FURP.ORG / PUBLIC DATA EXPLORER

LAKEVIEW MEDICAL CENTER INC OF RICE LAKE: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
LAKEVIEW MEDICAL CENTER INC OF RICE LAKE (EIN 39-0837206)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-17
IRS object ID
202022309349301942
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)
Return2020-08-17T11:33:33-05:00ReturnTs
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)
EIN390837206EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAKEVIEW MEDICAL CENTER INCBusinessNameLine1Txt
Business Name Line2OF RICE LAKEBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% CATHY BUKOWSKI VP OF FINANCInCareOfNm
Business Name ControlLAKEBusinessNameControlTxt
Phone7152341515PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11700 W STOUT STREETAddressLine1Txt
CityRICE LAKECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54868ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGORDON T EDWARDSPersonNm
Person TitleCOO/CFOPersonTitleTxt
Phone7152241515PhoneNum
Signature2020-08-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHolly K MoenPreparerPersonNm
PTINP01800653PTIN
Phone6123055000PhoneNum
Preparation2020-08-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.206.0.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id41438720202305000005FederalOriginalSubmissionId
Federal Original Submission Id2020-08-17FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEA4B65EE71D42BE71D1FFD4325509DD549A18899AtSubmissionCreationDeviceId
At Submission Filing Device Id0AD48136B8CA164DDEFA78FE78BBACDA039E3F98AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUSAN TURNEY MD CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 N OAK AVENUEAddressLine1Txt
CityMARSHFIELDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54449ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$146,035,085GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LAKEVIEWMEDICAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1919FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionWE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers250TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,146PYContributionsGrantsAmt
CY Contributions Grants$34,516CYContributionsGrantsAmt
PY Program Service Revenue$91,617,589PYProgramServiceRevenueAmt
CY Program Service Revenue$142,960,710CYProgramServiceRevenueAmt
PY Investment Income$244,415PYInvestmentIncomeAmt
CY Investment Income$348,904CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$2,752CYOtherRevenueAmt
PY Total Revenue$91,869,150PYTotalRevenueAmt
CY Total Revenue$143,346,882CYTotalRevenueAmt
PY Grants And Similar Paid$350PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,310,967CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$31,264,547PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$66,163,991CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$45,241,336PYOtherExpensesAmt
CY Other Expenses$61,971,722CYOtherExpensesAmt
PY Total Expenses$76,506,233PYTotalExpensesAmt
CY Total Expenses$129,446,680CYTotalExpensesAmt
PY Revenues Less Expenses$15,362,917PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,900,202CYRevenuesLessExpensesAmt
Total Assets BOY$96,586,658TotalAssetsBOYAmt
Total Assets EOY$106,412,465TotalAssetsEOYAmt
Total Liabilities BOY$46,662,520TotalLiabilitiesBOYAmt
Total Liabilities EOY$44,212,059TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,924,138NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$62,200,406NetAssetsOrFundBalancesEOYAmt
MissionWE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$107,093,866ExpenseAmt
Grant$1,310,967GrantAmt
Revenue$142,963,462RevenueAmt
DescLAKEVIEW MEDICAL CENTER INC. OF RICE LAKE IS A NOT-FOR-PROFIT 40-BED COMMUNITY HOSPITAL LOCATED IN RICE LAKE, WISCONSIN THAT PROVIDES MEDICAL, SURGICAL, EMERGENCY, OUTPATIENT, DIALYSIS, AMBULANCE, ONCOLOGY, HOSPICE AND HOME HEALTH SERVICES.Desc
Total Program Service Expenses$107,093,866TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
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 LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
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 HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
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
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
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 OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCATHY BUKOWSKI VP OF FINANCPersonNm
Phone7153875511PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Sue Tindell
Chair1.00.0Yes (X)Yes (X)$0$0$0
Carol Hakala
Vice Chair1.00.0Yes (X)Yes (X)$0$0$0
Brittany Nielsen
Secretary1.00.0Yes (X)Yes (X)$0$0$0
Mark Nymo MD
Board Member1.00.0Yes (X)$0$0$0
Tom Lundquist MD
Board Member1.040.0Yes (X)$0$223,184$53,402
Scott Polenz
Board Member1.040.0Yes (X)$0$263,697$51,695
Craig Fowler
Board Member1.00.0Yes (X)$0$0$0
Dan Ringwelski
Board Member1.00.0Yes (X)$0$0$0
Brenda Kupferschmidt
Board Member1.00.0Yes (X)$0$0$0
Bob Berg
Board Member1.00.0Yes (X)$0$0$0
Neelakantan Namboodiri MD
Board Member1.042.0Yes (X)$0$361,550$48,101
Bradley Groseth
Chief Admin Officer40.00.0$0$297,246$31,214Yes (X)
Narayana Murali MD
MCHS Chief Strategy Officer1.046.0$0$854,715$55,886Yes (X)
Jerard Jensen
MCHS General Counsel1.044.0$0$874,226$53,928Yes (X)
Gordon Edwards
MCHS CFO/COO1.044.0$0$702,259$57,140Yes (X)
Susan Turney MD
MCHS CEO1.046.0$0$2,454,892$291,090Yes (X)
Steven Kulick
Chief Experience Officer1.044.0$0$225,580$11,227Yes (X)
Ned Wolf
Former LMC CEO0.040.0$0$366,846$57,835Yes (X)
Cindy Arts-Strenke
Former LMC COO0.040.0$0$202,476$47,172Yes (X)
Daniel Ramsey
Former MCHS COO0.00.0$0$557,013$456Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,383,684TotReportableCompRltdOrgAmt
Total Other Compensation$759,146TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonNonePersonNm
FieldValueIRS element (for citing)
Contractor AddressContractorAddress
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$15,427RelatedOrganizationsAmt
Government Grants$19,089GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Total Contributions$34,516TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue621110$141,199,407$141,199,407
Intercompany Revenue621110$995,221$995,221
Cafeteria Revenue621110$467,804$467,804
Misc Other Operating Revenue621110$236,767$236,767
Wellness Revenue621110$61,511$61,511
FieldValueIRS element (for citing)
Total Program Service Revenue$142,960,710TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$230,686TotalRevenueColumnAmt
Exclusion$230,686ExclusionAmt

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$94,649RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$94,649RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,709,345SecuritiesAmt
Other$2,427OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,579,535SecuritiesAmt
Other$14,019OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$129,810SecuritiesAmt
Other-$11,592OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$118,218TotalRevenueColumnAmt
Exclusion$118,218ExclusionAmt
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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescVending RevenueDesc
Business900099BusinessCd
Total Revenue Column$2,752TotalRevenueColumnAmt
Related Or Exempt Func Income$2,752RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,752OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$143,346,882TotalRevenueColumnAmt
Related Or Exempt Func Income$142,963,462RelatedOrExemptFuncIncomeAmt
Exclusion$348,904ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,310,967TotalAmt
Program Services$1,310,967ProgramServicesAmt

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$316,747TotalAmt
Management And General$316,747ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$52,745,284TotalAmt
Program Services$52,041,850ProgramServicesAmt
Management And General$703,434ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,302,488TotalAmt
Program Services$4,217,688ProgramServicesAmt
Management And General$84,800ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,884,349TotalAmt
Program Services$5,760,486ProgramServicesAmt
Management And General$123,863ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,915,123TotalAmt
Program Services$2,866,310ProgramServicesAmt
Management And General$48,813ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$2,367TotalAmt
Program Services$2,367ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,371,145TotalAmt
Program Services$1,808,437ProgramServicesAmt
Management And General$562,708ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$237TotalAmt
Program Services$237ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,006,547TotalAmt
Program Services$935,886ProgramServicesAmt
Management And General$70,661ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$376,839TotalAmt
Program Services$278,061ProgramServicesAmt
Management And General$98,778ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$976,093TotalAmt
Program Services$949,872ProgramServicesAmt
Management And General$26,221ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$447,930TotalAmt
Program Services$433,863ProgramServicesAmt
Management And General$14,067ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,530,962TotalAmt
Program Services$1,530,962ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,707,378TotalAmt
Program Services$3,707,378ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$140,684TotalAmt
Program Services$140,684ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$27,385,238$27,381,226$4,012
I/C Purchased Services$20,213,878$20,213,878
WI Medicaid Access Tax$1,431,788$1,431,788
Equipment Repairs$1,028,301$1,028,231$70

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,352,335TotalAmt
Program Services$1,267,573ProgramServicesAmt
Management And General$84,762ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$129,446,680TotalAmt
Program Services$107,093,866ProgramServicesAmt
Management And General$22,352,814ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,776,678BOYAmt
EOY$9,751,637EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$138,369BOYAmt
EOY$139,926EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,097,080BOYAmt
EOY$32,936,780EOYAmt

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$1,181,989BOYAmt
EOY$2,006,031EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$104,555BOYAmt
EOY$69,879EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$105,931,294LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,852,541LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$62,523,061BOYAmt
EOY$61,078,753EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,268,395BOYAmt
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$496,531BOYAmt
EOY$429,459EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$96,586,658BOYAmt
EOY$106,412,465EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,394,746BOYAmt
EOY$1,356,132EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
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EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
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Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
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EOY$42,426,468EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$496,531BOYAmt
EOY$429,459EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$46,662,520BOYAmt
EOY$44,212,059EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$49,924,138BOYAmt
EOY$62,200,406EOYAmt

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$49,924,138BOYAmt
EOY$62,200,406EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$96,586,658BOYAmt
EOY$106,412,465EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$13,900,202ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$18,276NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$14,790PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$1,657,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd
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$4,503,454OtherCostOrOtherBasisAmt
Book Value$4,503,454BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$70,930,710OtherCostOrOtherBasisAmt
Depreciation$22,710,718DepreciationAmt
Book Value$48,219,992BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$427,997OtherCostOrOtherBasisAmt
Depreciation$252,220DepreciationAmt
Book Value$175,777BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$26,620,291OtherCostOrOtherBasisAmt
Depreciation$20,117,189DepreciationAmt
Book Value$6,503,102BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,448,842OtherCostOrOtherBasisAmt
Depreciation$1,772,414DepreciationAmt
Book Value$1,676,428BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$61,078,753TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATIONDesc
Amt$429,459Amt
FieldValueIRS element (for citing)
Total Liability$429,459TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Sch D Part X Line 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION APPLIES 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. BASED ON AN ANALYSIS PREPARED BY THE SYSTEM, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE ORGANIZATION AT SEPTEMBER 30, 2019 OR 2018.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$517,570TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$517,570NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,865,836TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,064,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,801,003NetCommunityBenefitExpnsAmt
Total Expense0.04530TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,383,406TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,064,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,318,573NetCommunityBenefitExpnsAmt
Total Expense0.04930TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$255,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$57,978DirectOffsettingRevenueAmt
Net Community Benefit Expns$197,040NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,316TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,316NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$264,334TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$57,978DirectOffsettingRevenueAmt
Net Community Benefit Expns$206,356NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,647,740TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,122,811DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,524,929NetCommunityBenefitExpnsAmt
Total Expense0.05090TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,416TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,416NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,416TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,416NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$462,161BadDebtExpenseAmt
Reimbursed By Medicare$34,778,160ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$41,528,964CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,750,804MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1NoneBusinessNameLine1Txt
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARSHFIELD MEDICAL CENTER - RICE LAKEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11700 W STOUT STREETAddressLine1Txt
CityRICE LAKECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54868ZIPCd
FieldValueIRS element (for citing)
State License82StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MARSHFIELD MEDICAL CENTER - RICE LAKEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.lakeviewmedical.comOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.lakeviewmedical.comStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Supplemental InformationFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Supplemental InformationFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Supplemental InformationFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Sch H Part V Line 5Marshfield Medical Center-Rice Lake (MMC-RL) completed the 2018 CHNA in partnership with Barron County Department of Health and Human Services (DHHS), Wisconsin Division of Public Health, University of Wisconsin-Eau Claire, Wisconsin Indianhead Technical College (WITC), ADRC of Barron, Rusk, and Washburn Counties, and the other healthcare systems in the community. In addition to analyzing demographic information, the group collected secondary data through both an online and paper survey concerning disease, death, disability, injury and community opinions. The survey was translated to Somali and Spanish to include feedback from underserved populations in the county.
Form 990 Sch H Part V Line 6aThe CHNA was conducted with the following hospital facility(s): - Mayo Clinic Health Systems - Cumberland Healthcare - Amery Hospital and Clinic
Form 990 Sch H Part V Line 6bThe CHNA was conducted with the following non-hospital facility(s): - Barron County Department of Health and Human Services (DHHS) - Wisconsin Division of Public Health-Western Region Office - University of Wisconsin-Eau Claire - Western Indianhead Technical College (WITC) - Aging and Disability Resource Center of Barron, Rusk, and Washburn Counties - Rice Lake Area Free Clinic - Northlakes Community Clinic
Form 990 Sch H Part V Line 11Marshfield Medical Center-Rice Lake will implement many strategies to collaborate with community and Marshfield Clinic Health system partners. Community change is a long-term process that no one organization can accomplish alone, therefor partnerships are essential for success. The following were identified by the Community Health Assessment: - Substance Abuse - Mental Health - Chronic Disease Due to the interconnected nature of the top identified health priorities, MMC-RL chose to combine a number of health priorities and are as follows along with the goals and strategies identified to achieve them. Alcohol and Substance Abuse Community-based goals are to reduce underage and excessive alcohol consumption and opioid related deaths and harm. Strategy 1: Support Implementation of an Alcohol and Other Drug Abuse (AODA) Prevention Curriculum - MMC-RL will partner with local organizations to support the implementation of an AODA prevention curriculum to reduce underage alcohol consumption and/or prevent substance use and abuse. Strategy 2: Support local policy related to underage drinking prevention - MMC-RL will partner with local organization(s) to support the implementation of a new or improved policy related to underage drinking prevention. Strategy 3: Engage in AODA prevention community groups - MMC-RL staff will actively engage in the Barron County Community Coalition (BC3) that addresses AODA. Behavior Health Community-based goals are to decrease suicide rates and improve social and emotional development of children and adolescents. Strategy 1: Support Community Training Related to Mental Health and Suicide Prevention - MMC-RL will support local community organization(s) in providing QPR trainings to 500 Barron County Residents. Strategy 2: Support Community Educational Event(s) Related to Mental Health and/or Suicide Prevention - MMC-RL will partner with at least one community organization to host educational event(s) where the documentary, The Ripple Effect, will be viewed. Strategy 3: Develop AODA and Mental Health Resource App. - MMC-RL will assist in the development of an app focused on providing community members, specifically youth access to information about existing AODA and mental health services and resources. Strategy 4: Engage in Mental Health community groups - MMC-RL staff will actively engage in Community Connections to Prosperity (CCP): Mental Health Action Team that addresses mental health. Chronic Disease Community-based goals are to improve access to healthy foods and physical activity, improve self-management of chronic conditions and reduce tobacco use. Strategy 1: Provide a yearly primary prevention strategy that supports care delivery efforts related to Chronic Disease management - MMC-RL will participate along with Cumberland Healthcare and Mayo Clinic Health System in holding Know Your Numbers events open to the community that screen residents for chronic disease risk factors. Strategy 2: Provide self-management education of pre-diabetes through the National Diabetes Prevention Program - MMC-RL will improve referrals/access to MMC-RL National Diabetes Prevention Program (DPP) Strategy 3: Improve Access to Healthy Choices - MMC-RL will implement an educational campaign regarding sugar sweetened beverages Strategy 4: Engage in Chronic Disease Prevention Community Groups - MMC-RL staff will actively engage in Thrive: Barron County Chronic Disease Prevention coalition that addresses chronic disease The following health priorities will not be addressed by MMC-RL for reasons indicated: - Injury & Violence Prevention: injury and violence are import areas of focus. Instead of leading this charge, MMC-RL staff participate in a variety of community groups supporting this area including, Barron-Washburn County Caregiver Coalition and Community Connections to Prosperity (CCP). Embrace Inc. (a domestic violence and sexual assault agency that provides safe shelter and supportive services for survivors), Aging and Disability Resource Center (ADRC) of Barron, Rusk, and Washburn Counties, and Barron County Department of Health and Human Services (DHHS) lead and have expertise in this area. - Communicable Disease Prevention & Control: This is an important area of focus, MMC-RL has systems and processes in place to prevent and reduce the spread of communicable diseases. The hospital will not take the lead on this area in community outreach as this is an area the Barron County Department of Health and Human Services (DHHS) leads and has expertise in. - Oral Health: Marshfield Clinic Rice Lake Dental Center addresses the community need for oral health by serving patients regardless of ability to pay or insurance status. While MMC-RL addresses oral health it is not listed as one of the top health priorities. - Reproductive & Sexual Health: While MMC-RL does provide this service, community lead initiatives are best lead by the Barron County Department of Health and Human Services (DHHS) and other agencies with expertise in the area. - Environmental & Occupational Health: While MMC-RL does have a vibrant Occupational Health Department, the hospital will not take the lead on this area in community outreach as this is an area the Barron County Department of Health and Human Services (DHHS) leads and has expertise in.
FORM 990 Sch H PART V LINE 16A-CTHE FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY) AND THE FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE AT THIS URL: HTTPS://WWW.MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSIS TANCE

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Sch H Part I Line 3cAN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON INCOME AS COMPARED WITH FEDERAL POVERTY GUIDELINES. OTHER ELIGIBILITY FACTORS INCLUDE: ASSET LIMITATIONS, INSURANCE STATUS AND RESIDENCY. ACCOUNT BALANCE IS CONSIDERED FOR MEDICAL INDIGENCE ELIGIBILITY.
Form 990 Sch H Part I Line 7EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE: AMOUNTS CALCULATED IN PART I, LINE 7 ARE DETERMINED BASED ON A COST-TO-CHARGE RATIO. OTHER BENEFITS ARE DETERMINED BASED ON THE DIRECT AND INDIRECT COSTS (WHERE ALLOCATED) ASSOCIATED WITH A PROGRAM NET OF EARNED REVENUE. Form 990 Sch H Part II Marshfield Medical Center-Rice Lake (MMC-RL) participated in various community building activities with the purpose to improve the health of the community, including addressing social determinates of health and health inequities. Some examples of community building activities included: Coalition Building Marshfield Medical Center-Rice Lake staff participated in more than ten different community coalitions and collaborations with the purpose of improving the health of the community. A list of coalitions and collaborations are listed in MMC-RL CHNA and IS documents on their main hospital website. Community Support Marshfield Medical Center-Rice Lake staff participated in community programs and events. Examples included: - Know Your Numbers and 50 Plus Events - Diabetes Prevention Program (DPP) - MMC-RL Health and Wellness Center - Free radiology and lab services to the Rice Lake Area Free Clinic Workforce Development Marshfield Medical Center-Rice Lake collaborated with area high schools to offer programs for high school students interested in medical careers as well as observational job experiences for high school graduates. MMC-RL functioned as a clinical site for student nurses, student nursing assistants, preceptors for healthcare jobs, and medical residents and interns.
Form 990 Sch H Part III Line 2BAD DEBT EXPENSE IS REPORTED AT COST USING A COST-TO-CHARGE RATIO.
Form 990 Sch H Part III Line 4Patient accounts receivable are reduced for explicit price concessions and by an allowance for uncollectible accounts as an implicit price concession. In evaluating the collectability of patients' accounts receivable, the System analyzes its past history and contractual terms and identifies trends for each of its major payor sources of revenue. For receivables associated with patients who have third-party coverage, the System analyzes contractually due amounts and provides an additional implicit discount, if necessary (i.e., for expected uncollectible deductibles and co-payments on accounts for which the third-party payor has not yet paid or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the System records an implicit discount 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. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance.
Form 990 Sch H Part III Line 8THE MEDICARE SHORTFALL ATTRIBUTED TO IDENTIFIED SUBSIDIZED HEALTH SERVICES ARE INCLUDED AS COMMUNITY BENEFIT IN THE CURRENT YEAR. THESE SERVICES INCLUDE AMBULANCE, HOME CARE AND HOSPICE AND DIALYSIS. THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE MEDICARE COST REPORT DO NOT FULLY CAPTURE THE ACTUAL COSTS OF PROVIDING THESE SERVICES THAT ARE ESSENTIAL TO VARIOUS UNDERSERVED POPULATIONS IN THE COMMUNITY.
Form 990 Sch H Part III Line 9bThe organization has a billing and collection policy which sets forth collection practices for patients who are known to be eligible or presumed to be eligible for financial assistance under the financial assistance policy. Multiple measures are taken to communicate the availability of financial assistance and determine whether a patient is financial assistance eligible before pursuing extraordinary collection actions (ECAs). ECAs may include: reporting to consumer credit reporting agencies, pursuing legal judgments, filing liens, garnishing wages, requiring prepayment for non-emergency services. ECAs will not be initiated and further action will not be taken on existing ECAs once a financial assistance application is in process. If the patient is determined financial assistance eligible, reasonable measures will be taken to reverse any ECA already in place.
Form 990 Sch H Part VI Line 2Marshfield Medical Center-Rice Lake assessed the health care needs of the communities by conducting standard CHNA practices, including: - Review of community partners reports (i.e. United Way) - Completion of key informant interviews with community leaders about the communitys health needs - Review of publicly available community health data (i.e. county health rankings) - Participation in community health committees and boards (i.e. Thrive Steering Committee)
Form 990 Sch H Part VI Line 3PATIENT ASSISTANCE CENTER COUNSELORS ASSIST INDIVIDUALS WITH IDENTIFYING, REFERRING AND/OR APPLYING FOR PUBLIC, PRIVATE OR CHARITABLE RESOURCES FOR WHICH THE PATIENT MAY QUALIFY. COUNSELORS ARE AVAILABLE VIA PHONE AND IN PERSON TO ASSIST INDIVIDUALS WITH FINANCIAL ASSISTANCE. INFORMATION ON THE MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) FINANCIAL ASSISTANCE POLICY IS POSTED IN HOSPITAL REGISTRATION AND ADMITTING LOCATIONS AND IN THE HOSPITAL EMERGENCY DEPARTMENT. FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON MONTHLY BILLING STATEMENTS AND INCORPORATED INTO OTHER COMMUNICATIONS IN ORDER TO WIDELY PUBLICIZE THE AVAILABILITY OF FINANCIAL ASSISTANCE, AS DESCRIBED IN THE MCHS BILLING AND COLLECTION POLICY. THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY ARE AVAILABLE IN ENGLISH, SPANISH, HMONG AND ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE SPOKEN BY THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE POPULATION OF THE SERVICE AREA. THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY MAY BE OBTAINED FREE OF CHARGE: ON THE HOSPITAL WEBSITE, IN PERSON, FROM FINANCIAL COUNSELORS, BY PHONE AND BY MAIL.
Form 990 Sch H Part VI Line 4Marshfield Medical Center-Rice Lake (MMC-RL) serves Barron County. Barron County is located in the Northern region of Wisconsin. The county is comprised of four cities (Barron, Chetek, Cumberland, and Rice Lake), six villages (Almena, Cameron, Dallas, Haugen, New Auburn, Prairie Farm, and Turtle Lake), and 25 townships with a total population of 45,164 and a population percent change of -1.5% in 2018. With 65.9% of Barron County residents living in a rural area. The county is bordered by Dunn, Chippewa, Rusk, Washburn, Burnett, and Polk counties. The racial make-up of Barron County is 93.3% Caucasian, 0.7% Asian, 2.6% Hispanic or Latino, 1.3% two or more races, 1.4% Black or African American, and 1.0% American Indian and Alaska Native. The median household income in Barron County is $49,257 compared to the state average of $56,759. The number of ALICE (Asset Limited, Income Constrained, Employed) households in Barron County is higher than the state average at 31% and 25.8% comparatively with the poverty rate of 13% which is higher than the state average of 11%. The unemployment rate in Barron County is 3.5% which is slightly higher than the state average of 3.3%. The education level of Barron County residents is lower than the statewide average. According to the latest census estimates, 90.6% of Barron residents have a high school diploma, compared to 91.7% statewide. Likewise, 19.5% of Barron residents have a Bachelors degree or higher, compared to 29% statewide.
Form 990 Sch H Part VI Line 5Marshfield Medical Center-Rice Lake (MMC-RL) furthered its exempt purpose by promoting the health of the community with the following: - Coordinated and hosted 50 Plus events, which are free wellness events for those over 50 years old and includes a variety of health screenings, community resources, and educational presentations. - Representation on the Community Connections to Prosperity (CCP) coalition. The mission of the coalition is to help individuals, organizations and agencies understand and deeply appreciate the immense power of poverty. - Representation and facilitation of the Mental Health Action Team (MHAT) developed from the CCP coalition. The mission of this action team is to educate and reduce stigma of mental illness, which will increase awareness and reduce the potentially debilitating consequences of mental illness (including poverty, substance abuse, homelessness and many chronic health conditions). - Offered free radiology and lab services to the Rice Lake Area Free Clinic, serving the underserved population in the area. - Offered community members the opportunity to exercise at the MMC-RL Health and Wellness Center while being supervised by medically trained staff. MMC-RL financially supported the operating cost as expenses exceed revenue. - Provided free monthly blood pressure screenings to community members. - Offered the National Diabetes Prevention Program (DPP).
Form 990 Sch H Part VI Line 6Marshfield Clinic was founded in 1916 by six physicians practicing in Marshfield, a rural central Wisconsin city. At its inception, Clinic founders saw research and education as critical to their practice of health care and that remains so today. The Clinic became a 501(c)(3) nonprofit organization in 1992 and in 2014, Marshfield Clinic Health System, Inc. (MCHS) was formed. The health systems mission is to enrich lives and create healthy communities through accessible, affordable, compassionate health care. The health system today is an integrated system serving Wisconsin and beyond, with more than 10,000 employees including over 1,200 providers in 86 specialties. MCHS and its affiliated entities provide service and health care to more than two million residents through over 50 clinical care centers in 34 Wisconsin communities. Unique to MCHS is its Center for Community Health Advancement (CCHA), which builds bridges between the healthcare system and the places in the community where people live, work and play. CCHA works with coalitions, businesses, educational systems, law enforcement agencies, tribal nations, local governments, and other healthcare providers, nonprofit organizations and other entities to improve community health. CCHA includes Marshfield Medical Center-Rice Lake staff who are closely involved in the Community Health Needs Assessment (CHNA) and Implementation Strategy in Barron County. This helps to align community health priorities identified in the CHNA with health system priorities. Marshfield Clinic Health System (MCHS) deeply believes in promoting community health through building and sustaining strong internal and external partnerships and collaborations. For this reason, MCHS and its affiliated entities work together internally and externally with community partners, stakeholders and residents to improve community health.

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 CareGrantTypeTxt
Recipient105RecipientCnt
Cash Grant$1,310,967CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Sch I Part I Line 2FormAndLineReferenceDesc
ExplanationMarshfield Clinic Health System (including Lakeview Medical Center Inc.) provides emergency and medically necessary health care services for free or at discounted rates to patients who meet certain eligibility criteria. Patients seeking financial assistance apply by completing a financial assistance application. Free care is available for patients with income and excess asset values at or below 200% of the Federal Poverty Guidelines.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsYes (true)CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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
Tom Lundquist MD
Board Member$0$209,061$0$9,761$0$4,362$0$29,497$0$25,534$0$278,215$0$0
Scott Polenz
Board Member$0$257,715$0$0$0$5,982$0$29,497$0$24,143$0$317,337$0$0
Neelakantan Namboodiri MD
Board Member$0$344,222$0$0$0$17,328$0$29,497$0$20,809$0$411,856$0$0
Bradley Groseth
Chief Admin Officer$0$289,116$0$7,500$0$630$0$2,080$0$31,339$0$330,665$0$0
Narayana Murali MD
MCHS Chief Strategy Officer$0$720,583$0$112,500$0$21,632$0$29,497$0$28,594$0$912,806$0$0
Jerard Jensen
MCHS General Counsel$0$741,937$0$112,500$0$19,789$0$29,497$0$26,636$0$930,359$0$0
Gordon Edwards
MCHS CFO/COO$0$570,052$0$90,000$0$42,207$0$29,497$0$29,848$0$761,604$0$0
Susan Turney MD
MCHS CEO$0$1,686,332$0$510,000$0$258,560$0$270,897$0$22,398$0$2,748,187$0$154,255
Ned Wolf
Former LMC CEO$0$333,897$0$0$0$32,949$0$29,497$0$30,543$0$426,886$0$0
Cindy Arts-Strenke
Former LMC COO$0$201,186$0$0$0$1,290$0$29,007$0$19,614$0$251,097$0$0
Daniel Ramsey
Former MCHS COO$0-$456$0$0$0$557,469$0$0$0$456$0$557,469$0$0
Steven Kulick
Chief Experience Officer$0$216,878$0$0$0$8,702$0$1,769$0$9,678$0$237,027$0$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Sch J Part I Line 1aTHE ORGANIZATION MAY OCCASIONALLY REIMBURSE OR PROVIDE A HOUSING ALLOWANCE FOR KEY EXECUTIVES IN ORDER TO ASSIST WITH RELOCATING TO THE AREA. THE ORGANIZATION MAY ALSO CONTRIBUTE TO OR REIMBURSE FOR HEALTH AND SOCIAL CLUB DUES AS DEEMED NECESSARY IN ORDER TO SUPPORT A BUSINESS NEED.
Form 990 Sch J Part I Line 3THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS.
Form 990 Sch J Part I Line 4aSEVERANCE DANIEL RAMSEY - $557,469
Form 990 Sch J Part I Line 4b457(F) PLAN SUSAN TURNEY, MD - $165,215
Form 990 Sch J Part I Line 5a & 5bSEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS.
Form 990 Sch J Part I Line 6a & 6bSEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Part IV Line 4Marshfield Clinic Health System (including Lakeview Medical Center Inc.) is a member of various healthcare associations (i.e. Wisconsin Hospital Association) that may perform some lobbying activity. All associated dues are disclosed on the Form 990 of Marshfield Clinic Health System, Inc. Form 990 Part V Line 2 ALL PERSONNEL SERVICES FOR LAKEVIEW MEDICAL CENTER, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. ALL PHYSICIAN SERVICES FOR LAKEVIEW MEDICAL CENTER, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC, INC. Form 990 Part VI Line 6 MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE.
Form 990 Part VI Line 7aMARSHFIELD CLINIC HEALTH SYSTEM, INC. (AS THE SOLE MEMBER) HAS THE AUTHORITY TO APPOINT MAJORITY OF THE CORPORATE BOARD MEMBERS AND APPROVE THE PUBLIC DIRECTORS OF LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE.
Form 990 Part VI Line 7bMARSHFIELD CLINIC HEALTH SYSTEM, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE. Marshfield Clinic Health System, Inc. (the sole member) has the right to initiate and approve long-term borrowing and other forms of long-term indebtedness, initiate and approve the purchase, sale or encumbrance of real and personal property and approve or disapprove annual operating and capital budgets. MARSHFIELD CLINIC HEALTH SYSTEM, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION.
Form 990 Part VI Line 11bMARSHFIELD CLINIC HEALTH SYSTEM, INC. ENGAGES A PUBLIC ACCOUNTING FIRM TO PREPARE AND REVIEW THE FORM 990 IN ADDITION TO REVIEW BY THE SYSTEM CFO, VP OF FINANCE AND CONTROLLER. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETE FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW.
Form 990 Part VI Line 12cALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990.
Form 990 Part VI Line 15a & 15bTHE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO THE COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION.
Form 990 Part VI Line 19LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE 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 X Line 20 Lakeview Medical Center Inc. is part of the Marshfield Clinic Health System obligated group. Since the obligated group is responsible for all outstanding financed debt obligations, all bond related reporting is disclosed on the Form 990 of Marshfield Clinic Health System Inc.
Form 990 Part XI Line 9OTHER CHANGES IN NET ASSETS NET ASSET TRANSFERS WTIH RELATED ORGS: ($1,657,000) --------------------------------------------------- TOTAL OTHER CHANGES IN NET ASSETS: ($1,657,000)

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
MARSHFIELD CLINIC INC
1000 N OAK AVEMARSHFIELDWI54449390452970Medical SvcsWI501(C)(3)3MCHSfalse
VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL
1700 W STOUT STRICE LAKEWI54868391329084SUPPORT ORGWI501(C)(3)12-TYPE IIINAfalse
SECURITY HEALTH PLAN OF WISCONSIN INC
1515 N ST JOSEPH AVEMARSHFIELDWI54449391572880HMOWI501(C)(4)N/AMCHSfalse
FLAMBEAU HOSPITAL INC
98 SHERRY AVEPARK FALLSWI54552390973724HOSPITALWI501(C)(3)3NAfalse
MARSHFIELD CLINIC HEALTH SYSTEM INC
1000 N OAK AVEMARSHFIELDWI54449461495343HOSPITALWI501(C)(3)12 TYPE IIINAfalse
FAMILY HEALTH CENTER OF MARSHFIELD INC
1000 N OAK AVEMARSHFIELDWI54449391681547COM HLTH CTRWI501(C)(3)7NAfalse
MCHS HOSPITALS INC
1000 N OAK AVEMARSHFIELDWI54449810977948HOSPITALWI501(C)(3)3MCHSfalse
MCHS FOUNDATION INC
1000 N OAK AVEMARSHFIELDWI54449812822823PHILANTHROPYWI501(C)(3)7NAfalse
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
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 OrgfalseAssetPurchaseFromOtherOrgInd
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 OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Sch RFormAndLineReferenceDesc
ExplanationMARSHFIELD CLINIC HEALTH SYSTEM, INC. (A 501(C)(3) ORGANIZATION), IS THE PARENT ORGANIZATION OF LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE. THE FOLLOWING COMPANIES ARE RELATED TO LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE THROUGH BROTHER/SISTER RELATIONSHIPS DUE TO A COMMON PARENT ORGANIZATION: MARSHFIELD CLINIC, INC. SECURITY HEALTH PLAN OF WISCONSIN, INC. FLAMBEAU HOSPITAL, INC. MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. MCHS HOSPITALS, INC.ExplanationTxt