2024-11-14T13:26:34-06:00 2023-12-31 990 2023-01-01 426059539 IOWA LUTHERAN HOSPITAL AUXILIARY IOWA 5152635227 1415 WOODLAND AVE E-200 DES MOINES IA 50309 JUDY STARK BOARD CHAIR-ELECT 5152416304 2024-11-09 0 2023 2024-10-15 13:58:12Z JUDY STARK 1415 WOODLAND AVE E-200 DES MOINES IA 50309 481250 0 X SEE SCHEDULE O X 1910 IA TO PROMOTE AND ADVANCE ACTIVITIES BENEFICIAL TO IOWA LUTHERAN HOSPITAL. 17 17 0 292 0 0 12633 11322 0 0 0 0 111620 162977 124253 174299 85505 101614 0 0 0 0 0 0 62 5245 3996 90750 105610 33503 68689 167935 230315 26788 20479 141147 209836 TO PROMOTE AND ADVANCE ACTIVITIES BENEFICIAL TO IOWA LUTHERAN HOSPITAL. 0 0 0 0 0 VOLUNTEER SERVICES AND PATIENT EDUCATIONIN 2023 THE IOWA LUTHERAN HOSPITAL AUXILIARY PROVIDED VOLUNTEER SUPPORT AND EDUCATION TO SERVE PATIENTS, GUESTS AND STAFF OF IOWA LUTHERAN HOSPITAL. THE TOTAL NUMBER OF VOLUNTEER HOURS PROVIDED WAS 22,459 WHICH IS EQUIVALENT TO OVER 10 FULL-TIME EMPLOYEES. VOLUNTEERS PROVIDED AUXILIARY SERVICES THAT INCLUDE, BUT ARE NOT LIMITED TO, GIFT SHOP AND NOT NEW SHOP SUPPORT, TELECARE SUPPORT TO HOMEWARD BOUND CLIENTS, TEDDY BEARS TO ALL CHILDREN UNDERGOING SURGERY, SENIOR HEALTH INSURANCE INFORMATION PROGRAM COUNSELING, ANIMAL ASSISTED THERAPIES, AND EDUCATION THROUGH THE PEDIATRIC ORIENTATION PROGRAM. 101614 101614 0 FINANCIAL SUPPORTTHE IOWA LUTHERAN HOSPITAL AUXILIARY FINANCIALLY STRENGTHENED THE HOSPITAL BY PROVIDING $84,614 FOR CAPITAL AND OPERATIONAL SUPPORT FOR IOWA LUTHERAN HOSPITAL AND ITS PATIENTS. THE IOWA LUTHERAN HOSPITAL AUXILIARY ALSO SUPPORTED EDUCATION BY CONTRIBUTING $17,000 FOR SCHOLARSHIPS. 101614 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X DANIEL LAGRANGE TREASURER 5152416289 1415 WOODLAND AVE SUITE E-200 DES MOINES IA 50309 X JUDY COLDIRON BOARD SECRETARY 1.00 0.00 X X 0 0 0 TERRY DAUGHERTY BOARD MEMBER 1.00 0.00 X 0 0 0 SUE EVANS BOARD MEMBER 1.00 0.00 X 0 0 0 BETTY HYDE BOARD MEMBER 1.00 0.00 X 0 0 0 GAIL KLANDERMAN BOARD MEMBER 1.00 0.00 X 0 0 0 DANIEL LAGRANGE BOARD TREASURER 1.00 0.00 X X 0 0 0 RAY LANGILL BOARD MEMBER 1.00 0.00 X 0 0 0 HARRIET LEWIS BOARD MEMBER 1.00 0.00 X 0 0 0 ROSY NEWBORG BOARD MEMBER 1.00 0.00 X 0 0 0 KATHY MCCONAUGHEY BOARD MEMBER 1.00 0.00 X 0 0 0 FRAN POTTINGER BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 NANCY ROSS BOARD CHAIR (TO 06/23) 1.00 0.00 X X 0 0 0 JUDY STARK BOARD CHAIR-ELECT 1.00 0.00 X X 0 0 0 TERRY SWANSON BOARD MEMBER 1.00 0.00 X 0 0 0 JEAN WATHEM BOARD MEMBER 1.00 0.00 X 0 0 0 MARDEAN WILCOX BOARD MEMBER 1.00 0.00 X 0 0 0 LISA YEH BOARD MEMBER 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 11322 11322 5636 44 5592 5592 464292 306907 157385 157385 174299 0 0 162977 84614 84614 17000 17000 4011 3949 62 MISCELLANEOUS EXPENSES -15 -15 105610 101614 3934 62 138328 205767 4701 0 24906 24548 34409 34409 0 0 167935 230315 -4006 -7431 -556 -556 31350 28466 26788 20479 X 141147 209836 141147 209836 167935 230315 68689 0 X 0 0 0 X 11189 11289 10820 12633 11322 57253 11189 11289 10820 12633 11322 57253 57253 29 29 28671 3493 5424 11337 5636 54561 111843 1941966 0.51190 0.47600 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING MISCELLANEOUS - 2019 AMOUNT: $ 28,671. 2020 AMOUNT: $ 3,493. 2021 AMOUNT: $ 5,424. 2022 AMOUNT: $ 11,337. 2023 AMOUNT: $ 5,636. 34409 34409 0 0 DUE TO AFFILIATES 28466 28466 481250 306951 306951 174299 0 174299 412561 306951 306951 105610 0 105610 PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES NETTED IN REVENUES 306,951. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES NETTED IN REVENUES 306,951. 1 IOWA HEALTH FOUNDATION ON BEHALF OF CENTRAL IOWA HOSPITAL CORPORATION 1415 WOODLAND AVENUE E-200 DES MOINES IA 50309 421467682 501(C)(3) 84614 0 PROGRAM SUPPORT 1 0 SCHOLARSHIPS 9 17000 PART I, LINE 2: THE IOWA LUTHERAN HOSPITAL AUXILIARY GRANTS FUNDS TO CENTRAL IOWA HOSPITAL CORPORATION FOR USE AT IOWA LUTHERAN HOSPITAL AND THEIR AFFILIATES. ALL REQUESTS ARE APPROVED BY THE AUXILIARY BOARD AS WELL AS APPROPRIATE ADMINISTRATION OF CENTRAL IOWA HOSPITAL CORPORATION. GRANTS ARE NOT TRANSFERRED UNTIL EXPENDITURES ARE MADE BY IOWA LUTHERAN HOSPITAL. THE ONLY EXCEPTION TO THIS RULE ARE THE SCHOLARSHIP FUNDS GRANTED TO TEEN VOLUNTEERS AT IOWA LUTHERAN HOSPITAL THAT HAVE MET ESTABLISHED CRITERIA. CHECKS ARE WRITTEN DIRECTLY TO THE CHOSEN COLLEGE AND STUDENTS MUST COMPLETE THE TERM OR REFUND THE SCHOLARSHIP. FORM 990, LINE J (WEBSITE): WWW.UNITYPOINT.ORG/JOIN-OUR-TEAM/VOLUNTEERS/IOWA-LUTHERAN-HOSPITAL-AUXIL IARY---DES-MOINES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY UNITYPOINT HEALTH'S CORPORATE SERVICES TAX DEPARTMENT AND GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE DEPARTMENT WITH ULTIMATE APPROVAL BY THE DIRECTOR OF TAX SERVICES. A COPY OF THE FORM 990 IS PROVIDED TO THE AUXILIARY FOR REVIEW WITH BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C A DESIGNATED PERSON WITHIN THE ORGANIZATION AND OTHER RELATED ORGANIZATIONS SUBJECT TO THIS POLICY SHALL SEND DISCLOSURE QUESTIONNAIRES TO ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES. PERSONS REQUIRED TO REPORT WHO HAVE NOT RETURNED QUESTIONNAIRES WILL BE CONTACTED AND FOLLOW-UP WILL CONTINUE ON A REGULAR BASIS IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE INFORMATION DISCLOSED WILL BE USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICARE QUESTIONNAIRES. THE DUTY TO IDENTIFY AND DISCLOSE POTENTIAL CONFLICTS OF INTEREST IS A DUTY THAT IS ONGOING. ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES SHALL IMMEDIATELY DISCLOSE SUCH POTENTIAL CONFLICT OR DUALITY OF INTEREST AS SOON AS THE INTEREST OCCURS. DISCLOSURE SHOULD BE MADE TO THE COVERED PERSON'S SUPERVISOR, THE CHIEF EXECUTIVE OFFICER OF THE COMPANY, OR THE BOARD CHAIR OF THE COMPANY, AS APPLICABLE. FORM 990, PART VI, SECTION C, LINE 19 ANY REQUESTS FOR COPIES OF DOCUMENTS ARE FORWARDED TO THE PRESIDENT OF IOWA LUTHERAN HOSPITAL AUXILIARY WHO ASSIGNS THE APPROPRIATE MEMBER OF THE BOARD TO PROVIDE COPIES OF ANY DOCUMENTS REQUESTED IN A TIMELY MANNER AND THEN REPORT BACK TO THE PRESIDENT THAT THE REQUEST HAS BEEN HANDLED.