Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2018
Open to Public Inspection
For calendar year 2018, or tax year beginning 01-01-2018 , and ending 12-31-2018
Name of foundation
Mid-Iowa Health Foundation
 
Number and street (or P.O. box number if mail is not delivered to street address)3900 Ingersoll Ave No 104
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Des Moines, IA503123535
A Employer identification number

42-1235348
B Telephone number (see instructions)

(515) 277-6411
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$14,496,882J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 174,261
2 Check bullet.............
3 Interest on savings and temporary cash investments 2,803 2,803  
4 Dividends and interest from securities... 315,120 315,120  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,126,030
b Gross sales price for all assets on line 6a 6,282,435
7 Capital gain net income (from Part IV, line 2)... 1,126,030
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 1,618,214 1,443,953  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 113,253 9,060   104,193
14 Other employee salaries and wages...... 84,365 0   84,365
15 Pension plans, employee benefits....... 39,891 1,353   38,538
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 13,600 0   13,600
c Other professional fees (attach schedule).... Click to see attachment 106,640 74,887   22,253
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 20,282 6,763   0
19 Depreciation (attach schedule) and depletion... Click to see attachment 833 0  
20 Occupancy.............. 17,928 0   17,928
21 Travel, conferences, and meetings....... 37,571 0   37,571
22 Printing and publications.......... 7,095 0   7,095
23 Other expenses (attach schedule)....... Click to see attachment -7,754 0   17,246
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 433,704 92,063   342,789
25 Contributions, gifts, grants paid....... 680,776 578,276
26 Total expenses and disbursements. Add lines 24 and 25 1,114,480 92,063   921,065
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 503,734
b Net investment income (if negative, enter -0-) 1,351,890
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2018)
Form 990-PF (2018)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 238,970 407,250 407,250
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................   5,500 5,500
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 13,038 8,836 8,836
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 7,161,639 Click to see attachment6,578,841 6,578,841
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 8,999,713 Click to see attachment7,496,073 7,496,073
14 Land, buildings, and equipment: basis bullet19,776
Less: accumulated depreciation (attach schedule) bullet19,394 1,215 Click to see attachment382 382
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 16,414,575 14,496,882 14,496,882
Liabilities 17 Accounts payable and accrued expenses.......... 10,536 17,528
18 Grants payable................. 77,500 180,000
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment25,100 Click to see attachment100
23 Total liabilities (add lines 17 through 22)......... 113,136 197,628
Net Assets or Fund Balances Foundations that follow SFAS 117, check here bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted.................. 16,301,439 14,299,254
25 Temporarily restricted...............    
26 Permanently restricted...............    
Foundations that do not follow SFAS 117, check here bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds........    
28 Paid-in or capital surplus, or land, bldg., and equipment fund    
29 Retained earnings, accumulated income, endowment, or other funds    
30 Total net assets or fund balances (see instructions)..... 16,301,439 14,299,254
31 Total liabilities and net assets/fund balances (see instructions). 16,414,575 14,496,882
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree with end-of-year figure reported on prior year’s return) ...............
1
16,301,439
2
Enter amount from Part I, line 27a .....................
2
503,734
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
16,805,173
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
2,505,919
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30 .
6
14,299,254
Form 990-PF (2018)
Form 990-PF (2018)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a Publicly Traded Securities      
b Capital Gains Dividends P    
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 5,858,173   5,156,405 701,768
b 424,262     424,262
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       701,768
b       424,262
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 1,126,030
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2017 992,723 15,181,753 0.065389
2016 813,117 14,103,070 0.057655
2015 808,963 15,268,779 0.052982
2014 757,514 15,699,162 0.048252
2013 739,076 14,580,962 0.050688
2
Total of line 1, column (d) .....................
2
0.274966
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years ......
3
0.054993
4
Enter the net value of noncharitable-use assets for 2018 from Part X, line 5......
4
16,035,933
5
Multiply line 4 by line 3......................
5
881,864
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
13,519
7
Add lines 5 and 6........................
7
895,383
8
Enter qualifying distributions from Part XII, line 4,.............
8
921,065
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form 990-PF (2018)
Form 990-PF (2018)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 13,519
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 13,519
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 13,519
6 Credits/Payments:
a 2018 estimated tax payments and 2017 overpayment credited to 2018 6a 6,000
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 12,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 18,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 245
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 4,236
11 Enter the amount of line 10 to be: Credited to 2019 estimated taxBullet4,236 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletIA
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2018 or the taxable year beginning in 2018? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletwww.midiowahealth.org
    14
    The books are in care ofbulletSuzanne Mineck Telephone no.bullet (515) 277-6411

    Located atbullet3900 Ingersoll Ave Suite 104Des MoinesIA ZIP+4bullet503123535
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2018, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet  
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2018?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2018, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2018?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2018 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2018.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2018?
    4b
     
    No
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    Kelly Grossman Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Cheryl Harding Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Hayley L Harvey Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Joseph Jones Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Libby Jacobs Vice-Chair
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Buck Olsen Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Tammy Gentry Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Judith Vogel Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Suzanne Mineck President
    40.00     		116,853 8,180 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Teree Caldwell-Johnson Chair
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Chris Cook Secretary/Treasurer
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Carrie Clogg Director
    1.00     		0 0 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    Denise Swartz Program Officer
    40.00     		87,965 6,158 0
    3900 Ingersoll Avenue Ste 104
    Des Moines,IA50312
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    15,935,916
    b
    Average of monthly cash balances.......................
    1b
    344,219
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    16,280,135
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    16,280,135
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    244,202
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    16,035,933
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    801,797
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    801,797
    2a
    Tax on investment income for 2018 from Part VI, line 5......
    2a
    13,519
    b
    Income tax for 2018. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    13,519
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    788,278
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    788,278
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    788,278
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    921,065
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    921,065
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    13,519
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    907,546
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2017     		(c)
    2017     		(d)
    2018
    1 Distributable amount for 2018 from Part XI, line 7 788,278
    2 Undistributed income, if any, as of the end of 2018:
    a Enter amount for 2017 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2018:
    a From 2013...... 29,745
    b From 2014......  
    c From 2015...... 62,190
    d From 2016...... 115,461
    e From 2017...... 257,589
    fTotal of lines 3a through e........ 464,985
    4Qualifying distributions for 2018 from Part
    XII, line 4: bullet$ 921,065
    a Applied to 2017, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2018 distributable amount..... 788,278
    e Remaining amount distributed out of corpus 132,787
    5 Excess distributions carryover applied to 2018. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 597,772
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2017. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2018. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2019 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2013 not
    applied on line 5 or line 7 (see instructions) ...     		29,745
    9Excess distributions carryover to 2019.
    Subtract lines 7 and 8 from line 6a ......     		568,027
    10 Analysis of line 9:
    a Excess from 2014....  
    b Excess from 2015.... 62,190
    c Excess from 2016.... 115,461
    d Excess from 2017.... 257,589
    e Excess from 2018.... 132,787
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2018, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2018 (b) 2017 (c) 2016 (d) 2015
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    Suzanne Mineck
    3900 Ingersoll Ave Suite 104
    Des Moines,IA503123535
    (515) 277-6411
    bThe form in which applications should be submitted and information and materials they should include:
    Please contact Denise Swartz or Suzanne Mineck at 515-277-6411 or go to the Mid-Iowa Health Foundation website at www.midiowahealth.org to learn more about the grant process and how to apply. Non-profit organziations may apply for a grant through the competitive application process. Contact Denise or Suzanne to discuss your ideas for addressing the HealthConnect Innovation Grants priority.
    cAny submission deadlines:
    See the website for application deadlines.
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Proposals are not considered for: for-profit entities, individuals, scholarships, conference registration fees, programs supporting religious activities, general operations or special camps, capital campaigns, endowment campaigns, debt reduction, or fundraising events.
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    AMOS - A Mid-Iowa Organizing Strategy
    3829 Grand Avenue
    Des Moines,IA50309     		  PC Invest Relationships, Invest Communites, Invest Health 40,000
    Blank Children's Hospital
    1200 Pleasant Street
    Des Moines,IA50309     		  PC Improve children's mental health and well being in Iowa 20,833
    Blank Children's Hospital
    1215 Pleasant Street
    Des Moines,IA50309     		  PC Blank Children's Hospital Foster Care Clinic 50,000
    Child and Family Policy Center
    505 Fifth Ave Ste 404
    Des Moines,IA50309     		  PC Make sure that children in Iowa have access to high-quality healthcare. 20,833
    Community Foundation of Greater Des Moines
    1915 Grand Avenue
    Des Moines,IA50309     		  POF MIHF Foundation Committee Advised Fund 12,618
    Community Foundation of Greater Des Moines
    1915 Grand Avenue
    Des Moines,IA50309     		  POF Johnny Danos Better Together Fund 500
    Community Youth Concepts
    1446 Martin Luther King Jr Pkwy
    Des Moines,IA50314     		  PC uVoice 24,000
    de Beaumont Foundation Inc
    7501 Wisconsin Ave Ste 1310e
    Bethesda,MD20814     		  PF BUILD Health Challenge 2.0 77,500
    Des Moines Public Schools
    2100 Fleur Drive
    Des Moines,IA50321     		  PC Trauma-Sensitive & Culturally-Responsive Initiative. 50,000
    Des Moines Public Schools
    2100 Fleur Drive
    Des Moines,IA50321     		  PC Mini-Grant 1,000
    EyesOpenIowa
    4000 Westown Pkwy Ste 204
    West Des Moines,IA50266     		  PC Creating a culture of support for pregnant and parenting young women. 14,960
    Foundations Inc
    701 East Gate Drive Suite 300
    Mt Laurel,NJ08054     		  PC Home assessment & remediation for services to children with chronic asthma. 20,833
    Grantmakers in Health
    1130 Connecticut Ave Ste 700
    Washington,DC20036     		  PC Technical Assistance 3,475
    Healthy Birth Day Inc
    PO Box 71093
    Clive,IA50325     		  PC Count the Kicks 50,000
    Iowa Arts in Education aka ArtForceIowa
    1111 University Ave
    Des Moines,IA50314     		  PC Flood Recovery 2,000
    Iowa Homeless Youth Centers
    612 Locust St
    Des Moines,IA50309     		  PC Produce a video addressing youth homelessness in the community 5,000
    Iowa Primary Care Association
    9943 Hickman Road Ste 103
    Urbandale,IA50322     		  PC Identifying the Assets, Risks, and Experiences of Vulnerable Central Iowans 40,000
    Latinas Latinos Al Exito Inc
    PO box 93531
    Des Moines,IA50393     		  PC Advocate for more inclusive policiesin schools to address mental health of Latino students 20,833
    Orchard Place
    2116 Grand Avenue
    Des Moines,IA50312     		  PC ACEs 360 Strategic Planning 6,000
    Planned Parenthood of the Heartland
    818 5th Ave Ste 200
    Des Moines,IA50309     		  PC Askable Adult Program 1,000
    Please Pass the Love
    PO Box 93873
    Des Moines,IA50393     		  PC School Mental Health System Intervention Outreach 20,000
    Polk County Continuum of Care
    505 5th Ave Ste 1000
    Des Moines,IA50309     		  GOV Ending Youth Homelessness 8,950
    Polk County Housing Trust Fund
    505 5th Ave Ste 1000
    Des Moines,IA50309     		  PC A "housing vaccine" for pediatric asthma 20,833
    Science Center of Iowa
    401 West Martin Luther King Jr Pkwy
    Des Moines,IA50309     		  PC Mind Matters Exhibit and Covening 15,000
    United Way of Central Iowa
    1111 Ninth St Ste 100
    Des Moines,IA50314     		  PC ACEs Prenatal Project 19,015
    United Way of Central Iowa
    1111 Ninth St Ste 100
    Des Moines,IA50314     		  PC ACEs 360 Educator Curriculum Development 5,260
    United Way of Iowa
    1111 Ninth St Ste 100
    Des Moines,IA50314     		  PC United Way ALICE report for Iowa. 5,000
    University of Northern Iowa
    1227 W 27th St
    Cedar Falls,IA50614     		  GOV Mini-Grant 500
    Young Women's Resource Center
    818 5th Ave
    Des Moines,IA50309     		  PC After School Empowerment Groups 1,500
    Youth Policy Institute of Iowa
    6200 Aurora Ste 206E
    Des Moines,IA50322     		  PC Housing asfety and stability for youth aging out of foster care 20,833
    Total .................................bullet 3a 578,276
    bApproved for future payment
    Iowa Public Radio
    2111 Grand Ave Ste 100
    Des Moines,IA50312     		  PC Hire a Full Time Health Reporter 120,000
    United Way of Central Iowa
    1111 Ninth St Ste 100
    Des Moines,IA50314     		  PC ACEs Prenatal Development and Collaboration 60,000
    Total .................................bullet 3b 180,000
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 2,803  
    4 Dividends and interest from securities....     14 315,120  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 1,126,030  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 1,443,953 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,443,953
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2018)
    Form 990-PF (2018)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    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 taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)?
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2018)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    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 Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2018
    Name of the organization
    Mid-Iowa Health Foundation
     
    Employer identification number

    42-1235348
    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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
    Name of organization
    Mid-Iowa Health Foundation
          		Employer identification number
    42-1235348
    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
    1
    Seafam Corporation
     
    1122 4th Street SW
     
    Calgary, ABT2R 1M1CA

    		$ 140,000


    (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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 3
    Name of organization
    Mid-Iowa Health Foundation
          		Employer identification number

    42-1235348
    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) (2018)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
    Page 4
    Name of organization
    Mid-Iowa Health Foundation
          		Employer identification number

    42-1235348
    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) (2018)

    Additional Data


    Software ID:  
    Software Version:  

    TY 2018 AccountingFeesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Accounting and tax services 13,600 0   13,600

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2018 DepreciationSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included
    FILE CABINET 1993-09-01 429 429 SL 7.000000000000 0 0    
    CONFERENCE TABLE 1995-08-25 1,408 1,408 SL 7.000000000000 0 0    
    FILE CABINET 1998-08-03 114 114 SL 10.000000000000 0 0    
    OFFICE FURNITURE 2000-05-04 1,081 1,081 SL 10.000000000000 0 0    
    FURNITURE 2002-06-04 468 468 SL 10.000000000000 0 0    
    FURNITURE 2004-04-01 2,587 2,587 SL 10.000000000000 0 0    
    FURNITURE 2004-05-06 1,577 1,577 SL 10.000000000000 0 0    
    FURNITURE 2004-09-01 372 372 SL 10.000000000000 0 0    
    FURNITURE 2004-09-01 152 152 SL 10.000000000000 0 0    
    Computer Printer 2006-02-14 1,978 1,978 SL 5.000000000000 0 0    
    Office Furniture 2006-11-27 3,156 3,156 SL 10.000000000000 0 0    
    OFFICE FURNITURE 2007-05-07 520 520 SL 10.000000000000 0 0    
    Lanier Copier/Printer 2011-10-18 1,399 1,399 SL 5.000000000000 0 0    
    SentrySafe 4-Drawer Fire-Safe file cabinet 2013-08-22 742 321 SL 10.000000000000 74 0    
    Optiplex 9020 minitower 2013-12-19 1,605 1,284 SL 5.000000000000 321 0    
    Optiplex 9020 minitower 2014-02-11 2,188 1,715 SL 5.000000000000 438 0    

    TY 2018 InvestmentsCorpStockSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABB Ltd 12,737 12,737
    ABBVIE Inc. 34,479 34,479
    ABN AMPRO Group 13,433 13,433
    Accenture PLC 29,189 29,189
    Activision Blizzard Inc. 27,476 27,476
    Adobe Systems Inc. 79,410 79,410
    AES Corp 22,196 22,196
    Albermarle Corp 27,206 27,206
    Alexion Pharmaceuticals Inc 30,376 30,376
    Alibaba Group 93,345 93,345
    Allergan PLC 6,148 6,148
    Allstate Corp 48,917 48,917
    Alphabet Inc. 78,372 78,372
    Alphabet Inc. 107,703 107,703
    Amazon Com Inc 171,225 171,225
    Ameriprise Financial Inc. 14,299 14,299
    Amgen Inc 59,958 59,958
    Anheuser Busche Inbev 20,138 20,138
    Anthem Inc 46,486 46,486
    Aon Plc 26,310 26,310
    Apple Inc 90,701 90,701
    Applied Materials Inc 27,076 27,076
    Ashtead Group PLC 4,780 4,780
    Assa Abloy Ab 23,656 23,656
    Bank of America Corp 83,406 83,406
    BB Seguridade Participacoes S/A 12,139 12,139
    BHP Billiton Ltd 29,602 29,602
    Biomarin Pharmaceutical Inc 32,612 32,612
    Boeing Co 150,930 150,930
    Bristol Myers Squibb Co 23,079 23,079
    Broadcom Ltd 39,413 39,413
    Canadian National Ry Co 12,673 12,673
    Capital One Financial Corp 2,117 2,117
    Carlsberg As-B 15,576 15,576
    Caterpillar Inc 38,756 38,756
    CBRE Group Inc 20,901 20,901
    Celgene Corp 17,817 17,817
    Centene Corp 19,370 19,370
    Chevron Corporation 50,261 50,261
    Chimera Invt Corp 6,736 6,736
    CIA Saneamento Basico 8,030 8,030
    Cielo SA 7,626 7,626
    CIT Group 16,456 16,456
    Citigroup Inc 79,652 79,652
    Comcast Corp 38,817 38,817
    Compagnie Financiere Richemont SA 10,836 10,836
    Compass Group PLC 23,847 23,847
    ConocoPhillips 67,899 67,899
    Costco Whosale Corp 53,983 53,983
    Crown Castle International Corp 29,982 29,982
    Daiwa House Ind Ltd 20,543 20,543
    Dbs Group Holdings 18,686 18,686
    Delta Air Lines Inc 31,637 31,637
    Devon Energy Corp 4,238 4,238
    Discover Financial 16,927 16,927
    Dxc Technology Co 21,108 21,108
    Energizer Holdings Inc 20,137 20,137
    Everest RE Group Ltd 22,865 22,865
    Equinor ASA 14,755 14,755
    Facebook Inc 80,751 80,751
    Ferguson Plc 16,135 16,135
    Fleetcor Technologies Inc 40,301 40,301
    General Motors Co 42,615 42,615
    GEO Grp Inc 6,225 6,225
    Gilead Sciences Inc 27,835 27,835
    Goldman Sachs Group Inc 51,618 51,618
    Hollyfrontier Corp 12,218 12,218
    Home Depot Inc 46,563 46,563
    Hospitality Properties 6,018 6,018
    HP Inc 26,046 26,046
    Humana Inc 50,134 50,134
    Hunstman Corp 12,789 12,789
    Icici Bank Ltd 24,521 24,521
    Illumina Inc 61,486 61,486
    JPMorgan Chase & Co 52,715 52,715
    KAO Corp 12,978 12,978
    Kasikornbank Pub Co Ltd 8,416 8,416
    Kering SA 36,469 36,469
    LAM Research Corp 22,332 22,332
    Lauder Estee Cos Inc 43,714 43,714
    Lincoln Natl Corp 18,574 18,574
    Makita Corporation ADR 20,120 20,120
    Marathon Oil Corp 3,241 3,241
    Marathon Petroleum corp 42,192 42,192
    Marriott Intl Inc 44,835 44,835
    Mastercard Inc 110,926 110,926
    McDonalds Corp 35,869 35,869
    Medtronic PLC 32,018 32,018
    Metlife Inc 5,543 5,543
    Michelin 12,916 12,916
    Microsoft Corp 150,730 150,730
    Morgan Stanley & Co 1,705 1,705
    Mr Price Group Ltd 9,647 9,647
    Netapp Inc 17,424 17,424
    Netflix Com Inc 98,767 98,767
    Newmont Mining Corp 3,708 3,708
    Nextera Energy Inc 23,813 23,813
    Nordea Bank Ab 15,647 15,647
    Novartis Ag 38,100 38,100
    NRG Energy Inc 22,018 22,018
    Nvidia Corp 44,856 44,856
    Paypal Holdings Inc 29,768 29,768
    Pepsico Incorporated 26,626 26,626
    Perusahaan Perseroan Persero Pt 10,877 10,877
    Pfizer Incorporated 74,729 74,729
    Piedmont Office Realty Tr inc 15,370 15,370
    Pilgrims Pride Corp 18,410 18,410
    Ping An Insurance 19,494 19,494
    Proctor & Gamble Co 10,938 10,938
    Prudential Financial Inc 5,056 5,056
    Prudential PLC 28,756 28,756
    Red Electrica Corporacion 24,265 24,265
    Red Hat Inc 43,383 43,383
    Regions Financial Corp 18,545 18,545
    Relx Plc Adr 23,701 23,701
    Royal Dutch Shell Plc 38,691 38,691
    Ryanair holdings Plc 13,555 13,555
    Ryohin Keikaku Co 23,673 23,673
    S&P Global Inc 28,900 28,900
    Safran SA 58,345 58,345
    Salesforce.com 107,384 107,384
    Sampo Oyja-a 22,438 22,438
    Sanlam Ltd 14,654 14,654
    SAP SE 32,752 32,752
    Sirius XM Holdings Inc 9,707 9,707
    Splunk Inc 37,222 37,222
    Steel Dynamics Inc 14,569 14,569
    Sumitomo Mitsui Finl Group Inc 18,723 18,723
    Suncor Energy Inc 23,299 23,299
    Taiwan Semiconductor Mfg Co 23,364 23,364
    Telenor Asa-Ads 19,719 19,719
    Tencent Holdings Ltd 140,513 140,513
    Tesla Motors Inc 70,554 70,554
    Toll Brothers 16,498 16,498
    Tyson Foods Inc 20,506 20,506
    Unilever Plc 20,743 20,743
    United Rentals Inc 17,533 17,533
    Unitedhealth Group Inc 55,305 55,305
    Velero Energy corp 46,856 46,856
    Vertex Pharmaceuticals Inc 41,925 41,925
    Vinci SA 16,429 16,429
    Visa Inc 95,525 95,525
    Vmware inc 22,764 22,764
    WalMart Stores Inc 29,342 29,342
    Walgreens Boots Alliance Inc 4,373 4,373
    Wellcare Health Plans Inc 19,359 19,359
    Western Digital Corp 3,956 3,956
    Wolters Kluwer NV 25,761 25,761
    Workday Inc 43,273 43,273
    Yandex NV 12,882 12,882
    Allison Transmission Holdings Inc 20,067 20,067
    American Express Company 19,350 19,350
    American Tower Corp REIT 14,237 14,237
    Amerisourcebergen Corp 9,151 9,151
    Astrazeneca PLC 62,287 62,287
    Centurylink Inc 18,574 18,574
    CF Industries Holdings Inc 15,968 15,968
    Chipotle Mexican Grill 18,567 18,567
    Cisco Systems Inc 44,023 44,023
    Citizens Financial Grp Inc 16,649 16,649
    Citrix Systems Inc 18,340 18,340
    Credit Acceptance Corp Michigan 25,960 25,960
    Domitar Corp New 17,214 17,214
    Dunkin' Brands Grp Inc 11,734 11,734
    Ebay Inc 24,309 24,309
    Edwards Lifescience Corp 19,299 19,299
    Emcor Group Inc 9,073 9,073
    Endo International PLC 2,475 2,475
    Entergy Corp New 20,571 20,571
    Exelon Corporation 39,553 39,553
    Fifth Third Bancorp 16,424 16,424
    First American Finl Corp 2,277 2,277
    Foot Locker Inc 11,598 11,598
    Freeport-Mcmoran Inc 13,001 13,001
    Genmab A/S Spon ADR 6,063 6,063
    H & R Block Inc 19,332 19,332
    Hanesbrands Inc 16,276 16,276
    HCA Healthcare Inc 12,569 12,569
    Herbalife Nutrition Ltd 21,045 21,045
    Hologic Inc 13,604 13,604
    International Game Technology PLC 11,923 11,923
    Intuitive Surgical Inc 29,214 29,214
    Jones Lang Lasalle Inc 16,585 16,585
    KLA-Tencor Corp 2,685 2,685
    Komatsu Ltd Spon ADR 10,770 10,770
    Life Storage Inc 13,763 13,763
    Lululemon Athletica Inc 15,080 15,080
    M & T Bank Corp 19,466 19,466
    Medical Properties Trust Inc 21,402 21,402
    Merck & Co Inc New 37,976 37,976
    MIcron Technology Inc 3,966 3,966
    Molson Coors Brewing Co 22,071 22,071
    Nike Inc 52,417 52,417
    OGE Energy Corp 16,499 16,499
    PBF Energy Inc 13,721 13,721
    Peabody Energy Corp 13,503 13,503
    Phillips 66 11,113 11,113
    Popular Inc 20,399 20,399
    Primerica Inc 15,829 15,829
    Qualcomm Inc 39,552 39,552
    Robert Half Intl Inc 18,304 18,304
    Rogers Communications CL 25,886 25,886
    Sabre Corp 19,627 19,627
    Seagate Technology PLC 7,216 7,216
    Servicenow Inc 23,325 23,325
    SL Green Rlty Corp Reit 18,505 18,505
    Sonova Holdings 6,753 6,753
    Spirit Rlty Cap Inc 22,913 22,913
    Square Inc 20,136 20,136
    Tenet Healthcare Corp 8,433 8,433
    Teradata Corp 5,907 5,907
    Travelers Cos Inc 68,018 68,018
    Tripadvisor Inc 6,041 6,041
    Ubisoft Entertainment SA ADR 14,327 14,327
    Union Pacific Corp 29,581 29,581
    United Continental Holdings Inc 33,659 33,659
    Urban Outfitters Inc 11,720 11,720
    Verizon Communications 70,450 70,450
    Vistra Energy Corp 20,418 20,418
    Vivendi SA 22,532 22,532
    Volkswagen AG 21,499 21,499
    Wendys Co 11,255 11,255
    58.Com Inc 10,246 10,246

    TY 2018 InvestmentsOtherSchedule2
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    DWS Enhanced Commodity Strat FMV 273,239 273,239
    Delaware Group Global & Intl Fds Emerging Mkts Fd FMV 493,032 493,032
    Eaton Vance Ser II Income Fund boston FMV 450,604 450,604
    American Funds New World Fund FMV 268,126 268,126
    Janus Henderson Fds Flexible Bd Fd FMV 1,538,006 1,538,006
    Lazard Fds Inc Lazard Developing Mkts Equity Port FMV 477,227 477,227
    Pimco Fds Pac invt Mgmt Ser Emerging Mkts Bd Fd FMV 444,301 444,301
    PGIM Jennison Mid-Cap Growth fd FMV 562,867 562,867
    Sterling Capital Fds Sterling Cap Stratton Small Cp Value Fd FMV 792,604 792,604
    Touchstone Fds Grp Mid Cap Value Fund FMV 511,175 511,175
    Artisan Fds Artisan Small Cap Fd FMV 944,166 944,166
    DWS RREEF Global Real Estate Securities Fund FMV 451,036 451,036
    T Rowe Price Real Estate Fund FMV 289,690 289,690

    TY 2018 LandEtcSchedule2
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    FILE CABINET 429 429 0  
    CONFERENCE TABLE 1,408 1,408 0  
    FILE CABINET 114 114 0  
    OFFICE FURNITURE 1,081 1,081 0  
    FURNITURE 468 468 0  
    FURNITURE 2,587 2,587 0  
    FURNITURE 1,577 1,577 0  
    FURNITURE 372 372 0  
    FURNITURE 152 152 0  
    Computer Printer 1,978 1,978 0  
    Office Furniture 3,156 3,156 0  
    OFFICE FURNITURE 520 520 0  
    Lanier Copier/Printer 1,399 1,399 0  
    SentrySafe 4-Drawer Fire-Safe file cabinet 742 395 347  
    Optiplex 9020 minitower 1,605 1,605 0  
    Optiplex 9020 minitower 2,188 2,153 35  


    TY 2018 OtherDecreasesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Description Amount
    Unrealized Gains (losses) on Investments 2,505,919


    TY 2018 OtherExpensesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Dues & Subscriptions 1,145 0   1,145
    Insurance 4,701 0   4,701
    Office Expense 1,151 0   1,151
    Telephone 2,673 0   2,673
    Information Technology 7,576 0   7,576
    Deferred Excise Taxes -25,000 0   0


    TY 2018 OtherLiabilitiesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Description Beginning of Year - Book Value End of Year - Book Value
    Deferred Federal Excise Tax 25,100 100


    TY 2018 OtherProfessionalFeesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Consulting 31,753 0   22,253
    Investment fees 74,887 74,887   0


    TY 2018 TaxesSchedule
    Name:
    Mid-Iowa Health Foundation
    EIN:
    42-1235348
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Federal Excise Tax 13,519 0   0
    Foreign taxes 6,763 6,763   0