PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC (EIN 39-0910727)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-09
- IRS object ID
- 201832219349301508
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-09T18:14:48-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27400 Northwestern Highway | AddressLine1Txt |
| City | Southfield | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48034 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390910727 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAUKESHA MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WAUK | BusinessNameControlTxt |
| Phone | 2629282496 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 AMERICAN AVENUE | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53188 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD J FARR | PersonNm |
| Person Title | CHIEF FINANCIAL/ADMIN OFFICER | PersonTitleTxt |
| Phone | 2629282496 | PhoneNum |
| Signature | 2018-07-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | David Lowenthal | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 2483522500 | PhoneNum |
| Preparation | 2018-07-26 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH WAUKESHA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN EDWARDS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 AMERICAN AVENUE | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53188 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $498,327,031 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | PROVIDER OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 2904 | TotalEmployeeCnt |
| Total Volunteers | 380 | TotalVolunteersCnt |
| Total Gross UBI | $2,788,982 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,931,542 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,436,910 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,061,641 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $475,812,598 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $492,017,870 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,293,397 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,989,151 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,975,128 | PYOtherRevenueAmt |
| CY Other Revenue | $1,943,929 | CYOtherRevenueAmt |
| PY Total Revenue | $481,518,033 | PYTotalRevenueAmt |
| CY Total Revenue | $498,012,591 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $25,020,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $17,400,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $147,659,131 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $141,328,852 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $290,990,936 | PYOtherExpensesAmt |
| CY Other Expenses | $303,133,508 | CYOtherExpensesAmt |
| PY Total Expenses | $463,670,067 | PYTotalExpensesAmt |
| CY Total Expenses | $461,862,360 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $17,847,966 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $36,150,231 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $502,796,777 | TotalAssetsBOYAmt |
| Total Assets EOY | $493,326,924 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $395,025,015 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $372,269,695 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $107,771,762 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $121,057,229 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $445,266,369 | ExpenseAmt |
| Grant | $17,400,000 | GrantAmt |
| Revenue | $489,354,029 | RevenueAmt |
| Desc | WAUKESHA MEMORIAL HOSPITAL FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. WAUKESHA MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. WAUKESHA MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 47,819 DAYS OF INPATIENT CARE AND APPROXIMATELY 336,530 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017. SEE SCHEDULE H FOR ILLUSTRATION OF ITS PROGRAM SERVICE ACCOMPLISHMENTS. | Desc |
| Total Program Service Expenses | $445,266,369 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 207 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2904 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD FARR | PersonNm |
| Phone | 2629284740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE SUITE | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531881131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | |||||||||
| PRESIDENT & CEO | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $1,309,663 | $832,068 | ||
| MIKE ERWIN | |||||||||
| VICE CHAIRPERSON | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARK MOHR | |||||||||
| CHAIRPERSON | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BETTY ARNDT | |||||||||
| SECRETARY | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JULIE SCHROEDER | |||||||||
| TREASURER | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID ROELKE | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG HASTAD | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| E JOHN RAASCH | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| RALPH RAMIREZ | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| SUE BELLEHUMER | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| KEN RIESCH | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY BEYER | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN HALLETT | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| JIM GANNON | |||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |||
| RONALD FARR | |||||||||
| CHIEF FINANCIAL/ADMIN OFFICER | 2.00 | 50.00 | Yes (X) | $0 | $644,036 | $181,999 | |||
| JOHN ROBERTSTAD | |||||||||
| CHIEF COMMUNITY LIAISON | 2.00 | 46.00 | $55,258 | $638,900 | $57,266 | Yes (X) | |||
| KENNETH PRICE | |||||||||
| CHIEF OPERATING OFFICER | 2.00 | 50.00 | $0 | $411,672 | $145,979 | Yes (X) | |||
| KARIN KULTGEN | |||||||||
| VP MEDICAL AFFAIRS | 40.00 | 0.00 | $382,446 | $0 | $34,618 | Yes (X) | |||
| ERIC HENDEE | |||||||||
| CHIEF PHYSICIST | 40.00 | 0.00 | $211,080 | $0 | $40,787 | Yes (X) | |||
| MICHAEL E KOWALOK | |||||||||
| PHYSICIST | 40.00 | 0.00 | $193,311 | $0 | $20,388 | Yes (X) | |||
| JOHN MAY | |||||||||
| VP - AMBULATORY | 40.00 | 0.00 | $344,905 | $0 | $42,037 | Yes (X) | |||
| MARGARET M PFITZINGER | |||||||||
| VP CLINICAL OPERATIONS | 40.00 | 0.00 | $198,208 | $0 | $38,828 | Yes (X) | |||
| JULIET UGARTE HOPKINS | |||||||||
| PHYSICIAN ADVISOR | 40.00 | 0.00 | $259,126 | $0 | $41,117 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,644,334 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,004,271 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,435,087 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 84 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JH FINDORFF & SON INC | |||||
| PO BOX 1647 | MADISON | WI | 53701 | CONSTRUCTION SERVICES | $10,517,869 |
| INDIANA UNIVERSITY HEALTH | |||||
| 2227 RELIABLE PARKWAY | CHICAGO | IL | 60686 | Cardiothoracic Services | $5,205,169 |
| EPIC SYSTEMS | |||||
| PO BOX 88314 | MILWAUKEE | WI | 532880314 | SOFTWARE MAINTENANCE | $2,668,441 |
| MEDICAL COLLEGE OF WI | |||||
| PO BOX 13308 | MILWAUKEE | WI | 53213 | FAMILY MEDICINE RESIDENT PROGRAM | $2,506,778 |
| J M BRENNAN INC | |||||
| 2101 W ST PAUL AVE | MILWAUKEE | WI | 53223 | CONSTRUCTION SERVICES | $1,815,061 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 90 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,706,425 | RelatedOrganizationsAmt |
| All Other Contributions | $355,216 | AllOtherContributionsAmt |
| Total Contributions | $2,061,641 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REV. | 622110 | $472,746,539 | $472,746,539 | |
| MEDICAL SERVICE LAB | 621500 | $8,120,696 | $5,467,741 | $2,652,955 |
| HOSPITAL JOINT VENTURE | 622310 | $3,925,751 | $3,925,751 | |
| ORTHO SURGERY CENTER | 621400 | $2,310,009 | $2,310,009 | |
| SURGERY CENTER | 621400 | $1,178,679 | $1,178,679 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,736,196 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,725,310 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $10,886 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $492,017,870 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,408,237 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $64,119 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,344,118 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $158,030 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $97,008 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $61,022 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,022 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $61,022 | UnrelatedBusinessRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $798,346 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $217,432 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $580,914 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $580,914 | TotalRevenueColumnAmt |
| Exclusion | $580,914 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722210 | $1,844,576 | $1,844,576 |
| GIFT SHOP | 453220 | $38,331 | $38,331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,882,907 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $498,012,591 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $489,354,029 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,788,982 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,807,939 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,400,000 | TotalAmt |
| Program Services | $17,400,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,573 | TotalAmt |
| Management And General | $428,573 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,435,401 | TotalAmt |
| Program Services | $105,856,618 | ProgramServicesAmt |
| Management And General | $4,578,783 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,011,536 | TotalAmt |
| Program Services | $965,848 | ProgramServicesAmt |
| Management And General | $45,688 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,872,190 | TotalAmt |
| Program Services | $20,884,296 | ProgramServicesAmt |
| Management And General | $987,894 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,581,152 | TotalAmt |
| Program Services | $7,418,195 | ProgramServicesAmt |
| Management And General | $162,957 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,514,399 | TotalAmt |
| Program Services | $122,454,002 | ProgramServicesAmt |
| Management And General | $8,060,397 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,639,076 | TotalAmt |
| Program Services | $13,633,699 | ProgramServicesAmt |
| Management And General | $5,377 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,080,937 | TotalAmt |
| Program Services | $4,892,242 | ProgramServicesAmt |
| Management And General | $1,188,695 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,290,377 | TotalAmt |
| Program Services | $10,290,377 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,205,919 | TotalAmt |
| Program Services | $43,205,919 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DRUGS & PHARMACEUTICALS | $37,177,338 | $37,177,338 |
| MEDICAL SUPPLIES | $34,272,031 | $34,272,031 |
| MEDICAID PROVIDER TAXES | $12,556,594 | $12,556,594 |
| BAD DEBTS | $10,604,328 | $10,604,328 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,792,509 | TotalAmt |
| Program Services | $3,654,882 | ProgramServicesAmt |
| Management And General | $1,137,627 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,862,360 | TotalAmt |
| Program Services | $445,266,369 | ProgramServicesAmt |
| Management And General | $16,595,991 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,474,154 | BOYAmt |
| EOY | $4,183,811 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,170 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,227,587 | BOYAmt |
| EOY | $56,571,870 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,499,127 | BOYAmt |
| EOY | $6,543,240 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,283,018 | BOYAmt |
| EOY | $5,823,843 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $937,603,292 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $559,339,102 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,664,720 | BOYAmt |
| EOY | $378,264,190 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,012,276 | BOYAmt |
| EOY | $6,227,785 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,265,416 | BOYAmt |
| EOY | $12,270,465 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,742,309 | BOYAmt |
| EOY | $23,441,720 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,796,777 | BOYAmt |
| EOY | $493,326,924 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,038,762 | BOYAmt |
| EOY | $55,115,810 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,610 | BOYAmt |
| EOY | $107,406 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,054,661 | BOYAmt |
| EOY | $5,404,778 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,828,982 | BOYAmt |
| EOY | $311,641,701 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,025,015 | BOYAmt |
| EOY | $372,269,695 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,740,182 | BOYAmt |
| EOY | $119,953,852 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,031,580 | BOYAmt |
| EOY | $1,103,377 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,771,762 | BOYAmt |
| EOY | $121,057,229 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,796,777 | BOYAmt |
| EOY | $493,326,924 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $36,150,231 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$579,016 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$22,285,748 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $0 | BeginningYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,710,388 | BeginningYearBalanceAmt |
| Other Expenditures | $6,710,388 | OtherExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,093,574 | OtherCostOrOtherBasisAmt |
| Book Value | $26,093,574 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $480,152,273 | OtherCostOrOtherBasisAmt |
| Depreciation | $212,605,000 | DepreciationAmt |
| Book Value | $267,547,273 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,781,387 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,669,909 | DepreciationAmt |
| Book Value | $111,478 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $423,043,189 | OtherCostOrOtherBasisAmt |
| Depreciation | $344,064,193 | DepreciationAmt |
| Book Value | $78,978,996 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,532,869 | OtherCostOrOtherBasisAmt |
| Book Value | $5,532,869 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $378,264,190 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED POSTRETIREMENT MEDICAL | $98,828 |
| FAIR VALUE-INTEREST RATE SWAP | $17,133,929 |
| ASSET RETIREMENT OBLIGATION | $37,865 |
| ACCUMULATED MIN PENSION LIABILITY | $11,394,320 |
| INTERCOMPANY NOTES PAYABLE | $272,154,237 |
| OTHER LONG TERM LIABILITY | $303,583 |
| LEASES PAYABLE | $9,388,837 |
| DEFERRED COMPENSATION LIABILITY | $1,130,102 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $311,641,701 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,122,116 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,122,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,109,435 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,812,073 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,297,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05380 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,231,551 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,812,073 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,419,478 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 25 | ActivitiesOrProgramsCnt |
| Persons Served | 160459 | PersonsServedCnt |
| Total Community Benefit Expns | $2,427,596 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,923 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,425,673 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 2080 | PersonsServedCnt |
| Total Community Benefit Expns | $4,241,862 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,241,862 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 291 | PersonsServedCnt |
| Total Community Benefit Expns | $8,789,216 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,087,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,701,296 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 27889 | PersonsServedCnt |
| Total Community Benefit Expns | $1,431,823 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,431,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 43 | ActivitiesOrProgramsCnt |
| Persons Served | 190719 | PersonsServedCnt |
| Total Community Benefit Expns | $16,890,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,089,843 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,800,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03290 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 43 | ActivitiesOrProgramsCnt |
| Persons Served | 190719 | PersonsServedCnt |
| Total Community Benefit Expns | $64,122,048 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,901,916 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $40,220,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08920 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 348 | PersonsServedCnt |
| Total Community Benefit Expns | $1,993 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,993 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 675 | PersonsServedCnt |
| Total Community Benefit Expns | $135,877 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $135,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 33 | PersonsServedCnt |
| Total Community Benefit Expns | $8,360 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 221 | PersonsServedCnt |
| Total Community Benefit Expns | $41,771 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $41,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 7 | PersonsServedCnt |
| Total Community Benefit Expns | $118,836 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $118,836 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 1284 | PersonsServedCnt |
| Total Community Benefit Expns | $306,837 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $306,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,800,124 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $957,805 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $88,700,869 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $115,467,596 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$26,766,727 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| 1 PROHEALTH ALIGNED LLC | ||
| AMBULATORY SURGERY CENTER | 0.51000 | 0.49000 |
| 2 THE ORTHOPEDIC SURGERY CENTER LLC | ||
| ORTHOPEDIC SURGICAL SERVICES | 0.49000 | 0.49000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Teaching HospitalTeachingHospitalInd | Emergency Room OtherEmergencyRoomOtherInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WAUKESHA MEMORIAL HOSPITAL INC | |||||||||||
| 1 | 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | WWW.PROHEALTHCARE.ORG | #41 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | |||||||||||
| 2 | 1625 COLDWATER CREEK DRIVE | WAUKESHA | WI | 53188 | Yes (X) | INPATIENT REHABILITATION | |||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | OtherOtherInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Income Level CriteriaIncomeLevelCriteriaInd | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd | Residency CriteriaResidencyCriteriaInd | Other CriteriaOtherCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Provided Nonprofit ContactProvidedNonprofitContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP TranslatedFAPTranslatedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Look Back Medicare PrivateLookBackMedicarePrivateInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
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| WAUKESHA MEMORIAL HOSPITAL INC | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 16 | Yes (1) | Yes (1) | 0 | Yes (1) | Yes (X) | FULL WEBSITE LISTED IN PART V SECTION C | Yes (X) | Yes (X) | Yes (1) | 16 | Yes (1) | SEE PART V, SECTION B, LINE 7D DISCLOSURE | 0 | Yes (1) | Yes (X) | 200.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX | Yes (X) | WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX | Yes (X) | WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | 0 | 0 | Yes (1) | Yes (X) | 150.000000000000 | 250.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 | ||||||||||||||||||||||||||||||||||||||
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 3j: TO ACCURATELY ASSESS THE HEALTH NEEDS OF OUR COMMUNITY, PROHEALTH CARE COMPILED DATA AND INFORMATION FROM A VARIETY OF SOURCES. OUR RESEARCH INCLUDED INFORMATION FROM EXPERTS AND COMMUNITY MEMBERS, INCLUDING PEOPLE WHOS PERSPECTIVES ARE OFTEN UNDER-REPRESENTED.-COMMUNITY HEALTH SURVEY: A TELEPHONE-BASED SURVEY OF 400 CONSUMERS COMMISSIONED BY THE MILWAUKEE HEALTH CARE PARTNERSHIP (WWW.MKEHCP.ORG), OF WHICH PROHEALTH CARE IS A MEMBER. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT PROHEALTHCARE.ORG-IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS: MORE THAN 50 INTERVIEWS WERE CONDUCTED WITH LEADERS OF VARIOUS NON-PROFIT ORGANIZATIONS, SCHOOLS, CIVIC AND BUSINESS LEADERS -COMMUNITY FEEDBACK: TWO INTERACTIVE FEEDBACK SESSIONS WITH HOSPITAL ADVOCATES (COMMUNITY MEMBERS) WERE CONDUCTED. THE ADVOCATES REVIEWED PERTINENT DATA AND 'VOTED' ON THEIR TOP CONCERNS FOR OUR COMMUNITY.-COMPILATION OF "SECONDARY DATA" USING A VARIETY OF SOURCES, INFORMATION WAS GATHERED, INCLUDING:-HEALTH STATISTICS SUCH AS LEADING CAUSES OF ILLNESS, DEATH AND DISABILITY-SAFETY STATISTICS SUCH AS CRIME RATES -SOCIO-ECONOMIC INDICATORS SUCH AS AVERAGE INCOMES, EDUCATION LEVELS, EMPLOYMENT RATES AND HOUSING |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 5: SEE PART V, SECTION B, LINE 3J DISCLOSURESUMMARY DATA AND A REVIEW OF MAJOR ISSUES WAS PRESENTED TO THE HOSPITAL ADVOCATES COMMITTEE. EACH COMMITTEE MEMBER PROVIDED FEEDBACK VIA A 'VOTING' METHODOLOGY. THIS FEEDBACK, ALONG WITH THE DATA FROM THE CONSUMER TELEPHONE SURVEY AND KEY INFORMANT INTERVIEWS SERVED AS ADVISORY RECOMMENDATIONS WHEN OUR PROHEALTH COMMUNITY BENEFIT COMMITTEE MADE THEIR PRIORITY DECISIONS USING IDENTIFIED CRITERIA IN A TWO-STEP NARROWING PROCESS. OUR NINE MEMBER COMMUNITY BENEFIT COMMITTEE IS A BOARD-LEVEL GROUP OF GOVERNMENTAL, COMMUNITY AND BUSINESS LEADERS IN OUR SERVICE AREA AND ARE RESPONSIBLE FOR OVERSIGHT OF OUR CHNA. |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 6a: OCONOMOWOC MEMORIAL HOSPITAL AND REHABILITATION HOSPITAL OF WISCONSIN LLC |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 7d: THE CHNA, WHICH INCLUDES THE IMPLEMENTATION STRATEGY, IS AVAILABLE AT WWW.PROHEALTHCARE.ORG/ABOUT-US-COMMUNITY-BENEFIT.ASPX AND TO COMMUNITY MEMBERS UPON REQUEST. |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 11: WE HAVE A COMPREHENSIVE IMPLEMENTATION/ACTION PLAN FOR EACH OF THE DEFINED PRIORITY AREAS. PROGRESS AND OUTCOMES FOR INDIVIDUAL TACTICS WITHIN THAT PLAN ARE MONITORED AND PRESENTED TO THE COMMUNITY BENEFIT COMMITTEE ON A QUARTERLY BASIS. WE FOUND THAT MANY NEEDS INTERSECTED WITH OTHER IDENTIFIED PRIORITIES (FOR EXAMPLE NEEDS OF THE ELDERLY, CHRONIC CONDITIONS AND THE LACK OF PHYSICAL ACTIVITY) AND AIMED TO DEVELOP STRATEGIES THAT ADDRESSED MULTIPLE ISSUES. NEEDS THAT WERE FOUND TO BE SIGNIFICANT BUT ARE NOT SPECIFICALLY ADDRESSED IN OUR CHNA PLAN ARE AT LEAST PARTIALLY ADDRESSED IN OUR ONGOING ACTIVITIES (E.G. ACCESS IS ADDRESS VIA OUR PARTNERSHIP/SUPPORT OF OUR LOCAL FQHC) OR ARE BEING ADDRESSED COLLABORATIVELY WITH COUNTY-WIDE INITIATIVES FOR WHICH WE ARE STRONG PARTNERS AND CONTRIBUTORS (E.G. WAUKESHA COUNTY CHIPP AND THRIVING WAUKESHA COUNTY). SEE PART VI LINE 2 FOR FURTHER DISCUSSION OF THE PRIORITY NEEDS IDENTIFIED. |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 13b: The hospital provides charity care or reduced cost care for a variety of patients in need. Some of these patients in need may technically have income in excess of minimum federal poverty guidelines. For additional details on the criteria used by the hospital facility to determine eligibility, please refer to the Financial Assistance Policy available on the hospital's website at: www.prohealthcare.org/patient-guest-services-billing-and-insurance.aspx |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | Part V, Section B, Line 13b: The hospital provides charity care or reduced cost care for a variety of patients in need. Some of these patients in need may technically have income in excess of minimum federal poverty guidelines. For additional details on the criteria used by the hospital facility to determine eligibility, please refer to the Financial Assistance Policy available on the hospital's website at: www.prohealthcare.org/patient-guest-services-billing-and-insurance.aspx |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 13h: THE FACILITY ALSO CONSIDERS THE FOLLOWING IN THE FINANCIAL ASSISTANCE POLICY: SIZE OF THE PATIENT'S FAMILY WILL BE DETERMINED BY THE NUMBER OF DEPENDENTS CLAIMED ON THE APPLICANT'S TAX RETURNS OR IDENTIFIED AS PART OF THE HOUSEHOLD, HOUSEHOLD INCOME WILL INCLUDE ALL INCOME FROM ANY SOURCE INCLUDING WAGES AND SALARIES AND OTHER SOURCES OF INCOME INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING:-ALL PENSIONS FROM STATE, FEDERAL OR PRIVATE SOURCES-INCOME FROM ANNUITIES, IRAS, TSAS, 401(K)S-STOCKS, OR BONDS-VETERANS BENEFITS-SOCIAL SECURITY PAYMENTS-REGULARLY RECEIVED INSURANCE CHECKS SUCH AS UNEMPLOYMENT BENEFITS AND WORKMAN'S COMPENSATION-ALIMONY/CHILD SUPPORT-RETURNS ON INVESTMENTS/NET RENTS AND NET PROFITS FROM BUSINESS |
| WAUKESHA MEMORIAL HOSPITAL, INC | Part V, Section B, Line 16j: REFERENCE TO THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE BACK OF ALL PATIENT STATEMENTS. ALSO THROUGH CUSTOMER RELATIONS VERBAL REMINDER OF THE FINANCIAL ASSISTANCE POLICY ARE PROVIDED WHEN DISCUSSING OPEN BALANCES. |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | Part V, Section B, Line 16j: Notified patients of financial assistance policy and offered application if patient or family member expressed financial hardship. |
| PART V, SECTION B, LINE 22: | PURSUANT TO PROHEALTH CARE, INC.'S FINANCIAL ASSISTANCE POLICY, WAUKESHA MEMORIAL HOSPITAL, INC. AND REHABILITATION HOSPITAL OF WISCONSIN, LLC USE THE LOOK-BACK METHOD TO CALCULATE AMOUNTS GENERALLY BILLED TO SELF-PAY PATIENTS. AMOUNTS GENERALLY BILLED TO SELF-PAY PATIENTS CONSIST OF GROSS CHARGES LESS A DISCOUNT (UNINSURED DISCOUNT). THIS UNINSURED DISCOUNT IS EQUIVALENT TO THE DISCOUNT PROVIDED BY THE THREE LARGEST PRIVATE HEALTH INSURERS OVER THE LAST YEAR AND IS APPLIED TO GROSS CHARGES FOR UNINSURED PATIENTS WHO REQUIRE EMERGENT OR MEDICALLY NECESSARY SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - REHAB HOSPITAL OF WI OUTPATIENT CLINIC | ||||
| 1625 COLDWATER CREEK DRIVE | WAUKESHA | WI | 53188 | OUTPATIENT REHABILATION CLINIC |
| 2 - PROHEALTH ALIGNED LLC | ||||
| 1111 DELAFIELD ST SUITE 100 | WAUKESHA | WI | 53188 | AMBULATORY SURGERY CENTER |
| 3 - THE ORTHOPEDIC SURGERY CENTER LLC | ||||
| W238 N 1610 BUSSE ROAD SUITE 100 | WAUKESHA | WI | 53188 | ORTHOPEDIC SURGERY CENTER |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | A COMMUNITY BENEFIT REPORT IS COMPLETED BY PROHEALTH CARE, INC. (EIN 39-1486873), THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. |
| Part I, Line 7: | THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE AMOUNTS ON LINES 7A-7D. THIS WAS CALCULATED BY USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I |
| Part I, Ln 7 Col(f): | $10,604,328 OF BAD DEBT EXPENSES FROM WAUKESHA MEMORIAL HOSPITAL, INC. WAS INCLUDED ON FORM 990, PART, IX, LINE 25. ADDITIONALLY, THERE WAS BAD DEBT EXPENSE OF $195,796 RELATED TO REHABILITATION HOSPITAL OF WISCONSIN, LLC. BOTH AMOUNTS WERE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE. |
| Part II, Community Building Activities: | WAUKESHA MEMORIAL HOSPITAL HAS FOSTERED A WIDE VARIETY OF PARTNERSHIPS WITH NUMEROUS AGENCIES AND INITIATIVES THAT BENEFIT OUR ENTIRE COMMUNITY BEYOND THOSE THAT ARE DIRECTLY ASSOCIATED WITH HEALTH. OUR EFFORTS TO HELP BUILD A SAFE AND VIBRANT COMMUNITY ARE IN SOME WAYS, JUST AS IMPORTANT AS OUR TREMENDOUS EFFORTS TO IMPROVE COMMUNITY HEALTH. WE BELIEVE COMMUNITY BUILDING IS ABOUT NEIGHBORHOODS AND ONE EXAMPLE OF THAT IS OUR SUPPORT OF LOCAL NEIGHBORHOOD GROUPS THAT ADDRESS SAFETY, PROPERTY APPEARANCE AND CONNECTIVITY OF RESIDENTS. WE PROVIDE FUNDING FOR BEAUTIFICATION AND THE CLEANUP OF COMMON PROPERTIES AND STREETS, AS WELL AS THE LAND, EXPERTISE AND RESOURCES FOR COMMUNITY RAIN AND CROP GARDENS. AS PART OF OUR LEADERSHIP VOLUNTEERISM PROGRAM, WE PROVIDE ASSISTANCE AT LOCAL LIBRARIES AND LITERACY PROGRAMS, AND HAVE A STRONG PRESENCE FOR NEIGHBORHOOD SAFETY INITIATIVES. INVOLVEMENT WITH YOUTH IS A YEAR-ROUND FOCUS AS WE ASSEMBLE AND DISTRIBUTE BACK-PACKS TO LOW INCOME CHILDREN, MAKING SURE THEIR SCHOOL YEAR GETS OFF TO A GOOD START AND WE VOLUNTEER AT LOCAL HIGH SCHOOLS FOR HEALTH CAREER AWARENESS AND "SAFE PROM/GRADUATION" EVENTS. WE ARE THE MAJOR SPONSOR OF "LEADERSHIP WAUKESHA", A PROGRAM THAT FOCUSES ON THE DEVELOPMENT OF EMERGING LEADERS IN OUR COUNTY. WE SUPPORT HOMELESS SHELTERS, ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION/CONTINUUM OF CARE AND THE COUNTY'S HISPANIC COLLABORATIVE NETWORK. WE ARE TREMENDOUSLY PROUD OF OUR WORK WITH EASTER SEALS AND THE WISCONSIN DEPARTMENT OF WORKFORCE DEVELOPMENT, SERVING AS WAUKESHA COUNTY'S ONLY SITE FOR PROJECT SEARCH, A WORKFORCE TRAINING PROGRAM FOR DEVELOPMENTALLY/PHYSICALLY DISABLED INDIVIDUALS. |
| Part III, Line 2: | THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX FOR WAUKESHA MEMORIAL HOSPITAL PLUS ITS SHARE OF THE BAD DEBT EXPENSE OF REHABILITATION HOSPITAL OF WISCONSIN LLC. |
| Part III, Line 3: | THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 30% OF TOTAL BAD DEBTS. |
| Part III, Line 4: | BAD DEBT EXPENSE FOOTNOTE FOR WAUKESHA MEMORIAL HOSPITAL, INC: ACCOUNTS RECEIVABLE FROM PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ARE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. NET ACCOUNTS RECEIVABLE IS BASED ON EXPECTED PAYMENT RATE FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A 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 DIFFERNECE 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 FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.BAD DEBT EXPENSE FOOTNOTE FOR REHABILITATION HOSPITAL OF WISCONSIN LLC:ACCOUNTS RECEIVABLE PRIMARILY CONSIST OF AMOUNTS DUE FROM THIRD-PARTY PAYORS AND PATIENTS. THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS. THE HOSPITAL'S POLICY TO RECORD AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON A PERCENTAGE OF NET RECEIVABLES BY AGE OF BALANCE AFTER DISCHARGE DATE.THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE, REVENUE TRENDS BY PAYOR CLASSIFICATION AND REVENUE DAYS IN ACCOUNTS RECEIVABLE. INDIVIDUAL PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.BAD DEBT EXPENSE IS RECORDED FOR FINANCIAL STATEMENT PURPOSES BASED ON UNCOLLECTED REVENUE, BUT THE RELATED COST COULD BE DETERMINED BY APPLYING COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT. DISCOUNTS ARE RECORDED TO AN APPROPRIATE CONTRA REVENUE ACCOUNT INCLUDING CHARITY CARE WHEN APPLICABLE; PAYMENTS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF WOULD DECREASE BAD DEBT EXPENSE. MOST OF THE PATIENTS FOR WHICH BAD DEBT EXPENSE IS RECORDED WOULD PROBABLY QUALIFY FOR SOME LEVEL OF FINANCIAL ASSISTANCE ACCORDING TO HOSPITAL POLICIES, BUT MANY CHOOSE NOT TO COMPLETE THE NECESSARY FINANCIAL ASSISTANCE APPLICATION SO THAT THIS CAN BE PROPERLY DETERMINED. |
| Part III, Line 8: | THE SHORTFALL ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. COSTING METHODOLOGY USED IS THE COST TO CHARGE RATIO AS REPORTED ON THE MEDICARE COST REPORT. |
| Part III, Line 9b: | PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE WILL HAVE A CHARITY DISCOUNT APPLIED TO THEIR BALANCES AT THE TIME OF BILLING. IF THIS RESULTS IN NO BALANCE DUE FORM THE PATIENT, THEN THE PATIENT WILL NOT RECEIVE A STATEMENT. IF A BALANCE REMAINS AFTER THE DISCOUNT PERCENTAGE IS APPLIED, THE PATIENT WILL RECEIVE A STATEMENT FOR THE BALANCE DUE. THE STATEMENT CYCLE IS CONSISTENT FOR ALL PATIENTS. |
| Part VI, Line 2: | COMMUNITY NEEDS ARE IDENTIFIED BASED UPON A REVIEW OF STATE, COUNTY AND COMMUNITY HEALTH DATA AND ASSESSMENTS. THIS INCLUDES SUCH DOCUMENTS AS: THE STATE HEALTH PLAN, THE COUNTY HEALTH REPORT CARD, THE WAUKESHA COMMUNITY HEALTH SURVEY, THE HEALTHY PEOPLE 2020 PLAN AND VARIOUS OTHER ASSESSMENTS, SUCH AS THE YOUTH BEHAVIORAL RISK SURVEYS, UNITED WAY/UNIVERSITY OF WISCONSIN SURVEY OF WAUKESHA COUNTY. WE ANALYZE THE DATA, IDENTIFY THE PRESSING NEEDS, AND PROACTIVELY PLAN AND IMPLEMENT COMMUNITY BENEFIT INITIATIVES TO ADDRESS THESE NEEDS. ADDITIONALLY, WE HAVE ACTIVELY PARTNERED WITH OUR COUNTY HEALTH DEPARTMENT IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS (CHIPP) ASSESSMENT AND SPEARHEADED A NUMBER OF COUNTY-WIDE IMPLEMENTATION STRATEGIES. THE MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN MAY 2016 AND THE IMPLEMENTATION PLAN WAS ADOPTED IN JUNE 2016. WE ALSO SHARE IN PARTNERSHIP WITH THE CHNA IMPLEMENTATION PLANS FOR THE REHABILITATION HOSPITAL OF WISCONSIN. THROUGH DATA ANALYSIS AND COMMUNITY DISCUSSION, WE SAW A NUMBER OF OVER-ARCHING THEMES THAT PROMPTED US TO CHOOSE THE FOLLOWING PRIORITY AREAS:PRIORITY AREA:NEEDS OF THE ELDERLYCORRELATED COMMUNITY HEALTH NEED: -MENTAL HEALTH ISSUES INCLUDING DEPRESSION, DEMENTIA AND ALZHEIMER'S DISEASE-AODA ISSUES (ALCOHOL AND OTHER DRUGS) ADVERSE EFFECTS FROM POLYPHARMACY-PREVALENCE OF CHRONIC CONDITIONS-ACCIDENTAL INJURY-SOCIAL VULNERABILITY AND ISOLATION-OBESITY-ACCESS: SCARCITY OF PROVIDERS SPECIALIZING IN GERONTOLOGYPRIORITY AREA: ALCOHOL AND OTHER DRUGSCORRELATED COMMUNITY HEALTH NEED:-BINGE DRINKING-PRESCRIPTION DRUG OVERDOSE/MISUSE-HEROIN AND OPIOID DEATHS/HOSPITALIZATIONS-ACCESS: SCARCITY OF PROVIDERSPRIORITY AREA:MENTAL HEALTHCORRELATED COMMUNITY HEALTH NEED:-SUICIDE RATE-ALZHEIMER'S DISEASE-DEPRESSION-ACCESS: SCARCITY OF PROVIDERSPRIORITY AREA:CHRONIC DISEASECORRELATED COMMUNITY HEALTH NEED: -CARDIOVASCULAR DISEASE-CANCER-DIABETES-OBESITY-ALZHEIMER'S DISEASE-OTHERSFOR MORE INFORMATION, PLEASE GO TO HTTP://WWW.PROHEALTHCARE.ORG/ABOUT-US-COMMUNITY-BENEFIT.ASPX |
| Part VI, Line 3: | EVERY PATIENT WITH A SELF PAY BALANCE RECEIVES A STATEMENT WHICH CONVEYS THE AVAILABILITY OF COMMUNITY (CHARITY) CARE AND A CONTACT NUMBER FOR FURTHER INFORMATION. PATIENTS THAT ARE UNINSURED RECEIVE AN UNINSURED DISCOUNT WHICH IS LISTED ON THE FIRST STATEMENT THAT THEY RECEIVE. PATIENTS RECEIVE A TOTAL OF FOUR STATEMENTS. EACH STATEMENT CONTAINS VERBIAGE REFERENCING THE HOSPITAL'S COMMUNITY CARE PROGRAM AND A CONTACT NUMBER FOR FURTHER INFORMATION. IF SOMEONE HAS BEEN FOUND ELIGIBLE FOR SOME LEVEL OF CHARITY CARE, THE ELIGIBILITY PERIOD IS THREE MONTHS SO ANY SUBSEQUENT ACCOUNTS DURING THAT TIMEFRAME WOULD BE DISCOUNTED AT WHATEVER LEVEL OF CHARITY CARE THE PATIENT IS DEEMED ELIGIBLE. PATIENTS MAY REAPPLY FOR COMMUNITY CARE WHEN THEIR ELIGIBILITY PERIOD HAS EXPIRED. SELF PAY PATIENTS MAY ALSO BE INFORMED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM WHILE THEY ARE INPATIENTS. SOCIAL WORK AND/OR THE BUSINESS OFFICE MAY MAKE CONTACT WITH THESE PATIENTS DURING THEIR STAY TO INFORM THEM OF THE COMMUNITY CARE PROGRAM AND ASSIST THEM WITH COMPLETION OF THE APPLICATION.INFORMATION IS AVAILABLE AT REGISTRATION AREAS RELATED TO OUR COMMUNITY CARE PROGRAM. THIS INFORMATION CONTAINS CONTACT INFORMATION FOR THE HOSPITAL'S CENTRAL BUSINESS OFFICE WHERE PATIENTS CAN RECEIVE ASSISTANCE IN OBTAINING AND COMPLETING APPLICATIONS. |
| Part VI, Line 4: | PROHEALTH CARE SERVES ABOUT 285,000 PEOPLE EACH YEAR IN WAUKESHA COUNTY AND PORTIONS OF SURROUNDING COUNTIES. IN EVERY FEDERAL POPULATION CENSUS, WAUKESHA COUNTY HAS RECORDED AN INCREASE IN POPULATION. SINCE 1950, THE POPULATION GREW FROM 85,901 TO OVER 390,000. WAUKESHA COUNTY HAS AN AGING POPULATION WITH 15.9% OVER THE AGE OF 65 AND A MEDIAN AGE OF 43.1 YEARS WHICH FAR SURPASSES STATE AVERAGES AND IS THE HIGHEST MEDIAN AGE OF PEER COUNTIES. THE RATE OF RETIREMENT IS LIKELY TO SURPASS THE RATE OF ENTRY INTO THE WORKFORCE BETWEEN 2015 AND 2020. THE RACIAL MAKEUP OF THE WAUKESHA COUNTY COMMUNITY IS AS FOLLOWS: WHITE 93.9%, HISPANIC OR LATINO 4.5%, ASIAN 3.1%, BLACK 1.4%. MEDIAN HOUSEHOLD INCOME IS $75,850, WITH 5.8% OF PEOPLE LIVING BELOW THE POVERTY LEVEL. THE LARGEST POCKET OF THOSE LIVING IN POVERTY IS IN THE URBAN ENVIRONMENT OF THE CITY OF WAUKESHA WITH A RATE OF 11.70%. UNEMPLOYMENT IN WAUKESHA COUNTY STOOD AT 3.1% IN OCTOBER, 2015. WAUKESHA COUNTY IS LARGE (580 SQUARE MILES) AND DIVERSE, INCLUDING URBAN, SUBURBAN AND RURAL AREAS. THE PRESENCE OF SOME HIGH INCOME COMMUNITIES IN WAUKESHA COUNTY OFTEN GIVES A MISTAKEN IMPRESSION OF OVERALL WEALTH. OFTEN OVERLOOKED IS A GROWING POPULATION OF LOW INCOME, NON-ENGLISH SPEAKING, VULNERABLE AND MARGINALIZED CITIZENS WHO FACE ENORMOUS ODDS IN ACCESSING HEALTH CARE. THE WAUKESHA COUNTY MEDICAID POPULATION HAS NEARLY TRIPLED IN 10 YEARS, AND NOW REPRESENTS 8.33% OF THE POPULATION. BETWEEN 2000 AND 2010, THE LATINO/A POPULATION IN WAUKESHA COUNTY GREW BY 6,620 RESIDENTS. DOWNTOWN WAUKESHA WAS DECLARED A "MEDICALLY UNDERSERVED" AREA AND A "HEALTH-PROFESSIONAL SHORTAGE AREA" BY THE FEDERAL GOVERNMENT IN 2008. AS AN UNDERSERVED AREA, MEDICAL OPTIONS FOR INDIVIDUALS, PARTICULARLY THOSE WITHOUT HEALTH INSURANCE OR WITH PUBLIC INSURANCE, ARE SEVERELY LIMITED BECAUSE PRIVATE SERVICE PROVIDERS OFTEN REFUSE TO CARE FOR THESE INDIVIDUALS. CONSEQUENTLY, PROHEALTH CARE EMBARKED ON A FUND-RAISING INITIATIVE TO SUPPORT THE FORMATION OF AN FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN DOWNTOWN WAUKESHA. THAT HEALTH CENTER OPENED IN LATE 2012 AND IS FINANCIALLY SUPPORTED BY PROHEALTH CARE. |
| Part VI, Line 5: | WAUKESHA MEMORIAL HOSPITAL IS GOVERNED BY A COMMUNITY BOARD. WE ARE PROUD OF THE NUMEROUS AND STRONG PARTNERSHIPS WE HAVE FORMED WITH A WIDE VARIETY OF NOT-FOR-PROFIT HEALTH AND HUMAN SERVICES AGENCIES AS WE WORK TOGETHER TO FORGE A STRONGER, HEALTHIER COMMUNITY. WE ARE ACTIVELY INVOLVED WITH PROGRAMMING, BOARD OVERSIGHT AND ONGOING FINANCIAL SUPPORT OF THE WAUKESHA COMMUNITY HEALTH CENTER, THE ONLY FEDERALLY-QUALIFIED HEALTH CENTER IN OUR AREA. WE ALSO PROVIDE FINANCIAL SUPPORT AS WELL AS IN-KIND SUPPORT TO TWO FREE CLINICS SERVING OUR AREA. WE WERE INSTRUMENTAL IN FORMING SEVERAL KEY AGENCIES DESIGNED TO MEET AN URGENT COMMUNITY NEED. FOR EXAMPLE, THROUGH OUR LEADERSHIP AND SUPPORT, THE WAUKESHA COUNTY COMMUNITY DENTAL CLINIC WAS FORMED AND WE HAVE PROVIDED ONGOING FINANCIAL SUPPORT AND PROVIDED CLINICAL AND OFFICE SPACE SO THIS AGENCY CAN CARRY OUT ITS MISSION. THE SAME IS TRUE FOR SAFE BABIES HEALTHY FAMILIES (PROVIDING SERVICES FOR AT RISK PREGNANT WOMEN AND THEIR CHILDREN) AND STILLWATERS CANCER SUPPORT SERVICES. WE PROVIDE SPACE AND CLINICAL EXPERTISE TO THE LOCAL 'MEALS ON WHEELS' PROGRAM, SERVING AT-RISK ELDERLY AND DISABLED INDIVIDUALS. SEVERAL OF OUR STAFF ARE ACTIVELY INVOLVED WITH THE HEALTH DEPARTMENT'S CHIPP AND SERVE ON A VARIETY OF COMMITTEES FOR THE AREA'S DEPARTMENT OF HEALTH AND HUMAN SERVICES. WE HOST COMMUNITY-WIDE HEALTH FAIRS OFFERING A WIDE VARIETY OF FREE SCREENINGS AND OFFER AN ONGOING AND IMPRESSIVE MENU OF FREE COMMUNITY EDUCATION CLASSES (INCLUDING EVIDENCE-BASED SELF-HELP WORKSHOPS). PROHEALTH CARE REACHES OUT INTO OUR COMMUNITY TO MEET THE NEEDS OF ITS RESIDENTS. FROM THE ALZHEIMER'S ASSOCIATION TO WAUKESHA DRUG FREE COMMUNITIES, AND DOZENS OF AGENCIES IN BETWEEN, PROHEALTH CARE IS THERE, PROVIDING VOLUNTEERS, FINANCIAL SUPPORT AND PARTNERSHIPS THAT HELP TO IMPROVE THE HEALTH OF OUR COMMUNITY. |
| Part VI, Line 6: | OUR HOSPITAL IS A MEMBER OF THE PROHEALTH CARE HEALTH SYSTEM WHICH SERVES AS OUR PARENT COMPANY. WHILE COMMUNITY BENEFIT RESPONSIBILITIES RESIDE WITH OUR HOSPITAL BOARD, THE PARENT COMPANY PLAYS A KEY ROLE IN COORDINATING COMMUNITY NEEDS ASSESSMENTS, COMMUNITY BENEFIT PROGRAM PLANNING, AND EVALUATION.A DESCRIPTION OF EACH AFFILIATES ROLE IN PROMOTING HEALTH WITHIN THE COMMUNITIES SERVED IS AS FOLLOWS:PROHEALTH CARE, INC. - HELPS TO MANAGE THE HOSPITALS TO ENSURE THEY CAN PROMOTE HEALTH AND WELLNESS WITHIN THE COMMUNITY.NATIONAL REGENCY OF NEW BERLIN, INC. - OWNS AND OPERATES SENIOR LIVING CENTERS AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH HOME CARE, INC. - PROVIDES HOSPICE AND HOME HEALTH CARE SERVICES AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH CARE FOUNDATION, INC. - SUPPORTS THE CHARITABLE MISSION OF WAUKESHA MEMORIAL HOSPITAL AND OCONOMOWOC MEMORIAL HOSPITAL SO THAT IT MAY PROVIDE HEALTH SERVICES WITHIN THE COMMUNITY.PROHEALTH CARE MEDICAL ASSOCIATES, INC. - PHCMA OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHCMA FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHCMA PROVIDED 430,607 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017.OCONOMOWOC MEMORIAL HOSPITAL, INC. - PROVIDES CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. OCONOMOWOC MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. OCONOMOWOC MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 7,941 DAYS OF INPATIENT CARE AND APPROXIMATELY 69,244 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017. |
| Part VI, Line 7, Reports Filed With States | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH CARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DR STE 200 | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531881131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391486873 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $17,400,000 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | TO ASSIST PROHEALTH CARE, INC. IN ITS CHARITABLE MISSION. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | ALL GRANTS ARE APPROVED AND PROCESSED BY THE ORGANIZATION'S MANAGEMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | ||||||||||||||
| PRESIDENT & CEO | $0 | $878,773 | $0 | $430,890 | $0 | $0 | $0 | $805,877 | $0 | $26,191 | $0 | $2,141,731 | $0 | $0 |
| RONALD FARR | ||||||||||||||
| CHIEF FINANCIAL/ADMIN OFFICER | $0 | $465,048 | $0 | $178,988 | $0 | $0 | $0 | $140,273 | $0 | $41,726 | $0 | $826,035 | $0 | $0 |
| JOHN ROBERTSTAD | ||||||||||||||
| CHIEF COMMUNITY LIAISON | $55,258 | $424,008 | $0 | $214,892 | $0 | $0 | $1,085 | $14,998 | $4,612 | $36,571 | $60,955 | $690,469 | $0 | $0 |
| KENNETH PRICE | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $295,861 | $0 | $115,811 | $0 | $0 | $0 | $112,089 | $0 | $33,890 | $0 | $557,651 | $0 | $0 |
| KARIN KULTGEN | ||||||||||||||
| VP MEDICAL AFFAIRS | $281,940 | $0 | $100,506 | $0 | $0 | $0 | $10,928 | $0 | $23,690 | $0 | $417,064 | $0 | $0 | $0 |
| ERIC HENDEE | ||||||||||||||
| CHIEF PHYSICIST | $203,620 | $0 | $7,460 | $0 | $0 | $0 | $8,577 | $0 | $32,210 | $0 | $251,867 | $0 | $0 | $0 |
| MICHAEL E KOWALOK | ||||||||||||||
| PHYSICIST | $187,382 | $0 | $5,929 | $0 | $0 | $0 | $9,684 | $0 | $10,704 | $0 | $213,699 | $0 | $0 | $0 |
| JOHN MAY | ||||||||||||||
| VP - AMBULATORY | $254,819 | $0 | $90,086 | $0 | $0 | $0 | $12,000 | $0 | $30,037 | $0 | $386,942 | $0 | $0 | $0 |
| MARGARET M PFITZINGER | ||||||||||||||
| VP CLINICAL OPERATIONS | $168,357 | $0 | $29,851 | $0 | $0 | $0 | $6,702 | $0 | $32,126 | $0 | $237,036 | $0 | $0 | $0 |
| JULIET UGARTE HOPKINS | ||||||||||||||
| PHYSICIAN ADVISOR | $229,140 | $0 | $29,986 | $0 | $0 | $0 | $7,213 | $0 | $33,904 | $0 | $300,243 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT |
| Part I, Line 4b | PROHEALTH CARE INC. (PHC) MAINTAINS TWO SUPPLEMENTAL RETIREMENT PLANS (SERPS) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THESE SERPS ARE UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLANS THAT ARE INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THESE SERPS ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. |
| Part I, Line 6 | PROHEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH & EDUCATIONAL FACILITIES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| CUSIP | 97710BB50 | CUSIPNum |
| Bond Issued | 2011-02-16 | BondIssuedDt |
| Issue Price | $32,039,358 | IssuePriceAmt |
| Purpose | CURRENT REFUND BONDS ISSUED 11/14/95 & CURRENT REFUND BONDS ISSUED 5/13/99. | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $26,634,580 | RetiredAmt |
| Total Proceeds | $32,039,358 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $597,186 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $31,442,172 | OtherSpentProceedsAmt |
| Substantial Completion | 2001 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, A - COL. C | THE CUSIP # OF 97710BB50 ON FORM 8038 WAS NOT THE NUMBER ON THE BOND OF THE LATEST MATURITY. THE NUMBER FOR THE LATEST MATURITY IS CORRECTLY REPORTED ON SCHEDULE K. |
| PART I, A - COL. E | THE TOTAL ISSUE PRICE ON FORM 8038 IS $35,678,572.65. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION. |
| PART II, A - LINE 3 | SALE PROCEEDS OF ISSUE IN AMOUNT OF $32,039,358 PLUS ZERO INVESTMENT PROCEEDS. |
| PART II, A - LINE 6 | PROCEEDS IN THE AMOUNT OF $31,442,172.63 ALLOCABLE TO REPORTING ORGANIZATION DEPOSITED IN REFUNDING ESCROWS ON 2/16/11; BALANCE ON 9/30/17 IS ZERO. |
| PART II, A - LINE 13 | YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 11/14/95 WAS 1995 AND YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 5/13/99 WAS 2001. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | PROHEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER. |
| Form 990, Part VI, Section A, line 7a | ACCORDING TO THE GOVERNING DOCUMENTS, THE BOARD OF THE FILING ORGANIZATION IS THE SAME AS THE BOARD OF THE SOLE CORPORATE MEMBER, PROHEALTH CARE, INC. |
| Form 990, Part VI, Section A, line 7b | PROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION, INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING AND CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS. |
| Form 990, Part VI, Section B, line 11b | AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, WHO THEN FORMALLY APPROVED THE FORM 990, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION. |
| Form 990, Part VI, Section B, line 12c | ALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION. |
| Form 990, Part VI, Section B, line 15 | AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO/PRESIDENT, EXECUTIVE DIRECTOR, VICE-PRESIDENT, SENIOR VICE-PRESIDENT AND ABOVE. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2017. |
| Form 990, Part VI, Section C, line 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS & CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 16B: | THE PROCESS IS TO HAVE ALL JOINT VENTURE ARRANGEMENTS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE IT MEETS ALL LEGAL REQUIREMENTS AND TO ENSURE THAT WAUKESHA MEMORIAL HOSPITAL, INC. MAY RETAIN ITS EXEMPT STATUS. |
| Form 990, Part IX, line 11g | PHYSICIAN FEES: Program service expenses 4,565,213. Management and general expenses 143,803. Fundraising expenses 0. Total expenses 4,709,016. PHMG PHYSICIAN SUBSIDY: Program service expenses 12,220,940. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,220,940. LINEN SERVICES: Program service expenses 1,590,798. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,590,798. OUTSIDE SERVICES: Program service expenses 7,421,369. Management and general expenses 991,125. Fundraising expenses 0. Total expenses 8,412,494. PHC SERVICES: Program service expenses 83,700,641. Management and general expenses 6,925,469. Fundraising expenses 0. Total expenses 90,626,110. MAINTENANCE CONTRACTS: Program service expenses 12,283,194. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,283,194. OUTSIDE PATIENT SERVICES: Program service expenses 671,478. Management and general expenses 0. Fundraising expenses 0. Total expenses 671,478. OUTSIDE SERVICES STRATEGIC: Program service expenses 369. Management and general expenses 0. Fundraising expenses 0. Total expenses 369. |
| Form 990, Part XI, line 9: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 7,163,387. CHANGE IN MINIMUM PENSION LIABILITY 4,470,983. INVESTMENT FUNDING TO RELATED ORGANIZATIONS -8,286,915. EQUITY TRANSFER FROM RELATED ORGANIZATIONS 520,000. OTHER CHANGES 71,797. TRANSFER TO PHC-PARENT -26,225,000. |
| FORM 990, PART XII, LINE 2C | THE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OCONOMOWOC MEMORIAL HOSPITAL INC | |||||||||||
| 791 SUMMIT AVENUE | OCONOMOWOC | WI | 53066 | 390794174 | HOSPITAL | WI | 501(c)(3) | Line 3 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE FOUNDATION INC | |||||||||||
| 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | 391314542 | CHARITABLE SUPPORT | WI | 501(c)(3) | Line 7 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH HOME CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 200067392 | HEALTHCARE | WI | 501(c)(3) | Line 3 | PROHEALTH CARE INC | Yes (1) | |
| NATIONAL REGENCY OF NEW BERLIN INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 391077992 | HEALTHCARE | WI | 501(c)(3) | Line 10 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 391486873 | MANAGEMENT | WI | 501(c)(3) | Line 12b, II | 0 | N/A | |
| PROHEALTH CARE MEDICAL ASSOCIATES INC | |||||||||||
| n17 W24100 RIVERWOOD DR SUITE 200 | wAUKESHA | WI | 53188 | 391083015 | HEALTHCARE | WI | 501(c)(3) | Line 3 | PROHEALTH CARE INC | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PROHEALTH ALIGNED LLC (DBA PROHEALTH CARE MORELAND SURGERY CENTER) | ||||||||||||||
| 1111 DELAFIELD STREET STE 100 | WAUKESHA | WI | 53188 | 263324572 | SURGERY CENTER | WI | WAUKESHA MEMORIAL HOSPITAL INC | RELATED | $1,374,148 | $3,518,840 | 0 | Yes (1) | 0.50000 | |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | ||||||||||||||
| 1625 COLDWATER CREEK DRIVE | WAUKESHA | WI | 53188 | 262332250 | INPATIENT REHABILITATION | WI | WAUKESHA MEMORIAL HOSPITAL INC | RELATED | $2,556,978 | $3,899,718 | 0 | Yes (1) | 0.49000 | |
| THE ORTHOPEDIC SURGERY CENTER LLC | ||||||||||||||
| W238 N1610 BUSSE ROAD | WAUKESHA | WI | 53188 | 208356016 | ORTHOPEDIC SURGICAL SERVICES | WI | WAUKESHA MEMORIAL HOSPITAL INC | RELATED | $1,113,992 | $1,721,853 | 0 | Yes (1) | 0.49000 | |
| PROHEALTH SOLUTIONS LLC | ||||||||||||||
| 2000 PEWAUKEE RD SUITE C | WAUKESHA | WI | 53188 | 273863494 | ACCOUNTABLE CARE ORGANIZATION | WI | N/A | |||||||
| LAKE COUNTRY ENDOSCOPY CENTER | ||||||||||||||
| 1185 CORPORATE CENTER DR | OCONOMOWOC | WI | 53066 | 261572986 | ENDOSCOPY SERVICES | WI | N/A | |||||||
| WAUKESHA IMAGING LLC | ||||||||||||||
| N17 W24100 RIVERWOOD DR STE 200 | WAUKESHA | WI | 53188 | 392036860 | RADIOLOGY SERVICES | WI | N/A | |||||||
| PHCOAW CO-MANAGEMENT COMPANY LLC | ||||||||||||||
| N17 W24100 RIVERWOOD DR STE 200 | WAUKESHA | WI | 53188 | 811823911 | MANAGEMENT SERVICES | WI | N/A | |||||||
| GI SPECIALISTS LLC (DBA Moreland Endoscopy Center) | ||||||||||||||
| 1111 DELAFIELD STREET | WAUKESHA | WI | 53188 | 205269133 | GI SERVICES | WI | N/A | |||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| WAUKESHA HEALTH SYSTEM INC | |||||||||
| N17 W24100 RIVERWOOD DRIVE SUITE 20 | WAUKESHA | WI | 53188 | 391507910 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA PACIFIC INC | |||||||||
| 31416 AGOURA RD STE 180 | WESTLAKE VILLAGE | CA | 91361 | 953070501 | HEALTHCARE | CA | N/A | C | 0 |
| NATIONAL AVENUE DEVELOPMENT CORPORATION | |||||||||
| N17 W24100 RIVERWOOD DRIVE SUITE 20 | WAUKESHA | WI | 53188 | 391417226 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA INC | |||||||||
| N17 W24100 RIVERWOOD DRIVE SUITE 20 | WAUKESHA | WI | 53188 | 391567366 | HEALTHCARE | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (25 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROHEALTH CARE MEDICAL ASSOCIATES INC | ||
| A | $2,036,653 | Actual Amount Received |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | ||
| A | $1,198,272 | Actual Amount Received |
| PROHEALTH CARE INC | ||
| B | $17,400,000 | Actual Amount Incurred |
| PROHEALTH CARE FOUNDATION INC | ||
| C | $1,706,425 | Actual Amount Received |
| WAUKESHA HEALTH SYSTEM INC | ||
| K | $74,545 | Actual Amount Incurred |
| PROHEALTH CARE MEDICAL ASSOCIATES INC | ||
| K | $557,480 | Actual Amount Incurred |
| NATIONAL REGENCY OF NEW BERLIN INC | ||
| K | $250,155 | Actual Amount Incurred |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | ||
| L | $230,039 | Actual Amount Received |
| PROHEALTH CARE INC | ||
| L | $52,895 | actual Amount received |
| PROHEALTH CARE INC | ||
| M | $90,626,110 | Actual Amount Incurred |
| WAUKESHA HEALTH SYSTEM INC | ||
| M | $847,965 | Actual Amount Incurred |
| PROHEALTH SOLUTIONS LLC | ||
| M | $511,099 | Actual Amount Incurred |
| PROHEALTH CARE MEDICAL ASSOCIATES INC | ||
| P | $12,756,625 | Actual Amount Incurred |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| Q | $3,120,044 | Actual Amount Received |
| WAUKESHA HEALTH SYSTEM INC | ||
| Q | $235,815 | Actual Amount Received |
| PROHEALTH CARE MEDICAL ASSOCIATES INC | ||
| Q | $4,432,194 | Actual Amount Received |
| PROHEALTH HOME CARE INC | ||
| Q | $175,198 | Actual Amount Received |
| NATIONAL REGENCY OF NEW BERLIN INC | ||
| Q | $124,995 | Actual Amount Received |
| PROHEALTH CARE INC | ||
| R | $34,511,915 | Actual Amount Incurred |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | ||
| S | $2,888,063 | Actual Amount Received |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| S | $520,000 | Actual Amount Received |
| PROHEALTH ALIGNED LLC (DBA MSC) | ||
| S | $878,267 | Actual Amount Received |
| THE ORTHOPEDIC SURGERY CENTER LLC | ||
| S | $2,444,789 | Actual Amount Received |
| WAUKESHA HEALTH SYSTEM INC | ||
| A | $106,143 | Actual Amount Received |
| PROHEALTH SOLUTIONS LLC | ||
| L | $941,000 | Actual Amount Received |