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, 2025 and 2024. 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, Quad Cities; and Meriter Health Services, Inc. and Subsidiaries, Madison, Wisconsin (collectively, the System). 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. Morningside University (MU) acquired St. Luke’s College (SLC) a subsidiary of St. Luke’s Health System, Inc. on December 31, 2025 pending Department of Education approval. SLC programs were integrated into MU with teach-out plans in place to support students and a commitment to employee role alignment.
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 15% de minimis indirect cost rate allowed under the Uniform Guidance. For the years ended December 31, 2025 and 2024, 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.
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, 2025 and 2024, consists of: See the Notes to the SEFA for chart/table
Augustana College (AC) signed an agreement to acquire the academic programs of Trinity College of Nursing & Health Sciences’ (TC) as announced on December 22, 2025. TC programs will become part of AC and students will continue to be served throughout the change in ownership and integration process. The System completed the sale on June 30, 2026 pending Department of Education approval.