FURP.ORG / PUBLIC DATA EXPLORER

BURNETT MEDICAL CENTER INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
BURNETT MEDICAL CENTER INC (EIN 39-0938661)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-08-06
IRS object ID
201932189349301153
Schema version
2017v2.3
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)
Return2019-08-06T13:23:56-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14890 OWEN AYRES COURT SUITE 200AddressLine1Txt
CityEAU CLAIRECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390938661EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BURNETT MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBURNBusinessNameControlTxt
Phone7154635353PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1257 WEST SAINT GEORGE AVENUEAddressLine1Txt
CityGRANTSBURGCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGORDON LEWISPersonNm
Person TitleCEOPersonTitleTxt
Phone7154635353PhoneNum
Signature2019-08-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHOLLY POKRANDT CPAPreparerPersonNm
PTINP00449155PTIN
Phone7158323407PhoneNum
Preparation2019-08-02PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address137.26.200.211IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-08-02IPDt
IP Tm10:09:53IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id797C4F87573F66E072DA29449866580050F7B08BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGORDON LEWISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1257 WEST SAINT GEORGE AVENUEAddressLine1Txt
CityGRANTSBURGCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$21,603,632GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BURNETTMEDICALCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE MISSION OF BURNETT MEDICAL CENTER IS TO PROVIDE COMPASSIONATE, COMPREHENSIVE, COMMUNITY HEALTHCARE THAT EXCEEDS OUR CUSTOMER'S EXPECTATIONS. OUR MISSION, AS WELL AS OUR VISION AND VALUES, SERVES AS A GUIDELINE FOR DAILY DECISION MAKING AND REPRESENTS THE PRINCIPLES AND PRACTICES THAT WE CONSTANTLY APPLY. THE COMFORT AND CARE OF OUR PATIENTS IS A MAJOR FOCUS OF OURS. WE WANT TO BE THE HEALTHCARE PROVIDER OF "CHOICE" - PROVIDING EXPERT AND COST EFFECTIVE CARE IN A "HOMETOWN" ATMOSPHERE. ANOTHER OBJECTIVE OF OURS IS TO PROVIDE EDUCATION THAT WILL INCREASE HEALTH AWARENESS. PART OF OUR MISSION IS TO CONTINUALLY PUT THE "CARE" IN HEALTHCARE. MORE HEALTHCARE INFORMATION IS NOW AVAILABLE FROM OUR WEBSITE, WHICH ALSO PROVIDES PATIENT EDUCATION RESOURCES FOR THOSE WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee275TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$1,630CYContributionsGrantsAmt
PY Program Service Revenue$20,111,163PYProgramServiceRevenueAmt
CY Program Service Revenue$20,874,707CYProgramServiceRevenueAmt
PY Investment Income$41,140PYInvestmentIncomeAmt
CY Investment Income$30,453CYInvestmentIncomeAmt
PY Other Revenue$35,897PYOtherRevenueAmt
CY Other Revenue$25,672CYOtherRevenueAmt
PY Total Revenue$20,188,200PYTotalRevenueAmt
CY Total Revenue$20,932,462CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,249,450PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,699,074CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,541,556PYOtherExpensesAmt
CY Other Expenses$9,581,661CYOtherExpensesAmt
PY Total Expenses$20,791,006PYTotalExpensesAmt
CY Total Expenses$21,280,735CYTotalExpensesAmt
PY Revenues Less Expenses-$602,806PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$348,273CYRevenuesLessExpensesAmt
Total Assets BOY$18,524,441TotalAssetsBOYAmt
Total Assets EOY$17,883,943TotalAssetsEOYAmt
Total Liabilities BOY$14,106,511TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,855,049TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,417,930NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,028,894NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF BURNETT MEDICAL CENTER IS TO PROVIDE COMPASSIONATE, COMPREHENSIVE, COMMUNITY HEALTHCARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$12,058,928ExpenseAmt
Grant$0GrantAmt
Revenue$15,246,883RevenueAmt
DescHOSPITAL - BURNETT MEDICAL CENTER, LOCATED IN RURAL NORTHWEST WISCONSIN IS A 17 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES THE FOLLOWING SERVICES THROUGHOUT A THREE COUNTY REGION: ACUTE CARE HAS 50+ EMPLOYEES WHO ALSO WORK IN OB, OR, ER, AND PAR. WE PROVIDE GENERAL INPATIENT MEDICAL AND SURGICAL CARE, AS WELL AS A LARGE VOLUME OF OUTPATIENT SERVICES WHICH INCLUDE: OP SURGERY, CHEMOTHERAPY, BLOOD TRANSFUSION, IV THERAPY AS EXAMPLES. ALL OF THE RN STAFF IS ACLS ACCREDITED AND THE ENTIRE STAFF IS CERTIFIED IN CPR. THE GOAL OF THE NURSING STAFF IS TO PROVIDE EXCELLENT PATIENT CARE, CLOSE TO HOME, NEAR FAMILY AND FRIENDS. WE ALSO PROVIDE A FULL RANGE OF SERVICES FROM A 24/7 ER TO CARDIAC REHAB, AND WE PROVIDE OTHER THERAPEUTIC AND DIAGNOSTIC SERVICES VIA RADIOLOGY, LAB, PHYSICAL THERAPY, AND OCCUPATIONAL THERAPY. DURING FY2018 IN A TOTAL OF 1270 PATIENT DAYS WE SERVED 344 PATIENTS IN OUR INPATIENT AND SWING BED PROGRAMS. WE PERFORMED 457 SURGICAL PROCEDURES, SAW 4,090 PATIENTS IN EMERGENCY AND URGENT CARE, AND PROVIDED SERVICES FOR OVER 12,000 OTHER OUTPATIENT VISITS. GROSS HOSPITAL REVENUE OF $31,560 WAS PROVIDED AS CHARITY CARE TO 14 DIFFERENT PATIENTS FOR 64 EPISODES OF CARE. SINCE JUNE OF 2004, BURNETT MEDICAL CENTER HAS BEEN PARTICIPATING IN A PROGRAM DEVELOPED BY ABBOTT NORTHWESTERN HOSPITAL AND THE MINNEAPOLIS HEART INSTITUTE. THE LEVEL 1 HEART ATTACK PROGRAM IS AN INNOVATIVE APPROACH TO TREATING PATIENTS SUFFERING FROM A HEART ATTACK. THE KEY INGREDIENT FOR SUCCESS IS SPEED IN TREATMENT. THE GOAL IS TO TREAT AND TRANSPORT PATIENTS WITHIN 120 MINUTES, MEANING 120 MINUTES FROM THE TIME A PATIENT ENTERS THE EMERGENCY ROOM AT BURNETT MEDICAL CENTER UNTIL THE FIRST BALLOON IS INFLATED OR STENT PLACED AT ABBOTT NORTHWESTERN HOSPITAL (ABNW).BECAUSE RURAL HOSPITALS DO NOT HAVE THE CAPABILITY TO DO ANGIOPLASTY, IT IS IMPORTANT TO MOVE A HEART ATTACK PATIENT TO THE NEAREST HOSPITAL THAT HAS A HEART CATHETERIZATION LAB. THE LEVEL 1 PROGRAM HAS A DEFINITE PROTOCOL TO MOVE THESE PATIENTS QUICKLY DURING THAT "GOLDEN HOUR" WHEN ANGIOPLASTY IS THE MOST SUCCESSFUL.BURNETT MEDICAL CENTER IS ONE OF 30 HOSPITALS IN MINNESOTA AND WISCONSIN PARTICIPATING IN THE LEVEL 1 PROGRAM. CLEARLY, THE LEVEL 1 PROGRAM IS ADVANTAGEOUS TO RESIDENTS OF BURNETT COUNTY, KNOWING THAT CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH FOR MEN AND WOMEN IN THE US. THIS TEAM APPROACH GIVES PATIENTS THE ADVANTAGE OF TIME WHICH TRANSLATES TO BETTER OUTCOMES AND DECREASED MORTALITY. BURNETT MEDICAL CENTER'S MEDICAL AND NURSING STAFF HAVE BEEN TRAINED FOR THIS PROGRAM AND ARE PREPARED AND PLEASED TO PROVIDE QUICK ACCESS TO EFFICIENT CARDIAC CARE THROUGH THE LEVEL 1 HEART ATTACK PROGRAM.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,022,727ExpenseAmt
Grant$0GrantAmt
Revenue$2,911,447RevenueAmt
DescCONTINUING CARE - THE CONTINUING CARE CENTER OF BURNETT MEDICAL CENTER OFFERS 46 SEMI-PRIVATE AND 4 PRIVATE ROOM ACCOMMODATIONS AND A FULL RANGE OF HEALTH AND PERSONAL CARE SERVICES. PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY ARE AVAILABLE, AS WELL AS NUTRITIONAL SERVICES, RECREATIONAL ACTIVITIES, AND SOCIAL SERVICES. ADDITIONALLY, ADULT DAY CARE AND RESPITE CARE IS AVAILABLE. THE GOAL OF THE CONTINUING CARE CENTER'S STAFF IS TO PROVIDE NECESSARY HEALTH SERVICES WHILE MAINTAINING AN ATMOSPHERE OF HOPE, HARMONY, HUMOR, AND A "HOME" AWAY FROM HOME.WE STRIVE TO ENHANCE THE QUALITY OF RESIDENTS' LIFE VIA A VENUE FOR COMMUNITY-BASED VOLUNTEERS SHARING THEIR TIME AND TALENT WITH OUR RESIDENTS, SUCH AS MUSICAL BANDS, ROTARY CLUB SPONSORED FUNCTIONS, ETC.DURING FY 2018 WE HAD 13,686 RESIDENT DAYS SERVING ABOUT 100 DIFFERENT RESIDENTS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,467,820ExpenseAmt
Grant$0GrantAmt
Revenue$2,695,704RevenueAmt
DescCLINIC - BURNETT MEDICAL CENTER CLINIC IS LOCATED JUST OFF HIGHWAY 70 IN GRANTSBURG AND IS PART OF OUR EXPANDED FACILITY. THE CLINIC IS STAFFED BY 21 EMPLOYEES INCLUDING (3) PHYSICIANS, (3) CERTIFIED NURSE PRACTITIONERS, AND (1) CERTIFIED NURSE MIDWIFE. SERVED SPECIALISTS INCLUDING A GENERAL SURGEON, A PULMONOLOGIST, AN INTERNAL MEDICINE PHYSICIAN AND OTHERS ALL SEE PATIENTS IN THE CLINIC. WE ARE PLEASED TO OFFER OUR PATIENTS A RANGE OF SERVICES INCLUDING: PHYSICALS (INCLUDING WELL CHILD CHECKS, PRE-OPERATIVE, DOT, ETC.), OBSTETRICAL EXAMS, HEALTH STATUS ASSESSMENTS, DIAGNOSIS AND TREATMENT OF COMMON, ACUTE AND CHRONIC HEALTH CONDITIONS, IMMUNIZATIONS, FAMILY PLANNING, DIABETIC EDUCATION, WOMEN'S HEALTH, COLONOSCOPY PROCEDURES, FRACTURE CARE, VASECTOMIES, ROUTINE LABORATORY TESTING, EKG'S, AND HOLTER MONITORING. ADDITIONALLY, THE CLINIC LABORATORY IS A CERTIFIED COLLECTION SITE FOR URINE DRUG SCREENING.HOURS OF OPERATION HAVE BEEN EXPANDED TO ALLOW PEOPLE INCREASED ACCESS, INCLUDING WORKING FAMILIES WITH SCHOOL-AGE CHILDREN, PEOPLE THAT WORK VARYING SHIFTS, ETC. OUR PROVIDERS HAVE COLLABORATIVE RELATIONSHIPS WITH AREA INDUSTRIES, INCLUDING THE LOCAL SCHOOL SYSTEMS. THIS ALLOWS BURNETT MEDICAL CENTER TO PROVIDE EDUCATIONAL OPPORTUNITIES TO EMPLOYEES OF THESE INDUSTRIES, INCLUDING BLOODBORNE PATHOGENS TRAINING, HEALTH EDUCATION TO SCHOOL CHILDREN, AND PARTICIPATION IN EMPLOYEE HEALTH FAIRS. BMC PROVIDERS PARTICIPATE IN THE LOCAL ROTARY GROUP AND IN COUNTY COALITIONS TO REDUCE PRESCRIPTION DRUG ABUSE AND IMPROVE AWARENESS OF WELLNESS ACTIVITIES IN THE AREA. WE ALSO SPONSOR AN ANNUAL 5K/10K, AND KID-FRIENDLY 100 YARD EVENT THAT RAISES FUNDS FOR A LOCAL CHARITY WHILE PROMOTING HEALTHY LIFESTYLESTHIS YEAR IS OUR 13TH ANNUAL! OVER 12,000 PRIMARY CARE CLINIC VISITS WERE PROVIDED DURING FY 2018. CLINIC GROSS REVENUE OF $1,490 WAS PROVIDED AS CHARITY CARE TO 10 DIFFERENT PATIENTS IN 53 VISITS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$18,549,475TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee275EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGORDON LEWISPersonNm
Phone7154635353PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1257 WEST SAINT GEORGE AVEAddressLine1Txt
CityGRANTSBURGCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
RANDY CAREY
DIRECTOR0.50Yes (X)$0$0$0
DAN DOWLING
DIRECTOR0.50Yes (X)$0$0$0
JULIE FIEDLER
DIRECTOR0.50Yes (X)$0$0$0
CHRIS SYBERS
DIRECTOR0.50Yes (X)$0$0$0
PATRICK TAYLOR
PRESIDENT0.50Yes (X)$0$0$0Yes (X)
RYAN BENSON
VICE PRESIDENT0.50Yes (X)$0$0$0Yes (X)
KATHRYN PALMQUIST
SECRETARY/TREASURER (THRU JANUARY)0.50Yes (X)$0$0$0Yes (X)
STEVEN MCNALLY
SECRETARY/TREASURER0.50Yes (X)$0$0$0Yes (X)
GORDON LEWIS
CEO40.00$176,229$0$2,747Yes (X)
CHARLES FAUGHT
CFO40.00$115,618$0$26,874Yes (X)
TIMOTHY NOVICK
PHYSICIAN36.00$299,608$0$27,847Yes (X)
JULIE ANDERSSON
PHYSICIAN'S ASSISTANT40.00$167,230$0$27,803Yes (X)
PATRICIA DOOLEY EID
NURSE PRACTITIONER36.00$155,116$0$17,742Yes (X)
MELINDA DEYE
NURSE PRACTITIONER32.00$147,061$0$1,965Yes (X)
MARK THAYER
PHYSICIAN40.00$128,833$0$28,732Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,189,695TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$133,710TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WOOD RIVER ANESTHESIA ASSOC LLC
1658 NILES AVESAINT PAULMN55116ANESTHESIA$450,000
DR BLAISE VITALE MD SC
22592 ASSEMBLY DRIVEGRANTSBURGWI54840CLINIC AND ER ROOM PHYSICIAN$335,659
SURGERY CLINIC OF SPOONER
N6142 LITTLE VL ROADSPOONERWI54801SURGICAL SERVICES$127,500
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$1,630AllOtherContributionsAmt
Total Contributions$1,630TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
HOSPITAL PATIENT SERVICE REVENUE621990$15,194,126$15,194,126
NURSING HOME RESIDENT SERVICE REV623000$2,911,447$2,911,447
CLINIC PATIENT SERVICE REVNUE621110$2,695,622$2,695,622
MISCELLANEOUS REVENUE900099$52,839$52,839
CAFETERIA REVENUE900099$20,673$20,673
FieldValueIRS element (for citing)
Total Program Service Revenue$20,874,707TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,922TotalRevenueColumnAmt
Exclusion$49,922ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$25,672RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$25,672RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,672TotalRevenueColumnAmt
Exclusion$25,672ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$651,701SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$671,170SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$19,469SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$19,469TotalRevenueColumnAmt
Exclusion-$19,469ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,932,462TotalRevenueColumnAmt
Related Or Exempt Func Income$20,854,034RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$76,798ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$321,468TotalAmt
Management And General$321,468ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,836,031TotalAmt
Program Services$7,710,480ProgramServicesAmt
Management And General$1,125,551ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,905,994TotalAmt
Program Services$1,645,306ProgramServicesAmt
Management And General$260,688ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$635,581TotalAmt
Program Services$540,104ProgramServicesAmt
Management And General$95,477ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,945TotalAmt
Management And General$9,945ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$62,300TotalAmt
Management And General$62,300ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,280,344TotalAmt
Program Services$2,983,096ProgramServicesAmt
Management And General$297,248ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$79,974TotalAmt
Management And General$79,974ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$213,844TotalAmt
Program Services$68,049ProgramServicesAmt
Management And General$145,795ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$85,581TotalAmt
Management And General$85,581ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$952,698TotalAmt
Program Services$892,335ProgramServicesAmt
Management And General$60,363ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$130,906TotalAmt
Program Services$116,922ProgramServicesAmt
Management And General$13,984ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,108,281TotalAmt
Program Services$1,108,281ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$88,749TotalAmt
Management And General$88,749ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,276,363$1,276,363
BAD DEBT EXPENSE$1,030,479$1,030,479
REPAIRS & MAINTENANCE$628,674$570,783$57,891
MINOR EQUIPMENT$436,196$432,912$3,284

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$197,327TotalAmt
Program Services$174,365ProgramServicesAmt
Management And General$22,962ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,280,735TotalAmt
Program Services$18,549,475ProgramServicesAmt
Management And General$2,731,260ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$250BOYAmt
EOY$83,199EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$981,255BOYAmt
EOY$1,086,806EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,777,539BOYAmt
EOY$3,732,388EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$410,439BOYAmt
EOY$370,706EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$281,384BOYAmt
EOY$80,038EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$27,945,086LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$18,182,261LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,756,506BOYAmt
EOY$9,762,825EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,980,189BOYAmt
EOY$2,711,310EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$336,879BOYAmt
EOY$56,671EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,524,441BOYAmt
EOY$17,883,943EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,298,456BOYAmt
EOY$1,588,139EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,375,172BOYAmt
EOY$11,775,982EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$432,883BOYAmt
EOY$490,928EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,106,511BOYAmt
EOY$13,855,049EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,387,640BOYAmt
EOY$3,996,359EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,290BOYAmt
EOY$32,535EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,417,930BOYAmt
EOY$4,028,894EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,524,441BOYAmt
EOY$17,883,943EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$348,273ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$54,420NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$13,657OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,224OtherActivitiesAmt
Total Lobbying Expenditures$3,224TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationBURNETT MEDICAL CENTER, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND DEVELOPMENT. THE AHA AND WHA HAVE NOTIFIED BURNETT MEDICAL CENTER, INC. THAT $3,224 ($2,214 TO AHA AND $1,009 TO WHA) OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,000OtherCostOrOtherBasisAmt
Book Value$50,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,066,173OtherCostOrOtherBasisAmt
Depreciation$11,245,265DepreciationAmt
Book Value$8,820,908BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,828,913OtherCostOrOtherBasisAmt
Depreciation$6,936,996DepreciationAmt
Book Value$891,917BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,762,825TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
Desc457(B) PLAN PAYABLEDesc
Amt$490,928Amt
FieldValueIRS element (for citing)
Total Liability$490,928TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$19,901,983TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$1,030,479OtherRevenueAmt
Revenue Not Reported-$1,030,479RevenueNotReportedAmt
Revenue Subtotal$20,932,462RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,932,462TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,250,256TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$20,250,256ExpensesSubtotalAmt
Other Expenses Not Included$1,030,479OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,030,479ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,280,735TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE -1,030,479.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 1,030,479.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,751TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,751NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,593,511TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,467,050DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,126,461NetCommunityBenefitExpnsAmt
Total Expense0.05560TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,613,262TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,467,050DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,146,212NetCommunityBenefitExpnsAmt
Total Expense0.05660TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,374TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,374NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,883,699TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,335,369DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,548,330NetCommunityBenefitExpnsAmt
Total Expense0.07650TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,752TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,408DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,344NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,893,825TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,338,777DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,555,048NetCommunityBenefitExpnsAmt
Total Expense0.07690TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,507,087TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,805,827DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,701,260NetCommunityBenefitExpnsAmt
Total Expense0.13350TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$572,422BadDebtExpenseAmt
Bad Debt Expense Attributable$286,211BadDebtExpenseAttributableAmt
Reimbursed By Medicare$7,371,407ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,510,351CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$138,944MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BURNETT MEDICAL CENTER INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1257 WEST SAINT GEORGE AVENUEAddressLine1Txt
CityGRANTSBURGCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54840ZIPCd
FieldValueIRS element (for citing)
State License1034StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BURNETT MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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 Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.BURNETTMEDICALCENTER.COM/GETPAGE.PHP?NAME=HEALTH_NEEDS_ASSESSMENOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.HEALTHYBURNETT.ORGOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.BURNETTMEDICALCENTER.COM/DOCS/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_2016.PDStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.BURNETTMEDICALCENTER.COMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.BURNETTMEDICALCENTER.COMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.BURNETTMEDICALCENTER.COM/GETPAGE.PHP?NAME=FINANCIAL_ASSISTANCE_PFAPSummaryOnWebsiteURLTxt
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
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
BURNETT MEDICAL CENTER, INC.PART V, SECTION B, LINE 5: THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, SPECIAL ATTENTION WAS FOCUSED ON UNDERSTANDING THE NEEDS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. TO ACHIEVE THIS, EFFORTS WERE MADE TO ENGAGE AND GATHER INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SERVED. THIS WAS ACCOMPLISHED IN THE FOLLOWING CAPACITIES:1. CHNA CORE PARTNERS: AS THE PRIMARY DRIVERS OF THE PROCESS, FACILITATORS OF THE CHNA FROM BURNETT MEDICAL CENTER, BURNETT COUNTY DHHS-PUBLIC HEALTH, AND THE ST. CROIX TRIBAL HEALTH CLINIC, EACH BROUGHT KNOWLEDGE OF THEIR POPULATION SERVED, THEIR NEEDS, AND RESOURCES CURRENTLY AVAILABLE TO ADDRESS THOSE NEEDS. CORE PARTNERS ARE ALSO ACTIVELY INVOLVED IN OTHER COMMUNITY HEALTH-RELATED GROUPS AND CONVEYED INPUT REGARDING THE HEALTH NEEDS OF THE GROUPS' RESPECTIVE TARGET POPULATIONS THROUGHOUT THE PROCESS.2. PILOT COMMUNITY OF WISCONSIN CHIPP INFRASTRUCTURE IMPROVEMENT PROJECT: CHNA PARTNERS TOOK INTO ACCOUNT INPUT FROM STATE AND REGIONAL HEALTH DEPARTMENTS IN PLANNING AND EXECUTING THE CHNA. TOOLS CREATED BY THE HEALTH EDUCATORS AT THE WISCONSIN WESTERN REGION DIVISION OF PUBLIC HEALTH PROVIDED INPUT ON DATA SOURCES TO UTILIZE IN THE ASSESSMENT, HOW TO ANALYZE THE DATA SOURCES TO IDENTIFY SIGNIFICANT HEALTH NEEDS, AND HOW TO EXECUTE THE PROCESS FOR PRIORITIZING SIGNIFICANT HEALTH NEEDS.3. FOCUS GROUPS AND KEY INFORMANT INTERVIEW: FOCUS GROUPS WERE CONDUCTED WITH MEDICAL PROVIDERS AT BURNETT MEDICAL CENTER-ONE BEING THE MEDICAL DIRECTOR FOR THE BURNETT COUNTY HEALTH DEPARTMENT-THE BURNETT COUNTY FAMILY RESOURCE CENTER, AND THE GRANTSBURG AND SIREN/WEBSTER ROTARY CLUBS. THE KEY INFORMANT INTERVIEW WAS COMPLETED WITH A GRANTSBURG SCHOOL DISTRICT PRINCIPAL. QUESTIONS ASKED IN EACH WERE DESIGNATED TO GATHER INPUT ON WHAT PARTICIPANTS FELT TO BE THE BIGGEST ASSETS AND HEALTH CONCERNS AMONG BURNETT COUNTY RESIDENTS.4. SURVEY: GREAT EFFORT WAS MADE TO GATHER INPUT FROM MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS THROUGH THE SURVEY. DEMOGRAPHIC QUESTIONS-ABOUT INCOME, INSURANCE TYPE, AND RACE/ETHNICITY, AMONG OTHERS-WERE ASKED IN ORDER TO IDENTIFY MEMBERS OF THOSE POPULATIONS AND THUS ENSURE THEIR REPRESENTATION. THE SURVEYS WERE DISTRIBUTED TO VARIOUS LOCATIONS AND GROUPS OF PEOPLE THROUGHOUT BURNETT COUNTY. THE SURVEY INSTRUMENT ASKED RESPONDENTS TO IDENTIFY WHAT THEY PERCEIVED TO BE THE BIGGEST HEALTH PROBLEMS AND RISKY BEHAVIORS AMONG BURNETT COUNTY RESIDENTS.5. COMMUNITY HEALTH MEETING: FINALLY, IN DISCUSSING AND PRIORITIZING THE SIGNIFICANT HEALTH NEEDS IDENTIFIED AT THE COMMUNITY HEALTH MEETING FACILITATED BY CHNA PARTNERS, INPUT WAS GATHERED FROM PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, AND OTHER INDIVIDUALS WHO SERVE UNDERSERVED GROUPS.
BURNETT MEDICAL CENTER, INC.PART V, SECTION B, LINE 6B: BURNETT COUNTY DHHS-PUBLIC HEALTHST CROIX TRIBAL HEALTH CLINIC
BURNETT MEDICAL CENTER, INC.PART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT:HTTP://WWW.BURNETTMEDICALCENTER.COM/DOCS/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_2016.PDF
BURNETT MEDICAL CENTER, INC.PART V, SECTION B, LINE 11: IN RESPONSE TO THE NEW REQUIREMENTS UNDER THE AFFORDABLE CARE ACT, BURNETT MEDICAL CENTER, IN PARTNERSHIP WITH THE BURNETT COUNTY PUBLIC HEALTH OFFICE, JOINTLY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH HAS BEEN HIGHLIGHTED IN OUR PREVIOUS 990H SUBMISSIONS. AS A RESULT OF THIS PARTNERSHIP, WE, ALONG WITH MANY PUBLIC AND PRIVATE HEALTHCARE INTERESTS, WORK COLLABORATIVELY VIA THE FORMATION OF HEALTHY BURNETT, AN ENTERPRISE THAT SEEKS AND WELCOMES OTHER COMMUNITY MEMBERS AND ORGANIZATIONS TO WORK TOGETHER IN ADDRESSING THE MOST COMPELLING NEEDS IDENTIFIED VIA THE CHNA. FOR THE CURRENT REPORTING PERIOD, THE THREE MOST SIGNIFICANT HEALTH NEEDS IDENTIFIED THAT BURNETT MEDICAL CENTER AND HEALTHY BURNETT ARE ADDRESSING ARE: 1) ALCOHOL AND OTHER DRUG ABUSE (AODA) BURNETT MEDICAL CENTER (BMC) SEEKS TO IMPROVE ACCESS TO COUNSELING BY KEEPING AN UPDATED LIST OF AODA COUNSELING SERVICES AND COLLABORATING WITH AODA STAKEHOLDERS TO ASSIST THE COMMUNITY IN EARLY REFERRAL AND POTENTIAL TREATMENT. BMC WILL DECREASE THE INCIDENTS OF PERINATAL DRUG USE AND ITS IMPACT ON NEWBORNS BY SCREENING ALL WOMEN OF CHILD BEARING AGE FOR ALCOHOL AND OTHER DRUG USE AND APPROPRIATELY COUNSEL ON THE IMPORTANCE OF ABSTINENCE. BMC WILL ALSO PROVIDE EDUCATION AND PROMOTION OF CURRENT RESOURCES THROUGH EVENTS AND USE OF SOCIAL MEDIA.2) BEHAVIORAL HEALTH BURNETT MEDICAL CENTER (BMC) WILL IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES BY WORKING TOWARDS OFFERING ADULT PSYCHIATRIC SERVICES VIA TELEMEDICINE WITH THE POTENTIAL OF ADDING PEDIATRIC/ADOLESCENT TELEPSYCHIATRY SERVICES IN FUTURE. BMC WILL PROMOTE AWARENESS OF BEHAVIORAL HEALTH SERVICES BY HAVING THE "BEHAVIORAL HEALTH PROVIDERS" BROCHURES READILY AVAILABLE THROUGHOUT THE FACILITY AS WELL AS THRU EVENTS AND USE OF SOCIAL MEDIA.3) TOBACCO USE AND EXPOSURE BURNETT MEDICAL CENTER (BMC) WILL EDUCATE PATIENTS ON THE IMPORTANCE OF TOBACCO ABSTINENCE/CESSATION THROUGH COUNSELING AND PROMOTION OF THE WISCONSIN TOBACCO QUIT LINE. BMC WILL PROVIDE EDUCATION TO COMMUNITY ADOLESCENTS ON THE IMPORTANCE OF TOBACCO ABSTINENCE AT AN AGE APPROPRIATE LEVEL.IN CLOSING, PLEASE KNOW THAT BURNETT MEDICAL CENTER IS THE SOLE HOSPITAL IN BURNETT COUNTY (880 SQUARE MILES). WE ARE A 17-BED, RURAL CRITICAL ACCESS HOSPITAL, COMBINED WITH AN EMPLOYED PROVIDER RURAL HEALTH CLINIC, 24/7 EMERGENCY DEPARTMENT, AND A 50 BED LONG-TERM CARE CENTER. AS SUCH, WE TAKE OUR MISSION SERIOUSLY, AND REMAIN EVER-FOCUSED ON OUR DAILY CALLING OF PROVIDING QUALITY, COMPASSIONATE CARE. MINDFUL OF OUR MISSION--WE, LIKE FEDERAL, STATE AND LOCAL GOVERNMENT--MUST BALANCE THE MANY COMPELLING AND COMPETING NEEDS, WITHIN A SEVERELY-CONSTRAINED RESOURCE ENVIRONMENT. THERE IS GREAT NEED AMONG THOSE WE SERVE. WE ACKNOWLEDGE THE MANY COMPETING HEALTH ISSUES INHERENT IN SERVING A POPULATION THAT HAS LESS FINANCIAL RESOURCES, THAT IS OLDER, AND IS MORE GEOGRAPHICALLY-DISPERSED THAN THAT OF EITHER THE STATE OR THE NATION.WE ARE ACUTELY AWARE AND RECOGNIZE THAT THERE ARE MANY OTHER COMPELLING HEALTHCARE ISSUES. WHILE WE CAN AND DO IDENTIFY THESE NEEDS, WE ARE FORCED TO PRIORITIZE THE MOST NEEDED AND COMPELLING AS DETERMINED BY OUR CHNA PROCESS, AND WITHIN THE LIMITED RESOURCES AVAILABLE IN A POOR, RURAL COUNTY. BE ASSURED THAT AS RESOURCES AND GRANT-FUNDING MAY BECOME AVAILABLE, BURNETT MEDICAL CENTER, IN PARTNERSHIP WITH OUR HEALTHY BURNETT CONSORTIUM, WILL CONTINUE TO ALLOCATE TIME, TALENT, AND RESOURCES TO THE SIGNIFICANT HEALTH NEEDS THAT HAVE BEEN CAPTURED IN OUR CONSENSUS-BUILDING CHNA PROCESS.
BURNETT MEDICAL CENTER, INC.PART V, SECTION B, LINE 16J: REGISTRATION AND CLINIC PERSONNEL OFTEN REFER UNINSURED AND LOW-INCOME INDIVIDUALS TO A FINANCIAL COUNSELOR TO DISCUSS THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - THE CONTINUING CARE CENTER OF BURNETT
MEDICAL CENTER 257 W ST GEORGE AVEGRANSTBURGWI54840SKILLED NURSING FACILITY
2 - BURNETT MEDICAL CENTER CLINIC
257 W ST GEORGE AVEGRANTSBURGWI54840PROVIDER BASED RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE MEDICAL CENTER'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990.
PART I, LINE 7G:THE COST OF SUBSIDIZED SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THE SKILLED NURSING HOME, THE CLINIC, AND THE EMERGENCY ROOM DEPARTMENT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH BURNETT MEDICAL CENTER, INC. IT HAS BEEN THE GOAL OF BURNETT MEDICAL CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,030,479.
PART II, COMMUNITY BUILDING ACTIVITIES:WE ARE CLOSE TO THE COMMUNITIES WE SERVE AND TAKE AN ACTIVE ROLE IN ADDRESSING THE ROOT FACTORS CONTRIBUTING TO OUR COMMUNITY'S HEALTH STATUS. WE DO SO THROUGH OUR INVOLVEMENT IN COMMUNITY-BUILDING PARTNERSHIPS THAT ADDRESS ECONOMIC DEVELOPMENT AND COMMUNITY HEALTH IMPROVEMENT ISSUES.THE ORGANIZATION'S CEO SERVES AS A BOARD MEMBER OF THE GRANTSBURG INDUSTRIAL DEVELOPMENT CORPORATION (GIDC) AS WELL AS THE BURNETT COUNTY DEVELOPMENT ASSOCIATION (BDCA). THESE ORGANIZATIONAL ENTERPRISES SEEK TO ENCOURAGE ECONOMIC GROWTH IN BURNETT MEDICAL CENTER'S PRIMARY SERVICE AREA. GIDC AND BDCA HAVE A STRONG HISTORY OF BRINGING NEW INDUSTRY INTO THE AREA WHICH RESULTS IN INCREASED EMPLOYMENT OPPORTUNITIES AND STRENGTHENS THE LOCAL ECONOMY. KNOWING THAT UNEMPLOYMENT LEADS TO AN INCREASE IN UNHEALTHY BEHAVIORS-WHICH IN TURN CAN LEAD TO INCREASED RISK FOR DISEASE OR MORTALITY-GIDC'S AND BDCA'S MISSION OF ENCOURAGING ECONOMIC GROWTH FAVORABLE AND DIRECTLY IMPACTS THE HEALTH OF BURNETT MEDICAL CENTER'S SERVICE AREA.FURTHERMORE, THE ORGANIZATION CONTINUES TO COLLABORATE WITH A LOCAL ADVOCACY GROUP, CITIZENS AGAINST POVERTY, WHICH SEEKS TO ELIMINATE BARRIERS CONTRIBUTING TO HIGH RATES OF POVERTY AMONG SERVICE AREA RESIDENTS. FOR EXAMPLE, HAVING IDENTIFIED LACK OF ACCESS TO TRANSPORTATION AS A ROOT CAUSE OF POVERTY, ONE AREA OF FOCUS HAS BEEN TO ADVOCATE FOR A MEANS OF PUBLIC TRANSPORTATION IN THE SERVICE AREA. DUE TO THE RURAL NATURE OF THE COMMUNITIES SERVED BY BURNETT MEDICAL CENTER, PROVIDING A MEANS OF TRANSPORTATION FOR RESIDENTS PROMOTES HEALTH BY INCREASING ACCESS TO JOB OPPORTUNITIES, TO GROCERY STORES AND FOOD SHELVES, AND TO HEALTHCARE SERVICES. HUNGER AND LACK OF ACCESS TO HEALTHY FOODS WAS IDENTIFIED AS ANOTHER ROOT CAUSE OF POVERTY. CITIZENS AGAINST POVERTY HAS UNDERTAKEN AN EFFORT TO ESTABLISH SUSTAINABLE SOURCES OF FOOD FOR AREA RESIDENTS BY PROVIDING SUPPLIES TO THEM AT NO COST TO CREATE RAISED BED GARDENS SO THEY ARE ABLE TO GROWN THEIR OWN PRODUCE.
PART III, LINE 2:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE MEDICAL CENTER'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CHARITY CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE MEDICAL CENTER ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITY CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL.
PART III, LINE 3:MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS ARE UNABLE TO COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES. EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS, A SMALL AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARTIY CARE.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTSDUE UNLIKELY.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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 AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8:BURNETT MEDICAL CENTER, INC. IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALY RECEIVED BY THE MEDICAL CENTER FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT BURNETT MEDICAL CENTER, INC. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT BURNETT MEDICAL CENTER, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF GRANTSBURG, WISCONSIN. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL MEDICAL CENTER PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE MEDICAL CENTER WOULD SHOW A LARGE LOSS ON THESE SERVICES. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:PATIENTS RECEIVE OUR COMMUNITY CARE APPLICATION WHEN THEY PRESENT FOR SERVICES. THEY ARE ENCOURAGED TO REVIEW THE APPLICATION AND SUBMIT THE REQUIRED INFORMATION TO APPLY FOR POTENTIAL COVERAGE. IF THEY HAVE QUESTIONS OR NEED HELP WITH THE APPLICATION THEY MAY MEET WITH OUR FINANCIAL COUNSELOR AND/OR OUR BUSINESS OFFICE MANAGER.
PART VI, LINE 2:WE CONTINUE TO RELY ON MARKETING AND DEMOGRAPHIC DATA FOR BOTH OUR PRIMARY AND SECONDARY SERVICE AREAS AS SUPPLIED BY PROPRIETARY SOURCES FROM THOMSON REUTERS MARKET EXPERT, ITS SUCCESSOR COMPANY, TRUVEN ANALYTICS, AND THE MINNESOTA HOSPITAL ASSOCIATION. SUCH MARKET-BASED ANALYSIS PROVIDES EVIDENCE-BASED ESTIMATES AND PROJECTIONS FOR THE MEDICAL NEEDS OF THOSE THAT LIVE WITHIN OUR SERVICE AREA. WE THEN ASSESS THE AVAILABILITY OF EXISTING HEALTHCARE PROVIDERS AND SERVICES TO DETERMINE WHAT GAPS MAY EXIST, AND HOW WE CAN BEST ALIGN OUR SERVICES IN ORDER TO BE ENGAGED IN THE ABILITY TO ADDRESS UNMET NEED IN PARTNERSHIP WITH BOTH PUBLIC AND PRIVATE PROVIDERS OF HEALTHCARE SERVICES. THE RESULT OF OUR REVIEW AND ANALYSIS SERVES AS A FUNDAMENTAL BASIS FOR THE DEVELOPMENT OF GOALS AND OBJECTIVES IN OUR STRATEGIC PLAN.FURTHERMORE, AS REQUIRED BY LAW, WE CONDUCT AND COMPLETE, ONCE EVERY THREE YEARS, A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS REQUIRED UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, AND RELY ON OUR FINDINGS TO DETERMINE ANY NEEDED CHANGES OR CHALLENGES IN OUR FOCUS. IN CONDUCTING THE CHNA, A COMPREHENSIVE HEALTH NEEDS ASSESSMENT, USING BOTH QUANTITATIVE AND QUALITATIVE DATA, IS PERFORMED IN COLLABORATION WITH TWO KEY COMMUNITY PARTNERS: BURNET COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES-PUBLIC HEALTH AND THE ST. CROIX TRIBAL HEALTH CLINIC.QUANTITATIVE DATA SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, THE UNITED STATES CENSUS BUREAU, THE WISCONSIN DEPARTMENT OF HEALTH SERVICES, WISCONSIN INTERACTIVE STATISTICS ON HEALTH, AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM WERE RELIED UPON AND USED TO ASSESS THE HEALTH NEEDS OF THE SERVICE AREA BY COMPARING COUNTY-LEVEL DATA FOR GIVEN INDICATORS OF HEALTH TO STATE AND NATIONAL BENCHMARKS. WE INTEGRATED THIS QUANTITATIVE DATA WITH THE QUALITATIVE DATA THAT WAS GATHERED FROM COMMUNITY MEMBERS AND ORGANIZATIONS TO DEVELOP A BETTER UNDERSTANDING OF COMMUNITY PERCEPTIONS OF THE SERVICE AREA'S HEALTH NEEDS. THIS DATA IS GATHERED THROUGH (1) AN INTERNET-BASED SURVEY AND PAPER SURVEY OF APPROXIMATELY 500 INDIVIDUALS, (2) FOCUS GROUPS, AND (3) A KEY INFORMANT INTERVIEW.AFTER DATA IS COLLECTED, CHNA PARTNERS FACILITATE A COMMUNITY FORUM IN WHICH REPRESENTATIVES OF OTHER HEALTHCARE PROVIDERS, COMMUNITY GROUPS, AND LOCAL NON-PROFIT ORGANIZATIONS THAT HAVE AN INTEREST AND EXPERTISE IN THE HEALTH OF SERVICE AREA RESIDENTS ARE INVITED TO OFFER ADDITIONAL INPUT ON THE HEALTH NEEDS OF THE COMMUNITIES SERVED AND HELP PRIORITIZE THE IDENTIFIED NEEDS.THE RESULTS OF THE ASSESSMENT AND COMMUNITY FORUM ARE USED ALONG WITH KNOWLEDGE OF EXISTING ASSETS AVAILABLE TO MEET IDENTIFIED HEALTH NEEDS IN DEVELOPING AN IMPLEMENTATION STRATEGY THAT DELINEATES HOW BURNETT MEDICAL CENTER WILL TARGET EXISTING PROGRAMS AND RESOURCES, TARGET AND DEPLOY ANY AVAILABLE ADDITIONAL RESOURCES, AND COLLABORATE WITH OTHER COMMUNITY ENTITIES TO ADDRESS THE IDENTIFIED HEALTH NEEDS. FURTHERMORE, BURNETT MEDICAL CENTER HAS TAKEN A LEAD ROLE IN FORMULATING A COMMUNITY-WIDE PLAN TO ADDRESS THE TOP HEALTH NEED IDENTIFIED THROUGH THE CHNA. THE PLAN IS BEING EXECUTED BY THE COMMUNITY COLLABORATIVE "HEALTHY BURNETT" THAT WAS CREATED AS A RESULT OF THE CHNA TO ADDRESS THE IDENTIFIED HEALTH NEEDS.
PART VI, LINE 3:PATIENTS ARE TOLD ABOUT OUR COMMUNITY CARE PROGRAM BY OUR FINANCIAL COUNSELOR, REGISTRATION STAFF , PATIENT ACCOUNT REPRESENTATIVES AND BUSINESS OFFICE MANAGER. IN ADDITION, WE HAVE SIGNS POSTED BY BOTH OUR CLINIC AND ER REGISTRATION AREAS INFORMING OUR PATIENTS OF THE COMMUNITY CARE PROGRAM AVAILABLE AT OUR FACILITY. IF THE PATIENT FEELS THEY WILL NEED ASSISTANCE WITH THEIR MEDICAL BILLS, THEY ARE ENCOURAGED TO APPLY FOR THE COMMUNITY CARE PROGRAM WITH ALL THE REQUIRED INFORMATION. FINALLY, PATIENTS ALSO HAVE ACCESS TO THE COMMUNITY CARE APPLICATION INFORMATION ON OUR WEBSITE, FOR EASIER ACCESS FOR OUR PATIENTS.WHILE WE DO NOT HAVE ANY CERTIFIED APPLICATION COUNSELORS, WE ARE CHARTER MEMBERS THAT JOINED THE FEDERAL GOVERNMENT'S CHAMPIONS FOR COVERAGE CAMPAIGN TO HELP EDUCATE PEOPLE ABOUT AND TO PROMOTE THE HEALTH INSURANCE MARKETPLACE. AS A CHAMPION FOR COVERAGE, WE HAVE UNDERTAKEN INITIATIVES TO DIRECT PEOPLE TO THE MARKETPLACE, INCLUDING SENDING OUR PATIENTS TO THE OFFICIAL CONSUMER SOURCES (HEALTHCARE.GOV WEBSITE AND CONSUMER CALL CENTER) TO LEARN ABOUT THE MARKETPLACE AND GET COVERAGE, HANGING POSTERS AND FACT SHEETS IN OUR FACILITY, INCLUDING AN ARTICLE ABOUT THE MARKETPLACE IN OUR QUARTERLY COMMUNITY NEWSLETTER, AND HAVING STAFF LEARN ABOUT THE MARKETPLACE IN EDUCATION SESSIONS. WE HAVE ALSO PARTICIPATED IN A COUNTY-WIDE EDUCATION SESSION ON THE NEW HEALTHCARE EXCHANGE AND HAVE WILLINGLY PROVIDED POSITIVE, RESPONSIVE ANSWERS TO MEDIA INQUIRIES.
PART VI, LINE 4:LOCATED IN RURAL, NORTHWESTERN WISCONSIN, BURNETT COUNTY IS 880 SQUARE MILES WITH 18.8 CITIZENS PER SQUARE MILE (COMPARED TO THE WISCONSIN AVERAGE OF 105 CITIZENS PER SQUARE MILE). ANOTHER WAY OF REALIZING THE SIZE OF BURNETT COUNTY IS EVIDENCED BY THE FACT THAT, THE COUNTY'S LAND MASS WOULD ACCOUNT FOR OVER 85% OF THE ENTIRE LAND MASS OF THE STATE OF RHODE ISLAND (WHICH HAS A POPULATION DENSITY OF OVER 1,000 CITIZENS PER MILE).BURNETT COUNTY IS THE PRIMARY SERVICE AREA FOR BURNETT MEDICAL CENTER (BMC) AND BMC IS THE SOLE HOSPITAL IN BURNETT COUNTY. WHILE BURNETT MEDICAL CENTER IS A 17 BED FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL, IT ALSO HAS A 50 BED LONG TERM CARE CENTER, AS WELL AS A PRIMARY CARE CLINIC. FURTHERMORE, BURNETT COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA/POPULATION (ID NUMBER 03764), HAVING BEEN SO DESIGNATED ON JUNE 28, 1984.NOT LIMITED TO SERVING JUST BURNETT COUNTY, BURNETT MEDICAL CENTER ALSO PROVIDES CARE FOR RESIDENTS IN VARYING DEGREES TO RESIDENTS LIVING IN ONE OF THE FOUR ADJOINING WISCONSIN COUNTIES (DOUGLAS, WASHBURN, POLK, AND BARRON) AS WELL AS TWO ADJOINING COUNTIES IN MINNESOTA (PINE AND CHISAGO). BOTH BURNETT COUNTY IN WISCONSIN AND PINE COUNTY IN MINNESOTA ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS, AND THE REMAINING COUNTIES AFOREMENTIONED, HAVE AREAS WITHIN THEIR COUNTIES DESIGNATED AS MEDICALLY UNDERSERVED AS WELL.DEMOGRAPHICALLY, BASED ON THE MOST CURRENTLY AVAILABLE US CENSUS DATA, THE 2016 ESTIMATES FOR BURNETT COUNTY REFLECT A POPULATION OF 15,159 WHICH IS A SLIGHT DECREASE FROM THE 2015 CENSUS RESULTS, OR A 1.9% DECREASE WHEN COMPARED TO THE 2010 CENSUS RESULTS.BURNETT COUNTY IS ONE OF WISCONSIN'S POORER COUNTIES APPROACHING NEARLY ONE IN FIVE PERSONS (16.5%) LIVING BELOW THE POVERTY LEVEL COMPARED TO THE STATE AVERAGE AND A MEDIAN INCOME WHICH IS WELL BELOW THE STATE MEDIAN INCOME. DEMOGRAPHICALLY OUR OVER 65 YEAR OLD POPULATION REPRESENTS MORE THAN ONE IN FOUR, OR 26.3% OF THE POPULATION, AND AGAIN WELL ABOVE THE WISCONSIN STATE AVERAGE OF 15.2%.ACCORDING TO THE US CENSUS DATA FROM JULY 2015, WHILE THE COUNTY POPULATION IS COMPRISED OF PREDOMINATELY WHITE PERSONS AT 91.85%, OUR NEXT LARGEST POPULATION IS AMERICAN INDIAN AT 4.7% (COMPARED TO 1.1% OVERALL FOR THE STATE).THERE ARE SIMILARITIES IN OUR SECONDARY SERVICE AREAS. FOR INSTANCE, IN THE NEIGHBORING COUNTIES OF POLK COUNTY IN WISCONSIN AND PINE COUNTY IN MINNESOTA, BASED ON CENSUS BUREAU DATA, THEIR COMPARISONS SHOW THEY TOO HAVE FAR FEWER PERSONS PER SQUARE MILE, ARE RELATIVELY LOWER THAN THEIR RESPECTIVE STATE AVERAGES FOR MEDIAN HOUSEHOLD INCOME, AND RELATIVELY HIGHER IN THE 65+ YEARS OF AGE POPULATION, AS WELL AS HAVING GREATER THAN STATE AVERAGE OF BOTH WHITE PERSONS AND AMERICAN INDIANS.DESPITE OUR RURAL LOCATION IN NORTHWEST WISCONSIN, WE ARE IN A RELATIVELY COMPETITIVE MARKET AS RESIDENTS FROM BOTH OUR PRIMARY AND SECONDARY SERVICE AREAS HAVE ACCESS TO TEN HOSPITALS (IN EITHER WISCONSIN OR MINNESOTA) WITHIN 50 MILES OF BURNETT MEDICAL CENTER'S GEOGRAPHIC LOCATION IN GRANTSBURG, WISCONSIN. AS STATED PREVIOUSLY, BURNETT MEDICAL CENTER OPERATES AN EMPLOYED-PROVIDER MEDICAL CLINIC WHICH IS ONE OF MANY COMPETITOR CLINICS WITHIN OUR PRIMARY AND SECONDARY MARKETS.FINALLY, WE TAKE OUR ROLE AS A VITAL PART OF A NECESSARY HEALTH CARE SAFETY NET FOR ALL SERIOUSLY, INCLUDING THE UNINSURED, AS EVIDENCED BY OUR 24/7 EMERGENCY DEPARTMENT WHICH PROVIDES EMERGENT, URGENT, AND PRIMARY CARE TO ALL THAT PRESENT TO THE EMERGENCY DEPARTMENT. WE STAND READY AS, WITH PRIDE, WE ARE ACUTELY AWARE OF OUR MISSION OF SERVICE TO EVERY PATIENT, EVERY MINUTE, OF EVERY DAY.
PART VI, LINE 5:AS A SOLE COMMUNITY RURAL HOSPITAL WE TAKE PRIDE IN BEING CLOSE TO THOSE WE SERVE. WE SHARE WITH THE COMMUNITY VIA PRINT, SOCIAL, AND ONLINE MEDIA OUTLETS RELEVANT AND HELPFUL KNOWLEDGE OF OUR SERVICES, AS WELL AS EDUCATIONAL INFORMATION ON VARIOUS HEALTH TOPICS. WE ALSO SHARE AND PROMOTE OUR MISSION THROUGHOUT THE COMMUNITIES SERVED. WE LEARN DIRECTLY FROM THOSE WE SERVE BY OUR BOARD OF DIRECTORS GOVERNING STRUCTURE WHICH IS COMPOSED OF SEVEN UNCOMPENSATED COMMUNITY VOLUNTEERS FROM THROUGHOUT BURNETT COUNTY, THAT RESIDE IN EITHER OUR PRIMARY OR SECONDARY SERVICE AREA, NONE OF WHICH ARE NEITHER EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS.WE ENJOY THE CONTINUED SUPPORT OF OUR COMMUNITY VIA A HEALTHCARE FOUNDATION, WHICH PROVIDES PHILANTHROPIC SUPPORT TO FULFILLING THE HOSPITAL'S MISSION.IN ORDER TO ENSURE CONTINUED AND READY ACCESS TO QUALIFIED HEALTHCARE PROVIDERS, WE TAKE PRIDE IN HAVING AN OPEN MEDICAL STAFF MODEL THAT EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN OUR COMMUNITY.WHEN WE HAVE SURPLUS FUNDS, THOSE FUNDS, COMBINED WITH OUR LOCAL FOUNDATION AND OTHER GRANTS OBTAINED THROUGH COMPETITIVE PROCESSES, ARE USED FOR IMPROVEMENTS IN PATIENT CARE AND QUALITY, AS EVIDENCED BY THE PURCHASE OF NEW AND NEEDED CAPITAL EQUIPMENT. WE ALSO HAVE CONTINUED INVESTMENTS AS AN EARLY ADOPTER OF THE ELECTRONIC MEDICAL RECORD AND WE REMAIN FOCUSED ON ACHIEVING THE GOALS OF FEDERALLY-ESTABLISHED MEANINGFUL USE GUIDELINES AND EXPECTATIONS.ADVOCACY OF THE COMMUNITIES HEALTHCARE NEEDS ARE DONE LOCALLY BY MEMBERS OF THE BOARD SPEAKING WITH LOCAL OFFICIALS ON RELEVANT ISSUES THAT MAY AFFECT THE HOSPITAL. ADDITIONALLY, THE ORGANIZATION'S CEO CONTINUES TO SERVE AS A MEMBER OF THE WISCONSIN HOSPITAL ASSOCIATION'S PUBLIC POLICY COUNCIL, AS WELL AS A MEMBER OF THE HOSPITAL ASSOCIATION'S NETWORK ADEQUACY TASK FORCE, AND TELEMEDICINE TASK FORCE IN SUPPORT OF THE ASSOCIATION'S MISSION AND STRATEGIC PLAN THAT EMPHASIZES ADVOCACY FOR INITIATIVES FOR COMMUNITY, STATE AND NATIONAL EFFORTS FOR IMPROVING THE OVERALL HEALTH OF THE POPULATION AND CONTINUED READY ACCESS TO QUALITY HEALTHCARE FOR ALL.FINALLY, MINDFUL OF THE NEED FOR SUPPORT OF VARIOUS METHODS OF INSURANCE, WE ARE PROUD OF OUR PARTICIPATION IN SUCH GOVERNMENTALLY-SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, AND TRICARE, ALL OF WHICH HAVE AN INCREASED FOCUS ON THE PROVISION OF VALUED BASED SERVICES, TO INCLUDE AN INCREASED EMPHASIS ON PREVENTATIVE CARE SERVICES. SUCH SERVICES FOCUS ON THE EARLY DETECTION AND INTERVENTION(S) WHICH ARE DESIGNED TO PREVENT OR DELAY THE HARMFUL ASPECTS MORE CHRONIC HEALTH CONDITIONS, SUCH AS DIABETES AND CONGESTIVE HEART FAILURE.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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
GORDON LEWIS
CEO$175,579$0$0$0$650$0$0$0$2,747$0$178,976$0$0$0
TIMOTHY NOVICK
PHYSICIAN$298,885$0$0$0$723$0$0$0$27,847$0$327,455$0$0$0
JULIE ANDERSSON
PHYSICIAN'S ASSISTANT$166,913$0$0$0$317$0$0$0$27,803$0$195,033$0$0$0
PATRICIA DOOLEY EID
NURSE PRACTITIONER$154,719$0$0$0$397$0$0$0$17,742$0$172,858$0$0$0
MARK THAYER
PHYSICIAN$113,833$0$15,000$0$0$0$0$0$28,732$0$157,565$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
BURNETT COUNTY
A3960056752007-03-23$7,000,000TO REFINANCE AND PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION000
VILLAGE OF GRANTSBURG
B3960062772007-04-10$5,000,000TO PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION000
VILLAGE OF SIREN
C3960084522007-04-25$4,850,000TO PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$2,504,883$7,000,000$140,000$5,464,764$1,395,2362008Yes (1)0Yes (1)Yes (1)
B$1,458,923$5,000,000$100,000$4,900,000200800Yes (1)Yes (1)
C$1,415,157$4,850,000$97,000$4,753,000200800Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000
C0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)000000
B00Yes (1)000000
C00Yes (1)000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART IV, LINE 2B, COLUMN AALL GROSS PROCEEDS WERE EXPENDED IN ACCORDANCE WITH THE BOND AGREEMENT , THEREFORE THERE IS AN EXCEPTION TO COMPUTING ANY REBATE REQUIREMENTS. THE ORGANIZATION GAINED APPROVAL FOR EXCEPTION FROM THE ISSUER.
SCHEDULE K, PART IV, LINE 2B, COLUMN BALL GROSS PROCEEDS WERE EXPENDED IN ACCORDANCE WITH THE BOND AGREEMENT , THEREFORE THERE IS AN EXCEPTION TO COMPUTING ANY REBATE REQUIREMENTS.
SCHEDULE K, PART IV, LINE 2B, COLUMN CALL GROSS PROCEEDS WERE EXPENDED IN ACCORDANCE WITH THE BOND AGREEMENT , THEREFORE THERE IS AN EXCEPTION TO COMPUTING ANY REBATE REQUIREMENTS.
SCHEDULE K, PART IV, LINE 7IN THE BOND ISSUANCE THERE WAS LANGUAGE INCLUDED REGARDING THE STRICT COMPLIANCE TO SECTION 148 AND THE NEED TO SPEND THE PROCEEDS WITHIN A CERTAIN TIME FRAME FOR ALL THREE BONDS LISTED. THE ORGANIZATION DID SO AND HAS NOT USED THEIR BUILDING AND IMPROVEMENTS FOR ANY OTHER PURPOSE THEN THEIR EXEMPT PURPOSE.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6EACH PERSON, BUSINESS, CORPORATION, OR ORGANIZATION WHO HAS CONTRIBUTED AND PAID ONE HUNDRED DOLLARS OR MORE TO BURNETT MEDICAL CENTER, INC. "THE MEDICAL CENTER" SHALL BE A LIFETIME MEMBER OF THE MEDICAL CENTER. EACH PERSON, BUSINESS, CORPORATION, OR ORGANIZATION IS ENTITLED TO HOLD A MAXIMUM OF ONE MEMBERSHIP CERTIFICATE. A HUSBAND AND WIFE, OR TWO OR MORE RELATED PERSONS, MAY HOLD A MEMBERSHIP AS JOINT TENANTS, HOWEVER, ONLY ONE VOTE PER MEMBERSHIP SHALL BE PERMITTED.
FORM 990, PART VI, SECTION A, LINE 7ATHE DUTIES OF THE MEMBERS OF THE MEDICAL CENTER SHALL BE: THE FORMULATION AND DEVELOPMENT OF THE OVERALL PURPOSES, OBJECTIVES, AND PHILOSOPHY OF THE MEDICAL CENTER; THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER; THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER; THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS; THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE MEDICAL CENTER; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE MEDICAL CENTER OR ITS MERGER WITH ANOTHER CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD OF DIRECTORS FOR BURNETT MEDICAL CENTER, INC. REVIEWS AND APPROVES FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CBURNETT MEDICAL CENTER, INC. HAS A CONFLICT OF INTEREST POLICY. THE PURPOSE OF THIS POLICY IS TO PROTECT THE INTEREST OF THE MEDICAL CENTER WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE CORPORATION. IT IS EXPECTED THAT SUCH PERSONS SHALL EXERCISE THE UTMOST GOOD FAITH IN ALL TRANSACTIONS TOUCHING UPON THEIR DUTIES AT BURNETT MEDICAL CENTER, INC. AND ITS PROPERTY. ALL MEMBERS OF THE BOARD COMPLETE A DISCLOSURE FORM UPON APPOINTMENT, AND REVIEW AND SIGN IT ANNUALLY THEREAFTER. THIS STATEMENT ESTABLISHES THE DUTY OF AN INTERESTED PARTY TO DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST DISCLOSE ALL MATERIAL FACTS. AFTER ANY SUCH DISCLOSURE, HE/SHE SHALL LEAVE THE GOVERNING BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD MEMBERS. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS OF SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF MEMBERS FAIL TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PART VI, SECTION B, LINE 15BURNETT MEDICAL CENTER INC.'S EXECUTIVE COMPENSATION POLICY IS DESIGNED WITH THE GOAL OF PROVIDING REMUNERATION THAT IS FAIR, REASONABLE, AND COMPETITIVE. THE MEDICAL CENTER'S BOARD MAY ESTABLISH A COMPENSATION COMMITTEE OR MAY ACT AS A COMMITTEE OF THE WHOLE IN EXECUTIVE SESSION. THE COMMITTEE OVERSEES THE TOTAL COMPENSATION PACKAGES TO ENSURE THAT THEY ARE COMPETITIVE WITH OTHER HEALTHCARE ORGANIZATIONS, REFLECT JOB RESPONSIBILITIES AND REQUIREMENTS, AND ARE FAIR, EQUITABLE, AND CONSISTENTLY MANAGED. THE COMMITTEE MEETS AS OFTEN AS IT DEEMS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES. IN GENERAL, THE MEDICAL CENTER POSITIONS TOTAL EXECUTIVE COMPENSATION AT THE MEDIAN OF THE MARKET. THE BOARD OF DIRECTORS USES CONTEMPORANEOUS DATA INCLUDING EXECUTIVE COMPENSATION DATA FROM THE WISCONSIN HOSPITAL ASSOCIATION AS A GUIDE WHEN APPROVING THE COMPENSATION OF THE ADMINISTRATOR AND CHIEF FINANCIAL OFFICER. THE POLICY IS MEANT TO BE FLEXIBLE SO THAT COMPENSATION CAN BE ABOVE OR BELOW THE MEDIAN BASED ON EXPERIENCE, PERFORMANCE, SIZE AND COMPLEXITY OF ORGANIZATION, AND BUSINESS NEED TO ATTRACT AND RETAIN EXECUTIVE TALENT.
FORM 990, PART VI, SECTION C, LINE 19BURNETT MEDICAL CENTER, INC. MAKES IT FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS.
FORM 990, PART IX, LINE 11GLAB SERVICES: PROGRAM SERVICE EXPENSES 349,701. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,701. ANETHESIOLOGY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 489,602. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 489,602. CLINIC PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 632,629. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 632,629. LAUNDRY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 198,511. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,511. DIETARY PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 329,338. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 329,338. EMERGENCY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 185,535. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 185,535. MEDICAL AND ADMIN PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 797,780. MANAGEMENT AND GENERAL EXPENSES 297,248. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,095,028.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 2,245. NET ASSETS RELEASED FROM RESTRICTIONS 11,412.
FORM 990, PART XII, LINE 2C:OVERSIGHT OF THE AUDIT: BURNETT MEDICAL CENTER, INC. DOES NOT HAVE A SPECIFIC COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.