ST CROIX REGIONAL MEDICAL CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ST CROIX REGIONAL MEDICAL CENTER (EIN 39-0890676)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-15
- IRS object ID
- 202431369349312388
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-15T16:03:55-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390890676 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CROIX REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STCR | BusinessNameControlTxt |
| Phone | 7154830556 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 STATE STREET | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIMBERLY ERICSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7154830556 | PhoneNum |
| Signature | 2024-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KIMBERLY | PersonFirstNm |
| Person Last | ERICSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2024-05-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL YOUSO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 STATE STREET | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $139,572,352 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SCRMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | WE HELP PEOPLE TO LIVE HEALTHIER, HAPPIER, AND LONGER LIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 1193 | TotalEmployeeCnt |
| Total Volunteers | 24 | TotalVolunteersCnt |
| Total Gross UBI | $801,206 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $469,277 | PYContributionsGrantsAmt |
| CY Contributions Grants | $500,914 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $141,994,360 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $138,237,202 | CYProgramServiceRevenueAmt |
| PY Investment Income | $219,785 | PYInvestmentIncomeAmt |
| CY Investment Income | $341,673 | CYInvestmentIncomeAmt |
| PY Other Revenue | $385,737 | PYOtherRevenueAmt |
| CY Other Revenue | $460,233 | CYOtherRevenueAmt |
| PY Total Revenue | $143,069,159 | PYTotalRevenueAmt |
| CY Total Revenue | $139,540,022 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,885 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $66,055,703 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,608,663 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $72,882,054 | PYOtherExpensesAmt |
| CY Other Expenses | $75,182,421 | CYOtherExpensesAmt |
| PY Total Expenses | $138,940,642 | PYTotalExpensesAmt |
| CY Total Expenses | $148,791,084 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,128,517 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$9,251,062 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $108,254,193 | TotalAssetsBOYAmt |
| Total Assets EOY | $104,423,130 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,835,893 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,255,892 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $87,418,300 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $78,167,238 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE HELP PEOPLE TO LIVE HEALTHIER, HAPPIER, AND LONGER LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $91,636,571 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $101,421,305 | RevenueAmt |
| Desc | OUTPATIENT SERVICES - SURGICAL, LABORATORY, BASIC, AND ADVANCED RADIOLOGY PROCEDURES. DURING FISCAL YEAR 2023, THERE WERE 11,912 EMERGENCY ROOM VISITS RECORDED, 4,307 OUTPATIENT SURGERIES, AND 54,392 HOSPITAL OUTPATIENT VISITS.INPATIENT SERVICES - OBSTETRIC, MEDICAL-SURGICAL, INTENSIVE CARE, AND SHORT STAY INPATIENT CARE. DURING FISCAL YEAR 2023, THERE WERE 228 BIRTHS, 1,626 INPATIENT ADMISSIONS, AND A TOTAL OF 5,644 INPATIENT DAYS FOR AN AVERAGE LENGTH OF 3.47 DAYS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $18,823,106 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $20,832,992 | RevenueAmt |
| Desc | ST. CROIX REGIONAL MEDICAL CENTER OPERATES FOUR PROVIDER-BASED CLINICS AND ONE FREE STANDING CLINIC. TOGETHER, THE CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 108,562 CLINIC VISITS OCCURRED IN FISCAL YEAR 2023. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,766,700 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,916,342 | RevenueAmt |
| Desc | ST. CROIX VALLEY PHARMACIES PROVIDE LOCAL PHARMACY CARE TO THE SERVICE AREA OF ST. CROIX REGIONAL MEDICAL CENTER. ST. CROIX VALLEY PHARMACIES IS THE SOLE MEMBER OF THE FOLLOWING COMMUNITY PHARMACIES: UNITY PHARMACY LOCATED IN THE UNITY CLINIC BUILDING NEAR BALSAM, WI, FREDERIC PHARMACY LOCATED IN THE FREDERIC CLINIC BUILDING IN FREDERIC, WI, AND, ST. CROIX FALLS PHARMACY LOCATED IN THE ST. CROIX FALLS CLINIC BUILDING IN ST. CROIX FALLS, WI. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,580,725 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,856,289 | RevenueAmt |
| Desc | CONTRACT PHARMACY - ST. CROIX REGIONAL MEDICAL CENTER BECAME ELIGIBLE TO PARTICIPATE IN THE 340B DRUG PRICING PROGRAM, WHICH IS MANAGED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OFFICE OF PHARMACY AFFAIRS (OPA), RESULTING IN THE REALIZATION OF A CONTRACT PHARMACY SERVICE. PARTICIPATION IN THE 340B DRUG PRICING PROGRAM RESULTS IN SIGNIFICANT SAVINGS, ESTIMATED TO BE 20-50%, ON THE COST OF PHARMACEUTICALS FOR USE BY OUTPATIENTS OF THE FACILITY. THROUGH THIS PROGRAM, ST. CROIX REGIONAL MEDICAL CENTER IS ABLE TO REACH MORE ELIGIBLE PATIENTS AND PROVIDE MORE COMPREHENSIVE SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,580,725 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $2,856,289 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $123,807,102 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 88 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1193 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIMBERLY ERICSON | PersonNm |
| Phone | 7154830556 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 STATE STREET | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JOHN DRISCOLL | ||||||||
| CHAIR/BOARD MEMBER | 0.50 | Yes (X) | Yes (X) | $1,850 | $0 | $0 | ||
| TRUDY CANINE | ||||||||
| VICE CHAIR/CHAIR | 0.50 | Yes (X) | Yes (X) | $1,650 | $0 | $0 | ||
| JOSEPH WHITE | ||||||||
| TREASURER (THRU APRIL 2023) | 0.50 | Yes (X) | Yes (X) | $1,500 | $0 | $0 | ||
| GURDESH BEDI | ||||||||
| TRUSTEE/PHYSICIAN OF SCRMC | 40.00 | Yes (X) | Yes (X) | $925,664 | $0 | $19,765 | ||
| KAREN HAUER | ||||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $1,450 | $0 | $0 | ||
| JOHN CUMMING | ||||||||
| TRUSTEE (THRU FEB. 2023) | 0.50 | Yes (X) | $1,050 | $0 | $0 | |||
| LISA EDSTROM | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $950 | $0 | $0 | |||
| REBECCA LYMAN MD | ||||||||
| TRUSTEE/PHYSICIAN (THRU JUNE 2023) | 40.00 | Yes (X) | $316,338 | $0 | $38,985 | |||
| WILLIAM TIES | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $1,650 | $0 | $0 | |||
| DAVE DOBOSENSKI | ||||||||
| CEO (THRU FEB. 2023) | 40.00 | Yes (X) | $503,925 | $0 | $49,427 | |||
| SALLY BAJAK | ||||||||
| CFO (THRU JULY 2022) | 40.00 | Yes (X) | $154,575 | $0 | $29,875 | |||
| KIMBERLY ERICSON | ||||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL YOUSO | ||||||||
| CFO/CEO | 40.00 | Yes (X) | $112,563 | $0 | $9,803 | |||
| JOHN KAMPA | ||||||||
| SCRMC PHYSICIAN | 40.00 | $742,120 | $0 | $29,344 | Yes (X) | |||
| MUHAMMAD KHAN | ||||||||
| SCRMC PHYSICIAN | 40.00 | $643,846 | $0 | $49,236 | Yes (X) | |||
| VITTAL NAGAR | ||||||||
| SCRMC PHYSICIAN | 40.00 | $578,714 | $0 | $46,859 | Yes (X) | |||
| MARISA SPENCER | ||||||||
| SCRMC PHYSICIAN | 40.00 | $581,005 | $0 | $18,954 | Yes (X) | |||
| DAVID NORDIN | ||||||||
| SCRMC PHYSICIAN | 40.00 | $604,468 | $0 | $31,957 | Yes (X) | |||
| PATRICK MCDONOUGH | ||||||||
| FORMER VC/SPORTS MED MD | 40.00 | $352,689 | $0 | $43,290 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,526,007 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $367,495 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 112 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REGIONS HOSPITAL | |||||
| PO BOX 772953 | DETROIT | MI | 482772953 | EMERGENCY PHYSICIAN | $3,127,157 |
| NEI ELECTRIC INC | |||||
| 4815 WHITE BEAR PKWY | WHITE BEAR LAKE | MN | 55110 | ELECTRICIAN | $2,705,778 |
| KRAUS-ANDERSON CONSTRUCTION COMPANY | |||||
| 501 S EIGHTH ST | MINNEAPOLIS | MN | 55404 | CONSTRUCTION | $2,336,910 |
| MIDWEST RADIOLOGY PA | |||||
| 2355 HWY 36 WEST STE 100 | ROSEVILLE | MN | 55113 | RADIOLOGY SERVICE | $2,144,402 |
| ST CROIX VALLEY ANESTHESIA LLC | |||||
| BOX 45 | OSCEOLA | WI | 54020 | ANESTHESIA SERVICE | $1,743,921 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 41 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $476,044 | GovernmentGrantsAmt |
| All Other Contributions | $24,870 | AllOtherContributionsAmt |
| Total Contributions | $500,914 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 624100 | $119,179,974 | $119,179,974 | |
| FREDERIC PHARMACY | 456110 | $4,809,744 | $4,506,730 | $303,014 |
| SCF PHARMACY | 456110 | $4,364,887 | $4,089,899 | $274,988 |
| UNITY PHARMACY | 456110 | $3,542,917 | $3,319,713 | $223,204 |
| 340B PHARMACY | 456110 | $2,856,289 | $2,856,289 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,483,391 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,912,658 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $570,733 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $138,237,202 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $370,736 | TotalRevenueColumnAmt |
| Exclusion | $370,736 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $65,883 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,267 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $62,616 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,616 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,616 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $29,063 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$29,063 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$29,063 | TotalRevenueColumnAmt |
| Exclusion | -$29,063 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | JOINT VENTURE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $397,617 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $99,049 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $298,568 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $397,617 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139,540,022 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $137,026,928 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $801,206 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,210,974 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,152,506 | TotalAmt |
| Program Services | $1,300,172 | ProgramServicesAmt |
| Management And General | $852,334 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,654,067 | TotalAmt |
| Program Services | $46,391,991 | ProgramServicesAmt |
| Management And General | $10,262,076 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,250,000 | TotalAmt |
| Program Services | $1,838,190 | ProgramServicesAmt |
| Management And General | $411,810 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,079,033 | TotalAmt |
| Program Services | $7,462,571 | ProgramServicesAmt |
| Management And General | $1,616,462 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,473,057 | TotalAmt |
| Program Services | $2,842,153 | ProgramServicesAmt |
| Management And General | $630,904 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,817 | TotalAmt |
| Program Services | $69,000 | ProgramServicesAmt |
| Management And General | $186,817 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,972 | TotalAmt |
| Management And General | $211,972 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,478 | TotalAmt |
| Management And General | $11,478 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,669,327 | TotalAmt |
| Program Services | $18,613,135 | ProgramServicesAmt |
| Management And General | $4,056,192 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,683 | TotalAmt |
| Program Services | $23,161 | ProgramServicesAmt |
| Management And General | $256,522 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,007 | TotalAmt |
| Program Services | $501,877 | ProgramServicesAmt |
| Management And General | $359,130 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,573,576 | TotalAmt |
| Program Services | $1,488,564 | ProgramServicesAmt |
| Management And General | $4,085,012 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,658,419 | TotalAmt |
| Program Services | $1,530,917 | ProgramServicesAmt |
| Management And General | $127,502 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,218 | TotalAmt |
| Program Services | $38,417 | ProgramServicesAmt |
| Management And General | $31,801 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,123 | TotalAmt |
| Program Services | $401,723 | ProgramServicesAmt |
| Management And General | $25,400 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,117 | TotalAmt |
| Program Services | $190,117 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,438,084 | TotalAmt |
| Program Services | $4,438,084 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $537,816 | TotalAmt |
| Program Services | $260,956 | ProgramServicesAmt |
| Management And General | $276,860 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS AND MEDS | $17,313,158 | $17,313,158 | |
| MEDICAL SUPPLIES | $16,769,891 | $16,005,396 | $764,495 |
| DUES AND PUBLICATIONS | $1,159,306 | $1,036,114 | $123,192 |
| REPAIRS AND MAINTENANCE | $980,063 | $946,927 | $33,136 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,775,366 | TotalAmt |
| Program Services | $1,114,479 | ProgramServicesAmt |
| Management And General | $660,887 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,791,084 | TotalAmt |
| Program Services | $123,807,102 | ProgramServicesAmt |
| Management And General | $24,983,982 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,117,787 | BOYAmt |
| EOY | $35,933 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,583,106 | BOYAmt |
| EOY | $29,411,423 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,039,876 | BOYAmt |
| EOY | $13,056,341 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,583 | BOYAmt |
| EOY | $402,303 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,748,483 | BOYAmt |
| EOY | $4,108,806 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,191,392 | BOYAmt |
| EOY | $892,276 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $83,825,854 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,574,234 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,347,159 | BOYAmt |
| EOY | $34,251,620 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,624,910 | BOYAmt |
| EOY | $1,865,781 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,500 | BOYAmt |
| EOY | $345,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,818,397 | BOYAmt |
| EOY | $20,053,647 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,254,193 | BOYAmt |
| EOY | $104,423,130 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,782,173 | BOYAmt |
| EOY | $15,019,118 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,969 | BOYAmt |
| EOY | $308,776 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,930 | BOYAmt |
| EOY | $793,093 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,396,821 | BOYAmt |
| EOY | $10,134,905 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,835,893 | BOYAmt |
| EOY | $26,255,892 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,418,300 | BOYAmt |
| EOY | $78,167,238 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,418,300 | BOYAmt |
| EOY | $78,167,238 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,254,193 | BOYAmt |
| EOY | $104,423,130 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$9,251,062 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,478 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,478 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | ST CROIX REGIONAL MEDICAL CENTER (THE ORGANIZATION") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE ORGANIZATION PAYS MEMBERSHIP FEES TO THE RWHC. RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. THE ORGANIZATION IS ALSO A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION. THESE DUES PAID ARE PRIMARILY USED TO ENSURE THEIR MEMBERS' PERSPECTIVES AND NEEDS ARE HEARD AND ADDRESSED IN NATIONAL HEALTH POLICY DEVELOPMENT, LEGISLATIVE AND REGULATORY DEBATES AND JUDICIAL MATTERS. THE ORGANIZATION IS ALSO A MEMBER OF THE NATIONAL RURAL HEALTH ASSOCIATION. THESE DUES PAID ARE PRIMARILY USED TO SUPPORT RURAL HEALTH ISSUES THROUGH ADVOCACY, COMMUNICATIONS, EDUCATION AND RESEARCH. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,833,069 | OtherCostOrOtherBasisAmt |
| Book Value | $4,833,069 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,667,943 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,883,547 | DepreciationAmt |
| Book Value | $14,784,396 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,734,139 | OtherCostOrOtherBasisAmt |
| Depreciation | $211,733 | DepreciationAmt |
| Book Value | $3,522,406 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,590,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,478,954 | DepreciationAmt |
| Book Value | $11,111,749 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,251,620 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| UNEMPLOYMENT RESERVE FUND | $415,156 |
| DEFERRED COMPENSATION PLAN | $6,192,696 |
| AMOUNTS RECEIVABLE FROM THIRD-PARTY REIMBURSEMENT PROGRAMS | $12,675,000 |
| DUE FROM RELATED PARTIES | $770,795 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $20,053,647 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $180,651 |
| DEFERRED COMPENSATION PLAN | $6,558,622 |
| LINE OF CREDIT | $3,395,632 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,134,905 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $202,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $202,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,269,483 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,567,893 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,701,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05180 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,472,277 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,567,893 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,904,384 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05320 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,506,116 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,385,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,120,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08830 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,506,116 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,385,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,120,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08830 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,978,393 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,953,884 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,024,509 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $77,676 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $38,838 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $31,206,311 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,334,078 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$127,767 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CROIX REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 STATE STREET | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SCRMC.ORG | WebsiteAddressTxt |
| State License | 1041 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CROIX REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.SAINTCROIXHEALTH.ORG/LEGAL-NOTICES/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION C, LINE 7D | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C, LINE 16J | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C, LINE 16J | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. CROIX REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 5: HAD A MULTI-SECTOR LEADERSHIPS TEAM. REACHED OUT TO ALL ORGANIZATIONS WITHIN THE 12 COMMUNITY SECTORS VIA PHONE CALL OR EMAIL. SENT AREA LEADERS AN OUTLOOK INVITATION. ALL LEADERS WOULD SHARE TIME/PLACE WITH THEIR EMPLOYEES AND THE COMMUNITY MEMBERS THEY HELPED/REPRESENTED. ONSITE VISIT OPTIONS WERE AVAILABLE FOR ALL THAT PREFERRED THAT METHOD (WE WOULD GO TO THEM). WE WANTED TO MAKE SURE WE WERE REACHING UNDERSERVED AREAS AND TRIED TO MAKE IT AS EASY AS POSSIBLE FOR EVERYONE TO PARTICIPATE. FOUR QUALITATIVE QUESTIONS WERE ASKED FOLLOWED BY QUANTITATIVE RANKINGS. |
| ST. CROIX REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 6A: AMERY HOSPITAL AND CLINIC AND OSCEOLA MEDICAL CENTER |
| ST. CROIX REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 6B: UNITED WAY ST. CROIX VALLEY, POLK COUNTY PUBLIC HEALTH, UNIVERSITY OF WISCONSIN-EXTENSION, MENTAL HEALTH TASK FORCE OF POLK COUNTY |
| ST. CROIX REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 7D: SECTION B, LINE 7B:HTTPS://CMS5.REVIZE.COM/REVIZE/POLK/POLKCOUNTYHEALTH/2022%20POLK%20COUNTY%20COMMUNITY%20HEALTH%20ASSESSMENT.PDFSECTION B, LINE 10A:HTTPS://WWW.SAINTCROIXHEALTH.ORG/LEGAL-NOTICES/ |
| ST. CROIX REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 11: ACCESS: THERE IS EQUAL ACCESSIBILITY TO CARE, SERVICES, AND OPPORTUNITIES FOR ALL COMMUNITY MEMBERS (REGARDLESS OF SOCIOECONOMIC STATUS).INCREASE CONVENIENT OPPORTUNITIES TO VISIT A HEALTH CARE PROVIDER.- TELEHEALTH EQUIPMENT WAS IMPROVED AND UPGRADED TO ENSURE EASY AND CONVENIENT ACCESS TO HEALTHCARE PROVIDERS.- MAMMOGRAPHY SERVICES WERE ADDED AT OUR WEBSTER, WI, LOCATION TO INCREASE SCREENING CONVENIENCE.- OUR PHYSICAL THERAPISTS AND OCCUPATIONAL THERAPISTS CONDUCT OUTREACH TO FREDERIC SCHOOL DISTRICT, UNITY SCHOOL DISTRICT, ST. CROIX FALLS SCHOOL DISTRICT, AND CLEAR LAKE SCHOOL DISTRICT. WE PROVIDE SERVICES TO STUDENTS WITH IEPS (INDIVIDUALIZED EDUCATION PLANS).- PATIENT ACCESS IMPLEMENTED SCHEDULING STAFF AT CHECK-OUT LOCATIONS IN OUR PRIMARY AND SPECIALTY AREAS TO FACILITATE FOLLOW-UP APPOINTMENTS, SCHEDULE IMAGING, AND COORDINATE CARE BEFORE PATIENTS LEAVE THE FACILITY. THIS INITIATIVE HAS INCREASED CONTINUITY OF CARE.- WE ENHANCED OUR PHONE OPERATIONS, ALLOWING PATIENTS TO CHOOSE THE DEPARTMENT OR SPECIALTY THEY NEED WITHOUT HAVING TO WAIT ON HOLD FOR A TRANSFER. THIS WAS ACHIEVED THROUGH THE IMPLEMENTATION OF A PHONE TREE SYSTEM.- WE INTRODUCED SAME-DAY APPOINTMENT AVAILABILITY WITH PRIMARY CARE AT ALL LOCATIONS.- SAME-DAY AVAILABILITY FOR MAMMOGRAM AND ULTRASOUND APPOINTMENTS IS NOW OFFERED.- QUICK CARE IS AVAILABLE AS AN ALTERNATIVE OPTION FOR PATIENTS WHO CANNOT SEE THEIR DOCTOR ON THE SAME DAY OR HAVE MORE URGENT MEDICAL NEEDS THAT CANNOT WAIT FOR A FUTURE VISIT.- PATIENT ACCESS COLLABORATES WITH CARE TEAMS TO DOUBLE-BOOK AND ACCOMMODATE ADDITIONAL PATIENTS WHO NEED TO BE SEEN SOONER.- PATIENTS CAN NOW SCHEDULE APPOINTMENTS WITH THEIR PRIMARY CARE PROVIDER INN MYCHART. SCREENING MAMMOGRAM APPOINTMENTS CAN ALSO BE SCHEDULED IN MYCHART.INCREASE TECHNOLOGY UTILIZATION TO IMPROVE PATIENT ENGAGEMENT AND SELF-CARE. - SCH UPGRADED OUR TELEHOSPITALIST AND TELE BEHAVIORAL HEALTH EQUIPMENT TO IMPROVE GENERAL AND SPECIALIZED ACCESS TO CARE AND EFFICIENCY FOR OUR PATIENTS.- SCH PARTNERED WITH LUMA HEALTH TO ENHANCE OUR COMMUNICATION WITH THE COMMUNITY REGARDING THEIR HEALTH NEEDS AND UPCOMING APPOINTMENTS. THROUGH THIS COLLABORATION, WE CAN EFFICIENTLY REMIND PATIENTS OF THEIR SCHEDULED APPOINTMENTS AND PROVIDE THEM WITH ANY NECESSARY, OR SPECIAL, INSTRUCTIONS. IN THE EVENT OF AN UNEXPECTED PHYSICIAN CANCELLATION, WE QUICKLY INFORM PATIENTS OF CHANGES VIA TEXT MESSAGE OR EMAIL IN REAL TIME. WE ALSO USE LUMA HEALTH TO SEND MASS COMMUNICATIONS TO PATIENTS DUE FOR PREVENTIVE CARE, HELPING US STAY PROACTIVE IN MEETING THEIR HEALTH NEEDS.- WE UTILIZE LOCAL PAPERS AND MULTIPLE SOCIAL MEDIA PLATFORMS TO SHARE AND ELEVATE LOCAL HEALTH CONCERNS. DEVELOP PLAN TO CREATE NEW, VISIONARY PHYSICAL STRUCTURE.- SCH PURCHASED 101 ACRES OF LAND FOR ITS NEW FUTURE CAMPUS. THE EXPANSIVE ACREAGE PROVIDES OPPORTUNITIES FOR GROWTH AND DEVELOPMENT, HELPING US OVERCOME OUR CURRENT LAND-LOCKED LIMITATIONS. PHASE I DRAFT DRAWINGS WERE COMPLETED WITH AN ARCHITECTURE FIRM. SUPPORT: COMMUNITY LEADERS WORK TOGETHER TO ALIGN STRATEGIC EFFORTS AND CREATE A "COMMUNITY HEALTH SYSTEM" THAT IS EASY TO USE, CREATES SEAMLESS TRANSITIONS, AND IS BUILT AROUND SUPPORTING COMMUNITY MEMBERS LIVE HEALTHIER, HAPPIER, AND LONGER LIVES (REGARDLESS OF SOCIOECONOMIC STATUS).ESTABLISH AND STRENGTHEN RELATIONSHIPS WITH OTHER COMMUNITY SECTORS.BECOME A COMMUNITY PARTNERSHIP LEADER.- MEMBER OF THE POLK COUNTY ECONOMIC DEVELOPMENT CORPORATION.- PARTICIPATED IN A POLK COUNTY-WIDE TRANSPORTATION FEASIBILITY STUDY IN COLLABORATION WITH NUMEROUS COMMUNITY PARTNERS.- JOINED FIVE LOCAL CHAMBERS OF COMMERCE, WITH STAFF AND LEADER REPRESENTATIVES FOR EACH: CHISAGO LAKES AREA CHAMBER OF COMMERCE, ST. CROIX FALLS/TAYLORS FALLS CHAMBER OF COMMERCE (KNOWN AS FALLS CHAMBER), BALSAM LAKE AREA CHAMBER OF COMMERCE, FREDERIC CHAMBER OF COMMERCE, AND WEBSTER CHAMBER OF COMMERCE.- PARTNERED WITH THE AMERICAN RED CROSS TO CONDUCT BLOOD DRIVES AND SUPPORT LOCAL BLOOD SUPPLY NEEDS.- WORKED WITH UNITED WAY ST. CROIX VALLEY TO COLLECT DIAPER AND WIPE DONATIONS TO HELP FILL DIAPER BANKS THROUGHOUT OUR SERVICE AREA.- COLLECTED AND DONATED FOOD TO LOCAL FOOD SHELVES.- INTRODUCED NEW PREVENTATIVE PRODUCTS FOR RSV, MAKING IT ACCESSIBLE FOR INFANTS (BOTH PRIVATELY AND PUBLICLY FUNDED), PREGNANT WOMEN, AND SENIORS ACROSS ALL CLINICS AND PHARMACIES.INCREASE RESOURCE REFERRALS FOR PATIENTS WITH UNMET SOCIAL NEEDS.CONNECT VULNERABLE POPULATIONS TO COMMUNITY RESOURCES.- OUR HOSPITAL ACTIVELY CONNECTS WITH COMMUNITY RESOURCES AND COLLABORATES WITH LOCAL AGENCIES TO ADDRESS PATIENT NEEDS. WE FACILITATE COORDINATION BETWEEN DIFFERENT AGENCIES TO ENSURE COMPREHENSIVE CARE. FOR INSTANCE, WHEN A PATIENT IS WORKING WITH AN INCLUSA WORKER, WE COLLABORATE WITH THEM AND OTHER EXTERNAL AGENCIES TO DEVELOP A SAFE DISCHARGE PLAN.- IN COLLABORATION WITH COMMUNITY PARTNERS, WE PROVIDE HOMELESS PATIENTS OR THOSE IN NEED WITH HOMELESS KITS THAT HAVE BASIC NECESSITIES. - OUR TEAM REGULARLY ENGAGES WITH THE POLK/BURNETT COUNTY DEMENTIA COALITION TO DISCUSS AND IMPLEMENT STRATEGIES FOR SUPPORTING COMMUNITY MEMBERS WITH MEMORY LOSS AND THEIR CAREGIVERS.- WE ORGANIZE CARE CONFERENCES INVOLVING VARIOUS COMMUNITY ORGANIZATIONS AND PATIENTS TO ENHANCE SUPPORT AND DELIVER INTEGRATED CARE.- WE PARTNER WITH OUR PUBLIC HEALTH TEAMS REGULARLY AND ARE PART OF THE COMMUNITY HEALTH LEADERSHIP TEAM.PROVIDE SUPPORT IN NAVIGATING THE HEALTH CARE SYSTEM.- AN OB NURSE NAVIGATOR POSITION WAS ESTABLISHED TO GUIDE PREGNANT WOMEN FROM THE BEGINNING OF THEIR PREGNANCY THROUGH THE POSTPARTUM PERIOD, INCLUDING THE FIRST COUPLE OF WEEKS AFTER BIRTH.- THE OBSTETRICS DEPARTMENT OFFERS RESOURCES TO PATIENTS SUCH AS PUBLIC HEALTH (WIC, ETC.), CPS, AND THE FAMILY RESOURCE CENTER IN POLK AND BURNETT COUNTIES. THESE RESOURCES SUPPORT PATIENTS WITH FOOD, SHELTER, CLOTHING, AND SAFETY NEEDS. WE ALSO RECEIVE GIVEAWAY BAGS FROM SECOND STORK IN MINNEAPOLIS, WHICH WE DISTRIBUTE TO LOW-INCOME FAMILIES IN NEED OF DIAPERS, WIPES, CLOTHING, PACK-AND-PLAYS, AND OTHER ESSENTIALS.- OUR CLINIC PROVIDES CHRONIC CARE MANAGEMENT TO PATIENTS WITH CHRONIC ILLNESSES. THIS PROGRAM COORDINATES CARE AND ADDRESSES PATIENTS' NEEDS EFFECTIVELY. ONCE WE HAVE A FULL STAFF, WE PLAN TO OFFER TRANSITIONAL CARE MANAGEMENT TO FURTHER COORDINATE CARE FOR PATIENTS UPON DISCHARGE.INCLUSION: COMMUNITY MEMBERS FEEL "BELONGING AND ARE EMPOWERED TO HELP THEMSELVES AND EACH OTHER LIVE HEALTHIER, HAPPIER, AND LONGER LIVES (REGARDLESS OF SOCIOECONOMIC STATUS).- DURING MENTAL HEALTH MONTH IN MAY, WE CONDUCTED A MONTH-LONG CAMPAIGN AIMED AT REDUCING THE STIGMA ASSOCIATED WITH MENTAL ILLNESS AND PROVIDING EDUCATION ON HOW TO TALK TO SOMEONE DEALING WITH MENTAL HEALTH ISSUES AND HOW TO SEEK HELP.PROMOTE A CULTURE OF "BELONGING" BY INCREASING AWARENESS IN HEALTH EQUITY, DIVERSITY, AND INCLUSION. - WE BEGAN EMPHASIZING INCLUSION AND BELONGING IN OUR INTERNAL WEEKLY COMMUNICATION NEWSLETTER TO EMPLOYEES AND ARE PROMOTING AN INCLUSIVE ENVIRONMENT THROUGH OUR SOCIAL MEDIA POSTS. WE ARE ALSO INCREASING SUPPORT BY FACILITATING MONTHLY REFLECTIVE QUESTION DISCUSSIONS WITH TEAMS TO ENCOURAGE OPEN DIALOGUE AND FOSTER A SUPPORTIVE ENVIRONMENT.CREATE OPPORTUNITIES TO INCREASE THE VOICE OF THE PATIENT/COMMUNITY MEMBERS.- SCH ESTABLISHED A TEMPORARY PATIENT ADVISORY COMMITTEE TO ENSURE WE ARE ATTENTIVE TO THE VOICES OF OUR PATIENTS AND COMMUNITY. |
| PART V, LINES 16A-C: | HTTPS://WWW.SAINTCROIXHEALTH.ORG/PATIENTS-VISITORS/INSURANCE-BILLING/FINANCIAL-ASSISTANCE/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ST CROIX FALLS CLINIC | ||||
| 216 SOUTH ADAMS STREET | ST CROIX FALLS | WI | 54024 | RHC PROVIDER BASED CLINIC |
| 2 - LINDSTROM CLINIC | ||||
| 12375 LINDSTROM LANE | LINDSTROM | MN | 55045 | FREE STANDING CLINIC |
| 3 - WEBSTER HEALTH CENTER | ||||
| 26425 LAKELAND AVE SOUTH | WEBSTER | WI | 54893 | RHC PROVIDER BASED CLINIC |
| 4 - FREDERIC CLINIC | ||||
| 205 OAK STREET WEST | FREDERIC | WI | 54837 | RHC PROVIDER BASED CLINIC |
| 5 - UNITY CLINIC | ||||
| 1504 190TH AVENUE | BALSAM LAKE | WI | 54810 | RHC PROVIDER BASED CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ST. CROIX REGIONAL MEDICAL CENTER, THROUGH ITS PATIENT ADVOCATES, EVALUATES EACH APPLICANT'S SITUATION IN ACCORDANCE WITH CRITERIA ESTABLISHED ANNUALLY BY THE BOARD OF DIRECTORS. THE CRITERIA INCLUDE:{1) INDIVIDUAL OR FAMILY INCOME{2) FAMILY SIZE{3) OTHER SOURCES OF PAYMENT FOR SERVICES. QUALIFICATION IS BASED ON ASSET LEVELS ESTABLISHED BY MEDICAL ASSISTANCE, FAMILY SIZE, AND INCOME LEVELS BASED ON 100% OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY BY THE FEDERAL GOVERNMENT. IN ADDITION TO THE ABOVE LISTED ELIGIBILITY REQUIREMENTS DEPENDENT UPON INCOME, SCRMC MAY ALSO PRESUMPTIVELY DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PORTIONS OF OR THE ENTIRE FINANCIAL APPLICATION PROCESS MAY BE WAIVED FOR CERTAIN PATIENTS/GUARANTORS WHO PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE AND ARE SUBSEQUENTLY VERIFIED BASED ON SCRMC POLICIES AND PROCEDURES. EXAMPLES MAY INCLUDE PATIENTS/GUARANTORS WHO ARE HOMELESS, DECEASED WITHOUT AN ESTATE, BANKRUPTCY, FOOD STAMPS AND/OR PATIENTS/GUARANTORS WHO QUALIFY BY EXTERNAL AVAILABLE DATA SOURCES SUCH AS CREDIT AGENCIES OR SOCIAL ECONOMIC STATUS OF QUALIFYING FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED ON FROM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART I, LINE 7G: | THE ORGANIZATION INCLUDED THE ACTIVITY OF FOUR RURAL HEALTH CLINICS FOR SUBSIDIZED HEALTH SERVICES. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 132,041. |
| PART III, LINE 2: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. |
| PART III, LINE 3: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. |
| PART III, LINE 4: | THE ORGANIZATION DID NOT HAVE AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDING 06/30/2023 DUE TO A CHANGE IN YEAR-END. SEE BELOW FOR THE DESCRIPTION USED IN PRIOR YEAR'S AUDITED FINANCIAL STATEMENTS:PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE MEDICAL CENTER EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS THAT REFLECT MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE MEDICAL CENTER ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.THE MEDICAL CENTER DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. |
| PART III, LINE 8: | THE MEDICAL CENTER PROVIDES CARE TO INDIVIDUALS WHERE GOVERNMENT DEPARTMENTS DETERMINE THE AMOUNT OF REIMBURSEMENT OF SERVICE REGARDLESS OF THE COST TO PROVIDE THE SERVICE. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES GROSS MEDICARE REVENUE BUT DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE ALSO DOES NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS RADIOLOGIST, RESPIRATORY THERAPY, URGENT CARE, OR ANESTHESIA PROFESSIONAL SERVICES. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE CALCULATION IS ALSO NOT INCLUDING THE ACTIVITY FROM FOUR RURAL HEALTH CLINICS AS THOSE AMOUNTS ARE BEING INCLUDED AS SUBSIDIZED SERVICES. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | THE FOLLOWING PROCEDURES ARE SECTION 8 IN SCRMC'S BILLING AND COLLECTION POLICY INCLUDED ON THEIR WEBSITE AND DESCRIBE THE POLICY AND PROCEDURES USED FOR PATIENTS THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE. ST. CROIX REGIONAL MEDICAL CENTER WILL MAKE REASONABLE EFFORTS TO PATIENT/GUARANTORS THAT FINANCIAL ASSISTANCE IS AVAILABLE, WHERE TO GET THE INFORMATION, HOW TO APPLY, AND ASSISTANCE AVAILABLE WITH APPLYING. ST. CROIX REGIONAL MEDICAL CENTER WILL ALLOW AND PROCESS A FINANCIAL ASSISTANCE APPLICATION UP TO 240 DAYS AFTER THE PATIENT/GUARANTOR'S FIRST BILLING STATEMENT AFTER A DATE OF SERVICE. ST. CROIX REGIONAL MEDICAL CENTER WILL TAKE STEPS TO NOTIFY PATIENT/GUARANTOR ABOUT OUR FINANCIAL ASSISTANCE POLICY AND WILL NOT TAKE EXTRAORDINARY COLLECTION ACTIONS BEFORE 120 DAYS FROM PATIENT/GUARANTOR'S FIRST BILLING STATEMENT AFTER A DATE OF SERVICE. IF A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED DURING THE APPLICATION PERIOD, ST. CROIX REGINAL MEDICAL CENTER WILL SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT, MAKE AN ELIGIBILITY DETERMINATION AS TO WHETHER THE PATIENT/GUARANTOR IS ELIGIBLE FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT/GUARANTOR IN WRITING. IF ELIGIBLE, THE FINAL NOTIFICATION PERIOD WILL BE RESET FOR ANOTHER 30-DAY PERIOD. IF A PATIENT/GUARANTOR DOES NOT APPLY FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY BY THE LAST DAY OF THE FINAL NOTIFICATION PERIOD, AND THE PATIENT/GUARANTOR HAS RECEIVED THE 30-DAY NOTICE DESCRIBED IN FINAL NOTIFICATION PERIOD, THEN ST. CROIX REGIONAL MEDICAL CENTER MAY INITIATE EXTRAORDINARY COLLECTION ACTIONS. IF A PATIENT/GUARANTOR HAS APPLIED FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY IN THE LAST SIX MONTHS, AND IT WAS DETERMINED THAT THE PATIENT/GUARANTOR IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, THEN SCRMC MAY INITIATE EXTRAORDINARY COLLECTION ACTIONS. IF AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION UNDER THE FINANCIAL ASSISTANCE POLICY IS RECEIVED PRIOR TO THE FINAL NOTICE, THEN EXTRAORDINARY COLLECTION ACTIONS WILL BE SUSPENDED, AND PATIENT/GUARANTOR WILL BE PROVIDED A WRITTEN NOTICE THAT DESCRIBES ADDITIONAL INFORMATION REQUIRED UNDER THE FINANCIAL ASSISTANCE POLICY. IF ADDITIONAL INFORMATION REQUESTED IS NOT PROVIDED, THEN THE FINAL NOTIFICATION PERIOD WILL BE RESET. |
| PART VI, LINE 2: | IN ADDITION TO THE CHNA, THERE IS REGULAR COMMUNICATION AND COLLABORATION ON EACH COUNTY'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WITH THE EFFORT AND INTENT TO INCLUDE THE 12 COMMUNITY SECTORS (SUBSTANCE USE ORGANIZATIONS, STATE/LOCAL/TRIBAL GOVERNMENT, HEALTHCARE PROFESSIONAL, RELIGIOUS/FRATERNAL ORGANIZATIONS, CIVIC/VOLUNTEER ORGANIZATIONS, LAW ENFORCEMENT, YOUTH SERVING ORGANIZATIONS, SCHOOLS, MEDIA, BUSINESS, PARENTS, YOUTH). ST. CROIX HEALTH ATTENDS AND INTERACTS WITH THESE GROUPS CONSISTENTLY TO CREATE, MAINTAIN AND DEVELOP A CHIP WITH UP TO DATE DATA THAT STAYS "ALIVE" WITHIN OUR COMMUNITIES. WITH OTHER PUBLIC HEALTH DEPARTMENTS AND HEALTHCARE ORGANIZATIONS HAVING DIFFERENT CHNA/CHA "CYCLES," DATA IS CONSISTENTLY COMING IN THAT ADDRESSES VARIOUS COMMUNITY NEEDS. INTERNALLY, LEADERS AND EXECUTIVE PARTNERS ARE KNOWLEDGEABLE ABOUT THE "PULSE" OF OUR COMMUNITIES AND INTERNAL EMPLOYEE/PROVIDER "THINKING." |
| PART VI, LINE 3: | OUR WEBSITE HAS DETAILS ABOUT PRICE TRANSPARENCY, HOW TO PAY A BILL, AND INFORMATION ON FINANCIAL ASSISTANCE. THERE ARE FINANCIAL ASSISTANCE PACKETS AT EACH REGISTRATION STATION IN ALL LOCATIONS.IF A PATIENT CALLS AND ASKS TO TALK TO SOMEONE ABOUT FINANCIAL ASSISTANCE OR CONCERNS ON BEING ABLE TO PAY FOR A BILL RECEIVED, ST. CROIX HEALTH PATIENT ACCESS REPRESENTATIVES DIRECT THE PATIENT TO A PATIENT FINANCIAL COUNSELOR WHO GOES OVER ELIGIBILITY OF ASSISTANCE BASED ON INCOME AND OTHER FACTORS. DEPENDENT ON QUALIFICATIONS, THE PATIENT FINANCIAL COUNSELOR DISCUSSES FINANCIAL ASSISTANCE OPTIONS THAT MAY INCLUDE A DISCOUNTED RATE AND PAYMENT CADENCE. |
| PART VI, LINE 4: | OUR PRIMARY SERVICE AREA INCLUDES CHISAGO COUNTY (MN), POLK COUNTY (WI), AND BURNETT COUNTY (WI). TOTAL POPULATION OF THE THREE COUNTIES IS 115,991 (BASED ON 2020 US CENSUS BUREAU DATA). WE SERVE A GEOGRAPHIC AREA OF APPROXIMATELY 300 SQUARE MILES. 27% OF OUR POPULATION ARE BELOW 18 YEARS OF AGE; 22% ARE 65 YEARS OF AGE OR OLDER; 49% ARE FEMALE; 92% ARE NON-HISPANIC WHITE. 66% OF OUR PATIENTS ARE ON GOVERNMENT FUNDED INSURANCE. |
| PART VI, LINE 5: | ST. CROIX HEALTH HOLDS ACTIVE ROLES ON COMMUNITY HEALTH LEADERSHIP TEAMS IN PARTNERSHIP WITH PUBLIC HEALTH DEPARTMENTS, HEALTH SYSTEMS, AND OTHER COMMUNITY RESOURCE/PREVENTION/TREATMENT/EDUCATION GROUPS/ORGANIZATIONS. OUR COMMUNITY LEADERSHIP TEAMS UTILIZE THE 12 COMMUNITY SECTOR APPROACH BY SAMHSA/CDC TO ENSURE WIDESPREAD REPRESENTATION OF ALL COMMUNITY MEMBERS. ST. CROIX HEALTH IS ACTIVELY INVOLVED IN COMMUNITY EVENTS, PROVIDING AWARENESS AND EDUCATION WITH INTERACTIVE EXPERIENCES THAT ENGAGE COMMUNITY MEMBERS TO TAKE ACTION IN CREATING OR MAINTAINING HEALTHY LIFESTYLES. WE ARE PASSIONATE ABOUT CREATING COLLABORATIVE, INNOVATIVE, AND SUSTAINABLE SOLUTIONS WITH COMMUNITY PARTNERS. |
| PART VI, LINE 6: | ST. CROIX HEALTH CONTRACTS WITH THE ALLINA HEALTH SYSTEM FOR ELECTRONIC HEALTH RECORD (EHR) SERVICES. ALLINA PROVIDES SUPPORT FOR EHR OPTIMIZATION INCLUDING, BUT NOT LIMITED TO, SYSTEM UPGRADES, ACCESS, WORKFLOW IMPROVEMENT, TECHNOLOGY ADVANCEMENT INTEGRATION, AND REPORTING. ST. CROIX HEALTH CONTRACTS WITH HEALTHPARTNERS TO SUPPLY PROVIDERS IN NEPHROLOGY, CARDIAC CARE, AND WITHIN OUR EMERGENCY DEPARTMENT. WE ALSO CONTRACT WITH HEALTHPARTNERS FOR OUR EMPLOYEE ASSSISTANCE PROGRAM, WELLBEING PLATFORM, AND HEALTH/DENTAL INSURANCEBENEFITS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI,MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GURDESH BEDI | ||||||||||||||
| TRUSTEE/PHYSICIAN OF SCRMC | $841,604 | $0 | $5,600 | $0 | $78,460 | $0 | $19,765 | $0 | $0 | $0 | $945,429 | $0 | $0 | $0 |
| JOHN KAMPA | ||||||||||||||
| SCRMC PHYSICIAN | $731,165 | $0 | $5,600 | $0 | $5,355 | $0 | $7,964 | $0 | $21,380 | $0 | $771,464 | $0 | $0 | $0 |
| MUHAMMAD KHAN | ||||||||||||||
| SCRMC PHYSICIAN | $560,886 | $0 | $5,600 | $0 | $77,360 | $0 | $17,400 | $0 | $31,836 | $0 | $693,082 | $0 | $0 | $0 |
| DAVID NORDIN | ||||||||||||||
| SCRMC PHYSICIAN | $597,708 | $0 | $1,400 | $0 | $5,360 | $0 | $656 | $0 | $31,301 | $0 | $636,425 | $0 | $0 | $0 |
| VITTAL NAGAR | ||||||||||||||
| SCRMC PHYSICIAN | $567,754 | $0 | $5,600 | $0 | $5,360 | $0 | $16,409 | $0 | $30,450 | $0 | $625,573 | $0 | $0 | $0 |
| MARISA SPENCER | ||||||||||||||
| SCRMC PHYSICIAN | $570,050 | $0 | $5,600 | $0 | $5,355 | $0 | $18,954 | $0 | $0 | $0 | $599,959 | $0 | $0 | $0 |
| DAVE DOBOSENSKI | ||||||||||||||
| CEO (THRU FEB. 2023) | $417,677 | $0 | $82,000 | $0 | $4,248 | $0 | $21,498 | $0 | $27,929 | $0 | $553,352 | $0 | $0 | $0 |
| PATRICK MCDONOUGH | ||||||||||||||
| FORMER VC/SPORTS MED MD | $269,922 | $0 | $5,600 | $0 | $77,167 | $0 | $14,664 | $0 | $28,626 | $0 | $395,979 | $0 | $0 | $0 |
| REBECCA LYMAN MD | ||||||||||||||
| TRUSTEE/PHYSICIAN (THRU JUNE 2023) | $236,105 | $0 | $3,824 | $0 | $76,409 | $0 | $12,390 | $0 | $26,595 | $0 | $355,323 | $0 | $0 | $0 |
| SALLY BAJAK | ||||||||||||||
| CFO (THRU JULY 2022) | $106,075 | $0 | $4,000 | $0 | $44,500 | $0 | $7,402 | $0 | $22,473 | $0 | $184,450 | $0 | $44,500 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | DAVE DOBOSENSKI, SALLY BAJAK, DR. REBECCA LYMAN, DR. PATRICK MCDONOUGH, DR. GURDESH BEDI, DR. MUHAMMAD KHAN, DR. CLAUDIA NUNES AND DR. JAMES WALLACE ARE ALL PARTICIPANTS IN A 457(F) PLAN. DEFERRALS DURING FISCAL YEAR 2023: GURDESH BEDI - $72,000 MUHAMMAD KHAN - $72,000 PATRICK MCDONOUGH - $72,000 REBECCA LYMAN - $72,000 DEFERRALS DURING CALENDAR YEAR 2022: GURDESH BEDI - $72,000 MUHAMMAD KHAN - $72,000 PATRICK MCDONOUGH - $72,000 REBECCA LYMAN - $72,000 DISTRIBUTIONS DURING FISCAL YEAR 2023: SALLY BAJAK - $44,500 DISTRIBUTIONS DURING CALENDAR YEAR 2022: SALLY BAJAK - $44,500 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JILL TIES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF WILLIAM TIES (BOARD MEMBER) | RelationshipDescriptionTxt |
| Transaction | $446,203 | TransactionAmt |
| Transaction | EMPLOYEE OF THE HOSPITAL | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, LINE 20B: | THE ORGANIZATION DID NOT OBTAIN AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDING 06/30/2023. THE ORGANIZATION IS UNDERGOING AN 18-MONTH AUDIT FOR THE YEAR 07/01/2022-12/31/2023 AS RESULT OF A CHANGE IN YEAR END. |
| FORM 990, PART VI, SECTION A, LINE 6 | AS OF APRIL 2023, THE CORPORATE MEMBERSHIP IS DISSOLVED. PRIOR TO THAT DATE, THE FOLLOWING DESCRIPTION WAS USED TO DESCRIBE THE CLASSES OF MEMBERSHIP: THERE IS ONE CLASS OF MEMBERSHIP IN THE CORPORATION. MEMBERSHIP WILL EXPIRE ON SEPTEMBER 1 OF EACH YEAR, UNLESS PRIOR TO THAT DATE THE MEMBERSHIP IS RENEWED BY TURNING IN THE COMPLETED ANNUAL MEMBERSHIP RENEWAL FORM PRIOR TO THE SEPTEMBER 1 EXPIRATION DATE. AN ANNUAL $5.00 HANDLING FEE MAY BE DONATED ON AN OPTIONAL BASIS. MEMBERSHIP MAY NOT BE TRANSFERRED OR ASSIGNED DURING THE LIFE OF THE MEMBER. MEMBERSHIP SHALL NOT PASS BY INHERITANCE OR BEQUEST UPON THE DEATH OF THE MEMBER. A SINGLE MEMBERSHIP MAY BE HELD JOINTLY BY SPOUSES, BUT ONLY ONE SHALL BE ENTITLED TO VOTE AT ANY TIME. OTHERWISE, A MEMBERSHIP IS NOT DIVISIBLE INTEREST AND MAY NOT BE HELD BY MORE THAN ONE PERSON. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS OF THE GOVERNING BOARD HAS DELEGATED OPERATIONAL LEADERSHIP AND OVERSIGHT TO THE EXECUTIVE COUNCIL AND THE MEDICAL EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE COUNCIL IS COMPRISED OF THE SENIOR LEADERSHIP TEAM INCLUDING THE CEO, CFO, CNO, CAO, DIRECTOR OF CLINIC SERVICES, AND VP OF MEDICAL AFFAIRS. THIS TEAM IS STRATEGIC IN NATURE AND REQUIRES SHORT- AND LONG-TERM DECISION-MAKING THAT ALIGNS WITH THE ORGANIZATION'S VALUES, MISSION, AND VISION. THE MEDICAL EXECUTIVE COMMITTEE IS COMPRISED OF THE VP OF MEDICAL AFFAIRS, CHIEF OF STAFF AND THE MEDICAL COMMITTEE CHAIRS. THIS TEAM REVIEWS AND APPROVES THE POLICIES AND PROCEDURES AS THEY RELATE TO THE HOSPITAL MEDICAL OPERATIONS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WENT THROUGH THE FOLLOWING REVIEW PROCESS BEFORE FILING WITH THE IRS: A DETAILED REVIEW WAS CONDUCTED BY THE ORGANIZATION'S CFO AND CEO. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS ELECTRONICALLY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERSHIP IS CONTINGENT UPON ANNUAL DISCLOSURE OF POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. THE DETERMINATION IS MADE AT THE BOARD LEVEL AND ALL BOARD MEMBERS MUST CERTIFY ANNUALLY. IF A BOARD MEMBER HAS A CONFLICT, THEY REFRAIN FROM VOTING OR PARTICIPATING IN DISCUSSIONS CONCERNING THE TOPIC. |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO - ANNUAL PERFORMANCE AND SALARY REVIEW IS CONDUCTED THROUGH THE PEOPLE & CULTURE COMMITTEE USING OUTSIDE CONSULTANTS AND VARIOUS COMPENSATION SURVEYS AS DEEMED NECESSARY. REVIEWS ARE TYPICALLY DONE IN THE FIRST QUARTER OF EACH CALENDAR YEAR. BASED UPON THE COMMITTEE'S RECOMMENDATION, IT IS PRESENTED TO THE GOVERNING BOARD FOR FINAL REVIEW AND APPROVAL. OTHER OFFICERS - THE HUMAN RESOURCE MANAGER WORKING WITH THE CEO CONDUCTS OUTSIDE RESEARCH USING COMPENSATION SURVEYS AND DATA TO DETERMINE REASONABLE COMPENSATION. THE CEO IN CONJUNCTION WITH THE HUMAN RESOURCE MANAGER'S RECOMMENDATION DETERMINES THE COMPENSATION OF THESE EMPLOYEES. REVIEWS ARE TYPICALLY DONE IN NOVEMBER/DECEMBER OF EACH CALENDAR YEAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 10,067,772. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,067,772. INDEPENDENT CONTRACTORS & OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,126,397. MANAGEMENT AND GENERAL EXPENSES 1,799,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,926,269. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 189,813. MANAGEMENT AND GENERAL EXPENSES 2,256,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,446,133. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 229,153. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,153. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| UNITY PHARMACY LLC | |||||||||
| 1504 190TH AVENUE SUITE 100 | BALSAM LAKE | WI | 54810 | 454471131 | PHARMACEUTICALS | WI | $3,542,917 | $692,695 | SCV PHARMACIES |
| FREDERIC PHARMACY LLC | |||||||||
| 201 OAK STREET WEST | FREDERIC | WI | 54837 | 464469897 | PHARMACEUTICALS | WI | $4,809,744 | $1,228,159 | SCV PHARMACIES |
| ST CROIX VALLEY PHARMACY LLC | |||||||||
| 235 STATE STEET | ST CROIX FALLS | WI | 54024 | 464463191 | PHARMACEUTICALS | WI | $0 | $5,480 | ST CROIX REGIONAL MEDICAL CENTER |
| ST CROIX FALLS PHARMACY LLC | |||||||||
| 216 SOUTH ADAMS STREET | ST CROIX FALLS | WI | 54024 | 464487348 | PHARMACEUTICALS | WI | $4,364,887 | $1,220,118 | SCV PHARMACIES |
| WEBSTER DENTAL CLINIC LLC | |||||||||
| 26425 LAKELAND AVENUE S | WEBSTER | WI | 54893 | 371911164 | DENTAL SERVICES | WI | $1,979,028 | $258,714 | ST CROIX DENTAL HEALTH LLC |
| ST CROIX DENTAL HEALTH LLC | |||||||||
| 26425 LAKELAND AVENUE S | WEBSTER | WI | 54893 | 831635026 | DENTAL SERVICES | WI | $0 | $0 | ST CROIX REGIONAL MEDICAL CENTER |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST CROIX VALLEY EMERGENCY MEDICAL SERVICES INC | |||||||||||
| 235 EAST STATE STREET | ST CROIX FALLS | WI | 54024 | 452872803 | TO LEASE, MAINTAIN, AND OPERATE AN EMERGENCY AMBULANCE SERVICE | WI | 501(C)(3) | LINE 10 | ST CROIX REGIONAL MEDICAL CENTER | Yes (1) | |
| CANCER CENTER OF WESTERN WISCONSIN | |||||||||||
| 501 HOSIPTAL ROAD | NEW RICHMOND | WI | 54017 | 273238660 | TO PROVIDE CARE TO CANCER PATIENTS | WI | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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