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THE FINLEY HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE FINLEY HOSPITAL (EIN 42-0680354)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201243199349300244
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T07:35:24-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN420680354EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE FINLEY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFINLNameControl
Phone5635821881Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1350 NORTH GRANDVIEW AVEAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code520016392ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAN L CARPENTERName
TitleVP FINANCE/CFOTitle
Phone5635892414Phone
Date Signed2012-10-18DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID R BRANDONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1350 NORTH GRANDVIEW AVEAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code520016392ZIPCode
FieldValueIRS element (for citing)
Gross Receipts128561542GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FINLEYHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1941YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES OF THE TRI-STATE AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees891TotalNbrEmployees
Total Nbr Volunteers346TotalNbrVolunteers
Total Gross UBI412347TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year917391ContributionsGrantsPriorYear
Contributions Grants Current Year666729ContributionsGrantsCurrentYear
Program Service Revenue Prior Year92817939ProgramServiceRevenuePriorYear
Program Service Revenue CY92716004ProgramServiceRevenueCY
Investment Income Prior Year4051160InvestmentIncomePriorYear
Investment Income Current Year2838520InvestmentIncomeCurrentYear
Other Revenue Prior Year830099OtherRevenuePriorYear
Other Revenue Current Year865189OtherRevenueCurrentYear
Total Revenue Prior Year98616589TotalRevenuePriorYear
Total Revenue Current Year97086442TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year32506GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY18610GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year43886807SalariesEtcPriorYear
Salaries Etc Current Year45993856SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year46152864OtherExpensePriorYear
Other Expenses Current Year43971431OtherExpensesCurrentYear
Total Expenses Prior Year90072177TotalExpensesPriorYear
Total Expenses Current Year89983897TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8544412RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7102545RevenuesLessExpensesCY
Total Assets BOY135117150TotalAssetsBOY
Total Assets EOY136710647TotalAssetsEOY
Total Liabilities BOY25152635TotalLiabilitiesBOY
Total Liabilities EOY22538891TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY109964515NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY114171756NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF THE FINLEY HOSPITAL IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES OF THE TRI-STATE AREA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense73591966Expense
Grants150Grants
Revenue92781544Revenue
DescriptionHEALTH-CARE SERVICESTHE FINLEY HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE IOWA, ILLINOIS AND WISCONSIN TRI-STATE AREA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH-CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. THE FINLEY HOSPITAL PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2011, THE FINLEY HOSPITAL ADMITTED 4,669 PATIENTS RESULTING IN A TOTAL OF 19,796 PATIENT DAYS. OUTPATIENT VISITS TOTALED 66,276 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 4,826. THERE WERE ALSO 23,653 EMERGENCY ROOM VISITS AND 691 BABIES DELIVERED.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4779870Expense
Grants18460Grants
Revenue0Revenue
DescriptionCOMMUNITY BENEFITS, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: THE FINLEY HOSPITAL 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 COST OF $796,417 IN 2011. IT IS MORE COMMON FOR FINLEY HOSPITAL TO RECEIVE PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. THE FINLEY HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. THE FINLEY HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $1,311,068 FOR 2011. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $2,107,383.OTHER BENEFITS: THE FINLEY HOSPITAL 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. THE FINLEY HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. THE FINLEY HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $2,672,487.Description
FieldValueIRS element (for citing)
Total Program Service Expense78371836TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096107NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees891NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledIAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DAN L CARPENTER VP FINANCECFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5635892414TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1350 N GRANDVIEW AVEAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code520016392ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
BILL ARNOLD
BOARD MEMBER1.00X152500
DAVID BRANDON
BOARD SEC/TREAS & PRESIDENT/CEO40.00X383085072932X
PAUL DELONG DMD
BOARD MEMBER1.00X171700
NANCY DUNKEL
BOARD MEMBER1.00X147400
FREDERICK HUNTER FUERSTE MD
BOARD MEMBER (FR 4/11)1.00X81100
PEG KERR
BOARD MEMBER1.00X81100
TIMOTHY KUNKEL
BOARD MEMBER1.00X81100
CHAD LEITCH
BOARD CHAIR1.00X11135630X
KEVIN LYNCH
BOARD VICE CHAIR1.00X81100X
SARAH MCDONALD HASKEN
BOARD MEMBER1.00X0154760
BRIAN NELSON MD
BOARD MEMBER1.00X81100
JAN POWERS
BOARD MEMBER1.00X81100
HILLARD SALAS MD
BOARD MEMBER1.00X000
NANCY WILSON
BOARD MEMBER1.00X81100
LAURA WITTHOEFT MD
BOARD MEMBER1.00X149300
KATHLEEN ABBA TO 611
VP FINANCE & CFO40.00490724019473X
KIM DUWE FR 611
INTERIM VP FIN & CFO40.0011265805387X
RYAN CLOOS
PHYSICIAN40.00567938031574X
HINA GUPTA
PHYSICIAN40.00384789015115X
CHAD WOLBERS
COO40.00221740040778X
DAVID ARNOLD
PHYSICIAN40.00300867018038X
THEODORE GIFFORD
PHYSICIAN40.00240278010664X
SANJEEV GUPTA
PHYSICIAN40.00539505025635X
ANTHONY MARKHAM
PHYSICIAN40.00325768031081X
PHILIP ZIMMERMAN
PHYSICIAN40.00357120032710X
JOHN KNOX TO 1010
FORMER BOARD MEMBER & PRES/CEO0.00052541735333X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3937471TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs541456TotalReportableCompFrmRltdOrgs
Total Other Compensation338720TotalOtherCompensation
Number Individuals GT100 K36NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UNITED CLINICAL LABORATORIES
205 BLUFF ST SUITE IDUBUQUEIA52001LAB3928121
ARAMARK MANAGEMENT SERVICES
24863 NETWORK PLACECHICAGOIL606731248DIETARY, HOUSEKEEPING, LAUNDRY MANAGEMEN1320433
HORIZON MENTAL HEALTH MGMT
PO BOX 840839DALLASTX752840839MANAGEMENT SERVICE479610
DUBUQUE ORTHOPAEDIC SURGEONS
ATTN MARILYN MCDERMOTTDUBUQUEIA52001OFFICE SHARING397153
DUBUQUE INTERNAL MEDICINE
1515 DELHIDUBUQUEIA52001DIALYSIS288900
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Related Organizations315248RelatedOrganizations
Government Grants79205GovernmentGrants
All Other Contributions272276AllOtherContributions
Total Contributions666729TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT REVENUE9000999001153290011532
SUBS & JOINT VENTURES90009982182881056111267
PHARMACY REVENUE446110723294$723,294
RENTAL REVENUE531100417934417934
MISCELLANEOUS REVENUE900099283570252532$31,038

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column457846TotalRevenueColumn
Related Or Exempt Function Income56766RelatedOrExemptFunctionIncome
Unrelated Business Revenue401080UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue92716004TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1185237TotalRevenueColumn
Exclusion$1,185,237ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real10685Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real6749Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real3936Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3936TotalRevenueColumn
Exclusion$3,936ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities32601726Securities
Other519908Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities31021180Securities
Other447171Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1580546Securities
Other72737Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1653283TotalRevenueColumn
Exclusion$1,653,283ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA/FOOD SVCS722210795713$795,713
MISCELLANEOUS REVENUE9000996554065540
FieldValueIRS element (for citing)
Total Other Revenue861253TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column97086442TotalRevenueColumn
Related Or Exempt Function Income91614865RelatedOrExemptFunctionIncome
Unrelated Business Revenue412347UnrelatedBusinessRevenue
Exclusion$4,392,501ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total18610Total
Program Services18610ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2358381Total
Management And General2358381ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total41386Total
Management And General41386ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total34467863Total
Program Services31634414ProgramServices
Management And General2833449ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1191659Total
Program Services1093698ProgramServices
Management And General97961ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5502400Total
Program Services5050072ProgramServices
Management And General452328ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2432167Total
Program Services2232229ProgramServices
Management And General199938ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3519156Total
Program Services1503537ProgramServices
Management And General2015619ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total35786Total
Management And General35786ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total231910Total
Program Services105ProgramServices
Management And General231805ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12197064Total
Program Services11202415ProgramServices
Management And General994649ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total171369Total
Program Services18537ProgramServices
Management And General152832ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2882020Total
Program Services2637402ProgramServices
Management And General244618ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4721506Total
Program Services3645212ProgramServices
Management And General1076294ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1194203Total
Program Services1185684ProgramServices
Management And General8519ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total316474Total
Program Services173704ProgramServices
Management And General142770ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total534195Total
Management And General534195ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5760567Total
Program Services5680419ProgramServices
Management And General80148ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total656359Total
Program Services656359ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES116224951158531137184
MISCELLANEOUS EXPENSES70986-162672612
GIFT SHOP EXPENSES TO B3152031520
PATIENT BAD DEBT2423424234

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1587Total
Management And General1587ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total89983897Total
Program Services78371836ProgramServices
Management And General11612061ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1675BOY
EOY4595050EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12364519BOY
EOY9480571EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11391754BOY
EOY12603193EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1426898BOY
EOY3242426EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2058294BOY
EOY2131869EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY791258BOY
EOY511272EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis116226234LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec66365006LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY51852294BOY
EOY49861228EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY47846598BOY
EOY46861073EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY90000BOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY7293860BOY
EOY7423965EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY135117150BOY
EOY136710647EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9185460BOY
EOY8646941EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY5000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY888306BOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY1881172EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15078869BOY
EOY12005778EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25152635BOY
EOY22538891EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY104766263BOY
EOY108943696EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3396018BOY
EOY3425826EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1802234BOY
EOY1802234EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY109964515BOY
EOY114171756EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY135117150BOY
EOY136710647EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7102545ReconcilationRevenueExpenses
Reconcilation Other Changes-2895304ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance33508847BeginningOfYearBalance
Investment Earnings Or Losses1996760InvestmentEarningsOrLosses
Other Expenditures202076OtherExpenditures
Administrative Expenses121502AdministrativeExpenses
End Of Year Balance35182029EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance28333902BeginningOfYearBalance
Investment Earnings Or Losses6334676InvestmentEarningsOrLosses
Other Expenditures1015141OtherExpenditures
Administrative Expenses144590AdministrativeExpenses
End Of Year Balance33508847EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance26824107BeginningOfYearBalance
Contributions25000Contributions
Investment Earnings Or Losses1599223InvestmentEarningsOrLosses
Other Expenditures114428OtherExpenditures
End Of Year Balance28333902EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance31069223BeginningOfYearBalance
Investment Earnings Or Losses-4116708InvestmentEarningsOrLosses
Grants Or Scholarships40305GrantsOrScholarships
Administrative Expenses88103AdministrativeExpenses
End Of Year Balance26824107EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.85140BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.05120PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.09740TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis949800InvestmentCostOrOtherBasis
Other Cost Or Other Basis3531743OtherCostOrOtherBasis
Book Value4481543BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis2794301InvestmentCostOrOtherBasis
Other Cost Or Other Basis65262334OtherCostOrOtherBasis
Depreciation35554760Depreciation
Book Value32501875BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6207191OtherCostOrOtherBasis
Depreciation4764759Depreciation
Book Value1442432BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36736232OtherCostOrOtherBasis
Depreciation25971183Depreciation
Book Value10765049BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis744633OtherCostOrOtherBasis
Depreciation74304Depreciation
Book Value670329BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings49861228TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (8 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC5000C
HEALTHNET CONNECT, LC100C
DUBUQUE ENDOSCOPY CENTER, LC128507C
FINLEY DEPARTMENT OF SURGERY CO-MANAGEMENT COMPANY, LLC143000C
UNITED CLINICAL LABORATORIES, INC.913098C
FINLEY/HARTIG HOMECARE, LLC842731C
HEALTH ENTERPRISES OF IOWA & RELATED PARTNERSHIPS163469C
BENEFICIAL INTEREST IN THE FINLEY HEALTH FOUNDATION5228060F
FieldValueIRS element (for citing)
Total Of Book Value Program Related7423965TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ASBESTOS REMOVAL LIABILITY$403,887
SELF-INSURANCE RESERVE$1,877,792
LONG-TERM RETENTION INCENTIVES$181,815
IOWA HEALTH SYSTEM NOTE PAYABLE$8,479,000
DUE TO AFFILIATES$428,474
MISCELLANEOUS LIABILITY$634,810
FieldValueIRS element (for citing)
Total Of Amounts12005778TotalOfAmounts
Total Revenue97086442TotalRevenue
Total Expenses89983897TotalExpenses
Excess Or Deficit For Year7102545ExcessOrDeficitForYear
Net Unrealized GL On Investments-3127188NetUnrealizedGLOnInvestments
Other$231,884OtherAmount
Total Adjustments-2895304TotalAdjustments
Excess Or Deficit Per FS4207241ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt93569000TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-3127188NetUnrealizedGainsInvestments
Other Revenues255450OtherRevenues
Revenue Not Rptd F990-2871738RevenueNotRptdF990
Revenue Subtotal96440738RevenueSubtotal
Investment Expenses Not Included171352InvestmentExpensesNotIncluded
Other Revenues Not Included474352OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt645704RevenueNotRptdOnFinStmt
Total Revenue Per Form99097086442TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt88959000TotExpensesEtcAuditedFinclStmt
Other Expenses Included53268OtherExpensesIncluded
Expenses Not Rptd F99053268ExpensesNotRptdF990
Expenses Subtotal88905732ExpensesSubtotal
Investment Expenses Not Included2171352InvestmentExpensesNotIncluded2
Other Expenses Not Included906813OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1078165ExpensesNotRptdOnFinStmt
Total Expenses Per Form99089983897TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X: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 FINLEY HEALTH FOUNDATION 231,884.
PART XII, LINE 2D - OTHER ADJUSTMENTS:REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 202,076. REVENUE RECORDED AS OFFSET TO EXPENSE ON BOOKS 51,763. ROUNDING 1,611.
PART XII, LINE 4B - OTHER ADJUSTMENTS:REVENUES IN UNRESTRICTED FUND BALANCE 202,076. IOWA HEALTH SYSTEM CONTRACTING SERVICES REBATES 272,276.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:REVENUE RECORDED AS OFFSET TO EXPENSE ON BOOKS 51,763. ROUNDING 1,505.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:EXPENSES IN UNRESTRICTED FUND BALANCE 634,537. IOWA HEALTH SYSTEM CONTRACTING SERVICES REBATES 272,276.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense796315TotalCommunityBenefitExpense
Net Community Benefit Expense796315NetCommunityBenefitExpense
Percent Of Total Expense0.00880PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served13559PersonsServed
Total Community Benefit Expense7547323TotalCommunityBenefitExpense
Direct Offsetting Revenue6236255DirectOffsettingRevenue
Net Community Benefit Expense1311068NetCommunityBenefitExpense
Percent Of Total Expense0.01460PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served13559PersonsServed
Total Community Benefit Expense8343638TotalCommunityBenefitExpense
Direct Offsetting Revenue6236255DirectOffsettingRevenue
Net Community Benefit Expense2107383NetCommunityBenefitExpense
Percent Of Total Expense0.02340PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs37NumberOfActivitiesOrPrograms
Persons Served15576PersonsServed
Total Community Benefit Expense295013TotalCommunityBenefitExpense
Direct Offsetting Revenue21068DirectOffsettingRevenue
Net Community Benefit Expense273945NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served384PersonsServed
Total Community Benefit Expense593879TotalCommunityBenefitExpense
Net Community Benefit Expense593879NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served567PersonsServed
Total Community Benefit Expense2535486TotalCommunityBenefitExpense
Direct Offsetting Revenue1607104DirectOffsettingRevenue
Net Community Benefit Expense928382NetCommunityBenefitExpense
Percent Of Total Expense0.01030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs15NumberOfActivitiesOrPrograms
Persons Served42823PersonsServed
Total Community Benefit Expense876281TotalCommunityBenefitExpense
Net Community Benefit Expense876281NetCommunityBenefitExpense
Percent Of Total Expense0.00970PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs57NumberOfActivitiesOrPrograms
Persons Served59350PersonsServed
Total Community Benefit Expense4300659TotalCommunityBenefitExpense
Direct Offsetting Revenue1628172DirectOffsettingRevenue
Net Community Benefit Expense2672487NetCommunityBenefitExpense
Percent Of Total Expense0.02960PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs57NumberOfActivitiesOrPrograms
Persons Served72909PersonsServed
Total Community Benefit Expense12644297TotalCommunityBenefitExpense
Direct Offsetting Revenue7864427DirectOffsettingRevenue
Net Community Benefit Expense4779870NetCommunityBenefitExpense
Percent Of Total Expense0.05300PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served3878PersonsServed
Total Community Building Expense159331TotalCommunityBuildingExpense
Net Community Building Expense159331NetCommunityBuildingExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense316TotalCommunityBuildingExpense
Net Community Building Expense316NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served987PersonsServed
Total Community Building Expense7772TotalCommunityBuildingExpense
Net Community Building Expense7772NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served686PersonsServed
Total Community Building Expense2557TotalCommunityBuildingExpense
Net Community Building Expense2557NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Persons Served5551PersonsServed
Total Community Building Expense169976TotalCommunityBuildingExpense
Net Community Building Expense169976NetCommunityBuildingExpense
Percent Of Total Expense0.00190PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,071,713BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare28678545AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare33853287CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5174742MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 DUBUQUE ENDOSCOPY CENTER LC
AMBULATORY SURGERY CENTER0.510000.49000
2 UNITED CLINICAL LABORATORIES INC
MERCY HEALTH CENTER AND PATHOLOGY ASSOC.0.333300.33330
3 FINLEY DEPARTMENT OF SURGERY CO MANAGEMENT COMPANY LLC
SURGERY SERVICE LINES0.500000.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE FINLEY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1350 NORTH GRANDVIEW AVEAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52001ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE FINLEY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Permit Other ActionsXPermitOtherActions
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DBA FINLEY HOME HEALTH CARE
1333 DELHI STDUBUQUEIA52001LICENSED TO OPERATE HOME HEALTH AGENCY IN WISCONSIN & ILLINOIS
DBA WENDT CANCER TREATMENT CENTER
350 N GRANDVIEW AVEDUBUQUEIA52001OUTPATIENT RADIATION ONCOLOGY SERVICES
DBA KEHL DIABETES CENTER
1550 UNIVERSITY AVEDUBUQUEIA52001OUTPATIENT DIABETES CLINIC
DBA FINLEY OUTPATIENT REHAB -GRANDVIEW
444 N GRANDVIEW AVEDUBUQUEIA52001OUTPATIENT REHAB CLINIC
DBA FINLEY OUTPATIENT REHAB -WESTMARK
1665 EMBASSY WEST DR STE 250DUBUQUEIA52002OUTPATIENT DIABETES CLINIC
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREETDUBUQUEIA52001OUTPATIENT CLINIC
FINLEYHARTIG HOMECARE LLC
703 MAIN STDUBUQUEIA52001OUTPATIENT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 6A: THE FINLEY HOSPITAL'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 I, LINE 7G: THE NET COMMUNITY BENEFIT COST OF SUBSIDIZED HEALTH SERVICES OF $928,382 IS ATTRIBUTED TO A PHYSICIAN CLINIC.
PART II: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE FINLEY HOSPITAL CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. I.E. FINLEY SPONSORS A MEAL SERVED AT THE LOCAL MISSION WITH STAFF SERVING AND FINLEY SUPPLYING THE FOOD ON A MONTHLY BASIS, SPACE IS PROVIDED FOR THE SHIIP PROGRAM (SENIOR HEALTH INSURANCE INFORMATION PROGRAM), ANNUALLY A HOLIDAY MEAL WITH SANTA, PRESENTS, AND A MEAL PROVIDED TO LOCAL FAMILIES IN NEED. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH.
PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR THE FINLEY HOSPITAL. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2.
PART III, LINE 8: THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL REPORTED ON LINE 7 ABOVE SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.
PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.
PART V, SECTION B, LINE 15E: GUARANTORS RECEIVE A CYCLE BILL EVERY 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, 16 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.THE FINLEY HOSPITAL
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 FINLEY HOSPITAL
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 FINLEY HOSPITAL
PART VI, LINE 2: THE FINLEY HOSPITAL CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, THE FINLEY HOSPITAL IS A SPONSORING PARTNER OF THE DUBUQUE VISITING NURSE ASSOCIATION'S (VNA) WORK ON THE DUBUQUE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT & HEALTH IMPROVEMENT PLAN (CHNA/HIP) THE CHNA/HIP IS A COMMUNITY COLLABORATIVE MANDATED BY IOWA CODE REQUIRING ALL IOWA COUNTIES' BOARDS OF HEALTH TO COMPLETE EVERY FIVE YEARS. THE VNA PROVIDES LEADERSHIP AND ASSISTANCE TO THE BOARD OF HEALTH TO COMPLETE THE CHNA/HIP AND IMPLEMENT ACTION PLANS DEVELOPED DURING THE PROCESS. THE CHNA/HIP ASSESSES COMMUNITY HEALTH NEEDS BASED ON DATA ON SPECIFIC INDICATORS, PRIORITIZES AND ADDRESSES NEEDS IN THE HEALTH IMPROVEMENT PLAN, AND THEN ASSISTS THE BOARD OF HEALTH TO IMPLEMENT WITH COMMUNITY PARTNERS. THROUGHOUT THE CHNA/HIP PROCESS THE VNA ASSISTS THE COMMUNITY AND BOARD OF HEALTH TO DEVELOP A HEALTH FIVE-YEAR AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. THE DUBUQUE VISITING NURSE ASSOCIATION WORKS COLLECTIVELY WITH THE BOARD OF HEALTH AND THE COMMUNITY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. THE FINLEY HOSPITAL, AS THE SPONSORING AGENCY OF THE VNA, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. EFFORTS ARE MONITORED IN PART BY OTHER PARTNER AGENCIES SUCH AS THE FAMILY AND CHILD POLICY CENTER WHICH MONITORS AND REPORTS SPECIFIC INDICATORS TO ASSESS EFFECTIVENESS AND AID IN THE DEVELOPMENT OF NEW PLANS OR REFINING EXISTING ONES. FURTHER, THE DUBUQUE VISITING NURSE ASSOCIATION WILL CONTINUE TO ASSIST THE BOARD OF HEALTH TO DEVELOP A MEASUREMENT PROCESS TO EVALUATE EFFECTIVENESS OF THE HEALTH IMPROVEMENT PLAN AND ADDITIONAL COMMUNITY NEEDS PERIODICALLY OVER THE NEXT FIVE YEARS. THE DUBUQUE VISITING NURSE ASSOCIATION ASSISTS THE BOARD OF HEALTH TO CONVENE TWO HEALTH ACCESS SUBCOMMITTEE MEETINGS ANNUALLY TO SEEK PROVIDER INPUT ON PROGRESS IN HEALTH INITIATIVES. FINLEY HOSPITAL ASSISTS THE COMMUNITY BY MONITORING EFFECTIVENESS OF COMMUNITY HEALTH AND WELLNESS. AN EXAMPLE OF COMMUNITY COLLABORATION IS THE FINLEY SUITE BEGINNINGS PROGRAM, WHICH PROVIDES PRE-NATAL EDUCATION AND POSTPARTUM HOME VISITS TO ALL NEWBORNS. BY IMPROVING PRENATAL EDUCATION, THIS PROGRAM HELPS IMPROVE NEONATAL OUTCOMES. THE DUBUQUE VNA ATTENDS ALL DUBUQUE COUNTY BOARD OF HEALTH MEETINGS REPORTING TO THE BOARD ON EACH MONTH'S PUBLIC HEALTH ACTIVITIES. FINLEY HOSPITAL IS ALSO A SPONSORING PARTNER FOR THE CRESCENT COMMUNITY HEALTH CENTER WHICH ENABLES COMMUNITY RESIDENTS TO MORE EASILY ACCESS HEALTH AND DENTAL CARE. THE FINLEY SERVING OTHERS OUTREACH INITIATIVE IS A PROGRAM THAT DIRECTLY SUPPORTS THE DUBUQUE RESCUE MISSION. FINLEY PROVIDES AND FINLEY EMPLOYEES SERVE A MONTHLY MEAL AT THE MISSION, AND PROVIDE MEDICAL ATTENTION TO COMMUNITY MEMBERS THAT OTHERWISE WOULD NOT HAVE THIS OPPORTUNITY. FINLEY HOSPITAL ALSO PARTICIPATES ACTIVELY IN THE ANNUAL UNITED WAY CAMPAIGN TO HELP FUND THE UNITED WAY PROGRAMS. FINLEY HOSPITAL HAS BEEN A LEADER IN LIVE HEALTHY IOWA FOR SEVERAL YEARS LEADING TO VERY SUCCESSFUL CAMPAIGNS IN DUBUQUE TO IMPROVE RESIDENT'S HEALTH. BOTH FINLEY HOSPITAL AND THE VNA HAVE PROVIDED LEADERSHIP IN THE SUCCESSFUL 2009 HARKIN WELLNESS GRANT APPLICATIONS RESULTING IN THE HEALTHY MEALS IN A HURRY PROGRAM IN COLLABORATION WITH HY-VEE AND THE BOARD OF HEALTH. THE PROGRAM FOCUSES ON CLASSES TO ENCOURAGE FAMILIES TO COOK HEALTHY MEALS AT HOME AND FOCUSES ON THE BENEFITS ON EATING MEALS AS A FAMILY. THE VNA AND THE BOARD OF HEALTH IMPLEMENTED A PERMANENT BOARD SUBCOMMITTEE ON FOOD, FITNESS, AND WELLNESS. THIS GROUP ACTIVELY HAS BEEN MEETING MONTHLY AND ADDRESSES NEEDS/STRATEGIES ASSOCIATED WITH HEALTH THAT CAN PRODUCE BEHAVIOR CHANGE. THIS WIDE BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR THE FINLEY HOSPITAL TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, FINLEY HOSPITAL CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO IT'S SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS OFTEN WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT.
PART VI, LINE 3: THE FINLEY HOSPITAL PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS: 1) PLACES SIGNAGE, INFORMATION, AND/OR PATIENT FINANCIAL POLICY BROCHURES IN APPROPRIATE AREAS OF THE HOSPITAL (E.G., THE EMERGENCY DEPARTMENT, AND REGISTRATION AND CHECK-OUT/CASHIER AREAS) STATING THAT 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: THE FINLEY HOSPITAL IS A 126 BED COMMUNITY HOSPITAL SERVING THE MIDWEST REGION. THE FINLEY HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF THE FINLEY HOSPITAL MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF CLAYTON, DELAWARE, DUBUQUE, JACKSON AND GRANT. THE FINLEY HOSPITAL ADMITS APPROXIMATELY 4,600,INPATIENTS AND CARES FOR 24,000 EMERGENCY PATIENTS PER YEAR. THERE ARE 9 OTHER HOSPITALS WITHIN THE 5-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $41,940 THRU $49,493 AND THE AVERAGE POVERTY RATE IS 10.4%. 62.9% OF FINLEY HOSPITAL'S INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID.
PART VI, LINE 5: THE FINLEY 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 27 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 200 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 24,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 3.1 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2.8 BILLION, IOWA HEALTH SYSTEM IS THE FIFTH 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 2011, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED MORE THAN $387 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,ILREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1FINLEY HEALTH FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1350 NORTH GRANDVIEW AVEAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code520016392ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient421286953EINOfRecipient
Amount Of Cash Grant6525AmountOfCashGrant
Purpose Of GrantPROGRAM SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DAVID BRANDON
2610540250000970310599340129980456017000
KATHLEEN ABBA TO 611
94117052869034373805481013992051019702466400
RYAN CLOOS
442708000125230098000217740599512000
HINA GUPTA
379597000519209800053150399904000
CHAD WOLBERS
1629690392870194840198590209190262518000
DAVID ARNOLD
2978190003048079040101340318905000
THEODORE GIFFORD
227625030000965309578010860250942000
SANJEEV GUPTA
49581300043692098000158350565140000
ANTHONY MARKHAM
29923002500024038098000212810356849000
PHILIP ZIMMERMAN
33424103000019879098000229100389830000
JOHN KNOX TO 1010
0281004078465016594807893027440056075000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS.
PART I, LINES 4A-BTHE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN TAXABLE INCOME: KATHLEEN ABBA $88,942. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: DAVID BRANDON $51,540 AND CHAD WOLBERS $12,001.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
DUBUQUE ENDOSCOPY CENTER LC
COMMON BOARD MEMBER/OFFICER128000INVESTMENT0
FINLEY DEPARTMENT OF SURGERY CO-MANAGEMENT COMPANY LLC
COMMON BOARD MEMBER/OFFICER143000INVESTMENT0
FINLEYHARTIG HOMECARE LLC
COMMON BOARD MEMBER/OFFICER843000INVESTMENT0
SANJEEV GUPTA
FAMILY MEMBER OF KEY EMPLOYEE HINA GUPTA565140EMPLOYMENT0
UNITED CLINICAL LABORATORIES INC
COMMON BOARD MEMBER/OFFICER5231000INVESTMENT, LAB SERVICES, AND LAB RENTS0
VICKI ARNOLD
FAMILY MEMBER OF BOARD MEMBER BILL ARNOLD41386EMPLOYMENT0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6FINLEY TRI-STATES HEALTH GROUP, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7AFINLEY TRI-STATES HEALTH GROUP, INC., AS SOLE MEMBER, APPOINTS ONE BOARD MEMBER AND APPROVES OTHERS. IOWA HEALTH SYSTEM, AS SOLE MEMBER OF FINLEY TRI-STATES HEALTH GROUP, APPOINTS ONE BOARD MEMBER AND APPROVES OTHERS.
FORM 990, PART VI, SECTION A, LINE 7BFINLEY TRI-STATES HEALTH GROUP, INC., AS SOLE MEMBER, APPOINTS AND REMOVES BOARD OF DIRECTORS, APPROVES AMENDMENTS TO ARTICLES AND BYLAWS, APPROVES INDEBTEDNESS, AND APPOINTS PRESIDENT.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2010 FOR THE FOLLOWING INDIVIDUALS: DAVID BRANDON, JOHN KNOX, AND CHAD WOLBERS 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 19IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.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: -3,127,188. CHANGE IN BENEFICIAL INTEREST OF FINLEY HEALTH FOUNDATION 231,884. TOTAL TO FORM 990, PART XI, LINE 5: -2,895,304.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ALLEN COLLEGE
1825 LOGAN AVENUEWATERLOOIA50703421351526EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALSIA501(C)(3)170(B)(1) (A)(II)ALLEN HEALTH SYSTEMS INC1
ALLEN HEALTH SYSTEMS INC
1825 LOGAN AVENUEWATERLOOIA50703421201924SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
ALLEN MEMORIAL HOSPITAL CORPORATION
1825 LOGAN AVENUEWATERLOOIA50703420698265HOSPITALIA501(C)(3)170(B)(1) (A)(III)ALLEN HEALTH SYSTEMS INC1
ANAMOSA AREA AMBULANCE SERVICE
101 GRANT WOOD DRIVEANAMOSAIA52205421466284PROVIDE AMBULANCE SERVICESIA501(C)(3)509(A)(2)ST LUKE'SJONES REGIONAL MEDICAL CENTER1
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREETDES MOINESIA50309421233759PROPERTY HOLDING COMPANYIA501(C)(2)CENTRAL IOWA HEALTH SYSTEM1
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421189791SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
CENTRAL IOWA HOSPITAL CORPORATION
1200 PLEASANT STREETDES MOINESIA50309420680452HOSPITALIA501(C)(3)170(B)(1) (A)(III)CENTRAL IOWA HEALTH SYSTEM1
FINLEY TRI-STATES HEALTH GROUP INC
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001421307495SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
HNC SERVICES
1200 PLEASANT STREETDES MOINESIA50309270987243SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM1
INTEGRATED CARE ORGANIZATION
1200 PLEASANT STREETDES MOINESIA50309274665007PROMOTE, SUPPPORT THE INTERESTS AND PURPOSES OF AFFILIATES' HOSPITALSIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM1
INTRUST
11333 AURORA AVENUEURBANDALEIA50322421477471HOME HEALTH CAREIA501(C)(3)509(A)(2)IOWA HEALTH SYSTEM1
IOWA HEALTH FOUNDATION
2700 GRAND AVE SUITE 109DES MOINESIA50312421467682CHARITABLE FUNDRAISINGIA501(C)(3)509(A)(3), TYPE IIICENTRAL IOWA HEALTH SYSTEM1
IOWA HEALTH SYSTEM
1200 PLEASANT STREETDES MOINESIA50309421435199SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE III1
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
8101 BIRCHWOOD COURTJOHNSTONIA50131421411630PRIMARY HEALTH CARE SERVICESIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM1
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUEWATERLOOIA50703421201138CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)ALLEN HEALTH SYSTEMS INC1
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111135HEALTHCAREIL501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM1
METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636510186460FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)METHODIST HEALTH SERVICES CORPORATION1
METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636370661223HEALTHCAREIL501(C)(3)170(B)(1) (A)(III)METHODIST HEALTH SERVICES CORPORATION1
METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636371111134OFFICE RENTALIL501(C)(3)509(A)(2)METHODIST HEALTH SERVICES CORPORATION1
NELLIE R SHERWOOD TRUST
1026 A AVENUE NECEDAR RAPIDSIA52402426061621PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAYIA501(C)(3)509(A)(3), TYPE IST LUKE'S METHODIST HOSPITAL1
NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED
720 KENYON DRIVEFORT DODGEIA50501420937390MENTAL HEALTH CAREIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC1
NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVDSIOUX CITYIA51104421019872HOSPITALIA501(C)(3)170(B)(1) (A)(III)IOWA HEALTH SYSTEM1
SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUEPEORIAIL61636376181831FUND SELF-INSURANCE PLANIL501(C)(3)509(A)(3), TYPE IIIMETHODIST MEDICAL CENER OF ILLINOIS1
SIOUXLAND PACE INC
313 COOK STREETSIOUX CITYIA51103261120134ALL-INCLUSIVE CARE FOR THE ELDERLYIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTH SYSTEM INC1
ST LUKE'S HEALTH RESOURCES
2720 STONE PARK BLVDSIOUX CITYIA51104421059182OUTPATIENT CLINICS AND HEALTHCARE SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTH SYSTEM INC1
ST LUKE'S HEALTH SYSTEM INC
2720 STONE PARK BLVDSIOUX CITYIA51104421294091SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIIOWA HEALTH SYSTEM1
ST LUKE'S HEALTHCARE
1026 A AVENUE NECEDAR RAPIDSIA52402421487968SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
ST LUKE'S METHODIST HOSPITAL
1026 A AVENUE NECEDAR RAPIDSIA52402420504780HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE1
ST LUKE'SJONES REGIONAL MEDICAL CENTER
1795 HIGHWAY 64 EASTANAMOSAIA52205421487967HOSPITALIA501(C)(3)170(B)(1) (A)(III)ST LUKE'S HEALTHCARE1
STL CARE COMPANY
1026 A AVENUE NECEDAR RAPIDSIA52402421276632IMPROVE PUBLIC HEALTH SERVICESIA501(C)(3)509(A)(2)ST LUKE'S HEALTHCARE1
THE DUBUQUE VISITING NURSE ASSOCIATION
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680410PUBLIC HEALTH SERVICES/HOME CAREIA501(C)(3)509(A)(2)FINLEY TRI-STATES HEALTH GROUP INC1
THE FINLEY HOSPITAL
350 NORTH GRANDVIEW AVENUEDUBUQUEIA52001420680354HOSPITALIA501(C)(3)170(B)(1) (A)(III)FINLEY TRI-STATES HEALTH GROUP INC1
THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
2701 17TH STREETROCK ISLANDIL61201363678909MENTAL HEALTH CAREIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM1
TPG HEALTH
802 KENYON ROADFORT DODGEIA50501453791448SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICESIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC1
TRINITY BUILDING CORPORATION
802 KENYON ROADFORT DODGEIA50501421376187PROPERTY HOLDING COMPANYIA501(C)(2)TRINITY HEALTH SYSTEMS INC1
TRINITY HEALTH FOUNDATION
802 KENYON ROADFORT DODGEIA50501421222381CHARITABLE FUNDRAISINGIA501(C)(3)170(B)(1) (A)(VI)TRINITY HEALTH SYSTEMS INC1
TRINITY HEALTH FOUNDATION
2701 17TH STREETROCK ISLANDIL61201363321751CHARITABLE FUNDRAISINGIL501(C)(3)170(B)(1) (A)(VI)TRINITY REGIONAL HEALTH SYSTEM1
TRINITY HEALTH SYSTEMS INC
802 KENYON ROADFORT DODGEIA50501421222877SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIA501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
TRINITY MEDICAL CENTER
2701 17TH STREETROCK ISLANDIL61201362739299HOSPITALIL501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM1
TRINITY REGIONAL HEALTH SYSTEM
2701 17TH STREETROCK ISLANDIL61201363351952SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CAREIL501(C)(3)509(A)(3), TYPE IIIOWA HEALTH SYSTEM1
TRINITY REGIONAL HOSPITAL AUXILIARY
802 KENYON ROADFORT DODGEIA50501426081474CHARITABLE FUNDRAISING AND VOLUNTEER SERVICESIA501(C)(3)509(A)(2)TRINITY REGIONAL MEDICAL CENTER1
TRINITY REGIONAL MEDICAL CENTER
802 KENYON ROADFORT DODGEIA50501421009175HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY HEALTH SYSTEMS INC1
UNITY HEALTHCARE
1518 MULBERRY AVENUEMUSCATINEIA52761420680337HOSPITALIA501(C)(3)170(B)(1) (A)(III)TRINITY REGIONAL HEALTH SYSTEM1

Form990 Schedule R Part III Form990ScheduleRPartIII (29 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Code VCodeVAmount
1776 WESTLAKES PARKWAY LC
4949 WESTOWN PARKWAY SUITE 200WEST DES MOINESIA50266205031651OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BUILDINGSIAN/AUNRELATED22964212309952010.33330
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC
1825 LOGAN AVEWATERLOOIA50703453237125ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICESIAN/ARELATED2292039683000.20000
CENTRAL ILLINOIS CANCER CARE CENTER LLC
7309 N KNOXVILLEPEORIAIL61614261128108RADIATION THERAPYILN/ARELATED10316131886570010.50000
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT STDES MOINESIA50309273625869CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICESIAN/ARELATED28102287957000.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT STDES MOINESIA50309382622972PARKING DECK OPERATIONSIARELATED5408013772221011.00000CENTRAL IA HEALTH PROP CORP
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500DUBUQUEIA52001201597161AMBULATORY SURGERY CENTERIARELATED660133210769010.51000THE FINLEY HOSPITAL
ENSEVA - HIAWATHA LLC
524 PARK ROADWATERLOOIA50704453437363COLLOCATION FACILITYIARELATED26242203353000.52000IOWA HEALTH SYSTEM
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVEDUBUQUEIA52001422808785SURGERY DEPARTMENT MANAGEMENT SERVICESIAN/ARELATED101716208966000.50000
FINLEYHARTIG HOMECARE LLC
703 MAIN STDUBUQUEIA52001421487138SALE/RENTAL OF MEDICAL EQUIPMENTIAN/ARELATED132479842404010.50000
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVEDUBUQUEIA52001421428503PROVIDE ACCESS TO LICENSED SOFTWAREIAN/ARELATED14037010.50000
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NECEDAR RAPIDSIA52402391894290INVESTMENT VEHICLE OWNING CLINICAL JVSIAN/AUNRELATED89797817011000.55670$57,299
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAYWEST DES MOINESIA50266263293530PRIMARY CARE CLINICIAN/ARELATED-17570544300010.50000
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
1200 PLEASANT STREETDES MOINESIA50309030482623OUTPATIENT DIAGNOSTIC IMAGINGIAN/ARELATED13234292917182010.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1200 PLEASANT STREETDES MOINESIA50309421511142GROUP PURCHASINGIAN/ARELATED477589415888961011.00000
LAKEVIEW SURGERY CENTER LC
1200 PLEASANT STREETDES MOINESIA50309421516120SURGERY CENTERIAN/ARELATED34436924825696010.50000
MEDICAL LABORATORIES OF EASTERN IOWA LC
1026 A AVE NECEDAR RAPIDSIA52402421359640MEDICAL LABORATORY SERVICESIAN/ARELATED664320870817010.50000
METRO MRI CENTER LIMITED PARTNERSHIP
615 VALLEY VIEW DRIVE SUITE 102MOLINEIL61265363710164PROVIDE MRI AND OTHER MEDICAL SERVICESILN/ARELATED6008761499952010.33970
MR ASSOCIATES LLP
1455 SHERMAN ROADHIAWATHAIA52233421260463OWN AND OPERATE MR UNITIAN/ARELATED25401431416839010.33330
NE IA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
1825 LOGAN AVEWATERLOOIA50703202124978ATHLETIC TRAINING AND SPORTS MEDICINEIAN/ARELATED-4107001
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
1200 PLEASANT STREETDES MOINESIA50309421508092AMBULATORY SURGERY CENTERIAN/ARELATED33148583461181010.50000
PIERCE STREET SAME DAY SURGERY LC
2730 PIERCE STREETSIOUX CITYIA51104205895205AMBULATORY SURGERY CENTERIAN/ARELATED9318163357708010.50000
QUAD CITY AMBULATORY SURGERY CENTER LLC
520 VALLEY VIEW DRIVE SUITE 300MOLINEIL61265364471903AMBULATORY SURGERY CENTER.ILN/ARELATED2557653500259010.50000
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110PEORIAIL61603810584193REHABILATION THERAPYILRELATED4487321397476010.60030METHODIST MEDICAL CENTER OF ILLINOIS
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SECEDAR RAPIDSIA52403721550812AMBULATORY SURGERY CENTER.IAN/ARELATED33103837115889010.50000
TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
4500 UTICA RIDGE RDBETTENDORFIA52722272562753ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICESIAN/ARELATED175377118891010.50000
TRI-WEBSTER LC
1610 COLLINS STWEBSTER CITYIA50595010740062MEDICAL BUILDING AND SURROUNDING PROPERTYIAN/ARELATED1107381715230010.50000
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREETWEST DES MOINESIA50266271414600ORTHOPEDIC SERVICE LINES MANAGEMENTIAN/ARELATED24430626600010.20000
WEST LAKES MEDICAL EQUIPMENT LLC
5950 UNIVERSITY AVENUE SUITE 321WEST DES MOINESIA50266263300536MEDICAL EQUIPMENT SALES AND RENTALIAN/AUNRELATED59770171967010.50000$59,770
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVENUE SUITE 2WEST DES MOINESIA50266263193923SLEEP DISORDER DIAGNOSTIC TESTING FACILITYIAN/ARELATED92541318508010.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
BROADBAND INC
1200 PLEASANT STDES MOINESIA50309273819741INFORMATION TECHNOLOGY MGMT.IAIHSC338870132386411.00000
CHARITABLE REMAINDER UNITRUST #1
INVESTMENTIASLHCFT
CHARITABLE REMAINDER UNITRUST #2
INVESTMENTIASLHCFT
CHARITABLE REMAINDER UNITRUST #3
INVESTMENTIASLHCFT
CHARITABLE REMAINDER UNITRUST #6
INVESTMENTIASLHCFT
IOWA HEALTH SYSTEM 457 DEF COMP PLAN
1415 WOODLAND AVE 2ND FLDES MOINESIA50309421435199INVESTMENTIAIHST26608745462701.00000
METHODIST HEALTH VENTURES INC
PO BOX 87PEORIAIL61650371140939PHARMACY/OFFICE STAFFINGILMHSCC86856624373931.00000
MEDIMORE INC
1200 PLEASANT STDES MOINESIA50309421414390MANAGED CAREIAIHSC2101701.00000
METHODIST PHYSICIAN SERVICES INC
PO BOX 87PEORIAIL61650363858550MEDICAL SERVICESILMHVIC1190867113059151.00000
PRECEDENCE INC
4622 PROGRESS DRIVE STE ADAVENPORTIA52807371288604MANAGED MENTAL CAREIARYCC5065344356571.00000
PROVIDER RESOURCE MANAGEMENT INC
PO BOX 87PEORIAIL61650371223550RESOURCE MANAGEMENTILMHSCC574271.00000
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVEDES MOINESIA50316261271143SPECIALTY PHYSICIANS MEDICAL CAREIACIHCC4818601980550.57000
STL HEALTH RESOURCES CO
1026 A AVE NECEDAR RAPIDSIA52402421193499PHYSICIAN OFFICE RENTALIASLMHC32212955775051.00000
TRIMARK PHYSICIANS GROUP INC
802 KENYON ROADFORT DODGEIA50501421335554MEDICAL CLINICSIATHSC442162471.00000
TRINITY HEALTH ENTERPRISES INC
2701 17TH STROCK ISLANDIL61201363320141RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACYILTRHSC329583229574651.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1DUBUQUE ENDOSCOPY CENTER LCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved650250AmountInvolved
Method Of Amt DeterminationBASED ON GAAP, CASH AND/OR FMV.MethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSECTION 512(B)(13) CONTROLLED ENTITYIdentifier
Return ReferenceSCHEDULE R, PART II, COLUMN (G)ReturnReference
ExplanationTHE 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