Title: Reporting Entity
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, either the cost principles in OMB Circular A-122, Cost Principles for Non-Profit Organizations, or the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected to not use the 10% de minimis indirect cost rate allowed under the Uniform Guidance.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Iowa Health System and Subsidiaries d/b/a UnityPoint Health (the System) under programs of the federal government for the years ended December 31, 2024 and 2023. Iowa Health System and Subsidiaries d/b/a UnityPoint Health include: Central Iowa Health System and Subsidiaries d/b/a UnityPoint Health – Des Moines, Des Moines, Iowa; St. Luke’s Healthcare and Subsidiaries, Cedar Rapids, Iowa; Allen Health Systems, Inc. and Subsidiaries, Waterloo, Iowa; St. Luke’s Health System, Inc., Sioux City, Iowa; Finley Tri States Health Group, Inc. and Subsidiaries, Dubuque, Iowa; Trinity Health System, Inc. and Subsidiaries, Fort Dodge, Iowa; Trinity Regional Health System and Subsidiaries, Rock Island, Illinois; Methodist Health Services Corporation and Subsidiaries, Peoria, Illinois and Meriter Health Services, Inc. and Subsidiaries, Madison, Wisconsin (collectively, the System).
On December 10, 2021, the System signed a nonbinding letter of intent to transition Methodist Health Services Corporation and Subsidiaries (Central Illinois) to The Carle Foundation, d/b/a Carle Health (Carle Health). Accordingly, on October 28, 2022, the System and Carle Health signed a strategic affiliation agreement, to transition Central Illinois to Carle Health. The transition was effective April 1, 2023, with the System and Central Illinois signing a mutual agreement to terminate its affiliation agreement.
The accompanying notes are an integral part of this Schedule. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the System, it is not intended to and does not present the financial position, changes in net assets or cash flows of the System.
Title: Basis of Accounting
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, either the cost principles in OMB Circular A-122, Cost Principles for Non-Profit Organizations, or the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected to not use the 10% de minimis indirect cost rate allowed under the Uniform Guidance.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, either the cost principles in OMB Circular A 122, Cost Principles for Non Profit Organizations, or the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. For the years ended December 31, 2024 and 2023, the System had no expenditures in the form of noncash assistance, had no federally provided insurance in effect, or loans or loan guarantees outstanding at year end.
Title: Loan Programs
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, either the cost principles in OMB Circular A-122, Cost Principles for Non-Profit Organizations, or the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected to not use the 10% de minimis indirect cost rate allowed under the Uniform Guidance.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The federal loan programs listed subsequently are administered directly by the System, and balances and transactions relating to these programs are included in the System’s consolidated financial statements. Loans outstanding at the beginning of the year and loans made during the year are included in the federal expenditures presented in the Schedule. The balance of loans outstanding at December 31, 2024 and 2023, consists of: See the Notes to the SEFA for chart/table
Title: Subsequent Events
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, either the cost principles in OMB Circular A-122, Cost Principles for Non-Profit Organizations, or the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (Uniform Guidance), wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected to not use the 10% de minimis indirect cost rate allowed under the Uniform Guidance.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
On May 29, 2025, UnityPoint Health announced it had signed a letter of intent to acquire MercyOne Siouxland Medical Center, including its affiliated physician practices and home care services. The transaction reflects a strategic initiative to preserve and enhance access to high-quality, community-led healthcare in the Siouxland region through not-for-profit leadership. The acquisition is anticipated to close on or around July 31, 2025, subject to customary closing conditions.
On July 15, 2025, St. Luke’s College announced its intent to enter into a transaction with Morningside University. The proposed transition, pending regulatory approval, will integrate St. Luke’s programs and services into Morningside University, with teach-out plans in place to support current students and a commitment to employee role alignment during the transition. The anticipated close date is December, 31st, 2025.