management And General | 18561 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3065576 | Total |
| Program Services | 2144509 | ProgramServices |
| Management And General | 921067 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73822 | Total |
| Program Services | 14470 | ProgramServices |
| Management And General | 59352 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1764815 | Total |
| Program Services | 1700700 | ProgramServices |
| Management And General | 64115 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 633694 | Total |
| Management And General | 633694 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 173476 | Total |
| Program Services | 173476 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38920 | Total |
| Program Services | 24820 | ProgramServices |
| Management And General | 14100 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39487 | Total |
| Program Services | 35643 | ProgramServices |
| Management And General | 3844 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355142 | Total |
| Management And General | 355142 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1119776 | Total |
| Program Services | 1119776 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82277 | Total |
| Management And General | 82277 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS EXPENSE | Description |
| Total | 164511 | Total |
| Program Services | 43985 | ProgramServices |
| Management And General | 120526 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15349420 | Total |
| Program Services | 12276049 | ProgramServices |
| Management And General | 3073371 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10280 | BOY |
| EOY | 4155882 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4263578 | BOY |
| EOY | 3483715 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1631943 | BOY |
| EOY | 2461849 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24775 | BOY |
| EOY | 14807 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198002 | BOY |
| EOY | 232280 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40284 | BOY |
| EOY | 25814 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16711719 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2808865 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14311430 | BOY |
| EOY | 13902854 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6014438 | BOY |
| EOY | 5922296 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878284 | BOY |
| EOY | 833222 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27373014 | BOY |
| EOY | 31032719 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1072073 | BOY |
| EOY | 1102995 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135944 | BOY |
| EOY | 46765 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2007827 | BOY |
| EOY | 1396524 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7342232 | BOY |
| EOY | 7165716 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10558076 | BOY |
| EOY | 9712000 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15936654 | BOY |
| EOY | 20487497 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878284 | BOY |
| EOY | 833222 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16814938 | BOY |
| EOY | 21320719 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27373014 | BOY |
| EOY | 31032719 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4897347 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -391566 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | 6892721 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -92142 | InvestmentEarningsOrLosses |
| Other Expenditures | 45062 | OtherExpenditures |
| End Of Year Balance | 6755517 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3068174 | BeginningOfYearBalance |
| Contributions | 3533384 | Contributions |
| Investment Earnings Or Losses | 746263 | InvestmentEarningsOrLosses |
| Other Expenditures | 455100 | OtherExpenditures |
| End Of Year Balance | 6892721 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6061324 | BeginningOfYearBalance |
| Contributions | 1425631 | Contributions |
| Investment Earnings Or Losses | 634751 | InvestmentEarningsOrLosses |
| Other Expenditures | 5053532 | OtherExpenditures |
| End Of Year Balance | 3068174 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3350789 | BeginningOfYearBalance |
| Contributions | 3627901 | Contributions |
| Investment Earnings Or Losses | -917366 | InvestmentEarningsOrLosses |
| End Of Year Balance | 6061324 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.87670 | BoardDesignatedEOYBalance |
| Term Endowment EOY Balance | 0.12330 | 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 | 297612 | OtherCostOrOtherBasis |
| Book Value | 297612 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12990802 | OtherCostOrOtherBasis |
| Depreciation | 1545798 | Depreciation |
| Book Value | 11445004 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3423305 | OtherCostOrOtherBasis |
| Depreciation | 1263067 | Depreciation |
| Book Value | 2160238 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13902854 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATES | Description |
| Amount | $7,165,716 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7165716 | TotalOfAmounts |
| Total Revenue | 20246767 | TotalRevenue |
| Total Expenses | 15349420 | TotalExpenses |
| Excess Or Deficit For Year | 4897347 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -346504 | NetUnrealizedGLOnInvestments |
| Other | -$45,062 | OtherAmount |
| Total Adjustments | -391566 | TotalAdjustments |
| Excess Or Deficit Per FS | 4505781 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 20170000 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -346504 | NetUnrealizedGainsInvestments |
| Other Revenues | 476699 | OtherRevenues |
| Revenue Not Rptd F990 | 130195 | RevenueNotRptdF990 |
| Revenue Subtotal | 20039805 | RevenueSubtotal |
| Investment Expenses Not Included | 18531 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 188431 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 206962 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 20246767 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15613000 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 369864 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 369864 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15243136 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 18531 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 87753 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 106284 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15349420 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 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: | 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 2008. 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 8 - OTHER ADJUSTMENTS: | CHANGE IN BENEFICIAL INTEREST OF JONES REGIONAL MEDICAL CENTER FOUNDATION -45,062. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EMLIMINATE SUBSIDIARY (AAAS) 472,793. SPECIAL EVENT EXPENSES 3,906. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | REVENUE IN UNRESTRICTED FUND BALANCE 100,000. EXPENSE REIMBURSEMENTS/REVENUE OFFSETS 70,815. IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCAHSE REBATE 13,590. ELMINATING ENTRIES 3,348. ROUNDING 678. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | ELIMINATE SUBSIDIARY (AAAS) 365,047. ROUNDING 911. SPECIAL EVENT EXPENSES 3,906. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | ELIMINATE ENTRIES 3,348. EXPENSE REIMBURSEMENTS/REVENUE OFFSETS 70,815. IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCAHSE REBATE 13,590. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2256 | PersonsServed |
| Total Community Benefit Expense | 437474 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 437474 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02850 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 343093 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 153275 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 189818 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01240 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2256 | PersonsServed |
| Total Community Benefit Expense | 780567 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 153275 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 627292 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04090 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 55992 | PersonsServed |
| Total Community Benefit Expense | 100448 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 23422 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 77026 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 201 | PersonsServed |
| Total Community Benefit Expense | 7421 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7421 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 558097 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 399916 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 158181 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 56193 | PersonsServed |
| Total Community Benefit Expense | 665966 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 423338 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 242628 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 58449 | PersonsServed |
| Total Community Benefit Expense | 1446533 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 576613 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 869920 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05670 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 743 | PersonsServed |
| Total Community Building Expense | 24917 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1093 | DirectOffsettingRevenue |
| Net Community Building Expense | 23824 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 45 | PersonsServed |
| Total Community Building Expense | 411 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 411 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 56 | PersonsServed |
| Total Community Building Expense | 263 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 263 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 844 | PersonsServed |
| Total Community Building Expense | 25591 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1093 | DirectOffsettingRevenue |
| Net Community Building Expense | 24498 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $256,248 | BadDebtExpenseAmount |
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 | JONES REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1795 HIGHWAY 64 EAST SUITE 2 | AddressLine1 |
| City | ANAMOSA | City |
| State | IA | State |
| ZIP Code | 52205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | ST LUKE'SJONES REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| 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 |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| 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 |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 6A: ST. LUKE'S/JONES REGIONAL MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.IHS.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. | ||
| PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. | ||
| PART II: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. | ||
| PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR ST. LUKE'S JONES REGIONAL MEDICAL CENETER. 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 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 V, SECTION B, LINE 15E: GUARANTORS RECEIVE A CYCLE BILL EERY 30 DAYS FOR THE LIFE OF THE ACCOUNT ON A/R. ON DAY 41, 11 DAYS AFTER THE SECOND BILLING CYCLE, A FIRST COLLECTION ATTEMPT IS MADE FROM THE TELEVOX DIALER. THE SECOND COLLECTION ATTEMPT IS MADE BY THE DIALER ON DAY 71, 11 DAYS AFTER THE THIRD AND FINAL BILLING CYCLE. THE THIRD COLLECTION ATTEMPT IS MADE BY THE DIALER ON DAY 87, E DAYS BEFORE THE ACCOUNT IS REVIEWED FOR COLLECTIONS. ACCOUNTS WITH SATISFACTORY PAYMENTS OR PREARRANGED PAYMENT ARRANGEMENTS THAT ARE CURRENT ARE NOT SENT TO THE DIALER. ACCOUNTS WITH A MENTAL HEALTH DIAGNOSIS, WORKERS COMPENSATION ACCOUNTS, ACCOUNTS WITH SKILLED NURSING FACILITIES, AND ACCOUNTS WITH NO PHONE NUMBER ARE ALSO NOT SENT TO THE DIALER. THESE ACCOUNTS ARE ON A MANUAL LIST WHICH THE COLLECTION TEAM REVIEWS AND MAKES CALLS MANUALLY AS DEEMED APPROPRIATE. WHEN THE ACCOUNTS ARE GREATER THAN OR EQUAL TO $5,000, THE COLLECTION TEAM WILL SEND A FINANCIAL ASSISTANCE APPLICATION IF THEY CANNOT MAKE CONTACT WITH THE GUARANTOR AND 10 BUSINESS DAYS LATER, A PAST LETTER. THEY WILL ALSO CHECK FOR MEDICAID ELIGIBILITY FOR THEIR STATE OF RESIDENCE. | ST. LUKE'S/JONES REGIONAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 19D: IF THE INDIVIDUAL APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE SERVICES AT THE HOSPITAL FACILITY TO DETERMINE THE AMOUNTS BILLED FOR ALL SERVICES, INCLUDING EMERGENCY OR MEDICALLY NECESSARY CARE. THIS OCCURS REGARDLESS WHETHER THE INDIVIDUAL HAS INSURANCE COVERAGE. ALSO, IF THE INDIVIDUAL HAS INSURANCE COVERAGE AND DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE INSURER'S NEGOTIATED RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY. HOWEVER, IF THE INDIVIDUAL DOES NOT HAVE INSURANCE COVERAGE AND EITHER DOES NOT APPLY OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE GROSS RATES FOR THOSE SERVICES TO DETERMINE THE AMOUNTS BILLED. IF THE UNINSURED INDIVIDUAL AGREES TO PAY THE BILL IN FULL, THE HOSPITAL FACILITY WILL PROVIDE A 20%-30% DISCOUNT FROM THE GROSS RATES FOR THOSE INDIVIDUALS. THE PERCENTAGE OF GROSS CHARGES ON SELF-PAY ACCOUNTS WITH NO DISCOUNT FOR 2011 WAS 2.2%. | ST. LUKE'S/JONES REGIONAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 21: AS DESCRIBED IN SCHEDULE H, PART V, LINE 19, IF THE PATIENT DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE AND ALSO IS UNINSURED OR RECEIVES NO BENEFIT FROM THEIR INSURANCE ON A SERVICE PROVIDED BY THE HOSPITAL FACILITY, THEY WOULD BE CHARGED AMOUNTS EQUAL TO GROSS CHARGES FOR THE SERVICES PROVIDED TO THE PATIENT. HOWEVER, IF THE PATIENT AGREES TO PAY IN FULL, THEY WILL RECEIVE A 20%-30% DISCOUNT FROM THE GROSS CHARGES. THE PERCENTAGE OF GROSS CHARGES ON SELF-PAY ACCOUNTS WITH NO DISCOUNT FOR 2011 WAS 2.2%. | ST. LUKE'S/JONES REGIONAL MEDICAL CENTER | |
| PART VI, LINE 2: ST. LUKE'S/JONES REGIONAL MEDICAL CENTER CONTINUALLYMONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT. ALSO, MANY STAFF MEMBERS SERVE ON COMMITTEES OR BOARDS FOR ORGANIZATIONSIN THE COUNTY AND GATHER FEEDBACK FOR HEALTH NEEDS THROUGH THOSE RELATIONSHIPS. IN ADDITION, STAFF MEMBERS PRESENT TO MANY COMMUNITY GROUPS THROUGHOUT THE YEAR AND RECEIVE FEEDBACK ON HEALTH NEEDS THROUGH THESE VENUES. | ||
| PART VI, LINE 3: ST. LUKE'S JONES 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: ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS A 22-BED COMMUNITY HOSPITAL SERVING EAST CENTRAL IOWA. ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF JONES. ST. LUKE'S JONES REGIONAL MEDICAL CENTER ADMITS APPROXIMATELY 600 INPATIENTS AND CARES FOR 8,000 EMERGENCY PATIENTS PER YEAR. MEDIAN HOUSEHOLD INCOMES RANGE FROM $21,000 TO $47,955 AND THE AVERAGE POVERTY RATE IS 8%. 91% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. ST. LUKE'S JONES REGIONAL DEMOGRAPIC REGION IS COMPRISED OF 96% CAUCASION, 2% AFRICAN AMERICAN AND 2% 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 26 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 140 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND WESTERN ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH NEARLY 20,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 2.5 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2 BILLION, IOWA HEALTH SYSTEM IS THE SIXTH 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 2009, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED MORE THAN $128 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 | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MILTON AUNAN II | |||||||||||||
| 0 | 258850 | 0 | 75067 | 0 | 32257 | 0 | 42716 | 0 | 11001 | 0 | 419891 | 0 | 0 |
| MICHELLE NIERMANN | |||||||||||||
| 0 | 203181 | 0 | 55812 | 0 | 16325 | 0 | 26867 | 0 | 21035 | 0 | 323220 | 0 | 0 |
| JOHN SHEEHAN | |||||||||||||
| 0 | 330891 | 0 | 87698 | 0 | 40701 | 0 | 57731 | 0 | 23415 | 0 | 540436 | 0 | 0 |
| THEODORE TOWNSEND JR | |||||||||||||
| 0 | 413881 | 0 | 127527 | 0 | 65765 | 0 | 112089 | 0 | 23587 | 0 | 742849 | 0 | 0 |
| VICTOR SALAS MD | |||||||||||||
| 302206 | 0 | 0 | 0 | 100 | 0 | 8868 | 0 | 19038 | 0 | 330212 | 0 | 0 | 0 |
| CHARLES SCHAUBERGER MD | |||||||||||||
| 0 | 133769 | 0 | 83380 | 0 | 126422 | 0 | 9057 | 0 | 7596 | 0 | 360224 | 0 | 0 |
| THOMAS SERBOUSEK MD | |||||||||||||
| 272203 | 0 | 0 | 0 | 110 | 0 | 8556 | 0 | 16538 | 0 | 297407 | 0 | 0 | 0 |
| JENNY BUTLER MD | |||||||||||||
| 222174 | 0 | 0 | 0 | 100 | 0 | 6750 | 0 | 8070 | 0 | 237094 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINES 4A-B | ReturnReference |
| Explanation | THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN TAXABLE INCOME: CHARLES SCHAUBERGER $100,117. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: MILTON AUNAN II $30,466, MICHELLE NIERMANN $15,746, JOHN SHEEHAN $45,463, AND THEODORE TOWNSEND, JR. $99,035. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ST. LUKE'S HEALTHCARE, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. LUKE'S HEALTHCARE CAN APPOINT FIVE BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ST. LUKE'S HEALTHCARE, AS SOLE MEMBER SHALL APPROVE ARTICLE AND BYLAW AMENDMENTS, DISSOLUTIONS, APPOINT FIVE BOARD MEMBERS AND APPROVE APPOINTMENT OF PRESIDENT. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN NOVEMBER 2011 FOR THE FOLLOWING INDIVIDUALS: MILTON AUNAN II, MICHELLE NIERMANN, JOHN SHEEHAN, THEODORE TOWNSEND, JR. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -346,504. CHANGE IN BENEFICIAL INTEREST OF JONES REGIONAL MEDICAL CENTER FOUNDATION -45,062. TOTAL TO FORM 990, PART XI, LINE 5: -391,566. | 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| CENTRAL IOWA HEALTH PROPERTIES CORPORATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421233759 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | CENTRAL IOWA HEALTH SYSTEM | 1 | |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| HNC SERVICES | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 270987243 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 1 |
| INTEGRATED CARE ORGANIZATION | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 274665007 | PROMOTE, SUPPPORT THE INTERESTS AND PURPOSES OF AFFILIATES' HOSPITALS | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 1 |
| INTRUST | ||||||||||
| 11333 AURORA AVENUE | URBANDALE | IA | 50322 | 421477471 | HOME HEALTH CARE | IA | 501(C)(3) | 509(A)(2) | IOWA HEALTH SYSTEM | 1 |
| IOWA HEALTH FOUNDATION | ||||||||||
| 2700 GRAND AVE SUITE 109 | DES MOINES | IA | 50312 | 421467682 | CHARITABLE FUNDRAISING | IA | 501(C)(3) | 509(A)(3), TYPE III | CENTRAL IOWA HEALTH SYSTEM | 1 |
| IOWA HEALTH SYSTEM | ||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421435199 | SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE | IA | 501(C)(3) | 509(A)(3), TYPE III | 1 | |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 III | METHODIST MEDICAL CENER OF ILLINOIS | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| TPG HEALTH | ||||||||||
| 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 | 1 |
| TRINITY BUILDING CORPORATION | ||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421376187 | PROPERTY HOLDING COMPANY | IA | 501(C)(2) | TRINITY HEALTH SYSTEMS INC | 1 | |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| 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 | 1 |
| UNITY HEALTHCARE | ||||||||||
| 1518 MULBERRY AVENUE | MUSCATINE | IA | 52761 | 420680337 | HOSPITAL | IA | 501(C)(3) | 170(B)(1) (A)(III) | TRINITY REGIONAL HEALTH SYSTEM | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (29 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Code VCodeVAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1776 WESTLAKES PARKWAY LC | |||||||||||||||
| 4949 WESTOWN PARKWAY SUITE 200 | WEST DES MOINES | IA | 50266 | 205031651 | OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BUILDINGS | IA | N/A | UNRELATED | 229642 | 12309952 | 0 | 1 | 0.33330 | ||
| ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC | |||||||||||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 453237125 | ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A | RELATED | 22920 | 39683 | 0 | 0 | 0.20000 | ||
| CENTRAL ILLINOIS CANCER CARE CENTER LLC | |||||||||||||||
| 7309 N KNOXVILLE | PEORIA | IL | 61614 | 261128108 | RADIATION THERAPY | IL | N/A | RELATED | 1031613 | 1886570 | 0 | 1 | 0.50000 | ||
| CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC | |||||||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 273625869 | CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES | IA | N/A | RELATED | 281022 | 87957 | 0 | 0 | 0.20000 | ||
| DES MOINES PARKING ASSOCIATES | |||||||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 382622972 | PARKING DECK OPERATIONS | IA | RELATED | 540801 | 3772221 | 0 | 1 | 1.00000 | CENTRAL IA HEALTH PROP CORP | ||
| DUBUQUE ENDOSCOPY CENTER LC | |||||||||||||||
| 1515 DELHI STREET SUITE 500 | DUBUQUE | IA | 52001 | 201597161 | AMBULATORY SURGERY CENTER | IA | RELATED | 660133 | 210769 | 0 | 1 | 0.51000 | THE FINLEY HOSPITAL | ||
| ENSEVA - HIAWATHA LLC | |||||||||||||||
| 524 PARK ROAD | WATERLOO | IA | 50704 | 453437363 | COLLOCATION FACILITY | IA | RELATED | 2624 | 2203353 | 0 | 0 | 0.52000 | IOWA HEALTH SYSTEM | ||
| FINLEY DEPT OF SURGERY CO-MGMT CO LLC | |||||||||||||||
| 350 N GRANDVIEW AVE | DUBUQUE | IA | 52001 | 422808785 | SURGERY DEPARTMENT MANAGEMENT SERVICES | IA | N/A | RELATED | 101716 | 208966 | 0 | 0 | 0.50000 | ||
| FINLEYHARTIG HOMECARE LLC | |||||||||||||||
| 703 MAIN ST | DUBUQUE | IA | 52001 | 421487138 | SALE/RENTAL OF MEDICAL EQUIPMENT | IA | N/A | RELATED | 132479 | 842404 | 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 | N/A | 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 | N/A | UNRELATED | 89797 | 817011 | 0 | 0 | 0.55670 | $57,299 | |
| HY-VEEIOWA HEALTH LC | |||||||||||||||
| 5820 WESTOWN PARKWAY | WEST DES MOINES | IA | 50266 | 263293530 | PRIMARY CARE CLINIC | IA | N/A | RELATED | -175705 | 44300 | 0 | 1 | 0.50000 | ||
| IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC | |||||||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 030482623 | OUTPATIENT DIAGNOSTIC IMAGING | IA | N/A | RELATED | 1323429 | 2917182 | 0 | 1 | 0.50000 | ||
| IOWA HEALTH SYSTEM CONTRACTING SERVICES LC | |||||||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421511142 | GROUP PURCHASING | IA | N/A | RELATED | 4775894 | 15888961 | 0 | 1 | 1.00000 | ||
| LAKEVIEW SURGERY CENTER LC | |||||||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421516120 | SURGERY CENTER | IA | N/A | RELATED | 3443692 | 4825696 | 0 | 1 | 0.50000 | ||
| MEDICAL LABORATORIES OF EASTERN IOWA LC | |||||||||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421359640 | MEDICAL LABORATORY SERVICES | IA | N/A | RELATED | 664320 | 870817 | 0 | 1 | 0.50000 | ||
| METRO MRI CENTER LIMITED PARTNERSHIP | |||||||||||||||
| 615 VALLEY VIEW DRIVE SUITE 102 | MOLINE | IL | 61265 | 363710164 | PROVIDE MRI AND OTHER MEDICAL SERVICES | IL | N/A | RELATED | 600876 | 1499952 | 0 | 1 | 0.33970 | ||
| MR ASSOCIATES LLP | |||||||||||||||
| 1455 SHERMAN ROAD | HIAWATHA | IA | 52233 | 421260463 | OWN AND OPERATE MR UNIT | IA | N/A | RELATED | 2540143 | 1416839 | 0 | 1 | 0.33330 | ||
| NE IA PHYSICAL THERAPY AND SPORTS MEDICINE LLC | |||||||||||||||
| 1825 LOGAN AVE | WATERLOO | IA | 50703 | 202124978 | ATHLETIC TRAINING AND SPORTS MEDICINE | IA | N/A | RELATED | -41070 | 0 | 1 | ||||
| ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC | |||||||||||||||
| 1200 PLEASANT STREET | DES MOINES | IA | 50309 | 421508092 | AMBULATORY SURGERY CENTER | IA | N/A | RELATED | 3314858 | 3461181 | 0 | 1 | 0.50000 | ||
| PIERCE STREET SAME DAY SURGERY LC | |||||||||||||||
| 2730 PIERCE STREET | SIOUX CITY | IA | 51104 | 205895205 | AMBULATORY SURGERY CENTER | IA | N/A | RELATED | 931816 | 3357708 | 0 | 1 | 0.50000 | ||
| QUAD CITY AMBULATORY SURGERY CENTER LLC | |||||||||||||||
| 520 VALLEY VIEW DRIVE SUITE 300 | MOLINE | IL | 61265 | 364471903 | AMBULATORY SURGERY CENTER. | IL | N/A | RELATED | 255765 | 3500259 | 0 | 1 | 0.50000 | ||
| REHABILITATION THERAPY SERVICES LLC | |||||||||||||||
| 416 ST MARKS CT 110 | PEORIA | IL | 61603 | 810584193 | REHABILATION THERAPY | IL | RELATED | 448732 | 1397476 | 0 | 1 | 0.60030 | METHODIST MEDICAL CENTER OF ILLINOIS | ||
| THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | |||||||||||||||
| 1075 FIRST AVENUE SE | CEDAR RAPIDS | IA | 52403 | 721550812 | AMBULATORY SURGERY CENTER. | IA | N/A | RELATED | 3310383 | 7115889 | 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 | N/A | RELATED | 175377 | 118891 | 0 | 1 | 0.50000 | ||
| TRI-WEBSTER LC | |||||||||||||||
| 1610 COLLINS ST | WEBSTER CITY | IA | 50595 | 010740062 | MEDICAL BUILDING AND SURROUNDING PROPERTY | IA | N/A | RELATED | 110738 | 1715230 | 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 | N/A | RELATED | 244306 | 26600 | 0 | 1 | 0.20000 | ||
| WEST LAKES MEDICAL EQUIPMENT LLC | |||||||||||||||
| 5950 UNIVERSITY AVENUE SUITE 321 | WEST DES MOINES | IA | 50266 | 263300536 | MEDICAL EQUIPMENT SALES AND RENTAL | IA | N/A | UNRELATED | 59770 | 171967 | 0 | 1 | 0.50000 | $59,770 | |
| WEST LAKES SLEEP CENTER LLC | |||||||||||||||
| 5950 UNIVERSITY AVENUE SUITE 2 | WEST DES MOINES | IA | 50266 | 263193923 | SLEEP DISORDER DIAGNOSTIC TESTING FACILITY | IA | N/A | RELATED | 92541 | 318508 | 0 | 1 | 0.50000 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BROADBAND INC | |||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 273819741 | INFORMATION TECHNOLOGY MGMT. | IA | IHS | C | 338870 | 13238641 | 1.00000 |
| CHARITABLE REMAINDER UNITRUST #1 | |||||||||||
| INVESTMENT | IA | SLHCF | T | ||||||||
| CHARITABLE REMAINDER UNITRUST #2 | |||||||||||
| INVESTMENT | IA | SLHCF | T | ||||||||
| CHARITABLE REMAINDER UNITRUST #3 | |||||||||||
| INVESTMENT | IA | SLHCF | T | ||||||||
| CHARITABLE REMAINDER UNITRUST #6 | |||||||||||
| INVESTMENT | IA | SLHCF | T | ||||||||
| IOWA HEALTH SYSTEM 457 DEF COMP PLAN | |||||||||||
| 1415 WOODLAND AVE 2ND FL | DES MOINES | IA | 50309 | 421435199 | INVESTMENT | IA | IHS | T | 266087 | 4546270 | 1.00000 |
| METHODIST HEALTH VENTURES INC | |||||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371140939 | PHARMACY/OFFICE STAFFING | IL | MHSC | C | 868566 | 2437393 | 1.00000 |
| MEDIMORE INC | |||||||||||
| 1200 PLEASANT ST | DES MOINES | IA | 50309 | 421414390 | MANAGED CARE | IA | IHS | C | 210170 | 1.00000 | |
| METHODIST PHYSICIAN SERVICES INC | |||||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 363858550 | MEDICAL SERVICES | IL | MHVI | C | 11908671 | 1305915 | 1.00000 |
| PRECEDENCE INC | |||||||||||
| 4622 PROGRESS DRIVE STE A | DAVENPORT | IA | 52807 | 371288604 | MANAGED MENTAL CARE | IA | RYC | C | 506534 | 435657 | 1.00000 |
| PROVIDER RESOURCE MANAGEMENT INC | |||||||||||
| PO BOX 87 | PEORIA | IL | 61650 | 371223550 | RESOURCE MANAGEMENT | IL | MHSC | C | 57427 | 1.00000 | |
| RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC | |||||||||||
| 700 E UNIVERSITY AVE | DES MOINES | IA | 50316 | 261271143 | SPECIALTY PHYSICIANS MEDICAL CARE | IA | CIHC | C | 481860 | 198055 | 0.57000 |
| STL HEALTH RESOURCES CO | |||||||||||
| 1026 A AVE NE | CEDAR RAPIDS | IA | 52402 | 421193499 | PHYSICIAN OFFICE RENTAL | IA | SLMH | C | 322129 | 5577505 | 1.00000 |
| TRIMARK PHYSICIANS GROUP INC | |||||||||||
| 802 KENYON ROAD | FORT DODGE | IA | 50501 | 421335554 | MEDICAL CLINICS | IA | THS | C | 44216247 | 1.00000 | |
| TRINITY HEALTH ENTERPRISES INC | |||||||||||
| 2701 17TH ST | ROCK ISLAND | IL | 61201 | 363320141 | RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY | IL | TRHS | C | 3295832 | 2957465 | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | 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 | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANAMOSA AREA AMBULANCE SERVICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionType |
| Amount Involved | 3348 | AmountInvolved |
| Method Of Amt Determination | BASED ON GAAP, CASH, AND/OR FMV | MethodOfAmtDetermination |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SECTION 512(B)(13) CONTROLLED ENTITY | Identifier |
| Return Reference | SCHEDULE R, PART II, COLUMN (G) | ReturnReference |
| Explanation | THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, "IOWA HEALTH SYSTEM." FOR ENTITIES THAT ARE PART OF THE CONSOLIDATED HEALTH SYSTEM (WITH COMMON CONTROL) THE ATTRIBUTION RULES OF IRC SECTION 318 APPLY; MEANING THAT ALL ORGANIZATIONS ARE DEEMED TO HAVE CONTROL OF THE ORGANIZATIONS OWNED BY THE CONTROLLING ORGANIZATION. AS SUCH, WE ARE REPORTING ALL RELATED ORGANIZATIONS OF THE HEALTH SYSTEM IN PARTS II, III & IV. FOR PART V REPORTING, THE TRANSACTIONS DISCLOSED ARE THOSE BETWEEN THE DIRECTLY CONTROLLED PARENT-SUBSIDIARY ONLY. | Explanation |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE ORGANIZATION E-FILED A REQUEST FOR AN ADDITIONAL EXTENSION OF TIME TO FILE TO NOVEMBER 15, 2012, ON PART II OF FORM 8868. THE E-FILED EXTENSION WAS ACCEPTED BY THE IRS ON JULY 31, 2012; HOWEVER, THE IRS ISSUED NOTICE CP211A, DATED AUGUST 27, 2012, WITH AN INCORRECT DATE FOR PART II OF AUGUST 15, 2012 INSTEAD OF NOVEMBER 15, 2012. AS SUCH, THE ORGANIZATION RESPECTUFLLY REQUESTS THE ORGANIZATION'S RECORDS BE UPDATED ACCORDINGLY TO SHOW THIS FORM 990 AS BEING EXTENDED TO NOVEMBER 15, 2012, AND TIMELY FILED. | Explanation |