2024-04-16T16:07:25-05:00 2023-06-30 990 2022-07-01 832074985 UNITYPOINT BROADLAWNS PSYCHIATRY EDUCATION FOUNDATION UNIT 5152416266 1415 WOODLAND AVENUE 140 DES MOINES IA 50309 WILLIAM YOST MD INSTITUTIONAL OFFICIAL 5152416266 2024-04-15 WILLIAM YOST MD XXX-XX-XXXX 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JASON KRUSE DO 1415 WOODLAND AVENUE 140 DES MOINES IA 50309 2229495 0 X WWW.BROADLAWNS.ORG/UNITYPOINT/DSMPSYCHRES X 2018 IA PROVIDE INFRASTUCTURE, RESOURCES & OVERSIGHT TO SUPPORT PSYCHIATRY RESIDENCY PROGRAM. 6 6 0 6 0 0 2145424 2145288 105005 84207 0 0 0 0 2250429 2229495 0 0 0 0 2182547 2117943 0 0 0 67882 111552 2250429 2229495 0 0 10000 10000 0 0 10000 10000 X PROVIDE THE INFRASTRUCTURE, RESOURCES AND OVERSIGHT NECESSARY TO SUPPORT A HIGH QUALITY RESIDENCY PROGRAM IN PSYCHIATRY AND THE NECESSARY LEARNING ENVIRONMENT REQUIRED TO TRAIN RESIDENTS TO BECOME PSYCHIATRISTS WHO WILL BE HIGHLY QUALIFIED TO EITHER PRACTICE IN THE COMMUNITY OR GO ON TO FURTHER TRAINING IN SUBSPECIALTIES. 0 0 2181455 0 84207 MENTAL HEALTH EDUCATIONSINCE THE PREVIOUS UPDATE, THE PSYCHIATRY RESIDENCY PROGRAM REMAINS WITH A COMPLEMENT OF 15 RESIDENTS. WE ARE ONE RESIDENT SHORT OF A FULL COMPLEMENT OF 16 BECAUSE IN 2020 WE ACCEPTED A RESIDENT WHO HAD COMPLETED A CATEGORICAL RESIDENCY PROGRAM AND THEREFORE, STARTED OUR PSYCHIATRY RESIDENCY AT THE PGY2 LEVEL. TO REMAIN WITHIN BUDGET FOR THE ACADEMIC YEAR, WE HAD TO REDUCE THE NUMBER OF INCOMING RESIDENTS TO THREE INSTEAD OF FOUR. THIS MEANT THAT WE HAD A THREE PGY1, FIVE PGY2, FOUR PGY3 AND FOUR PGY4 FOR A TOTAL OF 16 RESIDENTS THAT YEAR. WE GRADUATED THE FIVE PGY LAST YEAR LEAVING US WITH THREE PGY4, FOUR PGY3, FOUR PGY2, AND FOUR PGY1 RESIDENTS FOR A TOTAL OF 15 RESIDENTS IN THIS CURRENT CLASS. THE PROGRAM CONTINUES TO HAVE SEVERAL ROTATIONS THAT OCCUR WITH STATE AGENCIES, THE VA, STATE CORRECTIONAL FACILITIES, AND LOCAL/RURAL CLINICAL PRACTICES. AS OF JUNE 30, 2023, WE EMPLOY 15 RESIDENTS, ONE PROGRAM COORDINATOR, ONE PROGRAM DIRECTOR, ONE ASSOCIATE PROGRAM DIRECTOR, AND SEVERAL CORE RESIDENCY FACULTY. THE PROGRAM CONTINUES TO BE SUCCESSFULLY LOCATED ON TWO CAMPUSES IN DES MOINES, (BROADLAWNS MEDICAL CENTER AND UNITYPOINT HEALTH). IN ADDITION, RESIDENTS HAVE CLINICAL ROTATIONS AT THE VA HOSPITAL IN DES MOINES. 2181455 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 0 0 X LISA RYAN CIHC FINANCE DEPARTMENT 5152416507 1200 PLEASANT STREET DES MOINES IA 50309 KEVIN CARROLL EDD BOARD MEMBER (TO 11/22) 1.00 0.00 X 0 0 0 ANTHONY COLEMAN BOARD CHAIR 1.00 0.00 X X 0 0 0 DANA DANLEY MD BOARD MEMBER (FR 04/22) 1.00 0.00 X 0 0 0 NICHOLAS GALIOTO MD BOARD MEMBER 1.00 0.00 X 0 0 0 JOSHUA REHMANN DO BOARD MEMBER 1.00 0.00 X 0 0 0 LARRY SEVERIDT MD BOARD MEMBER (TO 04/22) 1.00 0.00 X 0 0 0 DAVID STARK BOARD MEMBER 1.00 0.00 X 0 0 0 CYNTHIA STEIDL-BISHOP BOARD MEMBER (FR 11/22) 1.00 0.00 X 0 0 0 REBECCA LUNDQUIST MD PROGRAM DIRECTOR 40.00 0.00 X 349849 0 53285 WILLIAM YOST MD INSTITUTIONAL OFFICIAL 15.00 0.00 X 0 0 0 349849 0 53285 0 0 0 1 0 2145288 2145288 RESIDENT SERVICES 900099 84207 84207 84207 2229495 84207 0 0 403134 403134 1587453 1587453 127356 127356 26794 26794 10386 10386 26502 26502 MISCELLANEOUS 26624 26624 RECRUITING 21246 21246 2229495 2181455 48040 0 5000 5000 5000 5000 10000 10000 0 0 X 10000 10000 10000 10000 10000 10000 0 0 X 0 0 0 X 399004 1325047 1704445 2145424 2145288 7719208 399004 1325047 1704445 2145424 2145288 7719208 7719208 7719208 230559 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 REBECCA LUNDQUIST MD PROGRAM DIRECTOR 349005 0 0 0 844 0 28792 0 24493 0 403134 0 0 0 FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION BROADLAWNS MEDICAL CENTER PAYS COMPENSATION TO REBECCA LUNDQUIST, MD. UNITYPOINT BROADLAWNS PSYCHIATRY EDUCATION FOUNDATION REIMBURSES COMPENSATION EXPENSE TO BROADLAWNS MEDICAL CENTER IN THE AMOUNT OF $349,850 BASE COMPENSATION, $28,792 DEFERRED COMPENSATION AND $24,493 FOR NONTAXABLE BENEFITS. FORM 990, PART VI, SECTION A, LINE 6 BROADLAWNS MEDICAL CENTER, A COUNTY AGENCY, AND CENTRAL IOWA HOSPITAL CORPORATION, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, ARE MEMBERS. EACH AGENCY APPOINTS AN EQUAL NUMBER OF VOTING BOARD MEMBERS AND THE TWO EX OFFICIO, NON-VOTING MEMBERS (DESIGNATED INSTITUTIONAL OFFICIAL AND PROGRAM DIRECTOR). FORM 990, PART VI, SECTION A, LINE 7A BROADLAWNS MEDICAL CENTER AND CENTRAL IOWA HOSPITAL CORPORATION DESIGNATE REPRESENTATIVES TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B BROADLAWNS MEDICAL CENTER AND CENTRAL IOWA HOSPITAL CORPORATION MUST APPROVE AMENDMENTS TO ARTICLES AND BYLAWS, AND APPROVE DISSOLUTIONS OR MERGER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE IOWA HEALTH SYSTEM TAX SERVICES DEPARTMENT USING INFORMATION GATHERED FROM THE FINANCIAL SERVICES AND ADMINISTRATIVE OFFICES OF THE ORGANIZATION. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE EXECUTIVE DIRECTOR FOR REVIEW. ONCE REVIEWED A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C A DESIGNATED PERSON WITHIN THE ORGANIZATION AND OTHER RELATED ORGANIZATIONS SUBJECT TO THIS POLICY SHALL SEND DISCLOSURE QUESTIONNAIRES TO ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES. PERSONS REQUIRED TO REPORT WHO HAVE NOT RETURNED QUESTIONNAIRES WILL BE CONTACTED AND FOLLOW-UP WILL CONTINUE ON A REGULAR BASIS IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE INFORMATION DISCLOSED WILL BE USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICARE QUESTIONNAIRES. THE DUTY TO IDENTIFY AND DISCLOSE POTENTIAL CONFLICTS OF INTEREST IS A DUTY THAT IS ONGOING. ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES SHALL IMMEDIATELY DISCLOSE SUCH POTENTIAL CONFLICT OR DUALITY OF INTEREST AS SOON AS THE INTEREST OCCURS. DISCLOSURE SHOULD BE MADE TO THE COVERED PERSON'S SUPERVISOR, THE CHIEF EXECUTIVE OFFICER OF THE COMPANY, OR THE BOARD CHAIR OF THE COMPANY, AS APPLICABLE. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR IS REIMBURSED BY A SET CONTRACTUAL PAYMENT AS A MANAGEMENT SERVICE TO THE ORGANIZATION. THIS IS BASED ON FAIR MARKET VALUE. THE ORGANIZATION REIMBURSES A SEPARATE ENTITY FOR THE ADMINISTRATIVE DIRECTOR'S SALARY. THIS SALARY IS BASED UPON THE COMPARISON OF LIKE POSITIONS AND MARKETS ACROSS THE STATE. 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 ARTICLES OF INCORPORATION ARE AVAILABLE THROUGH THE SECRETARY OF STATE'S OFFICE. OTHER GOVERNING DOCUMENTS MAY BE AVAILABLE UPON REQUEST. THE ORGANIZATION WILL PROVIDE COPIES OF ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.