TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) PEG ARMSTRONG-GUSTAFSON BOARD MEMBER	1.00	X		300	11,863	0
(2) LARRY BAKER DO BOARD MEMBER	1.00	X		275	0	0
(3) BRAD BRODY BOARD TREASUER	1.00	X	X	225	0	0
(4) BISHOP MICHAEL BURK BOARD SECRETARY	1.00	X	X	50	0	0
(5) CHARLES COLBY BOARD MEMBER	1.00	X		435	209	0
(6) ERIC CROWELL BOARD MEMBER/CEO	40.00	X	X	771,234	0	313,754
(7) KATRINA GUEST MD BOARD MEMBER (TO 3/10)	1.00	X		0	0	0
(8) JOHN HEFFERNAN MD BOARD MEMBER	40.00	X		392,426	0	60,434
(9) KENT HENNING BOARD CHAIR	1.00	X	X	135	0	0
(10) STEVE HERWIG DO BOARD MEMBER (FROM 3/10)	1.00	X		50	13,163	0
(11) JAMES HUBBELL III BOARD MEMBER	1.00	X		135	0	0
(12) BURTON 'TOBY' JOSEPH BOARD VICE CHAIR	1.00	X	X	275	0	0
(13) RICHARD MCCONNELL BOARD MEMBER	1.00	X		140	0	0
(14) JAMES PATTEN MD BOARD MEMBER	1.00	X		225	0	0
(15) CARLINE PHILLIPS BOARD MEMBER	1.00	X		410	0	0
(16) DON ROSS BOARD MEMBER	1.00	X		441	16,037	0
(17) BRUCE SHERMAN BOARD MEMBER	1.00	X		225	15,838	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) DAVID STUBBS MD BOARD MEMBER	40.00	X				0	19,267	1,174
(19) JULIUS TRIMBLE BOARD MEMBER	1.00	X				140	0	0
(20) RICHARD WILLIS BOARD MEMBER	1.00	X				135	0	0
(21) BRAD WINTERBOTTOM BOARD MEMBER	1.00	X				50	0	0
(22) WILLIAM YOST MD BOARD MEMBER	40.00	X				0	219,196	61,841
(23) JOSEPH CORFITS EXEC VP/CFO	40.00		X			412,550	0	124,641
(24) SUSAN ALLYN VP HUMAN RESOURCES	40.00			X		311,236	0	127,135
(25) AMY BETHEL EXEC DIR SURGERY	40.00			X		154,224	0	49,087
(26) CHRISTINE BLAIR ADMINISTRATOR-MWH	40.00			X		204,615	0	67,146
(27) DOUGLAS DORNER MD VP MEDICAL EDUCATION	40.00			X		630,889	0	46,855
(28) CECELIA KIRVIN EXEC DIR/CCO BCH	40.00			X		170,580	0	29,355
(29) ERIC LOTHE ADMINISTRATOR/VP-ILH	40.00			X		350,404	0	64,465
(30) JOYCE MCDANEL VP HUMAN RESOURCES	40.00			X		173,622	0	21,337
(31) MARK PURTLE MD VP MEDICAL AFFAIRS	40.00			X		466,859	0	181,233
(32) SIDNEY RAMSEY VP STRATEGIC BUSINESS DEV-CIHS	40.00			X		333,242	0	99,960
(33) JEANETTE SHELTON ADMINISTRATOR-PHYS PRACTICE	40.00			X		186,377	0	49,639
(34) DAVID STARK PRESIDENT/COO BCH & EVP IHDM	40.00			X		407,939	0	57,553
(35) STEPHEN STEPHENSON MD EXEC VP/COO-IHDM	40.00			X		516,530	0	183,089
(36) TIMOTHY HART MD PHYS-CARDIOLOGIST-ILH CARDIO	40.00				X	1,095,931	0	40,712
(37) AMAR NATH MD PHYS-CARDIOLOGIST-ILH CARDIO	40.00				X	1,097,464	0	38,428
(38) PRASAD PALAKURTHY MD PHYS-CARDIOLOGIST-ILH CARDIO	40.00				X	794,299	0	31,704
(39) JOHN PARGULSKI DO PHYS-CARDIOLOGIST-ILH CARDIO	40.00				X	760,698	0	37,357
(40) CRAIG STEVENS MD PHYS-CARDIOLOGIST-ILH CARDIO	40.00				X	820,730	0	39,778

(A) Name and business address	(B) Description of services	(C) Compensation
ARAMARK FACILITIES SERVICES 22506 NETWORK PLACE CHICAGO,IL60673	LAUNDRY, CLEANING & FOOD SERVICES	7,860,741
WEITZ COMPANY INC 5901 THORNTON AVE DES MOINES,IA50321	CONSTRUCTION	7,400,507
FLYNN WRIGHT INC 501 SW 7TH STREET DES MOINES,IA50309	ADVERTISING & PROMOTION	1,063,818
AJ ALLEN MECHANICAL CONTRACTORS INC PO BOX 931 DES MOINES,IA503040931	REPAIR & MAINTENANCE	574,810
GRAHAM CONSTRUCTION CO 421 GRAND DES MOINES,IA50309	CONSTRUCTION	523,809
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 24

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	2,887,518	2,887,518
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	8,098,544		8,098,544
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	390,539	390,539
7	Other salaries and wages	266,698,375	248,157,071	18,541,304
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	10,351,393	9,631,747	719,646
9	Other employee benefits .......	37,272,031	34,680,819	2,591,212
10	Payroll taxes ...........	16,771,388	15,605,414	1,165,974
11	Fees for services (non-employees):
a	Management ......	35,893,153	35,893,153
b	Legal .........	1,306,928	86,802	1,220,126
c	Accounting ...........
d	Lobbying ...........	24,000		24,000
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......	1,941,172		1,941,172
g	Other ..........	41,026,690	31,770,032	9,256,658
12	Advertising and promotion ....	1,936,251	208,860	1,727,391
13	Office expenses .......	132,495,580	130,822,644	1,672,936
14	Information technology ......	3,909,143	3,865,516	43,627
15	Royalties ..
16	Occupancy ...........	16,890,289	15,766,865	1,123,424
17	Travel ............	1,076,590	873,976	202,614
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	221,411	179,281	42,130
20	Interest ...........	8,175,736		8,175,736
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	32,215,550	31,893,831	321,719
23	Insurance ..............	892,521	899,216	-6,695
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	PATIENT BAD DEBT	20,910,718	20,910,718
b	MISCELLANEOUS EXPENSES	3,493,231	1,814,481	1,678,750
c	INCOME TAXES	1,454,000		1,454,000
d
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	646,332,751	586,338,483	59,994,268	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	35,945	1	35,649
2	Savings and temporary cash investments .......	15,824,014	2	19,857,649
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	79,256,659	4	83,025,267
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	1,283,055	5	661,730
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............	5,547,472	7	8,669,125
8	Inventories for sale or use ..............	10,388,122	8	10,472,938
9	Prepaid expenses and deferred charges ............	9,969,808	9	8,572,592
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	682,246,197
b	Less: accumulated depreciation. .....	10b	434,514,237	260,840,400	10c	247,731,960
11	Investments—publicly traded securities ..........	343,957,909	11	391,365,556
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..	34,085,792	13	30,228,353
14	Intangible assets .........	1,956,745	14	384,245
15	Other assets. See Part IV, line 11 ...........	101,883	15	83,635
16	Total assets. Add lines 1 through 15 (must equal line 34)...	763,247,804	16	801,088,699
	17	Accounts payable and accrued expenses .	59,462,155	17	61,264,550
18	Grants payable ..........	97,215	18
19	Deferred revenue ..........	418,924	19	478,794
20	Tax-exempt bond liabilities ..........	23,000,000	20	23,000,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	594,633	23	563,298
24	Unsecured notes and loans payable to unrelated third parties ....	200,000	24	100,000
25	Other liabilities. Complete Part X of Schedule D.....	209,608,780	25	193,743,110
26	Total liabilities. Add lines 17 through 25.....	293,381,707	26	279,149,752
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	440,336,205	27	495,594,082
28	Temporarily restricted net assets .....	16,479,262	28	11,884,147
29	Permanently restricted net assets .....	13,050,630	29	14,460,718
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	469,866,097	33	521,938,947
34	Total liabilities and net assets/fund balances .....	763,247,804	34	801,088,699

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization CENTRAL IOWA HOSPITAL CORPORATION
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization CENTRAL IOWA HOSPITAL CORPORATION
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

24,000

Total. lines 1c through 1i ...................................

24,000

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES:	PART II-B, LINE 1I:	PAID TO CONSULTING FIRM FOR LOBBYING ACTIVITIES ON BEHALF OF HEALTH CARE.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	345,461,149	247,692,356	310,035,426
b	Contributions ........	7,133,406	25,092,385	5,000,000
c	Investment earnings or losses ...	46,487,853	77,357,269	-52,884,188
d	Grants or scholarships .....	3,862,243	3,399,333	13,612,295
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....	1,455,747	1,281,528	846,587
g	End of year balance ......	393,764,418	345,461,149	247,692,356

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

93.730 %

Permanent endowment: SchDMd Bullet

3.670 %

Term endowment: SchDMd Bullet

2.600 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	9,922,760		9,922,760
b	Buildings ................	237,767,288	143,200,560	94,566,728
c	Leasehold improvements ............	18,541,705	13,641,025	4,900,680
d	Equipment ................	407,689,747	277,672,652	130,017,095
e	Other .................	8,324,697		8,324,697
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				247,731,960

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
ASBESTOS REMOVAL LIABILITY		3,103,168
CAPITAL LEASE PAYABLE		1,502,863
DUE TO AFFILIATES		11,467,916
SELF-INSURANCE RESERVE		11,789,581
LONG-TERM RETENTION INCENTIVES		9,717,189
IOWA HEALTH SYSTEM NOTE PAYABLE		149,562,000
HEALTH AND WELFARE BENEFITS RESERVE		5,223,559
MISCELLANEOUS LIABILITY		1,376,834

Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		193,743,110
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	685,413,012
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	646,332,751
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	39,080,261
4	Net unrealized gains (losses) on investments ..........................	4	14,655,497
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	-1,662,908
9	Total adjustments (net). Add lines 4 - 8 .............................	9	12,992,589
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	52,072,850

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	696,691,000
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	14,977,610
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	4,018,370
e	Add lines 2a through 2d .....................			2e	18,995,980
3	Subtract line 2e from line 1.....................			3	677,695,020
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	1,543,902
b	Other (Describe in Part XIV): ...........	4b	6,174,090
c	Add lines 4a and 4b.......................			4c	7,717,992
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	685,413,012

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	637,876,000
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d	7,096
e	Add lines 2a through 2d......................			2e	7,096
3	Subtract line 2e from line 1.....................			3	637,868,904
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	1,543,902
b	Other (Describe in Part XIV): ............	4b	6,919,945
c	Add lines 4a and 4b.......................			4c	8,463,847
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	646,332,751

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
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 OF IOWA HEALTH FOUNDATION 834,397. CHANGES IN PENSION LIABILITY -2,497,305.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		SALES OF INVENTORY 7,096. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 4,011,274.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 2,712,629. REVENUES IN UNRESTRICTED FUND BALANCE 3,460,902. ROUNDING 559.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		SALES OF INVENTORY 7,096.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATES 2,712,629. EXPENSES IN TEMPORARILY RESTRICTED FUND BALANCE 8,150. EXPENSES IN UNRESTRICTED FUND BALANCE 4,198,442. ROUNDING 724.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other 100000.0000000000 %

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..		7,179	7,574,467	0	7,574,467	1.210 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .		23,235	68,631,557	47,470,547	21,161,010	3.380 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....		30,414	76,206,024	47,470,547	28,735,477	4.590 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	27	80,256	5,355,976	1,253,525	4,102,451	0.660 %
f Health professions education (from Worksheet 5) ..	16	2,608	13,086,396	5,852,433	7,233,963	1.160 %
g Subsidized health services (from Worksheet 6) ..	1	3,679	37,114,941	30,741,220	6,373,721	1.020 %
h Research (from Worksheet 7)	1		587,746		587,746	0.090 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	8	2,084	2,245,253		2,245,253	0.360 %
jTotal Other Benefits ...	53	88,627	58,390,312	37,847,178	20,543,134	3.290 %
kTotal. Add lines 7d and 7j. ..	53	119,041	134,596,336	85,317,725	49,278,611	7.880 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	4	584	1,115	1,115	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other	1	0	543,531	543,531	0.090 %
10	Total	5	584	544,646	544,646	0.090 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

7,843,400

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

139,324,957

Enter Medicare allowable costs of care relating to payments on line 5.....

136,728,523

Subtract line 6 from line 5. This is the surplus or (shortfall)........

2,596,434

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
11 1776 WESTLAKES PARKWAY LC	OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BLDGS	33.330 %	66.670 %	0 %
22 CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT COMPANY	MANAGEMENT OF CARDIAC SERVICE LINE	20.000 %		24.350 %
33 IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC	OUTPATIENT DIAGNOSTIC IMAGING	50.000 %		50.000 %
44 LAKEVIEW SURGERY CENTER LC	SURGERY CENTER	50.000 %		50.000 %
55 ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC	AMBULATORY SURGERY CENTER	50.000 %		50.000 %
66 WEST HOSPITAL ORTHOPAEDIC CO-MANAGEMENT COMPANY	MANAGEMENT OF METHODIST WEST ORTHO SERVICE LINE	20.000 %		80.000 %
77 WEST LAKES SLEEP CENTER LLC	TREATMENT OF CHRONIC SLEEP DISORDERS	50.000 %		50.000 %
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?3 Name and address		Other (Describe)
1	IOWA METHODIST MEDICAL CENTER 1200 PLEASANT STREET DES MOINES,IA50309	X	X	X	X	X	X	X
2	IOWA LUTHERAN HOSPITAL 700 EAST UNIVERSITY AVENUE DES MOINES,IA50316	X	X					X
3	METHODIST WEST HOSPITAL 1660 60TH STREET WEST DES MOINES,IA50266	X	X					X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:N A

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?38
Name and address		Type of Facility (Describe)
1	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
2	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
3	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
4	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
5	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
6	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
7	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
8	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
9	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
10	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
11	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
12	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
13	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
14	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
15	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
16	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
17	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
18	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
19	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
20	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
21	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
22	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
23	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
24	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
25	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
26	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
27	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
28	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
29	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
30	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
31	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
32	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
33	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
34	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
35	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
36	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
37	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER
38	LAKEVIEW SURGERY CENTER LC 1750 60TH ST SERVI WEST DES MOINES,IA50266	SURGERY CENTER

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		PART I, LINE 6A: CENTRAL IOWA HOSPTITAL CORPORATION D/B/A IOWA HEALTH DES MOINES' COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH IS POSTED ON ITS WEBSITE AT WWW.IHS.ORG.IN ADDITION, THE HOSPITAL AND ITS REGIONAL AFFILIATES PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS POSTED ON ITS WEBSITE AT WWW.IOWAHEALTH.ORG.
		PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO.
		PART I, LINE 7G: THE NET COMMUNITY BENEFIT COST OF SUBSIDIZED HEALTH SERVICES OF $666,823 IS ATTRIBUTED TO A PHYSICIAN CLINIC.
		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 $ 20910718.
		PART II: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION. OTHER DONATIONS SUCH AS FOOD OR OTHER DURABLE GOODS PROVIDE AREA SHELTERS AND OTHER ORGANIZATIONS IN THE AREA. THIS ALLOWS THESE ORGANIZATIONS TO MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH 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 CENTRAL IOWA HOSPITAL CORPORATION. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2.
		PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $13,715,801. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE OF $20,289,490 AND REVENUE OF $9,920,669. AFTER TAKING THESE ITEMS INTO ACCOUNT WE CALCULATE AN ACTUAL MEDICARE SHORTFALL OF $24,084,622.THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
		PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.
		PART VI, LINE 2: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A SPONSORING PARTNER OF HEALTHY POLK WHICH IS A COMMUNITY COLLABORATIVE CONVENED BY POLK COUNTY HEALTH DEPARTMENT TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF POLK COUNTY. THROUGH A PLANNED AND ORGANIZED EFFORT, HEALTHY POLK DEVELOPS A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. HEALTHY POLK WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES, AS A SPONSORING AGENCY, ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. EFFORTS ARE MONITORED IN PART BY OTHER PARTNER AGENCIES SUCH AS THE FAMILY AND CHILD POLICY CENTER WHICH MONITORS AND REPORTS SPECIFIC INDICATORS TO ASSESS EFFECTIVENESS AND AID IN THE DEVELOPMENT OF NEW PLANS OR REFINING EXISTING ONES. FURTHER, HEALTHY POLK 2020 HAS DEVELOPED A MEASUREMENT PROCESS TO EVALUATE EFFECTIVENESS AS WELL AS NEED. HEALTHY POLK CONVENES TWO TOWN HALL MEETINGS ANNUALLY TO SEEK PUBLIC INPUT ON HEALTH INITIATIVES. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS ALSO A SPONSORING PARTNER IN DALLAS COUNTY PARTNERSHIP FOR HEALTH. THIS COLLABORATIVE ALSO COMPLETES A COMMUNITY HEALTH ASSESSMENT. FROM THIS, PRIORITIES AND STRATEGIES HAVE BEEN IDENTIFIED. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES HAS ACTIVELY ENGAGED IN ADDRESSING AND MONITORING HEALTH ISSUES AND NEEDS AS A RESULT OF THIS PROCESS.CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ALSO PARTICIPATES AS PART OF THE UNITED WAY COMMUNITY IMPACT COMMITTEE. THIS GROUP ACTIVELY ADDRESSES NEED AND STRATEGIES ASSOCIATED WITH HEALTH. MORE SPECIFICALLY, THIS GROUP OFTEN FOCUSES ON THE SOCIAL DETERMINANTS OF HEALTH AND HOW TO IMPACT THEM IN THE EFFORT TO RAISE THE COMMUNITY HEALTH STATUS. THIS WIDE-BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS OFTEN WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT.
		PART VI, LINE 3: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS: 1) PLACES SIGNAGE, INFORMATION, AND/OR BROCHURES IN APPROPRIATE AREAS OF THE PROVIDER (E.G., THE EMERGENCY DEPARTMENT, AND REGISTRATION AND CHECK-OUT/CASHIER AREAS) STATING THE PROVIDER/PHYSICIAN PRACTICE OFFERS CHARITY CARE AND DESCRIBES HOW TO OBTAIN MORE INFORMATION ABOUT FINANCIAL ASSISTANCE, 2) PLACES A NOTE ON THE HEALTH-CARE BILL AND STATEMENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE, 3) DESIGNATES INDIVIDUALS WHO CAN EXPLAIN THE PROVIDER'S CHARITY CARE POLICY, AND 4) INSTRUCTS STAFF WHO INTERACT WITH PATIENTS TO DIRECT QUESTIONS REGARDING THE CHARITY CARE POLICY TO THE PROPER PROVIDER REPRESENTATIVE.
		PART VI, LINE 4: CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS A 779-BED COMMUNITY HOSPITAL SYSTEM SERVING CENTRAL IOWA. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF DALLAS, GUTHRIE, JASPER, MADISON, MARION, POLK, STORY, AND WARREN. CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES ADMITS 31,184 INPATIENTS AND CARES FOR 80,267 EMERGENCY PATIENTS PER YEAR. THERE ARE 34 OTHER HOSPITALS WITHIN THE 30-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $45,594.00 TO $67,146.00 AND THE AVERAGE POVERTY RATE IS 9.81%. 51% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A IOWA HEALTH DES MOINES PATIENTS ARE ELIGIBLE FOR MEDICARE (40%) OR MEDICAID (11%). DALLAS, POLK AND STORY COUNTIES ARE THE ONLY COUNTIES IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATIONS. DALLAS COUNTY IS 6% HISPANIC, POLK COUNTY IS 5% AFRICAN AMERICAN, POLK COUNTY IS 6% HISPANIC, AND STORY COUNTY IS 6% ASIAN.
		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.
REPORTS FILED WITH STATES	PART VI, LINE 7	IA

Schedule H (Form 990) 2010

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number
42-0680452

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AMERICAN HEART ASSOCIATION1111 NINTH STREET SUITE 280 DES MOINES,IA50314	13-5613797	501(C)3	12,500	EVENT SPONSOR
(2) ARTHRITIS FOUNDATION2600 72ND ST STE D DES MOINES,IA503224724	26-4629290	501(C)3	9,002	EVENT SPONSOR
(3) BRAS FOR THE CAUSE - IOWA FOUNDATION INC650 S PRAIRIE VIEW DR SUITE 125 WEST DES MOINES,IA50266	23-0446913	501(C)3	75,000	EVENT SPONSOR
(4) BRAVO GREATER DES MOINES1915 GRAND AVE DES MOINES,IA50309	20-3598346	501(C)3	10,000	EVENT SPONSOR
(5) BROADLAWNS MEDICAL CENTER1801 HICKMAN RD DES MOINES,IA50314	42-1527407	501(C)3	1,400,000	CAPITAL BUILDING CAMPAIGN
(6) CENTRAL IOWA HEALTH SYSTEM1200 PLEASANT STREET DES MOINES,IA50309	42-1189791	501(C)3	123,784	PROGRAM SUPPORT
(7) CITY OF DES MOINES400 ROBERT D RAY DRIVE DES MOINES,IA50309	42-6004514	GOVERNMENT	179,716	PAYMENT IN LIEU OF TAXES
(8) CIVIC CENTER OF GREATER DES MOINES221 WALNUT ST DES MOINES,IA50309	51-0138181	501(C)3	10,000	CAPITAL BUILDING CAMPAIGN
(9) DES MOINES AREA COMMUNITY COLLEGE FOUNDATION2006 S ANKNEY BLVD ANKENY,IA500233993	23-7229486	501(C)3	50,525	EVENT SPONSOR
(10) DES MOINES UNIVERSITY3200 GRAND AVE DES MOINES,IA50312	42-0730347	501(C)3	20,000	CAPITAL BUILDING CAMPAIGN
(11) GREATER DES MOINES COMMUNITY FOUNDATION1915 GRAND AVE DES MOINES,IA50309	42-6139033	501(C)3	58,300	PROGRAM SUPPORT
(12) IOWA CAREGIVERS1211 VINE ST STE 1000 WEST DES MOINES,IA502654478	42-1457592	501(C)3	10,000	PROGRAM SUPPORT
(13) IOWA CLINIC HEALTHCARE FOUNDATION1215 PLEASANT ST SUITE 618 DES MOINES,IA50309	81-0599749	501(C)3	10,000	EVENT SPONSOR
(14) IOWA HEALTH SYSTEM1200 PLEASANT STREET DES MOINES,IA50309	42-1435199	501(C)3	365,446	PROGRAM SUPPORT
(15) JUVENILE DIABETES RESEARCH FOUNDATION5444 NW 96TH ST SUITE A JOHNSTON,IA50131	42-1907729	501(C)3	71,500	EVENT SPONSOR
(16) MARCH OF DIMES111 9TH STE 270 DES MOINES,IA50314	13-1846366	501(C)3	22,500	EVENT SPONSOR
(17) MEALS FROM THE HEARTLANDPO BOX 71606 CLIVE,IA50325	26-3443290	501(C)3	10,000	EVENT SPONSOR
(18) OPERATION DOWNTOWN700 LOCUST STREET SUITE 100 DES MOINES,IA50309	86-1058466	501(C)6	35,000	PROGRAM SUPPORT
(19) PRINCIPAL CHARITY CLASSIC2771 104TH ST STE 1 URBANDALE,IA50322	42-6139033	501(C)3	85,000	EVENT SPONSOR
(20) PUBLIC LIBRARY OF DES MOINES FOUNDATIONPO BOX 93243 400 LOCUST ST STE 350 DES MOINES,IA50393	42-1484890	501(C)3	20,000	CAPITAL BUILDING CAMPAIGN
(21) STAGEWEST THEATER COMPANYPO BOX 12127 DES MOINES,IA50312	31-1636048	501(C)3	7,500	EVENT SPONSOR
(22) TCOYD1110 CAMINO DEL MAR STE B DEL MAR,CA92014	33-0794608	501(C)3	5,000	EVENT SPONSOR
(23) THE GREATER DES MOINES PARTNERSHIP700 LOCUST STREET SUITE 100 DES MOINES,IA50309	42-1489668	501(C)6	205,000	CAPITAL BUILDING CAMPAIGN
(24) WAUKEE AREA ARTS COUNCILPO BOX 790 WAUKEE,IA50263	56-2472267	501(C)3	5,000	EVENT SPONSOR

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

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

Schedule I (Form 990) 2010

Additional Data

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Software Version:

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Yes

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) ERIC CROWELL	(i) (ii)	512,213 0	196,475 0	62,546 0	294,805 0	18,949 0	1,084,988 0	0 0
(2) JOHN HEFFERNAN MD	(i) (ii)	376,503 0	9,707 0	6,216 0	44,290 0	16,144 0	452,860 0	0 0
(3) WILLIAM YOST MD	(i) (ii)	0 219,096	0 0	0 100	0 42,032	0 19,809	0 281,037	0 0
(4) JOSEPH CORFITS	(i) (ii)	280,997 0	86,516 0	45,037 0	104,522 0	20,119 0	537,191 0	0 0
(5) SUSAN ALLYN	(i) (ii)	197,445 0	58,870 0	54,921 0	125,797 0	1,338 0	438,371 0	27,541 0
(6) AMY BETHEL	(i) (ii)	129,942 0	21,272 0	3,010 0	32,380 0	16,707 0	203,311 0	0 0
(7) CHRISTINE BLAIR	(i) (ii)	142,518 0	46,331 0	15,766 0	45,535 0	21,611 0	271,761 0	0 0
(8) DOUGLAS DORNER MD	(i) (ii)	351,496 0	109,745 0	169,648 0	29,263 0	17,592 0	677,744 0	140,313 0
(9) CECELIA KIRVIN	(i) (ii)	127,224 0	39,874 0	3,482 0	18,040 0	11,315 0	199,935 0	0 0
(10) ERIC LOTHE	(i) (ii)	263,987 0	50,039 0	36,378 0	38,172 0	26,293 0	414,869 0	0 0
(11) JOYCE MCDANEL	(i) (ii)	142,396 0	28,822 0	2,404 0	8,671 0	12,666 0	194,959 0	0 0
(12) MARK PURTLE MD	(i) (ii)	340,008 0	98,426 0	28,425 0	162,414 0	18,819 0	648,092 0	0 0
(13) SIDNEY RAMSEY	(i) (ii)	221,472 0	67,726 0	44,044 0	94,941 0	5,019 0	433,202 0	0 0
(14) JEANETTE SHELTON	(i) (ii)	147,255 0	20,582 0	18,540 0	33,253 0	16,386 0	236,016 0	0 0
(15) DAVID STARK	(i) (ii)	302,273 0	35,046 0	70,620 0	42,149 0	15,404 0	465,492 0	0 0
(16) STEPHEN STEPHENSON MD	(i) (ii)	355,252 0	109,070 0	52,208 0	170,774 0	12,315 0	699,619 0	0 0
(17) TIMOTHY HART MD	(i) (ii)	964,087 0	50,000 0	81,844 0	12,250 0	28,462 0	1,136,643 0	0 0
(18) AMAR NATH MD	(i) (ii)	970,341 0	50,000 0	77,123 0	12,250 0	26,178 0	1,135,892 0	0 0
(19) PRASAD PALAKURTHY MD	(i) (ii)	736,891 0	0 0	57,408 0	12,250 0	19,454 0	826,003 0	0 0
(20) JOHN PARGULSKI DO	(i) (ii)	705,334 0	0 0	55,364 0	12,000 0	25,357 0	798,055 0	0 0
(21) CRAIG STEVENS MD	(i) (ii)	714,139 0	50,000 0	56,591 0	12,250 0	27,528 0	860,508 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 1A	TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS.
	PART I, LINE 4B	THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: JOSEPH CORFITS $29,711, ERIC CROWELL $270,012, DOUG DORNER $7,119, JOHN HEFFERNAN $4,771, ERIC LOTHE $25,922, MARK PURTLE $150,164, SIDNEY RAMSEY $24,960, DAVID STARK $17,612, STEPHEN STEPHENSON $158,524, WILLIAM YOST $12,746.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) TIMOTHY HART RECRUITMENT INDUCEMENT		X	229,863	122,594		No	Yes		Yes
(2) AMAR NATH RECRUITMENT INDUCEMENT		X	229,863	122,594		No	Yes		Yes
(3) PRASAD PALAKURTHY RECRUITMENT INDUCEMENT		X	229,863	122,594		No	Yes		Yes
(4) JOHN PARGULSKI RECRUITMENT INDUCEMENT		X	229,863	122,594		No	Yes		Yes
(5) CRAIG STEVENS RECRUITMENT INDUCEMENT		X	229,863	122,594		No	Yes		Yes
(6) DAVID STARK RECRUITMENT INDUCEMENT		X	60,000	48,760		No	Yes		Yes
Total ............... $				661,730

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) 1776 WESTLAKES PARKWAY LC	COMMON BOARD MEMBER/OFFICER	730,000	INVESTMENT		No
(2) CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC	COMMON BOARD MEMBER/OFFICER	82,000	INVESTMENT AND FINANCIAL SERVICES		No
(3) IOWA HEALTH SYSTEM CONTRACTING SERVICES LC	COMMON BOARD MEMBER/KEY EMPLOYEE	756,123	PERFORMANCE OF SERVICES		No
(4) HEALTH SYSTEM EMERGENCY PHYSICIANS	COMMON BOARD MEMBER/OFFICER	800,000	RENTAL INCOME AND PURCHASED SERVICES		No
(5) HUBBELL REALTY COMPANY	COMMON BOARD MEMBER/OFFICER	1,591,000	RENT		No
(6) IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC	COMMON BOARD MEMBER/OFFICER	1,995,000	INVESTMENT AND LAUNDRY		No
(7) IOWA KIDNEY STONE CENTER	COMMON BOARD MEMBER/OFFICER	458,000	INVESTMENT		No
(8) LAKEVIEW SURGERY CENTER LC	COMMON BOARD MEMBER/OFFICER	1,219,000	INVESTMENT, SUPPLIES, FINANCIAL SERVICES, MAINTENANCE, TRANSCRIPTION, PHARMACISTS, BIO-TECH		No
(9) RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC	COMMON BOARD MEMBER/KEY EMPLOYEE	175,611	EXPENSE REIMBURSMENT		No
(10) ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC	COMMON BOARD MEMBER/OFFICER	961,000	INVESTMENT, SUPPLIES, LAUNDRY, MAINTENANCE, BIO-TECH, ETC.		No
(11) TRACY EKHARDT MD	FAMILY MEMBER OF KEY EMPLOYEE STEPHEN STEPHENSON, MD	352,452	EMPLOYMENT		No
(12) WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC	COMMON BOARD MEMBER/OFFICER	40,000	INVESTMENT AND FINANCIAL SERVICES		No
(13) WEST LAKES SLEEP CENTER LLC	COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE	130,000	INVESTMENT		No
(14) WINIFRED HALL	FAMILY MEMBER OF KEY EMPLOYEE JEANETTE SHELTON	42,535	EMPLOYMENT		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Identifier	Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2		BISHOP MICHAEL BURK; KENT HENNING; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 2		KENT HENNING; ERIC CROWELL; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 2		BISHOP MICHAEL BURK; ERIC CROWELL; BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6		CENTRAL IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A		CENTRAL IOWA HEALTH SYSTEM ELECTS BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B		CENTRAL IOWA HEALTH SYSTEM ELECTS AND CAN REMOVE BOARD OF DIRECTORS, APPROVE AMENDMENTS TO ARTICLES AND BYLAWS, AND APPROVE DISSOLUTIONS OR MERGER.
FORM 990, PART VI, SECTION B, LINE 11		THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
	FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY.
	FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2010 FOR THE FOLLOWING INDIVIDUALS: SUSAN ALLYN, JOSEPH CORFITS, ERIC CROWELL, DOUGLAS DORNER, ERIC LOTHE, JOYCE MCDANEL, MARK PURTLE, SIDNEY RAMSEY, DAVID STARK, STEPHEN STEPHENSON. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
	FORM 990, PART VI, SECTION C, LINE 19	IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 14,655,497. CHANGE IN BENEFICIAL INTEREST OF IOWA HEALTH FOUNDATION 834,397. CHANGES IN PENSION LIABILITY -2,497,305. TOTAL TO FORM 990, PART XI, LINE 5: 12,992,589.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CENTRAL IOWA HOSPITAL CORPORATION

Employer identification number

42-0680452

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) DMPA NO 2 LLC 1200 PLEASANT STREET DES MOINES,IA50309 27-2514210	PROPERTY MANAGEMENT	IA	0	32,500	CENTRAL IOWA HOSPITAL CORPORATION

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO,IA50703 42-1351526	EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS	IA	501(C)(3)	170(B)(1) (A)(II)	ALLEN HEALTH SYSTEMS INC	Yes
(2) ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO,IA50703 42-1201924	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(3) ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO,IA50703 42-0698265	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ALLEN HEALTH SYSTEMS INC	Yes
(4) ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA,IA52205 42-1466284	PROVIDE AMBULANCE SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'SJONES REGIONAL MEDICAL CENTER	Yes
(5) CENTRAL IOWA HEALTH PROPERTIES CORPORATION 1200 PLEASANT STREET DES MOINES,IA50309 42-1233759	PROPERTY HOLDING COMPANY	IA	501(C)(2)		CENTRAL IOWA HEALTH SYSTEM	Yes
(6) CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES,IA50309 42-1189791	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(7) CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES,IA50309 42-0680452	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	CENTRAL IOWA HEALTH SYSTEM	Yes
(8) FINLEY HEALTH FOUNDATION INC 350 NORTH GRANDVIEW AVENUE DUBUQUE,IA52001 42-1286953	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	THE FINLEY HOSPITAL AND THE DUBUQUE VISITING NURSE ASSOCIATION	Yes
(9) FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE,IA52001 42-1307495	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(10) HNC SERVICES 1200 PLEASANT STREET DES MOINES,IA50309 27-0987243	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	Yes
(11) INTRUST 11333 AURORA AVENUE URBANDALE,IA50322 42-1477471	HOME HEALTH CARE	IA	501(C)(3)	509(A)(2)	IOWA HEALTH SYSTEM	Yes
(12) IOWA HEALTH FOUNDATION 1440 INGERSOLL AVENUE DES MOINES,IA50309 42-1467682	CHARITABLE FUNDRAISING	IA	501(C)(3)	509(A)(3), TYPE III	CENTRAL IOWA HEALTH SYSTEM	Yes
(13) IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES,IA50309 42-1435199	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE III		Yes
(14) IOWA LUTHERAN HOSPITAL AUXILIARY 1440 INGERSOLL AVENUE DES MOINES,IA50309 42-6059539	SUPPORT IOWA LUTHERAN HOSPITAL MISSION TO IMPROVE HEALTHCARE	IA	501(C)(3)	509(A)(3), TYPE III		Yes
(15) IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 8101 BIRCHWOOD COURT JOHNSTON,IA50131 42-1411630	PRIMARY HEALTH CARE SERVICES	IA	501(C)(3)	170(B)(1) (A)(III)	IOWA HEALTH SYSTEM	Yes
(16) JONES REGIONAL MEDICAL CENTER FOUNDATION 104 BROADWAY PLACE ANAMOSA,IA52205 42-1429225	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ST LUKE'SJONES REGIONAL MEDICAL CENTER	Yes
(17) MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO,IA50703 42-1201138	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ALLEN HEALTH SYSTEMS INC	Yes
(18) NELLIE R SHERWOOD TRUST 1026 A AVENUE NE CEDAR RAPIDS,IA52402 42-6061621	PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY	IA	501(C)(3)	509(A)(3), TYPE I	ST LUKE'S METHODIST HOSPITAL	Yes
(19) NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED 720 KENYON DRIVE FORT DODGE,IA50501 42-0937390	MENTAL HEALTH CARE	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY HEALTH SYSTEMS INC	Yes
(20) NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY,IA51104 42-1019872	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	IOWA HEALTH SYSTEM	Yes
(21) ST LUKE'S HEALTH CARE FOUNDATION 855 A AVENUE NE STE 105 CEDAR RAPIDS,IA52402 42-1106819	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	ST LUKE'S METHODIST HOSPITAL (50 BENEFICIAL INTEREST)	Yes
(22) ST LUKE'S HEALTH FOUNDATION OF SIOUX CITY IOWA 2720 STONE PARK BLVD SIOUX CITY,IA51104 42-1301885	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	NORTHWEST IOWA HOSPITAL CORPORATION (50 BENEFICIAL INTEREST)	Yes
(23) ST LUKE'S HEALTH RESOURCES 2720 STONE PARK BLVD SIOUX CITY,IA51104 42-1059182	OUTPATIENT CLINICS AND HEALTHCARE SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'S HEALTH SYSTEM INC	Yes
(24) ST LUKE'S HEALTH SYSTEM INC 2720 STONE PARK BLVD SIOUX CITY,IA51104 42-1294091	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE III	IOWA HEALTH SYSTEM	Yes
(25) ST LUKE'S HEALTHCARE 1026 A AVENUE NE CEDAR RAPIDS,IA52402 42-1487968	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(26) ST LUKE'S METHODIST HOSPITAL 1026 A AVENUE NE CEDAR RAPIDS,IA52402 42-0504780	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ST LUKE'S HEALTHCARE	Yes
(27) ST LUKE'SJONES REGIONAL MEDICAL CENTER 1795 HIGHWAY 64 EAST ANAMOSA,IA52205 42-1487967	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	ST LUKE'S HEALTHCARE	Yes
(28) STL CARE COMPANY 1026 A AVENUE NE CEDAR RAPIDS,IA52402 42-1276632	IMPROVE PUBLIC HEALTH SERVICES	IA	501(C)(3)	509(A)(2)	ST LUKE'S HEALTHCARE	Yes
(29) THE DUBUQUE VISITING NURSE ASSOCIATION 350 NORTH GRANDVIEW AVENUE DUBUQUE,IA52001 42-0680410	PUBLIC HEALTH SERVICES/HOME CARE	IA	501(C)(3)	509(A)(2)	FINLEY TRI-STATES HEALTH GROUP INC	Yes
(30) THE FINLEY HOSPITAL 350 NORTH GRANDVIEW AVENUE DUBUQUE,IA52001 42-0680354	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	FINLEY TRI-STATES HEALTH GROUP INC	Yes
(31) THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 2701 17TH STREET ROCK ISLAND,IL61201 36-3678909	MENTAL HEALTH CARE	IL	501(C)(3)	170(B)(1) (A)(VI)	TRINITY REGIONAL HEALTH SYSTEM	Yes
(32) TRINITY BUILDING CORPORATION 802 KENYON ROAD FORT DODGE,IA50501 42-1376187	PROPERTY HOLDING COMPANY	IA	501(C)(2)		TRINITY HEALTH SYSTEMS INC	Yes
(33) TRINITY HEALTH FOUNDATION 802 KENYON ROAD FORT DODGE,IA50501 42-1222381	CHARITABLE FUNDRAISING	IA	501(C)(3)	170(B)(1) (A)(VI)	TRINITY HEALTH SYSTEMS INC	Yes
(34) TRINITY HEALTH FOUNDATION 2701 17TH STREET ROCK ISLAND,IL61201 36-3321751	CHARITABLE FUNDRAISING	IL	501(C)(3)	170(B)(1) (A)(VI)	TRINITY REGIONAL HEALTH SYSTEM	Yes
(35) TRINITY HEALTH SYSTEMS INC 802 KENYON ROAD FORT DODGE,IA50501 42-1222877	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IA	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(36) TRINITY MEDICAL CENTER 2701 17TH STREET ROCK ISLAND,IL61201 36-2739299	HOSPITAL	IL	501(C)(3)	170(B)(1) (A)(III)	TRINITY REGIONAL HEALTH SYSTEM	Yes
(37) TRINITY REGIONAL HEALTH SYSTEM 2701 17TH STREET ROCK ISLAND,IL61201 36-3351952	SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE	IL	501(C)(3)	509(A)(3), TYPE II	IOWA HEALTH SYSTEM	Yes
(38) TRINITY REGIONAL HOSPITAL AUXILIARY 802 KENYON ROAD FORT DODGE,IA50501 42-6081474	CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES	IA	501(C)(3)	509(A)(2)	TRINITY REGIONAL MEDICAL CENTER	Yes
(39) TRINITY REGIONAL MEDICAL CENTER 802 KENYON ROAD FORT DODGE,IA50501 42-1009175	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY HEALTH SYSTEMS INC	Yes
(40) TRINITY VISITING NURSE & HOMECARE ASSOCIATION 2701 17TH STREET ROCK ISLAND,IL61201 36-3052939	HOME HEALTH CARE	IL	501(C)(3)	509(A)(2)	TRINITY REGIONAL HEALTH SYSTEM	Yes
(41) UNITY HEALTHCARE 1518 MULBERRY AVENUE MUSCATINE,IA52761 42-0680337	HOSPITAL	IA	501(C)(3)	170(B)(1) (A)(III)	TRINITY REGIONAL HEALTH SYSTEM	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) 1776 WESTLAKES PARKWAY LC 4949 WESTOWN PARKWAY SUITE 200 WEST DES MOINES,IA50266 20-5031651	OWNERSHIP/RENTAL OF 2 COMMERCIAL OFFICE BUILDINGS	IA	N/A	UNRELATED	177,822	12,340,369		No		Yes		33.330 %
(2) CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC 1200 PLEASANT STREET DES MOINES,IA50309 27-3625869	CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES	IA	N/A	RELATED	80,551	66,239		No		Yes		20.000 %
(3) DES MOINES PARKING ASSOCIATES 1200 PLEASANT STREET DES MOINES,IA50309 38-2622972	PARKING DECK OPERATIONS	IA	CENTRAL IOWA HEALTH PROPERTIES CORPORATION	RELATED	267,486	3,933,296		No		Yes		100.000 %
(4) DUBUQUE ENDOSCOPY CENTER LC 1515 DELHI STREET SUITE 500 DUBUQUE,IA52001 20-1597161	AMBULATORY SURGERY CENTER	IA	THE FINLEY HOSPITAL	RELATED	671,118	126,090		No		Yes		51.000 %
(5) FINLEYHARTIG HOMECARE LLC 703 MAIN ST DUBUQUE,IA52001 42-1487138	SALE/RENTAL OF MEDICAL EQUIPMENT	IA	N/A	RELATED	172,294	783,074		No		Yes		50.000 %
(6) HEALTH CARE AFFILIATES OF THE TRI-STATES LLC 350 N GRANDVIEW AVE DUBUQUE,IA52001 42-1428503	PROVIDE ACCESS TO LICENSED SOFTWARE	IA	N/A	RELATED		14,037		No		Yes		50.000 %
(7) HEALTH ENTERPRISES VENTURES LC 4250 GLASS ROAD NE CEDAR RAPIDS,IA52402 39-1894290	INVESTMENT VEHICLE OWNING PARTS OF EACH OF THE CLINICAL JOINT VENTURES	IA	N/A	UNRELATED	-15,790	775,135		No	59,802		No	55.660 %
(8) HY-VEEIOWA HEALTH LC 5820 WESTOWN PARKWAY WEST DES MOINES,IA50266 26-3293530	PRIMARY CARE CLINIC	IA	N/A	RELATED	-172,539	31,249		No		Yes		0 %
(9) IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC 1200 PLEASANT STREET DES MOINES,IA50309 03-0482623	OUTPATIENT DIAGNOSTIC IMAGING	IA	N/A	RELATED	1,746,221	3,109,901		No		Yes		50.000 %
(10) IOWA HEALTH SYSTEM CONTRACTING SERVICES LC 1200 PLEASANT STREET DES MOINES,IA50309 42-1511142	GROUP PURCHASING	IA	N/A	RELATED	5,755,039	8,927,942	Yes			Yes		100.000 %
(11) LAKEVIEW SURGERY CENTER LC 1200 PLEASANT STREET DES MOINES,IA50309 42-1516120	SURGERY CENTER	IA	N/A	RELATED	3,292,459	5,440,740		No		Yes		50.000 %
(12) MEDICAL LABORATORIES OF EASTERN IOWA LC 1026 A AVE NE CEDAR RAPIDS,IA52402 42-1359640	MEDICAL LABORATORY SERVICES	IA	N/A	RELATED	420,861	977,532		No		Yes		50.000 %
(13) METRO MRI CENTER LIMITED PARTNERSHIP 615 VALLEY VIEW DRIVE SUITE 102 MOLINE,IL61265 36-3710164	PROVIDE MRI AND OTHER MEDICAL SERVICES	IL	N/A	RELATED	701,249	1,694,638		No		Yes		33.970 %
(14) MR ASSOCIATES LLP 1455 SHERMAN ROAD HIAWATHA,IA52233 42-1260463	OWN AND OPERATE MR UNIT	IA	N/A	RELATED	2,823,501	2,022,295		No		Yes		33.330 %
(15) NORTHEAST IOWA PHYSICAL THERAPY AND SPORTS MEDICINE LLC 1825 LOGAN AVENUE WATERLOO,IA50703 20-2124978	ATHLETIC TRAINING AND SPORTS MEDICINE	IA	N/A	RELATED	-91,474	28,104		No		Yes		50.000 %
(16) ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC 1200 PLEASANT STREET DES MOINES,IA50309 42-1508092	AMBULATORY SURGERY CENTER	IA	N/A	RELATED	2,578,454	3,587,597		No		Yes		50.000 %
(17) PIERCE STREET SAME DAY SURGERY LC 2730 PIERCE STREET SIOUX CITY,IA51104 20-5895205	AMBULATORY SURGERY CENTER	IA	N/A	RELATED	1,357,604	3,410,402		No		Yes		50.000 %
(18) QUAD CITY AMBULATORY SURGERY CENTER LLC 520 VALLEY VIEW DRIVE SUITE 300 MOLINE,IL61265 36-4471903	AMBULATORY SURGERY CENTER.	IL	N/A	RELATED	323,527	3,373,129		No		Yes		50.000 %
(19) TEAM DES MOINES PARTNERS LLC 1205 TECHNOLOGY PARKWAY CEDAR FALLS,IA50613 26-2753371	COMPUTER SUPPORT	IA	N/A	UNRELATED				No		Yes		0 %
(20) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC 1075 FIRST AVENUE SE CEDAR RAPIDS,IA52403 72-1550812	AMBULATORY SURGERY CENTER.	IA	N/A	RELATED	3,374,710	7,172,047		No		Yes		50.000 %
(21) TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC 4500 UTICA RIDGE RD BETTENDORF,IA52722 27-2562753	ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES	IA	N/A	RELATED	20,893	128,254		No		Yes		50.000 %
(22) TRI-WEBSTER LC 1610 COLLINS ST WEBSTER CITY,IA50595 01-0740062	MEDICAL BUILDING AND SURROUNDING PROPERTY	IA	N/A	RELATED	113,048	1,782,267		No		Yes		50.000 %
(23) WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC 1660 60TH STREET WEST DES MOINES,IA50266 27-1414600	ORTHOPEDIC SERVICE LINES MANAGEMENT	IA	N/A	RELATED	204,040	4,258		No		Yes		20.000 %
(24) WEST LAKES MEDICAL EQUIPMENT LLC 5950 UNIVERSITY AVENUE SUITE 321 WEST DES MOINES,IA50266 26-3300536	MEDICAL EQUIPMENT SALES AND RENTAL	IA	N/A	UNRELATED	67,986	198,717		No	65,291	Yes		50.000 %
(25) WEST LAKES SLEEP CENTER LLC 5950 UNIVERSITY AVENUE SUITE 2 WEST DES MOINES,IA50266 26-3193923	SLEEP DISORDER CENTER AS INDEPENDENT DIAGNOSTIC TESTING FACILITY	IA	N/A	RELATED	23,024	355,798		No		Yes		50.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) BROADBAND INC 1200 PLEASANT ST DES MOINES,IA50309 27-3819741	INFORMATION TECHNOLOGY MGMT.	IA	IHS	C	62,920		100.000 %
(2) MEDIMORE INC 1200 PLEASANT ST DES MOINES,IA50309 42-1414390	MANAGED CARE	IA	IHS	C	155,826		100.000 %
(3) PRECEDENCE INC 4622 PROGRESS DRIVE STE A DAVENPORT,IA52807 37-1288604	MANAGED MENTAL CARE	IA	RYC	C	535,068	395,659	100.000 %
(4) RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC 700 E UNIVERSITY AVE DES MOINES,IA50316 26-1271143	SPECIALTY PHYSICIANS MEDICAL CARE	IA	CIHC	C	406,868	164,732	57.100 %
(5) ST LUKE'S DEVELOPMENT COMPANY 1026 A AVE NE CEDAR RAPIDS,IA52402 42-1353658	LESSOR NONRESIDENTIAL REAL ESTATE	IA	SLHCF	C			100.000 %
(6) STL HEALTH RESOURCES CO 1026 A AVE NE CEDAR RAPIDS,IA52402 42-1193499	PHYSICIAN OFFICE RENTAL	IA	SLMH	C	1,075,846	6,293,579	100.000 %
(7) TRIMARK PHYSICIANS GROUP INC 802 KENYON ROAD FORT DODGE,IA50501 42-1335554	MEDICAL CLINICS	IA	THS	C	43,433,525	17,778,844	100.000 %
(8) TRINITY HEALTH ENTERPRISES INC 2701 17TH ST ROCK ISLAND,IL61201 36-3320141	RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY	IL	TRHS	C	3,554,376	3,394,181	100.000 %

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) CENTRAL IOWA HEALTH PROPERTIES CORPORATION	D	177,014	BASED ON GAAP, CASH, AND/OR FMV.
(2) CENTRAL IOWA HEALTH PROPERTIES CORPORATION	H	87,956	BASED ON GAAP, CASH, AND/OR FMV.
(3) CENTRAL IOWA HEALTH PROPERTIES CORPORATION	J	2,423,281	BASED ON GAAP, CASH, AND/OR FMV.
(4) CENTRAL IOWA HEALTH PROPERTIES CORPORATION	P	270,858	BASED ON GAAP, CASH, AND/OR FMV.
(5) RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC	P	175,611	BASED ON GAAP, CASH, AND/OR FMV.
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation
SECTION 512(B)(13) CONTROLLED ENTITY	SCHEDULE R, PART II, COLUMN (G)	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.

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: IMPROVING THE HEALTH OF THE COMMUNITY THROUGH HEALING, CARING AND TEACHING.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	15
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	6,253
6	Total number of volunteers (estimate if necessary) ....	6	3,858
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	12,606,364
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	2,890,895

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	7,283,762	5,648,151
9	Program service revenue (Part VIII, line 2g) .........	604,692,444	640,855,688
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	14,855,128	32,927,906
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,522,554	5,981,267
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	633,353,888	685,413,012
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,497,494	2,887,518
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	318,088,402	339,582,270
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	266,186,444	303,862,963
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	588,772,340	646,332,751
19	Revenue less expenses. Subtract line 18 from line 12......	44,581,548	39,080,261
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	763,247,804	801,088,699
21	Total liabilities (Part X, line 26)............	293,381,707	279,149,752
22	Net assets or fund balances. Subtract line 21 from line 20 .....	469,866,097	521,938,947

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4a	(Code: ) (Expenses $ 537,059,872 including grants of $ 1,087,321 ) (Revenue $ 641,162,001 )
	HEALTH-CARE SERVICESCENTRAL IOWA HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. CENTRAL IOWA HOSPITAL CORPORATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2010, CENTRAL IOWA HOSPITAL CORPORATION ADMITTED 34,723 PATIENTS RESULTING IN A TOTAL OF 168,679 PATIENT DAYS. OUTPATIENT VISITS TOTALED 633,097 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 10,864. THERE WERE ALSO 80,267 EMERGENCY ROOM VISITS AND 3,995 BABIES DELIVERED.

4b	(Code: ) (Expenses $ 49,278,611 including grants of $ 1,800,197 ) (Revenue $ 0 )
	COMMUNITY BENEFITS, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE TO 7,179 PEOPLE AT A VALUE OF $7,574,467 IN 2010. OFTENTIMES, CENTRAL IOWA HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. CENTRAL IOWA HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA METHODIST MEDICAL CENTER, IOWA LUTHERAN HOSPITAL, METHODIST WEST HOSPITAL AND BLANK CHILDREN'S HOSPITALS' NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $21,161,010 FOR 2010. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $28,735,477.OTHER BENEFITS: CENTRAL IOWA HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. CENTRAL IOWA HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. CENTRAL IOWA HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 88,627 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL NET OTHER BENEFITS REPORTED VALUE: $20,543,134.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 586,338,483

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	10,055,495	295,573	1,726,677

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		4,588,668
e	Government grants (contributions)1e		569,675

f	All other contributions, gifts, grants, and similar amounts not included above1f		489,808
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			5,648,151
			Business Code
2a	NET PATIENT REVENUE		900,099	612,414,482	612,414,482
b	LABORATORY SERVICES		621,510	11,288,340		11,288,340
c	SUBS & JOINT VENTURES		900,099	7,459,958	7,272,924	187,034
d	MGMT & SUPPORT SVCS		561,000	6,246,560	2,853,315	392,411	3,000,834
e	OTHER HEALTHCARE SVCS		900,099	971,711		535,088	436,623
f	All other program service revenue .			2,474,637	2,218,745	27,990	227,902
g	Total. Add lines 2a–2f........			640,855,688
3	Investment income (including dividends, interest
	and other similar amounts).....			6,780,510			6,780,510
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	407,745,497	94,407
b	Less: cost or other basis and sales expenses	381,604,552	87,956
c	Gain or (loss)	26,140,945	6,451
d	Net gain or (loss)..........			26,147,396			26,147,396
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a		9,417
b	Less: cost of goods sold ..b		7,096
c	Net income or (loss) from sales of inventory..			2,321			2,321
Miscellaneous Revenue			Business Code
11a	CAFETERIA/FOOD SVCS		722,210	4,556,570		175,501	4,381,069
b	CHILDCARE SERVICES		624,410	1,195,395			1,195,395
c	MISCELLANEOUS REVENUE		900,099	226,981	130,812		96,169
d	All other revenue ....
e	Total. Add lines 11a–11d ......			5,978,946
12	Total revenue. See Instructions....			685,413,012	624,890,278	12,606,364	42,268,219


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			35,945	1	35,649
2	Savings and temporary cash investments .......			15,824,014	2	19,857,649
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			79,256,659	4	83,025,267
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			1,283,055	5	661,730
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			5,547,472	7	8,669,125
8	Inventories for sale or use ..............			10,388,122	8	10,472,938
9	Prepaid expenses and deferred charges ............			9,969,808	9	8,572,592
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	682,246,197
b	Less: accumulated depreciation. .....	10b	434,514,237	260,840,400	10c	247,731,960
11	Investments—publicly traded securities ..........			343,957,909	11	391,365,556
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..			34,085,792	13	30,228,353
14	Intangible assets .........			1,956,745	14	384,245
15	Other assets. See Part IV, line 11 ...........			101,883	15	83,635
16	Total assets. Add lines 1 through 15 (must equal line 34)...			763,247,804	16	801,088,699
17	Accounts payable and accrued expenses .			59,462,155	17	61,264,550
18	Grants payable ..........			97,215	18
19	Deferred revenue ..........			418,924	19	478,794
20	Tax-exempt bond liabilities ..........			23,000,000	20	23,000,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			594,633	23	563,298
24	Unsecured notes and loans payable to unrelated third parties ....			200,000	24	100,000
25	Other liabilities. Complete Part X of Schedule D.....			209,608,780	25	193,743,110
26	Total liabilities. Add lines 17 through 25.....			293,381,707	26	279,149,752
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			440,336,205	27	495,594,082
28	Temporarily restricted net assets .....			16,479,262	28	11,884,147
29	Permanently restricted net assets .....			13,050,630	29	14,460,718
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			469,866,097	33	521,938,947
34	Total liabilities and net assets/fund balances .....			763,247,804	34	801,088,699