ALLEN MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: ALLEN MEMORIAL HOSPITAL CORPORATION (EIN 42-0698265)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-08
IRS object ID: 201113129349301591
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-11-08T15:08:26-06:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	420698265	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ALLE	NameControl
Phone	3192353544	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	507031916	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RENEE A RASMUSSEN	Name
Title	SR VP FINANCE/CFO	Title
Phone	3192353544	Phone
Date Signed	2011-10-25	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JOHN KNOX	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	507031916	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	271780627	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.ALLENHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1938	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	2360	TotalNbrEmployees
Total Nbr Volunteers	485	TotalNbrVolunteers
Total Gross UBI	1332383	TotalGrossUBI
Net Unrelated Business Txbl Income	28148	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	4039723	ContributionsGrantsPriorYear
Contributions Grants Current Year	4842489	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	200617505	ProgramServiceRevenuePriorYear
Program Service Revenue CY	211657935	ProgramServiceRevenueCY
Investment Income Prior Year	3649438	InvestmentIncomePriorYear
Investment Income Current Year	6237244	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2041865	OtherRevenuePriorYear
Other Revenue Current Year	2047124	OtherRevenueCurrentYear
Total Revenue Prior Year	210348531	TotalRevenuePriorYear
Total Revenue Current Year	224784792	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	5145701	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	4663803	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	94356762	SalariesEtcPriorYear
Salaries Etc Current Year	92967024	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	98136823	OtherExpensePriorYear
Other Expenses Current Year	111701607	OtherExpensesCurrentYear
Total Expenses Prior Year	197639286	TotalExpensesPriorYear
Total Expenses Current Year	209332434	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	12709245	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	15452358	RevenuesLessExpensesCY
Total Assets BOY	227554612	TotalAssetsBOY
Total Assets EOY	236917508	TotalAssetsEOY
Total Liabilities BOY	114055245	TotalLiabilitiesBOY
Total Liabilities EOY	106978269	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	113499367	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	129939239	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE MISSION OF ALLEN MEMORIAL HOSPITAL CORPORATION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	148175662	Expense
Grants	3730477	Grants
Revenue	212438940	Revenue
Description	HEALTH-CARE SERVICESALLEN MEMORIAL HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE GREATER CEDAR VALLEY COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. ALLEN MEMORIAL 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, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, 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, 2010, ALLEN MEMORIAL HOSPITAL CORPORATION ADMITTED 11,548 PATIENTS WITHOUT NEWBORNS AND 12,553 PATIENTS WITH NEWBORNS, RESULTING IN A TOTAL OF 42,742 PATIENT DAYS WITHOUT NURSERY AND NICU, AND 45,564 PATIENT DAYS WITH NURSERY AND NICU. OUTPATIENT VISITS TOTALED 277,290 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 9,690. THERE WERE ALSO 31,280 EMERGENCY ROOM VISITS AND 973 BABIES DELIVERED.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	15099363	Expense
Grants	933326	Grants
Revenue	0	Revenue
Description	COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: ALLEN MEMORIAL 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 2,066 PEOPLE AT A VALUE OF $4,827,729 IN 2010. OFTENTIMES, ALLEN MEMORIAL HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ALLEN MEMORIAL HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. ALLEN MEMORIAL HOSPITAL CORPORATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $4,139,083 FOR 2010. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $8,966,812.OTHER BENEFITS: ALLEN MEMORIAL HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY 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. ALLEN MEMORIAL HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. ALLEN MEMORIAL HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 29,079 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE: $6,132,551.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	163275025	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
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	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	0	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	137	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2360	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	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
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	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	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	RENEE RASMUSSEN SR VP FINANCECFO	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3192353544	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	50703	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 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
RUSSELL ADAMS MD
BOARD MEMBER	1.00	X	71	309790	67588
MARK BALDWIN
BOARD CHAIR	1.00	X	121	587	0	X
ASHAR AFZAL MD
BOARD MEMBER	1.00	X	0	0	0
BOB BUCKLEY
BOARD MEMBER	1.00	X	71	0	0
MICHAEL CHRISTIASON
BOARD MEMBER	1.00	X	71	0	0
LARRY COHRT
BOARD MEMBER	1.00	X	71	0	0
DAVE HAPPEL
BOARD MEMBER	1.00	X	71	0	0
JOHN KNOX FR 1110
PRESIDENT/CEO/BOARD MEMBER	40.00	X	77295	407186	199709	X
GENE LEONHART
BOARD MEMBER	1.00	X	71	0	0
LAWRENCE LIEBSCHER MD
BOARD MEMBER	1.00	X	71	13250	0
KATHY MCCOY
BOARD MEMBER	1.00	X	71	0	0
RICHARD SEIDLER TO 610
PRESIDENT/CEO/BOARD MEMBER	40.00	X	317602	295402	252337	X
BEV SMITH
BOARD MEMBER	1.00	X	71	0	0
BETTY STEEGE
BOARD MEMBER	1.00	X	71	0	0
KALYANA SUNDARAM MD
BOARD MEMBER	1.00	X	71	0	0
KEVIN SWALLEY
BOARD VICE CHAIR	1.00	X	71	0	0	X
JEAN TRAINOR
BOARD TREASURER	1.00	X	143	0	0	X
BISHOP STEVE ULLESTAD
BOARD MEMBER	1.00	X	71	0	0
MIKE WILLIAMS
BOARD MEMBER	1.00	X	201	13453	0
SARA POLING
SR VP/COO	40.00		323249	0	72974	X
RENEE RASMUSSEN
SR VP FINANCE/CFO	40.00		268657	0	64646	X
JEFFREY CRANDALL MD
CMO	40.00		0	347301	45455		X
JENNIFER FRIEDLY
DIRECTOR-OR	40.00		151813	0	22947		X
JUDITH RENAAS
CNE	40.00		249410	0	82495		X
JAMES WATERBURY
VP INSTITUTIONAL DEVELOP	40.00		206327	0	35450		X
JAY WILLSHER FR 910
VP REGIONAL OPERATIONS	40.00		143056	70826	75623		X
BILAL KAAKI
PHYSICIAN	40.00		550521	0	29399			X
RUCHIR KHURANA
PHYSICIAN	40.00		352034	0	31956			X
PAUL MCCAUGHEY
PHYSICIAN	40.00		479685	0	34832			X
ERIC OPHEIM
PHYSICIAN	40.00		360913	0	27584			X
PUBLIO ORTIZ
PHYSICIAN	40.00		478249	0	58434			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3960199	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1457795	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1101429	TotalOtherCompensation
Number Individuals GT100 K	71	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
CEDAR VALLEY MEDICAL SPECIALISTS
PO BOX 2758	WATERLOO	IA	50704	MEDICAL SERVICES	6451472
WEATHERBY LOCUMS INC
PO BOX 972633	DALLAS	TX	75397	ER & NEURO DOCTORS	2573057
ARAMARK SERVICEMASTER FACILITY
22506 NETWORK PLACE	CHICAGO	IL	60673	PERSONNEL	2404022
CARDINAL CONSTRUCTION INC
800 WATERLOO BUILDING	WATERLOO	IA	50704	CONSTRUCTION SERVICES	1438779
MAYO COLLABORATIVE SERVICES
PO BOX 9146	MINNEAPOLIS	MN	55480	LBAORATORY SERVICES	1045753

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	118	NumberOfContractorsGT100K
Membership Dues	3661	MembershipDues
Related Organizations	2967454	RelatedOrganizations
Government Grants	1869893	GovernmentGrants
All Other Contributions	1481	AllOtherContributions
Total Contributions	4842489	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	155692711	155692711
PHARMACY REVENUE	446110	52503672	48390600	1305651	$2,807,421
MGMT & SUPPORT SVCS	561000	1795808	1229840	12360	$553,608
RENTAL REVENUE	531100	1609375	1606655	2720
CHILDCARE SERVICES	624410	239823			$239,823

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-183454	TotalRevenueColumn
Related Or Exempt Function Income	-197422	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	11652	UnrelatedBusinessRevenue
Exclusion	$2,316	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	211657935	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	528368	TotalRevenueColumn
Exclusion	$528,368	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	7573	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	947	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	6626	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	6626	TotalRevenueColumn
Exclusion	$6,626	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	52353941	Securities
Other	129601	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	46564121	Securities
Other	210545	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	5789820	Securities
Other	-80944	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	5708876	TotalRevenueColumn
Exclusion	$5,708,876	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	71519	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	53184	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	18335	TotalRevenueColumn
Exclusion	$18,335	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	236269	GrossSalesOfInventory
Cost Of Goods Sold	167038	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	69231	TotalRevenueColumn
Exclusion	$69,231	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA/FOOD SVCS	722210	1105300	$1,105,300
MISCELLANEOUS REVENUE	900099	781005		781005
MGMT & SUPPORT SVCS	561000	66627	$66,627

Field	Value	IRS element (for citing)
Total Other Revenue	1952932	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	224784792	TotalRevenueColumn
Related Or Exempt Function Income	207503389	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1332383	UnrelatedBusinessRevenue
Exclusion	$11,106,531	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	4653403	Total
Program Services	4653403	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	10400	Total
Program Services	10400	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2480284	Total
Management And General	2480284	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	72852685	Total
Program Services	61920011	ProgramServices
Management And General	10932674	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2575134	Total
Program Services	2188695	ProgramServices
Management And General	386439	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9562072	Total
Program Services	8127135	ProgramServices
Management And General	1434937	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	5496849	Total
Program Services	4671961	ProgramServices
Management And General	824888	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	3426188	Total
Program Services	24799	ProgramServices
Management And General	3401389	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	331705	Total
Management And General	331705	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	354834	Total
Management And General	354834	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	19884035	Total
Program Services	12329447	ProgramServices
Management And General	7554588	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	455642	Total
Program Services	76038	ProgramServices
Management And General	379604	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	51722328	Total
Program Services	48569313	ProgramServices
Management And General	3153015	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	9410078	Total
Program Services	8164380	ProgramServices
Management And General	1245698	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2851654	Total
Program Services	555429	ProgramServices
Management And General	2296225	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	725581	Total
Program Services	403887	ProgramServices
Management And General	321694	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	160014	Total
Program Services	69799	ProgramServices
Management And General	90215	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	3439332	Total
Management And General	3439332	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	12554415	Total
Program Services	5157333	ProgramServices
Management And General	7397082	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	-549930	Total
Management And General	-549930	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
PATIENT BAD DEBT	6333435	6333435
MISCELLANEOUS EXPENSES	589496	19560	569936
INCOME TAXES	12800		12800

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	209332434	Total
Program Services	163275025	ProgramServices
Management And General	46057409	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3499	BOY
EOY	3748	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	22459836	BOY
EOY	19296085	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	128467	BOY
EOY	420605	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	21451653	BOY
EOY	22046453	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	4378868	BOY
EOY	4810917	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	5354753	BOY
EOY	6071709	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	500172	BOY
EOY	691855	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	206145829	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	103811773	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	108811948	BOY
EOY	102334056	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	57680492	BOY
EOY	71269803	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	242368	BOY
EOY	172362	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	5856154	BOY
EOY	6000763	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	686402	BOY
EOY	3799152	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	227554612	BOY
EOY	236917508	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	17747034	BOY
EOY	16345685	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	16697	BOY
EOY	22729	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	74826	BOY
EOY	45448	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	6225367	BOY
EOY	5416895	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	89991321	BOY
EOY	85147512	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	114055245	BOY
EOY	106978269	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	107732592	BOY
EOY	123972242	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4112821	BOY
EOY	4150372	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1653954	BOY
EOY	1816625	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	113499367	BOY
EOY	129939239	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	227554612	BOY
EOY	236917508	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	15452358	ReconcilationRevenueExpenses
Reconcilation Other Changes	987514	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 D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	62282606	BeginningOfYearBalance
Contributions	6212189	Contributions
Investment Earnings Or Losses	8740976	InvestmentEarningsOrLosses
Other Expenditures	1180548	OtherExpenditures
Administrative Expenses	278375	AdministrativeExpenses
End Of Year Balance	75776848	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	42620642	BeginningOfYearBalance
Contributions	10459126	Contributions
Investment Earnings Or Losses	10425170	InvestmentEarningsOrLosses
Other Expenditures	1016429	OtherExpenditures
Administrative Expenses	205903	AdministrativeExpenses
End Of Year Balance	62282606	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	59647961	BeginningOfYearBalance
Contributions	2042078	Contributions
Investment Earnings Or Losses	-12929473	InvestmentEarningsOrLosses
Grants Or Scholarships	6014219	GrantsOrScholarships
Administrative Expenses	125705	AdministrativeExpenses
End Of Year Balance	42620642	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.92130	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.02400	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.05470	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	645250	OtherCostOrOtherBasis
Book Value	645250	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	2081053	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	135837726	OtherCostOrOtherBasis
Depreciation	60867955	Depreciation
Book Value	77050824	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	391401	OtherCostOrOtherBasis
Depreciation	141519	Depreciation
Book Value	249882	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	61040460	OtherCostOrOtherBasis
Depreciation	38870390	Depreciation
Book Value	22170070	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6149939	OtherCostOrOtherBasis
Depreciation	3931909	Depreciation
Book Value	2218030	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	102334056	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescription	AmountAmount
ASBESTOS REMOVAL LIABILITY	$4,186,413
DUE TO AFFILIATES	$4,829,848
LONG-TERM RETENTION INCENTIVES	$1,304,796
MISCELLANEOUS LIABILITY	$75,000
IOWA HEALTH SYSTEM NOTE PAYABLE	$66,980,000
SELF-INSURANCE RESERVE	$4,559,807
DEFINED BENEFIT RETIREMENT PLAN LIABILITY	$3,211,648

Field	Value	IRS element (for citing)
Total Of Amounts	85147512	TotalOfAmounts
Total Revenue	224784792	TotalRevenue
Total Expenses	209332434	TotalExpenses
Excess Or Deficit For Year	15452358	ExcessOrDeficitForYear
Net Unrealized GL On Investments	2943916	NetUnrealizedGLOnInvestments
Other	-$1,956,402	OtherAmount
Total Adjustments	987514	TotalAdjustments
Excess Or Deficit Per FS	16439872	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	225049000	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	2781245	NetUnrealizedGainsInvestments
Other Revenues	168576	OtherRevenues
Revenue Not Rptd F990	2949821	RevenueNotRptdF990
Revenue Subtotal	222099179	RevenueSubtotal
Investment Expenses Not Included	278375	InvestmentExpensesNotIncluded
Other Revenues Not Included	2407238	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	2685613	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	224784792	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	202181000	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	167985	OtherExpensesIncluded
Expenses Not Rptd F990	167985	ExpensesNotRptdF990
Expenses Subtotal	202013015	ExpensesSubtotal
Investment Expenses Not Included2	278375	InvestmentExpensesNotIncluded2
Other Expenses Not Included	7041044	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	7319419	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	209332434	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 2007. 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-MEMORIAL FOUNDATION OF ALLEN HOSPITAL 30,310. CHANGES IN PENSION LIABILITY -1,986,712.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		COST OF GOODS SOLD 167,038. RENTAL EXPENSES REPORTED AS OFFSET TO RENTAL INCOME 947. ROUNDING 591.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		REVENUES IN UNRESTRICTED FUND BALANCE 1,092,265. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 7,241. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 1,307,732.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		COST OF GOODS SOLD 167,038. RENTAL EXPENSES REPORTED AS OFFSET TO RENTAL INCOME 947.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		EXPENSES IN UNRESTRICTED FUND BALANCE 5,731,758. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 1,307,732. ROUNDING 1,554.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SCRUB/CHOC/ART/BAKE SALES	NameOfEvent1
Gross Receipts Event1	55340	GrossReceiptsEvent1
Gross Revenue Event1	55340	GrossRevenueEvent1
Other Direct Expenses Event1	40518	OtherDirectExpensesEvent1
Name Of Event2	BOOK FAIRS	NameOfEvent2
Gross Receipts Event2	14913	GrossReceiptsEvent2
Gross Revenue Event2	14913	GrossRevenueEvent2
Other Direct Expenses Event2	12666	OtherDirectExpensesEvent2
Total Number Of Other Events	9	TotalNumberOfOtherEvents
Gross Receipts Other Events	1266	GrossReceiptsOtherEvents
Gross Revenue Other Events	1266	GrossRevenueOtherEvents
Other Direct Expenses Other Events	0	OtherDirectExpensesOtherEvents
Gross Receipts Total	71519	GrossReceiptsTotal
Gross Revenue Total Events	71519	GrossRevenueTotalEvents
Other Direct Expenses Total Events	53184	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	53184	DirectExpenseSummaryEvents
Net Income Summary	18335	NetIncomeSummary

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

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	1000.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
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	2066	PersonsServed
Total Community Benefit Expense	4827729	TotalCommunityBenefitExpense
Net Community Benefit Expense	4827729	NetCommunityBenefitExpense
Percent Of Total Expense	0.02380	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	8401	PersonsServed
Total Community Benefit Expense	17273999	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13134916	DirectOffsettingRevenue
Net Community Benefit Expense	4139083	NetCommunityBenefitExpense
Percent Of Total Expense	0.02040	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	10467	PersonsServed
Total Community Benefit Expense	22101728	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13134916	DirectOffsettingRevenue
Net Community Benefit Expense	8966812	NetCommunityBenefitExpense
Percent Of Total Expense	0.04420	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	24	NumberOfActivitiesOrPrograms
Persons Served	27610	PersonsServed
Total Community Benefit Expense	2405787	TotalCommunityBenefitExpense
Direct Offsetting Revenue	80182	DirectOffsettingRevenue
Net Community Benefit Expense	2325605	NetCommunityBenefitExpense
Percent Of Total Expense	0.01150	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	598	PersonsServed
Total Community Benefit Expense	225681	TotalCommunityBenefitExpense
Net Community Benefit Expense	225681	NetCommunityBenefitExpense
Percent Of Total Expense	0.00110	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	686	PersonsServed
Total Community Benefit Expense	829540	TotalCommunityBenefitExpense
Net Community Benefit Expense	829540	NetCommunityBenefitExpense
Percent Of Total Expense	0.00410	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	10	NumberOfActivitiesOrPrograms
Persons Served	185	PersonsServed
Total Community Benefit Expense	4022815	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1271090	DirectOffsettingRevenue
Net Community Benefit Expense	2751725	NetCommunityBenefitExpense
Percent Of Total Expense	0.01360	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	39	NumberOfActivitiesOrPrograms
Persons Served	29079	PersonsServed
Total Community Benefit Expense	7483823	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1351272	DirectOffsettingRevenue
Net Community Benefit Expense	6132551	NetCommunityBenefitExpense
Percent Of Total Expense	0.03030	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	39	NumberOfActivitiesOrPrograms
Persons Served	39546	PersonsServed
Total Community Benefit Expense	29585551	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14486188	DirectOffsettingRevenue
Net Community Benefit Expense	15099363	NetCommunityBenefitExpense
Percent Of Total Expense	0.07450	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	242	PersonsServed
Total Community Building Expense	44880	TotalCommunityBuildingExpense
Net Community Building Expense	44880	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	30	PersonsServed
Total Community Building Expense	618082	TotalCommunityBuildingExpense
Net Community Building Expense	618082	NetCommunityBuildingExpense
Percent Of Total Expense	0.00300	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	125	PersonsServed
Total Community Building Expense	14472	TotalCommunityBuildingExpense
Net Community Building Expense	14472	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	11	NumberOfActivitiesOrPrograms
Persons Served	397	PersonsServed
Total Community Building Expense	677434	TotalCommunityBuildingExpense
Net Community Building Expense	677434	NetCommunityBuildingExpense
Percent Of Total Expense	0.00330	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$2,582,958	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	67841861	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	63867073	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	3974788	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 (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership
1 NORTHEAST IOWA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
ATHLETIC TRAINING, ATHLETIC ENHANCEMENT AND SPORTS MEDICINE SERVICES	0.50000	0.50000
2 CEDAR VALLEY COMMUNITY HEALTHCARE LLC
PROVIDE HEALTH INSURANCE FOR INDIVIDUALS AND SMALL BUSINESSES	0.05880	0.46870	0.03130

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1825 LOGAN AVENUE	AddressLine1
City	WATERLOO	City
State	IA	State
ZIP Code	50703	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN MEMORIAL HOSPITAL CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	15	NumberOfOtherFacilities

Other Facilities OtherFacilities (15 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
ALLEN DIGESTIVE DISEASE CENTER-TWR PARK
125 EAST TOWER PARK DRIVE	WATERLOO	IA	50701	OUTPATIENT ONLY - DIGESTIVE DISEASE CENTER
ALLEN WOMEN'S HEALTH CENTER
233 VOLD STREET	WATERLOO	IA	50703	OUTPATIENT ONLY - WOMEN'S HEALTH CENTER
ALLEN WOMEN'S HEALTH CENTER
1824 W 8TH STREET	CEDAR FALLS	IA	50613	OUTPATIENT ONLY - WOMEN'S HEALTH CENTER
PMP OCCUPATIONAL HEALTH
4612 PRAIRIE PARKWAY SUITE 102	CEDAR FALLS	IA	50613	OUTPATIENT ONLY - OCCUPATIONAL HEALTH
ALLEN WOMEN'S HEALTH CENTER
91 E BREMER AVENUE	WAVERLY	IA	50677	OUTPATIENT ONLY - WOMEN'S HEALTH CENTER
ALLEN WOMEN'S HEALTH CENTER
3316 CEDAR HEIGHTS DRIVE	CEDAR FALLS	IA	50613	OUTPATIENT ONLY - WOMEN'S HEALTH CENTER
ALLEN WOMEN'S HEALTH CENTER
1600 1ST STREET E	INDEPENDENCE	IA	50644	OUTPATIENT ONLY - WOMEN'S HEALTH CENTER
BREAST BIOPSY SERVICES LC
4250 GLASS ROAD NE	CEDAR RAPIDS	IA	52402	PROVIDE BREAST BIOPSY SERVICES
CEDAR VALLEY COMMUNITY HEALTHCARE LLC
999 HOME PLAZA SUITE 210B	WATERLOO	IA	50701	REGIONAL HEALTH INSURANCE POOL
DIGITAL MAMOGRAPHY IMAGING SERVICES LLC
4250 GLASS ROAD NE SUITE 200	CEDAR RAPIDS	IA	52402	DIGITAL MAMOGRAPHY IMAGING
HEALTH ENTERPRISES VENTURES LC
4250 GLASS ROAD NE	CEDAR RAPIDS	IA	52402	INVESTMENT VEHICLE OWNING PARTS OF EACH OF THE CLINICAL JOINT VENTURES
MRIOWA LC
4250 GLASS ROAD NE	CEDAR RAPIDS	IA	52402	PROVIDE MOBILE MRI SERVICE
NE IA PHYSICAL THERAPY AND SPORTS MED
1825 LOGAN AVENUE	WATERLOO	IA	50703	ATHLETIC TRAINING AND SPORTS MEDICINE
HEALTH ENTERPRISES OF IOWA
4250 GLASS ROAD NE SUITE 200	CEDAR RAPIDS	IA	52402	MANAGEMENT COMPANY
HEALTHNET CONNECT LC
1200 PLEASANT STREET	DES MOINES	IA	50309	NETWORK ACCESS CONNECTIONS

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: ALLEN MEMORIAL HOSPITAL, INC'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 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6333435.
PART II: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE HOSPITAL 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 AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH.
PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR ALLEN MEMORIAL 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.
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.
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 SURPLUS OF $949,269. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE OF $198,511 AND REVENUE OF $81,116. AFTER TAKING THESE ITEMS INTO ACCOUNT WE CALCULATE AN ACTUAL MEDICARE SURPLUS OF $831,874.	MEDICARE SURPLUS	PART III, LINE 8C
PART VI, LINE 2: ALLEN MEMORIAL HOSPITAL CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN NORTHEAST IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, ALLEN MEMORIAL HOSPITAL IS A SPONSORING PARTNER OF THE COMMUNITY ADVISORY BOARD, A COMMUNITY COLLABORATIVE CONVENED BY ALLEN MEMORIAL HOSPITAL TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF BLACK HAWK COUNTY. THROUGH A PLANNED AND ORGANIZED EFFORT, THE COMMUNITY ADVISORY BOARD DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. THE COMMUNITY ADVISORY BOARD WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. ALLEN MEMORIAL HOSPITAL, AS A SPONSORING AGENCY, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITES THAT MATCH ITS MISSION AND CAPACITY. ALLEN MEMORIAL HOSPITAL IS ALSO A SPONSORING PARTNER IN TOGETHER FOR YOUTH. THIS COLLABORATIVE HAS COMPLETED A RECENT COUNTY-WIDE HEALTH ASSESSMENT. FROM THIS, PRIORITIES AND STRATEGIES HAVE BEEN IDENTIFIED. ALLEN MEMORIAL HOSPITAL HAS ACTIVELY ENGAGED IN ADDRESSING AND MONITORING HEALTH ISSUES AND NEEDS AS A RESULT OF THIS PROCESS. ALLEN MEMORIAL HOSPITAL ALSO PARTICIPATES AS PART OF THE UNITED WAY OF THE CEDAR VALEY. 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 OPPORTUNITES FOR ALLEN MEMORIAL HOSPITAL TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, ALLEN MEMORIAL HOSPITAL CONTINUALLY MONITORS COMMUNTIY 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: ALLEN MEMORIAL HOSPITAL PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABLITY 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 THAT THE PROVIDER/PHYSICIAN PRACTICE OFFERS CHARITY CARE AND DESCRIBES HOW TO OBTAIN MORE INFORMATION ABOUT FINANCIAL ASSISTANCE, 2) PLACES A NOTE ON THE HEALTH-CARE BILL AND STATEMENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASISTANCE, 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 AND, 5) POSTS CHARITY CARE AND PATIENT-DISCOUNT INFORMATION ON THE HOSPITAL WEB SITE'S HOME PAGE AT WWW.ALLENHOSPITAL.ORG UNDER FINANCE.
PART VI, LINE 4: ALLEN MEMORIAL HOSPITAL IS A 204-BED COMMUNITY HOSPITAL SERVING BLACKHAWK COUNTY. ALLEN MEMORIAL HOSPITAL, INC. IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF ALLEN MEMORIAL HOSPITAL, INC'S MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF BLACK HAWK, BREMER, BUCHANAN AND BUTLER. ALLEN MEMORIAL HOSPITAL, INC. ADMITS APPROXIMATELY 11,548 INPATIENTS AND CARES FOR 31,280 EMERGENCY PATIENTS PER YEAR. THERE ARE FIVE OTHER HOSPITALS WITHIN THE FOUR-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $51,366 TO $35,883 AND THE AVERAGE POVERTY RATE IS 7.4%. 60% OF ALLEN MEMORIAL HOSPITAL INC'S INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. BLACK HAWK COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 88% CAUCASIAN AMERICAN AND BOSNIAN, 8% AFRICAN-AMERICAN, 2% HISPANIC AND 2% ALL OTHER MINORITY POPULATIONS.
PART VI, LINE 6: 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 7: 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 25 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 140 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND WESTERN ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH NEARLY 20,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 2.5 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2.3 BILLION, IOWA HEALTH SYSTEM IS THE SIXTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. IOWA HEALTH SYSTEM AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2010, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED MORE THAN $152 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 (7 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
ALLEN HEALTH SYSTEMS INC
1825 LOGAN AVENUE	WATERLOO	IA	50703	421201924	501(C)(3)	7731	PROGRAM SUPPORT
AMERICAN HEART ASSOCIATION
460 N LINDBERGH BLVD	ST LOUIS	MO	63141	135613797	501(C)(3)	40000	PROGRAM SUPPORT
COMMUNITY MEMORIAL HOSPITAL
PO BOX 148	SUMNER	IA	50674	420670596	501(C)(3)	100000	PROGRAM SUPPORT
FINLEY HEALTH FOUNDATION INC
350 N GRANDVIEW AVE	DUBUQUE	IA	52001	421286953	501(C)(3)	355926	PROGRAM SUPPORT
GALLEGHER BLUEDORN UNI
UNIVERSITY OF NORTHERN IA	CEDAR FALLS	IA	50613	426004333	STATE OF IOWA	10839	PROGRAM SUPPORT
IOWA HEALTH SYSTEM
1200 PLEASANT ST	DES MOINES	IA	50309	421435199	501(C)(3)	4089772	PROGRAM SUPPORT
MEMORIAL FOUNDATION OF ALLEN HOSPITAL
1825 LOGAN AVENUE	WATERLOO	IA	50703	421201138	501(C)(3)	5500	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	6	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS	TypeOfGrant
Number Of Recipients	33	NumberOfRecipients
Amount Of Cash Grant	10400	AmountOfCashGrant

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: ALLEN MEMORIAL HOSPITAL CORPORATION MONITORS THE USE OF GRANT FUNDS ACCORDING TO THE STANDARD FINANCIAL POLICIES OF THE ORGANIZATION AND AS REQUIRED BY THE GRANT OR GRANTOR. THE POLICIES AND PROTOCOLS OF THE FUNDING SOURCE ARE ENFORCED AND MONITORED BY THE ORGANIZATION AND REPORTED AS REQUIRED.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	X	TravelForCompanions
Written Policy Re T And E Expenses	1	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 (15 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
RUSSELL ADAMS MD
71	307083	0	2682	0	25	0	55876	0	11712	71	377378	0	0
JOHN KNOX FR 1110
50351	232509	0	102586	26944	72091	169933	12250	9786	7740	257014	427176	0	0
RICHARD SEIDLER TO 610
170601	221612	104871	35000	42130	38790	28204	211047	5352	7734	351158	514183	0	0
SARA POLING
219430	0	45375	0	58444	0	59993	0	12981	0	396223	0	0	0
RENEE RASMUSSEN
201314	0	45569	0	21774	0	42193	0	22453	0	333303	0	0	0
JEFFREY CRANDALL MD
0	286354	0	59772	0	1175	0	31944	0	13511	0	392756	0	0
JENNIFER FRIEDLY
119927	0	0	0	31886	0	3750	0	19197	0	174760	0	0	0
JUDITH RENAAS
188863	0	39729	0	20818	0	76247	0	6248	0	331905	0	0	0
JAMES WATERBURY
152930	0	32539	0	20858	0	17859	0	17591	0	241777	0	0	0
JAY WILLSHER FR 910
80690	58301	32127	0	30239	12525	5235	45641	18102	6645	166393	123112	0	0
BILAL KAAKI
548351	0	0	0	2170	0	19267	0	10132	0	579920	0	0	0
RUCHIR KHURANA
316539	0	0	0	35495	0	9862	0	22094	0	383990	0	0	0
PAUL MCCAUGHEY
464595	0	0	0	15090	0	9803	0	25029	0	514517	0	0	0
ERIC OPHEIM
310403	0	0	0	50510	0	8555	0	19029	0	388497	0	0	0
PUBLIO ORTIZ
477799	0	0	0	450	0	39595	0	18839	0	536683	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS.
PART I, LINE 4B	THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: RUSSELL ADAMS $24,864, BILAL KAAKI $9,278, JOHN KNOX $169,933, SARA POLING $50,005, RENEE RASMUSSEN $26,537, JUDITH RENAAS $38,675, RICHARD SEIDLER $199,241, JAMES WATERBURY $10,211 AND JAY WILLSHER $41,995.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
CARDINAL CONSTRUCTION
COMMON BOARD MEMBER/OFFICER	1439000	CONSTRUCTION SERVICES	0
CEDAR VALLEY COMMUNITY HEALTHCARE LLC
COMMON BOARD MEMBER/OFFICER	44000	INVESTMENT	0
CEDAR VALLEY MEDICAL SPECIALISTS PC
COMMON BOARD MEMBER/SHAREHOLDER	3667000	RENT, MEDICAL SERVICES, LAUNDRY, PHONE, ETC.	0
KIRK GROSS COMPANY
COMMON BOARD MEMBER/OFFICER	287000	FURNITURE AND DESIGN SERVICES	0
NINA THOMAS
FAMILY MEMBER OF BOARD MEMBER BEV SMITH	40404	EMPLOYMENT	0
NORTHEAST IOWA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
COMMON BOARD MEMBER/OFFICER	28000	INVESTMENT	0
PROFESSIONAL OFFICE SERVICES INC
COMMON BOARD MEMBER/OFFICER	120000	SUPPLIES AND FORMS	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2	GENE LEONHART; DAVE HAPPEL; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	ALLEN HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGER, AND APPOINT BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE WILL BE THE SAME AS ALLEN HEALTH SYSTEMS, INC.
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.
	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 12C
	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 2010 FOR THE FOLLOWING INDIVIDUALS: JOHN KNOX, RENEE RASMUSSEN, SARA POLING, JUDITH RENAAS, JAMES WATERBURY 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 B, LINE 15
	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 VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:	NET UNREALIZED GAINS ON INVESTMENTS: 2,943,916. CHANGE IN BENEFICIAL INTEREST-MEMORIAL FOUNDATION OF ALLEN HOSPITAL 30,310. CHANGES IN PENSION LIABILITY -1,986,712. TOTAL TO FORM 990, PART XI, LINE 5: 987,514.	FORM 990, PART XI, LINE 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (41 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 HEALTH FOUNDATION INC
350 NORTH GRANDVIEW AVENUE	DUBUQUE	IA	52001	421286953	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	THE FINLEY HOSPITAL AND THE DUBUQUE VISITING NURSE ASSOCIATION	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
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
1440 INGERSOLL AVENUE	DES MOINES	IA	50309	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 LUTHERAN HOSPITAL AUXILIARY
1440 INGERSOLL AVENUE	DES MOINES	IA	50309	426059539	SUPPORT IOWA LUTHERAN HOSPITAL MISSION TO IMPROVE HEALTHCARE	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
JONES REGIONAL MEDICAL CENTER FOUNDATION
104 BROADWAY PLACE	ANAMOSA	IA	52205	421429225	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ST LUKE'SJONES REGIONAL MEDICAL CENTER	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
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
ST LUKE'S HEALTH CARE FOUNDATION
855 A AVENUE NE STE 105	CEDAR RAPIDS	IA	52402	421106819	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ST LUKE'S METHODIST HOSPITAL (50 BENEFICIAL INTEREST)	1
ST LUKE'S HEALTH FOUNDATION OF SIOUX CITY IOWA
2720 STONE PARK BLVD	SIOUX CITY	IA	51104	421301885	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	NORTHWEST IOWA HOSPITAL CORPORATION (50 BENEFICIAL INTEREST)	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
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
TRINITY VISITING NURSE & HOMECARE ASSOCIATION
2701 17TH STREET	ROCK ISLAND	IL	61201	363052939	HOME HEALTH CARE	IL	501(C)(3)	509(A)(2)	TRINITY REGIONAL HEALTH SYSTEM	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 (25 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	177822	12340369	0	1	0.33330
CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC
1200 PLEASANT STREET	DES MOINES	IA	50309	273625869	CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES	IA	N/A	RELATED	80551	66239	0	1	0.20000
DES MOINES PARKING ASSOCIATES
1200 PLEASANT STREET	DES MOINES	IA	50309	382622972	PARKING DECK OPERATIONS	IA		RELATED	267486	3933296	0	1	1.00000	CENTRAL IOWA HEALTH PROPERTIES CORPORATION
DUBUQUE ENDOSCOPY CENTER LC
1515 DELHI STREET SUITE 500	DUBUQUE	IA	52001	201597161	AMBULATORY SURGERY CENTER	IA		RELATED	671118	126090	0	1	0.51000	THE FINLEY HOSPITAL
FINLEYHARTIG HOMECARE LLC
703 MAIN ST	DUBUQUE	IA	52001	421487138	SALE/RENTAL OF MEDICAL EQUIPMENT	IA	N/A	RELATED	172294	783074	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 PARTS OF EACH OF THE CLINICAL JOINT VENTURES	IA	N/A	UNRELATED	-15790	775135	0	0	0.55660		$59,802
HY-VEEIOWA HEALTH LC
5820 WESTOWN PARKWAY	WEST DES MOINES	IA	50266	263293530	PRIMARY CARE CLINIC	IA	N/A	RELATED	-172539	31249	0	1	0.00000
IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	030482623	OUTPATIENT DIAGNOSTIC IMAGING	IA	N/A	RELATED	1746221	3109901	0	1	0.50000
IOWA HEALTH SYSTEM CONTRACTING SERVICES LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421511142	GROUP PURCHASING	IA	N/A	RELATED	5755039	8927942	1	1	1.00000
LAKEVIEW SURGERY CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421516120	SURGERY CENTER	IA	N/A	RELATED	3292459	5440740	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	420861	977532	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	701249	1694638	0	1	0.33970
MR ASSOCIATES LLP
1455 SHERMAN ROAD	HIAWATHA	IA	52233	421260463	OWN AND OPERATE MR UNIT	IA	N/A	RELATED	2823501	2022295	0	1	0.33330
NORTHEAST IOWA PHYSICAL THERAPY AND SPORTS MEDICINE LLC
1825 LOGAN AVENUE	WATERLOO	IA	50703	202124978	ATHLETIC TRAINING AND SPORTS MEDICINE	IA	N/A	RELATED	-91474	28104	0	1	0.50000
ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC
1200 PLEASANT STREET	DES MOINES	IA	50309	421508092	AMBULATORY SURGERY CENTER	IA	N/A	RELATED	2578454	3587597	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	1357604	3410402	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	323527	3373129	0	1	0.50000
TEAM DES MOINES PARTNERS LLC
1205 TECHNOLOGY PARKWAY	CEDAR FALLS	IA	50613	262753371	COMPUTER SUPPORT	IA	N/A	UNRELATED			0	1	0.00000
THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC
1075 FIRST AVENUE SE	CEDAR RAPIDS	IA	52403	721550812	AMBULATORY SURGERY CENTER.	IA	N/A	RELATED	3374710	7172047	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	20893	128254	0	1	0.50000
TRI-WEBSTER LC
1610 COLLINS ST	WEBSTER CITY	IA	50595	010740062	MEDICAL BUILDING AND SURROUNDING PROPERTY	IA	N/A	RELATED	113048	1782267	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	204040	4258	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	67986	198717	0	1	0.50000		$65,291
WEST LAKES SLEEP CENTER LLC
5950 UNIVERSITY AVENUE SUITE 2	WEST DES MOINES	IA	50266	263193923	SLEEP DISORDER CENTER AS INDEPENDENT DIAGNOSTIC TESTING FACILITY	IA	N/A	RELATED	23024	355798	0	1	0.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 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	Percentage OwnershipPercentageOwnership	Share Of EOY AssetsShareOfEOYAssets
BROADBAND INC
1200 PLEASANT ST	DES MOINES	IA	50309	273819741	INFORMATION TECHNOLOGY MGMT.	IA	IHS	C	62920	1.00000
MEDIMORE INC
1200 PLEASANT ST	DES MOINES	IA	50309	421414390	MANAGED CARE	IA	IHS	C	155826	1.00000
PRECEDENCE INC
4622 PROGRESS DRIVE STE A	DAVENPORT	IA	52807	371288604	MANAGED MENTAL CARE	IA	RYC	C	535068	1.00000	395659
RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC
700 E UNIVERSITY AVE	DES MOINES	IA	50316	261271143	SPECIALTY PHYSICIANS MEDICAL CARE	IA	CIHC	C	406868	0.57100	164732
ST LUKE'S DEVELOPMENT COMPANY
1026 A AVE NE	CEDAR RAPIDS	IA	52402	421353658	LESSOR NONRESIDENTIAL REAL ESTATE	IA	SLHCF	C		1.00000
STL HEALTH RESOURCES CO
1026 A AVE NE	CEDAR RAPIDS	IA	52402	421193499	PHYSICIAN OFFICE RENTAL	IA	SLMH	C	1075846	1.00000	6293579
TRIMARK PHYSICIANS GROUP INC
802 KENYON ROAD	FORT DODGE	IA	50501	421335554	MEDICAL CLINICS	IA	THS	C	43433525	1.00000	17778844
TRINITY HEALTH ENTERPRISES INC
2701 17TH ST	ROCK ISLAND	IL	61201	363320141	RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY	IL	TRHS	C	3554376	1.00000	3394181

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	0	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	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

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