FAMILY HEALTH CENTER OF MARSHFIELD INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
FAMILY HEALTH CENTER OF MARSHFIELD INC (EIN 39-1681547)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-11
IRS object ID
202002249349300705
Schema version
2018v3.3
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)
Return2020-08-11T11:06:06-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 Wells Fargo Ctr 90 S 7thAddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391681547EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Family Health Center of Marshfield INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Amanda SpindlerInCareOfNm
Business Name ControlFAMIBusinessNameControlTxt
Phone7152215700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 North Oak AvenueAddressLine1Txt
CityMarshfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54449ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREG NYCZPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone7152215720PhoneNum
Signature2020-07-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMONROE J GIERLPreparerPersonNm
PTINP01413237PTIN
Phone6123055000PhoneNum
Preparation2020-07-27PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.206.0.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id41438720202245000003FederalOriginalSubmissionId
Federal Original Submission Id2020-08-11FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id8A5C46716958F9D331A6DE825B8C303369DA92FCAtSubmissionCreationDeviceId
At Submission Filing Device IdEA4B65EE71D42BE71D1FFD4325509DD549A18899AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-22 18:59:49ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGreg NyczPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 North Oak AvenueAddressLine1Txt
CityMarshfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54449ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$91,541,255GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.familyhealthcenter.netWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1990FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,263,655PYContributionsGrantsAmt
CY Contributions Grants$9,002,617CYContributionsGrantsAmt
PY Program Service Revenue$76,346,075PYProgramServiceRevenueAmt
CY Program Service Revenue$69,681,189CYProgramServiceRevenueAmt
PY Investment Income$650,897PYInvestmentIncomeAmt
CY Investment Income$1,073,134CYInvestmentIncomeAmt
PY Other Revenue$11,500PYOtherRevenueAmt
CY Other Revenue$6,750CYOtherRevenueAmt
PY Total Revenue$86,272,127PYTotalRevenueAmt
CY Total Revenue$79,763,690CYTotalRevenueAmt
PY Grants And Similar Paid$1,497PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,498,612CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$211,379PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$213,682CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$94,436,110PYOtherExpensesAmt
CY Other Expenses$78,980,340CYOtherExpensesAmt
PY Total Expenses$94,648,986PYTotalExpensesAmt
CY Total Expenses$84,692,634CYTotalExpensesAmt
PY Revenues Less Expenses-$8,376,859PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,928,944CYRevenuesLessExpensesAmt
Total Assets BOY$113,413,179TotalAssetsBOYAmt
Total Assets EOY$85,418,675TotalAssetsEOYAmt
Total Liabilities BOY$48,569,545TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,320,568TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$64,843,634NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$61,098,107NetAssetsOrFundBalancesEOYAmt
MissionTHE 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$80,554,626ExpenseAmt
Grant$5,498,612GrantAmt
Revenue$69,681,189RevenueAmt
DescIN TOTAL, FAMILY HEALTH CENTER OF MARSHFIELD, INC. (FHC) SERVES APPROXIMATELY 69,616 UNIQUE PATIENTS ANNUALLY WHO WOULD NOT OTHERWISE RECEIVE CARE OR WOULD NEED TO OVERCOME SIGNIFICANT BARRIERS TO ACCESS CARE. FHC DOES THIS BY CONTRACTING FOR HEALTH, DENTAL AND BEHAVIORAL 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$80,554,626TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document52IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAmanda SpindlerPersonNm
Phone7152215727PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 N Oak AvenueAddressLine1Txt
CityMarshfieldCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54449ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
Anton Ziesler
President1.00.0Yes (X)Yes (X)$0$0$0
Sherry Moore
Vice President1.00.0Yes (X)Yes (X)$0$0$0
Robert Wiltrout
Treasurer1.00.0Yes (X)Yes (X)$0$0$0
Marla Hemke
Secretary1.00.0Yes (X)Yes (X)$0$0$0
Ronda Kopelke
Board Member1.00.0Yes (X)$0$0$0
Richard Kummerow
Board Member1.00.0Yes (X)$0$0$0
Janine Schiszek
Board Member1.00.0Yes (X)$0$0$0
Josephine Hegeholz
Board Member1.00.0Yes (X)$0$0$0
David Baxter
Board Member1.00.0Yes (X)$0$0$0
Austin Jirschele
Board Member1.00.0Yes (X)$0$0$0
Robert Twobears
Ex-Officio Board Member1.00.0Yes (X)$0$0$0
Marty Anderson
Ex-Officio Board Member1.040.0Yes (X)$0$171,406$50,429
Roderick Koehler MD
Ex-Officio Board Member1.040.0Yes (X)$0$348,141$54,711
Greg Nycz
Executive Director40.00.0$195,993$0$7,958Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$195,993TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$519,547TotReportableCompRltdOrgAmt
Total Other Compensation$113,098TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$577,382RelatedOrganizationsAmt
Government Grants$8,402,209GovernmentGrantsAmt
All Other Contributions$23,026AllOtherContributionsAmt
Total Contributions$9,002,617TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Service Revenue621400$64,613,294$64,613,294$0
Pharmacy Revenue621400$4,627,129$4,627,129
Prepaid Health Service Revenue621400$403,197$403,197
Misc Other Operating Revenue621400$37,569$37,569
FieldValueIRS element (for citing)
Total Program Service Revenue$69,681,189TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$926,453TotalRevenueColumnAmt
Exclusion$926,453ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$6,750RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$6,750RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,750TotalRevenueColumnAmt
Exclusion$6,750ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$11,924,226SecuritiesAmt
Other$20OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$11,777,427SecuritiesAmt
Other$138OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$146,799SecuritiesAmt
Other-$118OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$146,681TotalRevenueColumnAmt
Exclusion$146,681ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,763,690TotalRevenueColumnAmt
Related Or Exempt Func Income$69,681,189RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,079,884ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,356TotalAmt
Program Services$2,356ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$5,496,256TotalAmt
Program Services$5,496,256ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$194,381TotalAmt
Management And General$194,381ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,196TotalAmt
Management And General$8,196ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$11,105TotalAmt
Management And General$11,105ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$153,886TotalAmt
Management And General$153,886ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$14,300TotalAmt
Management And General$14,300ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$55,782TotalAmt
Management And General$55,782ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$47,526,575TotalAmt
Program Services$44,120,716ProgramServicesAmt
Management And General$3,405,859ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,107TotalAmt
Program Services$24,637ProgramServicesAmt
Management And General$470ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$886,261TotalAmt
Program Services$839,899ProgramServicesAmt
Management And General$46,362ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$163,504TotalAmt
Program Services$152,655ProgramServicesAmt
Management And General$10,849ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,460,630TotalAmt
Program Services$1,326,687ProgramServicesAmt
Management And General$133,943ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$314,465TotalAmt
Program Services$259,073ProgramServicesAmt
Management And General$55,392ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$20,688TotalAmt
Program Services$19,540ProgramServicesAmt
Management And General$1,148ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$344,048TotalAmt
Program Services$344,048ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,215,688TotalAmt
Program Services$2,215,688ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$73,775TotalAmt
Program Services$73,775ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Capitation$21,372,462$21,372,462
Medical Supplies$3,589,141$3,586,467$2,674
Misc Other Operating Expenses$458,743$415,082$43,661
Bad Debts$305,285$305,285

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$84,692,634TotalAmt
Program Services$80,554,626ProgramServicesAmt
Management And General$4,138,008ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,441,533BOYAmt
EOY$8,495,008EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$806,311BOYAmt
EOY$852,136EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,219,731BOYAmt
EOY$1,051,336EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$44,995,857BOYAmt
EOY$22,361,029EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$943,028BOYAmt
EOY$844,264EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$93,203BOYAmt
EOY$285,182EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,730,296LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$22,389,339LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,604,133BOYAmt
EOY$29,340,957EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$25,309,383BOYAmt
EOY$22,188,763EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$113,413,179BOYAmt
EOY$85,418,675EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$35,183,621BOYAmt
EOY$11,828,095EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$167,066BOYAmt
EOY$200,043EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,218,858BOYAmt
EOY$12,292,430EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$48,569,545BOYAmt
EOY$24,320,568EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$64,843,634BOYAmt
EOY$61,098,107EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,843,634BOYAmt
EOY$61,098,107EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$113,413,179BOYAmt
EOY$85,418,675EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,928,944ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,183,417NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,189,609CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26,424,071CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,895,359CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,263,655CurrentTaxYearMinus1YearAmt
Current Tax Year$9,002,617CurrentTaxYearAmt
Total$77,775,311TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,189,609CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26,424,071CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,895,359CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,263,655CurrentTaxYearMinus1YearAmt
Current Tax Year$9,002,617CurrentTaxYearAmt
Total$77,775,311TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$37,579,704SubstantialContributorsTotAmt
Public Support Total170$40,195,607PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$831,171CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$873,451CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$841,383CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$908,721CurrentTaxYearMinus1YearAmt
Current Tax Year$933,203CurrentTaxYearAmt
Total$4,387,929TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$82,163,240TotalSupportAmt
Gross Receipts Rltd Activities$390,502,948GrossReceiptsRltdActivitiesAmt
Public Support CY1700.48922PublicSupportCY170Pct
Public Support PY1700.41152PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementYes (true)PaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Sch C Part II-BFormAndLineReferenceDesc
ExplanationFAMILY 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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,513,971OtherCostOrOtherBasisAmt
Book Value$1,513,971BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$30,571,045OtherCostOrOtherBasisAmt
Depreciation$8,359,989DepreciationAmt
Book Value$22,211,056BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$794,762OtherCostOrOtherBasisAmt
Depreciation$305,954DepreciationAmt
Book Value$488,808BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$18,631,131OtherCostOrOtherBasisAmt
Depreciation$13,595,296DepreciationAmt
Book Value$5,035,835BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$219,387OtherCostOrOtherBasisAmt
Depreciation$128,100DepreciationAmt
Book Value$91,287BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$29,340,957TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$77,111,647TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,183,417NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$2,039,245DonatedServicesAndUseFcltsAmt
Revenue Not Reported$3,222,662RevenueNotReportedAmt
Revenue Subtotal$73,888,985RevenueSubtotalAmt
Investment Expenses Not Incld$55,782InvestmentExpensesNotIncldAmt
Other Revenues Not Included$5,818,923OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$5,874,705RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$79,763,690TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$80,857,174TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$2,039,245DonatedServicesUseFcltsAmt
Expenses Not Reported$2,039,245ExpensesNotReportedAmt
Expenses Subtotal$78,817,929ExpensesSubtotalAmt
Investment Expenses Not Incld2$55,782InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$5,818,923OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$5,874,705ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$84,692,634TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Sch D Part X Line 2FAMILY 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 BOTH SEPTEMBER 30, 2019 AND 2018, 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 A COMPANY'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. AS OF BOTH SEPTEMBER 30, 2019 AND 2018, FHC HAD NO UNCERTAIN TAX POSITIONS.
Form 990 Sch D Part XI, Line 4b AND part XII, line 4bInter-Company Contributions: $17,382 Provision for Bad Debts: $305,285 Charity Care $5,496,256 ---------------- Total: $5,818,923

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeCharity Care Assistance to IndividualsGrantTypeTxt
Recipient11709RecipientCnt
Cash Grant$5,496,256CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Sch I Part I Line 2FormAndLineReferenceDesc
ExplanationFamily 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

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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
Marty Anderson
Ex-Officio Board Member$0$168,854$0$0$0$2,552$0$24,771$0$26,921$0$223,098$0$0
Roderick Koehler MD
Ex-Officio Board Member$0$323,866$0$20,303$0$3,972$0$29,497$0$27,419$0$405,057$0$0
Greg Nycz
Executive Director$191,477$0$0$0$4,516$0$0$0$9,389$0$205,382$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Part I Line 1THE MISSION OF FAMILY HEALTH CENTER OF MARSHFIELD, INC. (FHC) IS TO IMPROVE ACCESS TO PRIMARY CARE SERVICES FOR THE MEDICALLY UNDERSERVED AND TO ENHANCE THE HEALTH OF OUR COMMUNITIES. THE PURPOSE IS TO OPERATE UNDER 42 USC SECTION 254C, WHICH SERVES MEDICALLY UNDERSERVED POPULATIONS. Form 990 Part VI Line 11b The Marshfield Clinic Health System VP of Finance, the Marshfield Clinic Health System Controller, 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.
Form 990 Part VI Line 12cFHC 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 Line 15aTHE 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 Line 19FHC 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 5ALL 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 IX LINE 11GDESCRIPTION:Purchased Services TOTAL FEES:47526575

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FLAMBEAU HOSPITAL INC
98 SHERRY AVEPARK FALLSWI54552390973724HOSPITALWI501(C)(3)3NAfalse
LAKEVIEW MEDICAL CENTER INC
1700 W STOUT STRICE LAKEWI54868390837206HOSPITALWI501(C)(3)3MCHSfalse
VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL
1700 W STOUT STRICE LAKEWI54868391329084SUPPORT ORGWI501(C)(3)12-TYPE IIINAfalse
MARSHFIELD CLINIC HEALTH SYSTEM INC
1000 N OAK AVEMARSHFIELDWI54449461495343SUPPORT ORGWI501(C)(3)12-TYPE IIINAfalse
MARSHFIELD CLINIC INC
1000 N OAK AVEMARSHFIELDWI54449390452970MEDICAL SVCSWI501(C)(3)3MCHSfalse
SECURITY HEALTH PLAN OF WISCONSIN INC
1515 N ST JOSEPH AVEMARSHFIELDWI54449391572880HMOWI501(C)(4)N/AMCHSfalse
MCHS HOSPITALS INC
1000 N OAK AVEMARSHFIELDWI54449810977948HOSPITALWI501(C)(3)3MCHSfalse
MCHS FOUNDATION INC
1000 N OAK AVEMARSHFIELDWI54449812822823PHILANTHROPYWI501(C)(3)7MCHSfalse
BEAVER DAM COMMUNITY HOSPITALS INC
707 S UNIVERSITY AVEBEAVER DAMWI53916391157876HOSPITALWI501(C)(3)3MCHS HOSPfalse
MEMORIAL HOSPITAL INC
216 SUNSET PLNEILLSVILLEWI54456390806828HOSPITALWI501(C)(3)3MCHS HOSPfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1THE DIAGNOSTIC & TREATMENT CENTER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13401 CRANBERRY BLVDAddressLine1Txt
CityWESTONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54476ZIPCd
FieldValueIRS element (for citing)
EIN200691634EIN
Primary ActivitiesMEDICAL SVCSPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V$0UBICodeVAmt
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (true)AssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SECURITY HEALTH PLAN OF WISCONSIN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypepTransactionTypeTxt
Involved$192,900InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt

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