PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC (EIN 39-0910727)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-06
IRS object ID
202142189349300209
Schema version
2019v5.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-06T08:18:16-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13000 TOWN CENTER SUITE 100AddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48075ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390910727EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROHEALTH WAUKESHA MEMORIALBusinessNameLine1Txt
Business Name Line2HOSPITAL INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlWAUKBusinessNameControlTxt
Phone2629282496PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53188ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRONALD J FARRPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2629282496PhoneNum
Signature2021-07-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHALPreparerPersonNm
PTINP00378651PTIN
Phone2483522500PhoneNum
Preparation2021-07-14PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUSAN EDWARDSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53188ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$542,308,831GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDER OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee2932TotalEmployeeCnt
Total Volunteers248TotalVolunteersCnt
Total Gross UBI$1,467,764TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,285,612PYContributionsGrantsAmt
CY Contributions Grants$10,138,104CYContributionsGrantsAmt
PY Program Service Revenue$543,418,169PYProgramServiceRevenueAmt
CY Program Service Revenue$528,699,239CYProgramServiceRevenueAmt
PY Investment Income$1,863,992PYInvestmentIncomeAmt
CY Investment Income$1,134,632CYInvestmentIncomeAmt
PY Other Revenue$2,515,864PYOtherRevenueAmt
CY Other Revenue$1,980,234CYOtherRevenueAmt
PY Total Revenue$550,083,637PYTotalRevenueAmt
CY Total Revenue$541,952,209CYTotalRevenueAmt
PY Grants And Similar Paid$1,600,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$152,728,009PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$156,560,678CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$324,122,149PYOtherExpensesAmt
CY Other Expenses$333,538,192CYOtherExpensesAmt
PY Total Expenses$478,450,158PYTotalExpensesAmt
CY Total Expenses$490,098,870CYTotalExpensesAmt
PY Revenues Less Expenses$71,633,479PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$51,853,339CYRevenuesLessExpensesAmt
Total Assets BOY$527,082,137TotalAssetsBOYAmt
Total Assets EOY$589,241,084TotalAssetsEOYAmt
Total Liabilities BOY$364,884,475TotalLiabilitiesBOYAmt
Total Liabilities EOY$386,674,148TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$162,197,662NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$202,566,936NetAssetsOrFundBalancesEOYAmt
MissionCONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$406,381,899ExpenseAmt
Revenue$527,668,416RevenueAmt
DescPROHEALTH WAUKESHA MEMORIAL HOSPITAL FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PROHEALTH WAUKESHA MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. PROHEALTH WAUKESHA MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 50,772 DAYS OF INPATIENT CARE AND APPROXIMATELY 313,565 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. SEE SCHEDULE H FOR ILLUSTRATION OF ITS PROGRAM SERVICE ACCOMPLISHMENTS.Desc
Total Program Service Expenses$406,381,899TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document177IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee2932EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRONALD FARRPersonNm
Phone2629284740PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DRIVE SUITEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP531881131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
SUSAN EDWARDS
PRESIDENT AND CEO2.0050.00Yes (X)Yes (X)$0$1,639,910$44,572
RONALD FARR
CHIEF FINANCIAL OFFICER2.0050.00Yes (X)$0$928,135$185,924
KENNETH PRICE
CHIEF OPERATING OFFICER2.0048.00$0$658,930$105,233Yes (X)
JOHN MAY
VP AMBULATORY50.000.00$403,803$0$55,517Yes (X)
MARGARET PFITZINGER
VP CLINICAL OPERATIONS50.000.00$300,339$0$56,621Yes (X)
JULIE JACKSON
VP CONTINUUM OF CARE50.000.00$283,413$0$51,968Yes (X)
KARIN KULTGEN
VP MEDICAL AFFAIRS50.000.00$255,748$0$43,288Yes (X)
ERIC HENDEE
CHIEF PHYSICIST50.000.00$219,639$0$23,590Yes (X)
ALAN JOHNSON
VP CRITICAL CARE & SPECIALTY50.000.00$222,094$0$12,475Yes (X)
KEN RIESCH
CHAIRPERSON2.008.00Yes (X)Yes (X)$0$0$0
MIKE ERWIN
VICE CHAIRPERSON2.008.00Yes (X)Yes (X)$0$0$0
BETTY ARNDT
SECRETARY2.008.00Yes (X)Yes (X)$0$0$0
JULIE SCHROEDER
TREASURE2.008.00Yes (X)Yes (X)$0$0$0
MARK MOHR
DIRECTOR2.008.00Yes (X)$0$0$0
SUE BELLEHUMER
DIRECTOR2.008.00Yes (X)$0$0$0
GARY BEYER
DIRECTOR2.008.00Yes (X)$0$0$0
E JOHN RAASCH
DIRECTOR2.008.00Yes (X)$0$0$0
JIM GANNON
DIRECTOR2.008.00Yes (X)$0$0$0
RALPH RAMIREZ
DIRECTOR2.008.00Yes (X)$0$0$0
DAVID ROELKE
DIRECTOR2.008.00Yes (X)$0$0$0
JOHN HALLETT
DIRECTOR2.008.00Yes (X)$0$0$0
EMERY HARLAN
DIRECTOR2.008.00Yes (X)$0$0$0
DAN MATOLA
DIRECTOR2.008.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,685,036TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,226,975TotReportableCompRltdOrgAmt
Total Other Compensation$579,188TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K117IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
JH FINDORFF & SON INC
PO BOX 1647MADISONWI53701CONSTRUCTION SERVICES$29,879,084
STAFFENCY LLC
221 W COLLEGE AVEAPPLETONWI54911PROFESSIONAL SERVICES$9,205,938
ACL LABORATORIES
PO BOX 27901WEST ALLISWI53227PROFESSIONAL SERVICES$6,347,520
APOGEE MEDICAL MANAGEMENT
15059 N SCOTTSDALE RDSCOTTSDALEAZ85254PROFESSIONAL SERVICES$6,178,870
EPIC SYSTEMS
PO BOX 88314MILWAUKEEWI53288PROFESSIONAL SERVICES$3,710,858
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K78CntrctRcvdGreaterThan100KCnt
Related Organizations$906,689RelatedOrganizationsAmt
Government Grants$8,961,819GovernmentGrantsAmt
All Other Contributions$269,596AllOtherContributionsAmt
Total Contributions$10,138,104TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REV.622110$502,221,495$502,221,495
MEDICAL SERVICE LAB621500$8,129,678$7,098,855$1,030,823
ORTHO SURGERY CENTER621400$4,147,230$4,147,230
HOSPITAL JOINT VENTURE622100$3,471,955$3,471,955
PHS DISSTRIBUTION622100$2,988,660$2,988,660

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,740,221TotalRevenueColumnAmt
Related Or Exempt Func Income$7,740,221RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$528,699,239TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$945,213TotalRevenueColumnAmt
Unrelated Business Revenue$14,605UnrelatedBusinessRevenueAmt
Exclusion$930,608ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Personal$540,038PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Personal$117,702PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Personal$422,336PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$422,336TotalRevenueColumnAmt
Unrelated Business Revenue$422,336UnrelatedBusinessRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$428,339OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$238,920OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$189,419OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$189,419TotalRevenueColumnAmt
Exclusion$189,419ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA722210$1,535,906$1,535,906
GIFT SHOP453220$21,992$21,992
FieldValueIRS element (for citing)
Other Revenue Total$1,557,898OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$541,952,209TotalRevenueColumnAmt
Related Or Exempt Func Income$527,668,416RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,467,764UnrelatedBusinessRevenueAmt
Exclusion$2,677,925ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$23,507TotalAmt
Management And General$23,507ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$118,365,501TotalAmt
Program Services$112,842,010ProgramServicesAmt
Management And General$5,523,491ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,445,578TotalAmt
Program Services$4,445,578ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$25,410,065TotalAmt
Program Services$24,754,981ProgramServicesAmt
Management And General$655,084ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,316,027TotalAmt
Program Services$8,316,027ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,653,439TotalAmt
Program Services$4,653,439ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$36,223,071TotalAmt
Program Services$35,143,436ProgramServicesAmt
Management And General$1,079,635ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,615TotalAmt
Program Services$25,615ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,371,912TotalAmt
Program Services$2,771,529ProgramServicesAmt
Management And General$600,383ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$11,595,859TotalAmt
Program Services$11,595,859ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,464,119TotalAmt
Program Services$4,888,107ProgramServicesAmt
Management And General$576,012ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$137,417TotalAmt
Program Services$136,773ProgramServicesAmt
Management And General$644ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$210,660TotalAmt
Program Services$210,660ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$8,462,548TotalAmt
Program Services$8,462,548ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$98,683,341TotalAmt
Program Services$23,782,685ProgramServicesAmt
Management And General$74,900,656ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$40,690,242TotalAmt
Program Services$40,690,242ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$784,691TotalAmt
Program Services$784,691ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS & PHARMACEUTICALS$50,554,687$50,554,687
MEDICAL SUPPLIES$42,637,204$42,542,047$95,157
BAD DEBTS$14,195,727$14,195,727
MEDICAID PROVIDER TAXES$12,969,622$12,969,622

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,878,038TotalAmt
Program Services$2,615,636ProgramServicesAmt
Management And General$262,402ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$490,098,870TotalAmt
Program Services$406,381,899ProgramServicesAmt
Management And General$83,716,971ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,353,894BOYAmt
EOY$34,703,729EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$73,467,000BOYAmt
EOY$63,893,975EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$8,802,331BOYAmt
EOY$9,245,695EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,388,066BOYAmt
EOY$9,882,950EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$948,472,604LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$517,956,598LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$393,996,389BOYAmt
EOY$430,516,006EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,551,352BOYAmt
EOY$3,211,778EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$13,481,974BOYAmt
EOY$13,191,311EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,041,131BOYAmt
EOY$24,595,640EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$527,082,137BOYAmt
EOY$589,241,084EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$67,028,345BOYAmt
EOY$90,448,177EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$215,651BOYAmt
EOY$2,122,957EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$297,640,479BOYAmt
EOY$294,103,014EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$364,884,475BOYAmt
EOY$386,674,148EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$160,712,188BOYAmt
EOY$201,042,077EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,485,474BOYAmt
EOY$1,524,859EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$162,197,662BOYAmt
EOY$202,566,936EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$527,082,137BOYAmt
EOY$589,241,084EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$51,853,339ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$828,689NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$10,655,376OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit Performed0FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,341,025OtherCostOrOtherBasisAmt
Book Value$26,341,025BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$498,371,967OtherCostOrOtherBasisAmt
Depreciation$237,858,777DepreciationAmt
Book Value$260,513,190BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,502,671OtherCostOrOtherBasisAmt
Depreciation$1,006,702DepreciationAmt
Book Value$1,495,969BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$333,812,042OtherCostOrOtherBasisAmt
Depreciation$279,065,445DepreciationAmt
Book Value$54,746,597BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$87,444,899OtherCostOrOtherBasisAmt
Depreciation$25,674DepreciationAmt
Book Value$87,419,225BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$430,516,006TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
ACCRUED POSTRETIREMENT MEDICAL$111,634
FAIR VALUE-INTEREST RATE SWAP$19,046,492
INTERCOMPANY NOTES PAYABLE$266,573,848
LEASES PAYABLE$8,194,011
DEFERRED COMPENSATION LIABILITY$14,627
ASSET RETIREMENT OBLIGATION$162,402
FieldValueIRS element (for citing)
Total Liability$294,103,014TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
Indiv Hospital Tailored PolicyYes (X)IndivHospitalTailoredPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$796,398TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$796,398NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,681,864TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,129,271DirectOffsettingRevenueAmt
Net Community Benefit Expns$30,552,593NetCommunityBenefitExpnsAmt
Total Expense0.06420TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,478,262TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,129,271DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,348,991NetCommunityBenefitExpnsAmt
Total Expense0.06590TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served65499PersonsServedCnt
Total Community Benefit Expns$2,902,698TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,902,698NetCommunityBenefitExpnsAmt
Total Expense0.00610TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs9ActivitiesOrProgramsCnt
Persons Served1916PersonsServedCnt
Total Community Benefit Expns$3,672,714TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,672,714NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served224PersonsServedCnt
Total Community Benefit Expns$7,760,171TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,067,604DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,692,567NetCommunityBenefitExpnsAmt
Total Expense0.01200TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs9ActivitiesOrProgramsCnt
Persons Served20567PersonsServedCnt
Total Community Benefit Expns$1,349,057TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,349,057NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs40ActivitiesOrProgramsCnt
Persons Served88206PersonsServedCnt
Total Community Benefit Expns$15,684,640TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,067,604DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,617,036NetCommunityBenefitExpnsAmt
Total Expense0.02860TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs40ActivitiesOrProgramsCnt
Persons Served88206PersonsServedCnt
Total Community Benefit Expns$64,162,902TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,196,875DirectOffsettingRevenueAmt
Net Community Benefit Expns$44,966,027NetCommunityBenefitExpnsAmt
Total Expense0.09450TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served46PersonsServedCnt
Total Community Benefit Expns$375TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$375NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served582PersonsServedCnt
Total Community Benefit Expns$104,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$104,975NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served37PersonsServedCnt
Total Community Benefit Expns$8,778TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,778NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served30PersonsServedCnt
Total Community Benefit Expns$33,808TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$33,808NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served10PersonsServedCnt
Total Community Benefit Expns$129,931TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$129,931NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs7ActivitiesOrProgramsCnt
Persons Served705PersonsServedCnt
Total Community Benefit Expns$277,867TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$277,867NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$14,207,340BadDebtExpenseAmt
Bad Debt Expense Attributable$1,192,900BadDebtExpenseAttributableAmt
Reimbursed By Medicare$87,248,090ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$109,372,248CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$22,124,158MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 PROHEALTH ALIGNED LLC
AMBULATORY SURGERY CENTER0.510000.49000
2 THE ORTHOPEDIC SURGERY CENTER LLC
ORTHOPEDIC SURGICAL SERVICES0.490000.49000
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndEmergency Room OtherEmergencyRoomOtherIndOtherOtherDesc
PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC
1725 AMERICAN AVENUEWAUKESHAWI53188WWW.PROHEALTHCARE.ORG#41Yes (X)Yes (X)Yes (X)Yes (X)
REHABILITATION HOSPITAL OF WISCONSIN LLC
21625 COLDWATER CREEK DRIVEWAUKESHAWI53188Yes (X)INPATIENT REHABILITATION

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndPrior CHNA ImpactPriorCHNAImpactIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctIncome Level CriteriaIncomeLevelCriteriaIndAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndResidency CriteriaResidencyCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndProvided Written NoticeProvidedWrittenNoticeIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndLook Back Medicare PrivateLookBackMedicarePrivateIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
PROHEALTH WAUKESHA MEMORIAL HOSPITAL IN
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)19Yes (1)Yes (1)0Yes (1)Yes (X)HTTPS://TINYURL.COM/Y9C7P5JJYes (X)Yes (X)Yes (1)19Yes (1)HTTPS://TINYURL.COM/Y9C7P5JJ0Yes (1)Yes (X)200.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
REHABILITATION HOSPITAL OF WISCONSIN LLC
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)19Yes (1)Yes (1)0Yes (1)Yes (X)HTTPS://TINYURL.COM/Y9C7P5JJYes (X)Yes (X)Yes (1)19Yes (1)HTTPS://TINYURL.COM/Y9C7P5JJ0Yes (1)Yes (X)200.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)HTTPS://TINYURL.COM/Y892WQSNYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 3J: THE CHNA RESULTS CAME FROM A 400 PERSON CONSUMER TELEPHONE SURVEY CONDUCTED BY THE UW CENTER FOR URBAN POPULATION HEALTH AT THE REQUEST OF PROHEALTH CARE AND OTHER MILWAUKEE COLLABORATIVE PARTNERS IN ADDITION TO 47 INTERVIEWS WITH OVER 71 RESPONDENTS ENCOMPASSING A RANGE OF PROVIDERS, POLICY-MAKERS AND OTHER LOCAL EXPERTS. AN ADDITIONAL 12 INTERVIEWS WERE CONDUCTED BY PROHEALTH CARE STAFF ALONE. SECONDARY DATA WAS COLLECTED FROM A WIDE RANGE OF PUBLICLY AVAILABLE SITES AND ORGANIZATIONS INCLUDING STATE AND FEDERAL RESOURCES. HEAVY UTILIZATION OF DATA WAS FROM MEDICARE CHRONIC DISEASE DASHBOARD, CENTER FOR DISEASE CONTROL, WISCONSIN DEPARTMENT OF HEALTH AND HUMAN SERVICES, WISH (WISCONSIN INTERACTIVE STATISTICS ON HEALTH) QUERY SYSTEM, AND COMMUNITY COMMONS 'DASHBOARDS'. THIS DATA HELPED IDENTIFY ADDED DEMOGRAPHICS SUCH AS POPULATIONS WITH ANY DISABILITY, WISCONSIN LEADING CAUSES OF DEATH, HOMELESSNESS AND SPECIFIC LIFESTYLE RISK FACTORS.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 3J: THE CHNA RESULTS CAME FROM A 400 PERSON CONSUMER TELEPHONE SURVEY CONDUCTED BY THE UW CENTER FOR URBAN POPULATION HEALTH AT THE REQUEST OF PROHEALTH CARE AND OTHER MILWAUKEE COLLABORATIVE PARTNERS IN ADDITION TO 47 INTERVIEWS WITH OVER 71 RESPONDENTS ENCOMPASSING A RANGE OF PROVIDERS, POLICY-MAKERS AND OTHER LOCAL EXPERTS. AN ADDITIONAL 12 INTERVIEWS WERE CONDUCTED BY PROHEALTH CARE STAFF ALONE. SECONDARY DATA WAS COLLECTED FROM A WIDE RANGE OF PUBLICLY AVAILABLE SITES AND ORGANIZATIONS INCLUDING STATE AND FEDERAL RESOURCES. HEAVY UTILIZATION OF DATA WAS FROM MEDICARE CHRONIC DISEASE DASHBOARD, CENTER FOR DISEASE CONTROL, WISCONSIN DEPARTMENT OF HEALTH AND HUMAN SERVICES, WISH (WISCONSIN INTERACTIVE STATISTICS ON HEALTH) QUERY SYSTEM, AND COMMUNITY COMMONS 'DASHBOARDS'. THIS DATA HELPED IDENTIFY ADDED DEMOGRAPHICS SUCH AS POPULATIONS WITH ANY DISABILITY, WISCONSIN LEADING CAUSES OF DEATH, HOMELESSNESS AND SPECIFIC LIFESTYLE RISK FACTORS.
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 5: SEE PART V, SECTION B, LINE 3J DISCLOSURESUMMARY DATA AND A REVIEW OF MAJOR ISSUES WAS PRESENTED TO THE HOSPITAL ADVOCATES COMMITTEE. EACH COMMITTEE MEMBER PROVIDED FEEDBACK VIA A 'VOTING' METHODOLOGY. THIS FEEDBACK, ALONG WITH THE DATA FROM THE CONSUMER TELEPHONE SURVEY AND KEY INFORMANT INTERVIEWS SERVED AS ADVISORY RECOMMENDATIONS WHEN OUR PROHEALTH COMMUNITY BENEFIT COMMITTEE MADE THEIR PRIORITY DECISIONS USING IDENTIFIED CRITERIA IN A TWO-STEP NARROWING PROCESS. OUR NINE MEMBER COMMUNITY BENEFIT COMMITTEE IS A BOARD-LEVEL GROUP OF GOVERNMENTAL, COMMUNITY AND BUSINESS LEADERS IN OUR SERVICE AREA AND ARE RESPONSIBLE FOR OVERSIGHT OF OUR CHNA.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 5: SEE PART V, SECTION B, LINE 3J DISCLOSURESUMMARY DATA AND A REVIEW OF MAJOR ISSUES WAS PRESENTED TO THE HOSPITAL ADVOCATES COMMITTEE. EACH COMMITTEE MEMBER PROVIDED FEEDBACK VIA A 'VOTING' METHODOLOGY. THIS FEEDBACK, ALONG WITH THE DATA FROM THE CONSUMER TELEPHONE SURVEY AND KEY INFORMANT INTERVIEWS SERVED AS ADVISORY RECOMMENDATIONS WHEN OUR PROHEALTH COMMUNITY BENEFIT COMMITTEE MADE THEIR PRIORITY DECISIONS USING IDENTIFIED CRITERIA IN A TWO-STEP NARROWING PROCESS. OUR NINE MEMBER COMMUNITY BENEFIT COMMITTEE IS A BOARD-LEVEL GROUP OF GOVERNMENTAL, COMMUNITY AND BUSINESS LEADERS IN OUR SERVICE AREA AND ARE RESPONSIBLE FOR OVERSIGHT OF OUR CHNA.
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 6A: PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL AND REHABILITATION HOSPITAL OF WISCONSIN LLC
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 6A: PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL AND PROHEALTH WAUKESHA MEMORIAL HOSPITAL
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 7D: THE CHNA, WHICH INCLUDES THE IMPLEMENTATION STRATEGY, IS AVAILABLE AT HTTPS://WWW.PROHEALTHCARE.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/CHNA/ AND TO COMMUNITY MEMBERS UPON REQUEST.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 7D: THE CHNA, WHICH INCLUDES THE IMPLEMENTATION STRATEGY, IS AVAILABLE AT WWW.PROHEALTHCARE.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/CHNA/AND TO COMMUNITY MEMBERS UPON REQUEST.
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 11: THE FACILITY CONTINUES TO FOCUS ITS COMMUNITY OUTREACH PROGRAMS ON THE PRIORITY NEEDS DETERMINED FROM THE LAST CHNA. THE ENTITY FEES ALL NEEDS ARE BEING ADDRESSED EITHER THROUGH DIRECT OUTREACH OR ENSURING OTHER COMMUNITY LEADERS ARE AWARE OF SIMILAR NEEDS AND THOSE PATIENTS OR USERS ARE PROVIDED WITH THOSE COMMUNITY RESOURCES IF NOT OFFERED BY THE FACILITY.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 11: THE FACILITY CONTINUES TO FOCUS ITS COMMUNITY OUTREACH PROGRAMS ON THE PRIORITY NEEDS DETERMINED FROM THE LAST CHNA. THE ENTITY FEES ALL NEEDS ARE BEING ADDRESSED EITHER THROUGH DIRECT OUTREACH OR ENSURING OTHER COMMUNITY LEADERS ARE AWARE OF SIMILAR NEEDS AND THOSE PATIENTS OR USERS ARE PROVIDED WITH THOSE COMMUNITY RESOURCES IF NOT OFFERED BY THE FACILITY.
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 13B: THE HOSPITAL PROVIDES CHARITY CARE OR REDUCED COST CARE FOR A VARIETY OF PATIENTS IN NEED. SOME OF THESE PATIENTS IN NEED MAY TECHNICALLY HAVE INCOME IN EXCESS OF MINIMUM FEDERAL POVERTY GUIDELINES. FOR ADDITIONAL DETAILS ON THE CRITERIA USED BY THE HOSPITAL FACILITY TO DETERMINE ELIGIBILITY, PLEASE REFER TO THE FINANCIAL ASSISTANCE POLICY AVAILABLE ON THE HOSPITAL'S WEBSITE AT: WWW.PROHEALTHCARE.ORG/PATIENTS-FAMILIES/BILLING-AND-INSURANCE/
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 13B: THE HOSPITAL PROVIDES CHARITY CARE OR REDUCED COST CARE FOR A VARIETY OF PATIENTS IN NEED. SOME OF THESE PATIENTS IN NEED MAY TECHNICALLY HAVE INCOME IN EXCESS OF MINIMUM FEDERAL POVERTY GUIDELINES. FOR ADDITIONAL DETAILS ON THE CRITERIA USED BY THE HOSPITAL FACILITY TO DETERMINE ELIGIBILITY, PLEASE REFER TO THE FINANCIAL ASSISTANCE POLICY AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.PROHEALTHCARE.ORG/PATIENTS-FAMILIES/BILLING-AND-INSURANCE/
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 13H: THE FACILITY ALSO CONSIDERS THE FOLLOWING IN THE FINANCIAL ASSISTANCE POLICY: SIZE OF THE PATIENT'S FAMILY WILL BE DETERMINED BY THE NUMBER OF DEPENDENTS CLAIMED ON THE APPLICANT'S TAX RETURNS OR IDENTIFIED AS PART OF THE HOUSEHOLD, HOUSEHOLD INCOME WILL INCLUDE ALL INCOME FROM ANY SOURCE INCLUDING WAGES AND SALARIES AND OTHER SOURCES OF INCOME INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING;- ALL PENSIONS FROM STATE, FEDERAL OR PRIVATE SOURCES- INCOME FROM ANNUITIES, IRAS, TSAS, 401(K)S- STOCKS, OR BONDS- VETERANS BENEFITS- SOCIAL SECURITY PAYMENTS- REGULARLY RECEIVED INSURANCE CHECKS SUCH AS UNEMPLOYMENT BENEFITS AND WORKMAN'S COMPENSATION- ALIMONY; CHILD SUPPORT- RETURNS ON INVESTMENTS; NET RENTS AND NET PROFITS FROM BUSINESS.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 13H: THE FACILITY ALSO CONSIDERS THE FOLLOWING IN THE FINANCIAL ASSISTANCE POLICY: SIZE OF THE PATIENT'S FAMILY WILL BE DETERMINED BY THE NUMBER OF DEPENDENTS CLAIMED ON THE APPLICANT'S TAX RETURNS OR IDENTIFIED AS PART OF THE HOUSEHOLD, HOUSEHOLD INCOME WILL INCLUDE ALL INCOME FROM ANY SOURCE INCLUDING WAGES AND SALARIES AND OTHER SOURCES OF INCOME INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING;- ALL PENSIONS FROM STATE, FEDERAL OR PRIVATE SOURCES- INCOME FROM ANNUITIES, IRAS, TSAS, 401(K)S- STOCKS, OR BONDS- VETERANS BENEFITS- SOCIAL SECURITY PAYMENTS- REGULARLY RECEIVED INSURANCE CHECKS SUCH AS UNEMPLOYMENT BENEFITS AND WORKMAN'S COMPENSATION- ALIMONY; CHILD SUPPORT- RETURNS ON INVESTMENTS; NET RENTS AND NET PROFITS FROM BUSINESS.
PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 16J: REFERENCE TO THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE BACK OF ALL PATIENT STATEMENTS. ALSO THROUGH CUSTOMER RELATIONS, VERBAL REMINDER OF THE FINANCIAL ASSISTANCE POLICY ARE PROVIDED WHEN DISCUSSING OPEN BALANCES.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 16J: REFERENCE TO THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE BACK OF ALL PATIENT STATEMENTS. ALSO THROUGH CUSTOMER RELATIONS, VERBAL REMINDER OF THE FINANCIAL ASSISTANCE POLICY ARE PROVIDED WHEN DISCUSSING OPEN BALANCES.
PART V, SECTION B, LINE 22BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. TO CALCULATE THE AGB, THE HOSPITAL FACILITIES USES THE "LOOK-BACK" METHOD DESCRIBED IN 26 C.F.R. 501 (R)-4(B)(2). IN THIS METHOD, THE HOSPITAL FACILITIES USE DATA BASED ON CLAIMS SENT TO MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE COMMERCIAL INSURERS FOR ALL MEDICARE CARE OVER THE PAST YEAR TO DETERMINE THE PERCENTAGE OF GROSS CHARGES THAT IS TYPICALLY PAID BY THESE INSURERS. THE AGB PERCENTAGE IS THEN MULTIPLIED BY GROSS CHARGES FOR EMERGENCY AND MEDICALLY NECESSARY CARE TO DETERMINE THE AGB. THE HOSPITAL FACILITIES RE-CALCULATE THE PERCENTAGE EACH YEAR. FOR FISCAL YEAR 2020, THE AGB PERCENTAGE FOR PROHEALTH WAUKESHA MEMORIAL HOSPITAL IS 31.02% AND FOR PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL IS 31.67%. EACH YEAR THE HOSPITAL FACILITIES WILL UPDATE THESE AMOUNTS.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - REHAB HOSPITAL OF WI OUTPATIENT CLINIC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188OUTPATIENT REHABILATION CLINIC
2 - PROHEALTH ALIGNED LLC
1111 DELAFIELD ST SUITE 100WAUKESHAWI53188AMBULATORY SURGERY CENTER
3 - THE ORTHOPEDIC SURGERY CENTER LLC
W238 N 1610 BUSSE ROAD SUITE 100WAUKESHAWI53188ORTHOPEDIC SURGERY CENTER

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:A COMMUNITY BENEFIT REPORT IS COMPLETED BY PROHEALTH CARE, INC. (EIN 39-1486873), THE SOLE CORPORATE MEMBER OF THE ORGANIZATION.
PART I, LINE 7:THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE AMOUNTS ON LINES 7A-7D. THIS WAS CALCULATED BY USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I
PART I, LN 7 COL(F):$14,195,727 OF BAD DEBT EXPENSES FROM PROHEALTH WAUKESHA MEMORIAL HOSPITAL, INC. WAS INCLUDED ON FORM 990, PART, IX, LINE 25 AND WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE.
PART II, COMMUNITY BUILDING ACTIVITIES:PROHEALTH WAUKESHA MEMORIAL HOSPITAL HAS FOSTERED A WIDE VARIETY OF PARTNERSHIPS WITH NUMEROUS AGENCIES AND INITIATIVES THAT BENEFIT OUR ENTIRE COMMUNITY BEYOND THOSE THAT ARE DIRECTLY ASSOCIATED WITH HEALTH. OUR EFFORTS TO HELP BUILD A SAFE AND VIBRANT COMMUNITY ARE IN SOME WAYS JUST AS IMPORTANT AS OUR TREMENDOUS EFFORTS TO IMPROVE COMMUNITY HEALTH. WE BELIEVE COMMUNITY BUILDING STARTS IN OUR OWN NEIGHBORHOODS AND ONE EXAMPLE OF THAT IS OUR SUPPORT OF LOCAL NEIGHBORHOOD GROUPS THAT ADDRESS SAFETY, PROPERTY APPEARANCE AND CONNECTIVITY OF RESIDENTS. WE PROVIDE FUNDING FOR BEAUTIFICATION AND CLEAN-UP OF COMMON PROPERTIES AND STREETS, AS WELL AS THE LAND EXPERTISE AND RESOURCES FOR COMMUNITY RAIN AND CROP GARDENS. AS PART OF OUR LEADERSHIP VOLUNTEERISM PROGRAM, WE PROVIDE ASSISTANCE AT LOCAL LIBRARIES AND LITERACY PROGRAMS AND HAVE A STRONG PRESENCE WITH MEMBERSHIPS IN A NUMBER OF ROTARY CLUBS AS WELL AS INVOLVEMENT IN OTHER SERVICE ORGANIZATIONS. INVOLVEMENT WITH YOUTH IS A YEAR-ROUND FOCUS AS WE ASSEMBLE AND DISTRIBUTE BACKPACKS TO LOW INCOME CHILDREN AND ASSIST WITH THE DISTRIBUTINO OF BLESSINGS IN A BACKPACK TO CHILDREN IN OUR LOCAL SCHOOLS. WE REGULARLY ADDRESS AND MENTOR LOCAL HIGH SCHOOL STUDENTS IN A VARIETY OF HEALTH CARE CAREER AWARENESS EVENTS AND INITIATIVES. WE ARE THE MAJOR SPONSOR OF "LEADERSHIP WAUKESHA", A PROGRAM THAT FOCUSES ON THE DEVELOPMENT OF EMERGING LEADERS IN OUR COUNTY. WE SUPPORT HOMELESS SHELTERS, ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION/CONTINUUM OF CARE AND THE COUNTY'S HISPANIC COLLABORATIVE NETWORK. WE ARE TREMENDOUSLY PROUD OF OUR WORK WITH EASTER SEALS AND THE WISCONSIN DEPARTMENT OF WORKFORCE DEVELOPMENT, SERVING AS A SITE FOR PROJECT SEARCH, A WORKFORCE TRAINING PROGRAM FOR DEVELOPMENTALLY/PHYSICALLY DISABLED INDIVIDUALS. DUE TO COVID-19, WORK IN THIS AREA ALTERED COURSE MID-YEAR.
PART III, LINE 2:THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX FOR PROHEALTH WAUKESHA MEMORIAL HOSPITAL PLUS ITS SHARE OF THE BAD DEBT EXPENSE OF REHABILITATION HOSPITAL OF WISCONSIN LLC.
PART III, LINE 3:THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 30% OF TOTAL BAD DEBTS.
PART III, LINE 4:BAD DEBT EXPENSE FOOTNOTE FOR WAUKESHA MEMORIAL HOSPITAL, INC: ACCOUNTS RECEIVABLE FROM PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIRENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACT, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CORPORATION RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE, BAD DEBT EXPENSE FOOTNOTE FOR REHABILITATION HOSPITAL OF WISCONSIN LLC:ACCOUNTS RECEIVABLE PRIMARILY CONSIST OF AMOUNTS DUE FROM THIRD-PARTY PAYORS AND PATIENTS. THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS. THE HOSPITAL'S POLICY TO RECORD AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON A PERCENTAGE OF NET RECEIVABLES BY AGE OF BALANCE AFTER DISCHARGE DATE.THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE, REVENUE TRENDS BY PAYOR CLASSIFICATION AND REVENUE DAYS IN ACCOUNTS RECEIVABLE. INDIVIDUAL PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.BAD DEBT EXPENSE IS RECORDED FOR FINANCIAL STATEMENT PURPOSES BASED ON UNCOLLECTED REVENUE, BUT THE RELATED COST COULD BE DETERMINED BY APPLYING COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT. DISCOUNTS ARE RECORDED TO AN APPROPRIATE CONTRA REVENUE ACCOUNT INCLUDING CHARITY CARE WHEN APPLICABLE; PAYMENTS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF WOULD DECREASE BAD DEBT EXPENSE. MOST OF THE PATIENTS FOR WHICH BAD DEBT EXPENSE IS RECORDED WOULD PROBABLY QUALIFY FOR SOME LEVEL OF FINANCIAL ASSISTANCE ACCORDING TO HOSPITAL POLICIES, BUT MANY CHOOSE NOT TO COMPLETE THE NECESSARY FINANCIAL ASSISTANCE APPLICATION SO THAT THIS CAN BE PROPERLY DETERMINED.
PART III, LINE 8:THE SHORTFALL ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. COSTING METHODOLOGY USED IS THE COST TO CHARGE RATIO AS REPORTED ON THE MEDICARE COST REPORT.
PART III, LINE 9B:PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE WILL HAVE A CHARITY DISCOUNT APPLIED TO THEIR BALANCES AT THE TIME OF BILLING. IF THIS RESULTS IN NO BALANCE DUE FORM THE PATIENT, THEN THE PATIENT WILL NOT RECEIVE A STATEMENT. IF A BALANCE REMAINS AFTER THE DISCOUNT PERCENTAGE IS APPLIED, THE PATIENT WILL RECEIVE A STATEMENT FOR THE BALANCE DUE. THE STATEMENT CYCLE IS CONSISTENT FOR ALL PATIENTS.
PART VI, LINE 2:COMMUNITY NEEDS ARE IDENTIFIED BASED UPON A REVIEW OF STATE, COUNTY AND COMMUNITY HEALTH DATA AND ASSESSMENTS. THIS INCLUDES SUCH DOCUMENTS AS: THE STATE HEALTH PLAN, THE COUNTY HEALTH REPORT CARD, THE WAUKESHA COMMUNITY HEALTH SURVEY, THE HEALTHY PEOPLE 2020 PLAN AND VARIOUS OTHER RESOURCES, SUCH AS THE WISH DATA, COMMUNITY COMMONS DASHBOARDS AND DATA FROM CMS. WE ANALYZE THE DATA, IDENTIFY THE PRESSING NEEDS, AND PROACTIVELY PLAN AND IMPLEMENT COMMUNITY BENEFIT INITIATIVES TO ADDRESS THESE NEEDS. ADDITIONALLY, WE HAVE ACTIVELY PARTNERED WITH OUR COUNTY HEALTH DEPARTMENT IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS (CHIPP) ASSESSMENT AND SPEARHEADED A NUMBER OF COUNTY-WIDE IMPLEMENTATION STRATEGIES. THE MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN MAY 2019 AND THE IMPLEMENTATION PLAN WAS ADOPTED IN JULY 2019. WE ALSO SHARE IN PARTNERSHIP WITH THE CHNA IMPLEMENTATION PLAN FOR THE PROHEALTH REHABILITATION HOSPITAL OF WISCONSIN. THROUGH DATA ANALYSIS AND COMMUNITY DISCUSSION, WE SAW A NUMBER OF OVER-ARCHING THEMES THAT PROMPTED US TO CHOOSE THE FOLLOWING PRIORITY AREAS:PRIORITY AREA:NEEDS OF THE ELDERLYCORRELATED COMMUNITY HEALTH NEED: -MENTAL HEALTH ISSUES INCLUDING DEPRESSION, DEMENTIA AND ALZHEIMER'S DISEASE-AODA ISSUES (ALCOHOL AND OTHER DRUGS) ADVERSE EFFECTS FROM POLYPHARMACY-PREVALENCE OF CHRONIC CONDITIONS-ACCIDENTAL INJURY-SOCIAL VULNERABILITY AND ISOLATION-OBESITY-ACCESS: SCARCITY OF PROVIDERS SPECIALIZING IN GERONTOLOGYPRIORITY AREA: ALCOHOL AND OTHER DRUGSCORRELATED COMMUNITY HEALTH NEED:-BINGE DRINKING-PRESCRIPTION DRUG OVERDOSE/MISUSE-HEROIN AND OPIOID DEATHS/HOSPITALIZATIONS-ACCESS: SCARCITY OF PROVIDERSPRIORITY AREA:MENTAL HEALTHCORRELATED COMMUNITY HEALTH NEED:-SUICIDE RATE-ALZHEIMER'S DISEASE-DEPRESSION-ACCESS: SCARCITY OF PROVIDERSPRIORITY AREA:CHRONIC DISEASECORRELATED COMMUNITY HEALTH NEED: -CARDIOVASCULAR DISEASE-CANCER-DIABETES-OBESITY-ALZHEIMER'S DISEASE-OTHERSFOR MORE INFORMATION, PLEASE GO TO HTTP://WWW.PROHEALTHCARE.ORG/ABOUT-US/
PART VI, LINE 3:EVERY PATIENT WITH A SELF PAY BALANCE RECEIVES A STATEMENT WHICH CONVEYS THE AVAILABILITY OF COMMUNITY (CHARITY) CARE AND A CONTACT NUMBER FOR FURTHER INFORMATION. PATIENTS THAT ARE UNINSURED RECEIVE AN UNINSURED DISCOUNT WHICH IS LISTED ON THE FIRST STATEMENT THAT THEY RECEIVE. PATIENTS RECEIVE A TOTAL OF FOUR STATEMENTS. EACH STATEMENT CONTAINS VERBIAGE REFERENCING THE HOSPITAL'S COMMUNITY CARE PROGRAM AND A CONTACT NUMBER FOR FURTHER INFORMATION. IF SOMEONE HAS BEEN FOUND ELIGIBLE FOR SOME LEVEL OF CHARITY CARE, THE ELIGIBILITY PERIOD IS THREE MONTHS SO ANY SUBSEQUENT ACCOUNTS DURING THAT TIMEFRAME WOULD BE DISCOUNTED AT WHATEVER LEVEL OF CHARITY CARE THE PATIENT IS DEEMED ELIGIBLE. PATIENTS MAY REAPPLY FOR COMMUNITY CARE WHEN THEIR ELIGIBILITY PERIOD HAS EXPIRED. SELF PAY PATIENTS MAY ALSO BE INFORMED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM WHILE THEY ARE INPATIENTS. SOCIAL WORK AND/OR THE BUSINESS OFFICE MAY MAKE CONTACT WITH THESE PATIENTS DURING THEIR STAY TO INFORM THEM OF THE COMMUNITY CARE PROGRAM AND ASSIST THEM WITH COMPLETION OF THE APPLICATION.INFORMATION IS AVAILABLE AT REGISTRATION AREAS RELATED TO OUR COMMUNITY CARE PROGRAM. THIS INFORMATION CONTAINS CONTACT INFORMATION FOR THE HOSPITAL'S CENTRAL BUSINESS OFFICE WHERE PATIENTS CAN RECEIVE ASSISTANCE IN OBTAINING AND COMPLETING APPLICATIONS.
PART VI, LINE 4:PROHEALTH CARE SERVES ABOUT 414,820 PEOPLE EACH YEAR IN WAUKESHA COUNTY AND PORTIONS OF SURROUNDING COUNTIES. IN EVERY FEDERAL POPULATION CENSUS, WAUKESHA COUNTY HAS RECORDED AN INCREASE IN POPULATION. SINCE 1950, THE POPULATION GREW FROM 85,901 TO OVER 400,000. WAUKESHA COUNTY HAS AN AGING POPULATION WITH 18.1% OVER THE AGE OF 65 AND A MEDIAN AGE OF 43 YEARS WHICH FAR SURPASSES STATE AVERAGES AND IS THE HIGHEST MEDIAN AGE OF PEER COUNTIES. THE POPULATION OF SENIORS IN WAUKESHA COUNTY 65+ IS EXPECTED TO DOUBLE BY 2050; AGE 85+ IS EXPECTED TO NEARLY QUADRUPLE. THE RACIAL MAKEUP OF THE WAUKESHA COUNTY COMMUNITY IS AS FOLLOWS: WHITE 92.9%, HISPANIC OR LATINO 4.8%, BLACK 1.6%. MEDIAN HOUSEHOLD INCOME IS $78,268, WITH 5.15% OF PEOPLE LIVING BELOW THE POVERTY LEVEL. THE LARGEST POCKET OF THOSE LIVING IN POVERTY IS IN THE URBAN ENVIRONMENT OF THE CITY OF WAUKESHA WITH A RATE OF 15%. UNEMPLOYMENT IN WAUKESHA COUNTY STOOD AT 3.2% IN JUNE, 2018. WAUKESHA COUNTY IS LARGE (580 SQUARE MILES) AND DIVERSE, INCLUDING URBAN, SUBURBAN AND RURAL AREAS. THE PRESENCE OF SOME HIGH INCOME COMMUNITIES IN WAUKESHA COUNTY OFTEN GIVES A MISTAKEN IMPRESSION OF OVERALL WEALTH. OFTEN OVERLOOKED IS A GROWING POPULATION OF LOW INCOME, NON-ENGLISH SPEAKING, VULNERABLE AND MARGINALIZED CITIZENS WHO FACE ENORMOUS ODDS IN ACCESSING HEALTH CARE. THE HOMELESS POPULATION IS INCREASING IN WAUKESHA COUNTY AS EVIDENCED BY A POINT IN TIME COUNT CONDUCTED IN JULY 2018 OF 85 INDIVIDUALS. AT THAT TIME, THE SHELTER SYSTEM WAS RUNNING AT 93% CAPACITY. DOWNTOWN WAUKESHA WAS DECLARED A "MEDICALLY UNDERSERVED" AREA AND A "HEALTH-PROFESSIONAL SHORTAGE AREA" BY THE FEDERAL GOVERNMENT IN 2008. AS AN UNDERSERVED AREA, MEDICAL OPTIONS FOR INDIVIDUALS, PARTICULARLY THOSE WITHOUT HEALTH INSURANCE OR WITH PUBLIC INSURANCE, ARE SEVERELY LIMITED BECAUSE PRIVATE SERVICE PROVIDERS OFTEN REFUSE TO CARE FOR THESE INDIVIDUALS. CONSEQUENTLY, PROHEALTH CARE EMBARKED ON A FUND-RAISING INITIATIVE TO SUPPORT THE FORMATION OF AN FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN DOWNTOWN WAUKESHA. THAT HEALTH CENTER OPENED IN LATE 2012 AND IS FINANCIALLY SUPPORTED BY PROHEALTH CARE.
PART VI, LINE 5:PROHEALTH WAUKESHA MEMORIAL HOSPITAL IS GOVERNED BY A COMMUNITY BOARD. WE ARE PROUD OF THE NUMEROUS AND STRONG PARTNERSHIPS WE HAVE FORMED WITH A WIDE VARIETY OF NOT-FOR-PROFIT HEALTH AND HUMAN SERVICES AGENCIES AS WE WORK TOGETHER TO FORGE A STRONGER, HEALTHIER COMMUNITY. WE ARE ACTIVELY INVOLVED WITH PROGRAMMING, BOARD OVERSIGHT AND ONGOING FINANCIAL SUPPORT OF THE WAUKESHA COMMUNITY HEALTH CENTER, THE ONLY FEDERALLY-QUALIFIED HEALTH CENTER IN OUR AREA. WE ALSO PROVIDE FINANCIAL SUPPORT AS WELL AS IN-KIND SUPPORT TO TWO FREE CLINICS SERVING OUR AREA. WE WERE INSTRUMENTAL IN FORMING SEVERAL KEY AGENCIES DESIGNED TO MEET AN URGENT COMMUNITY NEED. FOR EXAMPLE, THROUGH OUR LEADERSHIP AND SUPPORT, THE WAUKESHA COUNTY COMMUNITY DENTAL CLINIC WAS FORMED AND WE HAVE PROVIDED ONGOING FINANCIAL SUPPORT AND PROVIDED CLINICAL AND OFFICE SPACE SO THIS AGENCY CAN CARRY OUT ITS MISSION. WE PROVIDE TRAINED THERAPISTS AT HIGH SCHOOL ATHLETIC GAMES FREE-OF-CHARGE TO SCHOOL SYSTEMS IN AN EFFORT TO REDUCE INJURY. WE PROVIDE FREE OR REDUCED COST TRANSPORTATION FOR PATIENTS THAT REQUIRE ASSISTANCE GETTING TO FREE CLINICS FOR MEDICAL APPOINTMENTS. WE PROVIDE SPACE AND CLINICAL EXPERTISE TO THE LOCAL 'MEALS ON WHEELS' PROGRAM, SERVING AT-RISK ELDERLY AND DISABLED INDIVIDUALS. SEVERAL OF OUR STAFF ARE ACTIVELY INVOLVED WITH THE HEALTH DEPARTMENT'S CHIPP AND SERVE ON A VARIETY OF COMMITTEES FOR THE AREA'S DEPARTMENT OF HEALTH AND HUMAN SERVICES. WE HOST COMMUNITY-WIDE HEALTH FAIRS OFFERING A WIDE VARIETY OF FREE SCREENINGS AND OFFER AN ONGOING AND IMPRESSIVE MENU OF FREE COMMUNITY EDUCATION CLASSES (INCLUDING EVIDENCE-BASED SELF-HELP WORKSHOPS). PROHEALTH CARE REACHES OUT INTO OUR COMMUNITY TO MEET THE NEEDS OF ITS RESIDENTS. FROM THE ALZHEIMER'S ASSOCIATION TO WAUKESHA DRUG FREE COMMUNITIES, AND DOZENS OF AGENCIES IN BETWEEN, PROHEALTH CARE IS THERE, PROVIDING VOLUNTEERS, FINANCIAL SUPPORT AND PARTNERSHIPS THAT HELP TO IMPROVE THE HEALTH OF OUR COMMUNITY.
PART VI, LINE 6:OUR HOSPITAL IS A MEMBER OF THE PROHEALTH CARE HEALTH SYSTEM WHICH SERVES AS OUR PARENT COMPANY. WHILE COMMUNITY BENEFIT RESPONSIBILITIES RESIDE WITH OUR HOSPITAL BOARD, THE PARENT COMPANY PLAYS A KEY ROLE IN COORDINATING COMMUNITY NEEDS ASSESSMENTS, COMMUNITY BENEFIT PROGRAM PLANNING, AND EVALUATION. A DESCRIPTION OF EACH AFFILIATES ROLE IN PROMOTING HEALTH WITHIN THE COMMUNITIES SERVED IS AS FOLLOWS:PROHEALTH CARE, INC. - HELPS TO MANAGE THE HOSPITALS TO ENSURE THEY CAN PROMOTE HEALTH AND WELLNESS WITHIN THE COMMUNITY. NATIONAL REGENCY OF NEW BERLIN, INC. - OWNS AND OPERATES SENIOR LIVING CENTERS AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY. PROHEALTH HOME CARE, INC. - PROVIDES HOSPICE AND HOME HEALTH CARE SERVICES AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY. PROHEALTH CARE FOUNDATION, INC. - SUPPORTS THE CHARITABLE MISSION OF PROHEALTH WAUKESHA MEMORIAL HOSPITAL AND PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL SO THAT IT MAY PROVIDE HEALTH SERVICES WITHIN THE COMMUNITY. PROHEALTH MEDICAL GROUP, INC. - PHMG OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHMG FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHMG PROVIDED 446,257 VISITS (CLINIC, URGENT CARE, AND VIRTUAL VISITS) AS WELL AS 9,874 IMAGING PROCEDURES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 8,769 DAYS OF INPATIENT CARE AND APPROXIMATELY 72,316 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2020.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SUSAN EDWARDS
PRESIDENT AND CEO$0$1,018,182$0$621,728$0$0$0$12,500$0$32,072$0$1,684,482$0$0
RONALD FARR
CHIEF FINANCIAL OFFICER$0$521,830$0$291,132$0$115,173$0$132,697$0$53,227$0$1,114,059$0$115,173
KENNETH PRICE
CHIEF OPERATING OFFICER$0$396,983$0$224,087$0$37,860$0$60,171$0$45,062$0$764,163$0$37,860
JOHN MAY
VP AMBULATORY$282,700$0$121,103$0$0$0$12,500$0$43,017$0$459,320$0$0$0
MARGARET PFITZINGER
VP CLINICAL OPERATIONS$207,788$0$92,551$0$0$0$12,649$0$43,972$0$356,960$0$0$0
JULIE JACKSON
VP CONTINUUM OF CARE$202,373$0$81,040$0$0$0$9,500$0$42,468$0$335,381$0$0$0
KARIN KULTGEN
VP MEDICAL AFFAIRS$255,748$0$0$0$0$0$16,037$0$27,251$0$299,036$0$0$0
ERIC HENDEE
CHIEF PHYSICIST$218,208$0$1,431$0$0$0$13,481$0$10,109$0$243,229$0$0$0
ALAN JOHNSON
VP CRITICAL CARE & SPECIALTY$170,148$0$51,946$0$0$0$10,193$0$2,282$0$234,569$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT
PART I, LINE 4BPROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THIS SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS SERP IS TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. SERP PAYMENTS DURING THE YEAR ARE AS FOLLOWS: RONALD FARR: $115,173 KENNETH PRICE: $37,860
PART I, LINE 6PROHEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1R&R INSURANCEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionKEN RIESCH, BOARD DIRECTOR, IS A GREATER THAN 35% OWNER OF R&R INSURANCERelationshipDescriptionTxt
Transaction$119,318TransactionAmt
TransactionR&R INSURANCE RECEIVES INSURANCE COMMISSIONS FROM WMH FOR INSURANCE COVERAGE PROVIDED.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6PROHEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7AACCORDING TO THE GOVERNING DOCUMENTS, THE BOARD OF THE FILING ORGANIZATION IS THE SAME AS THE BOARD OF THE SOLE CORPORATE MEMBER, PROHEALTH CARE, INC.
FORM 990, PART VI, SECTION A, LINE 7BPROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION, INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING AND CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS.
FORM 990, PART VI, SECTION B, LINE 11BAFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, WHO THEN FORMALLY APPROVED THE FORM 990, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 12CALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION.
FORM 990, PART VI, SECTION B, LINE 15AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO, SENIOR EXECUTIVE TEAM MEMBERS, AND VICE-PRESIDENTS. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2020.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS & CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:THE PROCESS IS TO HAVE ALL JOINT VENTURE ARRANGEMENTS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE IT MEETS ALL LEGAL REQUIREMENTS AND TO ENSURE THAT WAUKESHA MEMORIAL HOSPITAL, INC. MAY RETAIN ITS EXEMPT STATUS.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -1,941,164. CHANGE IN MINIMUM PENSION LIABILITY 34,667,661. INVESTMENT FUNDING TO RELATED ORGANIZATIONS -783,335. OTHER CHANGES 39,384. PENSION PLAN TERMINATION LOSS -42,637,922.
FORM 990, PART XII, LINE 2CTHE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART XII, LINE 3B:THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT BEEN COMPLETED YET FOR THE FISCAL YEAR-END 9/30/20, BUT PLANS TO COMPLETED BY THE EXTENDED DUE DATE 9/30/21 AS ESTABLISHED IN OMB M-20-26.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC
791 SUMMIT AVENUEOCONOMOWOCWI53066390794174HOSPITALWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)
PROHEALTH CARE FOUNDATION INC
725 AMERICAN AVENUEWAUKESHAWI53188391314542CHARITABLE SUPPORTWI501(C)(3)LINE 7PROHEALTH CARE INCYes (1)
PROHEALTH HOME CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188200067392HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)
NATIONAL REGENCY OF NEW BERLIN INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391077992HEALTHCAREWI501(C)(3)LINE 10PROHEALTH CARE INCYes (1)
PROHEALTH CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391486873MANAGEMENTWI501(C)(3)LINE 12B, II0N/A
PROHEALTH MEDICAL GROUP INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391083015HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
PROHEALTH ALIGNED LLC (DBA PROHEALTH CARE MORELAND SURGERY CENTER)
1111 DELAFIELD STREET STE 100WAUKESHAWI53188263324572SURGERY CENTERWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$1,438,680$3,501,8670Yes (1)0.50000
REHABILITATION HOSPITAL OF WISCONSIN LLC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188262332250INPATIENT REHABILITATIONWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$3,113,758$3,715,7160Yes (1)0.49000
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N1610 BUSSE ROADWAUKESHAWI53188208356016ORTHOPEDIC SURGICAL SERVICESWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$4,297,571$2,377,9710Yes (1)0.49000
PROHEALTH SOLUTIONS LLC
2000 PEWAUKEE RD SUITE CWAUKESHAWI53188273863494ACCOUNTABLE CARE ORGANIZATIONWIN/A
LAKE COUNTRY ENDOSCOPY CENTER
1185 CORPORATE CENTER DROCONOMOWOCWI53066261572986ENDOSCOPY SERVICESWIN/A
WAUKESHA IMAGING LLC
N17 W24100 RIVERWOOD DR STE 200WAUKESHAWI53188392036860RADIOLOGY SERVICESWIN/A
PHCOAW CO-MANAGEMENT COMPANY LLC
N17 W24100 RIVERWOOD DR STE 200WAUKESHAWI53188811823911MANAGEMENT SERVICESWIN/A
GI SPECIALISTS LLC (DBA MORELAND ENDOSCOPY CENTER)
1111 DELAFIELD STREETWAUKESHAWI53188205269133ENDOSCOPY SERVICESWIN/A
SOUTHERN LAKES ENDOSCOPY CENTER
240 MAPLE AVENUEMUKWONAGOWI53149824245460ENDOSCOPY SERVICESWIN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
WAUKESHA HEALTH SYSTEM INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391507910HEALTHCAREWIN/AC0
EMPATHIA PACIFIC INC
31416 AGOURA RD STE 180WESTLAKE VILLAGECA91361953070501HEALTHCARECAN/AC0
NATIONAL AVENUE DEVELOPMENT CORPORATION
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391417226HEALTHCAREWIN/AC0
EMPATHIA INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391567366HEALTHCAREWIN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (23 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PROHEALTH CARE INC
M$98,683,341ACTUAL COST INCURRED
PROHEALTH MEDICAL GROUP INC
Q$6,750,735ACTUAL AMOUNT RECEIVED
PROHEALTH MEDICAL GROUP INC
P$4,694,268ACTUAL COST INCURRED
REHABILITATION HOSPITAL OF WISCONSIN LLC
S$3,696,577ACTUAL AMOUNT RECEIVED
THE ORTHOPEDIC SURGERY CENTER LLC
S$3,456,493ACTUAL AMOUNT RECEIVED
PROHEALTH MEDICAL GROUP INC
A$2,833,258ACTUAL AMOUNT RECEIVED
PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC
Q$2,706,886ACTUAL AMOUNT RECEIVED
PROHEALTH SOLUTIONS LLC
L$2,651,325ACTUAL AMOUNT RECEIVED
PROHEALTH ALIGNED LLC (DBA MSC)
S$1,440,234ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN LLC
A$1,265,364ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
M$1,082,022ACTUAL COST INCURRED
PROHEALTH SOLUTIONS LLC
M$936,198ACTUAL COST INCURRED
PROHEALTH CARE FOUNDATION INC
C$906,689ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
R$783,335ACTUAL COST INCURRED
PROHEALTH MEDICAL GROUP INC
K$693,421ACTUAL COST INCURRED
NATIONAL REGENCY OF NEW BERLIN INC
K$493,170ACTUAL COST INCURRED
WAUKESHA HEALTH SYSTEM INC
Q$200,460ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN LLC
L$168,655ACTUAL AMOUNT RECEIVED
PROHEALTH HOME CARE INC
Q$159,561ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
A$143,249ACTUAL AMOUNT RECEIVED
NATIONAL REGENCY OF NEW BERLIN INC
Q$117,456ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
K$78,175ACTUAL COST INCURRED
PROHEALTH CARE INC
L$58,995ACTUAL AMOUNT RECEIVED

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