Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
MERITER MEDICAL GROUP INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
202 SOUTH PARK STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MADISON, WI537151596
D Employer identification number

05-0545222
E Telephone number

G Gross receipts $ 58,238,439
F Name and address of principal officer:
ROBERT TURNGREN MD
202 SOUTH PARK STREET
MADISON,WI537151596
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MERITER.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 2002
M State of legal domicile: WI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: NETWORK OF PHYSICIANS AND HEALTH CARE PROVIDERS, DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 614
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 17,733 51,475
9 Program service revenue (Part VIII, line 2g) ......... 55,761,021 56,565,481
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 604,540 -161,461
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,910,194 1,782,171
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 58,293,488 58,237,666
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 60,819,948 60,856,567
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 17,969,919 17,667,169
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 78,789,867 78,523,736
19 Revenue less expenses. Subtract line 18 from line 12....... -20,496,379 -20,286,070
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 50,088,927 45,842,537
21 Total liabilities (Part X, line 26)............. 162,562,619 180,471,907
22 Net assets or fund balances. Subtract line 21 from line 20..... -112,473,692 -134,629,370
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE MERITER MEDICAL GROUP, INC.'S FOCUS IS ON IMPROVING PATIENT ACCESS AND PROVIDING THE BEST CARE POSSIBLE AT THE RIGHT TIME, IN THE RIGHT PLACE. OUR TEAM OF PHYSICIANS AND STAFF KEEP PATIENTS AT THE CENTER OF CARE. A VARIETY OF PRIMARY AND SPECIALTY PROVIDERS SUPPORT PATIENTS IN MERITER'S GROWING MULTI-SPECIALTY HEALTH CARE TEAM. THE MERITER MEDICAL GROUP'S GROWING NETWORK OF PHYSICIANS AND HEALTH CARE PROVIDERS ARE DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE AND LIVING BY MERITER'S MISSION TO HEAL, TEACH AND SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 69,544,867 including grants of $ 0 ) (Revenue $ 58,320,016 )
MERITER MEDICAL GROUP, INC. OFFERS AMBULATORY HEALTH CARE WITH A FOCUS ON PROVIDING EDUCATIONAL, OUTREACH AND REFERRAL PROGRAMS THAT INCLUDE WELLNESS AND DISEASE PREVENTION. THIS OCCURS THROUGH ALL SPECIALTIES FOR INDIVIDUALS AND IN GROUP SETTINGS SUCH AS INDIVIDUAL HEALTH EDUCATION SESSIONS WITH A NURSE PRACTITIONER FOR WOMEN MANAGING THEIR HEART DISEASE, OFFERING GROUP SESSIONS ON THE LATEST ADVANCEMENTS FOR TREATMENTS OF OSTEOARTHRITIS, AND EDUCATIONAL PROGRAMS FOR PREGNANT PARENTS ATTENDING CHILDBIRTH EDUCATION PROGRAMS. MERITER MEDICAL GROUP, INC. PROVIDERS ALSO OFFER VARIOUS EDUCATIONAL TALKS AND SCREENING OPPORTUNITIES AS PART OF COMMUNITY PROGRAMS/EVENTS EACH YEAR. MERITER MEDICAL GROUP, INC.'S ADULT PRIMARY CARE CLINICS INCLUDE DIABETES MANAGEMENT SERVICES THROUGH A TEAM CONSISTING OF ENDOCRINOLOGISTS, PROGRAM SERVICE ACCOMPLISHMENTS: CERTIFIED DIABETES EDUCATORS, DIETITIAN AND HEALTH PSYCHOLOGIST. HEALTH PSYCHOLOGY SERVICES ARE AVAILABLE TO PATIENTS WHO NEED EMOTIONAL SUPPORT AND GUIDANCE AS THEY WORK THROUGH PERSONAL HEALTH CHANGES. MERITER CHILD & ADOLESCENT PSYCHIATRY STAFF PROVIDE EDUCATIONAL SESSIONS FOR SCHOOL PERSONNEL. THE MERITER MEDICAL GROUP, INC. PRIMARILY SERVES PATIENTS FROM DANE COUNTY.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet69,544,867
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II..............
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
21
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
614
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
2
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRON SCHROEDER202 SOUTH PARK STREET   MADISON,WI537151596 (608) 417-5832
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DAVID BOYER TO 815......................................................................
FORMER BOARD CHAIR
 1.00
.................
2.00 		X   X       0 15,921 0
(2) SANFORD CARIMI MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           228,755 0 27,074
(3) DEREK CLEVIDENCE MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           259,647 0 33,314
(4) KENNETH FELZ MD TO 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           231,470 0 32,088
(5) KENNETH FOSTER MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           406,350 0 34,296
(6) AMY FRANTA MD FR 815......................................................................
BOARD MEMBER
 49.00
.................
1.00 		X           620,488 0 38,093
(7) PAULA GRAF MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           209,166 0 19,622
(8) CHRISTOPHER HARKIN MD FR 815......................................................................
BOARD MEMBER
 49.00
.................
1.00 		X           253,631 0 31,448
(9) JERRY JASKUNAS MD TO 815......................................................................
BOARD MEMBER
 49.00
.................
1.00 		X           297,563 0 31,625
(10) JEFF KOBERNUSZ APNP FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           92,261 0 24,997
(11) SARA KRECKMAN MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           281,522 0 33,080
(12) MARGARET NOREUIL RN PHD TO 815......................................................................
BOARD MEMBER
 1.00
.................
2.00 		X           0 0 0
(13) GEOFFREY PRIEST MD TO 815......................................................................
BOARD MEMBER
 5.00
.................
45.00 		X           0 672,852 30,357
(14) KATHERINE SCHMITT MD......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           372,165 0 31,301
(15) CHRISTINE SHARKEY MD FR 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           185,574 0 22,773
(16) JAMES SHROPSHIRE MD TO 815......................................................................
BOARD MEMBER
 50.00
.................
0.00 		X           247,689 0 32,273
(17) SUSAN TOTH MD TO 815......................................................................
BOARD MEMBER
 49.00
.................
1.00 		X           499,326 0 28,705
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) ROBERT TURNGREN MD........................................................................
BOARD CHAIR/PRESIDENT
 50.00
.......................0.00 		X   X       0 689,958 35,525
(19) MATT WOLFF MD FR 815........................................................................
BOARD MEMBER
 49.00
.......................1.00 		X           725,189 0 34,390
(20) ARTHUR NIZZA DSW FR 215........................................................................
BOARD MEMBER/CEO
 1.00
.......................49.00 		    X       0 512,068 77,811
(21) PETER THOREEN TO 215........................................................................
BOARD MEMBER/INTERIM CEO MHS
 1.00
.......................40.00 		    X       0 506,110 239,270
(22) BETH ERDMAN........................................................................
CFO/SECRETARY/TREASURER MHS
 1.00
.......................49.00 		      X     0 347,973 17,823
(23) MARY HANSEN........................................................................
SECRETARY/TREASURER
 45.00
.......................0.00 		      X     277,005 0 30,389
(24) PAMELA WETZEL........................................................................
AVP/SR. MEDICAL DIRECTOR
 50.00
.......................0.00 		      X     350,901 56,857 26,805
(25) JAMES BOWERS MD........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   729,292 0 35,769
(26) CRAIG DOPF MD........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   653,623 0 35,506
(27) GARY GRIGLIONE MD........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   740,013 0 31,943
(28) SUSAN LEPINSKI MD........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   697,025 0 31,123
(29) JOHN MOSES MD........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   645,723 0 34,104
(30) JAMES WOODWARD TO 0714........................................................................
FORMER CEO/PRESIDENT
 0.00
.......................0.00 		          X 0 708,537 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,004,378 3,510,276 1,081,504
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet127
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
NORTHERN X-RAY COMPANY

2118 4TH AVENUE S
MINNEAPOLIS,MN55404 		PURCHASED SERVICES 206,117
BADER BROTHERS ENTERPRISES

W7210 COUNTY ROAD B
MONROE,WI53566 		CONSTRUCTION 199,171
DANE COUNTY CYTOLOGY CENTER

2000 ENGEL ST STE 201
MADISON,WI53713 		PURCHASED SERVICES 148,792
CAPITAL LAWN SPRINKLER

636 S NINE MOUND ROAD
VERONA,WI53593 		CONSTRUCTION 135,837
STRATUM MEDICAL INC

102 E MAIN STREET
URBANA,IL61801 		CONSULTING 131,935
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet5
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 51,475
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 51,475
Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 900099 54,815,953 54,815,953    
b MGMT & SUPPORT SVCS 900099 1,749,528 1,749,528    
c
d
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 56,565,481
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet -160,688     -160,688
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   27,636
b Less: rental expenses   0
c Rental income or (loss)   27,636
d Net rental income or (loss)......MediumBullet 27,636     27,636
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses 773  
c Gain or (loss) -773  
d Net gain or (loss).....MediumBullet -773     -773
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..MediumBullet      
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..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a OTHER REVENUE 900099 1,754,535 1,754,535    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,754,535
12 Total revenue. See Instructions......MediumBullet 58,237,666 58,320,016 0 -133,825
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
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 domestic organizations and domestic governments. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 2,111,599 1,957,902 153,697  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 48,264,359 44,258,417 4,005,942  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,557,440 1,428,172 129,268  
9 Other employee benefits ....... 6,315,334 5,791,161 524,173  
10 Payroll taxes ........... 2,607,835 2,391,385 216,450  
11 Fees for services (non-employees):        
a Management ...... 316,389 247,047 69,342  
b Legal ......... 44,886   44,886  
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,485,559 1,362,258 123,301  
12 Advertising and promotion ....        
13 Office expenses ....... 349,027 247,949 101,078  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 3,045,362 2,163,425 881,937  
17 Travel ............ 192,620 136,837 55,783  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 18,496 13,140 5,356  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 2,227,988 1,582,763 645,225  
23 Insurance ... 451,737 320,914 130,823  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 5,384,074 3,824,846 1,559,228  
b TEST FEES 2,505,701 2,505,701    
c MISCELLANEOUS 1,098,548 924,516 174,032  
d EQUIPMENT RENT AND MAIN 329,534 234,101 95,433  
e All other expenses 217,248 154,333 62,915  
25 Total functional expenses. Add lines 1 through 24e 78,523,736 69,544,867 8,978,869 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 2,293,389 2 909,031
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 5,894,917 4 6,155,475
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........   8  
9 Prepaid expenses and deferred charges ...... 392,420 9 297,888
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 33,994,072
b Less: accumulated depreciation 10b 4,551,101 32,369,249 10c 29,442,971
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 9,138,952 15 9,037,172
16 Total assets. Add lines 1 through 15 (must equal line 34)... 50,088,927 16 45,842,537
Liabilities 17 Accounts payable and accrued expenses ..... 153,423,667 17 171,434,735
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other 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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 9,138,952 25 9,037,172
26 Total liabilities. Add lines 17 through 25.. 162,562,619 26 180,471,907
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets -112,473,692 27 -134,629,370
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... -112,473,692 33 -134,629,370
34 Total liabilities and net assets/fund balances ........ 50,088,927 34 45,842,537
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
58,237,666
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
78,523,736
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-20,286,070
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-112,473,692
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,869,608
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-134,629,370
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
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.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............. 1

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) MERITER HOSPITAL INC
  		390806367 3 Yes   0 0
Total 1 0 0

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
Yes
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
No
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
No
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
No
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
No
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
No
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
No
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
No
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
No
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
No
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
No
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
No
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
SCHEDULE A, PART I, LINE 11G(VI): MERITER MEDICAL GROUP IS A MULTISPECIALTY TEAM OFFERING INPATIENT AND OUTPATIENT CARE. MERITER MEDICAL GROUP PHYSICIANS AND ADVANCED PRACTITIONERS PROVIDE CARE IN MERITER PRIMARY AND SPECIALTY CLINICS, MERITER HOSPITAL AND SEVERAL REGIONAL HOSPITALS. ALL PROVIDERS WITH MERITER MEDICAL GROUP ARE MEMBERS OF THE MERITER MEDICAL STAFF WHO REFER PATIENTS TO MERITER HOSPITAL AND CLINICS FOR COORDINATED CARE.
SCHEDULE A, PART IV, SECTION C, LINE 1: MERITER MEDICAL GROUP AND MERITER HOSPITAL ARE EACH MEMBER-MANAGED, AND UNITYPOINT HEALTH IS THE SOLE MEMBER. UNITYPOINT HEALTH THEREFORE CONTROLS EACH ENTITY.
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......... 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
MERITER MEDICAL GROUP INC
  		Employer identification number
05-0545222
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
MERITER MEDICAL GROUP INC
  		Employer identification number

05-0545222
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
MERITER MEDICAL GROUP INC
  		Employer identification number

05-0545222
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2015)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ....    
5
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? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the 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, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
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 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ...   5,060,030 5,060,030
b Buildings   16,849,380 1,277,385 15,571,995
c Leasehold improvements   3,637,721 820,223 2,817,498
d Equipment ...   5,223,088 1,957,098 3,265,990
e Other ...   3,223,853 496,395 2,727,458
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 29,442,971
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DEFERRED COMPENSATION 9,037,172
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 9,037,172
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
DEFERRED COMPENSATION 9,037,172
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 9,037,172
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
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 XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
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  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  

Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2012. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL.
Schedule D (Form 990) 2015


Additional Data


Software ID:  
Software Version:  




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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1SANFORD CARIMI MD FR 815BOARD MEMBER (i)

(ii)		 195,911
-------------
0 		6,558
-------------
0 		26,286
-------------
0 		9,051
-------------
0 		18,023
-------------
0 		255,829
-------------
0 		0
-------------
0
2DEREK CLEVIDENCE MD FR 815BOARD MEMBER (i)

(ii)		 201,798
-------------
0 		37,483
-------------
0 		20,366
-------------
0 		10,396
-------------
0 		22,918
-------------
0 		292,961
-------------
0 		0
-------------
0
3KENNETH FELZ MD TO 815BOARD MEMBER (i)

(ii)		 191,487
-------------
0 		11,110
-------------
0 		28,873
-------------
0 		9,340
-------------
0 		22,748
-------------
0 		263,558
-------------
0 		0
-------------
0
4KENNETH FOSTER MD FR 815BOARD MEMBER (i)

(ii)		 353,433
-------------
0 		4,000
-------------
0 		48,917
-------------
0 		10,600
-------------
0 		23,696
-------------
0 		440,646
-------------
0 		0
-------------
0
5AMY FRANTA MD FR 815BOARD MEMBER (i)

(ii)		 543,896
-------------
0 		2,000
-------------
0 		74,592
-------------
0 		10,600
-------------
0 		27,493
-------------
0 		658,581
-------------
0 		0
-------------
0
6PAULA GRAF MD FR 815BOARD MEMBER (i)

(ii)		 181,727
-------------
0 		7,323
-------------
0 		20,116
-------------
0 		8,347
-------------
0 		11,275
-------------
0 		228,788
-------------
0 		0
-------------
0
7CHRISTOPHER HARKIN MD FR 815BOARD MEMBER (i)

(ii)		 216,707
-------------
0 		25,333
-------------
0 		11,591
-------------
0 		10,201
-------------
0 		21,247
-------------
0 		285,079
-------------
0 		0
-------------
0
8JERRY JASKUNAS MD TO 815BOARD MEMBER (i)

(ii)		 261,920
-------------
0 		8,154
-------------
0 		27,489
-------------
0 		10,600
-------------
0 		21,025
-------------
0 		329,188
-------------
0 		0
-------------
0
9SARA KRECKMAN MD FR 815BOARD MEMBER (i)

(ii)		 238,731
-------------
0 		7,000
-------------
0 		35,791
-------------
0 		10,600
-------------
0 		22,480
-------------
0 		314,602
-------------
0 		0
-------------
0
10GEOFFREY PRIEST MD TO 815BOARD MEMBER (i)

(ii)		 0
-------------
383,616 		0
-------------
189,321 		0
-------------
99,915 		0
-------------
10,600 		0
-------------
19,757 		0
-------------
703,209 		0
-------------
0
11KATHERINE SCHMITT MDBOARD MEMBER (i)

(ii)		 331,394
-------------
0 		6,000
-------------
0 		34,771
-------------
0 		10,600
-------------
0 		20,701
-------------
0 		403,466
-------------
0 		0
-------------
0
12CHRISTINE SHARKEY MD FR 815BOARD MEMBER (i)

(ii)		 184,461
-------------
0 		0
-------------
0 		1,113
-------------
0 		2,215
-------------
0 		20,558
-------------
0 		208,347
-------------
0 		0
-------------
0
13JAMES SHROPSHIRE MD TO 815BOARD MEMBER (i)

(ii)		 206,261
-------------
0 		22,868
-------------
0 		18,560
-------------
0 		9,835
-------------
0 		22,438
-------------
0 		279,962
-------------
0 		0
-------------
0
14SUSAN TOTH MD TO 815BOARD MEMBER (i)

(ii)		 430,105
-------------
0 		13,400
-------------
0 		55,821
-------------
0 		10,600
-------------
0 		18,105
-------------
0 		528,031
-------------
0 		0
-------------
0
15ROBERT TURNGREN MDBOARD CHAIR/PRESIDENT (i)

(ii)		 0
-------------
435,084 		0
-------------
165,444 		0
-------------
89,430 		0
-------------
10,328 		0
-------------
25,197 		0
-------------
725,483 		0
-------------
0
16MATT WOLFF MD FR 815BOARD MEMBER (i)

(ii)		 593,715
-------------
0 		46,000
-------------
0 		85,474
-------------
0 		10,600
-------------
0 		23,790
-------------
0 		759,579
-------------
0 		0
-------------
0
17ARTHUR NIZZA DSW FR 215BOARD MEMBER/CEO (i)

(ii)		 0
-------------
375,811 		0
-------------
100,000 		0
-------------
36,257 		0
-------------
60,260 		0
-------------
17,551 		0
-------------
589,879 		0
-------------
0
18PETER THOREEN TO 215BOARD MEMBER/INTERIM CEO MHS (i)

(ii)		 0
-------------
364,349 		0
-------------
97,797 		0
-------------
43,964 		0
-------------
220,026 		0
-------------
19,244 		0
-------------
745,380 		0
-------------
0
19BETH ERDMANCFO/SECRETARY/TREASURER MHS (i)

(ii)		 0
-------------
223,651 		0
-------------
94,974 		0
-------------
29,348 		0
-------------
10,600 		0
-------------
7,223 		0
-------------
365,796 		0
-------------
0
20MARY HANSENSECRETARY/TREASURER (i)

(ii)		 200,605
-------------
0 		67,469
-------------
0 		8,931
-------------
0 		10,600
-------------
0 		19,789
-------------
0 		307,394
-------------
0 		0
-------------
0
21PAMELA WETZELAVP/SR. MEDICAL DIRECTOR (i)

(ii)		 270,168
-------------
56,661 		79,845
-------------
0 		888
-------------
196 		10,600
-------------
0 		13,500
-------------
2,705 		375,001
-------------
59,562 		0
-------------
0
22JAMES BOWERS MDPHYSICIAN (i)

(ii)		 544,186
-------------
0 		121,469
-------------
0 		63,637
-------------
0 		10,600
-------------
0 		25,169
-------------
0 		765,061
-------------
0 		0
-------------
0
23CRAIG DOPF MDPHYSICIAN (i)

(ii)		 647,774
-------------
0 		2,667
-------------
0 		3,182
-------------
0 		10,600
-------------
0 		24,906
-------------
0 		689,129
-------------
0 		0
-------------
0
24GARY GRIGLIONE MDPHYSICIAN (i)

(ii)		 606,215
-------------
0 		38,250
-------------
0 		95,548
-------------
0 		10,600
-------------
0 		21,343
-------------
0 		771,956
-------------
0 		0
-------------
0
25SUSAN LEPINSKI MDPHYSICIAN (i)

(ii)		 497,394
-------------
0 		7,000
-------------
0 		192,631
-------------
0 		10,600
-------------
0 		20,523
-------------
0 		728,148
-------------
0 		0
-------------
0
26JOHN MOSES MDPHYSICIAN (i)

(ii)		 430,364
-------------
0 		68,178
-------------
0 		147,181
-------------
0 		10,600
-------------
0 		23,504
-------------
0 		679,827
-------------
0 		0
-------------
0
27JAMES WOODWARD TO 0714FORMER CEO/PRESIDENT (i)

(ii)		 0
-------------
0 		0
-------------
85,889 		0
-------------
622,648 		0
-------------
0 		0
-------------
0 		0
-------------
708,537 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A FIRST CLASS OR CHARTER TRAVEL: THERE WERE TWO CHARTER FLIGHTS RELATED TO THE AFFILIATION WITH UNITYPOINT HEALTH. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: BUSINESS CLUB DUES WERE PAID FOR ONE PERSON. THE BUSINESS CLUB IS AN IRS SECTION 501(C)(7).
PART I, LINES 4A-B SEVERANCE PAYMENT OR CHANGE OF CONTROL PAYMENT: SEVERANCE PAYMENTS WERE RECEIVED BY THE FOLLOWING INDIVIDUAL(S): JAMES WOODWARD $622,648. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SELECT INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: ARTHUR NIZZA, DSW $60,260 AND PETER THOREEN $205,920.
Schedule J (Form 990) 2015
Additional Data


Software ID:  
Software Version:  
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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 MERITER HOSPITAL, INC., A TAX-EXEMPT, WISCONSIN NOT-FOR-PROFIT CORPORATION, IS THE SOLE VOTING MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A MERITER HOSPITAL, INC., AS SOLE MEMBER, ELECTS ALL MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B MERITER HOSPITAL, INC., AS SOLE MEMBER, SHALL APPROVE THE FOLLOWING ACTIONS: A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; C) SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; AND E) THE ADMISSION OF ADDITIONAL MEMBERS OF THE CORPORATION.
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 MERITER MEDICAL GROUP, INC. BOARD OF DIRECTORS CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON A PROACTIVE BASIS, DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST ARE SIGNED WHEN EACH DIRECTOR JOINS THE BOARD AND ANNUALLY THEREAFTER. THE CEO AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE 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 2015 FOR THE FOLLOWING INDIVIDUALS: BETH ERDMAN; ARTHUR NIZZA, DSW; GEOFFREY PRIEST. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG.
FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY -501,463. UPH ASSET TRANSFER -1,368,145.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
MERITER MEDICAL GROUP INC
 
Employer identification number

05-0545222
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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










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 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
 
 
No
(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
 
 
No
(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
 
 
No
(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
 
 
No
(5)BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC
3251 WEST NINTH STREET

WATERLOO,IA50702
42-0733463 		MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC
 
 
No
(6)CENTRAL IOWA HEALTH PROPERTIES CORPORATION
1200 PLEASANT STREET

DES MOINES,IA50309
42-1233759 		PROPERTY HOLDING COMPANY IA 501(C)(2)   CENTRAL IOWA HEALTH SYSTEM
 
 
No
(7)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
 
 
No
(8)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
 
 
No
(9)DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC
1415 WOODLAND AVE SUITE 130

DES MOINES,IA50309
42-1412497 		COORDINATION OF MEDICAL EDUCATION PROGRAMS IA 501(C)(3) 509(A)(3), TYPE III  
 
No
(10)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
 
 
No
(11)FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER
3820 HILLSIDE DRIVE

CEDAR FALLS,IA50613
42-1372380 		CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC
 
 
No
(12)HULT CENTER FOR HEALTHY LIVING INC
5409 N KNOXVILLE AVE

PEORIA,IL61614
36-3510390 		HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1) (A)(VI) PROCTOR HOSPITAL
 
 
No
(13)IOWA HEALTH FOUNDATION
1415 WOODLAND AVE SUITE E-200

DES MOINES,IA50309
42-1467682 		CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) CENTRAL IOWA HEALTH SYSTEM
 
 
No
(14)IOWA HEALTH SYSTEM
1776 WEST LAKES PKWY 400

WEST DES MOINES,IA50266
42-1435199 		SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III  
 
No
(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
 
 
No
(16)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
 
 
No
(17)MERITER FOUNDATION INC
202 SOUTH PARK STREET

MADISON,WI53715
23-7098688 		CHARITABLE FUNDRAISING WI 501(C)(3) 170(B)(1) (A)(VI) MERITER HEALTH SERVICES INC
 
 
No
(18)MERITER HEALTH SERVICES INC
202 SOUTH PARK STREET

MADISON,WI53715
39-1412318 		SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE WI 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM
 
 
No
(19)MERITER HOSPITAL INC
202 SOUTH PARK STREET

MADISON,WI53715
39-0806367 		HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) MERITER HEALTH SERVICES INC
 
 
No
(20)MERITER MEDICAL GROUP INC
202 SOUTH PARK STREET

MADISON,WI53715
05-0545222 		SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES WI 501(C)(3) 509(A)(3), TYPE II MERITER HOSPITAL INC
 
 
No
(21)METHODIST HEALTH SERVICES CORPORATION
221 NORTHEAST GLEN OAK AVENUE

PEORIA,IL61636
37-1111135 		SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM
 
 
No
(22)METHODIST MEDICAL CENTER FOUNDATION
221 NORTHEAST GLEN OAK AVENUE

PEORIA,IL61636
51-0186460 		CHARITABLE FUNDRAISING IL 501(C)(3) 170(B)(1) (A)(VI) METHODIST HEALTH SERVICES CORPORATION
 
 
No
(23)METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUE

PEORIA,IL61636
37-0661223 		HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION
 
 
No
(24)METHODIST SERVICES INC
221 NORTHEAST GLEN OAK AVENUE

PEORIA,IL61636
37-1111134 		OFFICE RENTAL IL 501(C)(3) 509(A)(2) METHODIST HEALTH SERVICES CORPORATION
 
 
No
(25)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
 
 
No
(26)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
 
 
No
(27)NORTHWEST IOWA HOSPITAL CORPORATION
2720 STONE PARK BLVD

SIOUX CITY,IA51104
42-1019872 		HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTH SYSTEM INC
 
 
No
(28)PROCTOR HEALTH CARE INCORPORATED
5409 N KNOXVILLE AVE

PEORIA,IL61614
37-1133412 		SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION
 
 
No
(29)PROCTOR HEALTH SYSTEMS
5409 N KNOXVILLE AVE

PEORIA,IL61614
36-4147437 		PRIMARY HEALTH CARE SERVICES IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED
 
 
No
(30)PROCTOR HOSPITAL
5409 N KNOXVILLE AVE

PEORIA,IL61614
37-0681540 		HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED
 
 
No
(31)SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS
221 NORTHEAST GLEN OAK AVENUE

PEORIA,IL61636
37-6181831 		FUND SELF-INSURANCE PLAN IL 501(C)(3) 509(A)(3), TYPE I METHODIST MEDICAL CENER OF ILLINOIS
 
 
No
(32)SHARED MAGNETIC RESONANCE IMAGING FACILITY INC
1104 JOHN NOLEN DRIVE

MADISON,WI53713
39-1534744 		MEDICAL TECHNOLOGY WI 501(C)(3) 509(A)(3), TYPE I  
 
No
(33)SIOUXLAND PACE INC
313 COOK STREET

SIOUX CITY,IA51103
26-1120134 		ALL-INCLUSIVE CARE FOR THE ELDERLY IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTH SYSTEM INC
 
 
No
(34)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
 
 
No
(35)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
 
 
No
(36)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
 
 
No
(37)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
 
 
No
(38)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
 
 
No
(39)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
 
 
No
(40)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
 
 
No
(41)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
 
 
No
(42)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
 
 
No
(43)TRIMARK PHYSICIANS GROUP
802 KENYON ROAD

FORT DODGE,IA50501
45-3791448 		SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES IA 501(C)(3) 170(B)(1) (A)(III) TRINITY HEALTH SYSTEMS INC
 
 
No
(44)TRINITY BUILDING CORPORATION
802 KENYON ROAD

FORT DODGE,IA50501
42-1376187 		PROPERTY HOLDING COMPANY IA 501(C)(2)   TRINITY HEALTH SYSTEMS INC
 
 
No
(45)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
 
 
No
(46)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
 
 
No
(47)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
 
 
No
(48)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
 
 
No
(49)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
 
 
No
(50)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
 
 
No
(51)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
 
 
No
(52)UNITY HEALTHCARE
1518 MULBERRY AVENUE

MUSCATINE,IA52761
42-0680337 		HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) TRINITY REGIONAL HEALTH SYSTEM
 
 
No
(53)UNITY HEALTHCARE FOUNDATION
1518 MULBERRY AVENUE

MUSCATINE,IA52761
42-1525031 		SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE I TRINITY REGIONAL HEALTH SYSTEM
 
 
No
(54)UNITYPOINT AT HOME
11333 AURORA AVENUE

URBANDALE,IA50322
42-1477471 		HOME HEALTH CARE IA 501(C)(3) 509(A)(2) IOWA HEALTH SYSTEM
 
 
No
(55)UNITYPOINT HEALTH AT WORK
1776 WEST LAKES PKWY 400

WEST DES MOINES,IA50266
81-0872241 		EMPLOYER ONSITE MEDICAL SERVICES AND OCCUPATIONAL MEDICINE IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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 V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ADVANCED IMAGING CENTER LLC

615 VALLEY VIEW DRIVE
MOLINE,IL61265
36-4356301 		DIAGNOSTIC RADIOLOGY CENTER IA N/A
                  
(2) ALLEN MEMORIAL HOSPITAL ORTHOPEDIC CO-MANAGEMENT CO LLC

1825 LOGAN AVE
WATERLOO,IA50703
45-3237125 		ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES IA N/A
                  
(3) CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC

1200 PLEASANT ST
DES MOINES,IA50309
27-3625869 		CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES IA N/A
                  
(4) CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY

1200 PLEASANT STREET
DES MOINES,IA50309
45-3017991 		ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES IA N/A
                  
(5) CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC

1200 PLEASANT ST
DES MOINES,IA50309
47-1608704 		SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICES IA N/A
                  
(6) DUBUQUE ENDOSCOPY CENTER LC

1515 DELHI STREET SUITE 500
DUBUQUE,IA52001
20-1597161 		AMBULATORY SURGERY CENTER IA N/A
                  
(7) ENSEVA - HIAWATHA LLC

755 METZGER DRIVE
HIAWATHA,IA52233
45-3437363 		COLLOCATION FACILITY IA N/A
                  
(8) FINLEY DEPT OF SURGERY CO-MGMT CO LLC

350 N GRANDVIEW AVE
DUBUQUE,IA52001
42-2808785 		SURGERY DEPARTMENT MANAGEMENT SERVICES IA N/A
                  
(9) HEALTH CARE AFFILIATES OF THE TRI-STATES LLC

350 N GRANDVIEW AVE
DUBUQUE,IA52001
42-1428503 		PROVIDE ACCESS TO LICENSED SOFTWARE IA N/A
                  
(10) IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC

1200 PLEASANT STREET
DES MOINES,IA50309
03-0482623 		OUTPATIENT DIAGNOSTIC IMAGING IA N/A
                  
(11) IOWA HEALTH SYSTEM CONTRACTING SERVICES LC

1776 WEST LAKES PKWY 400
WEST DES MOINES,IA50266
42-1511142 		GROUP PURCHASING IA N/A
                  
(12) LAKEVIEW SURGERY CENTER LC

1200 PLEASANT STREET
DES MOINES,IA50309
42-1516120 		SURGERY CENTER IA N/A
                  
(13) MERITER UW PHYSICIANS CONTRACTING COMPANY LLC

202 SOUTH PARK STREET
MADISON,WI53715
39-1998819 		HEALTH SERVICES WI N/A
                  
(14) MISSISSIPPI VALLEY SLEEP DISORDER CENTER LC

3400 DEXTER COURT
DAVENPORT,IA52807
42-1489697 		MEDICAL LABORATORY SERVICES IA N/A
                  
(15) MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

221 NE GLEN OAK AVE
PEORIA,IL61636
46-1219459 		ORTHOPEDIC MANAGEMENT & ADMINISTRATIVE SERVICES IL N/A
                  
(16) MMCI SURGERY CO-MANAGEMENT COMPANY LLC

221 NE GLEN OAK AVE
PEORIA,IL61636
47-1323385 		SURGERY MANAGEMENT & ADMINISTRATIVE SERVICES IL N/A
                  
(17) MR ASSOCIATES LLP

1956 1ST AVENUE NE
CEDAR RAPIDS,IA52402
42-1260463 		OWN AND OPERATE MR UNIT IA N/A
                  
(18) ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC

1200 PLEASANT STREET
DES MOINES,IA50309
42-1508092 		AMBULATORY SURGERY CENTER IA N/A
                  
(19) REGIONAL HEALTH PARTNERS LLC

1258 W SOUTH ST
KEWANEE,IL61443
80-0899158 		AMBULATORY HEALTH CLINICS IL N/A
                  
(20) REHABILITATION THERAPY SERVICES LLC

416 ST MARKS CT 110
PEORIA,IL61603
81-0584193 		REHABILATION THERAPY IL N/A
                  
(21) SLRMC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC

2720 STONE PARK BLVD
SIOUX CITY,IA51104
45-5322324 		CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES IA N/A
                  
(22) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC

1075 FIRST AVENUE SE
CEDAR RAPIDS,IA52403
72-1550812 		AMBULATORY SURGERY CENTER. IA N/A
                  
(23) TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

4500 UTICA RIDGE RD
BETTENDORF,IA52722
27-2562753 		ORTHOPEDIC SERVICE LINES ADMINISTRATIVE SERVICES IA N/A
                  
(24) TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY LLC

500 JOHN DEERE ROAD
MOLINE,IL61265
90-0953327 		ONCOLOGY MANAGEMENT SERVICES IL N/A
                  
(25) UNITYPOINT AT WORK LC

1825 LOGAN AVE
WATERLOO,IA50703
47-2181113 		OCCUPATIONAL MEDICINE IA N/A
                  
(26) UPHT-SCA HOLDINGS LLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
47-3564984 		AMBULATORY SURGERY CENTER INVESTMENT DE N/A
                  
(27) WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

1660 60TH STREET
WEST DES MOINES,IA50266
27-1414600 		ORTHOPEDIC SERVICE LINES MANAGEMENT IA N/A
                  
(28) WEST LAKES SLEEP CENTER LLC

5950 UNIVERSITY AVENUE SUITE 2
WEST DES MOINES,IA50266
26-3193923 		SLEEP DISORDER DIAGNOSTIC TESTING FACILITY IA N/A
                  
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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) BELCREST SERVICES LTD

5409 N KNOXVILLE AVE
PEORIA,IL61614
37-1196307 		MEDICAL SERVICES IL N/A
 C         No
(2) BROADBAND INC

1776 WEST LAKES PKWY 400
WEST DES MOINES,IA50266
27-3819741 		INFORMATION TECHNOLOGY MGMT. IA N/A
 C         No
(3) DELHI POINT CONDO ASSOCIATION

350 N GRANDVIEW
DUBUQUE,IA52001
42-1467002 		REAL ESTATE MANAGEMENT IA N/A
 C         No
(4) HCP CORPORATION

202 SOUTH PARK STREET
MADISON,WI53715
39-1177562 		REAL ESTATE RENTAL WI N/A
 C         No
(5) HEALTH PLUS INC

5409 N KNOXVILLE AVE
PEORIA,IL61614
37-1295532 		MANAGED CARE ADMINISTRATION IL N/A
 C         No
(6) HNC SERVICES

1776 WEST LAKES PKWY 400
WEST DES MOINES,IA50266
27-0987243 		FIBER OPTIC NETWORK SERVICES IA N/A
 C         No
(7) MEDIMORE INC

1776 WEST LAKES PKWY 400
WEST DES MOINES,IA50266
42-1414390 		MANAGED CARE IA N/A
 C         No
(8) MERITER HEALTH ENTERPRISES INC

202 SOUTH PARK STREET
MADISON,WI53715
39-1293620 		MANAGEMENT SERVICES WI N/A
 C         No
(9) MERITER MANAGEMENT SERVICES INC

202 SOUTH PARK STREET
MADISON,WI53715
39-1458235 		ADMINISTRATIVE SERVICES WI N/A
 C         No
(10) METHODIST HEALTH VENTURES INC

PO BOX 87
PEORIA,IL61650
37-1140939 		PHARMACY/OFFICE STAFFING IL N/A
 C         No
(11) METHODIST PHYSICIAN SERVICES INC

PO BOX 87
PEORIA,IL61650
36-3858550 		MEDICAL SERVICES IL N/A
 C         No
(12) PRECEDENCE INC

4622 PROGRESS DRIVE STE A
DAVENPORT,IA52807
37-1288604 		MANAGED MENTAL CARE IA N/A
 C         No
(13) PROVIDER RESOURCE MANAGEMENT INC

PO BOX 87
PEORIA,IL61650
37-1223550 		RESOURCE MANAGEMENT IL N/A
 C         No
(14) PHYSICIANS PLUS INSURANCE CORPORATION

2650 NOVATION PARKWAY SUITE 400
MADISON,WI53713
39-1565691 		FEDERALLY QUALIFIED HMO WI N/A
 C         No
(15) RURAL IOWA SPECIALTY PHYSICIAN CONSORTIUM INC

700 E UNIVERSITY AVE
DES MOINES,IA50316
26-1271143 		SPECIALTY PHYSICIANS MEDICAL CARE IA N/A
 C         No
(16) STL HEALTH RESOURCES CO

1026 A AVE NE
CEDAR RAPIDS,IA52402
42-1193499 		PHYSICIAN OFFICE RENTAL IA N/A
 C         No
(17) TRINITY HEALTH ENTERPRISES INC

2701 17TH ST
ROCK ISLAND,IL61201
36-3320141 		RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY IL N/A
 C         No
(18) TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD

4622 PROGRESS DRIVE STE A
DAVENPORT,IA52807
36-3924720 		MANAGED HEALTH CARE IA N/A
 C         No
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
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, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 32 HOSPITAL FACILITIES AND VARIOUS AMBULATORY SERVICE AND CLINIC LOCATIONS IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).
Schedule R (Form 990) 2015

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