2023-11-14T15:07:23-06:00 2022-12-31 990 2022-01-01 237098688 MERITER FOUNDATION INC MERI 6084175800 202 SOUTH PARK STREET MADISON WI 537151596 BETH ERDMAN CFO 6084175800 2023-11-09 BETH ERDMAN 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z REBECCA DOPART 202 SOUTH PARK STREET MADISON WI 537151596 8475446 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1970 WI RAISE, INVEST, GRANT AND STEWARD GIFTS ON BEHALF OF MERITER HOSPITAL, INC. 21 16 8 27 0 0 1176961 3391312 873221 873221 2789125 1419947 0 -400 4839307 5684080 487357 679440 0 0 645815 901872 0 0 705783 418394 959736 1551566 2541048 3287741 3143032 29708195 29127476 1195651 2242266 28512544 26885210 MERITER FOUNDATION EXISTS TO RAISE AND MANAGE GIFTS IN SUPPORT OF THE PROGRAMS AND SERVICES THAT ADVANCE THE MISSION OF MERITER HOSPITAL, INC. 0 0 933922 679440 873221 MERITER FOUNDATION, INC. IS A NOT-FOR-PROFIT 501 (C)(3) CHARITABLE ORGANIZATION THAT RAISES, INVESTS, GRANTS AND STEWARDS GIFTS ON BEHALF OF MERITER HOSPITAL, INC. THOUSANDS OF INDIVIDUALS AND ORGANIZATIONS HAVE OFFERED CHARITABLE GIVING SUPPORT THAT HAS HELPED ADVANCE MERITER'S COMMITMENT TO THE HEALTHCARE NEEDS OF OUR COMMUNITY. SUCH GIFTS HAVE A POSITIVE AND POWERFUL IMPACT THAT SPANS GENERATIONS AND EXTENDS BEYOND THE DOORS OF MERITER HOSPITAL, INC. INTO THE HEART OF DANE COUNTY AND BEYOND. PHILANTHROPY PROVIDES A MARGIN OF EXCELLENCE THAT ALLOWS MERITER TO ACCOMPLISH PROJECTS AND IMPLEMENT PROGRAMS THAT MIGHT NOT OTHERWISE BE POSSIBLE. IN ADDITION TO RAISING MONEY FOR PROGRAMS AND CAPITAL PROJECTS, THE FOUNDATION GRANTS FUNDS FROM EXISTING ASSETS TO SELECT RESEARCH AND HEALTH EDUCATION INITIATIVES. 933922 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 8 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X RON SCHROEDER 6084175832 202 SOUTH PARK STREET MADISON WI 537151596 JAMES ARNETT FR 622 PRESIDENT & CEO UPH-MERITER 1.00 49.00 X X 0 475198 91614 BOBBY ADAMOV BOARD MEMBER 1.00 0.00 X 0 0 0 TRICIA BRAUN BOARD MEMBER 1.00 0.00 X 0 0 0 HOLLY CREMER BERKENSTADT BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 SHERRY CASALI CNO UPH-MERITER 1.00 49.00 X 0 369475 53361 DIEGO CAMPOVERDE CISNEROS BOARD MEMBER 1.00 0.00 X 0 0 0 MARY CULLEN BOARD MEMBER 1.00 0.00 X 0 0 0 REBECCA DOPART PRESIDENT, FOUNDATION 50.00 0.00 X X 234045 0 38648 SUE ERICKSON TO 622 PRESIDENT & CEO UPH-MERITER 1.00 49.00 X X 0 770752 152817 GABE JAVIER FR 522 BOARD MEMBER 1.00 0.00 X 0 0 0 JEFFREY LEVY BOARD SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 CHAS MARTIN BOARD MEMBER 1.00 0.00 X 0 0 0 MATT MESSINGER BOARD MEMBER 1.00 0.00 X 0 0 0 TINA NOEL BOARD MEMBER 1.00 0.00 X 0 0 0 KATIE SCHMITT MD BOARD MEMBER 1.00 49.00 X 0 389794 47712 JOHN SIMS BOARD CHAIR 1.00 0.00 X X 0 0 0 TONY SULLIVAN BOARD MEMBER 1.00 0.00 X 0 0 0 ALIA STEVENSON BOARD MEMBER 1.00 0.00 X 0 0 0 MATT VANDERLOO BOARD MEMBER 1.00 0.00 X 0 0 0 PAM WETZEL MD CHIEF MED OFFICER UPH-MERITER 1.00 49.00 X 0 581759 86293 TYLER WHIPPLE TO 722 BOARD MEMBER 1.00 0.00 X 0 0 0 MAI ZONG VUE BOARD MEMBER 1.00 0.00 X 0 0 0 BETH ERDMAN CFO UPH-MERITER 1.00 49.00 X 0 424473 84425 BRIANNA YANKE SR DIRECTOR DEVELOPMENT 45.00 0.00 X 110603 0 9736 ART NIZZA DSW TO 221 FORMER CEO UPH-MERITER 0.00 0.00 X 0 814375 0 344648 3825826 564606 2 1 1 0 0 39266 188194 3163852 3391312 MANAGEMENT FEES-HOSPITAL 561000 873221 873221 873221 1105877 1105877 3105436 2791366 314070 314070 314070 MISCELLANEOUS REVENUE 900099 -400 -400 -400 5684080 873221 0 1419547 672440 672440 7000 7000 272693 204520 68173 499959 218007 708 281244 23136 6531 6144 10461 56831 16041 15093 25697 49253 13903 13080 22270 161629 89980 71649 65 65 49036 355 48681 50701 50701 11526 1147 10379 SHARED SERVICES FEES 517159 517159 MISCELLANEOUS 82543 456 82087 SPECIAL EVENTS 45723 2000 43723 PRINTING & PUBLICATIONS 35394 35394 5960 5960 2541048 933922 901343 705783 200 200 1078302 2434839 401970 1214332 134634 23339 13504 28093089 25441262 29708195 29127476 75495 936740 1120156 1082175 223351 1195651 2242266 X 15554847 12526386 12957697 14358824 28512544 26885210 29708195 29127476 X 3143032 -3968798 -801568 X 0 1 X 1 0 X 2473180 1530021 1144762 1176961 3391312 9716236 2473180 1530021 1144762 1176961 3391312 9716236 2037705 7678531 990541 683524 560664 2481516 1105877 5822122 1185060 1081614 1065106 873221 873221 5078222 20616580 5078222 0.37240 0.37800 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 1,185,060. 2019 AMOUNT: $ 1,081,614. 2020 AMOUNT: $ 1,065,106. 2021 AMOUNT: $ 873,221. 2022 AMOUNT: $ 873,221. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 634336 1738 636074 633336 1000 634336 633336 633336 632336 1000 633336 627836 4500 632336 0.00000 1.00000 0.00000 0 0 0 X PART X, LINE 2: UNITYPOINT HEALTH 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 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 2019. THE 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, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. 1 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 537151596 390806367 501(C)(3) 672440 0 FUNDING HOSPITAL NEEDS 1 0 COMPASSION GRANTS DUE TO COVID-19 4 7000 PART I, LINE 2: GRANT REQUESTORS MUST SUBMIT THEIR REQUEST ON A REQUEST FOR FUNDING FORM. THEY INCLUDE A BRIEF DESCRIPTION OF THE PROJECT, BENEFICIARIES AND MEASURABLE OUTCOMES. THE FORM IS REVIEWED AND SIGNED BY THE DEPARTMENT MANAGER AND VICE PRESIDENT FOR THEIR UNIT TO ASSURE THAT THE REQUEST MEETS HOSPITAL FUNDING PRIORITIES. THE FORM IS THEN REVIEWED AND SIGNED BY THE PRESIDENT OR GRANTS COORDINATOR TO ASSURE THAT IT HONORS DONOR INTENT AS OUTLINED IN THE FUND DESCRIPTION. THE GRANT REQUEST MUST INCLUDE A COPY OF ADEQUATE FINANCIAL DOCUMENTATION, WHICH HAS BEEN APPROPRIATELY COMPLETED AND SIGNED BY THEIR MANAGER. MERITER FOUNDATION ONLY REIMBURSES PREVIOUSLY INCURRED EXPENSES. 1 1 0 0 0 0 0 0 0 SUE ERICKSON TO 622 PRESIDENT & CEO UPH-MERITER 0 582404 0 166447 0 21901 0 130352 0 22465 0 923569 0 0 ART NIZZA DSW TO 221 FORMER CEO UPH-MERITER 0 0 0 0 0 814375 0 0 0 0 0 814375 0 0 PAM WETZEL MD CHIEF MED OFFICER UPH-MERITER 0 437614 0 130301 0 13844 0 65263 0 21030 0 668052 0 0 JAMES ARNETT FR 622 PRESIDENT & CEO UPH-MERITER 0 372084 0 96354 0 6760 0 63164 0 28450 0 566812 0 0 BETH ERDMAN CFO UPH-MERITER 0 320768 0 96043 0 7662 0 51312 0 33113 0 508898 0 0 KATIE SCHMITT MD BOARD MEMBER 0 377575 0 9950 0 2269 0 15250 0 32462 0 437506 0 0 SHERRY CASALI CNO UPH-MERITER 0 277110 0 82149 0 10216 0 40077 0 13284 0 422836 0 0 REBECCA DOPART PRESIDENT, FOUNDATION 205935 0 27820 0 290 0 9603 0 29045 0 272693 0 0 0 PART I, LINES 4A-B SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: ART NIZZA, DSW $814,375 NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: JAMES ARNETT $50,964, SHERRY CASALI $27,878, BETH ERDMAN $39,112, SUSAN ERICKSON $108,417 & PAM WETZEL $53,063. FORM 990, PART VI, SECTION A, LINE 6 MERITER HEALTH SERVICES, INC., A TAX-EXEMPT, WISCONSIN NONSTOCK CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL APPOINT ALL MEMBERS OF THE BOARD, OTHER THAN EX-OFFICIO MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL APPROVE: (A) ADOPTION OF AN ANNUAL BUDGET; (B) SELECTION OF THE CORPORATION'S INDEPENDENT AUDITORS; AND (C) SUCH OTHER POWERS AS THE SOLE MEMBER MAY DESIGNATE FROM TIME TO TIME. AUTHORITY GUIDELINES ALSO DICTATE WHICH ACTIONS REQUIRE APPROVAL OF THE FOUNDATION BOARD AND WHICH ACTIONS REQUIRE APPROVAL OF THE MERITER HEALTH SERVICES, INC. BOARD, AS SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B 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 BOARD MEMBERS SIGN CONFLICT OF INTEREST STATEMENTS WHEN THEY JOIN THE BOARD WITH THE EXPECTATION THEY WILL COMMUNICATE CONFLICTS THAT ARISE. THE PRESIDENT AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS 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 THE TOP 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 REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2022 FOR THE FOLLOWING INDIVIDUALS: JAMES ARNETT, SHERRY CASALI, BETH ERDMAN, SUSAN ERICKSON, & PAMELA WETZEL. 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 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY -56,147. RELEASE OF FUNDS -753,551. NET ASSETS WITHOUT DONOR RESTRICTION RELEASED 8,132. DONOR RESTRICTED CONTRIBUTIONS 3,066,553. ROUNDING -2. NET ASSETS WITH DONOR RESTRICTION RELEASED -3,066,553. FORM 990, LINE J, WEBSITE: WWW.UNITYPOINT.ORG/LOCATIONS/UNITYPOINT-HEALTH---MERITER-HOSPITAL ABBE CENTER FOR COMMUNITY MENTAL HEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421045257 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 ABBEHEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421373123 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'S HEALTHCARE 0 AGING SERVICES INC 740 N 15TH AVE NO A HIAWATHA IA 52233 237085316 SENIOR SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) ABBEHEALTH INC 0 ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS IA 501(C)(3) 170(B)(1) (A)(II) ALLEN HEALTH SYSTEMS INC 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ALLEN HEALTH SYSTEMS INC 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA IA 52205 421466284 PROVIDE AMBULANCE SERVICES IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'SJONES REGIONAL MEDICAL CENTER 0 BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC 3251 WEST NINTH STREET WATERLOO IA 50702 420733463 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 CENTER FOR ALCOHOL AND DRUG SERVICES INC 4869 FOREST GROVE DRIVE BETTENDORF IA 52722 421134273 SUBSTANCE ABUSE SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 0 CENTRAL IOWA HEALTH PROPERTIES CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 421233759 PROPERTY HOLDING COMPANY IA 501(C)(2) CENTRAL IOWA HEALTH SYSTEM 0 CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421189791 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 420680452 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC 1415 WOODLAND AVE SUITE 130 DES MOINES IA 50309 421412497 COORDINATION OF MEDICAL EDUCATION PROGRAMS IA 501(C)(3) 509(A)(3), TYPE III 0 EYERLY-BALL COMMUNITY MENTAL HEALTH SERVICES 945 19TH STREET DES MOINES IA 50314 420942273 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) CENTRAL IOWA HEALTH SYSTEM 0 FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 421307495 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER 3820 HILLSIDE DRIVE CEDAR FALLS IA 50613 421372380 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 420933383 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 GRINNELL REGIONAL MEDICAL CENTER FOUNDATION 210 FOURTH AVENUE GRINNELL IA 50112 421454737 CHARITABLE FUNDRAISING IA 501(C)(3) 509(A)(3), TYPE I GRINNELL REGIONAL MEDICAL CENTER 0 HULT CENTER FOR HEALTHY LIVING INC 5409 N KNOXVILLE AVE PEORIA IL 61614 363510390 HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1) (A)(VI) PROCTOR HOSPITAL 0 HUMAN SERVICE CENTER 600 FAYETTE PO BOX 1346 PEORIA IL 61654 371004882 MENTAL HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(VI) UNITYPOINT HEALTH - UNITYPLACE 0 IOWA HEALTH FOUNDATION 1415 WOODLAND AVE SUITE E-200 DES MOINES IA 50309 421467682 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) CENTRAL IOWA HEALTH SYSTEM 0 IOWA HEALTH SYSTEM 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421435199 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III 0 IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421411630 PRIMARY HEALTH CARE SERVICES IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO IA 50703 421201138 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 MERITER FOUNDATION INC 202 SOUTH PARK STREET MADISON WI 53715 237098688 CHARITABLE FUNDRAISING WI 501(C)(3) 170(B)(1) (A)(VI) MERITER HEALTH SERVICES INC 0 MERITER HEALTH SERVICES INC 202 SOUTH PARK STREET MADISON WI 53715 391412318 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE WI 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 390806367 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) MERITER HEALTH SERVICES INC 0 METHODIST HEALTH SERVICES CORPORATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111135 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 METHODIST MEDICAL CENTER FOUNDATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 510186460 CHARITABLE FUNDRAISING IL 501(C)(3) 170(B)(1) (A)(VI) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 370661223 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST SERVICES INC 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111134 OFFICE RENTAL IL 501(C)(3) 509(A)(2) METHODIST HEALTH SERVICES CORPORATION 0 NELLIE R SHERWOOD TRUST 1026 A AVENUE NE CEDAR RAPIDS IA 52402 426061621 PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY IA 501(C)(3) 509(A)(3), TYPE I ST LUKE'S METHODIST HOSPITAL 0 NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED 720 KENYON DRIVE FORT DODGE IA 50501 420937390 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(III) TRINITY HEALTH SYSTEMS INC 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTH SYSTEM INC 0 PARK COURT LIMITED 600 SOUTH 13TH STREET PEKIN IL 61554 371178386 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 509(A)(3), TYPE II METHODIST HEALTH SERVICES CORPORATION 0 PEKIN MEMORIAL HOSPITAL 600 SOUTH 13TH STREET PEKIN IL 61554 370692351 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 PRAIRIE VIEW VILLAS NO 1 1900 SPRING ROAD STE 300 OAK BROOK IL 60523 261755679 MENTAL HEALTH AND/OR DISABILITY RESIDENTIAL TREATMENT SERVICES IL 501(C)(3) 170(B)(1) (A)(VI) TAZWOOD MENTAL HEALTH CENTER INC 0 PROCTOR HEALTH SYSTEMS 5409 N KNOXVILLE AVE PEORIA IL 61614 364147437 PRIMARY HEALTH CARE SERVICES IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 PROCTOR HOSPITAL 5409 N KNOXVILLE AVE PEORIA IL 61614 370681540 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 376181831 FUND SELF-INSURANCE PLAN IL 501(C)(3) 509(A)(3), TYPE I METHODIST MEDICAL CENTER OF ILLINOIS 0 SIOUXLAND PACE INC 1200 TRI VIEW AVE SIOUX CITY IA 51103 261120134 ALL-INCLUSIVE CARE FOR THE ELDERLY IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTH SYSTEM INC 0 ST LUKE'S HEALTH RESOURCES 2720 STONE PARK BLVD SIOUX CITY IA 51104 421059182 OUTPATIENT CLINICS AND HEALTHCARE SERVICES IA 501(C)(3) 509(A)(2) ST LUKE'S HEALTH SYSTEM INC 0 ST LUKE'S HEALTH SYSTEM INC 2720 STONE PARK BLVD SIOUX CITY IA 51104 421294091 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 ST LUKE'S HEALTHCARE 1026 A AVENUE NE CEDAR RAPIDS IA 52402 421487968 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ST LUKE'S METHODIST HOSPITAL 1026 A AVENUE NE CEDAR RAPIDS IA 52402 420504780 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTHCARE 0 ST LUKE'SJONES REGIONAL MEDICAL CENTER 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 421487967 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTHCARE 0 STL CARE COMPANY 1026 A AVENUE NE CEDAR RAPIDS IA 52402 421276632 IMPROVE PUBLIC HEALTH SERVICES IA 501(C)(3) 509(A)(2) ST LUKE'S HEALTHCARE 0 TAZWOOD MENTAL HEALTH CENTER INC 3248 VANDEVER AVE PEKIN IL 61554 371278969 MENTAL HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(VI) UNITYPOINT HEALTH - 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IA N/A C 0 DELHI POINT CONDO ASSOCIATION 350 N GRANDVIEW DUBUQUE IA 52001 421467002 REAL ESTATE MANAGEMENT IA N/A C 0 HCP CORPORATION 202 SOUTH PARK STREET MADISON WI 53715 391177562 REAL ESTATE RENTAL WI N/A C 0 HANSEN CHARITABLE REMAINDER ANNUITY TRUST 210 FOURTH AVENUE GRINNELL IA 50112 396770806 INVESTMENT IA N/A T 0 HANSEN CHARITABLE REMAINDER UNITRUST 210 FOURTH AVENUE GRINNELL IA 50112 396770807 INVESTMENT IA N/A T 0 HEALTH ADVANTAGE PLUS INC 210 4TH AVENUE GRINNELL IA 50112 421436490 PHYSICAL THERAPY IA N/A C 0 HEALTH PLUS INC 5409 N KNOXVILLE AVE PEORIA IL 61614 371295532 MANAGED CARE ADMINISTRATION IL N/A C 0 HNC SERVICES 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 270987243 FIBER OPTIC NETWORK SERVICES IA N/A C 0 MEDIMORE INC 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421414390 MANAGED CARE IA N/A C 0 MERITER HEALTH ENTERPRISES INC 202 SOUTH PARK STREET MADISON WI 53715 391293620 MANAGEMENT SERVICES WI N/A C 0 MERITER MANAGEMENT SERVICES INC 202 SOUTH PARK STREET MADISON WI 53715 391458235 ADMINISTRATIVE SERVICES WI N/A C 0 METHODIST HEALTH VENTURES INC & SUB PO BOX 87 PEORIA IL 61650 371140939 PHARMACY/OFFICE STAFFING IL N/A C 0 OPTIMUM HEALTH SOLUTIONS INC 221 NORTHEAST GLEN OAK AVE PEORIA IL 61636 205430137 HEALTH & WELLNESS CONSULTING IA N/A C 0 PEKIN PROHEALTH INC 600 SOUTH 13TH STREET PEKIN IL 61554 371117052 CLINIC IL N/A C 0 PRECEDENCE INC 4622 PROGRESS DRIVE STE A DAVENPORT IA 52807 371288604 MANAGED MENTAL CARE IA N/A C 0 PRECEDENCE PLUS INC 4622 PROGRESS DRIVE STE A DAVENPORT IA 52807 364140096 MANAGED MENTAL CARE IA N/A C 0 PROVIDER RESOURCE MANAGEMENT INC PO BOX 87 PEORIA IL 61650 371223550 RESOURCE MANAGEMENT IL N/A C 0 STL HEALTH RESOURCES CO 1026 A AVE NE CEDAR RAPIDS IA 52402 421193499 PHYSICIAN OFFICE RENTAL IA N/A C 0 TRINITY HEALTH ENTERPRISES INC 2701 17TH ST ROCK ISLAND IL 61201 363320141 RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY IL N/A C 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $4.3B IN OPERATING REVENUE AND 27,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 370 CLINICS; 19 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.