2026-04-13T11:26:55-05:00 2025-06-30 450250958 Eide Bailly LLP 345 N Reid Pl Ste 400 Sioux Falls SD 571037034 990 2024-07-01 420796764 Sioux Center Health SIOU 7127221271 1101 9th St SE Sioux Center IA 51250 Cory Nelson CEO 7127221271 2026-04-12 1 1 Laurie Hanson CPA P00851848 6053391999 2026-04-08 2024 2025-03-06 01:10:19Z Cory Nelson 1101 9th St SE Sioux Center IA 51250 77720404 0 X www.siouxcenterhealth.org X 1951 IA To provide medical care for all ages. 34 31 764 48 0 0 1105282 113836 66625503 75917585 339991 1016764 8976612 595524 77047388 77643709 10000 35372 0 0 37394984 39810933 0 0 0 33458027 33809984 70863011 73656289 6184377 3987420 112029574 116201465 61983019 61229397 50046555 54972068 X Bring hope, health and healing to life. 1 0 63519442 35372 75917585 Sioux Center Health operates a 19-bed acute-care hospital, a 99-bed nursing care facility, medical clinics, specialty physician clinic and independent/assisted living facilities (24 independent, 62 assisted apartments) located in Sioux Center, Iowa. During the fiscal year ending June 30, 2025, patient days were 1,559, swing-bed days were 944, and newborn days were 434.The Center also provides a wide variety of medically-related activities at less than, or at no cost to residents of communities throughout northwest Iowa. These activities include general community education programs and sponsorship of support groups for victims of chronic disease and their families. Other activities designed to measure or enhance the general health status of residents of the community include: classes related to CPR, diabetes, cardiac rehabilitation and childbirth; participation in health fairs at industrial and community sites throughout the area; cost free screenings to alert people with high blood pressure; providing use of meeting facilities at no charge to cancer, Alzheimer's, diabetes, weight maintenance, "senior and hospice support groups; programs for children; providing speakers for various events and education groups; and representation in community education programs.The Health Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Health Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. The estimated cost of providing these services was $423,597 for the year ended June 30, 2025, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients. 63519442 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 44 0 1 764 1 0 0 0 0 0 0 0 0 0 0 0 0 X 34 31 1 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X Crystal Richter 7127228153 1101 9th St SE Sioux Center IA 51250 Dr Nicholas Mouw General Surgeon 40.00 X 1042499 0 45077 Scott Rens Physician 40.00 X 437586 0 62888 Abby Stroeh Physician 40.00 X 437926 0 76783 Paul De Jong Physician 40.00 X 420193 0 57055 Daniel Vanden Bosch Physician 40.00 X 427959 0 32561 Cory Nelson CEO 40.00 X 322538 0 45582 Crystal Richter CFO 40.00 X 142951 0 59345 Nathan Bakker VP/President From 12/2024 1.00 X X 0 0 0 Kyle Hiemstra President Until 12/2024 1.00 X X 0 0 0 Bruce Dooyema Vice President From 12/2024 1.00 X X 0 0 0 Jennifer Jansen Secretary 1.00 X X 0 0 0 Cory Gotto Treasurer 1.00 X X 0 0 0 Josh Browar Treasurer/Director 1.00 X X 0 0 0 Janet Boone Director 1.00 X 0 0 0 Kellie Van Roekel Director 1.00 X 0 0 0 Curt Hohman Director 1.00 X 0 0 0 Neil Van Schouwen Director 1.00 X 0 0 0 Vernon Beernink Director 1.00 X 0 0 0 Terry Boote Director 1.00 X 0 0 0 Leslie Brommer Director 1.00 X 0 0 0 Tim Byl Director 1.00 X 0 0 0 Lisa Christians Director 1.00 X 0 0 0 Paul Closing Director 1.00 X 0 0 0 Faye DeKam Director 1.00 X 0 0 0 Brenda Dokter Director 1.00 X 0 0 0 Daniel Finley Director 1.00 X 0 0 0 Dan Hibma Director 1.00 X 0 0 0 Lauren Kaemingk Director 1.00 X 0 0 0 Rick Kattenberg Director 1.00 X 0 0 0 Heidi Kramer Director 1.00 X 0 0 0 Ardith Lein Director 1.00 X 0 0 0 John McDaniel Director 1.00 X 0 0 0 Matt Nice Director 1.00 X 0 0 0 David Eekhoff Director 1.00 X 0 0 0 Jeff Timmer Director 1.00 X 0 0 0 Dale Vander Berg Director 1.00 X 0 0 0 Brian Van Engen Director 1.00 X 0 0 0 Doug Van Meeteren Director 1.00 X 0 0 0 Lyle Vermeer Director 1.00 X 0 0 0 Marj Wagner Director 1.00 X 0 0 0 Scott Wynja Director 1.00 X 0 0 0 Verdean Wynja Director until 12/2024 1.00 X 0 0 0 Dorinda Oostenink Director 1.00 X 0 0 0 3231652 0 379291 25 0 1 0 Heart Medical Solutions LLC 3226 Laurel Ave Sioux City IA 51106 Temp Staffing 1604437 Thomas J Posch 234 Marina Dell Ave Yankton SD 57078 Radiology Readings 406146 Tadlock Inc 28588 SD Hwy 11 Canton SD 57013 Anesthesia services 355683 Independent Radiology Services PO Box 2746 Fargo ND 58108 Radiology 267307 Gary Tillman 1787 Willow Run Blvd Le Mars IA 51031 Anesthesia services 195281 6 113836 113836 Patient Service Revenue 623990 69521254 69521254 Pharmacy Revenue 900099 4118935 4118935 Assisted and Independent Living 623990 927935 927935 Investment in Affiliated 900099 268277 268277 1081184 1081184 75917585 1032213 1032213 83852 0 83852 83852 83852 15449 -15449 -15449 -15449 120116 61246 58870 58870 Employee Retention Credit 900099 452802 452802 452802 77643709 75917585 0 1612288 X 35372 35372 564218 564218 205388 205388 31171265 29043992 2127273 1304788 1207674 97114 4536325 4204708 331617 2028949 1861388 167561 6251 6251 47018 47018 8430604 6066316 2364288 349390 3939 345451 427222 231864 195358 509968 175271 334697 1103483 985487 117996 134557 120196 14361 111812 110822 990 1847144 1534133 313011 5124940 4656066 468874 530341 145864 384477 Medical Supplies 11189810 11189810 Taxes and assessments 1790529 1790529 Repair and Maintenance 1561857 1561857 645058 179295 465763 73656289 63519442 10136847 0 8477917 14443030 16740670 16457581 1238655 1058351 740750 628579 113845131 51279483 66407131 62565648 8382478 9377072 4710390 5963251 486893 510435 9029 7022 4835661 5190496 112029574 116201465 6414186 6042423 19731 6002386 5698678 44591581 43499219 4974866 5969346 61983019 61229397 X 48885224 53444840 1161331 1527228 50046555 54972068 112029574 116201465 X 3987420 938093 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 247170 247170 247170 247170 247170 247170 247170 247170 247170 247170 0.00000 1.00000 0.00000 1 0 2263964 2237776 4501740 88320250 35299176 53021074 18477624 14626357 3851267 2545517 1353950 1191567 62565648 Interest in Avera Health Foundation 5440740 F Investment in Avera Home Medical of Sioux Center LLC 522511 F 5963251 Deferred Compensation 4555123 Estimated third-party payor settlements 975000 Security deposits 333064 Operating lease liability 106159 5969346 X 78643049 938093 938093 77704956 -61247 -61247 77643709 73717536 61247 61247 73656289 0 73656289 Part V, Line 4: The Health Center's endowment consists of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The Center does not have a formal policy or agreement with the Foundation covering the distribution of endowment fund earnings. The Center expects the Foundation to allow its endowment to grow consistent with the Center's objective to maintain the purchasing power of the endowment assets in order to provide additional real growth through new gifts and investment return. However, there is no current intention of using the permanently endowed funds. Part X, Line 2: The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Change in net assets of Avera Health Foundation 938,093. Part XI, Line 4b - Other Adjustments: COGS -61,247. Part XII, Line 2d - Other Adjustments: COGS 61,247. 1 1 X 1 X 1 X 1 1 0 1 1 1 591 266000 266000 0.00360 1 3871379 2427150 1444229 0.01960 2 591 4137379 2427150 1710229 0.02320 2129 13768 13768 0.00020 39 15355 15355 0.00020 6 11553 15201925 11626847 3575078 0.04850 58190 58190 0.00080 6 13721 15289238 11626847 3662391 0.04970 8 14312 19426617 14053997 5372620 0.07290 3237 3237 0.00000 3237 3237 0.00000 0 966729 47089 14604528 14701704 -97176 X 1 1 1 1 Sioux Center Health 1101 9th St SE Sioux Center IA 51250 www.siouxcenterhealth.org 840080H X X X X 2 provider based clinics Sioux Center Health 1 0 0 1 X X X X X X X X X 24 1 1 1 1 X See Line 7d X See Line 7d X X 1 24 1 See Line 7d 0 1 X 150.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 Sioux Center Health Part V, Section B, Line 5: The CHNA was conducted using a collaborative planning and data collection process integrating secondary data and primary data collected from community members through a web-based questionnaire and focus group interviews. The web-based questionnaire was publicized through health system and local public health agency social media, email contact lists and radio publicity. A total of 670 responses were received with 485 fully completed surveys. Focus groups were held by representatives of four critical access hospitals in Orange City, Sioux Center, Hawarden and Rock Valley. This community input was collected between December 2024 and March 2025. Groups represented included underserved, older adults, minorities, low income, and patients with disabilities. Additionally, we reviewed, analyzed and compiled available data from a variety of existing data sets from national, state and local sources, prioritizing U.S. Census Data, Community Health Rankings data, and data from the Iowa Health and Human Services Tracking Portal. Sioux Center Health Part V, Section B, Line 6a: Hegg Memorial Health System Orange City Area Health System Hawarden Regional Healthcare Sioux Center Health Part V, Section B, Line 6b: Community Health Partners of Sioux County, the local public health agency for Sioux County.Promise Community Health Center Sioux Center Health Part V, Section B, Line 7d: https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/CHNA-2025-final.pdfPart V, Section B, Line 10a:https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/Signed-Implementation-strategy.pdf Sioux Center Health Part V, Section B, Line 11: A summary of the health issues raised through community input was presented to the collaborative planning group along with the secondary data report. Community Health Partners convened a stakeholder meeting with attendees representing the participating healthcare organizations. Participants reviewed a summary of all assessments (community input, secondary data), identified and prioritized key issues. To determine priorities that healthcare systems will address collaboratively, the collaborative team used the Stakeholder Survey Results, Community Health Status Report, and stakeholder meeting input to generate a list of health needs and issues. Identified issues were: *Mental Health*Obesity*Navigating SystemsWhile each of the health needs identified is important for overall community health, one additional health need that came up during the CHNA process is dental services, especially for children. This is a need that is difficult to effectually change for Sioux Center Health. One thing we have done, however, to help meet this disparity is offering fluoride treatments for children in the clinic. Sioux Center Health remains committed to helping where we can with organizations, including Promise Community Health Center, to meet this growing demand.Some of these needs are continuations of prior needs identified. Due to timing, Sioux Center Health focused on the needs identified in the prior implementation strategy during FY25:*Health care access*Heart disease*Mental health *Social determinants In the current year the facility has taken the following actions to address:Mental Health: Sioux Center Health has continued to grow its Behavioral (Mental) Health team, adding two full-time psychiatric mental health nurse practitioners, with a third joining in the summer of 2025, and an additional licensed mental health therapist. Behavioral health counselors expanded therapy outreach to local schools, including West Sioux, Boyden-Hull, and Unity Christian High Schools, while new service lines, including family and couples counseling, have been added to meet the evolving needs of the community. Sioux Center Health therapists also provide educational presentations to civic and community groups, further promoting mental health awareness.Sioux Center Health has partnered with Promise Community Health Center on collaborative marketing campaigns to reduce mental health stigma and promote behavioral health services. The 2024 Better Together and 2025 Growing Together campaigns emphasized that mental health is a journey and highlighted the importance of sunlight, time, and nourishment for personal growth. Growing Together featured video reels of therapists sharing words of encouragement, filmed at local greenhouses to symbolize growth and healing. Telehealth services are also provided through Flowstate to emergency room patients, ensuring that individuals in crisis have access to behavioral health support. Across our clinics, Sioux Center Health continues to expand behavioral health programming with satellite therapy offices in Hull and Hawarden. We provide 24/7 coverage for patients requiring mental health services and coordinate with inpatient facilities as needed, combining in-person and telehealth approaches to meet the needs of children, adolescents, and adults.Social Determinants of Health:Sioux Center Health provides a bilingual Care Coordinator to help patients navigate the healthcare system, access financial assistance programs, and understand available resources. Marketing materials and advertisements have increasingly been translated into Spanish to improve outreach and communication with the Spanish-speaking community. Certified medical interpreters are available on-site during clinic hours, with 24-hour remote interpretation services for urgent needs, ensuring accurate communication for all patients.Our care coordination program helps patients overcome barriers to accessing healthcare and connects them with social, financial, and health-related resources. Financial navigators assist patients in understanding medical expenses and developing manageable payment plans. Sioux Center Health partners closely with Promise Community Health Center to serve underinsured populations, with a Sioux Center Health physician serving as medical director for Promise. Through the electronic medical record system, all inpatient admissions are screened for social determinants of health, and social workers meet with patients when needs are identified. Additionally, Sioux Center Health continues support for All Kids Can, a program that provides financial support for children to participate in health-promoting activities.Heart Disease Prevention:Sioux Center Health has actively promoted heart health through community engagement, education, and clinical programs. We employ a diabetic educator and a registered dietitian who work with patients and community members to address obesity-related health issues and provide education on effective weight management. Individual and group performance enhancement classes are held in our physical therapy location at the American State Bank Sports Complex, and our nurse practitioner is trained in insulin pump management to support patients with diabetes.In February 2025, Sioux Center Health launched the "The Beat Goes On" marketing campaign to raise awareness about cardiac rehabilitation, nutrition, diabetes education, and primary care. The initiative included Heart Month drinks at nutritional tea shops in Sioux Center, Hull, and Hawarden, along with free community exercise classes offered at multiple local fitness centers. Sioux Center Health is also a partner and sponsor for the Siouxperman Triathlon, Harvest Half Marathon, and 10K run, further promoting cardiovascular wellness in the community.Healthcare Access:Sioux Center Health has expanded access to care through strategic hiring and innovative service delivery. Several new physicians and Advanced Practice Providers (APPs) have joined our team, including bilingual staff, to better serve Spanish-speaking patients. Partnerships with local employers, such as Perdue Premium Meat Company, provide on-site bilingual care for a primarily Spanish-speaking workforce. A same-day primary care clinic was established post-COVID to meet acute patient needs efficiently.Care coordination programs continue to assist patients in navigating healthcare barriers, and certified medical interpreters ensure accurate communication between providers and patients. Sioux Center Health also staffs three financial navigators to help patients understand medical expenses and develop manageable payment plans. Providers and nurses received certification in March 2025 to apply fluoride treatments during well-child visits.Looking ahead, Sioux Center Health plans to introduce da VinciV5 robotic-assisted surgical services in 2026, becoming the first rural Avera facility to offer this advanced technology and further expanding local access to high-quality surgical care. Sioux Center Health Part V, Section B, Line 13h: Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the policy. Sioux Center Health Part V, Section B, Line 16j: Self pay patients are given a self-pay packet that explains financial assistance. A statement is sent out to all patients indicating financial assistance is available upon request. The charity care and other financial assistance options are discussed with inpatients if requested. Sioux Center Health Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital has confirmed no FAP eligible patients had elective procedures. PART V SECTION B LINE 16 Financial Assistance Policy :https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/Financial-Assistance.pdfFinancial assistance application:https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/Attachment-l-Financial-Assistance-Application-and-Patient-Financial-Information.pdfFinancial Assistance Plain Language Summary:https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/Summary-of-Financial-Assistance.pdf 4 1 - Hawarden Medical Clinic 920 Avenue F Hawarden IA 51023 Physician clinic 2 - Crown Pointe Estates 1400 7th Ave SE Sioux Center IA 51250 Nursing Facility, Independent and Assisted Living 3 - Home Health & Hospice 1400 7th Ave SE Sioux Center IA 51250 Home health and hospice 4 - Occupational Health Center 38 19th St SW Sioux Center IA 51250 Occupational health Part I, Line 3c: Sioux Center Health (SCH) provides free care based on meeting presumptive eligibility requirements listed in the policy. Federal Poverty Guidelines and financial asset-liabilities are used to determine eligibility for discounted care.Additional factors used to determine financial assistance eligibility include Asset level, medical indigency, and underinsurance status.Part I, Line 6b:The community benefit report is maintained at Sioux Center Health, mailed to community members, and is available to the public upon request. Part I, Line 7: Charity care expense on line 7a and Medicaid on line 7b were converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Lines 7e, 7f, and 7i: Costs are reported based on data from the general ledger accounting system. The general ledger accounting system addresses all patient segments (inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, and self-pay). The cost for subsidized health services reported on line 7g was determined using the facility's cost accounting system. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: The estimated amount of implicit price concession attributable to patients that could have been eligible for charity care is based on estimated calculations from our collection agency. The agency calculated 4.87% of the total amount in collections could be charity care due to bankruptcy, deceased and charity adjustments on current accounts. Part III, Line 4: The footnote that describes implicit price concessions is on pages 14-15 of the attached audited financial statements. Part III, Line 8: Medicare allowable cost of care was calculated from the Medicare cost report for fiscal year ending 6/30/25. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: Accounts that meet the criteria for the financial assistance policy will be written off in accordance with the financial assistance policy. Accounts that do not meet the criteria for financial assistance will proceed through the collection process. If, during the collection process, it is determined that an account in collection belongs to a patient who is eligible for financial assistance, the account will be removed from collection and returned to the hospital for resolution. Part VI, Line 2: Sioux Center Health has a broad based Board of Directors providing community feedback on a quarterly basis. The organization normally holds an open public meeting annually to listen to issues of the community and share information regarding services and programs. The Hospital analyzes statistical data through IHA and Iowa Public Health to determine disease related needs, services and market share. The Hospital works closely with Community Health Partners to identify and address community health related needs. Additionally, the Hospital conducted a community health needs assessment during the year ended 6/30/25 in compliance with 501(r). Part VI, Line 3: Patients are made aware of financial assistance programs (English and Spanish) in a variety of ways:1. Self-pay patients are given a self-pay packet that explains financial assistance, payment plans, and the Hospital's 10% lump sum payment options. The self-pay packet includes a Medicaid application. 2. A statement is sent out to all patients indicating financial assistance is available upon request.3. The financial assistance application is available on the Hospital website in English and Spanish versions.4. The financial assistance application is available at the registration and ER desk in English and Spanish versions.5. Financial assistance information is included in SCH Facebook posts to increase awareness.Additionally, the financial assistance policy is available upon request and on the Sioux Center Health website. Part VI, Line 4: The community of Sioux Center is located in Sioux County, Iowa. Sioux Center Health provides health care services in Sioux Center and serves nearby communities including Hull. The service community for Sioux Center Health includes Sioux County and specifically the community of Sioux Center. Furthermore, included within this community are the medically underserved, low-income, minority populations, and all individuals regardless of their ability to care for services. The 2023 population estimate for Sioux Center is 8,543 as estimated by the U.S. Census Bureau. Between 2020 and 2023, the population in Sioux Center increased by 3.7%. Sioux Center's population is predominantly white, but between 2010 and 2020 there was a decrease in the percentage of the population that identifies as white. During that time, the percentage of population that identifies as of Hispanic origin grew from 13.1% to 21.0% in Sioux Center. According to 2020 Census data, 28.8% of the population of Sioux Center is age 17 and younger, while 18.7% is between ages 18-24. 13.9% of the population is age 65 and older, and the median age is 27.4 years in Sioux Center. The 2023 median household income in Sioux Center was $87,555, with 27.8% of households earning less than $50,000. In Sioux Center, 74.8% of occupied housing units are owner-occupied with 25.2% renter-occupied at a median gross rent of $884. Median monthly owner costs were 17.3% of household income. The estimated unemployment rate in Sioux Center was 1.2%. Part VI, Line 5: Sioux Center Health has a strong community focused perspective. The governing board is comprised of 48 volunteer members that reside in the community and primary service area. The Hospital is focused on its mission and serving people regardless of their ability to pay. The Hospital participates in mission projects throughout the year yielding support for various causes from local missions that provide after school activities, counseling, or domestic abuse services. This support comes in the form of paid staff volunteering their time, Hospital sponsored fundraisers, and direct financial support from the Hospital and its employees. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make improvements in patient care, medical education, and research.Sioux Center Health has a strong mission to bring hope, health and healing to life. The Hospital offers services for our patients, residents and family to support the mind, body and spirit. The Hospital operates an emergency room and is available to anyone, regardless of their ability to pay. The Hospital supports continuing education and training of all the healthcare professionals and assists in providing both internal and external opportunities. Sioux Center Health supports the communities it serves by being an active participant in the community. The hospital offers opportunities to volunteer for community events, has staff that participate in governance through chambers, businesses and churches. Also, the staff participate in various advisory groups supporting all ranges of ages and educational levels. The hospital supports advocacy activities focused on improved public health from organization walks, educational seminars and information shared with the public through various communication means. Part VI, Line 6: The Hospital is a managed facility of Avera Health. Avera Health and the Hospital work cooperatively to enhance healthcare throughout the community served by the Hospital. The Hospital also has access to "back office" support services, such as legal consultation, quality benchmarking, coding, computer services, contract negotiations, administrative consultation, group purchasing, human resource assistance and many other services. Avera Health is able to provide these services to the Hospital at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. Avera Health and the Hospital dedicate resources to endeavors that make a positive difference to improve the health of the communities they serve. These activities include leadership development and training for community members, economic development, physical improvements in the community, contributions to nonprofit community organizations, nonprofit event sponsorships, donated medical supplies, community health education and support groups, health screenings, flu-shot clinics, community health education and various other activities. 0 Raider Athletics Association 208 8th St SW Orange City IA 51041 420698196 501(c)(3) 6000 0 Sponsorship Sponsorship Chamber of Commerce 14 3rd St NW Sioux Center IA 51250 426065836 501(c)(6) 10000 0 Sponsorship Sponsorship 1 1 X X X 0 0 0 0 0 0 0 0 0 Dr Nicholas Mouw General Surgeon 707115 0 288531 0 46853 0 5800 0 39969 0 1088268 0 0 0 Scott Rens Physician 426161 0 0 0 11425 0 5800 0 58152 0 501538 0 0 0 Abby Stroeh Physician 337779 0 49645 0 50502 0 28800 0 49647 0 516373 0 0 0 Paul De Jong Physician 368012 0 46869 0 5312 0 5800 0 52857 0 478850 0 0 0 Daniel Vanden Bosch Physician 320034 0 61043 0 46882 0 5800 0 27822 0 461581 0 0 0 Cory Nelson CEO 315860 0 6000 0 678 0 18036 0 27546 0 368120 0 0 0 Crystal Richter CFO 142711 0 240 0 0 0 5800 0 54237 0 202988 0 0 0 A City of Hull Iowa 426004780 2017-12-18 8300000 Hospital Facility Revenue Refunding Bond, Series 2017(2012 issue). 0 0 0 A 2464302 8300000 156681 8143319 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 Kim Bosma Family member of Cory Gotto, Director 50470 Compensation as an employee 0 Val Hiemstra Family member of Cory Gotto, Director 45037 Compensation as an employee 0 Heather Van Engen Family member of Brian Van Engen, Director 34246 Compensation as an employee 0 Matt De Kam Family member of Faye De Kam, Director 75635 Compensation as an employee 0 Form 990, Part III, line 2 Radiofrequency Ablations. Form 990, Part VI, Section A, line 1a The Executive Committee is composed of four officers: President, Vice President, Secretary, Treasurer, and seven board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors. Form 990, Part VI, Section A, line 2 Board members Dale Vander Berg and Cory Gotto have a business relationship. Form 990, Part VI, Section A, line 7a One member of the governing body is appointed by Avera McKennan. Form 990, Part VI, Section B, line 11b The 990 is emailed to members of the Board of Directors for review and any questions are addressed prior to filing the return with the IRS. Form 990, Part VI, Section B, line 12c Officers, Directors and Trustees are required to complete conflict of interest questionnaires which are monitored and tracked. The questionnaires are reviewed by the Board for any possible conflicts with any noted conflicts being brought to management's attention. Conflicts are also reviewed at the Board level. After a conflict is deemed to exist, the individual(s) involved must abstain from the discussion and vote related to the issue. Form 990, Part VI, Section B, line 15a Compensation for the CEO is determined and approved annually by the board of directors after his performance review is completed. Compensation for the CFO is reviewed and approved annually by the CEO and Human Resources. Market data is used to determine an appropriate salary range. The review process and salary adjustment is documented in the personnel file. Form 990, Part VI, Section C, line 19 The documents are made available upon request. Form 990, Part IX, line 11g Medical Professional Fees: Program service expenses 715,955. Management and general expenses 0. Fundraising expenses 0. Total expenses 715,955. Purchased services: Program service expenses 5,298,258. Management and general expenses 1,754,611. Fundraising expenses 0. Total expenses 7,052,869. Other Consulting & Professional Fees: Program service expenses 52,103. Management and general expenses 609,677. Fundraising expenses 0. Total expenses 661,780. Form 990, Part XI, line 9: Change in interest in net assets of Avera Health Foundation 938,093.