FAMILY HEALTH CENTER OF MARSHFIELD INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY HEALTH CENTER OF MARSHFIELD INC (EIN 39-1681547)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-13
- IRS object ID
- 202232869349301148
- Schema version
- 2021v4.2
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-13T12:53:54-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391681547 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH CENTER OF MARSHFIELD INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 7152215700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG NYCZ | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7152215700 | PhoneNum |
| Signature | 2022-10-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | GREG | PersonFirstNm |
| Person Last | NYCZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 3122071040 | PhoneNum |
| Preparation | 2022-10-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREG NYCZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $84,391,224 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FAMILYHEALTHCENTER.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF FAMILY HEALTH CENTER OF MARSHFIELD, INC. IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTH CARE SERVICES FOR THE UNDERSERVED AND TO ENHANCE THE HEALTH OF OUR COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,151,159 | PYContributionsGrantsAmt |
| CY Contributions Grants | $31,609,863 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,364,433 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,896,151 | CYProgramServiceRevenueAmt |
| PY Investment Income | $121,538 | PYInvestmentIncomeAmt |
| CY Investment Income | $427,820 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,500 | PYOtherRevenueAmt |
| CY Other Revenue | $6,000 | CYOtherRevenueAmt |
| PY Total Revenue | $15,638,630 | PYTotalRevenueAmt |
| CY Total Revenue | $79,939,834 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $694,814 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,019,642 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,576 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $205,595 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,198,008 | PYOtherExpensesAmt |
| CY Other Expenses | $62,145,333 | CYOtherExpensesAmt |
| PY Total Expenses | $16,949,398 | PYTotalExpensesAmt |
| CY Total Expenses | $65,370,570 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,310,768 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,569,264 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $80,344,099 | TotalAssetsBOYAmt |
| Total Assets EOY | $83,844,933 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,136,489 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,399,051 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $55,207,610 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $80,445,882 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF FAMILY HEALTH CENTER OF MARSHFIELD, INC. IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTH CARE SERVICES FOR THE UNDERSERVED AND TO ENHANCE THE HEALTH OF OUR COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $57,901,859 | ExpenseAmt |
| Grant | $3,019,642 | GrantAmt |
| Revenue | $47,896,151 | RevenueAmt |
| Desc | IN TOTAL, FAMILY HEALTH CENTER OF MARSHFIELD, INC. (FHC) SERVED APPROXIMATELY 55,124 UNIQUE PATIENTS FOR THE 12 MONTHS ENDING DECEMBER 31, 2021 WHO WOULD NOT OTHERWISE RECEIVE CARE OR WOULD NEED TO OVERCOME SIGNIFICANT BARRIERS TO ACCESS CARE. FHC DOES THIS BY CONTRACTING FOR HEALTH CARE AND ADMINISTRATIVE STAFF TO PROVIDE CARE DIRECTLY TO PATIENTS WITHIN PROXIMITY TO THEIR COMMUNITIES, AND BY CONTRACTING FOR HEALTH CARE SERVICES FOR PATIENTS THROUGH A NETWORK OF HEALTH CARE PROVIDERS IN CENTRAL AND NORTHERN WISCONSIN. HEALTH CARE IS INCLUSIVE OF MEDICAL, ORAL, BEHAVIORAL AND VISION CARE. | Desc |
| Total Program Service Expenses | $57,901,859 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMANDA SPINDLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152215727 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 |
|---|---|---|---|---|---|---|---|---|
| ANTON ZIESLER | ||||||||
| PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RONDA KOPELKE | ||||||||
| VICE PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RITA KIRCHOFF | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARLA HEMKE | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CINDY KOCH | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHERRY MOORE | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD KUMMEROW | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TENA QUACKENBUSH | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID BAXTER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| AUSTIN JIRSCHELE | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG NYCZ | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | $191,895 | $0 | $9,838 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $191,895 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $9,838 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,535,744 | RelatedOrganizationsAmt |
| Government Grants | $19,073,804 | GovernmentGrantsAmt |
| All Other Contributions | $315 | AllOtherContributionsAmt |
| Total Contributions | $31,609,863 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $43,589,167 | $43,589,167 |
| PHARMACY REVENUE | 621400 | $4,006,730 | $4,006,730 |
| PREPAID HEALTH SERVICE REVENUE | 621400 | $274,923 | $274,923 |
| MISC OTHER OP REVENUE | 621400 | $25,331 | $25,331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,896,151 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $404,963 | TotalRevenueColumnAmt |
| Exclusion | $404,963 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,000 | TotalRevenueColumnAmt |
| Exclusion | $6,000 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,474,247 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,451,185 | SecuritiesAmt |
| Other | $205 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,062 | SecuritiesAmt |
| Other | -$205 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,857 | TotalRevenueColumnAmt |
| Exclusion | $22,857 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,939,834 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,896,151 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $433,820 | 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 | $11,883 | TotalAmt |
| Program Services | $11,883 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,007,759 | TotalAmt |
| Program Services | $3,007,759 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,733 | TotalAmt |
| Management And General | $201,733 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$7,760 | TotalAmt |
| Management And General | -$7,760 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,622 | TotalAmt |
| Management And General | $11,622 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,185 | TotalAmt |
| Management And General | $74,185 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,177 | TotalAmt |
| Management And General | $37,177 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,873,281 | TotalAmt |
| Program Services | $37,098,809 | ProgramServicesAmt |
| Management And General | $6,774,472 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,265 | TotalAmt |
| Program Services | $12,265 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,716 | TotalAmt |
| Program Services | $441,211 | ProgramServicesAmt |
| Management And General | $82,505 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,475 | TotalAmt |
| Program Services | $84,768 | ProgramServicesAmt |
| Management And General | $48,707 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,542,376 | TotalAmt |
| Program Services | $1,380,300 | ProgramServicesAmt |
| Management And General | $162,076 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,548 | TotalAmt |
| Program Services | $19,377 | ProgramServicesAmt |
| Management And General | $6,171 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,240 | TotalAmt |
| Program Services | $75,041 | ProgramServicesAmt |
| Management And General | $14,199 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,670 | TotalAmt |
| Program Services | $183,670 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,751,875 | TotalAmt |
| Program Services | $1,751,875 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,370 | TotalAmt |
| Program Services | $2,370 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CAPITATION | $7,977,289 | $7,977,289 | |
| MEDICAL SUPPLIES | $5,574,512 | $5,560,931 | $13,581 |
| MISC OTHER OP EXPENSES | $466,453 | $416,410 | $50,043 |
| BAD DEBT RECOVERY | -$122,099 | -$122,099 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,370,570 | TotalAmt |
| Program Services | $57,901,859 | ProgramServicesAmt |
| Management And General | $7,468,711 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,583,730 | BOYAmt |
| EOY | $10,845,296 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,006,597 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,175,862 | BOYAmt |
| EOY | $1,814,323 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,341,001 | BOYAmt |
| EOY | $26,523,351 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $883,005 | BOYAmt |
| EOY | $1,005,948 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,970 | BOYAmt |
| EOY | $110,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,862,157 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,579,013 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,024,277 | BOYAmt |
| EOY | $25,283,144 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,844,418 | BOYAmt |
| EOY | $16,698,902 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,239 | BOYAmt |
| EOY | $1,563,594 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,344,099 | BOYAmt |
| EOY | $83,844,933 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,456,728 | BOYAmt |
| EOY | $1,739,683 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,083,915 | BOYAmt |
| EOY | $263,923 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,595,846 | BOYAmt |
| EOY | $1,395,445 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,136,489 | BOYAmt |
| EOY | $3,399,051 | 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 | $55,207,610 | BOYAmt |
| EOY | $80,445,882 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,207,610 | BOYAmt |
| EOY | $80,445,882 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,344,099 | BOYAmt |
| EOY | $83,844,933 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $14,569,264 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$682,777 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $11,351,785 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,263,655 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,002,617 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,218,719 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,151,159 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,609,863 | CurrentTaxYearAmt |
| Total | $69,246,013 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,263,655 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,002,617 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,218,719 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,151,159 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,609,863 | CurrentTaxYearAmt |
| Total | $69,246,013 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $12,930,335 | SubstantialContributorsTotAmt |
| Public Support Total170 | $56,315,678 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $908,721 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $933,203 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $591,880 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $116,973 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $410,963 | CurrentTaxYearAmt |
| Total | $2,961,740 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $72,207,753 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $248,632,365 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.77990 | PublicSupportCY170Pct |
| Public Support PY170 | 0.90450 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II: | FormAndLineReferenceDesc |
| Explanation | BECAUSE OF THE SHORT YEAR-END FILING, THE COLUMNS IN SCHEDULE A PART II CORRESPOND TO THE FOLLOWING TAX YEARS: 2017 = FYE 9/30/18 2018 = FYE 9/30/19 2019 = FYE 9/30/20 2020 = SHORT YEAR-END 12/31/20 2021 = FYE 12/31/21 | ExplanationTxt |
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 | Yes (1) | 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 | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990 SCH C PART II-B | FormAndLineReferenceDesc |
| Explanation | FAMILY HEALTH CENTER OF MARSHFIELD, INC. (FHC) MAY OFFER RECOMMENDATIONS CONCERNING LEGISLATION OR REGULATIONS BEING CONSIDERED THAT HAVE A RELATIONSHIP TO THE ORGANIZATION'S OPERATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,513,971 | OtherCostOrOtherBasisAmt |
| Book Value | $1,513,971 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,637,660 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,103,649 | DepreciationAmt |
| Book Value | $20,534,011 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $795,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $414,469 | DepreciationAmt |
| Book Value | $380,580 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,696,090 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,904,622 | DepreciationAmt |
| Book Value | $2,791,468 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $219,387 | OtherCostOrOtherBasisAmt |
| Depreciation | $156,273 | DepreciationAmt |
| Book Value | $63,114 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,283,144 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $76,334,423 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$682,779 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$682,779 | RevenueNotReportedAmt |
| Revenue Subtotal | $77,017,202 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $37,177 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $2,885,455 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,922,632 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $79,939,834 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $62,447,938 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $205 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $205 | ExpensesNotReportedAmt |
| Expenses Subtotal | $62,447,733 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $37,177 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $2,885,660 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,922,837 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $65,370,570 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | FAMILY HEALTH CENTER OF MARSHFIELD, INC. (FHC) IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. FHC IS, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. AS OF DECEMBER 31, 2021 AND 2020, FHC HAD NO UNRELATED BUSINESS INCOME. IF THERE WERE UNRELATED BUSINESS INCOME, FHC WOULD APPLY FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. FHC DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 AND 2020. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CHARITY CARE 3,007,759. BAD DEBT -122,099. LOSS ON FIXED ASSETS -205. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON FIXED ASSETS 205. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CHARITY CARE 3,007,759. BAD DEBT -122,099. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHARITY CARE ASSISTANCE TO INDIVIDUALS | GrantTypeTxt |
| Recipient | 6919 | RecipientCnt |
| Cash Grant | $3,007,759 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FAMILY HEALTH CENTER PROVIDES CHARITY CARE FOR MEDICAL, DENTAL, AND MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO ELIGIBLE PATIENTS THROUGH A COMMUNITY HEALTH ACCESS PROGRAM, A PREPAID HEALTH SERVICES PROGRAM AND FINANCIAL ASSISTANCE BASED ON A SLIDING FEE DISCOUNT SCHEDULE. PATIENTS ARE ABLE TO APPLY FOR CHARITY CARE REGARDLESS OF AGE, GENDER, HEALTH CONDITIONS, RACE/ETHNICITY, CITIZENSHIP STATUS, ETC. IT IS THE GOAL OF OUR HEALTH CENTER TO ELIMINATE ALL BARRIERS, INCLUDING FINANCIAL, TO CARE FOR OUR AT-RISK POPULATIONS. OUR PROGRAMS ARE BOARD APPROVED AND BASED ON MANY FACTORS INCLUDING PATIENT INPUT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG NYCZ | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $187,881 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $4,014 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $9,838 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $201,733 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE MARSHFIELD CLINIC HEALTH SYSTEM TAX DEPARTMENT, THE FHC EXECUTIVE DIRECTOR AND FHC DIRECTOR OF FINANCE SHALL REVIEW THE COMPLETED FORM 990. AFTER THEIR REVIEW AND PRIOR TO FILING FORM 990 WITH THE IRS, A FINAL COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES WILL BE SHARED WITH THE FHC BOARD OF DIRECTORS IN ELECTRONIC OR PAPER FORM FOR REVIEW AND FINAL APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | FHC HAS ADOPTED A CONFLICT OF INTEREST POLICY. EACH DIRECTOR, OFFICER, AND OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER DECISIONS OF FHC IS REQUIRED TO ANNUALLY COMPLETE AND SIGN A DISCLOSURE STATEMENT THAT IS PART OF THE POLICY. THEY MUST ALSO DISCLOSE THE EXISTENCE OF A POTENTIAL CONFLICT AND ALL MATERIAL FACTS TO THE GOVERNING BOARD AS SOON AS THE PERSON HAS KNOWLEDGE THAT A POTENTIAL CONFLICT MAY OCCUR. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS OF FHC IS RESPONSIBLE FOR THE EXECUTIVE DIRECTOR'S ANNUAL EVALUATION AND MERIT CHANGES. THE FHC PERSONNEL COMMITTEE CONDUCTS THE PROCESS RELATED TO THESE ACTIVITIES AND MAKES A RECOMMENDATION TO THE FULL BOARD FOR APPROVAL. THE FHC PERSONNEL COMMITTEE UTILIZES A HUMAN RESOURCE REPRESENTATIVE WHO PROVIDES THEM WITH SALARY SURVEY INFORMATION RELEVANT TO THE POSITION. THE FHC PERSONNEL COMMITTEE ALSO UTILIZES RECOMMENDATIONS FROM THE MARSHFIELD CLINIC HEALTH SYSTEM INDEPENDENT COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | FHC DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 37,098,809. MANAGEMENT AND GENERAL EXPENSES 6,774,472. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,873,281. |
| FORM 990, PART IX, LINE 5: | ALL PERSONNEL SERVICES FOR FHC ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC, INC. AND MARSHFIELD CLINIC HEALTH SYSTEM, INC. WITH THE EXCEPTION OF THE EXECUTIVE DIRECTOR. MARSHFIELD CLINIC, INC. AND MARSHFIELD CLINIC HEALTH SYSTEM, INC. FILE ALL CORRESPONDING FEDERAL PAYROLL FORMS. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER FROM MARSHFIELD CLINIC, INC 11,351,785. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL INC | |||||||||||
| 98 SHERRY AVE | PARK FALLS | WI | 54552 | 390973724 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| LAKEVIEW MEDICAL CENTER INC | |||||||||||
| 1700 W STOUT ST | RICE LAKE | WI | 54868 | 390837206 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL | |||||||||||
| 1700 W STOUT ST | RICE LAKE | WI | 54868 | 391329084 | SUPPORT ORG | WI | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
| MARSHFIELD CLINIC HEALTH SYSTEM INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 461495343 | SUPPORT ORG | WI | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
| MARSHFIELD CLINIC INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 390452970 | MEDICAL SVCS | WI | 501(C)(3) | LINE 3 | MCHS | 0 | |
| SECURITY HEALTH PLAN OF WISCONSIN INC | |||||||||||
| 1515 N ST JOSEPH AVE | MARSHFIELD | WI | 54449 | 391572880 | HMO | WI | 501(C)(4) | N/A | MCHS | 0 | |
| MCHS HOSPITALS INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 810977948 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS | 0 | |
| MCHS FOUNDATION INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 812822823 | PHILANTHROPY | WI | 501(C)(3) | LINE 7 | MCHS | 0 | |
| BEAVER DAM COMMUNITY HOSPITALS INC | |||||||||||
| 707 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 391157876 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| MEMORIAL HOSPITAL INC | |||||||||||
| N3708 RIVER AVE | NEILLSVILLE | WI | 54456 | 390806828 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE DIAGNOSTIC & TREATMENT CENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3401 CRANBERRY BLVD | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54476 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200691634 | EIN |
| Primary Activities | MEDICAL SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| 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 | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SECURITY HEALTH PLAN OF WISCONSIN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $192,000 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Comments