THEDACARE MEDICAL CENTER-BERLIN INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: THEDACARE MEDICAL CENTER-BERLIN INC (EIN 39-0806359)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-13
IRS object ID: 202343179349311754
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-13T18:25:42+00:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	211 N Broadway Suite 600	AddressLine1Txt
City	St Louis	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	631022733	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390806359	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ThedaCare Medical Center - Berlin Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	THED	BusinessNameControlTxt
Phone	9203611313	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	549128025	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	IMRAN ANDRABI MD	PersonNm
Person Title	PRESIDENT/CEO	PersonTitleTxt
Phone	9203611313	PhoneNum
Signature	2023-11-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	WILLIAM	PersonFirstNm
Person Last	FLETT	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KRISTEN M HANKINS	PreparerPersonNm
PTIN	P01256574	PTIN
Phone	3142315544	PhoneNum
Preparation	2023-11-15	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	IMRAN ANDRABI MD	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	549128025	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$64,122,395	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.THEDACARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1910	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	IMPROVING THE HEALTH OF OUR COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	17	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,042,437	PYContributionsGrantsAmt
CY Contributions Grants	$2,098,462	CYContributionsGrantsAmt
PY Program Service Revenue	$61,506,436	PYProgramServiceRevenueAmt
CY Program Service Revenue	$61,601,093	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$422,840	CYOtherRevenueAmt
PY Total Revenue	$62,548,873	PYTotalRevenueAmt
CY Total Revenue	$64,122,395	CYTotalRevenueAmt
PY Grants And Similar Paid	$500	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,500	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$27,403,874	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$25,637,546	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$30,710,766	PYOtherExpensesAmt
CY Other Expenses	$31,293,974	CYOtherExpensesAmt
PY Total Expenses	$58,115,140	PYTotalExpensesAmt
CY Total Expenses	$56,933,020	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,433,733	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,189,375	CYRevenuesLessExpensesAmt
Total Assets BOY	$77,299,134	TotalAssetsBOYAmt
Total Assets EOY	$86,475,827	TotalAssetsEOYAmt
Total Liabilities BOY	$4,380,987	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,368,305	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$72,918,147	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$80,107,522	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$46,282,942	ExpenseAmt
Grant	$1,500	GrantAmt
Revenue	$61,601,093	RevenueAmt
Desc	THEDACARE IS A TAX-EXEMPT, NON-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEDACARE MEDICAL CENTER-BERLIN IS A 25-BED CRITICAL ACCESS HOSPITAL SERVING BERLIN AND NEARBY COMMUNITIES. THERE ARE MORE THAN 300 EMPLOYEES LOCATED ON THE BERLIN CAMPUS. THEDACARE MEDICAL CENTER-BERLIN PROVIDES PATIENT CARE AND SUPPORT SERVICES INCLUDING DIAGNOSTIC SERVICES SUCH AS X-RAY, ULTRASOUND, MRI, CT SCAN, MAMMOGRAPHY AND MEDICAL LABORATORY TESTING AND SPECIALTY SERVICES SUCH AS CANCER CARE, CARDIOVASCULAR CARE, ORTHOPEDIC CARE, NEUROLOGY, FAMILY BIRTH CARE, DIABETES, INTERNAL MEDICINE, EMERGENCY, OCCUPATIONAL HEALTH, PULMONOLOGY, WOMEN'S CARE, EAR, NOSE & THROAT, OUTPATIENT SURGERY AND THERAPY SERVICES. IN ADDITON, WE OFFER AND CONVENIENT WALK-IN CARE, AND E-VISITS FOR ENHANCED COMMUNITY ACCESS TO HEALTHCARE. AS PART OF THE THEDACARE SYSTEM, WE OFFER PUBLIC AWARENESS CAMPAIGNS, CHARITY CARE, SUPPORT GROUPS AND EDUCATION PROGRAMS TARGETED TO LOCAL COMMUNITY NEEDS. THEDACARE IS COMMITTED TO COMMUNITY FOCUSED EFFORTS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IN COUNTIES (GREEN LAKE AND MARQUETTE) WHERE SERVICES ARE PROVIDED. EFFORTS INCLUDE PARTNERSHIPS WITH LOCAL GOVERNMENTS, COMMUNITY PARTNERS, AND AREA HEALTH ORGANIZATIONS TO ADDRESS THE TOP HEALTH PRIORITIES IDENTIFIED IN ITS MOST RECENT CHNA. THEDACARE PROVIDES SCHOLARSHIPS, CHARITY CARE, INTERPRETING AND EDUCATIONAL SERVICES, AND VARIOUS OTHER COMMUNITY BENEFITS. THEDACARE OPERATES ON A NON-DISCRIMINATORY BASIS REGARDLESS OF RACE, COLOR, SEX, RELIGION, OR NATIONAL ORIGIN. THEDACARE PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. SERVICES ARE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES.	Desc
Total Program Service Expenses	$46,282,942	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHRIS SANBORN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9204544184	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	549128025	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd
Craig Batley DO
Board Member/Secretary, Physician	1.0	39.0	Yes (X)	Yes (X)	$0	$423,266	$64,354
Jayson Duffy
Vice Chair, Board Member	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
John Blazel ESQ
Chair, Board Member	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Kelly White DDS
Treasurer, Board Member	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Cynthia Fisher DO
Board Member/Physician	1.0	39.0	Yes (X)		$0	$253,067	$55,289
David Budde DO
Board Member/Physician	1.0	39.0	Yes (X)		$0	$479,031	$62,636
Jared Abbrederis
Board Member	1.0	0	Yes (X)		$0	$0	$0
Julia McCarroll
Board Member	1.0	0	Yes (X)		$0	$0	$0
Lynn Detterman
Board Member/Senior VP-South Region	20.0	20.0	Yes (X)		$0	$657,539	$230,308
Margaret Bostelmann
Board Member	1.0	0	Yes (X)		$0	$0	$0
Mark Cockley MD
Board Member/SVP Pop. Health/Acute Care SVS	1.0	39.0	Yes (X)		$0	$816,593	$264,038
Steven Rasmussen MD
Board Member/Physician	1.0	39.0	Yes (X)		$0	$350,902	$44,411
Tammy Bending
Board Member/Vice President-CAH Operations	20.0	20.0	Yes (X)		$0	$283,952	$73,416
Imran Andrabi MD
President & CEO - System	4.0	36.0		Yes (X)	$0	$1,808,832	$654,639
James Albin
Chief Information Officer	4.0	36.0		Yes (X)	$0	$494,205	$49,169
Maggie Lund
Chief Human Resource Officer	4.0	36.0		Yes (X)	$0	$534,688	$165,995
Mark Thompson
Senior VP, CFO & COO - System	4.0	36.0		Yes (X)	$0	$1,160,821	$311,108
Brian Sterns
Chief Digital Health Officer	4.0	36.0			$0	$266,613	$135,716	Yes (X)
Thomas Arquilla
Chief Strategy Officer	4.0	36.0			$0	$738,065	$188,954	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,267,574	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,300,033	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
TOTAL MSP LLC
221 W COLLEGE AVE 2ND FLOOR	APPLETON	WI	54911	MEDICAL STAFFING	$1,719,867
INTUITIVE SURGICAL INC
DEPT 33629 PO BOX 39000	SAN FRANCISCO	CA	94139	BIOMEDICAL REPAIRS/MAINTENANCE	$298,000
MAXIM HEALTHCARE STAFFING SERVICES INC
7227 LEE DEFOREST DRIVE	COLUMBIA	MD	21046	MEDICAL STAFFING	$287,483
AUGUST WINTER AND SONS INC
2323 N ROEMER ROAD	APPLETON	WI	54911	BUILDING REPAIRS/MAINTENANCE	$171,477
CANON MEDICAL SYSTEMS USA INC
2441 MICHELLE DR	TUSTIN	CA	92780	BIOMEDICAL REPAIRS/MAINTENANCE	$153,939

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	9	CntrctRcvdGreaterThan100KCnt
Related Organizations	$4,600	RelatedOrganizationsAmt
Government Grants	$2,093,862	GovernmentGrantsAmt
Total Contributions	$2,098,462	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Net Patient Service Revenue	Desc
Business	622110	BusinessCd
Total Revenue Column	$61,601,093	TotalRevenueColumnAmt
Related Or Exempt Func Income	$61,601,093	RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$61,601,093	TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$161,834	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$161,834	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$161,834	TotalRevenueColumnAmt
Exclusion	$161,834	ExclusionAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
Other operating revenue	900099	$171,123	$171,123
Cafeteria Revenue	722210	$89,883	$89,883

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$261,006	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$64,122,395	TotalRevenueColumnAmt
Related Or Exempt Func Income	$61,601,093	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$422,840	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,500	TotalAmt
Program Services	$1,500	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$20,226,275	TotalAmt
Program Services	$17,135,679	ProgramServicesAmt
Management And General	$3,090,596	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$447,578	TotalAmt
Program Services	$364,554	ProgramServicesAmt
Management And General	$83,024	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,806,889	TotalAmt
Program Services	$3,100,721	ProgramServicesAmt
Management And General	$706,168	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,156,804	TotalAmt
Program Services	$942,220	ProgramServicesAmt
Management And General	$214,584	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$1,071,482	TotalAmt
Management And General	$1,071,482	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,190,119	TotalAmt
Program Services	$5,733,186	ProgramServicesAmt
Management And General	$2,456,933	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$486,685	TotalAmt
Program Services	$486,685	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$871,766	TotalAmt
Program Services	$871,766	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$39,866	TotalAmt
Program Services	$39,866	ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$43,727	TotalAmt
Program Services	$43,727	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,501,304	TotalAmt
Program Services	$3,888,410	ProgramServicesAmt
Management And General	$612,894	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$154,668	TotalAmt
Program Services	$154,668	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$13,384,540	$10,970,143	$2,414,397
Equipment & Maintenance	$1,977,420	$1,977,420
Food/nutrition	$361,847	$361,847
Medicaid Assessment	$210,550	$210,550

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$56,933,020	TotalAmt
Program Services	$46,282,942	ProgramServicesAmt
Management And General	$10,650,078	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
EOY	$12,919,405	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,633,756	BOYAmt
EOY	$8,407,096	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,859,263	BOYAmt
EOY	$2,208,075	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$27,756	BOYAmt
EOY	$200,266	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$78,391,985	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$33,712,398	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$46,517,837	BOYAmt
EOY	$44,679,587	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$20,260,522	BOYAmt
EOY	$18,061,398	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$77,299,134	BOYAmt
EOY	$86,475,827	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3,452,071	BOYAmt
EOY	$2,195,472	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$870,379	BOYAmt
EOY	$1,000,000	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$58,537	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$3,172,833	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,380,987	BOYAmt
EOY	$6,368,305	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	$72,918,147	BOYAmt
EOY	$80,107,522	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$72,918,147	BOYAmt
EOY	$80,107,522	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$77,299,134	BOYAmt
EOY	$86,475,827	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$7,189,375	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$2,780	OtherActivitiesAmt
Total Lobbying Expenditures	$2,780	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	A PORTION OF THE WHA DUES REPRESENT LOBBYING PERFORMED IN REGARD TO HEALTHCARE ISSUES. TOTAL DUES PAID IN 2022 WERE $25,044. 11.1% OF THIS AMOUNT WAS SPENT ON LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,211,675	OtherCostOrOtherBasisAmt
Book Value	$4,211,675	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$51,271,404	OtherCostOrOtherBasisAmt
Depreciation	$18,761,952	DepreciationAmt
Book Value	$32,509,452	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,042,683	OtherCostOrOtherBasisAmt
Depreciation	$14,950,446	DepreciationAmt
Book Value	$7,092,237	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$866,223	OtherCostOrOtherBasisAmt
Book Value	$866,223	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$44,679,587	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATES
Other assets	$2,151,494
Due from affiliate	$15,909,904

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$18,061,398	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Operating lease liability	$13,286
Third Party Settlement	$3,159,547

Field	Value	IRS element (for citing)
Total Liability	$3,172,833	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 EVALUATION OF UNCERTAIN TAX POSITIONS	FormAndLineReferenceDesc
Explanation	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$418,905	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$418,905	NetCommunityBenefitExpnsAmt
Total Expense	0.0074	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	5689	PersonsServedCnt
Total Community Benefit Expns	$7,760,127	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,291,645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$468,482	NetCommunityBenefitExpnsAmt
Total Expense	0.0082	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	5689	PersonsServedCnt
Total Community Benefit Expns	$8,179,032	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,291,645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$887,387	NetCommunityBenefitExpnsAmt
Total Expense	0.0156	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	49709	PersonsServedCnt
Total Community Benefit Expns	$233,635	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$233,635	NetCommunityBenefitExpnsAmt
Total Expense	0.0041	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	62	PersonsServedCnt
Total Community Benefit Expns	$211,624	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$211,624	NetCommunityBenefitExpnsAmt
Total Expense	0.0037	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	3	PersonsServedCnt
Total Community Benefit Expns	$868,782	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$868,782	NetCommunityBenefitExpnsAmt
Total Expense	0.0153	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	34851	PersonsServedCnt
Total Community Benefit Expns	$205,744	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$205,744	NetCommunityBenefitExpnsAmt
Total Expense	0.0036	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	16	ActivitiesOrProgramsCnt
Persons Served	84625	PersonsServedCnt
Total Community Benefit Expns	$1,519,785	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,519,785	NetCommunityBenefitExpnsAmt
Total Expense	0.0267	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	16	ActivitiesOrProgramsCnt
Persons Served	90314	PersonsServedCnt
Total Community Benefit Expns	$9,698,817	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,291,645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,407,172	NetCommunityBenefitExpnsAmt
Total Expense	0.0423	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,544	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,544	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	4368	PersonsServedCnt
Total Community Benefit Expns	$116,343	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$116,343	NetCommunityBenefitExpnsAmt
Total Expense	0.0020	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	4368	PersonsServedCnt
Total Community Benefit Expns	$118,887	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$118,887	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$2,382,290	BadDebtExpenseAmt
Reimbursed By Medicare	$9,781,535	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,296,065	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$485,470	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	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	THEDACARE MEDICAL CENTER - BERLIN	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	225 MEMORIAL DRIVE	AddressLine1Txt
City	BERLIN	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54923	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.THEDACARE.ORG	WebsiteAddressTxt
State License	1060	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	THEDACARE MEDICAL CENTER - BERLIN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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	22	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://thedacare.org/ABOUT-US/COMMUNITY-HEALTH/NEEDS-ASSESSMENT-PLANS/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	23	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://thedacare.org/ABOUT-US/COMMUNITY-HEALTH/NEEDS-ASSESSMENT-PLANS/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/	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
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - THEDACARE MEDICAL CENTER - BERLIN, INC.. As part of the Needs Assessment Advisory Team, ThedaCare consulted with the Public Health Departments of Outagamie County, Winnebago County, Calumet County, Shawano, Menomonee, Green Lake, Marquette, Waushara, Waupaca and the City of Appleton. * Chuck Sepers, City of Appleton Public Health Officer * Bonnie Thelen RN, Calumet County Public Health Officer * Natalie Vandeveld, MS, REHS / WI RS * Doug Gieryn, Winnebago County Public Health Officer * Director Terri Harmala, MSN, RN, Shawano County Health Officer * Rachel Prellwitz, Green Lake County Public Health Officer * Jayme Sophe, Marquette County, Public Health Officer * Stefanie Eldredge, BSN, RN, Health Officer/Director * Jed Woldt, Waupaca County, Public Health Officer In addition, over the course of a one-year period, secondary data was collected, key informant interviews were conducted, ThedaCare CHAT Teams (Community Health Action Team) provided input and patient health data was studied. Vulnerable populations included low income, rural farm families, older adults, veterans, Hispanic/Latino population, Lesbian, Gay, Bisexual, Transgender (LGBT), Hmong population and African American population. ThedaCare CHAT of Berlin (Community Health Action Team) members: * Amanda Charis, Regional Development Director, ThedaCare * Becky Sell, parent, community member * Carrie McCarthy, Berlin Schools * Lisa Hager, Nurse Practitioner, Population Health, ThedaCare * Marge Bostelmann, retired community member, ThedaCare Board * Mindy Collado, Tri-County Boys and Girls Club Director of operations * Nicole Wienkes, BH Manager, Green Lake County DHHS * Nicole Tank, Children's Hospital, Prevention Supervisor * Rachel Prellwicz, Health Officer Green Lake County DHHS * Sara Rutkowski, Berlin City Administrator * Tammy Bending, VP ThedaCare Medical Center-Berlin * Tracey Ratzburg, ThedaCare CHI (facilitator * Paula Morgen, Director of ThedaCare Community Health Improvement
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - THEDACARE MEDICAL CENTER - BERLIN, INC.. THE THEDACARE COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS APPROVED BY THE THEDACARE BOARD OF TRUSTEES IN 2022. THE FOLLOWING PRIORITIES WERE IDENTIFIED AS THE TOP COMMUNITY HEALTH NEEDS FOR THE 2023-2025 CHNA CYCLE: MENTAL AND BEHAVIORAL HEALTH CHALLENGES CONTINUE WITH THE MENTAL AND BEHAVIORAL HEALTH OF OUR COMMUNITY. ACCESS TO MENTAL HEALTH SERVICES IS NOT KEEPING UP WITH DEMAND, AND THERAPISTS AND HEALTH PROFESSIONALS ARE LACKING IN RURAL AREAS. ADDITIONALLY, ANXIETY AND DEPRESSION HAVE RISEN 20-30% IN RECENT YEARS WHILE SELF-MEDICATION AND SUBSTANCE ABUSE, INCLUDING ALCOHOL, METHAMPHETAMINE, AND VAPING ARE ON THE RISE. TO ADDRESS THIS HEALTH NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT PEOPLE HAVE THE SUPPORT NEEDED TO LEAD MENTALLY HEALTHY LIVES, FREE OF RELIANCE ON HARMFUL SUBSTANCES AND TO SUPPORT UPSTREAM EFFORTS THAT FOSTER MENTAL HEALTH: 1) EXPAND THEDACARE BEHAVIORAL HEALTH TREATMENT CAPACITY a. EXPAND UTILIZATION OF/SERVICES OFFERED AT BEHAVIORAL HEALTH WALK-IN CARE CLINIC. ESTABLISH SAME-DAY ACCESS. b. EXPAND BEHAVIORAL HEALTH COLLABORATIVE CARE PROGRAM TO ALL PRIMARY CARE CLINICS BY 2026. c. INCREASE NUMBER OF MAT PROVIDERS. d. OPEN NEW BEHAVIORAL HEALTH CLINIC IN WAUPACA. e. ENHANCE RESOURCES OF PEDIATRIC PRIMARY CARE PROVIDERS TO ADDRESS COMMON BEHAVIORAL HEALTH NEEDS. 2) PARTNER TO ESTABLISH REGIONAL DETOXIFICATION CAPACITY, WORKING WITH COUNTY GOVERNMENTS, HEALTH SYSTEMS, PUBLIC HEALTH, LOCAL SUBSTANCE USE AGENCIES, AND LAW ENFORCEMENT. 3) STRENGTHEN, EXPAND AND DIVERSIFY BEHAVIORAL HEALTH WORKFORCE THROUGH: a. A REGIONAL TRAINING CENTER FOR NEW MENTAL HEALTH PRACTITIONERS NEEDING SUPERVISED CLINICAL HOURS. b. "JUST FOR ME" EMOTIONAL WELLNESS PROGRAMMING FOR MENTAL HEALTH PRACTITIONERS. 4) EXPAND ED2RECOVERY+ COACHING CAPACITY a. EXPAND TO INCLUDE REFERRALS FROM PRIMARY CARE AND COMMUNITY PARTNERS. b. ADDRESS ALL SUBSTANCES. 5) SUPPORT NEW MENTAL HEALTH CONNECTION. 6) ADDRESS MENTAL HEALTH NEEDS OF LGBTQ+ COMMUNITY a. SPONSOR LGBTQ+ MENTAL HEALTH SUMMIT. b. LGBTQ+ FRIENDLY MENTAL HEALTH RESOURCE DIRECTORY THROUGH NEW MENTAL HEALTH CONNECTION. c. PROVIDER LGBTQ+ CULTURAL COMPETENCY TRAINING. 7) PARTNER TO SUPPORT SOCIAL CONNECTION AND BELONGING WORK 8) SUPPORT CATALPA HEALTH AND CATALPA HEALTH "SEEDLINGS" PROGRAM ADDRESSING EARLY CHILDHOOD SOCIAL EMOTIONAL LEARNING. SOCIAL NEEDS AS THEDACARE SHIFTS ITS FOCUS UPSTREAM TO POPULATION HEALTH, IT IS IMPORTANT TO UNDERSTAND HOW VITAL CONDITIONS, SUCH AS CLEAN AIR, FAIR PAY, HOUSING, EDUCATION AND OTHER BASIC NECESSITIES CAN IMPACT AN INDIVIDUAL'S WELL-BEING. ADDITIONALLY, RELIABLE TRANSPORTATION, BELONGING AND CIVIC MUSCLE, AND PURPOSE ALL INFLUENCE HEALTH. TO ADDRESS THIS IDENTIFIED NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT THE BASIC NEEDS OF PATIENTS ARE MET: 1) ESTABLISH SYSTEMATIC SOCIAL NEEDS "CLOSED-LOOP" SCREENING AND REFERRAL OF THEDACARE PATIENTS. a. ACROSS INPATIENT, ED, AND PRIMARY CARE. b. PEDIATRICS. 2) IMPROVE ACCESS TO EMPLOYMENT TRANSPORTATION THROUGH WORKFORCE INNOVATION GRANT COLLABORATION. 3) ADDRESS SOCIAL NEEDS THROUGH EMPLOYEE VOLUNTEERING/GIVING EFFORTS THROUGH: a. HOUSING - HABITAT FOR HUMANITY b. FOOD INSECURITY - FEEDING AMERICA c. UNITED WAY CAMPAIGN 4) IMPLEMENT CULTURAL COMPETENCY TRAINING OF THEDACARE TEAM MEMBERS. 5) SUPPORT EXPANSION OF STAR PROGRAM ADDRESSING "OPPORTUNITY GAP" BETWEEN BLACK AND WHITE HIGH SCHOOL STUDENTS. 6) SUPPORT BE WELL FOX VALLEY AND EAT WELL FOR LIFE INITIATIVES ADDRESSING DIABETES MANAGEMENT AMONG LOW-INCOME POPULATIONS. 7) SUPPORT BASIC NEEDS GIVING PARTNERSHIP AND US VENTURE GOLF OUTING TO END POVERTY. STRONG START TO LIFE GROWING UP HEALTHY AND STRONG STARTS AT THE BEGINNING OF AN INDIVIDUAL'S LIFE. IN PARTNERSHIP WITH CHILDREN'S WISCONSIN, THEDACARE SEEKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, MENTAL, BEHAVIORAL AND INFANT HEALTH, AND SAFETY AND VIOLENCE IN CHILDREN THROUGH THE FOLLOWING: 1) SUPPORT REGIONAL FIRST 5 FOX VALLEY EARLY CHILDHOOD COALITION AND HELP ME GROW CENTRALIZED FAMILY SUPPORT ACCESS POINT. 2) SUPPORT REGIONAL COLLEGE SAVINGS ACCOUNT INITIATIVE FOR LOW-INCOME FAMILIES. 3) ESTABLISH THEDACARE PEDIATRIC SDOH COMMUNITY RESOURCE NAVIGATION ASSISTANCE IN RURAL MARKETS THROUGH ADVANCING A HEALTHIER WISCONSIN GRANT AND EXPAND TO ENTIRE SERVICE AREA. 4) PARTNER TO ESTABLISH COMMUNITY RESOURCE NAVIGATION SUPPORT WITHIN CATALPA. 5) EXPLORE EXPANSION OF WELCOME BABY COMMUNITY MODEL IN RURAL MARKETS. 6) FACILITATE COLLABORATIVE REGIONAL ASSESSMENT OF AVAILABILITY AND ACCESSIBILITY OF PARENTING PROGRAMS AND SUPPORTS: a. COLLABORATE TO ADDRESS GAPS AND IMPROVE ACCESSIBILITY TO OFFERINGS. b. ADDRESS BASIC PARENTING AND GROWING OBESITY AND MENTAL HEALTH CONCERNS ACROSS INFANT TO TEEN SPECTRUM. REGIONAL ALIGNMENT IN ORDER TO POSITIVELY AFFECT COMMUNITY HEALTH, HEALTH SYSTEMS, NOT-FOR-PROFIT ORGANIZATIONS, AND THE PUBLIC SECTOR MUST BE UNITED ON THEIR PRIORITIES AND COMMITMENTS. THEDACARE WILL WORK WITH PARTNERS TO ESTABLISH COMMON INFRASTRUCTURE NEEDED TO IMPROVE ALIGNMENT OF HEALTH PRIORITIES AND ACTIONS THROUGH THE FOLLOWING: 1) ESTABLISH COMMON COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNED IMPROVEMENT PLANS ACROSS HEALTH SYSTEMS AND PUBLIC HEALTH PARTNERS. 2) DEVELOP COLLABORATIVE REGIONAL NETWORK AND INFRASTRUCTURE FOR ADDRESSING SOCIAL NEEDS. 3) DEVELOP ALIGNMENT AND SYNERGY ACROSS CHAT TEAMS THROUGH IMPLEMENTATION OF CHAT 2.0 MODEL. 4) SUPPORT IMAGINE FOX CITIES REGIONAL VISIONING INITIATIVE. SIGNIFICANT NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA THAT WILL NOT BE ADDRESS IN THE CURRENT THREE-YEAR PLAN ARE: 1) HIGH PAYING JOBS/ECONOMIC OPPORTUNITY - LIMITED RESOURCES TO ADDRESS 2) INTERNET - BEING ADDRESSED BY OTHERS 3) FOOD INSECURITY - BEING ADDRESS BY OTHERS 4) MOTOR VEHICLE CRASH DEATHS - LIMITED RESOURCES TO ADDRESS 5) EXERCISE OPPORTUNITIES - LIMITED RESOURCES TO ADDRESS.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - THEDACARE MEDICAL CENTER - BERLIN, INC.. PATIENTS ARE SENT AN OVERVIEW LETTER EXPLAINING THE PROCESS FOR APPLYING FOR OUR ASSISTANCE PROGRAM OR OUR STAFF WALKS THEM THROUGH THE PROCESS. THEY ARE ASKED TO COMPLETE AN APPLICATION THAT INCLUDES REQUESTS FOR INFORMATION. THIS INFORMATION IS NEEDED IN ORDER TO MAKE A DECISION AS TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ACCEPTANCE, AND IF ACCEPTED, WHAT LEVEL OF ASSISTANCE WILL BE PROVIDED. ONCE THE DECISION IS MADE, WE WILL NOTIFY THE PATIENT AND IF ACCEPTABLE, WRITE OFF THE BALANCE AS DETERMINED.
Schedule H, Part V, Section B, Line 15 Facility , 1	Facility , 1 - THEDACARE MEDICAL CENTER - BERLIN, INC.. CONTRACTED WITH ELIGIBILITY VENDOR (CARDON) TO WORK DIRECTLY WITH THE UNINSURED PATIENT TO ASSIST THEM WITH INSURANCE ENROLLMENT AND EDUCATION.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - THEDACARE MEDICAL CENTER - BERLIN, INC.:. THE FAP AND APPLICATION WERE AVAILABLE AT HOSPITAL CASHIER OFFICES, ON WEB SITE AND OFFERED TO ALL PATIENTS THAT EXPRESSED A FINANCIAL HARDSHIP WHEN CALLING THE BILLING OFFICE. THE PLS WAS PRINTED ON EVERY STATEMENT AND A FOOTER WAS ADDED TO THE FRONT OF THE STATEMENT ADVISING PATIENT TO SEE REVERSE SIDE OF STATEMENT FOR FINANCIAL ASSISTANCE AND PAYMENT OPTIONS. NOTIFICATION OF FINANCIAL ASSISTANCE AVAILABILITY WAS ADDED TO THE INITIAL LETTER SENT BY THE THIRD PARTY COLLECTION AGENCY.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JULIETTE MANOR	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	482 Oak Street	AddressLine1Txt
City	Berlin	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54923	ZIPCd

Field	Value	IRS element (for citing)
Facility	SKILLED NURSING FACILITY	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c DISCOUNTED CARE EXCEPTIONS	SEE PART V, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT CARE.
Schedule H, Part I, Line 7 COLUMN F	The bad debt expense is not considered a community benefit expense and is not included in Schedule H, Part I, Line 7. The amount excluded is $2,382,290.
Schedule H, Part I, Line 7g	No physician clinic costs are included in the Community Benefit expenses.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	THEDACARE, INC. 39-1509362
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COMBINATION OF AVERAGE COSTS AND ACTUAL COSTS PERTAINING TO SUPPLIES, WAGES, AND BENEFITS. FOR SUPPLIES, THE ACTUAL COST OF ITEMS USED FOR EACH EVENT IS APPLIED. IF NO ACTUAL COST IS AVAILABLE, WE THEN USE AN ESTIMATE. WAGES ARE CALCULATED BY MULTIPLYING THE AVERAGE WAGE RATE TIMES ACTUAL HOURS WORKED. THE BENEFIT RATE USED INCLUDES A FRINGE RATION OF ALL BENEFITS RELATED TO THE ABOVE WAGE CALCULATION. THE COST ACCOUNTING SYSTEM DOES NOT DIFFERENTIATE BETWEEN DIFFERENT PAYER TYPES AND NO COST-TO-CHARGE RATIO IS USED.
Schedule H, Part II Community Building Activities	The hospital facility participates in numerous community building activities. Specific activities reported in Schedule H, Part II include: Economic Development - The primary aim of the chamber is to protect the interest of the business community as a whole. Strong employment is a social determinant of health, reducing poverty and providing individual and family sustainability. ThedaCare works together with local Chambers of Commerce in all of the communities it serves. Community Support - Caring Hearts is a financial assistance program designed for patients who are unable to pay for medically necessary services provided by all divisions within ThedaCare. The Caring Hearts Program covers services which are deemed to be medically necessary as determined by their physician. This cost is for time and expense needed to support Caring Hearts. The Caring Hearts financial assistance program is in effect at all ThedaCare facilities - ThedaCare Regional Medical Centers in Appleton and Neenah, ThedaCare Medical Center- Berlin, ThedaCare Medical Center-New London, ThedaCare Medical Center-Shawano, ThedaCare Medical Center-Waupaca and ThedaCare Medical Center-Wild Rose.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	PATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THEDACARE EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THEDACARE BILLS THIRD-PARTY PAYORS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYOR, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENTS. THEDACARE DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. FOR THIRD-PARTY PAYORS, INCLUDING MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL PAYORS, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL PAID CLAIMS DATA BY PAYOR. FOR UNINSURED PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR EXPECTED RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	THE HOSPITAL IS REPORTING $0 BECAUSE IT DOES NOT HAVE A METHOD OF REASONABLY ESTIMATING THE PORTION OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT WHO DID NOT COMPLETE A FINANCIAL ASSISTANCE APPLICATION.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	SEE "PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY" IN NOTE 1 ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. THE SHORTFALLS SHOULD BE CONSIDERED COMMUNITY BENEFIT AS THEY MUST BE ABSORBED IN ORDER TO CONTINUE PROVIDING CARE TO OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICILY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFITS STANDARD.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	OUR POLICY IS NOT TO PURSUE ACCOUNTS TO THE EXTENT ANY CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. IF ONLY A PORTION OF THE CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT AND COLLECTED IN ACCORDANCE WITH OUR NORMAL COLLECTION POLICY.
Schedule H, Part V, Section B, Line 16a FAP website	- THEDACARE MEDICAL CENTER - BERLIN: Line 16a URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- THEDACARE MEDICAL CENTER - BERLIN: Line 16b URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- THEDACARE MEDICAL CENTER - BERLIN: Line 16c URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/;
Schedule H, Part VI, Line 2 Needs assessment	THEDACARE COVERS A 9-COUNTY PRIMARY SERVICE AREA SERVED BY 7 HOSPITALS. THEDACARE CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS FOR EACH HOSPITAL GATHERING DATA PERTINENT TO THAT COMMUNITY AND THE SURROUNDING AREAS. INFORMATION COLLECTED INCLUDES DATA FROM THE WISCONSIN COUNTY HEALTH RANKINGS, FOX CITIES LIFE STUDY (LOCAL INDICATORS FOR EXCELLENCE), THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, INSIGHTS FROM INTERVIEWS OF PUBLIC HEALTH OFFICIALS, INSIGHTS FROM INTERVIEWS WITH REPRESENTATIVES OF VULNERABLE POPULATIONS, EMERGENCY DEPARTMENT PATIENT DATA AND INSIGHTS GATHERED FROM MONTHLY MEETINGS OF THE THEDACARE-LED CHAT TEAM (COMMUNITY HEALTH ACTION TEAM) COMPRISED OF COMMUNITY LEADERS IN BUSINESS NON-PROFIT, CLERGY, EDUCATION, DIVERSE POPULATION GROUPS, HEALTHCARE, UNITED WAY, PUBLIC HEALTH AND THE LOCAL COMMUNITY FOUNDATIONS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	PATIENT EDUCATION BEGINS WHEN A PATIENT IS ADMITTED TO A THEDACARE HOSPITAL. ADMISSION SPECIALISTS MEET WITH EACH PERSON INDIVIDUALLY TO ASSESS INSURANCE STATUS AND FINANCIAL NEED. IF NECESSARY, SPECIALISTS REFER PATIENTS TO CARE MANAGEMENT SPECIALISTS WHO ASSIST WITH THE ENROLLMENT OF PATIENTS IN AN APPLICABLE PROGRAM. THE HOSPITAL PATIENT HANDBOOK IS PROVIDED TO ALL IN-PATIENTS. INTERNAL POLICIES SUCH AS DISCOUNTED SERVICES POLICY, CARING HEARTS POLICY AND PAYMENT FOR SERVICE POLICY FOR SELF-PAY BALANCES PROVIDE GUIDANCE. THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY-TO-UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE.
Schedule H, Part VI, Line 4 Community information	THEDACARE MEDICAL CENTER - BERLIN DEFINES ITS PRIMARY HOSPITAL SERVICE AREA (HSA) AS GREEN LAKE AND MARQUETTE COUNTIES IN WISCONSIN. THE TOTAL POPULATION FOR THE HSA WAS 34,493 ACCORDING TO THE MOST RECENT AVAILABLE DATA. THE POPULATION IS PREDOMINANTLY RURAL WITH MORE THAN 24% AGE 65 AND OLDER. IN THE LAST DECADE, THE HISPANIC/LATINO POPULATION HAS HAD THE MOST GROWTH IN BOTH COUNTIES; HOWEVER, THE POPULATION IS PRIMARILY NON-HISPANIC WHITE. APPROXIMATELY ONE-THIRD OF HOUSEHOLDS ARE LIVING BELOW THE ALICE THRESHOLD, WHICH INDICATES A HOUSEHOLD EITHER ABOVE OR BELOW THE FEDERAL POVERTY LEVEL BUT STILL NOT EARNING ENOUGH TO AFFORD BASIC NECESSITIES.
Schedule H, Part VI, Line 5 Promotion of community health	THE FOUNDATION OF COMMUNITY HEALTH WITHIN THEDACARE IS COMMUNITY HEALTH IMPROVEMENT. THEDACARE COMMUNITY HEALTH IMPROVEMENT IS FUNDED THROUGH OPERATING BUDGET, GRANTS, AND THE THEDACARE FAMILY OF FOUNDATION SUPPORT. THEDACARE PROVIDES FUNDING AND DEDICATED STAFF TO MAKE CHAT COMMUNITY HEALTH EFFORTS POSSIBLE. THE COMMUNITY HEALTH TEAM WORKS WITH LOCAL COMMUNITY HEALTH ACTION TEAM (CHAT), GROUPS OF COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS. CHAT IS THE FOUNDATION OF INNOVATIVE, COLLABORATIVE SOLUTIONS FOR COMMUNITY ISSUES THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THERE ARE THEDACARE LED CHAT'S IN THE FOX CITIES OF APPLETON/MENASHA/NEENAH, BERLIN, NEW LONDON, SHAWANO, WAUPACA AND WILD ROSE.
Schedule H, Part VI, Line 6 Affiliated health care system	THEDACARE, INC., THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH HOSPITAL AND SURROUNDING COMMUNITIES WITHIN ITS SERVICE AREA. PLANS ARE APPROVED BY LOCAL HOSPITAL BOARDS. EACH THEDACARE HOSPITAL, ALONG WITH CHI STAFF AND COMMUNITY MEMBERS DETERMINE HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE LOCAL LEVEL.
Schedule H, Part VI, Line 7 State filing of community benefit report	WI

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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
Craig Batley DO
Board Member/Secretary, Physician	$0	$369,351	$0	$52,375	$0	$1,540	$0	$40,443	$0	$23,911	$0	$487,620	$0	$0
Mark Cockley MD
Board Member/SVP Pop. Health/Acute Care SVS	$0	$575,735	$0	$233,144	$0	$7,715	$0	$246,497	$0	$17,541	$0	$1,080,631	$0	$0
Lynn Detterman
Board Member/Senior VP-South Region	$0	$453,427	$0	$196,369	$0	$7,742	$0	$206,397	$0	$23,911	$0	$887,847	$0	$0
David Budde DO
Board Member/Physician	$0	$416,923	$0	$60,954	$0	$1,154	$0	$38,725	$0	$23,911	$0	$541,667	$0	$0
Steven Rasmussen MD
Board Member/Physician	$0	$267,565	$0	$82,919	$0	$418	$0	$20,500	$0	$23,911	$0	$395,313	$0	$0
Tammy Bending
Board Member/Vice President-CAH Operations	$0	$218,799	$0	$62,614	$0	$2,540	$0	$65,222	$0	$8,194	$0	$357,368	$0	$0
Cynthia Fisher DO
Board Member/Physician	$0	$223,264	$0	$29,421	$0	$382	$0	$31,378	$0	$23,911	$0	$308,356	$0	$0
Maggie Lund
Chief Human Resource Officer	$0	$370,127	$0	$157,543	$0	$7,018	$0	$157,901	$0	$8,094	$0	$700,683	$0	$0
Imran Andrabi MD
President & CEO - System	$0	$1,069,773	$0	$625,104	$0	$113,954	$0	$654,639	$0	$0	$0	$2,463,471	$0	$0
Mark Thompson
Senior VP, CFO & COO - System	$0	$823,122	$0	$321,783	$0	$15,916	$0	$287,197	$0	$23,911	$0	$1,471,929	$0	$0
James Albin
Chief Information Officer	$0	$219,539	$0	$170,014	$0	$104,652	$0	$38,878	$0	$10,291	$0	$543,374	$0	$0
Thomas Arquilla
Chief Strategy Officer	$0	$479,252	$0	$200,574	$0	$58,239	$0	$171,313	$0	$17,641	$0	$927,019	$0	$0
Brian Sterns
Chief Digital Health Officer	$0	$200,386	$0	$59,016	$0	$7,210	$0	$111,805	$0	$23,911	$0	$402,329	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

SENIOR LEVEL EXECUTIVES OF THE COMPANY ARE ENTITLED TO AN ANNUAL FLEXIBLE BENEFIT EQUAL TO 20% OF THE MIDPOINT OF THEIR SALARY RANGE. THIS 457(F) SUPPLEMENTAL BENEFIT PLAN COMPLIES WITH THE FINAL REGULATIONS UNDER SECTION 409(A) AND 457(F) OF THE INTERNAL REVENUE CODE. PARTICIPANTS MAY ELECT THE BENEFIT TO BE USED TO PURCHASE PARTICULAR INSURANCE BENEFITS, INVEST IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, OR A COMBINATION OF THE TWO. BENEFITS ARE ACCRUED ON A MONTHLY BASIS AND ARE SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE AGREEMENT SIGNED BY THE PARTICIPANTS. PLAN CONTRIBUTIONS ARE MADE ON A QUARTERLY BASIS. DURING THE YEAR, THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENT FROM THE PLAN, WHICH IS INCLUDED IN THEIR TAXABLE COMPENSATION: IMRAN ANDRABI, MD $102,463 THOMAS ARQUILLA $45,524 JAMES ALBIN $95,700 DURING THE YEAR, THE FOLLOWING INDIVIDUALS ACCRUED AN AMOUNT FROM THE PLAN, WHICH IS INCLUDED IN DEFERRED COMPENSATION: IMRAN ANDRABI, MD $162,871 MARK COCKLEY, MD $47,919 LYNN DETTERMAN $45,363

Schedule J, Part I, Line 7 Non-fixed payments

EXECUTIVE AT RISK COMPENSATION PLAN: THE PLAN OBJECTIVES ARE TO ENHANCE THEDACARE, INC'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING A TOOL FOR STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE AMONG LEADERS AND TO WORK TOGETHER AS A COHESIVE GROUP TOWARDS COMMON GOALS. LEADERS FROM MANAGER LEVEL TO THE PRESIDENT AND CEO ARE ELIGIBLE TO PARTICIPATE IN THIS PLAN. THE PERCENTAGE FOR WHICH AN INDIVIDUAL IS ELIGIBLE IS DETERMINED BY THE PARAMETERS LISTED FOR THE LEADERSHIP POSITION AND IN THE PLAN DOCUMENT ON FILE. LEADERS MAKE RECOMMENDATIONS FOR THEIR MANAGEMENT LEVEL DIRECT REPORTS TO THEIR EXECUTIVE LEADER BASED ON PERFORMANCE RESULTS. THE PRESIDENT AND CEO ALSO REVIEWS AND APPROVES. FOR SENIOR VICE PRESIDENTS, THE EXECUTIVE LEADERSHIP TEAM, AND THE PRESIDENT AND CEO, THE RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD. THESE COMMITTEES ALSO REVIEW THE TOTAL SPEND FOR THE INCENTIVE PLANS. THESE LEADERS MUST BE IN ACTIVE REGULAR SERVICE OF THEDACARE, INC. FOR THE ENTIRE PLAN YEAR (JANUARY 1, 2022, TO DECEMBER 31, 2022) TO RECEIVE A 2023 BONUS. CARING FOR SUCCESS: THE PLAN OBJECTIVES ARE TO PROVIDE INCENTIVE TO FOCUS THE ORGANIZATION'S RESOURCES, ENERGY AND ATTENTION TO THE FULFILLMENT OF THEDACARE'S MISSION. EMPLOYEE ELIGIBILITY IS BASED ON THE NUMBER OF HOURS WORKED. ALL ELIGIBLE EMPLOYEES SHARE IN THE PAYOUT. THE PAYOUT AMOUNT IS A FLAT DOLLAR AMOUNT, DETERMINED BASED ON BOTH FINANCIAL AND QUALITY THRESHOLDS. THE AMOUNT PER EMPLOYEE IS DETERMINED BY DIVIDING THE TOTAL GAIN REALIZED (THE EMPLOYEE SHARE) BY HOURS PAID TO ALL ELIGIBLE EMPLOYEES. THE THEDACARE BOARD OF TRUSTEES APPROVES THE SPEND FOR THE PLAN.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part V, Line 1a	ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, THEDACARE, INC., EIN 39-1509362.
Form 990, Part V, Line 2a	ALL APPLICABLE W-2 AND W-3 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, THEDACARE, INC., EIN 39-1509362.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	An employee/employer relationship exists for individuals on Part VII who are employees of ThedaCare, Inc. and individuals listed on Part VII who also serve as Directors or Officers of ThedaCare, Inc. - Business relationship
Form 990, Part VI, Line 3 Delegation of management duties	ALL MANAGEMENT AND ADMINISTRATIVE FUNCTIONS ARE PROVIDED BY EMPLOYEES OF THEDACARE, INC., THE SOLE MEMBER AND PARENT COMPANY OF THEDACARE MEDICAL CENTER - BERLIN, INC.
Form 990, Part VI, Line 6 Classes of members or stockholders	THEDACARE MEDICAL CENTER - BERLIN, INC.'S SOLE MEMBER IS THEDACARE, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THEDACARE, INC. HAS SOLE AUTHORITY IN THE CORPORATION TO VOTE AND TAKE ANY ACTION WITH RESPECT TO THE ELECTION OF DIRECTORS AND OFFICERS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THEDACARE, INC. HAS THE SOLE AUTHORITY WITH RESPECT TO THE FOLLOWING MATTERS: 1. MERGE, CONSOLIDATE, OR CHANGE CONTROL OF THE ORGANIZATION; 2. SELL, LEASE, TRANSFER, OR DISPOSE OF MATERIAL ASSETS; 3. ENTER JOINT VENTURES OR AFFILIATIONS; 4. AMEND BYLAWS AND ARTICLES OF INCORPORATION; 5. DEVELOP AND APPROVE CAPITAL AND OPERATING BUDGETS; 6. AUTHORIZE AND MAKE CAPITAL EXPENDITURES; 7. APPROVE STRATEGIC PLANS, WITH MANAGEMENT AND BOARD OVERSIGHT; 8. APPROVE THE SAFETY AND QUALITY PLAN; 9. APPROVE THE DISSOLUTION OR LIQUIDATION; 10. APPOINT AUDITORS AND LEGAL COUNSEL; AND 11. RETAIN INVESTMENT ADVISORS AND ESTABLISH INVESTMENT POLICIES.
Form 990, Part VI, Line 11b Review of form 990 by governing body	A DRAFT OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION AT A BOARD MEETING. THE FINAL VERSION OF THE FORM 990 IS EMAILED TO THE ENTIRE BOARD BEFORE THE RETURN IS FILED.
Form 990, Part VI, Line 12c Conflict of interest policy	QUESTIONNAIRES ARE SENT TO ALL MANAGERS, TRUSTEES, AND OFFICERS ANNUALLY. COMPLETED FORMS ARE RETURNED TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES AND FOLLOWS UP WITH ANY QUESTIONS ABOUT THE MANAGERS' ANSWERS ON THE CONFLICT OF INTEREST FORMS. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THEDACARE HIRES AN OUTSIDE CONSULTING FIRM TO CONDUCT A THOROUGH MARKET REVIEW OF EXECUTIVE COMPENSATION EVERY OTHER YEAR. THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD WAS FORMED IN DECEMBER, 2018. THE OUTSIDE CONSULTANT PRESENTED HIS FINDINGS TO THE CHIEF HUMAN RESOURCES OFFICER, THE PRESIDENT AND CEO. THE INFORMATION WAS THEN PRESENTED TO THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THEN TO THE EXECUTIVE COMMITTEE OF THE BOARD. BOTH COMMITTEES WERE PROVIDED THE INFORMATION FOR REVIEW, EDUCATION AND ACCEPTANCE IN 2021.
Form 990, Part VI, Line 19 Required documents available to the public	THEDACARE MEDICAL CENTER - BERLIN, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND INTERNAL FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
Form 990, Part IX, Line 11g Other Fees	Contract labor/agency fees - Total Expense: 3361270, Program Service Expense: 2080719, Management and General Expenses: 1280551, Fundraising Expenses: ; Physician/professional fees - Total Expense: 31878, Program Service Expense: 19733, Management and General Expenses: 12145, Fundraising Expenses: ; Fees for other services - Total Expense: 4796971, Program Service Expense: 3632734, Management and General Expenses: 1164237, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
THEDACARE INC
PO BOX 8025	APPLETON	WI	549128025	391509362	HEALTHCARE	WI	501(c)(3)	10	NA	false
THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC
PO BOX 8025	APPLETON	WI	549128025	390830664	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE MEDICAL CENTER - NEW LONDON INC
PO BOX 8025	APPLETON	WI	549128025	390869788	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE MEDICAL CENTER - WAUPACA INC -
PO BOX 8025	APPLETON	WI	549128025	390871113	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE REGIONAL MEDICAL CENTER -APPLETON INC
PO BOX 8025	APPLETON	WI	549128025	390824015	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE MEDICAL CENTER - SHAWANO INC -
PO BOX 8025	APPLETON	WI	549128025	390807068	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE MEDICAL CENTER - WILD ROSE INC -
PO BOX 8025	APPLETON	WI	549128025	396089134	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC	Yes (true)
THEDACARE FAMILY OF FOUNDATIONS INC
PO BOX 8025	APPLETON	WI	549128025	464112255	FOUNDATION	WI	501(c)(3)	7	THEDACARE INC	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
N APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC
122 E CAPITOL DR	APPLETON	WI	54911	262497187	RENTAL	WI	NA	N/A
ENCIRCLE REALCO LLC
65 HIDDEN RAVINES DRIVE SUITE 100	POWELL	OH	43065	853472736	PROPERTY HOLDING	OH	THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC	Excluded

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd