BELLIN MEMORIAL HOSPITAL INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- BELLIN MEMORIAL HOSPITAL INC (EIN 39-0884478)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-15
- IRS object ID
- 202412289349300211
- 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 I
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-15T06:58:24-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | 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 | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390884478 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLIN MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BELL | BusinessNameControlTxt |
| Phone | 9204457260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 744 S WEBSTER AVENUE | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN CEELEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9204457260 | PhoneNum |
| Signature | 2024-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| 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 | 2024-08-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN CEELEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 744 S WEBSTER AVENUE | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $870,061,251 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BELLIN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1908 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | BELLIN MEMORIAL HOSPITAL, INC. (BMH) PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH THE MISSION OF BMH, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, BMH PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNINSURED OR UNDERINSURED. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID, ARE ALSO CONSIDERED PART OF THE BELLIN HEALTH BENEFITS PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN COST. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 5177 | TotalEmployeeCnt |
| Total Volunteers | 225 | TotalVolunteersCnt |
| Total Gross UBI | -$629,594 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,359,167 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,162,165 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $683,719,953 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $709,523,707 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,926,534 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,193,165 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,239,673 | PYOtherRevenueAmt |
| CY Other Revenue | $15,215,240 | CYOtherRevenueAmt |
| PY Total Revenue | $715,245,327 | PYTotalRevenueAmt |
| CY Total Revenue | $746,094,277 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $417,366 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $370,153 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $388,681,979 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $448,123,218 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $299,917,865 | PYOtherExpensesAmt |
| CY Other Expenses | $270,228,938 | CYOtherExpensesAmt |
| PY Total Expenses | $689,017,210 | PYTotalExpensesAmt |
| CY Total Expenses | $718,722,309 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $26,228,117 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $27,371,968 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $907,349,413 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,083,165,495 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $297,888,102 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $435,967,534 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $609,461,311 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $647,197,961 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BELLIN HEALTH IS A COMMUNITY OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR IMPROVING THE HEALTH AND WELLBEING OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN, AND ALL OTHERS WE SERVE. WE CARRY OUT THIS RESPONSIBILITY THROUGH INDIVIDUALIZED CARE EXCELLENCE, COMMUNITY HEALTH IMPROVEMENT, AND EQUITABLE HEALTHCARE FINANCING PLANS ALL DESIGNED TO POSITIVELY IMPACT HEALTH AND WELLBEING. WE ARE STEADFAST IN OUR COMMITMENT TO PROVIDING COMPASSIONATE, SAFE, AND COORDINATED CARE THAT IS ACCESSIBLE AND AFFORDABLE FOR EVERYONE. WE BUILD TRUSTED RELATIONSHIPS AND ADVANCE TRUE COLLABORATION, FUELING OUR DESIRE TO CONSTANTLY IMPROVE AND INNOVATE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $602,191,225 | ExpenseAmt |
| Grant | $370,153 | GrantAmt |
| Revenue | $722,999,732 | RevenueAmt |
| Desc | THE HOSPITAL PROVIDES ACUTE HOSPITAL CARE TO RESIDENTS OF NORTHEASTERN WISCONSIN. DURING FISCAL YEAR 2023 35,889 INPATIENT DAYS WERE PROVIDED (27,406 ADULTS AND PEDIATRICS), AS COMPARED TO 38,920 (34,783 ADULTS AND PEDIATRICS) IN FISCAL YEAR 2022. THE NUMBER OF OUTPATIENTS REGISTERED FOR 2023 AND 2022 WERE 188,613 AND 179,048, RESPECTIVELY. BELLIN MEMORIAL HOSPITAL ALSO PROVIDED 1,443,533 (AS COMPARED TO 1,217,838 IN 2022) PHYSICIAN CLINIC VISITS THROUGH BELLIN MEDICAL AND SPECIALTY GROUPS. | Desc |
| Total Program Service Expenses | $602,191,225 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | 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 | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 376 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5177 | 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 | Yes (1) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERIC JACOBSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9204457260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 744 S WEBSTER AVENUE | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (47 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAVID STAMPFL MD | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,783,573 | $0 | $44,639 | ||||
| ROBERT ANDERSON MD | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,633,936 | $0 | $46,003 | ||||
| CHRISTINE WOLESKE | |||||||||
| EXECUTIVE VICE PRESIDENT | 50.00 | $1,323,496 | $0 | $30,380 | 1.55 | Yes (X) | Yes (X) | ||
| PATRICK MCKENZIE MD | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,197,677 | $0 | $40,151 | ||||
| JAMES SPEARS MD | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,174,033 | $0 | $41,205 | ||||
| KANWAR ARORA MD | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,109,079 | $0 | $20,868 | ||||
| SCOTT RATHGABER MD | |||||||||
| BOARD MEMBER/BGHS CEO | 0.50 | $0 | $1,020,916 | $67,219 | 0.50 | Yes (X) | |||
| STEVEN GERNDT MD | |||||||||
| BOARD MEMBER (THRU 12/2022) | 50.00 | $1,027,761 | $0 | $38,384 | 0.50 | Yes (X) | |||
| JENNIFER LYNCH MD | |||||||||
| B.M./PRESIDENT SPECIALTY GROUP | 50.00 | $716,659 | $0 | $21,957 | Yes (X) | ||||
| JIM DIETSCHE | |||||||||
| EVP/CFO/COO | 50.00 | $624,652 | $0 | $34,569 | Yes (X) | ||||
| PETER VANDEHOUTEN | |||||||||
| BOARD MEMBER/SVP-LEGAL COUNSEL | 50.00 | $487,169 | $0 | $30,399 | Yes (X) | ||||
| SHARLA BAENEN | |||||||||
| BOARD MEMBER/COO | 50.00 | $457,331 | $0 | $39,616 | 0.50 | Yes (X) | Yes (X) | ||
| MICHAEL LANDRUM MD | |||||||||
| BOARD MEMBER/CMO | 50.00 | $385,910 | $0 | $42,756 | Yes (X) | ||||
| LAURA HIEB | |||||||||
| BOARD MEMBER/CNO | 50.00 | $333,362 | $0 | $25,448 | 0.50 | Yes (X) | |||
| ROBERT MEAD MD | |||||||||
| B.M./PAST PRES. ME (THRU 03/2022) | 50.00 | $319,361 | $0 | $37,328 | 0.50 | Yes (X) | |||
| LISA HARTON | |||||||||
| BOARD MEMBER (THRU 12/2022)/CQO | 50.00 | $250,970 | $0 | $24,811 | 0.50 | Yes (X) | |||
| NAN BUSH | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $151,472 | $0 | $33,562 | 0.50 | Yes (X) | |||
| PAUL CASEY MD | |||||||||
| PRES MED STAFF (THRU 03/2022) | 40.00 | $135,250 | $0 | $0 | 0.25 | Yes (X) | |||
| STEVE LITTLE | |||||||||
| BMH CFO (START 08/2023) | 45.00 | $0 | $0 | $0 | 2.00 | Yes (X) | |||
| GERALD OETZEL | |||||||||
| BMH CFO (THRU 08/2023) | 45.00 | $0 | $0 | $0 | 2.00 | Yes (X) | |||
| TERRY FULWILER | |||||||||
| CHAIR | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | Yes (X) | ||
| JOHN DYKEMA | |||||||||
| VICE CHAIR | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | Yes (X) | ||
| ELL LEE DDS | |||||||||
| BOARD TREASURER | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | Yes (X) | ||
| NANCY ARMBRUST | |||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| SAIED ASSEF MD | |||||||||
| B.M. /PHYSICIAN DIRECTOR | 50.00 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| SUSAN FINCO | |||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| BARB GILLING | |||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | 1.00 | Yes (X) | |||
| BRAD WOZNEY MD | |||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| MARK MCMULLEN | |||||||||
| BOARD SECRETARY (THRU 03/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | Yes (X) | ||
| DANIEL ARIENS | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| CONNIE BOERST | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| BILL BOHN | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| BOB CLAUSEN | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| G CORT CONDON | |||||||||
| BOARD MEMBER (THRU 03/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| JANE DANOWIT MD | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| MICHAEL HADDAD | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| SAID HASSAN | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| GEORGE KERWIN | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| CINDY LASECKI MD | |||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| NICOLE POLAREK | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| JAMES RIDER MD | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| MARK RINGWELSKI MD | |||||||||
| B.M./FORM. PRES. S (THRU 03/2022) | 40.00 | $0 | $0 | $0 | Yes (X) | ||||
| FRED SCHMIDT MD | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| KARL SCHMIDT | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| SABINA SINGH MD | |||||||||
| BOARD MEMBER/PRES MED (THRU 03/2022) | 50.00 | $0 | $0 | $0 | Yes (X) | ||||
| JAMIE SPITZER | |||||||||
| BOARD MEMBER (THRU 12/2022) | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| WILLIAM WITTMAN MD | |||||||||
| B.M. (THRU 12/2022)/BMG PHYSICIAN | 0.50 | $0 | $0 | $0 | 0.50 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $13,111,691 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,020,916 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $619,295 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 574 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MIRON CONSTRUCTION CO INC | |||||
| 1471 MCMAHON DR | NEENAH | WI | 54956 | GENERAL CONTRACTOR | $32,693,209 |
| STAFFENCY LLC | |||||
| 221 W COLLEGE AVE FL 2 | APPLETON | WI | 54911 | CONTRACTED NURSING SERVICES | $12,128,879 |
| IEI GENERAL CONTRACTORS INC | |||||
| 1725 MIDWAY RD | DE PERE | WI | 54115 | FACILITY CONTRACTORS | $9,706,843 |
| COMPHEALTH MEDICAL STAFFING | |||||
| 6440 S MILLROCK DR STE 175 | SALT LAKE CITY | UT | 84121 | CONTRACTED PHYSICIAN/MANAGEMENT SERVICES | $4,902,185 |
| APOGEE MEDICAL MANAGEMENT | |||||
| 15059 N SCOTTSDALE RD STE 600 | SCOTTSDALE | AZ | 85254 | CONTRACTED PHYSICIAN/MANAGEMENT SERVICES | $4,679,362 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 66 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,809,960 | RelatedOrganizationsAmt |
| Government Grants | $430,146 | GovernmentGrantsAmt |
| All Other Contributions | $922,059 | AllOtherContributionsAmt |
| Total Contributions | $3,162,165 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621500 | $693,900,773 | $695,113,703 | -$1,212,930 | |
| CONTRACTED SERVICES | 621110 | $2,344,250 | $2,344,250 | ||
| CAFETERIA REVENUE | 621110 | $1,907,509 | $1,907,509 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,371,175 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,816,464 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $533,633 | UnrelatedBusinessRevenueAmt |
| Exclusion | $21,078 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $709,523,707 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,060,280 | TotalRevenueColumnAmt |
| Exclusion | $11,060,280 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $988,123 | RealAmt |
| Personal | $49,703 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $547,901 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $440,222 | RealAmt |
| Personal | $49,703 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $489,925 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $49,703 | UnrelatedBusinessRevenueAmt |
| Exclusion | $440,222 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $130,483,978 | SecuritiesAmt |
| Other | $67,980 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $123,414,913 | SecuritiesAmt |
| Other | $4,160 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,069,065 | SecuritiesAmt |
| Other | $63,820 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,132,885 | TotalRevenueColumnAmt |
| Exclusion | $7,132,885 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EHR INCENTIVE | 621110 | $14,440,193 | $14,440,193 |
| GAIN FROM HEALTHCARE AFFILIATES | 900099 | $285,122 | $285,122 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,725,315 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $746,094,277 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $722,999,732 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$629,594 | UnrelatedBusinessRevenueAmt |
| Exclusion | $20,561,974 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,153 | TotalAmt |
| Program Services | $370,153 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,687,181 | TotalAmt |
| Program Services | $3,834,017 | ProgramServicesAmt |
| Management And General | $4,853,164 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,120,831 | TotalAmt |
| Program Services | $310,272,380 | ProgramServicesAmt |
| Management And General | $52,848,451 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,018,736 | TotalAmt |
| Program Services | $13,655,165 | ProgramServicesAmt |
| Management And General | $2,363,571 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,079,622 | TotalAmt |
| Program Services | $32,362,826 | ProgramServicesAmt |
| Management And General | $6,716,796 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,216,848 | TotalAmt |
| Program Services | $17,684,726 | ProgramServicesAmt |
| Management And General | $3,532,122 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,094 | TotalAmt |
| Management And General | $458,094 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,691 | TotalAmt |
| Management And General | $225,691 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,104 | TotalAmt |
| Management And General | $21,104 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,307 | TotalAmt |
| Management And General | $604,307 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,224,073 | TotalAmt |
| Program Services | $8,938,753 | ProgramServicesAmt |
| Management And General | $3,285,320 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,181,945 | TotalAmt |
| Program Services | $34,389 | ProgramServicesAmt |
| Management And General | $8,147,556 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,983,817 | TotalAmt |
| Program Services | $3,087,197 | ProgramServicesAmt |
| Management And General | $2,896,620 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,665,765 | TotalAmt |
| Program Services | $2,535,929 | ProgramServicesAmt |
| Management And General | $14,129,836 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,367,127 | TotalAmt |
| Program Services | $8,562,712 | ProgramServicesAmt |
| Management And General | $804,415 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,488,166 | TotalAmt |
| Program Services | $1,054,166 | ProgramServicesAmt |
| Management And General | $434,000 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,013,083 | TotalAmt |
| Program Services | $1,036,819 | ProgramServicesAmt |
| Management And General | $976,264 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,650,651 | TotalAmt |
| Program Services | $1,162,880 | ProgramServicesAmt |
| Management And General | $4,487,771 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,922,586 | TotalAmt |
| Program Services | $23,601,887 | ProgramServicesAmt |
| Management And General | $6,320,699 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,421,472 | TotalAmt |
| Program Services | $399,394 | ProgramServicesAmt |
| Management And General | $1,022,078 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $135,292,165 | $135,292,165 | |
| EQUIPMENT RENT & MAINT | $15,063,837 | $12,660,612 | $2,403,225 |
| BAD DEBTS | $13,091,929 | $13,091,929 | |
| WI MEDICAID ACCESS FEE | $6,746,824 | $6,746,824 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,806,302 | TotalAmt |
| Program Services | $5,806,302 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $718,722,309 | TotalAmt |
| Program Services | $602,191,225 | ProgramServicesAmt |
| Management And General | $116,531,084 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,629 | BOYAmt |
| EOY | $18,550 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,262,803 | BOYAmt |
| EOY | $210,714,059 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,921,401 | BOYAmt |
| EOY | $101,931,900 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,840,978 | BOYAmt |
| EOY | $8,826,274 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,227,116 | BOYAmt |
| EOY | $9,708,728 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,229,106 | BOYAmt |
| EOY | $8,827,986 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $700,660,513 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $295,718,870 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,260,362 | BOYAmt |
| EOY | $404,941,643 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,121,175 | BOYAmt |
| EOY | $271,503,593 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,083,920 | BOYAmt |
| EOY | $36,926,044 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $618,206 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,766,717 | BOYAmt |
| EOY | $29,766,718 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,349,413 | BOYAmt |
| EOY | $1,083,165,495 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,973,519 | BOYAmt |
| EOY | $93,132,598 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,297,695 | BOYAmt |
| EOY | $215,703,875 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,416,888 | BOYAmt |
| EOY | $127,131,061 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,888,102 | BOYAmt |
| EOY | $435,967,534 | 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 | $604,027,313 | BOYAmt |
| EOY | $641,329,740 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,433,998 | BOYAmt |
| EOY | $5,868,221 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $609,461,311 | BOYAmt |
| EOY | $647,197,961 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,349,413 | BOYAmt |
| EOY | $1,083,165,495 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $27,371,968 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $9,720,987 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $643,695 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $21,104 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $21,104 | 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 | BELLIN MEMORIAL HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) & AMERICAN HOSPITAL ASSOCIATION VIA WHA. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAS NOTIFIED THE HOSPITAL THAT $21,104 OF THE COMBINED ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,628,543 | BeginningYearBalanceAmt |
| Contributions | $156,644 | ContributionsAmt |
| Investment Earnings Or Losses | $170,469 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $23,803 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,931,853 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,831,774 | BeginningYearBalanceAmt |
| Contributions | $55,830 | ContributionsAmt |
| Investment Earnings Or Losses | -$229,949 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $29,112 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,628,543 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,628,725 | BeginningYearBalanceAmt |
| Contributions | $22,638 | ContributionsAmt |
| Investment Earnings Or Losses | $209,789 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $29,378 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,831,774 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,570,504 | BeginningYearBalanceAmt |
| Contributions | $29,310 | ContributionsAmt |
| Investment Earnings Or Losses | $68,422 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $39,511 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,628,725 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,516,577 | BeginningYearBalanceAmt |
| Contributions | $95,800 | ContributionsAmt |
| Investment Earnings Or Losses | $42,781 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $84,654 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,570,504 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.88357 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.11643 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,199,811 | OtherCostOrOtherBasisAmt |
| Book Value | $10,199,811 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $272,262,238 | OtherCostOrOtherBasisAmt |
| Depreciation | $105,224,224 | DepreciationAmt |
| Book Value | $167,038,014 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $273,198,855 | OtherCostOrOtherBasisAmt |
| Depreciation | $190,494,646 | DepreciationAmt |
| Book Value | $82,704,209 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $144,999,609 | OtherCostOrOtherBasisAmt |
| Book Value | $144,999,609 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $404,941,643 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $19,526,176 |
| FINANCE LEASE OBLIGATIONS | $94,953,916 |
| OPERATING LEASE OGLIGATIONS | $9,223,573 |
| DUE TO RELATED PARTIES | $3,427,396 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $127,131,061 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | A RELATED ORGANIZATION, THE BELLIN HEALTH FOUNDATION, INC., HAS SEVERAL ENDOWMENT FUNDS. THE ENDOWMENT FUNDS ARE DESIGNATED FOR SCHOLARSHIPS, HEALTH CARE SERVICES AND EMPLOYEE TRAINING AND DEVELOPMENT. | ExplanationTxt |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 220.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,035,734 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,035,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,181,150 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,674,177 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,506,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05600 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $84,216,884 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,674,177 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $43,542,707 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,374,765 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,374,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,889,488 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,889,488 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,690,347 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,690,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,954,600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,954,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02690 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $103,171,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,674,177 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $62,497,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08860 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $369,833 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $369,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $369,833 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $369,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,796,683 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $209,070,699 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $242,925,946 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$33,855,247 | 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 | BELLIN MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 744 S WEBSTER AVE | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BELLIN.ORG | WebsiteAddressTxt |
| State License | 147 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLIN MEMORIAL HOSPITAL | 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 | 20 | 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 | SEE PART V, SECTION C, LINE 7D | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION B, 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 | 220.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C, LINES 16A-C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C, LINES 16A-C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE PRIORITIES FROM 2020-2021 WERE MENTAL HEALTH, ALCOHOL/DRUG USE AND ABUSE, AND NUTRITION/PHYSICAL ACTIVITY. WE NOW KNOW THAT WE NEED TO LOOK AT THE REASONS WHY HEALTH GAPS EXIST. COMMUNITY FEEDBACK WAS INCLUDED IN THE COMMUNITY MEMBER CHA SUMMARY. FEEDBACK WAS SOLICITED IN THE FOLLOWING WAYS:- ONGOING CHA/CHIP SURVEY ON THE BCHP WEBSITE, WHICH ASKS FOR FEEDBACK IN ENGLISH, HMONG OR SPANISH. SEVENY-NINE RESPONSES WERE RECEIVED FROM THE GENERAL PUBLIC. - ORGANIZATIONAL REPRESENTATIVES WERE ALSO SURVEYED AND ASKED FOR THEIR FEEDBACK ON THE PRIORITIES, WITH TWENTY-ONE RESPONSES, WITH THOSE ORGANIZATIONS LISTED BELOW.- ADS WERE RUN IN THE NEWSPAPER AND ON SOCIAL MEDIA ASKING FOR COMMUNITY MEMBERS' FEEDBACK -BEYOND HEALTH STEERING COMMITTEE, WHICH INCLUDES REPRESENTATION FROM LOCAL PUBLIC HEALTH AGENCIES, AREA HEALTH SYSTEMS, AND COMMUNITY AGENCIES. THE FOLLOWING ARE REPRESENTED ON THE BEYOND HEALTH STEERING COMMITTEE:- BROWN COUNTY PUBLIC HEALTH- DE PERE HEALTH DEPARTMENT- WI DEPARTMENT OF HEALTH SERVICES, DIVISION OF PUBLIC HEALTH- BROWN COUNTY UNITED WAY- NEW COMMUNITY CLINIC- PREVEA HEALTH- HSHS- ADVOCATE AURORA- BELLIN HEALTHORGANIZATIONS REPRESENTED THROUGH FEEDBACK TO SURVEYS:- UNIVERSITY OF WISCONSIN-MADISON, DIVISION OF EXTENSION BROWN COUNT- BROWN COUNTY VETERANS SERVICE- WELLO- FORWARD SERVICE CORPORATION- JACKIE NITSCHKE CENTER- THE FRIENDS OF THE FOX RIVER TRAIL- OPTIONS FOR INDEPENDENT LIVING- NWTC- GREEN BAY AREA PUBLIC SCHOOLS- CONNECTIONS FOR MENTAL WELLNESS- UNIVERSITY OF WISCONSIN-MADISON, DIVISION OF EXTENSION FOODWISE- ASHWAUBENON SCHOOL DISTRICT- UW CENTER FOR TOBACCO RESEARCH AND INTERVENTION- GREEN BAY POLICE DEPT- NEW NORTH, INC.- DOWNTOWN GREEN BAY, INC.- ONEIDA COMMUNITY HEALTH SERVICES- HMONG/ASIAN COMMUNITY |
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: AURORA BAYCARE MEDICAL CENTER (GREEN BAY) AND ST. MARY'S AND ST. VINCENT HOSPITALS (HSHS, GREEN BAY) |
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: BEYOND HEALTH, A STEERING COMMITTEE COMPRISED OF LEADERS FROM BOTH THE PUBLIC AND PRIVATE SECTORS: HEALTHCARE PARTNERS, PUBLIC HEALTH AGENCIES, AND NON-PROFIT PARTNERS WHO WORK COLLABORATIVELY TO IDENTIFY ACTIONABLE PRIORITIES, MINIMIZE DISPARITIES IN HEALTH, AND ADAPT AS NEEDED TO NEW AND EMERGING HEALTH CONCERNS. |
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: FULL URL FOR PART V, SECTION B, LINE 7A & 10A:HTTPS://BELLIN.ORG/ABOUT-BELLIN-HEALTH/COMMUNITY-HEALTH-INITIATIVES |
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: THE MOST RECENT CHNA IDENTIFIED COMMUNITY NEEDS FOR FISCAL YEARS 2021 THROUGH 2023.AS DETAILED IN THE CHNA REPORT, BELLIN HEALTH, IN COLLABORATION WITH COMMUNITY PARTNERS, IDENTIFIED THE FOLLOWING HEALTH PRIORITIES IN BROWN COUNTY: EQUITABLE ACCESS SOCIAL COHESION UNIFIED PLANNING AND POLICYUNDER THE BROAD UMBRELLAS OF THESE PRIORITIES, BASED ON THE HEALTH OUTCOME DATA AND OBSERVED COMMUNITY NEEDS, BELLIN HAS CHOSEN TO FOCUS SPECIFICALLY ON THE AREAS OUTLINED IN THE ACTION PLAN.PLANNED ACTIONS EQUITABLE ACCESSSTRATEGY: PARTNER WITH LOCAL HEALTH SYSTEMS AND THE N.E.W. COMMUNITY CLINIC ON EFFORTS TO INCREASE ACCESS TO PREVENTATIVE SCREENINGS AND EARLY INTERVENTION SERVICES FOR DIVERSE POPULATIONS. PRIORITY FOCUS WILL BE AROUND ACCESS TO DIABETES SERVICES AND EQUITABLE ACCESS TO DEPRESSION SCREENINGS.STRATEGY: INCREASE ACCESS TO SCREENINGS AND EARLY INTERVENTION SERVICES FOR INDIVIDUALS OF COLOR AND THE SOMALI AND REFUGEE COMMUNITY.STRATEGY: CONTINUE TO SUPPORT THE ORAL HEALTH PARTNERSHIP AND PROVIDE ACCESS TO ORAL CARE FOR THE LOW-INCOME CHILDREN IN OUR COMMUNITY.PLANNED ACTIONS UNIFIED POLICY AND PLANNINGSTRATEGY: CONTINUE TO SUPPORT THE ALCOHOL AND DRUG COALITION FOR CHANGE WITH COMMUNITY PARTNERS TO INCREASE POLICY CHANGES THAT CREATE SAVER COMMUNITIES AND SUPPORT CULTURAL CHANGE AROUND ALCOHOL AND DRUG USE.STRATEGY: LEAD A UNIQUE COLLABORATION WITH LOCAL NURSING HOME, HEALTH SYSTEM, COLLEGE, AND THE WISCONSIN NATIONAL GUARD TO PRODUCE MORE CERTIFIED NURSING ASSISTANTS (CNAS) AND INCREASE CAPACITY AT A LOCAL NURSING HOME.PLANNED ACTIONS SOCIAL COHESIONSTRATEGY: FACILITATION OF THE COMMUNITY-WIDE ALCOHOL AND DRUG COALITION FOR CHANGES WITH A FOCUS ON INTERVENTIONS THAT LEAD TO INCREASED SOBER AWARENESS AND CULTURAL CHANGE AT LOCAL EVENTS AND BUSINESSES.HEALTH NEEDS THAT WILL NOT BE ADDRESSED AT THIS TIME:IN ADDITION TO THE HEALTH NEEDS BELLIN SELECTED AS TOP PRIORITIES, THE CHNA IDENTIFIED OTHER SIGNIFICANT HEALTH NEEDS IN BROWN COUNTY. STRATEGY OWNERS/ORGANIZATIONS ARE ASSIGNED TO LEAD WORK WITHIN THIS SPACE AND CAPITALIZE ON COMMUNITY RESOURCES AND PARTNERS COLLABORATING TO ADDRESS THE NEEDS. |
| BELLIN MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY INCLUDES FACTORS AS: HOMELESS, DECEASED WITH NO KNOWN ESTATE, APPROVED COURT BANKRUPTCY, PAYMENT ASSISTANCE RANK ORDER SCORE, ELIGIBLE FOR STATE OF WI FOOD SHARE PROGRAM. |
| PART V, SECTION B, LINES 16A-C: | PART V, SECTION B, LINE 16A:HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BELLIN_-_BUSOF.001_-_FINANCIAL_ASSISTANCE_POLICY.PDFPART V, SECTION B, LINE 16B:HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/COMMUNITY_CARE_APPLICATION.PDFPART V, SECTION B, LINE 16C:HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BELLIN_-_PLAIN_LANGUAGE_SUMMARY_-_PATIENT_FINANCIAL_ASSISTANCE.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 34 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (34 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FAMILY MEDICAL CENTER ASHWAUBENON | ||||
| 1630 COMMANCHE AVE | GREEN BAY | WI | 54313 | PROVIDER CLINIC SITE |
| 2 - BELLIN HEALTH TITLETOWN SPORTS MEDICINE | ||||
| 1970 S RIDGE ROAD | GREEN BAY | WI | 54304 | PROVIDER CLINIC SITE |
| 3 - BELLIN HEALTH IRON MOUNTAIN | ||||
| 440 WOODWARD AVE | IRON MOUNTAIN | MI | 49801 | PROVIDER CLINIC SITE |
| 4 - FAMILY MEDICAL CENTER BELLEVUE | ||||
| 3263 EATON RD | GREEN BAY | WI | 543116830 | PROVIDER CLINIC SITE |
| 5 - FAMILY MEDICAL CENTER DE PERE EAST | ||||
| 555 REDBIRD CIRCLE | DE PERE | WI | 54115 | PROVIDER CLINIC SITE |
| 6 - NEUROLOGY CONSULTANTS OF BELLIN HEALTH | ||||
| 725 S WEBSTER AVE | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 7 - BELLIN HEALTH ESCANABA | ||||
| 610 S LINCOLN ROAD | ESCANABA | MI | 49829 | PROVIDER CLINIC SITE |
| 8 - FAMILY MEDICAL CENTER HOWARD | ||||
| 2714 RIVERVIEW | GREEN BAY | WI | 54313 | PROVIDER CLINIC SITE |
| 9 - BELLIN HEALTH GENERATIONS | ||||
| 704 S WEBSTER AVE SUITE 300 | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 10 - FAMILY MEDICAL CENTER GREEN BAY | ||||
| 704 S WEBSTER AVE | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 11 - BELLIN HEALTH EAR NOSE AND THROAT | ||||
| 923 ELIZA ST | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 12 - FAMILY MEDICAL CENTER DE PERE WEST | ||||
| 1800 LAWRENCE DR | DE PERE | WI | 54115 | PROVIDER CLINIC SITE |
| 13 - FAMILY MEDICAL CENTER KEWAUNEE | ||||
| 575 - 4TH STREET | KEWAUNEE | WI | 54216 | PROVIDER CLINIC SITE |
| 14 - FAMILY MEDICAL CENTER BRILLION | ||||
| 964 W RYAN ST SUITE B | BRILLION | WI | 54110 | PROVIDER CLINIC SITE |
| 15 - THE CANCER TEAM OF BELLIN HEALTH | ||||
| 1580 COMMANCHE AVE | GREEN BAY | WI | 54313 | HOSPITAL BASED SITE |
| 16 - FAMILY MEDICAL CENTER ALGOMA | ||||
| 831 PARKER AVE | ALGOMA | WI | 54201 | PROVIDER CLINIC SITE |
| 17 - FAMILY MEDICAL CENTER MANITOWOC | ||||
| 3415 CUSTER ST SUITE D | MANITOWOC | WI | 54221 | PROVIDER CLINIC SITE |
| 18 - BELLIN HEALTH ASTHMA & ALLERGY | ||||
| 519 S MONROE AVENUE | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 19 - BELLIN HEALTH SURGICAL ASSOCIATES | ||||
| 720 S VAN BUREN ST SUITE 201 | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 20 - CARDIOLOGY ASSOCIATES OF BELLIN HEALTH | ||||
| 744 S WEBSTER AVE | GREEN BAY | WI | 54301 | HOSPITAL BASED SITE |
| 21 - GASTROENTEROLOGY ASSOCIATES OF GREEN BAY | ||||
| 725 S WEBSTER AVE | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 22 - FAMILY MEDICAL CENTER DENMARK | ||||
| 595 COUNTY ROAD R | DENMARK | WI | 54208 | PROVIDER CLINIC SITE |
| 23 - BELLIN HEALTH ENDOCRINOLOGY | ||||
| 704 S WEBSTER SUITE 501 | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 24 - FAMILY MEDICAL CENTER SEYMOUR | ||||
| 405 COMMERCIAL ST | SEYMOUR | WI | 54165 | PROVIDER CLINIC SITE |
| 25 - FAMILY MEDICAL CENTER PULASKI | ||||
| 723 S WISCONSIN ST | PULASKI | WI | 541620109 | PROVIDER CLINIC SITE |
| 26 - FAMILY MEDICAL CENTER LUXEMBURG | ||||
| 140 B SCHOOL CREEK TRAIL | LUXEMBURG | WI | 54217 | PROVIDER CLINIC SITE |
| 27 - FAMILY MEDICAL CENTER STURGEON BAY | ||||
| 311 N 3RD AVE | STURGEON BAY | WI | 43235 | PROVIDER CLINIC SITE |
| 28 - FAMILY MEDICAL CENTER WRIGHTSTOWN | ||||
| 555 QUALITY CT | WRIGHTSTOWN | WI | 54180 | PROVIDER CLINIC SITE |
| 29 - BELLIN HEALTH NEPHROLOGY | ||||
| 2020 RIVERSIDE DR SUITE 200 | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
| 30 - FAMILY MEDICAL CENTER BONDUEL | ||||
| 401 W MILL ST | BONDUEL | WI | 54107 | PROVIDER CLINIC SITE |
| 31 - BELLIN HEALTH FASTCARE - GREEN BAY WEST | ||||
| 2015 SHAWANO AVE | GREEN BAY | WI | 54303 | CONVENIENT CARE CENTER |
| 32 - BELLIN HEALTH FASTCARE - GREEN BAY EAST | ||||
| 1976 LIME KILN RD | GREEN BAY | WI | 54311 | CONVENIENT CARE CENTER |
| 33 - FAMILY MEDICAL CENTER TWO RIVERS | ||||
| 1516 WASHINGTON STREET | TWO RIVERS | WI | 54241 | PROVIDER CLINIC SITE |
| 34 - BELLIN HEALTH CARDIOVASCULAR & THORACIC SU | ||||
| 720 S VAN BUREN ST SUITE 303 | GREEN BAY | WI | 54301 | PROVIDER CLINIC SITE |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | BELLIN MEMORIAL HOSPITAL IS INCLUDED IN THE BELLIN HEALTH SYSTEMS, INC. COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7: | AMOUNTS ARE CALCULATED BASED ON COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $13,091,929 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES FOCUS ON SOCIAL CONDITIONS THAT CONTRIBUTE TO HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND OTHER LIVING CONDITIONS AFFECTING THE QUALITY OF LIFE. THESE RANGE FROM DEVELOPING COMMUNITY LEADERS, DISASTER READINESS, AND SUPPORT OF LOCAL ECONOMIC DEVELOPMENT, TO HEALTH IMPROVEMENT ADVOCACY. BELLIN MEMORIAL HOSPITAL IS ACTIVE IN THE GREEN BAY PUBLIC SCHOOLS WITH OUR THRIVE PROGRAM THAT ASSISTS IN SETTING AND MEETING HEALTH AND WELLNESS GOALS FOR STUDENTS IN THIS SCHOOL SYSTEM. BELLIN ALSO HOLDS AN ANNUAL BELLIN RUN/WALK 10K EVENT EACH YEAR WITH OVER 7,000 PARTICIPANTS OF ALL AGES LEARNING FIRST-HAND THE VALUE OF EXERCISE IN DAILY LIFE. |
| PART III, LINE 2: | THE BAD DEBT EXPENSE AT COST IS CALCULATED BASED ON THE COST TO CHARGE RATIOS. |
| PART III, LINE 3: | THE HOSPITAL UTILIZES HFMA #15 THEREFORE NONE OF THE BAD DEBT WOULD BE DEEMED CHARITY CARE. |
| PART III, LINE 4: | THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE HOSPITAL'S POLICY ON PAGE 19 OF THE FINANCIAL STATEMENTS. CONSISTENT WITH BELLIN HEALTH SYSTEMS' MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, BELLIN HEALTH SYSTEMS HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS BELLIN HEALTH SYSTEMS EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. BELLIN HEALTH SYSTEMS' POLICY IS TO PROVIDE A 35% DISCOUNT FROM ESTABLISHED CHARGES TO UNINSURED PATIENTS. THIS POLICY DID NOT CHANGE IN 2023 AND 2022. |
| PART III, LINE 8: | THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RULE 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVICES PATIENT WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, FOR-PROFIT HOSPITALS HAVE CARVED OUT HIGH-MARGIN SERVICES (I.E. ONCOLOGY, ORTHO, ETC.) LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS MEANS THAT THE SHORTFALL IS NOT NECESSARILY FROM INEFFICIENT OPERATIONS. MEDICARE CAN BE THE LARGEST PAYOR AND HOSPITALS HAVE NO ABILITY TO DENY COVERAGE. THIS, IN TURN, IS A PROMOTION OF ACCESS TO HEALTHCARE SERVICES (A COMMUNITY BENEFIT). ALSO, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. |
| PART III, LINE 9B: | FOR PATIENTS WHO CANNOT MEET THE EXPECTATIONS OF THE DEBT COLLECTION POLICY, THE ORGANIZATION OFFERS FINANCIAL ASSISTANCE. THE ORGANIZATION WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE DETERMINING WHETHER A GUARANTOR IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY EXPLAINING THE FINANCIAL ASSISTANCE PROGRAM AS PART OF THE REGISTRATION PROCESS IN ADDITION, ALL STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABILITY. |
| PART VI, LINE 2: | IN FY2023, BELLIN MEMORIAL HOSPITAL CONTINUALLY ASSESSED THE HEALTHCARE NEEDS OF OUR COMMUNITIES, IN PARTNERSHIP WITH THE BEYOND HEALTH COLLABORATIVE OF BROWN COUNTY, WIUNDER STRATEGY 1.3 IMPROVING EQUITABLE ACCESS TO HEALTHCARE, EFFORTS CONTINUE TO ASSESS AND ADDRESS HEALTHCARE DISPARITIES AROUND DEPRESSION SCREENINGS (PHQ-9), BREAST CANCER SCREENINGS, AND COLORECTAL CANCER SCREENING FOR OUR POPULATIONS. BELLIN HEALTH HAS IMPLEMENTED TARGETED IMPROVEMENT EFFORTS TO STRATIFY OUR DATA BY RACE, ETHNICITY, GENDER, AND PAYER TO IDENTIFY AND GAIN KNOWLEDGE OF ROOT CAUSES OF DISPARITIES. INTERVENTIONS INCLUDE TARGETED OUTREACH AND EDUCATION IN PATIENT'S PREFERRED LANGUAGE, COLLECTION, AND REVIEW OF QUANTITATIVE AND QUALITATIVE DATA FROM COMMUNITY POPULATIONS, AND EFFORTS TO REMOVE BARRIERS TO SCREENING WITH EXTENDED HOURS OF SERVICE AS WELL AS TRANSPORTATION AND TARGETED STRATEGIES WITH PAYER AND EMPLOYER POPULATIONS. DATA COLLECTION ON THE SOCIAL DETERMINANTS OF HEALTH CONTINUE TO INFORM TEAMS AND DRIVE DECISIONS ON CONNECTING PATIENTS TO LOCAL RESOURCES. MONTHLY MEETINGS CONTINUE VIRTUALLY TO ADDRESS THESE DISPARITIES AND ENGAGE MULTIPLE INTERNAL AND EXTERNAL STAKEHOLDERS INCLUDING EMPLOYER PARTNERS. |
| PART VI, LINE 3: | FINANCIAL COUNSELORS ADVISE PATIENTS OF ASSISTANCE PROGRAMS. A SERVICE CALLED HRS ERASE IS USED TO REVIEW SELF-PAY ACCOUNTS FOR POSSIBLE COVERAGE THROUGH GOVERNMENT PROGRAMS. |
| PART VI, LINE 4: | BELLIN MEMORIAL HOSPITAL SERVES NORTHEAST WISCONSIN AND UPPER MICHIGAN. THE BELLIN REGION ENCOMPASSES A POPULATION OF OVER 968,000 PEOPLE, WITH A MEDIAN AGE OF 42 YEARS OLD. THE AREA IS APPROXIMATELY 44% URBAN, 36% RURAL AND 20% SUBURBAN. REGIONALLY, 88% OF THE POPULATION IS WHITE NON-HISPANIC, 5% HISPANIC, 1% BLACK NON-HISPANIC, AND 6% OTHER NON-HISPANIC. OUR CURRENT PAYOR SUPPLEMENTAL INFORMATION MIX IS 43% MEDICARE AND 42% MEDICAID. |
| PART VI, LINE 5: | A MAJORITY OF BELLIN MEMORIAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN BELLIN MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. IN ADDITION, BELLIN MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. BELLIN MEMORIAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, EDUCATION, AND FACILITIES. |
| PART VI, LINE 6: | BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. DIRECTLY, AND IN PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING SAFE, RELIABLE, COST-EFFECTIVE TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE WORK WILL IMPACT HEALTHCARE DELIVERY IN OUR REGION AS WELL AS THROUGHOUT THE WORLD. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| NEW COMMUNITY CLINIC | ||||||||
| 610 N BROADWAY | GREEN BAY | WI | 54303 | 391200636 | 501(C)(3) | $50,000 | $0 | DONATION |
| FAMILY SERVICES OF NORTHEAST WISCONSIN INC | ||||||||
| 300 CROOKS ST | GREEN BAY | WI | 54305 | 390827320 | 501(C)(3) | $45,000 | $0 | DONATION |
| ENCOMPASS EARLY EDUCATION AND | ||||||||
| 2589 S WEBSTER AVE | GREEN BAY | WI | 54301 | 390824004 | 501(C)(3) | $30,000 | $0 | DONATION |
| GREATER GREEN BAY COMMUN FOUND | ||||||||
| 310 W WALNUT | GREEN BAY | WI | 54303 | 391699966 | 501(C)(3) | $49,400 | $0 | GREEN BAY NEIGHBORHOOD LEADERSHIP COUNCIL, ACHIEVE BROWN COUNTY |
| ALTRUSA HOUSE | ||||||||
| 1116 E MASON ST | GREEN BAY | WI | 54301 | 391593989 | 501(C)(3) | $25,000 | $0 | COMMUNITY SPONSORSHIP |
| YWCA GREATER GREEN BAY | ||||||||
| 230 S MADISON ST | GREEN BAY | WI | 54301 | 390806277 | 501(C)(3) | $25,000 | $0 | DONATION |
| ACHIEVE BROWN COUNTY | ||||||||
| 340 N BROADWAY STE 400 | GREEN BAY | WI | 54303 | 474100686 | 501(C)(3) | $20,000 | $0 | CAMPAIGN PLEDGE |
| UNIV OF WI GREEN BAY | ||||||||
| 2420 NICOLET DR | GREEN BAY | WI | 54311 | 391805963 | GOVT-STATE AGENCY | $20,000 | $0 | MARK REINKE, MD MEMORIAL SCHOLARSHIP |
| CURATIVE CONNECTIONS | ||||||||
| 2900 CURRY LN | GREEN BAY | WI | 54311 | 390806435 | 501(C)(3) | $15,000 | $0 | DONATION |
| KIWANIS SKI CLUB | ||||||||
| LOWER PINE MOUNTAIN RD | IRON MOUNTAIN | MI | 49801 | 383254313 | 501(C)(3) | $10,000 | $0 | COMMUNITY SPONSORSHIP |
| NEVILLE PUBLIC MUSEUM | ||||||||
| PO BOX 325 | GREEN BAY | WI | 54305 | 930756332 | 501(C)(3) | $10,000 | $0 | DONATION |
| ALZHEIMER'S ASSOCIATION | ||||||||
| 225 N MICHIGAN AVE FLOOR 17 | CHICAGO | IL | 60601 | 133039601 | 501(C)(3) | $5,500 | $0 | DONATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 12 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION REQUIRES A COMPREHENSIVE REQUEST OF THE GRANTEE TO PROVIDE RATIONALE FOR THE REQUEST. REQUIRED INFORMATION TO BE PROVIDED BY THE GRANTEE INCLUDES, TAX-EXEMPT STATUS, IDENTIFICATION OF USE OF RESOURCES AND FOLLOW UP INFORMATION AS TO THE UTILIZATION OF THE RESOURCES. THE ORGANIZATION REVIEWS EACH GRANTEE REQUEST IN RELATIONSHIP TO THE MISSION OF THE ORGANIZATION AND COMMUNITY SUPPORT. ALL REQUESTS REQUIRE APPROVAL BY SENIOR LEADERSHIP OF THE ORGANIZATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID STAMPFL MD | ||||||||||||||
| PHYSICIAN | $1,686,385 | $0 | $96,000 | $0 | $1,188 | $0 | $21,166 | $0 | $23,473 | $0 | $1,828,212 | $0 | $0 | $0 |
| ROBERT ANDERSON MD | ||||||||||||||
| PHYSICIAN | $1,536,804 | $0 | $94,846 | $0 | $2,286 | $0 | $22,650 | $0 | $23,353 | $0 | $1,679,939 | $0 | $0 | $0 |
| CHRISTINE WOLESKE | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $918,647 | $0 | $250,000 | $0 | $154,849 | $0 | $19,922 | $0 | $10,458 | $0 | $1,353,876 | $0 | $141,843 | $0 |
| PATRICK MCKENZIE MD | ||||||||||||||
| PHYSICIAN | $1,194,391 | $0 | $1,000 | $0 | $2,286 | $0 | $19,385 | $0 | $20,766 | $0 | $1,237,828 | $0 | $0 | $0 |
| JAMES SPEARS MD | ||||||||||||||
| PHYSICIAN | $905,552 | $0 | $266,195 | $0 | $2,286 | $0 | $17,732 | $0 | $23,473 | $0 | $1,215,238 | $0 | $0 | $0 |
| KANWAR ARORA MD | ||||||||||||||
| PHYSICIAN | $1,012,305 | $0 | $96,000 | $0 | $774 | $0 | $18,217 | $0 | $2,651 | $0 | $1,129,947 | $0 | $0 | $0 |
| SCOTT RATHGABER MD | ||||||||||||||
| BOARD MEMBER/BGHS CEO | $0 | $1,015,579 | $0 | $180 | $0 | $5,157 | $0 | $44,225 | $0 | $22,994 | $0 | $1,088,135 | $0 | $0 |
| STEVEN GERNDT MD | ||||||||||||||
| BOARD MEMBER (THRU 12/2022) | $903,669 | $0 | $123,318 | $0 | $774 | $0 | $17,661 | $0 | $20,723 | $0 | $1,066,145 | $0 | $0 | $0 |
| JENNIFER LYNCH MD | ||||||||||||||
| B.M./PRESIDENT SPECIALTY GROUP | $620,195 | $0 | $96,050 | $0 | $414 | $0 | $20,677 | $0 | $1,280 | $0 | $738,616 | $0 | $0 | $0 |
| JIM DIETSCHE | ||||||||||||||
| EVP/CFO/COO | $514,542 | $0 | $50,000 | $0 | $60,110 | $0 | $6,962 | $0 | $27,607 | $0 | $659,221 | $0 | $49,313 | $0 |
| PETER VANDEHOUTEN | ||||||||||||||
| BOARD MEMBER/SVP-LEGAL COUNSEL | $367,216 | $0 | $88,375 | $0 | $31,578 | $0 | $19,728 | $0 | $10,671 | $0 | $517,568 | $0 | $30,804 | $0 |
| SHARLA BAENEN | ||||||||||||||
| BOARD MEMBER/COO | $366,586 | $0 | $60,000 | $0 | $30,745 | $0 | $14,581 | $0 | $25,035 | $0 | $496,947 | $0 | $20,236 | $0 |
| MICHAEL LANDRUM MD | ||||||||||||||
| BOARD MEMBER/CMO | $326,936 | $0 | $58,560 | $0 | $414 | $0 | $24,198 | $0 | $18,558 | $0 | $428,666 | $0 | $0 | $0 |
| LAURA HIEB | ||||||||||||||
| BOARD MEMBER/CNO | $298,065 | $0 | $0 | $0 | $35,297 | $0 | $13,665 | $0 | $11,783 | $0 | $358,810 | $0 | $28,553 | $0 |
| ROBERT MEAD MD | ||||||||||||||
| B.M./PAST PRES. ME (THRU 03/2022) | $289,970 | $0 | $27,105 | $0 | $2,286 | $0 | $15,741 | $0 | $21,587 | $0 | $356,689 | $0 | $0 | $0 |
| LISA HARTON | ||||||||||||||
| BOARD MEMBER (THRU 12/2022)/CQO | $215,556 | $0 | $35,000 | $0 | $414 | $0 | $15,337 | $0 | $9,474 | $0 | $275,781 | $0 | $0 | $0 |
| NAN BUSH | ||||||||||||||
| BOARD MEMBER (THRU 12/2022) | $134,186 | $0 | $15,000 | $0 | $2,286 | $0 | $10,848 | $0 | $22,714 | $0 | $185,034 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | BELLIN MEMORIAL HOSPITAL PAYS FOR A PORTION OF MEMBERSHIP DUES AT A LOCAL COUNTRY CLUB FOR CHRISTINE WOLESKE IN ORDER TO HOLD VARIOUS EVENTS AT THE CLUB. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION. |
| PART I, LINE 4B | THE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. LAURA HIEB, PETER VANDEHOUTEN, SHARLA BAENEN, JAMES DIETSCHE AND CHRISTINE WOLESKE PARTICIPATED IN THE 457(F) PLAN. THE FOLLOWING DISTRIBUTIONS WERE MADE DURING CALENDAR YEAR 2022: CHRISTINE WOLESKE $141,843 JAMES DIETSCHE $49,313 PETER VANDEHOUTEN $30,804 LAURA HIEB $28,553 SHARLA BAENEN $20,236 |
| FORM 990, PART VII, SECTION A, LINE 5 | SAIED ASSEF WAS COMPENSATED BY BELLIN HEALTH PARTNERS, AN UNRELATED ORGANIZATION, FOR INDIVIDUAL SERVICES RENDERED TO BELLIN MEMORIAL HOSPITAL, INC. IN THE AMOUNT OF $180,875 DURING CALENDAR YEAR 2022. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| A | 391337855 | 97712DLH7 | 2015-04-09 | $44,994,006 | REFUND AND LEGALLY DEFEASE | 0 | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| B | 391337855 | 2011-11-23 | $12,944,000 | REFINANCING OF 2001 BONDS | 0 | 0 | 0 | |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| C | 391337855 | 2019-08-29 | $35,000,000 | FUNDING OF NICU EXPANSION PROJECT AND VARIOUS RENOVATION AND EQUIPMENT PURCH | 0 | 0 | 0 | |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| D | 391337855 | 2019-08-29 | $8,000,000 | FUNDING OF IT INFRASTRUCTURE | 0 | 0 | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | In Reserve FundInReserveFundAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,355,000 | $44,994,006 | $528,236 | $44,465,770 | 2009 | 0 | Yes (1) | Yes (1) | Yes (1) | ||
| B | $1,514,000 | $12,944,000 | $79,844 | 2001 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| C | $41,624,205 | $314,452 | 2023 | 0 | 0 | Yes (1) | Yes (1) | $12,546,069 | $28,763,684 | ||
| D | $8,351,848 | $74,748 | 2023 | 0 | 0 | Yes (1) | Yes (1) | $8,277,100 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
| B | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
| C | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
| D | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd | CUSIPCUSIPNum |
|---|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| A | 391337855 | 2022-12-14 | $100,000,000 | AMBULATORY SURGERY CENTER BUILDING COMPONENTS | 0 | 0 | 0 | |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| B | 391337855 | 2022-12-14 | $30,000,000 | AMBULATORY SURGERY CENTER MOVEABLES AND EQUIPMENT | 0 | 0 | 0 | 97712JGU1 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $106,130,278 | $2,073,735 | $982,522 | $103,074,021 | 0 | 0 | 0 | Yes (1) |
| B | $31,617,523 | $31,302,977 | $314,546 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
| B | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN FINCO | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | OWNER OF LEONARD & FINCO COMMUNICATIONS | RelationshipDescriptionTxt |
| Transaction | $51,513 | TransactionAmt |
| Transaction | PROVISION OF MARKETING SERVICES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | SABINA SINGH, MARK MCMULLEN, AND TERRY FULWILER HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. HAS THE POWER TO APPOINT BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR A CONFLICT OF INTEREST REQUEST DOCUMENT IS PROVIDED TO EACH BOARD MEMBER. ALL DOCUMENTS ARE PROVIDED BACK TO ADMINISTRATION AND REVIEWED. ALL EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AS PART OF ANNUAL MANDATORY EDUCATION. IF THERE IS A CONFLICT OF INTEREST, THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE WHICH IS A COMMITTEE OF THE BOARD OF DIRECTORS IS NOTIFIED. THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE ADDRESSES THE ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANT'S REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. CEO COMPENSATION: CEO PRESENTS RESULTS OF PERFORMANCE OBJECTIVES TO THE EXECUTIVE COMMITTEE IN JANUARY OF EACH YEAR. THE CHAIR APPLIES A FORMULA TO THE RESULTS AND COMES UP WITH A RECOMMENDATION. THE CHAIR FACILITATES GETTING APPROVAL FROM OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. SENIOR LEADERS: COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION 953,821. INTEREST RATE SWAP AGREEMENT -310,126. |
| FORM 990, PART XI, LINE 2B-2C | BELLIN MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | EINEIN |
|---|---|---|---|---|---|---|---|---|---|
| ASHLAND WEST LLC | |||||||||
| 744 S WEBSTER AVENUE | GREEN BAY | WI | 54301 | REAL ESTATE | WI | $0 | $0 | BELLIN MEMORIAL HOSPITAL INC | |
| BELLIN NORTH VENTURES LLC | |||||||||
| 744 S WEBSTER AVENUE | GREEN BAY | WI | 54301 | REAL ESTATE | WI | $0 | $0 | BELLIN MEMORIAL HOSPITAL INC | |
| BELLIN-THEDACARE ENTERPRISES LLC | |||||||||
| 744 S WEBSTER AVENUE | GREEN BAY | WI | 54301 | REAL ESTATE | WI | $0 | $0 | BELLIN MEMORIAL HOSPITAL INC | |
| ASHWAUBENON WEST PROPERTIES LLC | |||||||||
| 744 S WEBSTER AVENUE | GREEN BAY | WI | 54301 | REAL ESTATE | WI | $0 | $18,481,131 | BELLIN MEMORIAL HOSPITAL INC | 871079621 |
| WEST GB LLC | |||||||||
| 744 S WEBSTER AVENUE | GREEN BAY | WI | 54301 | REAL ESTATE | WI | $0 | $0 | BELLIN MEMORIAL HOSPITAL INC | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BELLIN GUNDERSEN HEALTH SYSTEM INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 920504278 | PARENT | WI | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| BELLIN HEALTH SYSTEMS INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512904 | SUPPORT OF HEALTHCARE ORGANIZATIONS | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN GUNDERSEN HEALTH SYSTEM INC | |
| LAKE MICHIGAN HEALTH SERVICES INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512903 | SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| BELLIN COLLEGE INC | |||||||||||
| 3201 EATON ROAD | GREEN BAY | WI | 54311 | 391620530 | NURSING COLLEGE | WI | 501(C)(3) | LINE 2 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| THE BELLIN HEALTH FOUNDATION INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391809171 | FOUNDATION | WI | 501(C)(3) | LINE 7 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| BELLIN PSYCHIATRIC CENTER INC | |||||||||||
| PO BOX 23725 | GREEN BAY | WI | 54305 | 391657627 | PSYCHIATRIC HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| OCONTO HOSPITAL & MEDICAL CENTER INC | |||||||||||
| 820 ARBUTUS AVENUE | OCONTO | WI | 54153 | 061745397 | HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | BELLIN MEMORIAL HOSPITAL INC | |
| GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391866425 | SUPPORTING ORGANIZATION | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN GUNDERSEN HEALTH SYSTEM INC | |
| GUNDERSEN LUTHERAN MEDICAL CENTER | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 390813416 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| GUNDERSEN CLINIC LTD | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391028657 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| GUNDERSEN LUTHERAN ADMINISTRATIVE SVC | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391606449 | SUPPORTING ORGANIZATION | WI | 501(C)(3) | LINE 12B, II | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391249705 | FOUNDATION | WI | 501(C)(3) | LINE 7 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| TRI-COUNTY MEMORIAL HOSPITAL | |||||||||||
| 1860 LINCOLN STREET | WHITEHALL | WI | 54773 | 390704510 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| HARMONY COMMUNITY HEALTHCARE INC | |||||||||||
| 815 MAIN AVENUE | SOUTH HARMONY | MN | 55939 | 410711606 | HEALTHCARE | MN | 501(C)(3) | LINE 10 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| TWEETEN LUTHERAN HEALTHCARE CENTER INC | |||||||||||
| 125 FIFTH AVENUE | SE SPRING GROVE | MN | 55974 | 411565003 | HEALTHCARE | MN | 501(C)(3) | LINE 10 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| TRI-STATE AMBULANCE INC | |||||||||||
| 235 CAUSEWAY BOULEVARD | LA CROSSE | WI | 54603 | 391965415 | MEDICAL TRANSPORTATION | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| TRI-STATE REGIONAL AMBULANCE | |||||||||||
| 235 CAUSEWAY BOULEVARD | LA CROSSE | WI | 54603 | 391962965 | MEDICAL TRANSPORTATION | WI | 501(C)(3) | LINE 10 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| LUTHERAN REAL ESTATE HOLDING CORP | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391480826 | HOUSING | WI | 501(C)(3) | LINE 12C, III-FI | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| COMMUNITY HOUSING OF LA CROSSE | |||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391586700 | INDEPENDENT LIVING | WI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN REAL ESTATE HOLDING CORP | |
| LUTHERAN HOUSING OF LA CROSSE | |||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391751934 | INDEPENDENT LIVING | WI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN REAL ESTATE HOLDING CORP | |
| ST JOSEPH'S HEALTH SERVICES INC | |||||||||||
| 400 WATER AVENUE | HILLSBORO | WI | 54634 | 390929538 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| ST JOSEPH'S MEMORIAL FOUNDATION INC | |||||||||||
| 400 WATER AVENUE | HILLSBORO | WI | 54634 | 391455787 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | ST JOSEPH'S HEALTH SERVICES INC | |
| TRI-COUNTY MEMORIAL FOUNDATION INC | |||||||||||
| 18601 LINCOLN STREET | WHITEHALL | WI | 54773 | 300093022 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | TRI-COUNTY MEMORIAL HOSPITAL | |
| MEMORIAL HOSPITAL OF BOSCOBEL | |||||||||||
| 205 PARKER STREET | BOSCOBEL | WI | 53805 | 390845590 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| PALMER LUTHERAN HEALTH CENTER INC | |||||||||||
| 112 JEFFERSON STREET | WEST UNION | IA | 52175 | 421320763 | HEALTHCARE | IA | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| MOUNDVIEW MEMORIAL HOSPITALS & CLINICS INC | |||||||||||
| 402 WEST LAKE STREET | FRIENDSHIP | WI | 53934 | 390944012 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
| MEMORIAL HEALTHCARE FOUNDATION INC | |||||||||||
| PO BOX 40 | FRIENDSHIP | WI | 53934 | 391775074 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | MOUNDVIEW MEMORIAL HOSPITAL | |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA INC | |||||||||||
| 1200 5TH GRANT BOULEVARD | WEST WABASHA | MN | 55981 | 410693877 | HEALTHCARE | MN | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEMS INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BEL-REGIONAL HOME MEDICAL INC | |||||||||
| 617 S ROOSEVELT | GREEN BAY | WI | 54301 | 391504766 | DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS | WI | N/A | C | 0 |
| GUNDERSEN LUTHERAN INVISION LLC | |||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 264706546 | RENEWABLE ENERGY | WI | N/A | C | 0 |
| GUNDERSEN EDGE LLC | |||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54301 | 921783811 | INNOVATION | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| OCONTO HOSPITAL & MEDICAL CENTER INC | ||
| E | $7,300,000 | ACTUAL |
| OCONTO HOSPITAL & MEDICAL CENTER INC | ||
| J | $9,177,764 | ACTUAL |
| OCONTO HOSPITAL & MEDICAL CENTER INC | ||
| K | $1,981,725 | ACTUAL |
| OCONTO HOSPITAL & MEDICAL CENTER INC | ||
| O | $9,506,767 | ACTUAL |
| OCONTO HOSPITAL & MEDICAL CENTER INC | ||
| R | $2,324,070 | ACTUAL |
| BELLIN HEALTH FOUNDATION INC | ||
| C | $1,809,960 | ACTUAL |
| BELLIN HEALTH FOUNDATION INC | ||
| O | $729,083 | ACTUAL |
| BELLIN HEALTH FOUNDATION INC | ||
| S | $240,498 | ACTUAL |
| BELLIN PSYCHIATRIC CENTER INC | ||
| E | $16,135,319 | ACTUAL |
| BELLIN PSYCHIATRIC CENTER INC | ||
| J | $58,122 | ACTUAL |
| BELLIN PSYCHIATRIC CENTER INC | ||
| O | $694,708 | ACTUAL |
Comments