CENTRAL IOWA HOSPITAL CORPORATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: CENTRAL IOWA HOSPITAL CORPORATION (EIN 42-0680452)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-14
IRS object ID: 201243199349300739
Schema version: 2011v1.2
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-14T07:35:24-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	420680452	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CENTRAL IOWA HOSPITAL CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CENT	NameControl
Phone	5152416212	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 PLEASANT ST	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	503091453	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOSEPH F CORFITS	Name
Title	SENIOR VP/CFO	Title
Phone	5152416396	Phone
Date Signed	2012-11-06	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	ERIC T CROWELL	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1200 PLEASANT ST	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	503091453	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	973611180	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.IOWAHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1933	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	IMPROVING THE HEALTH OF THE COMMUNITY THROUGH HEALING, CARING AND TEACHING.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	21	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	15	NbrIndependentVotingMembers
Total Nbr Employees	6517	TotalNbrEmployees
Total Nbr Volunteers	5483	TotalNbrVolunteers
Total Gross UBI	12759568	TotalGrossUBI
Net Unrelated Business Txbl Income	2303113	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	5648151	ContributionsGrantsPriorYear
Contributions Grants Current Year	9455763	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	640855688	ProgramServiceRevenuePriorYear
Program Service Revenue CY	668022800	ProgramServiceRevenueCY
Investment Income Prior Year	32927906	InvestmentIncomePriorYear
Investment Income Current Year	20742840	InvestmentIncomeCurrentYear
Other Revenue Prior Year	5981267	OtherRevenuePriorYear
Other Revenue Current Year	7101192	OtherRevenueCurrentYear
Total Revenue Prior Year	685413012	TotalRevenuePriorYear
Total Revenue Current Year	705322595	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	2887518	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	4127361	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	339582270	SalariesEtcPriorYear
Salaries Etc Current Year	361594672	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	303862963	OtherExpensePriorYear
Other Expenses Current Year	300283479	OtherExpensesCurrentYear
Total Expenses Prior Year	646332751	TotalExpensesPriorYear
Total Expenses Current Year	666005512	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	39080261	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	39317083	RevenuesLessExpensesCY
Total Assets BOY	801088699	TotalAssetsBOY
Total Assets EOY	816650125	TotalAssetsEOY
Total Liabilities BOY	279149752	TotalLiabilitiesBOY
Total Liabilities EOY	306304651	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	521938947	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	510345474	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	IMPROVING THE HEALTH OF THE COMMUNITY THROUGH HEALING, CARING AND TEACHING.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	534553664	Expense
Grants	3720789	Grants
Revenue	669514584	Revenue
Description	HEALTH-CARE SERVICESCENTRAL IOWA HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. CENTRAL IOWA HOSPITAL CORPORATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2011, CENTRAL IOWA HOSPITAL CORPORATION ADMITTED 35,797 PATIENTS RESULTING IN A TOTAL OF 173,653 PATIENT DAYS. OUTPATIENT VISITS TOTALED 678,275 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 12,416. THERE WERE ALSO 82,908 EMERGENCY ROOM VISITS AND 4,047 BABIES DELIVERED.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	42827191	Expense
Grants	406572	Grants
Revenue	0	Revenue
Description	CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE TO 10,938 PEOPLE AT A VALUE OF $9,993,577 IN 2011. OFTENTIMES, CENTRAL IOWA HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. CENTRAL IOWA HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA METHODIST MEDICAL CENTER, IOWA LUTHERAN HOSPITAL AND BLANK CHILDREN'S HOSPITALS' NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $19,371,352 FOR 2011. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $29,364,929.OTHER BENEFITS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. CENTRAL IOWA HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. CENTRAL IOWA HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 101,901 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL NET OTHER BENEFITS REPORTED VALUE: $13,462,262.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	577380855	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	1	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	453	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	6517	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	21	NbrVotingGoverningBodyMembers
Number Independent Voting Members	15	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	IA	StatesWhereCopyOfReturnIsFiled
Own Website	X	OwnWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JOSEPH F CORFITS SENIOR VPCFO	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5152416470	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1200 PLEASANT ST	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	50309	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (42 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
LARRY BAKER DO
BOARD MEMBER	1.00	X	208763	0	19024
BRAD BRODY
BOARD TREASURER	1.00	X	1173	0	0	X
BISHOP MICHAEL BURK
BOARD SECRETARY	1.00	X	1429	0	0	X
MARY CHAPMAN
BOARD MEMBER	1.00	X	1033	0	0
ERIC CROWELL
BOARD MEMBER/CEO	40.00	X	785263	0	243606	X
STEVE GOLDSTEIN
BOARD MEMBER	1.00	X	1697	0	0
DIANA GORSCHE
BOARD MEMBER	1.00	X	1033	0	0
KENT HENNING
BOARD CHAIR	1.00	X	1350	11671	0	X
STEVE HERWIG
BOARD MEMBER	1.00	X	758	14953	0
JAMES HUBBELL III
BOARD MEMBER	1.00	X	43	0	0
BURTON TOBY JOSEPH
BOARD VICE CHAIR	1.00	X	1702	0	0	X
RICHARD MCCONNELL
BOARD MEMBER	1.00	X	1924	14789	0
PAT MCGOLDRICK
BOARD MEMBER	1.00	X	1970	0	0
JANETTE MILLER-STRAUB
BOARD MEMBER	1.00	X	1900	0	0
MARY O'KEEFE
BOARD MEMBER	1.00	X	1033	0	0
JAMES PATTEN MD
BOARD MEMBER	1.00	X	2047	0	0
BRUCE SHERMAN
BOARD MEMBER	1.00	X	2123	15250	0
BISHOP JULIUS TRIMBLE
BOARD MEMBER	1.00	X	43	0	0
RICHARD WILLIS
BOARD MEMBER	1.00	X	1033	0	0
BRAD WINTERBOTTOM
BOARD MEMBER	1.00	X	1349	0	0
WILLIAM YOST MD
BOARD MEMBER	1.00	X	0	238726	51734
JOSEPH CORFITS
EXEC VP/CEO	40.00		443946	0	104196	X
SUSAN ALLYN
VP HUMAN RESOURCES	40.00		426776	0	62447		X
AMY BETHEL
EXEC DIR SURGERY	1.00		164334	0	35795		X
CHRISTINE BLAIR
CHIEF ADMINISTRATIVE OFFICER-W	40.00		212952	0	45808		X
DOUGLAS DORNER
VP MEDICAL EDUCATION	40.00		663220	0	37227		X
CECELIA KIRVIN
EXEC DIR/CCO BCH	40.00		165478	0	29824		X
TODD KRANPITZ
EXEC DIR DIAGNOSTIC SVCS	40.00		154925	0	23658		X
ERIC LOTHE
VP OPERATIONS/CAO-ILH	40.00		403332	0	51435		X
JOYCE MCDANEL
VP HUMAN RESOURCES	40.00		235639	0	28837		X
DEBRA MOYER
CHIEF NURSING EXEC	40.00		311676	0	34910		X
MARK PURTLE
VP MEDICAL AFFAIRS	40.00		499847	0	225741		X
SIDNEY RAMSEY
VP STRATEGIC BUSINESS DEV-CIHS	40.00		347703	0	21047		X
JEAN SHELTON
ADMINISTRATOR-PHYS PRACTICE	40.00		227174	0	33291		X
LESLIE SMIAROWSKI
EXEC DIR-FACILITY SVCS	40.00		152513	0	25132		X
DAVID STARK
PRESIDENT/COO BCH & EVP IHDM	40.00		474130	0	58689		X
STEPHEN STEPHENSON
EXEC VP/COO-IHDM	40.00		542170	0	80414		X
ROBERT GOEBEL
MENTAL HLTH THRPST MSW-PCDC	40.00		847764	0	30501			X
TIMOTHY HART
PHYS-CARDIOLOGIST-ILH CARDIO	40.00		1105386	0	37016			X
AMAR NATH
PHYS-CARDIOLOGIST-ILH CARDIO	40.00		1086199	0	36745			X
PRASAD PALAKURTHY
PHYS-CARDIOLOGIST-ILH CARDIO	40.00		873129	0	34771			X
JOHN TRIANTAFYLLOS
PHYSICIAN-RADIATION ONCOLOGIST	40.00		799974	0	36210			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	11155933	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	295389	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1388058	TotalOtherCompensation
Number Individuals GT100 K	297	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ARAMARK FACILITIES S
22506 NETWORK PLACE	CHICAGO	IL	60673	LAUNDRY SVCS, CLEANING SVCS, AND FOOD	7481815
WEITZ COMPANY INC
5901 THORNTON AVE	DES MOINES	IA	50321	CONSTRUCTION	2380968
GRAHAM CONSTRUCTION
421 GRAND	DES MOINES	IA	50309	CONSTRUCTION	1344447
FLYNN WRIGHT INC
501 SW 7TH STREET	DES MOINES	IA	50309	ADVERTISING AND PROMOTIONAL	1058419
FINLEY LAW FIRM
699 WALNUT STREET 1900	DES MOINES	IA	50309	LEGAL SERVICES	624627

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	35	NumberOfContractorsGT100K
Related Organizations	8232987	RelatedOrganizations
Government Grants	587020	GovernmentGrants
All Other Contributions	635756	AllOtherContributions
Total Contributions	9455763	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
NET PATIENT REVENUE	900099	631812658	631812658
LABORATORY SERVICES	621510	11097917		11097917
SUBS & JOINT VENTURES	900099	8523570	8523570
MGMT & SUPPORT SVCS	561000	8458896	4440520	368335	$3,650,041
MISCELLANEOUS REVENUE	900099	3741801	3741801

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4387958	TotalRevenueColumn
Related Or Exempt Function Income	3018030	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	885253	UnrelatedBusinessRevenue
Exclusion	$484,675	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	668022800	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	8533875	TotalRevenueColumn
Exclusion	$8,533,875	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	280457380	Securities
Other	35502	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	268175201	Securities
Other	108716	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	12282179	Securities
Other	-73214	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	12208965	TotalRevenueColumn
Exclusion	$12,208,965	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	7572	GrossSalesOfInventory
Cost Of Goods Sold	4668	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2904	TotalRevenueColumn
Exclusion	$2,904	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
CAFETERIA/FOOD SVCS	722210	4553682	108995	169595	$4,275,092
CHILDCARE SERVICES	624410	1331412			$1,331,412
MISCELLANEOUS REVENUE	900099	659384	659384

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	553810	TotalRevenueColumn
Related Or Exempt Function Income	315342	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	238468	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	7098288	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	705322595	TotalRevenueColumn
Related Or Exempt Function Income	652620300	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	12759568	UnrelatedBusinessRevenue
Exclusion	$30,486,964	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	4127361	Total
Program Services	4127361	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	12492260	Total
Management And General	12492260	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	383717	Total
Management And General	383717	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	279417589	Total
Program Services	248083193	ProgramServices
Management And General	31334396	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	12272338	Total
Program Services	10896096	ProgramServices
Management And General	1376242	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	37704884	Total
Program Services	33476592	ProgramServices
Management And General	4228292	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	19323884	Total
Program Services	17156869	ProgramServices
Management And General	2167015	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	10682045	Total
Program Services	10682045	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1518195	Total
Program Services	32279	ProgramServices
Management And General	1485916	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	24000	Total
Management And General	24000	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	1841780	Total
Program Services	73903	ProgramServices
Management And General	1767877	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	56182148	Total
Program Services	41196691	ProgramServices
Management And General	14985457	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	2121122	Total
Program Services	175148	ProgramServices
Management And General	1945974	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	21012861	Total
Program Services	19511929	ProgramServices
Management And General	1500932	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	32406687	Total
Program Services	32351482	ProgramServices
Management And General	55205	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	17109622	Total
Program Services	16017666	ProgramServices
Management And General	1091956	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	1630675	Total
Program Services	1153830	ProgramServices
Management And General	476845	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	646530	Total
Program Services	403394	ProgramServices
Management And General	243136	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	7984928	Total
Management And General	7984928	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	33171501	Total
Program Services	32655842	ProgramServices
Management And General	515659	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2113733	Total
Program Services	55684	ProgramServices
Management And General	2058049	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	109738787	109016777	722010
INCOME TAXES	991052		991052
MISCELLANEOUS EXPENSES	962629	168890	793739
PATIENT BAD DEBT	145184	145184

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	666005512	Total
Program Services	577380855	ProgramServices
Management And General	88624657	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	35649	BOY
EOY	31220	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	19857649	BOY
EOY	8476448	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	83025267	BOY
EOY	88474989	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	661730	BOY
EOY	266291	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	8669125	BOY
EOY	19996950	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	10472938	BOY
EOY	10811158	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	8572592	BOY
EOY	2285534	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	715008364	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	461131674	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	247731960	BOY
EOY	253876690	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	391365556	BOY
EOY	402563279	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	30228353	BOY
EOY	29474958	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	384245	BOY
EOY	392608	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	83635	BOY
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	801088699	BOY
EOY	816650125	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	61264550	BOY
EOY	65953827	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	478794	BOY
EOY	1205866	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	23000000	BOY
EOY	23000000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	563298	BOY
EOY	11491566	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	100000	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	193743110	BOY
EOY	204653392	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	279149752	BOY
EOY	306304651	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	495594082	BOY
EOY	486999833	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	11884147	BOY
EOY	8946204	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	14460718	BOY
EOY	14399437	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	521938947	BOY
EOY	510345474	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	801088699	BOY
EOY	816650125	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	39317083	ReconcilationRevenueExpenses
Reconcilation Other Changes	-50910556	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$24,000	OtherActivitiesAmount
Total Lobbying Expenditures IIB	24000	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	PAID TO CONSULTING FIRM FOR LOBBYING ACTIVITIES ON BEHALF OF HEALTH CARE.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	393764418	BeginningOfYearBalance
Contributions	14837391	Contributions
Investment Earnings Or Losses	-4633215	InvestmentEarningsOrLosses
Administrative Expenses	1274466	AdministrativeExpenses
End Of Year Balance	402694128	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	345461149	BeginningOfYearBalance
Contributions	7133406	Contributions
Investment Earnings Or Losses	46487853	InvestmentEarningsOrLosses
Grants Or Scholarships	3862243	GrantsOrScholarships
Administrative Expenses	1455747	AdministrativeExpenses
End Of Year Balance	393764418	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	247692356	BeginningOfYearBalance
Contributions	25092385	Contributions
Investment Earnings Or Losses	77357269	InvestmentEarningsOrLosses
Grants Or Scholarships	3399333	GrantsOrScholarships
Administrative Expenses	1281528	AdministrativeExpenses
End Of Year Balance	345461149	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	310035426	BeginningOfYearBalance
Contributions	5000000	Contributions
Investment Earnings Or Losses	-52884188	InvestmentEarningsOrLosses
Grants Or Scholarships	13612295	GrantsOrScholarships
Administrative Expenses	846587	AdministrativeExpenses
End Of Year Balance	247692356	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.94290	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.03580	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.02130	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	11290822	OtherCostOrOtherBasis
Book Value	11290822	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	238533426	OtherCostOrOtherBasis
Depreciation	146819288	Depreciation
Book Value	91714138	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	431866269	OtherCostOrOtherBasis
Depreciation	299711041	Depreciation
Book Value	132155228	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	33317847	OtherCostOrOtherBasis
Depreciation	14601345	Depreciation
Book Value	18716502	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	253876690	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescription	AmountAmount
ASBESTOS REMOVAL LIABILITY	$2,513,873
DUE TO AFFILIATES	$17,234,118
SELF-INSURANCE RESERVE	$15,425,796
LONG-TERM RETENTION INCENTIVES	$10,772,980
IOWA HEALTH SYSTEM NOTE PAYABLE	$142,564,000
HEALTH AND WELFARE BENEFITS RESERVE	$2,256,551
MISCELLANEOUS LIABILITY	$1,606,834
DEFINED BENEFIT RETIREMENT PLAN LIABILITY	$12,279,240

Field	Value	IRS element (for citing)
Total Of Amounts	204653392	TotalOfAmounts
Total Revenue	705322595	TotalRevenue
Total Expenses	666005512	TotalExpenses
Excess Or Deficit For Year	39317083	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-22598619	NetUnrealizedGLOnInvestments
Other	-$28,311,937	OtherAmount
Total Adjustments	-50910556	TotalAdjustments
Excess Or Deficit Per FS	-11593473	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	675660000	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-22311862	NetUnrealizedGainsInvestments
Other Revenues	5274	OtherRevenues
Revenue Not Rptd F990	-22306588	RevenueNotRptdF990
Revenue Subtotal	697966588	RevenueSubtotal
Investment Expenses Not Included	1348369	InvestmentExpensesNotIncluded
Other Revenues Not Included	6007638	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	7356007	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	705322595	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	655604000	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	4678	OtherExpensesIncluded
Expenses Not Rptd F990	4678	ExpensesNotRptdF990
Expenses Subtotal	655599322	ExpensesSubtotal
Investment Expenses Not Included2	1348369	InvestmentExpensesNotIncluded2
Other Expenses Not Included	9057821	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	10406190	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	666005512	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	IOWA HEALTH SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE HEALTH SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2008. THE HEALTH SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME DURING THE CARRYFORWARD PERIOD. NO INCOME TAX BENEFIT HAS BEEN RECOGNIZED FOR THE NET OPERATING LOSS CARRYFORWARDS OR OTHER POTENTIAL DEFERRED TAX ASSETS IN THE CONSOLIDATED FINANCIAL STATEMENTS BECAUSE THE HEALTH SYSTEM BELIEVES REALIZATION OF THESE BENEFITS IS UNLIKELY.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		CHANGE IN BENEFICIAL INTEREST OF IOWA HEALTH FOUNDATION -1,690,400. CHANGES IN PENSION LIABILITY -25,193,259. CHANGES IN DEFERRED REVENUE -1,428,278. TOTAL TO SCHEDULE D, PART XI, LINE 8: -28,311,937.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		SALES OF INVENTORY 4,668. ROUNDING 606.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 2,370,246. REVENUES IN UNRESTRICTED FUND BALANCE 3,507,788. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 129,604.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		SALES OF INVENTORY 4,668. ROUNDING 10.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 2,370,246. EXPENSES IN UNRESTRICTED FUND BALANCE 6,677,426. EXPENSES IN TEMPORARILY RESTRICTED FUND BALANCE 10,149.

Schedule H IRS990ScheduleH

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

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	10938	PersonsServed
Total Community Benefit Expense	9993577	TotalCommunityBenefitExpense
Net Community Benefit Expense	9993577	NetCommunityBenefitExpense
Percent Of Total Expense	0.01500	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	48299	PersonsServed
Total Community Benefit Expense	78212884	TotalCommunityBenefitExpense
Direct Offsetting Revenue	58841532	DirectOffsettingRevenue
Net Community Benefit Expense	19371352	NetCommunityBenefitExpense
Percent Of Total Expense	0.02910	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	59237	PersonsServed
Total Community Benefit Expense	88206461	TotalCommunityBenefitExpense
Direct Offsetting Revenue	58841532	DirectOffsettingRevenue
Net Community Benefit Expense	29364929	NetCommunityBenefitExpense
Percent Of Total Expense	0.04410	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	27	NumberOfActivitiesOrPrograms
Persons Served	99272	PersonsServed
Total Community Benefit Expense	3256952	TotalCommunityBenefitExpense
Direct Offsetting Revenue	269864	DirectOffsettingRevenue
Net Community Benefit Expense	2987088	NetCommunityBenefitExpense
Percent Of Total Expense	0.00450	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13	NumberOfActivitiesOrPrograms
Persons Served	2629	PersonsServed
Total Community Benefit Expense	10658422	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5910390	DirectOffsettingRevenue
Net Community Benefit Expense	4748032	NetCommunityBenefitExpense
Percent Of Total Expense	0.00710	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	46323541	TotalCommunityBenefitExpense
Direct Offsetting Revenue	41370922	DirectOffsettingRevenue
Net Community Benefit Expense	4952619	NetCommunityBenefitExpense
Percent Of Total Expense	0.00740	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	367951	TotalCommunityBenefitExpense
Net Community Benefit Expense	367951	NetCommunityBenefitExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	406572	TotalCommunityBenefitExpense
Net Community Benefit Expense	406572	NetCommunityBenefitExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	43	NumberOfActivitiesOrPrograms
Persons Served	101901	PersonsServed
Total Community Benefit Expense	61013438	TotalCommunityBenefitExpense
Direct Offsetting Revenue	47551176	DirectOffsettingRevenue
Net Community Benefit Expense	13462262	NetCommunityBenefitExpense
Percent Of Total Expense	0.02020	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	43	NumberOfActivitiesOrPrograms
Persons Served	161138	PersonsServed
Total Community Benefit Expense	149219899	TotalCommunityBenefitExpense
Direct Offsetting Revenue	106392708	DirectOffsettingRevenue
Net Community Benefit Expense	42827191	NetCommunityBenefitExpense
Percent Of Total Expense	0.06430	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	50	PersonsServed
Total Community Building Expense	505897	TotalCommunityBuildingExpense
Net Community Building Expense	505897	NetCommunityBuildingExpense
Percent Of Total Expense	0.00080	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	50	PersonsServed
Total Community Building Expense	505897	TotalCommunityBuildingExpense
Net Community Building Expense	505897	NetCommunityBuildingExpense
Percent Of Total Expense	0.00080	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$8,005,133	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	156215145	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	166185024	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-9969879	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT COMPANY
MANAGEMENT OF CARDIAC SERVICE LINE	0.20000	0.25450
2 IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
OUTPATIENT DIAGNOSTIC IMAGING	0.50000	0.50000
3 LAKEVIEW SURGERY CENTER LC
SURGERY CENTER	0.50000	0.50000
4 ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
AMBULATORY SURGERY CENTER	0.50000	0.50000
5 WEST LAKES SLEEP CENTER LLC
TREATMENT OF CHRONIC SLEEP DISORDERS	0.50000	0.50000

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	3	NumberOfHospitalFacilities

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

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Childrens HospitalChildrensHospital	Teaching HospitalTeachingHospital	Critical Access HospitalCriticalAccessHospital	Research FacilityResearchFacility	Er24 HoursEr24Hours
IOWA METHODIST MEDICAL CENTER
1	1200 PLEASANT STREET	DES MOINES	IA	50309	X	X	X	X	X	X	X
IOWA LUTHERAN HOSPITAL
2	700 EAST UNIVERSITY AVENUE	DES MOINES	IA	50316	X	X					X
METHODIST WEST HOSPITAL
3	1660 60TH STREET	WEST DES MOINES	IA	50266	X	X					X

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

Hospital Facility NumberHospitalFacilityNumber	Eligibility Criteria ExplainedEligibilityCriteriaExplained	Uses FPG FreeUsesFPGFree	FPG Free PercentFPGFreePercent	Uses FPG DiscountedUsesFPGDiscounted	FPG Discount PercentFPGDiscountPercent	Explains BasisExplainsBasis	Income LevelIncomeLevel	Asset LevelAssetLevel	Medical IndigencyMedicalIndigency	Explains Application MethodExplainsApplicationMethod	Includes Publicity MeasuresIncludesPublicityMeasures	Posted On WebsitePostedOnWebsite	Attached To InvoicesAttachedToInvoices	Available On RequestAvailableOnRequest	Actions On NonpaymentActionsOnNonpayment	Permit Report To Credit AgencyPermitReportToCreditAgency	Permit LawsuitPermitLawsuit	Permit Lien On ResidencePermitLienOnResidence	Permit Other ActionsPermitOtherActions	Collection ActivitiesCollectionActivities	Report To Credit AgencyReportToCreditAgency	LawsuitLawsuit	Lien On ResidenceLienOnResidence	Notify Upon AdmissionNotifyUponAdmission	Notify Before DischargeNotifyBeforeDischarge	Notified All PatientsNotifiedAllPatients	Documented DeterminationDocumentedDetermination	Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy	Used Other MethodUsedOtherMethod	Amounts Generally BilledAmountsGenerallyBilled	Gross ChargesGrossCharges
IOWA METHODIST MEDICAL CENTER
1	1	1	200.000000000000	1	400.000000000000	1	X	X	X	1	1	X	X	X	1	X	X	X	X	1	X	X	X	X	X	X	X	1	X	0	1
IOWA LUTHERAN HOSPITAL
2	1	1	200.000000000000	1	400.000000000000	1	X	X	X	1	1	X	X	X	1	X	X	X	X	1	X	X	X	X	X	X	X	1	X	0	1
METHODIST WEST HOSPITAL
3	1	1	200.000000000000	1	400.000000000000	1	X	X	X	1	1	X	X	X	1	X	X	X	X	1	X	X	X	X	X	X	X	1	X	0	1

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	43	NumberOfOtherFacilities

Other Facilities OtherFacilities (43 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
1776 WESTLAKES PARKWAY LC
1776 WESTLAKES PARKWAY	WEST DES MOINES	IA	50266	OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BLDGS
ALTOONA FAMILY CARE CENTER
2720 8TH STREET SW	ALTOONA	IA	50009	PHYSICIAN CLINIC
CARDIO THORACIC
1200 PLEASANT ST	DES MOINES	IA	50309	PHYSICIAN CLINIC
CENTRAL IOWA CARDIOVASCULAR CO-MGMT
1200 PLEASANT ST	DES MOINES	IA	50309	MANAGEMENT OF CARDIAC SERVICE LINE
CENTRAL IOWA SURGERY
1200 PLEASANT ST	DES MOINES	IA	50309	PHYSICIAN CLINIC
CHILDREN'S HEALTH CENTER
MOB I STE 300	DES MOINES	IA	50309	PHYSICIAN CLINIC
COUNSELING CENTER
6000 UNIVERSITY AVE SUITE 200	WEST DES MOINES	IA	50266	PHYSICIAN CLINIC
EAST DES MOINES FAMILY CARE CENTER
840 EAST UNIVERSITY AVENUE	DES MOINES	IA	50316	PHYSICIAN CLINIC
GRIMES FAMILY PHYSICIANS
1551 SE 3RD STREET	GRIMES	IA	50111	PHYSICIAN CLINIC
HIGHLAND PARK FAMILY PHYSICIANS
2301 E 14TH ST	DES MOINES	IA	50315	PHYSICIAN CLINIC
HUXLEY FAMILY PHYSICIANS
305 SO HWY 69	HUXLEY	IA	50124	PHYSICIAN CLINIC
HY-VEEIOWA HEALTH LC
1200 PLEASANT ST	DES MOINES	IA	50309	PHYSICIAN CLINIC
INGERSOLL FAMILY PHYSICIANS
2103 INGERSOLL AVENUE	DES MOINES	IA	50312	PHYSICIAN CLINIC
IOWA DIAGNOSTIC IMAGING & PROCEDURE CTR
6000 UNIVERSITY AVE SUITE 150	WEST DES MOINES	IA	50266	OUTPATIENT DIAGNOSTIC IMAGING
IOWA HEALTH CARDIOLOGY
1301 PENN AVENUE SUITE 100	DES MOINES	IA	50316	PHYSICIAN CLINIC
IOWA HEALTH CARDIOLOGY WEST
6000 WEST UNIVERSITY AVENUE A20	WEST DES MOINES	IA	50266	PHYSICIAN CLINIC
IOWA HEALTH DES MOINES BARIATRIC SERVICE
6000 UNIVERSITY AVENUE SUITE 300	WEST DES MOINES	IA	50266	PHYSICIAN CLINIC
IOWA HEALTH PAIN MANAGEMENT CLINIC
1215 PLEASANT STREET SUITE 506	DES MOINES	IA	50309	PHYSICIAN CLINIC
IOWA HEALTH PSYCHIATRY SERVICES
1215 PLEASANT STREET SUITE 514	DES MOINES	IA	50309	PHYSICIAN CLINIC
IOWA KIDNEY STONE CENTER (INACTIVE)
818 5TH AVENUE	DES MOINES	IA	50309	REMOVAL OF KIDNEY STONES
IOWA SPECIALTY PHYSICIANS
4949 PLEASANT ST	WEST DES MOINES	IA	50266	PHYSICIAN CLINIC
JOHN STODDARD CANCER CENTER - RADIATION
1221 PLEASANT STREET	DES MOINES	IA	50309	PHYSICIAN CLINIC
JOHNSTON FAMILY PHYSICIANS
5900 NW 86TH STREET SUITE 100	JOHNSTON	IA	50131	PHYSICIAN CLINIC
LA CLINICA
2679 MAURY STREET	DES MOINES	IA	50317	PHYSICIAN CLINIC
LAKEVIEW SURGERY CENTER LC
1750 60TH ST	WEST DES MOINES	IA	50266	SURGERY CENTER
MIDWIVES
1440 PLEASANT ST STE1	DES MOINES	IA	50309	PHYSICIAN CLINIC
NORTHWEST FAMILY PHYSICIANS
5700 HICKMAN ROAD	DES MOINES	IA	50310	PHYSICIAN CLINIC
NORWALK FAMILY PHYSICIANS
800 COLONIAL CIRCLE SUITE 200	NORWALK	IA	50211	PHYSICIAN CLINIC
OCC MED
6000 UNIVERSITY AVE SUITE 124	WEST DES MOINES	IA	50266	OCCUPATIONAL MEDICINE
ORTHOPAEDIC OUTPATIENT SURGERY CENTER
1600 60TH ST	WEST DES MOINES	IA	50266	AMBULATORY SURGERY CENTER
PENN AVENUE INTERNAL MEDICINE
1201 PENN AVENUE	DES MOINES	IA	50316	PHYSICIAN CLINIC
PENN AVENUE OBGYN
1250 E 9TH ST	DES MOINES	IA	50316	PHYSICIAN CLINIC
PENN INTERNAL MEDICINE METHODIST
1215 PLEASANT STREET SUITE 506	DES MOINES	IA	50309	PHYSICIAN CLINIC
PERINATAL
MOB II STE 116	DES MOINES	IA	50309	PHYSICIAN CLINIC
PIH OP THERAPY EAST
2720 8TH STREET SW	ALTOONA	IA	50009	THERAPY
PLEASANT HILL
5148 E UNIVERSITY AVE	PLEASANT HILL	IA	50327	PHYSICIAN CLINIC
PRAIRIE TRAIL ANKENY
2515 SW STATE STREET SUITE 200	ANKENY	IA	50021	PHYSICIAN CLINIC
SOUTHWEST FAMILY PHYSICIANS
4821 SW 9TH STREET	DES MOINES	IA	50315	PHYSICIAN CLINIC
TRANSPLANT CTR & CENTER FOR LIVER DISEAS
1215 PLEASANT STREET SUITE 506	DES MOINES	IA	50309	PHYSICIAN CLINIC
URBANDALE FAMILY PHYSICIANS & SPORTS MED
2901 86TH STREET	URBANDALE	IA	50322	PHYSICIAN CLINIC & THERAPY
WEST DES MOINES FAMILY PHYSICIANS
6010 MILLS CIVIC PARKWAY SUITE 200	WEST DES MOINES	IA	50266	PHYSICIAN CLINIC
WEST HOSPITAL ORTHOPAEDIC CO-MANAGEMENT
1660 60TH ST	WEST DES MOINES	IA	50266	MANAGEMENT OF METHODIST WEST ORTHO SERVICE LINE
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVE	WEST DES MOINES	IA	50266	TREATMENT OF CHRONIC SLEEP DISORDERS

Form990 Schedule H Part VI Form990ScheduleHPartVI (22 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: THE 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 $999,601 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. [CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION. OTHER DONATIONS SUCH AS FOOD OR OTHER DURABLE GOODS PROVIDE AREA SHELTERS AND OTHER ORGANIZATIONS IN THE AREA. THIS ALLOWS THESE ORGANIZATIONS TO MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH.
PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'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 CENTRAL IOWA HOSPITAL CORPORATION. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2.
PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $21,560,287. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.
PART 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, THREE 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.	IOWA METHODIST MEDICAL CENTER
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, THREE 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.	IOWA LUTHERAN HOSPITAL
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, THREE 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.	METHODIST WEST 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.IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDREN'S HOSPITAL) 0.79%IOWA LUTHERAN HOSPITAL 2.44%METHODIST WEST HOSPITAL 2.64%	IOWA METHODIST MEDICAL CENTER
PART V, SECTION B, LINE 19D: IF THE INDIVIDUAL APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE SERVICES AT THE HOSPITAL FACILITY TO DETERMINE THE AMOUNTS BILLED FOR ALL SERVICES, INCLUDING EMERGENCY OR MEDICALLY NECESSARY CARE. THIS OCCURS REGARDLESS WHETHER THE INDIVIDUAL HAS INSURANCE COVERAGE. ALSO, IF THE INDIVIDUAL HAS INSURANCE COVERAGE AND DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE INSURER'S NEGOTIATED RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY. HOWEVER, IF THE INDIVIDUAL DOES NOT HAVE INSURANCE COVERAGE AND EITHER DOES NOT APPLY OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE GROSS RATES FOR THOSE SERVICES TO DETERMINE THE AMOUNTS BILLED. IF THE UNINSURED INDIVIDUAL AGREES TO PAY THE BILL IN FULL, THE HOSPITAL FACILITY WILL PROVIDE A 20%-30% DISCOUNT FROM THE GROSS RATES FOR THOSE INDIVIDUALS. IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDREN'S HOSPITAL) 0.79%IOWA LUTHERAN HOSPITAL 2.44%METHODIST WEST HOSPITAL 2.64%	IOWA LUTHERAN 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. IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDREN'S HOSPITAL) 0.79%IOWA LUTHERAN HOSPITAL 2.44%METHODIST WEST HOSPITAL 2.64%	METHODIST WEST 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. IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDREN'S HOSPITAL) 1.23%IOWA LUTHERAN HOSPITAL 1.76%METHODIST WEST HOSPITAL 0.75%	IOWA METHODIST MEDICAL CENTER
PART V, SECTION B, LINE 21: AS DESCRIBED IN SCHEDULE H, PART V, LINE 19, IF THE PATIENT DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE AND ALSO IS UNINSURED OR RECEIVES NO BENEFIT FROM THEIR INSURANCE ON A SERVICE PROVIDED BY THE HOSPITAL FACILITY, THEY WOULD BE CHARGED AMOUNTS EQUAL TO GROSS CHARGES FOR THE SERVICES PROVIDED TO THE PATIENT. HOWEVER, IF THE PATIENT AGREES TO PAY IN FULL, THEY WILL RECEIVE A 20%-30% DISCOUNT FROM THE GROSS CHARGES. IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDREN'S HOSPITAL) 1.23%IOWA LUTHERAN HOSPITAL 1.76%METHODIST WEST HOSPITAL 0.75%	IOWA LUTHERAN 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. IOWA METHODIST MEDICAL CENTER (INCLUDES BLANK CHILDRENS HOSPITAL) 1.23%IOWA LUTHERAN HOSPITAL 1.76%METHODIST WEST HOSPITAL 0.75%	METHODIST WEST HOSPITAL
PART VI, LINE 2: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A SPONSORING PARTNER OF HEALTHY POLK WHICH IS A COMMUNITY COLLABORATIVE CONVENED BY POLK COUNTY HEALTH DEPARTMENT TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF POLK COUNTY. THROUGH A PLANNED AND ORGANIZED EFFORT, HEALTHY POLK DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. HEALTHY POLK WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES, AS A SPONSORING AGENCY, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. EFFORTS ARE MONITORED IN PART BY OTHER PARTNER AGENCIES SUCH AS THE FAMILY AND CHILD POLICY CENTER WHICH MONITORS AND REPORTS SPECIFIC INDICATORS TO ASSESS EFFECTIVENESS AND AID IN THE DEVELOPMENT OF NEW PLANS OR REFINING EXISTING ONES. FURTHER, HEALTHY POLK 2020 HAS DEVELOPED A MEASUREMENT PROCESS TO EVALUATE EFFECTIVENESS AS WELL AS NEED. HEALTHY POLK CONVENES TWO TOWN HALL MEETINGS ANNUALLY TO SEEK PUBLIC INPUT ON HEALTH INITIATIVES. CENTRAL IOWA HOSPITAL CORPORATIONS D/B/A IOWA HEALTH DES MOINES IS ALSO A SPONSORING PARTNER IN DALLAS COUNTY PARTNERSHIP FOR HEALTH. THIS COLLABORATIVE ALSO COMPLETES A COMMUNITY HEALTH ASSESSMENT. FROM THIS, PRIORITIES AND STRATEGIES HAVE BEEN IDENTIFIED. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES HAS ACTIVELY ENGAGED IN ADDRESSING AND MONITORING HEALTH ISSUES AND NEEDS AS A RESULT OF THIS PROCESS. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ALSO PARTICIPATES AS PART OF THE UNITED WAY COMMUNITY IMPACT COMMITTEE. THIS GROUP ACTIVELY ADDRESSES NEED AND STRATEGIES ASSOCIATED WITH HEALTH. MORE SPECIFICALLY, THIS GROUP OFTEN FOCUSES ON THE SOCIAL DETERMINANTS OF HEALTH AND HOW TO IMPACT THEM IN THE EFFORT TO RAISE THE COMMUNITY HEALTH STATUS. THIS WIDE BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR CENTRAL IOWA HOSPTIAL CORPORATION D/B/A IOWA HEALTH DES MOINES TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS OFTEN WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT.
PART VI, LINE 3: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS: 1) PLACES SIGNAGE, INFORMATION, AND/OR BROCHURES IN APPROPRIATE AREAS OF THE PROVIDER (E.G., THE EMERGENCY DEPARTMENT, AND REGISTRATION AND CHECK-OUT/CASHIER AREAS) STATING THE PROVIDER/PHYSICIAN PRACTICE OFFERS CHARITY CARE AND DESCRIBES HOW TO OBTAIN MORE INFORMATION ABOUT FINANCIAL ASSISTANCE, 2) PLACES A NOTE ON THE HEALTH-CARE BILL AND STATEMENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE, 3) DESIGNATES INDIVIDUALS WHO CAN EXPLAIN THE PROVIDER'S CHARITY CARE POLICY, AND 4) INSTRUCTS STAFF WHO INTERACT WITH PATIENTS TO DIRECT QUESTIONS REGARDING THE CHARITY CARE POLICY TO THE PROPER PROVIDER REPRESENTATIVE.
PART VI, LINE 4: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A 779-BED COMMUNITY HOSPITAL SYSTEM SERVING CENTAL IOWA. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF DALLAS, GUTHRIE, JASPER, MADISON, MARION, POLK, STORY, AND WARREN. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ADMITS 35,797 INPATIENTS AND CARES FOR 82,908 EMERGENCY PATIENTS PER YEAR. THERE ARE 34 OTHER HOSPITALS WITHIN THE 30-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $46,396.00 TO $67,037.00 AND THE AVERAGE POVERTY RATE IS 9.875%. FIFTY TWO PERCENT OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES PATIENTS ARE ELIGIBLE FOR MEDICARE (41%) OR MEDICAID (11%). DALLAS, POLK AND STORY COUNTIES ARE THE ONLY COUNTIES IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATIONS. DALLAS COUNTY IS 6 PERCENT HISPANIC, POLK COUNTY IS 6 PERCENT AFRICAN AMERICAN AND 7 PERCENT HISPANIC, AND STORY COUNTY IS 6 PERCENT ASIAN.
PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE.
PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM. INITIALLY FORMED IN 1995, IOWA HEALTH SYSTEM IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 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	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (24 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
ADULT DAY CARE CENTER AT WESLEY ACRES
5508 NW 88TH ST	JOHNSTON	IA	50131	203970256	501(C)3	25000	CAPITAL BUILDING CAMPAIGN
AMERICAN HEART ASSOCIATION
1111 NINTH STREET SUITE 280	DES MOINES	IA	50314	135613797	501(C)3	39500	EVENT SPONSOR
BRANDSTAD REYNOLDS SCHOLARSHIP FUND
PO BOX 3747	URBANDALE	IA	50323	273956456	501(C)3	9000	PROGRAM SUPPORT
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREET	DES MOINES	IA	50309	421189791	501(C)3	93387	PROGRAM SUPPORT
CITY OF DES MOINES
400 ROBERT D RAY DRIVE	DES MOINES	IA	50309	426004514	GOVERNMENT	159201	OTHER
CIVIC CENTER OF GREATER DES MOINES
221 WALNUT ST	DES MOINES	IA	50309	510138181	501(C)3	10000	CAPITAL BUILDING CAMPAIGN
DES MOINES UNIVERSITY
3200 GRAND AVE	DES MOINES	IA	50312	420730347	501(C)3	10000	CAPITAL BUILDING CAMPAIGN
GRANDVIEW UNIVERSITY
1200 GRANDVIEW AVE	DES MOINES	IA	50316	420681049	501(C)3	20000	PROGRAM SUPPORT
GREATER DES MOINES COMMUNITY FOUNDATION
1915 GRAND AVE	DES MOINES	IA	50309	426139033	501(C)3	50500	OTHER
IOWA CLINIC HEALTHCARE FOUNDATION
1215 PLEASANT ST SUITE 618	DES MOINES	IA	50309	810599749	501(C)3	15000	EVENT SPONSOR
IOWA HEALTH SYSTEM
1200 PLEASANT STREET	DES MOINES	IA	50309	421435199	501(C)(3)	3205023	PROGRAM SUPPORT
IOWA HOMELESS YOUTH CENTERS
701 GRAND AVE	DES MOINES	IA	50309	421051609	501(C)3	5000	EVENT SPONSOR
IOWA HOSPITAL ASSOCIATION
100 EAST GRAND AVE 100 PO BOX 763	DES MOINES	IA	50309	420706508	501(C)6	15000	EVENT SPONSOR
JUVENILE DIABETES RESEARCH FOUNDATION
5444 NW 96TH ST SUITE A	JOHNSTON	IA	50131	421907729	501(C)3	15000	EVENT SPONSOR
LINK ASSOCIATES
4301 NE 14TH ST	DES MOINES	IA	50313	420815363	501(C)3	15000	PROGRAM SUPPORT
MAINSTREAM
2012 EAST 13TH ST	AMES	IA	50000	421042459	501(C)3	5000	PROGRAM SUPPORT
MARCH OF DIMES
111 9TH STE 270	DES MOINES	IA	50314	131846366	501(C)3	10150	EVENT SPONSOR
MID-IOWA COUNCIL BOY SCOUTS OF AMERICA
1659 E EUCLID AVE	DES MOINES	IA	50316	420981715	501(C)3	11500	EVENT SPONSOR
OPERATION DOWNTOWN
700 LOCUST STREET SUITE 100	DES MOINES	IA	50309	861058466	501(C)6	25000	PROGRAM SUPPORT
PRINCIPAL CHARITY CLASSIC
2771 104TH ST STE 1	URBANDALE	IA	50322	426139033	501(C)3	85000	EVENT SPONSOR
PUBLIC LIBRARY OF DES MOINES FOUNDATION
PO BOX 93243 400 LOCUST ST STE 350	DES MOINES	IA	50393	421484890	501(C)3	20000	CAPITAL BUILDING CAMPAIGN
SALISBURY HOUSE FOUNDATION SALISBURY HOUSE & GARDENS
4025 TONAWANDA DRIVE	DES MOINES	IA	50312	421415581	501(C)3	10000	CAPITAL BUILDING CAMPAIGN
SCIENCE CENTER OF IOWA
401 W MLK JR PARKWAY	DES MOINES	IA	50309	426097912	501(C)3	20000	CAPITAL BUILDING CAMPAIGN
THE GREATER DES MOINES PARTNERSHIP
700 LOCUST STREET SUITE 100	DES MOINES	IA	50309	421489668	501(C)6	175000	CAPITAL BUILDING CAMPAIGN

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	21	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	3	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (24 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LARRY BAKER DO
168471	0	0	0	40292	0	9818	0	9206	0	227787	0	0	0
ERIC CROWELL
527761	0	189984	0	67518	0	221399	0	22207	0	1028869	0	0	0
WILLIAM YOST MD
0	237352	0	0	0	1374	0	31825	0	19909	0	290460	0	0
JOSEPH CORFITS
297505	0	97985	0	48456	0	83713	0	20483	0	548142	0	0	0
SUSAN ALLYN
8144	0	105011	0	313621	0	62153	0	294	0	489223	0	279729	0
AMY BETHEL
138420	0	22111	0	3803	0	19201	0	16594	0	200129	0	0	0
CHRISTINE BLAIR
147469	0	49895	0	15588	0	24617	0	21191	0	258760	0	0	0
DOUGLAS DORNER
362325	0	118312	0	182583	0	19917	0	17310	0	700447	0	147526	0
CECELIA KIRVIN
140433	0	20415	0	4630	0	19097	0	10727	0	195302	0	0	0
TODD KRANPITZ
142523	0	10275	0	2127	0	7781	0	15877	0	178583	0	0	0
ERIC LOTHE
274134	0	89448	0	39750	0	34822	0	16613	0	454767	0	0	0
JOYCE MCDANEL
187836	0	25991	0	21812	0	22780	0	6057	0	264476	0	0	0
DEBRA MOYER
225526	0	42688	0	43462	0	29830	0	5080	0	346586	0	0	0
MARK PURTLE
358085	0	110354	0	31408	0	207858	0	17883	0	725588	0	0	0
SIDNEY RAMSEY
227929	0	73012	0	46762	0	15855	0	5192	0	368750	0	0	0
JEAN SHELTON
158733	0	49995	0	18446	0	17097	0	16194	0	260465	0	0	0
LESLIE SMIAROWSKI
129144	0	21527	0	1842	0	7819	0	17313	0	177645	0	0	0
DAVID STARK
307348	0	106774	0	60008	0	38570	0	20119	0	532819	0	0	0
STEPHEN STEPHENSON
364724	0	119937	0	57509	0	58172	0	22242	0	622584	0	0	0
ROBERT GOEBEL
565591	0	276610	0	5563	0	12250	0	18251	0	878265	0	0	0
TIMOTHY HART
1051207	0	500	0	53679	0	12250	0	24766	0	1142402	0	0	0
AMAR NATH
1031520	0	1000	0	53679	0	12250	0	24495	0	1122944	0	0	0
PRASAD PALAKURTHY
750542	0	61000	0	61587	0	12250	0	22521	0	907900	0	0	0
JOHN TRIANTAFYLLOS
514773	0	284544	0	657	0	12250	0	23960	0	836184	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD AS "NONCASH COMP" (IMPUTED MISCELLANEOUS) TO PAYCHECK IN ORDER TO TAX APPROPRIATELY.
PART I, LINE 1B	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD AS "NONCASH COMP" (IMPUTED MISCELLANEOUS) TO PAYCHECK IN ORDER TO TAX APPROPRIATELY.
PART I, LINE 4B	THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: JOSEPH CORFITS $59,272, ERIC CROWELL $198,085, ERIC LOTHE $22,572, JOYCE MCDANEL $11,788, DEBRA MOYER $17,580, MARK PURTLE $195,608, SIDNEY RAMSEY $-12,320, DAVID STARK $26,320, STEPHEN STEPHENSON $49,722. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: SUSAN ALLYN $279,729, DOUGLAS DORNER $147,526.

Schedule L IRS990ScheduleL

Loan Table LoanTable (4 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
TIMOTHY HART
RECRUITMENT INDUCEMENT	X	$229,863	76621	0	1	1
AMAR NATH
RECRUITMENT INDUCEMENT	X	$229,863	76621	0	1	1
PRASAD PALAKURTHY
RECRUITMENT INDUCEMENT	X	$229,863	76621	0	1	1
DAVID STARK
RECRUITMENT INDUCEMENT	X	$60,000	36428	0	1	1

Field	Value	IRS element (for citing)
Total Balance Due	266291	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (16 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
1776 WESTLAKES PARKWAY LC
COMMON BOARD MEMBER/OFFICER	646000	INVESTMENT	0
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
COMMON BOARD MEMBER/OFFICER	1778000	INVESTMENT, MANAGEMENT FEE AND FINANCIAL SERVICES	0
DES MOINES AREA COMMUNITY COLLEGE
COMMON BOARD MEMBER/OFFICER	492674	TUITION	0
DRAKE UNIVERSITY
COMMON BOARD MEMBER/OFFICER	277000	STUDENT HEALTH AGREEMENT AND TUITION	0
HEALTH SYSTEM EMERGENCY PHYSICIANS
COMMON BOARD MEMBER/OFFICER	243000	RENTAL INCOME AND PURCHASED SERVICES	0
HUBBELL REALTY COMPANY
COMMON BOARD MEMBER/OFFICER	1278000	RENT	0
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
COMMON BOARD MEMBER/OFFICER	1690000	INVESTMENT AND LAUNDRY	0
IOWA KIDNEY STONE CENTER
COMMON BOARD MEMBER/OFFICER	465000	INVESTMENT	0
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
COMMON BOARD MEMBER/KEY EMPLOYEE	740090	PERFORMANCE OF SERVICES	0
LAKEVIEW SURGERY CENTER LC
COMMON BOARD MEMBER/OFFICER	1161000	INVESTMENT, SUPPLIES, FINANCIAL SERVICES, MAINTENANCE, TRANSCRIPTION, PHARMACISTS, BIO-TECH	0
PRINCIPAL FINANCIAL GROUP
COMMON BOARD MEMBER/OFFICER	380011	SPONSORSHIP BENEFITS	0
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
COMMON BOARD MEMBER/OFFICER	1082000	INVESTMENT, MAINTENANCE, TRANSCRIPTION, PHARMACY, MAINTENANCE, BIO-TECH	0
TRACY EKHARDT MD
DAUGHTER OF KEY EMPLOYEE	341690	FAMILY MEMBER OF KEY EMPLOYEE STEPHEN STEPHENSON, MD	0
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
COMMON BOARD MEMBER/OFFICER	1219000	INVESTMENT, MANAGEMENT FEE AND FINANCIAL SERVICES	0
WEST LAKES SLEEP CENTER LLC
COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE	171000	INVESTMENT	0
WINIFRED HALL
FAMILY MEMBER OF KEY EMPLOYEE WINIFRED HALL	42023	MENTAL HLTH THRPST MSW-PCDC	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	BISHOP MICHAEL BURK; ERIC CROWELL; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 2	BISHOP MICHAEL BURK; KENT HENNING; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 2	KENT HENNING; ERIC CROWELL; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	CENTRAL IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	CENTRAL IOWA HEALTH SYSTEM ELECTS BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	CENTRAL IOWA HEALTH SYSTEM ELECTS AND CAN REMOVE BOARD OF DIRECTORS, AND APPROVE DISSOLUTIONS OR MERGER. IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION CAN AMEND THE ARTICLES AND BYLAWS AFTER CONSULTATION WITH CENTRAL IOWA HEALTH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2011 FOR THE FOLLOWING INDIVIDUALS: JOSEPH CORFITS, ERIC CROWELL, DOUGLAS DORNER, ERIC LOTHE, JOYCE MCDANEL, DEBRA MOYER, MARK PURTLE, SIDNEY RAMSEY, DAVID STARK, STEPHEN STEPHENSON. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19	IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS.
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -22,598,619. CHANGE IN BENEFICIAL INTEREST OF IOWA HEALTH FOUNDATION -1,690,400. CHANGES IN PENSION LIABILITY -25,193,259. CHANGES IN DEFERRED REVENUE -1,428,278. TOTAL TO FORM 990, PART XI, LINE 5: -50,910,556.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	DMPA NO 2 LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1200 PLEASANT STREET	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	50309	ZIPCode

Field	Value	IRS element (for citing)
EIN	272514210	EIN
Primary Activities	PROPERTY MANAGEMENT	PrimaryActivities
Legal Domicile State	IA	LegalDomicileState
Total Income	0	TotalIncome
EOY Assets	32500	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CENTRAL IOWA HOSPITAL CORPORATION	BusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
ALLEN COLLEGE
1825 LOGAN AVENUE	WATERLOO	IA	50703	421351526	EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS	IA	501(C)(3)	170(B)(1) (A)(II)	ALLEN HEALTH SYSTEMS INC	1
ALLEN HEALTH SYSTEMS INC
1825 LOGAN AVENUE	WATERLOO	IA	50703	421201924	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
ALLEN MEMORIAL HOSPITAL CORPORATION
1825 LOGAN AVENUE	WATERLOO	IA	50703	420698265	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ALLEN HEALTH SYSTEMS INC	1
ANAMOSA AREA AMBULANCE SERVICE
101 GRANT WOOD DRIVE	ANAMOSA	IA	52205	421466284	PROVIDE AMBULANCE SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'SJONES REGIONAL MEDICAL CENTER	1
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREET	DES MOINES	IA	50309	421233759	PROPERTY HOLDING COMPANY	IA	501(C)(2)		CENTRAL IOWA HEALTH SYSTEM	1
CENTRAL IOWA HEALTH SYSTEM
1200 PLEASANT STREET	DES MOINES	IA	50309	421189791	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
CENTRAL IOWA HOSPITAL CORPORATION
1200 PLEASANT STREET	DES MOINES	IA	50309	420680452	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	CENTRAL IOWA HEALTH SYSTEM	1
FINLEY TRI-STATES HEALTH GROUP INC
350 NORTH GRANDVIEW AVENUE	DUBUQUE	IA	52001	421307495	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
HNC SERVICES
1200 PLEASANT STREET	DES MOINES	IA	50309	270987243	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	1
INTEGRATED CARE ORGANIZATION
1200 PLEASANT STREET	DES MOINES	IA	50309	274665007	PROMOTE, SUPPPORT THE INTERESTS AND PURPOSES OF AFFILIATES' HOSPITALS	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	1
INTRUST
11333 AURORA AVENUE	URBANDALE	IA	50322	421477471	HOME HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	1
IOWA HEALTH FOUNDATION
2700 GRAND AVE SUITE 109	DES MOINES	IA	50312	421467682	CHARITABLE FUNDRAISING	IA	501(C)(3)	509(A)(3), TYPE III	CENTRAL IOWA HEALTH SYSTEM	1
IOWA HEALTH SYSTEM
1200 PLEASANT STREET	DES MOINES	IA	50309	421435199	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE III		1
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
8101 BIRCHWOOD COURT	JOHNSTON	IA	50131	421411630	PRIMARY HEALTH CARE SERVICES	IA	501(C)(3)	170(B)(1) (A)(III)	IOWA HEALTH SYSTEM	1
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUE	WATERLOO	IA	50703	421201138	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ALLEN HEALTH SYSTEMS INC	1
METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	371111135	HEALTHCARE	IL	501(C)(3)	509(A)(3), TYPE III	IOWA HEALTH SYSTEM	1
METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	510186460	FUNDRAISING	IL	501(C)(3)	170(B)(1) (A)(VI)	METHODIST HEALTH SERVICES CORPORATION	1
METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	370661223	HEALTHCARE	IL	501(C)(3)	170(B)(1) (A)(III)	METHODIST HEALTH SERVICES CORPORATION	1
METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	371111134	OFFICE RENTAL	IL	501(C)(3)	509(A)(2)	METHODIST HEALTH SERVICES CORPORATION	1
NELLIE R SHERWOOD TRUST
1026 A AVENUE NE	CEDAR RAPIDS	IA	52402	426061621	PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY	IA	501(C)(3)	509(A)(3), TYPE I	ST LUKE'S METHODIST HOSPITAL	1
NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED
720 KENYON DRIVE	FORT DODGE	IA	50501	420937390	MENTAL HEALTH CARE	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY HEALTH SYSTEMS INC	1
NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVD	SIOUX CITY	IA	51104	421019872	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	IOWA HEALTH SYSTEM	1
SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUE	PEORIA	IL	61636	376181831	FUND SELF-INSURANCE PLAN	IL	501(C)(3)	509(A)(3), TYPE III	METHODIST MEDICAL CENER OF ILLINOIS	1
SIOUXLAND PACE INC
313 COOK STREET	SIOUX CITY	IA	51103	261120134	ALL-INCLUSIVE CARE FOR THE ELDERLY	IA	501(C)(3)	170(B)(1) (A)(III)	ST LUKE'S HEALTH SYSTEM INC	1
ST LUKE'S HEALTH RESOURCES
2720 STONE PARK BLVD	SIOUX CITY	IA	51104	421059182	OUTPATIENT CLINICS AND HEALTHCARE SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'S HEALTH SYSTEM INC	1
ST LUKE'S HEALTH SYSTEM INC
2720 STONE PARK BLVD	SIOUX CITY	IA	51104	421294091	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE III	IOWA HEALTH SYSTEM	1
ST LUKE'S HEALTHCARE
1026 A AVENUE NE	CEDAR RAPIDS	IA	52402	421487968	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
ST LUKE'S METHODIST HOSPITAL
1026 A AVENUE NE	CEDAR RAPIDS	IA	52402	420504780	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ST LUKE'S HEALTHCARE	1
ST LUKE'SJONES REGIONAL MEDICAL CENTER
1795 HIGHWAY 64 EAST	ANAMOSA	IA	52205	421487967	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ST LUKE'S HEALTHCARE	1
STL CARE COMPANY
1026 A AVENUE NE	CEDAR RAPIDS	IA	52402	421276632	IMPROVE PUBLIC HEALTH SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'S HEALTHCARE	1
THE DUBUQUE VISITING NURSE ASSOCIATION
350 NORTH GRANDVIEW AVENUE	DUBUQUE	IA	52001	420680410	PUBLIC HEALTH SERVICES/HOME CARE	IA	501(C)(3)	509(A)(2)	FINLEY TRI-STATES HEALTH GROUP INC	1
THE FINLEY HOSPITAL
350 NORTH GRANDVIEW AVENUE	DUBUQUE	IA	52001	420680354	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	FINLEY TRI-STATES HEALTH GROUP INC	1
THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH
2701 17TH STREET	ROCK ISLAND	IL	61201	363678909	MENTAL HEALTH CARE	IL	501(C)(3)	170(B)(1) (A)(VI)	TRINITY REGIONAL HEALTH SYSTEM	1
TPG HEALTH
802 KENYON ROAD	FORT DODGE	IA	50501	453791448	SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY HEALTH SYSTEMS INC	1
TRINITY BUILDING CORPORATION
802 KENYON ROAD	FORT DODGE	IA	50501	421376187	PROPERTY HOLDING COMPANY	IA	501(C)(2)		TRINITY HEALTH SYSTEMS INC	1
TRINITY HEALTH FOUNDATION
802 KENYON ROAD	FORT DODGE	IA	50501	421222381	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	TRINITY HEALTH SYSTEMS INC	1
TRINITY HEALTH FOUNDATION
2701 17TH STREET	ROCK ISLAND	IL	61201	363321751	CHARITABLE FUNDRAISING	IL	501(C)(3)	170(B)(1) (A)(VI)	TRINITY REGIONAL HEALTH SYSTEM	1
TRINITY HEALTH SYSTEMS INC
802 KENYON ROAD	FORT DODGE	IA	50501	421222877	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
TRINITY MEDICAL CENTER
2701 17TH STREET	ROCK ISLAND	IL	61201	362739299	HOSPITAL	IL	501(C)(3)	170(B)(1) (A)(III)	TRINITY REGIONAL HEALTH SYSTEM	1
TRINITY REGIONAL HEALTH SYSTEM
2701 17TH STREET	ROCK ISLAND	IL	61201	363351952	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IL	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	1
TRINITY REGIONAL HOSPITAL AUXILIARY
802 KENYON ROAD	FORT DODGE	IA	50501	426081474	CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES	IA	501(C)(3)	509(A)(2)	TRINITY REGIONAL MEDICAL CENTER	1
TRINITY REGIONAL MEDICAL CENTER
802 KENYON ROAD	FORT DODGE	IA	50501	421009175	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY HEALTH SYSTEMS INC	1
UNITY HEALTHCARE
1518 MULBERRY AVENUE	MUSCATINE	IA	52761	420680337	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY REGIONAL HEALTH SYSTEM	1

Form990 Schedule R Part III Form990ScheduleRPartIII (29 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Code VCodeVAmount
1776 WESTLAKES PARKWAY LC
4949 WESTOWN PARKWAY SUITE 200	WEST DES MOINES	IA	50266	205031651	OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BUILDINGS	IA	N/A	UNRELATED	229642	12309952	0	1	0.33330
ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC
1825 LOGAN AVE	WATERLOO	IA	50703	453237125	ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES	IA	N/A	RELATED	22920	39683	0	0	0.20000
CENTRAL ILLINOIS CANCER CARE CENTER LLC
7309 N KNOXVILLE	PEORIA	IL	61614	261128108	RADIATION THERAPY	IL	N/A	RELATED	1031613	1886570	0	1	0.50000
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT ST	DES MOINES	IA	50309	273625869	CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES	IA	N/A	RELATED	281022	87957	0	0	0.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT ST	DES MOINES	IA	50309	382622972	PARKING DECK OPERATIONS	IA		RELATED	540801	3772221	0	1	1.00000	CENTRAL IA HEALTH PROP CORP
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500	DUBUQUE	IA	52001	201597161	AMBULATORY SURGERY CENTER	IA		RELATED	660133	210769	0	1	0.51000	THE FINLEY HOSPITAL
ENSEVA - HIAWATHA LLC
524 PARK ROAD	WATERLOO	IA	50704	453437363	COLLOCATION FACILITY	IA		RELATED	2624	2203353	0	0	0.52000	IOWA HEALTH SYSTEM
FINLEY DEPT OF SURGERY CO-MGMT CO LLC
350 N GRANDVIEW AVE	DUBUQUE	IA	52001	422808785	SURGERY DEPARTMENT MANAGEMENT SERVICES	IA	N/A	RELATED	101716	208966	0	0	0.50000
FINLEYHARTIG HOMECARE LLC
703 MAIN ST	DUBUQUE	IA	52001	421487138	SALE/RENTAL OF MEDICAL EQUIPMENT	IA	N/A	RELATED	132479	842404	0	1	0.50000
HEALTH CARE AFFILIATES OF THE TRI-STATES LLC
350 N GRANDVIEW AVE	DUBUQUE	IA	52001	421428503	PROVIDE ACCESS TO LICENSED SOFTWARE	IA	N/A	RELATED		14037	0	1	0.50000
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NE	CEDAR RAPIDS	IA	52402	391894290	INVESTMENT VEHICLE OWNING CLINICAL JVS	IA	N/A	UNRELATED	89797	817011	0	0	0.55670		$57,299
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAY	WEST DES MOINES	IA	50266	263293530	PRIMARY CARE CLINIC	IA	N/A	RELATED	-175705	44300	0	1	0.50000
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	030482623	OUTPATIENT DIAGNOSTIC IMAGING	IA	N/A	RELATED	1323429	2917182	0	1	0.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421511142	GROUP PURCHASING	IA	N/A	RELATED	4775894	15888961	0	1	1.00000
LAKEVIEW SURGERY CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421516120	SURGERY CENTER	IA	N/A	RELATED	3443692	4825696	0	1	0.50000
MEDICAL LABORATORIES OF EASTERN IOWA LC
1026 A AVE NE	CEDAR RAPIDS	IA	52402	421359640	MEDICAL LABORATORY SERVICES	IA	N/A	RELATED	664320	870817	0	1	0.50000
METRO MRI CENTER LIMITED PARTNERSHIP
615 VALLEY VIEW DRIVE SUITE 102	MOLINE	IL	61265	363710164	PROVIDE MRI AND OTHER MEDICAL SERVICES	IL	N/A	RELATED	600876	1499952	0	1	0.33970
MR ASSOCIATES LLP
1455 SHERMAN ROAD	HIAWATHA	IA	52233	421260463	OWN AND OPERATE MR UNIT	IA	N/A	RELATED	2540143	1416839	0	1	0.33330
NE IA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
1825 LOGAN AVE	WATERLOO	IA	50703	202124978	ATHLETIC TRAINING AND SPORTS MEDICINE	IA	N/A	RELATED	-41070		0	1
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421508092	AMBULATORY SURGERY CENTER	IA	N/A	RELATED	3314858	3461181	0	1	0.50000
PIERCE STREET SAME DAY SURGERY LC
2730 PIERCE STREET	SIOUX CITY	IA	51104	205895205	AMBULATORY SURGERY CENTER	IA	N/A	RELATED	931816	3357708	0	1	0.50000
QUAD CITY AMBULATORY SURGERY CENTER LLC
520 VALLEY VIEW DRIVE SUITE 300	MOLINE	IL	61265	364471903	AMBULATORY SURGERY CENTER.	IL	N/A	RELATED	255765	3500259	0	1	0.50000
REHABILITATION THERAPY SERVICES LLC
416 ST MARKS CT 110	PEORIA	IL	61603	810584193	REHABILATION THERAPY	IL		RELATED	448732	1397476	0	1	0.60030	METHODIST MEDICAL CENTER OF ILLINOIS
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SE	CEDAR RAPIDS	IA	52403	721550812	AMBULATORY SURGERY CENTER.	IA	N/A	RELATED	3310383	7115889	0	1	0.50000
TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
4500 UTICA RIDGE RD	BETTENDORF	IA	52722	272562753	ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES	IA	N/A	RELATED	175377	118891	0	1	0.50000
TRI-WEBSTER LC
1610 COLLINS ST	WEBSTER CITY	IA	50595	010740062	MEDICAL BUILDING AND SURROUNDING PROPERTY	IA	N/A	RELATED	110738	1715230	0	1	0.50000
WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC
1660 60TH STREET	WEST DES MOINES	IA	50266	271414600	ORTHOPEDIC SERVICE LINES MANAGEMENT	IA	N/A	RELATED	244306	26600	0	1	0.20000
WEST LAKES MEDICAL EQUIPMENT LLC
5950 UNIVERSITY AVENUE SUITE 321	WEST DES MOINES	IA	50266	263300536	MEDICAL EQUIPMENT SALES AND RENTAL	IA	N/A	UNRELATED	59770	171967	0	1	0.50000		$59,770
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVENUE SUITE 2	WEST DES MOINES	IA	50266	263193923	SLEEP DISORDER DIAGNOSTIC TESTING FACILITY	IA	N/A	RELATED	92541	318508	0	1	0.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
BROADBAND INC
1200 PLEASANT ST	DES MOINES	IA	50309	273819741	INFORMATION TECHNOLOGY MGMT.	IA	IHS	C	338870	13238641	1.00000
CHARITABLE REMAINDER UNITRUST #1
					INVESTMENT	IA	SLHCF	T
CHARITABLE REMAINDER UNITRUST #2
					INVESTMENT	IA	SLHCF	T
CHARITABLE REMAINDER UNITRUST #3
					INVESTMENT	IA	SLHCF	T
CHARITABLE REMAINDER UNITRUST #6
					INVESTMENT	IA	SLHCF	T
IOWA HEALTH SYSTEM 457 DEF COMP PLAN
1415 WOODLAND AVE 2ND FL	DES MOINES	IA	50309	421435199	INVESTMENT	IA	IHS	T	266087	4546270	1.00000
METHODIST HEALTH VENTURES INC
PO BOX 87	PEORIA	IL	61650	371140939	PHARMACY/OFFICE STAFFING	IL	MHSC	C	868566	2437393	1.00000
MEDIMORE INC
1200 PLEASANT ST	DES MOINES	IA	50309	421414390	MANAGED CARE	IA	IHS	C	210170		1.00000
METHODIST PHYSICIAN SERVICES INC
PO BOX 87	PEORIA	IL	61650	363858550	MEDICAL SERVICES	IL	MHVI	C	11908671	1305915	1.00000
PRECEDENCE INC
4622 PROGRESS DRIVE STE A	DAVENPORT	IA	52807	371288604	MANAGED MENTAL CARE	IA	RYC	C	506534	435657	1.00000
PROVIDER RESOURCE MANAGEMENT INC
PO BOX 87	PEORIA	IL	61650	371223550	RESOURCE MANAGEMENT	IL	MHSC	C		57427	1.00000
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVE	DES MOINES	IA	50316	261271143	SPECIALTY PHYSICIANS MEDICAL CARE	IA	CIHC	C	481860	198055	0.57000
STL HEALTH RESOURCES CO
1026 A AVE NE	CEDAR RAPIDS	IA	52402	421193499	PHYSICIAN OFFICE RENTAL	IA	SLMH	C	322129	5577505	1.00000
TRIMARK PHYSICIANS GROUP INC
802 KENYON ROAD	FORT DODGE	IA	50501	421335554	MEDICAL CLINICS	IA	THS	C	44216247		1.00000
TRINITY HEALTH ENTERPRISES INC
2701 17TH ST	ROCK ISLAND	IL	61201	363320141	RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY	IL	TRHS	C	3295832	2957465	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	1	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
J	2525675	BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
P	264590	BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
D	177014	BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
H	328643	BASED ON GAAP, CASH, AND/OR FMV.
CENTRAL IOWA HEALTH PROPERTIES CORPORATION
R	220000	BASED ON GAAP, CASH, AND/OR FMV.
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
P	169177	BASED ON GAAP, CASH, AND/OR FMV.

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	SECTION 512(B)(13) CONTROLLED ENTITY	Identifier
Return Reference	SCHEDULE R, PART II, COLUMN (G)	ReturnReference
Explanation	THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, "IOWA HEALTH SYSTEM." FOR ENTITIES THAT ARE PART OF THE CONSOLIDATED HEALTH SYSTEM (WITH COMMON CONTROL) THE ATTRIBUTION RULES OF IRC SECTION 318 APPLY; MEANING THAT ALL ORGANIZATIONS ARE DEEMED TO HAVE CONTROL OF THE ORGANIZATIONS OWNED BY THE CONTROLLING ORGANIZATION. AS SUCH, WE ARE REPORTING ALL RELATED ORGANIZATIONS OF THE HEALTH SYSTEM IN PARTS II, III & IV. FOR PART V REPORTING, THE TRANSACTIONS DISCLOSED ARE THOSE BETWEEN THE DIRECTLY CONTROLLED PARENT-SUBSIDIARY ONLY.	Explanation

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	THE ORGANIZATION E-FILED A REQUEST FOR AN ADDITIONAL EXTENSION OF TIME TO FILE TO NOVEMBER 15, 2012, ON PART II OF FORM 8868. THE E-FILED EXTENSION WAS ACCEPTED BY THE IRS ON JULY 31, 2012; HOWEVER, THE IRS ISSUED NOTICE CP211A, DATED AUGUST 27, 2012, WITH AN INCORRECT DATE FOR PART II OF AUGUST 15, 2012 INSTEAD OF NOVEMBER 15, 2012. AS SUCH, THE ORGANIZATION RESPECTUFLLY REQUESTS THE ORGANIZATION'S RECORDS BE UPDATED ACCORDINGLY TO SHOW THIS FORM 990 AS BEING EXTENDED TO NOVEMBER 15, 2012, AND TIMELY FILED.	Explanation